agenda description page · 2015-06-11 · date: june 10, 2015 documents pertaining to 6/25/15...
TRANSCRIPT
MH Commission Packet June 25, 2015
Office: 2640 Martin Luther King, Jr. Way, Berkeley, CA 94704 • [email protected] (510) 981-7721 • (510) 981-5265 FAX
Health, Housing & Community Services Mental Health Commission
To: Mental Health Commissioners From: Carol Patterson, Commission Secretary Date: June 10, 2015
Documents Pertaining to 6/25/15 Agenda items: Agenda Item
Description Page
2.B.
June 25, 2015 Agenda
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2.D.
May 28, 2015 Minutes
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2.E.
Commission Comfort Agreement
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2.E.
Staff Updates
Staff Updates memo
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6/4/15 Memo from Zach Cowan
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6/10/15 memo clarifying Conflict of Interest for MH Commission
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4.
Suicide Statistics Council Report (draft)
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6.
Commission Updates
6.A.
Berkeley Safe Neighborhoods Committee Letter retraction – 6/9/15
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6.B.
Letter to City Council – 6/1/15
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6.C.
City Council Report 6/9/15 Item 38a
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City Council Companion Report 6/9/15 Item 38b
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7.
Election of Officers, pp. 23-5 Commissioners’ Manual
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A Vibrant and Healthy Berkeley for All
Office: 2640 Martin Luther King, Jr Way • Berkeley, CA 94704 • (510) 981-7721
(510) 981-5255 FAX • [email protected]
Health, Housing & Community Services Department Mental Health Commission
Berkeley/Albany Mental Health Commission
Regular Meeting Thursday, June 25, 2015
Time: 7:00 p.m. – 9:00 p.m. North Berkeley Senior Center
1901 Hearst Ave., Workshop B
AGENDA
All Agenda Items are for Discussion and Possible Action
Public Comment Policy: Members of the public may speak on any items on the Agenda and items not on the Agenda during the initial Public Comment period. Members of the public may also comment on any item listed on the agenda as the item is taken up. Members of the public may not speak more than once on any given item. The Chair may limit public comment to 3 minutes or less.
7:00 pm 1. Roll Call
2. PRELIMINARY MATTERS A. Selection of Acting Chair for this meeting B. Agenda Approval C. Public Comment on items not on the agenda D. Approval of the May 28, 2015 Minutes E. Staff Announcements/Updates
3. Presentation on Suicide Statistics 4. Discussion and Possible Action Item: Pertaining to the City’s
collection of suicide statistics
5. Albany Update A. Update from Berkeley Mental Health Division on services provided to
clients from Albany including but not limited to outreach, clinic services and crisis services.
B. Update from BMH Division on all funds received to serve Albany. C. Update on relationship of Albany to Mental Health Commission 6. Commission Updates A. Berkeley Safe Neighborhood Committee letter B. City Council letter
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2640 Martin Luther King, Jr Way • Berkeley, CA 94704 • (510) 981-7721 • (510) 981-5255 FAX
6. Commission Updates con’t C. Commission Council report on Recommendations on Alternatives to AB1421 implementation D. Commission By-Laws report.
7. Action Item: Election of Chair and Vice Chair
8. Possible Action Item: Recommendations to City Council on improving services to persons in mental health crisis
A. Identify recommendations to be included in report 9. Report from Mental Health Division – Steve Grolnic-McClurg (20
minutes) 10. Discussion and Possible Action regarding proposing increased mobile
crisis and increased certified CIT officers to address concerns about problem behaviors with the homeless population and recommending
Mental Health First Aid training
11. Report on CIBHCS train-the-trainer training. A. Discussion as to whether or not to have a Commission training in future. 12. Liaison Reports
A. MHSA Advisory Committee B. City Council (Jesse) C. BMH Safety Committee 13. Discussion and Possible Action Item: The Role of the California Association of Local Mental Health Boards and Commissions (CALMHB/C) and the Berkeley/Albany Mental Health Commission: expectations and future relationship 14. Agenda Items for July meeting
15. Announcements
9:00 pm 16. Adjournment Communications to Berkeley boards, commissions or committees are public record and will become part of the City’s electronic records, which are accessible through the City’s website. Please note: e-mail addresses, names, addresses, and other contact information are not required, but if included in any communication to a City board, commission or committee, will become part of the public record. If you do not want your e-mail address or any other contact information to be made public, you may deliver communications via U.S. Postal Service or in person to the secretary of the relevant board, commission or committee.
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2640 Martin Luther King, Jr Way • Berkeley, CA 94704 • (510) 981-7721 • (510) 981-5255 FAX
If you do not want your contact information included in the public record, please do not include that information in your communication. Please contact the secretary to the relevant board, commission or committee for further information. The Health, Housing and Community Services Department does not take a position as to the content.
Contact person: Carol Patterson, Mental Health Commission Secretary at 981-7721 or [email protected].
Communication Access Information: This meeting is being held in a wheelchair accessible location. To request a disability-related accommodation(s) to participate in the meeting, including auxiliary aids or services, please contact the Disability Services specialist at 981-6342 (V) or 981-6345 (TDD) at least three business days before the meeting date. Please refrain from wearing scented products to this meeting. Attendees at trainings are reminded that other attendees may be sensitive to various scents, whether natural or manufactured, in products and materials. Please help the City respect these needs. Thank you. SB 343 Disclaimer Any writings or documents provided to a majority of the Commission regarding any item on this agenda will be made available for public inspection in the SB 343 Communications Binder located at the Adult Clinic at 2640 Martin Luther King, Jr. Way, Berkeley.
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A Vibrant and Healthy Berkeley for All
3282 Adeline St. Berkeley, CA 94704 Tel: 510.981-7721 Fax: 510.981-5255 TDD: 510.981-6903
Department of Health Services Mental Health Commission
Berkeley/Albany Mental Health Commission Unadopted Minutes
North Berkeley Senior Center Regular Meeting 1901 Hearst Ave. May 28, 2015 at 7:00 pm Workshop B Members of the Public Present: Shelby Heda, Paul Kealoha-Blake, Jonah Markowitz, Andrew Phelps, Staff Present: Carol Patterson, Tenli Yavneh 1. Call to Order at 7:02 pm
Commissioners Present: Jeffrey Davis, Jennifer Fazio, Bart Grossman, Judy Kerr, Carole Marasovic, Jean Marie Hervé Michel, Jr, Cameron Silverberg. Commissioners Absent: Jesse Arreguin, Shirley Posey.
2. Preliminary Matters A. Approval of May 28, 2015 Agenda
M/S/C (Grossman, Silverberg) Move to approve the May 28, 2015 Agenda as written. Ayes: Davis,Fazio, Grossman, Kerr, Marasovic, Michel, Silverberg; Noes: None; Abstentions: None; Absent: Arreguin, Posey.
B. Public Comment (2) One member of the public distributed booklets from the Anti Defamation League out of concern for the climate of the Commission. Another member of the public apologized for missing last meeting and encouraged the Commission to continue its good work.
C. Approval of the April 23, 2015 minutes
M/S/C (Kerr, Michel) Move to approve the March 26, 2015 minutes as published. Ayes: Fazio, Grossman, Kerr, Marasovic, Michel, Silverberg; Noes: None; Abstentions: Davis (did not attend meeting); Absent: Arreguin, Posey.
D. Staff Updates i. Jane Micallef retired as Director of Health, Housing & Community Services on May
12. Kelly Wallace will be the Acting Director during the search for the new Director. Tasha Tervalon will be Acting Deputy Director in the interim.
ii. The 5th Mental Health First Aid class has been completed with 84 graduates. We are getting ready to plan the trainings in the coming year and have been awarded some training manuals from United Advocates for Children and Families.
iii. Please be aware that email conversations with Commissioners can result in a serial meeting in violation of the Brown Act.
iv. Community Health Towne Hall on June 16.
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Mental Health Commission – May 28, 2015
v. Webinar training, “How to Have Great Board” on Saturday, June 6, 10 -3 pm. vi. Michael Diehl, a former Commissioner is ill.
3. Presentation on Recommendations to Council by Homeless Task Force – this item was deferred until the presenter arrives.
4. Further Consideration of recommendations for Reappointment to Mental Health
Commission A. The Secretary reviewed the selection criteria with Commissioners B. The interview of Shelby Heda continued. M/S/C (Michel, Fazio) The Mental Health Commission recommends the re-
appointment of Shelby Heda. Ayes: Davis, Fazio, Grossman, Kerr, Marasovic, Michel, Silverberg; Noes: None;
Abstentions: None; Absent: Arreguin, Posey. C. Paul Kealoha-Blake was interviewed for re-appointment. M/S/C (Grossman, Silverberg) The Mental Health Commission recommends the
re-appointment of Paul Kealoha-Blake. Ayes: Davis, Fazio, Grossman, Kerr, Marasovic, Michel, Silverberg; Noes: None;
Abstentions: None; Absent: Arreguin, Posey. D. Carole Marasovic was interviewed for re-appointment. M/S/C (Davis, Michel) The Mental Health Commission recommends the re-
appointment of Carole Marasovic Ayes: Davis, Fazio, Grossman, Kerr, Marasovic, Michel, Silverberg; Noes: None;
Abstentions: None; Absent: Arreguin, Posey. 5. Election of Chair M/S/C (Grossman, Davis) Move to postpone the election of the chair. Ayes: Davis, Fazio, Grossman, Kerr, Marasovic, Michel, Silverberg; Noes: None; Abstentions: None; Absent: Arreguin, Posey. 6. Discussion and Possible Action Item: Response to Report from Berkeley Safe
Neighborhoods M/S/C (Kerr, Silverberg) The Mental Health Commission recommends we reach
out to Berkeley Safe Neighborhoods Committee to be on their agenda to review statistics on the incidence of violence pertaining to people with mental illness.
Ayes: Davis, Fazio, Grossman, Kerr, Marasovic, Michel, Silverberg; Noes: None; Abstentions: None; Absent: Arreguin, Posey.
The Secretary will contact the Committee and notify the other Commissioners of their meetings. Judy will put statistics together and would like to attend the meeting to also talk about person first language.
M/S/C (Grossman, Michel) The Mental Health Commission recommends sending
the following letter to Berkeley City Council: Dear Mayor Tom Bates and Members of the City of Berkeley City Council The City of Berkeley and Albany Mental Health Commission has reviewed the April 23, 2015 letter submitted by Berkeley Safe Neighborhoods Committee to the Mayor and Council.
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Mental Health Commission – May 28, 2015
In response, the Commission certainly agrees that the number of persons who contact the Berkeley Police Department with mental health issues merits an improved response. Many of these calls are handled by BPD officers when the more appropriate response to a mental health crisis is a response from the Berkeley Mobile Crisis team. In order to do so, Berkeley Mobile Crisis needs to be expanded to a fuller 24/7 staff who can respond to these persons in crisis with CIT-trained BPD officers nearby, if necessary. Expansion of both the Mobile Crisis team and additional CIT-trained officers is a critical need for the Berkeley community.
Where the Commission differs with Berkeley Safe Neighborhoods is BSN's correlation of mental health issues as presenting a physical danger to others. The correlation of mental health issues as a predictor of dangerousness is a myth that has been long ago dispelled. Berkeley Safe Neighborhood's failure to utilize person first language when referring to persons experiencing mental health issues itself demonstrates a lack of comprehension of the nature of mental illness. Where the Commission and Berkeley Safe Neighborhoods stand in agreement is that both a fully expanded 24/7 Mobile Crisis team and additional CIT-trained officers are critical to meet the needs of the City of Berkeley. We hope that the Mayor and the City Council will greatly improve these resources for the benefit of the Berkeley community including those persons who experience mental health crisis.
Ayes: Davis, Fazio, Grossman, Kerr, Marasovic, Michel, Silverberg; Noes: None; Abstentions: None; Absent: Arreguin, Posey. 7. Discussion and Possible Action regarding proposing increased mobile crisis and
increased certified CIT officers to address concerns about problem behaviors with the homeless population and recommending Mental Health First Aid training – Tabled to a future meeting.
8. Possible Action Item: Approval of Commission By-Laws It was noted that language concerning the relationship of the Commission to the City
of Albany was not included in Article IIIE of the By-Laws. M/S/C (Grossman, Michel) The Mental Health Commission recommends to City
Council the adoption of the proposed By-Laws as required by California Welfare and Institutions Code 5604 (a)1. et sq.
Ayes: Davis, Fazio, Grossman, Marasovic, Michel, Silverberg; Noes: Kerr; Abstentions: None; Absent: Arreguin, Posey.
9. Discussion and Possible Action item: The recent Train-the-Trainer Workshop in
Long Beach – Tabled due to lack of time.
10. Report from Mental Health Division – Tabled due to lack of time. 11. Liaison Reports – Tabled due to lack of time.
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Mental Health Commission – May 28, 2015
12. Possible Action Item: Recommendations to City Council on Improving Services to person in mental health crisis – Tabled due to lack of time. 13. Discussion and Possible Action Item: The Role of the California Association of Local Mental Health Boards and Commissions (CALMHB/C) and the Berkeley/Albany Mental Health Commission: expectations and future relationship – Tabled due to lack of time. 14. Agenda items for June meeting – The relationship to the Commission to the City of Albany; Presentation on Suicide Statistics from Captain Harris of BPD; 15. Announcements Agenda items for June meeting are due Monday, June 1. US Social Forum in San Jose in June 16. Adjournment at 9:12 pm. Minutes submitted by: ____________________________________ Carol Patterson, Commission Secretary
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As approved by the Berkeley/Albany Mental Health Commission, 9/27/12
Corrected 10/25/12
• Do not use language derogatory to others, or yell or
scream
• Be attentive when others are speaking
• Be respectful when others are speaking
• Please do not talk over anyone
• Hold a goal to allow people to feel heard (this is a
value the group holds vs. a behavior)
Berkeley/Albany Mental Health Commission
COMFORT AGREEMENT
“Rules to make it comfortable to work together”
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A Vibrant and Healthy Berkeley for All
2640 Martin Luther King, Jr Way, Berkeley, CA 94704 Tel: 510.981.7721 TDD: 510.981.5373 Fax: 510.981.5265
E-mail: [email protected]
Health, Housing & Community Services Mental Health Division
Memorandum To: Mental Health Commissioners From: Carol Patterson, Commission Secretary
Date: 6/11/2015
Re: Staff Updates
1) The date for the next May Is Mental Health Month event has been set for Thursday, May 12, 2016 from 6:30 – 9:30 pm so that there is adequate time to confirm outside speakers.
2) The next City of Berkeley Mental Health First Aid training will be in September.
3) After 9 years, I have termed out as Secretary to the Mental Health Commission. Over the next several months we will be transitioning Karen Klatt into the role of Secretary. I will be freed up to work on, among other things, the Peer Leadership Program. 4) The City Clerk’s office is in the process of updating the Commissioner’s Manual. I have sent your By-Laws to the City Clerk to see if some of the areas that conflict with the current Commissioner’s manual can be resolved in the new version. 5) Please review the memo from the City Attorney clarifying Conflict of Interest for Commissioners as well as my memo clarifying conflict on interest with regard to WIC 5604(d). if you have any questions about a potential conflict of interest plase contact the City Attorney at 981-6998.
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2640 Martin Luther King, Jr Way, Berkeley, CA 9470
Health, Housing & Community Services Mental Health Division
Memorandum To: Mental Health Commissioners
From: Carol Patterson, Commission Secretary
Date: 6/10/2015
Re: Conflict of Interest and How
Attached is a memo from the City Attorney addressing state law (Civil Code Section process. The Mental Health Commission doea City-issued Request for Proposalin reviewing bids/proposals for funding Services Act. A Section 1090 community agency proposals member of one of the community agencies As a reminder, the Welfare and Institutionsinterest provision. Section 5604(d) pertains to, among other things, roles in public mental health or contract agencies.Section 5604(d), the individual is not eligible to serve on the Commission5604(d) states:
“No member of the board or his or her spouse shall be a fullemployee of a county mental health service, an employee of the State Department of Health Care Services, or an employee of, or a paid member of the governing body of, a mental health contract agency.”
A Vibrant and Healthy Berkeley for All
, Berkeley, CA 94704 Tel: 510.981.7721 TDD: 510.981.5373 Fax: 510.981.526
E-mail: [email protected]
Mental Health Commissioners Carol Patterson, Commission Secretary
Conflict of Interest and How it Intersects with WIC 5604 (d)
Attached is a memo from the City Attorney issued to a number of City Commissions Civil Code Section 1090) conflicts of interest related to the contracting
The Mental Health Commission does not as a body review bids or proposalsissued Request for Proposal. However, at times Commissioners have been involved
in reviewing bids/proposals for funding from community agencies through the Mental Health on 1090 issue may exist if a Commissioner was asked to review
community agency proposals for MHSA funding, and he or she is a non-paidone of the community agencies that submitted a proposal.
As a reminder, the Welfare and Institutions Code Section 5604 has a separate conflict of interest provision. Section 5604(d) pertains to, among other things, compensatedroles in public mental health or contract agencies. If a conflict exists of the type listed in
vidual is not eligible to serve on the Commission
“No member of the board or his or her spouse shall be a full-time or partemployee of a county mental health service, an employee of the State Department of Health Care Services, or an employee of, or a paid member of the governing body of, a mental health contract agency.”
510.981.5373 Fax: 510.981.5265
issued to a number of City Commissions related to the contracting
or proposals in response to However, at times Commissioners have been involved
through the Mental Health asked to review
paid board
separate conflict of compensated (paid)
If a conflict exists of the type listed in vidual is not eligible to serve on the Commission at all. Section
time or part-time county employee of a county mental health service, an employee of the State Department of Health Care Services, or an employee of, or a paid member of the governing body of,
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Health, Housing & Community ServicesMental Health Commission
2180 Milvia Street, Berkeley, CA 94E-Mail: manager@CityofB
To: Honorable Mayor and Members of the City Council
From: City of Berkeley
Submitted by: Paul Kealoha-BlakeCarole Marasovic, Vice Chair, Mental Health Commission
Subject: Adopt a Resolution to direct Berkeley Policerecord, categories of 10Department records divisiontheir reports
RECOMMENDATION Adopt a Resolution to direct Berkeley categories of Berkeley police code 10Division and record categories consistent with documentation in police reports completed by Berkeley Police Department officers.should be released with correct categorical designation as recorded by police officers. The Mental Health Commission Fazio, Kealoha-Blake, Marasovic, Michel, Posey, Silverberg.;Dixon; Absent: Grossman, Arreguin. FISCAL IMPACTS OF RECOMMENDATIONNone. There should not be any additional time as documented from reports completed by the Department's police officers.
CURRENT SITUATION AND ITS EFFECTSIn her individual capacity as a private citizen, the ViceCommission, made a California Public Records Act request for statistics for suicides and attempted suicides in Berkeley for the last five years.56s, completed suicides, and 10identify those categories by the Berkeley Police Department.
The Vice Chair of the Mental Health Commission made this request to share information with the Mental Health Commission which is exploring the need for additional mental health crisis services.
Health, Housing & Community Services
94704 ● Tel: (510) 981-7000 ● TDD: (510) 981-6903 ● Fax: ofBerkeley.info Website: http://www.CityofBerkeley.info/Man
ACTION CALENDARDecember 9, 2014
Honorable Mayor and Members of the City Council
City of Berkeley Mental Health Commission
Blake, Chairperson, Mental Health CommissionCarole Marasovic, Vice Chair, Mental Health Commission
Adopt a Resolution to direct Berkeley Police Department to distinguish, and ecord, categories of 10-56 suicide statistics, in Berkeley Police
Department records division, as recorded by Berkeley police officers in
Adopt a Resolution to direct Berkeley Police Department to distinguish between categories of Berkeley police code 10-56s in Berkeley Police Department Records
egories consistent with documentation in police reports completed by Berkeley Police Department officers. Upon records requests, records should be released with correct categorical designation as recorded by police officers.
The Mental Health Commission approved this recommendation: Ayes: Davis, Heda, Blake, Marasovic, Michel, Posey, Silverberg.; Noes: None;
Dixon; Absent: Grossman, Arreguin.
FISCAL IMPACTS OF RECOMMENDATION There should not be any additional time involved in recording statistics verbatim
as documented from reports completed by the Department's police officers.
CURRENT SITUATION AND ITS EFFECTS In her individual capacity as a private citizen, the Vice-Chair of the Mental Health
lifornia Public Records Act request for statistics for suicides and attempted suicides in Berkeley for the last five years. She expressly requested 1056s, completed suicides, and 10-56As, suicide attempts, those police codes utilized to
tegories by the Berkeley Police Department.
The Vice Chair of the Mental Health Commission made this request to share information with the Mental Health Commission which is exploring the need for additional mental
x: (510) 981-7099 anager
CALENDAR December 9, 2014
Health Commission and Carole Marasovic, Vice Chair, Mental Health Commission
Department to distinguish, and statistics, in Berkeley Police
as recorded by Berkeley police officers in
Department to distinguish between 56s in Berkeley Police Department Records
egories consistent with documentation in police reports Upon records requests, records
should be released with correct categorical designation as recorded by police officers.
Davis, Heda, Noes: None; Abstain:
involved in recording statistics verbatim as documented from reports completed by the Department's police officers.
Chair of the Mental Health lifornia Public Records Act request for statistics for suicides
She expressly requested 10-56As, suicide attempts, those police codes utilized to
The Vice Chair of the Mental Health Commission made this request to share information with the Mental Health Commission which is exploring the need for additional mental
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ACTION Calendar Police Department Records of Suicide Calls December 9, 2014
Page 2
Upon picking up the records which the Vice-Chair, in her individual capacity, had ordered, which totaled twenty-two single-spaced pages listing incidents, dates, times, and street names, the Vice-Chair learned that only 10-56s had been released to her. Upon a second California Public Records Act request for the same purposes, the Vice-Chair was advised repeatedly that regardless of the manner in which police officers documented these police calls for 10-56s (completed suicides) and 10-56As (attempted suicides), the Berkeley Police Department records division consolidated all 10-56s into one category. There are also individual 10-56 codes used for suicide threats (10-56T) suicide attempt reports (10-56AR) and suicide reports (10-56R). It is unclear if these incidents have also been consolidated into the 10-56s released. The work that Berkeley police officers undertake when they document incidents by the proper code on each of their reports is blurred by the Berkeley Police Department records division when they consolidate all codes under one category. As such, there is no way to distinguish statistics of suicide-related incidents accurately. BACKGROUND In order to evaluate the need for additional mental health crisis services, the Mental Health Commission should have accurate data from which to refer. Since the police records fail to distinguish between completed suicides, suicide attempts and suicide threats, this lack of accurate data makes the evaluation process difficult. ENVIRONMENTAL SUSTAINABILITY There are no environmental impacts.
RATIONALE FOR RECOMMENDATION Berkeley police officers record incidents properly under the corresponding police code. The Berkeley Police Department Records Division consolidates statistics together. The disconnect between the proper recording at the Berkeley Police Department and the Berkeley Police Department's records division has no rational basis. Maintaining more specific statistics pertaining to persons in mental health crisis will provide the Mental Health Commission and the City of Berkeley the data to evaluate the need for additional mental health crisis services. ALTERNATIVE ACTIONS CONSIDERED No alternative actions were considered.
CITY MANAGER The City Manager [TYPE ONE] concurs with / takes no position on the content and recommendations of the Commission’s Report. [OR] Refer to the budget process.
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ACTION Calendar Police Department Records of Suicide Calls December 9, 2014
Page 3
Note: If the City Manager does not (a) concur, (b) takes any other position, or (c) refer to the budget process, a council action report must be prepared. Indicate under the CITY MANAGER heading, “See companion report.”
CONTACT PERSON Paul Kealoha-Blake, Chair, Mental Health Commission, (510) 610-3577 Carole Marasovic, Vice-Chair, Mental Health Commission, (510) 225-5060 Carol Patterson, Secretary, Mental Health Commission, (510) 981-7721
Attachments: 1: Resolution and/or Ordinance
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RESOLUTION NO. ##,###-N.S.
RECOMMENDATION TO DIRECT THE BERKELEY POLICE DEPARTMENT TO HAVE ITS RECORDS DIVISION RECORD 10-56 BERKELEY POLICE SUICIDE
CODES BY CATEGORIES AS DOCUMENTED IN POLICE REPORTS WHEREAS, in order to evaluate the need for additional mental health crisis services; and WHEREAS, the Berkeley Police Department currently has police officers who distinguish between 10-56 completed suicide and suicide-related incidents and document specific categories of Berkeley police code 10-56s properly, the Berkeley Police Department records division consolidates all the 10-56s together making accurate data impossible to identify; and WHEREAS, the Berkeley Police Department shall be directed to have its record division record categories of 10-56s as its police officers have so identified in their reports. NOW THEREFORE, BE IT RESOLVED by the Council of the City of Berkeley, the Berkeley Police Department records division shall document categories of Berkeley police code 10-56s as identified by Berkeley Police Department officers in their reports and release upon request, where required by law, accordingly.
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1
Patterson, Carol
From: Patterson, CarolSent: Wednesday, June 10, 2015 3:22 PMTo: Patterson, CarolSubject: FW: Retraction of Letter from Mental Health Commission
Mental Health Commissioners: I was directed by management to send a retraction of the letter from the Mental
Health Commission. See below.
Carol Patterson Community Services Specialist II
Mental Health Commission Secretary
2640 Martin Luther King, Jr Way (effective April 1, 2015)
Berkeley, CA 94704
(510) 981-7721
(510) 981-5265 FAX
From: Patterson, Carol
Sent: Tuesday, June 09, 2015 4:33 PM
To: Shirley Dean ([email protected]) Subject: Retraction of Letter from Mental Health Commission
President Dean: I am very sorry to say that I sent to you the June 1, 2015 letter from the Mental Health Commission in error. Per its enabling resolution, the Mental Health Commission is only permitted to communicate directly to Berkeley City Council and the Mental Health Manager. In order for the Commission to request to be on the Berkeley Safe Neighborhoods Committee agenda, they will first need to request City Council to request on their behalf. Please disregard the June 1, 2015 letter as it has now been retracted.
Carol Patterson Community Services Specialist II
Mental Health Commission Secretary
2640 Martin Luther King, Jr Way (effective April 1, 2015)
Berkeley, CA 94704
(510) 981-7721
(510) 981-5265 FAX
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Health, Housing & Community Services Mental Health Commission
2180 Milvia Street, Berkeley, CA 94704 ● Tel: (510) 981-7000 ● TDD: (510) 981-6903 ● Fax: (510) 981-7099 E-Mail: [email protected] Website: http://www.CityofBerkeley.info/Manager
ACTION CALENDAR June 9, 2015
To: Honorable Mayor and Members of the City Council
From: Mental Health Commission
Submitted by: Carole Marasovic, Acting Chairperson, Mental Health Commission
Subject: Support for Recommendations as to Implementation of AB 1421 Alternatives developed by Alameda County Behavioral Health Services Stakeholder's Group
RECOMMENDATION Adopt a Resolution directing the City Manager to send a letter of support to the Alameda County Board of Supervisors from the City of Berkeley for the recommendations developed by the AB 1421 stakeholder group reviewing the programs identified as addressing the needs of persons with serious mental illness not currently engaged in mental health treatment. These recommendations were submitted by Alex Briscoe, Director, Health Care Services Agency to the Alameda County Board of Supervisors on January 13, 2015. FISCAL IMPACTS OF RECOMMENDATION None.
CURRENT SITUATION AND ITS EFFECTS Recommendations for implementation of AB 1421 alternatives submitted by Health Services Agency Director Alex Briscoe are currently being reviewed by the Alameda County Board of Supervisors. Behavioral Health Care Services is in the process of submitting to the Board of Supervisors appropriation and revenue details as operational plans for the programs are finalized. A decision by the Alameda County Board of Supervisors on AB 1421 implementation is imminent. BACKGROUND Since implementation is at the discretion of each individual county, AB1421 has been a subject of discussion for several years in multiple counties across California since it was first passed in 2002. By 2010, Nevada County became the first and only county to implement AB 1421, also known as Laura's Law. More recently, a handful of other counties have voted to implement it. The great majority of counties have not. In recent years, there has been discussion in Alameda County as to whether or not AB 1421 should be implemented. Persuasive arguments have been made in favor of
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Support for Recommendations as to Implementation of AB 1421 Alternatives ACTION Calendar June 9, 2015
Page 2
voluntary non-coercive models to target the same population, that being those with serious mental illness not currently engaged in mental health treatment. In response, the Alameda County Board of Supervisors established the working group of stakeholders to conduct a comprehensive review of programs targeted towards this population. A thorough study and subsequent report were issued placing Alameda County with the greater majority of California counties who have identified alternatives to AB 1421 based on a voluntary non-coercive model as the best means of working with this population. As a result of extensive discussion in Alameda County, a stakeholder's group, as described above, was established, at the direction of the Alameda County Board of Supervisors, to conduct a comprehensive review of programs that could serve the AB 1421 population based on a voluntary, non-coercive model. Alternatives were identified by the stakeholder's group which are detailed in the attached report. These recommendations were submitted to the Alameda County Board of Supervisors by Health Services Agency Director Alex Briscoe. Behavioral Health Care Services is in the process of submitting to the Board of Supervisors appropriation and revenue details as operational plans for the programs are finalized. The Mental Health Commission passed the following motion at its regular meeting on Thursday, February 26. 2015: M/S/C (Marasovic, Grossman) The Mental Health Commission recommends that the City of Berkeley support the Alameda County Behavioral Health Care Services Task Force’s recommendations to implement compassionate and voluntary alternatives to AB 1421, also known as Laura’s Law.
Ayes: Davis, Grossman, Heda, Kealoha-Blake, Kerr, Marasovic, Michel, Posey
Noes: None Abstentions: None Absent: Arreguin, Dixon, Fazio
ENVIRONMENTAL SUSTAINABILITY There are no identifiable environmental effects or opportunities associated with the subject of this report. RATIONALE FOR RECOMMENDATION There are multiple programs available to address the needs of persons with serious mental illness and engage them in treatment. Alameda County Behavioral Health Care Services, after careful study, has chosen to adopt these programs for implementation, as an alternative to AB 1421, pending the County Board of Supervisors' approval.
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Support for Recommendations as to Implementation of AB 1421 Alternatives ACTION Calendar June 9, 2015
Page 3
ALTERNATIVE ACTIONS CONSIDERED The City of Berkeley, as part of Alameda County, is bound, by state statute, to follow the position on AB 1421 that Alameda County chooses to implement. CITY MANAGER See companion report.
CONTACT PERSON Carole Marasovic, Acting Chair, Mental Health Commission (510) 225-5060 Carol Patterson, Mental Health Commission Secretary, HHCS, (510) 981-7721
Attachments: 1: Resolution
Exhibit A: Re-envisioning Engagement: AB1421 Stakeholder Planning BHCS Response and Implementation Plan, November 12, 2014
Exhibit B: January 13, 2015 Briscoe letter to Board of Supervisors
28
RESOLUTION NO. ##,###-N.S.
SUPPORT OF AB 1421 ALTERNATIVES WHEREAS, the City of Berkeley is committed to serve persons with serious mental illness including those currently not engaged in mental health treatment; and WHEREAS, the Alameda County Board of Supervisors directed Alameda County Behavioral Health Care Services to form a stakeholder's working group to conduct a comprehensive review of mental health programs and identify recommendations as to AB 1421 and serving the population of persons with serious mental illness not currently engaged in treatment; and WHEREAS, a thorough review of all programs by the stakeholder's group was conducted and multiple recommendations were made, establishing programs that would serve persons under a voluntary, non-coercive model; and WHEREAS, the Alameda County Health Services Agency Director has submitted these recommendations to the Alameda County Board of Supervisors and a budget for the implementation of these programs is being formulated. NOW THEREFORE, BE IT RESOLVED that the Council of the City of Berkeley directs the City Manager to submit a letter of support to the Alameda County Board of Supervisors consistent with the recommendations made by Alameda County Behavioral Health Care Services to implement compassionate and voluntary alternatives to AB 1421. Exhibits A: Re-envisioning Engagement: AB1421 Stakeholder Planning BHCS Response and
Implementation Plan, November 12, 2014 B: January 13, 2015 Briscoe letter to Board of Supervisors
29
Re-E
nvis
ioni
ng E
nga
gem
ent
: A
B1
42
1 S
take
hold
er
Pla
nnin
g
BH
CS R
esp
ons
e a
nd Im
ple
ment
ation
Pla
n
Nove
mb
er
12
, 2
01
4
30
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
2
Sum
mar
y o
f A
B 1
421
Sta
keh
old
er P
lan
nin
g P
roce
ss a
nd
Re
com
me
nd
atio
ns
On
Feb
ruar
y 2
5, 2
014
, th
e A
lam
eda
Co
un
ty B
oar
d o
f Su
per
viso
rs p
arti
cip
ate
d in
a d
iscu
ssio
n o
n A
B1
42
1, t
he
Stat
e le
gisl
atio
n t
hat
au
tho
rize
s an
d
pro
vid
es g
uid
elin
es t
o im
ple
men
t co
urt
-ord
ered
Ass
iste
d O
utp
atie
nt
Trea
tmen
t (A
OT)
fo
r in
div
idu
als
wit
h s
ever
e m
enta
l illn
ess
that
are
re
sist
ant
to t
reat
men
t. T
he
Bo
ard
dir
ecte
d B
ehav
iora
l Hea
lth
Car
e Se
rvic
es (
BH
CS)
sta
ff t
o c
on
ven
e an
d u
se a
wo
rkin
g gr
ou
p o
f ke
y st
akeh
old
ers,
ove
r a
90
day
per
iod
, to
co
nd
uct
a c
om
pre
hen
sive
rev
iew
of
the
pro
gram
s th
at c
ou
ld s
erv
e th
e p
op
ula
tio
n t
arge
ted
by
AB
142
1.
The
wo
rkgr
ou
p’s
pu
rpo
se w
as t
o c
on
sid
er a
lte
rnat
ives
to
AB
14
21 t
hat
are
mo
re c
om
pas
sio
nat
e o
pti
on
s fo
r ac
com
plis
hin
g th
e go
als
of
AB
142
1 a
nd
to
bri
ng
bac
k
reco
mm
end
atio
ns.
Un
der
th
e B
oar
d’s
dir
ecti
on
, BH
CS
init
iate
d a
sta
keh
old
er p
lan
nin
g p
roce
ss t
o e
xplo
re a
nd
iden
tify
pro
gram
s an
d s
erv
ices
th
at t
oge
ther
wo
uld
mee
t th
e m
enta
l hea
lth
car
e n
eed
s o
f th
ese
ind
ivid
ual
s w
ith
th
e go
al o
f re
du
cin
g u
nn
ece
ssar
y h
osp
ital
izat
ion
s an
d in
crea
sin
g th
eir
en
gage
men
t
wit
h m
enta
l hea
lth
tre
atm
ent.
BH
CS
iden
tifi
ed s
take
ho
lder
s b
ased
on
th
e st
akeh
old
er g
rou
ps
nam
ed in
th
e A
B1
42
1 le
gisl
atio
n, w
hic
h p
rovi
des
gu
idan
ce t
o p
lan
nin
g p
roce
sses
,
and
to
ref
lect
un
iqu
e as
pec
ts o
f th
e C
ou
nty
’s g
eogr
aph
y, p
op
ula
tio
n d
emo
grap
hic
s an
d s
erv
ices
mix
. Th
e w
ork
gro
up
incl
ud
ed t
wen
ty f
ou
r
mem
ber
s, in
clu
din
g co
nsu
mer
s, f
amily
mem
ber
s an
d s
ervi
ce p
rovi
der
s, a
s w
ell
as r
ep
rese
nta
tive
s fr
om
th
e C
ou
nty
’s S
oci
al S
ervi
ces
Age
ncy
,
Sher
iff’
s O
ffic
e an
d P
ub
lic D
efen
der
.
BH
CS
enga
ged
Res
ou
rce
Dev
elo
pm
ent
Ass
oci
ates
(R
DA
) to
des
ign
an
d im
ple
men
t th
e st
akeh
old
er w
ork
gro
up
. RD
A u
sed
a p
has
ed, c
on
sen
sus
bas
ed f
acili
tati
on
ap
pro
ach
des
ign
ed t
o c
reat
e a
com
mo
n f
ou
nd
atio
n o
f u
nd
erst
and
ing
abo
ut
the
curr
ent
syst
em; t
he
targ
et p
op
ula
tio
n, i
ts s
ize,
leve
l of
en
gage
men
t, a
nd
nee
ds;
par
tici
pan
ts’ h
op
es a
nd
co
nce
rns
rela
ted
to
Ass
iste
d O
utp
atie
nt
Trea
tmen
t; a
nd
ult
imat
ely
, a s
et
of
pro
gram
and
se
rvic
e re
com
men
dat
ion
s to
ad
dre
ss t
hes
e n
eed
s.
For
the
pu
rpo
ses
of
this
pla
nn
ing
pro
cess
, BH
CS
def
ined
th
e ta
rget
po
pu
lati
on
as
Ad
ult
s w
ith
4 o
r m
ore
Psy
chia
tric
Em
erge
ncy
Ser
vice
vis
its,
wit
h
at le
ast
2 re
sult
ing
ho
spit
aliz
atio
ns
wit
hin
a 1
2 m
on
th p
erio
d.
BH
CS
use
d d
ata
on
se
rvic
es f
or
the
fisc
al y
ear
end
ing
Jun
e 3
0, 2
01
2, t
o id
enti
fy
205
Ala
med
a C
ou
nty
res
iden
ts in
th
is t
arge
t p
op
ula
tio
n, O
f th
is g
rou
p, 5
1%
we
re m
ale,
an
d 7
9%
fel
l bet
wee
n t
he
ages
of
25
an
d 5
9; 9
8 w
ere
Afr
ican
Am
eric
an a
nd
64
wer
e C
auca
sian
, wit
h 1
9 id
enti
fies
as
Asi
an-P
acif
ic Is
lan
der
an
d 1
6 a
s La
tin
o.
Pla
nn
ing
par
tici
pan
ts w
ere
pro
vid
ed w
ith
add
itio
nal
det
ails
ab
ou
t th
is p
op
ula
tio
n, w
hic
h a
re c
on
tain
ed in
th
e at
tach
ed f
inal
rep
ort
.
The
wo
rkgr
ou
p m
et f
ive
tim
es, e
xte
nd
ing
the
pro
cess
fro
m A
pri
l to
Ju
ne
20
14
, an
d a
gree
d u
po
n t
en
rec
om
men
dat
ion
s fo
r B
oar
d c
on
sid
erat
ion
and
ap
pro
val.
Th
ey id
enti
fied
rec
om
men
dat
ion
s to
ad
dre
ss s
yste
m a
nd
pro
gram
issu
es a
s d
escr
ibed
bel
ow
. Th
e w
ork
gro
up
als
o c
on
sid
ered
tw
o
add
itio
nal
pro
po
sals
on
Co
mm
un
ity
Co
nse
rvat
ors
hip
an
d A
OT
bef
ore
ad
op
tin
g th
eir
fin
al r
eco
mm
end
atio
ns,
wh
ich
res
ult
ed in
su
pp
ort
fo
r a
Co
mm
un
ity
Co
nse
rvat
ors
hip
pilo
t. F
or
add
itio
nal
, det
aile
d in
form
atio
n, s
ee t
he
BH
CS
Rep
ort
on
th
e A
B14
21
Pla
nn
ing
Pro
cess
.
31
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
3
BH
CS
Ap
pro
ach
to
th
e R
eco
mm
end
atio
ns
BH
CS
revi
ewed
eac
h o
f th
e te
n s
yste
m a
nd
pro
gram
rec
om
men
dat
ion
s, a
s w
ell a
s th
e C
om
mu
nit
y C
on
serv
ato
rsh
ip r
eco
mm
end
atio
n, a
nd
dev
elo
ped
op
erat
ion
al n
ext
ste
ps,
wh
ich
are
ou
tlin
ed in
th
e at
tach
ed t
able
. T
he
stak
eho
lder
rec
om
men
dat
ion
s, in
ad
dit
ion
to
th
e n
ine
init
ial
reco
mm
end
atio
ns
app
rove
d b
y th
e B
oar
d in
Feb
ruar
y 2
01
4, f
ocu
s o
n in
crea
sin
g ca
pac
ity
acro
ss t
he
syst
em a
nd
exp
and
ing
pro
gram
s, w
ith
a
shar
p f
ocu
s o
n c
reat
ing
inte
nti
on
al li
nka
ges
for
con
sum
ers
and
fam
ilies
wit
h B
HC
S se
rvic
es a
nd
co
mm
un
ity
sup
po
rts.
BH
CS
will
lau
nch
imp
lem
enta
tio
n, f
ollo
win
g th
e B
oar
d’s
rev
iew
an
d a
pp
rova
l of
the
new
rec
om
men
dat
ion
s.
The
tab
le h
igh
ligh
ts e
ach
of
the
stak
eh
old
er r
eco
mm
end
atio
ns
and
pro
vid
es u
pd
ate
s an
d li
nks
to
th
e p
rio
r n
ine
Bo
ard
-ap
pro
ved
reco
mm
end
atio
ns.
B
HC
S w
ill r
etu
rn t
o t
he
Bo
ard
fo
r ap
pro
val o
f ap
pro
pri
atio
n a
nd
re
ven
ue
incr
ease
s as
op
erat
ion
al p
lan
s ar
e fi
nal
ized
.
As
a re
sult
of
the
AB
1421
pla
nn
ing
pro
cess
es a
nd
th
e d
ata-
dri
ven
an
alys
is o
f cr
isis
nee
ds
and
cu
rren
t B
HC
S cr
isis
cap
acit
y, t
he
dep
artm
ent
is
lau
nch
ing
a C
risi
s P
lan
nin
g P
roce
ss, w
hic
h w
ill f
orm
ally
co
nve
ne
in e
arly
Dec
emb
er 2
01
5.
BH
CS
has
co
ntr
acte
d w
ith
th
e R
DA
co
nsu
ltan
ts t
o
faci
litat
e th
is p
roce
ss, g
iven
th
eir
sign
ific
ant
kno
wle
dge
an
d u
nd
erst
and
ing
of
the
BH
CS
syst
em a
nd
se
rvic
e d
eliv
ery.
Th
is w
ill b
e a
sho
rt t
erm
,
inte
nsi
ve p
lan
nin
g p
roce
ss, w
ith
a b
road
var
iety
of
stak
eh
old
ers,
res
ult
ing
in a
set
of
reco
mm
end
atio
ns
by
the
end
of
Feb
ruar
y, 2
01
5.
BH
CS
inte
nd
s to
dev
elo
p R
FPs
as n
eed
ed f
or
new
or
exp
and
ed c
risi
s p
rogr
ams,
wit
h t
he
goal
of
hav
ing
new
ser
vice
s in
pla
ce n
ear
the
sta
rt o
f FY
15
/16
.
32
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
4
Syst
em
Level R
eco
mm
endations
Reco
mm
endation
s
Imple
menta
tion
N
ext Ste
ps
& T
imeline
Links
to I
nitia
l 9 R
eco
mm
endatio
ns
Ap
pro
ved b
y B
oard
of
Superv
isors
#
1 H
ire a
n A
dm
inis
trato
r D
esc
ription:
thi
s posi
tion
will
overs
ee
the im
ple
ment
ation
of
new
pro
gra
ms,
serv
e a
s a
reso
urce
and
tech
nica
l ad
viso
r to
mana
gers
, st
aff
, co
mm
unity
pro
viders
, and
clie
nts
and
fam
ily
mem
bers
/ca
regiv
ers
; p
art
icip
ate
in
the d
eve
lopm
ent
of
clie
nt leve
l and
ag
gre
ga
te o
utco
mes,
in
part
ners
hip
with
the Q
ualit
y M
ana
gem
ent
Uni
t;
and
tra
ck a
nd r
esp
ond
to o
utco
mes,
w
ork
ing w
ith
direct
ca
re p
rovi
ders
.
Needs
Add
ress
ed: w
ill p
rovi
de
ove
rsig
ht a
nd c
oord
ination
for
the
eng
agem
ent
of
and
serv
ice f
or
people
with
a r
ece
nt h
isto
ry o
f re
curr
ent
psy
chia
tric
room
visits
and
ho
spitaliz
ations
who
are
sig
nifi
cant
ly
dete
riora
ting
and
unw
illin
g/unab
le t
o
eng
age in
volu
ntary
serv
ices
to
supp
ort
the
ir r
eco
very
. T
his
posi
tion
will
use
utiliza
tion
and
out
com
e d
ata
to
dri
ve ind
ivid
ual a
nd s
yst
em
s-le
vel
deci
sion
makin
g.
BH
CS h
as
ident
ifie
d t
he m
ana
gem
ent
cla
ssific
ation
Pro
gra
m S
erv
ices
Coord
inato
r fo
r th
is p
osi
tion,
whi
ch w
ill re
port
to t
he A
dul
t Syst
em
of
Care
Direct
or.
BH
CS p
lans
to f
ill thi
s posi
tion
and
will
open
recr
uitm
ent
in
Janua
ry 2
01
5.
The s
ala
ry r
ang
e f
or
this c
lass
ific
ation
is $
86
, 11
7 t
o $
91
,062
plu
s
em
plo
yee b
ene
fits
. E
stim
ate
d a
nnua
l co
st is
$13
2,8
40;
this p
osi
tion
will
be f
und
ed b
y M
HSA
.
BH
CS h
as
hire
d a
Cri
tica
l C
are
Manager
for
John
G
eorg
e P
sych
iatr
ic P
avilio
n (
JGPP), w
ho s
tart
ed
work
in
Oct
ober
201
4. Th
is m
ana
ger
will
work
w
ith
JGPP s
taff
to ident
ify B
HC
S s
erv
ices
and
co
mm
uni
ty r
eso
urce
s fo
r cl
ient
s/co
nsum
ers
in
Psy
chia
tric
Em
erg
enc
y S
erv
ices
(PES
) or
the
hosp
ital a
nd d
ivert
ind
ivid
uals
fro
m t
he P
ES t
o
com
muni
ty s
ettin
gs.
33
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
5
#2 Incr
ease
Data
-Shari
ng C
apaci
ty
Desc
ription:
Inc
rease
the
ca
pa
city
for
da
ta s
hari
ng b
etw
een
BH
CS, th
e
netw
ork
of
pro
viders
and
the
A
lam
eda
Count
y S
heri
ff t
o s
upp
ort
cl
ient
ca
re. Reco
gni
zing
lega
l im
pedim
ent
s to
data
-sha
ring
mus
t b
e
ad
dre
ssed;
this m
ay inc
lude a
ce
ntra
lized d
ata
base
, da
ta
ware
hous
e o
r oth
er
mech
ani
sms
to
share
data
.
Needs
Add
ress
ed: W
ill im
pro
ve
coord
ination
of
care
for
clie
nts
and
pro
vide d
ata
for
syst
em
s-le
vel
eva
luation
to a
dd
ress
the
ove
rlap o
f people
with
recu
rrent
psy
chia
tric
em
erg
enc
y r
oom
visits
and
ho
spitaliz
ations
and
inv
olv
em
ent
with
the c
rim
inal ju
stic
e s
yst
em
.
BH
CS Inf
orm
ation
Tech
nolo
gy a
nd D
eci
sion
Sup
port
are
work
ing t
o
enh
anc
e d
ata
int
egra
tion,
within
the
depa
rtm
ent
’s r
egul
ato
ry, pri
vacy
and
data
secu
rity
req
uire
ment
s a
nd c
urre
nt inf
orm
ation
tech
nolo
gy
pro
gra
ms. Pla
nnin
g is
underw
ay f
or
the im
ple
ment
ation
of
a n
ew
BH
CS E
lect
roni
c H
ealth
Reco
rd, w
hic
h w
ill st
ream
line d
ata
int
egra
tion
and
acc
ess
to inf
orm
ation.
#3 D
evelo
p P
rovid
er
and S
taff
C
apaci
ty
Desc
ription:
Off
er
a t
rain
ing s
eri
es
on
six e
videnc
e-b
ase
d p
ract
ices
(EBPs)
to
expa
nd t
he s
yst
em
’s c
ap
aci
ty to s
erv
e
the t
arg
et p
opul
ation
rega
rdle
ss o
f th
eir p
oin
t of
eng
agem
ent
. N
eeds
Add
ress
ed:
Incr
ease
the
kn
ow
ledg
e a
nd c
ap
aci
ty o
f p
rovi
ders
and
sta
ff t
o u
tiliz
e t
he a
pp
ropri
ate
pra
ctic
es
for
clie
nts’
speci
fic
needs.
In J
anua
ry 2
01
4, th
e B
HC
S T
rain
ing U
nit w
ill co
mple
te a
n RFP p
roce
ss
and
deve
lop a
tra
inin
g s
chedule
for
the f
ollo
win
g t
hree t
rain
ings:
Motiva
tiona
l In
terv
iew
ing (
MI)
Seeki
ng S
afe
ty
Cogni
tive
Beha
viora
l Th
era
py (
CBT)
The s
take
hold
er
reco
mm
end
ations
also inc
luded:
Dia
lect
ical Beha
viora
l Th
era
py (
DBT)
–
BH
CS w
ill c
ont
ract
with
a D
BT
train
er
Welln
ess
Reco
very
Act
ion
Pla
nnin
g (
WRA
P)
–
BH
CS c
urre
ntly
fun
ds
WRA
P t
rain
ing t
hroug
h a c
ont
ract
with
PEE
RS, an
Ala
meda
Count
y c
ons
umer
pro
vider,
and
pla
ns t
o
ad
just
the
cont
ract
to o
ffer
additio
nal pro
vider
train
ings
Co-O
ccur
ring
(M
ent
al H
ealth
and
Sub
stanc
e U
se D
isord
ers
)
Cond
itio
ns –
BH
CS O
pera
tiona
l Le
ad
ers
hip is
revi
ew
ing e
vid
enc
e-b
ase
d
train
ings
rela
ted t
o c
o-o
ccur
ring
cond
itio
ns, w
ith
the g
oal of
expa
ndin
g a
nd s
treng
theni
ng p
rovi
der
and
sta
ff c
apa
city
acr
oss
the
syst
em
. Th
e T
rain
ing U
nit, w
ork
ing w
ith t
he S
yst
em
of
Care
Direct
ors
and
O
pera
tiona
l Le
ad
s, w
ill o
ffer
train
ings
on
DBT
and
Co-O
ccur
ring
34
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
6
Cond
itio
ns, fo
llow
ing t
he d
eve
lopm
ent
of
a t
arg
ete
d, Pro
vider
Train
ing P
lan.
#4 E
ngage F
am
ilie
s
Desc
ription:
Seek
mech
ani
sms,
as
perm
itte
d u
nder
the 4
2 C
ode o
f Fe
dera
l Regul
ations
(42
CFR
),
Calif
orn
ia M
edic
al In
form
ation A
ct
(CM
IA)
and
Health
Insu
ranc
e
Port
ab
ility
and
Acc
oun
tab
ility
Act
(H
IPPA
), to a
llow
fam
ily
mem
bers
/ca
regiv
ers
to s
upp
ort
co
nsum
ers
and
pa
rtic
ipa
te in
their
care
, to
the
exte
nt t
hat
their love
d o
ne
allo
ws.
Needs
Add
ress
ed: F
am
ily m
em
bers
se
rve a
s cr
itic
al re
sour
ces
to t
heir
love
d o
nes,
whe
n th
ey a
re a
ccess
ing
serv
ices,
and
can
pro
vide inf
orm
ation
that
woul
d s
upp
ort
the
ir love
d o
nes.
BH
CS r
eco
gni
zes
that
care
giv
ers
’ ab
ility
to p
rovi
de s
upp
ort
to c
lient
s
is e
nhanc
ed w
hen
they h
ave
pert
inent
inf
orm
ation.
In
add
itio
n, the
ca
pab
ility
of
BH
CS s
erv
ice p
rovi
ders
to e
ffect
ively
tre
at
clie
nts
can
be
incr
ease
d b
y inf
orm
ation
rece
ived f
rom
fam
ily c
are
giv
ers
.
BH
CS s
upp
ort
s a
colla
bora
tive
model of
pra
ctic
e, w
hich
pro
mote
s th
e
volu
ntary
sha
ring
of
info
rmation
am
ong
clie
nts,
BH
CS a
nd c
ontr
act
ag
enc
y s
taff
, and
care
giv
ers
to t
he g
reate
st e
xte
nt f
easi
ble
in
ord
er
to f
aci
litate
the
reha
bili
tative
/re
cove
ry p
roce
ss f
or
clie
nts.
Calif
orn
ia a
nd f
edera
l la
ws
and
sta
tute
s re
qui
re a
dul
t co
nsum
ers
to
pro
vide w
ritten
cons
ent
to s
hare
inf
orm
ation
with
their f
am
ily
mem
bers
/ca
regiv
ers
. In
an
eff
ort
to p
rom
ote
a m
ore
open
exch
ang
e
of
info
rmation
am
ong
clie
nts,
the
ir c
are
giv
ers
and
pro
viders
, BH
CS
has
deve
loped a
set of
Conf
ident
ialit
y G
uideline
s th
at
pro
tect
the
st
atu
tory
rig
hts
of
clie
nts
to p
riva
cy a
nd f
ocu
s on
the im
port
anc
e o
f su
pp
ort
syst
em
s a
nd o
pen
dia
logue
betw
een
clie
nts
and
the
ir
care
giv
ers
, ke
epin
g in
min
d t
he c
lient
’s p
riva
cy r
ight
s.
BH
CS L
ead
ers
hip, w
ork
ing w
ith
the F
am
ily G
roup
, a
pp
rove
d t
hese
gui
delin
es
and
will la
unc
h a
pro
vider
train
ing s
eri
es
in t
he F
irst
Q
uart
er
of
201
5. T
he g
oals
are
to inc
rease
pro
vider
aw
are
ness
of
the im
port
anc
e o
f fa
mily
inv
olv
em
ent
, he
lp p
rovi
ders
und
ers
tand
the
ne
eds
of
fam
ilies
and
cre
ate
opp
ort
unitie
s fo
r fa
mily
inp
ut,
reco
gni
zing
the
lega
l co
nfid
entialit
y r
equi
rem
ent
s a
nd t
he r
ole
the
y
can
pla
y in
supp
ort
ing t
heir love
d o
nes.
The B
HC
S T
rans
itio
n A
ge Y
out
h Syst
em
of
Care
pla
ns t
o e
xpa
nd M
ultif
am
ily G
roup
s to
sup
port
fa
mily
mem
bers
of
yout
h w
ho a
re n
ot eng
aged o
r pa
rtic
ipa
ting
in
their t
reatm
ent
.
35
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
7
#5 Involv
e P
eers
and F
am
ily
Mem
bers
in M
eanin
gfu
l W
ay
s
Desc
ription:
C
ont
inua
lly s
eek
ways
to
incl
ude p
eer
and
fam
ily s
upp
ort
sp
eci
alis
ts t
hroug
hout
the
BH
CS s
erv
ice
syst
em
. N
eeds
Add
ress
ed: Inc
reasi
ng p
eer
and
fam
ily s
peci
alis
ts, off
eri
ng t
heir
ow
n live
d e
xperi
enc
e, bene
fits
both
co
nsum
ers
rece
ivin
g c
are
and
the
ir
love
d o
nes.
BH
CS r
eco
gni
zes
the v
alu
e o
f co
nsum
ers
and
fam
ily m
em
bers
work
ing
acr
oss
the
syst
em
, and
act
ively
seeks
new
role
s a
nd o
pp
ort
unitie
s to
in
corp
ora
te p
eer
and
fam
ily s
upp
ort
s.
Dur
ing t
he 1
42
1 P
lann
ing
Pro
cess
, BH
CS r
eco
gni
zed t
he n
eed t
o inc
rease
sup
port
for
fam
ily
mem
bers
of
adul
t co
nsum
ers
, esp
eci
ally
to f
am
ily m
em
bers
experi
enc
ing a
cri
sis
with
their love
d o
ne.
Two o
f th
e 1
42
1 P
lann
ing P
roce
ss P
rogra
m R
eco
mm
end
ations
inc
lude
peer
and
fam
ily s
upp
ort
s to
help
clie
nts
and
fam
ilie
s na
viga
te t
he
syst
em
. T
hey a
re d
esc
ribed in
more
deta
il in
the
pro
gra
m s
ect
ion.
36
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
8
Pro
gra
m L
evel R
eco
mm
endations
Reco
mm
endation
s
Imple
menta
tion
N
ext Ste
ps
& T
imeline
Links
to I
nitia
l 9 R
eco
mm
endatio
ns
Ap
pro
ved b
y
Board
of
Superv
isors
#
6 E
xpa
nd C
risi
s R
esi
dential
Tre
atm
ent
(CR
T)
Desc
ription: Lo
cate
add
itio
nal C
RT
beds
in
Nort
hern
Ala
meda
Count
y t
o s
upp
lem
ent
the e
xisting
pro
gra
m c
ap
aci
ty in
the
Cast
ro V
alle
y/San
Leand
ro a
rea.
Deve
lop t
he c
apa
city
at th
e C
RT
to a
ccept
refe
rrals
direct
ly f
rom
Beha
viora
l H
ealth
Serv
ices
and
to a
void
Psy
chia
tric
Em
erg
enc
y S
erv
ices
(PES
) ut
iliza
tion,
as
perm
issi
ble
by T
itle
s IX
and
XX
II a
nd w
hen
clin
ica
lly a
pp
ropri
ate
. Th
e C
RT w
ill a
lso
deve
lop inc
rease
d c
o-o
ccur
ring
co
mpete
ncy t
o s
erv
e ind
ivid
uals
re
cove
ring
fro
m c
om
ple
x m
ent
al he
alth
and
sub
stanc
e u
se c
ond
itio
ns.
Need A
ddre
ssed
: Pro
vide a
ltern
ative
s to
ho
spitaliz
ation
by e
xpa
ndin
g C
risi
s Resi
dent
ial Tr
eatm
ent
(C
RT)
capa
city
in
Ala
meda
Count
y.
Inco
rpora
te thi
s re
com
mend
ation
into
the
Cri
sis
Pla
nnin
g P
roce
ss, w
hich
will st
art
in
Nove
mber/
Dece
mber
201
4 a
nd f
inalize
re
com
mend
ations
no late
r th
an
Febru
ary
201
5.
BH
CS int
end
s to
deve
lop a
16 b
ed C
risi
s Resi
dent
ial pro
gra
m.
An
add
itio
nal re
com
mend
ation f
rom
the
work
gro
up
was
to c
reate
a 2
4-h
our
Cri
sis
Sta
bili
zation
Unit.
BH
CS is
alread
y p
lann
ing t
o incl
ude t
his
reco
mm
end
ation
as
part
of
the b
road
er
Crisi
s Pla
nnin
g P
roce
ss in
Nove
mber/
Dece
mber
20
14
.
The M
HSA
Pla
n U
pd
ate
, co
min
g b
efo
re t
he B
oard
’s H
ealth
Com
mitte
e in
Nove
mber
201
4, a
nd t
he f
ull Board
in
Dece
mb
er
20
14
, co
ntain
s fu
ndin
g a
ugm
ent
ations
for
the f
ollo
win
g p
rogra
ms:
Th
e S
TEPS A
dult Inte
nsi
ve C
ase
Managem
ent Pro
gra
m t
o
ad
dre
ss a
bro
ad
er
targ
et p
opul
ation
that
incl
udes
clie
nts/
cons
umers
experi
enc
ing e
arl
y e
pis
odes
of
ment
al ill
ness
in
the h
osp
ital a
nd t
o inc
rease
the
flo
w o
f cl
ient
s/co
nsum
ers
to less
re
stri
ctiv
e c
om
muni
ty-b
ase
d s
erv
ices.
$2
50
,000
aug
ment
ation/
will be inc
luded in
annu
al M
HSA
fund
ing
Th
e F
ore
nsi
c A
ssert
ive C
om
munity T
reatm
ent (F
AC
T)
Team
to
ad
dre
ss a
bro
ad
er
targ
et p
opul
ation
that
incl
udes
clie
nts/
cons
umers
experi
enc
ing e
arl
y e
pis
odes
of
ment
al ill
ness
w
hile
inc
arc
era
ted a
nd t
o inc
rease
the
flo
w o
f cl
ient
s/co
nsum
ers
to
less
rest
rict
ive c
om
mun
ity-b
ase
d s
erv
ices.
FA
CT
serv
es
pers
ons
w
ho h
ave
a h
isto
ry o
f exce
ss u
tiliz
ation
of
ment
al he
alth,
subst
anc
e a
bus
e a
nd c
rim
inal ju
stic
e s
yst
em
s in
Ala
meda
Count
y
and
utilize
s th
e A
CT
model.
$3
75
,000
aug
ment
ation/w
ill be inc
luded in
annu
al M
HSA
fund
ing
In
add
itio
n, tw
o T
ran
sition A
ge Y
outh
(ages
18
-24)
pro
gra
ms,
in
clud
ed in
the ini
tial re
com
mend
ations
, re
ceiv
ed f
undin
g f
rom
the
Sta
te’s M
HSA
Ove
rsig
ht a
nd A
ccoun
tab
ility
Com
missi
on
Cri
sis
Tria
ge G
rant
s. T
he $
2.6
millio
n a
ward
will
cove
r th
e c
ost
s of
these
pro
gra
ms
for
thre
e y
ears
. B
HC
S r
ece
ntly
com
ple
ted the
RFP
pro
cess
, se
lect
ed a
pro
vider
for
these
pro
gra
ms
and
is
subm
itting
a letter
to the
Board
of
Sup
erv
isors
seeki
ng f
undin
g a
ppro
val fo
r th
e p
rogra
ms
out
lined b
elo
w.
The S
treet
Youth
Outr
each
Team
will
meet a
nd e
nga
ge y
oun
g
people
“w
here
the
y’re a
t” in
the c
om
mun
ity o
r in
the
hosp
ital, a
nd
will
help
lin
k th
em
to s
erv
ices
and
tre
atm
ent
. Th
e T
AY
Inte
nsi
ve C
ase
Man
agem
ent Pro
gra
m w
ill w
ork
with
yout
h w
ho a
re d
iffi
cult t
o e
nga
ge, re
qui
re a
ssista
nce w
ith
main
tain
ing t
heir a
ctiv
itie
s of
daily
liv
ing a
nd w
oul
d b
ene
fit fr
om
th
ese
serv
ices.
37
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
9
#7 D
evelo
p a
Peer
Resp
ite P
rogra
m
Desc
ription:
Peer
Resp
ite is
a p
eer-
led,
com
muni
ty-b
ase
d c
risis
model th
at
may o
r m
ay n
ot in
clud
e a
clin
ical or
health
care
co
nsul
tant
. P
eer
Resp
ite p
rovi
des
pro
-act
ive d
ivers
ion
to a
ssist
people
in
crises
and
off
ers
sup
port
to t
hem
.
Need A
ddre
ssed:
Pro
vides
an
ad
ditio
nal
altern
ative
to h
osp
italiz
ation
with
short
-
term
resi
dent
ial se
rvic
es
that
cons
umers
ca
n acc
ess
dur
ing t
imes
of
cris
is in
ord
er
to
div
ert
Psy
chia
tric
Em
erg
enc
y S
erv
ice (
PES
) vi
sits
and
hosp
italiz
ations
.
BH
CS w
ill inc
orp
ora
te t
his
reco
mm
end
ation
into
the
C
risi
s Pla
nnin
g P
roce
ss, w
hich
will
sta
rt in
Nove
mber/
Dece
mber
201
4 a
nd f
inalize
re
com
mend
ations
no late
r th
an
Febru
ary
201
5.
BH
CS r
eco
gni
zes
the v
alu
e o
f a
dd
ing a
peer
resp
ite p
rogra
m to the
arr
ay o
f co
mm
unity-b
ase
d
crisis
serv
ices.
BH
CS s
taff
have
rese
arc
hed p
eer
resp
ite m
odels in
Calif
orn
ia a
nd a
cross
the
coun
try.
This inf
orm
ation
will b
e s
hare
d a
nd d
iscu
ssed in
gre
ate
r d
eta
il in
the
Cri
sis
Pla
nnin
g P
roce
ss.
#8 D
evelo
p a
“R
apid
En
gagem
ent
Team
”
Desc
ription:
RET
is
base
d o
n th
e f
idelit
y
model of
Ass
ert
ive C
om
mun
ity T
reatm
ent
and
is
com
pri
sed o
f a
mul
ti-d
isci
plin
ary
, m
obile
sta
ff t
hat
incl
udes
clin
ical,
peer
and
fam
ily s
upp
ort
s.
RET
is
desi
gne
d t
o
“meet p
eople
whe
re t
hey a
re a
t” a
nd
pro
vide f
ield
-ba
sed, fl
exib
le s
erv
ices
to
supp
ort
ind
ivid
uals
as
they m
ove
thr
oug
h th
e s
tag
es
of
reco
very
. N
eed A
ddre
ssed:
RET
is
desi
gne
d t
o
eng
age ind
ivid
uals
whi
le t
hey a
re s
till
in
the h
osp
ital,
suba
cute
faci
lity, and
/or
jail
to b
egin
the
rela
tions
hip
-bui
ldin
g p
roce
ss
and
enr
oll
them
in
the R
ET t
eam
.
The A
dult S
yst
em
of
Care
vie
ws
RET
as
a t
arg
ete
d,
short
-term
app
roach
to e
nga
gin
g c
lient
s a
nd
ass
isting
the
m w
ith
bene
fits
, ho
usin
g a
nd a
“w
arm
ha
ndoff
” to
the
app
ropri
ate
com
muni
ty-b
ase
d
serv
ice. Th
e t
eam
can
supp
ort
ind
ivid
uals
who
are
ne
w t
o t
he s
yst
em
and
tho
se w
ho h
ave
not b
een
eng
ag
ed in
serv
ices
and
may b
e h
avi
ng d
iffi
culty
mana
gin
g t
heir liv
es
and
wellness
.
These
serv
ices
mirro
r co
mpone
nts
of
existing
AC
T,
Inte
nsiv
e C
ase
Ma
nag
em
ent
and
cri
sis
pro
gra
ms,
with
the a
dd
itio
n of
cons
umer
and
fam
ily s
upp
ort
s and
mobile
sta
ff. T
he A
dult S
yst
em
of
Care
su
gg
est
s th
at th
is r
eco
mm
end
ation
be inc
orp
ora
ted
into
the
Cri
sis
Pla
nnin
g p
roce
ss t
o d
ete
rmin
e t
he
best
pro
gra
mm
atic
fit a
nd s
truc
ture
. Th
ese
serv
ices
may b
e p
rovi
ded t
hroug
h expa
ndin
g o
r sh
ifting
sta
ff r
ole
s in
existing
pro
gra
ms. A
ny a
dd
itio
nal p
rogra
m c
ost
s w
ill b
e
dete
rmin
ed d
urin
g t
he C
risis
Pla
nnin
g p
roce
ss a
nd
woul
d b
e f
unded b
y M
HSA
.
38
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
10
#9 D
evelo
p a
Co
-Occ
urr
ing C
onditio
ns
Full S
erv
ice P
art
ners
hip
(FSP)
Desc
ription:
FSP
s p
rovi
de
a fu
ll ra
nge
of
ou
tpat
ien
t w
elln
ess
an
d r
eco
very
se
rvic
es, i
ncl
ud
ing
ho
usi
ng.
Need A
ddre
ssed: En
hanc
e s
erv
ices
and
im
pro
ve o
utco
mes
for
clie
nts
with
both
m
ent
al he
alth
and
sub
stanc
e u
se d
isord
ers
.
Whi
le t
he s
take
hold
er
gro
up r
eco
mm
end
ed
deve
lopm
ent
of
an
add
itio
nal FS
P, BH
CS
Lead
ers
hip r
eco
mm
end
s expans
ion
of
co-o
ccur
ring
ca
paci
ty a
cross
all
nine
FSPs,
to im
pro
ve o
utco
mes
for
clie
nts
with
both
ment
al he
alth
and
sub
stanc
e
use d
isord
ers
. BH
CS E
xecu
tive
and
Opera
tiona
l Le
ad
ers
hip a
re
revi
ew
ing n
ationa
lly r
eco
gni
zed e
videnc
e-b
ase
d
pra
ctic
es
(EBPs)
tha
t su
pp
ort
ind
ivid
uals
with
co-
occ
urri
ng d
isord
ers
and
work
ing w
ith
FSP p
rovi
ders
to
ident
ify tra
inin
g a
nd c
apa
city
needs
in t
hese
pro
gra
ms.
In
corp
ora
ting
co-o
ccur
ring
cap
aci
ty a
cross
the
FSPs
repre
sent
s a
sig
nifica
nt s
yst
em
cha
nge e
ffort
and
w
ill r
equir
e s
igni
fica
nt p
lann
ing w
ith
BH
CS S
yst
em
of
Care
Direct
ors
, O
pera
tiona
l Le
ad
s a
nd
pro
viders
.
#10 D
evelo
p a
“Bri
dges”
Sy
stem
N
avig
ation T
eam
D
esc
ription:
“Bri
dges”
is
a m
ulti-
dis
ciplin
ary
team
tha
t w
oul
d p
rovi
de
out
reach
and
eng
agem
ent
serv
ices
as
well
as
syst
em
s na
viga
tion
supp
ort
. T
his
pro
gra
m w
oul
d e
nga
ge t
hose
who
are
not
curr
ent
ly r
ece
ivin
g m
ent
al he
alth
serv
ices
and
main
tain
rela
tions
hips
with t
hese
in
div
idua
ls a
s th
ey m
ove
thr
oug
h th
e
vari
ous
leve
ls o
f ca
re.
Need A
ddre
ssed: T
he “
Bri
dges”
Team
w
oul
d s
erv
e a
s a
cons
iste
nt s
our
ce o
f su
pp
ort
regard
less
of
how
and
whe
re a
n
indiv
idua
l m
ove
s w
ithi
n th
e m
ent
al he
alth
syst
em
.
BH
CS s
ees
sim
ilari
ties
betw
een
the “
Bri
dges”
Team
and
the
In
Hom
e O
utre
ach
Tea
m, one
of
the ini
tial
Re-E
nvisio
ning
Eng
agem
ent
/14
21
re
com
mend
ations
. BH
CS r
eco
mm
end
s th
at
the “
Bridges”
Team
pilo
t is
in
corp
ora
ted int
o M
HSA
Inn
ovations
Gra
nts
Roun
d
4, w
hic
h w
ill fo
cus
on
Out
reach
and
Eng
agem
ent
st
rate
gie
s. In
nova
tions
Roun
d 4
will
be la
unch
ed in
Janu
ary
201
5, a
nd w
ill pro
vid
e 1
8 m
ont
hs o
f fu
ndin
g t
o s
ele
cted g
rant
ees.
A
t th
e e
nd o
f th
e
gra
nt p
eri
od, BH
CS w
ill e
valu
ate
resu
lts
and
id
ent
ify im
ple
ment
ation
opp
ort
unitie
s.
The I
n H
om
e O
utr
each
Team
(IH
OT)
will pro
vide h
om
e o
r co
mm
uni
ty-b
ase
d s
upp
ort
and
educ
ation
to c
lient
s/co
nsum
ers
, fa
mily
mem
bers
and
care
giv
ers
. M
odele
d a
fter
San
Die
go
Coun
ty’s
suc
cess
ful pilo
t, IH
OT
focu
ses
on
out
reach
, eng
agem
ent
and
sup
port
and
lin
ks p
art
icip
ant
s to
serv
ices
and
com
muni
ty
reso
urce
s.
Estim
ate
d M
HSA
gra
nt f
undin
g: $
275
,000
(2 t
eam
s) to
$4
00
,000
(3 t
eam
s)
The P
eer
Na
vig
ato
r Pro
gra
m w
ill o
ffer
indiv
idua
l peer
supp
ort
to
clie
nts/
cons
umers
dur
ing c
are
tra
nsitio
ns b
etw
een
diffe
rent
leve
ls
of
care
and
pro
vide lin
kages
to p
rim
ary
and
beha
viora
l he
alth
serv
ices
and
to c
om
mun
ity r
eso
urce
s.
Estim
ate
d M
HSA
gra
nt f
undin
g: $
200
,000
Th
ese
tw
o p
ilot p
rogra
ms
will
be inc
luded in
the M
HSA
Inn
ovations
G
rant
s Roun
d 4
, fo
cuse
d o
n O
utre
ach
and
Eng
agem
ent
. BH
CS p
lans
to r
ele
ase
a R
eque
st f
or
Pro
posa
l (R
FP) fo
r a
Post
C
risi
s Peer
Support
Pro
gra
m (
calle
d a
Ment
ors
on
Disch
arg
e
Pro
gra
m in
the ini
tial ni
ne r
eco
mm
end
ations
) fo
r co
nsum
ers
bein
g
dis
charg
ed f
rom
John
Georg
e P
sych
iatr
ic P
avi
lion,
ba
sed o
n pro
misin
g p
ract
ices
from
MH
SA
Inno
vation
Gra
nts
Roun
d 1
. Ex
pect
ed R
FP d
ate
: F
irst
Qua
rter
201
5
Estim
ate
d p
rogra
m c
ost
: $1
87
,50
0, fu
nded b
y M
HSA
39
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
11
Com
munity C
onse
rvato
rship
and A
ssis
ted O
utp
atient Tre
atm
ent (A
OT)
Sum
mary
The A
B1
42
1Pla
nnin
g P
roce
ss w
ork
gro
up c
ons
idere
d tw
o a
dditio
nal pro
posa
ls o
n C
om
mun
ity C
ons
erv
ato
rshi
p a
nd A
OT
befo
re
adop
ting
their
fin
al re
com
mend
ations.
Th
ere
was
no e
xpect
ation tha
t th
e g
roup
woul
d r
each
cons
ens
us r
ega
rdin
g the
se p
ote
ntia
l
serv
ice o
ptions.
Led
by the
cons
ulta
nts,
the g
roup
eng
ag
ed in a
pla
nned e
xerc
ise to d
ete
rmin
e w
hich
of
these
tw
o p
rog
ram
s ha
d s
trong
er
ove
rall
sup
port
fro
m t
he s
take
hold
ers
. F
ollow
ing a
faci
lita
ted d
iscu
ssio
n, th
e g
roup
dem
ons
trate
d s
trong
er
cons
ens
us f
or
Sa
n Fr
anc
isco
’s
Lant
erm
an-P
etr
is-S
hort
Act
(LP
S) C
om
mun
ity Independ
enc
e P
lace
ment Pro
gra
m (C
IPP) m
odel w
ith
ada
pta
tions
to the
speci
al ne
ed
s in
Ala
med
a C
oun
ty. T
he g
roup
the
n v
ote
d to r
eque
st that BH
CS d
eve
lop a
nd im
ple
ment a h
ybrid
mod
el of
com
mun
ity c
ons
erv
ato
rshi
p.
Sa
n Fr
anc
isco
’s L
PS C
IPP p
rovi
des
cons
erv
ato
rshi
p, m
edic
ation,
and
case
mana
gem
ent se
rvic
es
to c
lient
s w
ho h
ave
a h
isto
ry o
f
psy
chia
tric
hosp
italiz
ations
and
non-c
om
plia
nce w
ith
treatm
ent
, and
who
are
at risk
of
re-h
osp
ita
liza
tion
of
adm
itta
nce to a
long
er-
term
lock
ed
psy
chia
tric
faci
lity
in the
fut
ure w
itho
ut pro
per
care
. T
he g
oal of
the L
PS C
IPP p
rogra
m is
volu
nta
ry a
nd p
art
icip
ation
requi
rem
ent
s are
expla
ined to the
indiv
idua
l by the
tre
atm
ent
pro
vider
and
their a
ppoin
ted c
oun
sel.
There
wa
s a
separa
te, fa
cilita
ted d
iscu
ssio
n aro
und the im
ple
ment
ation
of
AO
T. S
take
hold
ers
ha
d the
op
port
unity to d
iscu
ss the
ir
conc
ern
s a
nd q
uest
ions
in o
rder
to f
ully
eng
age in the
cons
ens
us p
roce
ss. W
hile
part
icip
ant
s exp
ress
ed
an
und
ers
tand
ing
of
the
inhe
rent
cha
llenges
in e
ngagin
g the
targ
et popul
ation,
the
re w
as
a lack
of
cons
ens
us a
roun
d the incl
usion
of
AO
T in
the
reco
mm
end
ations.
U
ltim
ate
ly, A
OT
did
not re
ceiv
e the
sam
e level of
support
as
the C
om
mun
ity C
ons
erv
ato
rshi
p m
od
el a
nd there
fore
cann
ot b
e c
ons
idere
d a
cons
ens
us r
eco
mm
end
ation.
Ple
ase
see the
BH
CS R
eport
on
the A
B 1
421 P
lann
ing P
roce
ss f
or
a m
ore
deta
iled d
esc
ription
of
the f
aci
lita
ted
pro
cess
and
sta
keho
lder
com
ment
s.
Pro
gra
m R
eco
mm
endation #
11 C
onsi
der
a H
ybri
d M
odel of
Com
munity C
onse
rvato
rship
BH
CS L
ea
ders
hip, th
e S
oci
al Serv
ices
Agenc
y D
irect
or
and
Off
ice o
f th
e P
ublic
Gua
rdia
n, the
Pub
lic D
efe
nder, a
nd C
oun
ty C
oun
sel
have
held
ini
tial m
eeting
s to
revi
ew
and
explo
re the
com
mun
ity c
ons
erv
ato
rshi
p r
eco
mm
end
ation a
nd to d
iscu
ss w
hat m
ight
work
in
Ala
med
a C
oun
ty. A
s th
ese
discu
ssio
ns
pro
gre
ss, in
form
ation w
ill b
e s
hare
d.
40
Re-E
nvis
ionin
g E
ngagem
ent: A
B1421 S
takehold
er
Pla
nnin
g
12
Novem
ber
4,
20
14
A
B14
21
Sta
keho
lder
Reco
mm
end
ations
Pre
sent
ed
to the
Boa
rd o
f Sup
erv
isors
Janu
ary
20
15
La
unch
MH
SA
In
nova
tions
Gra
nts
Roun
d 4
:
Re-E
nvis
ioni
ng
Eng
ag
em
ent
Str
ate
gie
s
(Eng
ag
em
ent
and
N
avi
ga
tor
Reco
mm
end
ations
)
Fir
st Q
uart
er
20
15
Rele
ase
RFP
for
Volu
nta
ry C
om
mun
ity-
Ba
sed
C
risis
Serv
ices
(w
ill inc
lud
e C
risi
s Resi
dent
ial a
nd P
eer
Resp
ite, as
well
as
ad
ditio
nal C
risi
s Syst
em
Pla
nnin
g
reco
mm
end
ations
) Rele
ase
RFP
for
a P
ost
C
risis
Peer
Sup
port
Pro
gra
m
Laun
ch P
rovi
der
Tra
inin
g S
eri
es
on
Evid
enc
e-B
ase
d
Pra
ctic
es
La
unch
Pro
vid
er
Tra
inin
gs
on
Conf
ident
ialit
y
Gui
delin
es
and
AB
14
24
BH
CS Im
ple
ment
ation
Tim
elin
e
Re-E
nvis
ioni
ng E
ngagem
ent: A
B1421 S
take
hold
er
Pla
nnin
g
Reco
mm
end
ations
Novem
ber
24,
20
14
MH
SA
Pla
n U
pd
ate
to B
oard
of
Sup
erv
isors
Hea
lth
Com
mitte
e f
or
Revi
ew
Dece
mber
2014
MH
SA
Pla
n U
pd
ate
Pre
sent
ed
to
the
Boa
rd o
f Sup
erv
isors
for
Revi
ew
and
App
rova
l
Dece
mber
2014
If
the
Boa
rd o
f Sup
erv
isors
a
ppro
ves
the
Com
mun
ity
Cons
erv
ato
rshi
p
pilo
t,
Conv
ene
the
p
lann
ing
pro
cess
w
ith
Coun
ty a
nd
com
mun
ity p
art
ners
.
Nov
/Dec
20
14
La
unch
Syst
em
C
risis
Pla
nnin
g
pro
cess
Febru
ary
20
15
Com
ple
te C
risi
s p
lann
ing
pro
cess
a
nd f
ina
lize
reco
mm
end
ations
fo
r BH
CS
Lea
ders
hip
41
ALAMEDA COUNTY HEALTH CARE SERVICES
AGENCY Alex Briscoe, Director AGENDA January 27, 2015
January 13,2015
A D M I N I S T R A T I O N & INDIGENT H E A L T H 1000 San Leandro Boulevard, Suite 300
San Leandro, CA 94577 TEL (510) 518-3452 FAX (510) 351-1367
The Honorable Board of Supervisors Administration Building 1221 Oak Street Oakland, CA 94612
Dear Board Members:
S U B J E C T : A P P R O V A L O F PLANNING AND I M P L E M E N T A T I O N O F R E C O M M E N D A T I O N S F R O M T H E K E Y S T A K E H O L D E R W O R K G R O U P R E V I E W I N G T H E P R O G R A M S T H A T C O U L D S E R V E T H E P O P U L A T I O N T A R G E T E D B Y AJB 1421
R E C O M M E N D A T I O N :
Approve the planning and implementation of the ten recommendations developed by the AB 1421 Stakeholder Workgroup to address the needs of individuals with serious mental health issues who have not been engaged in ongoing treatment through the current array of behavioral health services
S U M M A R Y :
On February 25, 2014, your Board participated in a discussion on AB 1421, the State legislation that authorizes and provides guidelines to implement court-ordered Assisted Outpatient Treatment (AOT) for individuals with severe mental illness that are resistant to treatnent. Your Board directed Behavioral Health Care Services (BHCS) staff to convene and use a working group of key stakeholders, over a 90 day period, to conduct a comprehensive review of the progi-ams that could serve the population targeted by AB 1421. The workgroup's purpose was to consider alternatives to AB 1421 that are more compassionate options for accomplishing the goals of AB 1421 and to bring back recommendations. BHCS is requesting that the Board approve moving forward with the final planning and implementation of those recommendations.
DISCUSSION:
Under the Board's direction, BHCS initiated a stakeholder planning process to explore and identify programs and services that together would meet the mental health care needs of these individuals with the goal o f reducing unnecessary hospitalizations and increasing their engagement with mental health treatment.
BHCS identified stakeholders based on the stakeholder groups named in the AB1421 legislation, which provides guidance to planning processes, and to reflect unique aspects of the County's geography, population demographics and services mix. The workgroup included twenty-four members, including consumers, family members and service providers, as well as representatives from the Count>''s Social Services Agency, Sheriffs Office and Public Defender.
42
The Honorable Board of Supervisors Januao' 13. 2015 Page 2 of 4
BHCS engaged Resource Development Associates (RDA) to design and implement the stakeholder workgroup. RDA used a phased, consensus-based facilitation approach designed to create a common foundation of understanding about the current system; the target population, its size, level of engagement, and needs; participants' hopes and concerns related to AOT; and ultimately, a set of program and service recommendations to address these needs.
For the purposes of this planning process, BHCS defined the target population as Adults with 4 or more Psychiatric Emergency Service visits, with at least 2 resulting hospitalizations within a 12 month period. BHCS used data on services for the fiscal year ending June 30, 2012, to identify 205 Alameda County residents in this target population. Of this group, 51 percent were male, and 79 percent fell between the ages of 25 and 59; 98 were African American and 64 were Caucasian, with 19 identified as Asian-Pacific Islander and 16 as Latino. Planning participants were provided with additional details about this population, which are contained in the attached final report.
The workgroup met five times, extending the process from April to June 2014, and agreed upon ten recommendations for your Board's consideration and approval. They identified recommendations to address system and program issues as described below. The workgroup also considered two additional proposals on Community Conservatorship and AOT before adopting their final recommendations, which resulted in support for a Community Conservatorship pilot. For additional, detailed information about the 1421 Stakeholder Planning Process, see tlie attached final report.
System-Level Recommendations
1. Hire an Administrator: This position wi l l provide oversight and coordination for the engagement and service of people with a recent history of recurrent psychiatric emergency room visits and hospitalizations that are significantly deteriorating and unwilling/unable to engage in voluntary services to support tlieir recovery. This position wil l use utilization and outcome data to drive individual and systems-level decision making.
2. Increase Data-Sharing Capacity: Increase the capacity for data-sharing between Behavioral Health Care Services, the network o f providers and the Sheriff to support client care and systems-level evaluation to address the overlap of people with recurrent psychiatinc emergency room visits and hospitalizations and the criminal justice system.
3. Develop Provider and Staff Capacity: Offer the following trainings to expand the system's capacity to serve these individuals regardless of their point of engagement: a. Cognitive Behavioral Therapy for Psychosis b. Dialectical Behavioral Therapy c. Motivational Interviewing d. Seeking Safety e. Wellness Recovery Action Planning f Co-Occurring (Mental Health and Substance Use) Disorders
4. Engage Families: Look for mechanisms, as permitted under the 42 Code of Federal Regulations (42CFR) and Health Insurance Portabiiit>' and Accountability Act (HIPAA), to allow family members to support consumers and participate in their care, to the extent that their loved one allows. Family members serve as critical resources to their loved ones when accessing services.
5. Involve Peers and Family Members in Meaningful Ways: Continue to seek ways to include peer and family support specialists throughout the service system.
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The Honorable Board of Supervisors Januar>'13, 2015 Page 3 of4
Program Level Recommendations
6. Expand Crisis Residential Treatment: Provide alternatives to hospitalization by expanding Crisis Residential Treatment (CRT) capacity. Locate additional CRT beds in Northern Alameda County to supplement the existing program capacity in the Castro Valley/San Leandro area. Develop the capacity at the CRT to accept referrals directly from Behavioral Health Ser\'ices and to divert Psychiatric Emergency Services (PES) utilization, as permissible by Titles IX and X X I I and when clinically appropriate. The CRT w i l l also develop increased co-occurring competency to serve individuals recovering from complex mental health and substance use conditions.
7. Develop a Peer Respite Program: Provide an additional alternative to hospitalization with short-term residential services that consumers can access during times of crisis in order to divert avoidable PES visits and hospitalization. Peer Respite is a peer-led model and may or may not include a clinical consultant.
8. Develop a "Rapid Engagement Team (RET)": RET is based on tlie fidelity model of Assertive Community Treatment and is comprised of a multi-disciplinary, mobile staff that includes clinical, peer, and family supports. The RET is designed to engage individuals while they are still in the hospital, sub-acute facility, and/or ja i l to begin the relationship-building process and enroll them in the RET team. The RET is also designed to "meet people where they're at" and provide field-based, flexible services to support individuals as they move through the stages of recovery.
9. Develop a Co-Occurring Conditions Full Service Partnership (FSP): While the stakeholder group recommended development of an additional FSP, BHCS Leadership recommends expansion of co-occuning capacity across all nine FSPs, to improve outcomes for clients with both mental health and substance use disorders. FSPs provide a full range of outpatient wellness and recovery services, including housing. FSP providers wi l l increase their competency in working with people with co-occurring disorders, and the FSP teams wil l include a certified substance abuse counselor.
10. Develop a "Bridges" System Navigation Team: Bridges is a multi-disciplinaiy team that would provide outreach and engagement services as well as systems navigation support. Tliis program would engage those who are not currently receiving mental health services and maintain relationships with these individuals as they move through the various levels of care. They would serve as a consistent source of support regardless of how and where the person moves within the mental health system.
An additional recommendation from the workgroup was to create a 24-hour Crisis Stabilization Unit. BHCS is already planning to include this recommendation as part of a broader Community Crisis Planning effort that wi l l launch in February 2014.
Community Conservatorship and Assisted Outpatient Treatment (AOT) The workgroup considered two additional proposals on Community Conservatorship and AOT before adopting their final recommendations. There was no expectation that the group would reach consensus regarding these potential service options.
Led by the consultants, the gioup engaged in a planned exercise to determine which of these two programs had stronger overall support from the stakeholders. Following a facilitated discussion, the group demonstrated stronger consensus for San Francisco's LPS Community Independence Placement Program (CIPP) model with adaptations to the special needs in Alameda County. The group then voted to request that BHCS develop and implement a hybrid model of community conservatorship.
There was a separate, facilitated discussion around the implementation of AOT. Stakeholders had the opportunity to discuss their concerns and questions in order to fully engage in the consensus process.
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The Honorable Board of Supen'isors Jaiiuar>' 13, 2015 Page 4 of 4
While participants expressed an understanding of the inherent challenges in engaging the target population, there was a lack of consensus around the inclusion of AOT in tlie recommendations. Ultimately, AOT did not receive the same level of support as the Community Conservatorship model and therefore cannot be considered a consensus recommendation.
11. Convene a "plan to plan" process to develop and pilot a Community Conservatorship model based on San Francisco's L P S CIPP with adaptations to the special needs in Alameda County. San Francisco's LPS CIPP provides conservatorship, medication, and case management services to clients who have a history of psychiatric hospitalizations and non-compliance with treatment, and who are at risk of re-hospitalization or admittance to a longer-term locked psychiatric facility in the future witliout proper care. The goal of the LPS CIPP is to provide sufficient supports to enable tliese clients to live independently and maintain stability. The LPS CIPP program is voluntary and participation requirements are explained to the individual by the treatment provider and their appointed counsel.
The BHCS "plan to plan" process wi l l include BHCS Leadership, Social Services Agency Office of the Public Guardian; the Public Defender; County Counsel; the Court; John George Psychiati-ic Pavilion Administration; Patient Rights Advocate; BHCS service providei'(s) and consumer and family representatives. Using San Francisco's CIPP model as a guide, the goal is to develop a community conservatorship model that addresses the needs of Alameda County's clients and is supported by the County partners.
SELECTION CRITERIA AND PROCESS:
BHCS will obtain goods and/or seiyices according to county procurement guidelines.
F I N A N C I N G :
BHCS wi l l return to the Board of Supervisors for approval of appropriation and revenue increases as operational plans are fmalized.
Respectfuilysiipmitted,
Alex BriscoerDirector Health Care Services Agency
AB:TT
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Office of the City Manager
2180 Milvia Street, Berkeley, CA 94704 ● Tel: (510) 981-7000 ● TDD: (510) 981-6903 ● Fax: (510) 981-7099 E-mail: [email protected] Website: http://www.CityofBerkeley.info/Manager
ACTION CALENDAR June 9, 2015
To: Honorable Mayor and Members of the City Council
From: Christine Daniel, City Manager
Submitted by: Kelly Wallace, Acting Director, Health, Housing, and Community Services
Subject: Support for Recommendations as to Implementation of AB 1421 Alternatives Developed by Alameda County Behavioral Health Services Stakeholder's Group
RECOMMENDATION Review additional background information related to the Mental Health Commission's recommendations regarding implementation of AB 1421 alternatives developed by Alameda County Behavioral Health Services stakeholder's group. FISCAL IMPACTS OF RECOMMENDATION None identified.
CURRENT SITUATION AND ITS EFFECTS In February 2014, the Alameda County Board of Supervisors considered ten recommendations from Alameda County Health Care Services Agency Director, Alex Briscoe, connected to Assembly Bill (AB) 1421. The Board adopted the nine initiatives designed to engage this target population in voluntary services, and requested that Alameda County Behavioral Healthcare Services (ACBHCS) initiate a stakeholder planning process to address the tenth recommendation, an Assisted Outpatient Treatment (AOT) pilot project, and return with recommendations. The BOS action was as follows: “The Board voted to direct staff to convene and use a working group of key stakeholders over a 90-day period to conduct a comprehensive review of the programs that could serve the population that is targeted by AB1421 for the purpose of considering alternatives to AB1421 that are more compassionate options for accomplishing the goals of AB1421 and bring back recommendations.” In May 2014, ACBHCS began a stakeholder planning process to explore and identify programs and services that would meet the mental health care needs of the target population, evidenced by a reduction in unnecessary hospitalizations and an increase in engagement with mental health services. ACBHCS identified stakeholders based on the groups named in the AB1421 legislation, which provides guidance to planning processes, and to reflect unique aspects of the County’s geography, population
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Support for Recommendations as to Implementation of ACTION CALENDAR AB 1421Alternatives Developed by Alameda County June 9, 2015 Behavioral Health Services Stakeholder's Group
demographics and service mix. The committee was comprised of twenty-four members, including consumers, family members, and service providers (including Berkeley Mental Health), as well as representatives from Alameda County’s Social Services Agency, Sheriff’s Office, and Public Defender. ACBHCS engaged a consultant, Resource Development Associates (RDA), to design and implement this planning process. The recommendations of the stakeholder committee were submitted to ACBHCS in October 2014 to develop supporting budget and implementation details prior to submission to the Board of Supervisors. These recommendations were incorporated into a letter to the Alameda County Board of Supervisors from Alex Briscoe on January 13, 2015. The letter outlines eleven system level recommendations, and does not include a pilot of AOT. If ACBHCS is directed to enact the recommendations of the stakeholder committee, the City of Berkeley will not be required to enact any programs or required to make any changes to funding. These new programs will provide additional types of services for the residents of Berkeley who utilize the inpatient and acute care system within ACBHCS. The adoption of any of the recommendations of the stakeholder committee does not preclude the Alameda County Board of Supervisors from implementing AB 1421at this or any other time. BACKGROUND Prior to the work of the ACBHCS stakeholder planning process, on November 19, 2013, the Berkeley City Council passed a resolution to urge the Alameda County Board of Supervisors to adopt recommendations for improved Mental Health Services as proposed by Health Care Services Director, Alex Briscoe, and in particular to approve the pilot of Assisted Outpatient Treatment (AOT) for five seriously ill clients. The Assisted Outpatient Treatment Demonstration Project Act (AB 1421) was passed by the California State Assembly in 2002. AB1421, also known as “Laura’s Law,” was developed in response to the 2001 Nevada County shooting of a mental health worker by a man who was not participating in psychiatric treatment. AB1421 provides court-ordered intensive outpatient services for individuals with a recent history of recurrent psychiatric emergency room visits and hospitalizations who are significantly deteriorating and unwilling or unable to engage in voluntary services to support their recovery. These programs, known as Assisted Outpatient Treatment (AOT), attempt to address a gap in the continuum of treatment for these individuals. Services provided in AOT include psychological and substance abuse services; medication support; housing assistance; family and parenting support; peer support; and age, gender and culturally appropriate services.
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Support for Recommendations as to Implementation of ACTION CALENDAR AB 1421Alternatives Developed by Alameda County June 9, 2015 Behavioral Health Services Stakeholder's Group
ENVIRONMENTAL SUSTAINABILITY There are no identifiable environmental effects or opportunities associated with the subject of this report. RATIONALE FOR RECOMMENDATION No recommendation is being made.
ALTERNATIVE ACTIONS CONSIDERED The Berkeley City Council could choose not to make any recommendation to Alameda County Board of Supervisors concerning the implementation of AB 1421 Alternatives developed by Alameda County Behavioral Health Services Stakeholder's Group. CONTACT PERSON Steven Grolnic-McClurg, Mental Health Manager, HHCS, (510) 981-5249
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