Other Voices: County Behavioral Health Services – a public-private partnership
December 19, 2009
The mission of the Nevada County Behavioral Health Department is to provide high quality, culturally competent mental health and substance abuse treatment services to Nevada County residents. The philosophy and approach are based on a belief that all people can live full and meaningful lives.
Active consumer participation in treatment planning is encouraged, and recovery and resiliency principles are integrated throughout the system of care. The staff focuses on individual and family strengths, and attempts to deliver a seamless integration of services.
The priority target population includes indigent individuals with serious mental illnesses, individuals with Nevada County Medi-Cal, children receiving special education services, adults at risk of hospitalization or incarceration, and children at risk of out of home placement.
The department has a budget of $19.8 million and 44 employees. The department served 1,645 people last year, consisting of approximately 1,178 adults and 467 children. Services are currently provided by county staff in two clinic sites in Grass Valley and one in Truckee.
Funding for services is a combination of federal Medicaid (37 percent), Mental Health Services Act Proposition 63 (23 percent), state general funds (18 percent), and a portion of state sales tax and motor vehicle license fees (13 percent). The county general fund contribution (the state required maintenance of effort) is less than 1 percent.
The mental health department provides a comprehensive array and full range of mental health services, including; crisis evaluation and intervention, short- and long-term inpatient hospitalization, residential treatment, psychotherapy, rehabilitation, case management, a peer run support center, and medication management.
In addition, the department strives to employ a variety of evidence-based practices, offering parent-child interactive therapy, aggression replacement therapy, functional family therapy, assertive community treatment (ACT), and children’s wraparound (WRAP).
Approximately 52 percent of funding for all services is directed to contracted providers. In some instances, such as psychiatric hospitalization and locked long-term care, there are no local or county-operated alternatives. However, we believe that a partnership between the public behavioral health entity and various individual and nonprofit organizational providers is the best way to offer a comprehensive array of high quality services to our community.
To achieve this goal, the department expanded and improved services during the past four years through the vehicle of contractual arrangements. The department increased from 59 to 118 contracts from 2005 to 2009.
Although there are sometimes cost savings represented in contracted services, the more important reason we moved in this direction was to efficiently and rapidly bring experienced, talented, and well established organizations into Nevada County. Some examples include:
Turning Point Community Programs provides ACT to 77 seriously mentally ill adults. ACT is an intensive treatment model utilizing 24/7 service availability, small caseloads, substance abuse counseling, employment counseling, nursing support, supportive housing, field-based services, and multi-disciplinary staffing.
WRAP is provided to 86 children and their families by Victor Community Support Services and EMQ FamiliesFirst. WRAP is designed to prevent out of home placement for children and includes intensive family support, home and field-based services, and 24/7 service availability.
Sierra Family Services provides crisis intervention and emergency hospital evaluation services in the Emergency Department of Sierra Nevada Memorial Hospital. There were 682 crisis assessments completed last year, often the prelude to locked psychiatric treatment.
Sierra Forever Families provides psychotherapy and case management services to 31 children and their families. The focus is to facilitate successful permanent homes for adopted children.
Finally, the department contracts with 27 individual psychotherapists to provide treatment to 90 individuals each year. These therapists work independently in their private offices throughout Nevada County, representing a wide range of specific skills and expertise with a variety of problems.
Substance abuse services include assessment, outpatient treatment, residential detox, residential treatment for 30-60-90 days, school-based youth mentoring, drunk driving school, and outreach and prevention activities.
Depending upon funding availability, the department collaborates closely with law enforcement and the courts, including adult and juvenile drug courts, and pre and post-sentencing drug diversion treatment and education programs.
There are two sites certified to provide outpatient substance abuse counseling services, fully funded by Medi-Cal. The department also relies on contracted services in the area of substance abuse assessment and treatment, utilizing Community Recovery Resources, Common Goals and Progress House as the main providers.
If you would like additional information on any of the services or programs noted above, please call me at (530) 265-1437. You may also browse the Web site at http://www.mynevadacounty.com/bh.
Michael Heggarty is director of Behavioral Health Services for Nevada County.