LOCAL PLAN

FOR

FISCAL YEARS 2006-2007

THE MENTAL HEALTH MENTAL RETARDATION

AUTHORITY OF BRAZOS VALLEY

Reviewed and Approved by:

Leon Bawcom, Executive Director Date

Judge Dorothy Morgan Date

Chair, Board of Trustees

TABLE OF CONTENTS

I. Mission and Values………………………………………...…………………..1

II. Agency History……………………………………………………………...….2

· Map of Local Service Area

· Organizational Chart

III. Demographic Profile….………………………………………………………..5

IV. Priority Population Definitions………………………………………………..6

Target Populations for Resiliency and

Disease Management

Mental Health
Mental Retardation
Early Childhood Intervention

V. Array of Services…………………………………………………...…………..9

· Mental Health: Provider Services

· Resource Allocation

· Mental Retardation: Residential Services

· Resource Allocation

· Early Childhood Intervention

· Resource Allocation

VI. Local Planning Process…………………………………………………...…..14

· Citizen and Network Advisory Committee

· Needs Assessment and Community Questioner

· Planning Outcomes and Products

VII. Survey Results…………...………………………….…………………..…….18

VIII. Community Questionnaire Results……………………………………….....21

IX. Service Waiting List Information……………………………………………23

X. Strategic Goals and Objectives………………………………………………24

XI. Network Management………………….…………………………………….27

XII. Attachments…………………………………………..……………………….34

· Information Supplement

Community Participation

Citizen and Network Advisory Committee

Planning Considerations

· Jail Diversion Plan

· Quality Management Plan

· Provider of Last Resort Plan

XIII. Appendices…………………………………………………………………….43

· Survey Instrument, analysis and tables

· Community Questionnaire Instrument and Results

· Contact Information

VISION, MISSION, AND VALUES

Mental Health Mental Retardation Authority of Brazos Valley’s (MHMRABV) Board of Trustees, Executive Management, and staff approach all planning with the agency’s vision, mission statement, and values as a centerpiece. Decisions to implement change are first and foremost evaluated in terms of their relationship to our vision, mission, and values. Thus, to understand our planning process, one must first understand our guiding tools.

Vision

As the local community mental health and mental retardation center in the Brazos Valley, we envision this community to be a place where full participation and inclusion of each individual is achieved through the provision of an array of individualized community-based services. Our vision is actualized as we:

Promote a proactive recovery model based on quality treatment and habilitation services to foster growth, success, and full integration into one’s community
Promote a safe environment for consumers and staff
Ensure persons seeking and receiving services are educated on all options and choices of services, and that they have access to services in the least restrictive environment appropriate to the person’s care
Offer opportunities for community-based alternatives to institutional care, including the criminal justice system
Foster positive experiences and opportunities for consumers, staff, Board, and the community and highlight mutual dignity, respect, and cooperation in our relationships
Educate consumers, families, and the community at large

Mission

MHMRABV is committed to:

“Provide the highest quality of services

to the customer through available resources.”

Values:

q We value the individuality, dignity, respect, and cultural diversity of those we serve

q We value the importance of teaching and promoting independence, learning and self-esteem skills

q We value the importance of the fostering natural family relationships for children and adolescents who are receiving services

q We value the role of the community in the lives of our consumers and support their efforts to achieve maximum independence in their home community

q We value consumer choice of services, and access to those chosen services for our defined Priority Populations

q We value a safe, secure and supportive work environment for our well-trained, diverse workforce

q We value the strength and therapeutic value of the treatment team approach

q We value our responsibilities as stewards of public monies in the efficient provision of our services, including seeking innovative approaches to maximize our resources

q Successful demonstration of positive impacts and outcomes for consumers.

HISTORY

The Mental Health Mental Retardation Authority of Brazos Valley (MHMRABV) began on March 1, 1974. It had grown out of the volunteer and professional efforts of local advocacy groups as well as community mental health and mental retardation professionals. Also in 1974, it was incorporated as a 501 (c) (3) non-profit organization. At that same time, MHMRABV was designated a Governmental Entity by the County Commissioners of the Brazos Valley’s seven counties: Brazos, Grimes, Madison, Washington, Burleson, Leon and Robertson. Its original name, the Brazos Valley Mental Health Mental Retardation Center, was changed to its current name in 1982.

In 1976, MHMRABV, renting property owned by the local Association for Retarded Citizens (ARC), opened an Intermediate Care Facility for persons with Mental Retardation (ICF-MR). This was the first ICF-MR facility in Texas. The program provided residential services to adult men with mental retardation. In 1982, MHMR purchased this property as permitted under newly passed legislation. In 1986 a long-term facility for adults with mental retardation was added to the residential program.

In 1977, MHMRABV received sufficient funds from the Texas Education Associa-tion (TEA) and local donations to begin a small, home-based infant stimulation program. In 1982, a greatly expanded entitlement program for early childhood intervention (ECI) was begun with funds from ECI, TEA and again local funds. This program has dramatically grown over the years to its current outreach and intervention programs including physical, occupational and speech therapy as well as service coordination, case management and family education. In September 2004, the ECI service area was expanded to include Walker and northern Montgomery counties.

MHMRABV’s vocational programs began as with most of its programs, through local volunteer, community action and State assistance. The first program was developed by the Brenham State School, the Brazos Valley Rehabilitation Center and the local ARC. This program was folded into MHMRABV’s program structure in 1980. MHMRABV’s vocational program for adults with mental retardation consisted of contracted work for the individuals to complete to learn vocational skills that would allow them to become independently employed in the community. Additionally, a supported employment program was available for job development, job placement and job coaching. MHMRABV expanded its vocational programs throughout the service area including sheltered workshops in four counties. A transition from this vocational model to Day Habilitation Services for adults with mental retardation began in 2000. Day Habilitation is a program designed to build daily living skills, including safety skills, which allows individuals to become more independent in the community. Supported employment services are still available for persons with mental retardation and individuals with mental illness. For persons with mental illness, skills training done on-site at MHMRABV evolved into community based skills training in 2001 to support individuals living in their own homes or family homes.

In 1977 the Center began to expand its own mental health services. This initial expansion took on some urgency when the other local providers of public mental health services closed their doors in 1979. MHMRABV developed the full array of required services by creating in-patient, out-patient and emergency services in addition to educational and consultative programs. A transitional living unit was added to the residential array available in the Brazos Valley. An additional residential facility, a crisis center, was added in 1985. The crisis center closed in 1986, reopened in 1994 and was modified to a crisis - respite unit in 2002. In April of 2004 it was closed again as was the Community Living Skills program. Also in April 2004 the Assisted Living facility was closed. Of the 15 remaining residents, 2 were placed with family, 1 went into a nursing home and the remaining went to a personal care home near the San Antonio area.

Over the last decade, MHMRABV has developed a successful children’s mental health program which included medication, service coordination and counseling services. Additionally, a successful program has been implemented for individuals with Co-occurring Psychiatric and Substance Disorders (COPSD) using the Good Chemistry model. Good Chemistry is a therapy model for treating individuals with a diagnosis of mental illness and a substance abuse or dependence problem. The Good Chemistry leader facilitates the consumer’s support of one another by discuss-ing drug abuse problems that parallel neurobiological problems. Consumers learn to maintain drug free lifestyles while learning symptom and medication manage-ment for their mental illness. More than 60% of group attendees have a year or more of abstinence from drugs and alcohol.

Also put in place over the last decade is an effective Assertive Community Treat-ment (ACT) team. An ACT team is a group of staff who deal directly with a small caseload of those with the most persistent and pervasive mental illnesses. The team consists of a case manager, a nurse, a chemical dependency counselor, a housing specialist and a supported employment specialist. The ACT team provides intense, comprehensive and individualized services to consumers in their home and/or community to increase the consumer’s quality of life and independence as well as to reduce the number of psychiatric hospitalizations.

Major reorganization at the state level took place in 2004 and as a result, two of the thirteen legacy agencies dissolved that directly impacted MHMRABV. Those agencies were the Texas Department of Mental Health and Mental Retardation and the Interagency Council on Early Childhood Intervention. The services provided by our local agency were redistributed into three new state level departments under the umbrella of Health and Human Services Commission. Services for persons with mental retardation are now a part of the Department of Aging and Disability Services (DADS); mental health and alcohol and drug abuse services are a part of the Department of State Health Services (DSHS); and, Early Childhood Interven-tion Services are included in the Department of Assistive and Rehabilitative Services (DARS).

In September 2004, the Department of State Health Services implemented a new benefit plan for adult and children/adolescent mental health services in the form of a major initiative referred to as Resiliency and Disease Management (R&DM). The overall aim of this initiative is to design a benefit package and financing methodo-logy for community mental health services. Through this process the department will better define:

Who is eligible for services
What services will be provided
Methods for managing utilization of services
Cost and price for the services, and
The expected outcomes of services.

Also in 2004, a Task Force was organized by MHMRABV to evaluate the need to address the problem of severely mentally ill individuals being housed in jails rather than receiving proper mental health treatment. Brazos County, the largest county in the service area, estimates the jail population with mental health issues requiring treatment is 10% at any given time. The problem places a burden on the correctional system, costs counties large amounts of money and, perhaps most importantly, people with mental illness are being inappropriately detained in local jails in lieu of receiving proper mental health treatment. As our Task Force deliberated the issues, two main needs were identified: the need for a crisis triage/diversion facility and the need for law enforcement training. The end result of that Task Force is a new Jail Diversion Plan which is attached to this Local Plan.

Beginning in early 2005 a first step in implementing the new Jail Diversion Plan was begun at MHMRABV. A daily report of all arrests made in the seven county area served by MHMRABV is being sent to the Program Manager of the Assertive Community Team (ACT). The Program Manager then notifies law enforcement which of those persons listed is receiving services through MHMRABV. A goal of this initial step is to prevent people with mental illness from being inappropriately detained in local jails in lieu of receiving proper mental health treatment.

From September 1, 2004 to May 13, 2005, 101 persons who are offenders with a mental illness, referred through the TCOOMMI program, have been served by MHMRABV. Probationers referred through the Brazos County Community Supervision division are receiving case management services and skills training services, and those referred directly from prison are served in the Continuity of Care program.

In light of the direction of funding sources in the state, a Funding Raising Committee composed of interested community members was organized in early 2005. They meet on a regular basis to explore new and innovative ways to add additional resources to provide needed services in our seven-county area. MHMRABV also employs a full-time grant writer and a report of 2004 grant applications and results is attached.

Despite serious financial constraints MHMRABV has received outstanding annual consumer satisfaction surveys and strives to continue to fulfill our mission: to provide the highest quality services to the consumer through available resources.

Insert Organizational Chart (1 Page)

Insert Map of Seven Counties (1 Page)