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HomeMy WebLinkAbout07-22-2024 Behavioral Health Minutes CJCC- Behavioral Health Subcommittee Minutes July 22, 2024 10:30 AM St. Croix County Service Center - Room 172 1752 Dorset Lane, New Richmond, Wisconsin Call to Order Chair Rohret called the July 22, 2024, meeting of the Community Justice Collaborating Council (CJCC) Behavioral Health Subcommittee to order at approximately 10:30 AM. Roll Call PRESENT: Kait Breuer, Brandie Hart, Sharlene Lopez, Dave Ostness, Eilidh Pederson, Mark Richert, Bob Rohret, Peter VanDusartz, Gordon Young, ABSENT: Selena Freimark, Elizabeth Klasen, Amy Walsh, Stephanie Schmidt Others in Attendance: Captain Tim Kufus, Behavioral Health Supervisor Natalie Radich, BH Intern Natalie Redinger, Approval of Minutes Chair Rohret asked if after the review of the minutes from the CJCC Behavioral Health Subcommittee May 20, 2024, meeting if any editing was needed. With no changes requested, the minutes were accepted as submitted. 1. Minutes of Previous Meeting - May 20, 2024 Public Comment Chair Rohret opened the meeting to public comment for items on or off the agenda. No public comment today. Business 1. Regulatory Challenges: Update from Western Wisconsin Health on Rules 75 & 35 Western Wisconsin Health (WWH) CEO Eilidh Pederson provided an update on Rules 75 and 35 and how they are impacting their services. These two chapters help govern the behavioral health departments. Chapter 35 is needed to provide broad behavioral health services and allows to apply for grants and use Medicaid as a payment source, but Chapter 75 allows for more specific substance-use disorder treatments with its own regulations.Currently, no dual enrollment is allowed in both 35 and 75, but is under reform and the hope is that we will see changes The lack of having Chapter 75 has prevented WWH from using their certified counseling staff to provide these much-needed services. They have applied for an exception with DHS, but theirs was denied, as were others, with no explanation. The understanding now is that there is no exemptions in Chapter 75. They have had several meetings with Wisconsin Hospital Associations (WHA) and with the Dept. of Human Services (DHS). They had some positive movement with DHS who has made some concessions allowing for some unique ways for special billing. This will hopefully allow them to be enrolled in Chapter 75 as well as enrolled in Chapter 35 based on their rural clinic status. There are still some hoops to jump through with billing, but it is now looking more favorable. WWH plans to continue their medication assisted program and are committed to continuing this even though ARPA funding will run out at the end of the year. WWH will keep this committee updated as their program moves forward. Discussion and questions followed. 2. Updates on Dementia Care Unit HHS Director Rohret informed that plans are in the works to open the Kitty Rhoades 10-bed facility at the Health Care Campus to serve people with dementia. Workforce shortages haven't allowed this to happen previously, but this is improving, and the hope is to open. HHS Deputy Director Shar Lopez shared information about a grant opportunity that could help with the start-up costs of opening the Kitty Rhoades facility. This grant became available, with a short turn around, for opening a crisis stabilization unit in the amount of $300,000. SCC is at an advantage as we have a beautiful facility and a license. The plan is to house Emergency Protective Placements for a short-term stay of up to 28 days to get medication management and stabilization vs. being transported to Winnebago. This will not change much in how things are handled in the ER or in law enforcement's role in this, but will be a shorter commute for both law enforcement and clients. This will also help keep clients closer to home and their families. If we receive this grant, we will work to instill some of the work Kitty Rhoades did in promoting the power of Music Therapy. The grant is due July 29th with funds awarded soon afterward. Discussion had on the need for dementia crisis, as well as geriatric mental health and the challenges involved with both. Additional questions asked, and other discussions were had. 3. Wisconsin Counties Association Mental Health Priorities & overview of Acts 177 and 249 Health and Human Services (HHS) Director Bob Rohret shared information regarding the Wisconsin Counties Association's behavioral health legislative priorities and also reviewed two Bills passed last session. Wisconsin Counties Association (WCA) legislative agenda is again mental health focused, as it was last year, with mixed results. State funding for crisis services and early intervention for those with serious mental illness is limited, placing a greater cost burden on counties. Funding for community - based, early intervention services, can prevent high-cost placements and result in better outcomes for the person. In 2021, HHS used American Rescue Plan Act (ARPA) funding to create upstream positions like co-responders, Peer Support Specialist, Community Case Managers, and the Withdrawal Management project with Western WI Health, which have had an impact on reducing costs and improving outcomes, but the funding is time-limited. The WCA is asking for funds to cover the federal share of Medicaid costs that counties pay and to help offset the uninsured costs that counties incur. This is a continuation from last legislative session. WI Act 249 - Crisis urgent care and observation facilities, was passed in the last legislative session. This is an Act allocating 10 million dollars for start-up and development of regional Crisis Urgent Care and Observation Facilities in Wisconsin, with priority given to the Western region of the state. This Act requires DHS to write rule language, and HHS Director Rohret may be able to serve on an advisory committee to assist. DHS will then put out an RFP for entities to apply for the funding. Drafting rule language will take time to write, possibly 1-2 years. Act 177 was also approved last session, which requires DHS to apply for a federal waiver to allow Medicaid spending in IMD settings, which are typically mental health or addiction treatment facilities with more than 15 beds. This waiver could help counties reduce expenses when placing clients in high-cost, IMD settings. Receiving approval from the Centers for Medicare and Medicaid (CMS) may also take 1-2 years. Additional questions asked and discussion had. 4. Grant Proposals Submitted by HHS- Pending Announcements HHS Director Rohret shared information on some additional grant proposals that are awaiting award. The first being a $55,000 grant for a vending machine for the front vestibule which would include harm-reduction products. We currently give out these types of products, and they would remain free from the vending machine, but this would allow us to track which products are most heavily used. Deputy Director Shar Lopez discussed where things are at with the federal "Abuse in Later Life" grant being done along with Fond du Lac County Assistant DA Amber Hahn. The target population is victims of abuse, domestic violence, stalking, neglect, or economic abuse to those over 50. This is a planning grant, so would need to hire a person to be a coordinator for all training that would include law enforcement, judges, the DA's office, public defenders, ADRC, and others that serve the elderly. We would partner with Turning Point, and they would be the sub-awardees and would help with most of the training. Once everyone is trained, a community assessment would be done to determine where the gaps are in service to reduce adult protection needs. The outcome of this assessment will help determine the next steps for the following 3 years. We will need to demonstrate the need to provide for the under served population. Our focus is on the many homeless shelters, sober living facilities, and CBRF's in our communities-which serve a high need population. The award is expected around October 1st. Rohret also shared another potential grant for $100,000/ year for up to 4 years for a harm reduction. If awarded, this would be used to hire a community case manager to work with the addicted population to provide them with resources and education on harm reduction strategies and provide them with harm reduction products. This award is expected in Sept. 5. White Paper: Group discussion on moving forward with this effort Chair Rohret reminded the subcommittee that a workgroup was formed about a year ago to write a paper to better engage with criminal justice around our system of care, and how to better respond to those that end up in the legal system who have behavioral health conditions. There was an outline started, but things stalled when one member got promoted to a new position, so we are now wondering how to revive the effort or if it's worth pursuing. Discussion was had, and it was determined that this may be a good time to take a pause with this workgroup, and focus energy on the many other things discussed today. If, in the future, the effort is revived, we will have a starting point. Request for Future Agenda Items Chair Rohret asked if there are any requests for future agenda items. If other agenda items arise, please email Chair Rohret or Colleen Linder for consideration on the agenda. Some items suggested: * Updates on the projects discussed today * County budget updates * Update on SUD position working with Children Services and families involved with CPS * Discuss where opioid settlement dollars were spent and the status of ARPA funded positions Announcements Chair Rohret asked if anyone has announcements today. * Lieutenant Brandi Hart informed that after approval by Judge Needham, Captain Tim Kufus will be replacing her on this subcommittee. Thanks Brandi for your commitment to this subcommittee. * Shop with a Cop is scheduled for Aug. 14th. Anyone can be referred and registered. Contact Leiutenant Chuck Colemen * Aug 6th is National Night Out * The Community Health Needs Assessment is available on the county website. PH would appreciate it if you took the time to take it and spread the word in the community * Protecting Seniors from Scams and Frauds Seminar will be held July 24, 2024, from 2-3:30 PM @ Hudson United Methodist Church, 1401 Laurel Ave, Hudson WI 54016 Adjournment Chair Rohret called this July 22, 2024 meeting of the CJCC Behavioral Health Subcommittee adjourned at approximately 11:38 AM. Date of Next Meeting 1. Date of Next Meeting - September 23, 2024