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C. 28
To: Board of Supervisors
From: Kathy Gallagher, Employment & Human Services Director
Date: November  5, 2019
The Seal of Contra Costa County, CA
Contra
Costa
County
Subject: Increase the Hours of one Community Services Mental Health Clinical Supervisor from 20/40 to 40/40 in the EHSD

APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE

Action of Board On:   11/05/2019
APPROVED AS RECOMMENDED OTHER
Clerks Notes:

VOTE OF SUPERVISORS

AYE:
John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor
Contact: Michelle Fregoso, (925) 608-5025
cc: Michelle Fregoso    
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED:     November  5, 2019
David Twa,
 
BY: , Deputy

 

RECOMMENDATION(S):

ADOPT Position Adjustment Resolution No. 22543 to increase the hours of one (1) Community Services Mental Health Clinical Supervisor-Project (CJH3) (unrepresented) position number 12927 at salary plan and grade C85 1541 ($5,875.95 - 7,142.25) from 20/40 to 40/40 in the Community Services Bureau of Employment and Human Services Department (EHSD).

FISCAL IMPACT:

Upon approval, this action will have an annual cost increase of $67,643, which will be funded 100% by Federal Head Start and Medi-Cal revenues. The action will not result in additional net County costs for EHSD. Costs are further offset by the net decrease of one position from a previous Board Action, Resolution 2019/181 approved by the Board on May 21, 2019.  









BACKGROUND:

The Community Services Bureau (CSB) Early Head Start/Head Start programs are required to provide a broad spectrum of mental health services to support the social-emotional well-being of children critical for their future school and life success. Approximately 2,130 children between the ages of zero and five years are enrolled in CSB administered early education programs throughout Contra Costa County. CSB provides education, mental health, disabilities, health and nutrition services. The primary focus of CSB’s Mental Health program is to prevent and treat social and emotional concerns of enrolled children by utilizing a multi-modal approach to working with children, their families/caretakers and staff. The types of services provided include: clinical services - individual and family psychotherapy; clinical assessment; consultation with staff; treatment planning; case management; collateral sessions with parents/guardians and crisis intervention.  
  
The majority of clients receiving Mental Health services are Medi-Cal beneficiaries. As such, Medi-Cal is appropriately billed and reimburses for these services. Currently, CSB has two part-time (20/40) Mental Health Clinical Supervisors to provide these services. The CSB Mental Health (MH) Clinical Supervisors supervise mental health interns who earn required hours by providing direct service to children and families enrolled in CSB programs. For Graduate Interns, the MH Clinical Supervisors are required to provide one-hour of group supervision for every ten face-to-face interactions with clients along with two-hours of group supervision a week. Additionally, for interns enrolled in a Master’s program, the MH Clinical Supervisors are required to provide one-hour of individual supervision for every five face-to-face interactions with clients along with the two-hours of group supervision per week.  
  
Currently, the number of children and families enrolled in CSB programs experiencing trauma has increased. Additionally, due to changes in the Medi-Cal billing system, the CSB MH Clinical Supervisors administrative responsibilities have been expanded and there are not enough remaining hours for the MH Clinical Supervisors to provide the interns with the number of supervision hour required. The time constraints have also impacted the MH Clinical Supervisors from attending Provider Service Meetings and trainings or to focus on increased collaboration with the internal CSB staff or other Community agencies to ensure all clients are receiving quality, sustainable services.  
  
The increased hours for the CSB MH Clinical Supervisor will allow for CSB to meet the required intern supervision requirements, to bring on more interns and ultimately provide more mental health services to children in need. This will also allow CSB to meet their obligation to serve a minimum of 100 clients as stipulated in the Memorandum of Understanding with Contra Costa County Health Service's Behavioral Health.  

CONSEQUENCE OF NEGATIVE ACTION:

If the action is not approved, the Community Services Bureau‘s Mental Health program will not have sufficient staff to provide adequate mental health services to enrolled children or to provide the required supervision hours for CSB MH Interns.

CHILDREN'S IMPACT STATEMENT:

This action will support three of the five Contra Costa County's community outcomes – Outcome 1- Children Ready for and Succeeding in School; Outcome 2: Children and Youth Healthy and Preparing for Productive Adulthood; Outcome 4: Families that are Safe, Stable and Nurturing

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