Agenda

1.

Introductions

Due to the large attendance, the meeting was relocated to Room 101 and convened at 12:00 noon.

2.

Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited to three minutes).

No one requested to speak during the public comment period.

3.

RECEIVE and APPROVE the draft Record of Action for the October 22, 2018 Family & Human Services Committee meeting.

The Committee approved the minutes of the October 22, 2018 FHS meeting as presented.

AYE:	Chair Candace Andersen, Vice Chair John Gioia
Passed

Attachments:

DRAFT FHS Committee Record of Action for October 22, 2018

4.

ACCEPT follow-up report from the Employment and Human Services Director in response to CalFresh Partnership recommendations pertaining to wait times experienced by CalFresh clients.

Wendy Therrian presented the staff report.

Mariana Moore expressed frustration about the long wait times for food stamps. She acknowledged the department's efforts but said more should be done to reduce wait times and that a bolder response is needed. She requested an estimate of the number of staff that would be needed to address the problem.

Larry Sly expressed concern about the additional workload associated with the "tsunami of people" that will be wanting services due to pending SSI changes. He wanted to know how the County was preparing for this workload spike. He opined that the County's Single Audit report is incomprehensible and not a good substitute for clear department reporting or an independent analysis. He stated that he was requesting only a one-time funding allocation.

Kathy Gallagher responded that not all who are eligible for SSI will actually apply, and that Mathematica (policy research) makes estimates at the state level. She noted that these estimates have no relation to the state dollar allocation to the County. She acknowledged that there is a tight window during which to hire and train staff. EHS plans to hire in January, as applications will be accepted in May, to be effective June 1. She consented to having an independent analysis conducted if private funding were made available to fund such an analysis.

Community organization representatives commented that the strategies necessary to expedite the process such as flexible interviews and telephone signatures, will require additional staff, and that the homeless and mentally ill are unable to complete the benefits applications nor can they store/file the information.

Gigi Crawford suggested drop-in sites vs. telephone interviews and suggested that new staff training include curriculum on mentally ill recipients.

Carly Finkle suggested that staff need to be trained by May 1 and that the State's estimate was an additional 10,000 applicants, a 33% increase over the County's current workload.

Supervisor Gioia acknowledged that in lieu of lifting the hiring freeze, EHS is reassigning staff internally to address workload shifts. He suggested starting the hiring process early in anticipation of the SSI changes. He acknowledged the needs and explained that the County Budget is a zero-sum exercise and the Board has the challenge of balancing all of the County's needs within the limited resources available. He described some of the other critical County needs, including the need to curtail staff turnover occurring due to hard-to-afford employee health benefits.

The Committee accepted the staff report with direction to the EHS Director to report back again next year.

AYE:	Chair Candace Andersen, Vice Chair John Gioia
Passed

Attachments:

Follow-up EHSD Report on Sept 24 CalFresh Partnership Recommendations

5.

RECOMMEND to the Board of Supervisors the appointment of Jill Kleiner to At Large #19 seat with a term expiring September 30, 2019, and Steve Lipson to At Large #6 seat, and Jatin Mehta to At Large #8 seat with terms expiring September 30, 2020, on the Advisory Council on Aging, as recommended by the Council.

The Committee approved the appointment of Jill Kleiner to At Large #19 seat with a term expiring September 30, 2019, and Steve Lipson to At Large #6 seat, and Jatin Mehta to At Large #8 seat with terms expiring September 30, 2020, on the Advisory Council on Aging and directed staff to forward the recommendations to the Board of Supervisors.

AYE:	Chair Candace Andersen, Vice Chair John Gioia
Passed

Attachments:

J. Kleiner Recommendation Memo

J. Kleiner Application

J. Mehta Recommendation Memo

J. Mehta Application

S. Lipson Recommendation Memo

S. Lipson Application

6.

ACCEPT the annual report from the Public Health Division of the Health Services Department on the implementation of the Secondhand Smoke Protections Ordinance and DIRECT staff to forward the report to the Board of Supervisors for their information.

DIRECT staff to provide another update on the Secondhand Smoke Protections Ordinance to the Family and Human Services Committee in 2019.

Dan Peddycord and Jen Grand presented the staff report. The Committee accepted the report and directed staff to send a letter to each City Manager inviting them to model their own city ordinances after the County's ordinance.

AYE:	Chair Candace Andersen, Vice Chair John Gioia
Passed

Attachments:

2018 Second Hand Smoke Report

7.

ACCEPT the annual report from the Public Health Department on the implementation of the Tobacco Retailer Licensing and Businesses Ordinances and DIRECT staff to forward the report to the Board of Supervisors for their information.

DIRECT staff to report back to the Family and Human Services Committee in 2019.

Dan Peddycord presented the staff report, citing 74% compliance with pack and flavor restrictions based on a spot check of stores. He noted that Senator Glazer has introduced a bill to prohibit flavored tobacco and that many other jurisdictions have established local ordinances doing so.

The Committee accepted the staff report and directed staff to provide another status report in six months.

AYE:	Chair Candace Andersen, Vice Chair John Gioia
Passed

Attachments:

2-18 Tobacco Retail Environment Report

8.

CONSIDER accepting the cumulative evaluation report from the Health Services Department on the implementation of Laura’s Law – Assisted Outpatient Treatment (AOT) program during the period February 2016 through June 2018, and

CONSIDER recommending to the Board of Supervisors that the AOT Program be extended beyond the previously authorized three-year pilot period as part of Contra Costa Behavioral Health Services’ ongoing service delivery for persons experiencing serious mental illness.

Fiscal Impact (if any):
Actual expenditures for FY 17/18:                  Funding Source:
CCBHS -                       $1,812,919                  Mental Health Services Act
County Counsel -                 32,379                  County General Fund
Public Defender -                56,250                   County General Fund
Superior Court -                     2,585                  County General Fund
                                       $1,904,133

Funds are budgeted for the CCBHS portion of the AOT Program for the balance of FY 2018/19, and MHSA revenue is expected to sustain the CCBHS portion of the program costs for the fiscal years 2020-23.

Dr. Matt White introduced Roberta Chambers of RDA, who presented the cumulative AOT Program evaluation report for the period February 2016 through June 2018. The main findings reported were that the program cost less than expected, enrollees are receiving a high degree of service, and that court-involved participants received less service than voluntary participants. She reported that 13/70 participants were homeless and that the program coordinates and trains with police, the CORE Team, H3 and County Mental Health to link qualified requestors with the program.

Warren Hayes commented that there are 20 scattered housing sites/slots available to the program. Rich Penksa commented that eligibility for these housing slots requires enrollment in AOT.

Douglas Dunn commented that County Counsel was too restrictive and that judicial petition is underused. He expressed concern that premature discharge of enrollees led to relapse.

Lauren Rettagliata commented that we have ACT but no judicial element (AOT). She suggested that the judge needs to meet quarterly and establish a bond of trust with the mentally ill person. She said that the judge should become like the mentally ill person's advocate. She also identified a communication gap in that the 4C hearing officer is routinely not aware if an individual was dismissed from AOT.

Teresa Pasquini express gratitude for the program but concurred with the comments made by others.

Bill Green suggested setting up a group to study easing program restrictions because the program is underutilized.

Alicia Austin-Townsend commented that MH is not actually discharging, but has identified a few individuals for judicial intervention -- ACT first, and then determine if AOT is warranted.

Supervisor Gioia advised that implementation issues were better discussed at AOT workgroup meetings. The Committee accepted the evaluation report and decided to recommend to the Board of Supervisors continuation of the AOT Program beyond the three-year pilot authorization.

AYE:	Chair Candace Andersen, Vice Chair John Gioia
Passed

Attachments:

Contra Costa County Assisted Outpatient Treatment (AOT) Cumulative Evaluation Report 2016-2018

Contra Costa County Assisted Outpatient Treatment (AOT) Cumulative Evaluation Report Presentation

9.

This is the final meeting of the 2018 Committee. No further meetings are scheduled.

10.

Adjourn

Chair Andersen adjourned the meeting at 2:10 p.m.