ADOPTED MINUTES

Mental Health Board

Wednesday, July 08, 2009

City Hall, Room 278

San Francisco, CA

 

BOARD MEMBERS PRESENT: James L. McGhee, Chair; Jagruti Shukla, MD, MPH, Vice- Chair; James Shaye Keys, Secretary; Officer Kelly Dunn, M. Lara Siazon Arguelles; Mary Ann Jones, PhD; LaVaughn Kellum King; Susan McIntyre; Tom Purvis; Njoroge Tho-Biaz, M.A; and Virginia Wright.

BOARD MEMBERS ON LEAVE: Lisa Williams; and Errol Wishom

BOARD MEMBERS ON ABSENT:

OTHERS PRESENT: Robert Cabaj, MD., Director of Community Behavior Health Services (CBHS); Helynna Brooke (MHB Executive Director); Loy M. Proffitt (MHB Administrator); Sarah Accomazzo (Intern); Iris Haas-Biel; Brian Tseng, Physician Organizing Committee; Florence Fee, No Health Without Mental Health; Dale Milfay, San Francisco National Alliance on Mental Illness (NAMI).

CALL TO ORDER

The meeting was called to order at 6:35 PM by Mr. Keys.

ROLL CALL

Ms. Brooke called the roll.

AGENDA CHANGES

ITEM 1.0 DIRECTORS REPORT

1.1  Discussion regarding Community Behavioral Health Services Department Report, a report on the activities and operations of Community Behavioral Health Services, including budget, planning, policy, and programs and services.

Mr. Keys:  Dr. Bob Cabaj, the Director of Community Behavioral Health Services (CBHS) will give the Director s report and then follow that with a presentation of the current state of budget cuts and its impact on services.

Dr. Cabaj:  I would like to highlights a few recommendations that were made at the Board of Supervisors Budget and Finance Committee at last week s meeting.

In front of you is my written report showing the Board of Supervisors restoring many of the items that were originally cut.  All current contracts are continued with funding.  There will be some impact; but not that bad.  The Mega RFP will be released shortly, but the contracts will not start until next fiscal year, on July 1, 2010.  50% of MHSA Annual Plan funds should be put aside in reserve, but CBHS spent it.  The State said we had to return the reserve but without cutting programs.  They gave us an extra year.  The State is concerned that revenue from the tax base may be reduced.

Mr. Purvis:  Why does CBHS want to have the prudent reserve?

Dr. Cabaj:  It is a rainy day fund, and we have funded about $1 million.  We are afraid that anything we leave on the table, the State will grab it.

1.2 Public Comment

Mr. Tseng:  How much money from Proposition 63 comes to the City?

Dr. Cabaj:  The exact amount is about $17 million.  We already got the money and have started funding mental health programs.  Lots of other counties have had their money withheld.

Ms. Milfay: She mentioned that services for the chronically ill have been cut for the past ten years.  She expressed the opinion that San Mateo County is doing better with case management than San Francisco.

 

Monthly Director s Report

July 8, 2009

 

1.      Budget Update

Last week, the Board of Supervisors' Budget and Finance Committee made the following recommendations regarding CBHS programs for the FY09-10 Budget: to be voted on by the entire Board next week:

1. Rejected eliminating the Single Standard of Care ($707,352)--if passed, this means no changes to the way CBHS sees indigent clients and allows over seven staff to keep their jobs;
2. Restore funding to specific Behavioral Health Contractors (a total of $5,559,742 with both the Board's add-back and the Mayor's technical adjustment)--if passed, 18 contractors would not loose some targeted reductions;
3. Restore $4 Million to the CBHS Mega-RFP--if passed, that means the funding level for the programs to be bid-out under the Mega-RFP for 09-10 would remain at the level they are now with the mid-year and across-the-board reductions already included;
4. Restore $100,000 of the $125,000 reduction to Drug Court--if passed, would allow most services via drug court to continue as they are now;
5. Restore $400,000 for vocational rehabilitation services--if passed, there would still be a shortage of $105,000 for voc rehab services and $495,000 of current General Fund for voc rehab would be converted to MHSA funding that would match the Department of Rehabilitation resulting in a net increase of funding for employment-ready clients;
6. Restore $36,646 in funding for CBHS clinics--if passed, funding can be used to help with the clinic changes ahead;
7. Restore $300,000 of $366,667 to the MAP Van--if passed, this would allow transportation services to continue near to the present level;
8. Add $25,000 for a support for families of homicide victims program--if passed, will work with the Board to see what they intending for this funding.

 

The following did not get restored:

1. Funding reduction to Baker Places that could lead to the closure of Acceptance Place; apparently the Board did intend to restore this funding but there seems to have been a mix-up in all the late night negotiations. CBHS will work with DPH, the Board, and the Controller's Office to determine the next steps;
2. 5% across the board reduction to mental health programs and the 25% reduction to substance abuse services;
3. Reductions of 12.24 FTE clinical staff and 8.38 administrative staff (total reduction: $2,917,769);
4. Redirection of $1,039,533 of GF covered services and 11.75 FTE GF covered positions ($2,062,493) to MHSA funding.

 

There were department-wide reductions that impact CBHS such as additional position reductions, grant and project close-outs, salary attrition, IT reductions, and budget analyst reductions. No other mid-year reductions were restored. With these changes, the impact of CBHS was not as severe as it could have been. The coming fiscal year, however, remains uncertain in terms of the City tax base and the impact of the State budget reductions and the impact of one-time funding from the Federal stimulus package so there are likely to be mid-year reductions early in the 09-10 fiscal year. The State has proposed reduced funding to Prop 36 programs and that will have a major impact on drug-related services in San Francisco if it happens.

 

2.      Mega-RFP Update

With the $4 Million Mega-RFP restoration, the pressure to issue the Mega-RFP for implementation in the 09-10 fiscal year was reduced. The start date for new contracts under the Mega-RFP and accompanying stand-alone RFPs will be July 1, 2010, allowing DPH to issue a full year contract to the various community-based organizations for this 09-10 fiscal year.

 

3.      Mental Health Service Act (MHSA) Update

 

THE REDWOOD CENTER PROJECT NOW POSTED FOR PUBLIC COMMENT

The Redwood Center project, part of our Capital Facilities Plan, has now been posted for a 30-day public review and comment period.  To review and/or comment by e-mail, go to the MHSA web site:  http://www.sfdph.org/dph/comupg/oservices/mentalHlth/MHSA/default.asp and click on the web link: Menu of 30-Day Public Notices.  The timeline has changed since the original posting on June 16, 2009, estimating the construction rent up period to occur in June 2010 instead of April 2011.  A comparison of the old and new timelines is also posted on the website indicated above.

RESULTS OF IT PLANNING COMMITTEE HAVE BEEN FINALIZED

On May 26, 2009, the IT Planning Committee held its last meeting to vote upon and finalize the IT recommendation for inclusion in the County Plan.  The top vote-getter prioritizes a consumer-staffed help desk, located at 40 provider sites, operating eight hours a day for three years, at a cost of $4,148,350.  The next phase for this recommendation is to draft the County Plan, which will then be posted for a 30-day public review and comment period, followed by a formal presentation of the proposal to the San Francisco Mental Health Board.  Frank Isidro, Co-Chair of the IT Planning Committee, thanked all the members of the committee and the public for its interest and participation and for all the time and hard work put into these recommendations.

WAIVER OF THE PRUDENT RESERVE REQUIREMENT DENIED BY DMH

The Department of Mental Health (DMH) has denied a request by CBHS to waive the prudent reserve requirement for MHSA funding for fiscal year 2009-2010.  The amount in question is estimated at 50% of the recently approved Annual Plan of $16.4M.  The State has agreed to delay the deadline for the setting aside of a prudent reserve until June 30, 2011.  This resulting action will necessitate a re-design of some of CBHS programs and services during the course of the next two years in order to meet the required prudent reserve of $8M.

RFP FOR WET/PEI ROGRAM PROPOSALS RELEASED

The Request for Proposals (RFP) for all interested parties for the Workforce Development, Education, and Training and the Prevention and Early Intervention components of the MHSA was released on Friday, June 19, 2009.  A Bidders Conference for Directors of services and providers interested in bidding on the RFP was held on July 2, 2009, from 9:00 am until 12 noon, at 1380 Howard Street, wherein several interested bidders posed a variety of questions.  Proposals from all applicants are due by 12 noon on Thursday, July 30, 2009.

MHSA ADVISORY COMMITTEE MEETINGS:

The newly recruited MHSA Advisory Committee will take on a very active role in defining the projects to be funded through the Innovation Component.  As a result, the next scheduled meeting will be comprised of established as well as newly recruited members, who have agreed to meet four times specifically to review proposals and ideas for the Innovation component.  The dates for these meetings are:

 

Wednesday, July 8, 09	3:00-5:00	1380 Howard St., 5th Floor Conference Room
Wednesday, July 22, 09	3:00-5:00	1380 Howard St., 5th Floor Conference Room
Wednesday, August 5, 09	3:00-5:00	1380 Howard St., 5th Floor Conference Room
Wednesday, August 19, 09	3:00-5:00	1380 Howard St., 5th Floor Conference Room

 

The regular MHSA Advisory Committee meetings, which take place every two months, will be determined when the committee meets on July 8th.

 

4.      SAVE THE DATE!

October 28, 2009

"Don't Worry Be Happy": Anxiety Disorders in Primary Care

10:00am-4:00pm, Mission Bay Conference Center at UCSF, 1675 Owens Street, San Francisco

 

The San Francisco Department of Public Health, Community Behavioral Health Services division, is sponsoring a conference targeting Primary Care Physicians and Nurses, Psychiatrists, Psychologists, Mental Health and Substance Abuse Counselors, Social Workers, LCSW's, MFT's, and Community Based Organizations.  This conference will focus on integrating treatment of anxiety disorders and other behavioral health conditions in Primary Care Settings.  Conference Brochure and Registration to follow.

 

For questions or additional information, please contact the conference event planner at kathleen.minioza@sfdph.org.

 

COST:  FREE

Continuing Education: 6 Hours (Free)

 

This is an activity offered by Community Behavioral Health Services (CBHS), a CMA accredited provider. Physicians attending this course may report up to 6 hours of Category credits toward the California Medical Association s Certification in Continuing Medical Education and the American Medical Association s Physician s Recognition Award.

_____________________________________________________________________________

Past issues of the CBHS Monthly Director s Report are available at:http://www.sfdph.org/dph/comupg/oservices/mentalHlth/CBHS/CBHSdirRpts.asp  

To receive this Monthly Report via e-mail, please e-mail richelle-lynn.mojica@sfdph.org

 

 

Item 2.0  MENTAL HEALTH SERVICE ACT UPDATES AND PUBLIC HEARINGS

2.1 Updates

Mr. McGhee:  Dr. Cabaj  will provide updates regarding the Mental Health Services Act.

Dr. Cabaj:  In the Mental Health Services Act (MHSA) Update I have the following: The Redwood Center project, part of our Capital Facilities Plan, has now been posted for a 30-day public review.  Please go to http://www.sfdph.org/dph/comupg/oservices/mentalHlth/MHSA/default.asp

CBHS wants to waive the MHSA s $8 M prudent reserve requirement for two years, but it was denied by the California State Department of Mental Health (DMH).

On May 26, 2009, the IT Planning Committee voted for the help-desk to be staffed by a consumer, 40 provider sites to be operated eight hours a day for three years, at a cost of $4,148,350.  After the 30-day public review and comment period, there will be an IT planning presentation to the San Francisco Mental Health Board.

On June 19, 2009, the Request for Proposals (RFP) for the Workforce Development, Education, and Training (WDET) and the Prevention and Early Intervention (PEI) became available for interested contractors.  They have until July 30, 2009 to submit their bids.

2.2 Public comment

No public comments.

Item 3.0 PRESENTATIONS:

• INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH CARE: MITCH KATZ, MD, DIRECTOR OF DPH

 

• GENDER APPROPRIATE BEHAVIORAL HEALTH SERVICES, SARAH ACCOMAZZO, MHB SPECIAL PROJECTS COORDINATOR

3.1 Presentations:

PRESENTATION I: INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH CARE: MITCH KATZ, MD, DIRECTOR of DPH

Mr. McGhee:  Regrettably, our scheduled presentation by Dr. Katz must be postponed to another meeting.  We just found out a few minutes ago that Dr. Katz is responding to a family emergency.  We are sending our best wishes to him.

We have several members of the public who came here specifically for Dr. Katz s presentation.  Although Dr. Katz is not available to answer their questions, their questions will be published in the public comment section.

Mr. Purvis:  I would like to submit the following question: Even if Kaiser Permanente claims that they are not responsible for intensive services for chronic mental illness or chronic addiction, DPH could report the amount of money used to provide these services to Kaiser Permanente enrollees and make these figures known to the City, given Kaiser Permanente s tax exemption privilege, right?  Would not that be very helpful to the Mayor and the Board of Supervisors?

Ms. King:  We understand that Kaiser Permanente psychiatric patients/clients sometimes end up in the San Francisco County funded facilities, and there is a sum totaling tens of millions of dollars in unreimbursed care that Kaiser may owe the County.  Why does DPH under your direction fail to bring this to the attention of the City?

Mr. Keys:  This Fall, about 400 employees of the City from DPH are slated to be laid off.  There was a direct advocacy from myself, James Keys, to the Board of Supervisors to have the Office of Labor and Standard Enforcement (OLSE) be restored.  How will the new revenue be utilized?

3.2 Public comment

Ms. Milfay:  Ms. Dale Milfay is the Vice President of San Francisco NAMI.  She submitted the following:  Given the shortage of psychiatric beds and care in the City, and the City s continued budget problems, under your direction, cannot DPH recommend to the Mayor s office and the Board of Supervisors that they hold Sutter Health and Kaiser Permanente accountable to provide the chronic psychosis and addiction care, or revoke their local property-tax exemptions and utilize the money for psychiatric services that are being cut at San Francisco General Hospital or other City supported and run clinics?  After all, California Pacific Medical Center (CPMC) is only projecting to have 18 psychiatric beds by 2016.

Ms Oropeza: Ms. Francesca Oropeza, FMT works at Southeast Mission Geriatric. She submitted the following:  The Center for Special Problems was closed and there are social workers who are yet to be placed in another clinic.  The administration placed one of those social workers at SEMG.  Why is the administration not placing more needed clinicians at this clinic?

Why is the administration intent on moving the staff to a location which does not have enough space for all of the clinicians?  They are not testing their own theory, thus this is an elimination of services, not a merger or consolidation.  And, if this is true, why is the administration so adamant about calling this project an expansion of services?

Who will be benefitting from older adults with illnesses and psychiatric disorders taking two to three buses to be able to see their psychiatrist and social worker?

Since the Board of Supervisors restored the rent money ($36,000/yr) why is Mitch Katz going forth with the closure?

Since this clinic serves and assists the poorest and most disenfranchised populations from taking more beds at psychiatric wards (SFGH) and making more emergency room visits, why is Mitch Katz so unwilling to add needed staff and keep this clinic open?  This does not make sense fiscally.

PRESENTATION II: Gender Appropriate Behavioral Health Services, Sarah Accomazzo, MHB Special Projects Manager

Mr. McGhee:  Sarah Accomazzo will present her work in leading the Gender Appropriate Behavioral Health Services Workgroup and her recommendations for the coming fiscal year.  Sarah began her work as an intern while pursuing her masters in social work at Berkeley.  She was then accepted into the PhD program for social work. She has been promoted to Special Projects Manager for the MHB.

Ms. Accomazzo:  Thank you so much for having me here tonight.  I feel privileged for the opportunity to work for Gender Appropriate Behavior Health Services (GABHS) for Gals and the Mental Health Board over the past year.  I am here to report to you what we have accomplished in the past year and share our goals for the upcoming year.

First is a quick background.  From 2003-2006, DPH staffed an  Office of Women s Health with a part-time person.  It issued a Woman s Health Plan that laid out nine guiding principles and three main strategies to promote women s health.  But the program was cut in 2006, and currently, no one focuses on women s health, let alone behavior health.  Ms Raema Quam a Coro Fellow in the spring of 2008, found that gender neutral policies and practices are prevalent in San Francisco.  Those policies and practices have been based on good intentions, but there is a big difference between gender neutral, gender specific and gender appropriate programming.

GABHS for Gals, which started in the summer of 2008, is a group of clinicians, managers, civil servants, mental health workers, health educations, administrators and consumers committed to advocating for appropriate services for women and girls in San Francisco s behavior health system, and we meet every third Monday of the month from 2-4 pm at 1380 Howard.

Gender appropriate services are services that take into account the biological differences between genders and the distinct social and cultural issues experienced by each gender that influence an individual s behavioral health needs.  We strongly feel that services must be culturally competent and gender appropriate!

We have accomplished much over the past year.  For more information, please see the FY 08-09 Summary.  You can also get more information on our new website: www.gabhs.org that was put together by Mr. Loy Proffitt in the spring 2009.  You can also find information on GABHS for Gals at www.mhbsf.org and http://www.sfgov.org/site/mental_health_index.asp

On June 11, 2009, we held a special event:  Women, Girls and Behavioral Health: Where Do We Go From Here?  a resource sharing and networking reception to raise awareness about these issues.  We had about 80 people at the reception, and everyone brought flyers from their agencies.  We were honored to have Assemblywoman Fiona Ma and Deputy Chief of Staff for Gavin Newsom, Catherine Dodd as speakers.  We were entertained by Rising Voices, a performing group of young adult females who have been previously incarcerated.

Our top three goals for the coming year are safety in programs, eating disorders and body image issues and trauma.

Before finishing up the presentation, I also want to introduce Ms. Iris Haas-Biel who is volunteering for GABHS for Gals for 60 hours this summer.  Thank you so much to Iris for all your hard work.

Please feel free to contact me if you have any questions.

Ms. King:  Is there anything you would like to improve?

Ms. Accomazzo:  That is a good question.  I really hope to have a core group of 20-30 people through recruitment who represent the diverse populations we serve in San Francisco.

Mr. Purvis:  Do you know if there is any issue between psychiatric medications for men versus women.

Ms. Accomazzo:  A recent study by the National Institute of Health showed significant differences between men and women with certain psychiatric medications. I hope to continue research on medication effects on men and women and various stages of a woman s life.

Dr. Shukla:  You have talked lots about gender appropriate services.  What are some of the gender inappropriate services?

Ms. Accomazzo:  There are many gender inappropriate things happening in programs.  For example, I think safety and sexual harassment in programs is one of the biggest issues facing women and girls.  We hear many stories about women being harassed in City and non-profit run single room occupancy (SRO s) hotels, program waiting rooms, food lines, etc., and then women do not feel safe to come back to services.  I hope to raise more awareness about this during the upcoming year.

Mr. McGhee:  What are your outreach methods.

Ms. Accomazzo:  So far our outreach effort has been through email.  We are looking for ways to expand our email lists and outreach efforts.

Ms. King:  We have a list from the Southeast Sector to help you with outreaching to youth between 12-24 years old.

Mr. Tho-Biaz:  Do you have any men in your group who advocate services for women?

Ms. Accomazzo:  We have no men who are active participants in GABHS for Gals, though we do have some men on our mailing list.  We would love to have male participation in this group.

Public comment

No public comments.

ITEM 4.0 ACTION ITEMS

4.1. Public comment

No public comments.

4.2. Resolutions

4.2. a PROPOSED RESOLUTION: Be it resolved that the minutes of the Mental Health Board meeting of May 13, 2009 be approved as submitted.

Resolution unanimously approved.

4.2 b PROPOSED RESOLUTION: Be it resolved that the notes of the Mental Health Board meeting of June 10, 2009 be approved as submitted.

Resolution unanimously approved.

4.2 c PROPOSED RESOLUTION: Be it resolved that the Mental Health Board Endorses the Guiding Principles of Budget Reduction Strategies Created by the San Francisco Human Services Network. (Attachment A).

Resolution unanimously approved.

ITEM 5.0 REPORTS

5.1 Report from the Executive Director of the Mental Health Board.

Ms. Brooke called attention to the handout regarding the new Consumer Rights organization, and encouraged Board Members to attend Budget Hearings.

5.2 Report of the Chair of the Board and the Executive Committee:

Mr. McGhee:  There were over 200 people attended the California Association of Local Mental Health Boards (CALMB) conference in June. I was re-elected as President of the CALMB and the Board of Psychologists and Chair of the Conard House Board of Directors.

5.3 Report by Members of the Board on Their Activities on Behalf of the Board.

Mr. McGhee:  Are there any board members who would like to report on their activities on behalf of the Board or any announcements for the board? Has anyone gone to any of the budget hearings for the Health Commission or the Board of Supervisors?

Ms. King:  The Southeast Group Meeting of Community Wellness Partners is making great progress, and we have received the RFP and there is lots of excitement and lots of dialogue about it.  I am working with Mr. George Jurand from the Healing circle to assist CAL-Works participants in gaining employment, and they have received ten applicants.

I would like to add that the national NAMI conference is at the Hilton this week, and the person from the Soloist movie is a guest speaker.

Ms. Williams and I did the Bayview Mental Health Clinic program review.  They just do not have enough revenue to support the needs of such a large population.

Mr. Tho-Biaz:  I did a program review at the Westside Crisis Clinic.  I found it was interesting that socialization is very important to people, and the Westside Crisis Clinic provides that.

Ms. Dunn:  Do you know if the Westside Crisis Clinic will be closed?

Ms. Brooke:  I have heard that the Westside Crisis program will reduce hours but not be closed.

Ms. Dunn:  I went to Schrader House, which is near St. Mary s Hospital and Golden Gate Park.  It is an Acute Diversion Unit (ADU).  The staff were very committed to the well being of clients, but clients said they did not feel they have clear communication from the staff about their medications.  The staff were preoccupied with concerns about cuts to their program.  How can they do their jobs well when they are preoccupied with the budget cuts!

Mr. Purvis:  Does Schrader House have a volunteer program?

Ms. Dunn:  That is a good idea.  I will ask Schrader House about that.

Mr. Keys:  I did a program review with The Avenue s House which provides a two week stay for clients.  What they need is a computer.

Ms. Arguelles:  I did a program review at the OMI Clinic.  They need a decent kitchen to sell coffee to generate some sustainable revenue.

Mr. Purvis:  Ms. McIntyre and I did the program review for Walden House.  It has the east wing and west wing for short-term and long-term stays and a co-ed facility.  We were very impressed.

5.4 New business - Suggestions for future agenda items to be referred to the Executive Committee.

Mr. Keys:  I would like to do a resolution to save the Southeast Geriatric Services,. According to Ms. Oropeza, the program may be closed in two weeks.  I hope to send a strong letter to the Board of Supervisors, the Mayor, Dr. Mitch Katz, and the Chair of the Health Commission.  Also I would like to look at senior meal sites.

Mr. McGhee:  I would like to invite the new supervisors to come to our meeting, so they can stay abreast of mental health issues.

Ms. McIntyre:  I would like to invite the Public Defender, Jeff Adachi to come to us to talk about the Community Justice System and how mentally ill citizens are being treated.

Ms. Dunn:  I would like point out that the Dore Urgent Care is open 24 hours, seven days a week now.

Mr. Tho-Biaz:  I would like a presentation on wellness so we know what the definition of wellness is and how wellness is applied in mental health.

5.5 Public comment

No public comments

ITEM 6.0 PUBLIC COMMENT

Dr. Gruver: She is a psychologist in the Sutter Health system which is reducing the 81 psychiatric beds to 18 beds by 2016.  She mentioned that psychiatric beds are not very profitable which explains why they are being eliminated.    She also pointed out that the hospital has non-profit status and must fulfill their charitable obligations to ensure that people do not fall through the cracks.

Ms. Fee: Ms. Florence Fee is with the No Health without Mental Health, an organization she founded.  She was very disappointed that Dr. Katz was not available.  She hoped his absence is not a reflection of his lack of care for mental health.  She believes that the issue of integration of mental health into primary care is very important.

Dr. Shukla:  I share the disappointment with the public that Dr. Mitchell Katz did not show up.  The Mental Health Board is very interested in the integration issue.

Member of the Public:  The member mentioned that both Sutter Hospital and Kaiser Permanente are very profitable and, at the same time, has seen large HMOs promoting lucrative services and cutting mental health services.  The member stated that HMOs have been denying treatments to their patients who have psychoses and addictions, and such practice is just short of patient dumping.  The member pointed out that police and fire departments are doing a lot more 5150 cases.  The member is seeing the County of San Francisco being left holding the bag by large HMOs.  The member is concerned that the County is not holding HMO executives who set the tone, culpable for charity care.

Ms Francesca Oropeza: Ms. Francesca Oropeza submitted the speech she made at the Beilenson Hearing on Tuesday, June 16, 2009.

Supervisors,

I am here on my own time compelled to speak because of my professional and ethical responsibilities.  The mental health department is putting requirements on my job duties which are contrary to my professional responsibilities as a licensed Marriage & Family Therapist.  This is not only about making my job more difficult; it is about my ability to perform my job duties in a way that does not violate the ethical standards that are necessary to maintain my license.  Southeast Mission Geriatrics also has on staff a licensed LCSW and a psychiatrist both of whom have similar professional responsibilities.  Currently I am not able to fulfill my duties under the ethical standards for CAMF (California Association of Marriage and Family therapists), 1.3 & 1.8.  I have too many clients.

 

1.3 states.  MFT are aware of their professional and clinical responsibilities to provide consistent care to patients and do not abandon or neglect patients

 

1.8 states MFT do not abandon or neglect patients in treatment.  If a therapist is unable to continue to provide care, the therapist will assist the patient in making reasonable arraignments for continuation of treatment.

 

Closing SEMG will make this situation worse.  It will be more difficult to see patients because of the limitations of the new facilities, either OMI or Mission Mental Health.  These locations have inadequate space & compromised confidentiality.  The OMI clinic does not have adequate office space for SEMG staff.  There is no room for social workers to meet individually with clients.  Confidentiality laws will be violated and the senior clients and staff will be placed into a more disorganized and chaotic system.  Also, the seniors will face a decreased sense of safety and comfortability.  Older adults will no longer have a quiet and safe setting.  Seniors will be exposed to mentally ill adults who can seem intimidating and threatening to many seniors from receiving the services they need.

 

SEMG is the safety net for the City s poorest and most vulnerable seniors.  If I can not provide care, I can not assist my clients in making reasonable arraignments for continuation of treatment-there is none.

Adjournment

Meeting adjourned at 8:36 PM.