VIRTUAL MEETING OF THE BOARD OF DIRECTORS
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VIRTUAL MEETING
OF THE
BOARD OF DIRECTORS
Thursday, June 17, 2021, 5:00 p.m.
Board Officers
Thomas F. Morehouse, III, Chair
Venerria Thomas, Vice Chair
Steven Bond, Esq., Treasurer
June R. Owens, Secretary
Members of the Board of Directors
Ann Abdullah Sheriff Karen Bowden
Steven Brown Arva Davidson
Randie Dyess, Jr. Jane Hobbs
Mary Stewart Elva Williams Hunt
A CARF Accredited AgencyVision
The Hampton-Newport News Community Services Board is the premier provider of
behavioral health and intellectual and developmental disability services. We are
recognized throughout Virginia for our leadership, excellence and commitment to
service. We earn this distinction by creating a community where people can find their
own strength and become self-determining.
Mission
To provide a comprehensive continuum of services and supports promoting
prevention, recovery, and self-determination for people affected by mental illness,
substance use, and intellectual and developmental disabilities, and advancing the
well-being of the communities we serve.Strategic Planning Goals
(2017 - 2021)
Strategic Objective #1
Continue to develop the administrative systems and service array necessary to
maintain and further Hampton-Newport News Community Services Board’s
reputation as THE premier provider in the context of the changing Virginia’s
behavioral health system.
Strategic Objective #2
Pursue further revenue diversification and expansion of services, supports and
prevention activities so that Hampton-Newport News Community Services Board
can improve the quality of life for the individuals, families and communities we
serve.
Strategic Objective #3
Celebrate and communicate the Hampton-Newport News Community Services
Board’s performance and reputation as a center of excellence and center of
influence, through on going engagement of the community we serve.INDEX
HAMPTON-NEWPORT NEWS COMMUNITY SERVICES BOARD
VIRTUAL MEETING OF THE BOARD OF DIRECTORS
Thursday, June 217 2021 - 5:00 p.m.
Documents Page #
Cover Letter .................................................................................................................................. 1
Agenda .......................................................................................................................................... 2
Electronic Meeting Special Rules ............................................................................................. 3-4
Action Items .................................................................................................................................. 5
Information Items...................................................................................................................... 6-8
Clinical Division Program Highlights.................................................................................... 9-48
Minutes of the Board of Director Meeting ~ May 27, 2021 ................................................. 49-56
Red Folder Items
--- Committee Reports: Board Quality Management; Budget, Finance & Audit
--- Media Articles1
DATE: June 10, 2021
TO: Members of the Board of Directors
FROM: Natale Christian, Executive Director
SUBJECT: Virtual Meeting of the Board of Directors
June 17, 2021 at 5:00 p.m.
Dear Members of the Board:
The fiscal year 2021 is coming to a close and our final meeting will be held on June 17, 2021 at
5:00 p.m. Most of the Board business for this fiscal year has been successfully completed and we
thank you for all your hard work during this very challenging year. Election of Officers for FY22
will be held during the June meeting. We will continue to explore dates for the August Board
Retreat.
This month, Board Quality Management Committee met on Thursday, June 10, 2021 at 4:00
p.m. and the Budget, Finance, and Audit Committee will meet on June 14 at 4:00 p.m. As a
reminder we will continue to meet virtually and Zoom links will be sent out in advance.
Please remember that all Board Standing Committee Meetings are open to Members of the Board
of Directors for the Hampton-Newport News Community Services Board.
Thank you for all that you do on behalf of those we serve! We look forward to meeting with you
next week.
NWC:jj
Enclosures
300 Medical Drive, 2nd Floor ● Hampton, Virginia 23666 ● Telephone: (757) 788-0300 ● Facsimile: (757) 788-0968-- www.hnncsb.org2
ELECTRONIC MEETING
OF THE BOARD OF DIRECTORS
Thursday, June 17, 2021, 5:00 p.m.
AGENDA
1. Welcome & Call to Order
2. Remarks of the Chair
COVID-19 Pandemic Statement
Electronic Meeting Special Rules
Meeting Roll Call
3. Public Comment Period
4. Action Items
A-1. Minutes of the Board of Directors Meetings May 27, 2021
A-2. FY22 Proposed Slate of Officers
5. Standing Board Committee Reports
Board Quality Management
Budget, Finance and Audit
6. Information Items
I-1. COVID-19 Update
I-2. STEP VA Update
I-3. Legislative Update
7. Clinical Division Program Highlights
8. Adjournment3
MEETING OF THE BOARD OF DIRECTORS
Thursday, June 17, 2021, 5:00 p.m.
Electronic Meeting Special Rules
While the Commonwealth of Virginia remains under the current State of Emergency due to the
COVID-19 Pandemic, Members of the Board of Directors for the Hampton-Newport News
Community Services Board, an entity of local government, shall conduct its monthly Board of
Director Meetings by synchronous electronic medium as a way of providing immediate,
spontaneous interaction between meeting participants. This opportunity comes to Members of the
Board of Directors under the legal opinion of CSB Counsel, Patrick McDermott, Esq., in compliance
with the legal opinion of State Attorney General Mark Herring to the Commonwealth of Virginia
dated March 20, 2020.
Special Rules, or conduct, of the Board of Directors for the Hampton-Newport News
Community Services Board during the use of electronic meetings shall be as follows:
1. Ample Notice of Electronic Meetings shall be provided to Members of the
Board no less than one week before the scheduled meeting(s) and shall provide:
a. The date and time of the meeting; and
b. The telephone number and access code to connect to the electronic
meeting.
2. All Members of the H-NNCSB Board of Directors shall call into Electronic
meetings 15 minutes before the start of scheduled meeting(s); and announce
themselves at the first opportunity after joining the meeting, but may not
interrupt a speaker for the purpose of doing so.
3. Once Members announce themselves after joining the meeting, it is
respectfully requested that the Member “Mute” their personal telephones
so as not to interrupt the meeting with background noise.
4. Technical Malfunctions and Requirements. Each Member is responsible for
his or her own connection to the telephone conference call; and no action shall
be invalidated on the grounds that the loss of, or poor quality of, a Member’s
individual connection prevented him or her from participating in the meeting.4
5. Once the meeting is called to order by the Board Chair, a verbal Roll Call
will be taken to: (1) confirm meeting participants, (2) confirm that a Board
Meeting quorum exists; and (3) take note of any Members of the Public present
on the call.
Please note that a Roll Call may be requested by any Member of
the Board following the departure of any Member, or following
the taking of any Vote for which the announced totals add to less
than a quorum.
6. To seek recognition by the Board Chair and obtain the floor during the
Electronic Meeting, a Member shall address the Chair, and state his or her
own name to be recognized, but may not interrupt a speaker for the purpose of
doing so. The Board Chair shall call the name of the Member who wishes to
be recognized in the order of the request.
7. All Motions are to be made orally by Members once obtaining the floor or
being recognized by the Board Chair.
8. All Votes shall be taken by roll call, except that only the number of votes on
each side and the number of members present, but not voting, shall be entered
into the minutes unless the Board orders a fully recorded roll-call vote.
Business may also be conducted by unanimous consent.
9. Members needing to disconnect from the meeting prior to adjournment shall
announce their departure as soon as practical, but may note interrupt a speaker
for the purpose of doing so. It is respectfully requested that Members of the
Board do not disconnect from the electronic meeting during the Motion or
Voting process.5
ACTION ITEMS
April 22, 2021
A-1. Board Approval of the Minutes of the Board of Director Meetings from
May 27, 2021
Issue: Board Approval of the Minutes of the Board of Director Meetings held on May 27,
2021.
Background: Minutes of the Board are provided to Members of the Board of Directors
for their review in Board packet distributed on June 10, 2021.
ACTION: Board approval of the Minutes of the Board of Director Meetings held May
27, 2021.
Enclosure: May 27, 2021 meeting Minutes.
A-2. FY22 Proposed Slated of Officers
Issue: Nomination & Selection Committee Recommendation ~ FY22 Proposed Slate of
Officers.
Background: Each year, in compliance with Article VIII, Section 4(c), of the Board By-
Laws, Members of the Nomination and Selection Committee have the annual responsibility
of preparing a Proposed Slate of Officers to present at the May Meeting of the Board of
Directors so that an election of Officers can be held at the June Meeting of the Board.
Please note that as reported at the May Meeting of the Board of Directors by the Chair of
the Nomination and Selection Committee, Members of that Committee confirmed its FY22
Proposed Slate of Officers to be as follows:
Mrs. Venerria Thomas ~ Chair
Mr. Steven Bond ~ Vice Chair
Mr. Thomas Morehouse ~ Treasurer
Mrs. June Owens ~ Secretary
For your information, additional Board Member nominations for the FY22 Slate of Officers
may be provided during the June Board of Directors Meeting. Members of the Board
must approve a FY22 Slate of Officers at the June Meeting.
ACTION: Board approval of the FY22 Slate of Officers.6
INFORMATION ITEMS
I-1. COVID-19 Update
During the month of May, one staff member tested positive for COVID-19, bringing the total to
81 positive cases since the pandemic began and continuing the trend of declining numbers of
positive cases as the year progresses. The Agency last saw a single positive case among staff in
September 2020. There were also fewer instances of possible exposure. In the cases where there
was potential exposure, staff had been vaccinated and per guidance from the Virginia Department
of Health, were not required to quarantine. A spreadsheet of vaccination locations continued to be
sent out weekly to advise staff of vaccine opportunities for themselves and the people they support.
In order to encourage more staff to receive the vaccine, the Agency devised a plan to offer a
vaccination incentive to staff starting on June 1st. The hope is that this will result in more staff
receiving the vaccine. By current estimates, the Agency has not yet reached a 50% threshold of
vaccinated staff.
Plans to more fully open the agency were reviewed and approved for each Division with the goal
of being able to serve more individuals onsite by July 1st. The Executive Leadership Team
continues to discuss Agency restrictions in light of the decreasing number of positive cases and
the rescinding of the Governor’s emergency orders mandating masks and social distancing;
however, as a healthcare provider, staff, customers, and visitors are still required to wear a mask
and socially distance while on H-NNCSB premises.
I-2. STEP-VA
The Agency has continued to plan for the implementation of the Service Members Veterans and
Families (SMVF) and Peer and Family Support steps of STEP-VA scheduled to take effect on July
1st. As a result of these required steps, a SMVF Coordinator/Licensed Therapist, a SMVF Peer
Recovery Specialist, and a Family Peer Support Partner have been added to the Agency’s
complement of staff. Job descriptions for these positions were developed and the position
announcements have been posted for recruitment. The Agency’s Training Services Department
has informed staff of the requirement to complete the Military Cultural Competency training that
will be required of all staff providing direct services. Data and metric requirements for these steps
have been discussed with the Management Team. Additionally, recruitment is underway for a
Licensed Therapist at the Adult Outpatient Clinic. This position was funded by additional funds
awarded in FY 22 which will be ongoing to address the Outpatient step of STEP-VA.7
I-3. Legislative Update
General Assembly Session Overview
The General Assembly (GA) will be having a special session in late July or August to determine
how to spend the $4.8 billion in one time funds that is coming from the federal government. These
funds are separate funds from the additional COVID relief one time funds coming through the MH
and SA Block grants and SOR Funds. The governor has identified four priorities for these funds.
Public Health is one of those priorities. VACSB is meeting with its members to determine its
proposals for these funds.
Marijuana Legalization
The three boards listed below are being formed because of marijuana legalization. There
will be one CSB representative on the Public Health Advisory Board and a CSB
representative can be appointed by the Governor to the Cannabis Equity Reinvestment
Board.
1. Cannabis Control Authority, Board of Directors
2. Cannabis Public Health Advisory Board
3. Cannabis Equity Reinvestment Board
Behavioral Health Loan Repayment Implementation
The Behavioral Health Loan Repayment Program (BHLRP) has received $1.6M in funds.
The program will pay up to 25% of a staff person’s student loan debt each year. The staff
person would have to commit to two years working for the CSB or other providers that
qualify for this program, and could continue the program for a third and fourth year.
The budget language states that the program would give preference to CSBs and other
providers that are located in Health Professional Shortage Areas (HPSAs) or Medically
Underserved Area (MUAs).
Because the $1.6M might not be enough to go around to the CSBs that are not in HPSA,
VDH will be tracking the data from the first and maybe second rounds of these funds to
see of the funding amounts need to be tweaked to be able to include additional providers
(not just the HPSA providers).
Marcus Alert Implementation
The development of the state plan is on its third draft. There are separate initiatives being
implemented under the umbrella of the State Plan which has caused some confusion.
DBHDS is trying to make improvements to the state crisis system, and at the same time those
improvements will play a role in making the MARCUS Alert more successful.
The MARCUS Alert itself is a set of protocols that dictates what happens when law
enforcement is alerted to someone in crisis. Those protocols for the first 5 sites are due to be
implemented by December 1, 2021.
There are a number of other things that are also in the state plan that are not part of the
MARCUS Alert protocols and therefore will not be complete on December 1, 2021, when the
Marcus Alert protocols are implemented in the first 5 sites.8 SJ47 SJ47 had a law enforcement-focused subcommittee meeting in May and will have another law enforcement-focused meeting on June 8th. The law enforcement workgroup meetings are supposed to be problem solving meetings. DBHDS will bring up the alternative transportation contract to see if alternative transportation can potentially be used as a band aid in place of law enforcement officers having to spend hours waiting in the emergency department with an individual.
9
CLINICAL DIVISION PROGRAM HIGHLIGHTS
Addiction and Recovery Treatment Services (ARTS)
Anthony Crisp, Director
Division Goals
Goal 1: To focus on staff retention and building staff morale by establishing a work climate
that fosters teamwork and an appreciation of each person’s position and duties.
Goal 2: To provide services that are person-centered and evidence-based with a primary focus
on trauma-informed care, treatment/service engagement, adherence and retention and
recovery-based.
Goal 3: To ensure that Peer Recovery Services are fully integrated in services offered as a
means to engage and retain persons served to help persons served reach their
recovery pathways.
Goal 4: To maintain current level of service infrastructure by billing were appropriate and
continue to monitor workflow to assure service and billing targets are met.
Overview
1. Hampton Roads Clinic (HRC/HRC+): HRC offers medication assisted treatment (MAT)
to adults with a long history of opioid use disorders (OUD). HRC offers a full range of
diagnostic and clinical services, which include a clinical and a medical assessment,
methadone medications, in-depth substance use education and a full range of counseling,
care coordination and recovery support services.
Number of Individuals Served / Admissions / Discharges:
For this reporting period, we served a total of 226 individuals; 22 individuals were served
through HRC+ (our SAMHSA Grant Program). We had a total of 8 admissions and 16
discharges (HRC/HRC+).
Staff Vacancies / New Hires:
We have a vacant LPN (PRN) position. This position is needed to provide back-up during
the week and to cover weekend and holiday shifts. We also have a Therapist I and a SUD
Counselor (HRC+) vacancy.10
External Trainings / Conferences:
Several clinical and medical staff participated in the 2021 AATOD (American Association
for the Treatment of Opioid Dependence) Virtual Conference.
Several staff participated in the ASAM Criteria Skill Building Training. Other
webinars/training include the following:
SAMHSA webinars on Financial Management and Navigating ERA.
Peer Recovery Support Specialist: Spotlight Series Part 1, Training Emerging
Recovery Pathways; Revive and the LGBTQ Virtual Conference.
Understanding the Roles of Addiction Professionals in Behavioral Health Care
Ethics and Social Media in the 21st Century
Spirituality and Recovery: The Science of Healing
Evidence-Base Solution Focused Brief Therapy
Cognitive Behavioral Therapy for Substance Use Disorders
Journey Through Grief and Loss
Harm Reduction: 1 May be Enough and 1,000 is too Many
Counseling African American With SUD; Volume 1 & 2
The Grief Summit: Grief Counseling and Treatment in a Pandemic of Loss
Building Therapeutic Alliances
Signs and Symptoms of Spectrum illnesses
Why do we screen and how do we eliminate barriers to screening
Overcoming COVID-19 Vaccine Hesitancy among Behavioral Health staff and
patients
RN Supervisor, Michelle Todd, received her PALS (pediatric advanced life
support) certification. She also received training in PMADs (perinatal mood
and anxiety disorders). The certification and training are critical to have when
providing services to pregnant and postpartum OUD (opioid use disorders)
mothers/
Community Events/ Participation:
None due to COVID-19 Restrictions
STEP-VA Progress / Milestones and Other relevant program-specific information:
In April, HRC celebrated “Counselor Appreciation Month” with a spaghetti lunch, cards
of appreciation, and digital exchanges. Nurses’ Week in May was celebrated in the same
manner. On May 26, HRC staff participated in a 5 minute “get up and move dance off” as
a teambuilding initiative.11
The Program Medical Director, Clinical Services Administrator, Clinical Supervisor and
the Nurse Supervisor met to review and to update the program’s take home policy. The
policy was updated to provide a more flexible take home schedule to individuals served. A
person-centered approach was utilized and individuals with take homes under the
emergency exception was grandfathered in and allowed to keep the take-homes if they met
the time is service requirement.
The plan to bring staff and clients back into the clinic after COVID is being implemented.
Relevant Regional, Association Notes and Council Information:
The Clinical Services Administrator, Lillian Chamberlain, was a participant on the Sentara
Collaborative Grant Planning Committee to assist with the preparation of a Letter of Intent
for a Sentara Collaborative Grant. This grant will establish a system of care for pregnant
and parenting women. The LOI (letter of intent) was due May 31, 2021. The collaborative
participants included representatives from ODU, NSU, EVMS, 3 CSBs, Optima Health
and the Virginia Neonatal Perinatal Collaborative.
Continued weekly pandemic updates with the State Methadone Authority.
Audits / Reviews:
DBHDS Triennial Licensure Review in progress
Program Challenges / Significant Issues:
Promoting methadone treatment services utilizing a street outreach approach continues to
be a challenge due to Covid-19 restrictions and thereby resulting in a reduction in
enrollment for opioid services for both HRC+ and HRC. However, community outreach
initiatives were put into place by the SAMHSA Grant Project Director and Peer Recovery
Specialist. Signs and posters were placed in some local businesses in the East End
community of Newport News.
On site face-to-face groups remain suspended due to the pandemic and thus renders groups
unavailable to those individuals who do not have the hardware to participate in groups vial
zoom.
Establishing working partnerships for direct referrals for MAT with first responders, i.e.,
police, EMTs and hospitals still remain a high priority. The Hampton and Newport News
offices of EMS were contacted and flyers regarding the SAMHSA Grant was e-mailed.
Efforts to improve this partnership will continue.
2. Partners in Recovery (PIR): PIR offers comprehensive, integrated addiction and mental
health treatment in a single program. Services include outpatient counseling, Medication
Assisted Treatment (Buprenorphine & Vivitrol), psychiatric and medication management
services for individuals experiencing substance use and mental health disorders.12
Number of Individuals Served / Admissions / Discharges:
For this reported period we served 474 individuals in Medication Management. We had 26
admissions and 11 discharges. For OBOT (Medication Assisted Treatment), we served 68
individuals; 3 admissions and 4 discharges. For Outpatient Therapy (RU 143/437), we
served 181 individuals; 63 admissions and 53 discharges. Our SOAR Peers provided
support to 117 individuals and received 29 warm-line calls.
Staff Vacancies / New Hires:
Partners in Recovery (PIR) is fully staffed.
External Trainings / Conferences:
The therapists and the Clinical Service Administrator attended the following trainings:
Borderline, Narcissistic, Antisocial and Histrionic Personality Disorders (6
CEUs);
Ethical Principles in the Practice of Virginia Mental Health Professionals (6.25
CEU’s);
Trauma-Related Dissociation and Dissociative Disorders: Assessment and
Treatment Strategies (6 CEUs); and,
PESI’s 2 days Grief Summit (12 CEUs).
James Strickland, Clinical Services Administrator and Jessica Walters-
Houston, Therapist II participated in the 2021 AATOD (American Association
for the Treatment of Opioid Dependence) Virtual Conference.
Tony Crisp attended SOR II Contingency Management Training. This training
revealed that offering incentives to treatment participants often improve
treatment adherence.
Community Events/ Participation:
James Strickland, Clinical Services Administrator, continues to promote the Warm-Line
and ARTS Services via mailed letters to local churches, the police departments and other
organizations in Hampton and Newport News.
STEP-VA Progress / Milestones and Other relevant program-specific information:
PIR Medical staff have begun to provide more face to face services to individuals. There
has been a reduction in the number of referrals coming to PIR through Same Day Access.
Most referrals are coming directly for OBOT Services or internally for Medication
Management Services.
Relevant Regional, Association Notes and Council Information:
ARTS Director, Tony Crisp, attended the virtual VACSB Spring Conference.13
Tony Crisp attended the DMAS/DBHDS ASAM Level of Care Modification Update as it
related to the revisions of ARTS Medicaid Benefits and licensed programs.
At the most recent Virginia Medicaid SUPPORT Act Grant Stakeholder Meeting,
Northwestern Community Services Board offered a presentation of their Peer Services; in
particular, their successful Peer Bridger Program with their local hospitals. Plans are to
reach out to Northwestern as to replicate their success.
The ARTS Director continues to be an active participant of PCOR and the Regional
VACSB MH/SUD Council.
Audits / Reviews:
Quarterly chart review continues,
The Triennial Licensure review audit is underway
Program Challenges / Significant Issues:
No major challenges.
3. Adult Drug Courts. The Hampton and Newport News Drug Treatment Courts and The
Hampton Veterans Treatment Docket are specialized courts given the responsibility to
handle cases involving non-violent felony with substance use and co-occurring mental
health disorders through a comprehensive system of supervision, drug testing, substance
use treatment, and regular court appearances.
Number of Individuals Served / Admissions / Discharges:
Hampton Drug Treatment Court to include the Hampton Veterans Docket served a total of
8 participants. There was no new admission, one (1) person is incarcerated and one (1)
person absconded.
Newport News Adult Drug Court served a total of 16 participants. There were no new
admissions, and three (3) absconded.
Staff Vacancies / New Hires:
We have two vacant therapist positions at the NN Drug Treatment Court (NNDC).
Hampton Drug Treatment Court (HDC) has had a vacant therapist position since April 5.
A candidate has been selected, and she is currently in pre-employment.
External Trainings / Conferences:
All clinical staff are participating in webinars on addiction and various counseling
techniques.14
STEP-VA Progress / Milestones and Other relevant program-specific information:
All participants are performing daily check-ins to maintain intensive supervision. HDC
participants are also attending group as required by their phase, as well as, individual
sessions by way of zoom.
The Hampton Drug Court and Veterans Docket Advisory Committee met on April 28th to
discuss the program’s low census and referrals. Since some key stakeholders were not
present, a new meeting was scheduled for June 1st. In the interim, a special emergency
meeting was call with key stakeholders to address the same concerns. The meeting was
well attended, but no resolution was determined. However, interest were expressed to a
proposed “lower-level intervention track” that may increase referrals and the census.
Relevant Regional, Association Notes and Council Information:
Program Administrator, Sherry Glasgow, is an active member of the H-NNCSB 50th
Anniversary Celebration Committee. The committee has met several times and has begun
celebrations in the form of a Memorial link to CSB staff who have passed on, Throwback
Thursdays and Fun Fact Fridays.
Audits / Reviews:
Quarterly chart reviews continue to yield positive compliance. The program is maintaining
data entry in compliance with the requirements of the Supreme Court of Virginia’s MIS
system.
Program Challenges / Significant Issues:
Staffing is a major challenge for both drug courts. Additionally, HDC continues to have a
low census and lack of referrals.
4. South-Eastern Family Project (SEFP): is licensed both as a 3.5 & 3.1 comprehensive
residential treatment program for pregnant and postpartum women diagnosed with a
substance use disorder. Gender specific substance use treatment services are provided in a
healthy, stable and secure environment.
Number of Individuals Served / Admissions / Discharges:
Data April May
Number served 5 7
Admission 0 2
Discharges 0 115 Staff Vacancies / New Hires: Residential Manager, 2 Peer Recovery Specialists, 2 CSA II FTE, 4 CSA II PT & 1 CSA II PRN New Hires: Paulette Brothers, CSA II, will join the SEFP team as a part-time employee for every other week end on the 12-8 shift. Ms. Brothers is a former SEFP employee who will be returning. Several staff from other ARTS programs have agreed to work a 2nd position at SEFP to assist with the staff shortage. External Trainings / Conferences: Grief Summit Webinars STEP-VA Progress / Milestones and Other relevant program-specific information: The clinical structure for the 3.5 Level of care has been revised and updated Relevant Regional, Association Notes and Council Information: The program leadership participated in the monthly Substance Use in Pregnant and Parenting Women Collaborative meeting. Audits / Reviews: The SEFP successfully completed the Triennial Licensure Review by DBHDS. Program Challenges / Significant Issues: Staff vacancies are the primary challenge at this time, currently staff vacancies in the program are more than 60%. Client admissions for May continued to increase slightly. The program capacity is currently 75%. Admissions and referrals are still somewhat a challenge for the program in the face of the COVID-19 restrictions. Individuals’ attitudes and motivation for entering residential care that requires a pre-treatment COVID test, and a 5-day quarantine, continue to impact community referrals and client follow-through significantly. Referrals from the local correctional facilities and criminal justice agencies still remain impacted by the Pandemic, but are showing slow signs of improving. COVID-19 restrictions continue to prevent the current residents from the experience of attending recovery meetings in the community as well as limit outings for the current residents. Residents are not able to have face-to-face visits with family at this time due to the COVID restrictions, communication with family has been limited to phone calls and virtual visits. Challenges also remain with public networking, promotions and outreach to the community due to the COVID restrictions. There are currently no client passes or visitors due to CoVID-19 restrictions.
16
5. ARTS Case Management Services: Case Management meets the personal, interpersonal,
occupational/educational and social needs to adults who are diagnosed with substance use
and/or co-occurring disorders (substance use and metal health disorders). We do this
through various specialized services: Case Management Services for Men, Project Link
(women and their children, birth through age 7), Special Outreach via our Women’s
Services Navigator and Re-entry positions; linkage to residential treatment, managed
withdrawal services and housing supports via SARPOS and contracted services: Inner
Reflections (Jail-based SUD Counseling Services) and Substance Use Screening and
Education Program with the cities of Hampton and Newport News’ VIEW/TANF
Programs.
Number of Individuals Served / Admissions / Discharges:
Project Link served 168 women and children; 1 admission and 8 discharges; Case
Management Services for Men served 131; 9 admissions and 2 discharges; Inner
Reflections-served 6 individuals and 110 offenders were screened for services; 0
admissions and 1 discharge. Re-entry- 1 screened; 0 referred for services; Women’s
Services Navigator (orientation) - 0 screened; 0 referred for services; SARPOS- 7 people
were served. In addition there were 97 care coordination contacts provided through our
contracted VIEW/TANF Service with 29 individuals referred for additional support.
Staff Vacancies / New Hires:
A Project Link Case Manager was hired. A second candidate was selected and is
currently in pre-employment. Project Link still has a vacant position; additionally, we
have one position out on FMLA.
External Trainings / Conferences:
ARTS Case Management staff attended the following trainings: Wrap for Addictions;
Welcome to Relias Training; The Game Elements Tour in Relias; Neurobiology of
Anxiety, Depression and Addiction; Competing Against Eating Disorders: Clinical
Themes in Treatment of Athletes; The Grief Summit; Food, Substances & Anxiety: What
I learned about Recovery on my year long road trip; Conscious Ungathering: Unmasking
Your Vision of What’s Next and Medication Assisted Treatment.
Community Events/ Participation:
Program staff attended the Peninsula Community Advisory Meeting which was held
virtually to provide information about programs in the ARTS Division and network.
STEP-VA Progress / Milestones and Other relevant program-specific information:
ARTS Case Management recognized several “Shining Stars” during the monthly staff
meeting; staff who have gone above to support the goals of the program. Agency
anniversaries are also celebrated during the monthly meeting.17
The Program Manager met with the Director of Catapult Parent Education who presented
information on classes and a support group available to women with a history of
incarceration in the Hampton Roads area.
Relevant Regional, Association Notes and Council Information:
The Program Manager, Kat Cannady, attended the Regional Substance Use Disorder
Pregnant and Parenting meeting to provide updates and agency information on services for
women.
The Re-entry Coordinator, Bernadette Gayden, attended the Hampton Re-entry Council
Meeting and provided current information about ARTS Services.
The Program Manager attended the DMAS: ARTS SUD Stakeholder Meeting; The
Pregnant and Parenting Women’s Supportive Housing Grant Meeting and participated in
the Permanent Supported Housing Focus Group.
Audits / Reviews:
The Triennial Licensure review audit is underway.
Program Challenges / Significant Issues:
COVID-19 Emergency precautions continue to be in place, which has impacted our ability
to outreach and engage with some individuals.
Vacancies and extended medial leave in the program continue to impact our ability to bring
new clients in to the program as quickly as we prefer. The program continues to work
diligently with HR to fill the vacancies.
6. Peer Recovery Services: Peer Recovery Services at HNNCSB promotes hope, self-
determination, choice, and multiple pathways to the recovery process. Peer Recovery
Services support and assist an individual through a process of change to improve the
individual’s health, recovery, resiliency and wellness; live a self-directed life; and strive to
reach their full potential.
Number of Individuals Served / Reached:
Supporting 20 Board’s PRS (Peer Recovery Specialists) who have reached many
individuals (in and out of services) experiencing difficulties with both mental health and
substance use issues.
Staff Vacancies / New Hires:
The agency currently has 2 PRS I vacancies at SEFP. Sherea Ryan, a PRS from ACOS
resigned, but a new PRS I, Travis Fleming was hired. Taylor McEachin, a CPRS I in
Road2Home recently received her Bachelor’s Degree.18 External Trainings / Conferences: Renee Cox, Peer Recovery Coordinator (PRC), participated in the DBHDS/VCU sponsored “Recovery Leadership Academy Training.” This training academy will continue monthly until September 14, 2021. This training is for emerging leaders and each emerging leader is paired with a mentor. In this training the Peer Recovery Coordinator is a mentor. PRC also attended LGBTQIA+ Connectedness on April 28 and MH/SUD Connectedness training on May 26; both were sponsored by Region V CAC. Region V CAC also hosted an Ethics training on April 10. Community Events/ Participation: PRC facilitated REVIVE Training to PACT team on April 27 and with Prevention Services on May 14, 2021 to 7 members of the community. PRC participated in a meeting with Darlene Jones regarding Catapult Parent Education. This program is starting a support group for women that were previously incarcerated. The first group is June 3, 6-7:30 pm. Milestones and Other relevant program-specific information: The Peer Recovery Coordinator (PRC), on behalf of Health Planning Region V Consumer Advisory Council, offered input on how to utilize a $100,000 STEP VA grant from DBHDS. Relevant Regional, Association Notes and Council Information: The PRC attended the DBHDS Virginia Recovery Initiative meeting in April and attended the DBHDS PRS Stakeholders Meeting on May 25, 2021. Challenges / Significant Issues: Some peers have expressed being stigmatized. To help offset this dilemma, Renee Cox, PRC, shared the following link with program managers and supervisors, during their quarterly meeting, as a way to understand the stigma that peer staff often experience. Reducing Negative Attitudes Faced by Peer Support Staff | Resources for Integrated Care
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Adult Care Coordination
April & May 2021
Robert Deisch, Director
Division Goals:
Goal 1: Adult Care Coordination programs will provide opportunities for staff to develop their
skills and also provide training and opportunities to advance into leadership roles.
Adult MH Case Management (AMHCM): CMs cover for Supervisors and Supervisors
cover for Managers. Encouraging CMs and Supervisors to attend applicable trainings that
are available.
Programs of Assertive Community Treatment (PACT): All staff are regularly
encouraged to participate in training and opportunities that will help them advance in their
careers (i.e. seeking licensure, taking advantage of additional trainings offered by the
agency, and returning to school for continued education). We currently require all staff to
complete a 10 hour course on Motivational Interviewing as utilizing MI is considered best
practice on an ACT team. We currently have two staff registered with the Board of
Counseling as LMHP-Es.
Goal 2: Adult Care Coordination programs will focus on staff retention and increasing staff
morale by establishing a work climate that fosters teamwork and an appreciation of each
person’s position and duties.
AMHCM: Working from home is going well for CM morale. Unable to do birthday get
together. We all help with problem solving when issues arise while working from home
and use team work to meet client’s needs.
PACT: Daily team meetings readily lend themselves as a great opportunity to foster
teamwork. These are currently being held via Zoom. Staff are encouraged to assist and
support each other. The Manager, Supervisor, and RN Supervisor strive to set the tone of
a supportive environment. Instances of staff assisting and covering for their teammates
occur on almost a daily basis.
Goal 3: Adult Care Coordination will maximize collaboration between Primary Health Care
and Behavioral Health Care to benefit the individuals served.
AMHCM: Still referring clients to SEVHS. Monitoring BMI. Scheduling Medicaid cabs,
sending bus tickets and calling client’s to remind them of their appts.
Discharge Planning Team: Staff continue to provide linkages to medical care, including
referrals to primary care providers. Staff are also providing consumers with COVID
vaccination information resources and assisting with registering for a vaccine if requested.
PACT staff continue to coordinate to ensure that all individuals’ medical appointments
were scheduled accordingly. Individuals are assisted with appointments based on
individual’s needs. Some individuals are accompanied to all of their appointments and
some individuals are able to coordinate their medical care independently. We have started
to use a system that tracks attended medical appointments and follow up needed.20
Goal4: Adult Care Coordination programs with waiting lists will strive to eliminate the
waiting list to expedite individuals accessing services.
AMHCM: 10 Medicaid cases assigned and 4 have be opened. The wait list is 50.
PACT: – enrolled one individual from the wait list in April and May. We attempted to
engage two other individuals with no success. The team also has been carefully reviewing
referrals to ensure lesser intensive supports have been tried before accepting individuals to
the wait list.
PACT Forensic - PACT Forensic currently does not have a wait list.
Program Overview:
Adult Mental Health Case Management serves individuals who have a Serious Mental Illness
or Serious Mental Illness and Co-occurring Substance Use Disorders. We assist individuals with
linkage to services in the community such as: housing, SSI benefits, applying for and maintaining
Medicaid, Food, Clothing, Psychiatric Services, Therapy, SA Treatment, Vocational, PCPs,
Medication and any other services or needs that may arise. AMHC Monitors the services to insure
all of our individuals needs are met.
State Hospital Discharge Planning team provides case management and discharge planning
services to individuals admitted to State psychiatric facilities. The team advocates for individuals’
needs, monitors individuals’ progress with treatment goals, and coordinates optimal transition to
the community.
Reinvestment Case Management provides discharge planning and short term case management
services for the uninsured at local psychiatric hospitals.
Mobile Crisis Response Team (MCRT) provides intensive support services to individuals
recently discharged from psychiatric facilities or at risk for hospitalization. The team provides
coping skills education, recovery tools, and linkages to CSB and community resources.
The Program of Assertive Community Treatment (PACT) is an intensive, community based,
interdisciplinary treatment program for adults with serious mental illness. Individuals must be high
risk of hospitalization, homelessness, or intervention from the legal system to qualify. It is
expected individuals would have tried less intensive community supports with limited success
prior to being referred to PACT.
Mental Health Regional Supervised Housing program (Transcend) is a twelve bed facility.
Staff work closely with the individuals to engage them in treatment such as psychiatric, substance
abuse, medical and any other services that they may need. Staff assist with obtaining a
psychosocial day program and other community agencies that will meet their needs. The
individual's independent living skills are assessed and staff provide education and instruction in
those identified areas. Services are individualized based on each individual's goals, needs and
desires.21 Projects for Assistance in Transition from Homelessness (PATH) and Newport News Outreach provide outreach to individuals that are experiencing homelessness and who have a Serious Mental Illness. The goal is to engage these individuals into services for mental health treatment and other resources and services to increase community integration and reduce the reoccurring risk of homelessness. Safe Harbors Permanent Supported Housing addresses the needs of chronic homeless individuals with Housing Fist Model. Once the individuals are housed staff work with the individual at the individuals pace to address various needs such as mental health and or substance abuse treatment, benefits and medical services can be addressed. Client’s pay rent and maintain their apartments. Staff assist with Activities of Daily Living Skills Training, assistance with treatment needs, transportation and housing applications (among many other things). The goal is to move the client at their pace into the community with supports and again reduce the risk of reoccurring homelessness. Number of Individuals Served/Admissions/Discharges: AMHCM: 529 clients served 449 have full Medicaid. 4 Admissions and 2 Discharges State Hospital Discharge Planning: Staff continue to monitor Civil and Not Guilty by Reason of Insanity (NGRI) forensic cases. April 2021: Central State Hospital (CSH)-7 consumers; Piedmont- 3 consumers; NVMHI-1 consumer; SVMHI-1 consumer; Western State- 1 consumer; Catawba-1 consumer; Eastern State Hospital(ESH)- 56 consumers. NGRI cases-46 NGRI Acquittees; 27 consumers admitted to the State Hospital and 19 Acquittees in the community on conditional release. Two consumers remain in temporary custody pending court decisions of whether they will be conditional released or committed. One Acquittee was granted conditional release and discharged to the community to the CSB apartment while KEYS staff assist with the search for independent housing. One Acquittee at ESH who was granted conditional release, but pending nursing home placement was removed from conditions and switched to civil status. May 2021: Central State Hospital-8 consumers; Piedmont-3 consumers; NVMHI-1 consumer; SVMHI-2 consumers; SWVMHI-2 consumer; Western State Hospital- 1 consumer; Catawba- 2 consumers; Eastern State Hospital- 57 consumers. NGRI cases- 46 NGRI Acquittees; 26 consumers admitted to the State Hospital and 20 Acquittees in the community on conditional release. One NGRI remain in temporary custody pending court’s decisions of whether he will be conditional released or committed. One of two NGRI Acquittees who was still in temporary custody last month was committed this month and the other has been recommended for commitment by both evaluators, but waiting for the court’s decision. One Acquittee at ESH has been granted conditional release and discharged to Tidewater Cove. Reinvestment- April 2021- 7 acute care admissions and 9 discharges.
22 May 2021 - 11 acute care admissions and 8 discharges. Mobile Crisis Response Team- April 2021- 22 consumers served. May 2021 - 20 consumers served. There is one vacant Case Manager Position on this team. PACT: At the end of May we had 94 enrolled individuals, 21 of those enrolled under the forensic enhancement. We had two discharges in April and May, one graduation and one individual who had been at ESH for over a year. We had two admissions. One individuals was enrolled from the wait list and one individual is a return enrollment following time served in a correctional facility. PATH, Newport News Outreach and Safe Harbors: PATH and Newport News Outreach have a flexible case load of about 20-30 each. Most shelters are not at full capacity because of Covid- 19 restrictions and self-distancing. NN Outreach has a current case load of 27. PATH has a current case load of 26 with several scheduled pending intakes. Both programs have clients that are eligible for Safe harbors Permanent Supported Housing. Outreach continues to be limited with COVID. NN Outreach and PATH staff are offering limited outreach hours at the Four Oaks Day Center. Outreach now includes the HELP Day Center in Hampton. In April and May Safe Harbor had 25 residents. Six residents of Safe Harbors have moved to the community following being awarded a Main Stream Voucher from Newport News Redevelopment and Housing or Hampton Redevelopment and Housing. Two additional residents have move in with family or friends on a permanent basis. Currently 5 other residents have been awarded Main Stream Voucher and Safe Harbors Staff is assisting these residents with looking for suitable housing. Currently there are two apartments that are empty and are being cleaned, repaired and some furniture replaced. When completed Safe Harbors will fill these slots. Also a new apartment has been obtained in Newport News and is in the process or being furnished. Soon Safe Harbor will fill these vacancies as well. Emergency Housing / Shelter: Remains at 50% capacity to provide self-distancing and safety for residents. As of May 31st the Male Emergency Housing/Shelter and Female Emergency Housing Shelters remained full at 50% capacity. New funds have been awarded for an additional shelter. This will provide 4 more male beds. A location has been secured and plans to open soon are underway. This will also add one more staff to Homeless Services. Staff Vacancies/New Hires: PACT: In May we had resignations of one LPN and one Service Coordinator. We filled the Employment Counselor position. We have a LPN that accepted our offer and starts June 7th. We have interviews for the Service Coordinator position scheduled.
23 PATH, Safe Harbors: PATH has an open position for a PATH Outreach Assistant. This position has been posted and interviews are in the process of being scheduled. One staff member for Safe Harbors has been on maternity leave for most of April and May. AMHCM: One CM out on FMLA. One Vacant CM Position and one CM retiring July 1st. External Trainings/Conferences: PACT: Program Manager still participates in a monthly virtual meet-up hosted by the UNC Institute for Best Practices in which issues related to providing ACT services in a pandemic are discussed with PACT providers across the US (and even some in other countries). PACT Program Manager and PACT Supervisor also participated in a virtual meeting with ACT leads from across the state of Virginia to discuss PACT related issues. PACT Manager has participated in the workgroup for Behavioral Health Enhancement regarding ACT. PACT Manager and PACT Supervisor attended a virtual ACT 101 for Leadership training. PATH/Newport News Port & Safe Harbors Permanent Supported Housing: All staff that participate in HMIS data entry have trainings every quarter. PATH staff have webinars on program changes and best practices. Two staff are SOAR trained to assist with Social Security Applications. These two employees have a quarterly training that is attended over Zoom. Community Events/Participation: STEP-VA progress/milestones and other relevant program-specific information: PACT: Behavioral Health Enhancement changes will become effective for ACT on 7/1. This includes changes to DBHDS/Office of Licensing Regulations as well as changes to the reimbursement structure. We will be changing from billing per unit to billing per diem. The most noticeable change to the public will be the name of the program. Previously being called Program of Assertive Community Treatment (PACT) we will now be called Assertive Community Treatment (ACT) which aligns us with the national standard. Clinically, services are essentially the same. During the recent ACT 101 for Leadership training the range of TMACT (Tools for Measurement of Assertive Community Treatment, a fidelity review) scores obtained in Virginia were revealed. Out of the around 8 teams that have been reviewed so far the highest score was 3.94, which is the score our team received! Audits/Reviews: AMHCM: Our last Targeted CM review score was 93.5% PATH: A HMIS (homeless Management Information System) audit was done in April. The Audit scoring was either pass or fail. Homeless Services PASSED! Program Challenges/Significant Issues: PACT: The pandemic continues to restrict our ability to provide the intensity of face to face service that the program typically provides. We have been able to modify services and provide more service via telephone. In October new billing guidelines from DMAS were implemented and this increased our billing. We exceeded our billing targets in April and May for both PACT and
24
PACT Forensic. PACT Forensic was able to increase billing by enrolling over census since there
were several individuals in jail or the hospital for which ACT was still coordinating but not
providing services in the community.
PATH/Newport News Port & Safe Harbors Permanent Supported Housing: Staff are still
very vigilant about taking precautions to assist clients and remain safe as COVID continues. Staff
continuously educates clients on safe behaviors, awareness of the virus and to practice good
hygiene. Limited face to face time is a challenge. More outreach is needed. PATH and Newport
News Outreach are challenged by not having “Walk in Wednesday”. Staff is attempting to provide
services safely and the best way we currently can to meet this fragile population needs.
All PATH/Safe Harbor Staff have been vaccinated.
Crisis Services
Ryan Dudley, Director
Division Goals
Goal 1: Crisis Services’ programs will continually examine service delivery models and work-
flow and, as appropriate, make adjustments to ensure efficient and timely response.
Goal 2: Enhance collaborative relationships with our Stakeholder partners to develop and build
onto sustainable responses to challenges encountered with addressing emergency psychiatric
needs.
Goal 3: Crisis Services will ensure active representation at the local, regional and statewide
levels participating in planning, development and implementation for future models of Crisis &
Forensic Services in Virginia.
Program Overview
Emergency Services (ES) provides 24 hour / 7 days a week assessments, supports, and referral
services for individuals who are experiencing a behavioral health crisis in community settings,
including conducting mandated pre-screening evaluations in order to determine the need for
involuntary hospitalization. ES works very closely with Law Enforcement, Hospitals, Magistrates,
Jails, and other treatment providers and stakeholders. We have maintained a unique partnership
with Sentara Careplex Hospital (SCH) for years providing all behavioral health assessments in
their Emergency Department (ED). Based on increased demands faced by the ES, we have
provided notice of this contract which will end on June 30th.25 Number of Individuals Served/Admissions/Discharges: ES conducted a total of 785 assessments for the months of April and May, including participation in 205 Commitment Hearings. Due to the inability to secure an accepting private psychiatric bed for individuals recommended for involuntary hospitalization prior to the expiration of an Emergency Custody Order (ECO), H-NNCSB had 12 “bed of last resort” admissions to the State Hospital in April and 10 admissions in May. This included 10 incidences during these two months requiring individuals to be diverted to other State Hospitals across Virginia due to lack of beds at Eastern State Hospital (ESH). Additionally, Temporary Detention Orders (TDO’s) to the State Hospital, not reflected above, have been issued and placed on “delayed status” due to the lack of private and state psychiatric beds. This is leading to prolonged stays in the Emergency Dept. (ED), and at times, it has taken some individuals’ days before eventually being placed in a private facility. The scarcity of available psychiatric beds has also been a significant issue for children and adolescents with two (2) admissions to the Commonwealth Center for Children and Adolescents (CCCA) in April and five (5) in May also due to the inability to secure private psychiatric beds. CCCA, the only State Hospital for children and adolescents has operated with 18 beds offline for some time due to staffing challenges. On June 4th, the Commissioner reported that they would be further reducing capacity to 24 beds. Prior to this additional reduction in beds, CCCA has already consistently maintained a wait-list for youth ordered to the facility for treatment having no other available resource from private hospitals. Similar to adults, children and adolescents have experienced significant delays with placement well past TDO’s issued to the State Hospital causing them to remain in the ED as well. As a result, there have also been multiple elopements for both adults and children who have remained in the ED due to these delays. Staff Vacancies/New Hires: The Program continues to recruit for vacancies and hired one new ES Counselor in May with another internal candidate, Centierra Boyd, starting with the program in mid-June. Centierra has worked with the agency for over five years, most recently in Forensic Discharge Planning (FDP). Both our Gina O’Halloran, Program Manager, and Erin Holland, LPC, Clinical Supervisor, continue to do an outstanding job managing the Program’s “around the clock” response as the program continues to navigate very complex situations and lengthy involvement in cases that should not be encountered with the “bed of last resort”. This includes responsiveness around the clock to their staff. Relevant Regional or Council Information: Mrs. O’Halloran and Crisis Director continue to represent the Agency on a number of regional workgroups including: HPRV ES Council, Regional Leadership Operational Guidance Workgroup, Regional Crisis Task Force, Regional Operations Committee and the HPR-V MOT Workgroup. In addition, H-NNCSB coordinates a quarterly Stakeholder’s Meeting to collectively address aforementioned challenges. The next Stakeholder’s Meeting is scheduled for July 20th.
26 Program Challenges/Significant Issues: The absence of available psychiatric beds, including those ordered to be involuntarily hospitalized continues to be a critical issue leading to significant challenges occurring daily. While the pandemic created many challenges with regard to placement and further delay in review and acceptance by psychiatric facilities, many were already encountered routinely in the past and had been nearing critical status. This is also evident by the number of individuals who are not COVID- 19 positive remaining in the ED and in law enforcement custody well past the timeframes mandated in legislation to be served by the State Hospitals. As a result of an inability to place individuals in psychiatric beds, they necessitate Commitment Hearings to occur at “bedside” in the ED without the involvement of the State Hospital or the Dept. of Behavioral Health and Developmental Services (DBHDS) despite being identified as the treating facility in the order. This encumbers tremendous time of ES staff detracting them from other critical activities and extending work days on a case without the ability to provide a resolution; and instead receiving more requests by State Hospitals to continue searching for beds primarily due to the lack of capacity at their facilities. Other significant challenges arise from delayed responses for review of referrals and ongoing requests from ESH to conduct additional statewide bed searches after the individual is ordered to the State Hospital. This practice has led to continual and increasingly difficult challenges with our stakeholder partners causing individuals to remain in the ED and in law enforcement custody, and leading to a tremendous strain in these partnerships for which we are unable to resolve. Leadership within HPR-V continues to seek resolutions from DBHDS regarding their role for individuals who have been ordered to the State Hospital, but for whom there is no bed provided, necessitating Commitment Hearings in the ED due to a lack of placement options. The ES Council has requested support due to a significant drift by ESH from the Regional Protocols, which were established based on the Code of Virginia, as well as the lack of involvement by the State Hospital in this process identified by the Code, but are deferring to CSBs. Regional Crisis Stabilization Center (RCSC) is an 11-bed residential crisis stabilization / ambulatory detox program serving HPR-V and offering an alternative to acute psychiatric hospitalization for individuals experiencing a crisis as a result of behavioral health or co-occurring needs. The multidisciplinary approach offers rapid access for the brief intervention through psychiatry, nursing, therapy, psychoeducation, peer recovery supports, a structured milieu and comprehensive care coordination. Number of Individuals Served/Admissions/Discharges: The Program continues to operate with “Single Room Occupancy” (6-beds) and has been fortunate not to have required closure during the pandemic as many other CSUs have. During May, the program served 26 individuals, 19 from Hampton and Newport News area, and has a 91% occupancy rate based on open beds.
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