Community Mental Health Meeting November 21, 2022

Community Mental Health Board of Chicago
Monday, November 21, 2022 6:00 PM – 8:00 PM (CST)
Please join the meeting from your computer, tablet or smartphone.
https://meet.goto.com/820399293
You can also dial in using your phone.
(For supported devices, tap a one-touch number below to join instantly.)

United States: +1 (872) 240-3212
– One-touch: tel:+18722403212,,820399293#

Access Code: 820-399-293

Agenda
Welcome
Approval of Meeting Minutes
Street Outreach
Administrative updates
Mental Health Service Equity: Access to evening hours
marketing, staff hiring,
Crisis Services (New residents, CARE, CESSA, DHS 590, Walk-ins)
CARF/QIP
OIG Audit Plan
Approved 2023 City Mental Health Budget
Legislation/Referendum
Board operations
Next Regular Meeting:
December 19, 2022

Future meeting topics/Parking lot issues:
What should the experience of city mental health care be? Participant surveys; Counseling on Access to Lethal Means; No-shows; Access to medication/monitoring; Social Supports; Legal issues; Re-entry; Perinatal depression;

***

Exposure to Gun Violence Among the Population of Chicago Community Violence Interventionists
https://www.ipr.northwestern.edu/documents/working-papers/2022/wp-22-12.pdf

BETWEEN A BULLET AND ITS TARGET: STREET INTERVENTION, TRAUMA EXPOSURE, AND PROFESSIONAL IMPLICATIONS
https://www.streetsupport.org/wp-content/uploads/2022/01/BBT-Executive-Summary-10.pdf
https://www.streetsupport.org

Audit & Program Review (APR)
https://igchicago.org/2022/10/19/oig-2023-apr-draft-audit-plan/
https://www.surveymonkey.com/r/APRSurvey2023

OIG Draft Plan to Audit CDPH Mental Health Framework

The City of Chicago Office of Inspector General has posted its draft program audit plan for calendar year 2023 and is seeking comment. One of the programs under consideration for review is the Chicago Department of Public Health Framework for Mental Health Equity. See draft page 11/12. https://igchicago.org/wp-content/uploads/2022/10/OIG-2023-APR-Draft-Audit-Plan.pdf

 Has CDPH implemented the goals outlined in Mayor Lightfoot’s Framework
for Mental Health Equity?
• Does CDPH measure the progress of its mental health equity initiatives to
inform future goals?

Please consider giving feedback to OIG on its review plan and share your recommendations at the board meeting.
Audit & Program Review (APR)
https://igchicago.org/2022/10/19/oig-2023-apr-draft-audit-plan/
https://www.surveymonkey.com/r/APRSurvey2023

2023 Proposed City Budget


2023_Budget_Aldermanic_Book

CDPH One Pagers for Aldermen – Budget Hearing 10/17

Proposed budget amendment:

Amendment of 2023 Annual Appropriation Ordinance by reappropriating salaries from police vacancies to fund Department of Public Health’s mental health crisis response teams to address crises and off load stress on 911 system
Sponsors: Rodriguez Sanchez, Rossana , Sigcho-Lopez, Byron, Taylor, Jeanette B. , La Spata, Daniel , Vasquez, Jr., Andre, Hadden, Maria E. , Ramirez-Rosa, Carlos

https://chicago.legistar.com/LegislationDetail.aspx?ID=5897848&GUID=4B79F424-3E10-46B6-AEB5-299B938B5D2C&Options=Advanced&Search=&FullText=1

Community Mental Health Meeting 10/17/2022

Community Mental Health Board Meeting
Monday, October 17, 2022 6:00 PM (CDT)

Please join the meeting from your computer, tablet or smartphone.

https://meet.goto.com/397561669

You can also dial in using your phone.
(For supported devices, tap a one-touch number below to join instantly.)

United States: +1 (312) 757-3121

  • One-touch: tel:+13127573121,,397561669#

Access Code: 397-561-669

Agenda
Welcome
Approval of Meeting Minutes
Administrative updates
2023 Proposed City Mental Health Budget
Health Center Data
Crisis Services/New residents
Legislation/Referendum
Future meeting topics/Parking lot issues:
What should the experience of city mental health care be? Participant surveys; Counseling on Access to Lethal Means; No-shows; Access to medication/monitoring; Social Supports; Legal issues; Re-entry; Perinatal depression;
Board operations
Next Regular Meeting:
November 21, 2022

04182022_CMHBCdraft

CMHBCMinutes08152022Draft

09192022CMHBCMeetingDraft1Minutesc

Budget Discussion

Review of 2023 proposed Chicago Mental Health Budget – updated 10/27/2022

33 – 2023 Proposed Chicago City Budget Departmental Opening Statements:

https://www.chicago.gov/city/en/depts/obm/provdrs/budget/svcs/2023BudgetHearingOpeningStatements.html

Chicago Mayor’s 2023 City Budget statements
Mayor’s 2023 budget message
2023 Chicago Budget Documents

CDPH section from the 2023 Aldermanic Budget Book
Of all CDPH purchases the year (total): $211,375,951
4.7% went to Minority and/or Women businesses in the first half of 2022.
This is up from 3.9% in 2021 and 2.2% in 2020.
As of September 26, 2022, there were 500 vacant jobs in CDPH.

*******

Questions for the DHR commissioner:
Why did it take almost six months to advertise vacant clinical therapist jobs? Why have you removed the posting for the clinical therapist positions when there are still many unfilled positions?
Why aren’t all vacant CDPH mental health positions currently posted?
What do you do to recruit people to fill direct service clinical positions such as the clinical therapists, psychiatrists, psychologists, etc.?
What’s needed to create a mental health peer recovery support specialist job?
To-date, how much money has the city “salvaged” in 2022 through unfilled mental health service jobs, unfilled CDPH jobs, unfilled city jobs?
Should the city waive the residency requirement to expand the pool of applicants to fill chronically vacant direct service mental health jobs?


No new or additional positions for mental health services are added in the Mayor’s 2023 Recommended Budget.
Clinical therapists recommended for 2023:
The 2023 City of Chicago Mayor’s Recommended Budget includes 56 Clinical Therapist III positions (including one “Clinical Therapist III- Excluded”) distributed across four city departments: Chicago Department of Public Health (CDPH=31), Chicago Fire Department (CFD=2), Chicago Police Department (CPD=22), and Department of Human Resources (DHR=1).

Also continued in 2023 are 5 Mental Health Crisis Clinicians and one Senior Director of Crisis Services.
The 2023 CDPH budget removes one of two Senior Data Entry positions.

*******

From the 2023 Overview Glossary (page 185)

Contractual Services: Comprised of costs incurred related to services provided to the City that are dictated by a contractual agreement, such as information technology or auditing services.

Delegate Agencies: Organizations that provide services on behalf of the City through a grant contract.

So delegate funding through grants (appropriation account 135) is a form of contractual service.

The Glossary doesn’t define Professional and Technical Services (appropriation account 140).

The City Council Office of Financial Analysis (COFA) puts Delegate and Professional and Technical Services together in its fact sheets as Contractual Services (01). Putting these two together, then, contractual services is where most of CDPH money can be found or about 80% (Delegate Agencies 12.4% and Professional & Technical Services 66.8%). Contractual services represent $767M of the 2023 CDPH proposed budget of $964M. By comparison, CDPH Personnel (00) accounts for about 16% or $150M.

Most CDPH funding is going to pay for services performed by nongovernmental entities [whose workers are not required to be city residents].

https://chicagomentalhealth.files.wordpress.com/2022/10/2023proposedcdphbudgetbyaccountsummary.xlsx

**********

What is the relationship between CDPH’s budget by program view and OBM’s Overview of CDPH program budget? Please see attached.

Recently, CDPH introduced a different way of categorizing its funding that’s not in the published budget documents. The proportions in the new categories do not match or add up to the ones found in the published Overview.

It’s not that their new categories are wrong. But CDPH hasn’t shown the money behind the pieces of its new pie.

Their new budget pie shows behavioral health (inclusive of mental health, substance use, and violence prevention) with 13%. But the Overview shows behavioral health with 18% of the budget pie, mental health 7%, and substance use ~1%, for a total of 26%. Which is correct, 13% or 26%?

CDPH hasn’t made public the funds, divisions, sections, accounts, appropriation authorities, titles that make up its new groupings of programs and bureaus.





Community Mental Health Meeting 9/19

Community Mental Health Board of Chicago
Monday, September 19, 2022 6:00 PM – 8:00 PM (CDT)

Please join the meeting from your computer, tablet or smartphone.

https://meet.goto.com/281083269

You can also dial in using your phone.
(For supported devices, tap a one-touch number below to join instantly.)

United States: +1 (872) 240-3412

  • One-touch: tel:+18722403412,,281083269#

Access Code: 281-083-269

Agenda
Welcome
Approval of Meeting Minutes
Administrative updates
2022 and 2023 City Mental Health Budget
Delegate agency services
Crisis Services/New residents
Legislation/Referendum
Suicide
Upcoming meeting topics:
What should the experience of city mental health care be? Participant surveys; Counseling on Access to Lethal Means; No-shows; Access to medication/monitoring; Social Supports; Legal issues; Re-entry; Perinatal depression; Board operations
Next Regular Meeting:
October 17, 2022

***************************

Hello Monday’s meeting participants,

Thank you for attending the meeting.  I apologize that we did not discuss delegate agency services, new residents, legislation, or suicide prevention. We need more comments on the budget.

It is suicide prevention month.

https://chicagohealthatlas.org/indicators/VRSU?topic=suicide-mortality

CDPH budgeted $1M CARES ACT – CDBG grant funds for Suicide Prevention in 2020. Obviously, the funds came after the beginning of 2020. The funds were not spent in 2020 but carried over to 2021. The same $1M was appropriated in the 2021 CDPH budget. These funds were again rolled over to 2022.

There was also $70K under an Narcan/Opioid Prevention in 2021 for Zero Suicide [280W 0Y94 Zero Suicide 70,000]

There is a Chicago Collaborative of Bullying and Suicide Prevention (CCBSP).

https://www.chicago.gov/city/en/depts/cdph/supp_info/violence_prevention/bullying-and-suicide-prevention.html

Habilitative Systems, Inc has the grant to use the CARES ACT funds (up to $1M). Attached is an excerpt from the HSI contract work plan.

March 2022, TICC delegate agencies were informed about an IDPH virtual training held in April: Assessing and Managing Suicide Risk (AMSR).

https://sprc.org/resources-programs/assessing-managing-suicide-risk-core-competencies-mental-health-professionals

https://solutions.edc.org/solutions/zero-suicide-institute/amsr/curricula/amsr-outpatient

https://dph.illinois.gov/topics-services/prevention-wellness/suicide-prevention.html

Question: Was information about the training given to CDPH mental health center staff? Did any CDPH staff take advantage of the training? We have previously asked whether CDPH clinicians are trained to screen for and discuss access to lethal means.  Why not share information about educational programs with the public?

Crisis Services/New Residents

How is the Department helping new residents recently arrived from Texas? Reportedly a help center was set up by OEMC at the North River complex. Is CDPH reaching out to help?

Legislation. 

It was suggested that we formally support the #TreatmentNotTrauma referendum and the city council ordinance proposal for non-police involved mobile crisis response programs. https://chicago.legistar.com/LegislationDetail.aspx?ID=5734017&GUID=A73A7FAD-DEC8-4803-8E3C-CDB7E296B40A&Options=Advanced&Search=

C4 and 988 Regional Crisis Call Hubs.

Vibrant (a nonprofit) has the call center contract with C4.  IDHS gave some additional SAMSHA funds to C4, but only because C4 already had a contract with Vibrant.

https://www.samhsa.gov/newsroom/press-announcements/202106161430 https://www.dhs.state.il.us/page.aspx?item=143353

There continue to be questions about how 988, 911 and CESSA, and Chicago’s CARE Team connect or don’t. I’m not sure where the narrative is coming from that it will take five (5) years for these connections to be realized.

The most recent CESSA Statewide Advisory Committee meeting recording has been posted. A description or overview of how the pieces are supposed to fit together can be found there.
https://illinois2.webex.com/recordingservice/sites/illinois2/recording/0f0c23fe14f3103bbafd1a71bbefc3ce/playback

There is a meeting tomorrow. https://www.dhs.state.il.us/page.aspx?item=146282

Similarly, the Cook County Alternate Response Task Force meetings cover this, too.
https://cook-county.legistar.com/DepartmentDetail.aspx?ID=48025&GUID=1A558E0C-5C78-4E42-807A-B3DF40D418DF

Presentation documents are accessible here:
ALT-HIR Task Force
https://app.box.com/s/g7nmg5kypz9fcjcd94qlqxdj7o8evqzk

For your information and review:

FY22 Q1-2 Dashboard Delegate Agency Mental Health Services

https://app.box.com/s/wnr1l54p7m7yeslg4gaq37cg8kcp8j74

Community Mental Health Meeting 8/15

Community Mental Health Board of Chicago Meeting
Monday, August 15, 2022 6:00 PM (CDT)

Please join the meeting from your computer, tablet or smartphone.

https://meet.goto.com/812498629

You can also dial in using your phone.
(For supported devices, tap a one-touch number below to join instantly.)

United States: +1 (872) 240-3212

  • One-touch: tel:+18722403212,,812498629#

Access Code: 812-498-629

Agenda
Welcome
Approval of Meeting Minutes
Brief mention:
2023 Chicago Budget
Administrative updates
Delegate agency services
Mayor’s CCMHE
Follow up public health response to violence discussion
Joint Committee: Health and Human Relations; Public Safety

Discussion of City’s crisis response system: coordination between 988, 911, Crisis Assistance Response and Engagement (CARE), State crisis services, CESSA, Cook County Alternative Response, and mental health services

Upcoming meeting topics:
What should the experience of city mental health care be? City of Chicago 2023 Budget; Participant surveys; Counseling on Access to Lethal Means; No-shows; Access to medication/monitoring; Social Supports; Legal issues; Re-entry; Perinatal depression; Board operations
Next Regular Meeting:
September 19, 2022

Crisis Assistance Response and Engagement (CARE) Team Dashboard

Illinois 988 FAQs – August 2022 Edition

CESSA statewide advisory committee meeting

Cook County Alternative Health Intervention & Response Task Force

Some Chicago aldermen are have drafted a proposal for an ordinance on gun safety

Mental Health Clinic Encounter Stats graph

Community Mental Health Meeting July 18, 2022

Community Mental Health Board of Chicago Meeting
Monday, July 18, 2022 6:00 PM

Please join the meeting from your computer, tablet or smartphone.
https://meet.goto.com/638918629
You can also dial in using your phone.
(For supported devices, tap a one-touch number below to join instantly.)
United States: +1 (872) 240-3412

  • One-touch: tel:+18722403412,,638918629#
    Access Code: 638-918-629

Agenda
Welcome
Approval of Meeting Minutes
Discussion of CDPH Violence Prevention Activities with Marlita White,
Director of the CDPH Office of Violence Prevention
Administrative updates: Staff vacancies/CDPH hiring plan; Service expansions; Outreach; CARE Team
Quality/Access Issues: CARF; Access to laboratory services; After Hours Calls/Crisis Services; Individual Counseling; Utilization Report; Psychological testing
Delegate agency services
Mayor’s group
Upcoming meeting topics:
What should the experience of city mental health care be? CDPH and 988 and Chicago’s Crisis Response System; City of Chicago 2023 Budget; Participant surveys; Counseling on Access to Lethal Means; No-shows; Access to medication/monitoring; Social Supports; Legal issues; Re-entry; Perinatal depression; Board operations
Next Regular Meeting:
August 15, 2022

04182022_CMHBCdraft
https://chicagomentalhealth.files.wordpress.com/2022/06/04182022_cmhbcdraft.pdf

Encounters2018toDateMay2022
https://chicagomentalhealth.files.wordpress.com/2022/07/encounters2018todatemay2022.pdf

SummaryNAMIReferrals
https://chicagomentalhealth.files.wordpress.com/2022/07/summarynamireferrals.pdf

IndividualCounselingSessions2022May
https://chicagomentalhealth.files.wordpress.com/2022/07/individualcounselingsessions2022may.pdf

PhysicianAPNVisits2022May – corrected 7/19/2022
https://chicagomentalhealth.files.wordpress.com/2022/07/physicianapnvisits2022may.pdf

JulyPsychiatrySchedule2022
https://chicagomentalhealth.files.wordpress.com/2022/06/julypsychiatryschedule2022.pdf