* Other includes all segments less than 1% of the total. Negative segments are not shown.
GENERAL SERVICES
CLINICS EXPANSION
The Health Services Agency (HSA) has completed
an extensive remodel at the Emeline Clinic to add
14 exam rooms and completed a remodel at the
Watsonville Health Center to add four exam
rooms. HSA continues to look for opportunities to
expand space and services for the Homeless
Persons Health Project clinic. The services
provided at HSA clinics continue to expand,
particularly around Integrated Behavioral Health
(IBH) services and Medication Assisted Treatment
(MAT) services. IBH services have gone from
approximately 2,500 visits in 2015 to close to 10,000
in 2018 and are continuing to climb. MAT case
management services increased from almost 0 in
2015 to over 1,200 in 2018 and are also continuing
to increase as HSA adds more provider capacity.
BEHAVIOR HEALTH
FIT PILOT
The Focused Intervention Team (FIT) pilot is an
initiative to enhance community safety and move
into treatment high-frequency criminal offenders
funded by Measure G. The FIT Pilot is not an off-the
-shelf public safety or behavioral health program,
but a hybrid drawing from established law
enforcement and behavioral health practices. FIT
Pilot clients are connected with a range of
wraparound services, including medical and food
benefits, housing navigation and more. The
program leverages the resources of existing
community partners including the newly restarted
PACT Court, which also serves as the court for the
Homeless Outreach, Proactive Engagement &
Services (HOPES) program.
PUBLIC GUARDIAN
The county Public Guardian (PG) office is legally
mandated to provide conservatorships to oversee
the care and treatment, or to financially manage an
estate through probate court, for clients who are
gravely disabled. In the last few years, the PG
office has experienced a significant increase in the
need for conservatorships. In addition, many of
HSA's conservatees reside in out-of-County
placements, increasing the time needed for the PG
Deputies and Social Workers to travel to these
placement for visits and case management.
HSA has been working collaboratively with the
Human Services Department and the hospitals to
help support the increased demand for services, as
hospitals struggle with arranging safe discharges
for adults who lack the capacity to care for
themselves. Increasing staffing by 5.0 FTE positions
for this program will help decrease ongoing risk of
abuse or neglect and increase the level of service
for these conservatees who are among the most
vulnerable citizens and aging population
throughout Santa Cruz County.
DRUG MEDICAL ODS
Drug Medi-Cal Organized Delivery System (DMCODS) is a statewide waiver pilot project to test a
new paradigm for the organized delivery of SUD
health care services for Medi-Cal-eligible
customers. Accomplishments in the first year have
allowed HSA to provide an increased range of DMC
services and benefits including early intervention,
outpatient services, intensive outpatient services,
short-term residential treatment, case management,
withdrawal management, recovery maintenance
services, and physician consultation services.
Withdrawal management continues to be a
challenging modality for our system, as the County
does not have sufficient treatment opportunities to
meet the community need. As a result, HSA is
seeking creative solutions, such as contracting with
an out-of county provider to serve County
beneficiaries.
While engaged in service expansion efforts, HSA
has concurrently partnered with the community to
implement cultural shifts to treatment milieus that
more thoroughly meet the diverse needs of our
beneficiary population. Treatment opportunities are
more heavily client-directed under DMC-ODS, with
beneficiaries striving towards accomplishment of
self-identified goals in episodes of varying length
dependent on their medical necessity.
This includes shifting criminal justice mandates to
indicate compliance with the appropriate level of
care determined by the assessment process, as
opposed to the historical practice of prescribing a
set number of days in a specific level of care.
Finally, programs have embraced the harm
reduction continuum model, which creates space
for all beneficiaries to receive care regardless of
their current drug or alcohol use patterns.
ENVIRONMENTAL HEALTH
Environmental Health will be implementing new
State requirements for a higher level of oversight of
Onsite Wastewater Treatment Systems, requiring a
much higher level of data management. This
additional work will be facilitated by the addition of
a Departmental Administrative Analyst and
Administrative Aide, primarily funded through CSA
12, Wastewater Management.
There continues to be a high number of sites
contaminated by past releases of toxic materials. An
additional Resource Planner position will help
address the backlog of known sites and identify
additional sites through more oversight of soil
investigations. This position will be fee-supported.
Environmental Health is also partnering to keep
county water resources safe and sustainable. A
groundwater sustainability study will be completed
by December 2020, and the division is working with
the Resource Conservation District and other
partners to complete additional stormwater capture
and recharge projects.
For additional information please see the full
budget document.
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