The STAY (Serving Transitional Age Youth) is an innovative program designed to address the needs of the San Bernardino County’s diverse Transitional Age Youth (TAY, age 18 up to 26) population who are experiencing an acute psychiatric episode or crisis and are in need of a higher level of care than board and care residential, but a lower level of care than psychiatric hospitalization. The STAY is a short term, 14-bed crisis residential treatment center that provides up to a 30 day stay for TAY with or without Medi-cal. The facility is the only center of its kind in the state, funded by Proposition 63. The STAY is open 24 hours a day, 365 days a year for voluntary admissions. Program participant’s benefit from residential, case management, connections to TAY housing, education, healthcare, community and mental health services designed to meet their specific needs.
The STAY was developed in response to stakeholders concerns around the lack of specific crisis stabilization programing for TAY. The STAY fills this need by providing a peer designed/supported, culturally and linguistically appropriate TAY based crisis stabilization program. Valley Star Children and Family Services, Inc. is the contracted agency that provides program services. Attached are some pictures and legacy stories of transitional age youth that have benefited from the STAY.
Office of Cultural Competency and Ethnic Services
The San Bernardino County Department of Behavioral Health’s Office of Cultural Competence and Ethnic Services (OCCES) is responsible for developing, implementing, and monitoring cultural competency throughout all levels of the organization. Services include: multicultural education and training, coordination of language services such as translation and interpretation, as well as assistance and consultation in the development of linguistically and culturally appropriate, recovery oriented services.
OCCES has a community-driven Cultural Competency Advisory Committee (CCAC) with twelve (12) culture-specific sub-committees. These advisory groups engage in policy advocacy, develop trainings and conduct outreach activities by recruiting members of the community. Members attend scheduled forums to address the needs of their community and develop strategies to address those needs. This community outreach and engagement approach assists DBH in designing program and services that are community driven, and culturally informed. The subcommittees comprises of community members, stakeholders, staff from various county departments, faith based organizations, and school reps. All subcommittees meet on a monthly basis, and in between as needed. The following are the names of the community-driven CCAC sub-committees:
• Asian/Pacific Islander Awareness Sub-committee
• Co-Occurring and Substance Abuse Awareness Committee (COSAC)
• Disabilities Awareness Subcommittee
• African American Awareness Sub-committee
• Consumer and Family Member Awareness Subcommittee
• Latino Awareness Subcommittee
• Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) Awareness Sub-committee
• Native American Awareness Committee
• Spirituality Awareness Sub-committee
• Transitional Age Youth (TAY) Awareness Sub-committee
• Veteran’s Awareness Sub-committee
• Women’s Awareness Sub-committee
These committees have played an integral part in the development of various proclamations that have been adopted by the Board of Supervisors in San Bernardino County. Each proclamation is themed around mental health awareness. To see the work done by these committees please check out the Customs, Heritage, Ancestry, Nationality, Gender, Equality (CHANGE) Newsletter
Homeless Outreach Support Team
The San Bernardino County Department of Behavioral Health’s (DBH) Homeless Outreach Support Team (HOST) and Housing and Employment Programs, in collaboration with the Housing Authority of the County of San Bernardino (HACSB), receive funding from the Department of Housing and Urban Development (HUD) to assist homeless individuals with mental illness and their families into permanent supportive housing under the Homeless Assistance Shelter Plus Care grant. HACSB is the primary recipient of the HUD funding and provides the housing vouchers. DBH staff provides service match in the form of wrap around case management services. HOST is an outreach based program providing services in the field to engage those chronically homeless individuals with mental illness into permanent supportive housing. HOST collaborates with the Sheriff’s Homeless Outreach Proactive Enforcement (HOPE) team to conduct outreach events, go out into the field, and engage the most difficult and hard to reach clients. HOST staff works with qualified individuals to complete the necessary applications and assessments in the field and, upon receipt of housing voucher, will assist the individual to locate and move into housing. HOST continues to offer recovery-based wrap around case management services to the individual to assist them to recover, gain wellness, become resilient and reintegrate into the community with the ultimate goal of independence and self-sufficiency.
Recovery Based Engagement Support Teams (RBEST)
The San Bernardino County Department of Behavioral Health’s (DBH) Recovery Based Engagement Support Team (RBEST) project is an Assisted Outpatient Treatment alternative that began October of 2014, and is funded by Mental Health Services Act (MHSA) as an Innovation Project. MHSA Innovation Projects allow Mental Health Plans (MHP), such as DBH, to test, evaluate or determine new, creative or novel approaches to behavioral health care. The RBEST project provides community (field-based) services throughout San Bernardino County for those individuals living with mental illness who are not engaged in medically necessary psychiatric care in an effort to voluntarily “activate” the individual into the behavioral health system to receive appropriate services. The multi-disciplinary nature of the engagement teams presents a holistic approach to the needs of consumers and their families. In an attempt to mirror Laura’s Law, RBEST works on an inclusionary basis, eliminating program qualifiers that may act as a barrier to individuals participating in necessary care. It should be noted that consumers that participate in RBEST still meet medical necessity criteria for Specialty Mental Health Services (SMHS), but that the structure of the program is non-traditional in its approach. The RBEST program response is fluid and changes it’s parameters in real time to best serve the consumer where ever they are. It does not require consumers to come anywhere, go through any structured clinic or program based steps, is provided in the field, has a heavy focus on transportation and assisting individuals navigating the public systems that are meant to assist them with basic needs. The program also heavily focuses on consumer support systems, specifically families and care givers of individuals living with mental illness, and is similarly flexible. Services are provided in the field, in homes, in homeless shelters, and issues being addressed are specific to that family, their loved ones needs, and building capacity within the supportive structure to understand, navigate, and successfully access the systems in place meant to support both family members, and their loved one. From October 2014 through May 2015, 300 individuals were served in RBEST, with an expectation that approximately 300 individuals will be served per year.
Workforce Education and Training – Remote Group Supervision for Rural Intern Placement
San Bernardino County is the largest county in California and the nation at 20,105 square miles. It is slightly larger than the states of Connecticut, Delaware, New Jersey, and Rhode Island combined. As the Mental Health Plan, the Department of Behavioral Health provides behavioral health services throughout the county to individuals with Medi-Cal, some types of Medicare and individuals who are uninsured.
San Bernardino County Department of Behavioral Health (DBH) is committed to the “Grow our Own” model. The Employee Educational Internship was created to encourage current employees to pursue their educational pursuits to become clinicians. The program offers qualified DBH employees an opportunity to enroll in a part-time educational internship program leading to a Master of Social Work or Marriage and Family Therapy or related degree. This program allows employees to participate in a field placement (internship) within the department while working full-time for DBH.
The Remote Group Supervision for Rural Intern Placements Program was a pilot program created to address placement challenges in rural community behavioral health settings. The purpose of the program is to alleviate long distance travel for an intern to attend weekly group supervision and allow her to complete her education to be a clinical therapist in a location that traditionally has recruitment challenges. An employee intern, a person that works for the Department of Behavioral Health (DBH) that is allowed to participate in field placement while working full-time in DBH, was placed at a rural mental health clinic – Needles Behavioral Health Center in Needles, CA – that was up to a 4 hour drive to the group supervision location – Training Institute in San Bernardino, CA.
To attend the weekly group supervision, the intern would log into Microsoft Lync from Needles. Microsoft Lync is a web-based program that allows visual connection of remote locations via the internet. Using the web camera, the intern was able to able to fully participate in the discussion. Using this web-based technology complimented the intern’s online graduate school program.