2008uaeport - Dutchess County

Transcription

2008 uaeport
Department of Mental Hygiene
“We Care For Our Community”
A Message From
County Executive
William R. Steinhaus
Message from the County Executive
The Dutchess County Department of Mental Hygiene’s 2008 Annual Report tells a story of
the thousands of residents, who are dealing with issues of mental health, substance abuse
and/or developmental disabilities, being served with dedication and commitment by our county
employees and agency partners.
The strong partnerships that have developed among the employees of the Department of Mental
Hygiene (DMH) as they collaborate with other County Government departments and community
partners have resulted in programs and services that efficiently and effectively serve the needs
of our community.
DMH employees continually strive for quality improvements to assure excellence throughout
each of the DMH units. As you read through this annual report, you will clearly see the how this
quest for excellence pays off in the services delivered to our residents.
Thank you to Dr. Kenneth Glatt, the entire staff of the Department of Mental Hygiene and our
contract agency partners for all of their efforts on behalf of the residents of Dutchess County.
With best wishes,
Dutchess County Executive
Message From The Commissioner
"In 2008, the Department of Mental Hygiene, with
another no-growth budget--the 8th in as many years-continued to refine Dutchess County's mental hygiene
system and to improve the way services are delivered
to the mentally ill, chemically dependent, and developmentally disabled citizens of our county. Of necessity,
we have become more efficient; we hold our contract
agencies to high standards of accountability; and we
remain steadfast in our commitment to continuous quality improvement."
As I recollect and reflect upon the Department's accomplishments this past year, we have much to be
proud of, and here are just a few of them: the inauguration of a Corporate Compliance Hotline; the relocation
of the Millbrook Continuing Treatment Center to a beautifully renovated Eastern Dutchess Government Center;
the latest effort of our Integrative Treatment Team to develop policies and procedures for implementing drug
screenings in the mental health clinics; the replacement of a shared-staff nurse in the Clinic for the Multi-Disabled;
and the satisfaction of knowing that all of our units are now using Anasazi for demographics, assessments, and
progress notes, as we move toward Phase IV (treatment plans)--the last phase in the transition from paper to an
electronic record. In addition, many thanks must go to the HELPLINE staff for being instrumental in the rescue
of suicidal individuals from the five Hudson River bridges where hotlines have been installed. Finally, in 2008,
with Saint Francis Hospital's psychiatric units full most of the time, necessitating the transfer of over 30 persons
a month to other hospitals, we began establishing predischarge planning processes at the hospitals that receive
the most patients.
There will be challenges for us in the coming year: we must expand the Department's Pre-Release Planning Program in order to ensure that Dutchess County residents who are transferred for psychiatric inpatient
treatment to hospitals outside the county receive the same kind of discharge planning services as they would
have received from the Department had they been able to be treated locally. We also hope to expand successful
programs in the criminal justice system; to strengthen the support services infrastructure which has been severely
taxed over the past decade of no-growth budgets; and to better coordinate services to the elderly and youth of
our community.
Bearing all of this in mind, I salute the professionalism, dedication, talent, and flexibility of Department
staff--support, clinical and administrative--of whom I'm very proud and who serve Dutchess County with distinction.
Kenneth M. Glatt, Ph.D., ABPP
Commissioner
2008
Annual Program Report
Dutchess County
Department of Mental Hygiene
"We Care For Our Community"
Administration
230 North Road
Poughkeepsie, New York 12601
•
Vision
The Department of Mental Hygiene,
in fulfilling its commitment to insure
high quality patient care to the citizens of Dutchess County,
will continue to improve, refine and expand
the mental hygiene system so that all in need have access to
prevention, treatment, and rehabilitation services.
•
County Executive
Kenneth M. Glatt, Ph.D., ABPP
Commissioner of Mental Hygiene
Dutchess County
Community
Mental Health Center
Dutchess County Mental Health Center
2008
County Legislature
Family & Human Services Committee
Barbara Jeter-Jackson, Chairman
Alison MacAvery, Vice Chairman
Angela Flesland
Suzanne Horn
Marge Horton
Dan Kuffner
Steve White
ii
2008
Members
Dutchess County Mental Hygiene Board
(Dutchess County Charter)
Dutchess County Community Services Board
(New York State Mental Hygiene Law)
Dutchess County Community Mental Health Center Board
(Federal CMHC Legislation)
Frank Falanga, Chair
Almerin O'Hara,Jr., Vice Chair
Susan Blodgett, Secretary
Joyce Carter-Krawczyk, LMSW
Isaac Rubin, Ph.D.
Falisia Cotten, LCSW
Paula Sarvis
James H. Warner, III
E. Mark Stern,
James J. Fealey
Ed.D., ABPP
Aviva Kafka
Aviva Kafka
Suzanne Manning, LCSW
Jennifer L. Rowe, Ph.D.
Carl Needy, MD
James R. Kelly
iii
Table of Contents
Page
2008 - HIGHLIGHTS OF THE YEAR.....................................................................................................1
Organization/Administration.................................................................................................................10
Organizational Chart............................................................................................................................ 11
Service Network Map...........................................................................................................................12
Service Report......................................................................................................................................13
Volume of Patient Services..................................................................................................................17
Demographic Characteristics...............................................................................................................18
Sources of Referral..............................................................................................................................19
Admissions By Residence Area...........................................................................................................20
Cost of Services - 2007........................................................................................................................21
Sources of Revenue - 2007..................................................................................................................22
Office of Community Consultation & Children's Services....................................................................23
Division of Mental Health Services.......................................................................................................34
Services for the Elderly........................................................................................................................40
Division of Chemical Dependency Services.........................................................................................44
Division of Developmental Disabilities Services...................................................................................51
Office of Quality Improvement..............................................................................................................55
iv
HIGHLIGHTS OF THE YEAR - 2008
LEADERSHIP TRAINING
"Discipline" was the subject presented on
January 14 as part of the Department's Leadership
Training Series. The Presenter was Keith Byron from
the County Attorney's Office. Keith explained the
process of discipline of county employees, including
(a) Proper documentation of poor performance; (b)
Discipline letters; (c) How and when to involve the
County Attorney; and (d) Personnel action. The goal
of the leadership program is to train staff who would
like to be supervisors/administrators in the future.
Award participants: Betsy Brockway, Director, Dutchess
County Health & Human Services Cabinet; Bill Johnson;
Margaret Hirst; Elaine Trumpetto, Executive Director,
CAPE.
HISTORICAL LECTURE
Dr. James Regan, an Associate Professor at
Marist College and former Executive Director of Hudson River Psychiatric Center, educated his audience
with a visual presentation on "De-Institutionalization:
A Historical Perspective on the Good, the Bad, and
the Ugly." The session was held on February 29 and
covered mental health treatment from the 1800's to
present day practices.
At the session: Seated, l-r:: Keith Byron; Bonnie Scheer,
LCSW, Director of Community Services. Standing, l-r:
Cristy -Joy Rose, Senior Program Assistant, Poughkeepsie
Continuing Treatment Center; Ellen Marx, Psy.D., Psychologist II, Poughkeepsie Continuing Treatment Center; Olga
Mirabilio, Support Services Manager.
CAPE HONORS HIRST
Margaret Hirst, LCSW, Division Chief, Chemical Dependency Services, and Bill Johnson, STOPDWI Coordinator, received "Power of Prevention"
Awards at the Annual Meeting of the Council on
Addiction Prevention & Education, Inc. (CAPE). The
event took place on April 4 at Christo's Catering in
Poughkeepsie.
1
At the lecture: Dr. Regan is shown with Jane O'Bien,
RN, (center), Community Mental Health Nurse, Millbrook
Continuing Treatment Center and Jane Amsden, LCSW,
Hudson Valley Mental Health, Inc.
HEALTH FAIR
AGENCIES MEET
Shoppers at Poughkeepsie Plaza Mall stopped
at the DMH exhibit at a Health Fair which took place on
Saturday, February 9. Representing the Department
were Kathleen Spencer, RNC, Quality Improvement
Coordinator and Holly Greer, LCSW, Vocational/Educational Coordinator.
A Multi-Agency Focus Group, composed of
representatives from several local agencies, meets
periodically at the Mental Health Center to discuss
cases which require multiple services and, therefore,
cross agency jurisdictions. On January 29, the group
met to discuss needs of adults. On April 29, a focus
group discussed services for children.
Group on adult needs, l-r: Frank DeSiervo, LCSW, Division Chief, Mental Health Services; Robert Allers, Commissioner, Department of Social Services (DSS); Patricia
Evans, Protective Services for Adults, DSS; Dave Barnier,
Protective Services for Adults, DSS.
Visitors at booth: Mary Babcock, LCSW, Clinical Unit Administrator, Clinic for the Multi-Disabled, stopped by with
her daughters Sarah (left) and Olivia.
INTERVIEWS WITH CGR
For much of 2008, the Center for Governmental
Research (CGR) conducted interviews with both DMH
staff and contract agency personnel. The intent of
the project was to improve efficiencies and increase
effectiveness. The completed report commended
the Department on its high quality of care and also
offered suggestions on improvements in organizational
structure and delivery of services.
Focus on children: Seated, l-r: Maryanne Maruschak, DSS;
Kathy Jamison, CASA, New York Connects; Linda Lurie,
CASA; MaryKaye Dolan, Office for the Aging. Standing,
l-r: Alan Lowitz, NYS Office of Children & Family Services;
Bonnie Scheer, LCSW, Director, Office of Community
Services.
ALCOHOL AWARENESS MONTH
Conducting an interview: Maria Aayob, Senior Research
Assistant and Donald Pryor, Ph.D., CGR Project Director,
interviewed Benjamin S. Hayden, Ph.D, Division Chief,
Developmental Disabilities Services, on January 29.
During April, Alcohol Awareness Month in
Dutchess County, the Department's Office of Communications is involved in numerous public awareness
events to educate the community about the physical
and social ramifications of alcohol abuse. Advertisements appeared in local media publications, and billboards were located in various sections of the county.
Radio spots, recorded by Commissioner Glatt, ran on
the following stations: Lite, Kiss, K104 and WBPM
during the month.
2
MHA HONORS DESIERVO
Frank DeSiervo, LCSW, Division Chief, Mental
Health Services, was presented with the Winfield B.
Van Bramer Award at the Annual Meeting of Mental
Health America of DC, Inc. (MHA). The event took
place on May 9 at the Poughkeepise Grand Hotel. Presented by MHA Executive Director, Jacki Brownstein,
the award recognizes those who have made significant
contributions to community mental health services in
the county and to the MHA. Mr. Van Bramer was one
of the pioneers of community mental health services
in Dutchess County and served on the original MHA
Board of Directors in 1954, remaining on the Board
until 1980 when he became an honorary member.
Billboard in Poughkeepsie: Located at the intersection
of Salt Point Turnpike and Innis Avenue, the sign reads:
"Drinking Too Much? If Others Think You Are, You Are."
AGENCY DISPLAYS
Educational displays by local agencies are
featured at the Poughkeepsie Galleria's Center
Court during the first week of "May Is Mental Health
Month." This first week of the month is also observed
as "Children's Mental Health Week" and "Suicide
Prevention Week."
ART EXHIBIT
"Celebration of the Arts," an exhibit by artists
of DMH, was held from May 21 (Opening Reception)
through August 29 at the Mental Health America Gallery on Mansion Street in the City of Poughkeepsie.
According to Theresa Monte-Caruso, Recreational
Therapy Assistant, Poughkeepsie Continuing Treatment Center, many of the 18 works of art were sold
"which is a wonderful experience for the patients."
At the Galleria: Isaac Rubin, Ph.D., a member of the
Dutchess County Mental Hygiene Board and National Alliance for the Mentally Ill (NAMI); Cheryl Begor, Office of
Community Services; Charles Flynn, President of NAMI and
also representing Taconic Resources for Independence,
Inc., one of the agencies represented at Center Court.
At the Art Show Reception: Seated, l-r: Nate Milligan, Mental Health America; Patricia Guercio, Southern Dutchess
Continuing Treatment Center; Jacki Brownstein, Executive
Director, Mental Health America; Dave Crabtree, Poughkeepsie Continuing Treatment Center. Standing, l-r: Frank
DeSiervo, LCSW, Division Chief, Mental Health Services;
Tia Lattrell, Millbrook Continuing Treatment Center; Kelly
Bilyou, Rhinebeck Continuing Treatment Center; Theresa
Monte-Caruso; Dr. Kenneth M. Glatt, Commissioner.
3
PREVENTION MESSAGE
SERVICE AWARDS
The Department's Suicide Prevention campaign continued through the first week in May, with
advertisements and several billboards featured. The
billboard shown is located on the corner of Main Street
and Clinton Square in the City of Poughkeepsie.
At the Spring Meeting of the entire staff, which
was held on May 16 from 3-5 PM at the Mental Health
Center, several staff were presented with awards for
service by Commissioner Glatt.
Billboard display: "Anxious? Depressed? Suicidal?
We're Here for You! DUTCHESS COUNTY HELPLINE
1.877.485.9700 Toll-Free 24/7 Dutchess County Government Cares"
Service Recognition: Seated, l-r: Theresa Monte-Caruso,
30 Years; Terry Stuart, 20 Years; Beth Alter, LCSW, 20
Years. Standing, l-r: Karen Trokan, LCSW, 20 Years; Dr.
Glatt; Linda Monkman, LCSW, 20 Years. Not pictured:
Alan Humphrey, LCSW, 35 Years;
VASSAR HEALTH FAIR
CRAFTS GALORE!
Educational materials were handed out to
employees at Vassar Brothers Medical Center during
their 10th Annual Employee Wellness Fair, "Celebrate
Health," which took place on May 13 in the Joseph
Tower Auditorium from 10 AM to 4 PM.
Celebrating Health: Seated: Carol Clifford, RN, DMH
Special Services Team. Standing, l-r: Center Employees:
Lynne Higgins, R-PA-C; Eileen Heckle; Nancy Wills, RN;
Pat Sullivan.
"Spring Fever," featuring many craft items for
sale, was conducted by staff and patients from Millbrook Continuing Treatment Center. The event was
held on May 16 from 10 AM to 3 PM in the Cafe at
North Road, prior to the DMH Semi-Annual Meeting.
4
At the sale, l-r: Roz Shankman, Mental Health Services;
Donna Lehnert, Commissioner's Office; Cheryl Specht,
Dutch Treat Cafe; Tonya Clifford, Office of Information
Technology; Sue Costa, Office of Information Technology;
Emilie Klump, Millbrook Continuing Treatment Center.
ORIENTATION
An Orientation to DMH Services was presented
to new employees at a session held on June 25 at the
Mental Health Center. It was the first showing of the
new program, which is a Power Point presentation
featuring over 100 images. The project was produced
by MaryAnn Lohrey, MS, Communications Director
and Kelle Farinacci, Support Services Assistant. On
October 20, the presentation, with further updates,
was shown to the members of the Dutchess County
Mental Hygiene Board.
Blood pressure checks: Sue Haight, RN, checks blood
pressure for Peter Idema, a former Supervisor of the Town
of East Fishkill and currently a volunteer for the Retired
Senior Volunteer Program (RSVP).
ANASAZI TRAINING
A comprehensive training program on DMH's
Anasazi Software System (Train the Trainer) for selected staff took place from 9 AM to 5 PM on July 9
and 10 at the Mental Health Center. The focus was on
Treatment Plans, Progress Notes and Billing Issues.
The trainings were under the direction of Robin Trush,
an Anasazi Project Manager, who came to DMH from
the headquarters in Phoenix, Arizona.
Principal assistance: Presenting the new Orientation Program were Chris Herriman, Microcomputer/ Word Processing Support Assistant, Office of Information Technology;
Kelle Farinacci; MaryAnn Lohrey.
SCREENINGS FOR SENIORS
Blood pressure screenings proved to be a
popular service at the Office for the Aging's (OFA)
picnic for seniors which was held at the Whortekill
Rod & Gun Club, Town of East Fishkill, on August 7.
Administering the tests was Sue haight, RN, Southern
Dutchess Continuing Treatment Center. MaryAnn
Lohrey, MS, Communications Director, hosted a
table of literature and other handouts for the seniors.
This event was one of a series held in various towns
throught the summer and sponsored by OFA.
5
At the trainings, l-r: Ben Fassett, Programming and Operations Supervisor, Office of Information Technology;
Brian Palmer, Director, Office of Information Technology;
Betty Picciuolo, Community Mental Health Aide, Rhinebeck
Continuing Treatment Center; Eunice Skelly-Senatore,
LCSW, Clinical Unit Administrator, Hedgewood; Robin
Trush; Kelle Farinacci, Support Services Assistant, Mental
Health Services; Kathleen Spencer, RNC, Quality Improvement Coordinator; Christine Manning, LCSW, Clinical Unit
Administrator, Special Services Team.
RECOVERY MONTH
Inc., Office of Veterans Services, Youth Services Unit,
and units of the Departments of Health, Probation &
Community Corrections, and Social Services.
In observance of September--National Alcohol
& Drug Addiction Recovery Month--a billboard was
designed and installed at several locations throughout the county, and advertisements were placed in
the weekly newspapers. On September 26, DMH
cosponsored a conference with the Council on Addiction Prevention & Education, Inc. and The Turning
Point entitled "The Treatment of Alcohol, Tobacco and
Other Drug Addictions: An Evidence-Based Model
featuring Motivational Interviewing as well as Theory
and Application."
At the Open House: Standing, l-r: Frank DeSiervo, LCSW,
Division Chief, Mental Health Services; Betsy Brockway,
Director, Dutchess County Health & Human Services Cabinet; Christine Blossy, NPP, Millbrook Continuing Treatment
Center; Maryann Dunn, LCSW, Millbrook Continuing Treatment Center; Tracey Osetek, Millbrook Continuing Treatment Center. Seated, l-r: Tia Lattrell, Millbrook Continuing
Treatment Center; Mark Henderson, LCSW, Poughkeepsie
Continuing Treatment Center; William Cusack, LCSW,
Millbrook Continuing Treatment Center; Joann Mizzi, RN,
Millbrook Continuing Treatment Center.
Billboard on North Hamilton Street in the City of Poughkeepsie.
EXPO 2008
MD HONORED
The Culinary Institute of America's 17th Annual
Wellness Expo took place on September 15 from 11
AM to 3:30 PM at the Route 9 campus.
The life of Jaime Rodrigues-Tellez, MD, Clinic
for Multi-Disabled, was profiled in a 2008 edition of the
Mid-Hudson Psychiatric Society's newsletter. Born
in Bogota, Colombia, Dr. Rodriguez has enjoyed an
illustrious career in psychiatry, having begun here
with a residency at Hudson River Psychiatric Center
in 1964. In 1998, he was named a Distinguished Life
Fellow of the American Psychiatric Association. Dr.
Rodeiguez has served on the Executive Council of
Mid-Hudson since 1980, in various capacities.
OPEN HOUSE
Several Department staff attended the official
opening of the Eastern Dutchess Government Center in Millbrook on October 21. Refreshments made
by the staff and patients at the Millbrook Continuing
Treatment Center were served at the Open House,
which was held from 5-7 PM. Other agencies in
the newly renovated facility include: Hudson Valley
Mental Health, Inc., Lexington Center for Recovery,
Students at the DMH Booth: Nick Marquez, Baking & Pastry, and Rise Namiki, Culinary Arts, visit with Carol Clifford,
RN, Special Services Team.
6
WELLNESS FAIR
LEGISLATIVE EVENTS
The McCann Center at Marist College was alive
with students at their Annual Wellness Fair, held on
September 12 from Noon-4 PM. Kathleen Spencer,
RNC, Quality Improvement Coordinator, and MaryAnn
Lohrey, MS, Communications Director, represented
the Department, answering questions and handing
out brochures.
Two local New York State legislators, Assemblyman Joel Miller and Senator Steve Saland, hosted
Health Fairs on September 13. Assemblyman Miller's
Annual Health Fair took place at the Poughkeepsie
Galleria from 11 AM to 3 PM. Senator Saland's 17th
Annual Golden Gathering was held at Arlington
High School in LaGrangeville from 9:30 AM-12:30
PM. Both events featured entertainment, health
testing and informational tables. The Department
was represented at the two events by Holly Greer,
LCSW, Vocational/Educational Coordinator; Kathleen
Spencer, RNC, Quality Improvement Coordinator;
Carol Clifford, RN, Special Services Team; MaryAnn
Lohrey, MS, Communications Director.
Students visit the DMH Booth: Gillian Kape, Westfield
New Jersey (left) and Lauren Tillotson, Islip, Long Island
(right).
OMH AUDIT HELD
Key staff gathered at 230 North Road on
September 18 to discuss issues pertaining to an audit
of the Poughkeepsie Continuing Treatment Center.
Conducting the review were Frank Barr and Roseanne Avila from the New York State Office of Mental
Health.
MaryAnn Lohrey greets Senator Saland at the DMH
booth.
UNITED WAY CAMPAIGN
At the Review: Standing, l-r: Gerry Battista, LMSW,
Poughkeepsie Continuing Treatment Center; Frank DeSiervo, LCSW, Division Chief, Mental Health Services; Frank
Barr;Kathleen Spencer, RNC, Quality Improvement Coordinator. Seated, l-r: Wendy Weiner, LCSW, Poughkeepsie
Continuing Treatment Center; Roseanne Avila.
Many thanks go to all of the DMH staff who
donated to the 2008 United Way Campaign. Dutchess
County Government contributions were over $96,000,
and the Department contributed $13,936.50 towards
that amount. As in past years, several prizes were
raffled off to the donors at the Department's Semi-Annual Meeting held in November. Assisting MaryAnn
Lohrey, MS, Communications Director, in this year's
efforts was Cheryl Begor, Office Assistant. Both attended the Kick-Off Breakfast on September 5 at the
Grandview and the Final Report Luncheon on October
31, which was held at the Poughkeepsie Grand.
7
DR. GLATT CHOSEN
VETS APPRECIATION DAY
On Friday evening, September 26, Commissioner Glatt was one of five persons honored as one
of "those who do so much for seniors" at the First Annual Celebration of the Dutchess County Association
for Senior Citizens, Inc. The event was held at the
Holiday Inn, Fishkill.
The Dutchess County Veterans Service Agency
hosted its Third Annual Veterans Appreciation Day on
Saturday, November 8, reaching over 400 Dutchess
County veterans, family members and friends. The
event was held from noon to 3 PM at the Wallace
Center in Hyde Park. Holly Greer, LCSW, Vocational/Educational Coordinator, and Kathy Montana,
LCSW, Chemical Dependency Services, staffed the
DMH booth.
At the celebration, l-r: Special Guest Speaker Johnny
Blanchard, former New York Yankee Outfielder; James
Kelly, Executive Director, Association for Senior Citizens;
Dr. Glatt; Robert Oppenheim, LCSW, Geriatric Services
Coordinator.
STRESS DISORDERS
Tom Quinn, LCSW,a veteran and employee
of Montrose VA Hospital, was the Presenter at a
program on "Post Traumatic Stress Disorder" which
took place on December 5 from 3-5 PM at 230 North
Road. Upwards of 40 DMH staff and guests attended
the session, where Tom explained the many paths
to the internalization of stress reactions and the four
elements of PTSD.
Reviewing the program: Nelson Eddy Rivera, Veterans
Director; County Executive William R. Steinhaus; Betsy
Brockway, Director, Health & Human Services Cabinet.
Among the attendees, l-r: Karen Hughes-Shahda, LMSW,
Hudson Valley Mental Health, Inc.; Tom Quinn; James
Baxter, LCSW, Astor Services; Gerry Battista, LMSW,
Poughkeepsie Continuing Treatment Center.
At the DMH Booth: Kathy Montana chats with one of the
many veterans who attended the event.
8
FALL MEETING HELD
BOARD LUNCHEON
DMH staff gathered in the Multi-Purpose Room
at 230 North Road from 3-5 PM on Friday, November
21, for the Fall Meeting of all staff. Service Recognition Certificates and Outstanding Employee Awards
were among the items on the agenda.
Members of the Mental Hygiene Board welcomed the Executive Council and the 2008 Outstanding Employees at a Holiday Luncheon held in conjunction with their regular December meeting. Officers
were elected at the December 15 event, which was
held at 230 North Road. The luncheon was catered
by the Dutch Treat Cafe.
Awards of Excellence: Standing, l-r: Masum Ahmed, MD,
Psychiatrist I, Special Services Team; Darla Steinhauer,
Office Assistant, Chemical Dependency Services; Commissioner Glatt; Helen Traver, Senior Program Assistant,
Budget & Finance. Seated, l-r: Janet Nuccilli, Senior
Office Assistant, Assisted Outpatient Treatment Program;
Kimberly Langenau, LCSW, Social Worker I, Poughkeepsie
Continuing Treatment Center; Debra Tears, RN, Community
Mental Health Nurse, Jail-Based Services; Maryann Dunn,
LCSW, Social Worker II, Millbrook Continuing Treatment
Center.
Service Awards: Standing, l-r: Anne Needham, CASAC,
Rhinebeck Continuing Treatment Center, 20 Years; Penny
Butler, Rhinebeck Continuing Treatment Center, 20 Years;
Commissioner Glatt; Fran Sutherland, Millbrook Continuing Treatment Center, 30 Years; Deborah Vail, Millbrook
Continuing Treatment Center, 20 Years. Seated, l-r: Margaret Hirst, LCSW, Chemical Dependency Services, 30
Years; Mary Babcock, LCSW, Clinic for the Multi-Disabled,
20 Years; Deborah Walters, Information Technology, 25
Years.
At the meeting: Dr. Glatt congratulated the newly elected
officers for 2009, l-r: Frank Falanga, Chair; Susan Blodgett,
Secretary; Almerin O'Hara, Jr., Vice-Chair.
HOLIDAY COLLECTIONS
DMH's Billing Unit collected a record 60-plus
toys from staff during the annual toy drive conducted
by Dutchess County Government and Dutchess
Community College. These donations are the primary source of toys for The Salvation Army's holiday
program.
9
Billing Unit Tree and Toys: Pamela Highbridge, Billing Unit
Manager (left), with Accounting Clerks Cheryl Mayfield
and Debbie Piotti.
ORGANIZATION/ADMINISTRATION
The Dutchess County Department of Mental Hygiene is comprised of:
COMMISSIONER OF MENTAL HYGIENE
15-MEMBER MENTAL HYGIENE BOARD
Committees & Subcommittees
OFFICES DIVISIONS
Communications
Administrative Operations
Community Consultation Chemical Dependency Services
& Children's Services
Developmental Disabilities Services
Quality Improvement
Mental Health Services
Psychiatric Services
CONTRACT AGENCIES
Abilities First, Inc.
Astor Services for Children & Families, Inc.
Cardinal Hayes Home for Children
Council on Addiction Prevention & Education, Inc.
Dutchess ARC (ARC,DC)
Gateway Community Industries, Inc.
Hudson River Housing
Lexington Center for Recovery, Inc.
Mental Health America of D.C., Inc.
Mid-Hudson Addiction Recovery Centers, Inc.
Mid-Hudson Library System
PEOPLe, Inc
Rehabilitation Support Services, Inc. (RSS)
Taconic Resources for Independence, Inc.
OTHER AFFILIATED AGENCIES
Anderson Center for Autism
New Hope Manor
Cornerstone of Rhinebeck
New Horizons Resources
Daytop Village
Hudson River Psychiatric Center
Homer Perkins
Richard C. Ward Treatment Center
Four Winds Hospital
Rockland Children's Psychiatric Center
Greystone Programs, Inc.
Saint Francis Hospital
Hudson River Psychiatric Center
Taconic Developmental Disabilities Services
The Organization Chart, showing areas of responsibility for each Office and Division, are contained in the structure
of the Department. (See Figure 1, page 11). The mental hygiene system's wide range of services, accessible
in many locations throughout Dutchess County, are shown in the Service Network Map (Figure 2, page 12).
10
Figure 1
11
Figure 2
SERVICE LOCATIONS
Astor Center
Cornerstone
PEOPLe, Inc.
Hudson Valley Mental Health
Lexington Center
Millbrook CTC
Daytop Village
Rhinebeck CTC
Hudson Valley
Mental Health
Lexington Center
HRPC Crisis Residence
DMH Administration
Methadone Program
Partial Hospital Unit
Support Services
24-hour HELPLINE
Abilities First School & Clinic
Mental Health Library
Astor Center
Cardinal Hayes
Home
Mental Health America
Mid-Hudson
Library System
Mansion Street Center
DD Services Division
Special Services Team
Astor HBCI
Hudson Valley
Mental Health
Lexington Center
Astor Center
Chemical Dependency
Crisis Center (MARC)
Poughkeepsie CTC
HRPC Center for Change
Dutchess Horizons
ARC, DC
Astor Center
St. Francis Hospital
Emergency Services
Inpatient Units
The Turning Point
Taconic Day
Program
RSS
Chemical Dependency
Services Division
Astor Day
Treatment
Council on Addiction
Prevention & Education
So. Dutchess CTC
HR Housing
Lexington Center
Lexington Center
Abilities First
Beacon County Center
Astor Center
Revision 04-09
12
Service Report, 2008
Census in the following programs remained
relatively unchanged from last year: Hudson Valley
Mental Health Clinics, Astor Programs, Lexington
Center for Recovery, Mid-Hudson Addiction Recovery
Centers, Clinic for the Multi-Disabled, Abilities First,
ARC,DC and Taconic Day Program.
Totals in each service element in the DMH
system are shown in Table I on the following pages.
In obtaining these numbers, the Information Technology Unit continues the process of converting the
Department's software system from a Management
Information System (MIS) to the state-of-the-art
Anasazi Software System--an integrated clinical
and financial package which addresses the need for
reliable, secure and up-to-date patient information in
both electronic and paper form.
While DMH's Chemical Dependency Division
showed an 11% increase in the number of visits, the
number of persons served remained relatively stable.
Compared with 2007, Saint Francis Hospital showed
increases in the number of persons served in both
the Inpatient Units and the Emergency Department.
The Case Management Program operated by Mental
Health America showed increases as well.
Decreases in service of no major significance
were recorded for the Special Services Team, Partial
Hospitalization Program and the Continuing Treatment
Centers.
It should be noted that the Volume of Service
numbers only include direct services (i.e., face-toface visits with patient, family members, collaterals).
Indirect services, e.g., telephone calls, case management (which does planning, linking, monitoring and
advocacy) are described as such in the text.
In 2008, there were insignificant decreases
in both the number of persons served--1.5%-- and in
the total volume of services--3.8% over the previous
year,
Figure 3 on page 17 compares the Volume of
Patient Services for all programs over a longer period of
time. The baseline year of 1981 is used as it reflects
the Department's initial operation of its computerized
Management Information System (MIS).
HELPLINE recorded 17,722 units of service,
or an increase of 11% over last year; These figures
include both telephone and Face-to-Face contacts,
The average number of phone contacts per month
was 1,312.
Continued increases in the past two
years reflect the fact that all five Hudson River bridge
crossings now have a connection into the 485-9700
number, and also DMH's membership with LifeNet, a
national suicide prevention hotline where calls taken
with the local area code are automatically forwarded
to HELPLINE.
The pie charts in Figure 4 on page 18 illustrate
the demographics of patients served by age, gender
and ethnicity. Figure 5 on page 19 denotes referral
sources for patients seen in Year 2007, and Figure
6 on page 20 depicts the distribution of patients by
residence area.
Figures 7 and 8, on pages 21 and 22, show the
cost of services and the source of revenues for all
DMH and contract agency operations in 2008.
Figure 9 on page 26 illustrates the number of
community hospital inpatient admissions as compared
to those of the state facility--1,731 for Saint Francis
Hospital and 74 to HRPC. These figures reflect the
existing philosophy of providing care in the least restrictive setting.
Of the 1,834 total hospitalizations from Saint
Francis Hospital's Emergency Department, 819, or
45%, were public sector patients, i.e., individuals
registered with DMH or one of its contract agencies
(see Figure 10 on page 27).
13
Table I
DUTCHESS COUNTY DEPARTMENT OF MENTAL HYGIENE SERVICE REPORT JANUARY - DECEMBER 2008
ON
ROLLS ADMITS
1/1/2008
TOTAL DC / DMH 2008
TERMS
PERSONS
ON
SERVED
ROLLS
JAN-DEC
12/31/2008 EPISODES
VOLUME OF
SERVICE
7374
7637
7347
7664
20656
517388
103
23
44
263
46
252
101
34
147
286
3112
4537
236
144
87
165
61
32
22
69
60
49
35
72
237
127
74
162
297
176
109
234
24773
20903
12220
18671
1249
84216
MENTAL HEALTH DIVISION
DMH PROGRAMS
SPECIAL SERVICES
PARTIAL HOSPITALIZATION
Continuing Services Programs
DAY TREATMENT
SOUTHERN DUTCHESS CDT
RHINEBECK CDT
MILLBROOK CDT
POUGHKEEPSIE CDT
758
491
514
735
MENTAL HEALTH AMERICA
SUPPORTIVE CASE MANAGEMENT
BLENDED SUPPORTIVE CASE MANAGEMENT
GENERIC CASE MANAGEMENT
INTENSIVE CASE MANAGEMENT
BLENDED INTENSIVE CASE MANAGEMENT
HEDGEWOOD CASE MANAGEMENT
SUB-TOTAL
488
264
71
80
117
369
185
44
56
41
304
228
55
61
37
553
221
60
75
121
857
449
- (A)
115
136
158
13163
6070
1568
2818
3582
2987
COMMUNITY SUPPORT PROGRAMS (B)
279
50
70
259
329
14970
1299
745
755
1289
2044
45158
1125
97
422
144
131
473
96
234
91
148
652
73
227
79
118
946
120
429
156
161
1598
193
656
235
279
0
65
65
0
65
65
1919
1107
1214
1812
3026
37656
436
154
143
2
33
9
10
21
18
65
125
430
129
131
18
28
1
27
27
32
22
43
298
101
115
17
44
3
25
24
35
26
59
568
182
159
3
17
7
12
24
15
61
109
866
283
274
20
61
10
37
48
50
87
168
9644
4049
3556
401
1372
351
1142
1259
466
11261
20731
1016
888
747
1157
1904
54232
TOTAL MENTAL HEALTH DIVISION
4992
3231
3230
4993
8223
221262
TOTAL DC / DMH 2008
7374
7637
7347
7664
20656
517388
SUB-TOTAL
HVMH MENTAL HEALTH CLINICS
POUGHKEEPSIE
MILLBROOK
BEACON
EASTERN DUTCHESS
RHINEBECK
COURT EVALUATIONS
SUB-TOTAL
ASTOR PROGRAMS
POUGHKEEPSIE COUNSELING CENTER
RED HOOK COUNSELING CENTER
BEACON COUNSELING CENTER
HOME-BASED CRISIS INTERVENTION PROGRAM
SCHOOL-BASED PROGRAM
FAMILY-BASED TREATMENT
PINS OUTREACH
INTENSIVE CASE MANAGEMENT
SUPPORTIVE CASE MANAGEMENT
DAY TREATMENT CENTER
ADOLESCENT DAY TREATMENT
SUB-TOTAL
.
18754
2310
9731
3233
3563
(A) THERE WERE 310 PATIENTS SERVED BY MHA GENERIC CASE MANAGEMENT; 287 WERE SEEN FACE-TO-FACE.
(B) INCLUDES COMPEER, DUTCHESS HORIZONS, BEACON PSYCHOSOCIAL CLUB, AND THE YOUNG ADULT PROGRAM
14
Table I
DUTCHESS COUNTY DEPARTMENT OF MENTAL HYGIENE REPORT JANUARY - DECEMBER 2008
ON
ROLLS
1/1/2008
TOTAL DC / DMH 2008
ADMITS
7374
7637
TERMS
7347
ON
PERSONS SRVD.
ROLLS
JAN-DEC
12/31/2008 (EPISODES)
VOLUME OF
SERVICE
7664
20656
517388
DIVISION OF CHEMICAL DEPENDENCY SERVICES
DMH CHEMICAL DEPENDENCY CLINICS
ITAP DAY REHAB PROGRAM
44
65
59
50
109
11741
CD CLINIC
13
22
20
15
35
712
-
-
-
-
-
457
81
292
301
72
1116
592
373
667
1001
1116
592
3102
138
379
380
137
2225
19388
ROAD TO RECOVERY
VOCATIONAL CASE MANAGEMENT
CD CASE MANAGEMENT
CD ASSESSMENT
FORENSIC COORDINATION
JAIL-BASED SERVICES
SUB-TOTAL
LCR CHEMICAL DEPENDENCY CLINICS
METHADONE PROGRAM
220
50
38
232
270
41555
MANCHESTER ROAD CD CLINIC
479
1022
852
649
1501
37316
MILLBROOK CD CLINIC
BEACON CD CLINIC
EASTERN DUTCHESS CD CLINIC
RHINEBECK CD CLINIC
RED HOOK CD CLINIC
19
114
22
22
15
54
225
102
77
13
34
208
64
52
20
39
131
60
47
8
73
339
124
99
28
831
5411
2486
1377
297
891
1543
1268
1166
2434
89273
9
330
327
12
339
3271
TOTAL DIVISION OF CHEMICAL DEPENDENCY S
1038
2252
1975
1315
4998
111932
TOTAL DC / DMH 2008
7374
7637
7347
7664
20656
517388
SUB-TOTAL
MARC
ALCOHOL CRISIS CENTER
15
Table I
DUTCHESS COUNTY DEPARTMENT OF MENTAL HYGIENE SERVICE REPORT JANUARY - DECEMBER 2008
ON
ROLLS ADMITS
1/1/2008
TOTAL DC / DMH 2008
TERMS
ON
ROLLS
12/31/2008
PERSONS SRVD.
JAN-DEC
(EPISODES)
VOLUME OF
SERVICE
7374
7637
7347
7664
20656
517388
HELPLINE
-
-
-
-
-
17722
HRPC CRISIS RESIDENCE
9
261
257
13
270
176
-
1731
-
1729
-
178
-
1907
3937
20132
3937
185
1992
1986
191
6114
45642
377
5
56
1
44
2
389
4
433
6
4633
280
382
57
46
393
439
4913
254
245
14
28
38
15
17
46
19
265
237
10
282
283
29
47614
37433
3700
513
81
82
512
594
88747
123
46
15
5
11
13
127
38
138
51
18797
5677
169
20
24
165
189
24474
95
4
4
95
99
20418
TOTAL DIVISION OF DEVELOPMENTAL DISABILITIES
1159
162
156
1165
1321
138552
TOTAL DC / DMH 2008
7374
7637
7347
7664
20656
517388
OFFICE OF COMMUNITY SERVICES
ST. FRANCIS HOSPITAL
INPATIENT
EMERGENCY DEPARTMENT
TOTAL OFFICE OF COMMUNITY SERVICES
(A)
3851
DIVISION OF DEVELOPMENTAL DISABILITIES
CLINIC FOR MULTI-DISABLED
CMD MENTAL HEALTH PROGRAM
CMD CHEMICAL DEPENDENCY PROGRAM
SUB-TOTAL
ABILITIES FIRST
DAY HAB
WORK TRAINING
WARYAS RECOVERY HOUSE
SUB-TOTAL
ARC
SHELTERED WORKSHOP
AMENIA SATELLITE WORKSHOP
SUB-TOTAL
TACONIC
TACONIC DAY PROGRAM
(A) DUTCHESS COUNTY RESIDENTS ONLY.
16
302.6
322.5
382.7
416.5
422.6
435.0
433.0
451.9
461.6
494.0
502.9
527.5
556.8
551.7
557.5
569.0
564.7
552.5
563.6
569.1
594.1
594.0
572.8
563.5
557
520.7
551721
'84
557521
'85
'87
569044
'86
564724
'88
563652
'91
569113
'92
'93
'94
594130
17
YEAR
'90
552505
'89
'95
'96
'97
'98
'99
'00
'01
517388
537691
512108
461580
451938
433034
434964
422559
416484
382652
322523
'81 '82 '83 '84 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 08
'83
556800
'82
594018
0
527523
'81
572838
100000
'80
563521
0
100000
200000
557077
200000
494044
300000
520780
300000
400000
500000
600000
700000
502913
400000
500000
600000
700000
No. of Services
DUTCHESS COUNTY DEPT OF MENTAL HYGIENE
VOLUME OF PATIENT SERVICES
DUTCHESS COUNTY DEPT OF MENTAL HYGIENE
VOLUME OF PATIENT SERVCES
Figure 3
NO. OF SERVICES
Figure 4
DEMOGRAPHIC CHARACTERISTICS OF PATIENTS SERVED
DURING THE YEAR
Includes DMH Directly-Operated Programs;
Hudson Valley Mental Health, Inc's. Mental Health Clinics; Lexington Center for Recovery, Inc's. Chemical
Dependency Clinics; and Astor Community-Based Programs.
AGE IN YEARS
0-17
15%
70+
2%
18-21
7%
22-29
16%
30-39
17%
60-69
6%
50-59
15%
40-49
22%
GENDER
FEMALE
45%
MALE
55%
ETHNICITY
HISPANIC
8%
ASIAN
0.5%
OTHER
5%
WHITE
67%
18
AFRICAN
AMERICAN
20%
NATIVE
AMERICAN
0.4%
19
OTHER
5%
M.H. HOSPITAL / FACILITY
9%
PRIVATE PRACTITIONER
3%
MR / DD FACILITY
3%
SELF
20%
REFs AMONG DMH, HVMH, LCR
16%
COURT / JAIL / POLICE
18%
GEN. HOSPITAL / NURSING HOME
7%
SCHOOL / COLLEGE
2%
PUBLIC HEALTH / WELFARE
6%
FAMILY / FRIEND
10%
ALCOHOL PROGRAM
1%
DC/DMH * REFERRAL SOURCES FOR PATIENTS SEEN IN 2008
Includes DMH Directly-Operated Programs; Hudson Valley Mental Health, Inc's. Mental Health Clinics;
Lexington Center for Recovery, Inc's. Chemical Dependency Clinics; and Astor Community-Based Programs.
Figure 5
Figure 6
DISTRIBUTION OF PATIENTS SERVED IN 2008, BY RESIDENCE AREA
DUTCHESS COUNTY
Includes DMH Directly-Operated Programs; Hudson Valley Mental Health, Inc's. Mental Health Clinics;
Lexington Center for Recovery, Inc's. Chemical Dependency Clinics;
and Astor Community-Based Programs.
9%
NORTH (12%)*
55%
11%
CENTRAL (41%)*
11434
EAST (16%)*
25%
SOUTH (31%)*
* Percentage of county population
(2000 Census data)
20
Chemical Dependency
Services ($4,761,085)
Administration
($4,024,696)
21
TOTAL EXPENDITURES: $31,690,898
Mental Health Services
($21,993,182)
Developmental
Disabilities Services
($911,935)
COST OF SERVICES - 2008
Figure 7
22
*Includes: Medicaid, Medicare, Insurance, Self-Pay.
$11,514,684
STATE FUNDS
(36.3%)
TOTAL ALLOCATION: $31,690,898
PATIENT FEES*
$8,042,539
(25.4%)
COUNTY FUNDS
$12,133,675
(38.3%)
SOURCE OF REVENUE - 2008
Figure 8
Office of Community Consultation
& Children's Services
HELPLINE
The Office of Community Consultation &
Children's Services (formerly known as the Office
of Community Services) administers the consultation and education activities of the Department and
provides supervision for HELPLINE, the 24-hour/7
day-a-week crisis counseling, information, and referral
service. In addition, the Director provides administrative oversight for community-based services to
children and youth, monitors inpatient admissions
and discharges, tracks emergency admissions to
Saint Francis Hospital's Emergency Department, supervises the student internship programs, as well as
heading up the Trauma Team and the Mental Health
Committee for the Dutchess County Medical Reserve
Corps. The Director also represents DMH on the
Universal Response to Domestic Violence Committee and serves on the Board of The Coalition Against
Domestic Violence. In August, Beth Alter, LCSW, was
appointed Director, replacing Bonnie Scheer, LCSW,
who had retired after serving more than 30 years with
the Department.
The Department’s crisis counseling, information, and referral service also provides a centralized
pre-intake and schedules initial (intake) appointments
24 hours a day, whenever a person in need calls.
Anyone calling HELPLINE for any reason can schedule an appointment at any one of the outpatient
clinics during that same call without having to call
back or be called by staff. HELPLINE provides the
pre-intake screenings and appointments for all of the
public behavioral healthcare programs. Hence, there
is one telephone number, 845-485-9700 (Toll-free:
877-485-9700), to call for both adult and children's
services in Dutchess County, regardless of location.
This service is also a part of LifeNet, a federally-funded
National Suicide Hotline. Suicide prevention phones
have been installed on all Hudson River bridges: MidHudson Bridge, Bear Mountain, Beacon-Newburgh,
Kingston-Rhinecliff and Rip VanWinkle. HELPLINE's
Clinical Unit Administrator is John Stern, LCSW.
HELPLINE SERVICES - Phone & Face-To-Face
Crisis
Interv.
Pre-
Intake
Info &
Referral
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEPT
OCT
NOV
DEC
703
659
758
561
624
506
579
656
604
573
570
567
601
426
480
492
540
493
676
562
579
654
529
614
198
195
149
111
174
169
53
94
83
47
44
25
Totals
7,360
6,646
23
1,342
Other
Total
177
119
118
77
79
153
209
202
281
305
295
359
1,679
1,399
1,505
1,241
1,417
1,321
1,517
1,514
1,547
1,579
1,438
1,565
2,374
17,722
They have become familiar with the different responses
to emergencies that occur and how a psychological
trauma team can provide assistance. The Team also
offers its services to all DMH staff who have suffered
personal loss and also for clinicians who have a patient
die while in treatment.
Volume of Service:
17,722
(93 of the 17,722 services were face-to-face)
No. of Phone Contacts
Average No. Per Month
15,753
1,312
Two team members also participate on the
Dutchess County Critical Incident Response Team
(CIRT). The Team provides critical incidence services
to emergency personnel (i.e., Firefighters, Emergency Medical Technicians, and Police) throughout
Dutchess County.
Emergency Services
Psychiatric emergency services are provided
by Saint Francis Hospital (SFH) in its Emergency Department (ED). In 2008, there were 3,937 face-to-face
contacts in the Emergency Department, of which
819 were open patients of the public behavioral
healthcare system.
The long awaited move of HELPLINE staff to their new
location in the east end of 230 North Road took place
on July 15. The staff seems to be delighted with having
ample space and plenty of sunlight from the large picture
windows. Shown working the HELPLINE phones: Glenn
Peters, Angela Mastrantuono,LMSW, Donna Grey, Bernice
Rodriguez.
The dispositions of public sector patients from
SFH's ED are shown in Figure 10 on page 27.
Disposition of Public Sector
Patients Seen at SFH / ED
The Trauma Team
In 2008, the Dutchess County Trauma Team
completed its 18th full year of providing service. The
Team’s specific purpose is to aid in community and
family disasters where emotional and psychological
support is indicated and/or requested. All members of
the Team, consisting of the Coordinator and thirteen
staff members, are senior clinicians in administrative
positions who have the flexibility to respond immediately in emergency situations and have had training
in crisis counseling. The Team has also had training
in Critical Incident Stress Management (CISM) and
in Community Response to Emergencies and Disasters.
The Trauma Team responds immediately (or at an
appropriate time following an incident) to: untoward
deaths; suicides; disasters (e.g., fires or accidents
involving police, fire and rescue squads) and situations requiring crisis counseling and/or debriefing.
Referred
back to
Clinics
JAN
FEB/
MAR
APR
MAY
JUN
JUL/
AUG
SEPT
OCT
NOV
DEC
24
Admitted
to SFH
Referred Total
to other
Program
42
61
17
42
7
27
66
130
35
37
22
51
19
18
24
55
9
29
14
29
63
84
60
135
29
49
43
38
18
22
18
20
14
18
5
7
61
89
66
65
TOTAL 407
253
159
819
Psychiatric Inpatient Services
Crisis Residence
The Department has access to community-based
acute inpatient care for individuals in need of psychiatric hospitalization through contractual agreements
with Saint Francis Hospital (SFH) in Poughkeepsie.
The hospital is located directly across North Road from
the Mental Health Center. When all of the beds at FH
are full, arrangements are made through the Office
of Community Consultation & Children's Services to
admit patients to other area community hospitals.
Hudson River Psychiatric Center (HRPC)
operates a Crisis Residence for individuals over 18
years of age who are mentally ill and who are experiencing acute difficulties which require their removal
from their regular living environment but, at the same
time, not so severe as to require admission to an
inpatient unit. Typically, referrals to this program are
made by the Department’s HELPLINE staff, Mental
Health America's Case Management Program staff
and from SFH's ED
Hudson River Psychiatric Center (HRPC), the
New York State-operated facility which serves local
residents, is utilized for intermediate and longer term
hospitalizations. HRPC admits persons over the age
of 18 years.
No. of Patients
Served
270*
The trend in psychiatric inpatient admissions
in the two major components of state/community care
in the Dutchess County network of service is shown in
Figure 9, page 26. Throughout this time frame, the
number of admissions to community-based hospitals
has risen, while admissions to the state facility have
continued to show drastic reductions, reflecting the
philosophy of providing community care wherever
possible. The result has been that community access
to HRPC's beds is strictly limited.
Volume
of Service
3,851
*Dutchess County residents only
Comparison of Inpatient Admissions:
Saint Francis Inpatient
HRPC
1,731
74
Prior to leaving DMH, Bonnie Scheer, LCSW, Director, Office
of Community Services, called a meeting of the Trauma
Team on July 28. Much to her surprise, it turned out to be
a farewell party, with Bonnie as the guest of honor. All of
the Team members donned their official shirts for the occasion. Team members, Seated, l-r: Holly Greer, LCSW;
Kate Castell, LCSW, Astor Services; Naomi Ferleger, Ph.D.;
Kathleen Spencer, RNC; Sue Haight, RN. Standing, l-r:
Burt Morgan, LCSW; Beth Alter, LCSW; Bonnie; Robert
Oppenheim, LCSW; Evelyn Soto, RN.
Figure 10 on page 27 reflects the number of hospital admissions from the SFH Emergency Department
to the various inpatient facilities in 2006.
Admissions from Saint Francis ED:
HRPC
Other Hospitals
1,338
13
483
Total Hospitalizations
1,834
25
26
0
200
400
600
800
1000
1200
1400
1600
1800
2000
'81
'82
'83
'84
'85
'86
'87
'88
'89
'90
'91
'92
'94
SFH
'93
'96
HRPC
'95
'97
'98
'99
'00
'01
COMPARISON OF INPATIENT ADMISSIONS
1981 - 2008
'02
'03
'04
'05
'06
'07
08
Figure 9
SFH (1338) (73%)
HOSPITAL ADMISSIONS 2008
27
HRPC (13) (0.7%)
(NOTE: Of the 1,834 total hospitalizations, 819, or 45%,
were public sector patients [individuals registered with DMH
or one of its contract agencies].)
OTHER HOSPITALS (483) (26.3%)
FROM SAINT FRANCIS HOSPITAL EMERGENCY DEPARTMENT
Figure 10
Student Internship
Programs
Field Placements:
The Office of Community Services also provided field placement experiences for undergraduate
students from Dutchess Community College and
Cleveland State University.
In Psychology:
The Pre-Doctoral Psychology Internship
Training Program admitted the 21st class of interns
in September. This training program, which has
been fully accredited by the American Psychological
Association (APA) since 1989, selects six interns from
approximately 60 applicants. The students are chosen
from a diverse nationwide pool of doctoral candidates
from graduate university programs or independent
schools of professional psychology. The year long
program is a requirement for students in order to
obtain their Doctoral Degree in Psychology.
The interns are required to complete a primary
placement within a DMH program. Students are placed
in clinical sites where their caseload is supervised by
licensed psychologists who are assigned to these
units. The faculty consists of licensed psychologists,
certified social workers and a clinical neuropsychologist. The interns, most of whom have already
obtained a Master's Degree in Psychology, perform
most, if not all, of the psychological assessments
conducted within the Department's units as well as in
outpatient programs operated by contract agencies.
In addition, they participate in an ongoing series of
weekly seminars, symposia, and inservice training
presentations.
An inservice on "Use of Imagery in Psychotherapy" was
conducted by Oliver Fassler, Psychology Intern, on May
30 at the Mental Health Center. The session was one of a
series presented to all interested staff by the Interns. On
June 6, Melissa Velazquez, MS, gave a talk on "Depression in United States Hispanics: Diagnostic and Treatment
Considerations." Interns present included: Seated: Oliver
Fassler. Standing, l-r: Mickie Fisher, Walter Kendall, Nicole
Richardson, George Schinkel, Melissa Velazquez.
Consultation and Education
Consultation and Education (C&E) activities are
conducted primarily through the DMH Offices of
Community Consultation & Children's Services and
Communications, as well as under contract with Mental Health America of Dutchess County, Inc. (Mental
Health) and the Council on Addiction Prevention &
Education, Inc. (Chemical Dependency).
Naomi Ferleger, Ph.D., was appointed the Director of the Internship Training Program in January.
Following an APA Site Visit for Reaccreditation in July,
the Internship Program was awarded the maximum,
five year recertification allowed by the APA.
In Social Work:
C&E activities include a wide range of services
to outside individuals, groups and agencies, as well
as providing ample inservice opportunities for professionals and support staff. The DMH Communications
Director, MaryAnn Lohrey, MS, serves as a resource
person for community education, public information
and promotion of C&E activities taking place in the
community.
Two social work students completed the
Academic Year 2008. The students, from Adelphi
University, were placed in supervision in the Poughkeepsie Continuing Treatment Center and Intensive
Treatment Alternatives Program.
28
With the Department having been approved
by the State Education Department's Office of Professional Credentialing as a provider of training, the
Office of Community Services offers ongoing training
sessions in child abuse reporting for individuals
who have been designated as mandated reporters.
The Office also provides training on mental hygiene
issues to new police personnel in the region.
October:
November: •Military Mental Health
December: •Post Traumatic Stress
Disorder (PTSD)
There were inservice training sessions which
were offered to Department staff and affiliated
agency staff. The following is a listing of inservices
presented:
January:
•Integrated Treatment - The 4
Quadrant Model
•Grand Rounds: Case Presentation
on Concurrent Disorders
and Integrated Treatment
•Logic Models and Performance
Outcome Reporting
• Child Abuse and Neglect
Mandated Reporters
February:
• Trauma Treatment
• Psychological Dynamics of Pain
Management
•De-Institutionalization: A Historical
Perspective on the Good, the
Bad, and the Ugly
March:
• Integrated Treatment: A "Welcoming"
Approach to Working with
Dually-Diagnosed Individuals
April:
• Psychodynamic Treatment of Panic
Disorder and Agoraphobia:
A Case Study
•Understanding and Integrating
Spirituality in Treatment
•Culturally Sensitive Disaster
Mental Health
•Medications and Addictions
"Child Abuse and Neglect for Mandated Reporters",
an inservice presented by Bonnie Scheer, LCSW,
Director of Community Services, was held on January
18 at the Mental Health Center. Non-DMH attendees
are charged a fee, and Certificates for the mandated
training are issued upon completion of the course.
Shown, l-r: Bonnie Scheer, LCSW; Mickie Fisher,
Psychology Intern; George Schinkel, Psychology Intern; Marian Pomeroy, Social Work Student assigned
to Rhinebeck Continuing Treatment Center.
May:
• Working with Forgiveness and
Self-Forgiveness in a Therapeutic
Setting
•Best Practices in Wellness
and Recovery
•Use of Imagery in Psychotherapy
June:
•Depression in United States
Hispanics: Diagnostic and
Treatment Considerations
September: •Logic Models and Performance
Outcome Reporting
•Treatment Plans
•GAF - Global Assessment of
Functioning
29
An inservice dealing with "Integrated Treatment--The 4
Quadrant Model" was held on October 3 from 3-5 PM at 230
North Road. The Presenters were: Naomi Ferleger, Ph.D.,
Director, Psychology Internship Program and Kathleen
Spencer, RNC, Quality Improvement Coordinator. Shown
at the presentation, l-r: Phyllis Maness, LCSW, Clinic for
the Multi-Disabled; Dr. Naomi Ferleger; Christopher Evans,
Psychology Intern; Ani Tosheva, Psychology Intern.
Bonnie Scheer, LCSW, is shown with Scott Barkstrom,
Ph.D., Clinical Director of Saint Francis Hospital's
Outpatient Mental Health Clinic, who was the featured
speaker at an inservice held on February 15 at the
Mental Health Center. Dr. Barkstrom discussed "The
Psychological Dynamics of Chronic Pain."
"Military Mental Health" was the subject of a presentation by
Bruce Nathanson, Ph.D., Poughkeepsie Continuing Treatment Center, held on November 7 at 230 North Road. Dr.
Nathanson, who had served recently in the military, spoke on
diagnosis and treatment of post-deployment psychological
problems. Dr. Nathanson (seated) is shown with several of
the attendees, l-r: Lois Dougherty, RN, Southern Dutchess
Continuing Treatment Center; Kathleen Spencer, RNC,
Quality Improvement Coordinator; Burt Morgan, LCSW,
Assisted Outpatient Treatment Coordinator; Jackie Pope,
LCSW, Hudson Valley Mental Health, Inc.; Debbie Faria,
LCSW, Hudson Vallry Mental Health, Inc.
Eli Lilly Pharmaceutical hosted an inservice on "Best Practices in Wellness and Recovery" on May 8 at the Mental
Health Center. The presenter was Joy Murphy, Psy.D.,
Cox Health Systems, Springfield, Missouri. Among the attendees were, l-r: Robert Oppenheim, LCSW, Clinical Unit
Administrator, Southern Dutchess Continuing Treatment
Center; Carol Klein, RN, Southern Dutchess Continuing
Treatment Center; Dr. Murphy; Marie Rush, Specialty
Sales Representative, Eli Lilly; Sue Haight, RN, Southern
Dutchess Continuing Treatment Center.
30
Services for Children
and Youth
Affiliated Agencies Serving
Children and Youth:
Coordination
Astor Services for Children
& Families, Inc.
Providing for the mental hygiene needs of
children and youth requires the coordination of a
variety of services and systems that touch the lives
of children and families -- mental health, substance
abuse, education, social services, juvenile justice
and family support.
DMH contracts with Astor Services for Children & Families to provide mental health treatment
services for children, youth and families. Astor Counseling Centers are located in Beacon, Poughkeepsie, Red Hook and Wassaic. A school-based clinic
satellite program serves children and families in the
Pine Plains School District.
The Department's Children and Youth Services
Coordinator, Linda Monkman, LCSW, oversees the
system of services for children and youth, monitors
the contract agencies whose clinics and programs
provide mental health services, and works in conjunction with other community providers:
School-based day treatment services are
provided through Astor's Day Treatment programs.
The preschool day treatment program is located in
Astor's Early Childhood Center on Delafield Street
in the City of Poughkeepsie; children ages 5-12 attend the Astor Day Treatment Program at the Family Partnership Center on North Hamilton Street in
Poughkeepsie. Middle and high school day treatment
students are served in collaboration with Dutchess
County BOCES at the BOCES/BETA and Salt Point
sites. In conjunction with BOCES, Astor also operates a chemical dependency program for youth at
the BOCES/BETA Alternative High School site.
• Astor Services for Children & Families, Inc.
• Mental Health America
of Dutchess County, Inc.
• Saint Francis Hospital
• Four Winds Hospital in Katonah
• Rockland Children's Psychiatric Center
Additional services offered by Astor include
clinic-based generic case management, a "Single
Point of Access" to Home-Based Service Coordination, which includes the following programs: The
Home and Community-Based Services Waiver program, Intensive Case Management, Supportive Case
Management, Family-Based Treatment and Single
Point of Access (SPOA) screenings.
The Coordinator chairs the Children's Providers Committee, which meets several times a year to
facilitate communication, coordination and planning.
Members include key child-serving agencies, school
district representatives and other county and community agencies.
The Coordinator also serves as staff liaison
to the Children & Youth Subcommittee of the Mental Hygiene Board, which meets monthly to identify
mental hygiene needs of children and families, target
service barriers and gaps, review the performance of
contract agencies, and develop integrated program
planning recommendations.
The Coordinator represents DMH on interagency committees including: the Children's Services
Council, the Coordinated Children's Services Initiative, the School Safety Advisory Committee, and a
number of committees focused on the needs of youth
in the criminal justice system and youth transitioning
to the adult service system.
The Coordinated Children's Services Initiative
(CCSI), staffed by an Astor Coordinator and Family
Advocate, functions as a multi-agency collaboration
with the goals of improving service coordination and
reducing residential placements for children with
emotional disabilities. Crisis services are provided
by the Home-Based Crisis Intervention Program.
31
Sexually abused children are referred to the
Counseling Centers for services provided by the
Sexual Abuse Treatment Team. In addition, the Centers serve patients and their families in a "Pathways
to Healthy Living Program" for children who engage in
sexualized behaviors. The service provides individual
and family therapy, weekly group therapy and education, and an educational/supportive group therapy for
parents.
The Respite Programs offer a wide-ranging
array of services for families with SED (Severely
Emotionally Disturbed) children. Although technically, respite services are "for" parents, the primary
interaction occurs between trained respite workers
and children through individual excursions to provide
a "break" from parenting as well as through group
recreational activities.
Astor continues to serve hard-to-engage youth
by providing outreach, assessment and linking services
at the River Haven emergency shelter and onsite at
Dutchess County Probation through the services of
an Astor clinician on the PINS "Collaborative Solutions"
intervention team and of a clinical social worker who
serves as the PINS Outreach.
With funding from the Foundation for Community Health, Sharon CT, volunteers present informative
and entertaining programming to young children using
life-size puppets from the National Kids on the Block.
578 children were served in 2008.
Astor Forensic Team
Family Court Evaluations
No. of Evaluations
Units of Service
Persons Served
(17 and under)
Astor Centers
1,423 Home-Based
20
Family-Based
10 School-Based
61
PINS Outreach
37
Int. Case Mngt.
48
Supp. Case Mngt. 50
AD Treatment
168 Day Treatment
87
Total
1,904 54,232
192
317
Saint Francis Hospital (SFH) has been providing
emergency psychiatric assessment for children and
adolescents in its Emergency Department. Acute
inpatient care is provided to adolescents (12-18) in
a 13-bed Adolescent Unit. This service was scheduled to be discontinued in April 2009. An intensive
outpatient clinic program for adolescents is provided
through the SFH Mental Health Clinic.
Volume
of Service
17,249
401
351
1,372
1,142
1,259
466
20,731
11,261
Other Hospitals
Four Winds Hospital in Katonah provides inpatient care for children and adolescents, ages 5 to
18. Rockland Children's Psychiatric Center (RCPC)
provides inpatient treatment for youth ages 12 through
17 who require a longer hospitalization.
Hospitalizations of Children/Youth
~Dutchess County Residents~
DMH contracts with this community not-for-profit
agency to provide a range of support and advocacy services to families who have mental health
needs.
32
RCPC
SFH
Four Winds
21
550
61
Total
732
Children's Services Activities:
On November 18, DMH, along with the Children's Providers Committee's Re-Entry Subcommittee, presented a
workshop on "Planning For Successful Re-Entry." The
event, organized by Linda Monkman, LCSW, was held at
230 North Road from 9-11 AM. Subcommittee members,
l-r: Chrystal Marr, LaSalle School; Linda Monkman; Kate
Castell, Astor Services; Melissa Thompson, NYS Office
of Mental Health, Rockland Children's Psychiatric Center;
Susan Christantiello, Astor Services.
The Public Forum on Service Needs of Children & Youth
took place on May 5 from 4-6 PM at the Mental Health
Center. Agency representatives described local initiatives including additional school to community transitional
services for students at BOCES; beds for transitioning
youth ages 18-25 years; a grant for treatment received by
Lexington Center for Recovery; and additional training for
service providers. Members in the audience cited long
waiting lists for treatment, the need for transportation to
activities, and more mental health services in the schools.
Subcommittee members present included: Seated, l-r:
Aviva Kafka, Sharon Strack, Lynn Rogers, Cindy Merritt.
Standing, l-r: Linda Monkman, LCSW, Children's Services
Coordinator; Suzanne Manning, LCSW; Susan Blodgett;
Angela Rogers.
Other participants at the Workshop, l-r: Marissa O'Brian,
Poughkeepsie School District; Ken Kerrs, Beacon School
District; Chrystal Marr, LaSalle School; Joann Pinello,
LCSW, BOCES; Christine Bexley, Saint Anne's Institute.
A new bookmark , designed for distribution among agencies serving children and youth in Dutchess County, was
on display at the Forum. Shown with the display, l-r: Karen
Trokan, LCSW, Division Chief, Developmental Disabilities
Services; Cheryl Begor, Office of Community Services;
Linda Monkman, LCSW.
33
Division of Mental Health Services
The Division of Mental Health Services, with
a full-time Division Chief who is responsible for its
day-to-day operation, is divided into several units: a
Partial Hospitalization Program, the Special Services
Team, and four Continuing Day Treatment Centers
(CTC's), including a Satellite Center at Hedgewood
Adult Home in the City of Beacon. Each unit has its
own Clinical Unit Administrator or Supervising Clinician. Several staff also report directly to Frank
DeSiervo, LCSW, the Division Chief. These include:
the Geriatrics Services Coordinator, the Assisted Outpatient Treatment Coordinator, a Housing Coordinator
and a Vocational/Educational Coordinator.
hospitalizations or to gradually phase individuals back
into the community after a psychiatric hospitalization.
Robin Peritz, LCSW, the Clinical Unit Administrator,
supervises a full staff of professionals who provide a
coordinated, intensive treatment that is more concentrated than traditional outpatient care. The structured
format provides medical monitoring (or psycho-pharmacological assessments) plus therapeutic groups.
Participants attend sessions Monday through Friday
and treatments usually last 4-6 weeks, depending
on the person's progress. Patients who successfully
complete their stay move on to the level of care most
appropriate for their mental health condition.
The Division also provides administrative oversight for mental health services in contracted outpatient adult mental health clinics. The Division Chief
and staff interact with a variety of local agencies
which provide housing, vocational, education and
support services for mentally ill persons living in the
community.
In addition to extensive administrative functions,
the Division Chief chairs a Providers Committee,
which meets quarterly to provide coordination and
communication among various local agencies which
serve persons with mental illness. Division staff
also act as liaisons to the Mental Health and Geriatric
Subcommittees of the Mental Hygiene Board.
286
Volume
of Service
4,537
Special Services Team
The Special Services Team (SST) , under the
direction of Christine Manning, LCSW, is a completely
independent unit which deals with persons who are
difficult to treat and/or who are resistive toward
traditional treatment services. Many of the cases
are referred for poor or non-attendance at programs.
Much activity consists of interviewing, assessment,
and negotiation. The Team provides individual, family
and couples therapy, as well as psychiatric evaluations and medication management.
Both consumers and providers of mental
health services participated in a Department-sponsored Public Forum dealing with service needs of
adults which took place at the Mental Health Center
in May. These events assisted staff in the preparation of the 2009 Local Services Plan.
Partial Hospitalization
Program
The Partial Hospitalization Program (PHP) is a
short-term outpatient program that provides support
and treatment for persons who are in acute distress.
The goal is to stabilize individuals to prevent psychiatric
No. of Patients
Served
No. of Persons Served
147*
*Face-to-face services
34
Volume
of Service
3,112
Continuing Services
Program
Four Continuing Day Treatment Centers
(CTCs) and a Satellite offer supportive, flexible
and continuous treatment programs that (a) assist
individuals with severe mental illness; (b) monitor and
manage psychiatric symptoms; and (c) sustain and/
or improve emotional, cognitive and social functioning. The centers are located in Hopewell Junction,
Millbrook, Poughkeepsie and Rhinebeck. A Satellite
program is offered to residents of Hedgewood Adult
Home in the City of Beacon.
To escape the doldrums of a cold, damp season, staff at
Poughkeepsie Continuing Treatment Center staged a Winter
Carnival complete with imaginative cold weather gear. The
event was held after 3:30 PM on March 7. Assembled, lr: Frank Ramos, Recreational Therapy Assistant; Valerie
Keto, Recreational Therapist; Carol Slinskey, Community
Mental Health Aide; Fern Williamson, Activity Therapy Aide;
Theresa Monte-Caruso, Recreational Therapy Assistant;
Cristy-Joy Rose, Senior Program Assistant; Jacqueline
White, LCSW, Housing Coordinator; Gail Cutrone, Occupational Therapy Assistant; Vivian Boone, Receptionist.
A primary focus of the program is to provide
individually-tailored treatment services that address
substantial skill deficits in specific life areas which
interrupt an individual's ability to maintain community living. Because of the heterogeneous nature
of individual needs, the programs provide multiple
treatment approaches.
In addition to intensive psychiatric rehabilitation, many different activity/therapy groups are offered. Staff at the CTCs also concentrate on making
community agencies and services more responsive
to the needs of the patients and on integrating patients into the communities where they live. The
therapeutic focus of the program includes individual
therapy, group therapy, occupational therapy, socialization skills, community living skills, nursing, speech
and hearing program, activities of daily living, work
activities, medication management, recreation and
vocational/educational supports.
Number of Persons Served in the CTCs
Volume
of Service
Millbrook CTC
Poughkeepsie CTC Rhinebeck CTC
So. Dutchess CTC
109
234
176
297
12,220
18,671
20,903
24,773
Total CTC's
816
76,567
Staff from the Rhinebeck Continuing Treatment Center gave
a case presentation regarding Concurrent Disorders and
Integrated Treatment. The inservice was held at the Mental
Health Center on October 10. At the Case Conference:
Standing, l-r: Jean Simone, LMSW, Hudson Valley Mental
Health, Inc.; Mary Babcock, LCSW, Clinic for the Multi-Disabled. Seated is Marie Dynes, LCSW, Presenter.
35
AOT Coordination
Vocational / Educational
Coordination
Holly Greer, M.A.,L.C.S.W., Vocational
/Educational Coordinator, works with all disability
groups to coordinate vocational services and serves
on numerous committees to ensure that vocational
and educational needs of individuals in recovery are
considered. Ms. Greer serves as a vocational resource
person for the community. The coordinator is a strong
advocate for increased vocational opportunities for
people in recovery and for the supports they need
to maintain employment in the community.
New York State's Assisted Outpatient Treatment (AOT) Program (Kendra's Law) has been
in effect since August 1999 when New York State
enacted legislation to provide for certain mentally
ill individuals who, in view of their treatment history
and circumstances, are unlikely to survive safely in
the community without supervision. This law establishes a procedure for obtaining court orders for these
individuals to receive and accept outpatient treatment.
Coordination of these services is the responsibility
of the Department's AOT Coordinator, Francis (Burt)
Morgan, LCSW.
Dutchess County had a monthly average of
104 people in OMH Funded Extended Follow-Along
during 2008. These individuals were employed in
over 109 area businesses. Some of the businesses
included: Coon’s Florist, Macy’s, UPS/ Montgomery,
Get Mobile Advertising. People were employed in a
wide array of positions, and they represent a range of
abilities. Some examples of the areas of work included
direct care, personal care aides, retail, food service,
landscaping, factory work, bookkeeping, advocacy,
cleaning and secretarial.
The petition process involves researching the
treatment history of the patient to establish that their
non-compliance has caused them to be hospitalized
at least twice within the preceding 36 months or led
to dangerous acts towards self or others within the
preceding 48 months. A psychiatrist assigned to the
AOT Program must testify in court that the person
meets these criteria and that the treatment plan proposed is the least restrictive to enable them to survive
safely in the community.
DMH provided three Dutchess Community
College classes on-site at Continuing Treatment
Centers for 25 people. In addition, 10 people were
sponsored for a class on campus at Dutchess
Community College or other adult education
programs.
It is the responsbility of the licensed service
providers to monitor and ensure that the treatment
services are provided to the patients. An Intensive
Case Manager is assigned to monitor the patient's
progress in treatment and to report findings to the
AOT Coordinator.
The Mobile Benefit Advisement Counselor
had 442 contacts during 2008. The contacts included
either individual consultation or group presentations to
staff and consumers. Through an OASAS vocational
grant, individuals in treatment for chemical dependency
achieved work readiness status, and 108 individuals
in treatment for chemical dependency became newly
employed.
The goals of the program are to (1) assist
individuals to receive the treatment they need to
remain stable in the community; (2) to decrease the
need for hospitalization by providing supports and
supervision; and (3) to prevent incarcerations for
these individuals.
Since the inception of the Program, there
have been 371 investigations for AOT petitions and,
of these, 86 unduplicated AOT Orders and a total
of 176 AOT Orders granted. An additional 152 individuals have signed voluntary Enhanced Services
Contracts.
Referrals increasingly come from the inpatient
facilities in Dutchess and surrounding counties. Hospitalizations for the AOT patients have increased due
to severity of their illness rather than non-compliance
with treatment.
At the end of November, Ms. Greer transferred
to the Division of Chemical Dependency Services and
a replacement was under consideration.
36
Housing Coordination
Ms. White co-chairs the Dutchess County
Housing Consortium (DCHC), a large and diverse
group of community leaders in government and local
organizations which work together to identify housing needs for people who have distinct needs. The
Housing Consortium is actively working to address the
needs of vulnerable people at risk to be homeless or
who are homeless. Subcommittees address housing issues to work on specific target goals. They are
working to finalize the federal initiative to develop a
10-Year Plan to End Homelessness.
The development and preservation of a full
continuum of residential housing options for those
with mental illness is a priority in Dutchess County.
The Housing Coordinator, Jacquelyn White, LCSW,
ACSW, monitors the current housing needs, contracts,
and assists in planning and development. The Coordinator oversees all licensed and unlicensed housing
programs for persons coping with mental illness, which
sometimes includes housing for families. She is a
resource to the housing providers who house those
individuals with chemical dependency or developmental disabilities. The Coordinator also participates
in the local NYS Office of Mental Health Field Office
site reviews and acts as a housing resource to local
and state agencies.
The DC Department of Planning & Development, along with the assistance of DMH, submits a
yearly HUD grant application. In 2008, Dutchess
County was awarded $826,603 from the SuperNOFA
process. This award included renewal funding for:
Hudson River Housing, Inc.'s Hillcrest House Independent Living Program; River Haven's Home Based
Apartments and Shelter-Plus Care; Gateway Community Industries' MICA Supported Apartments; MARC's
Shelter Plus Care Apartments; MHA's Living Room
(homeless services project); Rehabilitation Support
Services, Inc.'s MICA Shelter Plus Care Apartments;
Grace Smith House's Transitional Apartments; and
Northeast Shelter. These projects serve homeless
individuals with a "disabling condition" as defined by
HUD. Also, $45,120 was included in the SuperNOFA
for the Homeless Management Information System
(HMIS) for HUD-funded programs to count unduplicated numbers of people and services in HUD-funded
projects.
One of the Coordinator's responsibilities is to
facilitate quarterly length-of-stay (LOS) meetings with
various licensed community residence providers and
to monitor those residences to insure that patients
are receiving appropriate residential services. The
meetings are scheduled at the not-for-profit community residences, and State-operated community
residences.
2008 marked the eighth year of the Single
Point of Entry (SPOE) initiative. The SPOE provides
a centralized access point to a variety of community
living options in the mental health housing sector. The
Coordinator reviews the applications and distributes
them to the appropriate housing agencies based on
the need for a specific level of housing. To date, 1,848
applications for residential services were processed
and 639 received placements (not all individuals
met the criteria, or found alternate housing arrangements). The SPOE Housing Providers meet monthly
in conjunction with Case Management to discuss and
resolve individualized housing issues.
The Coordinator attends the weekly "Difficult to
Place" Committee meeting. This committee includes
clinical staff from DMH, Hudson River Psychiatric Center, Lexington Center for Recovery,Inc., Saint Francis
Hospital, and Mental Health America of Dutchess
County, Inc. (MHA). They work together to develop
creative and coordinated community-based plans for
high need individuals. Ms. White is also a member
of the Assertive Community Treatment/SPOA Committee to assist in the eligibility process for incoming
ACT applications.
Residences
The need for a wide range of communitybased mental hygiene residential services for Dutchess
County residents has been clearly established, due in
large part to its unique extensive population of residents released or discharged from New York State
psychiatric and developmental centers. Two such
facilities are located in Dutchess County: Hudson
River Psychiatric Center and the Taconic Developmental Center. At the same time, private community
residences continue to find it difficult to stay in business.
One adult home with 15 beds closed this year.
37
To address the variety of supported residential needs, the Department, along with its community
partners, has developed a wide continuum of residential options for individuals, couples and families
Category
with mental illness, chemical dependencies, and/or
developmental disabilities. These opportunities are
located throughout the county and provide various
levels of support and assistance. Some housing options provide round-the-clock supervision and skill
development and others provide apartments with
monthly visits only. Each consumer is assisted in
accessing appropriate housing which promotes the
highest level of independence. It has been recognized that many individuals can live successfully in
apartments with suppports. Most of the residential
growth this year was in the development of 15 Long
Term beds, aka Special Use Beds for individuals who
have a chronic mental illness. The funding for these
apartments was provided by NYS Office of Mental
Health.
No. of Residences
I. Residences Licensed By
NYS/Office of Mental Health:
Astor RTF
1
Astor Family Based Tx
6
Astor Family Respite Beds 4
Crisis Residence
1
Private Congregate Tx.
3
State-operated CR's
4
Not-for-Profit CR's
4
Supportive Apts. Tx.
22
Family Care Homes
13
Unlicensed Supp. Housing207
Transitional Residence
1
Subtotal
265
The Housing Continuum is overseen and
continually evaluated by the DMH Housing Coordinator. As new needs or new resources develop, DMH
and its partners respond.
C
apacity
20
10
4
12
69
78
52
36
48
205
16
534
II. Residences Licensed by NYS Office
of Alcoholism & Substance Abuse Services:
Community Residence
3
49
Supportive Living Facility
1
12
Crisis Center
1
12
Unlicensed Supp. Units
32
32
Subtotal
37
105
The demand for safe, affordable housing is
evidenced by economic shifts including the fallout
of the sub-prime market. Current housing trends,
particularly vacancy rates, heavily impact the consumers who seek apartments or other residential
opportunities. The Section 8 Program changes have
also impacted the availability of affordable apartments.
DMH, along with New York State government offices,
continues to address housing needs as a major issue
for recovering persons.
III. Residences Licensed by NYS/Office of Mental
Retardation & Developmental Disabilities:
Voluntary Family Care 8
State-Op Family Care
46
Voluntary Supp. Housing
2
Voluntary RTF/ICF
12
State-Operated RTF/ICF
3
Voluntary IRA
9
1
State-Operated IRA
39
Supported Housing
4
Voluntary Respite Beds
1
State Respite Beds
2
(Uncertified Beds)
1
Subtotal
209
19
131
4
169
17
430
220
4
4
3
4
1005
IV. Residences Licensed by
NYS/Department of Health
38
PPHAs
Assisted Living
Foster Family Care Homes
Residence for Adults
10
3
36
1
534
115
69
52
Subtotal
50
770
561
2,414
Total
Other Division Activities:
The Henry A. Wallace Center (at FDR Library) in Hyde Park
was the location on August 8 for a conference sponsored
by Taconic Resources for Independence (TRI), a contract
agency. The yearly event is held to celebrate the anniversary of the Americans with Disabilities Act. DMH was
represented by Holly Greer, LCSW, Vocational/Educational
Coordinator. Guest Speaker, award-winning Author Shirley Cheng, choose the topic: "How to Turn Your Disability
Into Ultra-Ability." At the TRI celebration, l-r: Isaac Rubin,
Ph.D., Mental Hygiene Board; Almerin O'Hara, Jr., Mental
Hygiene Board; Holly Greer, LCSW.
The Family Consultation Program at Rhinebeck Continuing
Treatment Center sponsored a Resource Fair for patients
and their families on February 2 at the Center. Family
Consultation is designed to provide information, support
and practical guidance to members of a patient's family or
social network. Information about mental illness, diagnosis,
and treatment options are provided. Holly Greer, LCSW,
Vocational/Educational Coordinator, made arrangements
for four service providers to give information to the participants. They were: National Alliance for the Mentally
Ill, Mental Health America, PEOPLe and DMH. Planning
Committee members included, l-r: Nirja Kumar, Community
Mental Health Counselor; Wendy Linehan, RN, Community Mental Health Nurse; Amy D'Antonio, Recreational
Therapist; Karen Whitton, LCSW, Social Worker II. Not
pictured: Holly Greer, LCSW.
The patient art work at Rhinebeck Continuing Treatment
Center is an integral part of the Center's activity therapy
program and the work is exhibited throughout the building
at 47 West Market Street. Shown in the Art Room are Marie Dynes, LCSW, Social Worker II (left) and Kelly Bilyou,
Community Mental Health Aide.
39
The highlight of the the Public Forum on Mental Health
Services for Adults, held on May 20, was an announcement by Frank DeSiervo, LCSW, Division Chief, that
Dutchess County would be receiving 28 supported beds
from NYS/OMH. Five of the beds will go to Mental Health
America for transitional individuals between the ages of
18-25. Among the 100-plus persons attending the event
were agency representatives who gave reports on their
activities and improvements in service delivery over the
past year. Comments from consumers in the audience
were duly recorded. Among the participants: Seated, l-r:
Jennifer Rowe, Ph.D., Mental Hygiene Board; Christine Fail,
Mental Health Subcommittee; Almerin O'Hara, Jr., Mental
Hygiene Board; Julie Renda, Mental Health Subcommittee.
Standing, l-r: Isaac Rubin, Ph.D., Mental Hygiene Board;
Patricia Colbert, Mental Health Subcommittee; Frank DeSiervo, LCSW, Division Chief; Robert Oppenheim, LCSW,
Geriatric Services Coordinator.
Services for the Elderly
Affiliated Agencies Serving Adults
and Families:
A range of mental hygiene services to the
elderly population (65+) is available through DMH,
Saint Francis Hospital, Mental Health America of
Dutchess County, Inc. (MHA), Lexington Center for
Recovery, Inc.(LCFR), and Hudson Valley Mental
Health, Inc.(HVMH). Both DMH and contract agency
staff provide outreach services to the geriatric population through MHA's Case Management Unit as well
as the Department's HELPLINE, the Continuing
Day Treatment Centers and the Special Services
Team (SST).
Hudson Valley Mental Health, Inc.(HVMH), is a
private agency which operates five outpatient mental
health clinics under contract with Dutchess County.
The clinics, which are located in Beacon, Dover
Plains, Millbrook, Poughkeepsie and Rhinebeck, are
licensed by the NYS Office of Mental Health (OMH)
as Article 31 outpatient clinics. They offer diagnosis,
treatment, and referral services for Dutchess County
residents age 18 and over who suffer from a full range
of emotional disorders.
Robert Oppenheim, LCSW, Clinical Unit
Administrator of the Southern Dutchess Continuing
Treatment Center, also serves as the Geriatric Services
Coordinator, and is the staff liaison to the Geriatric
Subcommittee of the Mental Hygiene Board. The
Subcommittee meets at least quarterly to discuss
issues concerning the elderly and their mental health
and/or chemical dependency needs.
Members
participate in the Public Forum on Service Needs of
Adults with Mental Illness, which is held in May at the
Mental Health Center.
Services include individual, group and family
therapy, evaluation and medication management.
Referral to a range of services such as housing,
vocational and case management is available. The
clinics are staffed by professionals, including social
workers, psychologists, psychiatrists, nurse practitioners and nurses.
The Geriatric Services Coordinator is on the
Board of the Dutchess County Office for the Aging
(OFA), attending meetings and providing mental
health information to the members. The Coordinator
also serves as Chairperson of the Dutchess County
Office for the Aging's New York Connects Long-Term
Care Council. The purpose of the Council is to review
long-term care systems planning and development in
order to ensure achievement of the goals and objectives of the County's Single Point of Entry for long-term
care.
No. of Elderly
Served
Initiatives in 2008 included creation of the position of Coordinator of Clinical Services and Quality
Assurance. Also, clinical staff members received
training in the areas of Dialectical Behavioral Therapy
(DBT) and Wellness (as part of the NYS Office of
Mental Health's Wellness Initiative). The agency also
embarked on a plan to establish a Cultural Competence
Committee which will involve staff from all sites and
job categories. The initiative was kicked off in April
with enhanced training from OMH staff.
Volume
of Service*
DMH Programs
HVMH Clinics
LCR Clinics
MHA
188 202
25
n/a*
13,306
2,321
408
1,764
Total
415
17,799
No. of Persons
Served
Beacon
Eastern Dutchess
Millbrook
Poughkeepsie
Rhinebeck
Total
*Case Management Services provided to elderly
persons served in the various programs and clinics.
40
Volume of Service*
656
235
193
1,598
279
9,731
3,233
2,310
18,754
3,563
2,961
37,591
Community Education
The goal of Community Education is to provide
a variety of opportunities for all age groups to receive
mental health information.
Mental Health America of Dutchess County,
Inc. (MHA), formerly known as the Mental Health
Association, is a voluntary, not-for-profit organization dedicated to the promotion of mental health, the
prevention of mental illness, and improved services to
persons with mental illness. The agency was formed
in 1954 by a group of local citizens to insure that
mental health services were accessible to all citizens
of Dutchess County.
•Supported Education: Through on-campus
support, 22 Dutchess Community College students
were served.
•Kids on the Block: This volunteer puppet
troupe presented performances to 578 young children
in Dutchess County. The scripts presented included
the topics of childhood obesity, learning disabilities,
bullying and multiculturalism.
MHA provides family support and advocacy
programs, respite programs, rehabilitative services,
case management, community education, and services to the homeless.
•Information and Referral. Using a variety of
resources, people seeking information are connected
by accessing MHA's website, reading the calendar
of community events, the newsletter and calls to the
agency. A private referral list includes psychiatrists,
psychologists and social workers in Dutchess County.
In 2008, there were 607 Information/referral calls,
Circulation of newsletters: 7,500; Circulation of calendars: 5,000.
In 2008, the agency was chosen by the
Poughkeepsie Journal to receive the Richard K.
Wager Workplace Inclusiveness Award for a large
business.
Case Management Program
The Case Management Program serves
people over the age of 18 who have a mental illness.
The primary goal of the service is to decrease, if not
avoid, hospitalizations for the clients. This is accomplished by working with them in what can only be
described as a true partnership. People are assisted
in accessing necessary medical, social, financial, vocational, residential and educational services, along
with any other services for which they are entitled.
• Library: Since 1969, MHA's Library has
been open to the community where they can use a
computer, read journals, borrow books, and browse
the reference collection. Located on the second
floor of the Dutchess County Mental Health Center
at 230 North Road, Poughkeepsie, the Library also
maintains a collection of more than 250 videos. In
2008, the Library had a total circulation of 780 and
had 499 visitors.
• Trainings/Workshops/Conferences: Two
Depression/Anxiety Screening days were scheduled
for the year: one in May and one in October. Subsequently, through a grant from NYS/OMH, five additional
screenings took place in several County locations. With
funding from the Community Foundation, six sessions
of "Men Get Depression" served 125. "Parenting Challenging Teens" is a new series and follows "Managing
Defiant Behavior" and "Parenting the Explosive Child"
for parents and caregivers. Total number attending
classes/workshops/trainings/conferences: 2,372.
Case Management Services - Adult*
No. of Patients
Served
2,025
Volume
of Service
30,188
*Includes /Supportive, Blended, Generic, Intensive,
Blended Intensive and Hedgewood Case Mangement.
41
Family Support and Advocacy
• Compeer: This program is a person-to-person volunteer service which provides a vital linkage
for a person receiving mental health services with a
trained and caring community member. The focus of
the Compeer volunteer is to ease the isolation, build
trust, and offer support in a goal-oriented, time-limited
relationship within the community setting. Number
of Persons Served: 65, with 1,350 visits.
These varied programs address the needs of
families where one or more family members has a
mental illness. Working from a consistently strengthbased and family-friendly orientation, often in collaboration with other community organizations, multiple
programming offers skill-building, peer support, education, empowerment, advocacy, and opportunities for
social interacting, education, empowerment, respite,
advocacy, and opportunities for social interaction. The
number of clients served in the various programs in
2008 were:
Family Support Program
EMERGE Program
Respite programs
Adult Advocacy
Youth Intervention
Court Programs
• Social Rehabilitation: A joint program of MHA
and DMH, the primary emphasis is to promote social
rehabilitation, readiness assessments, pre-vocational
assessments, and life care assessments for persons
who have the most serious mental illnesses. Number
of Persons Served: 450, with 8,044 visits.
237
109
164
842
175
73
• Young Adult: The primary emphasis of this
program is to provide opportunities for young adult
consumers ages 18-30 (approximately) to socialize
and enjoy recreational activities together. Members
participated in many recreational activities, held
monthly meetings, and elected club officers. Number
of Members Served: 27, with 1,063 visits.
Homeless and MICA Services
The Living Room provides a safe haven and
supportive services to individuals who are homeless or
at risk of becoming homeless and have mental health
and/or substance abuse related needs. It provides
day and weekend services, referring visitors to the
services they need for treatment, benefits, employment
and housing. In addition to contracts with DMH, the
program also receives funding from federal supports
for the homeless program. Number of individuals
served: 879, with 16,507 visits.
Rehabilitation Services
Mental Health America and the Department of Mental
Hygiene observed National Depression Screening Day
on October 10 by holding a screening at MHA offices, 253
Mansion Street, Poughkeepsie. According to Janet Caruso,
Director of Community Education, the MHA has scheduled
additional screenings in the future at Dutchess Community
College, Town of Beekman, City of Beacon and eastern
Dutchess County. The screenings, for depression and
anxiety, will be available through a grant from NYS/OMH.
At the screening were, l-r: Janice Hulce, LCSW, Mental
Health America; Janet Caruso; Betsy Fratz, RN, DMH
Nursing Supervisor.
Psychosocial rehabilitation programs provide
experiences that improve their ability to function in the
community.
• Dutchess Horizons: This social rehabilitation program strives to improve the social, vocational
and recreational skills of persons over the age of 18
recovering from mental illness. The program stresses
the importance of developing an active participation
of members in the rehabilitation process. Number of
Members Served: 140, with 13,726 visits.
42
The staff, under the supervision of William Eckert,
LCSW, Clinical Unit Administrator, is comprised of a
Chemical Dependency Counselor and two full-time
case managers. This team provides assessment,
pre-release planning and post-release linkages to
treatment services for individuals suffering from mental
illness and/or chemical dependency. The services
are partially funded by the DC Department of Social
Services.
PEOPLe, Inc.
PEOPLe, Inc. (Projects to Empower and Organize the Psychiatrically Labeled), is a contract agency
of the Department, and receives funding from the
New York State Office of Mental Health. The agency,
in operation for nineteen years, has experienced
growth since its inception, and currently operates
programs in Dutchess as well as other counties in
New York State. The DMH Mental Health Services
Division Chief, Frank DeSiervo, LCSW, serves as the
liaison between DMH and PEOPLe. Meetings with
the agency staff are held regularly to discuss agency
status, housing issues, and planning recommendations.
Rehabilitation Support Services, Inc.
(RSS)
This not-for-profit agency provides a wide array
of rehabilitation services for residents throughout the
Hudson Valley and Capitol District areas. In Dutchess
County, they offer an extensive continuum of housing
opportunities. This includes community residence
beds in Poughkeepsie and Fishkill. In addition, the
agency operates supported beds and supervised
apartment beds throughout the County. RSS is also
a large provider of job coaching supports as well as
operating the Dutch Treat Cafe at the Dutchess County
Mental Health Center in Poughkeepsie.
The primary mission of PEOPLe is to advocate
for and with individuals with mental health issues. As
a consumer-run agency, the efficacy of its services is
measured by the ability of consumers to move on to
the next aspect of their recovery. With the support
of self-help groups and wellness tools, individuals
are empowered to take control of their own recovery.
Continued services with vocational assistance and
support, plus a supported housing program, provide
a full array of services to accompany persons on their
own "road to recovery."
Hudson River Housing, Inc. (HRH)
Providing decent, affordable housing for low to
moderate income people in our community is the focus
of this agency. HRH programs enable participants
to become more self-sufficient and to gain maximum
influence over their lives. In Dutchess County, HRH
has set aside 15 units at its Hillcrest House facility
specifically for individuals with a chronic psychiatric diagnosis. In addition, they operate a 10-bed
supported apartment program, also for chronically
mentally ill individuals and/or families. HRH operates
many other housing programs in Dutchess County for
singles and families. The agency's programs include
emergency, transitional and permanent housing opportunities, Homebuyer Education Services, and
independent living skill development for youth.
Throughout the year, services were provided to
persons who were living independently in residences
and in state psychiatric centers. In addition, PEOPLe
operates several apartment programs for chronically
mentally ill individuals.
Gateway Community
Industries, Inc.
Founded in 1957, Gateway is a not-for-profit
vocational rehabilitation and training center for people
with psychiatric and/or physical disabilities. The
agency provides comprehensive services in vocational
evaluation, job training, job placement, supported
employment, and residential services throughout
Dutchess County. On the vocational side, Gateway
operates the Southern Dutchess Vocational Alternatives Program and the Internship Program in addition to
extended follow-along job coaching support throughout
Dutchess County. On the housing side, Gateway operates a 12-bed community residence in Beacon and
also maintains supported beds in scattered locations
throughout the County. The Department, in collaboration with the Dutchess County Sheriff's Department,
provides services at the Dutchess County Jail on
North Hamilton Street in the City of Poughkeepsie.
Taconic Resources for Independence,
Inc. (TRI)
43
TRI operates a center for independent living
in Dutchess County. The agency's goals are to assist
people with disabilities to be active and independent
and to educate and involve the community in disability issues. Specifically, TRI advises clients and
family members on benefits available to them.
Division of Chemical Dependency Services
The Division of Chemical Dependency Services
is responsible for providing and/or coordinating a broad
array of community services to Dutchess County residents suffering from the diseases of alcoholism and/or
other chemical dependencies. These services include
clinical therapeutic services, medication management,
counseling, intensive programs, primary alcoholism
services, methadone maintenance, detoxification and
rehabilitation, emergency shelter, crisis services for
public intoxicants, coordination and linkage with a
variety of detoxification, transitional living, outpatient
services and public education.
The Division Chief also serves as staff liaison to
the Mental Hygiene Board's Chemical Dependency
Services Subcommittee. The Subcommittee works
with the Department's contract agencies--MARC,
LCR, and CAPE-- to monitor the performance indicators for each program.
Under the sponsorship of the Subcommittee, the
annual Public Forum took place on April 10th from
4-6 PM., at the Mental Health Center. Input from the
meeting was incorporated into the DMH 2009 Local
Services Plan for Chemical Dependency Services.
Ms. Hirst presented the plan to the Mental Hygiene
Board at its June meeting, where it was approved
and subsequently forwarded to the New York State
Office of Alcoholism and Substance Abuse Services
(OASAS).
The Division Chief for Chemical Dependency
Services, Margaret Hirst, LCSW, is responsible for the
planning and coordination of all services for Dutchess
County residents and works closely with other providers of chemical dependency services as well as with
an array of allied community agencies.
• Vocational Services: DMH continues to offer
work readiness training which provides linkages to
job placement and job development for individuals
in the Southern Dutchess area. MARC provides
job development & vocational case management follow-along services for individuals in Dutchess County.
The intent is to assist the patient, once employment
is obtained, to remain on the job.
In addition to its directly-operated programs,
the Department has contracts with Lexington Center
for Recovery, Inc. (LCR) for outpatient clinical services and methadone maintenance, the Mid-Hudson
Library System for health education, the Council
on Addiction Prevention & Education, Inc. (CAPE)
for prevention and education services, and the MidHudson Addiction Recovery Centers, Inc. (MARC) for
crisis residence and halfway/quarterway house services. Affiliated agencies include The Turning Point,
which offers detoxification and inpatient rehabilitative
services; Cornerstone of Rhinebeck, Daytop Village,
Homer Perkins and New Hope Manor provide inpatient treatment services. A New York State-operated
Alcoholism Treatment Center, located in Middletown,
Orange County, serves Dutchess County residents.
• Welfare To Work: The Department works
closely with the DC Department of Social Services
(DSS) to meet the goals of the Welfare to Work
Program in New York State. DMH provides an
assessment of individuals applying for Public Assistance and Medicaid who have a history of chemical
dependency. Through this assessment, persons are
evaluated for their ability to work and/or their need
for treatment. This allows DSS and the Department
to track progress in treatment and movement toward
work and job retention.
• The Enhanced Case Management Program
assists individuals who have high Medicaid costs to
engage in chemical dependency treatment and move
forward toward economic independence.
There is a Dutchess County Chemical Dependency Providers Committee, chaired by the Division
Chief, which is comprised of all local agencies which
deal with chemical dependency. The Committee
meets every two months to discuss issues of mutual
concern.
44
Intensive Treatment Alternatives Program (ITAP)
with other agencies such as VESID, Family Services,
Inc.'s Domestic Abuse Awareness Class (DAAC), and
the YWCA Battered Women's Program. Additionally
in 2007, ITAP staff introduced a Wellness curriculum
designed to teach a holistic approach to recovery.
Teaching models included nutrition, smoking cessation, exercise and leisure skills. Program staff also
initiated an Integrated Treatment approach to working
with individuals with mental health or trauma issues
as well as chemical dependency issues.
The Intensive Treatment Alternatives Program
(ITAP) is a New York State Office of Alcoholism &
Substance Abuse Services (OASAS) licensed outpatient day rehab program which provides alcohol/
substance abuse services to those requiring a highly
structured, supportive and long-term treatment experience. It specializes in treating the criminal justice
patient and also serves as an alternative to inpatient
treatment. The program is unique in that Probation
Officers are integrated into the program as part of
the treatment team process and work on-site at the
treatment program.
Drug Courts
Since 2001, the Cities of Poughkeepsie and
Beacon have implemented Drug Court programs.
The mission of these programs is "to offer chemically
dependent defendants an opportunity to engage in
a court-supervised treatment program designed to
achieve recovery and, thereby, eliminate the associated criminal behavior and the cost to the community
thereon in order to increase public safety." The target
group is the multiple misdemeanant offender who
commits crimes because of his/her chemical dependency. A Family Treatment Court targets adults who
are petitioned by the Family Court for abuse or neglect
and are chemically dependent. A Juvenile Treatment
Court in the Family Court became operational in
2006.
The criminal justice or Alternative-To-Incarceration (ATI) patient is referred for assessment by
the Office of Probation & Community Corrections ,
the Public Defender's Office, the Courts, the District
Attorney's Office or by private attorneys. Patients accepted into the Program are also supervised by one
of the ITAP Probation Officers. Most ATI patients also
attend the Program while concurrently residing at a
Probation-supervised community residence. These
two programs work closely together in coordinating
the treatment planning process.
Road To Recovery
ITAP has developed a comprehensive working
relationship with the Bolger Halfway House for those
patients who complete the Transitions Residence
and continue to require a highly structured residential
component. Michael North, LCSW, the Program's
Clinical Unit Administrator, continued to meet regularly
during the year with Probation staff at the Transitions
Residence. There is daily contact between ITAP and
the Residence to communicate concerns and problems that have occurred during the day, evening and
weekends. Probation staff attend weekly rounds
with ITAP staff to help coordinate decision-making
in regard to furloughs, planning and general patient
status. Staff have also continued to work in conjunction
with the Hillcrest Residence for residential placement
of those coming out of Transitions.
The Road to Recovery Program, an initiative
jointly funded by OASAS and the NYS Department
of Criminal Justice Services as an alternative to incarceration program continued in 2008. In Dutchess,
the program targets the multiple felony offenders
who are nonviolent and chemically dependent. The
offenders must participate in six to nine months of intensive residential treatment, followed by six months
of community residential placement with participation
in outpatient day rehabilitation at ITAP.
Case management services are provided
throughout the program to ensure good communication
among all the partners and smooth transition through
the phases.
In 2008, ITAP continued to provide GED
classes on-site so that patients have an opportunity to
earn a high school equivalency degree. The classes
are taught by BOCES staff twice weekly. The Program
also continues to have a very positive relationship
The individual completes the treatment phase
with three months of aftercare clinic and community
living. A case manager is assigned to each participant
to ensure that there is consistency in communication,
transition from each phase is accomplished smoothly,
45
and that all aspects of the individual's treatment and
necessary family supports are addressed. The project
is jointly administered locally between DMH and the
District Attorney's Office. Bimonthly Advisory Committee meetings are held to review progress, address
systemic issues and resolve problems.
Pre-Trial Diversion Services
Pre-Trial Diversion Services in the City of
Poughkeepsie Court. DMH, in collaboration with the
Office of Probation & Community Corrections, identifies individuals who may be suffering from serious
mental illness or co-occurring disorders who have
been arrested in the City of Poughkeepsie. If eligible
for Probation supervision, community supports such
as treatment, medication, case management and
housing are immediately put in place for the individual,
thereby avoiding incarceration. DMH staff continue
to monitor the individual's progress and provide periodic reports to the Court until the legal issues are
resolved. In 2008, 37 individuals were assessed; 31
were admitted to the Diversion Program. Of those,
16 individuals were diverted from incarceration.
Volume
of Service
ITAP Day Rehab
109
CD Clinic
35
Road To Recovery
--
Vocational Case Mngt.
--
CD Case Mngt.
--
CD Assessment
1,116
Forensic Coordination 592
Jail-Based Services
373
11,741
712
457
667
1001
1,116
592
3,102
Total DMH
19,388
2,225
Number of Dutchess County Residents Served
at Richard C. Ward Alcohol Treatment Center,
(Middletown ATC): 232
Jail-Based Services
The Department, in collaboration with the
Dutchess County Sheriff's Department, provides services at the Dutchess County Jail on North Hamilton
Street in the City of Poughkeepsie. The staff, under
the supervision of William Eckert, LCSW, Clinical
Unit Administrator, is comprised of a Chemical Dependency Counselor and two full-time case managers.
This team provides assessment, pre-release planning
and post-release linkages to treatment services for
individuals suffering from mental illness and/or chemical dependency. The services are partially funded by
the DC Department of Social Services.
46
Contract agencies serving chemically
dependent individuals:
Other Division Activities:
Lexington Center
for Recovery, Inc.
Under contract with Dutchess County, Lexington Center for Recovery, Inc. (LCR), a Westchester
County-based agency, operates outpatient chemical
dependency clinics and a Methadone Treatment &
Rehabilitation Program.
Outpatient Chemical Dependency
Mario Malvarosa, MD, an addictions specialist consultant with Lexington Center for Recovery, Inc.,
presented an inservice on "Medications and Addictions" to staff on March 7. Dr. Malvarosa reviewed
the medical issues related to chemical dependency
and described those medications used to treat dually diagnosed individuals. Dr. Malvarosa, a former
DMH employee, is currently the Medical Director of
Downstate Correctional Facility in Fishkill. Shown, l-r:
Christine Manning, LCSW, Clinical Unit Administrator,
Special Services Team; Bonnie Scheer, LCSW, Director, Office of Community Services; Debbie Masterson,
RN, Community Mental Health Nurse, ITAP; Kathleen
Spencer, RNC, Quality Improvement Coordinator; Dr.
Mario Malvarosa; Paul Wilson, Physician Assistant,
Methadone Program; Jane O'Brien, RN, Community
Mental Health Nurse, Millbrook Continuing Treatment
Center.
Five outpatient clinics serve adults, adolescents and families as well as treating clients with
co-occurring disorders in the following locations:
Manchester Road in the Town of Poughkeepsie,
Beacon, Eastern Dutchess, Millbrook and Rhinebeck.
Services include individual, group and family therapy.
In addition, the agency provides individual and group
therapy to adolescents in Red Hook in a secure state
residential facility. In December, 2008, the agency
opened a satellite site in the City of Poughkeepsie and
continued renovating a new, larger site in the City of
Beacon.
Several specialized programs for both men and
women provide treatment which focuses on issues
of early recovery, relapse prevention, compliance,
healthy relationships and social supports, parenting,
and vocational planning. Many of the clients have
criminal justice involvement and the staff liaison to
mandated services in collaboration with Probation and
Parole to assure effective communication and treatment planning. The agency is also a team member
of the Dutchess County Family Drug Court, the Drug
Courts in the Cities of Poughkeepsie and Beacon,and
the Dutchess County Youth Court in Poughkeepsie.
During 2008, the agency continued to expand
existing treatment programming as well as the following initiatives: providing services to clients referred
by CPS (Child Protective Service) through a special
"Co-Location Grant;" continued to participate in an
Adolescent Grant which provides enhanced
47
Mid-Hudson Addiction
Recovery Centers, Inc.
mentoring services and treatment, offering a 16-week
series in cognitive behavioral therapy for mandated
clients; and continued to offer an Anger and Addiction Group, which primarily addresses the treatment
needs of the mandated population.
The Mid-Hudson Addiction Recovery Centers,
Inc. (MARC) operates an OASAS-licensed Chemical
Dependency Crisis Center in the City of Poughkeepsie, and three OASAS-licensed community residences.
The Crisis Center offers short-term housing, counseling and support services for individuals under
the influence of alcohol and/or other drugs who do
not need hospitalization. In addition, MARC serves
non-intoxicated persons at high risk of relapse as
they prepare for placement in chemical dependency
treatment facilities. MARC also operates a network
of rent-subsidized, sober, supported apartments for
individuals and families in recovery.
Parenting classes continue to be offered to
all clients on-site through the Child Abuse Prevention
Center. In addition, DMH provides vocational counseling assistance to those clients seeking employment,
assists in job readiness skills, and helps clients with
job applications. The Department also offers on-site
case management for all clients who could benefit
from the service.
Methadone Program
MARC's community residences include
Florence Manor, a 13-bed halfway house for women
in Fishkill; Bolger House, a 24-bed halfway house
in the City of Poughkeepsie for men; and Dowling
House, a 13-bed three-quarterway house in the Town
of Poughkeepsie for men and women.
For those who are addicted to opiates, LCR
operates a Methadone Maintenance and Rehabilitation Program which offers a comprehensive treatment
and counseling service, including vocational and
educational programs and referral services. Adjunct
services such as couples, marital and family counseling, as well as referral to community support groups,
are also a part of the program. If indicated, clients
also attend chemical dependency treatment at the
Manchester Road site to assist them in maintaining
abstinence from other drugs while receiving Methadone. Discussion continues regarding plans to expand
Methadone services in the City of Beacon area.
Both staff and clients of the agency are
extremely active in community affairs directly and
indirectly related to chemical dependency services.
No. of Persons Volume of
Served
Service
Methadone Program 270
Manchester Rd.
1,501
Millbrook
73
Beacon
339
Eastern Dutchess
2,486
Rhinebeck
99
Red Hook Clinic
28
41,555
37,316
831
5,411
124
Total
89,273
2,434
1,377
297
48
Volume of Service
339
3,271
Council on Addiction Prevention
and Education of Dutchess County,
Inc.
works with the Professional Development Program at
Rockefeller College at the University of Albany. The
goal of RTATC is to support NYS/OASAS-funded and
certified agencies as they address tobacco dependence treatment and recovery.
The Council on Addiction Prevention and Education (CAPE), has been providing school-based and
community substance abuse prevention, education
and counseling services to the youth and families
of Dutchess County since 1987.
Victim Impact Panel (VIP): The program serves
the entire community by providing a monthly forum on
the painful consequences of drunk driving from people
whose lives have been forever changed by a drunk
driver. People convicted of Driving While Intoxicated
(DWI) and Driving While Ability Impaired (DWAI) are
mandated by the courts to attend VIP with the aim of
reducing recidivism.
The Student Assistance Program: Provides counselors in four school districts and 10 schools providing
substance abuse prevention education to students,
faculties, and families, community, individual and group
counseling, information and referral services as well
as family communication programs.
Teen Driving: A Family Affair: A program that
brings the VIP model into local high schools as part of
the student's application for a parking permit to allow
students to drive to school. The program mandates
that both student and parent attend this modified VIP,
which includes victims as well as representatives
from the District Attorney's Office and the insurance
industry.
Alcohol and Education Program: Conducts presentations in schools and colleges and to communitybased organizations throughout the county related to
drinking and driving, underage drinking, and alcohol
and substance abuse. The program also works with
the Dutchess County MADD Chapter and the schoolbased SADD Chapters.
Campus Coalition: The Council Coordinates the
College Consortium, a group of representatives from
the various local colleges who come together to address the issues of substance abuse, underage and
binge drinking on campus.
Information and Referral Services: Provides substance abuse information and treatment referrals to
hundreds of people each year, including individuals,
families, students, businesses, law enforcement, and
educators. The Council also provides Intervention
Services in the community.
Professional Education Program: A series of
substance abuse-related trainings sponsored by the
Council for people working in the field of addiction.
Tobacco-Free Schools Support System: Serves
as the State-wide initiative to help school districts
develop and implement comprehensive tobacco policies. The goal of the program is to work with schools
to design an enforceable policy for students, staff,
and visitors, based on successful models from other
schools and the guidelines of NYS and the Centers
for Disease Control.
The Marathon Project: An after school training program that pairs adult mentors with at-risk youth in the
Poughkeepsie and Beacon City School Districts, as
well as the Dutchess County Office of Probation and
Community Corrections and The Children's Home.
The aim is to reduce risk factors such as childhood
obesity, gang involvement, school drop out, and
substance abuse. The Project provides opportunities for students to set and achieve goals, explore
avenues for character development, improve health,
and build positive student/adult relationships through
mentoring.
The Southern Dutchess Coalition: A partnership
of individuals, agencies, and businesses working
together to assess and prevent unhealthy behaviors, especially substance abuse among youth while
strengthening families. CAPE is the lead agency for
the Coalition.
Mid-Hudson Valley Regional Technical Assistance
& Trainer Center (RTATC): Provides customized
advice and solutions for tobacco-related challenges
in chemical dependency programs. The program
49
The Northeast Community Coalition: CAPE's
newest initiative engages the Towns of Amenia, Dover, Northeast, and Pine Plains in the development
of a community coalition which will address growing
human services needs, particularly substance abuse
issues among youth.
2008 Services Provided:
Student Assistance Program
Educational Presentations:
Students
Professionals
Parents/Community
Individual Counseling Sessions
Group Counseling Sessions
Family Counseling Sessions
Family Participants
community-based prevention education programs for
teens in five Mid-Hudson Library System libraries and
supplies prevention information materials to youth,
their families, educators and agencies serving youth
in all public libraries in the system.
324
27,788
3,502
5,265
3,440
227
334
368
Class Action Program: An evidence-based program
focusing on the social and legal consequences of underage drinking implemented as a summer program at
the Howland Public Library. This program has shown
results that include a delay in the onset of alcohol use,
reduction in underage use, and a limit to problems
associated with underage drinking among teens.
The Teen Intern Program: A 10-week summer program implemented at five Health Information Center
libraries.
Teens evaluate prevention information
materials in video, book and web formats to determine
those most relevant and useful for the young adult
population. Program outcome evaluations indicate
prevention behavior gains in information, peer communications skills, and refusal strategies. In addition,
the teen interns provide input for the purchase of
prevention education materials to be made available through all libraries in the Mid-Hudson Library
System.
Community Educator/Alcohol Highway
Traffic Safety:
Presentations
306
Individuals Served
5,300
Teen Driving Programs
12
Students Served
1,843
Parents Served
1,849 Materials Distributed
11,000
Under 21: Individuals Served
38
Health Fairs
9
Victim Impact Panel:
1,470
Tobacco Free Youth Initiative:
Individuals Served
Presentations
2,047
1,496
The Marathon Project:
Students Served
Volunteer Adult Mentors
Professional Education Program:
Area Peer Presentations: Class Action and Teen
Intern Program participants schedule Peer Presentations for area middle and high school classes. During
these sessions, the interns focus on media literacy
skills gained, prevention insights learned, and on current youth-relevant materials and resources available
through the library.
Health Information Centers: Seventeen MidHudson Library System Health Information Centers
circulate prevention information videos and books.
Access to these materials continues to be facilitated
by the coordinated library catalog which allows for
the free borrowing of materials through 66 libraries
in the five-county System area as well as statewide.
The Project website (http://hip.midhudson.org) is
maintained to provide ease of access and borrowing
of project materials.
56
52
53
Mid-Hudson Library System
Health Information Project
2008 Services Provided:
Teen program participants
Prevention Materials Used
by teens, adults and educators
The Mid-Hudson Library System Health Information Project, funded by the New York State Office
of Alcoholism and Substance Abuse Services, and
in part by Dutchess County Government, provides
50
166
4,919
Division of Developmental Disabilities Services
Coordination of Services
The Division of Developmental Disabilities
(DD) Services is responsible for the coordination
of services for persons who have developmental
disabilities (i.e., autism, mental retardation, cerebral
palsy or other neurological impairments occurring
before the age of 22). Karen Trokan, LCSW, the Division Chief, provides liaison among the Department,
its contract agencies and other service providers in
Dutchess County. She works closely with the three
DMH contract agencies: Abilities First, Inc. (formerly
REHAB Programs, Inc.), Dutchess ARC, and Cardinal
Hayes Home for Children. She also serves as liaison
to the Taconic Developmental Disabilities Services
Organization (DDSO), which is the regional office of
the New York State Office of Mental Retardation and
Developmental Disabilities (OMRDD). The Department provides regular clinical consultation to Abilities
First and Dutchess ARC by providing representatives to
the Special Review Committees for both agencies.
individuals, families and agencies concerned with the
transition of special education students from school
to the world of adult activities and services. In 2008,
this group again sponsored a series of information
nights for students and parents, and organized tours
of selected residential and day habilitation programs.
Representatives from BOCES, DMH, the Taconic
DDSO, VESID, Dutchess Community College and a
number of local agencies provided information needed
by families and students preparing for this transition,
including information about OMRDD eligibility and the
Dutchess County Central Registry.
The Division Chief serves as the staff liaison
to the Developmental Disabilities Subcommittee of
the Dutchess County Mental Hygiene Board. Members of this Subcommittee are involved in planning for
services and in monitoring the performance of contract
agencies. In this capacity, members participate in
agency site visits to evaluate contract compliance
and to better understand the range of services. During 2008, the Subcommittee visited the Anderson
School for Autism, and New Horizons Resources as
well as receiving a presentation on the services of
the DMH Clinic for the Multi-Disabled. In keeping
with the Subcommittee's interest in the transition
process from infancy and early childhood to school,
and from school to adult services, the Subcommittee
heard presentations from the Vassar Brothers Medical
Center Neonatal Intensive Care Unit staff, from the
Early Childhood Coordinated Services Initiative and
from the Parent Advocate at Taconic Resources for
Independence about the assistance each provides to
families.
The Division Chief serves as Chairperson
of the Developmental Disabilities Planning Council
(DDPC). The DDPC is composed of directors of
voluntary agencies and senior staff of the Taconic
DDSO. The Council meets monthly to coordinate
services and to engage in county-wide planning for
the developmentally disabled. The DDPC provides
input each year for the DMH Local Services Plan for
individuals with developmental disabilities.
In 2008, for the first time, the NYS Offices of
Mental Health, Alcoholism and Substance Services,
and Mental Retardation and Developmental Disabilities came together to engage in a joint local planning
process, allowing for priorities to be set for mental
hygiene services in Dutchess County that encompass
priority needs for all three disability groups.
The Division Chief represents Dutchess
County through participation on the Developmental
Disabilities Committee of the NYS Conference of
Local Mental Hygiene Directors. This committee provides input to OMRDD on major issues in the field,
with particular emphasis on how those issues affect
individuals and agencies on a county level.
Ms. Trokan represents DMH on the Dutchess
County Transition Network Committee. This committee provides information and coordination to those
On March 11, the DD Subcommittee sponsored the annual Public Forum on Service Needs
for People with Developmental Disabilities. Needed
services highlighted included: enhanced access to
transportation and employment opportunities, as well
as day habilitation programs for individuals with more
intense medical needs.
The DDSO and the local provider agencies
continued to make progress in the down-sizing of the
Developmental Center and of the larger community
residences. Development of new residential oppor-
51
tunities and completion of renovations continued. A
new, community-based day habilitation program for
individuals with autism was opened by the Anderson
Center in June, and an after-school program was
developed by Maranatha Services.
Adolescents and adults with developmental
disabilities often require services and supports from
more than one system. A multifaceted approach to
service delivery may be necessary (e.g. mental health,
social services, housing and other government and
voluntary agencies). Coordination of services and
agencies benefits both patients and caregivers. Staff
continue to serve on a number of community boards
and committees of local agencies which serve the
DD population.
Clinic for the Multi-Disabled
There were several significant staff changes
during the year:
The Clinic for the Multi-Disabled (CMD), under
the supervision of Mary Babcock, LCSW, provides
outpatient mental health treatment to mentally ill,
mentally retarded/developmentally disabled individuals ages 15 and older. CMD utilizes an intensive
systems interaction approach to treatment, working
in conjunction with the individual's existing community
support systems to maximize all possible supports
to the person. CMD staff, representing the disciplines
of psychiatry, psychology, social work, and nursing
provide a full range of mental health services including
psychotherapy (individual, group, family/couples),
psychiatric and psychological evaluation as well as
treatment, medication management and crisis intervention.
- Kathleen Anderson, RN, began full time
duties in January.
- Christine Piotti, RN, was reassigned to DMH's
Continuing Treatment Center and Bernice Romig,
RN, was reassigned from Poughkeepsie Continuing
Treatment Center to the Clinic for the Multi-Disabled
in April.
-Sushil Chandra, MD, began working two and
a half days per week at CMD in June.
No. of Persons
Served
Services are provided at the main clinic site,
9 Mansion Street, Poughkeepsie, as well as at five
satellite locations in various areas in the County. 439
Volume
of Service
4,913
The clinical staff also provide advocacy to
developmentally disabled persons in addition to providing consultation and education to staff of agencies
or to families who are involved in the care, treatment
and/or management of the person or persons requiring the services.
A Chemical Dependency Services (CDS)
component within the Clinic is certified by the NYS
Office of Alcoholism and Substance Abuse Services
(OASAS), and consists of a Licensed Clinical Social
Worker who provides and coordinates a broad array
of outpatient treatment services to individuals 18
years and older who are chemically dependent. The
CDS staff also provides educational, consultative and
networking activities with both the developmental
disability service providers and the chemical abuse
service providers. Administrative and clinic service
needs such as psychiatry, psychology, social work
and nursing are provided by the CMD staff.
Family, friends, and colleagues attended a special retirement celebration honoring Dr. Benjamin S. Hayden at
Christo's Catering on March 14. After 32 years of service
at DMH, Dr. Hayden is now pursuing his many hobbies as
well as keeping up with happenings in the mental hygiene
field. Shown at the event, l-r: Bill Busby, Assistant Executive
Director, Cardinal Hayes Home for Children; Jack Fenton,
Program Specialist, Taconic DDSO; William Carroll, Executive Director, Abilities First, Inc. (Ret.); Dr. Hayden.
52
Contract agencies serving developmentally disabled persons:
• Guardianship Program
• Recreation and Youth Services
• Residential Options
• Service Coordination Department
Dutchess ARC (a.k.a. ARC, DC)
Dutchess ARC, --"Advocacy, Respect, Community"--a chapter of NYSARC, Inc., is one of approximately 50 across New York State. The agency
offers a full array of services to Dutchess County
residents with developmental disabilities and their
families. Services range from family resources and
services coordination to recreational programs, from
vocational and clinical services to residential opportunities. ARC employs approximately 300 people at
sites throughout Dutchess County.
In addition to the many services available, ARC
is experienced in providing consultation to families
who may need assistance navigating the system. ARC
also has the ability to develop specific services and
opportunities based on individual and family needs.
LaGrange Center
Amenia Center
138
51
18,797
5,677
Total
189
24,474
Home For Children
The Cardinal Hayes Home for Children specializes in the care and treatment of young people with
severe disabilities. The Franciscan Missionaries of
Mary are sponsors of the agency, which has been in
operation for 65 years. Respite care services are
partially funded by DMH.
Respite Care: A community respite service
provides planned periods of short-term relief to families caring for a developmentally disabled member at
home. Respite helps reduce stress and improves the
quality of life for all family members. The program
provides over 4,500 hours annually for families
burdened with extraordinary care. Medicaid waiver
respite is also provided for individuals approved for
funding.
Services provided by Dutchess ARC at the
Vocational Centers are partially funded through the
auspices of DMH.
Other significant services provided by Cardinal
Hayes include the following:
Other significant services provided by Dutchess
ARC include the following:
Volume of
Service
Cardinal Hayes
Vocational Services: ARC's Career Options Department works to secure meaningful employment
opportunities throughout the County based on the
individual's preferences and capabilities. Vocational
training facilities located in LaGrange and Amenia
focus on prevocational training. Supported employment provides individuals with supports needed to
be successful in community-based employment.
Consultation, vocational assessment, resume development, career counseling, placement, on-the-job
training and follow-up services are also provided by
the staff. Students transitioning from the educational
model can find exploration and training experiences
through transitional service options.
• Clinic Services
• Day Services:
• Family Support and
Educational Advocacy
53
• Residential Services
• Service Coordination
• Adult Day Training
• Recreational Services
Abilities First, Inc.
Taconic Developmental
Disabilities Services Office (DDSO)
Abilities First, In. (formerly known as REHAB
Programs, Inc.), is a local, not-for-profit agency
which serves both children and adults who have a
developmental disability.
Staff of the DDSO, the regional office of the
NYS Office of Mental Retardation and Developmental
Disabilities, has service responsibility for developmentally disabled children and adults from Dutchess
County and surrounding areas. Staff work closely with
the DMH Division Chief, Developmental Disabilities
Services, for community placements and for provision
of community-based services.
The Work Training Centers, partially funded
by DMH, provide basic job skills training and workrelated skill development in a sheltered environment
which mirrors a community industrial setting. Subcontract packaging and assembly work is provided.
The Advanced Work Training Center provides training
on various types of machinery (e.g., drilling, spooling,
shrink wrapping) in the complete assembly and production of a hand-sewing awl. Increased self-esteem
and self-confidence are direct by-products of these
vocational training mediums.
Day Treatment Program: This program, located in
the Town of LaGrange, serves residents in the Taconic
District's Intermediate Care Facilities, Community
Residences, Family Care Homes, and Individualized
Residential Alternatives.
A Behavioral Support Team serves clients in
Dutchess and Ulster Counties. The group is proving effective in reducing psychiatric hospitalizations.
Where such hospitalizations have taken place, the
Team has worked well with all parties to effect a planful discharge.
Vocational counseling is provided daily to foster independence and productivity, with the ultimate
goal of community job placement. Ancillary programs
include literacy training, day habilitation (offering
increased community integration opportunities), volunteer services, support groups, and computer skills
development.
No. of Persons
Served
Day Habilitation
Work Training
Waryas House
Total:
Volume of
Service
282
283
29
No. of Persons
Served 594
47,614
37,433
3,700
88,747
Additional significant services provided by Abilities
First include the following:
Additional Adult Services:
• Integrated Employment Services (IES)
• Day Habilitation Services
• Residential Services
• Social Work and Case Management
Children's Services:
• Educational, Preschool
• Educational, School
• Medical Rehabilitation Clinic
54
99
Volume of
Service
20,418
Office of Quality Improvement
(2) Contract Agency Site Visits - QI Committee
members, along with members of the Mental Hygiene
Board and Subcommittees, schedule visits to selected
contract agencies whose programs are not otherwise
inspected by New York State licensing agencies.
These visits provide DMH with additional qualitative
information about program performance beyond the
outcome reporting of performance outcomes. Following a review by the agency, final reports of these
visits are provided to the Executive Council and to
the relevant Mental Hygiene Board members. During
2008, visits were made to the vocational programs of
PEOPLe, Inc. and Gateway Community Industries,
Inc.
The DMH Office of Quality Improvement
(QI), under the direction of Karen Trokan, LCSW, is
responsible for the Quality Improvement Plan, Quality Improvement activities of the Department, and
Quality Improvement measures as they pertain to
contract agencies. Kathleen Spencer, RNC, as the
Quality Improvement Coordinator, is key player in the
QI monitoring process. Corporate Compliance activities fall under the Office of QI, and Ms. Spencer also
serves as DMH's Corporate Compliance Officer.
• The Quality Improvement Committee
The Quality Improvement Committee (QIC)
is chaired by the Quality Improvement Director and
is composed of members of DMH staff representing a range of functions, disciplines and programs.
The QIC also includes two members who represent
consumers of service and family members.
•Safety and Disaster Preparedness
In conjunction with the activities of the DMH
Safety Committee and the Safety Officer, the Office of
QI conducts semiannual Tabletop Emergency Drills to
prepare staff to manage untoward events effectively
and to raise consciousness about emergency procedures.
The mission of the QIC is to provide oversight
for the QI Program. The QI Program employs a variety
of mechanisms to assess systematically the quality
of patient care and to identify, correct and monitor
patient care issues.
In 2008, two tabletop drills were conducted:
the first, in March, involved a scenario in which a fire
occurred in the laundry room at the Hedgewood Adult
Home, during a time when administrative staff was
not present. The response developed by the Unit
Administrator and site Supervising Social Worker
included coordination with the staff of the facility in
developing plans for relocation of patients, locating
temporary office space, continuing medication management, providing trauma support to patients, and
arranging for meals and transportation needs.
Quality Improvement Subcommittees:
(1) Performance Outcomes Subcommittee This Subcommittee is composed of Division Chiefs
and Coordinators responsible for monitoring DMH
contract agencies. The Subcommittee meets quarterly
to review the performance of contract agencies and
of DMH units. DMH has maintained outcome-based
contracts for some time. However, in 2008, all contract
agencies were required to develop outcomes using
logic models and to report outcomes in a consistent
fashion. Also in 2008, DMH units were asked to develop and report on performance indicators, by unit.
The second tabletop emergency drill, held in
September, challenged the Poughkeepsie Continuing
Treatment Center to respond to a scenario in which
there had been a motor vehicle accident involving an
agency van carrying patients and staff in which two
fatalities were reported. The response prepared by
the Unit Administrator involved convening the unit
Disaster Team, assigning staff to both the disaster
site and the program site to address actions needed,
requesting the assistance of the DMH Trauma Team
for support, informing staff and patients about the disaster in a clinically thoughtful manner, and providing
support to victims and their families.
As part of a county-wide initiative in this area
by the Health & Human Services Cabinet, training
was made available by Beth Quinn, Ph.D. Dr. Quinn
provided two training sessions for DMH Administrators
and Supervising Social Workers in September and
October of 2008. Dr. Quinn also provided training
and individualized consultation to contract agencies
and to DMH contract managers related to specific
program issues.
55
respect to correct completion of authorizations. The
QI Coordinator visited each unit to address issues
with staff.
Responses to both tabletop scenarios showed
that staff had considered the range of complex actions
needed, and used the resources of the Department
and the community effectively.
(2) In March, an assessment of the content
and timeliness of Psychiatric Evaluations and Mental
Status Exams was conducted. 121 records were
reviewed on all DMH units of cases opened within
the past three years where a Psychiatric Evaluation
was indicated. Also reviewed were those cases
in which patients had been hospitalized during the
past three years and a Mental Status Exam following discharge was required. Reviewers' comments
were overwhelmingly positive, but it was noted that
not all assessments addressed the areas required on
the templates for the Psychiatric Evaluation and the
Mental Status Exam. The review was followed up by
Richard Miller, MD, Medical Director, to clarify time
frames and report content with the medical staff.
• Patient Care/Utilization Review
(PC/URC) Committee
Scheduled Program Reviews
The PC/URC consists of seasoned DMH staff
members from a variety of clinical disciplines and
units. The PC/URC meets twice monthly to review
randomly-selected patient records to insure that effective treatment is taking place and that it is documented according to the applicable State and Medicaid
regulations. Appropriateness of the admission and
of level of care are also assessed. Fiscal issues are
monitored as part of the process. A review of safety
and the therapeutic environment is conducted at each
site and any deficiencies noted for correction.
(3) Integrative Treatment - In July, a review
was conducted which focused on the integration
and documentation of substance abuse and mental
health treatment in the records of those who are dually-diagnosed (MH and CD) in both mental health
and chemical dependency programs. 118 records
were reviewed across all units. There was wide
variation in the documentation of appropriate goals
and objectives for CD treatment issues, as well as
wide variation in the implementation of drug testing
across units. The unit-specific performance will be
taken into consideration as training for Integrative
Treatment is planned.
The PC/URC regularly reviews the clinical
records of three of DMH's largest contract agencies:
Hudson Valley Mental Health, Inc., Lexington Center
for Recovery, Inc., and Mental Health America of
Dutchess County, Inc. A separate subcommittee,
privileged in child and adolescent treatment, monitors the records of Astor Services for Children and
Families, Inc. in a similar fashion.
The QI Coordinator summarizes the findings of
the PC/URC review and the fiscal review in a report.
The responses of the Unit Administrator to questions
raised or corrective actions needed are discussed at
Executive Council.
(4) In November, a focused review was conducted targeting the completion of annual lab work.
This was verified by finding the lab results filed in the
clinical record. Reviewers looked at records at all DMH
units with the exception of the Partial Hospitalization
Program (due to the brief length of stay). A total of 199
records were reviewed. The results varied widely, by
unit. The PC/URC made three recommendations:
1) that the Medical Director review the lab work requirements with the licensed prescribers at the next Medical Staff Meeting; 2) that Unit Administrators review
the procedure for tracking when lab work is due and
assign staff responsibilities related to this procedure
and; 3) if a patient refuses to get lab work done, a notation be made in the record and the Medical Director
consulted to review risks and benefits of continuing
to prescribe in the absence of lab results.
Focused Reviews:
Each year, the PC/URC conducts additional
focused reviews on specific aspects of care identified
during the course of reviews or in Committee discussion. In 2008, four such reviews were conducted.
(1) In January, a review was conducted on a
random sample of records to determine if the Notice
of Privacy Practices (NPP) and the Pregnancy Policy
Statement were present in the record. It also examined authorizations for completeness and accuracy.
A total of 205 records were reviewed at all sites.
While results varied by site, in general, the NPP and
the Pregnancy Policy Statement were being used
effectively; however, there remained issues with
56
• Treatment Outcomes Measurement
participating agencies with training along with access
to pharmacy data on Medicaid patients. The initiative
required each agency to choose an indicator to monitor
and to identify patients meeting the project criteria.
In keeping with the requirements, DMH established a
PSYCKES Quality Improvement Team consisting of the
Medical Director, the Supervisor of Nursing, the Quality
Improvement Director and Quality Improvement
Coordinator. In October of 2008, the QI Team received
training by OMH and developed a PSYCKES QI Plan.
The QI Team chose polypharmacy as the indicator to
be monitored and identified potential patients meeting
criteria for further clinical evaluation by the treatment
team and prescribers. Those able to have their
polypharmacy reduced will be encouraged to do so
and tracked as to the outcome of the process – Was
it successful for the patient? Were there any negative
consequences? The QI Team will track and report
results to OMH and to the DMH QI Committee.
The measurement of treatment outcomes
using patient-specific information is one aspect of
performance outcomes monitoring. Since 2000, DMH
has collected data on treatment outcomes across most
units, using a standard instrument, the Treatment
Outcome Profile System (TOPS). The TOPS provides
specific outcome measures in the areas of quality of
life, symptomatology and functionality. The instrument
is administered on admission and again at discharge or
at a later point in treatment. The second administration
includes items which measure patient satisfaction
as well as changes in symptoms and functionality.
There are a small number of questions which track
substance use.
Throughout the years of its administration, the
results continue to confirm positive change in the areas
of quality of life, symptomatology and functionality, with
some variation across units and from year to year.
• Clinical Incident Monitoring
DMH has added a treatment outcomes indicator
for those contract agency programs that provide
mental health and chemical dependency treatment.
The Lexington Center for Recovery, Inc. utilizes the
TOPS, and it is anticipated that Hudson Valley Mental
Health, Inc. will begin to utilize the TOPS sometime
in 2009.
The Quality Improvement Coordinator presents an
annual report to the Executive Council detailing the
clinical incidents that occurred during the prior year
(2007). Trends, if any, are identified and discussed.
Incidents are classified by category: deaths, selfinjurious behavior, assaults, accidental injury, alleged
abuse, medication errors, assaults and drug reactions.
Annually, the number of incidents occurring in each
category is compared with the previous year’s
reports.
• New York State Office of Mental Health - QI
Initiative (OMH-QI) and the PSYCKES
Project
In 2007, the total number of incidents reported
was 73. This number represented an increase of 28
incidents over the number reported in 2006. DMH
programs reporting an increase in incidents greater
than 2 were: Millbrook Continuing Treatment Center
(increase of 7), Rhinebeck Continuing Treatment
Center (increase of 12) and Special Services
Team (increase of 5). For each incident, specific
recommendations were made related to the individual
and the circumstances.
The New York State Office of Mental Health has
offered enhanced funding to Article 31 Outpatient
Clinics agreeing to participate in a QI Initiative. The
DMH Article 31 clinic, which incorporates two units:
the Clinic for the Multi-Disabled (CMD) and Special
Services Team, chose to participate when the program
was offered in 2007. DMH developed a QI Plan to meet
OMH specifications and began additional surveys of
family and agency satisfaction with programs, along
with a measurement of GAF scores on admission
and discharge.
In 2008, OMH QI began a new initiative, PSYCKES
(Psychiatric Services and Clinical Knowledge
Enhancement System). This initiative seeks to reduce
the negative cardiovascular impact of psychiatric
medications on the seriously mentally ill through
monitoring of one of two indicators: cardio-metabolic
risk factors or polypharmacy. PSYCKES provides
57
The increase of incidents noted was examined for
trends. The increase in assaults at MCTC was noted
to be related to the high number of individuals with
legal involvement and histories of problem behavior
attending the program. The increase in accidents
noted at RCTC was addressed individually, and did
not reveal a trend. The increase in medication errors
noted for RCTC was attributable to procedural issues
at one community residence and this issue was
addressed with both the residence manager and the
licensing agency.
authority in the area of compliance, also presented
information at this workshop. The committee
gathered information regarding consulting agencies
with corporate compliance expertise, with a goal
of engaging a consulting agency on retainer for
clarification of issues as they arise.
• Anasazi
The Anasazi (QI) Project Team has continued
to meet regularly to address the process of conversion
to a paperless record. A series of demonstration and
training meetings were held in 2008 by the team with
Unit Administrators and unit staff to troubleshoot as
various elements of the electronic record were piloted
and implemented. In 2008, DMH program staff was
trained in the completion of electronic progress notes.
In several units, handwritten notes continue to be used,
in addition to electronic notes, due to equipment and
personal or unit-specific needs/ restrictions.
In January 2008, Ms. Barbara Piotti assumed
the role of Corporate Compliance Specialist. Ms.
Piotti reviews DMH clinical records continuously
for corporate compliance, reviewing each record
approximately 4-5 times per year.
In 2008 the DMH Corporate Compliance
Hotline was installed. Instructions were provided for
anyone wishing to make an anonymous report.
The Corporate Compliance Plan was revised
in September 2008 and presented to staff at the
annual Departmental Meeting in November. The Plan
was also made available for reference on the DMH
website. New staff is provided with a copy of the Plan
and information about corporate compliance at the
time of hiring.
In August 2008, ITAP became the first DMH
unit to pilot a “modified paperless record”; clinical
assessments and progress notes completed in the
patient’s electronic record on the Anasazi System
are no longer printed and filed in the paper chart.
In November 2008, Partial Hospitalization also
transitioned to a modified paperless record. In 2009,
other units will transition to the paperless record. It
is not practical at the present time to have a fully
electronic record, since several forms require the
patient’s signature, and there is no method in place
for obtaining this electronically.
As part of the 2009 contract process, contract
agencies will be asked to develop and implement
a Corporate Compliance Plan. In preparation for
this requirement, the QI Director and Coordinator
met with contract agency administrators to review
existing compliance plans, identify missing elements
and provide information and support to the agencies.
Agencies receiving consultation on their plans
included: Hudson Valley Mental Health, Inc., Astor
Services for Children & Families, Inc., Mental Health
America, Inc., Lexington Center for Recovery, Inc.,
Abilities First, Inc., Dutchess ARC and the Cardinal
Hayes Home for Children.
The Anasazi Project Team continues to
develop and refine the electronic Treatment Plan. It is
anticipated that the electronic version of the Treatment
Plan will be piloted at ITAP and Special Services Team
during the first quarter of 2009.
• Corporate Compliance
In keeping with the DMH Corporate Compliance
Plan, the QI Coordinator, in her role as Corporate
Compliance Officer, chaired regular meetings of the
DMH Corporate Compliance Committee at which a
variety of corporate compliance issues pertaining to
State regulations, documentation and monitoring were
identified and discussed. The Corporate Compliance
Committee met five times in 2008. On March 10, 2008,
several committee members attended a workshop
at Hofstra University, sponsored by the Council of
Behavioral Healthcare Providers. The NYS Medicaid
Inspector General spoke at this meeting and outlined
the recoupment of monies anticipated from future
Medicaid audits. Mary Thornton, a respected
• County Interdepartmental Activities
The DMH QI Director continued to participate
monthly in meetings of the Dutchess County Health &
Human Services Cabinet’s Performance Evaluation
Work Group. Activities of this work group included
a revision of the County Contract Management
Manual and the provision of training to County and
contract agency staff in areas related to contracts.
Training included the development of logic models,
measuremen of performance, insurance requirements
and related issues.
58
In 2008, Dutchess County made available to its
departments and contract agencies the services of
Beth Quinn, Ph.D. to provide training and consultation
in the development and measurement of program
outcomes. DMH utilized Dr. Quinn’s expertise in two
trainings for Unit Administrators and supervisors and
received individualized consultation for some contract
agency programs.
In October, several members of the Quality Improvement
Committee conducted a safety inspection at the Mental
Health Center, 230 North Road. Standing, l-r: Karen
Trokan, LCSW, Director, Quality Improvement Program;
Kathleen Spencer, RNC, Quality Improvement Coordinator;
Betsy Fratz, RN, Nursing Supervisor.
A meeting of the Research Committee was convened by Dr. Benjamin S. Hayden prior to his
retirement. The group met on February 19 at the
Mansion Street Center. Policies and procedures
as they pertain to human subject research in DMH
are designed primarily to address the effects of
research procedures on prospective subjects.
Standing, l-r: George Schinkel, Psychology Intern; Naomi Ferleger, Ph.D., Director, Psychology
Internship Program; Beth Quinn, Ph.D., Marist
College; Dr. Hayden. Seated, l-r: Janet Berger,
Confidential Secretary, Developmental Disabilities
Services Division; Marie Dynes, LCSW, Social
Worker II, Rhinebeck Continuing Treatment
Center; Richard DePass, Ph.D., Psychologist II,
Partial Hospitalization Program.
A training for Unit Administrators, Directors and Supervisors
involved in the development and reporting of outcomes of
contract agencies reported to 230 North Road on September 16 and again on October 22 for a presentation by Beth
Quinn, Ph.D., Marist College. The topic was "Logic Models
and Performance Outcome Reporting." At the October
22 session: Dr. Beth Quinn (seated) is shown with, l-r:
William Cusack, LCSW, Millbrook Continuing Treatment
Center; Patricia Albright, CASAC, Chemical Dependency
Services; Karen Trokan, LCSW, Developmental Disabilities Services; Eunice Skelly-Senatore, LCSW, Rhinebeck
Continuing Treatment Center.
59

2008uaeport - Dutchess County

Transcription

Similar documents

Hospital Trustees Celebrate Quality Initiatives

Dutchess BOCES - November/December 2011 HIghlights

Health Department:Healthy Living

WCSD "In Print" Newsletter May 2011

Dear Students, Faculty and Staff

44th Annual Rhinebeck RC Jamboree

promoters` guide - the Mid

Hamilton Area YMCA Program Offering Brochure

Falls

UNIVERSITI TEKNOLOGI MALAYSIA √