We applied our experience working
on Technological Needs Policy and Procedures for MHSA funded consumer computers
(Kiosks) at multiple OCHCA clinic sites to help out the MHSOAC with their
Innovations and Prevention & Early Intervention Regulations. We performed the work for the MHSOAC
pro-bono. We did it in exchange for
return favors in the future. In-addition
Keith “Buster” Torkelson MS wanted his name listed in the final regulation as a
contributing author.
Learning & Motivation
The motivation for Buster working
up a Housing Related topic such as bed quality is that he lives in a dynamic
environment that caters to Dying Old Men (DOMs). When someone or something comes between him
and his GoodBed he processes the problem by writing and publishing. After this prime motivator he publishes for
the benefit of others. Our Housing
Solutions Bundle (HSB) will generate much need learning. For example we will uncover what really
matters to each population in need. Need
for Substance Users differ a bit from let us say DOMs.
Trading Favors Revisited
When Buster volunteered to help
the MHSOAC write and rewrite their MHSA Innovation Regulation the deal was to
trade favors. In this report we ask for
some favors. The original MHSOAC people he
worked with are long gone. The current
MHSOAC Rep for Innovation has yet to return Buster’s email.
Innovations Staff
We are discovering shortfalls
with both local and state-level staff who work with MHSA Innovations. Out of four (4) or so people we have called
and or email none can read the email and respond intelligently. We call this MHSA Communication Breakdown or
MCB.
Cost-benefit studies
Locally at the MHSA Steering
Committee Meetings (SCMs) stakeholders as well as committee member have
repeatedly asked for cost-benefit studies.
MHSA related administrator indicted that these studies we too difficult
and costly to perform. We find that this
hurdle is due in part to the fact that it is hard to monetize the benefits with
the counties’ services and supports. It
looks like the OCHCA has a project that could determine the net Performance
Earned Value of intervening about psychosis.
Without cost-benefit numbers it is hard to prove underperforming
programs that should be cut. From the
consumer angle we talk with many individuals that say the county cut them
sort. The county almost solely reports
on its’ successes.
Failure to Perform
In response to COVID related
issue the county with a degree of urgency slashed some programs and
budget. These elements in a System of
Care (SOC) were obviously deemed unnecessary.
From Buster’s perspective he was seeing many OCHCA MHSA programs and
project that were failing to perform and thus unnecessary.
Stakeholders are concerned
It is 2022 and the MHSA
stakeholders are concerned. The
stakeholders such as Behavioral Health Advisory Board (BHAB) members are not
seeing “Nothing about us without us”.
Zoom meetings marginalized consumer stakeholders who did not have the
resources and skill to attend Zoom meetings.
The OCHCA mentions this forum or survey including consumers just to
cover home plate. The time tested
Steering Committee Infrastructure has disintegrated. At the upcoming Meeting of the Minds (MOMs)
on April 15, 2022 the county table should have a survey to collecting
Satisfaction with the OCHCA’s role with the MHSA and MHSA programs.
Early Innovations Rounds
Buster has been involved with
MHSA Innovations from the start. The
first round of Innovations he tracked and used as a learning tool. In subsequent INN rounds he sat on the OCHCA
Innovations Advisory Committee (IAC).
For one round the IAC worked vetting all project submitted per
round. In 2014 Buster collected and
inventoried all Assessment Tools the county was using with their Innovations
projects. He submitted the results to
the county to the MHSOAC and we published them online.
MSGBase > Metadata >
New Projects Being Sold
As we will address later in the
paper a “Hold” was placed by the county for new INN Project Idea (IPI)
submission. The county has not made it
clear that the “Hold” has been lifted.
We are getting close to going to press.
Perfect timing we just received the documentation for the upcoming
Innovation Public Hearing. The hearing
is scheduled for Wednesday, April 13, 2022
From 9:00 a.m. – 11:15 a.m. Both Sharon Ishikawa and Flor Yousefian
Tehrani will address: Opening Remarks and Overview of the Innovations Project
Proposals for forty (40) minutes. This
confirms that Sharon and Flor are the go to people when it comes to OCHCA MHSA
Innovations. Neither Sharon nor Flor
have been able to communicate with us as well as their predecessors. How can we have new Innovations Project Ideas
(IPIs) when the process is on “Hold”?
New Projects Nature
Next week, April 13, 2022, the
county will be addressing two (2) Innovation Project Ideas (IPIs) at a special
public hearing meeting. This is good
because it gives us a bit more time to impress upon the county and the MHSOAC
the concerns we outline in this paper.
1. Improving the Early Identification
of Youth at Clinical High Risk for Psychosis and Increasing Access to Care
Innovation Proposal
[Recommend
Against]
2. Examining Whether Integrating
Early Intervention Services into a Specialized Court Improves the Well-Being of
Justice Involved Young Adult Men: A Randomized Control Trial
[Out
of Scope]
3. Orange County Innovation
Community Program Planning
[This
effort may clear things up some]
Direct to MHSOAC
In preparation for severe
shortage with staffing in Health & Human Services (HHS) we recommend that
the MHSOAC position itself to handle more of the work in MHSA Innovation
previously delegated to each county. In
other words prepare for direct submissions of INN Project Ideas (IPIs) from
those submitting the IPIs. This would
improve the efficiency of the MHSA Innovations process. Another route would be to cut out the middle
thing. In this case it would be
eliminate the MHSOAC’s role as well as the frustrations in causes with plan
approvals. It would be an Innovation if
the MHSOAC graduates the counties while picking up a stronger role in customer
service, product evaluation and quality control. Included with product evaluation would be
cost-benefit studies.
Communicating with the MHSOAC
Near the end of the report we
include information about communicating with the MHSOAC. Circa 2010-2014 we were satisfied with the
ability of the MHSOAC to communicate directly with us here at Mentalation
Solutions Group. We will save our
current impressions about the MHSOAC for later in this report.
Hold & Selective Hold
This is the most important
portion of this report. The OCHCA put a
“Hold” on the Innovation Project Idea (IPI) process. They shared this position on one of their
Internet Webpages. We are not certain if
the INN Regulations as authored by the MHSOAC permit putting a “Hold” in the
INN process. It would be like they put a
hold on submitting their MHSA 3 Year Plan just on a much smaller scale. The “Hold” has been or was in place for more
than two years. The interesting is they
have covered up the “Hold” by erasing the message and placing a re-direct on
the old “Hold” page. Now they get to be
less accountable about their “Hold”. We
blew it be not capturing the “Hold” page with PrintScreen.
Figure – OCHCA Innovation Forum
Homepage Message
As late as March 15, 2022
OCHCA INN Centered Observations (x 12)
- “Hold on INN submission process”
- Distractions such PADs and Psychosis
- Existing psychosis projects have
failed to deliver
- Failing to listen to a broad range of stakeholders
- Ignoring Innovations needed with Housing
- Making big things of small things such as PADs
- Not responding to communications
- Our INN Project Idea might be better delivered as a PEI
Program
- Picking and choosing stakeholders
- Potential selective “Hold” New Project Developments
- Staffing problems including in administration
- Too distracted about COVID-19 (Corona & Dr. Chau)
Impact of MHSOAC saying no
A few years back the MHSOAC shut
down enough OCHCA Innovation Plans that the OCHCA panicked a bit. In this paper we discuss some of the OCHCA
reactions to having their hand slapped.
Aside, we wonder why the MHSOAC still needs to be involved. By now they should have educated the counties
on getting Innovations correct.
Requirements and Specifications
Last Reviewed: 20220408-F:
Impact of MHSOAC Saying NO to the
OCHCA!
We here at Mentalation Solutions
Group (MSG) have been working with Orange County Health Care Agency (HCA)
Mental Health Service Act (MHSA) efforts since 2009. Our principal Keith Torkelson MS was assigned
HCA Technological Needs while waiting while the HCA formed the MHSA Innovation
Advisory Committee (IAC) (See Mini-bios).
Religiously Mr. Torkelson attended HCA MHSA Steering Committee Meetings
(SCMs). More often than not the Steering
Committee (SC) had at least one action item to vote on the approval of budgets,
plans and projects. In over ten years
the SC failed to vote down something.
Then sometime in the last three years something remarkable
occurred. The Mental Health Services
Oversight & Accountability Commission (MHSOAC) vetoed over half of the HCA’s
Innovations (INNs) project idea proposal plans.
We knew that at some point Mentalation Solutions Group (MSG) as an MHSA
stakeholder would reach out to the MHSOAC for assistance with the HCA’s INN
project idea submission process. Submissions
seem to be on “Hold” yet new ideas are being presented. This report discusses intelligence that Mr.
Torkelson feels might benefit the MHSOAC.
In addition we have a few MHSA related questions and a few
recommendations.
No Viable INN Submission Route
Found – Unexpected Hurdle
We here at Mentalation Solutions
Group (MSG) have wished to write the Mental Health Services Oversight &
Accountability Commission (MHSOAC) for quite some time. MSG’s principal is Keith “Buster” Torkelson
MS. After going the distance as an
advisor on Orange Counties’ (HCA) Mental
Health Services Act (MHSA) Innovations Advisory Committee (IAC) Buster decided
to author some Innovations Project Ideas (IPIs) of his own. All of his ideas have been centered about
Housing and Housing Solutions. He knew
well the process as it was orchestrated from circa 2014-2018. As he readied our submission he was directed
to the HCA Innovation Forum. In the
forum he discovered substantial revisions were made to the INN process. Here is what we found in effect with the
forum. If you search using the link below
you will see the “Hold” message is still in effect.
Last Link Check – March 18, 2022
(F) Returns “Page not found”. For both
accountability and transparency we know that when you remove information from
the web you state what was removed and why it was removed. Now at the forum site there is no notation
that the Hold existed. We were hoping it
was going to say the hold had ended and how to go about post-hold Innovations
activities. Looks like now the HCA
doesn’t have to be transparent or accountable for their INN “Hold”. There was a good deal of information derived
interactively in the Forum all lost now.
We can see if you were new to the forum it would be rather complex. Someone said well this is too complex and
mostly out of scope: Get rid of it!
New Search Thread Initiated
“OCHCA MHSA Innovations submission process”
Hopefully the powers that be that
deleted the forum patched up the Innovations process. We will start a new search thread to see if
we can hit upon the new and improve OCHCA Innovations processes.
See Appendix for Updated List of
online hits for “OCHCA MHSA Innovations submission process”
FAQ
Did the MHSOAC INN Regulations
permit placing INN Project Idea submissions on “Hold”?
OCHCA INN Forum Webpage > Link >
https://www.ochealthcareagency.com/innovations/forum/
Hold Message Copied Over
Unfortunately we did not see
deleting the forum coming. If we though
that there was a potential for cover-up we would have taken a screenshot of the
forums home page. The re-direct page
should include who in authority ordered deletion of the forum. Yet we did catch the hold message as it
appeared on the forum home page.
Figure – OCHCA Innovation Forum
Homepage Message
As late as March 15, 2022
“Status Updates” – Selective
“Hold”
We assume that a good way to
update the status on the “Hold” would be via the forum page where we find the
“Hold” message. Now with the forum
deleted the OCHCA could address the hold status on the new re-direct page. If the status update clearing the “Hold”
happened elsewhere we have not heard anywhere.
Yet we did find indications that new MHSA INN ideas such as Psychiatric
Advanced Directives (PADs) are being worked on by the HCA.
Note: MHSA INN Regulations
Because we wanted our Innovations
Project Idea to go through we decided after Buster finished his term with the
OCHCA Innovation Advisory Committee (and workgroup) he should help out the
MHSOAC. Back in 2014 he helped refining
the MHSOAC Innovations Regulations. Make
note that the MHSOAC did not adopt any of his suggestions on policy such as
limiting all Innovations to three (3) years and limiting budgets to $1,000,000
per year. Later in 2016 he examined the
MHSOAC Prevention & Early Intervention Regulations.
Ethical Concern
We here
at MSG are not certain if the MHSOAC Innovations Regulations permit a county to
stop accepting INN Project Idea submissions.
OCHCA (HCA) - Communication
Breakdown
We here at MSG waited patiently
for the “Hold” to be taken down for over two (2) years. We sent emails and made phone calls the
principals in our HCA network. One
administrator to a group indicated that the OCHCA lacks the staff to manage
communications properly. We messaged
both the MHSA Coordinator and the MHSA Innovations Coordinator. They did not pick up the phone or respond to
emails. We waited patiently. We hoped the November 28, 2019 “Hold” would
be replaced with the: Who, how and when to submit an Innovation Project Idea
(IPI).
Impact #2 of MHSOAC Says to the
OCHCA!
MHSOAC Says No!
Remember since there has not been
in-person for quite some time that many communications come through “A
Wire”. We heard through a wire at a MHSA
Steering Committee Meeting (SCM) that the MHSOAC had turned down over half of
the projects that the HCA submitted in an Innovation (INN) round or cycle. This bothered the OCHCA (HCA) so greatly that
they paid to have people go up to Sacramento presumably to learn from the
MHSOAC how to get things right. In other
words the OCHCA wished to learn from the MHSOAC how to submit project ideas
that will be approved. That is part of
our purpose for this study: How to get our Innovations Project Idea approved, perhaps
directly to the MHSOAC. We have
discovered how fragile and unreliable the HCA INN process is.
Seeking out a higher authority –
MHSOAC
Just like the HCA we here at MSG
need help from the MHSOAC.
For Innovation see Nev Jones @ (916)
445-8713 or
Nev.Jones@mhsoac.ca.gov
FYI – We include some MHSOAC and related contacts in the
Appendix – MHSOAC Page
Why are we here at MSG invested in MHSA-Innovation?
The Mental Health Services Act (MHSA)
was founded on a principle of better engaging the consumer: “Nothing about us
without us”. Of all of the MHSA
Components Innovations (INN) was to permit consumers to solve issues for
consumers (peer-to-peer). It is fine
that MHSA Components Prevention & Early Intervention (PEI) and
Technological Needs (TNs) be delivered by people without diagnoses (including
providers) yet we recommend only approving INN projects written by consumers
and family members. This is Innovative
of itself.
Audit and Program Culling
The current INN projects we see
in the works have provider written all over them. Non-consumer providers should stay with the
other MHSA components. This would help components
such as Prevention & Early Intervention flux more by getting rid of poor
performing programs. Due to improper
inter-program measurement pretty much any PEI Program implemented is considered
a success. We suggest it prudent to
audit the PEI programs and cut away ¼.
This would open up PEI happenstance for better solutions.
Seriously Unmet Needs
If one listens to consumers and
questions them a bit you will find that one if not thee major concern is
meeting their unmet Housing Needs. If
the provider approaches to remedying our serious housing problems in Orange
County are effective (more than ten years trying) then we would not have the
current housing crisis. COVID has
marginalized Orange County’s housing problems.
We measure this partially with the OCHCA Directors message in the What’s
Up Newsletter. We feel that here in “The
OC” as well as any sizable urban area that Housing will best be solved
primarily by the consumers: For the consumers.
The reason we here at MSG are vested in MHSA Innovations is that it is
supposed to be a user-friendly route for consumers to engage creating solutions
for Behavioral Health. We are working on
an extension to Certified Peer Support Specialists (CPSSs). We call these well trained consumers
Certified Peer Housing Specialists (CPHSs).
Suggestion
– Removing Middle-people
It might
be best to take out the middle-people and have stakeholders mostly consumers
submit project ideas to the MHSOAC directly.
Now! That would be an Innovation
in and of its’ self. Actually we could
save a good deal of money and time with the Direct Submission Method (DSM).
Selective Hold
Even though we queried several
times across several different Health Care Agency (HCA) administrators the: How,
when and what to submit an MHSA Innovations Project Idea (IPI) for more than a
year yet we have yet to receive the personalized responses to which we are
accustomed. Thus we believed that the “HOLD”
on submissions remains in effect. By
spring quarter 2021 HCA COVID driven reactions were in full gear. The county eliminated in person oversight
meetings such as the monthly MHSA Steering Committee Meeting (SCM). The county restricted in person office hours
with the administrators. In a zoom Behavioral
Health Advisory Board (BHAB) meeting a small team was permitted to present on
Psychiatric Advanced Directives (PADs). The
PAD project was being promoted as an Innovation project. On one hand Buster liked the PAD idea because
he believes in advanced planning. On the
other, with PADs something is fishy in the State of Denmark because we classify
PADs as a post-hold effort.
Communication Breakdown
MSG returned to the forum site just
to observe that new idea submissions appear to remain on “Hold”. Buster wanted to discuss this fluke with
Admin yet could not get time in office hours.
Again, most likely HCA communication restrictions are in part due to
COVID. Buster wrote to the powers that
be such as the HCA MHSA Coordinator and could never get a response. Buster made phone calls and the lines were
not being picked up. He left messages
and he received no call backs. So we renewed
are effort to share our frustrations and work through the MHSOAC. The MHSOAC has a good track record of getting
back to us. In the meantime we wait for
the Hold status to be lifted. As we
discussed earlier the hold message is gone from the forum website yet there are
no instructions about how to get on track.
Pre-hold Projects V New Projects
Lets’ assume that any Innovations
projects that the OCHCA (HCA) is working with were submitted before their Innovation
(INN) project “Hold” was in place. We
would really like to know when the “Hold” will be lifted and new projects
accepted. Even though the Hold message
has been deleted there are details about HCA Mental Health Services Act (MHSA) INN
post-hold.
Need to know:
For MSG
and other stakeholders alike: When will Innovations (INN) open up to the
full-spectrum of contributors, what format should we work with, and what are the
route(s) to submit new INN Projects?
New Project Being Sold – Time
Sensitive
Here we address the time
sensitivity of our report here. The
project below was presented at the monthly OCHCA Behavioral Health Advisory
Board (BHAB) related Substance Use Disorder (SUD) System of Care (SOC) Zoom Meeting
early this March (2022). We hope we
caught it in time.
We
recommend the MHSOAC not approve “Improving the Early Identification of Youth
and Clinical High Risk for Psychosis and Increasing Access to Care” in any
incarnation (See reasoning below).
Metadata >
10_Psychosis_INN_CHR_22031501_MHSOAC_Notes
Figure – “Psychosis” Presentation
for OCHCA
Reasoning - Intelligence – Time
Sensitive
- The psychosis project is being presented
while the Innovation process is on “Hold”
- Housing has a higher priority
than diagnostics
- It fails to address a strong
linkage between housing and prodromal symptoms including those of psychosis
- It very likely supplants existing
services and supports such as First Onset of Psychosis
- Limits stakeholder participation
- The project is too big as
measured by yearly budget requests of over $2,000,000
- Very likely better fit for
Prevention & Early Intervention funding
- What they want to learn should
have already been learned through prior efforts addressing psychosis
Innovation Process Timelines
We have other concerns with the “psychosis”
presentation. Note our local time tested
MHSA Steering Committee (SCM) process has been supplanted. Since January 2021 our new and improved
Behavioral Health Advisory Board (BHAB) is gradually addressing what our SCM
did. Historically, most presenters to the
SCM shared exactly where their products lay in the Standardized Project Development
Timeline (SPDT). Below we include
typical INN Project Idea timing stages. The
two “psychosis” presenters Jason & Theresa alluded to a Request for
Interest (RFI). If the “psychosis”
project has already passed the MHSOAC Approval Stage then our recommendation
about this project is mute. We found one
thing peculiar about their presentation.
The presenters came across as if they own or will own the contract. In other words it is as if they responded to
a Request for Proposal (RFP) and were awarded the contract.
Figure - MHSA Innovation Process Timeline – New Projects
Link >
https://www.smchealth.org/sites/main/files/file-attachments/inn_timeline.pdf?1525134146
New Projects
Community Input (Three-Year Planning)
Steering Cmtee
Innovation Ideas and. Prioritization
Metadata >
01_Assess_MHSA_SCM_Value_17110602_Tool
V2022
Innovation Project Discovery -
The Divide – Pre-existing V New Projects
We here at Mentalation Solutions
Group (MSG) have been trying to determine as centered about the OCHCA’s MHSA
INN project idea “Hold”: Where do existing submissions end and new submissions
begin? It took us awhile yet we finally
found a good resource addressing many not all OCHCA INN Projects approved by
the MHSOAC.
First Round
Figure – OCHCA INN Plan Work
Began 2010
Query > “MHSOAC Innovations
Approvals”
We are looking for a list of
OCHCA Innovations Plans that went through the MHSOAC, funded and
implemented. We know that in the list
above created by Mentalation Solutions Group (MSG) that several of the work
plans were completed.
Distractions
It is likely that any Innovations
plans approved after May 23, 2019 are new ideas. In addition any idea in the works after May
23, 2019 would be a new submission. If
this is true the OCHCA failed to inform all of its’ pre-existing stakeholders
that the “Hold” was off. Two projects
that appear to be new are: Psychiatric Advance Directives (PADs) and Improving
the Early Identification of Youth at Clinical High Risk for Psychosis and
Increasing Access to Care (CHR). We here
at Mentalation Solutions Group (MSG) feel that anything that does not address
Housing is a distraction. We find that
the PADs do have a smidgen of Housing value.
20220405-TU:
Query “Submitting a MHSA Innovations
Plan to the OCHCA”
Hit in Scope
You would figure about now if you
apply the query above that we would hit on what we need to know for moving
forward with our Housing Solutions Bundle (HSB). The PDF document reference below does not
appear to be maintained. In other words
the “Idea Generation Website” has not been noticeably updated since Jun 18,
2018. The sample project included is the
Early Psychosis (EP) Collaborative Evaluation project. We’ve visited this resource (page) at least 2
times in 2022. Our last visit was
3/13/22.
Metadata
Orange County Health Care Agency Behavioral Health Services
https://www.ochealthinfo.com/sites/hca/files/import/data/files/80073.pdf
Jun 18, 2018 - MHSA Innovation (INN) Projects
MHSOAC Stability
20220325-F: Note: After one (1)
week the email we sent to Nev the Innovation Rep with the MHSOAC still has not
garnered a response. Years ago Buster
performed work for the MHSOAC pro-bono.
He worked both on the MHSA Innovation Assessment Register and
Innovations Regulations. The deal was
that if and when he needed assistance he could get it. Unfortunately most if not all of his MHSOAC
contacts have retired or moved on. It is
April 5, 2022 and we still have not heard from the go to MHSOAC Innovations
person “Nev”.
Metadata > Summary included in the Appendix
Inventorying OCHCA Project
At the link below we found a list
of the projects that were approved by the MHSOAC. It conflicts a little with reality. For “The OC” round 1 of the Innovations
projects implemented before 2014 are not listed. The information appears to be owned by State
Of California Department Of Health Care Services Health And Human Services
Agency. It addressed the term FY
2019/20. If looks like the Innovation
list only addresses projects that would spend money circa 2019/20. Step forward appears to be the oldest
project.
Metadata > OCHCA Innovations
https://www.ochealthinfo.com/sites/hca/files/import/data/files/119403.pdf
MSGBase > Metadata >
Note > Page 19 - From the document above we extracted the
following
Figure – An Inventory
OCHCA MHSA INN Projects Approved by the MHSOAC
Project Inventories (Continued)
We have yet to find a complete OCHCA
MHSA Innovations (INN) project inventory that includes: Projects submitted, project accepted locally,
projects planned, projects submitted to the MHSOAC, MHSOAC determinations, the
measureable outcomes and products, cost-benefit summaries of each project. Early on (2009) we here at MSG fancied reviewing
the Innovation’s Projects Final Reports (IFRs).
As well as The OC we looked into other counties such as Stanislaus. We found the ones published locally on a
county server were easier to access than the ones shared through the
MHSOAC. Generating and sharing thorough
INN related inventories can aide in many ways including helping those submitting
ideas work up their idea.
Request
If
possible can the MHSOAC provide with a link that includes comprehensive INN
related inventories by county?
Impression V Actual
In 2012 Buster with the Orange
County Health Care Agency’s (HCA’s) newly formed Innovation Advisory Committee
(IAC) was asked to Vet some 22 Innovation (INN) Project Ideas. Of the original 22 only 14 were pre-screened as
feasible. After the IAC’s voting day we here
at Mentalation Solutions Group (MSG) had no idea of how many of the 14 were
picked up as “Viable” by the OCHCA for plan development. We thought that number would be associated
with how much INN money the county had to spend. If the information in the Figure above –
OCHCA MHSA INN Projects Approved by the MHSOAC is correct between 2014 and 2019
only three from OC’s original round we approved by the MHSOAC.
New Gap Emerges – Innovation Gap
In all it looks like at least seven
(7) HCA MHSA INN plans have been approved by the MHSOAC. We had no idea that the rate of conversion
from submitted ideas to MHSOAC approved projects was so low. We now see in part why the HCA is squirming
and stressing a bit with the INNs Component.
It takes a good deal of work to write the INN Project Idea Plans (IPIs). Difficulty is no cause to cut away many of our
local stakeholders including consumer and family member stakeholders. With respect to INNs and other MHSA Components
we see a new emerging Gap has formed roughly since the “INN Hold” was enacted. Since we signed on the MHSA driven “Good
Fight” communication at multiple levels has broken down.
Stakeholders indicate Concern
A few years back the MHSOAC found
cause to slap the hand of our Orange County Health Care Agency (HCA) when the
HCA submitted too many non-viable and invalid Mental Health Services Act (MHSA)
Innovations’ Project Idea (IPIs) plans.
We feel it might be wise the MHSOAC guide them again. Several of us stakeholders such as those with
the relatively newly formed Behavioral Health Advisory Board (BHAB) are
concerned with the marginalization of consumer and family members. Technology driven Zoom meetings have too few
consumer stakeholders attending. Some
call this feature part of the “Technology Gap”.
Figure – OCHCA Early work with
Innovations
Communication Effort Revisited
Basically believing that
Innovation Project Idea (IPI) submissions were placed on “Hold” on November 28,
2019 we paused a few months to puzzle MSGs’ post-hold efforts including sales. On February 24, 2020 we attended an MHSA Steering
Committee Meeting (SCM) that largely dealt with the HCA MHSA Innovation’s
Component (INN). We selected the go to
people for addressing our concerns with MHSA Innovation processes were Sharon
Ishikawa the MHSA Coordinator and Flor Yousefian Tehrani the MHSA INN Manager. As we will demonstrate we sent forward communications
to both. It is March 25, 2022 and we
still have no responses from either.
Just recently we tried Annette Mugrditchian, Director of OCHCA Operations. We here at Mentalation Solutions Group (MSG)
always favored Annette because Buster’s HCA Technological Needs supervisor
Kathleen Murray indicated that Annette does good work. Annette has not responded either. In public various administrators have said
the communication breakdown is in part due to staffing concerns. A staff that cannot communicate appropriately
while working in a Sociological arena! Yes,
we see that would be a problem. We had
grown accustomed that those in our OCHCA Network communicated well.
MHSA Innovation (INN) Projects
It appears as if on June 18, 2018
the Orange County Health Care Agency (HCA) Behavioral Health Services (BHS) was
working with an Innovations project called Early Psychosis (EP) Collaborative
Evaluation. This project would be
considered an existing project before “The Hold”. Records indicate that project was renamed
Statewide Early Psychosis Learning Health Care Collaboration Network. The MHSOAC approved it on 12/17/2018. We allude to this project because we will
address it later with Supplanting.
Metadata > June 18, 2018
https://www.ochealthinfo.com/sites/hca/files/import/data/files/80073.pdf
Web-based Idea Generation
Back around 2018 the HCA changed
the manner for submitting MHSA Innovations Ideas. They launched what they call the “INN Idea
Generation website launched May 2018”.
The site says it “allows for ongoing submission of project ideas”. The HCA also supported their web-based
Innovations Forum. Sometime around
November 2019 the following message appeared on the HCA’s “Forum” site. Note: During March 2022 the forum was pulled
and replaced with a redirect page.
Original Message
[“November 28, 2019 submissions
placed on hold”]
Data Outcome Advisory Committee and Work Group
Early Warning Assessments
Back
in 2010 Buster was invited by his then HCA supervisor Kathleen Murray to sit on
the Data Outcomes Advisory Committee (DOAC).
When they took up resolving issues presented to Child and Youth Services
(CYS) the committee determined an originally authored screening tool was in
order. Because at the time a strengths
polarity was considered a promising practice the DOAC decided to go with a
county authored instrument measuring “Resilience”. The author of the county tool was Dr. Janel
Alberts. For MSG Buster wrote a
comparative Resilience Scale. We tested
them in parallel and both yielded very similar results (scores). Our hope was that the county partner with the
Orange County Department of Education (OCDE) and assess all public school kids
once per year. This would include any
kids with prodromal signs of psychosis.
Failure
to Perform
The
county has a few programs in place to address both kids and psychosis. The fact that the HCA is still seeking new
approaches as this point in a sign of failure.
County employees and contractor employees are assigned disparate
tasks. As Dr. Casey Dorman (HCA-Psychologist)
said before his retirement: Our offices,
divisions, administrators Etc. are operating in “Vacuums”. If I could do anything right before
retirement that would be vastly improve intra-county agency communication. Well Early Psychosis (EP)
Collaborative Evaluation was approved and what can we say: People in the know
are still writing bad programs using the strong MHSA programming language. We call the MHSA the Steinberg Programming
Language (SPL). Incidentally, we found
UC Davis is a collaborative lead on the EP project. Buster takes a little more time when UCD
comes up because he earned his BS and MS from UCD – Go Aggies!
[We are
determining if the new psychosis project idea is associated with the 2018 EP
project. It is very likely the new
psychosis project is being developed while for the marginalized the HCA
Innovations process in on HOLD. As of
March 25, 2022 we still cannot get an update on the HOLD]
CalMHSA
Early Psychosis implies intervention
at a Preventative stage or level. If the
county were to implement their Early Psychosis (EP) Collaborative Evaluation the
best fitting MHSA Component would be Prevention & Early Intervention
(PEI). EP project implies a statewide
collaboration. We know statewide
projects are best managed by CalMHSA.
Incidentally, we feel that in a manner CalMHSA is letting the state
down. CalMHSA promises to resolve Stigma
& Discrimination, Student Mental Health, and Suicide Prevention have not
come to fruition.
EP – Cost-effectiveness
Outcome measures and sharing
efficiently was to be built into ALL MHSA programs and projects. So why would you need to spend so much money
to assess the cost-effectiveness programs such as those dealing with psychosis.
Studying Mary Hale’s Tenure
Mary Hale MS took over as the
OCHCA BHS Director back around February 2017 after a successful five year run
by Mark Refowitz. Many times at the
monthly MHSA Steering Committee Meetings (SCMs) members would ask Mary for
cost-benefit studies for her MHSA programs.
Repeatedly Mary said they are very hard to do and we would have to hire
consultants. The system of care is
expanding and it will be prudent to address cost-benefit analyses. You could just close it all down and start
again.
Mark Says – “I Know You Will Get
This Right”
The goal of the EP project is to:
“Goal: Assess program and cost-effectiveness of EP programs across the state”. OK
fine so spend: “Estimated Budget: OC will request up to $2.5M”. You had better get this right as to set a
standard for all future comparisons. We
here in “The OC” are facing a huge audit challenge. After we have produced some odd 100
cost-benefit studies this project may prove its’ concept. It is not so much to address psychosis as it
is to create an audit standard. This
audit if done correctly should be the standard of excellence and applied in some
shape way or form to not only all local MHSA endeavors yet statewide.
FYI - Action Item
“Approve plan to join Statewide
Early Psychosis Learning Health Care Network Innovation Plan”
Back to Communications
[We have
attempted several times to contact the OCHCA “INN Team” using their prescribed routes
as listed below. See sample
communication below]
Metadata >
SCR_OCHCA_BHS_MHSA_Sharon_Ishikawa_21042103_Notes
V2022]
Sharon Ishikawa was the last
known OCHCA MHSA Coordinator. We here at
Mentalation Solutions Group (MSG) lack the resources to grow partnerships with
all OCHCA administrators. Our go to
person was Dr. Jeff Nagel yet he moved on back in December 2021. We never thought we would have the need to
transact with Sharon. We just monitored
her activities. At this point it is
either go with the MHSOAC or link with the new HCA Deputy Director.
Web-based Contact Information
“Contact the INN Team!”
The last time we tried to contact the INN team was March 25,
2022. Normally we would pick up the
phone and call. Yet it is probably not a
good time to distract and just finish our report here.
FYI – Pertains to OCHCA
Hyperlinks are not active
“Visit the Community
Forum page and check the Calendar for upcoming events!”
Actual Message Sent to Group
You’re Message
1220PM: 20210104-M:
Greetings Doctors FY Tehrani, S
Ishikawa and J Nagel]
Repeated 20210225-TH
Last time
we checked as of “November 28, 2019 the idea submission process was placed on
hold in order to focus on further review of the existing idea submissions”.
Are you
accepting OCHCA MHSA Innovations’ Idea submissions at this time? If so how do we submit and in what level of
detail. We have reviewed the OCHCA MHSA
Innovation Forum and the ideas shared there appear to be brief and in a bit
different format than priors INN submissions.
Should we follow the format as demonstrated in the INN forum? We know that Corona has tied up substantial
resources. Yet our INN idea addressing
housing issues and fixes is still a priority.
Thank you for your time and consideration. Keith “Buster” Torkelson MS. (Sales and
Marketing stages)
OCHCA MHSA Innovations Process
Basically the scheme was: The
Innovation Project Idea (IPI) submitter works up their idea while following the
HCA’s standardized format. Next, you
submit your idea usually via email to the HCA.
The ideas in a round were pooled and the HCA INN staff follows the steps
in the table below. After attempting for
more than a year we here at Mentalation Solutions Group (MSG) have yet to garner
a concrete instruction to whom to submit our IPI, when to submit our IPI, and
in what format.
MSGBase > Metadata >
9/13/2019
Online Research
About this time we would like to
search “OCHCA MHSA Innovations Project Idea Submissions” to obtain some up to
date and accurate information on what to do next. The benefit of this “Hold” is that we have
been looking into finding other funding such as Prevention & Early
Intervention (PEI) monies. In the long
run our Housing Solutions Bundle (HSB) is best sustained as a PEI program.
FYI > Website Review Process
Preliminary Review
Below is a table of what the
OCHCA indicates are the “Roles of Innovations (INN) Staff”. We break things
down into Tasks. Again the word on the
streets is the OCHCA is having staffing problems. Just a heads up that the MHSOAC might be
asked to step up, level statewide resources and do more of the work that the
county is assigned.
Table – Roles of Innovations
Staff
If Only 1 or 2 - Role in the
Mental Health System
Mentalation Solutions Group’s (MSG’s)
primary roles in the Mental Health System are as follows. Our foremost effort is to act in the capacity
of External Quality Review. Most of our
work is associated with CMS. Buster’s
Behavioral Health Doctor (BHD) recognizes Buster as a Housing Advocate. Much of our work is supported with Quantitative
Assessment. We deliver on our
Performance Earned Value (PEV) and on our Health Related Engagement (HRE)
products. We have developed our
Structured Temporal Reconciliation approach into a promising practice. Buster has taken his degree in Pathology and
reworked it on his way to mastering Social Pathology. MSG is family driven.
Past Experience
Keith “Buster” Torkelson MS has
submitted at least three (3) Innovations Project Ideas. All were turned down at the county
level. At least one (1) dealt with
Housing issues. The issues that Buster
was working to fix still plague Orange County.
Back in 2014 we shared our takes on MHSA Innovations in our Innovation
Component Minute (ICM) publications.
While we wait for a green light from the MHSOAC and or the OCHCA to
submit our current idea we will review some of our minutes as published on
Google Blogger. As far as the roles
listed in the table below we here at MSG identify as other: Stakeholder and
Advocate. Our primary concern is housing
the disadvantaged including the homeless.
Table – Legacy OCHCA Innovations Idea Form
MSGBase > Metadata for Innovation Component Minute
Learning
You
might wonder what learning our Housing Solutions Bundle (HSB) project will
deliver. We will discover once and
forall the weight that Housing Quality and Bed Quality play in human health
including behavioral health and substance use disorder. We will track cost-benefit with respect to
Housing those in the most dire need. We
will begin to formally inventory the beds in existence. One bed at a time we will discover the nature
of GoodBeds and BadBeds,
Networking - Annette and Veronica
Yesterday March 31, 2022 Buster
attended a Be Well related initiative meeting.
Our new Behavioral Health Director, Veronica Kelley, shared in-person for
the better part of an hour. Dr. Kelley
asked for questions yet Buster was not positioned to ask germane
questions. Particularly when we have
questions to ask that the general attendee need not hear. In the same administrative hierarchy that now
has Dr. Kelley near the top the Operation’s Manager Annette is near the
top. Who is the HCA top dog? Dr. Clayton Lon Chau. We mentioned Annette earlier on. We may have detected some animosity between
Dr. Kelley and Annette. We had emailed
Annette with a few questions yet have yet to receive an answer. One question was: What is Dr. Kelley’s
email? At the Be Well meeting Dr. Kelley
shared it with all in attendance. So at
least we completed one item in our MHSA Spring Quarter to do list.
Concentration Psychosis – Failure
to Deliver on Time
Now it looks a psychosis project
may be competing with our funding. To
keep it short remedying psychosis was funded here in “The OC” nearly from the
inception of our MHSA. The HCA has a
Full Service Partnership (FSP) to address the first onset of psychosis. If the agency is asking for more money to
remedy psychosis this would mark that the programs in existence are failing. They have failed to bring into fruition the
deliverables they promised. In this case
that is substantially solving psychosis and surrounding issues. FSP is supposed to be a comprehensive
wrap-around approach.
HCA History - Psychosis Efforts
Research Psychosis – Work Done
Of course psychosis is a serious
concern that needs to be addressed. Now
our existing services appear to be performing poorly. We measure performance as a reduction in new cases
as well as substantial remediation of existing cases. In our community a significant number of
those diagnosed with psychotic features are just timing out. In other words they are dying before any help
arrives. Although our Housing Solutions
Bundle (HSB) is not directly designed to mitigate psychosis associated issues
it will have a considerable impact on the Quality of Life (QOL) of those
impacted by psychosis.
[PICTURE OF A PSYCHOTIC PERSON DYING]
Figure – The BadBed
[ROCHESTER GALLERY & & LINK TO WOUNDED WARRIOR]
Wounded Warrior – BASALT –
Presented by Keith Edward Torkelson, M.Sci. With MSG
https://ktork46.blogspot.com/2017/03/wounded-warrior-basalt-presented-by.html
Publication Stats for Wounded
When we discuss housing issues we get fewer readers that
let’s say a report on PEACE. To have 191
readers with housing and unmet needs is a good achievement.
OCHCA Psychosis Summary
“ochca psychosis support”
Peculiars about the new INN
Project, Improving the Early Identification of Youth at Clinical High Risk for
Psychosis and Increasing Access to Care (CHR).
In short, First Onset and Early Learning should cover the bases as
discussed with Clinical High Risk (CHR).
As we see it any new effort that is not substantially different will
supplant the existing services. Our
housing approach is a less clinical approach to tame ancillary issues such as
psychosis. Our Housing Solutions Bundle
(HSB) will globally impact the lives of those dealing with Behavioral Health
issue including Substance Use Disorder (SUD).
MSGBase > Metadata
Evidence of Shady Ideas
Now we return to submitting MHSA
Innovations Project Ideas (IPIs). First
and foremost the HCA website that says INN project submission is on “Hold”
while concurrently new projects are being presented. The MHSOAC most likely has in its’ records
the request from Orange County associated with HCA’s COVID response to migrate
MHSA INN funds into other accounts such as CSS to balance the books. Reports indicate that the MHSOAC responded
saying such an action could not be done.
Now more than ever before the OCHCA is increasing secrecy. Consumers and other stakeholders say the HCA
is failing its’ role with MHSA mandated communications.
Ethical Issues – Transparency & Accountability
One of the MHSA Principles is
transparency. Immediately the County
should be encouraged to share at a Behavioral Health Advisory Board (BHAB) the:
Who, what, when, how we stakeholders can get back on track with respect to
OCHCA MHSA Innovations. If an interested
party Googles “OCHCA MHSA Innovations” they should hit the page telling any and
all stakeholders what to do. In terms of
accountability the HCA needs to generate and share cost-benefit studies. Once again one of the psychosis projects
listed above could pave the way.
Staffing Issues
In the day, 2010, the OCHCA (HCA)
provided the public with both the HCA and MHSA Hierarchies. Included in said hierarchies was include
administrative vacancies. At the BHAB
meetings the emerging BHAB members have asked for the current hierarchies
including contact information. From what
we can tell the HCA is facing significant staffing issues. For example the HCA director Clayton Chau MD has
doubled and may still double as Chief Medical Officer. Try as we may we cannot figure out for any
degree of certainty who heads up MHSA Coordination.
Catch Up – The Last Network
The last lead we had on MHSA
Coordination leads us to Sharon Ishikawa yet she did not respond. We have an outstanding email to Annette
Mugrditchian, Director of Operations: Orange County Health Care Agency:
Behavioral Health Services yet she has failed to respond. The HCA indicates this failure to communicate
is due to a shortage of staff and too much work. We always thought the Annette was in line
after Dr. Jeffery A Nagel to take over as the HCA deputy director in charge of
Behavioral Health Services. Someone in
the county, potentially Dr. Chau, selected Dr. Veronica Kelley as BHS
Director. Dr. Kelley so far does not
appear as literate as Annette. When it
comes to the full picture spanning more than ten years it looks like Dr. Kelley
has about nine more months to catch up.
If now by then then the unfolding on new will dominate her time spent
and her MHSA History learning curve we flatten.
One thing she can do is cancel existing programs and start over.
Work on Regulations
Years ago Buster helped the
MHSOAC with drafting their MHSA Innovation’s regulation. He just wanted to get his word in when it
came to MHSA Innovation (INN). One he
tried to push that INN project should have a 3 year time limit. He suggested that Innovation projects might
be timewise aligned better. In addition,
no INN Project should cost more the $1,000,000.00 per year. Now we believe that $2,000.000.00 is OK. In keeping we feel the five or so million for
the proposed psychosis management project is way over the top.
Recommendation
[We
recommend against approving the new OCHCA Psychosis CHR project]
Not leveraging existing
infrastructure
Instead of building the CHR system
from scratch they could piggyback it on an existing program. Give money to the existing FSP to develop the
tools they specify.
Strategically of the Mark
Back before COVID (2019) the
county wide consensus was that we need to resolve Housing Concerns including
getting our homeless into GoodBeds. We
know resolving psychosis is fundamental to Health and Human Services. Yet, given the current efforts have not
substantially remedied psychosis we need to re-tool existing programs. Since 2020 Housing has been left out to
dry. We monitor the OCHCA What’s Up
Newsletter to see what Director Chau is busy with. He has not been busying himself with
Housing. The psychosis money would
better be spend back with Housing.
New Administrator Asks for No
Complaining
In December of 2021 the OCHCA
appointed a new deputy director. This
marked the retirement of our friend Dr. Jeffery A Nagel. During January and February 2022 the new
deputy director of Behavioral Health Services (BHS) took the time to orient her
one of her communities (BHAB) about how is and she will do things. It reminds Buster of when doctors say: “This
is how I choose to run my practice”. The
new and improved BHS Director specified that she would not entertain any
complaints. The MHSA was actually
founded off of complaints. Complaining
is the MHSA way. This paper is one way
that we here at Mentalation Solutions Group (MSG) will process our concerns so
Buster can complain less. In this
incidence we escalate up to our friends at the MHSOAC. Rather than saying we have some complaints,
we will just say the material presented here are serious concerns.
Underservice and Inappropriate
Service
On any given day Buster observes
up to twenty persons out in our community that are under-served or receiving
inappropriate services. This concept is
out of scope for our study here yet we include a link to one of publications.
[INCLUDE LINK TO HOMELESS]
Friday, October 30, 2020 [Exhaustive Homeless Gallery]
“We Walk quietly among our Homeless” Homeless Gallery -
Orange County Centered by Keith “Buster” Torkelson and MSG (202010)
https://housingadvisoryboard.blogspot.com/2020/10/we-walk-quietly-among-our-homeless.html
New Deputy Director – Selective
Hold
In December of 2021 the OCHCA
appointed a new Deputy Director. The new
director’s specialty is Behavioral Health Service. We really probably would not mention them
except this year (2022) at a BHAB meeting they gave an Innovations Projects
update. The projects presented appear to
be new projects. How can we get to new
projects with the “Hold” in place?
MSGBase > Metadata >
MHRS Chief’s Report – Dr.
Veronica Kelley
Whereas prior administrators at
her level called the position Director of Behavioral Health Services (BHS) Dr.
Kelley is going with Chief, Mental Health and Recovery Services (MHRS). In her report, Dr. Kelley noted that Orange
County submitted two No Place Like Home (NPLH) applications for MHSA housing
projects. She noted that the MHSA Community Engagement Meetings (CEMS) for general
community members started in February and will continue through March 3, 2022,
and that they conducted meetings on two potential Innovation projects- Clinical
High Risk and Early Psychosis and Young Adult Courts. We have been following NPLH ever since 2018
when Dr. Janel Alberts sold us the idea.
We do not support investing too much in the NPLH solution. Just other approaches to creating Beds
without our Housing Solutions Bundle (HSB) the county will find it hard to put
(place) people is a GoodBed.
Feature – Innovations Project Idea (Revisited)
MSGBase > Metadata > CHR
Supplanting
The County of Orange already has
programs in place to address psychosis in youth. An example is the Full Service Partnership OC
CREW. If something as big as the
proposed Improving the Early Identification…is now justifiable this indirectly
indicates that existing programs such as OC CREW are fallen way short. Full Service Partnership means just that full
and anything it takes.
FYI - Early Onset Psychosis - Orange
County, California
https://www.ochealthinfo.com/services/children-families/mental-health-and-recovery-services/children-youth-services/early-onset
“The Orange County Center for
Resiliency, Education and Wellness (OC CREW) program provides early
intervention services to Orange…”
CHR - Awarding the Contract
The presenters Schiffman and
Nguyen put a good deal of effort into their presentation. In fact it is one of the more detailed
Innovation’s presentations that we have reviewed. One again we don’t know where they are or
think they are in the MHSA INN cycle. Schiffman
(UCI) and Nguyen (MHA) came across as if they had responded to the RFP and were
awarded the contract. As we the majority
of those who submit an idea usual do not get the contract.
Too much money
We wonder why they want to push forward
an idea costing some odd $5,000,000 per year.
One reason may be that big projects take less effort than do many small
efforts. We feel that it would be nice
if we could look at the MHSOAC website and webpages to answer our Innovations
related questions. Questions such as: With
all of the HCA MHSA Innovations projects, what are the projects and where is
each in the delivery cycle. In addition
are any of the results worthwhile.
Project Sizing – I Don’t Come
Easy
No one ever said that
administering to the MHSA Innovation Component will be easy. When we worked on the MHSOAC Innovation’s
regulations we pushed for a $1,000,000 cap per project per year. Since MHSA funding is associated with
population size Orange County has a sizable INN funding base. We propose that any project asking for more
than $2,000,000 per year is too big. In
the beginning “The OC” developed small and medium projects. We consider a round of projects to start when
the HCA sends off their INN project idea plans (proposals) to the MHSOAC. With a relatively recent round of projects plans
that “The OC” sent up to the MHSOAC numbering more than five (5) the MHSOAC
turned down more than half.
System Transformation
Since the MHSOAC kick in the rear
“The OC” has favored planning large projects to save time, effort and
heartache. An example of pushing
through a large project is Behavioral Health Services (BHS) System
Transformation that spent $9,000,000 fiscal year 2019-2020. It is hard to believe that System
Transformation is an Innovation. It
defies any grassroots philosophy. System
Transformation seems more like General System Development (GSD) to us.
2020 - COVID and Squeezing out
Innovations
Soon after the idea shut-down and
“Hold” COVID hits! Financial analysts
expected the worst about MHSA monies. In
order to get the over and through COVID the MHSA Budget concerns the county
proposed moving Innovations monies away to cover CSS and PEI. An HCA administrator indicated that the
MHSOAC would not permit it. Then the HCA
posits supporting larger than average projects.
Yet remember the “Hold” is still supposed to be in place. Another idea to balance the books was to take
some or all of the Prudent Reserve. They
were squirming yet budget wise this are better again.
SCM V MHSOAC - History of Yeses
Buster has attended OCHCA MHSA
Steering Committee Meetings (SCMs) since 2009.
In that time he has not witnessed any proposed program or project voted
down by the SCM. After something passes
with the SCM then the Mental Health Board (MHB) had a shot at it. We do not know the voting distribution for the
MHB because Buster did not attend all that may MHB meetings. Yet, he was surprised to discover that the
MHB is associated with the HCA. We feel
the MHB / HCA association is a conflict of interest for the community at
large. Here we encourage the MHSOAC to
not approve the OCHCA’s Innovations project addressing earlier that early intervention
particularly with youth.
20210419-M:
OCHCA MHSA SCM
At the middle lay many things
that are MHSA, Sharon Ishikawa advices for the stakeholders to have “Patience”. She said to plan your MHSA including
Innovations (INNs) efforts for future money circa 2023. Yet before we know it 2023 will be here and
we will have yet to get an up-to-date Submission schedule”. OCHCA MHSA INN materials originally indicated
submission had a deadline for each round.
Now it looks like INN submissions are open ended. At some point there must be deadlines because
without them they would find it hard to cutoff the submissions and begin
further processing.
From the MHSOAC we request >
[Who-How-When-What]
Housing Solutions Bundle (HSB)
In some ways we have benefited
from our problems with OCHCA MHSA Innovations.
We have had the opportunity to critically review some of the younger administrators. Even though Mentalation Solutions Group’s (MSG’s)
Housing Solutions Bundle (HSB) was needed yesterday it we be a better and more
fully developed product in the face of the “Hold”. We also feel that it might be best sold under
the Prevention & Early Intervention (PEI) component to CalMHSA.
Last Reviewed: 20220314-M:
All were HCA Deputy Directors Except Dr. Chau is now the HCA Director
and Chief Medical Officer and Dr. Kelley is now the incumbent HCA Deputy
Director over Behavioral Health Services.
Housing Solutions Bundle Promotion [STAYED]
We will assume we have described Mentalation Solutions
Group’s (MSG’s) Housing Solutions Bundle adequately for our purpose here.
MSGBase > Metadata >
14_Address_Board_BHAB_HSB_22030901_Notes
Impact of MHSOAC Saying to the
OCHCA!
MHSOAC Says No #3!
Really Shaken Up! – HCA Reaction to
Champion Huge Projects
We here at MSG consider any
Innovations project with a yearly budget exceeding two million dollars per year
a Huge Project. A benefit of picking huge projects is that it reduces the
county workload. No one ever said that
properly administering to the MHSA INN Component should be easy. The OCHCA now reduces time spent for a round
of Innovations. This forgoes true
Innovations that could yield a rainbow of solutions. What if one of the HCA’s Huge Projects fails
to deliver? Not all Innovations projects
after close are picked up to sustain by the HCA.
Impact of MHSOAC - Wasted Effort
After an Innovations plan passes
the initial vetting stage it takes a good deal of time to prepare an idea as a
plan for sales with those that may approve it.
It broke some at the HCA’s hearts when the MHSOAC failed to green light
so many proposed plans. The HCA reacted
quite liberally. For example the OCHCA’s
shut down the submission of new ideas.
Another reaction was to select projects that would spend a good deal of
money. If the HCA gets turned down by
the MHSOAC for an Innovations project plan this causes a scramble. Public Health is rather crazy. One the HCA cannot make a profit. The HCA must spend the allocated monies in
this case Innovations dollars. If they
do not spend money the money could revert.
Remember back in 2010 a substantial amount of MHSA money was stuck in
Sacramento. Stuck up top enough money
that moving it away from the MHSA was placed on the ballot as Proposition 1E. And yes if we were in the HCA’s shoes we
would freak out a bit.
Summary
Here we summarize going
backwards. We only select things that
will help us with selling our Housing Solutions Bundle (HSB) product-line. For this report we will try something
new. We will are writing a summary then
moving it up front as the Abstract – Executive Summary. Return to the top for
the Summary.
Context Assessing MHSA Innovations Component
Results for Outcome Measures Manual (MSG, 2014)
Orange County: MHSA: Innovations Round 1 – Tools Used in
Projects
Outcome Measures Matrix (Table)
Last Reviewed: 20220407-TH: Results of MSG’s Outcome
Measures Study about Instruments Used in Orange County
MHSOAC Related List of Contacts https://mhsoac.ca.gov/contact-us/
Address an MHSA-Related Problem?
Do you have an MHSA-related issue
to bring to the attention of California’s Department of Health Care Services?
Yes we do
have a few issues to bring to the CDHS.
Less that one (1) month ago we tired to go through channels and have the
MHSOAC help us out. The Rep to which we
were assigned has been unable to communicate with us in a timely manner. We were going to call yet we have to stop
somewhere in our efforts and print our findings. For the time being we here at Mentalation
Solutions Group (MSG) are not satisfied with the MHSOAC.
Please submit your concern by
email to mhsa@dhcs.ca.gov or in writing
to:
Department of Health Care
Services
- Mental Health Services Division
- Attention: MHSA Issue Resolution
Process
- 1500 Capitol Avenue, MS 2702
- P.O. Box 997413
- Sacramento, CA 95899-7413
Old Contacts MHSA Network 2.0
For Keith “Buster” Torkelson MS
we are building our third MHSA Network (Network 3.0). Buster came on board with the OCHCA back in
2009. He assumed many roles (refer to
Mini-bios up front) including odd jobs.
The HCA persons in place as of 2009 formed Buster MHSA Network 1.0. As HCA employees moved on, dropped out or
retired his Network 1.0 developed many holes.
When Mary Hale MS was apparently fired Buster began forming his MHSA
Network 2.0. As of January 2022 we are
creating what we hope with be Buster’s last MHSA network 3.0. Two of the old-timers in Network 3.0 are
Clayton Lon Chau and Andrew Inglis. This
succession business can be challenging.
Just as someone appears to be doing good work they move on.
Current (2022)
https://mhsoac.ca.gov/contact-us/
Program Operations Dr. Sharmil
Shah > sharmil.shah@mhsoac.ca,gov
MHSOAC Current Resources
Around 2014 Buster peeked with
his work associated with the MHSOAC. Now
we prefer written documentation over phone calls. If we had obtained written records we would
better proof of how much time Buster spent helping the MHSOAC. We checked online finding these to be the
MSOAC go to people. After this will
include some of Buster out of date MHSOAC go to people. You can see how old our MHSOAC go to list is
particular about Matt with a DMH address.
DMH has gone extinct.
“Please contact MHSOAC staff for any questions regarding the
MHSA”
We did and have received nothing that we asked for! We contacted Nev below because most of our
issue center about MHSA Innovations.
MHSOAC - Contact Us
Mental Health Services Oversight and Accountability
Commission
http://archive.mhsoac.ca.gov/ContactUs/ContactUs.aspx
Table – 2022 MHSOAC Contacts
Rapport Developed During Work on MHSOAC authored
Regulations. In addition with helped the
MHSOAC with some work on Innovation Assessments
Table – MHSOAC Legacy Contacts
FYI
“Correspondence to the MHSOAC as a whole, or to an
individual Commissioner, should be addressed to the following address”
Mail: 1300 17th Street, Suite 1000; Sacramento, CA 95811
Email: MHSOAC@mhsoac.ca.gov
Figure – Timeframe for the work Buster did on behalf of the
MHSOAC writing Regulations.
MSGBase > Metadata
Query Hits - Order in Google hit
list.
We retained the original order for
the Google Hits with “OCHCA MHSA Innovations submission process”. If things were up-to-date what we need to
know about the current HCA MHSA Innovation process should come up in living
color. All the hits are out-of-date with
respect to current (2022) goings on with HCA MHSA Innovations. As you can see Google reports us visiting
some links more than one time. The most
up-to-date material is date Feb 25, 2022.
We will focus on this a bit more than the other Google hits.
AGENDA - Orange County Health Care
Agency
https://www.ochealthinfo.com/sites/hca/files/import/data/files/107972.pdf
Sep 13, 2019
This hit addresses the relatively
new MHSA Innovation Idea Generation Website.
It provides resources and information about the MHSA INN process. It addresses the “Submission Process”. Before we knew this didn’t apply anymore we
found this tool confusing.
You've visited this page 2 times.
Last visit: 2/23/22
Orange County Health Care Agency
Behavioral Health Services
https://www.ochealthinfo.com/sites/hca/files/import/data/files/80073.pdf
Jun 18, 2018
This hit addresses MHSA Innovation
(INN) Projects. It advises us stakeholder
that “viable ideas submitted before June 8 may be posted for use of AB 114
reverted INN funds”. The document is not
time stamped so we have to assume the year is 2018. The document also indicated the information
contained within will help us with the “Submission Process” including offering
“Helpful Tips”
You've visited this page 2 times.
Last visit: 3/13/22
Innovation | Orange County,
California - Health Care Agency
https://www.ochealthinfo.com/page/innovation
This is actually an undated
website. It basically offers an overview
of “The MHSA Innovation component”. This
information at one was to gold standard in working up a MHSA INN Project Idea.
It says that the MHSA INN
component “The MHSA Innovation component is designed to evaluate the
effectiveness of new or changed practices in the field of mental health, with a
primary focus on learning rather than filling a need or a gap. Five percent of the
MHSA funds are dedicated to the Innovation component. Each project must be
approved by the Mental Health Services Oversight and Accountability Commission.
Innovation projects are time-limited to a maximum of five years, after which an
alternative source of funding must be identified if the project is deemed
successful.”
You've visited this page 2 times.
Last visit: 1/14/22
Mental Health Services Act
https://www.ochealthinfo.com/sites/hca/files/import/data/files/40122.pdf
Oct 3, 2014
This was about time that the
Innovations Advisory Committee on which Buster served was disbanded. The document addresses HCA INN Round 3
Innovations. The Round 3 format was taught by the county to any
interested. Buster attended the
training. The document discusses the “Idea
Submission Process”, the role of the “MHSA Steering Committee” and some “Background
Information on MHSA”. The background information addresses the MHSA as “Proposition
63 passed in 2004”.
Orange County Community Planning
Proposal 2-25-2022.pdf (2 Pages)
https://www.ochealthinfo.com/sites/hca/files/2022-02/Orange%20County%20%20Community%20Planning%20Proposal%202-25-2022.pdf
Feb 25, 2022
This is the document that we
hoped would solve our complaints. Doctor
Chau an acquaintance is in the header.
Even though his total time with the HCA is fairly long he is relatively
new to his job a HCA Director. In
addition Veronica Kelley, DSW, LCSW is included in the header. Dr. Kelley is very new to her job with the HCA. Since December of 2021 Dr. Kelley has been
HCA Deputy Director over Behavioral Health Services. For some reason she changed the name of the
position Behavioral Health Services to Chief of Mental Health & Recovery
Services. It has already been a quarter
of working for Dr. Kelley we recommend that she create a how am I doing survey
to collect stakeholder impressions at the upcoming (April 15, 2022) Mental
Health Association (MHAOC) Meeting of the Minds. All-in-all this document didn’t have what we
are looking for.
MHSA Innovation Project/Budget
Proposed Changes – Orange County
https://www.ochealthinfo.com/sites/hca/files/import/data/files/74712.pdf
Dec 1, 2017
Let us just call this the HCA INN
Round centered about 2017. These
projects would be considered old projects.
Right up front they shot down three (3) projects. The document
concentrates on what they call at the time Mental Health Technology Suite. Doctor Chau seems to like technology. Actually MHTS might better be funded under
MHSA Technological Needs. The document
does offer a bit of an INN primer and the role of the MHSOAC.
