HomeMy WebLinkAboutResolutions - 1985.07.25 - 11164June 27, 1985
MISCELLANEOUS RESOLUTION 85197
BY: HEALTH AND HUMAN RESOURCES COMMITTEE, Nancy McConnell, Chairperson
IN RE: COMMUNITY MENTAL HEALTH -- Assertive Community Treatment Program
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS:
Mr. Chairperson, Ladies and Gentlemen:
WHEREAS there exists a core group of chronically mentally ill adults in
Oakland County who account- for a disproportionately high number of admissions
and days of care at Clinton Valley Center, resulting in the so—called "revolving
door" problem at the State hospital; and
WHEREAS these same patients, when not in the hospital,- are for the most
part homeless or living in marginal situations; unemployed; and lacking any
meaningful structure in their lives; and
WHEREAS the Community Mental Health program at present lacks the resources
to provide an adequate level of treatment and case management for this group of
chronic patients, in light of their continuing and multiple needs for services; and
WHEREAS the Michigan Department of Mental Health has now awarded funding to
the Community Mental Health Board for an "Assertive Community Treatment Program"
which is specifically designed and staffed to provide a high level of care for
75 of these most needy patients, and the Board intends to award a contract to
Pontiac General Hospital for operation of the program, which the Hospital is
willing and able to do; and
WHEREAS the Assertive Community Treatment Program is based on model programs
in several other areas which have demonstrated their effectiveness in meeting the
special needs of the most chronic mentally in adults, helping them achieve and
maintain their maximum level of functioning in the community and reduce their
need for hospitalization;
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners
approve the proposed Assertive Community Treatment Program as presented by the
Community Mental Health Division, and authorize necessary County matching funds
for the Program.
Mr. Chairperson, on behalf of the Health and Human Resources Committee,
move the adoption of the foregoing resolution.
/
Hearth and Hg,u-nan Resources Committee
TOTAL
County
ASSERTIVE COMMUNITY TREATMENT PROGRAM
The Assertive Community Treatment (ACT) Program is an intensive outpatient
service providing case management, supportive therapy and medications for
75 chronically mentally ill adults. These services are not provided at an
office, but in the clients' homes and apartments, and out in the community.
The goals of the program are to stabilize the clients as much as possible,
help them achieve and maintain their maximum level of functioning in the
community, and reduce the frequency and duration of necessary episodes of
rehospitalization.
Clients for the program are being hand-picked from our total caseload of known
chronically ill adults, based on pre-established criteria and history of
frequent, repeated hospitalizations at Clinton Valley Center -- generally
three or more per year Most of these clients live in the Pontiac area when
they are not in the State hospital.
The program is based on successful models in Wisconsin, Chicago, and elsewhere
in Michigan. The services offered are similar to those of the Board's
Alternative Treatment Program run by Pontiac General Hospitaj. However, a
unique feature of the planned ACT Program is that it does not expect to
discharge its clients after a period of time. Basically, clients are in the
program for life, unless they move out of the County, or are totally unco-
operative with treatment. Clients are followed into and out of the hospital
when they do need inpatient treatment. The premise is that these clients
have a permanent or at least very long-term disability which requires
continuing support and case management.
Staffingconsists of a clinical supervisor (who spends half time in direct
patient service); seven Case Management Coordinators (two of whom are to be
psychiatric nurses); an accounts clerk and two typists; and 20 hours per week
of consultant psychiatrist time. Office space requirements are minimal, since
almost all contact with the clients takes place away from the office.
The budget also includes $6,000 for medications for indigent clients; $5,000
to purchase emergency shelter for the clients at motels/hotels, or in vacant
Adult Foster Care beds; and $3,500 for a patient assistance fund to provide
pocket money, clothing, emergency meals, and other necessities which may
from time to time exceed the clients' SSI income.
The Department of Mental Health will arrange training for the program staff
by other programs which have been set up on the same model. Phase-up of
the program to the full 75 client capacity is expected to take at least six
months. Clients from the pre-selected list may be admitted as an alternative
to hospitalization at Clinton Valley Center; upon discharge from CVC; or
from the community at large. Detailed statistics will be kept to assess the
outcomes of the program, particularly the anticipated reduction in the clients'
need for rehospitalization.
Budget(July - December, 1985):
Personnel $147,548
Operating 58,405
Furniture & Fixtures 13,970
$219,923
21,992
FISCAL NOTE
BY: FINANCE COMMITTEE, DR. G. WILLIAM CADDELL, CHAIRPERSON
IN RE: COMMUNITY MENTAL HEALTH - ASSERTIVE COMMUNITY TREATMENT PROGRAM -
MISCELLANEOUS RESOLUTION #85197
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Mr. Chairperson, Ladies and Gentlemen:
Pursuant to Rule RI-C of this Board, the Finance Committee has reviewed
Miscellaneous Resolution #85197 and finds:
1) The Oakland County Community Mental Health Services Board has received
State funding for an "Assertive Community Treatment Program",
2) The Community Mental Health Services Board intends to enter into a
contract with Pontiac General Hospital to provide treatment and cage
management for 75 chronically mentally ill adults,
3) The annual budget for this program is $425,876; the State portion is
$383,288 (90%) and the County portion is $42,588 (10%), (see attached
schedule),
4) The effective date of this program is July 1, 1985,
5) The increase to the 1985 Community Mental Health budget is $219,923,
requiring the following transactions:
Appropriation
22200-166-New Unit-00-3042 Client Services $219,923.
Revenue
22200-166-New Unit County Match $ 21,992
22200-903-01-00-9340 State Match 197,931
$219,923
10100-909-01-00-9900 Contingency "(21,992)
FINANCE COMMITTEE
M. R. #85197 COMMUNITY MENTAL HEALTH -
ASSERTIVE COMMUNITY TREATMENT PROGRAM
6 Months 12 Months
Salaries & Fringe Benefits $147,548 $295,096
Operating:
Professional Services 26,000 52,000
Rent 7,800 15,600
Mileage 6,000 12,000
Supplies 18,605 37,210
Furniture 13,970 13,970
Total $219,923 $425,876
#85I97 July 25, 1985
25th_ day of 19 85
IYNN40_.ALLEN
Counky Clerk/Register of Deeds
1
Moved by Susan Kuhn supported by McPherson the resolution be adopted.
AYES: Nelson, Olsen, Pernick, Price, Rewold, Skarritt, Webb, Wilcox,
Aaron, Caddell, Calandro, Doyon, Fortino, Gosling, Hassberger, Hobart, R. Kuhn,
S. Kuhn, Lanni, McDonald, McPherson, Moffitt. (22)
NAYS: None. (0)
A sufficient majority having voted therefor the resolution was adopted'.
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lynn D. Allen, Clerk of the County of Oakland and having a seal,
do hereby certify that I have compared the annexed copy of the attached
Miscellaneous Resolution adopted by the Oakland County Board of Commissioners
at their meeting held on July 25,19,:85
with the orginial record thereof now remaining in my office, and
that it is a true and correct transcript therefrom, and of the
whole thereof.
In Testimony Whereof, I have hereunto set my hand and affixed the
seal of said County at Pontiac, Michigan
this