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County Health and Mental Hygiene Departments to merge into Department of Behavioral & Community Health in 2016

Published: 10/8/2015

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Colleen Pillus

Poughkeepsie, NY… In advance of the submission of the 2016 Dutchess County Executive Budget, County Executive Marc Molinaro on Thursday joined Budget Director Valerie Sommerville and Deputy County Executive Bill O’Neil for a presentation to the Dutchess County Legislature’s Budget, Finance & Personnel Committee meeting about the merger of the Dutchess County Departments of Health and Mental Hygiene – creating the new Department of Behavioral & Community Health (DBCH) in 2016 to provide a more holistic health and behavioral health care system focused on prevention, intervention and diversion.      The DBCH component of the 2016 Executive Budget is expected to show a net county cost reduction between $800,000 and $900,000, with enhanced service offerings for the public.

County Executive Molinaro said, “In our society, there has been a disconnect between physical health, public health, and behavioral health, instead of a holistic focus on the person as a whole.  With the merger of the Departments of Health and Mental Hygiene, the County is breaking down barriers with the goal of more comprehensive care focused on prevention, outreach, education and integration.  As the health care system changes, Dutchess County is on the forefront of those changes and we prepared to advance our vision of being the healthiest county in New York State.”

County Executive Molinaro first announced the concept of merging the Departments of Health and Mental Hygiene in his 2013 State of the County Address.    With funding provided by the Dyson Foundation, the County engaged the Center for Government Research (CGR) to determine the feasibility of merging the two departments.   The final report, issued in February 2014, recommended the merger of the two departments under a single commissioner.    Since then, the County’s Health & Human Services Cabinet and the external Health and Human Services Advisory Council have worked collaboratively to provide input and comments, and an internal Merger Transition Team was formed.

Collaboratively, the new Department’s vision and mission statements were established.   The vision calls for Dutchess County to be the healthiest county in New York State with the mission statement of:  “The Dutchess County Department of Behavioral and Community Health will assess and protect the community from health risks, assure access to high-quality services and promote holistic care that integrates physical and behavioral health outcomes.”

While the DBCH will not be completely co-located in a single facility, the transition team has streamlined fiscal and administrative unit functions to be more efficient in a single department and  those units are now co-located at the Poughkeepsie Journal building.   Information Technology (IT) services have been consolidated and communication outreach has been integrated.   There have been multiple joint efforts, including a unified focus to address prescription drug and opiate abuse, cross-training in suicide prevention and mental health first aid, as well as a joint disaster preparedness exercise.

At the same time, a national search was also undertaken for Commissioner of the new department, which was also funded by community partner, the Dyson Foundation, seeking an individual who can bring the necessary combination of management skill and clinical knowledge to lead this newly merged department through change and transition.   A search committee - which includes representatives from the County Legislature and internal county staff,  as well as external stakeholders -  has interviewed candidates and the process, including getting necessary state approvals, is coming to a close.   County Executive Molinaro stated, “Our goal is to present the new DBCH Commissioner for confirmation by the County Legislature for the November board meeting.”

The consolidation of the DOH and DMH into the Department of Behavioral & Community Health will include several position restructuring recommendations that will be included in the 2016 Executive Budget to better align positions under the new organization.    There will be no net increase in the number of positions.

Among the future initiatives the DBCH will undertake:

  • Training to primary medical community
  • Shared use of epidemiology & biostatistics expertise
  • Participation in task force for prevention of human trafficking
  • Outreach to colleges and schools
  • Activities targeting veterans

And as the paradigm shifts towards a more community health focus, additional initiatives will include:

  • Integration of chronic disease management into behavioral health clinics, smoking cessation and pre-diabetes screenings
  • Integration of mental health & substance abuse screening into public health clinics
  • Incorporating behavioral health support into Maternal Child Health home visits
  • Crisis Stabilization Center & comprehensive jail program integrating health & mental health.

The Crisis Stabilization Center is part of the County’s ongoing focus of prevention, intervention and diversion and is the natural progression following the creation of the Mobile Crisis Intervention Team (MCIT) in 2012, a team of resources available immediately to individuals in crisis to help avoid an Emergency Department (ED) visit and/or support individuals in the community following a brief ED intervention.   The team is also available to assist law enforcement who may have a situation involving an individual in crisis.   Earlier this year, the MCIT was expanded to 24 hour a day, 7 day a week availability to ensure the service is available around the clock.  In 2015, the MCIT has provided over 13,500 units of service.   Also this year, Crisis Intervention Team (CIT) training began for local enforcement designed to help educate police officers on how to effectively interact with individuals in their communities who are in crisis due to behavioral health or developmental disorders, creating a partnership between the law enforcement, advocacy and mental health communities.    The development of the Crisis Stabilization Center is the next step in those efforts and a result of the work done by the Dutchess County Criminal Justice Council’s (CJC) Diversion Committee, led by Steve Miccio, CEO of PEOPLe, Inc.    The center is modeled after a successful project in San Antonio and has been endorsed by mental health and other service providers throughout Dutchess County as an important step in changing the mental health system.     The center will serve as a location for the MCIT as well as law enforcement to bring individuals in order to de-escalate and stabilize, rather than taking them to emergency rooms or in many cases, the county jail.

The Crisis Stabilization Center will be a 23-hour unit, able to accommodate up to 24 individuals at a time.    It will be an important resource for both the MCIT and law enforcement to be able to bring individuals in crisis to and get them the help they need.    Local service providers including Mid-Hudson Regional Hospital of Westchester Medical Center, Hudson Valley Mental Health, Mid-Hudson Alcohol Recovery Center, Lexington Center for Recovery, Astor,  Mental Health America (MHA) of Dutchess County, and PEOPLe Inc., have all committed to fast-tracking individuals who come through the center into ongoing services.

Andrew O’Grady, Executive Director for MHA of Dutchess County, said, “This is an important project that will have meaningful impact on our mental health system.    In the Crisis Stabilization Center, intervention will be immediate, and there will be a commitment to ongoing care with a wait from all collaborating partners, include MHA of Dutchess County.   I applaud County Executive Molinaro for his commitment to invest in this unique and vital project that will make a positive difference in so many lives.”

The Crisis Stabilization Center will be located at 230 North Road, in the same building as the current Department of Mental Hygiene, utilizing space currently occupied by Abilities First (which is consolidating its operations into a new facility in LaGrange).    Remediation and remodeling work are expected to begin early next year with the anticipated opening by the end of 2016.     Renovations to the entire facility will enable the County to consolidate HELPLINE resources and the MCIT as well as the Partial Hospital program with medically supervised clinical services to assist with the ongoing recovery process.

Construction funding for the Crisis Stabilization Center will require a bond authorization from the Dutchess County Legislature.    It is expected the authorizing resolution will be presented to the Legislature along with the 2016 Dutchess County Executive Budget, which is required to be submitted to the Dutchess County Legislature no later than November 1st.