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HomeMy WebLinkAboutMH Implementation Plan - FY 2011-13Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org AGENDA REQUEST & STAFF REPORT For Board Business Meeting of April 14, 2010 Please see directions for completing this document on the next page. DATE: April 8, 2010. FROM: Scott Johnson. Health Services 322-7502 TITLE OF AGENDA ITEM: Consideration of Board adoption and Chair signature of the 2011-2013 Deschutes County Biennial Implementation Plan for mental health, alcohol and drug, and gambling prevention and treatment services. PUBLIC HEARING ON THIS DATE? No BACKGROUND AND POLICY IMPLICATIONS: Each County Mental Health Authority in Oregon, including Deschutes County, is required to prepare and submit to the Oregon Department of Human Services a Biennial Implementation Plan outlining preliminary plans for mental health, alcohol and drug, and gambling prevention and treatment servLces in the upcoming biennium. Deschutes County Health Services—Behavioral Health Division, in consultation with several community groups, has prepared the proposed 2011-2013 Biennial Plan (Document Number 2010-246) for Deschutes County. The Deschutes County Commission on Children & Families has prepared the alcohol and drug prevention plan on our behalf. The document is attached and is provided to the Deschutes County Board of County Commissioners for review and adoption. NOTE: This Biennial Plan document outlines only those elements of our work that are referenced in the State's Biennial Plan form. The full Deschutes County Strategic Plan was adopted by the Board of County Commissioners in May, 2008. Information outlined in this Biennial Plan is included in that more comprehensive and long-term document. FISCAL IMPLICATIONS: This Plan relates to our financial priorities in fiscal years 2012 and 2013. Proposed financial plans and expenditures will be outlined in the County Budgets for those years. Proposed budgets will be consistent with the priorities and projects outlined in the Biennial Plan. RECOMMENDATION & ACTION REQUESTED: Adoption of the 2011-2013 Deschutes County Biennial Implementation Plan. ATTENDANCE: Scott Johnson, Deschutes County Health Services DISTRIBUTION OF DOCUMENTS: Signed original to: Kathe Hirschman, Deschutes County Health Services, 2577 NE Courtney Drip, e, Bend, OR 97701 DESCHUTES COUNTY DOCUMENT SUMMARY (NOTE: This form is required to be submitted with ALL contracts and other agreements, regardless of whether the document is to be on a Board agenda or can be signed by the County Administrator or Department Director. If the document is to be on a Board agenda, the Agenda Request Form is also required. If this form is not included with the document, the document will be returned to the Department. Please submit documents to the Board Secretary for tracking purposes, and not directly to Legal Counsel, the County Administrator or the Commissioners. In addition to submitting this form with your documents, please submit this form electronically to the Board Secretary.) Date: April 8, 2010 Please complete all sections above the Official Review line. Contractor/Supplier/Consultant Name: Contractor Contact: N/A1 Department: N/A1 Type of Document: Implementation Plan Health Services Contractor Phone #: NMI Goods and/or Services: Preparation (for adoption) of the 2011-2013 Deschutes County Biennial Implementation Plan for mental health, alcohol and drug, and gambling prevention and treatment services. Background & History: Each County Mental Health Authority in Oregon, including Deschutes County, is required to prepare and submit to the Oregon Department of Human Services a Biennial Implementation Plan outlining preliminary plans for mental health, alcohol and drug, and gambling prevention and treatment services in the upcoming biennium. Deschutes County Health Services—Behavioral Health Division, in consultation with several community groups, has prepared the proposed 2011-2013 Biennial Plan (Document Number 2010-246) for Deschutes County. The Deschutes County Corrlmission on Children & Families has prepared the alcohol and drug prevention plan on our behalf. The document is attached and is provided to the Deschutes County Board of County Commissioners for review and adoption. NOTE: This Biennial Plan document outlines only those elements of our work that are referenced in the State's Biennial Plan form. The full Deschutes County Strategic Plan was adopted by the Board of County Commissioners in May, 2008. Information outlined in this Biennial Plan is included in that more comprehensive and long-term document. Agreement Starting Date: July 1,2011 Annual Value or Total Payment: $9.5 million est. Ending Date: ❑ Insurance Certificate Received check box) Insurance Expiration Date: June 30, 2013 Check all that apply: Not applicable ❑ RFP, Solicitation or Bid Process ❑ Informal quotes (<$150K) ❑ Exempt from RFP, Solicitation or Bid Process (specify – see DCC §2.37) 4/8/2010 Funding Source: (Included in current budget? ❑ Yes ❑ No Not applicable If No, has budget amendment been submitted? I I Yes ❑ No Is this a Grant Agreement providing revenue to the County? ❑ Yes ® No Special conditions attached to this grant: Deadlines for reporting to the grantor: If a new FTE will be hired with grant funds, confirm that Personnel has been notified that it is a grant -funded position so that this will be noted in the offer letter: I I Yes I I No Contact information for the person responsible for grant compliance: Name: Phone #: Departmental Contact and Title: Scott Johnson, Director Phone #: 322-7502 Department Director Approval: Signature Date Distribution of Document: Who gets the original document and/or copies after it has been signed? Include complete information if the document is to be mailed. Signed original to: Kathe Hirschman, Deschutes County Health Services Official Review: County Signature Required (check one): ❑ BOCC 0 Department Director (if <$25K) 0 Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. ) Legal Review Date Document Number 4/8/2010 Deschutes County Health Services (DCHS) 7n7 7-7n7 R nahnvinral HaaIth Rinnnial Tmnlementatinn Plan OVERVIEW Department Description Deschutes County Health Services (DCHS) was formed in 2009, as a consolidation of the County Health and Mental Health Departments. Health Services offers services at more than 40 community locations including 26 public schools, health clinics in downtown Bend, Redmond and La Pine, five school clinics, agencies such as the KIDS Center and State Department of Human Services, area hospitals, care facilities and homes. Services are also provided through mobile outreach. Behavioral Health Our projected Behavioral Health Division budget totals $15.5 million with 106 FTE. The Division helps County residents who face serious mental health and addictions issues. Staff and contracted agencies also help people with developmental disabilities and their families. Priority populations include Oregon Health Plan members, uninsured County residents with nowhere else to turn and people in crisis, who are often in unstable situations or are a danger to themselves or others. The Division also coordinates services for County residents in care at the State Hospital or served through other agencies or facilities. These services alleviate community problems, assist people in need, promote client health and prevent more costly care and intervention. Behavioral Health will help more than 4,000 County residents in FY 2011. Behavioral Health consists of five program areas: Child and Family, Adult Treatment, Seniors Mental Health, Developmental Disabilities and Business Services. Public Health Deschutes County Health Services also has a primary responsibility to address issues related to the basic health and wellness of Deschutes County and its residents. The Public Health Division budget totals $8.7 million with 69 FTE. The Division assesses, preserves, promotes, and protects the public's health. A number of direct services are provided including immunizations, family planning, prenatal care and school based health centers as well as nutrition to young children and their mothers. Other services include disease control, disaster preparedness, tobacco prevention, health education and monitoring of community health. Patient visits are projected to total more than 35,000 in FY 2011. Public Health consists of six program areas: Community Health, Reproductive Health, Maternal Child Health, Women, Infants & Children (WIC), Environmental Health (a July 2010 transfer from the County Community Development Department) and Business Services. 2011-13 Preliminary Priorities in Behavioral Health Deschutes County Health Services will place a continuing emphasis on departmental efficiencies, service integration and better access to care. Recognized as a behavioral health integration project by the State of Oregon through 2015, the Department will continue to work actively to improve the overall health of our client populations by focusing on general community (public) health as well as coordinated care between primary care and behavioral health. Examples: better coordination of care with Mosaic Medical, La Pine Community Clinic, Volunteers in Medicine, Cascade Healthcare Community (CHC) Behavioral Health, CHC acute care and area Emergency Departments. The Department will integrate primary and behavioral healthcare in five school-based health centers (including two new centers in Sisters and Redmond). 2011-12 plans also include expanding behavioral health service capacity in Sisters, Redmond and La Pine as well as medical capacity in the Bend area. Page 1 of 15 In 2011-13, with sufficient resources, maintenance of effort will include (examples): • Helping OHP members and the highest need uninsured residents; • Servicing two treatment courts and our Bridge Program (post incarceration); • Funding acute rare and operating mobile and day crisis services; • Offering clinic, case management and outreach services throughout the County; • Significantly expanding supported housing and residential treatment options; • Continuing supported employment and homeless outreach services; • Offering help to children and families at clinics, public schools and the KIDS Center; • Offering mediation services at the Rosie Bareis Campus (Bend) • Expanding the benefit of our Early Assessment & Support Alliance; • Expanding the benefit of the Launch program (abuse prevention; wellness); • Continuing to offer geriatric services through a small specialized team; • Partnering with the Cascade Peer & Self -Help Center • Developing peer support positions at multiple locations; and • Contracting with numerous community providers. Essential partnerships include work with all contracted providers, Health Matters, COIHS (the fully capitated health plan) and Pacific Source, Accountable Behavioral Health Alliance, and the Community Mental Health Programs in Crook (Lutheran Community Services NW) and Jefferson (BestCare Treatment Services) counties. Other partnerships include the three area school districts and the High Desert Education Service District, the Commission on Children & Families, local law enforcement agencies, the Circuit Court (11th Judicial District), the Department of Human Services (state and local), the new Oregon Health Authority and the Deschutes County Local Public Safety Coordinating Council. The Department is most grateful for the support and assistance of the Deschutes County Board of Commissioners and the County Administrator as the local mental health authority for the County and to the citizens serving on the 19 -member Deschutes County Addictions & Mental Health Advisory Board. Financial support from the County General Fund increases our range and level of services, particularly to uninsured residents of Deschutes County. 2010-11 Departmental Priorities In addition to ongoing operation of a wide range of public health, behavioral health and support services, we are in the process of identifying a number of critical projects that require special effort in CY 2010. Our preliminary list is geared to developing and strengthening our new department. It includes the following: 1. Public Health Accreditation - Selected as one of 19 counties nationwide, DCHS is using Public Health Accreditation to assess our operation and strengthen our agency. Deliverables: Assessment; improvement priorities, quality improvement project. 2. Budget FY 2011 - Prepare the 2011-12 budget based on operating costs and emerging priorities, adjusting for potential funding reductions. Deliverable: Adopted budget. 3. Electronic Record Project - Begin a multi-year project to convert most DCHS operations to an electronic system. Deliverable: 2010 selection and implementation. 4. Environmental Health transfer - Integrate the Environmental Health Unit in the Community Development Dept. into DCHS. Deliverable: Transfer of budget and staff July 2010. Note: Also requires relocation of some DCHS services to another Bend site. 5. Health Report - Publish the new 2010 Report. Deliverables: With the Advisory Boards, review and select 1-3 projects for attention; disseminate the report; educate the public. Page 2 of 15 6. Integration - A major collaborative regional project through 2015, develop a model to integrate primary care and behavioral health services throughout Central Oregon. Deliverables: Single point of accountability; infrastructure development; improve health outcomes, client satisfaction and Vvo1containment. 7. Launch Development - As a major project through 2015, kick off our new child abuse prevention and child wellness initiative (5-year Federal grant). Deliverable: Expand integrated services at no less than three school-based health centers. 8. New Manager - Hire a new manager for Program Support Services with an emphasis on strengthening our quality improvement, initiating our new service integration project, and supporting our planning and evaluation activities. Deliverable: Hire in first quarter. 9. Plan: County Goals & Objectives - The County asks each Department to develop these measures as part of the budget process. Deliverables: Post quarterly updates of our progress in achieving 2009-10 objectives; propose 2011-12 goals and objectives. 10. Plan: Behavioral Health Biennial Implementation Plan - The State requires this plan every two years. Deliverable: Develop and submit the adopted 2011-2013 plan to the State. 11. Plan: Public Health Annual Plan - The State requires this plan every year, with a comprehensive plan due every three years. Deliverable: Develop and submit the adopted 2010-2011 plan to the State. 12, Policy Manual DCHS - Review prior behavioral health and public health policies guiding our operation; update as needed. Deliverable: Policy manual. 13. Residential Development - Consistent with our housing continuum, increase affordable housing for people with mental illness by 32 slots/units. De/iverab/e: Four projects completed by December 2010 including three in Bend and one in Redmond. 14. Redmond 2011 - With the County, explore the feasibility of creating a Redmond Service Center including a range of community based DCHS programs and services. Deliverable: A plan of services to be offered in Redmond in 2011 or later. 15. School-based health centers - Continue County efforts to expand school based centers throughout the County. Deliverable: Open a second center in Redmond and the first center in Sisters in the fall of 2010. 16. Strategic Plan - The Department currently has two adopted strategic plans. De/iverable: Integrate and streamline the material into a single plan early in 2011. 17. Website Update - Recreate the current web sites into a single informative site that is easy to navigate and serves the public well. Deliverable: Launch of new site in 2011 Page 3 of 15 STATE REQUIRED FORMAT AND INFORMATION 1. County/Community Mental Health Program (CMHP) Area Name: Deschutes 2. County/CMHP Physical Address: 2577 NE Courtney Drive, Bend, OR 97701 3. Addiction Treatment Services Contacts 1) Lori Hill, Adult Treatment Program Manager; 2) Scott Johnson, Director 2577 NE Courtney Drive, Bend, OR 97701 Email: 1) LoriH@deschutes.org; 2) ScottJ@deschutes.org Phone: 1) 541-322-7535; 2) 541-322-7502 Fax: 1 & 2) 541-322-7565 4. Prevention Services Contacts 1) Jessica Kelly, Substance Abuse Prevention Coordinator 2) Hillary Saraceno, CCF Director 3) Scott Johnson, DCHS Director 1 & 2) 1130 NW Harriman, Suite A; 3) 2577 NE Courtney Drive 1,2,3 Bend, OR 97701 Email: 1) JessicaK@deschutes.org; 2) HiIS@deschutes.org; 3) ScottJ@deschutes.org Phone: 1) 541-330-4632; 2) 541-317-3178; 3) 541-322-7502 Fax: 1 & 2) 541-385-1742; 3) 541-322-7565 5. Mental Health Services Contacts 1) Lori Hill, Adult Treatment Program Manager; 2) Barrett Flesh, Child & Family Program Manager; 3) Kathy Drew, Senior Services Program Manager 1, 2 & 3) 2577 NE Courtney Drive; 1, 2 & 3) Bend, OR 97701 Email: 1) LoriH@deschutes.org; 2) BarrettF@deschutes.org; 3) KDrew@deschutes.org Phone: 1) 541-322-7535; 2) 541-322-7591; 3) 541-322-7557 Fax: 1) 541-322-7565; 2 & 3) 541-322-7566 6. State Hospital/Community Co -Management Plan Contacts 1) Tara Gross, Housing Specialist: 2) Lori Hill, Adult Treatment Program Manager 1) 1128 NW Harriman; 2) 2577 NE Courtney Drive; 1 & 2) Bend, OR 97701 Email: 1) TaraG@deschutes.org; 2) LoriH@deschutes.org Phone: 1) 541-317-3116; 2) 541-322-7535 Fax: 1) 541-330-4642; 2) 541-322-7565 7. Subcontractors: Note: All funding amounts are preliminary estimates only, reflecting 2009- 2010 contractors, Deschutes County and Deschutes County Health Services reserve the right to modify this list of contractors and contracted amounts. #1 Subcontractor Name: BestCare Treatment Services Approval/ License #: 93-1269087 Amount of Funds: $233,000 Program Area: Alcohol & Drug Treatment --Adult #2 Subcontractor Name: Commission on Children and Families Approval/ License #: 93-6002292 Amount of Funds: $360,000 Program Area: Alcohol & Drug Prevention --Youth Page 4 of 15 #3 Subcontractor Name: Pfeifer & Associates Approval/ License #: 93-1254885 Amount of Funds: $542,000 Program Area: Alcohol &. Drug TreNtment--Add suit R Youth #4 Subcontractor Name: Rimrock Trails Adolescent Treatment Center Approval/ License #: 93-1019081 Amount of Funds: $80,000 Program Area: Alcohol & Drug Treatment --Youth #5 Subcontractor Name: Cascade Healthcare Community, Inc. Approval/ License #: 93-0602940 Amount of Funds: $2,211,000 Program Area: $Mental Health --Adult #6 Subcontractor Name: Oregon Treatment Network Approval/ License #: 93-1187763 Amount of Funds: $74,000 Program Area: Alcohol & Drug Treatment --Adult #7 Subcontractor Name: Maple Star Oregon, Inc. Approval/ License #: 93-1263318 Amount of Funds: $120,000 Program Area: Mental Health --Youth #8 Subcontractor Name: Dr. Joseph Barrett Approval/ License #: MD24477, expires 12/31/2011 Amount of Funds: $40,000 Program Area: Mental Health --Adult #9 Subcontractor Name: Dr. Marc Williams Approval/ License #: MD22829, expires 12/31/2011 Amount of Funds: $490,000 Program Area: Mental Health --Adult &Youth #10 Subcontractor Name: Gayle Woosley Approval/ License #: 200050099NP, expires 1/9/2012 Amount of Funds: $146,000 Program Area: Mental Health --Youth #11 Subcontractor Name: Dr. Angelina Montoya Approval/ License #: MD26047, expires 12/31/2011 Amount of Funds: $16,000 Program Area: Mental Health --Youth #12 Subcontractor Name: Sarah Cota, QMHA Approval/ License #: NPI: 1962597245 Amount of Funds: $16,000 Program Area: Mental Health --Youth #13 Family Resource Center of Central Oregon Amount of Funds: $16,824 Program Area: Mental Health—Youth #14 Healthy Families of the High Desert Amount of Funds: $12,000 Program Area: Mental Health—Youth 8. Signature pages for all who review and sign -off on this plan. This section will include the reviews and comments by the Deschutes County Commission on Children & Families (March 18, 2010 review), the Deschutes County Local Public Safety Coordinating Council (April 5, 2010), approval of the Deschutes County Addictions & Mental Health Board (April 7, 2010), Pat Carey, Regional DHS representative (March 31, 2010) and adoption by the Deschutes County Board of Commissioners (April 14, 2010). Page 5 of 15 9. County Planning Process Page 6 of 15 Place X for Priorities Identified (in 56 555 Community Plan) a New Stratcyy Pi upuncu Access to Care X Increase use of subcontracted services to manage demand. Utilization management process to better manage caseloads. Adult Mental Health X Increase peer supports and peer delivered services. Improve integration with primary care. Affordable Housing X Work with local housing authority to increase supported/affordable housing options. Children's Mental Health X Increase parent involvement and behavioral - public health integration through use of Parent -Child Interaction Therapy. Increase suicide prevention activities in conjunction with Commission on Children & Families. Continue to develop Early Assessment Support Alliance (EASA) program for first break psychosis. Decrease Juvenile Arrests Domestic Violence Health Insurance X Resource to help with Health Kids and OHP enrollment information and referral Reduce Adult Substance Abuse X Expand co-occurring disorder treatment capacity. Maintain jail partnerships for alcohol and drug treatment services to corrections population. Reduce Child Mistreatment X Maintain therapeutic services @ the KIDS Center Reduce High School Drop Out X Therapeutic services to homeless youth at Cascade Youth & Family Services Reduce Homelessness X Continue provision of PATH services. Work with local housing authority to increase supported/affordable housing options. Contract with Cascade Youth & Family Services providing therapeutic services to homeless young adults in transition. Reduce Adult Crime & Recidivism X Maintain Mental Health and Family Drug Courts and Jail Bridge Program; expand as resources allow. Maintain jail partnerships for alcohol and drug treatment services to corrections population. Reduce Juvenile Delinquency & Recidivism X Offer safe school risk assessments as part of the Safe School Alliance Reduce Teen Pregnancy X Offer family planning services; special focus on adolescents at our Downtown Health Center; support services for Public Health My Future My Choice Program for middle school youth Runaway & Homeless Youth X See Cascade Y&F reference above Page 6 of 15 10. Does your county have a written Cultural Competency Plan? (*) No, but we undertake a number of activities to address cultural competency. (11. If yes, and plan is complete, submit via U. S. mail along with all forms to be mailed specified in question 8.) 12. If no, list strategies the CMHP will implement to ensure culturally competent services will be provided, including developing a Cultural Competency Plan. We emphasize the strengths inherent in all cultures and examine how our system can effectively deal with cultural differences and related treatment issues. We view cultural competence as a developmental process. We are sensitive and strive to adapt services in response to cultural mores, appropriateness and efficacy of interventions. We try to include the minority family and community in developing resources, setting goals and outlining action steps. A percentage of staff attends cultural competency classes on an ongoing basis and shares this training within the department. We have adjunct staff available who are fluent in a variety of foreign languages, and interpreters are provided at no charge. We contract with Latino Community Association to provide oral and written translation services, and cultural competency trainings. Each subcontractor is encouraged to attend cultural competency training each year. All local programs are notified of cultural competency trainings as they become available. We maintain alcohol and drug treatment for minority populations through our own services and investment in local providers. BestCare Treatment Services is a valuable community resource in these efforts. BestCare provides Spanish language, culturally specific, evidence -based alcohol and drug treatment services in Bend and Redmond. These services are an essential part of our Deschutes County system. We have initiated an internal work group to critically review our operations and make recommendations for improving our cultural competency. While we recognize more work is needed in this area, we will struggle to make the improvements that are needed without resources. At a minimum, we will actively work to attract qualified bilingual/bicultural staff over the next several years as called for in our Strategic Plan. Any assistance possible from AMH and higher education institutions to recruit and train qualified professionals will be greatly appreciated. 13. Check the data sources consulted that will demonstrate to us data driven planning responsive to the needs of Oregonians. (*) County Demographics ( ) Prevalence Data (*) AMH Reports ( ) Minimum Data Sheets (*) Problem Gambling Data (*) Mental Health Data (*) County Profiles (*) Other: Youth behavior surveys, law enforcement record data, school district data, environmental scans, community readiness assessments, internal data system. 14. List steps that link detox, outpatient and residential treatment services ensuring a continuum of care in addiction treatment and recovery. Deschutes County Health Services (DCHS) uses available resources to help fund local detox and residential treatment, in addition to outpatient services, to help ensure access to a continuum of care in Central Oregon. Clinicians primarily use local resources when clients Page 7 of 15 are in need of detox and/or residential services, which helps to facilitate service coordination. DCHS therapists, case managers and crisis staff regularly make referrals when needed. Detox/residential facilities also coordinate discharge planning when referral is to DCHS. DCHS also provides staff support to the Addictions Committee. a back DCHS u�o.. i.rC. �.,.._, staff ...,rr-.. �....._...--'--•-"- --.......'---� - committee of the County Addictions & Mental Health Advisory Board and a networking vehicle for provider coordination. 15. In reference to ORS 430.420 and 430.630 (10) (J): check all populations that will continue to be addressed through coordination and integration of care supported by this plan. ( ) Juvenile Drug Courts (*) Adult Drug Court (*) Mental Health Court (*) Mental Health Jail Diversion (*) Local Juvenile Detention (*) Adult Jail (*) Youth Offender Re-entry (local) ( ) Youth Offender Re-entry (OYA) (*) Adult Offender Re-entry (local) (*) Adult Offender Re-entry (DOC) 16. List the current functional linkages with the state hospital system including child and adolescent program (SCIP and SAIP) and mental health acute care inpatient providers. Acute Care: Weekly meetings of local acute care staff, community mental health program (CMHP) staff, and the Extended Care Management Unit (ECMU) liaison to discuss hospitalized clients with longer term needs. Treatment options are reviewed and discharge planning discussed including state hospital transfers and diversions to community resources when possible. Adult Mental Health: CMHP crisis staff maintain regular coordination with the state hospital when newly committed clients are transferred for long-term care. If a hospitalization extends beyond several months, this role is transferred to the CMHP's residential specialist. The residential specialist has regular meetings with state hospital and ECMU liaison to facilitate discharge planning and community placements. The residential specialist also maintains contact with other facilities if a county resident is placed in a facility outside the county. Child Mental Health: Children's System of Care Initiative is being implemented. When child is unable to maintain placement in community, we engage Accountable Behavioral Health Alliance (ABHA) children's care coordinator. Regular meetings with ABHA and Greater Oregon Behavioral Health regarding continuity of care, placement concerns and future planning to reduce residential, sub -acute and acute placements and to identify and develop more local resources to support youth in their community. Use of ECSII and CASII to assess acuity and levels of care necessary. We work closely from the time of placement with residential, sub -acute and acute facilities, including SCIP and SAIP, to coordinate care and assure a supportive and seamless transition back into community. We use local natural supports such as parents, teachers, relatives, friends and families to support placements and empower youth in successful transitions. 17. List steps to collaborate with other child -serving providers that ensure services and supports are comprehensive and well coordinated: Page 8 of 15 Foster Care: Coordinate and implement a recertification process of Maple Star, a local foster care agency, to assure quality services. Contract with Maple Star for respite and therapeutic foster care services. Coordinate with Central Oregon regional CMHPs (Crook, Jefferson and Deschutes). Work closely with local DHS regarding placement, treatment and transition. Monthly meeting with MHOs, DHS, Maple Star and State regional placement coordinator. Early Intervention: Coordinated efforts with KIDS Center for children who have been physically and/or sexually abused; therapy provided on-site by Deschutes County Behavioral Health therapists. Monthly meetings with DHS to staff common cases and interventions. Behavioral health services at School Based Health Clinics for youth 0-6 and their families, in conjunction with Public Health. Linking Actions to Unmet Needs in Children (LAUNCH) federal grant serving children 0-8 in Deschutes County who are at risk for neglect and abuse, in conjunction with Public Health. Referral to Family Resource Center for parenting classes. Other: County DD child service coordinators meet with Child & Family behavioral health providers to plan together for the best services for the child and family. 18. List steps to involve young adults in transition (age 14-25) in making decisions that impact addictions and mental health services in your community. Annual focus group brings transitional age youth consumers together with Addictions & Mental Health Advisory Board members to discuss insights gained into delivery of behavioral health services to this population. EASA (Early Assessment and Support Alliance) consumer involvement in treatment planning and service delivery. 19. List steps to coordinate continuity of care over time and through episodes of care that ensure children/youth remain at home, in school, out of trouble, and with friends. In the Children's System of Care Initiative (CSCI), we offer wrap-around services in community settings. Regular continuity of care wrap-around meetings include all parties involved with each child: the child, parents, teacher, relatives, foster parent, DHS caseworker, Deschutes County Behavioral Health Staff, Juvenile Justice, Family Court Coordinator, coach, friends, etc. We use the services of Cascade Child Center for Day Treatment Services as well as Maple Star for local foster and respite placements. With local office of the State Department of Human Services, we coordinate therapeutic foster care services provided by Maple Star. Use of Qualified Mental Health Associate (QMHA) and Qualified Mental Health Professional (QMHP) skills trainers and therapists (both in-house and contracted) to provide services in home and community settings. Also work closely with local Family Court coordinator. Regular monthly meetings with ABHA and GOBHI regarding continuity of care, placement concerns and future planning to reduce residential, sub -acute and acute placements and identify and develop more local resources to support youth in their community. We use flexible funding to enhance positive experiences for children in the community through involvement in sequential esteem building activities such as Healing Reins equine therapy, Juniper Swim & Fitness, dance classes, etc. We work closely from the time of placement with residential, sub -acute and acute care facilities to coordinate care and assure a supportive and seamless transition back into our community. We use local natural supports such as parents, teachers, relatives, friends and families to support placements and empower youth in successful transitions. Page 9 of 15 20. List steps the Mental Health Authority takes to ensure access to services, and interagency coordination with the local Seniors and People with Disabilities. C -...e work to develop good knowledge of State Seniors R Ponpla with Disabilities �.aac nia nayciS uc ... �.. r. yC.... ..��.... �....7..... ..,...... .. _...... .. ,....._�._ with _.... _. (SPD) services as well as to maintain good relationships with individual SPD workers. This enables us to facilitate clients' access to benefits, including medical benefits and food stamps. Clinicians and the supervisor in the Enhanced Care Outreach Services (ECOS) program meet monthly with SPD staff to ensure coordinated services for shared clients. There are increasing instances of adult mental health clients having significant medical needs, and at times this can cause issues in terms of service eligibility between agencies. Currently these situations are managed on a case-by-case basis. A regular meeting with SPD and Behavioral Health would be helpful to better facilitate interagency communication regarding these situations, at both the system and the individual levels. A plan to establish this is in process. 21. List support services the Community Mental Health Program (CMHP) intends to purchase with these funds during 2011-2013 for any of the populations included in this plan. Housing: On-site case management at all supported housing sites. Help clients obtain housing vouchers, work with landlords to secure stable housing. PATH services & work with homeless shelters. Work with residential treatment providers and maintain capacity. Education Assistance: none. Employment Assistance: Supported Employment program will continue to operate with a high fidelity score. Transportation: Limited vouchers 22. List planned strategies to integrate mental health, physical health (including dental) and addiction services for all populations, birth through older adult. Deschutes County Health Services is a core partner in the Central Oregon Link 4 Health (L4H) Health Integration Project, a state demonstration site for integration. (Contact Jane - Ellen Weidanz at AMH for more information.) This pilot project will remain in place with State technical assistance and support through at least 2015 and will focus on Triple -Aim outcomes (i.e., health improvement, client experience and cost of care). In addition, the federally funded Linking Actions to Unmet Needs in Children (LAUNCH) Project will integrate behavioral health Parent -Child Interaction Therapy in School Based Health Centers. Public health screening identifies women with pregnant -post -partum depression and refers to behavioral health for counseling services. Intention is to maintain proficiency in treating co-occurring disorders. Provide information and referral of behavioral health clients to Living Well with Chronic Conditions program. Participate in grant -funded program to place dental hygienists in WIC clinics. Visits by the Dental Van are announced to behavioral health clients. 23. List steps taken to prioritize drug court participants. Assessment within 24 hours of referral. Intensive addiction treatment, with 5 -phase system of advancement toward graduation. Parenting skills training is required. Flexible funds help with housing, transportation, dental services and child care. Deschutes County Health Services provides grant administration with program support and coordination through the 11th Judicial District and the core treatment team. Page 10 of 15 24. What is the amount of funding that the Community Mental Health Program (CMHP) contributes to treatment court programs including both adolescent and adult drug courts, mental health courts, etc.? $490,767 annually 25. Complete the table for funding allocation for each service element: Subject to change. 26. Describe rationale for any changes in funding allocations from the 2009-2011 biennium. Not applicable. These decisions will be assessed and finalized in the spring of 2011, based on need, local investment decisions and the outcome of the 2011 Legislative Session. 27. How much Beer and Wine tax funding does your CMHP area receive annually? Approximately $125,500 Page 11 of 15 AMH Funding Amount Programs/Projects Funded Amount of County MOE Matching Funds Planned Expenditure of MOE Funds SE 60 SE 61 SE 61A SE 62 SE 66 [ 1,182,452 ] [ 51,844 ] [ Outpatient addictions treatment ] SE 67 SE 67A SE70 [282,000] [0] SE 71 SE 80 [ 89,051 ] [ 0 ] SE81 [70,000] [0] SE 1 [ 222,372 ] [ 0 ] SE 20 [ 2,078,202 ] [ 0 ] SE22 [618,428] [0] SE 24 [ 1,731,342 ] [ 0 ] SE 25 [ 744,198 ] [ 0 ] SE 28 [ 885,440 ] [ 0 ] SE30 [84,704] [0] SE 31 [ 436,992 ] [ 0 ] SE 34 [ 842,376 ] [ 0 ] SE 35 [ 18,734 ] [ 0 ] SE 36 [ 20,072 ] [ 0 ] SE 38 [ 298,584 ] [ 0 ] SE 39 SE201 [43,526] [0] The following are new service elements; include in table if we are requesting to use them A&D 72 A&D 73 MHS 26 MHS 27 Peer -led 26. Describe rationale for any changes in funding allocations from the 2009-2011 biennium. Not applicable. These decisions will be assessed and finalized in the spring of 2011, based on need, local investment decisions and the outcome of the 2011 Legislative Session. 27. How much Beer and Wine tax funding does your CMHP area receive annually? Approximately $125,500 Page 11 of 15 28. List how beer and wine tax money is allocated: $16,000 allocated to Adolescent residential $4/,00n allnratori to Aril lit riatnx $67,500 allocated to Adult outpatient services 29. Check whether the Community Mental Health Program (CMHP) has alcohol & drug, gambling prevention and/or treatment services and/or supports in place to reach the following populations of interest. If yes, list strategies for each: Children (0-6): (*) Yes 1) Evidence based parenting curriculum (Incredible Years); 2) Development and distribution of a parent resource guide; 3) Support for Family Resource Center Youth: (*) Yes 1) Drug and alcohol assessment; 2) Counseling and referral services; 3) Toward No Drug Abuse and gambling prevention program 4) Evidence based curricula in schools; 5) Training and support for prevention coalitions; 6) Community mobilization of stakeholders, community partners and members; 7) Retailer training for proper sale of alcohol; 8) Reward -Reminder and minor compliance checks of alcohol; 9) Social norming and media awareness campaigns; 10) Advocacy for evidence based strategies as a standard; 11) Support for the Community Schools Initiative and Family Resource Center Young Adults in Transition (14-25 y/o): (*) Yes 1) Drug and alcohol assessment; 2) Counseling and referral services; 3) Toward No Drug Abuse and gambling prevention program. Cultural Groups: (*) Yes We maintain alcohol and drug treatment for minority populations through our own services and investment in local providers. BestCare Treatment Services is a valuable community resource in these efforts. BestCare provides Spanish language, culturally specific, evidence -based alcohol and drug treatment services in Bend and Redmond. These services are an essential part of our Deschutes County system. Co-occurring Disorders: (*) Yes Deschutes County Health Services provides mental health, alcohol and drug, and gambling treatment services in house. Many staff are dually credentialed so that services are integrated within the agency and often with a single provider. Veterans: (*) No specialized program. Some veterans served. Older Adults: (*) Yes Addiction issues are usually addressed by the geriatric specialist working with the individual. The therapist would have access to consult with other therapists in the agency who have expertise in treating substance abuse or gambling. 30. Check whether CMHP has mental health treatment services and/or supports in place to reach the following populations of interest. If yes, describe strategies for each: Children (0-6): (*) Yes 1) Assessment and diagnosis; 2) Individual, family and group counseling and intensive wrap-around services available in schools, School Based Health Centers, main clinic and homes; 3) Skills training; 4) Safe School Assessments; 5) Suicide prevention; 6) Parenting Wisely curriculum. Page 12 of 15 Youth: (*) Yes 1) Assessment and diagnosis; 2) Individual, family and group counseling and intensive wrap-around services available in schools, School Based Health Centers, main clinic and homes; 3) Skills training; 4) Safe School Assessments; 5) Suicide prevention; 6) Parenting Wise..!y n..irrin....h...i.m . Young Adults in Transition (14-25 y/o): (*) Yes 1) Assessment and diagnosis; 2) Individual, family and group counseling and intensive wrap-around services available in schools, School Based Health Centers, main clinic and homes; 3) Skills training; 4) Safe School Assessments; 5) Suicide prevention; 6) Parenting Wisely curriculum; 7) Early Assessment and Support Alliance (EASA) early intervention program for first break psychosis. Cultural Groups: (*) Yes We strive to adapt services in response to cultural mores, appropriateness and efficacy of interventions. We try to include the minority family and community in developing resources, setting goals and outlining action steps. Staff attend cultural competency classes. We have Spanish speaking therapists on staff and adjunct staff available who are fluent in a variety of foreign languages, and interpreters are provided at no charge. Co-occurring Disorders: (*) Yes Deschutes County Health Services provides mental health, alcohol and drug, and gambling treatment services in house. Many staff are dually credentialed so that services are integrated within the agency and often with a single provider. Veterans: (*) No specialized program. Federal VA community clinic is located next door to the primary Bend location of Deschutes County Health Services. Some veterans served in DCHS programs. Older Adults: (*) Yes Deschutes County Health Services has four QMHPs and one QMHA who have received special training in providing mental health services and supports to the older adult population. Group and individual services are provided in addition to consultation with physicians, residential providers and families. Most of these services are provided at the client's place of residence, and transportation is coordinated or provided for groups. 31. Mental Health carry over funds amount: It is difficult to project possible carry over funding in June 2011. Richard Harris, AMH Director, has expressed an interest in removing grant funding streams to support our pilot integration efforts and we are supportive of this change if it is made operational. This could allow us to invest additional dollars in integration efforts. We are specifically requesting this change. Potential areas for carry-over include EASA. 32. Alcohol and drug carry over funds amount: None 33. Select the top three prevention priorities from Comprehensive Plan (SB555) by clicking on three choices and complete the table in Question 34. (*) Reduce teen alcohol use (*) Increase parent disapproval of substance use (*) Increase community engagement Page 13 of 15 34. Prevention Priorities: Developed through a partnership with the Deschutes County Commission on Children & Families. Identified priorities from question 33. Evidence -based Program/Tribal Best Practice Projected Funding Outcomes Be Specific Reduce teen alcohol use 1. Communities Mobilizing for Change on Alcohol 2. Friendly Peersuasion 3. Positive Social Norming campaign $37,000 la. Increase retailer ID checking skills by 20% as a result of training. lb. Achieve 8O% or higher retailer compliance as measured by minor compliance checks or reward/ reminder initiatives. lc. Conduct assessment of alcohol messaging by doing an environmental scan of alcohol establishments, advertising and prevalence at community events. 2. 75% of participating girls will report an increased knowledge of coping and resistance skills. 3. Implement a positive social norming campaign that reaches 8O% of 8th graders in Deschutes County. Collaborate with regional partners—Jefferson & Crook counties—as possible. Increase parent disapproval of substance use 1. Strategic media awareness 2. Parenting forums $9,000 1. Implement a strategic media awareness approach that reaches 80% of parents of school aged youth. 2. 70% of participating parents will report an increased knowledge of how to implement prevention strategies in their home.] Increase community engagement 1. Community based coalitions 2. Community mobilization $138,000 1. Provide ongoing technical assistance, funding and training to 5 local coalitions. la. 5 local coalitions will have work plans grounded in the strategic prevention framework. 2a. Advocate for and assist with developing consistent policies and laws around AOD use, possession, enforcement and referral. 2b. Support school district implementation of prevention curriculum and policy/environmental strategies known to be effective. 2c. Provide and support training to increase the community's ability to address the issues. 2d. Assist in resource development and bringing community resources together to work on the issue. 2e. Employ media campaigns to inform the public on important issues. 2f. Assist the community in applying the strategic prevention framework to all prevention work. Page 14 of 15 35. Prevention Strategies Identified Priority List strategies to support and maintain Inca! coalitions Projected Funding Outcomes Strategy 1 Assist in resource development and bringing community resources together to work on the issue. $200,000 Apply for grant funds to assist in prevention coalition activities in local communities and school districts Strategy 2 Provide ongoing technical assistance, funding and training to 5 local coalitions. $90,000 5 local coalitions will have work plans grounded in the strategic prevention framework. Strategy 3 Provide and support training to increase the community's ability to address the issues. $10,000 Provide 3 training opportunities to community coalitions. Participants will return to the community and apply new knowledge. 36. List planned strategies the prevention program will use to address gender and cultural considerations. Deschutes County will continue to support programs and services for adolescent girls. Strategies include implementation of Friendly Peersuasion, Girls Circle and the Girls Summit. In addition, contractors and employees are encouraged to attend cultural competency training each fiscal year. All local programs are notified of cultural competency trainings as they are made available. 37. Is the county Prevention Coordinator CPS Certified? (*) Yes 4/8/2010 \\ ZEUS \katheh\MY DOCUMENTS\ANNUAL REPORTS\IMPLEMENTATION PLANS\Implementation Plan \2011-2013\2011-2013 Biennial Imp Plan to BOC 040810.doc Page 15 of 15 Addictions and Mental Health Division — Attachment 1 BOARD OF COUNTY COMMISSIONERS REVIEW AND APPROVAL County: Deschutes In accordance with ORS 430.258 and 430.630, the Board of County Commissioners has reviewed and approved the mental health and addiction services County Biennial Implementation Plan for 2011-2013. Any comments are attached. Name of Chair: Address: Telephone Number: Signature: Date: Addictions and Mental Health Division — Attachments 2 and 3 LOCAL ALCOHOL AND DRUG PLANNING COMMITTEE AND LOCAL MENTAL HEALTH ADVISORY COMMITTEE REVIEW AND COMMENTS County: Deschutes Deschutes County's Addictions & Mental Health Advisory Board serves as the following mandated boards and committees: (1) The Mental Health Advisory Board, as mandated by Oregon Administrative Rule 309-014-0020; (2) The Local Alcohol and Drug Planning Committee, as mandated by Oregon Revised Statues 430.290, 430.342, and 430.350; OAR 415-012-0030; and by Deschutes County Code Chapter 2.40.1 Section 2.40.020-2.40-040; and (3) The Quality Management Committee, as mandated by Oregon Administrative Rules 309-032-0595 and 309-032-1200. Attach a list of committee members. Identify members that are consumers with a "C" and members that are family members with an "F." Use an asterisk (*) next to the name to identify members who are minorities (ethnics of color according to the U. S. Bureau of Census.) In accordance with ORS 430.342, the Deschutes County Addictions & Mental Health Advisory Board, established in accordance with ORS 430.630(7), recommends acceptance of the 2011- 2013 Biennial County Implementation Plan and recommends the state funding of alcohol and drug treatment services as described in the Plan. Further comments and recommendations are attached. Name of Chair: Glenda Lantis Address: 2577 NE Courtney Drive Bend, OR 97701 Telephone Number: (541) 318-3753 Signature: Date: 5//7/°ze/U DESCHUTES COUNTY ADDICTIONS AND MENTAL HEALTH ADVISORY BOARD 2010 ROSTER Glenda Lantis, Chair "F" Darrel Wilson, Vice Chair Pat Croll Dolores Ellis Mary Fuller Chuck Hemingway Jennifer McKague Marty Miller "F" Roger Olson "F" Kristin Powers Lee Ann Ross "F" Nancy Ruel Julie Rychard Marianne Straumfjord Lindsay Stevens"F" Bert Swift Patricia von Riedl "C" 4/1/2010 \\ZEUS'katheh\MY DOCUMENTSWNNUAL REPORTS\LMPLEMENTATION PLANSUmplementation Plan \2011-2013\AMHAB Sign Of Sheet in Word.doc Addictions and Mental Health Division — Attachment 4 COMMISSION ON CHILDREN & FAMILIES REVIEW AND COMMENTS County: Deschutes The Deschutes County Commission on Children & Families has reviewed and approved the alcohol and drug abuse prevention and treatment portions of the County Biennial Implementation Plan for 2011-2013. Any comments are attached. Name of Chair: John McLaughlin Address: 1130 NW Harriman, Suite A Bend, OR 97701 Telephone Number: (541) 317-3178 Signature: Date: April 5, 2010 Comments and Recommendations: 1) Overall the plan is comprehensive and complete and the inclusion of prevention efforts in the planning is greatly appreciated. 2) Appreciated local efforts from DCHS, JCJ and CCF to coordinate surveys for the JCP Plan, the AMH Plan and the Comp Plan updates thereby reducing duplication and making it less time consuming and confusing for local agencies to participate (resulting in an 82% return rate on the combined survey). 3) State agencies/DHS need to continue to work on coordination of time lines for the various plans so that they happen at the same time. 4) Recommend the state standardize the planning process so that all organizations are utilizing a similar format and process. 5) Due to declining resources and capacity, continue to simplify and streamline planning and reporting processes. Addictions and Mental Health Division - Attachment 5 OY FUNDS MAINTENANCE OF EFFORT ASS TR A NCF. County: Deschutes As required by ORS 430.359(4), I certify that the amount of County funds allocated to alcohol and drug treatment and rehabilitation programs for 2011-2013 is not projected to be lower than the amount of County funds expended during 2009-2011. The County Budget process occurs annually and future revenue available to Deschutes County is uncertain. Final amounts are subject to the recommendations by the County Administrator and the annual County Budget Committee process as well as final action by the Board of Commissioners. The County has consistently supported health services with County General Fund and discretionary resources. While the County's contribution is not expected to decline, some cuts could occur if circumstances warranted. This information is available in June of each year at the time of budget adoption. Scott Johnson, Director Signatur Ato Si 200 Date Addictions and Mental Health Division — Attachment 6 REVIEW AND COMMENTS BY THE LOCAL CHILDREN, ADULTS AND FAMILIES DISTRICT MANAGER FOR THE DEPARTMENT OF HUMAN SERVICES County: As Children, Adults and Families District Manager for the Department of Human Services, I have reviewed the 2011-2013 Biennial County Implementation Plan and have recorded my recommendations and comments below or on the attached document. Name of District Manager 3 -5I -J(9 Date Addictions and Mental Health Division — Attachment 7 REVIEW AND COMMENTS BY THE LOCAL PUBLIC SAFETY COORDINATING COUNCIL County: The local Public Safety Coordinating Council has reviewed the 2011-2013 Biennial County Implementation Plan. Comments and recommendations are recorded below or are provided on the attached document. No G�rnn2eNs Name of Chair: ThicoicecP 1 C. S,J1 ✓/vN Address: noo N,w l doruA 9770/ Telephone Number: .5--q/ 3fff? Li1300 65, ate✓/ U Signature: Date: J 6 eui 206 a { Partner Inclusion Matrix Partner/Stakeholder T pe of Participation 1�2 3 4 5 6 7 Partici • ation Level 8 None Low Med High Community Members Consumer & Families Advocates X People w/special needs Cultural groups (spec fY) Local Public Safety Coordinating Council X Local Mental Health Advisory Committee Mental Health Organization (MHO) x Local Alcohol & Drug Planning Committee Governor's Council on A & D Programs External Qual X ty Improvement Committee Local Services Delivery Area (SDA) Tribal Council x Local Commission on Children & Families X Local Workforce Investment Board Chamber of Commerce x x Business Partners Faith Communities Education Partners School Board X Local Schools/School Districts x x x x Early Intervention/Early Childhood Special Ed ESD PTA Services & Social Support Providers Housing x Employment X Community Action Agency Transportation Mental Health & Addiction Treatment Providers Child Care Resources X Medical Commun ty Fully Capitated Health Plans Primary Care Provider Organization Public Health Department X x x Adult & Juvenile Justice/Corrections OYA X Community Justice: Adult Probation x Community Justice: Juvenile Division County Jail Local Law Enforcement Agency (Sheriff/City Police) Participation Key 1= Advisory Board 2= Community Planning Partner 3= Mental Health Planning Partner 4= Client Referral Only 5= Consul ation Only 6= Joint Case Planning/Consultation 7= Collateral Service Provision 8= On -Site Co -Delivery of Service Involvement and Follow-up High= consistent, active Medium= Occasional Low= Infrequent or minimal None= Not involved at this time Deschutes County Mental Health Department Sliding Fee Schedule Reduced fees may be available for families experiencing financial difficulties. Your fee is determined by your ability to pay. Family income and number of dependents will be considered when assessing your fee. Individuals seeking only a formal evaluation (written report) and not seeking treatment will not be offered a sliding scale fee. OIIUtI IlJ 1 cc ../lelIr.MMI'. Number in Household Gross Monthly Income 1 $3.00 2 $0.00 3 $0.00 4 $0.00 5 $0.00 6 $0.00 7+ $0.00 $ 0 - $867. $ 868.- $1167. $3.00 $3.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1168.- $1467. $6.00 $3.00 $3.00 $0.00 $0.00 $0.00 $0.00 $1468.- $1767. $9.00 $6.00 $3.00 $3.00 $0.00 $0.00 $0.00 $1768. - $2067. $12.00 $9.00 $6.00 $3.00 $3.00 $0.00 $0.00 $2068. - $2367. $15.00 $12.00 $9.00 $6.00 $3.00 $3.00 $0.00 $2368. - $2667. $18.00 $15.00 $12.00 $9.00 $6.00 $3.00 $3.00 $2668. - $2967. $21.00 $18.00 $15.00 $12.00 $9.00 $6.00 $3.00 $2968. - $3267. $24.00 $21.00 $18.00 $15.00 $12.00 $9.00 $6.00 $3268. - $3567. $27.00 $24.00 $21.00 $18.00 $15.00 $12.00 $9.00 $3568. - $3867. $54.00 $51.00 $48.00 $45.00 $42.00 $39.00 $36.00 $3868. - $4167. $57.00 $54.00 $51.00 $48.00 $45.00 $42.00 $39.00 $4168. - $4467. $60.00 $57.00 $54.00 $51.00 $48.00 $45.00 $42.00 $4468. - $4767. $63.00 $60.00 $57.00 $54.00 $51.00 $48.00 $45.00 $4768. - $5067. $66.00 $63.00 $60.00 $57.00 $54.00 $51.00 $48.00 $5068. - $5367. $69.00 $66.00 $63.00 $60.00 $57.00 $54.00 $51.00 $5368. - $5667. $72.00 $69.00 $66.00 $63.00 $60.00 $57.00 $54.00 $5668. + $120.00 Deschutes County Mental Health is committed to offering affordable services. No person will be refused care due to an inability to pay. We promise to make every effort to obtain public dollars to assist in reducing our sliding scale fees. Sliding Fee Schedule FY O8-09