Joint Meeting of the Flagler County Board of County Commissioners

and the Public Safety Coordinating Council

Wednesday, February 13, 2019, 8:45 a.m. Emergency Operations Center, Building 3, Training Rooms A & B

1769 E. Moody Blvd., Bunnell, FL 32110

AGENDA

1. Call to Order by Flagler County Commission Chair

2. Call to Order by Public Safety Coordinating Council (PSCC) Chair

3. Pledge to the Flag and Moment of Silence

4. Welcomes and Introductionsa. Flagler County Commission Chairb. Public Safety Coordinating Council Chair

5. Discussion of Opioid Epidemica. Introduction of Discussion -- Commissioner Joe Mullinsb. Use of Narcan by First Responders – Flagler County Deputy Fire Chief Joe King

i. General Location of Incidentsc. Impacts on Law Enforcement and Jail – Flagler County Sheriff Office Chief Paul

Bovino and Chief Steve Cole d. Location of Treatment Facilities – Alicia Vincent, Vice President Flagler Services,

SMA Healthcare e. Treatment Program Parameters – Alicia Vincentf. DCF Report on Drug Use and Impacts – Charles Puckett, Circuit 7 Community

Development Administrator

6. Commission Comment

7. Council Comment

8. Public Comment

9. Next PSCC Meeting Date: March 13, 2019

10. Adjournment

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Sources: Esri, HERE, Garmin, Intermap, increment P Corp., GEBCO, USGS,FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri Japan,METI, Esri China (Hong Kong), swisstopo, © OpenStreetMap contributors, andthe GIS User Community

µ

LegendNarcan Data 2018 FCFRNatureOfCallc Unknown - 56

c Altered level of consciousness - 4

c Breathing Problem - 8

c Cardiac Arrest - 12

c Choking - 1

c Convulsions/Seizure - 1

c Diabetic - 1

c Ingestion/Poisoning - 14

c Trauma - 3c OD - 3

c Psychiatric Problem - 2

c Sick Person - 12

c Stroke - 1

c Unconscious/Fainting - 27

c cardiac Arrest - 2

c sick person - 2Flagler County Boundary

Item 5(b)

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Sources: Esri, HERE, Garmin, Intermap, increment P Corp., GEBCO, USGS,FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri Japan,METI, Esri China (Hong Kong), swisstopo, © OpenStreetMap contributors, andthe GIS User Community

µ

LegendNarcan Data 2018 FCFRAgekj 2 - 18 = 5kj 20 - 29 = 20kj 30 - 39 = 16kj 40 - 49 = 12kj 50 - 59 = 20kj 60 - 69 = 23kj 70 - 79 = 24kj 80 - 89 = 17kj 90 plus = 13

Flagler County Boundary

Transforming Lives Through Hope and Healing

MENTAL HEALTH SUBSTANCE ABUSE SERVICES IN FLAGLER COUNTYPRESENTER: ALICIA VINCENT

Item 5(d)

• SMA Healthcare is located in the 7th Circuit: Flagler, Putnam, Volusia and St. Johns.

• SMA Healthcare is the largest mental health and substance abuse Provider in Volusia County with the longest history (over 50 years)

BED SPACE BY COUNTY

❑ST. JOHNS = 16

❑PUTNAM = N/A

❑FLAGLER = 88

❑VOLUSIA = 54

WHO IS ELIGIBLE:• PREGNANT WOMEN & WOMEN

AGE 18 AND OVER• WITH A PRIMARY SUBSTANCE

USE DISORDER• HAVE A SECONDARY DIAGNOSIS

OF A MENTAL HEALTH DISORDER.

• MAT PARTICIPANTS WHO ARE IN NEED OF A HIGHER LEVEL OF CARE.

Services Offered:

• Individual Counseling w/ a licensed master level clinician

• Small group Counseling sessions

• Life Skills training

• Wellness training

• Emotional Management Skills Groups – Grounding

• Relapse Prevention

• Comprehensive recovery groups, workshops, and activities

• On-site AA/NA support group meetings

WARM @ VINCE CARTER SANCTUARY - LEVEL 1

LENGTH OF STAY:WAR LEVEL 1PROGRAM IS IDENTIFIED

Length of Stay:WARM Level 1 Program is identified by ASAM as an intense short term residential level of care. The length of stay is assessed based on clients’ needs and varies from 30 to 60 days.

MOST INSURANCE AND PRIVATE PAY ACCEPTED

ContactKathy Deissler-GageOffice: 386-236-1728Mobile: 386-566-2848Fax: 386-254-1254

kgage@smahealthcare.org

WARM @ VINCE CARTER SANCTUARY - LEVEL 1

WARM @ VINCE CARTER SANCTUARY - LEVEL 2

•WARM Level 2 is a long term residentialtreatment facility for women exhibitingsymptoms of drug and alcoholdependence

•60 residential beds

•Women who are pregnant, post-partum,and parenting young children

•Women without children

•Children under the age of 6 years old canreside on campus with mother

•On-site childcare provided by EasterSeals

• Individual and group counselingsessions

• Life skills training

• Enhanced parenting skills

• Healthy boundaries and copingskills

• Trauma based therapy (work withCharlie our therapy dog)

• On-site culinary program under thedirection of Chef Kevin Gallagher

• MAT program available

• Relapse prevention

• On-site AA/NA support groupmeetings

The Crisis Triage and Treatment Unity (CTTU) is a grant-funded program that collaborates with the local law enforcement, social services agencies, Baker-Act receiving facilities, and regional behavioral health &alcohol/drug treatment providers. CTTU offers several services to the Flagler County Community:

• Transports people who are placed under Baker Act to the nearest Baker Act receiving Facility in Volusia County on behalf of Flagler County Law Enforcement Departments and Advent Health Hospital.

• Ensure law enforcement officers are able to transition a client into CTTU care and be back on patrol within 15 minutes of arrival to the CTTU.

• Provide Crisis Case Management to client who are seeking crisis assistance voluntarily.

• Provide assistance to clients seeking detox services, when detox beds are available.

CTTU (CRISIS TRIAGE AND TREATMENT UNIT)

Services Available:

•Behavioral Health Crisis Screening/Triage

•Baker Act Evaluations

•Marchman Act Evaluations

•Social Service Needs Assessment

•Telephonic and Face-To-Face Informationand Referral

•Medical Health Screenings and Referral byPsychiatric RN

•Detoxification Screening and Referral

Length of Stay:

Once CTTU has interacted with a client, the client remains open to the CTTU for 365 days fro follow-ups by case management and life skills coaches.

Who is Eligible:

Any person who is in acute mental health crisis and is seeking mental health or substance abuse services are eligible for CTTU services.

CTTU (CRISIS TRIAGE AND TREATMENT UNIT)

CTTU Office: 386-254-1290 CTTU Cell: 386-527-8530

• Mental Health Outpatient Services are for adults with severe and persistent mental illnesses and behavioral health needs.

• Our services are comprehensive in we work with the entire person including symptom management, relationship building and life management in the community with therapy and life skills being provided.

• Med OP services are able to continually assess clients at their visits and refer them to a verity of services based on their needs; which provides clients with a support system and comprehensive approach to their mental health management.

Services offered:

• Psychiatric Evaluations

• Brief Behavioral Status Exams

• Individualized Treatment Plans

• Nursing Assessments

• Collaboration with Primary Care Physician’s

• Lab Work

• Individual Therapy

• Community and Internal Referrals

SMA HEALTHCAREMED OUTPATIENT SERVICES IN FLAGLER COUNTY

√SMA HEALTHCARE

AOP & ADOP (Adult and Adolescent Outpatient)

AOP:Adult Outpatient is for adults 18 years

and older who are participating in DUI, dependency drug courts, probation and voluntary.

• AOP Services provide individual and group therapy, individualized treatment plans, treatment plan reviews all by a licensed therapist.

• Family participation in treatment is encouraged, and family educational and counseling services are provided to support the family in the recovery process.

ADOP:ADOP are services for adolescent’s ages 13-

18 years old, provided by masters level, licensed and/or certified professional.

• ADOP services include individual therapy with individualized treatment plan and treatment plan review.

• Family involvement with options to include group therapy and other research based approaches to effect a positive change in the client.

• Treatment is specifically directed toward repairing disrupted relationships, reducing impulsivity, developing social and life skills and provide treatment interventions for youth to remain substance free.

CARE COORDINATION FLAGLER COUNTY

•90 day outpatient program for at-risk and high-service utilizers•Designed to address gaps in services •Address a wide variety of issues: mental health, substance abuse, housing, employment, and identifying appropriate resources•The goal is to assist the client in reducing or eliminating issues for the client that lead to continued use of Crisis Stabilization or Detoxification services as a coping mechanism, or that lead toward suicidality.

• In all four counties: • Volusia - 4, Flagler - 3, St. John’s -

1 and Putnam – 1• Different funding sources allow

serving a variety of population:❑ at-risk and high service utilizers❑ Clients in jail who are currently

having suicidal ideations, or have had an ideation or attempt within the last month

❑ Adolescents between the ages of 12-17 who have had a mental health or substance abuse crisis requiring a Baker Act or Marchman Act

Who is Eligible:•Voluntary only•Anyone who is in jail and had had asuicidal ideation or attempt within thelast month•Any Veteran who does not qualify forVA benefits who have had a suicidalideation or attempt within the lastmonth.Services begin upon discharge from jail or VA benefits ending90 of services; can be extended if deemed necessaryWarm hand off to another service provider, case manager for extended services.

Services Offered:• Assistance with obtaining

community resources• Medication Management• Counseling Services• Employment• Housing• Social Security/disability• Finding transportation for above

services

ZERO SUICIDE CARE COORDINATION

Who is Eligible:• Adolescents or adults between 12-

25, who are in acute mental health crisis

Length of Services:• Up to 90 days

• Can be extended if deemed clinically necessary

• After 90 days, clients are given a warm hand off to another service provider, or case manager so client is not left without assistance

Services Offered:• 24/7 availability to contact

someone at SMA Healthcare for services for both crisis and non-crisis.

• CTTU assists Flagler County Law Enforcement with transportation of Clients under Baker Acts to nearest Baker Act receiving facility.

• Follow-up care by a Care Coordinator within 48 hours of discharge from crisis unit.

• Care Coordination services.

CRISIS RESPONSE TEAM

Wednesday AM from 8:00 AM to 12:00 PM301 Justice Lane

Brown and Brown BuildingBunnell, FL 32110

Free unless a UA is required (which cost is $12.00)

Contact for Appointment:Access # 1-800-539-4228

SUBSTANCE ABUSE SCREENINGS

24/7 Access # 800.539.4228

STEWART-MARCHMAN-ACSTEWART-MARCHMAN-ACT VOLUSIA/FLAGSTEWART-MARCHMAN-ACT VOLUSIA/FLAGLER/ST. JOHNS/PUTNAMLER/ST. JOHNS/PUTNAMT VOLUSIA/FLAGLER/ST. JOHNS/PUTNAM

SMA HEALTHCARE VOLUSIA/FLAGLER/ST. JOHNS/PUTNAM

NORTHEAST VOLUSIACARE CENTER1220 Willis Ave.Daytona Beach,

FL 32114

CHET BELL CRISIS CENTER

1150 Red John Dr.Daytona Beach,

FL 32124

VINCE CARTER SANCTURAY

301 Justice LaneBunnell, FL 32110

DR. JAMES E. HUGER ADOLESCENT CAMPUS

3875 Tiger Bay Rd.Daytona Beach,

FL 32124

PUTNAM CARE CENTER

330 Kay Larkin Dr.Palatka, FL 32177

ENRICHMENT 225 Fentress Blvd., Suite ADaytona Beach, FL 32114

FLORIDA ASSERTIVE COMMUNITY TREATMENT

207 San Juan Ave.Daytona Beach, FL 32114

ADMINISTRATIVE SERVICES

150 Magnolia Ave.Daytona Beach, FL

32114

DAYTONA BEACH WORK RELEASE

3601 US Hwy 92Daytona Beach,

FL 32124

DELAND CARE CENTER105 W. Calvin St.DeLand, FL 32720

DMRT1251 N. Stone St.DeLand, FL 32720

SMA FOUNDATION150 Magnolia Ave.Daytona Beach, FL

32114

SOUTH EAST VOLUSIA CARE CENTER

311 N. Orange St.New Smyrna Beach,

FL 32168

ST. JOHNS CARE CLINIC200 San Sebastian View

St. Augustine, FL 32084

ST. AUGUSTINE DROP-IN CENTER

920 State Road 16St. Augustine,

FL 32084

FOUR TOWNES CARE CENTER

356 Englenook Dr.DeBary, FL 32720

RESOURCES

For more information on SMA Healthcare services:Visit - www.smahealthcare.org

➢ALICIA VINCENT

Vice President of Flagler Service - SMA Healthcare301 Justice Lane, Bunnell, FL 32110

Office: 386-236-1732. Cell: 386-547-2651avincent@smahealthcare.org

ACCESS CENTER 24/7

800-539-4228

THANK YOU

* SMA partners with numerous agencies and organizations, all of which may not be included here.

Focus on Flagler Child Abuse Investigations

Charles PuckettCircuit 7 Community Development Administrator

Item 5(f)

2

On Average, Flagler County received 80 new abuseinvestigations per month in FY 17-18. This is an increase of 4 investigations over both FY15-16 and FY 16-17.

3

NoIndicator

Not Substantiated

Verified Total % Verif/NS

Abandonment 5 1 16 22 77.3%Asphyxiation 8 3 2 13 38.5%

Bizarre Punishment 8 4 12 33.3%Bone Fracture 3 1 2 6 50.0%

Burns 3 3 100.0%Death 2 2 4 100.0%

Environmental Hazards 208 43 22 273 23.8%Failure to Protect 15 8 21 44 65.9%

Failure to Thrive/ Malnutrition/ Dehydration 4 2 6 33.3%Household Violence Threatens Child 149 207 74 430 65.3%

Human Trafficking - CSEC 4 1 5 20.0%Human Trafficking - Labor 2 2 0.0%Inadequate Supervision 280 82 57 419 33.2%

Internal Injuries 2 2 100.0%Intimate Partner Violence Threatens Child 52 55 11 118 55.9%

Medical Neglect 26 13 12 51 49.0%Mental Injury 70 10 1 81 13.6%

Physical Injury 290 40 19 349 16.9%Sexual Abuse - Sexual Battery 17 4 12 33 48.5%

Sexual Abuse - Sexual Exploitation by Pa 2 2 0.0%Sexual Abuse - Sexual Molestation 46 5 10 61 24.6%

Substance Exposed Newborn 11 18 7 36 69.4%Substance Misuse 30 9 4 43 30.2%

Substance Misuse - Alcohol 129 83 47 259 50.2%Substance Misuse - Illicit Drugs 148 99 56 303 51.2%

Substance Misuse - Prescription Drugs 56 27 10 93 39.8%Threatened Harm 10 2 28 40 75.0%

Substance Misuse (ALL) 374 236 124 734 49.0%Domestic Violence (ALL) 201 262 85 548 63.3%

Maltreatments & Findings FY17-18

4

On average, there have been 63 children removed in Flagler County in the last five years.

5

Combined, Parent & Child Drug and Alcohol Abuse accounted for 39% of all removals in Flagler County in the last three Fiscal Years.