Donna Mather, Community Member
Sharon Bullock, Peer Reviewer
Sarah McConnell, Facilitator
A review of the
mental health (MH) services provided by Railbelt Mental Health and Addictions
(RMHA) was conducted from May 1 to
This report is the summation of the impressions of a community team after interviewing consumers, staff members, community members, and staff of other agencies. It also includes a limited administrative review. It does not represent or reflect a comprehensive review of this agency. The community team has collaborated on this report and the findings represent their consensus.
RMHA’s service area
includes the communities of Nenana, Anderson, Clear, Cantwell, Healy, Denali,
and McKinley Village, all located within a 142-mile span along the George Parks
Highway. The population of this area is reported to be 3,100 year round
residents, with a summer increase including seasonal employees at the Denali
National Park area plus other employees and transients drawn by the visitor
industry. The population is highly diverse
economically and culturally.
RMHA has an annual
budget of $328,806 (including MH and substance abuse grants from the State of
Alaska). The agency has also received funds from the Denali Borough School
District for services in their schools; the Nenana Ice Classic for their summer
activity program; cash and fees; and in-kind contributions, in particular,
office space in Healy and Nenana. They maintain an office in Nenana and in
Healy, share office space in Cantwell and Anderson, and provide services in the
schools at Healy, Anderson, and Cantwell.
RMHA functions by
agreement with the City of Nenana, which provides administrative oversight.
Personnel benefits, all expenditures, and incoming funds are handled by the
City. A five-member executive Board of Directors governs RMHA. Attempts are
made to have a Board member from each community, plus at-large members and at
least two consumers. While the Board is required to meet quarterly, they
reportedly meet one or two times per month. They hold their meetings
alternately in each community within the service area. The extensive travel,
and nine months of harsh weather producing hazardous driving conditions,
present special challenges for this Board.
RMHA currently
reports a client group of approximately 71, including about 20 youth diagnosed
as severely emotionally disturbed, 12 adults diagnosed with a serious mental
illness, and three clients (through an MOA with the LEAP program) are provided
services related to domestic violence. RMHA reports that they offer services to
children and adolescents that include identification, referral, case management
and counseling services. MH services include intake, referral, case management
and counseling services for individuals, families, couples and groups for
adults, children and adolescents.
RMHA offers once
per month psychiatric services and medication management to people identified
as having a serious mental illness.
Other clinical services are provided by a full time mental health
clinician and the agency is currently recruiting for a second full time
position for a clinical supervisor. A
substance abuse counselor and an administrative director are also employed.
Emergency services
are reportedly provided by giving home phone numbers of staff members to pertinent
community providers. All agency staff are said to be “trained to assess suicide” with directions to call a clinician, the
local clinic, or law enforcement as needed.
There is currently
no secretary due to funding issues. This has reportedly contributed to a
community feeling that “No one’s ever
there.” The Administrative Director reports that RMHA hired a secretary for
two weeks specifically for the purpose of aiding with this Integrated Quality
Assurance Review.
As a multi-service
agency RMHA also employs a substance abuse counselor for assessments, referral,
aftercare, and outpatient needs. However, they report that consumers do not
typically receive integrated mental health and substance abuse services. A
non-paid, substance abuse treatment intern has been added to the agency during
the past year.
To conduct this
review, a team consisting of one facilitator, one community member and one peer
reviewer met for three days in Nenana. The team conducted 26 interviews and
reviewed program/agency materials. The team interviewed 14 consumers and family
members (in 10 interviews), 1 staff member, 4 Board members, 11 community
members and related service providers.
Of those consumers
interviewed, 8 interviews were with randomly selected individuals and families
who receive services from RMHA. Four children (including one sibling pair) were
interviewed with a parent or guardian present. Of those interviews, one parent
is also a direct consumer; two were parents of consumers; one was a youth; and
four were adult consumers. Two of the adults were volunteers, not in the random
sample.
Interviews were
conducted at the City of Nenana offices, a local restaurant, the Nenana health
clinic, a home visit and by telephone. The interviews lasted from 15 minutes to
an hour. An Open Forum was announced and held at the Marge Anderson Senior
Center in Nenana on Tuesday evening. After all the interviews were completed
and the information gathered, the team members met to contribute to this
report. A written report was drafted, reviewed and edited by team members. The
written report was then presented to staff on the final day of the review. This
report is based on the Department of Health and Social Services’ integrated
program standards.
An Open Forum was
scheduled for 7:00–8:30 P.M. at the Marge Anderson Senior Center in Nenana. It
was advertised twice in the Nenana newspaper. Posters were faxed to four
locations in Cantwell, five locations in Healy, two in Anderson and five in
Nenana. No one attended the Open Forum.
The following are
the areas requiring response identified during the review conducted May 24–26,
1999. The Administrative Standards referred to are from the 1999 report.
Progress in each area is noted below:
1. The stated mission of RMHA is too global and
does not meet the requirement of the standards by using empowering People
First, non-stigmatizing language to offer consumer centered services (Standard
#1).
Progress: There was not a copy of the 1999
Mission Statement available for comparison. While the Mission Statement has
reportedly been revised, and is somewhat more specific, it remains quite global
and does not contain consumer-centered language to describe how consumers and
their families are empowered. The current Mission Statement is not displayed in
the RMHA Nenana office. Standard partially met.
2. The team did not observe that staff and key
people communicate in the presence of and away from the person using People
First, non-stigmatizing language. (Standard #2).
Progress: The team consistently observed
staff communicating with and about consumers in respectful terms during the
three days on site. However, there is no
evidence whatsoever of any agency-wide education and orientation about mission,
philosophy and values that promote understanding and commitment to
consumer-centered services in daily operation. The Administrative Director
requested explanation and definition of
“People First” and what this standard means, reflecting the absence of
adequate staff training on consumer-centered programming. She was referred to
the DMH/DD Regional Coordinator. Standard not met.
3. Formalize inclusion of consumer input in
policy setting and program delivery in the policies and procedures (Standard
#12).
Progress: A policy and procedure (page C.2)
was entered in the manual 6/2000, which provides for program evaluation and the
appointment of “persons from the public to participate in evaluation studies.”
This procedure does not require that some of the “persons from the public”
appointed to participate be consumers; and does not specify the frequency of
the program evaluation. Standard partially met.
4. There is no policy and procedure documenting
how involvement of consumers, staff and the community will be facilitated in
annual agency planning and evaluation (Standard #13).
Progress: The agency reports that it
completes a consumer satisfaction survey twice per year. A consumer
satisfaction survey is also available on the RMHA web site. No policy and
procedure exists to require that the consumer satisfaction survey be completed,
nor the frequency with which it should be completed. See also item #3 above.
Standard partially met.
5. Document policies and procedures developing
annual goals and objectives in response to consumer, community and
self-evaluation activities (Standard #14).
Progress: The activities reported relative
to this program standard are of note. The Board of Directors engaged in a
self-evaluation during this past year, establishing a three-year plan. Consumer
satisfaction surveys were reportedly distributed twice during the past year,
and a community needs-assessment was performed. A written policy and procedure
needs to be available to formalize these activities and insure their completion
on an on-going basis. Standard partially met.
6. Person centered language regarding people
who receive mental health services is absent in publications and documents
(e.g., "this population", "client", "in a nutshell, no
pun intended"). Services focus on situational and substance abuse needs.
Referrals from citizens concerned about others in the community should take a
back seat in agency publications while focusing on support services available
to those who identify a need and consent to receive services from professionals
they choose and trust (Standard #16).
Progress: Newsletters demonstrate
significant improvement in this area since the spring of 2000, and, with minor
exceptions, are of an outstanding quality. Standard met.
7. Personnel policies and procedures do not
document a system for review and revision of all job descriptions (Standard
#20).
Progress: Policy and procedure “Review of
Job Descriptions” (E.79) revised 9/2000 is now part of the Policy and Procedure
Manual. Standard met.
8. Create a procedure to incorporate consumers
into the hiring and evaluating of direct service staff (Standard #22).
Progress: Policy and procedure “Hiring
Committee for Direct Service Personnel” (E.80) revised 9/2000 is now part of
the Policy and Procedure Manual. Standard partially met.
9. Include a policy that staff identify,
respect and encourage local natural supports for consumers (Standard #26).
Progress: Policy and procedure “Development
of Natural Supports” (F.32) revised 9/2000 is now part of the Policy and
Procedure Manual. Standard met.
10. Assure that staff receive necessary training
in Medicaid documentation.
A Medicaid documentation training has been
conducted by DMH/DD staff. Standard met.
+ Community
awareness efforts including the initiation of an RMHA web site and quarterly
newsletters, with a reported circulation of 800, are impressive.
+ The “Nenana
Explorers,” a summer youth activity program with supportive funding by the
Nenana Ice Classic has received outstanding reviews from community members.
+ Efforts to reach
an extensive geographical area through school-based services in the Denali
Borough School District have been identified as a strength by citizens,
consumers and related agencies of the Denali Borough.
+ It is commendable
that RMHA currently maintains positively regarded services with only one FTE
mental health clinician, who is consistently described as professional and
helpful. The agency’s effort to hire a Clinical Supervisor appears critical to
continuing the high quality of the clinician’s services.
The team identified
the following strengths under Choice and Self-Determination for those receiving
MH services:
+ Most consumers
feel that they are given choices, and that they have satisfactory input in
their treatment plan.
+ Most consumers
feel listened to.
+“I’d watch her (Keri) with other kids. They came and talked with her. Then I
chose her to work with my child.”
+ “I’m absolutely satisfied with the services
I received; Keri is awesome, empathic, helpful and everything a counselor
should be.”
The team identified
the following weaknesses under Choice and Self-Determination for those
receiving MH services:
- Many consumers
express negative feelings about having to change counselors without warning and
without being consulted.
- Several consumers
note that they feel their choices are limited by the number of clinicians and
by the limited clinician time available in each community.
- “Mary’s leaving unexpectedly, having to
start all over with a new clinician… I just told all my story and had trust in
her.”
- “We didn’t know she (Mary) was leaving.
Telling our story again was a real inconvenience. Gaining trust again makes it
real hard.”
The team identified the following strengths under Dignity, Respect and Rights for those receiving MH services:
+ All consumers
interviewed report feeling consistently treated with respect and dignity. They
feel they are treated with “kindness,” and “patience,” by staff described as “pleasant,” “professional,” “discrete,” and
“friendly.”
+ Most consumers
report that they participate in their treatment planning and sign their
treatment plan after regular reviews.
+ All consumers are
aware of their rights, and have an idea of what to do if they have a grievance.
+ Most consumers
state that they would feel comfortable talking with either Traci or Keri if
they had a concern.
+ “Dr. Ackley really listens to me and he’s working
with me to figure out a combination of medication that doesn’t cause as many
side effects.”
+ “They treat us like people – we’re treated
really well”
+ “Traci is very helpful, and respectful.”
The team identified
no weaknesses under Dignity, Respect and Rights for those receiving MH
services.
The team identified the following strengths under Health, Safety and Security for those receiving MH services:
+ Many consumers recognize that RMHA helps them to gain access to a variety of services.
+ Some consumers
report feeling “safe” to “fairly safe” in their homes and in their
village.
+ One consumer reports feeling safer in their community because they have a new
policeman.
+ Some consumers report feeling secure in their ability to access needed
services.
+ Two consumers
reportedly receive important medical care as a direct result of encouragement
and support from RMHA staff.
+ One consumer
reports that RMHA assistance in acquiring a cell phone has helped greatly in
accessing needed services.
+ “RMHA helps out with food when necessary.”
+ “Keri is helping me get dental needs met.
I’m still on a waiting list.”
The team identified
the following weaknesses under Health, Safety and Security for those receiving
MH services:
- Some consumers
report feeling “not so safe” after a
murder occurred in Nenana in January.
- Some consumers
reported feeling “not safe” in Nenana
because of “all the drunks in town.”
- Several consumers
report concerns about reaching an answering machine during business hours at
the RMHA offices.
- Several consumers
would like to have more flexible and more frequent access to psychiatric
services.
- One consumer
reports transportation problems in accessing dental and vision services, which
are only available in Fairbanks.
- Some consumers
express concern that they don’t know what services they can access at RMHA.
- “RMHA needs to use radio and newspaper more
in announcing their activities so more people know what’s going on.”
- “Dr. Ackley is here only once per month on Sunday, there’s not always someone to assist with getting there.”
- “Just getting a machine is not helpful.
Someone who was depressed like I was – it took a lot of courage just to call.
When I got a machine I hung up and it took weeks before I could leave a
message. That’s critical to someone who’s depressed.”
The team identified the following strengths under Relationships for those receiving MH services:
+ Most consumers
feel that they are assisted in developing relationship skills.
+ Some consumers
feel that their work with RMHA is supportive of their relationships,
specifically peer and family relationships.
+ Some consumers
identify involvement of the family in treatment as very helpful to family
relationships.
+ “The medication is helping in gaining
relationship skills – the medication helps me be more comfortable in social
situations.”
+ “Yes, our work has been real helpful in improving sibling
relationships.”
+ “Keri teaches social skills through games
and discussions.”
+ “Keri’s social coaching in the school setting supports relationships with the teachers and other students.”
The team identified
the following weaknesses under Relationships for those receiving MH services:
- Some consumers
report concerns about either a lack of integration of family counseling or a
lack of parenting skills training.
- One consumer
expresses concern that “No parenting
skills are taught. We’ve talked about it, but nothing has happened yet.”
The team identified the following strengths under Community Participation for those receiving MH services:
+ Several consumers
report that RMHA has been very helpful at involving youth in safe and drug-free
community activities.
+ One consumer reports that staff helped them realize the importance of
participation in school.
+ One parent of a consumer applauds the good teamwork between the school and
RMHA, which has resulted in increased inclusion in activities for young
consumers. (Anderson)
+ “In summertime RMHA organized some great
activities – horseback riding, pizza, swimming at Hamme Pool – for Nenana
Explorers. They organized it and arranged funding.”
+ “My counselor is wonderful in helping me to
find employment.”
+ “In my community I don’t feel
discriminated against or anything.”
(Healy)
+ “Keri’s a godsend! I’d like to see her around for a long while!”
The team identified the following weaknesses under Community Participation for
those receiving MH services:
- Some consumers
express their wish for safe, healthy activities for youth in the wintertime,
too.
- Some consumers
express reluctance to become involved in their community.
- “I don’t get involved in the community, I
don’t like the politics.”
- “No, they haven’t helped me get involved
in community activities.”
There is currently
only one mental health service provider at RMHA. She was interviewed, with the
following results.
The staff
interviewed expressed a consumer-centered approach to their work with clients.
She reports that treatment goals are selected by consumers, and efforts are
made to introduce local service resources in addition to RMHA. Family education
about mental illness is a priority, with the goal of enhancing consumers’
family and community relationships. An art group is offered by this clinician
for social skills practice.
This clinician has
an excellent grasp on the agency’s philosophy and mission, as reflected by her
statement “(The mission is) to provide
the best services possible to a diverse and scattered population, with a
history of difficulty accessing services, and to meet their needs in the
community in which they live.” She has learned much about cultural
diversity within the natural support system in the community. She reflects a
joy and enthusiasm in her work.
The current level
of work, with very limited staff, is “exhausting”.
Travel demands are different from many rural sites in Alaska because of the
concentration and skills required to drive to the various communities in extremely
harsh weather conditions and hazardous driving conditions most of the year. A
good thing this clinician “enjoys driving!”
It will be a relief for the agency to gain clinical staff.
Concerns are few,
and relate to intense work responsibilities created by clinical staff
departure, and the need for improved communication within the organization.
Nine people from
related agencies were interviewed. Agencies and communities represented in the
interviews included: Denali Borough, Denali Borough School District, Healy
physician’s assistant, the mayor of Nenana, Nenana Senior Center, Nenana
village elder, magistrate, Nenana Native health clinic, Tanana Chiefs
Conference, Nenana law enforcement and Nenana fire/EMT services.
There was a wide
variety in the feedback provided.
Positive comments regarding the agency, staff, and services included:
+ One community member related that services were offered free of charge for a period of time following the community’s multiple tragedies. (Nenana)
+ “I’ve nothing but good to say; psychiatrist is excellent;
utilization good in our community (Healy); I’m a full supporter of their
system.”
+ “Emergency services system worked well when
we had to use it.”
+ “I’m very supportive of the program and
hope to see them increase services; I would like to use local services.”
Those interviewed
expressed a number of concerns and frustrations with the agency. The
frustration with the answering machine, and not being able to access staff was
shared by several community members. Some of their comments follow:
-
“They need to communicate better with other
agencies, to let them know what services they provide and when they’re
available.”
-
“No one knows what’s going on down there.”
-
“There’s no flexibility for working consumers
who are not able to take time off work.”
-
“RMHA work is not suitable to the Nenana
population; people would just rather not use that agency.”
-
“Type of counseling provided didn’t fit
client needs, and there was no flexibility in treatment method.”
-
“How much we work together has depended on
the leadership and how much they communicate about services available – it’s
not happening now. There’s no follow through with emergency services system, so
back to using Fairbanks.”
-
“Even though agency provides both MH and SA
services, dually diagnosed consumers are not consistently receiving integrated
services.”
-
“We all need more support from the
legislature for kids – we’re all being asked to do more with less resources.”
-
“No
one from there comes to the Senior Center.”
-
“More
of a delay in service response than I’d like to see.”
-
“There are concerns about a perception of
conflict between the former Director and the Board.”
-
“We
don’t interact with them unless they need something.”
-
“Crisis management is not consistently
available.”
-
“We
have had times when we needed attention immediately and couldn’t get hold of
anyone. We can’t get a response from the answering machine. Something needs to
happen.”
The Administrative
and Personnel Checklist is included at the end of this report. It includes 34
items, of which 22 are completely met by RMHA. Only one standard is not met,
and 11 are partially met. It should be noted that RMHA has taken numerous
positive actions in the area of evaluation and planning and simply needs to
translate these activities into formal policy and procedure documents in order
to meet fully several standards. Those standards not fully met are:
1.
Standard #1: Partially met. The Mission Statement remains quite global and does
not contain consumer-centered language to describe how they empower consumers
and their families.
2.
Standard #2: Not met. The team consistently observed staff communicating with
and about consumers in respectful terms during the three days on site in
preparation of this report. However, there is no evidence whatsoever of any
agency-wide education and orientation about mission, philosophy and values that
promote understanding and commitment to consumer-centered services in daily
operation. The Administrative Director requested explanation and definition of
this standard. She was referred to the DMH/DD Regional Coordinator in order to
gain the information with which to comply with this standard.
3.
Standard #6: Partially met. With appreciation for geographic and
weather-related barriers, the Board should continue efforts to recruit Board
members from communities that are not represented, to increase cultural
diversity to reflect the population of the service area, and to increase consumer
membership on the Board.
4.
Standard #9: It is unclear if this standard is fully met, because the mayor of
Nenana, rather than the governing board, has final approval of RMHA new hires,
including any Director level position.
5.
Standard #12: Partially met. Progress in this area is notable. A policy and
procedure (page C.2) was entered in the manual 6/2000, which provides for
program evaluation and the appointment of “persons from the public to
participate in evaluation studies.” This procedure should require that some of
the “persons from the public” appointed to participate be consumers; and
specify the frequency of the program evaluation.
6.
Standard #13: Partially met. While it is encouraging that the agency reports a
consumer satisfaction survey is completed twice per year, and a consumer
satisfaction survey was viewed at the RMHA web site, there is neither policy
nor procedure to require this activity, describe the frequency for soliciting
the information, or suggest how the information should be used to assist in
agency planning and evaluation.
7.
Standard #14: Partially met. The agency has engaged in a number of excellent
activities aimed at meeting this standard. A policy and procedure need to be
established to formalize these activities and insure their completion on an
on-going basis, as well as insuring that these activities will indeed be used
to guide the planning process.
8.
Standard #17: Partially met. There are mixed reports regarding this standard.
RMHA is recognized for active participation with most of the agencies in their
service area. While the Administrative Director reports efforts to work with
Tanana Chiefs Conference (TCC) and the Nenana Tribal Council, there has not
been success in this area. Important components of the TCC system to establish
working relationships with would include, but not be limited to, Yukon-Tanana
Subregion itinerant mental health and prevention counselors, Tribal Family and
Youth Services, Old Minto Recovery Camp (re: consumers with a dual diagnosis),
and case management.
Note:
In the Exit Interview, the Administrative Director noted that there is a MOA
with Old Minto Recovery Camp, but it is “not very active.” It was not clarified
if this includes mental health services or is limited to substance abuse services.
9.
Standard #19: Partially met. The mental health clinician is reported to have a
plan for passing an acceptable licensing exam in October, 2001. Clinical
supervision is currently being contracted and efforts are in progress to hire a
Clinical Supervisor.
10.
Standard #22: Partially met. Progress in this area is good. Consumers
participate in the hiring process. There is no procedure to incorporate
consumer input with evaluation of direct service providers.
11.
Standard #25: Partially met: All orientation/training areas are covered except
cultural diversity and “potential work related hazards associated with serving
individuals with severe disabilities.” Given the population of the RMHA service
area, it is a priority to provide orientation/training in the area of cultural
diversity.
The facilitator
reviewed the personnel file of the one current mental health service provider;
the agency’s Policy and Procedure Manual; the Independent Auditor’s Report of
October, 1999 (most recent available); a letter, dated April 16, 2001, noting
“nothing out of the ordinary” in the Community Mental Health Services Special
Revenue Fund; four newsletters; and the RMHA web site. Additionally the
facilitator interviewed the Administrative Director for two and one-half hours
regarding the Action Plan from the last review, current compliance with
Administrative Standards, and clarification of the agency overview.
The Administrative
Director expressed concern that the review did not include a review of the
Administrative Director’s personnel file.
The Administrative
Director addressed concerns about the abrupt departure of the recently departed
Clinical Director, explaining that the process leading to her resignation was a
confidential matter with the Board of Directors. When asked about closure for
consumers, she stated that the former Clinical Director had been offered the
opportunity to have closure contact with consumers but declined that
opportunity.
1.
Address
and resolve the problem of accessing a person during business hours, with
attention to issues of protecting confidentiality.
2.
Address
balance of services to schools and other consumers. Assure that SED youth are identified
for service, and that RMHA is providing service to priority populations as
established by DMH/DD.
3.
The
agency should address integration of substance abuse treatment with mental
health treatment for consumers with co-occurring conditions.
4.
Engage
in efforts to recruit local staff, and encourage employees to make a commitment
for extended service to the agency. Consider establishing a policy/procedure
for repayment of training funds to the agency if employees leave the agency
soon after receiving those training funds.
5.
Agency
should carefully consider the inherent complications of having a Clinical
Supervisor under the supervision of a non-clinically trained Administrative
Director.
6.
Agency
should insure that only clinically trained staff are engaging in clinical
mental health activities.
7.
Clarify
the Crisis Procedures (F.2) as they relate to suicide risk, depression, and
other frequent presenting concerns. Clarify procedure for non-clinically
trained staff response.
8. Standard #1: After receiving training in
consumer-centered language and services for Board
and employees, review and revise Mission
Statement to be more specific and reflect
consumer-centered language that describes
how RMHA empowers consumers and their
families. While not a requirement of
Standard #1, the agency is encouraged to display their
revised Mission Statement in their
offices, visible to consumers, which is a grant regulation.
9. Standard #2: Provide agency-wide education
and orientation about mission, philosophy, and
values that promote understanding and
commitment to consumer-centered services in daily
operations.
10. Standard #6: With appreciation for
geographic and weather-related barriers, the Board should
continue efforts to recruit Board members
from communities that are not represented, to
increase cultural diversity to reflect
the population of the service area, and to increase
consumer membership on the Board.
11. Standard #9: Clarify with DMH/DD if this
standard is fully met, relative to the mayor of Nenana,
rather than the governing board, having
final approval of RMHA new hires, including any
Director level position. This was
reported by Board members.
12.
Standard #12: Add language to the Procedure which will require that some of the
“persons from
the public” appointed to participate in
the program evaluation be consumers; and specify the
frequency of the program evaluation.
13. Standard #13: Complete a policy and
procedure to insure the completion of consumer
satisfaction surveys twice per year, and
maintenance of the consumer satisfaction survey at
the RMHA web site. It would also be
important to specify the frequency for soliciting the
information, and suggest how the
information should be used to assist in agency planning and
evaluation.
14. Standard #14: A written policy and procedure
needs to be available to formalize activities such
as the needs assessment and consumer
satisfaction surveys, insuring their completion on an
on-going basis, as well as insuring that these activities will indeed be
used to guide the planning
process.
15. Standard #17: Consult and continue efforts
to work with Tanana Chiefs Conference (TCC) and
the Nenana Tribal Council. Important components
of the TCC system to establish working
relationships with would include, but not
be limited to, Yukon-Tanana Subregion itinerant
mental health and prevention counselors,
Tribal Family and Youth Services, Old Minto
Recovery Camp (re: consumers with a dual
diagnosis), and case management.
16. Standard #19: Pursue established plan for
Mental Health Clinician to pass an acceptable
licensing exam in October, 2001. Continue
clinical supervision as contracted and agency
efforts to hire a Clinical Supervisor.
17. Standard #22: Establish a procedure to
incorporate consumer input with evaluation of direct
service providers.
18.
Standard
#25: All orientation/training should provide information on cultural diversity
and
“potential work related hazards
associated with serving individuals with severe disabilities.”
Given the population of the RMHA service
area, it is a priority to provide orientation/training in
the area of cultural diversity.
1.Outreach/needs
assessment could include Senior Citizens in order to assist in identifying
mental health needs of elders in the communities served.
2. Evaluate
scheduling options to minimize clinician driving time.
3. Employees who
have earned a degree in a mental health field should post their degree
credentials after their names in official
agency business.
The team wishes to
thank the staff of RMHA, their consumers, and the City of Nenana for their
cooperation and assistance in the completion of this review. Special
appreciation goes to Traci Wiggins, Keri Frazier, and Dallene Adams for their
efforts. A process such as this can be very disruptive to the office
environment and your hospitality was much appreciated by all of the team members.
The final draft of
this report will be sent to Northern Community Resources for review. You will receive the final report within
approximately thirty days, including a Plan of Action form listing the Areas
Requiring Response. You will then have an additional thirty days to complete
the Plan of Action. The directions on how to proceed from there will be
included in a cover letter you will receive with the final report and Plan of
Action form.
Once NCR has
reviewed the completed Plan of Action, it will be sent to the DMHDD Quality
Assurance Section. The QA Section will
then contact you to develop collaboratively a plan for change.
Attachments:
Administrative and Personnel Checklist, Interview Form for Staff of Related
Agencies (tallied), Report Cards (averaged)
NCR 8/00