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Alpine Workforce Education and Training (WET) Plan 1 MENTAL HEALTH SERVICES ACT (MHSA) WORKFORCE EDUCATION AND TRAINING COMPONENT THREE-YEAR PROGRAM AND EXPENDITURE PLAN Fiscal Years 2015-16, 2016-17, 2017-18 County: ALPINE County Mental Health Director Name: Alissa R. Nourse, Ed.M. Telephone Number: [PHONE REDACTED] E-mail: [EMAIL REDACTED] Project Lead Name: Alissa R. Nourse, Ed.M. Telephone Number: [PHONE REDACTED] E-mail: [EMAIL REDACTED] Mailing Address: Alpine County Behavioral Health Services 75-C Diamond Valley Rd. Markleeville, CA 96120 This County’s Workforce Education and Training component of the Three-Year Program and Expenditure Plan addresses the shortage of qualified individuals who provide services in this County’s Public Mental Health System. This system includes community based organizations and individuals in solo or small group practices who provide publicly-funded mental health services to the degree they comprise this County’s Public Mental Health System workforce. This Workforce Education and Training component is consistent with and supportive of the vision, values, mission, goals, objectives and proposed actions of California’s MHSA Workforce Education and Training Five-Year Strategic Plan (Five-Year Plan), and this County’s current MHSA Community Services and Supports component. Actions to be funded in this Workforce Education and Training component supplement state administered workforce programs. The combined Actions of California’s Five-Year Plan and this County’s Workforce Education and Training component together address this County’s workforce needs as indicated in Exhibits 3 through 6. Funds do not supplant existing workforce development and/or education and training activities. Funds will be used to modify and/or expand existing programs and services to fully meet the fundamental principles contained in the Act. All proposed education, training, and workforce development programs and activities contribute to developing and maintaining a culturally competent workforce, to include individuals with client and family member experience who are capable of providing client- and family-driven services that promote wellness, recovery, and resiliency, leading to measurable, values-driven outcomes. This Workforce Education and Training component has been developed with stakeholders and public participation. All input has been considered, with adjustments made, as appropriate. Progress and outcomes of education and training programs and activities listed in this Workforce Education and Training component will be reported and shared on an annual basis, with appropriate adjustments made. An updated assessment of this county’s workforce needs will be provided as part of the development of each subsequent Workforce Education and Training component. Alissa Nourse, Ed.M. Mental Health Director (PRINT) Signature Date ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 2 TABLE OF CONTENTS EXHIBIT 1: WORKFORCE FACE SHEET 1 EXHIBIT 2: STAKEHOLDER PARTICIPATION SUMMARY 3 EXHIBIT 3: WORKFORCE NEEDS ASSESSMENT 4 EXHIBIT 4: WORK DETAIL 6 EXHIBIT 5: ACTION MATRIX 11 EXHIBIT 6: BUDGET SUMMARY 12 ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 3 EXHIBIT 2: STAKEHOLDER PARTICIPATION SUMMARY The Alpine County Behavioral Health Services (ACBHS) Workforce Education and Training (WET) planning process continued the comprehensive work of our established MHSA planning efforts by utilizing our excellent partnerships with consumers, family members, staff and community stakeholders. Input on the WET component was obtained through a variety of sources, including a WET survey, Mental Health Board meetings, and a WET focus group. With this information, we were able to determine the unique needs of our small, remote community and develop a WET program that is well designed for our county. We developed a WET survey that provided staff, allied service providers, volunteers, consumers, and family members the opportunity to give feedback on training needs, effective learning methods, and career pathways. The survey was distributed to current staff in Behavioral Health and partner agencies. Consumers and family members interested in volunteering or working for mental health were also given the WET survey. Nine WET surveys were completed (see Attachment A for results). The results of the Survey were reviewed and discussed with the ACBHS Mental Health Board and at a stakeholder meeting held on November 23, 2015 to review and discuss the information with stakeholders. This meeting and the surveys were facilitated by IDEA Consulting. The stakeholders used this information to determine the highest training needs, the most effective training methods, and possible recruitment strategies. Specific actions for each WET category were developed that would best fulfill ACBHS’ training and recruitment needs. Input from planning activities were compiled and developed into the core components of the WET Plan. An initial draft of the WET Plan was distributed to key stakeholders for further input and feedback. This input was integrated into the draft WET Plan, which has been posted for additional public comment on our website for 30 days, from May 2 through May 31, 2016. The WET Plan has also been distributed across the county and placed at the clinics, wellness center, allied agencies, and public library. A public hearing will be held on June 6, 2016 at 12:00 noon at the Local Mental Health Board meeting to be held at the Firehouse Building, 96 Washoe Blvd. Markleeville, CA. Input on the WET Plan will be reviewed and incorporated into the final document, as appropriate, prior to submitting to the County Board of Supervisors and the California Mental Health Services Oversight and Accountability Commission (MHSOAC). ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 4 EXHIBIT 3: WORKFORCE NEEDS ASSESSMENT A. Shortages by occupational category: Alpine County Behavioral Health Services (ACBHS) has a shortage of licensed/waivered mental health clinicians, as well as clinicians who are trained to service persons with co-occurring mental health and substance use disorders. ACBHS does not have any case managers, rehabilitation specialists, or positions for persons with lived experience and/or their family members. ACBHS utilizes to meet the needs of our mental health clients. Currently, there are only 2 FTE non-clinical positions dedicated to overseeing and implementing all of Alpine County’s MHSA programs and services. Alpine County’s cultural humility and competence needs are more complex than simply a need for Spanish speaking staff. ACBHS has needs staff members who have experience, training and competence in providing services and programs for people from other cultures as well, such as substance abuse recovery, consumer culture, Native American traditional healing, co-occurring disorders, TAY and youth culture. B. Comparability of workforce, by race/ethnicity, to target population receiving public mental health services: Although Alpine County does not have a threshold language, ACBHS strives to provide materials and services to any members of the Spanish-speaking population. ACBHS has no Spanish speaking or bi-lingual clinicians or staff. Alpine County has a large Native American population, encompassing 40% of the total county population. ACBHS has an identified shortage of Native American staff in clinical and non-clinical positions. ACBHS needs staff members who are Native American and can engage the community and provide culturally- sensitive services. C. Positions designated for individuals with consumer and/or family member experience: ACBHS does not have any positions designated for persons with lived experience and/or their family members. ACBHS has begun discussions with the Personnel Department in regards to creating positions based on these criteria. D. Language proficiency: It is difficult to hire staff, especially clinical staff who speak Spanish in this rural and remote area. ACBHS continually recruits staff members who are bilingual and culturally diverse. More importantly, ACBHS continues to recruit staff who are Native American and specifically from the Washoe Tribe and who speak Washoe to fill both clinical and non-clinical positions. E. Other, miscellaneous: It is very difficult to recruit and retain staff to work in this small, remote county. In the winter, due to the Highway 4 closure, the distance between the two Alpine County clinics, in ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 5 Markleeville and Bear Valley is 131 miles, which takes 3 hours and 20 minutes. In the summer, with Highway 4 open, the distance between the two towns is 36 miles. Due to the road conditions, this drive is still 1 hour and 33 minutes. The population in Markleeville is 210 (2010 census), an increase of 13 from 197 in 2000. The total population of the county is 1100. This data helps provide an image of the challenges of hiring staff in this frontier county. ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 6 EXHIBIT 4: WORK DETAIL A. WORKFORCE STAFFING SUPPORT Action #1 – Title: MHSA WET Coordination Description: ACBHS will hire an MHSA Coordinator who will implement all components of the WET plan as well as the CSS, PEI and CFTN components of the MHSA Plan. The MHSA Coordinator will coordinate and sustain an education and training program for ACBHS staff, volunteers, partners and consumers. Under the supervision of the ACBHS Director, this individual is responsible for promoting a work environment that values learning, cultural and linguistic competence and humility, as well as personal and professional development. Activities to be implemented under the WET component include developing curriculum for training modules to address specific topics, including state and federal regulations, consumer culture, and core skills; conducting training; and arranging for staff to participate in training outside of the county as appropriate. The MHSA Coordinator will also support the expansion of the ACBHS workforce to include staff that are representative of Alpine County’s consumer culture, ensuring that the ACBHS system is responsive to the needs of our community. The MHSA Coordinator will be supervised by the ACBHS Director. Objectives: • Implement and sustain our WET Plan. • Assess workforce education and training needs by employment category, including county staff, contract providers, interns, volunteers, consumers, family members, and partner agencies. • Establish a viable education and training program that meets the needs of the workforce, and promotes personal and professional development. • Support a learning environment throughout our agency and across county partners. Coordinate efforts with the established stakeholder groups, including the Mental Health Board. • Develop the curriculum and training materials for core components. • Train staff on select core components. • Assist staff to develop and deliver training related to their unique skills and experience. • Review the ACBHS WET Plan on a regular basis to ensure effectiveness, quality, and relevancy. • Coordinate any reporting and or stakeholder involvement in the WET planning and implementation process. ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 7 B. TRAINING AND TECHNICAL ASSISTANCE Action #2 – Title: Fundamental Learning Program Description: ACBHS will develop contracts with various learning providers to deliver trainings to clients, family members, staff from Behavioral Health, members of the Mental Health Board, and partner agencies. Training topics will include rehabilitation skills; the recovery model; Trauma-Informed Cognitive Behavioral Health Services, integrated care; and delivering comprehensive services for promoting wellness and recovery. Cultural competency and humility, team building, and client- and family-driven services will also be a focus of ACBHS trainings. ACBHS will join a small-county consortium to access Relias Learning, which offers online courses, staff ethics and regulations compliance training, and an array of clinical skills-building courses that also fulfill continuing education requirements for licensed behavioral health professionals. In addition, ACBHS will identify regional and statewide trainings – such as those offered through NAMI and CASRA – for staff, clients, family members, and other stakeholders to enhance their understanding of the recovery model, promote effective service delivery, increase cultural competency and humility, promote leadership and team building, and learn other essential skills for working in the behavioral health field. As an added training component, ACBHS will provide staff and consumers with technical software training for core computer programs, such as Word, Excel and Power Point. Training and core computer software programs will enhance the skill set of staff and consumers/family members who work or volunteer for ACBHS. Objectives: • Secure a multi-year contract with Relias Learning through a small-county consortium. • Train staff to utilize the Relias Learning online courses. • Identify training in computer skills and support individuals to attend the training. • Coordinate core software training Word, Excel, etc.) for staff and consumer/family members through off-site technical training centers or online. • Document and record training received by individuals in the county. • Identify regional and statewide training for staff, clients, family, and other stakeholders and support the cost for individuals to attend these trainings. • Develop and deliver training on understanding consumer culture; Native culture; culture; Hispanic culture; veterans; TAY; older adults; etc. • Identify training in team building and leadership skills and support individuals to attend the training. • Identify training to deliver individual job skills and support individuals to attend the training. • Attend the NAMI National and/or Regional Conference annually. • Identify other state or regional conferences and workshops to support the activities, programs and services provided by ACBHS and support individuals to attend. • Support law enforcement and mental health staff to attend a regional Crisis Intervention Training (CIT). ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 8 C. MENTAL HEALTH CAREER PATHWAY PROGRAMS Action #3 – Title: Increasing Mental Health Staff through Educational Stipends Description: To increase the amount of educated staff working for ACBHS with consumer/family member experience and those representing the Native American community and consumer culture. Stipends would be available to individuals enrolled in a Bachelors and Master’s level educational pathway toward a degree in social work, mental health or related field. After application and acceptance, a grade point average of or better would be required to continue to receive the stipend each quarter/semester. The MHSA Coordinator will recruit and identify individuals who may qualify. Feedback from stakeholders showed an overwhelming focus on creating educational opportunities to support individuals from Alpine County to receive support to be trained and educated to become mental health professionals. Many Alpine County youth, especially Native youth, do not have the opportunity and resources to attend college. These WET funds would offer an incentive to local youth to attend college, desire a career in the mental health field, and eventually return to the community to work in the Behavioral Health program. Objectives: To recruit high school youth from Alpine County, especially Native youth, to select a degree in a mental health related field social work, counseling, substance use treatment) and pursue a Bachelors and/or Master’s degree. To offer a stipend to these students to help pay for tuition each quarter/semester. Renewal of the stipend is dependent upon maintaining a 3.0 grade point average (B or better) across all subjects/courses. ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 9 D. RESIDENCY, INTERNSHIP PROGRAMS Alpine County has determined through the stakeholder process that implementing programs in this category is not feasible due to the county’s remote and rural nature. Alpine County may develop residency or internship programs in future fiscal years, as feasible and appropriate. ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 10 E. FINANCIAL INCENTIVE PROGRAMS Action #4 – Title: Financial Incentive Programs Description: ACBHS will support stipends for educational funding for up to four individuals seeking Nurse Practitioner, graduate Social Work or graduate counseling education and licensing. These funds will be available to staff who meet enrollment criteria, in exchange for a commitment to work in the county mental health system for a specified period of time. The MHSA Coordinator (see Action will identify distance learning and educational resources that facilitate enrollment for identified individuals. Objectives: • Recruit/retain a minimum of two individuals who have completed education programs leading to professional licensure by providing loan assumption for educational career pathway expenses up to $10,000 annually. Priority will be given to candidates with cultural and language proficiency, consumer and/or family member lived experience, and to hard-to-fill positions. • Provide required supervision for licensure to candidates. • Provide incentives for hiring qualified personnel with special characteristics to meet identified need including clinical licensure and ethnic/racial and/or language competencies. These incentives may include support for moving expenses and other transitional expenses. ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 11 EXHIBIT 5: ACTION MATRIX Please list the titles of ACTIONS described in Exhibit 4, and check the appropriate boxes that apply. Actions Promotes wellness, recovery, and resilience Promotes culturally competent service delivery Promotes meaningful inclusion of clients/family members Promotes an integrated service experience for clients and their family members Promotes community collaboration Staff support (infrastructure for workforce development) Resolves occupational shortages Expands postsecondary education capacity Loan forgiveness, scholarships, and stipends Regional partnerships Distance learning Career pathway programs Employment of clients and family members within MH system (10) (11) (12) (13) (14) Action MHSA Coordination X X X X X X X X X Action Fundamental Learning Program X X X X X X X X X X Action Educational Stipends X X X X X X X X X X X X Action Financial Incentives X X X X X X X X X X X X ---PAGE BREAK--- Alpine Workforce Education and Training (WET) Plan 12 EXHIBIT 6: BUDGET SUMMARY Fiscal Year 2015 / 2016 Action Item Budget 1. MHSA Coordination $90,000 2. Fundamental Learning Program $30,000 3. Educational Stipends $10,000 4. Financial Incentives $20,000 Total Funds FY 15/16 $150,000 Fiscal Year 2016 / 2017 Action Item Budget 1. MHSA Coordination $90,000 2. Fundamental Learning Program $30,000 3. Educational Stipends $10,000 4. Financial Incentives $20,000 Total Funds FY 16/17 $150,000 Fiscal Year 2017 / 2018 Action Item Budget 1. MHSA Coordination $90,000 2. Fundamental Learning Program $30,000 3. Educational Stipends $10,000 4. Financial Incentives $20,000 Total Funds FY 17/18 $150,000