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HomeMy WebLinkAbout2018-06-18 JM BOS-SC-min Joint Meeting – June 18, 2018 Page 1 of 7 Joint Board of Selectmen and School Committee Meeting Monday, June 18, 2018 A Joint Meeting of the Board of Selectmen and School Committee was called to order at 7:00 p.m. on Monday, June 18, 2018 in Estabrook Hall of the Cary Memorial Building for the purpose of holding the sixth in a series of presentations and discussions related to Mental Health Services provided by the Town of Lexington and the Lexington School Department. Present for the Selectmen (BOS) were Ms. Barry, Chair; Mr. Pato (7:15 arrival); Ms. Ciccolo; Mr. Lucente; Ms. Hai; Mr. Valente, Town Manager; and Ms. Siebert, Recording Secretary. Present for the School Committee (SC) were Ms. Jay, Chair; Ms. Colburn; Mr. Alessandrini; Ms. Linehan; Ms. Sawhney; and Ian Daily, Acting Superintendent of Schools; Val Viscosi, K-12 Director of Guidance; Julie Fenn, K-12 Physical Education and Wellness Coordinator; Jill Gasparini, School Health Services Coordinator. Also present were: Wendy Rundle, Facilitator; Charlotte Rodgers, Director of Human Services; Melissa Interess, Assistant Director of Senior Services; and Tony Serio, Youth and Family Services. Town and School Staff Presentation Regarding Mental Health Services Ms. Rundle opened the meeting by restating the framing question that has formed the foundation of these discussions: “What should be the role of the Municipal and School departments and the community in providing mental health services to the Lexington community?” Mr. Valente said, at this sixth meeting, staff will make recommendations for how to improve mental heath services provided by the Town and Schools but continue current programs/services because they are “strong and appropriate.” The recommendations are based on the discussions at the five previous School Committee and Board of Selectmen Joint meetings, comments from the public, and staff deliberations. These recommendations should be thought of as “the what” but not “the how” of what will be accomplished; actions will depend on staff and financial resources, as well as input from the new Town Manager and new Superintendent of Schools. To coordinate efforts going forward, a Mental Health Task Force has been formed which will report directly to the Town Manager and Superintendent of Schools. The recommendations are also “sustainable” and include a coordinated community training program to improve early identification of mental health issues. Ms. Viscosi reviewed the four phases/entry points of Lexington’s mental health model: identification, prevention, intervention, and post-vention. This model underpinned all previous discussions and will continue to frame efforts going forward, although the prevention phase will be emphasized so services are proactive and not only responsive. Ms. Viscosi reported that one of the goals of the coordinated community training program will be to build a more positive community culture that will help achieve/maintain mental health and wellness. Joint Meeting – June 18, 2018 Page 2 of 7 Ms. Viscosi said, in answer to the framing question, staff have emphatically concluded that the Town does/will play a role in providing mental health services to the community in two particular areas: 1) it will provide 24/7 response for residents of all ages; and 2) it will provide sustainable, ongoing programs/services in conjunction with mental health partners. In order to do this, School and Municipal staff will collaborate; provide information, referrals, crisis intervention, short-term counseling, intervention, education and training; assess needs; identify barriers; align with changing community demographics; and include of other community partners in discussion and the shared mission. Ms. Viscosi listed several key points gleaned, to date, from community feedback (comments are still being received). The Town should reduce the stigma of mental illness; serve all age groups; reach out to diverse populations; improve access to services; reduce isolation and loneliness; provide a safe place for teens; increase education and training opportunities; improve communication and interdepartmental collaboration. The feedback above was incorporated into three staff recommendations: Improve Communication and Collaboration between School and Municipal Leadership Teams  Create a sustainable internal infrastructure by formalizing the Mental Health and Wellness Task Force (Initially a grant-funded effort). Task Force membership will include representatives from School Guidance and Counseling; School Nurses; Human Services; Health, Police; Fire.  Develop and align protocols, policies, procedures between departments.  Engage community stakeholders by establishing clear communication and roles. Ensure that mental health services are accessible to residents of all ages  Provide information about the mental health services offered through the Town (both municipal and school) with improved promotional strategies, use of web-based tools, social media, forums, and public events (such as Discovery Day).  Develop a multi-year plan that will strengthen mental health programs and services (staffing and programming).  Recognize the diverse needs of the Lexington community and provide specific outreach and services to subgroups. Reduce the stigma around mental illness.  Implement internal education and training for staff.  Develop coordinated community training to improve early identification and prevention of mental health issues, substance use/abuse, and suicide through evidence-based practices such as QPR (Question, Persuade, Refer), Mental Health First Aid, Signs of Joint Meeting – June 18, 2018 Page 3 of 7 Suicide, SBIRT (Screening, Brief Intervention, Referral to Treatment), and Preventure. (QPR sessions will start in the fall and other initiatives are planned such as Narcan training and a program for parents on vaping.)  Provide resource “hubs” that maximize access to mental health and wellness information (Town Offices; Schools; Community Center; Library).  Ongoing evaluation of education and training programs. In closing the staff presentation, Ms. Rodgers asked the Board of Selectmen and School Committee for their support of the recommendations and the resources necessary to achieve the goals. Mr. Lucente (BOS) started off the Boards’ comments by professing surprise at the generality of the recommendations. Because Annual Town Meeting 2018 approved close to $100,000 for the mental health initiative, he was expecting staff to advocate for more specific approaches, such as additional staffing or contracted referral service providers like Interface. Both the Boards and the community have been anxious to initiate something concrete. Mr. Lucente had hoped to hear a strategy that would improve access to services in the near term that could prevent crises before they happen. Ms. Lenihan (SC) concurred with Mr. Lucente’s assessment. She agreed that a multi-year plan, such as the one presented, is important but acute needs should be addressed as soon as possible. A referral service such as Interface would address a known need for a reasonable price ($15,000/yr.), at least in the interim as the Task Force begins its work. Ms. Lenihan noted that all but one community that has contracted with Interface continues to use the service and that the one that left wants to resume. Mr. Pato (BOS) agreed that there should be both concrete recommendations as well as a big- picture strategy. Until now, he had not known how much a year’s contract with Interface would cost so he had been reluctant to support anything until it was presented in the form of a request. Ms. Jay (SC) also agreed. She believes members of both Boards are ready for more substantive recommendations. Interface is one of several referral providers that could fill the gap to service access. In addition, Ms. Jay also believes that some of the other general recommendations could be broken into concrete action items and that both Boards and the community want to know, with greater specificity, the more immediate steps to be taken. Responding to the comments, Mr. Valente said there are concrete steps within the broader recommendations. If the Boards feel that hiring Interface is a high priority, it can be done. Prior to making the recommendations, staff discussed referral services, like Interface, that could play a role on the School side but a lesser of one on the Municipal side because Interface covers the same hours as Town staff. He noted as well that Interface would also require a two-year contract and cost $28,000 for that period; staff was unsure this would be the best use of available funds. Additionally, the new Town Manager and new Superintendent of Schools would need to be part of any more granular recommendations. Joint Meeting – June 18, 2018 Page 4 of 7 Ms. Hai (BOS) said it appears as though more specific steps might require an additional meeting. Mr. Valente said it would be helpful if the Boards identified the high priority items within the recommendations. Ms. Hai said, because the recommendations are so general, it would be hard to rank them. Ms. Colburn (SC) asked how staff felt about hiring Interface and if doing so would get in the way of the Task Force. Mr. Valente and Ms. Rodgers said it would not be problematic. Ms. Colburn said she believes having a resource such as Interface would be helpful for the Schools outside of school hours; it would also enable someone to access help without needing to book an appointment with Town or School staff. Mr. Alessandrini (SC) agreed. He believes Interface will also provide access for everyone, both inside and outside the School community. Being able to access support online also will be beneficial. Ms. Barry (BOS) agreed that the Boards had been expecting specifics, although the timing is difficult with new Town and School leadership coming onboard. However, she is frustrated that the recommendations as presented seem to stall forward movement over the summer and there is an imperative to provide help to the people of the community that need it. The William James/Interface option seems to fill a space in the spectrum of services for a comparatively small investment. She believes that Town and School staff are now collaborating better than when the mental health discussion began a year ago but she also believes Town leaders have an obligation to provide the help the community is asking for. Ms. Ciccolo (BOS) said she, too, is looking for more specificity. Since the prevailing sentiment seems to be to hire Interface, she asked if doing so would preclude hiring additional in-house staff or other consulting services and if deliberations like this are still ongoing. Ms. Viscosi said she believes there is currently good momentum but she understands the frustrations that have been expressed. She assured the Boards that work that will not be stalled over the summer as the “how to” pieces are already being put together. She noted that a new level of collaboration as been reached between the Schools and the Town and that the Task Force provides a sustainable structure for the future, although it is not meant to be a cure-all. She is concerned, however, about rushing ahead before new leadership is onboard but she also believes a more concrete list can be shared at the next joint meeting. Ms. Viscosi feels positively about hiring Interface: it would not get in the way of the Task Force and it would allow School staff not spend so many hours helping students/families access services. It would also increase access for that portion of the community that is uncomfortable asking for help within the School/Town system due to stigma/privacy concerns. Ms. Rodgers said that “breaking down the recommendations” is what the Task Force is doing right now. She agreed with the need for a more robust web presence but staffing to bring that work in-house is a concern. She questions whether bringing on a clinical staff person or an IT staff person would be the better choice, if resources allow for one or the other. Interface builds Joint Meeting – June 18, 2018 Page 5 of 7 an interactive website for its client towns and she sees a website as a way of making the community more aware of the services that are available. Another strategy to get the word out about services are the resource guides and cards that are being developed for distribution through the Library. Ms. Rodgers stressed that the Town already provides 24/7 coverage through Advocates which Human Services, Police, and Fire all can access. Ms. Ciccolo (BOS) questioned whether the Town would consider stepping away from its relationship with Interface after the two-year contract if other resources are identified/developed in the meantime. Ms. Alessandrini (SC) said that hiring Interface buys time while other issues are being worked out. Mr. Lucente (BOS) said that the data gathered by Interface should be useful to the Task Force. Given the moderate investment and positive staff feedback, it seems a practical plan to spend $15,000 of the FY19 $100,000 appropriation. Ms. Hai (BOS) asked who would own the website and database that Interface creates. Ms. Viscosi said that Interface would own it if the Town discontinued the relationship but the Town will have learned from the database and from having the website. Interface also provides mental health information in several languages and it facilitates appointment-making, matches insurance acceptance to policy holders, and does follow-ups. Ms. Rodgers noted that Town staff provide many of the same services, including a database of service providers through the Youth and Family Services website. Staff provide a personal connection and they assist families in the search for appropriate services. Staff also follow up to make sure services are adequate. However, Ms. Rodgers did note that Interface is available to all ages, not just youth and families. She clarified that Interface only staffs phonelines Monday- Friday 9 a.m. to 5 p.m., similar to the Town staff schedule, but the website is accessible no matter the hour. Ms. Interess noted that another benefit to Interface is the ability to access the services via multiple methods. Since many people first access mental health services through their primary care providers, the Town could market access to the Interface by reaching out to doctors or clergy. Lexington’s mental health services are only as good as its outreach. Ms. Colburn (SC) asked if citizens can access Advocates services on their own. Ms. Rodgers said they are able to do so without the assistance of staff. This, too, should be marketed to the community. Ms. Fenn said that staff all came into the collaborative process with ready lists of recommendations but taking a step back to discuss, collaborate, and consider was a healthy process. Integrating the new leadership is also vital to future progress. Ms. Fenn noted that staff will also be trained in the new Preventure program, an early detection model, which is seen as offering innovative tools and strategies. Joint Meeting – June 18, 2018 Page 6 of 7 Mr. Lucente asked when staff would be ready to make concrete recommendations. Ms. Viscosi said that there will be recommendations with budget considerations made in the fall and more than one year of funding requests may be necessary. Ms. Rodgers cited the grant process as well that offers another three years of funding after the initial pilot year that is underwriting the Task Force process. Ms. Sawhney (SC) noted that, because School will not be in session, it will be harder to get the word out about community access to Advocates. She urged staff to aggressively market the service now, with every available means, in order to bridge the two-month summer. Ms. Ciccolo (BOS) agreed and also encouraged heavy promotion of current services and a roll out of the new strategies in the fall, such as hiring Interface or providing a clear list with a marketing plan. Ms. Lenihan (SC) asked what would have to happen in order to move ahead with Interface and how much time the process would take. Mr. Valente said he is not sure if the procurement process is obligatory in this case; contracting with Interface might be exempt because it is medical or because of the relatively low spending threshold. If procurement was necessary, it would take 2-3 months to implement. Ms. Rodgers said the Interface process itself would take 3-4 months because of the need to set up staff members as Interface contacts who will work with the service. Interface also requires substantial community outreach efforts to be made. Ms. Barry (BOS) noted that the School Committee has already had a presentation from Interface. She asked Mr. Valente to set up a similar presentation for an upcoming Board meeting. Ms. Hai (BOS) asked if the pressure from the Selectmen and the School Committee to hire Interface is forcing staff into a direction they would otherwise not take. Ms. Fenn said, based on the research done by the Human Services Committee into other towns’ mental health programs, she sees no reason not to move toward hiring a service like Interface. Ms. Rodgers said that staff is still vetting the options and trying to make sure the available funds stretch as far as they need to. She suggested that the Task Force might decide to write a grant proposal for the next three years of the CHNA grant that would share referral service and/or other costs with the Town. Mr. Alessandrini (SC) said the proof of the value of Interface is that other Towns continue to use it. The Boards could decide to approve the expense of funds now so that the service is up and ready in the fall. Ms. Viscosi said staff are still discussing how best to use available funds. Public Comments Valerie Overton, 25 Emerson Gardens/Diversity Advisory Task Force, said she applauds the collaboration across departments but is not sure that Interface would address gaps with specific community groups such the disabled or parents of children with special needs. She asked that the “hows” include topics such as inclusion and diversity and that less conventional populations be kept in mind. Joint Meeting – June 18, 2018 Page 7 of 7 Next steps: Mr. Valente asked that the Boards allow time for the Mental Health Task Force to process the feedback from tonight’s meeting and to finalize the recommendations they are poised to make. Additionally, the group has not yet had time to reach out to some of the underserved subgroups. He believes, going forward, that these joint meetings should continue, at least annually. Finally, Mr. Alessandrini and Ms. Colburn (SC) urged the Boards to act, invest the $14,000 to hire Interface, and not let more time go by. Ms. Barry said the Board of Selectmen will continue to discuss mental health issues over the summer and hear a presentation from Interface. Ms. Jay said the School Committee has no planned meetings over the summer but said they could be scheduled, if necessary. Upon motion duly made and seconded, the Board of Selectmen voted 5-0 to adjourn at 8:39 p.m. The School Committee followed suit with a 5-0 vote. A true record; Attest: Kim Siebert Recording Secretary