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Maryland Advisory Council of the Deaf and Hard of Hearing Behavioral Health Subcommittee Mental Hygiene Administration ­ Jessup, MD September 27, 2010

Attendees: Marcia Andersen (MHA- C&A), Kate Callahan (AA Co. CSA), Patty Campanaro (SHC), Laurie Corcoran (DASAM & Advisory Council), David Ennis (ADAA), Mark Ehrlichmann (MDAD & Embracing Lambs), Sandi Johnson (UMC), Mindy Lipsky (SHC), Rachel Mogart (KKI), Susan Russell (MCPS), Rachel Sye (Service Coordination), Marie Williams (SHC), and Toby Witte-Dix (Deaf Shalom Zone). ODHH Staff: Lisa Kornberg and Laura Quinn Interpreters: Elaine Benson REVIEW & APPROVAL OF MINUTES The minutes from April 26 were approved with no changes. The minutes of the August 23 meeting were approved with the following changes: Page 1 ­ Correction: Under Action Items the name should be Marcia Andersen. Page 2 - Embracing Lambs ­ the process to begin the tutoring program began one year ago. Page 3 ­ Correction: Springfield Hospital Center, Deaf Unit ­the youngest patient they can accept is 14, but the youngest patient admitted last year was 17 years old. ANNOUNCEMENTS Renee Webster from the Office of Health Care Quality (OHCQ) was unable to present at this meeting due to illness and has been reschedule for the October 25th meeting. Carl Bailey, chairperson, was unable to attend this meeting due to illness. Laurie Corcoran presided over this meeting on his behalf as chairperson of the Advisory Council. OLD BUSINESS Communication Access Quality Control & Oversight At the August meeting issues of communication access were discussed and the question was raised of who oversees whether or not effective communication is provided in hospitals and residential treatment centers. It is believed that Renee Webster at the OHCQ is responsible for this, and the subcommittee looks forward to her presentation at the October meeting. Patient Advocacy for Children & Adolescents The Regional Institute for Children and Adolescents (RICA) has 2 residential treatment centers in Maryland and has an advocate on staff per shift. The patient advocate is normally one of the social workers. They help to arrange for interpreter services. If the patient is transferred for acute care, the primary clinical therapist is responsible for sharing the linkages. Harry Evans is the Patient Rights Advisor. Ms. Andersen has not received a response on what the procedures are for other locations

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Core Service Agencies (CSAs) CSAs also have complaint process for residential treatment centers and outpatient services that consumer would go to first in the counties, and then they would refer it to OHCQ. Emergency Medical Treatment and Active Labor Act (EMTALA) www.emtala.com EMTALA has been part of the Federal regulations for over 10 years and was established so that no one can be refused by an Emergency Room (ER) due to insurance status. If a community hospital accepts federal funds they are obligated to treat everyone regardless of various factors. Enforcement beyond the emergency department has increased nationwide and specifically in Maryland and fines are substantial. Hospitals are being responsive to this because they are being held accountable to the letter of the law. When consumers enter the ER the law does not state that the hospital is obligated to serve the consumer, if the services can be located elsewhere. If during patient admission it is requested, they can contact the SHC Deaf Unit. They don't have to be treated at the local hospital. If SHC doesn't have a bed, then the local hospital is required to accept them and they must provide accommodations. If no bed is available in the psychiatric unit of the admitting hospital they will continue to be treated in the ER until services are found. Some hospitals and consumers have heard that the Deaf Unit at SHC was closed, because there was discussion of the non forensic units being closed, but they worked hard and were able to keep the Deaf Unit in tact. ACTION ITEM: Laura Quinn will look into doing a conference call with the Joint Commission rather than having a presenter come due to the distance and cost. AGENCY REPORTS Springfield Hospital Center (SHC), Deaf Unit Services Review Board The Deaf Unit at SHC restored what was once called the Housing Review Board. It is now called the Service Review Board. The Board will address needs of individuals hospitalized in the Deaf Unit at SHC in order to prepare them to be discharged and to better meet their needs for placement. The Board will meet monthly, with consumer participation, beginning on October 4th at 11:30 a.m. Note: The Board is for agencies that are able to provide these services and the consumers they serve. It is NOT a networking opportunity. However, if agencies are looking for opportunities to meet with the purpose of networking, perhaps that is something that can be established separately. Child and Adolescents Marcia Andersen noted that in the child world there is a Multi-Agency Review Team for consumers in state custody or a state hospital unit 30 day past their ready for discharge date. The team reviews those situations to help make recommendations and works to develop and initiate a plan. Videos and Picture Books A recommendation was made that videos and/or picture books about provider services be developed and given to the hospital for deaf consumers to review prior to the meeting. Videos would preferably be signed, with voice and captions. Network of Care Kate Callahan suggested that this information be added to the Network of Care website. Lquinn 2 FINAL

Embracing Lambs Ministries Prison Mentoring Program A date for orientation has been schedule for the same date as this meeting, September 27th. There are 13 volunteers from the community signed up for the orientation, bringing the total number of mentors up to 20. This will allow them to increase the number of prisoners (students) with various degrees of hearing loss who want to learn ASL and/or English. It has been recognized that communication access impacts the mental health and critical thinking skills of the inmates. There may be an opportunity to apply for State funding. Community Services The concern was raised as to what services are available in Maryland if there were a deaf prisoner with problems with impulsive thinking. What is the procedure for shifting mental health responsibilities from the court to family or a community facility? Programs like People Encouraging People (PEP) work closely with individuals to make sure people under court order are able to comply. Other organizations that may also do this are Arundel Lodge, Inc. (ALI), and Deaf Independent Living Association (DILA). Family Services Foundation (FSF) used to do it, however no one was at the meeting from FSF to inform the subcommittee if they still do or not. Forensic Aftercare Program There are some individuals who have to have been found not criminally responsible for the crime. They didn't have the awareness between right and wrong. Maryland has an active Mental Health Court. Talbot County has a Problem Solving Court, because they don't have the scale for separate courts. One of the models being looked at is the Sequential Intercept Model which provides a conceptual framework for communities to use when considering the interface between the criminal justice and mental health systems as they address concerns about criminalization of people with mental illness. The model envisions a series of points of interception at which an intervention can be made to prevent individuals from entering or penetrating deeper into the criminal justice system. Also, the Community Expansion Workgroup is working to increase services in the community rather than in prison settings the programs such as a Security & Evaluation Therapeutic Treatment Program. Department of Health and Mental Hygiene (DHMH) Universal Newborn Hearing Screening Program (UNHS) The UNHS program, under the Genetics and Children with Special Needs Department of DHMH, has lost key staff and they are looking to possibly restructure the program and put it under Maternal Care. Other Statewide Changes Also, the Hearing Aid Loan Bank establish under the Maryland State Department of Education (MSDE), which formerly had an audiologist as the program director, has been changed to having a Director of Low Incident Populations. Response from Renata Henry No response has yet been received from Renata Henry on the Minimum Level Requirements for serving Deaf and Hard of Hearing consumers.

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Alcohol and Drug Abuse Administration (ADAA) The RFP for services is coming, but there is no date yet of when that will go out. Deaf Addiction Services at Maryland (DASAM) The ADAA is doing some perspective changes that reflect some of the ways that DASAM is doing things already. They are organizing a week long training about recovery oriented systems of care. Person Centered Approach One of these things is the Person Centered approach. DASAM's programs have already begun to change. One example is the start of some groups like a crocheting group. Some of the consumers are homeless and they talk about how it feels to accomplish something. DASAM also does some mental health case management. Staff A new therapist, Leo Yates, has been hired. He is starting on October 4th. NEW BUSINESS Resources to Distribute about Services for Deaf and Hard of Hearing Consumers The issue of communication access is broader than just Behavioral Health services; it is a concern for individuals receiving all types and levels of medical care. The Anne Arundel County Commission on Disability Issues distributed a brochure to medical offices outlining accommodations for people with disabilities. The subcommittee agreed to begin work on a list of resources to distribute listing organizations providing services to deaf and hard of hearing individuals. A working meeting has been scheduled for November 29th. ACTION ITEM: Mark Ehrlichmann will contact Dr. Cooper of Towson University's Deaf Studies Program to see if there are any students that way wish to assist in developing this information sheet. Network of Care This is something else that could be added to the Network of Care website. Grant Requests Holly Ireland mentioned that the Quota Club asking for requests for grants. ACTION ITEM: Laura will begin working to schedule a Maryland Hospital Association representative to come talk to the Subcommittee. NEXT MEETING Date: October 25, 2010 Time: 1:00 ­ 3:00 p.m. Location: MHA ­ Jessup, MD

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Behavioral Health Subcommittee

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