TURNING POINT OF CENTRAL CALIFORNIA, INC. TABLE OF CONTENTS CHIEF EXECUTIVE OFFICER'S MESSAGE Page 2 CHILDREN’S MENTAL HEALTH SERVICES Page 3 - 5 MENTAL HEALTH SERVICES ACT PROGRAMS Page 6 - 8 ADULT MENTAL HEALTH SERVICES Page 9 - 11 EMPLOYMENT SERVICES Page 12 COMMUNITY CORRECTIONAL TREATMENT SERVICES Page 13 - 15 SERVICES FOR THE DEVELOPMENTALLY DISABLED Page 16 OUTPATIENT DRUG AND ALCOHOL SERVICES Page 17 - 19 RESIDENTIAL DRUG AND ALCOHOL SERVICES Page 20 - 21 HOUSING PROGRAMS Page 22 - 23 ANCILLARY SERVICES Page 24 FUTURE GROWTH, SUCCESS STORIES Page 25 – 27 CLIENTS SERVED Page 28 CHIEF EXECUTIVE OFFICER’S MESSAGE This past year, Turning Point has continued to fulfill its mission of providing services to people in need. With the economy of the nation still sluggish, the need for many of our services is still great as we continue working to expand services, increase efficiency and generate more positive outcomes through adopting the best evidence-based practices available. In July of 2011 the State of California “realigned” funding for public safety, mental health and substance abuse treatment services under Assembly Bill 109. This realignment created great change for the counties and for service providers. There were negative and positive results. The major negative result for Turning Point was a loss of funding for our Mother and Infant program in Arvin California that we operated for many years. Thankfully, we were able to partner with another group to continue use of this facility to help homeless people in need of housing and other services. In addition, some of our other services for parolees have experienced a reduction of referrals due to the transfer of supervision of a large percentage of the parolee population to the counties. On the positive side, we have entered agreements with three different counties to provide a variety of new services for the county supervised Post Release Community Supervision (PRCS) cases that the realignment law created. These are the lower level offenders who were previously under state parole supervision. In Fresno County, we are providing outpatient treatment at our new First Street Center and Full Service Partnership type services through expansion of our Integrated Mental Health (IMH) Services. In Tulare County, we are providing residential treatment and housing services at our Visalia Reentry Center facility and in Kern County our Psychiatric Alternative Resource program is now serving PRCS placements. Our new permanent supportive housing program, Family Villa, continues to serve homeless families in the Fresno area and we continue looking for ways to expand existing services to meet the needs. Our new Court Street Transitional Housing program is another new service. Each year we serve thousands of people in our ongoing programs and on July 1, 2012 we installed a cloud based management information system that is designed to improve access to important care information and statistics that will be used to further improve services. In the first part of this year, our long-time President of the Board of Directors, E. Wayne Rogers had to resign from the Board due to health problems. He passed away shortly thereafter. On one of my last visits with “Buck” he wanted me to pass on to everyone that he felt Turning Point was one of the most efficient and professional organizations he had worked with and that he missed being involved. We recognize “Buck” for his steadfast contributions for over 40 years and continue to miss his involvement. In memory of Buck, we plan to honor the mission he helped create and continue to provide efficient and effective services. This is what he always encouraged us to do and I know he would be pleased that many people who need some help will continue to get their needs met through Turning Point programs. Sincerely, J. Jeff Fly, CEO 2 CHILDREN’S MENTAL HEALTH SERVICES Our CHILDREN’S MENTAL HEALTH SERVICES offer a wide range of Specialty Mental Health Services in Tulare County for children with emotional and behavioral problems who meet medical necessity requirements. Three program sites provide these services throughout the northern Tulare County service area: Visalia Youth Services (VYS), Dinuba Children’s Services (DCS) and Sequoia Youth Services (SYS) (with satellite offices in Farmersville and Woodlake). Services are also provided at most of the school sites and rural communities in the northern Tulare County service area. These clinics have provided outpatient mental health services to 3095 children this year, an increase of 83 clients over the previous year. Professional staff members provide treatment services in clinics, schools, homes and other appropriate places in the community, with the focus on removing or reducing emotional problems, developing secure caring relationships and assisting the children to reach their highest potential. Services are tailored to transition the children to progressively lower levels of care as well as prevent the development of more serious problems. Progress at school, home and in the community determines if the minor requires more intensive services. Medical necessity for services is assessed prior to provision of therapy, counseling, case-management support, medication management, and psychological testing. These services are successful when the children and youth are in school, at home and out of trouble. Professional and para-professional staff members provide a wide range of services. These services include assessment and referral services, crisis intervention, medication services, case management, mental health rehabilitation services, skills groups, therapy groups, family counseling and individual counseling. These services are provided using evidenced-based treatment standards, where applicable, and by staff trained in cultural competency. A staff liaison is assigned to work at each of the schools in the Visalia Unified School District and other schools in the northern half of Tulare County to provide services and receive referrals. Physicians, Central Valley Regional Center, the County Probation Department and Child Welfare Services are additional referral sources to the agency as well as partners in delivering services to their populations. Electronic Health Record Service (EHRS) was implemented in our Children’s Mental Health clinics this past year and went live on July 1st, 2012. The software vendor selected in this process was Credible which provides a service that integrates many processes together in one software service, including centralized scheduling, reporting, documentation, clinical outcomes, electronic signatures to sign and submit completed work instantly, e-prescribing and more, all of which is now done real time with up to the minute reporting. There are still many features to be developed with the use of the service. Along with improving operations of the clinics this is putting our Children’s Mental Health on firm footing to be prepared for mandates of the HITECH Act and healthcare reform. Evidence-Based Practice/Therapy (EBP/T) one of the EBPs directly related to the use of the Credible service will be in developing Concurrent Documentation, the process of enabling and empowering staff to complete documentation in the session with the client present. There are many benefits to this including work completion, improved morale for staff, better outcomes for clients and improved consumer satisfaction and engagement in their treatment process. 3 We also implemented Parent Child Interaction Therapy (PCIT) in August 2011. This was assisted and made possible through a grant for the equipment needed by First 5 of Tulare County. PCIT is a parent coaching model for parents of young children age 2 through 8 years old. It utilizes an in-ear device and the use of an observation room with camera equipment and a one-way viewing window to offer specific coaching techniques with the parent while they work with the child in the therapy room. We were able to serve 33 clients this past year and train three therapists to complete their certification in PCIT. A few other EBTs that are either implemented or are in the training phase of development are as follows: Dialectic Behavioral Therapy (DBT) - skills based training for our high risk consumers. Eye Movement Desensitization and Reprocessing (EMDR) – this is cognitive based therapy showing positive outcomes with many different types of trauma. Trauma Focused – Cognitive Behavioral Therapy (TF – CBT) - through no-cost online training, staff are utilizing stress reduction training and coping skills training designed for use with children and their parents. Therapeutic Behavioral Services (TBS) is a specialty mental health service that helps children and young adults to age 21 who (a) have severe emotional problems, (b) live in mental health placement or are at risk of placement, or (c) have been hospitalized recently for mental health problems or are at risk for psychiatric hospitalization. Under the direction of the California courts and the Department of Mental Health (DMH), this service is mandated to increase utilization across California. As such, the DMH has reduced barriers and restrictions to this service to increase utilization. Turning Point Clinics have maintained a team to provide these services and works along with other providers in our county to identify consumers eligible for the service, to promote the use of and increase the utilization of the service. These services are intensive and can be provided in any setting, i.e., home and community, but are focused on working with the consumer and significant support persons to reduce the behaviors that place them at risk. Last year, sixty-three (63) consumers received services by the Turning Point TBS team. During this year 67 consumers were served by the Turning Point TBS team. The Early Childhood Success Program (ECSP) is funded by a grant with Tulare County Office of Education, Headstart/Homebase. The program works with 0-5 year-olds, their parents and childcare providers to develop workable responses to address early-diagnosed behavioral problems. During the year, this program provides consultation, direct service and training in prevention of mental health issues relating to preschoolers for the Headstart/Homebase providers in Tulare County. 4 Program Referrals Total Annual Referrals from all Sources Percentage of Referrals from CWS/Probation Percentage of Referrals from Schools/Headstart Percentage of Referrals from Family/Self Percentage of Referrals from Physicians Percentage of Referrals from Other 5 DCS SYS VYS TOTALS 330 244 895 1469 27% 8% 27% 21% 17% 16% 37% 23% 41% 39% 23% 34% 12% 19% 1% 11% 3% 18% 12% 11% Mental Health Service Act Programs In Tulare County, Turning Point Mental Health Services Act (MHSA) Programs provide Outreach and Engagement, System Development Services, and Full Service Partnership services that target underserved and un-served populations. MHSA Programs are designed to expand and transform the mental health system to increase access, cultural competency and to use a holistic health approach which includes recovery, wellness, and resiliency treatment principles. Treatment services address (a) mental health, (b) alcohol and other substance abuse, (c) physical health, (d) food and housing, (e) vocational and (f) educational needs. The three MHSA programs under the Tulare County Health & Human Services Agency are the North County One Stop Program, Central County One Stop, and the North County Mobile Unit: “Unidos Para La Salud” The North County One Stop Program serves transitional age youth (ages 16-24 years) throughout northern Tulare County. A culturally diverse and linguistically appropriate group of staff members identify youth with barriers to accessing traditional mental health services. These youth are (a) linked to existing community services, (b) assessed for immediate mental health, alcohol/drug use, physical health treatment needs, and (c) assessed for psychiatric services, educational and vocational needs. High risk consumers are referred for Full Service Partnership services, which provide (a) independent living support, (b) psychiatric medication support, (c) intensive mental health and case management services, and (d) crisis intervention services on a 24-hour, seven-day per week basis. Services are provided to consumers in the location that is most accessible to the consumer, e.g., their home, school or other community locations. This program collaborates with numerous community agencies including Families First, Tulare County Department of Probation and Tulare County Child Welfare Services. “Unidos Para La Salud” (United for Health) is the North Tulare County Mobile Unit Program. With the Mobile Unit Program, culturally diverse staff members provide intensive outreach to the rural communities of northern Tulare County. This program offers services to mental health consumers of all ages. Consumers with access barriers are identified and assessed for immediate (a) mental health, (b) physical health, (c) alcohol and other drug abuse treatment, (d) medication and medication support services, and (e) educational needs. High risk consumers are also referred for eligibility for the Mobile Unit’s Full Service Partnership services, which provide intensive crisis intervention, mental health, and case-management services on a 24-hour, seven-day per week basis. Services to unserved and underserved adults and older adult populations are a special focus of this program. Transportation services are provided when needed. 6 The Central County One Stop Program serves transitional age youth (ages 16-24 years) throughout central Tulare County. This program provides intensive mental health services to consumers facing barriers in accessing traditional mental health services. These consumers are assessed for needs in the areas of mental health, alcohol/drug abuse, physical health treatment, psychiatric services, education and vocation. Going beyond assessment, this program refers highrisk consumers for Full Service Partnership services, links consumers to existing community services, refers to medication support, provides living support and transportation as well as mental health, case-management services and crisis intervention services on a 24-hour, seven-day per week basis. Services are provided to consumers in the location that is most accessible to the consumer, e.g. their home, school or other community locations. This program collaborates with numerous community agencies including the Wraparound Services Program, Tulare County Department of Probation and Tulare County Child Welfare Services. Number Served Full Service Partnership System Development Outreach & Engagement Totals Central County One Stop North County One Stop North County Mobile Unit Totals 14 35 32 81 49 101 154 304 47 110 103 239 271 457 421 1612 7 Hope House is a socialization center and peer support for persons recovering from mental illness and is supported through Madera County Behavioral Health Services (MCBHS) and the Mental Health Services Act (MHSA). SERVICES AVAILABLE Consumer Employment Opportunities Peer Support Groups Addiction Recovery Groups Socialization Skills Computer Lab Laundry Facilities Showers Cooking Classes Outreach Services in Chowchilla and Oakhurst Spanish Speaking Staff MEMBERSHIP Membership is open to all current, former, and prospective consumers of Madera County Behavioral Health Services (MCBHS). Applied Members Total Visits Average Weekday Participation Objective 150 500 25 25 Actual 90 8,853 34.4 18.2 8 Average Weekend Participation ADULT MENTAL HEALTH SERVICES We operated three programs that provide adult mental health services including the Psychiatric Alternative Resource (PAR) program in Bakersfield, the Intensive Community Services and Supports Team (ICSST) program in Fresno and the Rural Mental Health (RMH) programs in Fresno. Psychiatric Alternative Resource (PAR) program is a 40-plus outpatient program contracted by the Kern County Mental Health system of care to provide a broad array of services to adults who have a high level of persistent chronic mental health challenges and co-occurring substance abuse disorders. Services provided include (a) initial mental health assessment, (b) psychiatric evaluation, (c) medication management with nursing stabilization, (d) intensive case management, (e) individual or family psychotherapy, (f) educational counseling groups, (g) supportive housing placements, (h) support with General Assistance or Social Security access, (i) substance abuse education, (j) substance abuse counseling referrals, and (k) education/employment referrals. Staff members provide many of the services "in the field" and are committed to lessening the life demands of PAR clients due to their mental health challenges and empowering of PAR clients to be more independent and resourceful in the community at large. Throughout the 2011-2012 contract year, the PAR program was able to refer more clients to education/employment services while stabilizing more client’s housing problems. The Intensive Community Services and Support Team (ICSST) is a program contracted by the Fresno County Department of Behavioral Health to provide case management services to adults who have particularly high levels of use of mental health services. Criteria for admission include four or more psychiatric hospitalizations during the year prior to admission and having a diagnosis as Seriously Mentally Ill. Services provided include (a) psychiatric evaluations, (b) medication management, (c) health education, (d) case management, (e) individual psychotherapy, (f) educational groups, (g) supportive housing/placement, (h) social/educational/employment skills development, (i) substance abuse treatment, (j) money management/payee services, (k) assistance with applying for Social Security Disability Insurance (SSDI), (l) General Relief (GR), (m) Medi-Cal, (n) Medically Indigent Services Program (MISP), (o) State Disability Insurance (SDI), and (p) other resources. Staff members provide the majority of services “in the field” and are committed to a “whatever it takes” philosophy of wellness. Additionally, ICSST is looking at graduating several consumers who have met treatment goals, which is not unique. However, these individuals, during this process, have moved from the lowest of lows in their lives to being able to live independently, manage their own funds and perform all of the things the rest of us take for granted. The Co-Occurring Disorders Program is an integrated, comprehensive, consumer-centered mental health and substance abuse disorders program. This program works to support the consumer in recovery and self-sufficiency. The Co-Occurring Disorders program is a contracted service of Fresno County Department of Behavioral Health under the Mental Health Services Act. Services provided include: (a) case management, (b) housing, (c) daily living skills, (d) mental health treatment, (e) cooccurring integrated substance abuse services, (f) supported education and employment, (g) transportation, (h) advocacy and (i) peer support. 9 Rural Mental Health (RMH) is proud to conclude their fourth year (2011-2012) of providing outpatient mental health services to adults who are 18 years or older with a Serious Mental Illness (SMI) diagnosis and who reside in Fresno County. RMH referrals are mostly made by The County of Fresno (Department of Behavioral health) from the Pinedale, Sanger and Reedley communities. In 2011-2012, RMH successfully provided services to nearly 700 clients at the three levels of care (Full Service Partnership (FSP), Intensive Case Management (ICM), and Outpatient (OP)). RMH Clinics are designed to be welcoming, empathetic, culturally competent, trauma informed and communitybased. RMH is dedicated to empowering its consumers to recognize their strengths and abilities to successfully regain and achieve independence and self-sufficient in the community. Services provided are intensive case management services to help consumers access SSI benefits, housing assistance, Medi-Cal benefits, transportation assistance, appropriate medical care, general relief assistance and other identified community resource needs. RMH provides individual life skills training, symptom management training, individual/group therapy, psychiatric and nursing services, and 24-Hour Emergency Hotline assistance. Integrated Mental Health (IMH) is a Full Service Partnership service that provides comprehensive rehabilitation and recovery services for adults (ages 18-59) with severe mental health disabilities and that may be experiencing homelessness, drug and alcohol addictions, frequent hospitalizations, legal troubles, family issues, or job loss. The goal of IMH is to assist individuals regain independence of their lives in the community through informed decision-making with psychiatric, rehabilitative, and peer support. Services are based on the individual’s wellness and recovery goals and desired results. IMH operates with (a) Personal Service Coordinators (PSC) who manages a caseload of 20 clients and provides frequent supportive and rehabilitative services; (b) a Mental Health Professional who provides treatment planning and individual/family therapy; (c) a Mental Health Rehab Specialist who facilitates psycho-educational and support groups; and (d) a Housing Coordinator who helps locate and secure transitional and permanent affordable housing. The Integrated Services for Mentally Ill Parolee-Clients (ISMIP) is in its third year. We are an outpatient program, providing case management, individual and group counseling, transportation, food and other necessities. We help parolees with a mental health diagnosis to get stabilized and help them apply for benefits and entitlements. The culture of the program is therapeutic and unconditional, helping our clients begin to feel like valued people. With our support, 12 of our clients are now attending community college, and others are obtaining their GEDs. The recidivism rate for this population is very high, yet we have a great record for helping clients with an average “out” time of 30 to 60 days, stay out of prison for good. Sometimes this requires as much as 100 hours a month of intervention per client. This is unusual, but has proven necessary in some cases. The largest challenge faced by the majority of our clients is homelessness The Transitional Age Youth (TAY) Program is an outpatient mental health program serving consumers that are between the ages of 16-24. The TAY Program provides an opportunity for consumers to receive mental health services, secure affordable housing, and recognize their strengths and abilities to successfully gain independence and self–sufficiency in the community. Services are transitional in nature, with the goal for the consumers to achieve self-sufficiency. This is a program that assists consumers with life transitions and empowers consumers to achieve a variety of goals. Consumers also obtain the skills they need to learn to live independently in the community as adults. Services provided include: 10 Psychiatric evaluations/medication monitoring Health Education Referral and linkage to Primary Care Physician (88% of clients have been successfully linked) Case Management Individual, group, couples, and family Psychotherapy Rural Mental HealthFSP 90 Reduction in Days Hospitalized 80% Reduction in Days Incarcerated Social/educational/employment skills Substance abuse treatment Money management Life skills instruction Assistance with applying for Medi-Cal, SSI, GR and/or Medically Indigent Services Program(MISP) Psycho-educational groups Supportive Housing placement TAY CoOccurring Disorders ICSSTFSP IMH – FSP Total 78 139 60 116 172 612 87% 90% 90% 71% 93% 82% 84% N/A 82% 97% 92% 90% 97% 85% 92% Number Provided Stable Housing 68% 71% 100% 98% 75% 93% 99% 89% 16 26 18 4 64 52 171 Program Objectives Number of Clients Served Number Placed in Employment/Education PAR ISMIP 47 7 11 EMPLOYMENT SERVICES The Monterey County Adult Employment Program has been operating job training, placement and related services for adult offenders in Monterey County since 1975. Turning Point is the lead agency in a collaborative partnership service delivery system specifically designed for adults who face multiple barriers to employment and places them in productive work. The program focuses on integrated, comprehensive services to increase the employment, retention, earnings and occupational skill attainment of participants. Job retention is addressed through comprehensive assessment, preemployment skills training, individual and group counseling, supportive services, intensive case management and follow-up services. The Adult Employment Program is funded by the Monterey County Workforce Investment Act. Turning Point is also a key partner in the Silver Star Youth Program which is a day reporting center for youth on probation ages 16 to 21. Turning Point has just completed its 11th successful year of operation in collaboration with Monterey County Probation Department, Behavioral Health and Office of Education. Turning Point continues the partnership at Rancho Cielo with the Drummond Culinary Institute which provides one-year of vocational training for youth while they are earning their High School Diploma. Turning Point provides vocational and employment related services to the courtinvolved youth at Rancho Cielo effectively weaving jobs and a pay check with educational achievement. Successful completion of probation, employment, vocational certification and education are the focus of all program activities. The Program is funded by Monterey County Workforce Investment Act, Monterey County Probation Department, United Way Monterey County and Community Foundation for Monterey County. Program Objectives Number of Clients Served Successful Completions Monterey County Employment Program Silver Star Totals 440 255 695 100% 100% 100% 71 115 186 Number of Unemployed Individuals Placed in Employment 12 COMMUNITY CORRECTIONAL TREATMENT SERVICES Turning Point operates five community correctional programs in Salinas, Visalia, Fresno, and Bakersfield. These programs are similar in nature and have operated for over 25 years. All of them serve selected offenders in the community. The programs provide a range of services designed to reduce the likelihood of return to crime. Primary services include: 1. Job development 2. Substance abuse treatment and/or relapse prevention training 3. Victim awareness training 4. Life management skills 5. Stress management 6. Conflict resolution 7. Family reunification services 8. Religious activities Other ancillary services include: 1. Financial management 2. Drug and alcohol monitoring 3. Literacy training 4. Activity and behavior accountability 5. Correctional counseling Opportunities for people to change their thinking, feelings and behaviors toward the direction of positive law-abiding constructive patterns of living are guided and closely monitored and managed to maximize community safety and individual growth. Turning Point Community Treatment Programs are centrally located, to provide residents with easy access to (a) public transportation, (b) places of business for employment opportunities, (c) adult education sites, (d) substance abuse/mental health clinics, and (e) medical/dental offices when the need arises. A major goal of Turning Point Community Treatment Centers is to provide quality case management, treatment, supervision, and in-house services to residents. It is the mission of these centers to assist offenders in the establishment of law-abiding behavior and self-sufficient living. The Visalia Reentry Center underwent a number of changes during the past year. Under the new contract with the Department of Corrections and Rehabilitation which became effective January 1, 2012, the program structure underwent significant changes from previous years. The program is a 90 day intensive program designed to address the resident’s substance abuse issues, life and coping skills and to increase employability – with the primary goal of successful reentry into society. During Phase I of their stay, parolees must complete 260 hours of classroom training that include cognitive skills, anger management, victim awareness, parenting and family reintegration, finances, substance abuse, HIV awareness, computer skills, job readiness and community reentry planning. Upon successfully completing Phase I, the participant advances to Phase II which consists of 40 hours of classroom time focusing on interviewing skills. During this Phase II parolees may begin to job search or obtain employment. The length of the program may range from a minimum of 90 days to a maximum of 180 days and is determined by how rapidly the parolee advances through the two Phases. 13 In addition to continuing to provide services to male parolees from Tulare and Kings Counties, Visalia Reentry, through an agreement with the Tulare County Probation Department, began providing residential services for male probationers. The program offers two components—the intensive 90 day “life skills” program or the 90 day licensed substance abuse treatment program. Visalia Reentry, as a licensed substance abuse program, currently provides substance abuse treatment to Tulare County Probation referrals as well as parolee referrals from the Substance Abuse Services Coordination Agency (SASCA). The Bakersfield Reentry program, with a 125-bed capacity serves and assists state parolees, federal inmates, and probationers with their reintegration back into society. Since 1983, our goal has been to successfully assist our clients to be self-supporting upon completion of our program. As a Parolee Service Center (PSC) for California Department of Corrections and Rehabilitation, we provide a 90 day program for parolees who were referred to our program by their Parole Agent. We also have a contract with the Federal Bureau of Prisons as a Residential Reentry Center (RRC) for referrals from the federal system, and for federal probationers who are placed in our program by their probation officer if they have violated a condition of their probation, or are in need of housing. Our clients attend classes focusing on such topics as substance abuse education, money management, life skills, family reintegration, parenting and victim awareness. We have a Job Developer and a Social Services Coordinator assisting the clients in all areas of employment, mental/physical health and social services. Our clients also participate in community service projects and volunteer for various non-profit agencies. For FY 2011-2012, our program served over 600 clients with approximately 40 percent obtaining/retaining employment or volunteering full time. The average savings per client was approximately $1,500 which enabled them to purchase vehicles, and secure housing. Our staff members strive to assist our clients through a comprehensive social model that focuses on a therapeutic approach to case management. The Fresno G Street Program is a Parolee Service Center (PSC) that is designed to assist active parolees in becoming productive citizens. The Reentry Center Program has received ACA accreditation and contracts with the California Department of Corrections and the U.S. Bureau of Prisons. We are a co-ed facility that accommodates up to 75 residents at a time and has provided services to 580 clients this year. Initial placements are for 90 days; however, this can be extended for up to one year upon staff and parole agent approval. The Program provides an on-site 52 week domestic violence program, N.A. Meetings, Test of Adult Basic Education (T.A.B.E.) testing, and assistance with placement into GED classes or GED preparation to achieve a 12th grade level of education. Additional services provided include, but are not limited to victim awareness training; substance abuse prevention; individual, group and family reunification counseling; stress management; money management; job search training and job placement services. Community based organizations such as Labor Ready and MDT Personnel have assisted greatly in job placement for approximately one third of our employed clients. The Reentry Center Program staff members have devoted their time and effectively carried out the Turning Point mission statement to “serve people in need.” In times of budget concerns, the Program staff remarkably displayed dedication and collaboration in providing services to others while adhering to contractual requirements. 14 The Golden State - Residential Reentry Center, in Fresno, served the equivalent of 445 federal clients this year, which included In-house and Home Confinement participants. Due to unforeseen circumstances, our population declined and our facility, like many others, experienced budget strains and personnel changes. Our facility has a dedicated staff, and with varied degrees of education and experience. These talents are needed when addressing the challenges of a growing client population with extensive medical, mental health and social skill problems. As a Residential Reentry Center, our facility has the opportunity to see changes in character and behavior of clients, over the course of several months. Some clients, in their adult years, have never had employment or an independent living experience. Their previous lives were mainly dependent on low income social services or the Criminal Justice System. This year, our facility had the honor of witnessing some clients completing their high school requirements and receiving their diploma. In one case, the recipient was also honored as “Student of the Year,” for his dedication to the school and the employment that the school provided. From this employment he developed his own personal transportation and completed the program with healthy self-esteem. This was a good example of selfmotivation and assisted guidance. Many such role models exist under individual acceptance of responsibility. There have been those clients who have failed, however the success of some individuals often comes from a series of failures and finally making better choices. The Salinas Reentry Center is a 51-bed residential program, operating for over 28 years, for adult offenders returning to Monterey County from the Federal Bureau of Prisons and parolees supervised by the California Department of Corrections and Rehabilitation. The objective of the Reentry Center program is for offenders and parolees to become aware of their responsibility to society and to assist them with education and employment to enhance their success in obtaining and maintaining employability while in the program and after their return to the community. The program assists offenders and parolees in becoming productive citizens through transitional housing, supportive services and programming. As individual needs vary greatly, comprehensive assessments and effective case management are an integral part of the program. A combination of in-house and community based services are utilized to assure the full array of services necessary to support residents in their development of a crime/drug-free, self-sufficient lifestyle. Partnership activities are an essential service component to assist residents in the development of a reliable support system prior to program completion. 15 SERVICES FOR THE DEVELOPMENTALLY DISABLED It has been another year of success for our services to the developmentally disabled. There continues to be a need for intense residential services within the State of California and we have been able to remain full and provide supports to many children and families. We continue to meet each outcome measure successfully. This year, all of the children have effectively remained out of the developmental centers and successfully transition into their life-long plan. The long-term intensive therapeutic homes have paralleled the success of the short-term therapeutic homes and continue to offer supports towards person-centered planning. The children have been able to adapt to a community and feel as though they are a part of a life-long plan. The successful transitions have been one of reward and victory for the children that were able to be placed within their family unit. The Lake House residential program, one of our newest homes, has been able to meet all goals and objectives with emphasis on participant educational paths. The Lake County community has embraced our children and in doing so, it has made for successful and rewarding outcomes. Overall, this year has proven successful for the children and the families the programs support. Turning Point of Central California continues to recognize all of these children as individuals and with dignity and respect have accomplished a life-long plan for each child. Porterville Ukiah Journey On Ukiah Country Roads Occupancy Rate 100% 100% Successful Transitions to Less Restrictive Environment 100% Successful community integration as evidenced by participation in educational activities, vocational activities and other appropriate community activities Program Objectives Percentage of clients going to the Hospital Atascadero Ukiah Northern Lights Prairie House Lake House Overall Average 100% 100% 100% 100% 100% 100% 100% 80% 100% 100% 100% 100% 97% 100% 100% 80% 100% 100% 100% 100% 97% 0% 0% 80% 0% 0% 0% 0% 11% 16 OUTPATIENT DRUG AND ALCOHOL SERVICE The Turning Point Federal Aftercare Programs provide counseling and drug testing services for the U.S. District Court System in Fresno. Most of our clients have substance abuse problems and receive random drug testing to ensure compliance with their conditions of release. Nearly 35% of our clients receive either individual or group substance abuse counseling. Another 15% are seen by mental health professionals for individual psychotherapy. This past year we achieved a success rate of 88%. A total of 265 clients were served with only 10% being discharged for failure to comply with program expectations. The other 2% transferred to other programs or moved out of the area. The Kennemer Outpatient Drug Free Counseling Program has occupancy of approximately 71 adult clients at any given time in the intensive outpatient drug treatment program. Services were provided to 202 unduplicated participants in this last fiscal year. In the first three months of the program, phase one clients participate in group and individual counseling sessions at least five times a week. Clients who complete the first three months of the program learn and practice the necessary skills to gain sobriety and stability in their day to day life. As the client progresses through the 8-month program, the level of intensity decreases to three groups per week and includes an increased level of participation in community social support activities. Clients who successfully complete all phases of the program have created a solid foundation for continuing an alcohol and drug free lifestyle and becoming productive community members. The Treatment Goals are: “At the end of treatment, the client should demonstrate an understanding of factors that have contributed to his or her drug and/or alcohol use; an ability to deal with daily stressors without the use of drugs; participation and engagement in fulfilling activities that support recovery; and a commitment to abstinence.” (From Kern County Substance Abuse Standards of Care) Of 114 discharged clients, 25.4% successfully completed the comprehensive program, and another 12.3% of discharged clients left before completion, but had satisfactory progress during their treatment episode. This year’s Kern County Client Satisfaction Survey reported that clients of the Kennemer ODF program indicated a 100% satisfaction with the services that they received. Clients reported that the skills that they learned in the program relate to their family and social lives and that these skills relate directly to their abstinence. Of clients surveyed, 96 percent said that they would recommend the program to others. 17 Turning Point Youth Services (TPYS): This program assists youth in Tulare County to obtain and maintain a drug-free lifestyle. Program outcomes for the three major program components, Treatment, Student Assistance Programs and Project Alert, are as follows: Outpatient Drug-Free Treatment Component Teens are involved in group and individual counseling for approximately six months. The majority of referrals come from Probation and Schools. Recovery skills, family support, and the development of self-efficacy skills are the primary focus of treatment groups. This year the program has continued to increase access to rural communities in order to provide needed treatment services to at risk youth and their families. TPYS now provides services at 16 state certified locations in Tulare County. 1,011 Total Unduplicated Clients Served 4,320 Individual Counseling sessions 11,546 Group Counseling contacts 120 Family Support Groups completed, 9,197 Informational/Referral contacts 49% Clients successfully completed the program 56% of discharged clients had achieved 30 days or more of continuous clean time at the time of discharge 49% of discharged clients had achieved 60 days or more of continuous clean time at the time of discharge 35% of discharged clients had achieved 90 days or more of continuous clean time at the time of discharge Community Prevention Component Project Alert: Target Population *Universal Population *High School Students *Effects of Advertising on Alcohol Use *Peer Pressure and Tools to Resisting It *Communicating with Family about Alcohol *Effects of Drugs and Alcohol on the Body *Helping students to see that not everyone in High School drinks Voices: Target Population * Universal Population * Female High School students in Tulare County The program increases student awareness and skills related to: Alcohol and drug awareness Drug Education, Refusal skills Peer pressure and influence, stopping the cycle of abuse, Positive self-awareness Motivation to succeed Brain Food: Target Population * Universal Population: 362 clients served * Jr. High School students in Tulare County The program increases student awareness and skills related to: Alcohol and drug awareness Peer pressure and influence Life management lessons, Refusal skills, Money management Positive self-awareness, Motivation, and the Importance of education 18 Student Assistance Program Middle School and High School students are seen on school campuses throughout Tulare County to gain an understanding of how alcohol and other drugs may negatively affect their lives. Throughout the school year, educational/support groups are provided to give information and skills to make healthy choices and develop beneficial relationships with peers and family. Students are also referred to community supports and linkages as needed. 14 Schools served in Tulare County 1,036 Students served (an assessment was completed for each individual) 1,340 Educational/Counseling groups provided 5,318 Student Contacts in all groups Federal Kennemer Program Objectives Aftercare Outpatient How Many Clients Served 177 161 Percentage Successfully Completing Full Program 80% 29% 19 ISMIP TPYS Totals N/A 1,011 1349 N/A 49% 53% RESIDENTIAL DRUG AND ALCOHOL SERVICES The Quest House is a 30 bed co-ed residential treatment program. The Quest House provides residential treatment for substance abuse and other co-occurring disorders. The Quest House is licensed by the California Department of Alcohol and Drug Programs as an inpatient treatment facility. For the past few years, the Quest House has operated under contract with the Substance Abuse Services Coordinating Agency and the California Department of Corrections and fulfills a variety of needs for State Parolees. The Quest House has recently acquired a contract with Fresno County, providing services for the Parolee Services Network (PSN), as well as working in conjunction with other Turning Point facilities to provide residential treatment for those suffering from co-occurring disorders. The Quest House may also provide services for private pay individuals. The Quest House is a clean and sober environment, which is conducive to progress and success. The treatment program provides a well-structured 40 hours of curriculum per week. The curriculum includes various classes, such as: (a) Breaking Barriers, (b) Life Skills, (c) Substance Abuse Education, (d) Health Education, (e) Relapse Prevention, (f) Anger Management and (g) Parenting Skills and Family Group Education. Residents begin and end each day by attending an AA or NA Meeting. Residents also receive 1-2 Hours of individual counseling per week. The Quest House Counselors and Supervisors are Certified Addiction Specialists there is a Licensed Mental Health Specialist on staff. The Kennemer Center residential program in the fiscal year 2011-2012 provided substance abuse treatment to a total of 703 clients. Kennemer provides comprehensive alcohol and drug addiction treatment and prevention services for adult men and women parolees and to private pay individuals inside or outside the local area. This year will be remembered for being a major transitional year as a result of AB 109 realignment of the California Department of Corrections. Certain felonies, considered to be non-serious are no longer punishable by a state prison term and instead became eligible for county jail sentences. As jail and prison space became a major challenge all over the state, Kennemer’s certified counselors continued to provide an effective residential substance abuse treatment experience to higher risk offenders with co-occurring disorders which helped to reduce incarceration and recidivism rates. An on-site vocational program known as WESTEC provided certified training for many clients who then became gainfully employed ending their homelessness. Clients benefited greatly also from alumni meetings, aftercare services, support groups, recreational activities, and family gatherings held at the Kennemer Center. Clients often report that they learned to develop and sustain healthy relationships after completing anger management classes and while healing from many serious issues causing addiction. We have seen many clients experience a positive “Turning Point” in their lives after previous failed attempts to become clean and sober. We believe in our clients and the individual’s power to overcome addiction permanently. Lots of one-onones and groups with the clients seem to be a key factor in their success stories. It continues to be Kennemer’s goal to unearth, heal, and overcome underlying issues that caused them to resort to substance abuse in the first place. 20 Program Objectives Clients Served Percentage Obtaining Employment Residents Moved to Appropriate Living Arrangement Percentage Completing the Program Kennemer Residential Quest House Total 703 184 887 25% 7% 16% 75% 83% 79% 65% 69% 67% 21 HOUSING PROGRAMS New Outlook is a supportive housing program for homeless families. Fifty apartment units are utilized to house families who wish to receive supportive services which are directed to overcoming homelessness and finding permanent housing within a 24 month period of time. The New Outlook program housed 91 families comprised of 107 adults and 197 children. Despite the economy and deep cuts within state and county social service agencies, ninety six (96%) of the adults leaving the program found permanent housing with increased income from employment. The average length of stay increased this grant year to seventeen (17) months, due to the reasons previously stated. New Outlook staff of four (4) continues to exceed the requirements established and mandated by HUD. Stasis Center Permanent Supportive Housing serves persistently mentally ill individuals, many of whom have co-occurring disorders. Most of our residents are between their mid- thirties and early fifties. Our services include life skills education, crisis intervention, socialization and some case management services in referring residents to wrap around services. The goal for our residents is to help them live as independently as possible and to maintain stabilization in regard to their psychiatric disorders. The Turning Point Transitional Living Center (TLC) is a HUD funded program that was designed to assist the homeless in Fresno County, many of whom suffer from chronic mental and emotional disorders, as well as substance abuse issues. The Program’s success can be attributed to a highly experienced staff, as well as an emphasis on substance abuse and prevention. TLC first opened its doors in August of 1994, and since then, has served over 2000 residents, many of whom face significant barriers to independent living. TLC is part of the Fresno Madera Continuum of Care, and assists residents in maintaining their sobriety, stabilizing their mental health, finding meaningful employment, and regaining their independence. TLC works closely with the Residents and makes referrals to mainstream resources within the community, to ensure that they are connected with local resources to keep them on track, once they leave the program. 22 In the grant year of 4/1/11 through 4/30/12, Family Villa served 45 adults and 64 children. The grant provides for permanent supportive housing with a program goal to stabilize and maintain homeless families, whose parents have a disability caused by substance abuse and/or mental health illness. Forty-two percent have found employment or are enrolled in school. The supportive services and life skill classes offered to residents should help to keep these families from returning to homelessness. Court Street Transitional Center (CSTC) is a four-bed transitional housing program, serving homeless males as they transition to independence. CSTC received its first client in October of 2011. Since opening its doors the Court Street Transitional Center has served clients from Tulare County Probation, Turning Point’s TAY Program, and self-referrals. Upon intake and assessment, residents meet with the caseworker assigned to the facility to prepare an individualized case plan to include (a) in-house financial management, (b) computer skills job search and retention skills, (c) cognitive skills, (d) use of community resources, (e) victim awareness, (f) and substance abuse counseling, if applicable. Residents are required to participate in meaningful activities that facilitate reentry into the community such as vocational training, adult school or junior college and volunteer work or employment. CSTC’s primary goal is for the residents to secure appropriate permanent housing upon release. Program Objectives Nights of Shelter Clients Served Number Placed in Permanent Housing Percentage Successfully Overcoming Barriers to Improve or Obtain Employment Transitional New Living STASIS Outlook Center Family Villa Total 9,002 56,766 9,983 9,651 85,402 36 283 146 109 574 N/A 111 81 N/A 766 64% 97% 36% 42% 60% 23 ANCILLARY SERVICES Some services have developed as adjuncts to major programs to assist in the overall purpose and vision. One such service is the Payee Program, which provides money management services for mentally disabled individuals who need this type of assistance. Other ancillary services include (a) jail visitation programs, (b) electronic monitoring, (c) drug use detection, (d) self-help meetings, (e) public education, (f) community youth prevention activities, (g) peer support activities, (h) speaker’s bureaus and (i) tenant council development. Turning Point Payee Services Programs serve individuals that are unable to administer their own Social Security, veterans benefit or private funds in Fresno County. The majority of our clients have some type of mental health diagnosis and difficulty managing their money. This past year we administered over $3,977,647.09 in varied types of benefits, servicing 369 clients. This program serves a population that, without our help, could very easily become homeless and destitute. Program Objectives Fresno Payee Services Annual Deposits $3,977,647.09 Clients Served Average Annual Deposit 369 24 $10,780 FUTURE GROWTH We continue efforts to expand services to meet growing needs in the communities we serve. New programs for the developmentally disabled and homeless are in the process of implementation for the coming year. SUCCESS STORIES (pseudonyms are used in place of actual names) Fresno “G” Street We have had a number of residents come through the program and successfully complete a 90 day program. However one individual stands out for outstanding program completion. This resident who we will call Dan in this true story, entered the program early January of 2012 and received a certificate of completion for 90 days. At that point, he requested an extension that took him through a total of seven months in the program. Dan successfully began job searching and in no time secured full time employment with a local poultry packing plant. He complied with all program policies in making deposits in a timely manner as well as tending to all financial responsibilities that arose. Dan also fulfilled program requirements and all other responsibilities such as attending parenting classes, DUI classes and NA/AA meetings without it conflicting with his employment schedule. He was successful in completing program training, obtaining full-time employment, maintaining sobriety and was able to move into his own apartment that he was able to afford with the monies he had saved in his trust account. Even with all these successes perhaps his greatest success was regaining custody of his children. Integrated Services for Mentally Ill Parolee-Clients (ISMIP) We have many stories of clients who have turned their lives around, gotten stabilized and have managed to stay out of prison a year or two, possibly for good. One client, Michael aged 45, told us he averaged only two months out of jail for the past ten years. We recently attended his wedding and celebrated his first year of freedom. To date, he has been doing well and it has been over one and a half years. 25 Intensive Services for Mentally Ill Parolees (ISMIP) When Albert was released from prison over a year ago, he was released to the streets with no place to call home. Albert only had the clothes on his back, and no family or friends to help him out in any way. Once Albert began the ISMIP program, case managers immediately assisted him with finding food, clothing, and housing. That same day, his ISMIP case manager located all of the important necessities including shelter at a local sober living home. Albert was determined to turn his life around and relied on his faith to bring him through his hardships. We are proud of Albert because he has always maintained a positive attitude, and never let anything get in the way of his goals. Today Albert lives in his own apartment with the help of the Housing Authority. Albert is also currently a full time student at Bakersfield College and earning excellent grades in his second year. He is a full time student, but on his day off (Fridays) he spends the day with his support system, ISMIP. Bakersfield Reentry We have many client success stories but one client in particular benefitted greatly from our programming. We will call him “Jim” and when he entered our program he was very distraught due to various challenges he was facing. He was unemployed and had just recently lost custody of his children. He was committed to regaining his children and bringing his family back together in a safe environment. Jim attended all of the required classes while in the program including substance abuse education, parenting, money management, etc. Jim completed the three-week WESTEC training which provides the necessary certifications for various positions in the oil fields or construction industry. Job Developer, Mike Martinez worked closely with Jim to assist him during his job search process. Jim was able to secure employment in the oil fields utilizing his certifications. This job allowed him to save approximately $700 while in the program. He used this money towards a security deposit on an apartment. Working through Child Protective Services, he presented the judge his certificates of completion for our program and the various classes he attended. The judge was very impressed with Jim’s dedication and commitment to improving his life skills, and obtaining employment, along with providing suitable housing for his children. During his 90 days in the program, Jim never received a disciplinary report, and never tested positive for drugs or alcohol. The judge awarded Jim custody of his five children as a result of his positive actions and successful programming at Bakersfield Reentry. Jim is still employed and has custody of his children since leaving the program over one year ago. Integrated Mental Health Full Service Partnership Diane’s Story For most of us making our own decisions and having a home of our own is taken for granted. However, for some it is an almost impossible dream never reached due to mental health barriers. But someone forgot to tell Diane that her dream of having her own place to call home was impossible. Diane has been living with serious mental health issues for over two decades and has lived in numerous residential settings including locked and supervised facilities, while rarely being able to maintain independent living. She has been psychiatrically hospitalized many times in over three different counties and was even placed on conservatorship for a four-year period. Diane lost custody of her two children thirteen years ago because she was deemed mentally unfit to care for them. More recently, she was living homeless in Fresno for two months, had no access to psychiatric care or medications, and had zero support. 26 Since her engagement in the Integrated Mental Health Program last August, Diane has made great strides in her wellness and recovery process. Utilizing her strengths of persistence, spirituality, and faith, she has gained access to regular psychiatric care and has found a primary care physician. She has built a positive and trusting rapport with the program staff and has developed a small support network of friends. Diane has learned how to access public transportation and is able to attend most of her appointments on her own. She has successfully learned how to use coping skills and her support system to help her through times of crisis, and has managed to avoid hospitalization since August 2010. Additionally, Diane has maintained independent living for almost 5 months and recently secured and moved into her own apartment. She is looking forward to decorating her apartment for all of the seasons and holidays and maybe even a house warming party. Diane still has more goals to accomplish such as reuniting with her family and children, going back to college, and seeking employment, but for now she couldn’t be more happy having her very own place to call home and she is now truly living free. Mari’s Story Mari stated she was “rescued by Turning Point back in March” and remembered telling staff to go away and leave her alone. She has had a long history with mental health care needs for about 30 years and alcoholism for 15 years. Up until about three months ago, all that Mari thought about was going to sleep and never waking up again. Mari states she had an epiphany when Turning Point “rescued” her and felt compelled to change her life around. Mari states during this process she has even found God. Mari’s mental health recovery consists of being active by attending all available group therapy classes, going to Blue Sky, and socializing with her peers as much as possible for that extra support needed to be successful in her life. Mari states that she is excited to be alive again and does not ever see herself going backwards. Some of Mari’s goals are to write more, do more missionary work for her church and to continue managing her mental health symptoms so she can lead a fulfilling life. Mari says that her worst enemy is herself and when she gets out of the way of her own progress, she allows herself to walk more proudly and is ready to take on whatever comes her way. Mari stated her favorite coping skill is believing she can get through anything and finds that determination is her best defense against the unexpected. Mari wanted to tell everyone that “it works if you work it” and believe it or not that she is living proof of that. 27 TURNING POINT SERVICES 28
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