Wednesday, May 6, 2015

[Napa County] Grand jury says good county health agency can be even better


A generally upbeat Napa County grand jury report on the county Health and Human Services Agency (HHSA) recommends reviewing Upvalley services and streamlining a grant screening method.
The Health and Human Services Agency has a $93 million annual budget and provides services ranging from public health to mental health to child welfare. It served more than 33,000 people in 2014.
“Health and Human Services Agency, Vast and Visionary” is the tone-setting title of the 2014-15 grand jury report.
“Overall, the grand jury was pleased with the services provided by HHSA,” the report said. “However, we recognize a need to improve up valley services in the area of drug treatment for both youths and adults.”
For example, the report said, youths from Upvalley receiving drug treatment services travel to the city of Napa. The grand jury doesn’t consider giving the youths free bus passes for the journey to be sufficient.
The Health and Human Services Agency seems to lack specific measures to determine the adequacy of its upper valley services, the report said. It recommended the county review the situation by year’s end and require that, when feasible, upper valley services be provided at upper valley locations.
“We agree we need to look at Upvalley services, especially around alcohol and drugs, but other ways too,” Health and Human Services Agency Director Howard Himes said on Thursday.
Himes and the grand jury report noted that agency has decided to locate a drug treatment counselor in Calistoga and has selected a site. First, though, the state must certify the location. It’s uncertain how long this will take.
“We’re in constant communication with the state,” Himes said.
Also, the agency will assess the health and social service needs of three neighborhoods, one in Calistoga, Himes said. The approach involves looking at the unique aspects of a community and making the community part of the decision-making, he said.
“We want to be imbedded in that community, within the neighborhoods of that community in a way that meets specific needs of the community,” he said.
Preliminary work has already begun, Himes said. By year’s end, Calistoga residents should see such steps as a town hall meeting.
The grand jury also looked at how the county distributes national Tobacco Master Settlement Agreement money. The county awards $1 million annually to nonprofit groups to meet community health needs.
Applicants must follow 20 pages of instructions and do such things as submit pre-applications and full applications to be rated by a board of county employees. Grant awardees must complete three reports annually.
“The nonprofits reported that they often stretch beyond their capacity in meeting the very real needs of the people they serve,” the grand jury report said. “They further reported that most of their resources go to providing direct services, not to top-heavy administrative positions.”
Given this, nonprofits would like a less-burdensome grant process that still meets the county’s accountability concerns, the report said. It suggested someone with “fresh eyes” or a consultant explore fashioning streamlined procedures.
Himes isn’t ready to comment on what changes, if any, the county might make to the grant process. He said he wants the Board of Supervisors to weigh in as the county builds its response to the grand jury report.
The grand jury concluded its report by commending Himes for using the integrated services philosophy. That involves delivering various health and social services in a seamless way to those in need, as opposed to having each service in its own silo.
“I do appreciate that,” Himes said. “It was very nice of them to include that.”
May 2, 2015
Napa Valley Register
By Barry Eberling

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