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HomeMy WebLinkAboutM022574February 25, 1974 RECOnn7ENED: The Board reconvened at 9:00 a.m. Present: Supervisors Cameron Gilman, Ladd, McKillop and Chairman Madigan. Clif Miclcelson, Administrative Officer, Ban Blackstock, County Counsel, and Clark A. Nelson, County Clerk by Margie Catt, Board of Supervisors Clerk. 74-254 DISCUSSION: VARIOUS ASPECTS OF HEALTH SERVICES IN THE COUNTY I. History of Health Care in Butte County. Dr. Enloe, Health Director, gave a brief background history of Health care in Butte County. He presented a written preliminary report or. the various health programs in the County. Dr. Enloe explained how mental patients were handled in the past; he stated that these methods have changed with the advent of the Short Doyle Act. Drugs and medication have helped to control these patients. Dr. Enloe stated that Dr. Maguire would explain. the mental health program. II. Dr. Maguire presented coritten material on the history of Mental Health Care in Butte County. The Short Doyle Program has been in operation since 1967. Background of the program set out by Dro Maguire. Prior to the operation of the Short Doyle Program, the Chico Mental Health Care Clinic provided services to the County. He explained horn the clinic had been operated. The written statement was filed with the Clerk and copies were given to the Board members. Mr. Robert Florida, representing the State Department of Mental Health, spoke concerning payment of claims and the State's approval of the County's budget for mental health services. He said the County budget and the County plan received a careful review in Sacrament; he assured the Board that the plan as submitted was approved. Both the budget and the plan are acceptable to the State. He set out the problem of payment of claims. Statistical data has been gathered on how the programs were being handled. Complications were present and because of these problems, they had problems in getting tYe claims run through the computers and payments made. Matter of payment of the claims explained in full. Board members questioned Mr. Florida concerning the program, budget, funding the program and how the County's budget compares to other countieso Youth Crisis Programo Dr. Lorach explained the Youth Crisis program, explaining the history of the program and the services provided, The program was developed in the latter part of 1972. The object of the program was the diversion of the 601 type youth-the child that is out of parental control. Funding for the services were made possible by savings in the Mental Health program for the adults. He reviewed the things that have been done in this County under this program. He handed out material that refers to the statistical referrals. The peak age of the youths that are being handled are those between the ages of 15 through 16 years of age. Decree of impairment to the youth set out and evaluated, The object of the program was to divert these children from the court situation. Costs for operating the program set out and explained. Referrals of these youths explained by Dr. Lorach. Dr. Lorach stated that they are now proposing to include another area; this would be a preventive level, This program is for the elementary school level. They are working up a program to present to the elementary school s A pilot pragram will Page 2850 February 25, 1974 _ ~ _ ~ - _ __ _ _ _ _ _ _ _ _February_25,_1974 = _ ~ T = - _ _ _ - ~ _ _ _ start next week in the Chico elementary schools. RECE35: 10:00 RECONVENED: 10:15 Dr. Bedford presented a written statement on the review of Mental Health Services in Butte County. A copy of the report was presented to each of the Board members and filed with the Clerk. He set out the back- ground of mental health care over the past 20 years. Under the adoption of the Short Doyle Program, a change in treatment of the mentally ill patient took place. Use of medication was more effective; patients were released to return to their homes in the County and be treated in their homes. Counties had to develop a different type program for the treatment of these people. Dr. Bedford stated that the Auditor has expressed alarm over the size of the Mental Health Care Services budget. He explained the costs for these services. He went into some of the programs that Butte County h~ at this time. It was felt that the Auditor should send copies of his memos concerning Mental Health to the Mental Health Advisory Board and to Dr. Enlge. Dr. Bedford read a prepared statement; he filed a copy of said statement with the Clerk. Contract with the-Bridge. Dr. Lorach and Pat McCafferty explained the program. Dr. Lorach stated that the Bridge is a crisis counseling informational service. They operate a "Hot Line" in Chico. Originally it was set up ~y CCCJ. Program explained, setting out how it was operated. This is a County-wide service. Intensive 24-hour Care Programs. Dr. Maguire presented a prepared statement concerning the intensive 24-hour care programs. He explained how the patients are worked up and handled, He took issue with Mr. Lawrence's memo concerning the high cost of care at the Chico Community Hospital. He said this was for the medical workup of the patient. He presented a few samples of the workups that were chosen at random. He asked that the Board members take a few minutes to look at them as he feels that they speak for themselves. Dr. Ely spoke to the matter of the entry services. He explained what was done for the patient during this examination period. He explained what happened to the patient after he was admitted to the hospital. He said they were no longer placed in locked rooms. Dr. Ely stated that there wasn't a second staff member available at night. This is the part of the contract that is difficult to enforce. The entire patient population is transported over to the work training center in the morning, where they have a day room for patients who are not capable of taking part in the program. Patients that live at home are also accepted at the center during Che day so they won't be left along at home. Dr. John McLaughlin spoke to the Board on the same subject. He said that Dr. Ely had covered most of the program. He added that this is about the closest to a natural environment that a hospital can get. Page 286. February 25, 1974 February 25, 1974 Alcoholism Program. This is a proposed program for next year, presented in preliminary form. It has not yet received Mental Health Advisory Board approval. Mr. Chuck Westwater read his statement to the Board, a copy of which was given to the Board members. The proposal, in outline form, was attached. The proposal would involve the possibility of developing a 12-bed detoxification center supervised by trained personnel, R.N.'s, doctors, etc. The staff expansions would allow for evaluations within jail settings. Mr. Westwater explained that they are currently operating 4-bed capacity recovery home for non-intoxicated people. Staffing increases would provide for jail and recovery home evaluations and would be available to court evaluations. There would be more effort to tie in with other programs, such as Alcoholics Anonymous and Al Anon. Mr. Westwater stated that now the emphasis is on detoxification and not on follow-up programs. This program would emphasize those aspects. There was some discussion about the location of the home, which would depend on availability of services and space. Supervisor Ladd questioned about the possibility of treating alcoholics and mentally ill patients together. It was stated that there was considerable difference. Detoxification is very short term and needs lots of nurse observation and a fair amount of medical supervision since they are more prone to later ailments. Mr. i•7estwater also pointed out that the cost of mental health care is $60 per day and detoxification is $3fl per day and perhaps less. Tf they were combined, it would raise the detoxification cost. Discussion. RECESS: 12:05 RECONVENED: 1:30 TTT. CLINICS. DR. ENLOE Dr.~Enloe set out the need for clinics in the County. He said that with the advent of the Federal and State medical paid programs, the trend for the indigents was away from the County hospitals. He set up a graph which. showed increase use of private hospitals and less use of the County hospital. Emergency clinic care also dropped at the County hospital and increased at the private hospitals. He said his basic activity with the County hospital was in the spring and suirmier of 1972. The Blue Ribbon Committee report was reviewed; the Board of Supervisors had authorized a study of the County hospital. He also presented some of the questianai-res that had been sent out to the doctors in the County and their responses. Dr. Enloe presented statements to the Board members concerning the need for clinics in the Countya He said the problems should be identified. It is felt that there is a need for emergency access to doctors. It is felt that there is a need for low cost medical and dental care throughout the County. This problem is serious, he felt. Medical care for obstetrics patients set out. Page 287. February 25, 1974 T' _ _ _ _ _ _ _ _ _ _ _ _ _ February_25 x_1974 = _ _ _ _ _ _ _ _ _ _ _ It was Dr. Enloe's feeling that some changes or additions in Butte County are needed between the patient and the physician. He could not set out what the actual problem is that exists at this time. One thing that he did after last Tuesday's meeting was to have a survey mailed out to the physicians in the County. He received 57 replies to these questionaires sent out. This shows that the physicians are aware of the problems that are being faced here in this County, The need for clinics in this County is a complicated problem to determine. Dr. Enloe felt that it was not going to be solved from any one solution. 2. Alternatives a. Medical social service. The main complaint under this item is that there is a difficulty in getting the patient placed into the system. Several years ago when the hospitals had problems in discharging patients, they instituted a program of discharge nurses. In bringing this up, Dr. Enloe said he was talking about a patient advocate that could break down the barrier between the patient and the physicians. One solution that might make quite a difference is to have a person caorking as a bridge, when a patient has difficulty getting medical care, this person would know the resources of getting the patient in to see a phsician. g. Adequate Medi-Cal program. Dr. Enloe said this appears to be a major deterent in securing medical care far the patients. If this program could be improved, the patient would be more readily accepted. It is felt that the program should be modified. Dr. Enloe explained how the present program was operated. Dr. Enloe felt that the quality of care is very important. Dr. Enloe set out the alternatives as set out in the prepared agenda for this meeting. He explained the matter of county clinics. At the present time there are clinics operated in Oroville, Chico, Gridley and Paradise. The clinic policies were prepared by Dr. Heindl. He explained the clinics and there use. He said the clinics could be expanded to accegt more general patients. Matter of emergency rooms discussed. Medical Arts Center in Oroville has a new expansion going on to expand the emergency room facility. It might be able to be used for out-patient clinics. The present emergency room staffing pattern set out. Foundation alternative explained by Dr. Enloe. It would guarantee physicians services. This would allow free choice of physician by the patients. Supervisor McKillop said to boil this whole matter into one statement, it might be taken care of be expanding the existing clinics, The survey has not determined specifically what the problems are at present. RECESS: 3:15 RECONVENED: 3:30 IV. INDIGENT POLICY 1. Present status explained by Clif Nickelson, Administrative Officer. He said they have had several meetings with hosgital administrators, Page 288. February 25, 1974 February 25, 1974 If the person is a resident of the county, they are given medical care. at Bob Crisan, Welfare Director, stated that/the last meeting caith the hospital administrators, the County requested a breakdown of the work load. It was suggested thaC he place two workers on a commuting type basis at the hospitals and they would be able to handle these matters of individuals receiving emergency room service. The hospitals said they would provide them with a desk and phone. These workers would go to the various hospitals in the county and handle the farms. They would take care of the in-patient, out patient and emergency room care and would serve a1I five hospitals in the County. V. VETERANS SERVICE Bob O'Brien, Veterans Service Officer, presented a written report concerning Veterans Service. An investigation is being made concerning the possibility of transporting veterans to veteran hospitals. He said the veteran must be ambulatory and must have a real need. The Veteran's Service Officer does not have to transport these veterans; someone on his staff could do the transporting. Transporting of veterans discussed. DISCUSSION: BURIAL OF VETERAN Supervisor McKillop brought up a situation existing here in Orovilleo There is a veteran being held at a lacal mortuary and the Cemetery district will not give the family credit so that he can be buried in the cemeCeryo Tile Cemetery requests that the sum of $346 be paid prior to the burial of this man. The District does not have a credit system. Supervisor McKillop asked if the County had some type fund that could handle this matter. Dan Blackstock, County Counsel, will contact the Veterans Organizations and the Cemetery District and will report back to the Board at tomorrow's. meeting. VIII. HEALTH AEPARTMENT CLINIC SERVICES Dr. Enloe presented copies of his report on the Health Department Clinic Services. He went through this report rapidly, explaining the items as he went along. Chairman Madigan thanked Dr, Enloe and Dr. Maguire for their reports concerning these programs. No action taken, Dr, bfaguire requested that this type meeting be dyne on a yearly basis. 74-256 AI~TNOUNCEMENT: NOTIFICATION OF FISH & GAME HEARING ON HUNTING NEAR LAKE OROVILLE Supervisor Cameron stated he had received a call stating that the State Fish & Game was proposing a hearing to be held on March 8th, 1974 in San Francisco to discuss, as one of their items, hunting on Lake Oroville. He £elt that the County should contact someone and see if this item could be taken off their agenda. Mr. Nickelson will contact Mr. Mercer and the Butte County Fish & Game Commission and request that they appear at tomorrow's meeting. ADJOURNMENT: There being nothing further before the Board at this time, the meeting was adjourned at 4:15 to reconvene on Tuesday, February 26, 1974 at 9:00 a.m. ~ { / ATTEST: CLARK A, NELSON, COUNTY CLER& 1 ~~ . By: C airr~ian of the Board Board of S ervisors Clerk Page 289. February 25, 1974