March 2002 NACBHDD Newsletter
The Newsletter of the National Association of County Behavioral Health and Developmental Disability Directors
In this Issue...
Specialty Courts in All Varieties:
Mental Health, Drug and SAMI, Serving Dually Diagnosed "Frequent Flyers"
In Butler County, Ohio, dually diagnosed offenders were being screened out of drug court. Says Executive Director of the County Mental Health Board John Staup, judges were complaining, not knowing what to do with a population that continually cycled through their courtrooms: frequent flyers.
Staup had put together a plan for a program to serve dually-diagnosed offenders at a Gains Center conference but had shelved it for lack of financing. Two years later when the state offered money for co-occurring disorder treatment and he was able to get a foundation grant for training, he pulled it out and dusted it off, creating the state's only SAMI Court in 1999.
Based on the drug court model, Butler County's (population 330,000) SAMI court takes on people convicted of non violent felonies usually drug offenses. (Butler County has recently started a mental health court for misdemeanants.) SAMI participants also have Axis I psychiatric disorders. "They have major mental illness and a severe drug abuse or addiction problem," says Staup, "Typically they've got a long history of arrest." Staup does not kid himself about the difficulty of what he's trying to do through SAMI court. It means breaking a lifetime of habits in a seemingly intractable group of people. Those, who work with them in both the mental health and substance abuse disciplines have had to adopt new paradigms, says Staup.
So did the legal profession. Based on the New Hampshire/Dartmuth model SAMI serves people while they are continuing to use. "You don't have to be completely clean and sober you just have to be committed to making progress towards reducing your abuse," says Staup, noting that continuing to use cocaine is to commit a felony, something law enforcement initially frowned on.
A two-year program with indefinite follow-up, SAMI is a one-stop shop offering integrated treatment. Staup says he is able to offer about 80% of what an individual requires with the rest provided by other social services. The program serves a needy population, without family, employment or even benefits. "The nature of their problems is such they will require on going care and treatment for the rest of their lives, acknowledges Staup. With that in mind Butler County has started a Dual Recovery Anonymous (DRA) Program.
Because of the program's length and intensity Staup has had to limit the number of participants to 25. About half drop out or are terminated, so in two years the program may serve 40 to 45 people. Staup says if participants can be gotten past a nine month engagement phase they are more likely to stay in treatment. And in spite of slow and often frustrating progress he is determined not to compromise. "Everyone made a promise up front that we would not break rank with the model and would not find ourselves pressured into doubling or tripling caseload," he says. What Staup hopes is that in time program staff will get better at predicting who will benefit from the program.
Now, however, he isn't even sure how to gauge success. Program completion is one measure but he isn't sure how many completions it will take to judge the program effective. "We don't expect 80% of the people who start the program will graduate," Staup says "We know that the history of this population has been that they've failed at everything repeatedly."
But Staup wonders if some failures of compliance are more the fault of the program than of the individual. "If our programs were more flexible and tailored to more individuals maybe more people would benefit from them," he suggests. With SAMI court he may find out.
Mental Health Court in Sonoma Co., CA, is an "Inspirational Process"
Once a week a judge in Sonoma County (population 500,000) convenes mental health court for two hours. The clients are there, the treatment staff is there and so is the probation officer. The business at hand is to enroll new people in the program and for people who are already enrolled to make frequent check-ins. "It's quite a sight to behold," says County Mental Health Director Cathy Geary. "The judge is some combination of disciplinarian, cheer leader, wise counselor with the aim of trying to get people to acknowledge that they have a mental illness, to stay in treatment, stay on their meds and start trying to turn their lives around."
Sonoma's mental health court serves clients who are already in custody and have serious and persistent mental illness, one or more arrests and some contact with the mental health system. They plead guilty and are placed on probation while they undergo treatment. Funded with a four year California mental health offender grant, treatment for this population is costly, says Art Cwart, who manages the county's jail mental health programs. "These are very difficult people to treat. They don't engage very well At least 78% have dual diagnosis problems."
But Cathy Geary says the expense and trouble is well worth it. "Our outcomes have been stunning," she says, citing a dramatic 60% reduction in jail time and an almost 70 % reduction in hospital time. The program has reduced failures to appear in court by 55% saving both time and money. But to Geary, "the most stunning thing is the reduction in the number of felonies and misdemeanors that these individuals commit, a level of difference between what they did prior to enrollment and what they do after. There's an 88 percent reduction in felonies and 93% in misdemeanors." She cautions that the percentages are big because the numbers so far are small. While the program has capacity for 100 clients, only 75 are currently enrolled and when the program began there were even fewer participants.
Cost per client served by the program is $25,000 a year. However, a year in jail costs $30,000. There are also savings in court time and the reduction in offenses committed by program participants, where, Cwart says, the greatest saving is realized. Data on the first 25 program participants showed that while the expense of mental health treatment increased considerably, criminal justice costs fell even more - an overall savings of $500,000.
Naturally the program is popular with the county sheriff's department not only because of the cost savings but because it "takes some really tough characters out problem situations they have been in before," says Geary, who adds the relationship was a little "bumpy" at first.
If there is a down side, says Cwart, it is the cost of housing, which is particularly high in Sonoma County, outside of San Francisco. Most of the program participants have to be housed and for that reason, Cwart says, a program requirement is that participants qualify for SSI and Medicaid, which offsets costs a bit. Geary says the second biggest problem with the program has been substance abuse. She estimates alcohol abuse runs at about 80 to 90 percent and the clients don't want to give it up. "Our challenge is we don't think of ourselves traditionally as drug and alcohol people so we have to learn a lot of new skills and go through some change of identity to be able to do both," she says.
Research suggests the number of mentally ill in jail is up. Cwart thinks one reason is that minor crimes, like vagrancy, are less tolerated than they used to be. He also says that after the closing of the big mental health institutions, money needed to keep people in the community never materialized. But there is not a direct correlation. "When we went back and looked at our state hospital population, not one of them has ever ended up in jail," says Cwart.
He and Geary invented the model they use with the mental health court. "We've had a lot of experience with assertive community treatment so Art and I just said how do we take an assertive community treatment model and apply it this population," says Geary, who calls the resulting program "phenomenal". Unfortunately it's threatened by money. In its third year of a four-year grant, the program will end in June, 2003, without additional funding. "We're in the praying mode" for funds to continue, says Geary.
"Up Close Success Stories" in York County, PA, Drug Court
When York County Drug and Alcohol Program Specialist Katrina Kyle talks bout the success of the county's five year old drug court, she's not talking about program completions but about personal successes: "people who never had a job before getting a job, some of them paying more money that the probation officer earn; dead beat dads getting in touch with their kids, paying the child support; people completing high school."
Kyle, who has a case manager background, raves, "It is amazing, when people can be at the very bottom, what a little bit of help, guidance and understanding can do to effect a turnaround." For example, she points to an IV heroin user in his forties who had been using since he was 11 years old, having learned it from his mother. Never before in treatment, drug court forced him "to work through his issues and gave him support he never had," says Kyle.
York County's program is pre adjudication, meaning defendants plead guilty, but sentences are commuted while they undergo a year of intensive treatment with case manager-type follow-up through a daily reporting center. Started as a pilot in 1997, the program succeeds better than other forms of community treatment for the population it serves, according to Kyle. She stresses that the population showing up in drug court is "lower third" in terms of education, income and education. In many cases clients, who started using drugs when they were 11 or 13 "understand things the way an 11 or 13 year old would understand them," says Kyle.
"Addicts deal with the immediate," she maintains. By the time they get to drug court, they are at least no longer dealing with the substance because, having spent some time in jail, they are clean and sober. Then the threat of jail works as a deterrent. "No one changes a behavior unless that behavior becomes uncomfortable for them," says Kyle. "If Bob doesn't go to his appointment, if Bob uses drugs and he lies, he's going to face punishment." Immediate punishment, Kyle adds. The same client in standard probation would have to collect a series of violations, which then would take time to adjudicate, before consequences are applied. In addition, clients on regular probation are free to drink alcohol, which is not illegal.
Kyle also favors sanctions for those of her clients who suffer from mental illness as well as substance abuse. "If they have proper meds they can function normally," she says, asserting that not to hold the mentally ill accountable is to treat them in a patronizing manner.
An April, 2000, study of York County's drug court found the numbers support Kyle's claims of success. The study showed the program's retention rate was 70%, identical to a national rate identified by the General Accounting Office. The study also found that jail time was vastly reduced. The first twelve program graduates who would have spent an estimated 900 days in jail served only 136 days - sanctions for positive drug tests or failure to appear in court.
Combining Mental Health and Drug Courts in Treatment Court
Although it contains PA's fourth largest city, Erie County is a small county with a population of 290,000. The county has had a drug court since March, 2000, and this year started a mental health court. Now Erie County is combining the two in treatment court.
Out of necessity, says Executive Director of County Drug and Alcohol Abuse Namon McWilliams, the combination is a way of keeping expenses down. "We have one judge who's very good at working with both populations. It made sense to use the same team but different case managers and probation officers." He adds that in treatment court it will also be easier to serve dually diagnosed offenders, who might have slipped through the cracks before.
Even with the combining of courts, Erie County, like other counties, faces the loss of state funding. Yet, a study last year of the drug court program showed, among the 58 offenders selected for treatment, only one has been re-arrested. Thus, the program has a two percent recidivism rate
Families Favor Treating the Mentally Ill Before They Land in Jail
When Carla Jacobs' schizophrenic sister in law took her eight-year-old son to live on the CA streets there was nothing the family could do about it. Jacobs says the family tried to get treatment for her. "She was not dangerous, we thought, to anyone other than herself and the child," says Jacobs, who is on the board of national NAMI. "Mental health could do nothing because she had no insight into her illness." But law enforcement couldn't act either because the sister never participated in the small crimes that, a NAMI study shows, most often bring the CA mentally ill into the criminal justice system.
For two years mother and child lived on the streets until one day "without warning she took the child, taxied 75 miles and brutally murdered my mother in law," says Jacobs, re-making the point with quiet outrage, "with the child."
The sister in law was immediately ruled incompetent to stand trial. "The mental health system was saying she was well enough to live on the streets and raise a child and the criminal justice system was saying this woman is so ill she can't even aid her attorneys in her own defense," says Jacobs, adding that the story illustrates how the criminal justice system works as a treatment modality versus the mental health system, which in this case didn't work at all.
Ironically, the sister in law is getting some of the best treatment now. Judged not guilty by reason of insanity she is in intensive treatment in the state hospital and will eventually come out on conditional release to further treatment. "It would have cost $10,000 for upfront treatment and the family would have paid," Jacobs says. Instead the case has cost the state of CA some two point five million."
"We are going to have to shore up the community system if we are ever going reduce the back door system," Jacobs maintains. "When we're looking at mental health courts, when we're looking at diversion programs for parolees, I'm afraid what we're doing is building a better mousetrap."
Although she is not against mental health courts and diversion programs, Jacobs strongly supports updating mental health law to what she calls the level of knowledge. She is also an advocate of criminal justice/mental health collaborations (see Memphis CIT story below) such as Los Angeles' mental health evaluation (MET) teams which pair police officers and mental health workers who ride together to 911 calls involving mental illness. On the scene the mental health professional can access all mental health resources, not formerly available to police, who, Jacobs says, previously had only three options: do nothing, make an arrest or pursue involuntary treatment, a lengthy and time-consuming process.
What Jacobs likes about the MET is that it can keep the mentally ill out of jail, which, she says, is conducive to making people well. She has been working with an apple picker whose borderline mentally retarded and schizo-affective son was jailed on the third strike rule. His first two offenses were setting trashcan fires and the third, Jacobs says, was $1800 worth of thievery for which he was sentenced to 30 years in prison, reduced on appeal to 23. "Bodelia called me and said, `I cannot afford to keep Duane in prison anymore," relates Jacobs. "Other inmates were extorting her, saying if you don't send Duane money we will do this, this and this to him." That, says Jacobs, is what happens when you jail a cognitively impaired person with some of the most dangerous people in society."
However, she says some 65 percent of NAMI members have loved ones who have had some contact with the criminal justice system. The Bureau of Justice estimates the number of mentally ill in prison or jail at almost 284 thousand, while 548 thousand more are on probation.
Separating the Consumer from the Police is Key to Successful Mobile Response
The Crisis Interventions Team (CIT) in Memphis, TN - the grandfather of police/mental health mobile response teams - is now 14 years old and has spawned imitators all over the country. CIT head Major Sam Cochran has headed the team since the beginning. He cannot stress enough that key to its success post-crisis is the rapid transfer of the consumer from police to mental health custody. "Police have to have access to a friendly mental health delivery system," Major Cochran says "Many facilities require the police officer to wait while (a mental health) evaluation takes place. I have talked to people in some situations, literally the police officer has waited eight hours for a person to be evaluated." In those instances, the major says, the police are being used like security guards and often, they are left to make an arrest anyway when the person under review is ruled non-committable under the state standard. Major Cochran says the police officer, under pressure to get back on the street, will figure out quickly how the system works. "The officer will charge a mentally ill person with disorderly conduct instead and be back on the streets doing his duty. Let jail work it out."
In Memphis, a mental health intake center was established at the regional medical center, to take full custody of the mentally ill and determine level of care. "The police officer leaves within 15 minutes. It's faster than booking for the county jail, a win/win situation," declares Major Cochran. TN does not have a county-based system. However, a 2000 report in The Journal of the American Academy of Psychiatry and the Law says that county-based behavioral health delivery systems lend themselves to a high degree of cooperation with the police. Looking at successful CIT spin-offs in OH and OR, the report says, "The ability of a countrywide authority to plan for these changes appeared to be a critical ingredient."
Memphis stumbled into the CIT model after a mentally ill and substance abusing individual, wielding a butcher knife, was fatally shot by police. With the community in crisis the city mayor formed a task force and the local NAMI began an advocacy campaign. "NAMI felt when police came they were in as much of a crisis as their loved ones," recalls Major Cochran. "There was a lot of serious trepidation about calling police in regards to services." For their part, Memphis police thought "family members were not informed" since the eight hours of mental health training they were getting was twice the national average.
What the task force found was that immediate response to a mental health crisis was critical and from that was born the idea of a specially trained police response team. "We had no idea if it was going to work," says the Major, who was called in to lead the new unit at the time of the first training. The other officers - it takes a special type, says Major Cochran - were volunteers, who then went through a selection process and received 40 hours of training, provided and paid for by local mental health providers. In the first class, there was tension, reports the Major, "The officers had a tremendous amount of stigma to deal with and the mental health people would say things they just didn't understand or buy into."
The major did not think the new program would work until a few days after the first officers went out on the streets and one of them called in, "He said, you know that training we got about how to help de-escalate an individual who's out of control, it really works." Before long the officers bought into it. "Very, very proud, they wear a little CIT pin," reports Major Cochran, "Consumers will call and ask for a particular CIT officer."
About 190 officers serve in the CIT unit. When they are not handling calls related to mental illness, they perform regular patrol duties, which helps make the unit affordable. If a precinct CIT officer is in the field when a call comes in, the next nearest precinct is called. At least one CIT officer is on duty in all seven Memphis precincts at all times.
Outcomes have been good. Studies have shown that CIT model response times are generally less than ten minutes. In addition CIT units are able to resolve situations that previously would have required a greater response from police, thus cutting police costs. Finally, they are effective in keeping the mentally ill out of the criminal justice system. In Memphis the number of mental illness calls doubled within the program's first four years while police referrals to the regional psychiatric center increased 23%. A study that looked at the CIT arrest rate in a hundred randomly drawn calls, found it to be two percent. The national average is estimated at 20 percent.
Major Cochran says success is founded on a "real, genuine partnership" between the police and mental health system backed up by the appropriate infrastructure. He is currently involved in a community project to identify mentally ill individuals constantly circulating through the county jail system and explore why the system doesn't work for them.
NAMI cheers the CIT unit on by giving awards and banquet dinners. "Before CIT there was no connectedness," Major Cochran says. But he cherishes is the trust of a family member who says when she dies, she knows someone will be there to take of her mentally ill son.
Upcoming Elections Stifling Congress in 2002
By Thomas L. Joseph, III, Deputy Legislative Advocate, Los Angeles County
Congress returned in late January for a legislative year, which will be truncated and influenced by the mid-term elections in November. To date, little has been accomplished legislatively with many of the House and Senate committees holding hearings on the Enron debacle.
In early February, the President released his proposed budget for Fiscal Year 2003. While Congress ultimately decides which initiatives it will address and at what level of funding, the budget serves as a starting point for debate on a whole host of issues, including behavioral health. The Health and Human Services (HHS) budget can be found on the Internet at www.hhs.gov/budget/docbudget.htm.
The Administration's budget for mental health is essentially a 'status quo' request. Funding for most programs would be frozen at last year's levels, including the Mental Health Block Grant ($433 million), Children's Mental Health ($97 million) and protection and advocacy ($33 million). A 17% increase to $47 million is requested, however, for the PATH program, which supports homeless individuals with severe mental illness.
For substance abuse, the Administration's budget proposes a $127 million increase for substance abuse treatment programs. This includes a $60 million increase for the Substance Abuse Block Grant for FY 2003, boosting funding up to $1.8 billion, and a $67 million increase for competitive drug treatment grants.
The Administration is reviving its proposal for health tax credits as a means to reduce the number of uninsured in the country. A $1,000 per person tax credit would be available to low to middle income individuals who purchase private health insurance. Families with two or more children with incomes under $25,000 could receive up to $3,000 in credits. The credit phases out at $60,000 for families. The proposal, costing $89 billion over ten years, was rejected by Congress last year.
There will be another effort to enact a mental health parity bill this year. Although it was in a Senate spending bill late last year, the provision died due to the objections of some House republicans.
(Sally McElroy, NACo's health lobbyist, is on maternity leave.)
Tracking the Mentally Ill Through the New York Prison System
Tracking the Mentally Ill Through the New York Prison System is the idea behind a booklet soon to be distributed to all NY counties. Primarily intended for mental health workers to find clients who have disappeared in the criminal justice system, How to Help explains how the state justice system works, how to contact defense attorneys, how to advocate for treatment sentencing and how to arrange for discharge planning.
Author Heather Barr is now a staff attorney with the Urban Justice Center but before law school she was a direct service worker in a shelter for mentally ill homeless women in New York City. She says whenever she couldn't find a client she could pretty much count on her being in jail, "We never did anything to even try and find them let alone try and help them because we didn't understand the system. You get moved around, all these different places, you're kind of in the black hole where no one can find you for 24 hours. Then there are 14 different jails you could be in." To train mental health workers in criminal justice Barr found her own funding and began the mental health project at the Urban Justice Center four and a half years ago.
The county criminal justice guide is a spin-off of one she wrote for New York City a year ago, simply to consolidate the handouts she had been distributing at training sessions. But the response was huge. She says she has given out thousands of copies, in response to requests from 40 different states, Canada and India. She also had a huge number of requests from defense attorneys, which surprised and dismayed her, indicating that even they have trouble representing the mentally ill in NY's criminal justice system. She has started working on a booklet specifically for lawyers.
Hundreds of requests from around NY state led to the county version which will be distributed by New York NAMI. NAMI Criminal Justice Associate Director Bob Corliss says he hopes to get it out to affiliates by March first so that they can add local phone numbers. He praises the guide for being "real life" in the way it's written.
Although Barr can see the NYC guide being used by family members, her intention is to encourage mental health workers and agencies "to view advocating for someone in the criminal justice system as something they know how to do and as part of their job". If caseworkers don't want to advocate, Barr says, they can at least see that clients are taking their meds. To that end in a section at the back of the city guide Barr listed phone numbers, she says, aren't listed anywhere, like numbers for Rikers Island and the mental health director at Rikers Island.
"The level of apathy and sometimes hostility you encounter when you call the jails and just try to say look my client's there and he's supposed to be taking 15 mgs of Zyprexa is really unbelievable," laments Barr. But she says her booklet has opened up the system a bit, forcing jails to be less closed and defense attorneys more accountable. "(Attorneys) almost never call a program that a client of theirs is in," she says, "but now having the program call the lawyer forces him to at least consider if there are mental health issues.
A section of the county guide is devoted to discharge planning, which Barr describes as part of her agenda. Much of her time in the last several years has been spent suing city agencies to provide discharge planning. Thirty to 35,000 people a year receive mental health services in the New York City jail system, "the largest psychiatric institution in the state", says Barr. "But when people were ready for discharge they would just put them on a bus and dropped them off between 2:00 and 6:00 a.m. in a bad neighborhood in Queens with $1.50 in cash, a $3.00 dollar metro card, none of their medication and no referral anywhere to get treatment, no help getting Medicaid and other public benefits and no referral to shelter for the 50% who were homeless."
A court order requiring jails to do discharge planning was issued in the summer of 2000 but Barr says the city has not complied with the order and she is litigating a contempt motion. Her advice to community providers in New York and beyond is to plan now because discharge planning is eventually going to be required. She thinks that mental health provider contracts should include requirements that a percentage of clients come from the county jail: "You have to go into jail and find those clients, build a relationship with them while they're still in jail, work with them when they come out of jail. Programs that are successful have that person from the community who provides real continuity."
In-Jail Drug Treatment Reduces Crime Involvement and Criminality in Duval County, Florida
Duval County's in-jail drug treatment program packs six months of therapy into four. "Very intensive," says Program Manager for Substance Abuse Services, Tom Rogerson. Starting at 5:00 am the modified therapeutic entity modality program continues until 10:00 pm. Participants get about 12 hours a week individual addictions treatment as well as group and individual therapy. They work with case managers who follow them through the 120 days of in-jail treatment and then help them exit and re integrate into the community. For many inmates there is an after care program that can last up to nine months, which provides ancillary services like help with work, housing, drivers licenses etc.
The program in Florida's fourth largest county (population 1.2 million) was started in 1991 as a way to combat the crack cocaine epidemic. Eligible for the program are drug users convicted of either felonies or misdemeanors carrying sentences of a year or less. In FL those convicted to longer sentences are sent to the state prison. Some inmates simply volunteer for the program, others agree to be assigned by a judge with or without probation. Those with the best outcomes are in the court-ordered with probation group. Volunteers are second.
"We've kept a lot of individuals out of the state system," says Rogerson as he embarks on a litany of positive outcomes. For starters the program has a 78 percent completion rate. It has a positive effect on the rate of crime involvement. The average length of time before re-arrest is about double that of a non-treatment comparison group and the average number of days before re-arrest is about 150. In the first year post-release 30% had no further re-arrests at all and 28% had only one. The rate of recidivism also dropped by 64 %: offenders average 2.5 arrests pre-treatment, they average only .9 after completing the treatment.
Rogerson says the program also has a positive effect on the nature of crimes committed, making post-treatment completion offenses more likely to be misdemeanors than felonies. There is no difference in outcome between males and females, Rogerson says, adding, "We're proud that half a dozen former participants now work in program, two have gotten masters degrees. We're also proud because Jacksonville sheriff's office loves it." One reason the sheriff's office loves the treatment program is that participants in the program are model prisoners. Since they are no different demographically from the rest of the prison population, Rogerson believes they are kept in line by "intensive programming that provides `right living' teaching and experiential learning."
One of the largest in FL, the in-jail program treats about 300 offenders a year at a cost of $2,000 per prisoner. It is paid for out of general fund dollars. "Funded by the city, hosted by the sheriff and operated by non-profits, its more than cooperation," says Rogerson, "It's collaboration."
The program greatly enhanced the ability of the community to provide treatment, says Rogerson, since not everyone could get into community based services. This month Duval County will open a pair of mental health and substance abuse assessment centers to support its Memphis model (see story above) CIT program. "We don't have any pretenses of integrated services but who knows maybe down the road, after we get everything in place that'll probably be our evolution," says Rogerson, "The community's not driving these things, we're doing it because we know it's the right thing to do."
Drug Costs for Mentally Ill Inmates
Drug costs for mentally ill inmates in Alameda County, CA, jails will more than double this year because of the cost of newer medications, according to the Oakland Tribune newspaper. The newspaper says a contract with Pharmacy Plus of Franklin, Tenn., has increased from $422,000 to $900,000 for the current fiscal year.
Sonoma County Mental Health Director Cathy Geary says that because inmates loose their Medicaid in jail the cost of their meds and care - over a million dollars in Sonoma County - have to be absorbed by the criminal justice system. "They're not happy about it," she says.
In Alameda, county officials will be looking at ways to reduce costs. The newer drugs cost hundreds of dollars for a month's supply while older medications like Haldol are less than ten dollars a month. But the newspaper quotes Alameda County authorities as saying that the county wanted to be sure inmates got the same medications as mentally ill patients treated at outpatient clinics. The hope is that if patients improve, they'll stay out of the criminal justice system.
NACBHD's 7th Annual Conference
Behavioral Health & Disability Systems: Leadership for a Complex Environment
July 25 - 27, 2002
Clarion Bay View Hotel
San Diego, CA
Registration brochures and online registration at www.nacbhd.org will be available in mid-April.
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Vance, Granville, Franklin, Warren Area Authority is seeking three positions described below. VGFW Area Authority is located in Henderson, North Carolina and is easily accessible to the Research Triangle Area.
Application Procedure: Submit North Carolina State application, transcript and license, if appropriate, to: VGFW Area Authority, Human Resources Dept., 134 S. Garnett Street, Henderson, NC 27536. AAE/EOE. Deadline: All positions will remain open until filled.
Santa Barbara County
Assistant Alcohol, Drug, and Mental Health Director - Administration
$80,166-$97,026 annually, including annual benefit allowance
Santa Barbara County is looking for a dynamic administrator to join the team undertaking a major reassessment of operations
in a department known for its innovative programs. This position will enable a highly qualified professional to collaborate
with the executive team to assist in planning and organizing overall departmental operations and provide leadership, vision,
and inspiration in planning, directing, and evaluating departmental administrative support services, including financial,
fiscal, information systems, facilities, human resources, and contracts and grants management.
The position requires five years of administrative management experience that includes fiscal management, budget preparation, and supervision of staff with a governmental agency. Possession of a related bachelor's degree, CPA, and administrative experience in a behavioral health, mental health, alcohol & drug, or general health care setting are preferred. For information about the department or the position, contact Dr. James Broderick, ADMHS Director at 805-681-5233, email broderic@co.santa-barbara.ca.us.
For application information and to apply on-line, visit www.sbcountyjobs.com or call 805-568-2800. Job #02-5163-03. Apply by 4/12/02.
