November 2001 NACBHDD Newsletter
The Newsletter of the National Association of County Behavioral Health and Developmental Disability Directors
In this Issue...
Dealing with Short-Term Disaster, Coping with Long-Term Trauma, The Twin Towers of the Behavioral Health Response to Terror in NY
Commissioner of the Nassau County, Long Island Mental Health, Harold Saronsky sat in his office and watched the World Trade Towers burn across the East River on September 11th . Two and a half weeks later he compared himself to an amputee who still feels pain in a phantom limb. "I look out my window and I can still see the shadow of the two towers," he says.
That Saronsky was exhausted and still stunned could be heard in his voice. But in many ways his job of coping with the 9/11 disaster was just beginning. That day at the end of September his department was training 150 people in critical stress debriefing and was in the process of opening up two centers for children who had lost parents, as well as a one-stop shop, The Family Resource Center. The children's centers were being billed as "socialization" centers to avoid the stigma of a mental health label. "Most of the people who were impacted are not typically people who visit mental health clinics, Saronsky maintains, "Many of them resist the idea of seeking help." Making mental health practitioners available in more neutral environments is also the idea behind the family resource center, where families can get legal help or help with health insurance as well as counseling.
Saronsky was also doing a lot of work with the airlines and hoping to begin debriefing his own staff. "Imagine a pebble dropped in a pond at ground zero," he says, "concentric circles begin to expand outwards. That's what we're now doing, adding various additional populations that were not attended to immediately."
First Responses: Nassau County, with a population of 1.3 million, has had its share of disaster. Saronsky rattles off a list of plane crashes including TWA and Egyptian Air. He mentions the northeaster of 1992. Thus, the county has a cohort of trained mental health responders, critical incident debriefers, as well as bereavement counselors. They were mobilized right away to staff the county's emergency headquarters, which they did around the clock for the first week. Community mental health clinics were also mobilized. The county began right away to work with the Red Cross. An emergency hotline was established, as well as an on-call mental health response team to work with detectives doing missing persons reports. "We were expecting that first day large numbers of people to be brought out to Nassau for medical treatment," Saronsky says, "Didn't happen. Unfortunately most of the victims died. That was the real tragedy here." That, he says, is why there wasn't a whole lot for his department to do after mobilization. But as the circles have widened, more and more mental health services have been called for.
The Saturday after the Tuesday attacks, his department set up a bereavement center in a local hotel. The following Monday Nassau County lent 84 professionals to New York City to work at its Pier 94 Center. They went into the city under police escort. Meanwhile Nassau County established a DNA collection center, pairing police officers with mental health workers. "It's a very difficult thing for families to do and the police are really not trained to handle the emotional reaction that one would have in dealing with that situation," says Saronsky. His department also set up a children's corner through one of its child guidance clinics so that children did not have to sit with parents while they were going through the DNA stuff.
By the time of this interview at the end of September, Saronsky noted that the funerals were beginning and the city was issuing death certificates. He wasn't willing to commit himself to a death toll from Nassau County except to say a couple of hundred people were listed as missing persons. He expected the toll to rise: "People don't report. They don't want to go through the effort to find a body part. Why would you want to wait six, eight, nine months to get a finger? Most people just want to close it off."
The Ripple Effect: There has been a big surge in calls for assistance from the general public in the county. "If we didn't loose somebody close to us, everybody knows somebody who lost somebody. There is no one who survived this thing who has not been touched and affected by it," says Saronsky, who adds the public also has to be prepared for an uncertain future.
To deal with those problems in the long term he is using money from the Federal Emergency Management Administration (FEMA) to establish an independent crisis counseling structure. It will be tied into community mental health clinics operationally but not fiscally. Despite all the disasters Nassau County has had to deal with this is the first time it has had to plan for long-term crisis counseling.
"In the middle of all this we're trying to run mental health services," Saronsky sighs. He notes that the county, which is on the verge of bankruptcy, has a major election this year. But if the disaster can be said to have any bright spot, it is the new light cast on mental health: "It really has put us on the map and made our department something of value."
Logistics, Food, Clinicians: the Top Three NY Disaster Demands
New York State was prepared, not because the state office of mental health envisioned anything like what happened on 9/11, but because it had geared up for Y2K. Deputy Commissioner and Chief Fiscal Officer Peter Brown says his office prepared for the millennium knowing full well that there might not be any problems but "realizing there might come a time when something would be needed for some other event." Little did he realize when the preparations would come in handy and for what.
His department based its disaster response on the incident command process, whose genesis was in the fire service, where a command structure was needed to fight large forest fires, particularly out west. Not a new system but "we took it to heart" says Brown and it worked so well that SAMHSA has asked for an explanation about how it worked. Headed by a commander, the structure includes people who are responsible for operations, logistics, communications, security and public information. What NY added to the basic structure was an information person to handle electronic and telephone communications. This person turned out to be invaluable because communications did fail in the impacted area.
The first demand turned out to be logistics. "Fairly early when we thought there were going to be a lot of casualties, we had wards open and other places we were prepared to take people. We created a morgue," says Brown. But none of these things were needed. His department also found space for the living. "The City of New York people were forced out of their offices so we set them up in our field office in the city and provided some computers for them," says Brown. "Fairly quickly we were able to direct folks to go to the family center that was originally located at Lexington Armory and was then moved to Pier 94." His department was also called on to deal with truckloads of material sent in from all over the nation. The Hudson River Psychiatric Center became a depot.
Food was the next great need. The Department has a cook/chill facility, which provided ready-to-eat meals, as well as ready-to-cook meals to Salvation Army kitchens in lower Manhattan.
The third demand was for clinicians of all kinds to act as intermediate counselors. "These folks were not doing extensive grief counseling," Brown says, "they were just allowing people just to tell their stories and helping them through the process of deciding what to do next." Although this was not a traditional mental health service, Brown said a great many state employees and people who worked for other providers were prepared to pitch in.
The command post made it possible for all of these things to be accomplished. "Just the process of making sure that you know what is really the problem and what to do about it is an extremely important function," Brown asserts. In a disaster, he says, communications get very garbled and it's important to go back through the system to sort out what's really going on. Otherwise, there can be a duplicating or even triplicating of action. The command center was invaluable in keeping things straight and also, "a person acting as incident commander could turn to somebody and say would you do this, would you do that, and make sure that they had a ready and continuous flow of information," says Brown.
He wouldn't change a thing about his command center, saying it worked "as well as anybody could have hoped for." But Brown will be updating the phone numbers he has for people outside his organization, particularly in New York City, which has huge resources. The biggest problem he had was coordinating his efforts with theirs. Says Brown, "Getting in touch with them was one of the harder parts of this, I had to actually send people to find them in some cases."
The President's Corner: County Directors Respond to the Tragedy
By NACBHD President Jim Stewart
September 11, 2001, marked a watershed event in our country's history. Individuals and families throughout the nation experienced a fear and trauma previously unimagined. In New York City, Washington DC and Northern Virginia, where physical destruction is visible and recovery efforts will extend into the future, these tragedies will leave indelible scars. This is also true for those throughout the country who experienced the death of a loved one, a dear friend or trusted colleague. In every community we serve, the emotional impact resulting from these acts of terrorism will be long lasting and will require responses from our local mental health authorities.
Upon learning of the tragedies, I immediately contacted the New York State Office of Mental Health, which was coordinating the behavioral health response, to offer the assistance of our NACBHD members. In my home state of Virginia, many of our local Community Services Boards reached out to the county mental health agencies in Northern Virginia to support their continuing efforts with the Red Cross.
As I talked to our staff here in Henrico County during the days that followed the attacks, a commonly expressed feeling was the desire to help in some way. A number of our Mental Health Emergency Services clinicians were able to assist by providing critical incident debriefing for the staff of one local mental health authority in the Northern Virginia that has been working directly with those who were affected by the Pentagon incident. Through this small but important effort, we all felt that we had helped. From the flood of e-mail messages I have received this past month, it is evident that many of our member organizations assisted in similar way. This issue of The NACBHD Bulletin highlights the experiences of staff in several local authorities that have been intensely involved in responding to the NY and Pentagon incidents.
Arlington County, VA, Saying `Yes' to Federal Disaster Dollars
"We've been told, just say `yes'," says John Russotto, Executive Director of Arlington County's Community Services Board, about the federal money that's being offered to him behind the September plane that plunged into the Pentagon in the heart of his county. But Russotto has done more than answer in the affirmative, he's had to plan for the health of the 190,000 people who live in his community, something he's never had to do before.
Funding was being offered from two sources: a $600,000 FEMA/CMHS grant that will cover the behavioral health of the general population for the first 60 days with a nine-month renewal and money from SAMHSA, designed to fill in any gaps and provide for future disaster planning. Russotto had to come up with plans to qualify for both but in the case of FEMA it was uncharted territory. In the immediate aftermath of the attack on the Pentagon his department responded mostly to its mentally ill and substance abusing clients whose symptoms and anxiety increased. Then the department had to turn its attention to mentally and emotionally healthy clients. "We are looking at what kind of mental illness is likely to come out of this but also what can we do to prevent a relatively healthy community from falling down and not regaining its healthy status," said Russotto. "The worst thing to do is present it from a pathological stand point. You really need to say that what you're experiencing is what any normal person would experience having had disaster occur."
Russotto took his cue from Oklahoma City, which has experience in the aftermath of trauma (see story below) because of the bombing of the Murrah federal building in 1995. "They volunteered to come talk to us at their own expense and sent us a copy of their grant application," says Russotto, who calls the input generous and helpful. His plan built on theirs and called for the hiring of about 50 Bachelor's-level people with experience in both severe mental illness and substance abuse. Ideally, they also had case management experience and facility with low-income populations, who are the most vulnerable.
Most of the new hires are doing outreach and offering basic information about what a normal reaction is and when to know if it becomes abnormal. They are teaming up with non-profit agencies, such as Northern VA Family Services, the Salvation Army and Red Cross. The program, which began in mid-October, includes a substance abuse team but Russotto is not really expecting to see substance abuse problems until much later (see story below). The FEMA services build on what the county had already put in place: a toll-free hotline to answer any and all questions, community meetings, informational brochures in several languages and personal outreach to all county behavioral health clients. The department has gotten calls from businesses asking for someone to address employees, especially with the delay in re-opening Reagan National Airport and the economic effects of that. The director of a non-profit organization in a Hispanic neighborhood requested help with clients who were worried about making rent payments and also recalling memories from their own war-torn countries of origin. Russotto scheduled community meetings there.
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Disaster Response: "We did not have a plan per se for disaster or at least not a disaster of this magnitude," says Russotto. What Arlington did have was a skeletal plan developed for Y2K. Community Services was asked almost immediately to provide emotional support for firefighters and rescue workers on the scene at the Pentagon and to counsel victims' families. In concert with the Red Cross, which has jurisdiction over mental health services at disaster sites, a plan was drawn up to provide staff at the Pentagon around the clock. Trained in crisis intervention and critical stress management the staff was drawn from around the state.
Russotto and his directors went to see first hand what was needed. "What we all realized is that our counseling skills weren't being called for. Just being there particularly with the recovery guys, if they just came out from digging bodies or doing whatever they were doing and needed something to eat or something to drink we could give it to them, And maybe all we could do was offer a smile but let me tell you that went a long way." Russotto added that he and his staff did see a couple of people who had to be evaluated for commitment. As time went by, however, the FBI became concerned with the integrity of what was a federal crime scene, and it became harder for the county counselors to gain access to the Pentagon. Eventually they were sidelined.
At the same time the Red Cross and county counselors were asked to attend twice daily briefings for victims' families, who learned the grim facts from a military general. "Typically a briefing might have a hundred or so people," says Russotto, adding that many family members broke down. But here again, counseling became a matter of jurisdiction. "The Department of Defense felt it was their responsibility to provide mental health services," Russotto reports. "They also told the Red Cross thanks but no thanks."
Care of Caregivers: "What I tell staff is you've got to use common sense, if you are feeling overwhelmed, let your supervisor know," says Russotto, who has also given supervisors leeway to suspend standards of accountability. He, himself, took a few days off to attend a conference in early October.
One of the things that has happened since the disaster is that people in Russotto's department have drawn closer together. In one traditional program where mental health and substance abuse counselors occupy different offices, "those lines came down quickly." Says Russotto, "Everybody pitched in to help, volunteering for different shifts or additional shifts."
Oklahoma City, Surprised by the "Broad" Effect of the 1995 Bombing
In the month after the bombing of the Murrah Building in Oklahoma City mental health providers reported a blip in their caseloads of 8.4 percent. But that was only the beginning. The FEMA funded crisis center, Project Heartland, has only recently closed its doors after five years of operation and trauma related symptoms are still being reported. "We're still dealing with this," says Disaster Liaison for the OK State Department of Mental Health and Substance Abuse, Tom Thompson. To him it isn't what counselors are seeing that's surprising; it's the broad reach of the disaster's effects. He is used to natural disasters like floods and tornadoes but they have fairly localized consequences. "In terms of this type of violence," he says, "the effects are more diffuse throughout the community."
In 1996, a year after the bombing, the University of Oklahoma and the Gallup Organization did a study based on questionnaires sent out to Oklahoma City residents and also to residents of sister city Indianapolis (see results in box). In probing the eventual need for mental health or substance abuse services, the study found that the Oklahomans were "significantly more afflicted by helplessness, restlessness, avoidance and nightmares than were their counterparts in Indianapolis. They were also angrier, more stressed and reported drinking more alcohol."
Thompson says the University of OK/Gallup survey turned out to be a good predictor of what eventually happened in Oklahoma City. Immediately after the disaster his department began an outreach program, setting up a hotline, holding community meetings and disseminating information on symptoms and Six months, a year, two years later people began to come in suffering from sleeplessness, irritability and difficulty concentrating on the job - classic symptoms of post traumatic stress. What surprised Thompson most were the number of rescue workers who needed help. "When they go in, they save people and feel good about themselves," he says. "When rescue workers become recovery workers, its very hard on them."
He predicts the consequences of the terrorist attack in New York City are going to be huge, not just because of the large numbers involved but also because of the nature of the attack. "While the Murrah building could be seen to be a terrorist attack," he says , "I think a lot of us kind of look at that and say well okay it was a couple of people that were kind of crazy and did something very stupid, but we don't expect to see other Americans doing this on a regular basis." Thompson says the September 11th attacks are particularly unsettling because nobody really knows if something similar will happen again.
But out in OK, where Thompson says there is no county-based system because some OK counties have nobody in them, he is anticipating what he fears is the next natural disaster: foot and mouth disease.
Substance Use Disorder, a Lagging Effect of Trauma
Acceptance that increased substance abuse is an effect of trauma can be seen in the first wave of DHHS funding for disaster-related behavioral health services after the September 11th attacks. Out of an initial $6.8 million dollars in grants, $6.1 million went to substance abuse and prevention. Yet, in Oklahoma City the spike in substance abuse, which was fairly significant, did not appear until two years after the Murrah Building bombing.
"Seeds planted after the bombing are just now coming to fruition," says an Oklahoma City Triage Specialist whose office was established in the wake of the April 1995 bombing. He doesn't want to be named because he has promised the people he counsels that he will avoid being in the media.
That there may be a lag in substance abuse effects worries Executive Director of the Bucks County, Pennsylvania, Drug and Alcohol Commission Margaret Hanna because of future funding. The PA state substance abuse office has circulated a survey asking for comparisons of substance abuse referrals and calls between October, 2000 and September, 2001. "If a survey alone is the basis for more $$ than we are all in trouble," e-mails Hanna. What she has noted since 9/11 is an increase in hotline calls and crisis center visits from dually diagnosed patients. She is concerned "as we see a population that is fragile and very affected by recent events."
By comparing increased alcohol consumption in Indianapolis and Okalahoma City in the year following the bombing, the University of Oklahoma/Gallup study (see story above) found a difference of slightly more than three percent, leading to the assumption that substance abuse treatment would be needed for an additional 3,200 people amongst Oklahoma City's population of one million. The cost of this, according to the study, would be over three million dollars a year for those who were uninsured.
The specialist won't be pinned down to an increase in substance abuse, which he says is just one of a myriad of symptoms exhibited by the rescue workers, who make up the bulk of his client load. "What they don't say is my drinking has increased since the bombing," he says, although that often turns out to be the case. Instead he talks to them about "what's kicking your butt today; what's in your face and what can we do about it." He characterizes his clientele as "macho tough guys." They are a population that is hard to reach and this triage specialist uses a technique he calls "schmoozing". He hangs out at fire stations, giving out his phone and beeper numbers with the request to "please make your call at three o'clock in the morning." He promises to respond to all calls within two hours and make face-to-face contact within 24. Meetings take place in parking lots and the middle of dirt roads. Once the triage specialist met a client on a muddy riverbank.
When dealing with his clients the specialist tries to stay "below the threshold of mental health stigma" and avoid "psychobabble". He avoids "the `f' word (feelings)" and talks to a client about what's in his gut. What has worked for him is the Mitchell/Everly debriefing model, Critical Incidence Stress Debriefing (CISD). The specialist says he has a number of masters degrees but he won't specify which ones, choosing instead to tout his lifetime bass fishing license.
Most of his clients, he says, are reacting to abnormal situations in normal ways that may appear abnormal. Some, however, require the care of a psychologist or psychiatrist. The triage specialist is glad to be backed up by a team that includes a fireman, a policeman, a clergyman and, yes, a psychologist. The professionals, he says, bring "structure and control to trauma which is devoid of structure and control."
The effects of the 1995 Murrah Building bombing are by no means over even now. When there's another traumatic event, such as the execution of Timothy McVeigh or the 9/11 terrorist attacks, calls to the triage office increase. Yet after six and a half years of coping with the bombing aftermath, the triage specialist says he is amazed at "the resiliency of the human container."
Mental Health Fares Well on the Hill, Post-Terror
By Sally McElroy, NACO Associate Legislative Director
Like the rest of the country, the Congress was thrown into a state of uncertainty by the events of 9/11. A bi-partisan atmosphere emerged as Congress first focused on response and assistance in the aftermath of the attacks and then slowly returned to business with a re-prioritized agenda. Funding bills for fiscal year 2002, which began October 1st, are at the top of the list while other policy actions are still in play.
Labor, HHS Appropriations - Health programs faired well in both House and Senate versions of this funding bill. The House bill passed 10/11/01. The same day the Senate Labor, Health and Human Services, and Education Appropriations Subcommittee marked up its version. Mental health and substance abuse programs received increases over last year in both bills (see box).
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Parity - The Mental Health Equitable Treatment Act of 2001 (S-543), is again in limbo. Senate Majority Leader Tom Daschle (D-SD) had hoped to bring it to the floor the week of October 1st under a unanimous consent agreement -- a Senate procedure that allows for expedited consideration of bills with bipartisan clearance. However, several senators, who want to offer amendments, objected. So, S. 543 has been set aside while the Senate considers other legislation. In the House, the Mental Health and Substance Abuse Parity Amendments of 2001 (H.R. 162) is still pending in committee. A staff briefing on the legislation was held October 10th but it is unclear if this bill will move before Congress adjourns for the year.
Post Terrorism Mental Health Improvement Act - Senator Edward Kennedy (D-MA), Chairman of the Health, Education, Labor, and Pensions (HELP) Committee, is preparing a bill to improve disaster response capability in mental health services. The legislation grew out of a HELP Committee hearing September 26th on the psychological effects of the 9/11 disaster. The bill would provide federal monies for outreach, early intervention, and treatment to prevent the development of chronic mental health problems. The draft bill includes: a grant for school programs to treat children's post-disaster mental health needs; grants for state and local programs to respond to post-disaster mental health needs; grants for development or expansion of universal hotlines such as the 2-1-1 hotline; and a grant program for training mental health professionals in the treatment of mental health needs arising from disasters.
IMD Exclusion? No Problem, Says HHS Head Tommy Thompson
By Kathleen Hubert, Executive Director, Pennsylvania Association of County Drug and Alcohol Administrators, Inc.
When Secretary of Health and Human Services (HHS) Tommy Thompson invited 45 individuals representing the field of substance abuse services from around the country to a gathering in Washington in observance of 2001 National Alcohol and Drug Addiction Recovery Month, they did not miss the opportunity to bring up the Medicaid IMD exclusion issue. Mr. Thompson listened carefully and then turned to SAMSHA Administrator-nominee Charles Curie with the instruction to "take care of it." Says NACBHD Substance Abuse Committee Chair Dr. Sherry Knapp, "this is great news." IMDs (institutes for mental diseases) are inpatient facilities with 16 or more beds whose patient census exceeds 51% with an admitting diagnosis of mental illness. Federal Medicaid matching payments are prohibited for IMDs with a population between the ages of 22 and 64.
Present at the September 6 event were five Pennsylvania county authority representatives: Kathleen Hubert, Executive Director of the PA Association of County Drug and Alcohol Administrators, Deborah Beck, President of the Drug and Alcohol Service Providers Organization of Pennsylvania, Lynn Cooper, Policy Specialist with the Pennsylvania Community Providers Association, Dona Dmitrovic, Executive Director of Pennsylvania Recovery Organizations Alliance, and Margaret Hanna, Executive Director of the Bucks County Drug and Alcohol Commission. They were there at the invitation of Curie, former Deputy Secretary of Mental Health and Substance Abuse Services in PA's Department of Public Welfare.
The Secretary convened this first-of-its-kind dialogue for his department with interested stakeholders by stating his belief that more emphasis should be placed on prevention and treatment than incarceration. He stated that his experience as Governor of Wisconsin has helped transform his opinion on the need for more jails vs. more treatment. Individuals from around the country shared views on what HHS priorities should be, and what issues they felt should be addressed. Among the concerns introduced for his consideration was the IMD exclusion, insurance parity, issues of the Native American population and other culturally diverse groups, and better coordination of the divergent funding sources which must be tapped in order to provide comprehensive services to individuals in need.
It was heartening to experience the open exchange of information encouraged that day by Secretary Thompson. He agreed with the need for collaboration among all elements of his Department in order to better address service needs and potential system reform. He invited all who were present to "get themselves on committees" and work groups that are convened within his Department to address specific issues, and said that his door is always open to listen to what those in the field have to share. The PA delegation left with shared optimism that the Charles Curie-Tommy Thompson team in Washington could have positive implications for the field.
Intellectual Property, NACBHD's Prime Asset
Marketing and Public Relations Consultant Fred Hutchison describes himself as a jaded kind of guy but he says he was "blown away" by NACBHD's Annual Conference in July. "There were a lot of good people with a lot of ideas, a lot of meat there," he says. Hutchison, who has advised a number of associations and developed some grassroots coalitions, is helping NACBHD better promote itself in order to attract new members. He sees intellectual property as a large part of the bait. "My charge is to kick up the sizzle a little and to increase the size of the steak," he says, meaning that it is his job to promote NACBHD's intellectual property, but also to develop more of it.
In particular he was impressed by the real world case studies that were presented at the July meeting. These are exactly what members said they most valued about NACBHD in the recent membership survey. Hutchison said part of what NACBHD needs to do is encourage people to step forward and present their case studies, maybe along with some kind of informal peer review. "Material like that will not only advance the profession but will advance the association as well," he says.
About half of NACBHD's members participated in the survey, which also showed they valued regional workshops and the national leadership institute. Hutchison says that kind of participation in a survey is very high and points to another of NACBHD's assets: its members. Almost 70% of respondents said they first learned about NACBHD from a peer or colleague or from their state associations. Seventy-seven percent said the best way to reach potential new members was one on one contact. "Clearly this is one of those kinds of associations where word of mouth is really important," Hutchison points out, adding that NACBHD's marketing channels are real people. Growth in membership will require a lot of personalization, he says. Promoting case studies is one way to do that. Another is to put faces and bylines on marketing materials.
You Asked For It, You're Getting It: Newsletter Via E-Mail
In the recent membership survey 84 percent of you said you would like to get time sensitive materials like the newsletter through the Internet. Transmitting the newsletter electronically will mean that you get it in a more timely fashion. It also means the newsletter can be longer since it will no longer be bound by printing costs and it can be accompanied by relevant attachments. Says NACBHD Consultant Fred Hutchison (see above story), an e-newsletter means "more resources can be expended on intellectual property and less on the mechanics of getting it out."
Robert C. Egnew Excellence in Advocacy Award Announced
NACBHD is pleased to announce the Robert C. Egnew Excellence in Advocacy Award as a tribute to one of its founding members and mentor, Robert Egnew, Behavioral Health Director, Monterey County, CA. The award will recognize a county/local behavioral health authority director who has demonstrated exceptional effort during the past 12 months advocating at the state and/or federal level for an issue that has benefited the director's community, consumers and system of care. Bob has served in Monterey County for 20 years, is a past President of NACBHD and has provided committed, innovative leadership. It is fitting that we acknowledge his contribution by identifying a county director who has exhibited the qualities in advocacy work that Bob has modeled so well for all of us.
Nominations are welcome from current NACBHD members. Applications are due by March 30, 2002. An Advisory Committee consisting of NACBHD members will review all applications. The $2,500 award will be made at the Awards Luncheon during our Annual Conference next July in San Diego. See the Award Application Form attached to this newsletter. Recognize someone you know who has worked tirelessly on behalf of public behavioral health. Increase the visibility of our work and let others be aware of the work necessary to preserve and protect our local systems of care.
2002 Membership Campaign Underway
NACBHD's 2002 membership campaign is in full swing. Look for your renewal notice in the mail and respond quickly. Our work over the past year and our plans for the coming year, increase and expand our commitment to serving you the best way we can. Our influence in Washington is substantial and increasingly visible. Membership services are improving all the time. In difficult times such as these, it is imperative that we maintain our position in the public sector arena. County authorities cannot be overlooked. NACBHD works to ensure that your voice is always heard and your perspective is always considered. Return your renewal notice with payment, apply online at www.nacbhd.org or complete the attached application. Make the investment in your future, today.
NACBHD 2002 Conference Schedule
Legislative Conference:
February 27 - March 1st Madison Hotel
Washington, DC
Look for the registration brochure on our web site: www.nacbhd.org and in the
mail in mid-November.
Annual Conference:
July 25 - 27th
Clarion Bayview Hotel
San Diego, CA
Look for the Call for Proposals on NACBHD's web site and as an attachment
in this mailing.
Contribute to the program of the only conference designed with county authority directors in mind.
Job Announcement
Director of Clinical Services
Casey Family Services, headquartered in Shelton, CT seeks a Director of Clinical Services to serve as the lead clinician, and be responsible for the development and monitoring of clinical policy and practice used in the organization.
Reporting to the Deputy Executive Director of Field Operations, the Director of Clinical Services works with the eight geographically diverse division directors to create standardized practices that ensure quality treatment while allowing for flexibility to create programs to address the specific needs of local communities. The Director of Clinical Services will be a seasoned manager and a decisive, flexible clinical leader with both mental health and child welfare expertise. The successful candidate will have exemplary therapeutic training and will be expected to influence case activity in the divisions and serve as the central repository of divisional data.
The qualified candidate will bring an extensive national network as well as a broad knowledge of professional standards and recent developments in the field of child welfare and children's and family services. Knowledge of psycho-dynamics, family systems theory and practice and their application to family care will be expected. Qualified candidates will have a minimum of ten years of experience in child welfare or intensive work with children in a social service or mental health agency. A willingness to travel regularly and to be flexible in work schedule is necessary. An advanced degree from an accredited program of social work education or an advanced degreed from an accredited academic program in another related field of human services is required. Interested individuals please contact: Rhyan Mary Zweifler,Vice President, Kittleman & Associates, 300 S. Wacker, Suite 1710, Chicago, Illinois 60604; phone: 312-986-1166; fax: 312-986-0895; e-mail: rzweifler@kittleman.net
Conference
July 10 - 14, 2002: Washington, DC. "Developing Local Systems of Care for Children and Adolescents with Emotional Disturbances and their Families: Family Involvement and Cultural Competence". National Technical Assistance Center for Children's Mental Health at Georgetown University. Contact: (202) 687-5000.
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