Author Archives: Steve Kaplan

Housing, Mental Health and Recovery

Yesterday’s meeting of the Mental Health and Substance Abuse Recovery Commission focused on how the current housing situation in San Mateo County is impacting individuals and families with mental health and/or substance use challenges. Testimony about personal experiences were given to the Commission.  Rather than summarize and provide commentary I want to share some of the comments that were expressed to give you, the reader, a sense of how serious the housing crisis is for our consumers/clients and family members.

“Nearly impossible to keep hope”           “I don’t know if it’s worth trying”

“Depression escalating, lost hope”     “You don’t know how to survive”

“Devalued as a citizen”                     “If I die I at least won’t worry about being homeless”

“When I was using at least I was housed, as I have worked on my recovery I am homeless”

“Barely hanging on”                           “Lowest point in my life and my children’s”

“When you have to keep moving it is like having your soul in a box”

“When I had stable housing my kids flourished”    “Vulnerable to scams”

” More wealth less housing for us”       “Couldn’t help but fall into deep depression”

“People in abusive relationships are staying, nowhere else to go”

“No stability for me, none for my child”    “I am doing my part”

“Without stable housing-on the streets, hospital, jail”

“If you don’t have housing you only have stress”

“A constant jigsaw puzzle without all the pieces”




New BHRS Deputy Director Adult/Older Adult Services

I am very pleased to announce that Karen Krahn has been selected to fill the BHRS Deputy Director Adult/Older Adult position.

Karen has an extensive and rich history of experiences in behavioral health services in the public and private sectors. For the past 9+ years she has worked for the state of Hawaii Department of Health’s Behavioral Health Division. Among her responsibilities were directing clinical operations, strategic planning, compliance, performance improvement, forensic and multicultural service programs, implementation and oversight of supported housing, case management, co-occurring programs, supported employment, expansion of career ladder for peer specialists, crisis services, and contracting.

Karen also worked for Magellan Health Services as Vice President of Quality Improvement and was responsible for public sector policy, program development and oversight of quality improvement with 14 Medicaid managed care contracts in 12 states.

With Karen’s background she will be a great help to BHRS as we navigate the many challenges and opportunities that are here and ahead of us in the coming years.
Karen will join us at the end of February

We Can and Must Be Better

With 2015 coming to an end and the days of 2016 yet to unfold I wonder what lies ahead. We have much to look forward to and I am cognizant of how fortunate we are in San Mateo County with the resources we have and the support from our elected officials, sister county departments, providers, and the general community. However, despite these advantages, I am greatly concerned about the seemingly endless string of senseless acts of mass murder that unthinkably is becoming our “new normal” that struck again in Paris and a few short weeks ago in San Bernardino. What differentiates the San Bernardino tragedy from the others is that the victims were our colleagues…fellow County employees, public servants. Our hearts, thoughts and prayers go to their families, friends and to their co-workers who will return to work with pain in their hearts but who will continue to devote themselves to helping others. I have extended our support to my counterpart and our colleagues in San Bernardino on behalf of our BHRS staff.

If the carnage and loss of life were not enough, these tragic events and horrific killings has precipitated a storm of vitriolic declarations, whipped up simmering prejudices and initiated calls for drastic measures in clear violation of our country’s constitutional principles and guarantees. Scapegoating, targeting, isolating, and demonizing a single group of people, in this case people of Muslim faith regardless of whether they are an American citizen or not is reprehensible. Throughout history there are countless examples, Nazi Germany, South African apartheid, slavery in this country to name a few, of how this type of overt hostility travels a dangerous and slippery slope. It is appalling and disheartening that this is happening now in this country when tolerance and understanding is what is needed.

I send this message to you, my BHRS colleagues and to our stakeholders that as an organization and as individuals committed to public service and to the public good, we need to and will uphold our values honoring and respecting everyone regardless of their religious beliefs. We have an ethical responsibility that we will uphold to be vigilant against any erosion of these values as we continue our work in these troublesome times. We will ensure that each and every one of our BHRS colleagues feels welcome and supportive in the workplace. And we must apply the same sensitivity and support to our clients and family members, as this might be a particularly difficult and confusing time for them.

I have great regard for you my BHRS colleagues and our providers and the ethics and values you bring to work every day. I am confident that individually and collectively we will demonstrate humility, inclusion and commitment to social justice for everyone.

– Steve Kaplan, Behavioral Health and Recovery Services Director

Transforming Substance Use Treatment

This past August, the Department of Health Care Services (DHCS) received approval from the Center for Medicare and Medicaid Services, of their application to implement the Drug Medi-Cal Organized Delivery System (DMC-ODS) plan. The DMC-ODS expands the types of treatment available to Medi-Cal beneficiaries and for Federal reimbursement.

Medi-Cal beneficiaries will have access to a full continuum of services including: residential detox, residential treatment, intensive outpatient, outpatient, case management, recovery supports and more.

Counties have the option of “opting in” to implement the DMC-ODS or just offer the traditional and very limited benefits. For those counties opting in, they are required to submit an Implementation Plan to DHCS for review and approval. I am pleased to announce that BHRS, on November 20th submitted its Implementation Plan to DHCS.

There are several steps after we receive approval before the expanded services will be available to Medi-Cal beneficiaries. Our contract with DHCS will need our Board of Supervisors approval, contracts with our providers will need to be amended and approved by the Board, and staff and providers will need to be trained on key requirements of our plan.

I want to thank our BHRS staff and providers for their contributions to this plan. As we anxiously await approval from DHCS we are excited about what the future holds for providing the highest quality treatment and recovery supports for those struggling with substance use challenges.

Another Tragic Event

Just within the past few days another mass shooting with multiple people, young and old, killed and injured in a setting that the victims certainly had no reason to be fearful or cautious of. Similar to where other shootings and carnage have taken place. As visible as these tragedies become there are also smaller scale tragedies occurring everyday in this country. And what we know is  there is no place in our country that can declare immunity from a future such incident, as these are occurring in our rural, inner city and suburban areas alike.

Speaking on the shooting in Oregon, President Obama said, “We are not the only country on Earth that has people with mental illnesses or want to do harm to other people. We are the only advanced country on Earth that sees these kinds of mass shootings every few months.”

Focusing our attention on San Mateo County, I would be very interested in receiving your comments on what we can and should be doing to ensure that these types of events, regardless of whether they involve multiple or singular victims, are prevented.

I look forward to hearing from you.

Traveling Around the County

Over the past several weeks I have had the chance to attend some great events sponsored by BHRS and community partners. Each were highly successful as evidenced by the great turnouts and really high energy levels in the room.

On September 2nd, I went to the Central Community Services Area first ever “Day of Partnering”. Because of a prior commitment I arrived about an hour late. Not really knowing what to expect, as I neared the community room at the San Mateo Library the noise grew louder and louder. And when I entered I saw about 100 people engrossed in “speed partnering”, meeting each other and learning about the resources in the area. It was clear that this event “hit the spot”. What was great to see was representatives from organizations that are not typically found in our events such as dental services. The event epitomized one of the key tenets of our CSA model-creating a strong connection between BHRS staff and services with the broader community. Congratulations to Linda Simonsen, Bobbie Cervantes and all the others who planned the event!!

On September 12th I attended the East Palo Alto’s Substance Abuse Prevention Coalition’s annual Community Wide Retreat. As always, the event attracted a wide variety of community members who were there to affirm their community’s strong commitment to health and wellness for all residents. The day was highlighted by three youth from EPA telling their personal stories of how substance use impacted their families and themselves, how connecting to positive peers and strong adult allies has been key to their own wellness and gave some sage advice to the adults in the room on how to connect with they youth in EPA. As with all the various community events in EPA the spirit of hope prevailed. Thanks to Dr. Faye and her staff for all of their hard work in making this a continuous hit!!

This past Friday was the “Speak Up, Save A Life Prevention Forum” at the San Mateo Library. I arrived early and asked staff how many people they were anticipating. Their answers ranged from 30 to 50. Well by the time the program started it was standing room only that had staff scurrying for chairs. Such an affirmation of the importance of the event and recognition of the need to foster and grow the partnership. Kudos to the many staff and partners who were instrumental in making this happen.

And last but not least, this past Saturday was “Sana Sana” in Half Moon Bay. The weather could not have been better to draw so many families out to celebrate their community, receive critical health and behavioral health information, and get connected to health, social services and recreational resources. The focus on health and wellness permeated the event. Congratulation to Ziomara Ochoa, Hector Moncada, Arlette Molina, Regina Moreno and all the others who make this such a spirited and highly successful event!!

I am very fortunate to have the opportunity to attend such events. They each personify some of our key BHRS values, in particular: “Partnerships-We can achieve our mission and progress towards our vision only through mutual and respectful partnerships that enhance our capabilities and build our capacity.”

Empowering Parents and Engaging Educators

Included among our BHRS values are promoting culturally responsive and family centered recovery, and the importance of mutual and respectful partnerships that enhance our capabilities and build our capacity. The implementation of the Parent Project and Youth Mental Health First Aid by the BHRS Office of Diversity and Equity (ODE) personifies these values.

The Parent Project engages parents with a child or adolescent displaying challenging behaviors. Parents receive information on appropriate ways to discipline, preventing or stopping substance use, improving communication skills and improving grades and school attendance. ODE has worked in strong collaboration with the County Office of Education and school districts to make the Parent Project available to parents who are primary Spanish speakers, to Pacific-Islander and African-American communities. The results from the participants as well as their personal testimonies have been, to say the least most impressive.

Since 2013, 439 parents have attended at least one class and 339 or 77% have graduated. 1000 children live in the households of the participants. On all of the measures, including such things as satisfaction with parent/child relationship, spending time with their child, school attendance and behavioral problems, there were very significant improvements. One of the benefits that does not show up in the data is the bonds between the participants that takes hold over the 12 weeks of the class. Many of the participants have taken the initiative to maintain the camaraderie beyond the class.

Youth Mental Health First Aid (YMHFA) is an 8 hour education program which introduces participants to the unique risk factors and warning sign of mental health problems in adolescents, builds understanding of the importance of early intervention, and teaches individuals how to help an adolescent in crisis or experiencing mental health challenges

Since 2013 YMHFA has certified 917 individuals from 94 schools and 20 school districts! On the post-test and 6 month follow up, participants felt significantly more confident in recognizing signs, reaching out, assisting and connecting with a young person. Perhaps even more significant is that at a 6 month follow- up 77% of respondents reported having been in a situation at least once in which they applied what was learned through the YMHFA and 91% believed they were effective in addressing the situation.

The goal for YMHFA is to have a team of staff from every middle and high school campus (public and private) trained.

The San Mateo County Board of Supervisors and County Manager, through Measure A funding has made all of this possible for which we are most grateful

I want to thank Jei Africa for his leadership and Maggie Furrey-Parent Project and Kathy Reyes (YMHFA) and their team for the tremendous work in making all of this possible.

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