Challenges Identified: When the Community Problem Solvers first heard about the mental health transportation crisis facing Ellis County, it tugged at our heartstrings and immediately grabbed our interest. We recognized the project was good, but it is an uncomfortable subject. After finding that all of our other project ideas were unattainable due to the resources available to us, we requested that Mackie Owens, at the Hope Clinic, return to explain more about the problem, and what was being asked of us. Every month, an average of 400 Ellis County citizens require mental health assistance. Many seeking help are indigent, on Medicaid or lacking insurance. There is not a system in place to transport these individuals to the proper place to receive the care they need. Many are ignored by the system or mistakenly arrested for misdemeanors, because officers are not properly trained. Underlying Problem: Our team has realized from interviewing many community leaders that there is a desperate need for a transportation system dedicated to helping mental health patients in Ellis County. Furthermore, the peace officers in Ellis County should have mental health training. Therefore, we feel it necessary to create a system of transportation dedicated to transporting mental health patients in need, and training peace officers on identifying a mentally ill citizen. In a county where underprivileged mental health patients lack a means of obtaining medical assistance, how might we, the members of Project P.A.T.H., create a sustainable, reliable system for the transportation of mental health patients in Ellis County? The Plan: Our project this year is complex and time consuming. This will be the first planned county system specializing in transporting mental health patients in the State of Texas. This year our team found itself on a whole new frontier. At first we were overwhelmed by the intricate project we had chosen, but were motivated by our desire to make the lives of mental health patients better. Research statistics related to Ellis County population and mental health: • Total population of County (140,226) NCTCOG • Population of each city and parts of cities in the County • Number of patients serviced by NTBHA on a monthly basis county- wide by zip code • Compensation schedule of County peace officers • Mileage rate (.52/mile) • Training cost • Number of Sheriff Department transports for 2007 • Number of Midlothian Police Department transports for 2007 • Number of Waxahachie Police Department transports in 2007 Receive approval for system from city/county officials in Ellis County: • Presented at mental health town hall meeting and invited officials from all city governments • Presented to Ellis County Commissioners Court on December 21, 2007 • Met with Constable Terry Nay for input January 7, 2008 • Met with County Attorney Ann Montgomery for legal assistance January 9, 2008 • Met with Commissioner Sims January 15, 2008 • Met with Commissioners Sims and Brown February 5 • Submit documents and plan revision to Commissioners Court for consideration during February 11, 2008 meeting Hire drivers with background in law enforcement and/or mental illness: • Met with Constable Nay and Deputy Elliot. Deputy Elliott has already completed the 40-hour training and is a certified mental health officer. Deputy Elliott is interested in becoming a transport officer for Ellis County, but he is a reserve officer who does not receive a salary. • Emailed all constables asking if they are interested in providing the second officer for initial suggestions. No other constables provided input. • Constable Nay offered a second deputy as a mental health transport officer. He suggested this would allow one Ellis County office to maintain accurate, safe record keeping for future data analysis. • Attorney Ann Montgomery and Constable Fry suggested that 2 officers should provide transport, especially in the case of a female patient or child. Statute 574.045d states that a female patient must have a female attendant, or a brother, husband, or father must accompany her. It may be necessary to hire a female deputy constable for this purpose. Train constables to become mental health officers: • Deputy Elliott in Constable Nay’s office is already trained • Working with Vivian Lawrence of NTBHA- the biggest expense of the County will be the salary of the officer sent to the 40-hour training. Ms. Lawrence will provide a Train the Trainer Crisis Intervention Team course to one County officer. That officer will be certified to train all other County officers. Ms. Lawrence stated that she could insure that our officer will be trained at no cost to the County; in other words, they will not charge the County for the actual course. • We recommend that the Commissioner’s Court mandate that all County officers receive this training. Acquire vehicle to use for system, through purchase or donation: • Attorney Ann Montgomery instructed CmPS on appropriate donation issues. When the Commissioners Court approves the program, CmPS will write grants and/or seek donation from local automobile businesses. • Confirmed with Constable Nay and Deputy Elliott the type of vehicle should be a mini- van equipped with a partition (not a cage), and possibly two bench seats for transporting a family member. • Health and Safety Code 574.045 (e) states, “The patient may not be transported in a marked police or sheriff’s car or accompanied by a uniformed officer unless other means are not available.” Therefore, CmPS suggests that a small, existing County logo be used, or possibly a Project P.A.T.H. logo corresponding with a county logo. Funding and inter- local agreements between county and cities: • Attorney Ann Montgomery provided sample Inter-local Agreement to CmPS. CmPS revised agreement and received approval from Ms. Montgomery via e-mail. • The original Plan A or “Insurance” plan has been tabled by CmPS due to lack of accurate data from local police departments. • Plan B or “Pay as Needed” has been finalized. CmPS suggests that the County collect funds for transports from cities when the initial contact is made by local police departments or other methods of admitting have been done through city channels. All other transports that are the responsibility of the County will be at the County’s expense. • Plan B inter-local agreement combines the rate of one and two officers. If a second transport officer is needed it would cost $40/ hour between 8:00 A.M. and 5:00 P.M. Or, $60/ hour for all other hours. CmPS suggests that the County charge $30/ hour during normal business hours and $45/ hour all other hours. This will account for transports that will sometimes require two officers. This creates a standard rate. Mileage will be charged at $.52/ mile based on chart created by CmPS. • After approval from Commissioners Court, CmPS will visit each city to explain the program and ask for inter-local agreements using data collected. • If cities do not sign an inter-local agreement, the County will not be responsible for transporting patients unless a county official initiates the process. Our accomplishments have ranged from getting a mayor to pick up his phone, to implementing a system of transportation in a county with a population of 140, 266. When we first selected our project, we were not sure where to start, but now we have an entire calendar full of meetings and deadlines. One of the first things we accomplished was gaining support from the MISD School Board. All members felt the task may be unmanageable, but provided full support nonetheless. The next accomplishment was gaining support from the mental health community at our first town hall meeting. We created awareness about our project and the problem solving program. We also saw some of the faces of those we would help. They learned that someone actually cared, and was willing to help. The next stepping-stone was gathering data in order to create a plan to fund our system. Our next big accomplishment was creating an inter- local agreement with the assistance of our county attorney. We learned that lawyers play a huge role in government affairs. Thus, a blessing from her was an accomplishment of great magnitude. We also created and submitted a plan of action, proposal, and a budget to the Commissioners Court. The presentation committee gained an hour and fifteen minute workshop with the Commissioners Court. During this meeting the commissioners were not allowed to converse with each other, but spent the time questioning the project members. They answered seventeen problems that ranged fro the explanation of the problem, to discussing budgeting and liability for the County. Several elected officials were in attendance, including a Justice of the Peace and a constable. At 10:00 A.M., the regular meeting convened. Additional elected county officials arrived to hear the decision, including two Justices of the Peace, two constables, and representatives from the sheriff’s department. Mackie Owens also attended to show her support. The Commissioners Court gave us approval to implement Project P.A.T.H. On February 11, 2008, Administrative Agenda Item 3.3, for the approval of the issue of Mental Health Patient transport for Ellis County and possibly the cities inside Ellis County, was accepted and approved by the Commissioners Court by unanimous decision. This allows us to approach cities for future funding, and allows us to begin the process of attaining a vehicle.