Response provided by Lonzo Anderson, Assistant City Manager:
QUESTION 1: What are the comprehensive "local restoration" services that are available? Are these services for people incarcerated in the county jail and/or TDCJ? Are the prior to release or following?
The San Marcos Police Department (SMPD) collaborates with community members in need, aiming to provide support and diversion before any potential incarceration. Our primary goal is not to incarcerate individuals. We have established connections with community members who are not involved in the criminal justice system but could benefit from the Behavioral Advisory Team (BAT). This program is also inclusive of those who are post-incarceration.
Our focus is to address the needs of our community, particularly among indigent members. Our partners in this initiative include:
- Cenikor Prevention - San Marcos: offering groups, education, community events, case management, and medication-assisted treatment
- Evoke Wellness
- Outsiders Anonymous
- Texas Integrated Community Opioid Network (Icon)
- Alcoholics Anonymous (AA) meetings
- Celebrate Recovery
- San Marcos Mental Health Clinic (formerly known as the Schieb Center)
Together, we aim to enhance the well-being of our community members.
The team also is in possession of a Hays County resource guide that is penned with substance use services in this area.
SMPD is asking about services provided in jail, a response is pending.
PG. 357 - RE: SCOPE OF SERVICES
QUESTION 2: How many clinicians will be available at any given time to perform these evaluations? On average, following admission, how soon after are these evaluations conducted?
From Monday to Friday, Evoke has at least four clinicians and a Clinical Director available at all times. On weekends, there are two clinicians on duty each day. Pre-screenings are conducted before admission and usually take between 20 to 30 minutes. BioPsychSocial assessments are completed within 72 hours of admission.
QUESTION 3: What are some examples of what takes place during the bio-psychosocial assessment?
Biography: This section covers who the person is, their background, where they currently live, and details about their family composition.
Psychology: This section includes the individual's mental health history, any history of intellectual and developmental disabilities (IDD), psychiatric hospitalizations, and medications they have taken as both a child and an adult for mental or behavioral health issues.
Social: This section describes the person's interests and activities, who they live with, their friends, and their employment.
Spiritual: Some assessments may also include a spiritual component, which covers the person's religion or past religious beliefs, whether they attend a church, and their faith beliefs.
QUESTION 4: In practice, when the right to refuse has been invoked, what are some instances that may lead to this occurrence?
PG. 358 - RE: ITEM 10
The SMPD MHU refers patients voluntarily; they are not required to attend. Patients are treated with consent and can withdraw that consent at any time.
Evoke’s Clinicians reserve the right to refuse clinical services after a clinical assessment if the clinician, in their professional judgment, #1. feels that the client would not benefit from clinical services, #2. does not meet criteria, or #3. does not currently have the capacity for progress in an individual therapeutic setting due to cognitive functioning and limitations and/or medical needs that are beyond.
QUESTION 5: Who conducts the Financial Assessment and how is that process conducted in practice?
The SMPD does not perform a financial assessment during a crisis evaluation. Generally, if an individual in crisis has insurance, they will be billed for services. If the individual does not have insurance, they may still receive a bill, but the state might cover the costs for their crisis services. For those without insurance or any means of payment, a referral to apply for a scholarship will be provided.
Evoke is both a private-pay and insurance-based company. Most clients qualify for insurance coverage as we are in-network with all major carriers. If clients are unable to pay their deductible or out-of-pocket costs, this is managed through a promissory note signed during the first week of treatment. A payment plan will be established, starting after the treatment is completed.
QUESTION 6: Exhibit 1 still shows "The purpose of this contract is to establish a collaborative contractual relationship for providing substance use services and treatment for adults participating in the City of San Marcos Mental Health Court Program hereby referred to as “MHC"."
The City does not have a "Mental Health Court Program" - the county does.
QUESTION 7: And the funding is still a bit of a mystery. It looks like ARPA funding for $99,000. What is the source of funds of the additional $51,000? ARPA? When was this decision made?
ARPA is the sole source of all of the funding. City Council discussed prioritizing funding toward Mental Health Diversion and Support at their Visioning Session in January 2024. City Council reallocated American Rescue Plan Act funding toward this on April 16, 2024.
QUESTION 8: And what are we getting for the additional $51,000? ARF states "provide greater outreach to the San Marcos community" - what does this mean?
The greater outreach is through availability of funds so that more clients can potentially receive a scholarship.
QUESTION 9: Does this extend the time of the contract?
All ARPA funds must be expended by December 31, 2026.
QUESTION 10: What does the process look like following program completion or departure? How does the reentry process look for different lengths or types of stays?
The discharge process is different for everyone as each person has specific needs but Evoke supports a full continuum of care and encourages all clients to participate in the step-down process through DTX, RTC, PHP and IOP to achieve the best opportunity to be successful in their sobriety. Currently Evoke offers Detox, Residential and Intensive Outpatient services. Evoke has not had a lot of traction with PHP as the county is limited in sober living homes for the clients to live at while doing PHP. If a client is administratively discharged due to continued violation on behavior contracts and repeated offenses the clinical director will work with the client and their treatment team to ensure appropriate placement and encourages the client to accept the opportunity to transfer to another treatment program. If the client refuses a transfer the team will work with the client and/or family for the next steps on appropriate placement and safe place to return to.
