The holiday season is a time for looking toward the future and appreciating the gifts the prior year has offered to us. This year has been a difficult one for many who lost their homes in the wildfires that devastated our state, or lost loved ones due to accidental injury, illness, substance abuse or mental health conditions. As we celebrate the New Year, I encourage you to remember those who will need additional support by offering a bit more patience, a kind gesture or a helping hand.

In the past couple months I’ve been visiting our BHRS clinics and service locations, and meeting with teams and program leaders. I’ve been consistently impressed by our staff’s dedication to our clients’ welfare and commitment to providing excellent service. I’ve seen the same values reflected when meeting with our community based service partners and sister county agencies. San Mateo County is blessed to have a healthcare system that is strongly supported by its providers, leadership and community stakeholders.   

Sexual Orientation and Gender Identity (SOGI) Federal Requirement

Starting in January, 2018, BHRS will be including questions regarding sexual orientation, gender identification and gender status in our routine client information forms, including at the time of intake/admission for services. These questions, along with the existing items to self-identify a client’s race, ethnicity and language are essential to ensure we are providing appropriate services and gathering data to determine special health needs.      

This update to our client data gathering procedure arises from the Presidential Executive Order 11246, which became effective in April, 2015. Since that date, it has been illegal to discriminate in employment decisions or access to healthcare based on one’s sexual orientation and gender identity. Our new client information processes will not affect any of our existing HIPAA and confidentiality policies which protect all health information except when permission is granted to share this information, or in the case of a medical emergency when specific information is needed for appropriate intervention.   

Youth Marijuana Prevention Education

January 2018 will also initiate legal recreational marijuana use in California. This landmark change is supported by 64% of Americans, cutting across all political parties and all age groups under 65. In 2016, 63% of San Mateo County residents voted to support legalization. Marijuana use has clearly gained greater acceptance in our society. The decriminalization of marijuana is a significant step forward from a social justice perspective, however questions and concerns remain with regard to public health. As with tobacco and alcohol consumption, legalizing a substance does not mean it has no harmful health consequences, especially with excessive use and/or when used by persons at-risk of developing certain health, mental health and/or substance use disorders. Research is needed to continue studying the health effects of cannabis and its various compounds, both for medicinal benefits as well as adverse effects on the brain.

There is sufficient evidence to argue that marijuana use is not healthy for young people up to the age of 25. This is because there are key areas of the brain still in development, specifically related to memory and learning, decision making and planning, and emotional regulation. Also, a combination of these effects and genetic factors may lead to a higher risk of mental health disorders, including depression and psychosis. The negative impact of early marijuana use by youth does not appear to dissipate in adulthood.

This year BHRS will be partnering with other county agencies in public health, education and beyond to develop a youth prevention education program regarding marijuana use.

Health Information Exchange – “SMC Connected Care”

Finally, in the next few months, the San Mateo Health County System will begin implementing a health information exchange system. This is an important first step toward enabling better communication and coordination of care among health system providers. All confidentiality, privacy and safety measures under HIPAA are intact within SMC Connected Care. Participation in the health information exchange is entirely voluntary. Please carefully review this article and discuss any questions or concerns with your clinician or members of our management team.      

Wishing you peace and wellness in the New Year!