Crisis Residential Best Practices Toolkit May 19, 2017

Today’s Agenda Welcome Crisis Program Spotlist: Lighthouse- Colorado Springs, CO Content Overview: Intake Review Survey Results/Discussion Review Project Plan and Timeline Adjourn Housekeeping: Using Skype for questions—please mute us, but don’t put our call on hold Purpose: To develop a comprehensive Best Practice Toolkit for Crisis Residential Services, informed by Crisis Residential providers across the country.

www.TBDSolutions.com Crisis Program Development Quality Improvement Research & Analysis Integrated Care Coordination Data Analytics System Redesign Middle Management Training Metrics Development www.TBDSolutions.com

Workgroup Participants 110 participants from 30 states Plus England and Costa Rica Approximately 300 crisis homes exist nationwide Welcome new participants from UT, NY, NC, MT, TX, and VT

Crisis Program Spotlight: Apsen Pointe (CO) Legislative efforts in California and Colorado have brought about significant improvements and funding in the Crisis Services Continuum.

AspenPointe Barbara Kleve – Project Manager

Key Objectives – SB 13-266 Increase access to crisis services 24/7 “No Wrong Door” Open to all ages Services provided regardless of income or ability to pay Services provided regardless of residence presentation driven vs. diagnosis driven care Right Services, Right Location, and Right Time Expansion of Continuum of Care (Mobile response, Walk In, CSU, Respite) Mobile Assessment and Walk-In accessibility Person-Centered, Culturally Relevant, and Trauma- Informed Care Reduce ED burden for psychiatric emergencies Reduce Unnecessary Law Enforcement and First Responder transports

What does access to crisis services mean?

Rocky mountain crisis partners 1-844-493-8255 (TALK) or Text “Talk” to 38255 Crisis Line / Text Support Line Immediate crisis support and in the moment consultation Telephonic assessment for wide scope of mental health and substance use issues Suicide/safety assessments, substance use screenings Triage to other components of the Colorado Crisis Services Referral and resource linkage 3rd party consultation (friends, family, other professionals) Telephonic case management, continuity of care activities Follow up calls 9a – 11p 7 days a week Peer Specialists with lived experience with behavioral health challenges = Power of shared experience Provide in the moment or ongoing support Promote recovery and wellness Triage to Crisis Line as appropriate Follow up calls Referral and resource linkage

How does AspenPointe fit into Colorado Crisis Services?

AspenPointe – Southern Region Referral Based Services Mobile Unit Response Access to Services Available 24/7/365 Crisis Residential Respite 1) Alano House 2) Special Kids Special Families 3) El Pueblo Kids 4) Grand House HOTLINE / WARMLINE 1-844-493-TALK (8255) A program of Rocky Mountain Crisis Partners Crisis Walk-In Centers 1) 115 S. Parkside Dr. Colorado Springs, CO 2) 1310 Chinook Ln Pueblo, CO Crisis Stabilization Units 1) 115 S. Parkside Dr. Colorado Springs, CO 2) 1302 Chinook Ln Pueblo, CO

What are Walk In Crisis Services? No appointment necessary Services available regardless of the ability to pay Services available regardless of residency Staffed with licensed clinical providers through peer specialists If needed coordination of care with Detox ATU & Inpatient levels of care Emergency Department for Medical Services

What is mobile response or CRT? Collaboration between CSFD, CSPD, & AspenPointe. 2 units of 3 people – 1 officer, 1 medical professional from CSFD, & 1 licensed clinician. Response within Colorado Springs City Limits 7 days a week 10am – 7pm Outside of these times & the surrounding areas of El Paso County, a crisis clinician will be dispatched. Rural Crisis – Park & Teller counties each have a crisis clinician who will respond to crisis calls, outside of these hours a clinician is dispatched from El Paso County.

Questions??

Content Review: Intake December 2016: Staffing January 2017: Scope & Function February: Metrics & Outcomes March: Taxonomy & Community Relations April: Treatment Philosophy & Approach May: Intake

Intake Results: Staff Responsible Other Intake Staff Psychiatrists/Medical Director Nurse Practitioners (2) Therapist Everyone (2) Program Director Licensed MH Professional Program Coordinators

Intake Results: Referral Sources

Intake Results: Documentation “Moving to electronic soon” “Referrals are recorded in E.H.R.; paper is a checklist of items to review with clients at admission.” “Disclosure, consent, rules, bag check, etc. are done on paper; the rest is done electronically.” “Initial intake is completed on paper and scanned.”

Intake Results Results: Efficiency “We track length of time from referral to screening, length of time to complete screening, and length of time to complete admission.” “From referral to admission completion takes about 2 hours. It must be completed within 24 hours of admit, especially if someone comes in the middle of the night.”

Intake Results: Admission Time “Full beds and high numbers of referrals make this difficult to decipher information from.” “Within an hour for nearby counties, and within 90 minutes for outer counties.”

Treatment Philosophy & Approach Results: Models of Care Included in a handbook Selected house rules are reviewed in morning group

Intake Results: Waiting List Do electronic bed boards exist in your state for psychiatric hospital beds or crisis stabilization beds? If so, how do they function?

Intake Results: Care Coordination How does your crisis program work with referral sources to ensure strong coordination of care during the intake process? Outpatient therapist initiates phone screen with program manager Nurse-to-nurse/ Doc-to-Doc/ Clinician-to-clinician communication Coordination of Care discussion at intake and a 72-hour post-admission coordination of care meeting (PA) Shared access to medical records with hospitals (TX) “We require 3 case collaborations within 24 hours.” “Staff are trained to ask probing questions and request specific documentation.”

Intake Results: Admission Items & Planning for Discharge

What do you think? Ideas for future topics Feedback on Workgroup Client Outreach- Satisfaction, follow-up, alumni relations State policy for Crisis Services—Provider Manual, governing specs, compliance requirements Peer Supports Role of Volunteers & Interns Technology in Treatment Feedback on Workgroup Artwork/Graphic Design for website Email Travis at travisa@tbdsolutions.com

Upcoming Webinar Training: SAMHSA 4th Monday of each month April-September Monday May 22nd 3pm EST/12pm PST https://tinyurl.com/mezytde

Next Steps Next Conference Calls: Wednesday, June 21st @ 2pm EST/11am PST Friday, July 21st @ 1pm EST/10am PST Group Listserv: CrisisResidentialNetwork@TBDSolutions.com Website: www.CrisisResidentialNetwork.com (Meeting Slides stored here) Questions: TravisA@TBDSolutions.com