Crisis Best Practices Workgroup August 23, 2017

Today’s Agenda Welcome Content Overview: Governance & Regulations 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.

Crisis Best Practices Workgroup TBD Solutions is proud to sponsor the Crisis Best Practices Workgroup. Crisis Program Development Quality & Process Improvement Metrics Development Integrated Care Coordination Middle Management Training Research & Analysis Interactive Data Visualization Software Procurement Consulting www.TBDSolutions.com

Crisis Services Map

Workgroup Participants 98 Crisis Residential Providers 10 Crisis Providers, Psych Hospitals, or Peer Respites 4 State Behavioral Health Administrations Represented (TX, VA, WA, WI) 41 states Plus England and Costa Rica Approximately 375 crisis homes exist nationwide Welcome new participants from NE, MA, SC, TX

Content Review: Regulations & Governance December 2016: Staffing January 2017: Scope & Function February: Metrics & Outcomes March: Taxonomy & Community Relations April: Treatment Philosophy & Approach May: Intake June: Funding July: The Safety Net August: Regulations & Governance

Regulations & Governance Standards & Guidelines Maintaining Order Compliance vs. Quality Doing the Things vs. How you do the Things

Challenges with Regulations & Governance Continuous and Prescriptive Oversight Reactionary Policy Changes Power and Expertise Differentials Compliance vs. Quality

Regulations & Governance Survey Results: Rules & Guidelines

Regulations & Governance Survey Results: Crisis Contracts “In Costa Rica we are running the first Community Mental Health Center. The Secretary of Mental Health is supporting our efforts. The University supports our basic expenses.” n=21

Regulations & Governance Survey Results: Audits Internal Audits Community Care Licensing Local Behavioral Health Authority State Department of Health Care Services n=21

Regulations & Governance Survey Results: Accreditation Additions: Council on Accreditation (COA) (2 respondents) n=21

Regulations & Governance Survey Results Audit Discrepancies “The state recommends a “hard” lock on the facility, yet our local fire department will not approve that. So we have had to apply for special waivers from the state to have a 30-second egress lock.” “State auditors tend to focus on their area of expertise. CARF surveyors are wildly unpredictable to the point that it is sometimes difficult to recognize the standards at all.” n=21

Safety Net Survey Results: Contract Requirements

Regulations & Governance Survey Results: Performance Standards & Consequences “Plans of Correction” “We have always exceeded performance standards but I assume there would be a funding reduction.” n=21

Safety Net Survey Results: Maintaining Program Integrity d

Regulation & Governance Survey Results “Increased revenue” “Continued funding”

Regulations & Governance Survey Results: Performance Standards & Consequences “Annually” “We were just re-procured by the County for the first time in 37 years. We will now be on a five year re-procurement scheduled like all other county contracts. The VA also re-procured our contract this year for the first time.” n=21

Survey Participation

Survey Participation & Incentives Average participation is 25% of Crisis Residential Providers Crisis Residential Providers who complete 80% of surveys or more will have early access to Best Practices Toolkit Participants who contribute through substantial survey completion will also be recognized as contributors in the Toolkit

Survey Participation & Incentives Missing surveys will be sent to you by 9/30/17 Please complete missing surveys within 30 days of receiving request Email Claudia at claudiav@tbdsolutions.com with any questions

SAMHSA Webinar Series(es) 4th Monday of each month April-September Communities Addressing Trauma and Strife through Trauma-Informed Approaches 1-2:30pm ET/11am-12:30pm PT https://tinyurl.com/y9wpvu6a Trauma-Informed Innovations in Crisis Services 3-4pm ET/12-1pm PT https://tinyurl.com/mezytde

Next Steps Next Conference Calls: Friday, September 15th @ 1pm EDT/10am PDT (Topic TBA) Wednesday, October 25th @ 2pm EDT/11am PDT Group Listserv: CrisisResidentialNetwork@TBDSolutions.com Website: www.CrisisResidentialNetwork.com (Meeting Slides stored here) Questions: TravisA@TBDSolutions.com