Behavioral Health Department Radiant Scoggins, LCSW

Program Structure/Resources pre 2008 Psychiatric Nurse 1 Psychiatric Consultant (4hours per month) No outside Psychiatric Services; several inpatient Hospitalizations No Trained Behavioral Health Teams No Intake Process to evaluate appropriateness of new enrollees with Behavioral Health needs.

Program Structure (transition period) Dr. Alicia English founded CEI’s Behavioral Health Department Extensive training with teams to manage psychiatric emergencies Behavioral Health Team to include Psychiatric Social Workers Created assessment process for potential enrollees Contract with Specialists in the community Substance Abuse treatment IOP (intensive outpatient program)

Current Structure/Resources Behavioral health team : 1 Psychiatric Social Worker at each site Behavioral Health manager Consulting Psychiatrist (20 hours per week) – float to cover each site Psychology interns from the Wright Institute - 2 interns per site (8 total) ** Contracted Specialist including IOP, In-patient Substance Abuse Treatment, Psychotherapist (language specific)

Goals Increase network of contracted service providers specifically broaden language capacity. Expand training to extend to contracted care providers Residential Care Facilities and Skilled Nursing Facility staff.

Resources/tools Annual Cognitive screen – MOCA, SLUMS Bi-Annual Depression screening – Geriatric Depression Screen (GDS) Behavior Contract Substance Use Treatment Protocol Psychological Evaluation (assessment tool for enrollment)

Current Census 710 Participants 294 (41%) have a psychiatric diagnosis 230 (32%) have dementia 214 (30%) have a single diagnosis 57 (0.08%) have dementia only

CEI Participant’s are Diverse

Referrals Referral Mechanisms Internal referrals for consulting Psychiatrist created by the Provider Referrals for Outside Psychotherapy services facilitated by Psychiatric Social Worker On Site psychotherapy offered by Psychiatric Social Worker and Psychology Interns. Referrals made by ALL disciplines Referrals

Benefits of Behavioral Health Program “As our population gets older, behavioral issues are more prominent. Having a Behavioral Health specialist not only benefits the participant but the staff who can be trained on how to better serve a participant with behavioral issues”, CEI Nurse Practitioner Increased participant stabilization with intensive case management services. Decreased In-patient psychiatric hospitalizations Increased staff awareness and training on behavior management interventions

Survey on Behavioral Health Department

Psychiatric Hospitalizations

Participant’s in the Hospital

Advice in Developing a BH Program Incorporate regular on-going behavioral health training for all staff Communication between Provider and Behavioral Health Social Worker is essential

Advice “Continued” Determine specific needs of your population and provide training based on need i.e substance use, cognitive impairment, etc. Standardize caseload for Psychiatric Social Workers to reflect smaller load for intensive case management obligations.

Questions/Discussion: Email: Rscoggins@cei.elders.org Phone: 510-318-7528