Crisis Residential Best Practices Toolkit December 14, 2016

Welcome Agenda Roll Call Review Content Submissions- Staffing Discussion Review Project Plan and Timeline Adjourn Housekeeping: Using Skype for questions Purpose: To develop a comprehensive Best Practice Toolkit for Crisis Residential Services, informed by Crisis Residential providers across the country.

Anyone else on the call today? Roll Call Jeff Allen Crisis Intervention & Recovery Center (OH) Mark Boschelli Presbyterian Medical Svcs. (NM) Lori Carnahan DuPage Co. Health Dept. (IL) Char Cobb Hope Network (MI) Susan Cromwell Mosaic Comm. Svcs. (MD) Carol DiGiuseppe Hegira (MI) Myranda Green Hope Network (MI) Andrea Kocsis Human Dev. Svcs. Of Westchester (NY) Dan Maccia Comm. Research Foundation (CA) Shelley Mohang Waubonsie Mental Health Center (IA) Sara Lupkes Polk County Health Svcs.(IA) Mallory Tanis Hope Network (MI) JoAnn Toney MHC of Denver (CO) Dana Townsend Pathways Behavioral Health (TN) Amy Warren Bert Nash CMHC (KS) Jaime Webster Community Research Center (CO) Anyone else on the call today?

Content Submissions: Staffing Staff Make-up and Staffing Patterns Defining staff roles Challenges to maintaining a strong and healthy crisis home workforce Keeping employees engaged and expressing appreciation Initial and Ongoing Training Internships Balanced focus on operations and experience. Crowdsourcing knowledge & resources. While this project will focus on Crisis Residential services for adults, adolescent providers are welcome to participate as there may be many parallels between the programs. Providers of other crisis services, such as 23-hour crisis stabilization, peer respite, psychiatric emergency services, and others, are welcome to engage or participate, but should have a basic knowledge of the function and structure of Crisis Residential services so as to provide meaningful and contextual contributions.

Staffing Results: Staff Composition 56% (10/18) reported having a Nurse Practitioner Use of telemedicine? 39% (7/18) reported having Peer Support Specialists Direct care staff work 8-12 hour shifts

Staffing Results: Biggest Challenges Staff retention Competitive wages Advancement opportunities Increased acuity Stressful work environment/ Demanding work/Managing burnout Recruiting qualified staff with an interest/passion for crisis services Poor funding Maintaining staff health Working schedule prohibits all-staff activities Keeping PT/PRN staff up to date

Staffing Results: Employee Engagement & Appreciation Planning monthly activities Potlucks Appreciation notes/cards HR-facilitated challenges Flexible scheduling Surprise parties for each shift Regular supervision Monthly/Yearly Awards

Staffing Results: Direct Care Workforce “We tend to attract new grads who are willing to work off- shifts who need experience. Once they have experience, and due to the nature of crisis work (burn-out, or staff finding it is not for them), we lose staff at a somewhat higher rate in this program than other programs.” “Limited financial resources often results in not being able to hire or continue to employ some of the more skilled professionals.” “Insufficient funds often results in too few staff members with too many responsibilities. Excessive demands on staff can lead to higher rates of absenteeism, burnout, negativism, etc. When staff is overburdened certain tasks may be done at a minimal level or not at all.” http://phinational.org/sites/phinational.org/files/policy/wp-content/uploads/2011-PHIMI-Briefing-Paper.pdf

Staffing Results: Interns 83% (15/18) utilize interns Fields: Psychology (BA,MA, PsyD), Social Work (BSW, MSW), Counseling, Nursing, Marriage & Family Therapy) Many add significant value to the CR teams Exceptional interns are recruited for positions within the organization

Project Participation: Update Meeting participation: Monthly phone calls geared towards specific crisis topics to be included in the toolkit, engage in dialogue with providers from other areas to understand nuances in state policy and provider practice while building consensus for best practices. Content submission: Each month, all participants will be polled about their crisis home’s policies, procedures, and practices, which will be used to inform the toolkit Content/editorial review: With 40+ crisis homes participating (and 250+ homes across the country), the amount of input for each topic could be staggering. Assist in the review and refinement of input into best practice language. Initial content reviews will now be completed by the planning team. State policy research: Seek out crisis residential statutes in your state, as well as other governing bodies (e.g. Adult Foster Care, Recipient Rights) We recognize that engagement can be difficult, especially for those working in positions directly supporting the crisis homes.

Questions? Comments?

Next Steps Next Conference Call: Wednesday, January 18th @ 2pm EST/11am PST Group Listserv: CrisisResidentialNetwork@TBDSolutions.com Website: www.CrisisResidentialNetwork.com Questions: TravisA@TBDSolutions.com