Effective PATH Teams State of Missouri

Brooke Dawson, LCSW, Missouri State Contact Rural Anthony Smith, M.S Rehabilitation Admin. Assertive Community Outreach of Mental Health and Substance Abuse Kennett MO, and 32 Counties in Southeast MO. Urban Ron Hendee, LCSW Assertive Community Outreach of TMC BH Since 1988 Kansas City

Parent Organization 32 County Continuum of Care Outpatient Mental Health Clinics Illness Management and Recovery Programs Integrated Co-occurring Disorders Services Integrated Primary Health Care Residential and Outpatient Substance Abuse Treatment Facilities Drug Court, Corrections and Specialized Offender Programs Permanent and Transitional Housing Programs 24 Hours Crisis Intervention Clinical Statistics Annually admit 3,700 clients and handle 153,000 clinic visits annually Handle 1,000 crisis responses annually Provided $115,000 in uncompensated care in 2010 Employ 260 staff forming multiple multidisciplinary teams Offer 76 residential beds, 47 permanent housing slots, 32 transitional housing beds, and 4 sub-acute mental health beds

Parent Organization: Truman Medical Centers Two acute care hospitals Out-patient primary care clinics Comprehensive adult mental health facility including three in-patient psychiatric units 1/3 of community’s uncompensated care provided by TMCs Primary teaching hospital for University of Missouri- Kansas City School of Health Sciences Together these facilities: Admit 17,000 patients and handle over 291,000 outpatient visits annually Treat approximately 81,000 emergency room patients Provided $80 million in uncompensated care at cost in 2007 Deliver one-third of all babies born in Jackson County Employ more than 3,000 full-time employees Offer a combined capacity of 347 beds, 53 inpatient mental health beds and 212 long-term care beds Have 15 on-site language interpreters and provides translation services for approximately 30 different languages

City/County/COC Environment Downtown redevelopment a priority Lack of Municipal investment in homelessness Existing services funded by state or federally funded organizations Continuum of Care received $4.4 million in the last funding cycle 2006 County Commission adopted fair housing policies with a commitment to address homelessness thru community collaboration

City/County/COC Environment Downtown Redevelopment Lack of Government Investment in Homelessness Existing services funded by faith-based, state or federally funded organizations Homeless Services Coalition/Continuum of Care that received more than $8 million in the last funding cycle 2010 City government convened a metropolitan task force with a goal of endorsing a Ten Year plan

Components Outreach – Safe Haven community services, In-patient Unit referrals, Statewide Point-In Time Counts Consumer employment – Peer Support Specialist Treatment (short vs. long term) Health – Rural health clinics, FQHCs, Integrated Primary Care Services Housing – Safe haven, Supportive Permanent Housing, 811, and S+C Vocational and Employment – Vending Services, Janitorial Services, Vehicle Maintenance Services

Components Outreach: Drop-In Center, referrals, Evening Shelter Crisis Consumer employment: receptionists and peer support Treatment (short vs. long term): long-term support through state Medicaid program Health: TMC comprehensive health services, health care for the homeless, and a free health clinic Housing: respite, safe haven, supportive permanent housing, and S+C Vocational & Employment: pre-vocational groups

HUD RESOURCES Below is a listing of our H.U.D. partnerships: Year Awardee # Units/ Relationship 1993 Dept. of Mental Health Users of S + C 1995 Truman Medical Centers 10 beds/ A.C.O. Safe Haven 1999 Swope Health Services Contact of Crisis Services 1999 Heartland Housing 8 units/ A.C.O. is sole referral 2003 Department of Mental Health 21 units/ A.C.O. is project sponsor (S + C) 2004 Restart 19 units/ A.C.O. is sole referral 2005 Housing Authority 14 units/ A.C.O. is project sponsor (S + C) 2006 Housing Authority 14 units/ A.C.O. is one of two project sponsors (S + C) 2007 Department of Mental Heal 13 units/ A.C.O. clients were the intended recipients (S + C) 2008 Truman Medical Centers 4 units of “SRO” type housing attached to the Safe Haven 2008 Dept. of Mental Health 13 units of Shelter Plus Care

Treatment Initiatives - EBPs SOAR Patient Centered Care using CARF model Illness Management and Recovery (IMR) Motivational Interviewing (MI) Wellness Programs Integrated Co-Occurring Disorders Services (CoD)

Treatment Initiatives - EBPs Patient Centered Care IDDT Trauma Informed Services SOAR

Final Thoughts No two PATH programs look just alike Monitoring differences between rural and urban Use of Evidence Based Practices Community Differences Matching Program Practices to Intended Use Plans and Annual Data Reports Questions??