1 The Rural East Texas Health Network

Who we are: Anne Bondesen – Project Director for the Rural East Texas Health Network David Cozadd – Director of Operations for the Burke Center

3 The region we represent: Add map of area

4 The “lay of the land”: 12 Counties 11,000 square miles Population - 370,000 Rural communities – (money & transportation issues)

Our local region, larger than 5 states 5

Challenges

7 Contributing challenges: Funding cuts Limited healthcare resources Rising costs Greater than 20% uninsured System at capacity

8 Shortage of Resources: Medically and Psychiatrically underserved area Health Care Professional Shortage Mental Health Care Professional shortage No other comprehensive providers Lost inpatient beds locally and state-wide No forensic psych beds available

9 Burden placed on Hospitals and Law Enforcement  Long distances to resources Hurricanes Katrina & Rita 20% increase in hospitalizations Psychiatric beds stay full Overflow to hospitals and jails Heavy workload on hospitals & law enforcement departments Frustrated and outraged

Nacogdoches, TX to Louisville, KY = 818 miles An estimated travel time = 13 hours 36 minutes

Nacogdoches, TX to El Paso, TX = 820 miles Estimated Driving Time = 13 hours 48 minutes 11

12 Addressing the Problem

13 The Rural East Texas Health Network  Created in 2006 through a federal HRSA Network Planning Grant  In 2007, received Mental Health Transformation grant through the Texas Health Institute.  In 2008, received HRSA Network Development Grant

14 Purpose of the RETHN:  Line of communication between stakeholders  Line of communication between community and mental health provider  Educate community on issues and needs  Create a united voice working towards common goals  Provide a mechanism for collaborative problems solving

10/2/ RETHN Boards Local Advisory Boards Regional Board of Directors

16 In 2007, our request proposal for funds for a regional Psychiatric Emergency Service Center (PESC) Already organized and poised for action Need already identified 25% financial match received from community Support letters from stakeholders Pledge from Temple Foundation

17 The Results

18 PESC established: Locked Extended Observation Unit: up to 48 hour observation, assessment, and intervention Unlocked Voluntary Residential Unit: up to two weeks stay Staffing?

19 PESC - What we do: Accept people for evaluation 24/7 Staff will screen for appropriateness Do a comprehensive evaluation Telemedicine Begin to work quickly to alleviate symptoms and stabilize Move to a lesser level of care within 48 hours (higher level in limited cases) Work to return people to their homes and community

20 PESC - Who we serve: Persons 18 years of age or older AND Persons coming from any of our 12 counties AND Persons who have a mental illness AND Persons who are in imminent danger of harming themselves or others due to their mental illness

21 PESC - What we are not: We are not a hospital We are not a jail We are not a drunk tank, detox facility or alcohol/drug treatment facility We are not a homeless shelter We are not an Alzheimer or dementia treatment facility

22 PESC implementation: Protocols and Procedures were created Trainings were held across the region Opened on December 8, 2008 Opened in temporary location in Nacogdoches

23

24 New PESC in Lufkin:

Outcomes: Have admitted over 2,000 clients since opening in December 2008 Reduction in time involvement by law enforcement and hospital emergency departments Reduction in costs Reduction in higher utilization of more intensive treatment resources Less intrusive care option for consumers

27  Further progress in staying out of hospital emergency departments  Substance abuse  Continuing adequate funding and resources  Creating a new demand for outpatient treatment  Medication and transportation needs  Forensics Continuing Challenges:

10/2/ Other projects: Telemedicine/conferencing Web-site for RETHN Patient Information Index Mental Health Awareness

QUESTIONS

30 David Cozadd: (936) ; Anne Bondesen: (936) ; Contact Information: