1. Crisis Residential Best Practices Toolkit
November 17, 2016

2. Welcome Agenda Review Purpose Roll Call Project and Survey Responses
Determine Contents of Best Practices Toolkit
Review Project Plan and Timeline
Adjourn
Housekeeping: Using Skype for questions

3. Why We’re Here
Create a resource for Crisis Residential providers promoting best practices and shared experiences with operating crisis homes
Establish a community of providers for support, empathy, and encouragement
Advocacy for Crisis Residential Services
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.
Scope: Crisis Residential Services in the USA (and neighboring countries). These services go by many different names (Crisis Residential Unit, Crisis Stabilization Unit, Crisis Respite, etc.), but refer to a short-term, community-based, homelike setting with multi-day lengths of stay, often serving as a stepdown from, or alternative to, psychiatric hospitalization.

4. Toolkit Participants Access Services (IA)
Firelands Counseling & Recovery Services (OH)
Polk County Health Services (IA)
Access: Supports for Living (NY)
Frontier Health (TN)
Presbyterian Medical Services New Mexico (NM)
American Association for Emergency Psychiatry
Hegira Programs (MI)
Region 4 MHS (MS)
Arizona State Hospital (AZ)
Hope Network (MI)
Region 6 Life Help (MS)
Bert Nash Community Mental Health Center (KS)
Human Development Services of Westchester (NY)
RI International (AZ)
Burke (TX)
Kitsap Mental Health Services (WA)
River Edge Behavioral Health Center (GA)
Candeo (IA)
Maine Behavioral Healthcare (ME)
Riverbend Community Mental Health (NH)
The Center for Health Care Services (TX)
Mental Health Center of Denver (CO)
Rosecrance Ware Center (IL)
Mental Health Cooperative (TN)
START Programs (CA)
COMCARE of Sedwick County (KS)
MHMR Tarrant (TX)
The Harris Center for Mental Health and IDD (TX)
Common Ground (MI)
Mosaic Community Services (MD)
The Progress Foundation (CA)
Community Reach Center (CO)
Netcare Corporation (OH)
Turning Point (IA)
Crisis Intervention & Recovery Center, Inc. (OH)
Network180 (MI)
Universidad Latina de Costa Rica
Crisis Response Center and Connections AZ (AZ)
New Alternatives (CA)
Wisconsin Department of Health Services (WI)
Downtown Emergency Services Center (WA)
New River Valley Community Services (VA)
Dupage County Health Department (IL)
Pathways Behavioral Health (TN)
Easter Seals of Iowa (IA)
PEOPLe, Inc. (NY)
Any programs that are not represented on this list?

5. Group Make-up
50 participants
20 states
+Costa Rica

6. Group Make-up Client owned homes (HCBS funded) Observation Beds
Mobile Crisis and Inpatient Services as well
16 bed withdrawal management
IDD/MH high acuity, challenging behaviors, autism
Participation is open to any interested parties—potential providers, complementary providers

7. CR Best Practices Toolkit: Topics

8. CR Best Practices Toolkit: Topics
Crisis Residential Toolkit: Potential Topics
Staffing: Defined Roles/ Size/ Staffing Patterns/ Interns
92.9%
Treatment: Programming/ Group Therapy/ Peer engagement
Defining & Distinguishing Crisis Residential Services
89.3%
Philosophy of Care
Treatment Environment & Milieu
85.7%
Discharge
Intake
78.6%
Metrics/Outcomes: Measuring Success
Training: Initial & Ongoing
75.0%
Peer Supports
71.4%
Holistic Care: Co-occurring Conditions/ Integrated Care
67.9%
Community Relations: Social Media Presence/ Marketing/ PR
Care Coordination (Internal/External): MDT/ Engaging Providers
64.3%
Client Outreach: Engagement Post-Discharge
Physical Environment
60.7%
Challenges and Barriers: Utilization/ Reputation/ Funding
Technology in Treatment: EMRs/ Data Sharing
42.9%
Additional Ideas:
Style of Treatment (Medical vs. Social model)
Payment methods and sustainability
Understanding suicide screening and managing non-suicidal self-injury; Intervention protocols
Vetting of programs

9. Project Participation
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.
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.

10. Project Plan: Structure
Conference Calls
3rd Wednesday of the month beginning in December
Information Requests
Sent by the 1st Wednesday of each month
Submissions will be compiled and then reviewed during the conference call that month
Participants send responses back within 10 days
Reviewers consolidate responses
Group reviews responses in conference call
Responses are edited and finalized
Topic questions sent to group
Participants send responses back within 10 days
Reviewers consolidate responses
Group reviews responses in conference call
Responses are edited and finalized
Topic questions sent to group

11. Project Plan & Timeline
Content Example
Home Environment (Dec. 2016)
Safety
Trauma-Informed
Mental, Spiritual, and Emotional Considerations
Milieu Structure
Approximately 15 topics
1-2 topics/month = 9-12 months to complete
Projected Completion: December 2017
Finished product will be an electronic document available publicly
Reached out to SAMHSA

12. Project Plan: Contributors
Meeting Facilitation: Travis Atkinson / Lyndsay McGarry Meeting Minutes: Mallory Tanis / Lyndsay McGarry Content Inquiries: Myranda Green / Charlene Cobb Monthly Conference Calls: 25 Content submission of policies/procedures/practices: 16 Review and editing of best practice drafts: 18 State policy or best practices research: 11

13. Questions?
Questions about:
Content
Structure
Engagement
…anything?

14. Next Steps
Next Conference Call: Wednesday, December 2pm EST/11am PST Group Listserv: Website: Questions: