1. Crisis Residential Best Practices Toolkit
January 18, 2016

2. Welcome Agenda Roll Call Review Content Submissions- Scope & Function
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.

3. Anyone else joining the call today?
Roll Call
Jeff Allen (OH) Cicely Alvis (TN) Courtney Beardon (TX) Sherry Blyth (TX) Mark Boschelli (NM) Jeff Bracken (MD) Ross Buitendrop (MI) Lori Carnahan (IL) Brenda Clark (TX) Char Cobb (MI)
Jessica Coburn (IA)
Susan Cromwell (MD)
Chrystal Davis (TX)
Carol DiGiuseppe (MI)
Kelly Gluszewski (MI)
Adamn Graham (TN)
Myranda Green (MI)
Dawn Handley (TX)
Courtney Harvey (TX)
Andrea Kocsis (NY)
Rosa Chan Lopez (Costa Rica)
Sara Lupkes (IA)
Dan Maccia (CA)
Eilean MacKenzie (TX)
Meghann McCluskey (ME)
Lyndsay McGarry (MI)
Shelley Mohang (IA)
Laura Newsome (TX)
Anna Richardson (TX)
Jamie Sellar (AZ)
Micah Smith (IA)
Mende Snodgress (TX)
Sheryl Stiffler (TX)
Gwen Summers (MI)
Mallory Tanis (MI)
JoAnn Toney (CO)
Dana Townsend (TN)
Diane van Lier (TX)
Mark Ware (TX)
Amy Warren (KS)
Jaime Webster (CO)
Randy Weeks (MS)
Sharon Wilcox (NC)
Karen Wheelock (ME)
Anyone else joining the call today?

4. Workgroup Participants
70 homes from 25 states participating
Appprox. 290 crisis homes nationwide

5. Content Submissions: Scope and Function
History of Crisis Homes
Function of Service
Community Access
Participation in Treatment
Services Offered
Average Length of Stay
Funding & Per Diem Rate
Threats to Sustainability
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.

6. Scope and Function Results: History
Ranges from 1 year to 30+ years of service
Reasons for forming
Reduce state hospital admissions
Reduce psych hospital admissions
Reduce unnecessary ER admissions
Divert from jail
Dan Maccia (CA)- History of START CRU; No restrictions
Carrie Wirick (OH)- History of Netcare CRU; No restrictions
Mende Snodgress (CA)- History of Harris County CR; No restrictions

7. Scope and Function: Service Recipients

8. Scope and Function Results: Function of Service Scope
82% of crisis homes surveyed are unlocked

9. Scope and Function Results: Community Access & Treatment Participation
Netcare (OH), START (CA), Mende Snodgress (TX)
How much risk do programs bear? What is the environment of risk management vs. dignity, respect, and empowerment?

10. Scope and Function Results: Treatment & Services Offered
38% of homes prohibit smoking
Additional Responses: Detox as needed
Relapse prevention
Substance abuse screenings & counseling
Peer counseling

11. Scope and Function Results: Average LOS
Subsets of Crisis Residential Services can vary in length
Example: Texas
Extended Observation Units (EOUs)
Crisis Respite Units
Crisis Residential Units

12. Scope and Function: Funding & Per Diem Rate
Per diem rates range from $250-$800 per day
32% of crisis homes responding (6/19) reported their homes are funded outside of a per diem arrangement

14. Scope and Function: Threats to Sustainability
Homes expanding in California, Colorado in the past 3 years
Two homes closed in Michigan in 2016
Challenges of running a free-standing, low-bed home with limited revenue opportunities and consistent overhead costs

15. Tips for Sustainability
Company donations and fundraising
Sponsorship- local business, grocery stores
Food pantry access
Interns
Volunteers for activities (yoga)
Negotiating with managed care organizations
Purchasing in bulk
Co-locating programs
Grants
Flexible staff
Subcontracting
Consulting/Training Fees

17. 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: 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.

18. Questions? Comments?

19. Next Steps
Next Conference Call: Wednesday, February 2pm EST/11am PST OR Friday, February 1pm EST/10am PST Group Listserv: Website: Questions: