1. DONNA CHRISTIANSON, CRISIS PROGRAM DIRECTOR VICKI RILEY, CARE CENTER PROGRAM DIRECTOR Spotlight on the CARE Center

2. Background The initiative started as a result of La Crosse County Clinical Services Process Improvement initiative  Training  Screening/Filtering  Mandatory Services  Continuum of Care Continuum of Care subgroup identified “gaps” in our current service system  Crisis Center  Community Bridges

3. Mission Statement Create a crisis assessment center and detoxification center by the end of 2009 in order to provide more cost-effective triage and intervention for area individuals undergoing distress due to mental health or substance abuse concerns. Enhance available supports and services to help people maintain stability in community settings (Community Bridges)

4. Facility Criteria Identified: 2 nd Focus Group 6/09 Unlocked facility (home-like setting) 8 bed capacity for adults (male and female) Non Ch 51 (detentions will go to the hospital) Non medical detoxification Centrally located in La Crosse Well trained staff

5. CARE Center Timeline Request for Proposals reviewed (9/09) Tellurian, UCAN selected as the top applicant Awarded the contract (10/14/09) Site search, selection and construction Hiring and training staff Budget/contract negotiations Certification process and completion Policies and procedures Open House (4/10) and Grand Openning (5/18/10)

6. CARE Center Staff F.T. Program Director: Vicki Riley F.T. Community Liaison: Teri McDougle 10 FTE Human Service Assistance P.T. Registered Nurse 2 Peer Support Specialists

7. CARE Center Admission Process for Law Enforcement Law Enforcement contacts Mobile Crisis to assist with assessment when involved with mental health situations in the field If there are immediate medical concerns, arrange for transport to the hospital and then contact mobile crisis However, if there are no medical issues, assessing the crisis should occur in the community (ie.the home, CARE Center, etc)

8. CARE Center Admission Process for Hospitals After assessment in the ER, the Crisis Responder and Hospital Staff collaborate on the disposition. If CARE Center is deemed appropriate, CARE staff is contacted and they provide transportation to the CARE Center CARE Center is also used as a step down from the inpatient units. County crisis staff facilitate this also between the hospital and CARE Center

9. Alcohol Detox Challenges The statutes are restrictive as to who can be served at this level of care No other substances can be in the person’s system other than alcohol and benzodiazapines (received the OK for THC) The withdrawal score (CIWA) needs to be within a certain limit If there are other medical issues or a history of seizures they would be deemed inappropriate for admisson

10. CARE Center Data 2010MayJuneJulyAugustSeptOctNovDec # of admissions (MH/Detox) 18 17/0 32 31/1 46 44/2 43 40/3 41 39/2 Average LOS3.945.654.194.924.5 Average census 4-6 6-84-85 Readmission s 1-2x’s 1-3x’s 4 6 5-2x 1-3x 5 5 – 2x 5 4-2x 1-3x Police transport to Center 01132 MA Funded61% 11/18 59% 19/32 65% 30/46 70% 30/43 78% 32/41

11. Crisis Program Data 20022003200420052006200720082009 2010 Jan- Sept. (yr projection) Total Crisis Contacts 6026691363224841643700370542064167(5209) Police contacted crisis 587780836832796724 (905) Ch 51’s646541708686758722768610414 (518) Stabilization Bed (disposition in crisis situation) 101133126116108 178 (223) CARE Ctr open 5/18 County funded hospital bed days 588568388583348385 County charges for State Hospital (bed days) 16417816218568167

12. CARE Center: 4647 Mormon Coulee Rd

13. Program Director: Vicki Riley

14. Kitchen

15. Living Room Space

16. …More Living Room Space

17. Dining Room

18. Bedroom (2 residents per room)

19. …another bedroom

20. La Crosse Co. Satellite Office

21. Medication Storage Area

22. Shower Room (there are 2)

23. Open/light Spaces

24. Facility Comparison Hope HouseNew Crisis Center Limited staff hours24 hour awake staff Unlicensed facilityCBRF licensed facility Crisis therapist follow up next day Crisis therapist and Nurse Practitioner follow up No detox admissionsNon-medical detox admissions 4 bed capacity8 bed capacity

25. Problem Solving Strategy With every new process, there are bound to be problems that arise There are many players involved in these crisis situation Meetings have occurred twice/month, including CARE staff, Law Enforcement, Consumers, Crisis and Hospital staff to problem solve situations and improve our collaboration

26. Consumer Satisfaction “It’s not very often that you find a bunch of people that actually want to help people they don’t even know… It’s really nice to know that there are people out there that actually care.” “This environment is very healing.” “This facility is 100% better than what we had.” “The staff went above and beyond in meeting my needs. I felt safe here and the staff is very knowledgeable and friendly.”

27. CONTACT INFORMATION Donna Christianson La Crosse County Human Services  608-785-6118  christianson.donna @co.la-crosse.wi.us Vicki Riley CARE Center  608-519-3080  vriley@tellurian.org