Transcript No Slide Title

UNDERSTANDING THE COMMUNITY
MENTAL HEALTH SYSTEM
CHILDREN, YOUTH, AND FAMILIES
July 27, 2011
Julie de Losada, Laura Davis Yen
.
Centers for Medicare
& Medicaid Services
Federal Government
Mix of State Mental
Health and Federal $$
DSHS
ESH
WSH
DBHR
North Sound
Mental Health
Administration
•Region 2 North
•NSMHA
DDD JRA other
ADSA
other CA
RSN
CMHA
CMHA
CMHA
CLIP
•Pearl Street
•McGraw
• CSTC
• Tamarack
•Catholic Community Services NW
•Whatcom, Skagit, Snohomish
•Compass Health
•Skagit, Snohomish, San Juan
•SeaMar Behavioral Health
•Skagit, Snohomish, Whatcom
•Whatcom Counseling & Psychiatric
Clinic
From Washington to Washington…
39 Counties Grouped into 13 RSNs
It All Starts at “ACCESS”
How NSMHA works with
Volunteers of America
Access to Care
4 Ways to Enter the Community Mental Health System
1.
2.
3.
4.
Crisis Services
Outpatient Services
Inpatient Services*
CLIP*
Volunteers of
America (VOA)
*Neither NSMHA nor our Providers deliver inpatient or CLIP services. NSMHA may authorize for these levels of
care.
Role of VOA
24/7 Phone Crisis Intervention (800-584-3578)
24/7 Triage Clinician Line (800-747-8654)
Regional Lifeline call center (1-800-273-8255)
ACCESS to Outpatient counseling (888-693-7200)
Inpatient Certification & Authorization (800-707-4656)
Offers ASIST and SafeTALK community trainings
Accessing Crisis Services
 24/7 Phone Crisis Intervention Services
100,000 Annual Total Calls
Serving Five North Sound Counties
Self-Defined Crisis
Mental Health Professional Staff
Accessing Outpatient Services
 MUST meet Medicaid Financial Eligibility
o Established by Community Service Office (CSO)
 MUST have a covered “Access to Care” diagnosis
 MUST meet “medical necessity”
 MUST call ACCESS to Mental Health Services
Examples
Access to Care Standards
Access to Care Standards Continued
RSN/ CMHA Service
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Outpatient services offered by NSMHA contracted
Community Mental Health Agencies
 Catholic
Community Services NW
 Compass Health
 SeaMar
 Whatcom Counseling and Psychiatric Services
ALL Providers Offer…
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Assessment/ Evaluation
Individual Therapy
Group Therapy
Family Therapy
Medication Management
Case Management
Coordination with formal systems
Coordination with natural supports
SOME Providers Offer…
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CHAP – Children’s Hospitalization Alternative Program
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Co-Funded by Children’s Administration for 16 yrs.
Individualized/ intensive care
In-home & out-of-home
Respite
24/7 Crisis Response
Wraparound
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Family-driven/ Youth-Guided
Team Based
Natural Supports
Community Based
Culturally Competent
Strengths Based
Collaboration
Persistent
Outcomes Based
INTENSIVE SESSION
Systems of Care and
Wraparound: An
Overview
DAN EMBREE
2:40 RM 565 B/C
Assessments and Evaluations
Time Lines
14 Calendar Days from
Request to Intake
28 Calendar Days from
Intake to First Ongoing
7 Calendar Days from
Inpatient Discharge to
Intake or First Ongoing.
Individual and Tailored Care
Each person has a
unique combination
of strengths and
needs.
Services should be
designed to:
In the least
restrictive / most
normative manner
Utilize
Strengths
Meet
Needs
Family Voice and Participation
• Needs are not Services
• It’s not about us with
out us.
Considerations for Adolescents
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Youth who are thirteen and older can request mental
health services without the consent of their parents.
RCW 71.34.500
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Youth who are thirteen or older and who are a danger
to themselves or others, and refuse treatment may be
involuntarily detained and hospitalized. RCW
71.34.710
Transitioning to the Adult Mental
Health System
Planning Ahead…
Preparing for the transition
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Discuss transitioning to an adult mental health provider with the current
mental health provider:
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Apply for Medicaid if appropriate:
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Timing of the transition
Which agency and program can best meet the young adult’s needs?
Keep in mind, some programs take time to get into
Medical
Cash assistance
Food Benefit
Research and plan for housing:
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Housing authorities’ programs including voucher programs and public housing
Some mental health agencies have limited housing resources
Preparing for the transition,
Continued
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Community Resources: research what other assistance is available in your
community
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Food Banks
Transportation Options
Discounted utilities
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Any special needs
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Develop skills for independent living
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Plan for employment/education/daily activity
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Teach/coach the youth how to communicate about and navigate health
care; they will be driving their own care as an adult.
The Adult Mental Health System at a Glance
Inpatient MH Treatment
A Brief Overview…
Accessing Inpatient Services
• Voluntary
• Involuntary
2- Ways
RCW
71.34.600
• (1) A parent may bring, or authorize the bringing of, his or her minor child
to an evaluation and treatment facility or an inpatient facility licensed
under chapter 70.41, 71.12, or 72.23 RCW and request that the
professional person examine the minor to determine whether the minor
has a mental disorder and is in need of inpatient treatment.
When is Inpatient Appropriate?
Needs crisis stabilization in order to avoid a higher level of care.
Potential danger to self, others, or property.
Caregiver or youth are unable to ensure safety.
Needs constant supervision and adult intervention to assure safe
environment
Inability to think clearly or distinguish reality.
AND other less restrictive services have been tried which were not
successful or were unable to ensure the youth's safety
When is Inpatient Inappropriate?
When less restrictive interventions have not been
attempted.
Solely for “medication adjustments” or “medication
vacations”.
In lieu of “placement”.
When another system can better or more
appropriately serve the child/youth (detention,
Children’s Administration, primary care etc.)
When the crisis and youth’s primary diagnosis are
not directly related to mental health diagnosis.
What to expect…
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Time limited crisis stabilization (5-10 days)
Limited psychiatric evaluation/assessment
Possible medication assessments/ adjustments
Coordination with outpatient provider (if there is one)
Coordination with other systems (if indicated)
Discharge Planning
More about Inpatient Services
NO child/youth
psychiatric
inpatient facilities
in our region.
ALL child/youth
psychiatric
inpatient facilities
in WA are private.
Fairfax
(6-17)
Seattle
Children’s
(6-17)
Two-Rivers
Landing
(11-17)
Kitsap Youth
Inpatient
Unit (8-17)
NSMHA
www.nsmha.org
Questions?
360.416.7013
Julie de Losada, M.S. [email protected]
Laura Davis Yen, LICSW [email protected]
Contacts