Community Triage Center Baseline Data and Demand Estimates Triage - - PowerPoint PPT Presentation

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Community Triage Center Baseline Data and Demand Estimates Triage - - PowerPoint PPT Presentation

Feb 01, 2023 19 likes •460 views

Community Triage Center Baseline Data and Demand Estimates Triage Guiding Principles To establish client-centered, strength-focused care plans that identify a discharge strategy and support services. Clients may return to the CTC for

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Community Triage Center

Baseline Data and Demand Estimates

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Triage Guiding Principles

  • To establish client-centered, strength-focused care plans that identify a discharge

strategy and support services. Clients may return to the CTC for support groups, education, case management, and/or appointments with a psychiatrist until a long-term provider has an opening.

  • Recommend solutions that are driven by data, research, and best practices.
  • Provide an alternative to the justice system for the community to

utilize as a response to individuals in a behavioral health related

  • crisis. Specific decision points include a pre-arrest, arrest, pretrial

release, and reentry.

  • Provide an alternative to emergency rooms so they have more

availability for life threatening medical emergencies (heart attacks, diabetes issues, strokes, etc.)

  • Demonstrate that a collaborative approach is an effective, efficient strategy to provide
  • ptimal outcomes for those in our community with intensive needs while being fiscally and

programmatically cutting edge.

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INDICATORS OF NEED

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All Jail Bookings (2016)

24% 76%

MH or SUD Neither MH nor SUD

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62.6% 17.9% 8.3% 4.2% 2.5% 1.4% 1.0% 0.7% 1.3% 33.0% 18.8% 13.1% 8.9% 6.7% 4.5% 3.6% 2.8% 8.0%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 1 2 3 4 5 6 7 8 9+

Number of Bookings in 2016

Super Utilizers (Jail Bookings)

People (%) Bookings (%)

n=9,203 n=17,461 Top 5% 638 people 25.6% of bookings Top 1% 123 people 8.0% of bookings

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18.32% 34.95% 46.93% 54.87% 69.91% 6.52% 13.80% 21.70% 19.49% 29.31% 8.88% 13.01% 12.16% 15.38% 10.66% 2.91% 8.15% 13.07% 20.00% 29.94%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 1 2 3 4 5+

Number of Bookings in 2016

Self-reported SUD and MH Disorders by Number of Bookings

SUD or MH SUD alone MH alone Co-occurring

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Jail Super Utilizers (5+)

70% self-reported behavioral health problems

  • 446 people
  • 62 jail days per person
  • 27,710 bed days annually (76 per day)
  • $2,632,518 annually
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6364 6081 2542 2024 556

1000 2000 3000 4000 5000 6000 7000 Encounters (total) Mental health Substance abuse Substance abuse: Alcohol Substance abuse: Drugs

Behavioral Health ER Encounters (2016)

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3929 2341 73 24

500 1000 1500 2000 2500 3000 3500 4000 4500 Walk In EMS Law enforcement Unlisted/Other

Means of Arrival (2016)

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4722 593 556 218 199 161 112

500 1000 1500 2000 2500 3000 3500 4000 4500 5000

Disposition (2016)

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ER Behavioral Health Encounters

Average stay: 190 minutes (3.2 hours) Total ER time: 832 days 2.28 beds per day Total charges: $40,037,269 Average charges per encounter: $6,076

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Stage 1

  • Relocate Detox and Sobering Center
  • Add behavioral health moderate crisis

referrals

– Law enforcement referrals – Walk-ins without physical ailment

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Stage 1

Source

Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied

Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

2,106 5.7 6.4 1.5

TOTAL:

5,306 9.1

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Detox and Sobering Center

  • 2016 observed number of admissions and

length of stay

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Stage 1

Source

Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied

Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

2,106 5.7 6.4 1.5

TOTAL:

5,306 9.1

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Stage 1

Source

Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied

Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

2,106 5.7 6.4 1.5

TOTAL:

5,306 9.1

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Law enforcement referrals

  • Data sources:

– 2016 arrests by SF Police Dept. and Minnehaha Co. Sheriff’s Office – 2016 bookings in Minnehaha County Jail

  • Criteria: Adult, non-violent, Class 2 Misdemeanor

arrests where the only charges were

– Disorderly conduct, – Liquor law violations, – Trespassing, or – Curfew, loitering, or vagrancy

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Law enforcement referrals

  • 1,691 adult arrests met criteria

– 17.8% of arrests overall

  • Estimated referrals to CTC: 338

– 20% referral rate based on self-reported behavioral health disorders among

  • unsentenced (23.3%) bookings and
  • misdemeanor (21.2%) bookings
  • Length of stay: 9.7 hours

– Observed length of stay at Sobering Center

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Stage 1

Source

Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied

Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

2,106 5.7 6.4 1.5

TOTAL:

5,306 9.1

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Stage 1

Source

Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied

Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

2,106 5.7 6.4 1.5

TOTAL:

5,306 9.1

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3929 2341 73 24

500 1000 1500 2000 2500 3000 3500 4000 4500 Walk In EMS Law enforcement Unlisted/Other

Means of Arrival (2016)

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Walk-ins without physical ailment

  • Data sources:

– 2016 ER encounters at Avera McKennan and Sanford where primary, secondary, or tertiary diagnosis was behavioral-health related

  • Criteria: ER walk-ins who:

– Have a primary diagnosis that is a behavioral health issue, and – Were discharged to home/self-care, detox, law/jail/court, or admitted to Behavioral Health

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4722 593 556 218 199 161 112

500 1000 1500 2000 2500 3000 3500 4000 4500 5000

Disposition (2016)

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Walk-ins without physical ailment

  • 2,106 walk-ins met criteria

– 53.8% of behavioral health – related walk-ins

  • Length of stay: 6.4 hours

– Average of observed ER length of stay (3 hours) and Sobering Center length of stay (9.7 hours)

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Stage 1

Source

Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied

Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

2,106 5.7 6.4 1.5

TOTAL:

5,306 9.1

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Stage 1

Source

Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied

Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

2,106 5.7 6.4 1.5

TOTAL:

5,306 9.1

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Stage 2

  • Stage 1 plus

– Walk-ins with physical ailment – EMS drop-off

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Stage 2

Source Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

3,703 10.0 6.4 2.7

EMS referrals

2,206 5.9 6.4 1.6

TOTAL:

9,109 11.9

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Stage 2

Source Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

3,703 10.0 6.4 2.7

EMS referrals

2,206 5.9 6.4 1.6

TOTAL:

9,109 11.9

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3929 2341 73 24

500 1000 1500 2000 2500 3000 3500 4000 4500 Walk In EMS Law enforcement Unlisted/Other

Means of Arrival (2016)

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Walk-ins with or without physical ailment

  • Data sources:

– 2016 ER encounters at Avera McKennan and Sanford where primary, secondary, or tertiary diagnosis was behavioral-health related

  • Criteria: ER walk-ins who:

– Have a primary, secondary, or tertiary diagnosis that is a behavioral health issue, and – Were discharged to home/self-care, detox, law/jail/court, or admitted to Behavioral Health

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4722 593 556 218 199 161 112

500 1000 1500 2000 2500 3000 3500 4000 4500 5000

Disposition (2016)

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Walk-ins with or without physical ailment

  • 3,703 walk-ins met criteria

– 94.6% of behavioral health – related walk-ins

  • Length of stay: 6.4 hours

– Average of observed ER length of stay (3 hours) and Sobering Center length of stay (9.7 hours)

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Stage 2

Source Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

3,703 10.0 6.4 2.7

EMS referrals

2,206 5.9 6.4 1.6

TOTAL:

9,109 11.9

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Stage 2

Source Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

3,703 10.0 6.4 2.7

EMS referrals

2,206 5.9 6.4 1.6

TOTAL:

9,109 11.9

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3929 2341 73 24

500 1000 1500 2000 2500 3000 3500 4000 4500 Walk In EMS Law enforcement Unlisted/Other

Means of Arrival (2016)

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EMS drop-off

  • Data sources:

– 2016 ER encounters at Avera McKennan and Sanford where primary, secondary, or tertiary diagnosis was behavioral-health related

  • Criteria: ER arrivals by EMS who:

– Have a primary, secondary, or tertiary diagnosis that is a behavioral health issue, and – Were discharged to home/self-care, detox, law/jail/court, or admitted to Behavioral Health

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4722 593 556 218 199 161 112

500 1000 1500 2000 2500 3000 3500 4000 4500 5000

Disposition (2016)

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EMS drop-off

  • 2,206 EMS arrivals met criteria

– 94.9% of behavioral health – related EMS arrivals

  • Length of stay: 6.4 hours

– Average of observed ER length of stay (3 hours) and Sobering Center length of stay (9.7 hours)

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Stage 2

Source Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

3,703 10.0 6.4 2.7

EMS referrals

2,206 5.9 6.4 1.6

TOTAL:

9,109 11.9

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Stage 2

Source Annual Admissions Daily Admissions Length of Stay (hours) Average Daily Beds Occupied Detox

241 0.7 155 4.3

Sobering Center

2,621 7.2 9.7 2.9

Law enforcement referrals

338 0.9 9.7 0.4

Walk-ins

3,703 10.0 6.4 2.7

EMS referrals

2,206 5.9 6.4 1.6

TOTAL:

9,109 11.9

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suzanne.smith@augie.edu

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Summit slides to create

  • What’s next? Merging data. What do we hope

to learn?

– Cross-service super-utilizers – Were people flagged for behavioral health in jail already known to behavioral health service providers? (engagement and continuity of treatment)