Denton County Citizens Council on Mental Health February 27, 2014 - - PowerPoint PPT Presentation

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Denton County Citizens Council on Mental Health February 27, 2014 - - PowerPoint PPT Presentation

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Denton County Citizens Council on Mental Health February 27, 2014 Denton County Citizens Council on Mental Health Agenda Welcome & Introductions: Joe Mulroy, Co-Chair Introduction of Presenters: Dr. Ron Aldridge, Co-Chair

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February 27, 2014

Denton County Citizen’s Council on Mental Health

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LIVE UNITED

GIVE ADVOCATE VOLUNTEER

  • Welcome & Introductions: Joe Mulroy, Co-Chair
  • Introduction of Presenters: Dr. Ron Aldridge, Co-Chair
  • Mental Health Overview: Brandi Felderhoff, Chair NASW Texoma Branch
  • Overview of Denton County MHMR: Pam Gutierrez, CEO Denton County MHMR
  • Overview of Health Services of North Texas: Doreen Rue, CEO HSNT
  • Wrap Up and Housekeeping – Joe Mulroy, Co-Chair

Denton County Citizen’s Council on Mental Health Agenda

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LIVE UNITED

GIVE ADVOCATE VOLUNTEER

Brandi Felderhoff

Chair National Association of Social Workers Texoma Branch

Denton County Citizen’s Council on Mental Health Mental Health Overview

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LIVE UNITED

GIVE ADVOCATE VOLUNTEER

Pam Gutierrez

CEO MHMR of Denton County

Denton County Citizen’s Council on Mental Health MHMR Overview

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Denton County MHMR Center

February 27, 2014

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Center Locations

* Denton Outpatient Clinic 2519 Scripture Denton, Texas * Lewisville Outpatient Clinic 101 E, Corporate Dr Lewisville, Texas * Crisis Outpatient Clinic (New) 2509 Scripture Denton, Texas * Tompkins Outreach Services 830 S. I-35 E Denton, Texas * Morse Outpatient IDD Clinic 3823 Morse Rd Denton, Texas * Morse Clinic (additional IDD services) 3827 Morse Rd Denton Texas

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The Department of State Health Services (DSHS) contracts with Denton County MHMR to provide services for the following populations served: Adult Mental Health (MH) Priority Population – Adults who have severe and persistent mental illnesses such as schizophrenia, major depression, bipolar disorder, or other severely disabling mental disorders which require crisis resolution or ongoing and long-term support and treatment.

Scope of Current Service Delivery

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Child and Youth Mental Health (MH) Priority Population

Children/youth ages 3 through 17 with a diagnosis of mental illness (excluding a single disorder of substance abuse, IDD, autism or pervasive development disorder) who exhibit serious emotional, behavioral or mental health disorders and who:

1. Have a serious functional impairment; or

  • 2. Are at risk of disruption of a preferred living or child care environment due

to psychiatric symptoms; or 3. Are enrolled in a school system’s special education program because of serious emotional disturbance.

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Denton County MHMR Services Include:

Mobile Crisis Outreach Teams (MCOT 24 hour availability throughout Denton County).

Crisis Hotline, 1(800) 762-0157, (24 hour availability)

Crisis Outpatient Services (Psychiatric services, medication, Cognitive Behavioral therapy, chemical dependency and case management).

Psychiatric Services (Psychiatric evaluation, medication monitoring and management).

Service Coordination (Single point of contact for individuals served by the Center). Responsible for monitoring and coordinating mental health and substance abuse services.

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Additional Services Provided by the Center:

Housing and Urban Development (HUD) Homeless grant provides services to 19 individuals and one family. The Center currently has a wait list for this program.

Intellectual and Developmental Disabilities; Services include: (service coordination, community support, residential services, respite services, employment assistance and supportive employment, specialized therapies, vocational training and day habilitation).

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Texas 83 rd Legislative Session Key Points For Legislative Appropriations:

Funding to remove individuals currently on Community Centers’ waitlists.

Veterans Initiative-peer support and access mental health services.

Required DSHS to withhold 10% of funding to Community Centers. Payment is contingent on achievement of outcome targets set by

  • DSHS. Remove all adults and children from waitlist from

September 1, 2013 to February 28, 2014.

Increase funding for Mental Health Services and increased targets.

Do we think that funding will continue????

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Denton County MHMR

Impact of Legislative Mandates

  • Reduction of adult waitlist to

zero

  • No waitlist for children
  • Over-serving DSHS

performance targets in Mental Health services for children and adults.

  • Current DSHS funding

supports individuals removed from waitlist and receiving services at this time.

Ongoing Concerns

  • With current funding, the

Center will not be able to provide additional services.

  • Center is subject to

implementing a waitlist at this time.

  • Uncertainty of year to year

DSHS funding

  • Legislative appropriations

uncertainty

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New Funding Initiatives - 1115 Projects Federal Funding for Uncompensated Care

Project 1: Psychiatric Triage Facility – Provide a safe environment for individuals to receive crisis services outside of emergency rooms (Service provided 24/7).

Project 2: Integrated Primary and Behavioral Health – Focus on serving the individual holistically. Provide services to individuals with comorbid disorders currently served by the Center.

Project 3: Crisis Residential - Provide a supervised 24 hour crisis facility for individuals experiencing a psychiatric crisis.

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Future Possibilities for the Center

With the Center’s Board of Trustee’s direction, the Center has the

expertise to expand services based on the identified needs of the

  • community. In order to expand the current scope of services to the

citizens of Denton County additional funding is required.

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LIVE UNITED

GIVE ADVOCATE VOLUNTEER

Doreen Rue

CEO Health Services of North Texas

Denton County Citizen’s Council on Mental Health HSNT Overview

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HSNT Services

– Primary medical care for children and adults

  • preventative care
  • well exams
  • gynecology
  • on-site lab testing
  • immunizations
  • Treatment for acute and chronic

– physical – mental – social health conditions

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Your Key to Quality Care

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FQHC Designation

  • HSNT received the designation as a Federally

Qualified Health Center (FQHC) by the U.S. Department of Health and Human Services in

  • 2012. HSNT is the only FQHC in Denton

County.

  • FQHC provides the ability to establish the

federal intemental health support through community health centers

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Your Key to Quality Care

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HSNT Provider Resources

  • 1988-2009

– 1 Mental Health Therapist – 0.5 Medical Provider – Serving 500 +/- per year

  • 2010-2012

– 1 Mental Health Therapist – 2 Medical Providers – Serving 2,250 +/- per year

  • 2013

– 1 Mental Health Therapist – 2.6 Medical Providers – Serving 3,397 +/- per year – HSNT serving those with greatest need and for limited time – 1,675 or 49% of HSNT’s patients have a Diagnosed MH Condition. – HSNT has MH resources to support 1 medical provider – 1,300+ have limited or no access to MH care. – Service gap is due to limited resources.

Your Key to Quality Care

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HSNT 2013 Patient Data

  • 3,397 Patients Served in Health Center

– 49% of HSNT’s patients have a Diagnosed Mental Health Condition. – The most common diagnosis

  • Anxiety at 50%
  • Depression at 28%

Your Key to Quality Care

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Of the 1,675 HSNT Patients with MH Diagnosis

Patients with severe MH Disorders (151 patients or 9%)

  • 5 Schizophrenia
  • 96 Bipolar Disorder
  • 50 Major Depressive

Disorder Patients with other MH Conditions (1,524 patients or 91%)

  • 845 Anxiety
  • 465 Depression
  • 214 Other

Your Key to Quality Care

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Barriers to MH Care

  • Inadequate number of MH providers

– Medication Management – Therapists/Counselors – Uninsured and low income inordinately affected

  • Stigma related to Mental Health Care
  • Physical Health and Mental Health Services

not integrated.

Your Key to Quality Care

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Difficulties of Traditional MH Service Model

  • Traditional 1 hour Counseling sessions do not

address immediate crisis needs of patients

  • Services are limited for uninsured and

underinsured (85% of HSNT patients without insurance)

  • In 2013 using the traditional model, 5% of

HSNT MH patients were served.

Your Key to Quality Care

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HSNT Shifts Model of Care

  • In 2014 HSNT evolves the model of care with

FQHC

  • 70% of primary care visits stem from mental

health issues.

  • Better health outcomes occur when mental

health is addressed.

  • Coordinated team-based approach to care and

follow-up.

  • Screening, Brief Interventions, and follow-up

when patients are in medical clinic setting.

Your Key to Quality Care

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Integrated Care - Best Practices

  • Core Interdisciplinary Care Team of 3 HSNT

professionals to serve each group of 1,200- 1,400 patients

– Medical Provider (with nurse support) – Mental Health Provider – Case Manager

Your Key to Quality Care

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Current Unfunded Needs based on Model

To serve the existing HSNT patients, and projected 2014 patient growth:

  • Psychiatric Nurse Practitioner or Psychiatrist for

medication management

  • 2 additional MH Therapists/Counselors to

complete existing teams and additional resources as the patient population grows

  • Anticipate adding an additional full Primary Care

Team in 2014 which will require another MH Therapist.

Your Key to Quality Care

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LIVE UNITED

GIVE ADVOCATE VOLUNTEER

Joe Mulroy

Wrap-Up & Housekeeping

Denton County Citizen’s Council on Mental Health

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LIVE UNITED

GIVE ADVOCATE VOLUNTEER

  • Next Steps

 Inventory  Workgroups  Follow-up information from HSNT and MHMR

  • Next Meeting – March 20th at 10:00am to 11:30am

Denton County Citizen’s Council on Mental Health Wrap up and Housekeeping