Denton County Citizen’s Council on Mental Health February 27, 2014
Denton County Citizen’s Council on Mental Health Agenda • 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 LIVE UNITED GIVE ADVOCATE VOLUNTEER
Denton County Citizen’s Council on Mental Health Mental Health Overview Brandi Felderhoff Chair National Association of Social Workers Texoma Branch LIVE UNITED GIVE ADVOCATE VOLUNTEER
Denton County Citizen’s Council on Mental Health MHMR Overview Pam Gutierrez CEO MHMR of Denton County LIVE UNITED GIVE ADVOCATE VOLUNTEER
Denton County MHMR Center February 27, 2014
Center Locations * Denton Outpatient Clinic * Tompkins Outreach Services 2519 Scripture 830 S. I-35 E Denton, Texas Denton, Texas * Lewisville Outpatient Clinic * Morse Outpatient IDD Clinic 101 E, Corporate Dr 3823 Morse Rd Lewisville, Texas Denton, Texas * Crisis Outpatient Clinic (New) * Morse Clinic (additional IDD services) 2509 Scripture 3827 Morse Rd Denton, Texas Denton Texas
Scope of Current Service Delivery 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.
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.
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.
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).
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????
Denton County MHMR Impact of Legislative Ongoing Concerns • Mandates With current funding, the • Center will not be able to Reduction of adult waitlist to provide additional services. zero • • Center is subject to No waitlist for children implementing a waitlist at this • Over-serving DSHS time. performance targets in Mental • Uncertainty of year to year Health services for children and DSHS funding adults. • • Legislative appropriations Current DSHS funding uncertainty supports individuals removed from waitlist and receiving services at this time.
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.
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.
Denton County Citizen’s Council on Mental Health HSNT Overview Doreen Rue CEO Health Services of North Texas LIVE UNITED GIVE ADVOCATE VOLUNTEER
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 Your Key to Quality Care 16
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 Your Key to Quality Care 17
HSNT Provider Resources • 1988-2009 – 1 Mental Health Therapist – HSNT serving those with greatest need and for limited – 0.5 Medical Provider time – Serving 500 +/- per year – 1,675 or 49% of HSNT’s • 2010-2012 patients have a Diagnosed MH Condition. – 1 Mental Health Therapist – HSNT has MH resources to support 1 medical provider – 2 Medical Providers – 1,300+ have limited or no – Serving 2,250 +/- per year access to MH care. • 2013 – Service gap is due to limited – 1 Mental Health Therapist resources. – 2.6 Medical Providers – Serving 3,397 +/- per year Your Key to Quality Care 18
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 19
Of the 1,675 HSNT Patients with MH Diagnosis Patients with severe Patients with other MH Conditions MH Disorders (1,524 patients or 91%) (151 patients or 9%) • 5 Schizophrenia • 845 Anxiety • 96 Bipolar Disorder • 465 Depression • 50 Major Depressive • 214 Other Disorder Your Key to Quality Care 20
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 21
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 22
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 23
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 24
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 25
Denton County Citizen’s Council on Mental Health Joe Mulroy Wrap-Up & Housekeeping LIVE UNITED GIVE ADVOCATE VOLUNTEER
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