Parkland Behavioral Health & RIGHT Care Team Kurtis Y Young, M MSSW SW, LC LCSW SW Director o of S Soc ocial ial W Wor ork Behavioral Health Services Parkland Health & Hospital System
Agenda • Behavioral Health Services at Parkland • Changes in service over the past 2 years • Landscape of community mental health in the Dallas area • RIGHT Care Team pilot program
Behavioral Health at Parkland Capacity / Teams BH Service Area Capacity Teams Psych ED 20 patients 2 Extended Observation Area (EOU)* 18 patients 2 Team C (Main ED) / Psych Intake* Varies 3-4 Inpatient Psychiatric Unit 22 (28) 4 Consult Liaison Service Varies 3 Addictions Service* Varies 2 RIGHT Care Team* Varies 1 * Indicates program or service area that is less than 24 months old
Monthly Psych Contacts 2000 1889 1859 1872 1871 1849 1765 1800 1691 1688 1656 1559 1557 1600 1418 1382 Number of Contacts 1400 1200 1000 800 600 379 371 350 345 400 306 239 205 218 200 110 80 59 60 60 51 43 53 37 58 56 37 35 43 0 0 0 0 0 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Team C 793 717 797 748 652 626 562 555 462 489 489 437 261 Team C SW 76 90 143 189 219 250 271 218 220 176 205 126 164 PED 512 540 582 577 624 697 684 620 765 660 727 904 1034 EOU 0 0 0 0 110 218 205 239 371 306 379 345 350 Inpatient 37 35 37 43 51 58 43 56 53 60 59 60 80 Total 1418 1382 1559 1557 1656 1849 1765 1688 1871 1691 1859 1872 1889
Community Mental Health 2017 NorthStar sunsetted by legislature. North Texas Behavioral Health Authority (NTBHA) takes over indigent funding Community loses outpatient services through ABC Behavioral Health, ADAPT Community Solutions, LifeNet 2018 • Parkland partners with Meadows Mental Health Policy Institute and City of Dallas to pilot RIGHT Care Program • Timberlawn closes (128 beds) • Green Oaks closes PED (~80 beds) • THR takes 200 beds offline for renovation for compliance Sundance closed Garland and Arlington hospitals (256 beds) Dallas Behavioral Healthcare Hospital fails CMS review – nearly closes Parkland opens EOU in partnership with NTBHA due to increased volume 2019 • Psych Intake opens April 1 st • Parkland finishes construction to double size of inpatient psych unit to 28 beds
RIGHT Care Pilot Program 01/28/2018 – 05/30/2020 Multi-Disciplinary Team 911 Call Center Single-vehicle response to 911 MH calls Parkland Licensed Social Worker embedded • Dallas Police Officer in 911 Call Center • Dallas Fire & Rescue Paramedic Pilot • Parkland Licensed Social Worker • 2 shifts daily – only Monday-Friday Pilot 7am-3pm & 3pm-11pm • South – Central Police District only o • Serves the entire City of Dallas • Highest 911 MH calls in pre-study • 2 shifts daily – 7 days per week Purpose 7am-3pm & 3pm-11pm o • Triage & prioritize MH calls for MDT Purpose • Resource for 911 Call-Takers • Divert 911 calls from ERs & Jails • Provide support and resources to callers, • Reducing police resources for MH calls police, MDT regardless of location • Provide follow up care until outpatient services established • Call back for outreach and follow up as • Patient-Centered, Healthcare response clinically indicated
Total RCT Calls 350 324 300 315 310 292 285 280 270 250 247 242 242 238 Program Number 200 total: 4,014 150 152 135 135 133 127 122 122 100 114 110 108 105 Program 50 total: 2,126 0 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 RCT Calls 315 310 280 238 242 324 292 242 270 285 247 Unique Number 135 152 122 127 122 133 105 114 135 108 110 Served
Disposition Breakdown – May 2019 120 100 80 60 105 40 62 58 45 20 36 14 11 3 0 Emergency Arrests Diverted Housing Connect to Follow Up Transport Other Detention from Resolved MH Care by RCT to Parkland Jail/ER
Disposition Breakdown – Program Totals 1400 1200 1000 800 1225 1198 600 1136 808 400 608 200 146 144 108 0 Emergency Arrests Diverted Housing Connect to Follow Up Transport Other Detention from Resolved MH Care by RCT to Parkland Jail/ER
Emergency Detention Breakdown 45 40 40 36 35 33 30 Number 25 24 25 23 23 21 21 23 20 21 16 15 15 17 17 16 16 15 15 10 10 8 5 0 2 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 By RCT 2 21 8 15 10 17 17 23 16 16 15 By Patrol 36 40 16 33 15 25 23 23 21 24 21
Recognition • Parkland 2019 Patient Safety Team Champion – Innovative Team of the Year • Presenting at International Association of Chiefs of Police (October 2019) • American Society for Health Care Risk Management 2019 Annual Conference Presentation (October 2019) • Featured case study in Results for America • City of Dallas wins City Manager Excellence Award 2019 for RIGHT Care • Recognition by Senator John Cornyn and Representative Pete Sessions • Past Presentations: – Avia Healthcare – Meadows Mental Health & Policy Institute’s Excel & Engage Conference 2018 – Texas Hospital Association 2018 Conference
Next Steps • Fu rthe her dev evelopment o of 9 f 911 C Call Cent enter • Sec Secure fund funding ng – Maintain program after pilot program ends May 2020 – Expansion of teams to other areas of Dallas • Further er devel elop c community p y partner ersh ships – MetroCare Services – VA Medical Center – Homeward Bound – IPS – NTBHA – Southern Area Behavioral Health
RIGHT Care Questions & Comments Kurtis Young, MSSW, LCSW Director of Social Work Parkland Health & Hospital System 469.419.9663 kurtis.young@phhs.org
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