BHMHSA Collaborative Goals1. Develop a fully operational 24-Hour Crisis Center
2. Implement community case management
3. Provide intermittent professional care until provider availability
4. Develop integrated demographic and needs assessment with appropriate consents for treatment
5. Conduct regular networking meetings among service providers
6. Implement Community Education Plan
BHMHSA Collaborative Objectives1. Reduce inappropriate admissions to the hospital, jail and detox
2. Improve access to after-crisis follow-up and mental health and substance abuse treatment 3. Improve service integration and coordination among agencies and providers to help patients better navigate complex systems
4. Improve awareness about and access to services to assist people in entering the healthcare system for mental health and substance abuse services prior to the crisis state
Number and Type of CCC Staffas of July 31, 2011
Medical Director Dr. Garry, MD
Clinical Director Randy Allen CSW-PIP
Program Manager Teri Corrigan CSW, QMHP
QMHP’s (1 per shift) 3 FTE, 1 PT, 1 PRN
EMT’s (2 per shift) 7 FTE, 1 PT, 3 PRN
Case Manager 1 FTE (to be hired)
Pennington County Health & Human Services Case Managers are currently providing case management.
People Who Died by Suicide by Year in Pennington County
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100
5
10
15
20
25
30
35
17
9 8
17
14 1315
21 20
13
24 23
29
People Who Died by Suicide in 2010 vs 2011 in Pennington County as of July 31, 2011
As of July 31, 2011, there have been 9 suicide deaths compared to 19 as of this same date in 2010.
Number of CCC Client Visits by Month as of July 31, 2011 - Total Client Visits = 283
(Total Unique Clients= 236)
Number of Clients Returning to CCC for >1 Crisis Visits as of July 31, 2011
Total = 29 Clients
2 visits 3 visits 4 visits 5 visits 6 visits
19clients
1client
6clients
1client
2clients
Types of Services Provided When CCC Clients Returned in Crisis as of July 31, 2011
These 29 individuals accounted for 76 visits to the CCC.
Fifteen of these 29 individuals were existing clients with agencies such as BMS, the VA, Rebound, CCADP or the BH Workshop. They were referred back to these programs with appointments / follow-up contacts being made by CCC staff.
Returning to the CCC diverted these clients from 43 visits to the RCRH BHC and 27 visits to the RCRH ED.
The RCPD brought these return clients to the CCC for 54 of the 76 visits, and they returned as walk-ins for 22 visits.
Three were diverted from Jail.
Not all these return clients were diverted from another program.
CCC Referral Out to Direct Service Percentages as of July 31, 2011
BMS36%
CCDAP18%
LSS16%
CSS7%
Other5%
COM-MUNITY HEALTH
9%
DETOX2%
WAVI2%
YFS4%
CCC Clients Received and Attended Direct Service Appointments as of July 31, 2011
Behavior Management Systems 13 new referrals with 11 who attended first appointments
• 5 needed additional referrals to community resources• 11 scheduled follow-up appointments at BMS• 1 additional identified crisis
City / County Alcohol and Drug Programs 7 new referrals who attended first appointments
• 7 needed additional referrals to community resources• 3 scheduled follow-up appointments at CCADP
CCC Clients Received and Attended Direct Service Appointments as of July 31, 2011
Lutheran Social Services 6 new referrals with 6 who attended first appointments
• 0 needed additional referrals to community resources• 3 scheduled follow-up appointments at LSS• 0 additional identified crisis
Youth & Family Services 5 new referrals with 2 who attended first appointments
• 0 needed additional referrals to community resources• 0 scheduled follow-up appointments at YFS• 0 additional identified crisis
CCC Clients Received and Attended Direct Service Appointments as of July 31, 2011 Catholic Social Services
3 new referrals with 1 who attended a first appointment• 1 needed additional referrals to community resources• 0 scheduled follow-up appointments at CSS• 0 additional identified crisis
Community Health – Mental Health 2 new referrals with 2 who attended first appointments
• 0 needed additional referrals to community resources• 2 scheduled follow-up appointments at CHC• 0 additional identified crisis
Total Number of Services Provided by CCC as of July 31, 2011
283
212160
38 4110
38
All clients entering the CCC, receive a Medical Triage exam.
Number of CCC Clients Referred to Pennington County Health & Human Services (HHS) Case Management
as of July 31, 2011 / Total = 51
Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11
0
4
10
67
12 12
HHS Case Management Referrals by Percent as of July 31, 2011 / Total = 51 CCC clients
After receiving the initial referral, HHS Case Managers identified 96 additional crisis situations leading to 161 referrals.
CCC clients had 20 follow-up contacts with Pennington County HHS Case Managers.
Food14%
Housing15%
Medical16%
Mental Health12%
Education /Occupa-tion1%
Transportation42%
Method Client was Transported to CCC by Month as of July 31, 2011
(Separated from Referred By)
Feb Mar Apr May Jun Jul
9
3341 38 41
33
1
3
4 5 1 6
3
9
1712 10 141 2
RCPD PCSO BFPD/BEPD Walk-in
Referral Sources for CCC Clients as of July 31, 2011
Other includes Sioux San, CCC, YFS, CAP, Detox, EAFB, Job Corp, Nat’l Guard, and the VA.
RCPD
RCRH ER Self
PCSO BMS
Family
/Frie
nd
Medical D
octor
Other Law
Enforce
ment
Comm. Counse
lorUSA
F
Other
Unknown
107
77
3219
7 3 3 3 2 29
19
Homeless Statistics of All CCC Clients
as of July 31, 2011
Gender Statistics of All CCC Clients
as of July 31, 2011
Male 57%
Female 43%
Not Home-less
83%
Homeless17%
Race Statistics of all CCC Clients as of July 31, 2011
White 67%
American Indian 17%
Asian 2%
Black or African American 2%
Other 4% Unknown 7%
Age Statistics of all CCC Clients as of July 31, 2011
Total Unique CCC Clients = 236
18-2021-25
26-3031-35
36-4041-45
46-5051-55
56-6061-65
66-7071-75
76-8081-85
86-90
unknown
28
45
2126
2218
28
1519
63
0 0 0 14
Number of Non-Pennington County CCC Clients as of July 31, 2011 - Total = 33
MEADE
OUT OF S
TATE
LAW
RENCE
CUSTER
DEWEY
FALL
RIVER
BENNET
TBUTT
E
HAAKON
HUGHESJO
NES
MINNEH
AHA
SHANNON
UNKNOWN
77 6
2 2 2 1 1 1 1 1 01
15Not Home-less
Homeless
MEADE
OUT OF STATE
LAW
RENCE
CUSTER
DEWEY
FALL RIVER
BENNETT
BUTTE
HAAKON
HUGHES
JONES
MIN
NEHAHA
SHANNON
7 76
2 2 21 1 1 1 1 1 1
Breath Alcohol Level of CCC Clients Who Were Tested as of July 31, 2011
Nonex <
.08
.08 = > x < .2
.2 = > x < .3
.3 = > x < .4
.4 = > x
Unknown
69
9
22 21
5 1 4
Unknown levels are those where CCC staff knew a person was drinking but the breathalyzer was malfunctioning.
Funding Sources for CCC Clients as of July 31, 2011
47%
17%13%
9% 6% 4%0% 0% 2% 2%
Non-billable clients were those who were in briefly and/or were not able to provide or sign billing information.
CCC Indicated Diversions From Specific Programs as of July 31, 2011
Jan Feb Mar Apr May Jun Jul
6
2931
34
2932
1 3
13 12
20
15
25
RCRH BHC RCRH ER Detox Jail HSC
Total BHC Diversions =161
Total ER Diversions = 89
*
* There was 1 diversion from HSC in June 2011.
Total CCC Diversions as of July 31, 2011Total = 270
RCRH BHC RCRH ER Detox Jail HSC0
20
40
60
80
100
120
140
160
180
161
89
12 7 1
Diversions are tallied based on the alternative that the referring entity would have chosen had the CCC not been available.
CCC Clients Compared to MH Holds < 24 hr Admits as of July 31, 2011
Jan-10
Feb-10
Mar-
10
Apr-10
May
-10
Jun-10
Jul-1
0
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10Jan
-11
Feb-11
Mar-
11
Apr-11
May
-11
Jun-11
Jul-1
10
10
20
30
40
50
60
70
80
90
MH Holds CCC Clients
CCC Satisfaction Surveys as of July 31, 2011 (1)
Very Much Agree
Agree Disagree Very Much Disagree
74%
25%
1% 0%
I get the help I want from the
Crisis Care Center
Very Much Agree
Agree Disagree Very Much Disagree
76%
24%
0% 0%
I would recommend the Crisis Care Center's services to others
CCC Satisfaction Surveys as of July 31, 2011 (2)
Very Much Agree
Agree Disagree Very Much Disagree
82%
18%
0% 0%
I feel safe and comfortable in the Crisis Care Center
Very Much Agree
Agree Disagree Very Much Disagree
86%
14%
0% 0%
Crisis Care Center staff is friendly, courteous and respectful
CCC Referrals from CIT Officers as of July 31, 2011
January 31 – July 31, 2011 – The CCC received 31 referrals from law enforcement officers trained in CIT. 12 referrals from law enforcement officers who had
consulted with another officer trained in CIT.
June 1 – July 31, 2011 – The CCC received 16 referrals from law enforcement officers trained in CIT.
12 referrals from law enforcement officers who had consulted with another officer trained in CIT.
Average Length of Stay at the CCC as of July 31, 2011
January 31 – July 31, 2011 The average length of stay at the CCC was 8.49 hours.
June 1 – June 30, 2011 The average length of stay at the CCC was 10.34 hours.
July 1 – July 31, 2011 The average length of stay at the CCC was 9.8 hours.
Current average length of stay at the CCC is 9.0 hours
Cost per petition is estimated at $1,000.00 each. This does not include State Attorney staff time or Board Chairman’s time.
The savings represents an impact to Federal, State and Local agencies.