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NORTHWEST REGION

NORTHWEST REGION. CHILDREN’S SERVICES. WESTERN MO MENTAL HEALTH CENTER. Child and Adolescent Unit Designed for 10 beds, but staffed for fewer Acute psychiatric inpatient Front Door – Emergency Room typically, frequently Central or Regional Office recommendation. WMMHC Stats.

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NORTHWEST REGION

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  1. NORTHWEST REGION CHILDREN’S SERVICES

  2. WESTERN MO MENTAL HEALTH CENTER • Child and Adolescent Unit • Designed for 10 beds, but staffed for fewer • Acute psychiatric inpatient • Front Door – Emergency Room typically, frequently Central or Regional Office recommendation

  3. WMMHC Stats • Approximately 200 admissions in a year • Mood Disorder, Not Otherwise Specified by far the most frequent diagnosis (7x more frequently given than the next diagnosis which was Psychotic Disorder, NOS) • Approximately 45% referred by family/relatives • Approximately 25% referred by courts/law enforcement • 10% were involuntary commitments

  4. WMMHC Stats • 17% had dual diagnoses of MI/DD • Payor Sources • 38% Medicaid • 33% MC+ Managed Care • 17% “guest of the state” • 12% private insurance

  5. WMMHC Statistics • Average Length of Stay 11.5 days with a range from 2-126 days (10% exceeded 30 days) • Of the 10%, the classic presentation was • Dually diagnosed with MI/DD • Extreme Behavioral Presentations (typically aggression) • Co-occurring medical conditions • Multiple admissions to inpatient services

  6. Complicated Medical Conditions • One youth had the following medical conditions on Axis III • HYPOTHYROIDISM UNSPEC • OBESITY UNSPEC • TEAR FILM INSUFFIC UNSPEC • ALLERGIC RHINITIS UNSPEC • ESOPHAGEAL REFLUX • UNSPEC CONSTIPATION • ACUTE DERMATITIS SOLAR RAD • OBSTRUCTIVE HYDROCEPHALUS • STEVENS-JOHNSON SYNDROME • OTHER CONVULSIONS • OTHER DRUG ALLERGY

  7. NW Region Inpatient Bed Capacity for Children and Adolescents Crittenton 41 Research Psychiatric 25 Heartland –St. Joseph 0 St. Luke’s Northland 6 Two Rivers 20 ___________________________ Total Beds 102 Royal Oaks 33

  8. Capacity Development • Based on model developed by Robert Friedman out of Southern Florida in 1987 – updated through discussions in 2003 • Balanced system of care – excess or deficit in any area, impacts all other areas • Does not include services for prevention or early intervention • Public mental health services and funding, so would include schools, juvenile courts, child welfare and Medicaid

  9. NW Region Capacity Development

  10. NW Region Capacity Development

  11. NW Region Capacity Development

  12. Current Utilization

  13. Current Utilization

  14. Current Utilization

  15. Current Utilization • Total of 4921 youth served (unduplicated within a service but may be duplicated across services) • Total billings not included inpatient and residential = $10,838,534 • In a year, on average approximately 5 youth exceed 6 months in residential

  16. Profiles • 15 year old female – Truman/Kansas City Regional Office • Currently at Mid Mo since 2/09 (2nd transfer from WMMHC upon closing) • Children’s Division custody • 10 hospitalizations at Western Mo MHC • 2 KCRO placements • 1 Private sector In-patient Acute Hospitalization • Physical health issues prohibit SCL psychiatric placements • Has been denied out of state placements • 12 year old male – Swope/Kansas City Regional Office • Currently at (DMH/CPS)Hawthorn Children’s Hospital in St. Louis since 10/08 • Children’s Division custody • 2 hospitalizations at Western Mo MHC In-patient Unit • No community placement prospects with SCL or KCRO

  17. Profiles • 16 year old male – Comprehensive MHS • Parents custody • Crossed 3 Jackson Co Administrative Agents • Placed in SCL psychiatric placement at the State’s most elevated rate; no other statewide options • 9 year old female - Tri-County MHS • Parents custody • In SCL psychiatric placement for over 15 months in St. James, MO as there are no closer placements that will accept her

  18. Profile • 15 year old male – Comprehensive MHS/Kansas City Regional Office • Grandparents custody • Currently in JAG Unit - no other SCL/VPA Placement options • 4 combined SCL/MRDD placements • 14 year old male – ReDiscover MHS • Parents custody • Currently in JAG Unit – no other SCL/VPA Placement options • Has been denied SCL psychiatric and Children’s Division placements statewide

  19. Profiles • 14 year old female – Family Guidance Center/Albany Regional Office • Parents custody • Currently in SCL/MRDD Interdivisional Agreement in St. Louis; only placement that would accept her with very rigid conditions • 3 hospitalizations at Western Mo MHC • 1 hospitalization at Hawthorn Children’s Hospital in St. Louis • 4 SCL placements • 12 year old female – Swope/Kansas City Regional Office • Children’s Division custody • Currently in Children’s Division placement • 4 hospitalizations at Western Mo MHC • 1 SCL psychiatric placement • 1 KCRO community placement

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