Understanding the community mental health system

1. CHILDREN, YOUTH, and FAMILIES Understanding the community mental health system July 27, 2011 Julie de Losada, Laura Davis Yen .

2. CMHA CMHA CMHA Centers for Medicare & Medicaid Services Federal Government Mix of State Mental Health and Federal $$ DSHS DDD other ADSA JRA other CA • Pearl Street • McGraw • CSTC • Tamarack DBHR CLIP WSH ESH North Sound Mental Health Administration RSN • Catholic Community Services NW • Whatcom, Skagit, Snohomish • Compass Health • Skagit, Snohomish, San Juan • SeaMar Behavioral Health • Skagit, Snohomish, Whatcom • Whatcom Counseling & Psychiatric Clinic • Region 2 North • NSMHA From Washington to Washington…

3. 39Counties Groupedinto 13 RSNs

4. It All Starts at “ACCESS” How NSMHA works with Volunteers of America

5. Access to Care 4 Ways to Enter the Community Mental Health System Crisis Services Outpatient Services Inpatient Services* CLIP* Volunteers of America (VOA) *Neither NSMHA nor our Providers deliver inpatient or CLIP services. NSMHA may authorize for these levels of care.

6. Role of VOA

7. Accessing Crisis Services • 24/7 Phone Crisis Intervention Services • 100,000 Annual Total Calls • Serving Five North Sound Counties • Self-Defined Crisis • Mental Health Professional Staff

8. Accessing Outpatient Services • MUST meet Medicaid Financial Eligibility • Established by Community Service Office (CSO) • MUST have a covered “Access to Care” diagnosis • MUST meet “medical necessity” • MUST call ACCESS to Mental Health Services

9. Examples Access to Care Standards

10. Access to Care Standards Continued

11. RSN/ CMHA Service • Outpatient services offered by NSMHA contracted Community Mental Health Agencies • Catholic Community Services NW • Compass Health • SeaMar • Whatcom Counseling and Psychiatric Services

12. ALL Providers Offer… • Assessment/ Evaluation • Individual Therapy • Group Therapy • Family Therapy • Medication Management • Case Management • Coordination with formal systems • Coordination with natural supports

13. SOME Providers Offer… • CHAP – Children’s Hospitalization Alternative Program • Co-Funded by Children’s Administration for 16 yrs. • Individualized/ intensive care • In-home & out-of-home • Respite • 24/7 Crisis Response • Wraparound • Family-driven/ Youth-Guided • Team Based • Natural Supports • Community Based • Culturally Competent • Strengths Based • Collaboration • Persistent • Outcomes Based INTENSIVE SESSION Systems of Care and Wraparound: An Overview Dan Embree 2:40 RM 565 B/C

14. Assessments and Evaluations How Long Does it Take to Get an Appointment??!?!?!

15. Time Lines

16. Individual and Tailored Care

17. Family Voice and Participation

18. Considerations for Adolescents • Youth who are thirteen and older can request mental health services without the consent of their parents. RCW 71.34.500 • Youth who are thirteen or older and who are a danger to themselves or others, and refuse treatment may be involuntarily detained and hospitalized. RCW 71.34.710

19. Transitioning to the Adult Mental Health System Planning Ahead…

20. Preparing for the transition • Discuss transitioning to an adult mental health provider with the current mental health provider: • Timing of the transition • Which agency and program can best meet the young adult’s needs? • Keep in mind, some programs take time to get into • Apply for Medicaid if appropriate: • Medical • Cash assistance • Food Benefit • Research and plan for housing: • Housing authorities’ programs including voucher programs and public housing • Some mental health agencies have limited housing resources

21. Preparing for the transition, Continued • Community Resources: research what other assistance is available in your community • Food Banks • Transportation Options • Discounted utilities • Any special needs • Develop skills for independent living • Plan for employment/education/daily activity • Teach/coach the youth how to communicate about and navigate health care; they will be driving their own care as an adult.

22. The Adult Mental Health System at a Glance

23. Inpatient MH Treatment A Brief Overview…

24. Accessing Inpatient Services

25. When is Inpatient Appropriate?

26. When is Inpatient Inappropriate?

27. What to expect… • Time limited crisis stabilization (5-10 days) • Limited psychiatric evaluation/assessment • Possible medication assessments/ adjustments • Coordination with outpatient provider (if there is one) • Coordination with other systems (if indicated) • Discharge Planning

28. More about Inpatient Services

29. Questions? For more information, contact: NSMHA www.nsmha.org 360.416.7013 Julie de Losada, M.S. julie_de_losada@nsmha.org Laura Davis Yen, LICSW laura_davis@nsmha.org Contacts