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Central Receiving Center Update (CRC) 5 Years of Operation

Central Receiving Center Update (CRC) 5 Years of Operation. June 10, 2008. Presentation Outline. History What is the CRC? CRC Data Jail Impacts Funding Issues Summary. Presentation Outline. History What is the CRC? CRC Data Jail Impacts Funding Issues Summary. History. The Crisis

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Central Receiving Center Update (CRC) 5 Years of Operation

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  1. Central Receiving Center Update (CRC)5 Years of Operation June 10, 2008

  2. Presentation Outline • History • What is the CRC? • CRC Data • Jail Impacts • Funding Issues • Summary

  3. Presentation Outline • History • What is the CRC? • CRC Data • Jail Impacts • Funding Issues • Summary

  4. History The Crisis • Lack of Mental Health funding in District 7 • Lack of Coordination & Continuity in the Mental Health System • Over utilization of ER & Orange County Jail for Mental Health Consumers • Creation of Jail Oversight Commission (Chaired by Bill Sublette) • CRC was a major recommendation of the Medical, Mental Health & Substance Abuse Sub Committee (Chaired by Rich Morrison) • CRC opened in April 2003

  5. History The System of Care Before CRC • Jail had become the defacto mental health facility • Long waits for a consumer to be placed in a treatment bed at every entry point • Impacts on overcrowded emergency rooms for psychiatric patients and those needing detox services • Bookings in the Orange County Jail, and the costs associated with risk, psychotropic medications and jail resources to manage these vulnerable consumers

  6. Presentation Outline • History • What is the CRC? • CRC Data • Jail Impacts • Funding Issues • Summary

  7. What is the CRC? • Baker Act –Mental Health involuntary treatment act for those suffering with a mental illness in which they cannot take care of themselves and may be in danger to self or others due to their mental illness • schizophrenia • psychosis • depression • bipolar disease All brain disorders are classified as diseases

  8. What is the CRC? • Marchman Act is the involuntary treatment act that allows for treatment of a substance use disorder/addictive disorder in which the person may be dangerous to self or others due to their substance abuse • Drug Addiction • Alcohol Addiction • Polysubstance abuse– combinations of drugs and alcohol Also classified as a disease

  9. Center for Drug Free Living Addiction Receiving Facility (ARF) Lakeside Behavioral Healthcare Florida Hospital Emergency Room Law Enforcement Officer Orlando Regional Hospital Emergency Room Jail Health Central Pre CRC System of Care CONSUMER Mental Health Baker Act Substance Abuse Marchman Act

  10. What is the CRC? • Central point of access for integrated assessment for involuntary mental health (Baker Act) and substance abuse (Marchman Act) • Jail Diversion for Law Enforcement use in Orange County Partnerships Department of Children and Families Lakeside Behavioral Healthcare The Center for Drug Free Living Human Services Associates Florida Hospital and Orlando Regional Healthcare

  11. Central Receiving Center < 23 hours Law Enforcement Officer INVOLUNTARY Center for Drug Free Living Detox 3-5 days Lakeside Behavioral Healthcare Crisis Stabilization Unit / Short-term Residential Treatment Unit 3-4 days Lakeside Behavioral Healthcare Hospital 3-4 days ORH Behavioral Healthcare Florida Hospital Behavioral Healthcare Medical-Surgical Psychiatric 3-4 days VOLUNTARY Central Receiving Center Phase Two 3-6 months CRC Phase Two Permanent Housing Shelter + Care HUD, SRO Low income CRC System of Care

  12. What is CRC? • Consumers placed in most appropriate community resource within 24 hours • Consumers diverted from over crowded emergency departments and jail • 2005 award recipient as “most innovative” program from DCF and FADAA • State of the art facility, only one of its kind in the State of Florida

  13. Presentation Outline • History • What is the CRC? • CRC Data • Jail Impacts • Funding Issues • Summary

  14. CRC Data • Integrated 24/7 model • April 2003 - March 2008: • Approximately 23,000 screened • Of 23,000 - 86% Law Enforcement, 14% Hospitals • Of those screened: • 20,147 placed in mental health beds • 2,113 placed in substance abuse beds • 20% of those brought to the CRC are homeless

  15. CRC Data ER Referrals Placed by CRC

  16. CRC Data Saved ER Beds

  17. CRC Data Use of CRC by LEO Agencies

  18. Law Enforcement Savings

  19. Presentation Outline • History • What is the CRC? • CRC Data • Jail Impacts • Funding Issues • Summary

  20. Jail Impacts • April 2003 - March 2008 • No Marchman patients brought to jail for protective custody • Approximately 150 Baker Act patients received annually from Orange County Jail • Law enforcement is diverting over 8% of consumers from the jail • Nearly 52,000 jail bed days saved

  21. Jail Impacts Jail Beds Saved by CRC

  22. Jail Impacts Released From Jail to CRC

  23. Presentation Outline • History • What is the CRC? • CRC Data • Jail Impacts • Funding Issues • Summary

  24. Funding Issues Original Partners (2003) • Orange County $1,240,000 • Florida Hospital $ 250,000 • Orlando Regional $ 250,000 • State of Florida (DCF) $ 300,000

  25. Funding Issues Gains Via State Appropriations • FY ‘05 -$2.8M Added:20 MH Crisis Beds 6 Detox beds 7 Case Managers 10 Residential Substance Abuse beds • FY ‘06 - $3.0M • Kept the resources from previous year

  26. Funding Issues • FY ‘07 – Appropriation cut to $2.25M Lost: 10 Crisis MH beds 3 Detox beds 6 Residential substance abuse beds • FY ‘08 – Appropriation cut to $500,000 (As of July 1, 2008) Loss:17 Mental Health beds Case management program Some services out of CRC Fidelity of the CRC model Total Reduction of $1.75M from State

  27. Presentation Outline • History • What is the CRC? • CRC Data • Jail Impacts • Funding Issues • Summary

  28. Summary As Funding for the CRC decreases: • Increase in arrests for mental health and substance use disorders • Increase in jail population of those most vulnerable requiring more supervision and posing greater risks • Mental health inmates stay longer by 67% • Law enforcement may choose jail rather than emergency rooms for transport

  29. Central Receiving Center Update (CRC)5 Years of Operation June 10, 2008

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