Crisis Residential Best Practices Toolkit

1. Crisis Residential Best Practices Toolkit April 18, 2017

2. Today’s Agenda • Welcome • Review: Soteria Project • Content Overview: Treatment Philosophy & Approach • Review Survey Results/Discussion • Review Project Plan and Timeline • Adjourn Purpose: To develop a comprehensive Best Practice Toolkit for Crisis Residential Services, informed by Crisis Residential providers across the country.

3. Crisis Program Development • Research & Analysis • Data Analytics • Management Training • Quality Improvement • Integrated Care Coordination • System Redesign • Metrics Development www.TBDSolutions.com

4. Workgroup Participants • 110 participants from 29 states • Plus England and Costa Rica! • Approximately 325 crisis homes nationwide • Welcome new programs from NY, NC, MT, TX, and England

5. National Council Report: The Psychiatric Shortage • https://tinyurl.com/ldbtnc2

6. History: The Soteria Project

7. Content Review: Taxonomy • Names of Crisis Services • Crisis Residential • Crisis Stabilization • Crisis Respite • Facility Based Crisis • Extended Observation Unit • Acute Treatment Unit • Peer Respite • Crisis Resolution Center • Acute Stabilization • Crisis Recovery • Short Term Acute Residential Treatment (START)

8. Content Review: Taxonomy • Crisis Service Homophones • Crisis Stabilization Unit • Short-Term Crisis Residence • 23-hour Intnsive Treatment- AZ, NC, • Locked Treatment Facility mirroring Psychiatric Hospital (IN, FL) • Crisis Service Synonyms • Crisis Residential, Crisis Stabilization, & Crisis Respite • Crisis Respite & Peer Respite

9. Content Review: Taxonomy

10. Treatment Philosophy & Approach Results: Terminology

11. Treatment Philosophy & Approach Results: Terminology

12. Treatment Philosophy & Approach Results: Terminology

13. Treatment Philosophy & Approach Results: Terminology

14. Taxonomy: Treatment, Medications, and Peer Supports 58% of crisis programs reported treatment happens exclusively inside the program. 89%of crisis programs utilize a psychiatrist, while 54%utilize nurse practitioners for prescribing medications. 76% of crisis programs have Peer Support Specialists working directly in the home or providing support in the home from a partner agency.

15. Community Relations: Marketing Tools

16. Community Relations: Public vs. Private Approach to Marketing? • Public • “We will accept all referrals both internally and externally in order to increase census and attract new clients.” • “We want the community to be aware that we exist and what support we can offer.” • Private • “We turn away 40-50% of referrals, so no need for marketing” • “Limited marketing—not a walk-in program” • “Mostly word of mouth” • “As part of an LMHA, we are not permitted to market on a commercial level” • “We have limited resources and use it within programming” • Both • “We are currently only providing services to a region. We public market, however, only to our region at this time. We maintain the privacy of the location and limit the ability of referrals contacting the house. Any referrals are completed through a separate line and at the mental health center determine appropriateness of the admission.”

17. Community Relations: Alumni Engagement Less than 30% of crisis programs make efforts to engage their alumni in activities.

18. Community Relations:Maintaining Strong Provider Relationships Access Centers & Mobile Crisis Teams: Co-operated/co-located; scheduled meetings; email bed availability 2x/day; periodic workshops and phone calls; Case Management: Co-operated/co-located; scheduled meetings; encouraged to visit persons on-site; attend their staff meetings Psychiatric Hospitals: Honesty/transparency with clients we send to them; regular communication with discharge planner; Crisis Summit; monthly task force with CIT, jail diversion, local hospitals, and ER’s Emergency Departments: Attending each other’s meetings; Crisis Summit; e-mail daily with available beds;

19. Community Relations:Maintaining Strong Provider Relationships Law Enforcement: Law liaison on staff; provide training at the academy; developed a 24 hour hotline for officers; community meetings; Crisis summit; co-located with CIT team; sparingly call them for help; task force Primary Care Clinics: Scheduled meetings, crisis summit, referrals to primary car Funders/Health Plans: Monthly meetings; crisis summit invite for tours; daily conversation Donors/Grantors: Dedicated staff in agency to work with donors; crisis summit; individual meetings Neighbors: Provide program information; frequent check-ins; annual open house;

20. Community Relations: Additional Stories • “We have a county-wide meeting with leaders from various agencies that we attend monthly. Almost weekly we have staff presenting at various agencies throughout our service area with brochures explaining our services.” • “We aren't really in a position to need community relations but definitely at meetings offer ourselves as assistance and encourage referral sources/ area providers/ family members to always call our referal line even if it is not an appropriate referal we can share information about resources in the area.” • “We have formed a Community Crisis Summit that involved all different fractions and we are largely involved in CIT Council and community outreaches” • “Our alumni keep the surrounding property clean of debris thus improving relationships with neighbors.” • “We engage highly in community activities to promote positive relations. We attend health fairs, Relay for Life, Advisory Committee for Victim Rights, Food Pantry donations, Christmas donations, etc. We want to maintain a positive looks as well. Staff are required to dress in a professional manner in public for our program with a logo polo.”

21. Project Participation: Update

22. Upcoming Webinar Training: SAMHSA 4th Monday of each month April-September Monday April 24th 3pm EST/12pm PST https://tinyurl.com/mezytde

23. Next Steps Next Conference Call: Friday, May 19th @ 1pm EST/10am PST Group Listserv: CrisisResidentialNetwork@TBDSolutions.com Website: www.CrisisResidentialNetwork.com (Meeting Slides stored here) Questions: TravisA@TBDSolutions.com