DONNA CHRISTIANSON,CRISIS PROGRAM DIRECTOR
VICKI RILEY, CARE CENTER PROGRAM DIRECTOR
Spotlight on the CARE Center
Background
The initiative started as a result of La Crosse County Clinical Services Process Improvement initiative Training Screening/Filtering Mandatory Services Continuum of Care
Continuum of Care subgroup identified “gaps” in our current service system Crisis Center Community Bridges
Mission Statement
Create a crisis assessment center and detoxification center by the end of 2009 in order to provide more cost-effective triage and intervention for area individuals undergoing distress due to mental health or substance abuse concerns.
Enhance available supports and services to help people maintain stability in community settings (Community Bridges)
Facility Criteria Identified: 2nd Focus Group 6/09
Unlocked facility (home-like setting)8 bed capacity for adults (male and
female)Non Ch 51 (detentions will go to the
hospital)Non medical detoxificationCentrally located in La CrosseWell trained staff
CARE Center Timeline
Request for Proposals reviewed (9/09)Tellurian, UCAN selected as the top applicant Awarded the contract (10/14/09)Site search, selection and constructionHiring and training staff Budget/contract negotiationsCertification process and completionPolicies and proceduresOpen House (4/10) and Grand Openning
(5/18/10)
CARE Center Staff
F.T. Program Director: Vicki RileyF.T. Community Liaison: Teri McDougle10 FTE Human Service AssistanceP.T. Registered Nurse2 Peer Support Specialists
CARE Center Admission Processfor Law Enforcement
Law Enforcement contacts Mobile Crisis to assist with assessment when involved with mental health situations in the field
If there are immediate medical concerns, arrange for transport to the hospital and then contact mobile crisis
However, if there are no medical issues, assessing the crisis should occur in the community (ie.the home, CARE Center, etc)
CARE Center Admission Process for Hospitals
After assessment in the ER, the Crisis Responder and Hospital Staff collaborate on the disposition. If CARE Center is deemed appropriate, CARE staff is contacted and they provide transportation to the CARE Center
CARE Center is also used as a step down from the inpatient units. County crisis staff facilitate this also between the hospital and CARE Center
Alcohol Detox Challenges
The statutes are restrictive as to who can be served at this level of care
No other substances can be in the person’s system other than alcohol and benzodiazapines (received the OK for THC)
The withdrawal score (CIWA) needs to be within a certain limit
If there are other medical issues or a history of seizures they would be deemed inappropriate for admisson
CARE Center Data
2010 May June July August Sept Oct Nov Dec
# of admissions
(MH/Detox)
18
17/0
32
31/1
46
44/2
43
40/3
41
39/2
Average LOS 3.94 5.65 4.19 4.92 4.5
Average census
4-6 4-6 6-8 4-8 5
Readmissions
1-2x’s
1-3x’s
4 6
5-2x
1-3x
5
5 – 2x
5
4-2x
1-3xPolice
transport to Center
0 1 1 3 2
MA Funded 61%
11/18
59%
19/32
65%
30/46
70%
30/43
78%
32/41
Crisis Program Data
2002 2003 2004 2005 2006 2007 2008 2009 2010 Jan-Sept. (yr projection)
Total Crisis Contacts
602 669 1363 2248 4164 3700 3705 4206 4167(5209)
Police contacted crisis
587 780 836 832 796 724 (905)
Ch 51’s 646 541 708 686 758 722 768 610 414 (518)
Stabilization Bed (disposition in crisis situation)
101 133 126 116 108 178 (223)CARE Ctr open 5/18
County funded hospital bed days
588 568 388 583 348 385
County charges for State Hospital (bed days)
164 178 162 185 68 167
CARE Center: 4647 Mormon Coulee Rd
Program Director: Vicki Riley
Kitchen
Living Room Space
…More Living Room Space
Dining Room
Bedroom (2 residents per room)
…another bedroom
La Crosse Co. Satellite Office
Medication Storage Area
Shower Room (there are 2)
Open/light Spaces
Facility Comparison
Hope House New Crisis CenterLimited staff hours 24 hour awake staff
Unlicensed facility CBRF licensed facility
Crisis therapist follow up next day
Crisis therapist and Nurse Practitioner follow up
No detox admissions Non-medical detox admissions
4 bed capacity 8 bed capacity
Problem Solving Strategy
With every new process, there are bound to be problems that arise
There are many players involved in these crisis situation
Meetings have occurred twice/month, including CARE staff, Law Enforcement, Consumers, Crisis and Hospital staff to problem solve situations and improve our collaboration
Consumer Satisfaction
“It’s not very often that you find a bunch of people that actually want to help people they don’t even know… It’s really nice to know that there are people out there that actually care.”
“This environment is very healing.”“This facility is 100% better than what we
had.”“The staff went above and beyond in meeting
my needs. I felt safe here and the staff is very knowledgeable and friendly.”
CONTACT INFORMATION
Donna Christianson La Crosse County Human Services
608-785-6118 christianson.donna @co.la-crosse.wi.us
Vicki Riley CARE Center
608-519-3080 [email protected]
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