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NORTHWEST REGION CHILDREN’S SERVICES. WESTERN MO MENTAL HEALTH CENTER Child and Adolescent Unit Designed for 10 beds, but staffed for fewer Acute psychiatric.

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Presentation on theme: "NORTHWEST REGION CHILDREN’S SERVICES. WESTERN MO MENTAL HEALTH CENTER Child and Adolescent Unit Designed for 10 beds, but staffed for fewer Acute psychiatric."— Presentation transcript:

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 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 Rivers20 ___________________________ Total Beds102 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 CategoryTotal Slots* Specific ServiceSpecific Slots Hospitalization/ Stabilization less than 6 months 43Non-Medical Crisis Bed4 Medical Crisis Bed4 Residential9 Inpatient26 Hospital/Residential Treatment Centers greater than 6 months 43Transitional/Independent Living 37 Residential5 Inpatient greater than 6 months 1 Treatment Family Homes/Group Homes 340Treatment Family Homes255 Group Homes86

10 NW Region Capacity Development CategoryTotal Slots Specific ServiceSpecific Slots Home -Based851Respite247 Family Assistance238 In-home Therapy247 Intensive CPR119 Day Treatment851Full Program153 Individual Therapy Group Therapy Outpatient3404Physician Services2247 Access/Intake511 Evaluation Services34 Therapy Services613 1 Individual services added to existing program

11 NW Region Capacity Development CategoryService SlotSpecific ServiceSpecific Slot Case Management with WrapAround 2,3 5504POS CM1021 TCM Bachelors613 TCM Masters340 Maintenance CPR545 Rehab CPR885 WrapAround Parent Support Support and Educational Groups Total Service Slots8396 Total Youth6300 2Peer to Peer case management and parent partner models of cm would be included in this category 3WrapAround was calculated based on access for 70% of the youth receiving CM or home-based services 4Based on 20% of children served

12 Current Utilization Current ServiceCurrent Utilization or Slots Capacity Development Slots Recommended Acute Inpatient10226 Residential under 6 months 129/67*9 Crisis Beds(TFH)8 Inpatient over 6 months 1 Residential over 6 months 50*5 Transitional/ Independent Living *37 Group Homes*86

13 Current Utilization Current ServiceUtilization/SlotsCapacity Development Slots Recommended Treatment Family Homes9 (27)255 Respite Family Assistance238 In-home Therapy247 Intensive CPR Rehab CPR Maintenance CPR545 POS CM Bachelor level TCM Master level TCM

14 Current Utilization Current ServiceCurrent Utilization/Slots Capacity Development Slots Recommended WrapAround Day Treatment-Full Program49153 Individual Therapy Enhancement247 Group Therapy Enhancement81451 Physician Services Access/Intake Evaluation Services37734 Therapy Services499613

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 (2 nd 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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