Expanding Mental Healthcare Access for Adolescents and Children DSRIP 3-Year Project Presentation to Regional Learning Collaborative July 18, 2014

Background  Midland County and RHP 14 have long struggled with shortages of mental health providers.  Local MHMR services and various non-profit providers have filled some of the void, but the scope of services remains limited.  Access to advanced mental healthcare for children and adolescents is particularly short.  A recent rash of adolescent suicides energized the community to look for solutions to these chronic shortcomings.

Background (cont.)  Midland County Hospital District provides the only full-service emergency facility in the County.  Midland Memorial Hospital’s ED is the first stop for all mental health patients in crisis.  In fiscal 2013, 181 children and adolescents were discharged with mental health disorders.  MMH is not staffed and equipped to manage psychiatric patients.  Children and adolescents requiring intensive psychiatric care are typically transferred out of the community.

Background (cont.)  Oceans Behavioral Hospital of Permian Basin provides inpatient and outpatient services to Adult and Geriatric populations.  Previous private psychiatric hospitals have failed in this region.  Some of these have included adolescent programs.  Failures have been attributable to multiple factors, especially lack of qualified psychiatrists and psychologists.

Background (cont.)  Centers for Children and Families is a local non-profit organization, providing counseling services for all age groups.  Centers primarily utilizes licensed counselors as providers.  Provision of the full range of intensive counseling services for children and adolescents requires a PhD psychologist to complete the team.

Background (cont.)  Dr. Kimberly Macferran is a Developmental Pediatrician, working in association with MARC, a local non-profit dedicated to the care of individuals with disabilities.  Dr. Macferran and MARC collaborate in the care of children with various developmental concerns, including autism and related disorders  Provision of the full range of services needed by this population requires a PhD psychologist to provide testing and counseling to augment Dr. Macferran’s care.

The Project  Midland Memorial Hospital is providing support to its local partners for recruitment of a minimum of three mental health providers over the 3-year duration of the project:  One Child/Adolescent Psychiatrist (MD)  Two Child/Adolescent Psychologists (PhD)

The Project (cont.)  Oceans has renovated a 12-bed inpatient unit specifically for adolescents, and plans to open this new inpatient service in August.  Midland Memorial’s ED is expected to be a significant referral source for this unit, with half or more of its patients likely to be covered by Medicaid or uninsured.  Oceans will add an off-site outpatient service for adolescents as soon as appropriate space can be identified.  In DY3, Oceans has recruited two psychiatrists to assist in this program.  Midland Memorial is providing financial support for recruitment costs.

The Project (cont.)  Centers for Children and Families leadership is working closely with MMH leadership to recruit a PhD psychologist trained and experienced in counseling children and adolescents.  An experienced psychologist with ties to the region is in active negotiation with Centers to join their practice by the end of 2014 (early DY4).  Midland Memorial will provide financial support for recruiting costs, as well as ongoing income support as needed.  Over one-third of Centers’ patients lack any form of third-party insurance coverage for counseling services.

The Project (cont.)  For DY5 (our fiscal 2016), Midland Memorial will work closely with Dr. Kim Macferran and MARC to recruit a psychologist with training and experience in testing and counseling for developmentally-challenged children.  Midland Memorial will provide financial support for recruiting.  An affiliate of Midland Memorial provides management and ongoing financial support for Dr. Macferran’s practice, and will do so for the psychologist’s practice as well.  Dr. Macferran’s patients are primarily covered by Medicaid and CHIP.

Our Hope  Our region’s need for child and adolescent mental health services is significant and growing.  By helping to grow the available services in our community, we hope to:  Provide timely, local help for adolescents in crisis;  Enhance diagnostic capabilities and provide access to counseling as needed, to help avoid future psychiatric crises;  Assure access to care for children and adolescents who need it, regardless of ability to pay; and  Improve the mental health of our community’s children and adolescents.