1. Crisis Residential Best Practices Toolkit
May 19, 2017

2. Today’s Agenda Welcome
Crisis Program Spotlist: Lighthouse- Colorado Springs, CO
Content Overview: Intake
Review Survey Results/Discussion
Review Project Plan and Timeline
Adjourn
Housekeeping: Using Skype for questions—please mute us, but don’t put our call on hold
Purpose: To develop a comprehensive Best Practice Toolkit for Crisis Residential Services, informed by Crisis Residential providers across the country.

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

4. Workgroup Participants
110 participants from 30 states
Plus England and Costa Rica
Approximately 300 crisis homes exist nationwide
Welcome new participants from UT, NY, NC, MT, TX, and VT

5. Crisis Program Spotlight: Apsen Pointe (CO)
Legislative efforts in California and Colorado have brought about significant improvements and funding in the Crisis Services Continuum.

6. AspenPointe Barbara Kleve – Project Manager

7. Key Objectives – SB
Increase access to crisis services 24/7 “No Wrong Door”
Open to all ages
Services provided regardless of income or ability to pay
Services provided regardless of residence
presentation driven vs. diagnosis driven care
Right Services, Right Location, and Right Time
Expansion of Continuum of Care (Mobile response, Walk In, CSU, Respite)
Mobile Assessment and Walk-In accessibility
Person-Centered, Culturally Relevant, and Trauma- Informed Care
Reduce ED burden for psychiatric emergencies
Reduce Unnecessary Law Enforcement and First Responder transports

8. What does access to crisis services mean?

9. Rocky mountain crisis partners 1-844-493-8255 (TALK) or Text “Talk” to 38255
Crisis Line / Text
Support Line
Immediate crisis support and in the moment consultation
Telephonic assessment for wide scope of mental health and substance use issues
Suicide/safety assessments, substance use screenings
Triage to other components of the Colorado Crisis Services
Referral and resource linkage
3rd party consultation (friends, family, other professionals)
Telephonic case management, continuity of care activities
Follow up calls
9a – 11p 7 days a week
Peer Specialists with lived experience with behavioral health challenges = Power of shared experience
Provide in the moment or ongoing support
Promote recovery and wellness
Triage to Crisis Line as appropriate
Follow up calls
Referral and resource linkage

10. How does AspenPointe fit into Colorado Crisis Services?

11. AspenPointe – Southern Region
Referral Based Services
Mobile Unit Response
Access to Services Available 24/7/365
Crisis Residential Respite
1) Alano House
2) Special Kids Special Families
3) El Pueblo Kids
4) Grand House
HOTLINE / WARMLINE
TALK (8255)
A program of Rocky Mountain Crisis Partners
Crisis Walk-In Centers
1) 115 S. Parkside Dr. Colorado Springs, CO
2) 1310 Chinook Ln Pueblo, CO
Crisis Stabilization Units
1) 115 S. Parkside Dr. Colorado Springs, CO
2) 1302 Chinook Ln Pueblo, CO

12. What are Walk In Crisis Services?
No appointment necessary
Services available regardless of the ability to pay
Services available regardless of residency
Staffed with licensed clinical providers through peer specialists
If needed coordination of care with
Detox
ATU & Inpatient levels of care
Emergency Department for Medical Services

13. What is mobile response or CRT?
Collaboration between CSFD, CSPD, & AspenPointe.
2 units of 3 people – 1 officer, 1 medical professional from CSFD, & 1 licensed clinician.
Response within Colorado Springs City Limits
7 days a week 10am – 7pm
Outside of these times & the surrounding areas of El Paso County, a crisis clinician will be dispatched.
Rural Crisis –
Park & Teller counties each have a crisis clinician who will respond to crisis calls, outside of these hours a clinician is dispatched from El Paso County.

14. Questions??

15. Content Review: Intake
December 2016: Staffing
January 2017: Scope & Function
February: Metrics & Outcomes
March: Taxonomy & Community Relations
April: Treatment Philosophy & Approach
May: Intake

16. Intake Results: Staff Responsible
Other Intake Staff
Psychiatrists/Medical Director
Nurse Practitioners (2)
Therapist
Everyone (2)
Program Director
Licensed MH Professional
Program Coordinators

17. Intake Results: Referral Sources

18. Intake Results: Documentation
“Moving to electronic soon”
“Referrals are recorded in E.H.R.; paper is a checklist of items to review with clients at admission.”
“Disclosure, consent, rules, bag check, etc. are done on paper; the rest is done electronically.”
“Initial intake is completed on paper and scanned.”

19. Intake Results Results: Efficiency
“We track length of time from referral to screening, length of time to complete screening, and length of time to complete admission.”
“From referral to admission completion takes about 2 hours. It must be completed within 24 hours of admit, especially if someone comes in the middle of the night.”

20. Intake Results: Admission Time
“Full beds and high numbers of referrals make this difficult to decipher information from.”
“Within an hour for nearby counties, and within 90 minutes for outer counties.”

21. Treatment Philosophy & Approach Results: Models of Care
Included in a handbook
Selected house rules are reviewed in morning group

22. Intake Results: Waiting List
Do electronic bed boards exist in your state for psychiatric hospital beds or crisis stabilization beds?
If so, how do they function?

23. Intake Results: Care Coordination
How does your crisis program work with referral sources to ensure strong coordination of care during the intake process?
Outpatient therapist initiates phone screen with program manager
Nurse-to-nurse/ Doc-to-Doc/ Clinician-to-clinician communication
Coordination of Care discussion at intake and a 72-hour post-admission coordination of care meeting (PA)
Shared access to medical records with hospitals (TX)
“We require 3 case collaborations within 24 hours.”
“Staff are trained to ask probing questions and request specific documentation.”

24. Intake Results: Admission Items & Planning for Discharge

25. What do you think? Ideas for future topics Feedback on Workgroup
Client Outreach- Satisfaction, follow-up, alumni relations
State policy for Crisis Services—Provider Manual, governing specs, compliance requirements
Peer Supports
Role of Volunteers & Interns
Technology in Treatment
Feedback on Workgroup
Artwork/Graphic Design for website
Travis at

26. Upcoming Webinar Training: SAMHSA
4th Monday of each month April-September
Monday May 22nd
3pm EST/12pm PST

27. Next Steps
Next Conference Calls: Wednesday, June 2pm EST/11am PST Friday, July 1pm EST/10am PST Group Listserv: Website: (Meeting Slides stored here) Questions: