1. Crisis Best Practices Workgroup
August 23, 2017

2. Today’s Agenda Welcome Content Overview: Governance & Regulations
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. Crisis Best Practices Workgroup
TBD Solutions is proud to sponsor the Crisis Best Practices Workgroup.
Crisis Program Development
Quality & Process Improvement
Metrics Development
Integrated Care Coordination
Middle Management Training
Research & Analysis
Interactive Data Visualization
Software Procurement Consulting

4. Crisis Services Map

5. Workgroup Participants
98 Crisis Residential Providers
10 Crisis Providers, Psych Hospitals, or Peer Respites
4 State Behavioral Health Administrations Represented (TX, VA, WA, WI)
41 states
Plus England and Costa Rica
Approximately 375 crisis homes exist nationwide
Welcome new participants from NE, MA, SC, TX

6. Content Review: Regulations & Governance
December 2016: Staffing January 2017: Scope & Function February: Metrics & Outcomes March: Taxonomy & Community Relations April: Treatment Philosophy & Approach May: Intake June: Funding July: The Safety Net August: Regulations & Governance

7. Regulations & Governance
Standards & Guidelines
Maintaining Order
Compliance vs. Quality
Doing the Things vs. How you do the Things

8. Challenges with Regulations & Governance
Continuous and Prescriptive Oversight
Reactionary Policy Changes
Power and Expertise Differentials
Compliance vs. Quality

9. Regulations & Governance Survey Results: Rules & Guidelines

10. Regulations & Governance Survey Results: Crisis Contracts
“In Costa Rica we are running the first Community Mental Health Center. The Secretary of Mental Health is supporting our efforts. The University supports our basic expenses.”
n=21

11. Regulations & Governance Survey Results: Audits
Internal Audits
Community Care Licensing
Local Behavioral Health Authority
State Department of Health Care Services
n=21

12. Regulations & Governance Survey Results: Accreditation
Additions:
Council on Accreditation (COA) (2 respondents)
n=21

13. Regulations & Governance Survey Results Audit Discrepancies
“The state recommends a “hard” lock on the facility, yet our local fire department will not approve that. So we have had to apply for special waivers from the state to have a 30-second egress lock.”
“State auditors tend to focus on their area of expertise. CARF surveyors are wildly unpredictable to the point that it is sometimes difficult to recognize the standards at all.”
n=21

14. Safety Net Survey Results: Contract Requirements

15. Regulations & Governance Survey Results: Performance Standards & Consequences
“Plans of Correction”
“We have always exceeded performance standards but I assume there would be a funding reduction.”
n=21

16. Safety Net Survey Results: Maintaining Program Integrityd

17. Regulation & Governance Survey Results
“Increased revenue”
“Continued funding”

18. Regulations & Governance Survey Results: Performance Standards & Consequences
“Annually”
“We were just re-procured by the County for the first time in 37 years. We will now be on a five year re-procurement scheduled like all other county contracts. The VA also re-procured our contract this year for the first time.”
n=21

19. Survey Participation

20. Survey Participation & Incentives
Average participation is 25% of Crisis Residential Providers
Crisis Residential Providers who complete 80% of surveys or more will have early access to Best Practices Toolkit
Participants who contribute through substantial survey completion will also be recognized as contributors in the Toolkit

21. Survey Participation & Incentives
Missing surveys will be sent to you by 9/30/17
Please complete missing surveys within 30 days of receiving request
Claudia at with any questions

22. SAMHSA Webinar Series(es)
4th Monday of each month April-September
Communities Addressing Trauma and Strife through Trauma-Informed Approaches
1-2:30pm ET/11am-12:30pm PT
Trauma-Informed Innovations in Crisis Services
3-4pm ET/12-1pm PT

23. Next Steps
Next Conference Calls: Friday, September 1pm EDT/10am PDT (Topic TBA) Wednesday, October 2pm EDT/11am PDT Group Listserv: Website: (Meeting Slides stored here) Questions: