NC ADATC Service. NC Coalition for MH/DD/SAS By Division of State Operated Healthcare Facilities February, 2015 DSOHF ADATC 2.

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1 NC ADATC Service NC Coalition for MH/DD/SAS By Division of State Operated Healthcare Facilities February, 2015 DSOHF ADATC

2 Individuals in Need of Services Q3, SFY13, Community Systems Progress Report In 2011 there were 1,009,541 individuals in need of MH/DD/SA services. This represents 14% of the state population There were 57,189 Adults needing DD services There were 381,253 Adults needing MH services There were 571,099 Adults needing SA services DSOHF ADATC

3 Treated Prevalence Treated Prevalence by Disability Group CY 2012 Mental Health 46% Developmental Disabilities 37% Substance Abuse 10% 0% 20% 40% 60% 80% 100% % of Adults in Need Served SOURCE: Community Systems Progress Report, SFY13 Q3 (CY 2012 data) DSOHF ADATC

4 DSOHF Purpose We exist as a system of healthcare facilities that respects the dignity of individuals and provides individualized, compassionate, efficient quality of care to the citizens of North Carolina with intellectual and developmental disabilities, substance use disorders and psychiatric illnesses and whose needs exceed the level of care available in the community. DSOHF ADATC

5 ADATC Locations R.J. Blackley Opened 1950 Serves 25 central counties BLACK MOUNTAIN BUTNER GREENVILLE Julian F. Keith Opened 1969 Serves 38 western counties Walter B. Jones Opened 1968 Serves 37 eastern counties DSOHF ADATC

6 ADATC Services Evolution : The 3 Alcohol Rehabilitation Centers (ARCs) were opened. Historically, each of the 3 facilities were 28 Day programs offering substance abuse treatment, education, recreation, VR, group therapy, and AA groups. The patient profile for the facilities in the first few years was primarily white male alcoholics age : The facilities were renamed Alcohol and Drug Abuse Treatment Centers (ADATCs). In 2001, The General Assembly recommended that the ADATCs be adapted to accept all primary substance abuse State Psychiatric Hospital admissions : Approximately 500 State Psychiatric Hospital beds (adult long term, geriatric long term and nursing) were closed as part of planned hospital downsizing and funding was transferred to the community. 400 additional beds were closed for other reasons (budget reductions, staffing issues, certification issues, etc.) By February 2009, all ADATC locked units were fully operational to assist State Psychiatric Hospitals, local community hospitals and EDs. DSOHF ADATC

7 Alcohol and Drug Abuse Treatment Centers Acute Inpatient Level of Care - serving individuals: on IVC, in need of substance abuse/psychiatric stabilization and treatment, and/or with medical complications. DSOHF ADATC

8 Residential vs. ADATC Services Medical/ Clinical Staffing Residential Provides individual, group and family counseling and education in a structured living environment for individuals with SA disorders in a group setting. Individuals must be detoxed prior to admission. The counselor to bed ratio is 1:30. Minimum one staff member in the facility when clients are present. ADATC Comprehensive psychiatric services, medical services, 24-hour nursing, individual & group counseling, treatment planning, discharge planning and family services. Physicians available 24-hours a day. Appropriately staffed 24/7 with on-site nursing (RN, LPN, HCT) at an acute care level. DSOHF ADATC

9 Patient Acuity Acuity Information on Individuals Served in ADATCs SFY 2015, Q2 MH/SA Co-Occurring 78% High Medical Acuity 77% Medical Detox 67% Psychotropic Rx 61% SPMI Co-Occurring 35% 0% 20% 40% 60% 80% 100% Source: HEARTS; NC-TOPPS Percentage of Individuals Discharged from ADATC DSOHF ADATC

10 Profile of Patient History 54% Suicidal Ideations 29% History of Past Suicide Attempts 16% Homicidal Ideations 63% Have Used Opiates *Data Source: HEARTS and NC TOPPS DSOHF ADATC

11 Patient Profile Profile of Individuals Served in ADATCs CY 2014 DSM-IV Diagnoses Demographics Homeless/Temp Housing Unemployed/Not in Labor Force 63% 65% History of Arrests 82% Under Corr. Supervision 36% Major Depression Anxiety Disorder PTSD Bipolar Schizophrenia/ Psychoses 21% 18% 16% 11% 5% 0% 25% 50% 75% 100% Source: NC-TOPPS DSOHF ADATC

12 Primary Substances Used Primary Substance Used CY % 3% 16% 22% Alcohol Heroin Cocaine Marijuana Methamphetamine 44% Source: NC-TOPPS DSOHF ADATC

13 Prescription Medication Abuse Abuse of Prescription Medication CY 2014 Percentage of Individuals Admitted to ADATC 100% 80% 60% 40% 20% 0% 46% Misused Prescription Medication 53% Taken Someone Else's Prescription 19% Given/ Sold Prescription to Others Source: NC-TOPPS DSOHF ADATC

14 Census 75% admitted through Crisis Avg 95 admissions/month Same 1 st six months last year Avg 113 admissions/month 37% admitted after normal business hours Average Length of Stay; 14.7 days 30 Day Readmission Rate; 2.5% DSOHF ADATC

15 Patient Referral Sources: July 1 Dec Referral Source Total % Emergency Departments 1, Community Inpatient Hospital LME/MCO Other: OPT Clinic, Pregnant, Walk-In, State Psychiatric Hospital, etc Total Referrals: 2,633 Combining ED and Inpatient = 65% DSOHF ADATC

16 Questions? Thank you! DSOHF ADATC

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