I. Welcome and Call to Order. Review/ Approval of Minutes from last meeting

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1 Dallas County Behavioral Health Leadership Team Thursday, October 10, 2013 Henry Wade Juvenile Justice Center 2600 Lone Star Drive, Dallas, TX Room 203 A at 9:30 11:30 a.m. I. Welcome and Call to Order II. III. IV. Review/ Approval of Minutes from last meeting Recommendations for BHLT Action Review and Approve Crisis Services Project (CSP) DSRIP Report Reports from and Charges to BHLT Committees Clinical Operations Team FACT BHSC CSP Governance Committee Legislative Committee V. NTBHA Update VI. VII. VIII. IX. RHP Region 9 Updates RHP Region 9 Behavioral Health Gap Analysis Parkland s Role as RHP 9 Anchor New DY3 Projects RHP Region 9 Behavioral Health Projects Green Oaks Dallas Metrocare Public Comments Adjournment Page 1

2 Dallas County Behavioral Health Leadership Team Meeting Notes Thursday, September 12, 2013 Welcome and Call to Order, Commissioner Price: The meeting was called to order by Commissioner John Wiley Price at 9:42 AM. Review/Approval of Minutes: The minutes from the BHLT meeting held on August 8, 2013 were made a part of the packet. There was a motion made to accept the minutes as printed. The motion was seconded and approved. Special introductions were made for Charlene Randolph, Policy Analyst for the Crisis Services Project (CSP); Gail Berlin, CEO, for ValueOptions; Dr. Kehinde Ogundipe, Assistant Medical Director, Inpatient Psychiatry, Parkland Hospital; Dr. Sue Bornstein, Executive Director, Texas Medical Home Initiative Governor Texas ACP Northern, and Dr. Michael Ayoob, Retired Counselor, Dallas Independent School District (DISD). The guests expressed their appreciation for being invited, and their anticipation of working with the BHLT. Recommendations for BHLT Action: Adoption of Resolution for New Membership - Ron Stretcher directed the committee s attention to pages 6 through 10 of the packet to the letter of invitation to Dr. Sue Bornstein and the resume for Dr. Michael Ayoob. Mr. Stretcher made a motion for the committee to adopt resolution on page 11 of the packet to appoint Dr. Sue S. Bornstein to represent the BHLT as Primary Care Physician, and Dr. Michael Ayoob to represent the BHLT as School Liaison. The motion was seconded and accepted. Adoption of Resolution for DSRIP Milestone Reporting Ron Stretcher updated the BHLT on the current activities of the CSP. He reported that the contracts for Adapt Community Solutions and Transcare to work with Dallas County as the primary service providers for this project have been completed. The minutes from the September 3, 2013 CSP Governance Committee meeting, along with a status report and next steps were made part of the packet. Additional documents to support resolution were also made a part of the packet. The resolution requests that the BHLT endorse the submission of the required reporting metrics, milestones, and supporting documents on August 30, (As a point of clarification, Mr. Stretcher explained that even though the resolution for endorsement is being requested after the August 31, 2013 Page 2 Behavioral Health Leadership Team Minutes from September 12, 2013 Page 1 of 3

3 reporting deadline, it is the intention of the CSP Governance Committee to present future submission documentation and resolutions to the BHLT prior to the submission date). With the aforementioned clarification, a motion was made to endorse the submission of the required report on metrics and milestones. The motion was seconded and approved. Mr. Stretcher reported that the preliminary reporting on the potential new three year DSRIP projects is due on September 13, 2013 and along with that there will be a DSRIP a-thon on Wednesday September 18, Mr. Stretcher suggested that everyone be generous when filling out the self-assessment because that assessment will follow your project through the waiver. Commissioner Price mentioned the retirement of Jody Springer who has taken on the leadership for Region Healthcare Partnership (RHP9). He expressed some concern about the succession of her position. Mr. Stretcher suggested that a representative from Parkland Hospital s RHP9 be invited to the next BHLT to give the group an overview of the various DSRIP projects going on throughout region 9. Dr. Jacqueline Stephens agreed to relay the request for a presentation to Ms. Springer s department. Reports from and Charges to BHLT Committees: Clinical Operations Team Sherry Cusumano reported that this committee just met this morning and has been joined by Dave Hogan and Ron Cowart with Dallas Police Department s Crisis Intervention Unit. She believes that they will be very helpful in identifying the population of individuals that continue to cycle through the system. The workgroup continues to focus on the frequent flyers of the system, domestic violence among homeless women and the shelter gaps associated with this group, and then the chronically homeless population. The group will be working with ValueOptions, Metrocare, and the City of Dallas. BHSC Judge Wade was not able to attend this meeting. However, the minutes from the Behavioral Health Steering Committee (BHSC) held on August 15, 2013 were made a part of the packet for this meeting, beginning on page 15. Legislative Update: Janie Metzinger and Duane Steele reported that the thank you letters to the State Representatives and Senators have been delivered. The Regional Legislative Steering Committee is beginning to review how the funding that was appropriated state wide will be distributed to NorthSTAR. Ms. Metzinger expressed some concern about Representative Pitts no longer being on the Appropriations Committee. It will be imperative to remain vigilant in maintaining relationships and monitoring the decisions of this committee. The Regional Legislative Steering Committee is also reviewing bills that did not pass to determine where their focus should be. Craig Knuckles spoke about bills that did not pass that affected Med screens, and another that would have granted some authority to the Emergency Room (ER) physicians to hold a patient in the ER pending a hearing by a magistrate. Ron Stretcher directed the group s attention to a document prepared by the Hogg Foundation beginning on page 50 of the packet. The report gave a summary of mental health-related legislation that came out of the Texas 83 rd Legislative Session. Page 3 Behavioral Health Leadership Team Minutes from September 12, 2013 Page 2 of 3

4 Commissioner Dr. Theresa Daniel reported on an advisory committee formed by State Representative Garnet Coleman specifically focused on Mental Health funding. She stated that the Conference of Urban Counties has a representative on that committee and that representative should be able to follow how the funds are appropriated to NorthSTAR. This initiated a lengthy discussion regarding the role of Law Enforcement Officers (LEO) regarding the mental health community. Commissioner Price mentioned new policy that restricts LEO s and/or Detention Officers (DO s) from even being in the same room while treatment groups are in sessions. After some additional discussion, suggestions were made regarding staff training on de-escalation techniques and risk assessments that will allow clinicians to be prepared to handle situations where a client s behavior escalates to the point of intervention. NTBHA Update: Alex Smith reported that the North Texas Behavioral Health Authority (NTBHA) is in the process of updating the NorthSTAR Local Service Area Plan (LSAP). Please reach out to Brittony McNaughton if you have questions or thoughts regarding the online survey to provide your feedback and help with the development of the LSAP. Mr. Smith also reported that VO received a 2 year extension on their contract as the Behavioral Health Organization (BHO) for the system. Texas Department of State Health Services (DSHS) has granted NTBHA a role in the development of the request for proposal (RFP). NTBHA has created a board committee to oversee the development of the RFP and is soliciting suggestions from the BHLT in this endeavor. Update on Pending Issues: Ron Stretcher referenced the draft of the Jail-based Competency Restoration Program located on page 70 of the packet. He reported that a task force has been created to explore the possibility of Dallas County Jail being a target site for this pilot. Updates will be forthcoming. Public Comments: Tammy Wood with the Veterans Administration (VA) announced online contracts for supportive housing are now available. For more information please visit Commissioner Price extended his customary thank you from those that are unable to express their thanks. Chief Norman Seals with Dallas Fire Rescue announced an upcoming training for the Community Paramedic Program. He anticipates that the program will begin in January Dr. Akin Akinlawon, Medical Director for VO announced that he did address with his superiors the concerns of the committee in regard to the uncertainty of how DSHS will allocate the State appropriated funds. Adjournment: A motion was made, seconded and approved to adjourn the meeting at 10:44 AM. Page 4 Behavioral Health Leadership Team Minutes from September 12, 2013 Page 3 of 3

5 Crisis Services Project Staff Roster Agency Staff Member Title Start Date Trainings Dallas County Charlene Randolph Project Manager 8/26/2013 Employee orientation/ On job Transicare Bonnie Z. Athens Registered Nurse 7/1/2013 On job Transicare Timothy S. Black Project Manager 7/1/2013 On job Transicare Transicare Transicare Transicare Transicare Angela M. Byrd Project Coordinator 7/1/2013 June Goodman Licensed Practioner of Healing Arts 9/18/2013 Andrew N. Lomax Qualified Mental Health Professional 7/1/2013 Michelle B. Rivera Qualified Mental Health Professional 8/5/2013 LaJuan M. McGowan Qualified Mental Health Professional 8/5/2013 Employee orientation/ Rights Abuse Neglect/CPI/Clinicial Rounds/ DSRIP PATS/ Motivational Interviewing: Intro/ HIPPA/ First Aid/ Blood borne Path/ Employee orientation/ Clinicial Rounds/ DSRIP PATS Employee orientation/ Rights Abuse Neglect/CPI/Clinicial Rounds/ DSRIP PATS/ Motivational Interviewing: Intro/ HIPPA/ First Aid/ Blood borne Path/ Employee orientation/ Rights Abuse Neglect/CPI/Clinicial Rounds/ DSRIP PATS/ Motivational Interviewing: Intro/ HIPPA/ First Aid/ Blood borne Path/ CPR Employee orientation/ Rights Abuse Neglect/CPI/Clinicial Rounds/ DSRIP PATS/ Motivational Interviewing: Intro/ CPR Page 5

6 Crisis Services Project Staff Roster Agency Staff Member Title Start Date Trainings Transicare Transicare Timothy Parker Peer Support Specialist 7/1/2013 Dynatria N. Prince Peer Support Specialist 8/5/2013 Employee orientation/ Rights Abuse Neglect/CPI/Clinicial Rounds/ DSRIP PATS/ Motivational Interviewing: Intro/ HIPPA/ First Aid/ Blood borne Path/ CPR Employee orientation/ Rights Abuse Neglect/ CPI/ Clinical Rounds/ DSRIP PATS/ Motivational Interviewing: Intro Calvin D. Yarbrough Peer Support Specialist 7/1/2013 Employee orientation/ Rights Abuse Neglect/CPI/Clinicial Rounds/ DSRIP PATS/ Motivational Interviewing: Intro/ HIPPA/ First Aid/ Blood borne Transicare Path/ CPR Adapt Stephanie Denton Clinical Director, LPC (Dedicated) 9/8/2009 CPR/First AID/Crisis Worker Adapt Amy Ritcher Clnician, LPC (Dedicated) 6/6/2011 CPR/First AID/Crisis Worker Adapt Preston Looper Executive Director, LPC S (Shared) 3/17/2008 CPR/First AID/Crisis Worker Adapt Loren Hervey Clinician, LPC (Shared) 7/27/2010 CPR/First AID/Crisis Worker Adapt Roxanne Hotchkiss Clinician, LCSW (Shared) 8/16/2013 CPR/First AID/Crisis Worker Adapt Ashley Ray Clinician, LMSW (Shared) 1/12/2012 CPR/First AID/Crisis Worker Adapt Alexandra Barry Clinician, LMFT A (Shared) 7/2/2012 CPR/First AID/Crisis Worker Adapt Andrew Hill Clincian, LPC l (Shared) 10/31/2011 CPR/First AID/Crisis Worker Adapt Dorothy Hill Clinician, LPC l (Dedicated) 3/4/2013 CPR/First AID/Crisis Worker Adapt Jessica Hollingworth Clinician, LPC l (Shared) 6/17/2013 CPR/First AID/Crisis Worker Adapt Erin Kaufman Clinician, LPC l (Shared) 5/28/2013 CPR/First AID/Crisis Worker Adapt Aisha Madden Clinician, LMSW (Shared) 3/1/2013 CPR/First AID/Crisis Worker Adapt Carolina Ospina Clinician, LPC l (Shared) 12/6/2010 CPR/First AID/Crisis Worker Adapt Adriane Savage Clinician, LPC l (Shared) 7/1/2013 CPR/First AID/Crisis Worker Adapt Veronica Swink Clinician, LMFT A (Shared) 7/8/2013 CPR/First AID/Crisis Worker Page 6

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8 Transicare Service Report As of 9/27/2013, Transicare has served 22 consumers Service Delivery September 2013 #Active (consumers enrolled) # Engaged (consumers Transciare has met face to face) #Pending (a referral from ACS has been made) Jail Information Consumer Jail Book in Date Date consumer referred Jail Book out Date to Transicare #1 (EA) 1/1/2000 9/19/2013 9/24/2013 #2 (JD) 8/29/2013 9/10/2013 9/10/2013 #3 (DH) 10/18/2010 6/28/2013 9/10/2013 #4 (WJ) 9/1/2013 9/11/2013 9/17/2013 #5 (BM) 2/25/2013 9/11/2013 9/12/2013 #6 (JT) 1/15/2011 9/4/2013 9/5/2013 Page 8

9 RESOLUTION DALLAS COUNTY BEHAVIORAL HEALTH LEADERSHIP TEAM RESOULTION NO: DATE: October 10, 2013 STATE OF TEXAS } COUNTY OF DALLAS } BE IT REMEMBERED at a regular meeting of the Dallas County Behavioral Health Leadership Team held on the 10 th day of October 2013,the following Resolution was adopted: WHEREAS, WHEREAS, WHEREAS, WHEREAS, on February 14, 2013 the Dallas County Behavioral Health Leadership Team endorsed the 1115 Healthcare Transformation Waiver DSRIP Project, and development of Behavioral Health Crisis Stabilization Services as alternatives to hospitalization; and the Dallas County Behavioral Health Leadership Team is the governing body for the DSRIP project through a standing committee known as the Crisis Services Project (CSP) Governance Committee; and the CSP Governance Committee is responsible for the submission of required reporting on metrics and milestones; and functioning as the reporting entity, the CSP Governance Committee will report on the following milestones and submit supporting documents on October 31, 2013: Hire and train staff WHEREAS, functioning as the reporting entity, the CSP Governance Committee will make a carryforward request on the following milestones on October 31, 2013: Provide crisis stabilization services to consumers IT IS THEREFORE RESOLVED that the Dallas County Behavioral Health Leadership Team endorses the submission of this required report on metrics and milestones. DONE IN OPEN MEETING this the 10 th day of October, John Wiley Price Dr. Theresa Daniel Commissioner District #3 Commissioner District #1 Dallas County Dallas County Page 9

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13 FACT Meeting Minutes Wednesday, October 2, 2013 Attendees: Jane Le Vieux, Diana Weaver, Vanita Halliburton, Theresa Daniels, Charlene Randolph, Janie Metzinger, Cheryl Gayles, John Kennedy Introductions and overview of agenda were covered There was a group discussion regarding the lack of mid-level services and programs that serve children in the community. Also, FACT team members discussed the need for bringing together different programs in the community. A partner in this effort include: o Grant Halliburton Foundation is currently developing an online resourcee database of adult child and adolescent crisis services, which is ann initiative under the organization s I Am HERE initiative. Diana Weaver and Vanita Halliburton gave an overview of the database project. The database is expected to go-live inn early Over the next eight weeks, community program and service providers will be identified and contacted to upload their information into the database. Providers are allowed to stay in the database, as long they update their service informationn annually. Vanita Halliburton asked, once the database is operational, thatt BHLT members link their constituents to the site and advertise the project. As a way to notify the public, Halliburton Foundation is exploring having a provider fair sometime around the database launch date. At this event, crisis care providers can advertise their services. A team member recommended Eastfield College as a possible location, due to its adequate space and parking accessibility. The database site will also have instructions and papers written on topics such as: Understanding the Mental Health system for Mental Health Providers, What Happens when you Make a Crisis call to 911, What is a Crisis. I Am Here Coalition meets every 4 th Wednesday from 3-4:30 pm. The next meeting is scheduled for October 23 rd d. Questions weree raised and concerns weree discussed regarding team members unawareness of specific charges given by BHLT. o Team members stated that they previously turned in BHLT assignments; however, there has been no feedback. o Team members believe that the lack of direction and feedback is influencing low attendance at FACT meetings. o Charlene Randolph presented a resolution adopted 5/9/13 that details BHLT recommended charges. o In regards to the resolution, Jane Le Vieux will provide a list of FACT accomplishments. Jane Le Vieux gave a verbal listing of organizations families can access when their child is in crisis. o Jane will provide FACT members with a hard-copy also gave an overview of what happens to a child who of the list, along with instruction on how to access services. o Jane Le Vieux and Janie Metzinger is APOWW. During this event, by law, children are taken to Timberlawn. A discussion was held to re-visit the grant proposal/application for an Intensive Care Manager. o Team members lost interest in the grant proposal/application to the Juvenile Justice System Youth Advisory Board. o FACT will attempt to begin the proposal process again. Meeting Adjourned. Page 13

14 Inpatient Psychiatric Hospitals for Child and Adolescents Facility Office Fax Ages Children s (214) Medical District Drive Dallas, Tx Cook s Children s Hospital (682) th Avenue Ft. Worth, Tx Glen Oaks * (903) E. Division St. Greenville, Tx Green Oaks (214) Clodus Fields Dallas, Tx John Peter Smith Hospital* S. Main Street Ft. Worth, Tx Millwood (817) N. Cooper St. Arlington, Tx Hickory Trails (972) N. Old Hickory Trail Desoto, Tx Timberlawn Psychiatric Hospital* (214) Samuel Blvd Dallas, Tx Seay Behavioral Health (888) W. Parker Rd Plano, Tx Springwood Hospital (888) Hospital Parkway Bedford, Tx University Behavioral Health (940) W. University Dr Denton, Tx North Pointe Family Center (940) (UBH Day Treatment) Carrollton Tx Excel Center + * (817) W. Presidio Street Ft. Worth, Tx University Behavioral Health 2026 W. University Dr Denton, Tx (940) Page 14

15 Crisis Services and Inpatient Psychiatric Services for Children and Adolescents Crisis Services A child/adolescent seeking crisis services must meet the definition of a crisis cited in the Community Standards Rule: Crisis: A situation in which because of a mental health condition; the child/adolescent presents an immediate danger to self or others; or the child/adolescent s mental or physical health is at risk of serious deterioration; or a child/adolescent believes that he/she presents an immediate danger to self or others; or that his/her mental or physical health is at risk of serious deterioration. Crisis hotline: A telephone service available 24 hours a day, seven days a week for families to call to get information, support and referrals to help for their child when your child is experiencing a psychiatric crisis. Dallas MetroCare Services 1380 River Bend Drive Dallas, TX Crisis Phone: Main Phone: Website: Counties Served: Dallas Denton County MHMR Center 2519 Scripture Denton, TX Crisis Phone: Main Phone: Website: Counties Served: Denton Lakes Regional MHMR Center 400 Airport Road (P.O. Box 747) Terrell, TX Crisis Phone: Main Phone: Website: Counties Served: Camp, Delta, Ellis, Franklin, Hopkins, Hunt, Kaufman, Lamar, Morris, Navarro, Rockwall and Titus LifePath Systems 1416 N. Church St. McKinney, TX Crisis Phone: Main Phone: Website: Counties Served: Collin Page 15

16 Behavioral Health Steering Committee Thursday September 19, 2013 Minutes for September 19, 8:37 am Judge Kristen Wade was not in attendance. CJAB Coordinator Duane Steele opened the meeting and introductions were made. Last month s minutes were approved. Sheena Oriaboure gave an informative presentation regarding pregnant women in jail and her efforts in working with the courts to get these women needed services and/or released. Lee Pierson, MHDA, recently attended training for the DSM-V. He provided updates on changes in the DSM and websites/stores in which the DSM-V could be purchased. Based on the information provided, it does not appear updates in the new DSM-V will affect OCR. Lynn Richardson, Chief PD, and Ron Stretcher, Director of Criminal Justice, discussed methods to utilize ACS/PATS teams. After lengthy discussion, it was decided Ron and Lynn would speak later to determine a clearer process. Lynn also was able to attend a meeting regarding inpatient jail restoration and advised the County is one of the counties to be considered for this pilot program. Updates will be provided as new details emerge. Ron encouraged service providers to work together to ensure people are moving through the jail. He is taking a closer look at defendants who are staying in jail for long periods of time and will be reaching out to service providers to discuss a means of getting these individuals out. Ron asks that if he reaches out to you to please respond regarding the matter. SPN Reports: DIVERT Court A report was provided showing the program started with 82 and ended with 97; there was only 1 unsuccessful termination. The Bridge The Bridge reported accepting 4 jail discharges and 5 judicial reentry cases. Metrocare Sherry Lockhart reported 29 participants in Atlas, 42 in Post DDRTC, 19 in STAC, 28 in misdemeanor, 52 in DDRTC, 46 in FDU and 111 in ICM. Page 16 Behavioral Health Steering Committee Minutes from September 19, 2013 Page 1 of 2

17 NorthStar Increased to 22% of N* matches. On multi book-ins, one individual has been booked in 19 times this year. Probation Probation had 73 referrals and completed 67 assessments; 14 defendants were discharged. State Hospital There are 24 defendants waiting on a bed, 195 defendants at the hospital and 60 cases back from the state hospital waiting to be resolved. ANNOUNCEMENTS: Charlene Randolph is the new Project Analyst for the 1115 Waiver. She will be joined by Stephanie Denton, Lajuan McGowan and Amy Richter. Marium Uddin is the new MHPD! Welcome aboard ladies! 9:31 am Page 17 Behavioral Health Steering Committee Minutes from September 19, 2013 Page 2 of 2

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22 Parkland Health & Hospital System Department of Strategy and Business Development RHP Region 9 Behavioral Health Gap Analysis April 8, 2013 Issue Identified & Source Lack of integration of primary care and behavioral health services (RHP Region 9 market assessment p. 13) Relevant Region 9 DSRIP Projects Co locate and integrate behavioral health into the primary care setting at Baylor Medical Center at Garland Develop Care Management Function that integrates primary and behavioral health needs of individuals Baylor Medical Center at Garland Co locate and integrate behavioral health into the primary care setting at Baylor Medical Center of Irving Develop a Care Management function that integrates primary and behavioral health needs of individuals Baylor Medical Center at Irving Co locate and integrate behavioral health into the primary care setting provide services including behavioral health counseling, screening, treatment Develop Care Management Function that integrates primary and behavioral health needs of individuals Baylor University Medical Center Integrate care management functions for individuals with co morbid chronic diseases, mental illness, and/or substance use disorders, through collaborative partnership agreements Integrate Primary and Behavioral Health Care Services Denton County MHMR Center Partner with Green Oaks Hospital to establish integrated primary and behavioral health clinic for patients receiving OP psychiatric care Integrate Primary and Behavioral Health Services Medical City Dallas Hospital Lack of access to housing (RHP Region 9 market assessment p. 14, NTBH Community Survey 2011 p. 14) Limited mental health services available to children (RHP Region 9 market assessment p. 16) Expand pediatric behavioral health capacity in CMC primary care settings to align and coordinate care for behavioral and medical illnesses Enhance service availability to appropriate levels of behavioral 1 Page 22

23 Issue Identified & Source Relevant Region 9 DSRIP Projects health Children s Medical Center of Dallas Expand number of community based settings in underserved areas were behavioral health services may be delivered Pass 2 Expand Behavioral Health Outpatient Services for Children, Adults and Families Dallas County MHMR Center d/b/a Metrocare Services Lack of services and written materials available in Spanish (RHP Region 9 market assessment p. 17) Fewer inpatient psychiatric beds than state and national averages (RHP Region 9 market assessment p. 17) Lack of capacity for substance abuse treatment (RHP Region 9 market assessment p. 18) Need additional access to crisis services (RHP Region 9 market assessment p. 18) The Center for Children with Autism will provide 1:1 applied behavior analysis to children with on the autism spectrum and/or children with other developmental disabilities Intervention for targeted behavioral health population to prevent unnecessary use of services Center for Children with Autism Dallas County MHMR Center d/b/a Metrocare Services Establish a community based behavioral Health crisis stabilization program in Dallas County Develop behavioral health crisis stabilization services Dallas County Health and Human Services Develop community based behavioral health crisis stabilization services Develop behavioral health crisis stabilization services Lakes Regional MHMR Center Increase capacity for crisis residential services to better accommodate the high demand for crisis residential services and reduce potentially preventable admissions and readmissions to hospitals and jails Provide an intervention for a targeted behavioral health population to prevent unnecessary use of services in specified setting Denton County MHMR Center 2 Page 23

24 Issue Identified & Source Need additional access to subacute crisis residential level of care (RHP Region 9 market assessment p. 19) Lack of access to transportation (NTBH Community Survey 2011 p. 14) Lack of access to medication (NTBH Community Survey 2011 p. 14) Lack of access to family counseling (NTBH Community Survey 2011 p. 14) Lack of access to individual counseling (NTBH Community Survey 2011 p. 14) Relevant Region 9 DSRIP Projects Expand number of community based settings in underserved areas were behavioral health services may be delivered Pass 2 Expand Behavioral Health Outpatient Services for Children, Adults and Families Dallas County MHMR Center d/b/a Metrocare Services Expand number of community based settings in underserved areas were behavioral health services may be delivered Pass 2 Expand Behavioral Health Outpatient Services for Children, Adults and Families Dallas County MHMR Center d/b/a Metrocare Services Other Region 9 Behavioral Health DSRIP projects: Increase number of behavioral health residents and others trained in a community mental health setting to reduce shortage of behavioral health providers Workforce Enhancement to improve behavioral health access Dallas County MHMR Center d/b/a Metrocare Services Implement telehealth behavioral health care service for low income patients in rural areas in/around Kaufman County Introduce Telemedicine/ Telehealth Beh. Health Lakes Regional MHMR Center Implement telemedicine program with psychiatric specialists at Green Oaks Hospital for consult, evaluation and treatment of patients at remote sites/hospitals Introduce, Expand, Enhance Telemedicine/Telehealth Behavioral Health Medical City Dallas Hospital Utilize Behavior Treatment Services Assertive Community Wrap around Treatment Team (ACT) to be oncall to travel to an acute care facility, jail or school to assess and stabilize situation and provide follow up behavioral health services as appropriate Intervention for a targeted behavioral health population to prevent unnecessary use of services ACT Dallas County MHMR Center d/b/a Metrocare Services Page 24 3

25 Establish Family Preservation Program short term intensive program for medication management, case management and counseling to young patients discharged from psychiatric facilities and/or those at risk for out ofhome placement Intervention for a behavioral health population to prevent unnecessary use of services Family Preservation Dallas County MHMR Center d/b/a Metrocare Services The Behavioral Health Day Program will provide short term behavioral intervention, crisis diversion and urgent safety net services for individuals with intellectual and developmental disabilities Intervention for a targeted behavioral health population to prevent unnecessary use of services Day Program Dallas County MHMR Center d/b/a Metrocare Services Establish 24 hour psychiatric triage facility to better accommodate high demand for psychiatric triage services, and to reduce inappropriate ED utilization Process Improvement Methodology Denton County MHMR Center Design, implement and evaluate research supported and evidence based interventions tailored towards target population Lakes Regional Cognitive Enhancement Therapy Pass 2 Intervention for targeted behavioral health population to prevent unnecessary use of services in specified setting Lakes Regional MHMR Center Page 25 4

26 RHP Unique Project ID Project Option Dallas Metrocare DSRIP Projects CMS Review Center for Education and Research (CER) The CER will provide training to enhance the development of specialty behavioral health care and to improve consumer choice by expanding the number of behavioral health professionals (Psychiatrist, Child Psychiatrist, Psychologist, Licensed Clinical Social Workers, Licensed Professional Counselors) Southwest Clinical Hub Project will create a community mental health clinic located in Grand Prairie to provide behavioral health services to the underserved in that area. Services will include psychiatric evaluations, pharmacy services, counseling, rehabilitation and skills training and case management Integrated Care Initiative This project will create an integrated model of easy, open access to primary care services for persons who are receiving behavioral health services in our community based behavioral health clinics. This effectively establishes a one stop shop for patients to receive both behavioral and primary care services on the same day IDD Consumer ACT Team The ACT Team will be on call to travel to the acute care facility, jail or school to help assess and stabilize consumers and will also provide followup services to those clients to ensure the destructive pattern that led to the need for acute services is eliminated or significantly reduced Family Preservation Program (FPP) A short term, intensive program that provides crisis intervention, medication management, counseling and case management services to children recently released from the psychiatric hospital or those at risk for out of home placement and their families Center for Children with Autism at Metrocare CCAM will provide an applied behavior analysis based program to children on the autism spectrum and/or children with other developmental disabilities. The program will structured as a tiered system; offering 1:1 staff/ client ratio for Level 1, 1:2 staff/ client ratio for Level 2 and group participation for Level IDD Behavioral Day Program The Behavioral Day Program will provide short term behavior intervention and urgent safety net services for individuals with intellectual/developmental disabilities and mental health issues. Approved September 2013 Initially Approved Initially Approved Initially Approved Initially Approved Initially Approved Initially Approved Northwest Clinical Access The project will expand behavioral health access to the underserved by opening an additional outpatient clinic in the Northwest region of Dallas County where census tracking data demonstrates the highest need for additional outpatient services. The clinic will serve children and adults with psychiatric evaluation, pharmacy services, medication management, primary care, counseling, rehabilitation/skills training and case management services Patient Navigation Under this project, Metrocare will implement a patient navigation system to facilitate discharges for high risk patients from community emergency centers by linking them to a community mental health clinic and local community supports and services. The project will target individuals with co occurring mental illness, disabilities and chronic disease, employing a coaching method that supports patients to assert a more active role in their health Center for Children with Autism at Metrocare (CCAM) northwest and south central expansions. Metrocare will open more sites within the Dallas area enhancing accessibility to families with children diagnosed with developmental disabilities. CCAM will provide applied behavior analysis (ABA) based services to children on the autism spectrum and those with other developmental disabilities. CCAM emphasizes time limited treatment and return of clients to their community Rapid Assessment and Prevention (RAP) RAP is an intensive program targeting individuals returning to the community following a psychiatric hospitalization. The program goal is to prevent psychiatric readmissions. Services will be delivered based on a Critical Time Intervention (CTI) model with individualization to support the linkage of individuals to more permanent resources, including psychiatric treatment, medication management, housing or money management, substance abuse treatment, crisis management, and family interventions Integrated Pediatric Care Metrocare will implement integrated behavioral and primary healthcare services in our clinics which serve children and adolescents. The integration project will focus on consumers from birth 18yo and will lead to increasing access to care; improving continuity of care; and improved outcomes. The intervention will create an integrated model of easy, open access to primary care services within behavioral healthcare clinics or in primary care facilities located on the same campus as behavioral healthcare clinics. To be submitted Dec To be submitted Dec To be submitted Dec To be submitted Dec To be submitted Dec Page 26

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30 APAA Association of Persons Affected by Addiction October 2013 Training Session This comprehensive training is designed for professional and nonprofessional advocates as they become more skilled and resilient on coaching those on the path of recovery and / or re-entry. What is Recovery Coaching? Building Skills to Enhance Recovery Motivational Interviewing Cultural Competence Recovery Wellness Ethics Recovery Coach Institute A Recovery Coach is anyone interested in promoting recovery by: Removing barriers and obstacles to recovery by serving as a personal guide Education Motivational Interviewing Personal Boundaries Ethics These are all essential components to be a Recovery Coach. This training will give you the skills and resources needed to be a great Recovery Coach. Training Objectives A guide and ethical standard for non-professionals Motivational and Interviewing skills Defining the Recovery Coach role When: October 7, October 11, 2013 Monday-Friday 8am-5:30pm Where: APAA Education and Retreat Center 214 Hillvale Dallas, Texas Registration Fee: $ hours of training necessary to become a Recovery Coach Specialist This training is APAA and TAIRCOS Approved curriculum for recovery coaching. Submit payments to: APAA 3116 Martin Luther King Jr. Blvd. suite A Dallas, Texas For more information, please contact: APAA Trainer Coordinator Chester McGee REGISTER NOW! SEATS ARE LIMITED at Page 30