Continuity of Care Task Continuity of Care Task ForceForceFebruary 5, 2010

BACKGROUNDBACKGROUNDThe Texas State Psychiatric

Hospital system is nearing capacityWhile total admissions and civil

commitments have decreased, the number of forensic commitments has increased

Forensic commitments generally involve longer lengths of stay

The increased number of forensic commitments and longer term patients has overcome the impact of decreased admissions

TASK FORCE GOALSTASK FORCE GOALSExamine the overall continuum of

care for individuals with severe mental illness who move through multiple systems

Make and prioritize recommendations to improve efficiencies, access and quality

Examine barriers to discharge for individuals in State Hospitals with extended lengths of stay

Make and prioritize recommendations to resolve barriers to discharge

TIMELINETIMELINEFour Task Force Meetings

◦February 5, 2010◦February 19, 2010◦March 26, 2010◦April 16, 2010

Four Public Forums◦March 3, 2010, Czech Heritage Hall,

LaGrange, TXIndividual InterviewsMeetings with Key Professional GroupsFinal Report—September 30, 2010

SYSTEM MAPPINGSYSTEM MAPPINGState Hospital capacity issues are

multi-factorialHow do individuals move through

systems?What are the similarities and

differences of this movement across the state?

What are some potential points of intervention?

What additional data do we need?

POINTS OF POTENTIAL POINTS OF POTENTIAL INTERVENTIONINTERVENTION

Community PreventionLaw EnforcementJailsCourtsRe-Entry/Re-Integration

LAW ENFORCEMENTLAW ENFORCEMENT◦Community Based Alternatives to

Arrest/Incarceration Wide utilization of MCOT?

◦Specialized Law Enforcement Teams/Models Implemented in most urban areas? Rural alternatives?

◦Law Enforcement Training◦Discretion about Charges◦Data Needs?

JAIL BASED STRATEGIESJAIL BASED STRATEGIESScreening/AssessmentJail Based Treatment

◦Formularies◦Forced Medications

Utilization of 16.22/17.032 Release on Personal Bond

Data Needs?

COURT BASED COURT BASED STRATEGIESSTRATEGIESIdentification of behavioral health

issuesCourt coordinatorsRaising competencySpecialized dockets/courts/attorneysRestoration

◦Outpatient restoration of competency◦Not likely to regain

Data needs?

RE-ENTRY/RE-RE-ENTRY/RE-INTEGRATIONINTEGRATIONDischarge Planning

◦Jails◦Prisons◦Hospitals

AppointmentsMedicationsHousing

COMMUNITY PREVENTIONCOMMUNITY PREVENTIONExpansion of community based

(not just crisis) careTarget populationGuardianshipIntegrated Behavioral HealthACT/FACT/FICMData Needs?

NEXT STEPSNEXT STEPSSystem Mapping Follow Up

Examination of Extended Stay Population

Other Stakeholders?

Future Planning