Crisis Services Crisis services are required core services

IAC 331.397Chapter 24

• 25% of Iowans will have a diagnosable mental illness over the course of a year

• 6% of the population has a serious mental illness

• Suicide is the second leading cause of death for Iowa 15 to 24 year olds, and 25 to 44 year olds.

• Over an 8 years period of time 1,568 people committed suicide in rural counties of Iowa, versus 1,382 in the state’s urban parts.

The Need for Crisis Services in Iowa

Community Participation in Development of Crisis Plan

Met 3 times with community

Met 3 times with providers

Met with the Regional Advisory Committee

Three Regional Governing Board members participated in planning

Crisis Services Defined in the Code

1. Crisis screening 2. Assessment requirements  

3. Twenty-three-hour crisis observation and holding

4. Twenty-four-hour crisis line 5. 24 hour crisis response6. Crisis stabilization residential/community based services7. Mobile Crisis response

8. Warm line

Already have in region

Wait to see if data demonstrates a need

Already have. Need to expand region wide

New Service

24 Hour Crisis Line and Warm Line

24 hour crisis line • 24 hours per day. • screened and counseled • refer to the mobile crisis unit, other resources, or services if

needed.

Warm line Peer response • Short term• Non directive support to assist the caller

Mobile Crisis Response. (Expansion) Training will be provided using a nationally accredited model so the same service is provided throughout the region.

How does it work?

1. A call comes in.

2. Dispatch will send provider to the scene.

3. Assessment will be completed to determine level of care needed.

4. Person will be stabilized at home, transferred to a crisis bed or transported to the hospital.

Washington County Pilot23 people received crisis services2 went to the hospital 1 went to a detox facility  87% were diverted from the

hospital

Crisis Stabilization Services Residential and Community (Expansion)

Residential short term beds: • Goal is to stabilize the individual and return them to the

community • Stay up to five days.

• set up a place to live if needed, • set up with community support services• set up with psychiatrist and medications

Community: • Goal is to stabilize the individual in their home. • Services set up including but not limited to psychiatric,

medication, counseling, peer support and linkage to ongoing services.

Start with 4 beds with the ability to expand to 8 for the region if needed.

Warm

line Crisis

Line

Mobile Crisis

Dispatch

Mobile Crisis staff goes to a location anywhere in the region and does the assessment

Outcome 1Resolve the Crisis $

Outcome 2Crisis Bed or

stabilize in place $$

Outcome 3Hospitalization $$$

Outcome 2Crisis Bed or

stabilize in home $$

Outcome 3Hospitalization $$$

Outcome 3Hospitalization $$$

This is how most of the region looks today.

In a crisis situation there is nowhere to go except to the most expensive service(s). 2014 regional costs following

hospitalization$11,719,894.

Crisis

Line

Additional Costs to Expand Crisis Services

Service Cost for FY 2015

Warm Line $30,880

Chat and Text $107,354

Hotline $130,511

Mobile Crisis Coordination

$83,089

Mobile Crisis Service

$157,175

Crisis Stabilization3 additional beds

$246,375

Total $755,384

Sustainability: 1. Decrease commitment and long term care costs.

Use the savings that comes from diversion to fund future crisis services. 10% diversion = $1,171,989.00 savings which pays for the service.2. Medicaid will eventually fund part of the costs.3. If necessary, drop the service. No current clients and no provider expansion.

information and ed-ucation

service coordination

personal and en-vironmental sup-port

general admin

crisis preventioncommitment long term caretreatment services vocational