DONNA CHRISTIANSON,CRISIS PROGRAM DIRECTOR

VICKI RILEY, CARE CENTER PROGRAM DIRECTOR

Spotlight on the CARE Center

Background

The initiative started as a result of La Crosse County Clinical Services Process Improvement initiative Training Screening/Filtering Mandatory Services Continuum of Care

Continuum of Care subgroup identified “gaps” in our current service system Crisis Center Community Bridges

Mission Statement

Create a crisis assessment center and detoxification center by the end of 2009 in order to provide more cost-effective triage and intervention for area individuals undergoing distress due to mental health or substance abuse concerns.

Enhance available supports and services to help people maintain stability in community settings (Community Bridges)

Facility Criteria Identified: 2nd Focus Group 6/09

Unlocked facility (home-like setting)8 bed capacity for adults (male and

female)Non Ch 51 (detentions will go to the

hospital)Non medical detoxificationCentrally located in La CrosseWell trained staff

CARE Center Timeline

Request for Proposals reviewed (9/09)Tellurian, UCAN selected as the top applicant Awarded the contract (10/14/09)Site search, selection and constructionHiring and training staff Budget/contract negotiationsCertification process and completionPolicies and proceduresOpen House (4/10) and Grand Openning

(5/18/10)

CARE Center Staff

F.T. Program Director: Vicki RileyF.T. Community Liaison: Teri McDougle10 FTE Human Service AssistanceP.T. Registered Nurse2 Peer Support Specialists

CARE Center Admission Processfor Law Enforcement

Law Enforcement contacts Mobile Crisis to assist with assessment when involved with mental health situations in the field

If there are immediate medical concerns, arrange for transport to the hospital and then contact mobile crisis

However, if there are no medical issues, assessing the crisis should occur in the community (ie.the home, CARE Center, etc)

CARE Center Admission Process for Hospitals

After assessment in the ER, the Crisis Responder and Hospital Staff collaborate on the disposition. If CARE Center is deemed appropriate, CARE staff is contacted and they provide transportation to the CARE Center

CARE Center is also used as a step down from the inpatient units. County crisis staff facilitate this also between the hospital and CARE Center

Alcohol Detox Challenges

The statutes are restrictive as to who can be served at this level of care

No other substances can be in the person’s system other than alcohol and benzodiazapines (received the OK for THC)

The withdrawal score (CIWA) needs to be within a certain limit

If there are other medical issues or a history of seizures they would be deemed inappropriate for admisson

CARE Center Data

2010 May June July August Sept Oct Nov Dec

# of admissions

(MH/Detox)

18

17/0

32

31/1

46

44/2

43

40/3

41

39/2

Average LOS 3.94 5.65 4.19 4.92 4.5

Average census

4-6 4-6 6-8 4-8 5

Readmissions

1-2x’s

1-3x’s

4 6

5-2x

1-3x

5

5 – 2x

5

4-2x

1-3xPolice

transport to Center

0 1 1 3 2

MA Funded 61%

11/18

59%

19/32

65%

30/46

70%

30/43

78%

32/41

Crisis Program Data

2002 2003 2004 2005 2006 2007 2008 2009 2010 Jan-Sept. (yr projection)

Total Crisis Contacts

602 669 1363 2248 4164 3700 3705 4206 4167(5209)

Police contacted crisis

587 780 836 832 796 724 (905)

Ch 51’s 646 541 708 686 758 722 768 610 414 (518)

Stabilization Bed (disposition in crisis situation)

101 133 126 116 108 178 (223)CARE Ctr open 5/18

County funded hospital bed days

588 568 388 583 348 385

County charges for State Hospital (bed days)

164 178 162 185 68 167

CARE Center: 4647 Mormon Coulee Rd

Program Director: Vicki Riley

Kitchen

Living Room Space

…More Living Room Space

Dining Room

Bedroom (2 residents per room)

…another bedroom

La Crosse Co. Satellite Office

Medication Storage Area

Shower Room (there are 2)

Open/light Spaces

Facility Comparison

Hope House New Crisis CenterLimited staff hours 24 hour awake staff

Unlicensed facility CBRF licensed facility

Crisis therapist follow up next day

Crisis therapist and Nurse Practitioner follow up

No detox admissions Non-medical detox admissions

4 bed capacity 8 bed capacity

Problem Solving Strategy

With every new process, there are bound to be problems that arise

There are many players involved in these crisis situation

Meetings have occurred twice/month, including CARE staff, Law Enforcement, Consumers, Crisis and Hospital staff to problem solve situations and improve our collaboration

Consumer Satisfaction

“It’s not very often that you find a bunch of people that actually want to help people they don’t even know… It’s really nice to know that there are people out there that actually care.”

“This environment is very healing.”“This facility is 100% better than what we

had.”“The staff went above and beyond in meeting

my needs. I felt safe here and the staff is very knowledgeable and friendly.”

CONTACT INFORMATION

Donna Christianson La Crosse County Human Services

608-785-6118 christianson.donna @co.la-crosse.wi.us

Vicki Riley CARE Center

608-519-3080 vriley@tellurian.org