Rapid City

Crisis Care Center (CCC)

Report for January 31, 2011 to July 31, 2011

BHMHSA Collaborative Goals1. Develop a fully operational 24-Hour Crisis Center

2. Implement community case management

3. Provide intermittent professional care until provider availability

4. Develop integrated demographic and needs assessment with appropriate consents for treatment

5. Conduct regular networking meetings among service providers

6. Implement Community Education Plan

BHMHSA Collaborative Objectives1. Reduce inappropriate admissions to the hospital, jail and detox

2. Improve access to after-crisis follow-up and mental health and substance abuse treatment 3. Improve service integration and coordination among agencies and providers to help patients better navigate complex systems

4. Improve awareness about and access to services to assist people in entering the healthcare system for mental health and substance abuse services prior to the crisis state

Number and Type of CCC Staffas of July 31, 2011

Medical Director Dr. Garry, MD

Clinical Director Randy Allen CSW-PIP

Program Manager Teri Corrigan CSW, QMHP

QMHP’s (1 per shift) 3 FTE, 1 PT, 1 PRN

EMT’s (2 per shift) 7 FTE, 1 PT, 3 PRN

Case Manager 1 FTE (to be hired)

Pennington County Health & Human Services Case Managers are currently providing case management.

People Who Died by Suicide by Year in Pennington County

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

5

10

15

20

25

30

35

17

9 8

17

14 1315

21 20

13

24 23

29

People Who Died by Suicide in 2010 vs 2011 in Pennington County as of July 31, 2011

As of July 31, 2011, there have been 9 suicide deaths compared to 19 as of this same date in 2010.

Number of CCC Client Visits by Month as of July 31, 2011 - Total Client Visits = 283

(Total Unique Clients= 236)

Number of Clients Returning to CCC for >1 Crisis Visits as of July 31, 2011

Total = 29 Clients

2 visits 3 visits 4 visits 5 visits 6 visits

19clients

1client

6clients

1client

2clients

Types of Services Provided When CCC Clients Returned in Crisis as of July 31, 2011

These 29 individuals accounted for 76 visits to the CCC.

Fifteen of these 29 individuals were existing clients with agencies such as BMS, the VA, Rebound, CCADP or the BH Workshop. They were referred back to these programs with appointments / follow-up contacts being made by CCC staff.

Returning to the CCC diverted these clients from 43 visits to the RCRH BHC and 27 visits to the RCRH ED.

The RCPD brought these return clients to the CCC for 54 of the 76 visits, and they returned as walk-ins for 22 visits.

Three were diverted from Jail.

Not all these return clients were diverted from another program.

CCC Referral Out to Direct Service Percentages as of July 31, 2011

BMS36%

CCDAP18%

LSS16%

CSS7%

Other5%

COM-MUNITY HEALTH

9%

DETOX2%

WAVI2%

YFS4%

CCC Clients Received and Attended Direct Service Appointments as of July 31, 2011

Behavior Management Systems 13 new referrals with 11 who attended first appointments

• 5 needed additional referrals to community resources• 11 scheduled follow-up appointments at BMS• 1 additional identified crisis

City / County Alcohol and Drug Programs 7 new referrals who attended first appointments

• 7 needed additional referrals to community resources• 3 scheduled follow-up appointments at CCADP

CCC Clients Received and Attended Direct Service Appointments as of July 31, 2011

Lutheran Social Services 6 new referrals with 6 who attended first appointments

• 0 needed additional referrals to community resources• 3 scheduled follow-up appointments at LSS• 0 additional identified crisis

Youth & Family Services 5 new referrals with 2 who attended first appointments

• 0 needed additional referrals to community resources• 0 scheduled follow-up appointments at YFS• 0 additional identified crisis

CCC Clients Received and Attended Direct Service Appointments as of July 31, 2011 Catholic Social Services

3 new referrals with 1 who attended a first appointment• 1 needed additional referrals to community resources• 0 scheduled follow-up appointments at CSS• 0 additional identified crisis

Community Health – Mental Health 2 new referrals with 2 who attended first appointments

• 0 needed additional referrals to community resources• 2 scheduled follow-up appointments at CHC• 0 additional identified crisis

Total Number of Services Provided by CCC as of July 31, 2011

283

212160

38 4110

38

All clients entering the CCC, receive a Medical Triage exam.

Number of CCC Clients Referred to Pennington County Health & Human Services (HHS) Case Management

as of July 31, 2011 / Total = 51

Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11

0

4

10

67

12 12

HHS Case Management Referrals by Percent as of July 31, 2011 / Total = 51 CCC clients

After receiving the initial referral, HHS Case Managers identified 96 additional crisis situations leading to 161 referrals.

CCC clients had 20 follow-up contacts with Pennington County HHS Case Managers.

Food14%

Housing15%

Medical16%

Mental Health12%

Education /Occupa-tion1%

Transportation42%

Method Client was Transported to CCC by Month as of July 31, 2011

(Separated from Referred By)

Feb Mar Apr May Jun Jul

9

3341 38 41

33

1

3

4 5 1 6

3

9

1712 10 141 2

RCPD PCSO BFPD/BEPD Walk-in

Referral Sources for CCC Clients as of July 31, 2011

Other includes Sioux San, CCC, YFS, CAP, Detox, EAFB, Job Corp, Nat’l Guard, and the VA.

RCPD

RCRH ER Self

PCSO BMS

Family

/Frie

nd

Medical D

octor

Other Law

Enforce

ment

Comm. Counse

lorUSA

F

Other

Unknown

107

77

3219

7 3 3 3 2 29

19

Homeless Statistics of All CCC Clients

as of July 31, 2011

Gender Statistics of All CCC Clients

as of July 31, 2011

Male 57%

Female 43%

Not Home-less

83%

Homeless17%

Race Statistics of all CCC Clients as of July 31, 2011

White 67%

American Indian 17%

Asian 2%

Black or African American 2%

Other 4% Unknown 7%

Age Statistics of all CCC Clients as of July 31, 2011

Total Unique CCC Clients = 236

18-2021-25

26-3031-35

36-4041-45

46-5051-55

56-6061-65

66-7071-75

76-8081-85

86-90

unknown

28

45

2126

2218

28

1519

63

0 0 0 14

Number of Non-Pennington County CCC Clients as of July 31, 2011 - Total = 33

MEADE

OUT OF S

TATE

LAW

RENCE

CUSTER

DEWEY

FALL

RIVER

BENNET

TBUTT

E

HAAKON

HUGHESJO

NES

MINNEH

AHA

SHANNON

UNKNOWN

77 6

2 2 2 1 1 1 1 1 01

15Not Home-less

Homeless

MEADE

OUT OF STATE

LAW

RENCE

CUSTER

DEWEY

FALL RIVER

BENNETT

BUTTE

HAAKON

HUGHES

JONES

MIN

NEHAHA

SHANNON

7 76

2 2 21 1 1 1 1 1 1

Breath Alcohol Level of CCC Clients Who Were Tested as of July 31, 2011

Nonex <

.08

.08 = > x < .2

.2 = > x < .3

.3 = > x < .4

.4 = > x

Unknown

69

9

22 21

5 1 4

Unknown levels are those where CCC staff knew a person was drinking but the breathalyzer was malfunctioning.

Funding Sources for CCC Clients as of July 31, 2011

47%

17%13%

9% 6% 4%0% 0% 2% 2%

Non-billable clients were those who were in briefly and/or were not able to provide or sign billing information.

CCC Indicated Diversions From Specific Programs as of July 31, 2011

Jan Feb Mar Apr May Jun Jul

6

2931

34

2932

1 3

13 12

20

15

25

RCRH BHC RCRH ER Detox Jail HSC

Total BHC Diversions =161

Total ER Diversions = 89

*

* There was 1 diversion from HSC in June 2011.

Total CCC Diversions as of July 31, 2011Total = 270

RCRH BHC RCRH ER Detox Jail HSC0

20

40

60

80

100

120

140

160

180

161

89

12 7 1

Diversions are tallied based on the alternative that the referring entity would have chosen had the CCC not been available.

CCC Clients Compared to MH Holds < 24 hr Admits as of July 31, 2011

Jan-10

Feb-10

Mar-

10

Apr-10

May

-10

Jun-10

Jul-1

0

Aug-10

Sep-10

Oct-10

Nov-10

Dec-10Jan

-11

Feb-11

Mar-

11

Apr-11

May

-11

Jun-11

Jul-1

10

10

20

30

40

50

60

70

80

90

MH Holds CCC Clients

CCC Satisfaction Surveys as of July 31, 2011 (1)

Very Much Agree

Agree Disagree Very Much Disagree

74%

25%

1% 0%

I get the help I want from the

Crisis Care Center

Very Much Agree

Agree Disagree Very Much Disagree

76%

24%

0% 0%

I would recommend the Crisis Care Center's services to others

CCC Satisfaction Surveys as of July 31, 2011 (2)

Very Much Agree

Agree Disagree Very Much Disagree

82%

18%

0% 0%

I feel safe and comfortable in the Crisis Care Center

Very Much Agree

Agree Disagree Very Much Disagree

86%

14%

0% 0%

Crisis Care Center staff is friendly, courteous and respectful

CCC Referrals from CIT Officers as of July 31, 2011

January 31 – July 31, 2011 – The CCC received 31 referrals from law enforcement officers trained in CIT. 12 referrals from law enforcement officers who had

consulted with another officer trained in CIT.

June 1 – July 31, 2011 – The CCC received 16 referrals from law enforcement officers trained in CIT.

12 referrals from law enforcement officers who had consulted with another officer trained in CIT.

Average Length of Stay at the CCC as of July 31, 2011

January 31 – July 31, 2011 The average length of stay at the CCC was 8.49 hours.

June 1 – June 30, 2011 The average length of stay at the CCC was 10.34 hours.

July 1 – July 31, 2011 The average length of stay at the CCC was 9.8 hours.

Current average length of stay at the CCC is 9.0 hours

Cost per petition is estimated at $1,000.00 each. This does not include State Attorney staff time or Board Chairman’s time.

The savings represents an impact to Federal, State and Local agencies.

Collaboration: It’s an unnatural act between . . .

. . . two or more unconsenting adults