Childrens Community Mental Health Center MHC

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Childrens Community Mental Health Center (MHC)

• Bernalillo County Juvenile Detention Center
  (BCJDC)
• Tom Swisstack, Director

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Childrens Community Mental Health Center A
Partnership Between BCJDC and Value
Options.Outline

• Etiology History
• Licensure
• Case Management and Detention Reform
• Community Collaboration
• Funding Sources
• Lessons Learned
• Future Problems Solutions

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Childrens Community Mental Health Center (CCMHC)

• Founded in September 2001
• Collaborative effort with Bernalillo County
  Juvenile Detention Center, Medical Assistance
  Division and Medicaid Managed Care Organizations
• Developed from the identified need for a on-site
  mental health service.

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• Need Identify those youth who are in need of
  mental health treatment.
• Medication management and reduction of
  re-admittance to detention.
• Solution Create a community based mental health
  clinic that is readily available to our youth.

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Licensure

• Facility licensed as the only childrens
  community mental health center in the state of
  New Mexico.
• Services included in licensure
• Medication Assessment/Management
• Therapy
• Substance Abuse Services
• Case Management

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Case Management and Detention Reform

• Needs Assessment completed by case managers at
  CCMHC.
• Service Plan Developed Immediately.
• Ongoing coordination of care and needs by
  assigned case manager.

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Community Collaboration

• Developed Relationships with
• Probation Department
• Public Defenders
• Client Advocates
• Funding Sources
• Judges and Hearing Officers
• Community Providers
• Detention Staff
• Reform Staff
• Local Education Systems
• Government Entities

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Funding Sources

• Initial Start up
• Investment from Bernalillo County 110,000.00.
• Investment from Medicaid Managed Care
  Organization. Initial Set-up was 72,000.00
• Ongoing funding is facilitated through billing
  Medicaid for services rendered.

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• BCJDC reallocates staff and provides a physical
  plant.
• Obtain special licensure that is portable and
  good for other sites.
• Population has been reduced and units
  subsequently closed.
• Two Case Managers and more projected.
• One Nurse Practitioner
• Portable Buildings
• Billing Clerk

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• All inclusive with medication management,
  out-patient services, and case management
• HMOs contributed
• Recognized our youth were high cost clients
• Repetitive interventions
• Replace RTCs and/or In-patient placement
• - Technical expertise for management .
• Avoid expensive out of home placement.
• 80 Juvenile Justice 20 Community.

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Leveraging Community Resources

• Three contract Psychiatrists
• Very Experienced
• Constant Referrals
• Office Space
• Scheduling
• Billing
• Charge administrative fee

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Lessons Learned

• Strategic Planning
• Staff trained
• Understanding of licensure requirements
• Need for diversified funding and understanding of
  contracts
• Need for diversified programming
• Adequate infrastructure
• Billing
• Data Collection Interpretation
• Management Information System (MIS)

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• Does intervention and treatment impact future
  detention stays for new crimes?

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In line with the literature, those youth who
received and completed treatment were less likely
to commit a new crime. These data went out one
year after treatment was completed. Result A
significant impact on number booked into the
juvenile detention center for a new crime.
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When youth were brought back to the detention
center after completing treatment the top two
reasons were administrative.
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Most Common Diagnoses by youth entering the
Mental Health Clinic with a charge.
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The Future

• Expanded Clinic Hours
• 24 X 7 Case Management Model
• Case Management at Booking and at Discharge
• Transitional Living Services
• Intensive Outpatient Programming
• Mental Health
• Substance Abuse
• Tele Health Funded
• Additional contract for a psychiatrist 40 hours

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• Multi-site location within state
• Use vacated detention units for transitional
  living units (reimbursable service)
• Continuum of services
• Drug and Alcohol Detoxification Unit
• Immediate Available Treatment
• SAMHSA

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• Problems
• Not set up to run a business
• Billing Collection
• Record Keeping/HIPPA Compliance
• Running a Medical Office
• Need private sector experience and knowledge
• HMO loans staff for 20 hours per week
• Shows level of cooperation with private sector
• JPO Referral Process