From Triage to Treatment


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Presented by: David Cozadd, Director of Operations with the Burke Center

Thomas Kerss, Sheriff of Nacogdoches County; Current President of the Sheriff’s Association for Texas

Anne Bondesen, Project Director for the Rural East Texas Health Network (RETHN)

Published in: Health & Medicine
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From Triage to Treatment

  1. 1. From Triage to Treatment
  2. 2. Who are we: <ul><li>David Cozadd, Director of Operations with the Burke Center </li></ul><ul><li>Thomas Kerss, Sheriff of Nacogdoches County; Current President of the Sheriff’s Association for Texas </li></ul><ul><li>Anne Bondesen, Project Director for the Rural East Texas Health Network (RETHN) </li></ul>
  3. 3. The region we represent:
  4. 4. The “lay of the land”: <ul><li>12 Counties </li></ul><ul><li>11,000 square miles </li></ul><ul><li>Population - 370,000 </li></ul><ul><li>Rural communities – (money & transportation issues) </li></ul>
  5. 5. The Problem
  6. 6. Contributing challenges: <ul><li>Deinstitutionalization of the 60”s </li></ul><ul><li>Funding cuts </li></ul><ul><li>Limited Healthcare resources </li></ul><ul><li>Rising costs </li></ul><ul><li>Greater than 20% uninsured </li></ul><ul><li>System at capacity </li></ul>
  7. 7. Shortage of Resources: <ul><li>Medically and Psychiatrically Underserved Area </li></ul><ul><li>Health Care Professional Shortage </li></ul><ul><li>Mental Health Care Professional Shortage </li></ul><ul><li>No other comprehensive providers </li></ul><ul><li>Lost 84 inpatient beds 1996-2001 </li></ul><ul><li>No psych beds !!!! </li></ul>
  8. 8. Burden placed on Hospitals and Law Enforcement <ul><li>Lufkin to El Paso </li></ul><ul><li>Hurricanes Katrina & Rita </li></ul><ul><li>20% increase in hospitalization </li></ul><ul><li>Psychiatric beds stay full </li></ul><ul><li>Overflow to hospitals and jails </li></ul><ul><li>Heavy workload on hospitals & law enforcement departments </li></ul><ul><li>Frustrated and outraged </li></ul>
  9. 9. <ul><li>Addressing the Problem </li></ul>
  10. 10. The Rural East Texas Health Network <ul><li>Created in 2006 through a federal HRSA Network Planning Grant </li></ul><ul><li>In 2007, received Mental Health Transformation grant through the Texas Health Institute. </li></ul><ul><li>In 2008, received HRSA Network Development Grant </li></ul>
  11. 11. Purpose of RETHN: <ul><li>Line of communication between stakeholders </li></ul><ul><li>Line of communication between community and mental health provider </li></ul><ul><li>Educate community on issues and needs </li></ul><ul><li>Create a united voice working towards common goals </li></ul><ul><li>Provide a mechanism for collaborative problems solving </li></ul>
  12. 12. RETHN Boards <ul><li>Local Advisory Boards </li></ul><ul><li>Regional Board of Directors </li></ul>
  13. 13. In 2007, our request proposal to the state for Crisis Services Redesign funds for a regional Psychiatric Emergency Service Center (PESC) <ul><li>Already organized and poised for action </li></ul><ul><li>Need already identified </li></ul><ul><li>25% financial match received from community </li></ul><ul><li>Support letters from stakeholders </li></ul><ul><li>Pledge from Temple Foundation </li></ul>
  14. 14. <ul><li>The Result </li></ul>
  15. 15. PESC established: <ul><li>Protocols and Procedures were created </li></ul><ul><li>Trainings were held across the region </li></ul><ul><li>Opened on December 8, 2008 </li></ul><ul><li>Opened in temporary location in Nacogdoches </li></ul>
  16. 17. PESC: What it is: <ul><li>Locked Extended Observation Unit: 10 beds; 24-48 hour observation for crisis stabilization </li></ul><ul><li>Unlocked Voluntary Respite Unit: 14 beds; up to two week stay </li></ul><ul><li>Have admitted over 1,500 clients since opening in December 2008. </li></ul><ul><li>Staffing Pattern </li></ul>
  17. 18. PESC - What we do: <ul><li>Triage </li></ul><ul><li>Accept people for evaluation 24/7 </li></ul><ul><li>Staff will screen for appropriateness </li></ul><ul><li>Do a comprehensive evaluation </li></ul><ul><li>Telemedicine </li></ul><ul><li>Begin to work quickly to alleviate symptoms and stabilize </li></ul><ul><li>Move to a lesser level of care within 48 hours (higher level in limited cases) </li></ul><ul><li>Transporting to inpatient facilities </li></ul><ul><li>Work to return people to their homes and community </li></ul>
  18. 19. PESC - Who we serve: <ul><li>Persons 18 years of age or older AND </li></ul><ul><li>Persons coming from any of our 12 counties AND </li></ul><ul><li>Persons who have a mental illness AND </li></ul><ul><li>Persons who are in imminent danger of harming themselves or others due to their mental illness </li></ul>
  19. 20. PESC - What we are not: <ul><li>We are not a hospital </li></ul><ul><li>We are not a jail </li></ul><ul><li>We are not a drunk tank, detox facility or alcohol/drug treatment facility </li></ul><ul><li>We are not a homeless shelter </li></ul><ul><li>We are not an Alzheimer or dementia treatment facility </li></ul>
  20. 21. New PESC in Lufkin:
  21. 22. Other projects: <ul><li>Telemedicine/conferencing </li></ul><ul><li>Web-site for RETHN </li></ul><ul><li>Patient Information Index </li></ul><ul><li>Mental Health Awareness </li></ul><ul><li>  </li></ul>
  22. 23. <ul><li>Outcomes & </li></ul><ul><li>Continuing Challenges </li></ul>
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