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From Triage to Treatment
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From Triage to Treatment

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

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