This document discusses community-based diversion initiatives in Bexar County, Texas to address challenges related to mental illness, substance use, and homelessness. It describes the development of a comprehensive diversion system including a crisis care center, jail diversion programs, and partnerships between various agencies. Key outcomes of these efforts include reduced emergency room and jail utilization, lower costs, and improved access to treatment in the community. The initiatives illustrate how collaboration across systems and evidence-based practices can effectively serve individuals with behavioral health needs.
From Blind Side to Upside: Redesigning Our Response to Patients' Social NeedsJosinaV
Slides from masters defense presentation - Josina Vink.
Masters of Design in Strategic Foresight and Innovation, OCADU.
It has been suggested that as much as 50% of population health outcomes can be attributed to social determinants of health (SDOH), the conditions in which people live (O’Hara, 2005). Despite widespread recognition of the importance of SDOH, little has been done to support primary care in effectively responding to the social aspects of patients’ health (Bloch, Broden, & Rozmovits, 2011). Using a variety of design research methods, including interviews and observations, this study investigated why rural family physicians are unable to successfully address SDOH of low-income patients. This exploration revealed underlying cultural and systemic barriers that inhibit physicians from meeting the social needs of their patients. After understanding the gap around the social aspects of heath that exists in medicine, recently dubbed ‘health care’s blind side’ (Robert Wood Johnson Foundation, 2011), and the related design opportunity, the Community Health Accelerator (CHA) concept was developed. A CHA is a system innovation that catalyzes connections and conversations about the social side of health by leveraging the role of primary care and catalyzing community action. This concept has the potential to create significant population health improvements and long-term reductions in health care expenditures by reorganizing existing resources.
How has MS spent its disaster recovery CDBG funds? What percentage has gone towards lower-income storm victims? What would need to happen to meet Congressional goal?
Provides an overview of expansion of Michigan Health Centers and how it is increasing access to health care for the underinsured and medically underserved in Michigan,
Veterans Jail Diversion and Trauma Recovery ProgramGilberto Gonzales
Describes the Bexar County San Antonio Veterans diversion program establishing a community based best practice for diverting veterans with trauma related mental health needs from incarceration into trauma specific treatment.
From Blind Side to Upside: Redesigning Our Response to Patients' Social NeedsJosinaV
Slides from masters defense presentation - Josina Vink.
Masters of Design in Strategic Foresight and Innovation, OCADU.
It has been suggested that as much as 50% of population health outcomes can be attributed to social determinants of health (SDOH), the conditions in which people live (O’Hara, 2005). Despite widespread recognition of the importance of SDOH, little has been done to support primary care in effectively responding to the social aspects of patients’ health (Bloch, Broden, & Rozmovits, 2011). Using a variety of design research methods, including interviews and observations, this study investigated why rural family physicians are unable to successfully address SDOH of low-income patients. This exploration revealed underlying cultural and systemic barriers that inhibit physicians from meeting the social needs of their patients. After understanding the gap around the social aspects of heath that exists in medicine, recently dubbed ‘health care’s blind side’ (Robert Wood Johnson Foundation, 2011), and the related design opportunity, the Community Health Accelerator (CHA) concept was developed. A CHA is a system innovation that catalyzes connections and conversations about the social side of health by leveraging the role of primary care and catalyzing community action. This concept has the potential to create significant population health improvements and long-term reductions in health care expenditures by reorganizing existing resources.
How has MS spent its disaster recovery CDBG funds? What percentage has gone towards lower-income storm victims? What would need to happen to meet Congressional goal?
Provides an overview of expansion of Michigan Health Centers and how it is increasing access to health care for the underinsured and medically underserved in Michigan,
Veterans Jail Diversion and Trauma Recovery ProgramGilberto Gonzales
Describes the Bexar County San Antonio Veterans diversion program establishing a community based best practice for diverting veterans with trauma related mental health needs from incarceration into trauma specific treatment.
Overview presentation of the successful jail diversion program in Bexar County presented by Gilbert Gonzales at the Georgia JDTR Conference, October 20-22, 2013 Hyatt Regency, Savannah, Georgia
20 Ideas for your Website Homepage ContentBarry Feldman
Perplexed about what to put on your website home? Every company deals with this tough challenge. The 20 ideas in this presentation should give you a strong starting point.
So you’ve heard about the growing senior population. You have begun
or expanded development, preservation, and repair programs for elderly
housing. But is that enough? For seniors to age in place they need services.
Can your organization provide both the housing and services? Hear from
your peers on how they did it and why it’s important
Advocacy Workshop, National Rx Drug Abuse Summit, April 2-4, 2013. Successful Strategies for Community Change - Part 2 presentation by Fred Wells Brason II and Connie M. Payne.
Started in 2011, Project 25 aims to solve the many difficulties associated not just with chronic homelessness, but especially those who are frequent users of public systems such as local hospitals and law enforcement. In its first year alone, Project 25 demonstrated the following results and these trends have continued into subsequent years. First year results include:
• 56 percent decline in number of hospitalizations
• 58 percent decrease in days spent in the hospital
• 62 percent drop in ambulance rides
• 66 percent reduction in emergency room visits
• 63 percent cut in costs
Informative Speech Template Outline
I. Introduction (Approximately 30 sec-1min.)
A. Attention Getter
B. Background and Audience Relevance
C. Speaker Credibility
D. Thesis
E. Preview of Main Points
Transition to first main point
II. Body (Approximately 2-3 min)
A. Main Point 1:
1. Sub point 1
2. Sub point 2
Transition (signpost, summary, preview)
B. Main Point 2
1. Sub point 1
2. Sub point 2
Transition and signal closing
III. Conclusion (Approximately 30 seconds-1 minute)
A. Restate Thesis
B. Review Main Points
C. Memorable Closer
Selling Organs for Transplantation
LEWIS BURROWS, M . D .
Abstract
The need for transplant organs has far outstripped the supply of available cadaveric organs. Hundreds
of people on waiting lists, who could be saved by transplantation, die each year. This severe shortage
has justified the extension of transplantation to the use of living donors, but there are still not enough
organs to meet the need. This paper discusses the justification for changing policies in order to encour-
age organ donation. It presents reasons for allowing payments to be made to families that donate
cadaveric organs. It also presents reasons for allowing payments to be made to living donors, and
guidelines for how an ideal policy could be structured.
Key Words: Selling, payment, organs, transplant, financial remuneration, presumed consent, altruism,
ethics.
LIVING DONOR ORGAN TRANSPLANTATION is the
only field of medicine in which two individuals
are intimately involved: the donor and the re-
cipient. It is also the only field of medicine in
which altruistic giving of oneself is the basis of
the medical practice. I have been asked to ad-
dress a very specific aspect of this process, that
is, living organ donation for financial remuner-
ation. No other subject in the transplant experi-
ence is as controversial. Many of those in-
volved in the field—surgeons, physicians, so-
cial scientists, ethicists, and theologians—have
expressed an opinion on this issue.
As a result of impressive gains in this field,
organ recipients now have a significant chance
for both long-term survival and a reasonable
quality of life. These successes have led nearly
80,000 individuals to opt for transplantation as
a form of therapy. Unfortunately, the number of
organs available has lagged far behind the de-
mand. Every year thousands die while waiting
for the gift of life that an organ transplant could
provide.
In the case of cadaveric giving, the family
of the brain-dead person is asked to donate.
Address all correspondence to Lewis Burrows, M.D., 201 East
17th Street, Apt. 27H, New York, NY 10003; email: Rock-
[email protected]
Adapted from a presentation at the Issues in Medical Ethics
2001 Conference on "Medicine, Money, and Morals" at the
Mount Sinai School of Medicine, New York, NY on November 2,
2001, and updated as of Eebruary 2004.
There is a serious shortfall in cadaveric organ
donations, with only 40-60% of U.S. families
consenting to organ recov.
Slides from talks given to Anglesey Council on how to develop Citizen Directed Support locally and in Wales. Covering (1) problems in design of welfare state (2) history of innovations (3) key ideas and reforms (4) challenge of making changes work.
Community Foundation Boulder County – Wildfire Fund Plan, March 28, 2022CommunityFoundationB
Up to $20 million to support rebuilding efforts
Up to $2.5 million to support Unmet Basic Needs
$1 million to support the establishment of recovery navigation
Up to $1 million to assist with smoke/ash remediation
Up to $500,000 for social infrastructure / community resiliency
Up to $750,000 to support nonprofit organizations assisting with disaster response
Up to an additional $750,000 for mental health supports
Up to $2 million for debris removal (to support those who are underinsured / uninsured)
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Top 10 Best Ayurvedic Kidney Stone Syrups in India
2012 04-24 cuyahoga county ohio
1. Community Care Based Services
Maximizing Efficiency and
Treatment Effectiveness
Diversion Initiatives Addressing Challenges
Of Mental Illness, Substance Use
and Homelessness
Cuyahoga County,
Cleveland, Ohio
April 24, 2012
Leon Evans
President and Chief Executive Officer Gilbert Gonzales
The Center for Health Care Services Director, Communications
Mental Health and Substance Abuse and Diversion Initiatives
Authority The Center for Health Care Services
Bexar County San Antonio, Texas
San Antonio, Texas ggonzales@chcsbc.org 1
levans@chcsbc.org
6. Why ?
Poor communication
Poor system design
Silos
No strategic
improvement plan
Little use of prevailing best
practices
Lack of leadership and overview 6
7. The Problem
The Problem gets worse:
Poor and or reduced
funding
Scant, limited and
rationed services
Reduction of State Hospital
treatment beds
7
8. An Ounce of Prevention
Taxpayer Costs Avoided through Preventing
Crime
Criminal Behavior and Its Cost to Society
• 1.7 Trillion including victimless
crime – Perazzo 2002
• 674 Billion Federal, State and Local – Shapiro 1999
• 1.0 Trillion (2 million people incarcerated) – Adrienne
2005
Cost Avoided if One Criminal Career is Prevented
$ 976,217.81
• Average annual adult cost (2004) - $40,865
• Average annual juvenile cost (2004) - $32,888
Source: Dr. Victoria Reinhardt, An Ounce of Prevention presentation
8
To NACo, July 2008
9. The Case of Million MILLION-DOLLAR MURRAY
by MALCOLM GLADWELL
Dollar Murray The New Yorker Magazine, Issue of 2006-02-13
and 20, Posted 2006-02-06
“It cost us one million dollars not to do something about
Murray,”
News Release
Emergency Departments See Dramatic Increase in
People with Mental Illness Seeking Care Emergency
Physicians Cite State Health Care Budget Cuts at Root
of Problem
American Psychiatric Association
Hillarie Turner, 703-907-8536 June 2, 2004
hturner@psych.org Release No. 04-30
Sharon Reis 202-745-5103
“in one study, it had been concluded that one homeless person can cost the
City and County about $200,000 in one year”. Philip F. Mangano, Executive Director of the
United States Interagency Council on Homelessness (USICH), May 1, 2007.
9
10. Average Per Capita Spending
• In 1995, average monthly
spending per capita for clients
receiving services in Community Based vs Institutional Cost Per Day
"aged/disabled" home and $350
Institutional,
$320
community-based waivers $300
across all states with these $250
waivers was $485 per month. $200 Community
$150 Institutional
$100
• In contrast, average monthly $50
Community, $42
spending per Medicaid- $0
covered nursing home resident 1
was $2,426.14.
http://aspe.hhs.gov/daltcp/reports/costeff.htm
(per episode cost)
10
12. Integrating and Strengthening
Community-Based Care
• Community-based services, that are readily accessible
and convenient, help in the early detection and
treatment of mental health problems.
• Will help to reduce the
need for hospitalization
and increase the chances
that patients can fully regain
their mental health and help
them to live and work
successfully
within the community.
12
13. Community Care
Is better than Institutional Care
Costs less than institutional care
Is least restrictive
Allows for greater
family involvement
Produces better
outcomes
13
15. The Diversion Process
Point of Contact with CIT/Deputy 24/7 Crisis Emergency
Law Enforcement Mobile Outreach Services Transport to
Team Hospital
*Pre-Arrest Diversion
Referrals to
Community
Arrested Magistrate Post-Booking Diversion Providers
Court
Pre-Trial Bexar
Community-based
Diversion County Jail
Wraparound Care
Genesis Probation,
Incarceration, Treatment in lieu of
Parole Incarceration
Residential
Respite
16. Civil and Criminal
System County City-wide System Level
Entry Points
Judicial/Courts
Magistrate, County, District
Probation, Parole
County City-wide
Continuity of Care
Police, Sheriff
Treatment
Law Enforcement Crisis Care Center
Detention/Jail
Jail Diversion Mental Health
CIT Psychiatric and Medical
Public and Private
Providers
Clearance
Specialty Offender Services
Emergency Services
• Community Collaborative
• Crisis Care Center
• Crisis Transitional Unit
• Crisis Hotline (Nurselink)
Dynamic • CIT/DMOT
Community
• SP5
Crisis Jail Diversion • Jail and Juvenile Detention
Information Exchange • Statewide CARE Match
16
17. Stakeholder Collaboration via:
• Jail Diversion Oversight Committee
(34+ Community Agencies/Stakeholders)
• Community Medical Directors Roundtable
• Children’s Medical Directors Roundtable
• Bexar County Children’s Diversion School District Sub Committee
• Bexar County Children’s Diversion Child Protective Services Sub
Committee
• Bexar County Children’s Diversion Juvenile Justice Probation Sub
Committee
• Community Co-Location Coalition (29 Community Agencies including law
enforcement entities meeting to address the homeless & public inebriate)
17
22. What Works
Emergency Room
Utilization (Medical Clearance)
Emergency Room utilization has dropped 40% since
the inception of the Crisis Care Center.
40% of (7619 total seen at CCC) 3048
Persons diverted from the ER (in 2006 first year)
X $1545
Cost Savings relative to ER Utilization $4,709,160
Source: University Health System
22
23. Today 23
2012 – The Bexar County Sheriff and San Antonio Police Chief mandate CIT Training
24. Impact on WAIT TIME
for LAW ENFORCEMENT
Then (prior to Sept 2005) Now
• Wait times for Medical • The wait time for Medical
Clearance/ Screening at Clearance/ Screening at the
UHS ER - 9 hours, 18 min. Crisis Care Center is 45
minutes.
• Wait times for Medical • Wait time for Medical
Clearance/ Screening and Clearance/Screening and
Psychiatric Evaluation was Psychiatric Evaluation is
between 12 and 14 hours. 60-65 minutes. 24
26. Involuntary Outpatient Commitment
Program
First Year
Evaluation 150
79% Reduction in Bed
Pre Day Use, Post Program
100 IOPC
# Bed Days
Program
Used
50
Post
0
State Hospital Bed Day Utilization
Rate
1 Yr Prior 132
1 Yr Post 27
26
27. CRISIS CARE CENTER
• Crisis Line
• Crisis Assessment • Receives consumers
• Mobile Crisis Outreach Team
from law enforcement
• Crisis Transitional Unit
24/7
7137 W. Military 645-1651
• Minor medical clearance
• Call ahead preferred
210 225-5481
• Can not take violent or
medically compromised
individuals
27
28. CIT Mental Health Detail
• Mental health professional
partners with a CIT Officer
together to respond on calls
dealing with a psychiatric crisis.
• Team responds to high utilizer
calls for the City providing follow
up services to reduce the call
volume.
• Goal is to put officers back into
service for patrol as soon as
possible.
– Reduce inappropriate
incarcerations and costly
emergency room visits.
– Offer quality training to law
enforcement.
• Co-locate officer with the City unit
and Sheriff Mental Health Unit for
better collaboration and expedited
call response
29. Dispatcher Training for 911
Call Takers and Dispatchers
• In 2007 - decided that dispatchers
would also benefit from CIT
Instruction and met with SAPD
leadership to establish training.
• Provided an abbreviated 12 hour
CIT course for call takers and
dispatchers in collaboration with
CHCS
• The goal of this training is to
increase safety by educating caller
takers on essential intelligence
gathering and dispatching a CIT
Trained officer to the scene.
30. Partnered with Fire and EMS
• As of 2007 SAFD has attended
every community training
• has become co trainers with
joint PD and Sheriff’s Officers
• Have added a CIT component to
their EMS In-service training.
• Partnering for Integrated
training with Fire/EMS has
extended numerous
opportunities for growth:
– Officer and Fire/EMS better
communication
– Safety
– Better utilization of
resources
31. The
Restoration Center
Opened
•
April 15, 2008
• Public Safety- Sobering
Unit
• Detoxification Facility
• Community Court
• Outpatient Substance
Abuse Services
31
32. Haven for Hope Homeless Facility
CNN Video Clip
“Texas officials hope a massive new facility will keep
the homeless
out of jail, emergency rooms and re-integrated into
society”.
• http://www.diversioninitiatives.net/2010/07/haven-for-hope-cnn-video-just-before.html
32
33. Haven for Hope Homeless Transitional Facility
33
www.havenforhope.org
37. Funding
• Jail Diversion Planning and Oversight Committee - Judge Poly Jackson Spencer
• SAMHSA Jail Diversion Grant
• Changing the Law - Senate/House Bills Madla/Uresti,HB 2292 Mandated
Jail Diversion
• Police Chief Ortiz Funding - Drug Bust Money
• University Health System Partnership- Care Link & New Generation
Medications Program
• Texas Crisis Redesign - $82 million State-wide
• Bill Greehey/Bexar County - Transformation Center
• Texas Correctional Office on Offenders with Mental and Medical
Impairments (TCOOMMI)
• Genesis Outpatient Services - Probation and Parole
• Mentally Impaired Offenders Program-Probation
• Substance Abuse Treatment Facilities (SATF I and II)
• Medicaid Administrative Claiming
• Medicaid Eligibility and Carelink Workers
• Third Party Billing
37
38. Combined CCC and Restoration Documented and Immediate Cost Avoidance
Year One April 16, 2008 – March 31, 2009
Year Two April 16, 2009 – March31, 2010
Year Three April 16, 2010 – March 31, 2011
Cost Category City of San Antonio Bexar County Direct Cost Avoidance
Public Inebriates Diverted from Detention $435,435 $1,983,574 $2,419,009
Facility
$925,015 $2,818,755* $3,743,770
$1,322,685 $4,372,128 $5,694,813
A. B.
Injured Prisoner Diverted from UHS ER $528,000 $1,267,200 $1,795,200
$435,000 $1,044,000 $1,479,000
$421,000 $1,010,400 $1,431,400
C. D.
Mentally Ill Diverted from UHS ER Cost $322,500 $774,000 $1,096,500
$283,500 $676,000 $959,500
$276,500 $663,600 $940,100
E. F.
Mentally Ill Diverted from Magistration $208,159 $371,350 $579,509
Facility
$179,833 $322,300 $502,133
$126,893 $191,125 $310,018
G. H. 38
Summary next slide
40. BEXAR COUNTY DETENTION CENTER
SYSTEM POPULATION
MONTHLY AVERAGES
(Main, Annex)
4400 4357
4337
4292 4300 4302 4300
4280 4289
4300 4260 4263
4253 4272
4222 4231 4225
4254 4210 4208 4261
4193
SYSTEM POPULATION
4179
4200 4173 4171 4158
4156
4130 4139 4197 4190
4109 4133 4124
4095 4095 4094
4079 4084 4081
4100 4062
4094 4053 4040
4096 4028 4033
4015 4017
4077 4066
3987 4001 3993
4000 3981 4015
3960
3941 3946
3982
3897 On May 2011, there were 883
3900
empty beds in the jail 3845
3807
3854 3790 3791
3800 3743
3700
FEB
DEC
MAY
SEP
APR
JAN
MAR
JUN
AUG
OCT
JUL
NOV
2006 2007 2008 2009 2010 2011
41. The End Result
• Comprehensive service for most in need
• Increased availability of comprehensive
coordinated services
• Reduced barriers to service access and
increase motivation with treatment
compliance
• Employ evidence based practices known
to be effective
• Utilization of system tracking and outcome
based treatment
41
43. The Center for
Health Care Services
Leon Evans, President/CEO
The Center for Health Care Services
Mental Health Authority
210 731-1300
43
www.chcsbc.org
levans@chcsbc.org
Editor's Notes
7.3 List the mental health facilities in your area that can be utilized as a resource when encountering a subject/suspect you identify as having possible mental health issues Instructor Note: Use MHMR or comparable entity for state referral sources per region. Have students compile a referral list and research appropriate contact numbers.