1. Transforming the Concept, Process & Environment of the JTCMHC Evaluation Services Unit Oklahoma Department of Mental Health and Substance Abuse Services Jim Taliaferro Community Mental Health Center Background Overview The Jim Taliaferro Community Mental Health Center Triage Unit, established in early 1990 and is now referred to as the “Evaluation and Admission Unit”, provides consumer screening for mental health issues, substance abuse services, and provides timely crisis interventions for all Oklahomans in our nine county catchment area in Southwest Oklahoma. This project resulted from a decision to enhance the quality and cost effectiveness of our Evaluations Unit to 1) eliminate the need to admit consumers who do not meet Emergency Detention criteria and, 2) return the length of stay in our Inpatient Unit to pre-crisis levels. We set out to accomplish these goals: During the 2009 fiscal year, a severe shortage of physicians made it necessary to admit all consumers presenting to our Inpatient Unit under Emergency Detention status after 5:00 pm daily, as there was no physician available to evaluate them until the following morning. This situation produced an unacceptable number of unnecessary admissions with stays of less than 2 days. Reduce crowding, wait times, and the number of patients who leave without being seen. Improve the Emergency Detention Admission Process to provide better integration with Law Enforcement Agencies. Create a staffing plan that reduces costs and increases coverage during peak hours. Because the timeframe for completing all assessments is determined by the average length of stay, when we were surveyed in 2008 by CMS, we were required by them to change our policy and to complete all assessments in just 48 hours instead of the usual 72. This change made it necessary to have social workers on site 7 days a week, and even so, the 48 hour deadline was not consistently being met, placing our CMS certification in jeopardy. The initial goal of this project was to eliminate the need to admit consumers who did not meet ED criteria and return to our pre-crisis average length of stay. Develop call-coverage strategies and closer alignment with key physicians. Counties Served Provide better patient and staff safety while increasing overall program satisfaction. Expand and remodel the Evaluation Unit Provide comfort rooms to consumers and law enforcement personnel to make any wait times more tolerable. Results – SUCCESS! Costs and Returns Inpatient admissions were reduced by 48%, saving time and taxpayer dollars. Even after the project period, inpatient admissions of less than 24 hours have continued to decrease up through the present. Remodeling our Evaluation Unit to provide a warm and inviting atmosphere to both consumers and law enforcement - $10,000 Payroll saved because we reallocated current staff instead of new hiring - $233,840 48% Transportation and Operating costs deferred because of the prevention of frivolous E.D. Admissions - $228,000 One Oklahoman not receiving an unnecessary mental health record - PRICELESS For more information, contact Jim Taliaferro Community Mental Health Center: Jim Regan– (580) 248-5780 The mission of the Oklahoma Department of Mental Health and Substance Abuse Services is to promote healthy communities and provide the highest quality care to enhance the well-being of all Oklahomans.