Transcript Central Receiving Center Update

Central Receiving Center
Update (CRC)
5 Years of Operation
June 10, 2008
Presentation Outline
• History
• What is the CRC?
• CRC Data
• Jail Impacts
• Funding Issues
• Summary
Presentation Outline
• History
• What is the CRC?
• CRC Data
• Jail Impacts
• Funding Issues
• Summary
History
The Crisis
• Lack of Mental Health funding in District 7
• Lack of Coordination & Continuity in the
Mental Health System
• Over utilization of ER & Orange County Jail for
Mental Health Consumers
•
Creation of Jail Oversight Commission
(Chaired by Bill Sublette)
• CRC was a major recommendation of the
Medical, Mental Health & Substance Abuse
Sub Committee (Chaired by Rich Morrison)
• CRC opened in April 2003
History
The System of Care Before CRC
• Jail had become the defacto mental health facility
• Long waits for a consumer to be placed in a
treatment bed at every entry point
• Impacts on overcrowded emergency rooms for
psychiatric patients and those needing detox
services
• Bookings in the Orange County Jail, and the costs
associated with risk, psychotropic medications and
jail resources to manage these vulnerable
consumers
Presentation Outline
• History
• What is the CRC?
• CRC Data
• Jail Impacts
• Funding Issues
• Summary
What is the CRC?
• Baker Act – Mental Health involuntary
treatment act for those suffering with a
mental illness in which they cannot take care
of themselves and may be in danger to self
or others due to their mental illness
• schizophrenia
• psychosis
• depression
• bipolar disease
All brain disorders are classified as diseases
What is the CRC?
• Marchman Act is the involuntary treatment act that
allows for treatment of a substance use
disorder/addictive disorder in which the person
may be dangerous to self or others due to their
substance abuse
• Drug Addiction
• Alcohol Addiction
• Polysubstance abuse –
combinations of drugs and alcohol
Also classified as a disease
Lakeside
Behavioral
Healthcare
Center for
Drug Free Living
Addiction Receiving
Facility (ARF)
Florida Hospital
Emergency Room
CONSUMER
Mental Health
Baker Act
Substance Abuse
Marchman Act
Law Enforcement
Officer
Pre CRC
System
of Care
Jail
Health Central
Orlando Regional
Hospital
Emergency Room
What is the CRC?
•
Central point of access for integrated assessment for
involuntary mental health (Baker Act) and substance abuse
(Marchman Act)
•
Jail Diversion for Law Enforcement use in Orange County
Partnerships
Department of Children and Families
Lakeside Behavioral Healthcare
The Center for Drug Free Living
Human Services Associates
Florida Hospital and Orlando Regional Healthcare
CRC System of Care
Law
Enforcement
Officer
Central Receiving Center
< 23 hours
INVOLUNTARY
Center for
Drug Free Living
Detox
3-5 days
Lakeside
Behavioral Healthcare
Crisis Stabilization Unit /
Short-term Residential
Treatment Unit
3-4 days
Lakeside Behavioral
Healthcare
Hospital
3-4 days
ORH Behavioral
Healthcare
Florida Hospital
Behavioral
Healthcare MedicalSurgical Psychiatric
3-4 days
VOLUNTARY
Central Receiving Center
Phase Two
3-6 months
Permanent Housing
Shelter + Care
HUD, SRO
Low income
CRC
Phase Two
What is CRC?
• Consumers placed in most appropriate community
resource within 24 hours
• Consumers diverted from over crowded emergency
departments and jail
• 2005 award recipient as “most innovative” program
from DCF and FADAA
• State of the art facility, only one of its kind in the
State of Florida
Presentation Outline
• History
• What is the CRC?
• CRC Data
• Jail Impacts
• Funding Issues
• Summary
CRC Data
• Integrated 24/7 model
• April 2003 - March 2008:
– Approximately 23,000 screened
– Of 23,000 - 86% Law Enforcement, 14%
Hospitals
• Of those screened:
– 20,147 placed in mental health beds
– 2,113 placed in substance abuse beds
– 20% of those brought to the CRC are homeless
CRC Data
2000
1800
1600
1400
1200
1000
800
600
400
200
0
Screened
Placed
2003-2004 2004-2005 2005-2006 2006-2007 2007-2008
ER Referrals Placed by CRC
CRC Data
2000
1800
1600
1400
1200
1000
800
600
400
200
0
2004-2005
2005-2006
2006-2007
Saved ER Beds
2007-2008
CRC Data
Orange County Sheriff
Orlando Police
Winter Park
Orange County Corrections
Ocoee
Apopka
Winter Garden
Maitland
Eatonville
UCF
Edgewood
Oakland
Florida Highway Patrol
Windermere
9026
3512
1004
739
544
502
391
203
121
114
37
29
9
6
Use of CRC by LEO Agencies
Law Enforcement Savings
Prior to the CRC, LEO would spend approximately
2 - 4 hours with clients at an Emergency Department
Savings:
$1.2M over the last 5 years
=27 Additional Positions
Presentation Outline
• History
• What is the CRC?
• CRC Data
• Jail Impacts
• Funding Issues
• Summary
Jail Impacts
• April 2003 - March 2008
– No Marchman patients brought to jail for
protective custody
– Approximately 150 Baker Act patients received
annually from Orange County Jail
– Law enforcement is diverting over 8% of
consumers from the jail
– Nearly 52,000 jail bed days saved
Jail Impacts
14000
12614
12000
11560
9690
10000
8000
9894
7990
6000
4000
2000
0
2003-2004 2004-2005 2005-2006 2006-2007 2007-2008
Jail Beds Saved by CRC
Jail Impacts
180
160
140
120
100
80
60
40
20
0
2003-2004
2004-2005
2005-2006
2006-2007
2007-2008
Released From Jail to CRC
Presentation Outline
• History
• What is the CRC?
• CRC Data
• Jail Impacts
• Funding Issues
• Summary
Funding Issues
Original Partners (2003)
•
•
•
•
Orange County
Florida Hospital
Orlando Regional
State of Florida (DCF)
$1,240,000
$ 250,000
$ 250,000
$ 300,000
Funding Issues
Gains Via State Appropriations
• FY ‘05 - $2.8M
Added: 20 MH Crisis Beds
6 Detox beds
7 Case Managers
10 Residential Substance Abuse beds
• FY ‘06 - $3.0M
– Kept the resources from previous year
Funding Issues
• FY ‘07 – Appropriation cut to $2.25M
Lost: 10 Crisis MH beds
3 Detox beds
6 Residential substance abuse beds
• FY ‘08 – Appropriation cut to $500,000
(As of July 1, 2008)
Loss: 17 Mental Health beds
Case management program
Some services out of CRC
Fidelity of the CRC model
Total Reduction of $1.75M from State
Presentation Outline
• History
• What is the CRC?
• CRC Data
• Jail Impacts
• Funding Issues
• Summary
Summary
As Funding for the CRC decreases:
• Increase in arrests for mental health and substance
use disorders
• Increase in jail population of those most vulnerable
requiring more supervision and posing
greater risks
• Mental health inmates stay longer by 67%
• Law enforcement may choose jail rather
than emergency rooms for transport
Central Receiving Center
Update (CRC)
5 Years of Operation
June 10, 2008