Crisis Services Plan

Side-by-Side Comparison

During the months of September and October, 2007, stakeholder groups (Jail Diversion, Planning Network Advisory Committee, and Focus Group) attended meetings and reviewed the proposed enhancements to our Crisis System to be funded through Crisis Re-Design dollars appropriated through the 80th Texas Legislature.

The following table provides a comparison of our current crisis response system and the changes proposed for Fiscal Years 2008-2009.

We would also appreciate any comments you might have regarding the proposed changes. You may communicate those to us by posting your comments at this link.

You may also view the Crisis Services Report in its entirety here.
 

Existing Services

Enhanced Services *

* These services are in addition to services in left column

Staffing

• Crisis Director (24hr Administrative Supervision and serves as on call backup)

• 2 Full Time Equivalent (FTE) Crisis Day Clinicians (serves as on call backup)

• 1 FTE Adult Continuity of Care (COC) [also serves as on call backup]

• 1 Partial FTE Child/Adolescent COC

• 1 FTE Support Staff

• 38 Daytime caseworkers also serve on an on-call rotation after hours, divided by region.

• 1 FTE Director of Nursing (24hr Administrative Supervision only)

• 1 Psychiatrist is available to the RN by phone if indicated.
   

Staffing

• Add 2 FTE Crisis Follow-up and Relapse Prevention staff to Wichita/Archer/Clay service area.

• Add 1 FTE Crisis Follow-up and Relapse Prevention staff to Wise/Montague/Jack/Young region

• Add 1 FTE Crisis Follow-up and Relapse Prevention staff to Haskell service area.

• Crisis Follow-up and Relapse Prevention personnel are also added to the on call rotation after hours increasing the rotation from 38 to 42 staff center wide.

• Add 5 LPHA staff for after hour consultation 24/7

• Add 4 RN staff for after hour consultation 24/7 (includes DON who also serves as 24hr Administrative Supervision)
   

Hotline (Prior to September 1, 2007)

• Hotlines answered locally 24/7 by Wood Group contracted staff.

• These non-credentialed hotline personnel activate QHMP to respond face to face to each call.
   

Hotline (As of September 1, 2007)

• Hotlines answered by Avail Solutions (AAS Accredited) 24/7

• Hotline personnel are QMHP level and screen each call to determine whether face to face QMHP assessment should be activated.
   

Crisis Response

• On call QMHP activated by hotline and recommends disposition. Backup available for response to multiple calls at once.

• Walk in crisis services available at Crisis Center 8a-5p, M-F
   

Crisis Response

• LPHA consultation by phone 24/7 to confirm disposition

• RN Consultation by LPHA by phone 24/7 for medical screening if indicated

• COC contacts made during hospitalization and at discharge.
• Non Target clients are not tracked until presenting in crisis again.
   

• Non-Target clients are assigned to Relapse Prevention staff caseloads under Service Package 5
• Staff coordinate crisis referrals and ensure client has access to referral sources by using transportation and home contacts.
• Clients are tracked for at least 30 days to prevent relapse.
   

Training

• 8 hours New Employee Training for all crisis responders

• Annual refresher training required
   

Training

• Training for all existing staff regarding new crisis response process/resources

• Limited provision by Crisis Day Clinicians
• Crisis Respite Unit staff contracted to transport clients one day a week
   

• Relapse Prevention staff are each assigned vehicles dedicated to serving clients throughout the service regions and to ensure clients can access crisis referrals.
• Crisis Respite Unit staff contracted to transport clients five days a week
   

• On call pay for 38 crisis staff and backups = $173,000.⁰⁰

• Salary for Crisis Director, Crisis Day Staff = $227,482.⁰⁰

• Wood Group Annual Hotline Contract = $12,000.⁰⁰

• Wood Group CRU Contract = $338,125.⁰⁰

• TOTAL = $750,607.⁰⁰

• Adding 4 FTE Relapse Prevention staff = $162,016.⁰⁰

• Adding LPHA On Call Stipend = $36,000.⁰⁰

• Adding RN On Call Stipend = $28,800.⁰⁰

• Added Vehicle Cost = $9,600.⁰⁰

• New Avail Solutions Annual Contract = $64,000.⁰⁰

• TOTAL = $300,416.⁰⁰