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From Triage to Treatment
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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)
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The region we represent:
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The “lay of the land”:
12 Counties 11,000 square miles Population - 370,000 Rural communities – (money &
transportation issues)
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The Problem
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Contributing challenges:
Deinstitutionalization of the 60”s Funding cuts Limited Healthcare resources Rising costs Greater than 20% uninsured System at capacity
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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 !!!!
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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
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Addressing the Problem
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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
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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
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RETHN Boards Local Advisory Boards
Regional Board of Directors
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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
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The Result
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PESC established: Protocols and Procedures were created
Trainings were held across the region
Opened on December 8, 2008
Opened in temporary location in Nacogdoches
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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
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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
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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
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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
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New PESC in Lufkin:
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Other projects: Telemedicine/conferencing Web-site for RETHN Patient Information Index Mental Health Awareness
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Outcomes &
Continuing Challenges