NORTHWEST REGION
CHILDREN’S SERVICES
WESTERN MO MENTAL HEALTH CENTERChild and Adolescent UnitDesigned for 10 beds, but staffed for fewer
Acute psychiatric inpatientFront Door – Emergency Room typically, frequently Central or Regional Office recommendation
WMMHC StatsApproximately 200 admissions in a yearMood Disorder, Not Otherwise Specified by
far the most frequent diagnosis (7x more frequently given than the next diagnosis which was Psychotic Disorder, NOS)
Approximately 45% referred by family/relatives
Approximately 25% referred by courts/law enforcement
10% were involuntary commitments
WMMHC Stats17% had dual diagnoses of MI/DD
Payor Sources38% Medicaid33% MC+ Managed Care17% “guest of the state”12% private insurance
WMMHC StatisticsAverage Length of Stay 11.5 days with a
range from 2-126 days (10% exceeded 30 days)
Of the 10%, the classic presentation was Dually diagnosed with MI/DDExtreme Behavioral Presentations (typically
aggression)Co-occurring medical conditionsMultiple admissions to inpatient services
Complicated Medical ConditionsOne youth had the following medical conditions on
Axis IIIHYPOTHYROIDISM UNSPEC OBESITY UNSPEC TEAR FILM INSUFFIC UNSPEC ALLERGIC RHINITIS UNSPEC ESOPHAGEAL REFLUX UNSPEC CONSTIPATION ACUTE DERMATITIS SOLAR RAD OBSTRUCTIVE HYDROCEPHALUS STEVENS-JOHNSON SYNDROME OTHER CONVULSIONS OTHER DRUG ALLERGY
NW Region Inpatient Bed Capacity for Children and Adolescents
Crittenton 41
Research Psychiatric 25Heartland –St. Joseph 0St. Luke’s Northland 6Two Rivers 20___________________________Total Beds 102Royal Oaks 33
Capacity DevelopmentBased on model developed by Robert
Friedman out of Southern Florida in 1987 – updated through discussions in 2003
Balanced system of care – excess or deficit in any area, impacts all other areas
Does not include services for prevention or early intervention
Public mental health services and funding, so would include schools, juvenile courts, child welfare and Medicaid
NW Region Capacity DevelopmentCategory Total
Slots*Specific Service Specific
Slots
Hospitalization/ Stabilization less than 6 months
43 Non-Medical Crisis Bed 4
Medical Crisis Bed 4
Residential 9
Inpatient 26
Hospital/Residential Treatment Centers greater than 6 months
43 Transitional/Independent Living
37
Residential 5
Inpatient greater than 6 months
1
Treatment Family Homes/Group Homes
340 Treatment Family Homes 255
Group Homes 86
NW Region Capacity DevelopmentCategory Total
SlotsSpecific Service Specific Slots
Home -Based 851 Respite 247
Family Assistance 238
In-home Therapy 247
Intensive CPR 119
Day Treatment 851 Full Program 153
Individual Therapy1 247
Group Therapy1 451
Outpatient 3404 Physician Services 2247
Access/Intake 511
Evaluation Services 34
Therapy Services 6131 Individual services added to existing program
NW Region Capacity DevelopmentCategory Service Slot Specific
ServiceSpecific Slot
Case Management with WrapAround2,3
5504 POS CM 1021
TCM Bachelors 613
TCM Masters 340
Maintenance CPR
545
Rehab CPR 885
WrapAround3 2100
Parent Support4 1260 Support and Educational Groups
Total Service Slots
8396
Total Youth 63002 Peer to Peer case management and parent partner models of cm would be included
in this category3 WrapAround was calculated based on access for 70% of the youth receiving CM or
home-based services4 Based on 20% of children served
Current UtilizationCurrent Service
Current Utilization or Slots
Capacity Development Slots Recommended
Acute Inpatient 102 26
Residential under 6 months
129/67* 9
Crisis Beds (TFH) 8
Inpatient over 6 months
1
Residential over 6 months
50* 5
Transitional/ Independent Living
* 37
Group Homes * 86
Current UtilizationCurrent Service Utilization/Slots Capacity
Development Slots Recommended
Treatment Family Homes
9 (27) 255
Respite 133 247
Family Assistance 238
In-home Therapy 247
Intensive CPR 230 119
Rehab CPR 226 885
Maintenance CPR 545
POS CM 2555 1021
Bachelor level TCM 1656 613
Master level TCM 1045 340
Current UtilizationCurrent Service Current
Utilization/SlotsCapacity
Development Slots
Recommended
WrapAround 188 2100
Day Treatment-Full Program 49 153
Individual Therapy Enhancement
247
Group Therapy Enhancement 81 451
Physician Services 3216 2247
Access/Intake 1458 511
Evaluation Services 377 34
Therapy Services 499 613
Current UtilizationTotal of 4921 youth served (unduplicated
within a service but may be duplicated across services)
Total billings not included inpatient and residential = $10,838,534
In a year, on average approximately 5 youth exceed 6 months in residential
Profiles 15 year old female – Truman/Kansas City Regional Office
Currently at Mid Mo since 2/09 (2nd transfer from WMMHC upon closing)
Children’s Division custody 10 hospitalizations at Western Mo MHC 2 KCRO placements 1 Private sector In-patient Acute Hospitalization Physical health issues prohibit SCL psychiatric placements Has been denied out of state placements
12 year old male – Swope/Kansas City Regional Office Currently at (DMH/CPS)Hawthorn Children’s Hospital in St.
Louis since 10/08 Children’s Division custody 2 hospitalizations at Western Mo MHC In-patient Unit No community placement prospects with SCL or KCRO
Profiles16 year old male – Comprehensive MHS
Parents custodyCrossed 3 Jackson Co Administrative AgentsPlaced in SCL psychiatric placement at the
State’s most elevated rate; no other statewide options
9 year old female - Tri-County MHSParents custodyIn SCL psychiatric placement for over 15
months in St. James, MO as there are no closer placements that will accept her
Profile15 year old male – Comprehensive MHS/Kansas City
Regional OfficeGrandparents custodyCurrently in JAG Unit - no other SCL/VPA Placement
options4 combined SCL/MRDD placements
14 year old male – ReDiscover MHSParents custodyCurrently in JAG Unit – no other SCL/VPA Placement
optionsHas been denied SCL psychiatric and Children’s Division
placements statewide
Profiles 14 year old female – Family Guidance Center/Albany
Regional Office Parents custody Currently in SCL/MRDD Interdivisional Agreement in St. Louis; only
placement that would accept her with very rigid conditions 3 hospitalizations at Western Mo MHC 1 hospitalization at Hawthorn Children’s Hospital in St. Louis 4 SCL placements
12 year old female – Swope/Kansas City Regional Office
Children’s Division custody Currently in Children’s Division placement 4 hospitalizations at Western Mo MHC 1 SCL psychiatric placement 1 KCRO community placement