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NORTHWEST REGION. CHILDREN’S SERVICES. WESTERN MO MENTAL HEALTH CENTER. Child and Adolescent Unit Designed for 10 beds, but staffed for fewer Acute psychiatric inpatient Front Door – Emergency Room typically, frequently Central or Regional Office recommendation. WMMHC Stats.
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NORTHWEST REGION CHILDREN’S SERVICES
WESTERN MO MENTAL HEALTH CENTER • Child and Adolescent Unit • Designed for 10 beds, but staffed for fewer • Acute psychiatric inpatient • Front Door – Emergency Room typically, frequently Central or Regional Office recommendation
WMMHC Stats • Approximately 200 admissions in a year • Mood 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 Stats • 17% had dual diagnoses of MI/DD • Payor Sources • 38% Medicaid • 33% MC+ Managed Care • 17% “guest of the state” • 12% private insurance
WMMHC Statistics • Average 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/DD • Extreme Behavioral Presentations (typically aggression) • Co-occurring medical conditions • Multiple admissions to inpatient services
Complicated Medical Conditions • One youth had the following medical conditions on Axis III • HYPOTHYROIDISM 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 25 Heartland –St. Joseph 0 St. Luke’s Northland 6 Two Rivers 20 ___________________________ Total Beds 102 Royal Oaks 33
Capacity Development • Based 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
Current Utilization • Total 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
Profiles • 16 year old male – Comprehensive MHS • Parents custody • Crossed 3 Jackson Co Administrative Agents • Placed in SCL psychiatric placement at the State’s most elevated rate; no other statewide options • 9 year old female - Tri-County MHS • Parents custody • In SCL psychiatric placement for over 15 months in St. James, MO as there are no closer placements that will accept her
Profile • 15 year old male – Comprehensive MHS/Kansas City Regional Office • Grandparents custody • Currently in JAG Unit - no other SCL/VPA Placement options • 4 combined SCL/MRDD placements • 14 year old male – ReDiscover MHS • Parents custody • Currently in JAG Unit – no other SCL/VPA Placement options • Has 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