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Regional Navigation and Resource Center

Regional Navigation and Resource Center. Central Vermont medical center Washington County Mental health services. What Problems Are We Solving. Immediate Access to Out Patient Services Working to reduce emergency room visits and re-admissions

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Regional Navigation and Resource Center

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  1. Regional Navigation and Resource Center Central Vermont medical center Washington County Mental health services

  2. What Problems Are We Solving • Immediate Access to Out Patient Services • Working to reduce emergency room visits and re-admissions • Following up with individual to see if they followed through with the referral and identifying necessary supports to assist • Transportation, phone supports, housing, natural supports, brief case management, community outreach • Present the broad spectrum of supports in a person-directed approach: natural community supports; peer support programs; wellness and alternative approaches, as well as traditional (yoga, Reiki, mindfulness, exercise, group and individual therapy, employment, education, medical care to include psychiatric treatment) • Maximizing Resources • May Be a Resource for Teams/Providers Who Need Assistance in Challenging Discharges from Psychiatric Units

  3. Develop Your Work Group Start small and build Designated agency directors from counseling services; intensive care services; community support services; psychiatry; executive director; IT Medical center staff Director of hospital medical services; community health team director; medical practice administrative and medical director; psychiatric practice and unit directors; psychiatric family practice Patient representation Private counselor representation

  4. Functions of a Centralized Referral System • Perform follow-up phone calls to all people leaving the ER and psychiatric units to check in, offer services • Network with primary care provider offices to accept referrals and subsequently refer to appropriate level of treatment/support • Establish Intake Clinician(s) and Brief Treatment Case Management within the Hub for immediate referral • Track all referrals from moment of intake to and through engagement with referral • Information and Education Regarding the Regional Services

  5. Do We Need a Centralized Referral System in Our Region? • Assess needs and gaps for mental health and substance abuse services in the region & map • Examine data to determine need • Number of individuals who go to the ER who are not hospitalized but need follow up MH treatment/support • Number of people whose needs cannot be met in primary care and need a screening and assessment for mental health supports • Number of people being referred to mental health follow up treatment/supports upon psychiatric unit discharge • Number of people who are self-referring for treatment/support to the designated agencies • Approximate number of individuals being served by private counselors in the area • Assessment of peer programming • Assessment of designated agency and private provider wait lists

  6. System Networking • As we examine what problems we are trying to solve on behalf of patients/clients, we recognize that we are striving to build a stronger network • Build a system among providers that meets the need, bringing together DA services, primary care provider services, peer services, private counselors, and others • Reduce redundancy in systems and fill necessary gaps • Consider workforce pressures; maximize access • Consider IT needs to develop navigation system • Perform cost benefit analysis

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