Crisis Services

1. Crisis Services Crisis services are required core services IAC 331.397 Chapter 24

2. The Need for Crisis Services in Iowa • 25% of Iowans will have a diagnosable mental illness over the course of a year • 6% of the population has a serious mental illness • Suicide is the second leading cause of death for Iowa 15 to 24 year olds, and 25 to 44 year olds. • Over an 8 years period of time 1,568 people committed suicide in rural counties of Iowa, versus 1,382 in the state’s urban parts.

3. Community Participation in Development of Crisis Plan • Met 3 times with community • Met 3 times with providers • Met with the Regional Advisory Committee • Three Regional Governing Board members participated in planning

4. Crisis Services Defined in the Code • Crisis screening • Assessment requirements • Twenty-three-hour crisis observation and holding • Twenty-four-hour crisis line • 24 hour crisis response • Crisis stabilization residential/community based services • Mobile Crisis response • Warm line Already have in region Wait to see if data demonstrates a need Already have. Need to expand region wide New Service

5. 24 Hour Crisis Line and Warm Line • 24 hour crisis line • 24 hours per day. • screened and counseled • refer to the mobile crisis unit, other resources, or services if needed. • Warm line Peer response • Short term • Non directive support to assist the caller

6. Mobile Crisis Response.  (Expansion) Training will be provided using a nationally accredited model so the same service is provided throughout the region. How does it work? A call comes in. 2. Dispatch will send provider to the scene. Assessment will be completed to determine level of care needed. Person will be stabilized at home, transferred to a crisis bed or transported to the hospital. Washington County Pilot 23 people received crisis services 2 went to the hospital 1 went to a detox facility 87% were diverted from the hospital

7. Crisis Stabilization Services Residential and Community (Expansion) • Residential short term beds: • Goal is to stabilize the individual and return them to the community • Stay up to five days. • set up a place to live if needed, • set up with community support services • set up with psychiatrist and medications • Community: • Goal is to stabilize the individual in their home. • Services set up including but not limited to psychiatric, medication, counseling,peer support and linkage to ongoing services. Start with 4 beds with the ability to expand to 8 for the region if needed.

8. Warm line Crisis Line Mobile Crisis Dispatch Mobile Crisis staff goes to a location anywhere in the region and does the assessment Outcome 3 Hospitalization $$$ Outcome 3 Hospitalization $$$ Outcome 2 Crisis Bed or stabilize in home $$ Outcome 2 Crisis Bed or stabilize in place $$ Outcome 1 Resolve the Crisis $

9. Crisis Line This is how most of the region looks today. In a crisis situation there is nowhere to go except to the most expensive service(s). Outcome 3 Hospitalization $$$ 2014 regional costs following hospitalization $11,719,894.

10. Additional Costs to Expand Crisis Services Sustainability: Decrease commitment and long term care costs. Use the savings that comes from diversion to fund future crisis services. 10% diversion = $1,171,989.00 savings which pays for the service. 2. Medicaid will eventually fund part of the costs. 3. If necessary, drop the service. No current clients and no provider expansion.