Expanding Mental Healthcare Access for Adolescents and Children

1. Expanding Mental Healthcare Access for Adolescents and Children DSRIP 3-Year Project 136143806.1.100 Presentation to Regional Learning Collaborative July 18, 2014

2. Background Midland County and RHP 14 have long struggled with shortages of mental health providers. Local MHMR services and various non-profit providers have filled some of the void, but the scope of services remains limited. Access to advanced mental healthcare for children and adolescents is particularly short. A recent rash of adolescent suicides energized the community to look for solutions to these chronic shortcomings.

3. Background (cont.) Midland County Hospital District provides the only full-service emergency facility in the County. Midland Memorial Hospital’s ED is the first stop for all mental health patients in crisis. In fiscal 2013, 181 children and adolescents were discharged with mental health disorders. MMH is not staffed and equipped to manage psychiatric patients. Children and adolescents requiring intensive psychiatric care are typically transferred out of the community.

4. Background (cont.) Oceans Behavioral Hospital of Permian Basin provides inpatient and outpatient services to Adult and Geriatric populations. Previous private psychiatric hospitals have failed in this region. Some of these have included adolescent programs. Failures have been attributable to multiple factors, especiallylack of qualified psychiatrists and psychologists.

5. Background (cont.) Centers for Children and Families is a local non-profit organization, providing counseling services for all age groups. Centers primarily utilizes licensed counselors as providers. Provision of the full range of intensive counseling services for children and adolescents requires a PhD psychologist to complete the team.

6. Background (cont.) Dr. Kimberly Macferran is a Developmental Pediatrician, working in association with MARC, a local non-profit dedicated to the care of individuals with disabilities. Dr. Macferran and MARC collaborate in the care of children with various developmental concerns, including autism and related disorders Provision of the full range of services needed by this population requires a PhD psychologist to provide testing and counseling to augment Dr. Macferran’s care.

7. The Project Midland Memorial Hospital is providing support to its local partners for recruitment of a minimum of three mental health providers over the 3-year duration of the project: One Child/Adolescent Psychiatrist (MD) Two Child/Adolescent Psychologists (PhD)

8. The Project (cont.) Oceans has renovated a 12-bed inpatient unit specifically for adolescents, and plans to open thisnew inpatient service in August. Midland Memorial’s ED is expected to be a significant referral source for this unit, with half or more of its patients likely to be covered by Medicaid or uninsured. Oceans will add an off-site outpatient service for adolescents as soon as appropriate space can be identified. In DY3, Oceans has recruited two psychiatrists to assist in this program. Midland Memorial is providing financial support for recruitment costs.

9. The Project (cont.) Centers for Children and Families leadership is working closely with MMH leadership to recruit a PhD psychologist trained and experienced in counseling children and adolescents. An experienced psychologist with ties to the regionis in active negotiation with Centers to join their practice by the end of 2014 (early DY4). Midland Memorial will provide financial support for recruiting costs, as well as ongoing income support as needed. Over one-third of Centers’ patients lack any form of third-party insurance coverage for counseling services.

10. The Project (cont.) For DY5 (our fiscal 2016), Midland Memorial will work closely with Dr. Kim Macferran and MARC to recruit a psychologist with training and experience in testing and counseling for developmentally-challenged children. Midland Memorial will provide financial support for recruiting. An affiliate of Midland Memorial provides management and ongoing financial support for Dr. Macferran’s practice, and will do so for the psychologist’s practice as well. Dr. Macferran’s patients are primarily covered by Medicaid and CHIP.

11. Our Hope Our region’s need for child and adolescent mental health services is significant and growing. By helping to grow the available services in our community, we hope to: Provide timely, local help for adolescents in crisis; Enhance diagnostic capabilities and provide access to counseling as needed, to help avoid future psychiatric crises; Assure access to care for children and adolescents who need it, regardless of ability to pay; and Improve the mental health of our community’s children and adolescents.