Impacting Polk County through community-based integrated behavioral health care and support services

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1 Bill Gardam, CEO presenting Impacting Polk County through community-based integrated behavioral health care and support services Behavioral Health Services Integrated Medical & Mental Health Services - Wellness Clinic - New Beginnings and Forensic Intensive Case Management (FICM)

2 1 Musts info Connects with/meets Mission Statement of Polk County Healthcare 2

3 Musts Info PRC S OVERARCHING GOALS ARE TO BE: 1 - The Provider of Choice - The Employer of Choice - The Community Partner of Choice We accomplish this by ensuring responsible stewardship of public funds and the integrity and quality of services provided and being aligned with the Polk County Mission & Vision. 3

4 1 PRC CORE VALUES: CUSTOMER FOCUS EXCELLENCE COMMUNITY-BASED SERVICES & SUPPORTS RECOVERY ACCOUNTABILITY TEAMWORK 4

5 2 Documented Track record with at least 2 years of outcome-evidenced based results 5

6 2 PRC has been serving Polk County for over 67 years. We use over 20 different research- and evidencedbased practices to meet client needs 6

7 2 We use Evidenced-Based Practices in all areas: - Substance Use Services - Therapy Services - Supportive Housing - Club Success - Crisis Service Model - CAT Team, FACT Team, FIT Team 7

8 Peace River Center is a System of Care 2 *36 Programs *20 Locations in Polk County *380+ Team Members Including 8 Psychiatrists, 12 ARNPs, 20 RNs, 20 LPNs, 46 Florida Licensed Therapists, and 10 Certified Addiction Therapists Positively Impacting lives through Compassionate People and programs 8

9 2 Musts info TRACK RECORD DATA Behavioral Health Services 11,415 crisis line interventions 12,298 direct service patients 153,906 units of service Integrated Care Services 1,424 patients 7,488 units of service 9

10 3 R.O.I. (actual from past work and projected based on funding requested) 10

11 3 R.O.I IHC Behavioral Health Services 7.5 : 1 ROI 11

12 3 R.O.I IHC Integrated Services 2015 LRH study showed a 15% cost reduction through introduction of the integrated care model/family practice clinic. 12

13 3 Musts info Wellness Measures general notes - Diabetes - 83% of diabetics in therapy showed reduced A1C levels compared to 70% with medical intervention only - Depression & Anxiety - 7 therapy sessions reduced depressive symptoms by 37% reduction - 7 therapy sessions reduced anxiety symptoms by 43% reduction - Reduced depression and anxiety allows patients to function more effectively and increases ability to comply with medical and psychiatric treatment recommendations >>> reduces risk of ER and hospital use 13

14 4 Professional Standards and Accreditation 14

15 4 - Accredited by The Joint Commission for the Accreditation of Healthcare Organizations (TJC) - Licensed by AHCA & DCF as Public Baker Act Receiving Facility - Florida Certification Board certification 15

16 4 - Only Public Receiving Facility in Polk County (DCF) - Only Receiving Facility serving children under age 10 in Polk County 16

17 4 - All clinical programs are supervised by licensed professionals - Exemplary Program for United Way of Central Florida 17

18 5 Outcome comparisons to benchmarks and standards 18

19 5 State, County and Managed Care Performance Standards and Benchmarks - HEDIS Measures Healthcare Effectiveness Data and Information Set (HEDIS) is a national tool used in Florida by ACHA and Managed Care Plans 19

20 5 HEDIS Measure Example - Follow Up appointment post discharge from CSU - Benchmark/State Average = 53% - PRC Actual = 97% CFBHN Performance Measure Example - Percent adults who live in Stable Housing - Mental Health Crisis - Goal = 86% - PRC Actual = 100% 20

21 5 - Percent of School Days attended - Goal = 86% - PRC Actual = 92.4% - Children's Mental Health Crisis Care Number Served - Goal = PRC Actual = 1,163 21

22 5 - Wellness Measures - Depression Screening PHQ-9 - Goal = >50% - PRC Actual = 92% - Hypertension Blood Pressure Management - Goal = >60% - PRC Actual = 62% - Diabetes Care Hemoglobin A1C (HBA1c) - Goal = <25% - PRC Actual = 21% 22

23 6 Additional Funding Sources 23

24 6 Additional funding is constantly sought - Managed Care fee for service contracts - Medicaid & Medicare fee for service contracts - Other insurance - State/DCF contracts and/or Grants 24

25 7 Collaboration track record of relationships and connections across the county 25

26 7 PRC has >20 partnerships across Polk County - United Way of Central Florida - Sheriff s Department - Homeless Coalition of Polk County - Multiple Local Law Enforcement Departments - Lakeland Regional Health - Lakeside Pediatrics - Talbot House - Salvation Army 26

27 7 - Florida Department of Public Health, Polk County - Heartland for Children - DCF Substance Abuse and Mental Health Department & Regional Office - Multiple Assisted Living Facilities across the county (10) - Collaboration with Polk County School Board for Mindful Schools Grant resulted in placing 2 PRC therapists in 6 Polk County Schools AND training of PRC staff as trainers in Mental Health First Aid 27

28 7 - Collaboration to provide Forensic Intensive Case Management Services with Polk County and Tri County Human Services - Collaboration with Zoe s Journey, a failing residential program for women that includes child reunification (recommended closure of program due to inability to secure funding) 28

29 7 - Collaboration to provide residential services for men in Polk County with Tri County Human Services - Collaboration on a proposal to develop multi-county crisis response services with: Lakeland Regional Health, Winter Haven Hospital, Lake Wales Medical Center, Heart of Florida Hospital, Tri County Human Services, Police Departments of Bartow, Lakeland and Winter Haven, Sheriff s Department for all 3 counties 29

30 8 Meets documented (or unique) need (geographic, service, specialty, avoids duplication) 30

31 8 Polk County, Lakeland Regional Health and Winter Haven Hospital Community Needs Assessments ALL showed a need for access to more mental health and substance use disorder services Source: 31

32 8 Some key themes related to mental health and substance use disorders: - Lack of access to mental health services mentioned as concern in key informant and focus groups. (Page 4 and 17) - Consumers ranked mental health issues as among the greatest health problems and urgent risks to health and safety in Polk County in this and 2011 survey. (Page 6 and 38) 32

33 8 - Drug and alcohol abuse ranked among the greatest health issues and urgent risks in Polk County in 2011 and 2014 (Page 6 and 10) with the top three health problems shown as: - Overweight and obesity - Mental health and substance abuse - Chronic diseases 33

34 8 Department of Children and Families Bed Need Analysis indicates a need for added CSU beds and crisis services PRC is expanding bed capacity to meet this need by adding a 2 nd CSU in Lakeland. Grand Opening in May 2017! 34

35 8 - PRC behavioral health services do meet a documented and unique need: - Geography we serve - Services we provide - Lower cost alternative - Integrated services avoids duplication - On-site pharmacy improves access and medication compliance - Provide the opportunity for consumers to get access to services they want in the community of their choice 35

36 1 Wants info Customer Impact/Satisfaction 36

37 1 Wants info Peace River Conducts ongoing client satisfaction surveys across all programs and services as well as reviews client impact through our QA&I process. 37

38 Wants info 1 Customer Impact/Satisfaction Behavioral Health Services Access to Care General Satisfaction Quality Of Care Outcome Of Care Involvement in Treatment Social Connectedness Functional Satisfaction 91.5% 94.3% 92.8% 83.2% 90.9% 87.6% 83.1% 38

39 Wants info 1 Customer Impact/Satisfaction Integrated Care Services 97% Satisfaction 39

40 Wants info 2 Staff recommendations for technical efficiency (paperwork, budget, insurance) 40

41 Wants info 2 - Clinical Information System with an integrated billing system - Agency-wide QA&I process 41

42 Wants info 3 - Budget/funding history (evidence of financial and quality excellence, program viability) 42

43 Wants info 3 Funding History Behavioral Health Services F FY15 $961,298 F FY16 $912,972 F FY17 $912,972 Integrated Health Services F FY15 Funded through State LIP Grant F FY16 Funded through State LIP Grant F FY17 $672,000 43

44 Wants info - Annual Financial Audit 3 - Unmodified Opinion with No Findings or Adjustments - United Way of Central Florida - Exemplary Provider 2 years - CFBHN - Annual Monitoring Commendation for Exceptional Documentation - Wellcare - Designation as Medical Home 44

45 Wants info 4 - Outreach, communication, education, prevention component 45

46 Wants info 4 - Outreach, Communication, Education Prevention - Health fairs - CIT Training - Leadership Lakeland & Leadership Bartow - County education forums - Mental health screenings - Mental Health First Aid Training within the school system and community 46

47 Wants info 5 Matching Funds (cash and in-kind donations) 47

48 Wants info 5 Behavioral Health Services - Funding from Polk County is used to help meet $1.3 million DCF match requirement allowing access to $10.4 million in contract funding 48

49 Summary Info PRC s overarching goals are to be: 5 - The Provider of Choice - The Employer of Choice - The Community Partner of Choice We accomplish this by ensuring responsible stewardship of public funds and the integrity and quality of services provided and being aligned with the Polk County Mission & Vision. 49

50 Thank you! Bill Gardam, CEO x

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