Community Service Board Resources and Challenges in Rural Areas

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Community Service Board Resources and Challenges in Rural Areas O. J. Booker Chair, GACSB Public Image and Policy Committee CEO, Advantage Behavioral Health Systems, Athens ACCG Mental Health Summit August 1, 2018 Macon, Georgia

What is the Georgia Association of Community Service Boards? (gacsb.org) Represents interests of the 25 Georgia safety-net CSBs Supports the ongoing existence and wellbeing of the Georgia behavioral health public safety net Platform to share, exchange and benchmark information, ideas, solutions to problems and development of resources Provides the public with education and information about the purpose, role and services of CSBs

What are Community Service Boards? Part of Georgia s public system of care for behavioral health Georgia s public safety net for behavioral health 25 independent provider organizations Public companies and Instrumentalities of the State Boards are appointed by the County Commission

Georgia DBHDD Regions, State Psychiatric Hospitals, and Community Service Boards

481,000 popn in 10 counties 17 facilities, 100 vehicles 9,000 clients $32 M annual budget 420 employees CARF accredited

How is Advantage funded? 1% 7% 25% 40% State Contracts Medicaid Private Insurance, Medicare 27% County Contributions Other

Who do we serve? Children, adolescents, and adults Mental illness, addictive disease, and/or developmental disabilities. Severe and Persistent Mental Illness (SPMI) Schizophrenia, Major Depression, and Bipolar Disorder.

Georgia clients FY17* Diagnosis Cat/Age Group Number of Persons Served MH and AD Adults 113,755 MH and AD C&A 20,323 IDD Adults 4,424 Total 138,502 * 18 CSBs using SPQM Data Warehouse

Where are services delivered? Clinics/Day Programs Schools/Workplace Emergency Rooms Medical Offices Homeless Centers Day Reporting Centers Probation Offices Court Houses Clients Homes Under Bridges/ in Tent Cities

Primary Partners in the Community Sheriffs Offices Local ERs & Hospitals Probate & other Judges Day Reporting Centers Homeless Coalitions County Commissions Landlords Police Departments FQHCs Prisons and Jails Probation Officers Regional Development Faith Communities DFCS Employers Labor Department Vocational Rehab

Partnership and Connection with Community Resources Provide Coordination and Linkage to Comprehensive Treatment, Recovery and Supportive Services

Assertive Community Treatment Psychosocial Rehabilitation Peer Support Peer Recovery Supportive Employment Psychiatric Evaluation Nursing/BH Assessment Crisis Stabilization Unit Crisis Intervention SA Intensive Outpatient Program Intensive Residential Women s Services Homeless Services Traditional Outpatient Therapy (Individual, Family, Group) Mobile Crisis in Community Mobile Crisis in Emergency Rooms Semi-independent Housing Shelter Plus Care Residential for Homeless Forensics Day Housing and Treatment Community Support Team Assessment and Therapy in Corrections and Judicial Community Support Individual HIV support & education Service Delivery Continuum of Care Pharmacy and Medication Maintenance Transportation

Rural Challenges (and some urban!) Business related Population density and volume Economy of scale Bricks and mortar rent/cost Access - transportation Workforce Competition for scarce clinical staff

Initiatives / grants /programs Opioid treatment funding CARES Act, State Targeted Response Criminal Justice Partnerships Accountability courts X 7 Justice and Mental Health Collaboration BJA grant. ACCPD, Jail, etc. Clarke Stepping Up Initiative CIT, MHFA Reentry and forensic housing Youth programs Zero Suicide Initiative Youth MH Clubhouse EPIC APEX

Crisis Stabilization Units (CSUs) 24 hour units providing stabilization to those experiencing mental health crises or needing detoxification from substances. Provides medically monitored residential services for the purpose of providing psychiatric stabilization and substance withdrawal management services on a short-term basis Can take individuals who are involuntarily committed.

Behavioral Health Crisis Centers (BHCCs) Short-term, 24/7, walk-in crisis intervention and counseling services with emergency receiving capability and crisis stabilization beds. Individuals who are experiencing behavioral health crises are provided assessment, short-term crisis counseling, supportive services and referrals for ongoing care. Staffing includes physicians, nurses, licensed clinicians and other behavioral health professionals to provide interventions designed to de-escalate crisis situations and prevent out-of-community treatment or hospitalization. If individuals need a higher level of care, the attached CSU allows for admissions for short-term residential treatment.

Our Hope. is to create complimentary systems of care in the community is to promote collaboration with community partners is to avoid silos of care and work to reduce them is to use evidence based practice in caring for our clients, and to provide easy access to high-quality care that leads to a life of recovery and independence for the people we serve.

GACSB Headquarters Robyn Garrett Executive Director 3150 Golf Ridge Boulevard Suite 202 Douglasville, GA 30135 C: (912) 312-3205 F: (678) 868-1085 rgarrett@shpllc.com

Presenter Oliver J. ( O. J. ) Booker Chief Executive Officer Advantage Behavioral Health Systems 250 North Avenue Athens, GA 30601 Cell: (706) 818-4308 Office: (706) 389-6789 obooker@advantagebhs.org

Connect with us! http://www.gacsb.org/ www.facebook.com/gacsb http://www.linkedin.com/pub/robyn-garrett https://www.twitter.com/gacsb

County Sq Mi Popn Pop/SqMi Adult @75% SMI @ 4.2% Treatment @64.8% Clarke 121 123,912 1,024.07 92,934 3,903 2,529 Walton 330 88,399 267.88 66,299 2,785 1,804 Barrow 163 75,370 462.39 56,528 2,374 1,538 Jackson 343 63,360 184.72 47,520 1,996 1,293 Oconee 186 32,808 176.39 24,606 1,033 670 Madison 286 28,441 99.44 21,331 896 581 Elbert 374 19,364 51.78 14,523 610 395 Morgan 355 18,046 50.83 13,535 568 368 Greene 406 16,710 41.16 12,533 526 341 Oglethorpe 442 14,871 33.64 11,153 468 304 Total 3006 481,281 160.11 360,961 15,160 9,824