WHAT’S CURRENTLY WORKING WELL? GAPS Upstream preventative supports – outreach Connections with schools – preventative referrals Pediatricians – social workers in offices Proactive emergency plan – for individuals in contracts with hospitals. Designated Agency (DA) crisis teams on call. Dev. Services eligible participants Single point of entry for children – triage to correct service providers. Telehealth with psychiatry staff. Infiltration into schools and Primary Care Provider offices Alliances with DA Clinical Clara Martin Center (CMC) – outreach to prevent crisis. Work in schools – school can call CMC for assistance. Working with local pediatrician’s offices. Embedded social workers in police departments response in Rutland Post crisis response (up to 8 weeks) Establish relationship with kid and family Participate in community meetings Follow-up programs Each DA has response Other social service agencies have own response Centralized Intake Emergency Services (CIES/DCF-Family Services) called for permission to treat Collaborative response between DCF-Family Services and DA Different county to county Staffing high risk DCF/community-based kids Not enough beds Training for respite providers to support workforce – retention Family managed respite utilization Crisis responders – foundational training Danger/safety - protection Clinicians outside DA making referrals Rate of pay and paper regulations Soft transition home from crisis beds. Access to crisis beds for those with developmental disabilities. Access to psychiatry Not enough local resources Not enough psychiatrists Respite providers need training Emergency Department (ED) becomes default Workforce issues-find the and then retaining them Licensed clinicians for private practice. Access to crisis beds then support to transition home – ongoing support for family Who will do it? Workforce issues all over VT. Geography Personnel When at ED and then discharged then priority or eligibility changes Triage Education
Training re: tolerance of risk for crisis intervention, families, schools, mental health providers, FSD, etc. Supports for foster home (to increase tolerance/stability), $, service wrap Centralized call center Pros: May address workforce challenges One number Link with other crisis numbers (suicide lifeline, ESD) Cons: Cost and complexity of EHR Knowledge of local resources (when handed off to regional team) Planful discharges Discharge meetings – include DA, DCF (if involved), parents, schools Crisis Beds Training for ER staff Data – kids waiting volume Community cares home Do not want patients being sent to a wing at the correctional facility More public education on early intervention, coping skills More links with schools and law enforcement, first responders, police social workers, PCP (standardized screening) (CAMS) (ACES) (PHQ) Centralized EMR – with access by crisis workers. Build relationships with local PD’s RV idea idea “outside the box” Just go response – Get there! Response time one hour or less Most skilled staff should be on the front end. Kid-friendly sensory spaces – accessible to anyone and place to meet. State wide training for direct responders and triage Themes that came up in multiple groups) Meeting families they’re at – both literally and figuratively Need more peer to peer support Follow up supports after crisis Shared savings from reducing spending at higher levels of care and systems efficiencies Caller defines the crisis Focus on education/prevention to others who interact with children and families-hospital staff, law enforcement, schools Use a common language when talking to families in crisis (and de-escalation techniques) More partnership with local law enforcement Need more resources-financial, staff, settings Workforce challenges-recruiting and retaining staff is difficult Integrated Crisis teams to serve children with any challenge (MH, DD) Find existing family friendly space in the community and develop agreements for use of the space rather than having to meet families at the ED for a crisis response