2016 CFBHN Needs Assessment

Transcription

1 2016 CFBHN Needs Assessment pg. 1 Administrative Office 19 South US Highway 301 Tampa, FL

2 Needs Assessment (October 2016) I. Waitlist information A. Please populate the Special Populations on Waitlist, excel sheet. The spreadsheet is attached as Appendix A. CFBHN staff completed the attached spreadsheet by reviewing the data in the Central Florida Health Data System (CFHDS) waitlist and service data system. In addition, CFBHN sent out a survey to our network providers and asked them to enter information regarding community waitlists. This would include individuals waiting for services but are not included in the CFHDS waitlist data system. B. How existing resources will be redirected for substance use disorders to reduce numbers/days on waitlist CFBHN has redirected resources through the development of the Care Management Team to assist our provider partners in addressing the particular needs of the families and individuals requiring additional services to help them remain stable within the community. To reduce the waitlist, CFBHN has incorporated the following practices and has made changes: The CFBHN staff works with providers, families and individuals needing placement to find the needed services. In the event a provider partner has an individual identified as fitting into a priority population, the CFBHN staff will reach out of the provider network to find an appropriate placement. o This is particularly true when there are pregnant women and/or I.V. drug users. The Care Management staff review the waitlist three times a week and follow up with the provider partners to assist with accessing needed services. To make residential beds available, the Care Management staff review admissions to determine who has been in services greater than 90 days and they work with those provider partners to identify, where appropriate, individuals who are ready for discharge to make residential beds available. Care Management staff host a SA System of Care meeting for detoxification and residential service providers. One purpose of the meeting is to improve referral processes. CFBHN staff initiated Secret Shopper Calls to assess the accessibility of services and to identify opportunities for improvement. The results of the calls are shared with provider partners and technical assistance is offered where warranted. CFBHN allocated dollars to provide licensed clinicians to support Child Protective Investigators in Charlotte, Collier and Lee Counties. These licensed clinicians assist the investigators in identifying individuals with mental health and substance abuse issues for those families under investigation. These licensed clinicians assist in making referrals for services and help to improve the outcomes for the families/individuals involved. Depending on the family s situation, there are incidental funds and services through FIS or FIT to meet their needs. CFBHN allocates funding to meet the needs of the community and individuals served based on feedback and identified needs from community stakeholders and directives from DCF. This process is currently used and will continue as funds become available, either through re-allocation changes and/or new funding. pg. 2

3 When a provider partner is not able to utilize funds, these funds may be contracted through another provider. If a provider partner requests an approval to move funds within the contract, these requests are reviewed and approved by CFBHN to ensure the funding changes reflect the needs and priorities within the system of care. C. How existing resources will be redirected for mental health services to reduce numbers/days on waitlist. CFBHN has redirected resources through the development of the Care Management Team to assist our provider partners in addressing the particular needs of the families and individuals requiring additional services to help them remain stable within the community. To reduce the waitlist CFBHN made the following changes: In 2013, CFBHN changed the process for FACT admissions and discharges to ensure there are at least 10 discharges from the team annually. The process change has led to over 520 discharges and new admission to our 1 FACT teams. CFBHN staff control the admissions to residential beds throughout the region to ensure state hospital admissions and diversions from state hospitals are prioritized. The process change has reduced the waitlist for individuals on the State Hospital Seeking Placement list and diversions from receiving facilities. When services are no longer needed, dollars are reallocated to meet the needs of the community. Several years ago, CFBHN approved the movement of children s crisis dollars from Bayside to support children s mobile crisis services at Jewish Family and Children s Service of the Suncoast in Sarasota County. CFBHN staff initiated Secret Shopper Calls to assess the accessibility of services and to identify opportunities for improvement. The results of the calls are shared with provider partners and technical assistance is offered where warranted. As with substance abuse dollars, CFBHN allocates funding to meet the needs of the community and individuals served based on feedback and identified needs from community stakeholders and directives from DCF. This process is currently used and will continue as funds become available, either through reallocation changes and/or new funding. When a provider partner is not able to utilize funds, these funds may be contracted through another provider. If a provider partner requests an approval to move funds within the contract, these requests are reviewed and approved by CFBHN to ensure the funding changes reflect the needs and priorities within the system of care. II. Community Feedback A. For each group listed below, please describe any unmet needs identified, the process or methodology used to identify the unmet needs and response rates and the number of respondents for any survey or focus groups. Individuals served and their family members Providers of behavioral health services pg. 3

4 Other community stakeholders (particularly those from the child welfare, criminal justice and school systems) Overall methodology. CFBHN used survey monkey to gather the community input to complete the needs assessment. CFBHN developed the survey instrument with input from CFBHN staff and from input provided in community meetings. Some of the meetings included: Regional Councils Alliance meetings Acute care committees Program meetings Consortia meetings throughout the region Child welfare meetings Housing meetings Special project meetings (Executive order) Various County meetings NAMI meetings CFBHN compiled a broad range of gaps and goals from these meetings and developed the survey. During the development of the survey, there were four factors raised; at what level the responses should be gathered (county, circuit, or regional) extent of anonymity avoidance of jargon survey length The decision was made to collect data at the county level. Since different counties have different needs and individuals responding may not readily know the circuit or regional information, gathering information at the county level seemed most appropriate. CFBHN staff made the name and title optional for anonymity but the agency name was requested in order to provide clarification, if needed. CFBHN staff attempted to avoid jargon by providing goal descriptions and explanations in gaps in service that would ensure clarity. This was a concern because the survey was sent out to over one thousand individuals with various understandings of the system of care. CFBHN staff addressed the length of the survey. CFBHN decided to collect the information at the county level, which made the survey longer. If the respondent worked with a CFBHN organization that operated in multiple counties and had a waitlist not reported to CFBHN, then the survey would be longer. However, the survey design included logic to allow the respondent to skip sections of the survey. The survey development allows respondents to rank the top five service gaps and goals for CFBHN. The service gaps responses help identify those services missing or with limited availability within each of the counties and the goals responses help CFBHN develop an overall list of priorities. The identified service pg.

5 gaps and goals came from stakeholders and each of the respondents picked the five highest service gaps or goals and then ranked them from one to five, 1 being the highest priority and 5 being the lowest priority. The survey provided a space identified as other for respondents to add additional service gaps or goals if it was not on the list. To gather the responses, CFBHN uploaded addresses into survey monkey, a survey distribution and collections software. The software allowed CFBHN to monitor the survey collected and to send reminders requesting to complete the survey. The compiled list came from various CFBHN lists used throughout the network (A summary of the s distribution is below in Table 1). CFBHN sent 1,11 s and had an overall response rate of 23.13% or 259 responses. The surveys marked incomplete through survey monkey indicated surveys where respondents marked information for a county and did not complete information for the remaining counties. Respondents only entered for counties where they understood the needs or where they provided services. The information in Table 1 below contains a summary of the information of how respondents identified themselves. Please note that in most cases, respondents could skip questions and the number who skipped the question is listed for each table. The information in Table 2 shows the breakdown of responses for those respondents whose organizations do not receive funding through CFBHN. The information in Table 3 contains a summary of those respondents who entered Other to the question Which of these best describes your relationship to CFBHN? CFBHN staff summarized the responses during the data analysis. The grouping represents common entries among the written responses. Several of the responses could be added to the specific drop down contained in Table 2, however, to maintain the data integrity, this was not done. This would change the following data in Table 2: Law Enforcement would increase by to 1 and Government agency (state or local) would increase by 8 to 33. Table shows the total number of provider partners that had a response in the data. The overall response rate was 9.1% or 68 of the 86 that received an . pg. 5

6 Table CFBHN Behavioral Health Needs Assessment Survey Which of these best describes your relationship to CFBHN? Answer Options Survey Summary Number Percent Total s Sent 1,11 N/A Total Bounced Back ( Issues) % Total Opted Out (Survey Monkey Opt Out) 5 0.% Number of Incomplete Surveys (Respondents did not enter for all counties) % Number of Complete Surveys % Overall Response Rate (Complete and Incomplete) % Response Percent I am a CFBHN Board member I am a CFBHN staff member I am a consumer and/or family member of a consumer My organization is funded by CFBHN My organization does not receive CFBHN funding (See Breakdown below) Table 2. Other (please specify) Table 3 answered question skipped question Response Count % % % % % % Table 2. My Organization is not Funded by CFBHN Responses Percentage College, university or higher education provider 0 0.0% County Health Department 3 3.6% Government agency (state or local) % Housing or homeless services provider 0 0.0% Law enforcement, criminal justice or juvenile justice agency % Medical service provider or hospital % Mental health and/or substance abuse client/family advocacy 3 3.6% Mental health and/or substance abuse treatment provider % School or school district (K-12) 2 2.% Other (please specify) Specific Responses Are Not Added 1 16.% Total 8 pg. 6

7 Table 3. Other Please Specify (These are responses written in) Responses Percentage Attorney 1 1.2% Certified Peer Specialist 1 1.2% Community Provider 2 2.% Consumer Representative/Advocate/Volunteer 5 6.0% DCF/CBC 5 6.0% Governement/Funder 3 3.6% Hospital Staff/Provider 2 2.% Law Enforcement 8.3% Therapist/Provider/Contractor 9 10.% Total 35 Table. CFBHN Funded Provider Partners Number of CFBHN Funded Organzations Responding Total CFBHN Funded Agencies Response Rate Number % CFBHN staff distributed the survey electronically to 1,11 stakeholders. These stakeholders included: CFBHN Board Members CFBHN Staff members Consumer/Family Member of Consumers Organizations Funded by CFBHN Organizations Not Funded by CFBHN Other Several of the responses above required additional information. When respondents identified themselves as an Organization Funded by CFBHN, they identified the organization from a drop down list. This provided CFBHN a list of those agencies that completed the survey. When the respondent marked Other, they also chose the description that best identified them from a drop down list. An option for Other was included on this list and a space was provided for the respondent to enter a description. The list included: College, university or higher education provider County health department Government Agency (state or local) Housing or homeless services provider Law enforcement, criminal justice or juvenile justice agency Medical service provider Mental health and/or substance abuse treatment provider School or school district (k-12) Other (Please Specify); the following is a summary of the entries: o Acute Care Hospital o AFCH Provider with MH Individuals Living in Home pg.

8 o Attorney o Case Management Agency (Child Welfare) o CBC o County Funder o Consumer Representative o DCF o HMO/MMA Plan o Law Enforcement o Social Service Agency o Therapist The overall survey results by county and for the region are attached in Appendix B. B. For each of the groups listed below, please describe how existing resources will be redirected to address their unmet need. Individuals served and their family members Providers of behavioral health services Other community stakeholders (particularly those from the child welfare, criminal justice and school systems) CFBHN allocates funding to meet the needs of the community and individuals served based on feedback and identified needs from community stakeholders and directives from DCF. This process will continue as funds become available, either through allocation changes and/or new funding. In addition, when a provider partner is not able to utilize funds, these funds may be allocated to another provider either temporarily or permanently. If a provider partner requests an approval to move funds within the contract these requests are reviewed and approved by CFBHN to ensure the funding changes reflect the needs and priorities within the system of care. A summary of the funding movements within the System of Care is available for review. III. Training and Technical Assistance Needs A. Please describe any training or technical assistance needs for substance abuse treatment services and how they were identified. Secret Shopper Training was delivered to providers in the previous and current fiscal year in two webinars in January The annual Block Grant Requirements Review and Re-Attestation in June 2016, and review of procedures that comply with the Block Grant requirements in the review of the Secret Shopper call outcomes in the Adult System of Care webinar in August In addition, in response to the Secret Shopper Scorecards, providers indicated additional needs for training: Block Grant Requirements for front-end staff Engagement Customer Service Telephone Skills Community Resources Motivational Interviewing pg. 8

9 No-Wrong Door Policy B. Please describe any training or technical assistance needs for substance abuse prevention services and how they were identified. CFBHN meets quarterly, at a minimum, with prevention/coalitions providers. Presentations are conducted at these meetings as requested. Technical assistance is provided by CFBHN staff as well as DCF Tallahassee and the system designer of PBPS. C. Please describe any training or technical assistance needs for mental health services and how they were identified. The most requested and attended training by providers in fiscal year 2015/2016, based on the CFBHN Training Tracking included evidence-based practices such as Mental Health First Aid and Motivational Interviewing. CFBHN providers participated in trauma informed care trainings. CFBHN providers integrate substance abuse and mental health services in many ways, in accordance with the Continuous, Comprehensive, Integrated System of Care (CCISC) No Wrong Door philosophy. Training needs were identified irrespective of the providers primary focus of care. Training topics requested often meet multiple needs because many CFBHN providers encompass multiple levels of care and types of care i.e. (substance use/mental health, prevention/coalitions). For instance, Motivational Interviewing is an evidence-based practice used in substance use, mental health, primary health and a number of other settings. Below are the full results of the 2015 survey of the most needed and preferred training topics. The survey results indicated that the greatest training needs and interests were for information on Co-Occurring Disorders (%), Motivational Interviewing (%) and DSM-5 (33%). pg. 9

10 Co-Occurring Disorders Motivational Interviewing Topic Developing Community Resources DSM-5 Interviewing And The Assessment Process Group Facilitation Skills Wellness Recovery Action Plan (WRAP) Stages of Change Evidence-Based Practices Meeting State Data Requirements Suicide Awareness and Prevention Crisis Intervention and compassion fatigue Emerging Technology: Skype, Telemedicine, Behavioral Health Apps Trauma Informed Care Services for People Experiencing Homelessness Medications: Update of New Meds Overview of Psychiatric Medications SOAR: SSI/SSDI Outreach, Access, Recovery Depression Bipolar Disorder Peer-to-Peer Wraparound Practice Model Incident Reporting National Outcome Measures - SAMHSA Mental Health First Aid Ethics - Professional Conduct Domestic Violence - 2 hours Affordable Care Act Staff-Client Boundaries No Need 5.26% % % % % % % % % % % % % % % % 11.11% % 15.9% % % % 15.9% % % 15.9% % % % 2 Low Need 0.00% % % % 31.58% % % 11.11% % % % 29.1% % 15.9% % %.% % 2.11% 8.% % % % 0.00% % % %.3% % 6 Some Need.3% % 25.00% % 2.11% % % 61.11% % % % % 36.8% 52.63% 10.3% % 8 2.8% % 26.32% 5 2.8% % % % % % 3.3% % % 6.3% 9 Great Total Need.3% % % % % % % % % % % % % % % % % % % % % % % % % % % % % 2 19 pg. 10

11 Gender Identity Issues Schizophrenia Working With Families: System of Care Baker Act 10.53% % % % 3.3% % 6 2.8% % 31.58% % 8.% % % % % % 2 1 Marchman Act Topic No Need 10.53% 2 Low Need 36.8% Some Need 2.11% 8 Great Total Need 10.53% 2 19 CARF Accreditation Medical Errors Assessment Tool: CANS Substance Abuse Identification Clinical Supervision Cultural Diversity Mental Health Status Exam Group Interventions Sexual Behavior Problems in Youth Safety Planning for Youth with Sexual Behavioral Problems Teen Dating Violence Domestic Minor Human Trafficking Documentation Working With Consumer & Advocacy Groups Forensic Issues JCAHO Accreditation COA Accreditation HIV NIATx 20.00% 36.8% 2.8% % % % % % 36.8% 36.8% 35.29% % 10.53% % % 61.11% % % 22.22% 35.00% 36.8%.% % 52.63% % 36.8% 31.58% % 2.11% 8.06% % 2.11% % % % 5 2.8% % % % 21.05% 22.22% 1.18% 15.9% % % % % 15.9% % %.3% % % % % % 22.22% 10.00% % % % % % % % % % % % % % % % % % % 18 IV. System of Care A. Rank ordering of the top five unmet needs that have been identified from the Needs Assessment: pg. 11

12 Service Gaps Priority List 1. Increased availability of supportive housing programs 2. Increased availability of affordable housing 3. Need for additional short-term residential beds. Increased availability of psychiatric medical services 5. Service coordination and flexible funding for high service utilizing individuals B. Characteristics of no wrong door by acute care services: CFBHN acute care providers adopted the no wrong door philosophy. This means that a person is assessed with processes that are co-occurring capable. The goal is to link the person to the appropriate needed services and the appropriate level of care. This includes treatment and social support services. The no wrong door philosophy provides easy and convenient access to treatment. The acute care providers and local receiving facilities, transportation companies and law enforcement have agreements in place to ensure the most efficient and lease impactful process to the individual. The commitment for the concept to no wrong door was fully implemented during the contract negotiations with the Central Receiving Systems in Hillsborough and Manatee Counties. Although the concept is throughout the region, and ongoing training and contract requirements are in place, these negotiations represent a more advanced model that reaches across professions, providers and service providers, including medical services. C. A system that adopts recovery-oriented and peer-involved approaches a flexible and comprehensive menu of services that meet each individual s needs, the system offers services that are consumer-and family-driven. Family members, caregivers, friends, and other allies are incorporated in recovery planning and recovery support. Peer to peer recovery support services are make available. For your system, please identify and describe the characteristics of recovery-oriented and peer-oriented approaches they demonstrate. CFBHN adopted Substance Abuse and Mental Health Service Administration s (SAMHSA 2012) working definition of recovery from mental disorders and/or substance use disorders through the Recovery Support Strategic Initiative. This initiative supports the framework for the system of care in our region and will assist in analyzing the needs of our community. SAMHSA s Recovery Support Strategic Initiative includes four major dimensions (Health, Home, Purpose, and Community) and 10 Guiding Principles of Recovery (Hope, Person-Driven, Many Pathways, Peer Support, Relational, Culture, Addresses Trauma, Strengths/Responsibility, Respect, and Recovery) that support a life in recovery. (SAMHSA 2012) The following characteristics of recovery-oriented and peer-oriented approaches are demonstrated through CFBHN and its subcontracted service deliveries: pg. 12

13 Recovery can be achieved and transpires from Hope. Peers, family members, providers and other community members cultivate an inspiring and motivating message to individuals affected by mental illness and substance use that Hope is the springboard to the recovery process. CFBHN contracts with Mental Health and Substance Abuse grass roots organizations (local National Alliance on Mental Illnesses (NAMI) Affiliates (NAMI Pinellas County Florida, Inc.; NAMI of Collier County, Inc. and NAMI of Lee, Charlotte & Hendry Counties)); Clubhouses (Van Gogh's Palette, Inc. d/b/a Vincent House and Hope ClubHouse); Recovery Programs (Agency for Community Treatment Services, Inc. (ACTS); Centerstone of Florida, Inc.; Drug Abuse Comprehensive Coordinating Office, Inc. (DACCO); First Step of Sarasota, Inc.; Operation PAR, Inc.; SalusCare, Inc.; Tri-County Human Services, Inc. and WestCare Florida, Inc.) and Drop-In Centers (Project Return, Inc., Mental Health Community Centers, Inc., NAMI of Collier County, Inc. and Charlotte Behavioral Health Care, Inc.) to provide Hope. In addition, these agencies offer a variety of recovery-oriented programs such as Peer Supports, Supportive Employment and Support Groups. Next, recovery is person-driven. Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s) towards those goals. Individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist their recovery and resilience. In so doing, they are empowered and provided the resources to make informed decisions, initiate recovery, build on their strengths, and gain or regain control over their lives. (SAMHSA 2012) CFBHN s subcontractors provide peer support services that are included in service delivery through Florida Assertive Community Treatment (FACT) teams, drug treatment and mental health Peer Recovery Support. Subcontractors include (but are not limited to): FACT: o Baycare Behavioral Health, Inc.; Boley, Inc.; Mental Health Resource Center, Inc. (MHRC) (Clearwater, Collier, Tampa and Winter Haven), Northside Community Mental Health Center, Inc.; Peace River Center for Personal Development, Inc.; Suncoast Center, Inc. and Coastal Behavioral Healthcare, Inc. Agency for Community Treatment Services, Inc. (ACTS) Baycare Behavioral Health, Inc. Boley, Inc. Centerstone of Florida, Inc. Coastal Behavioral Healthcare, Inc. Charlotte Behavioral Health Center, Inc. Drug Abuse Comprehensive Coordinating Office, Inc. (DACCO) Directions for Mental Health, Inc. d/b/a Directions For Living First Step of Sarasota, Inc. Mental Health Community Centers, Inc. Mental Health Care, Inc. d/b/a GracePoint Operation PAR, Inc. Peace River Center for Personal Development, Inc. Personal Enrichment Through Mental Health Services, Inc. (PEMHS) SalusCare, Inc. Success Kids and Families, Inc. pg. 13

14 Suncoast Center, Inc. Tri-County Human Services, Inc. Van Gogh's Palette, Inc. d/b/a Vincent House WestCare Florida, Inc. FACT s Certified Recovery Peer Specialists assist the individual in the recovery process as they link them to community resources, provide social networking opportunities and support the individual in daily living activities. Mental health and drug treatment programs also include peer support through 12 Step programs and support groups; and the NAMI Signature programs and support groups provide education regarding the illnesses and diseases, as well as, one-on-one peer support. In addition, these support groups are run by trained peers who utilize national organizational support group training curriculum. CFBHN oversees and ensures that the children s and adult s system of care encourage the use of personcentered Evidence-Based Practices and Evidence-Support Practices that demonstrate improvements in real-life outcomes. Transition to Independence Process (TIP), Wellness Recovery Action Plan (WRAP) and the NAMI Family-to-Family facilitate a person-centered approach that provides supportive learning skills that engage in recovery. The Crisis Center of Tampa Bay, Inc.; David Lawrence Center Mental Health Center, Inc.; Directions for Mental Health, Inc. d/b/a Directions for Living; Tri-County Human Services, Inc.; WestCare Florida, Inc.; Mental Health Community Centers, Inc.; Mental Health Care, Inc. d/b/a GracePoint; Centerstone of Florida, Inc.; Peace River Center for Personal Development, Inc. and local NAMI affiliates are subcontracted to facilitate these evidence-based and support-based practices. In addition, these agencies provide recovery-oriented, peer-involvement opportunities through programs (Healthy Transitions (HT); Family Intensive Treatment (FIT) teams; Florida Assertive Community Treatment (FACT) teams; and Peer Assisted Liaison (PAL) program) that include assistance from Certified Recovery Peer Specialists (CRPS) as they provide role modeling; encouraging engagement in treatment; and offer ideas for various methods in coping skills. Moreover, these service deliveries encourage person-driven, self-directed goal planning that empowers, strengthens and encourages personal responsibility for the individual to exercise choice in services and treatment modality. Recovery occurs via many pathways. Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds including trauma experience that affect and determine their pathway(s) to recovery. Recovery is built on the multiple capacities, strengths, talents, coping abilities, resources, and inherent value of each individual. Recovery pathways are highly personalized. They may include professional clinical treatment; use of medications; support from families and in schools; faith-based approaches; peer support; and other approaches. Recovery is non-linear, characterized by continual growth and improved functioning that may involve setbacks. Because setbacks are a natural, though not inevitable, part of the recovery process, it is essential to foster resilience for all individuals and families. Abstinence from the use of alcohol, illicit drugs, and non-prescribed medications is the goal for those with addictions. Use of tobacco and non-prescribed or illicit drugs is not safe for anyone. In some cases, recovery pathways can be enabled by creating a supportive environment. This is especially true for children, who may not have the legal or developmental capacity to set their own course. (SAMHSA 2012) CFBHN contracts with Agency for Community Treatment Services, Inc. (ACTS); Centerstone of Florida, Inc.; Drug Abuse Comprehensive Coordinating Office, Inc. (DACCO); Mental Health Care, Inc. d/b/a GracePoint; Directions for Mental Health, Inc. d/b/a Directions For Living; First Step of Sarasota, Inc.; and Success Kids and Families, Inc., who are just a few of the subcontractors who deliver Recovery-Oriented pg. 1

15 services and provide a supportive environment to inspire necessary steps toward recovery. The Wraparound process, Community Action Team (CAT), outpatient mental health and drug abuse treatments and case management are some examples of programs and methods that an individual can highly personalize and choose from as they develop a recovery pathway. D. Please list all of your contracted providers who employ peer specialist that provide recovery support services. Name of Organization N=2 Agency for Community Treatment Services, Inc. (ACTS) Baycare Behavioral Health, Inc. Boley Centers, Inc. Centerstone of Florida, Inc. Charlotte Behavioral Health Center, Inc. Coastal Behavioral Healthcare, Inc. Drug Abuse Comprehensive Coordinating Office, Inc. (DACCO) Directions for Mental Health, Inc. d/b/a Directions For Living Hope ClubHouse First Step of Sarasota, Inc. Mental Health Care, Inc. d/b/a GracePoint Mental Health Community Centers, Inc. Mental Health Resource Center, Inc. NAMI Pinellas County Florida, Inc. NAMI of Collier County, Inc. NAMI of Lee, Charlotte & Hendry Counties Northside Behavioral Health Center, Inc. Peace River Center for Personal Development, Inc. Project Return, Inc. SalusCare, Inc. Success Kids and Families, Inc. Suncoast Center, Inc. Tri-County Human Services, Inc. WestCare Florida, Inc. E. Evidence informed practices utilized by the designated receiving facilities: Some of the evidence informed practices are: Motivational Interviewing, Motivational Enhancement strategy, Trauma Focused Behavioral Therapy, Wellness Recovery Action Planning, Recovery Model and Medically Supervised Methadone Maintenance. F. Services that require an individual to travel more than one hour Adult substance use residential pg. 15

16 Crisis Stabilization Unit (Highlands to Pasco county) (DeSoto to Charlotte county) (Hendry and Glades to either Collier, Lee or Palm Beach counties) Juvenile Addiction Receiving Facility (Highlands to Pasco to Hillsborough counties) Medication management (bus transportation is more than one hour to appointment) o This potentially is an impact in most of the counties in the SunCoast Region and C-10. Medical issues (physical health) Outpatient therapy (bus transportation is more than one hour to appointment) Short-Term Residential Treatment (SRT) (other counties to Polk County) G. Unmet needs identified through care coordination Acceptable identification i.e. state identification, driver s license, social security card Access to benefits Affordable / stable housing Easy access to medical services (not behavioral health) Residential services Transportation Use of telehealth (doctor/therapist as a result of staffing shortages and rural community) pg. 16

17 MANGING ENTITY: CFBHN PREPARED BY: CFBHN IT Staff REPORT PERIOD: FY SUBMITTED DATE: 10/21/2016 SUBSTANCE ABUSE SERVICES RESIDENTIAL TREATMENT OUPATIENT TREATMENT ACUTE CARE PEER SUPPORT SERVICES SUBSTANCE ABUSE SPECIAL POPULATIONS Number Placed on Waitlist Average Days Between Average Days Median Days on Assessment on Waitlist Waitlist and First Service Median Days Between Assessment and First Service Standard Deviation of Days Between Number Placed Average Days Assessment on Waitlist on Waitlist and First Service Median Days on Waitlist Average Days Between Assessment and First Service Median Days Standard Between Deviation of Number Placed Average Days Assessment Days Between on Waitlist on Waitlist and First Assessment and Service First Service Median Days on Waitlist Average Days Between Assessment and First Service Median Days Standard Between Deviation of Number Placed Assessment Days Between on Waitlist and First Assessment and Service First Service Average Days Between Average Days Median Days on Assessment on Waitlist Waitlist and First Service Median Days Between Assessment and First Service Standard Deviation of Days Between Assessment and First Service n/a (no admits) One Pregnant women who inject drugs n/a (no admits) n/a (no admits) 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Incarcerated, one declined services n/a (no admits) One Pregnant women n/a (no admits) n/a (no admits) 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Incarcerated, one declined services Women with dependent children (No wait) (No wait) n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Adults who inject drugs (No wait). 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Children who inject drugs 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Adults involved in the child welfare system (No wait) (No wait) 0 n/a (1 admit) 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Children involved in the child welfare system 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Adults who are homeless 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Children who are homeless 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Children involved in the juvenile justice system 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a All other adults (No wait) (No wait) n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a All other children 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a The waitlist includes those individuals who have received a face-to-face assessment and meet funding and service requirements and does not reflect all those needing services. MENTAL HEALTH SERVICES RESIDENTIAL TREATMENT OUPATIENT TREATMENT CRISIS SERVICES PEER SUPPORT SERVICES MENTAL HEALTH SPECIAL POPULATIONS Number Placed on Waitlist Average Days Between Average Days Median Days on Assessment on Waitlist Waitlist and First Service Median Days Between Assessment and First Service Standard Deviation of Days Between Number Placed Average Days Assessment on Waitlist on Waitlist and First Service Median Days on Waitlist Average Days Between Assessment and First Service Median Days Standard Between Deviation of Number Placed Average Days Assessment Days Between on Waitlist on Waitlist and First Assessment and Service First Service Median Days on Waitlist Average Days Between Assessment and First Service Median Days Standard Between Deviation of Number Placed Assessment Days Between on Waitlist and First Assessment and Service First Service Average Days Between Average Days Median Days on Assessment on Waitlist Waitlist and First Service Median Days Between Assessment and First Service Standard Deviation of Days Between Assessment and First Service Individuals with forensic involvement discharged from 0 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a State Mental Health Treatment Facilities Individuals with civil involvement discharged from State 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Mental Health Treatment Facilities Adults who are homeless 0 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Children who are homeless 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Pregnant women 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Individuals involved in the child welfare system 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Adults involved in the criminal justice system 0 n/a n/a n/a n/a n/a n/a (1 admit) 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a Children involved in the juvenile justice system 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a All other adults 1 n/a n/a n/a n/a n/a (No Wait) n/a n/a n/a n/a n/a 1 n/a n/a n/a n/a n/a All other children 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a 0 n/a n/a n/a n/a n/a The waitlist includes those individuals who have received a face-to-face assessment and meet funding and service requirements and does not reflect all those needing services. NOTE: If any of the requested information is not collected or available please indicate so. When calculating statistics for days between assessment and first service, please include all individuals that have an admission to a new episode of care, meaning the individuals has a mental health performance record with a purpose code of 1 (admission) or a substance abuse outcome record with a purpose code of 1 (admission). Take the date of the first non-assessment service and subtract the date of assessment. 1of 21

18 SERVICE - Description of crosswalk for CFBHN Data Pull and explanation. Case Management (AMH) Case Management (ASA) Case Management (CMH) Case Management (CSA) Intensive Case Management (AMH) Intensive Case Management (CMH) Crisis Stabilization (AMH) Crisis Stabilization (CMH) Mobile Crisis Support (AMH) Mobile Crisis Support (ASA) Mobile Crisis Support (CMH) Mobile Crisis Support (CSA) Walk-in Crisis Support (AMH) Walk-in Crisis Support (ASA) Walk-in Crisis Support (CMH) Walk-in Crisis Support (CSA) FACT Team (AMH) FACT Team (ASA) Inpatient (AMH) Inpatient (ASA) Inpatient (CMH) Inpatient (CSA) Medical Services (AMH) Medical Services (ASA) Medical Services (CMH) Medical Services (CSA) Medication-Assisted Treatment (ASA) Medication-Assisted Treatment (CSA) Outpatient (AMH) Outpatient (ASA) Outpatient (CMH) Outpatient (CSA) Recovery Support Provided by Certified Peer Recovery Specialists (AMH) Recovery Support Provided by Certified Peer Recovery Specialists (ASA) Recovery Support Provided by Certified Peer Recovery Specialists (CMH) Recovery Support Provided by Certified Peer Recovery Specialists (CSA) Recovery Support Provided by Paraprofessionals (ASA) Recovery Support Provided by Paraprofessionals (CSA) Residential Treatment Levels I-IV(AMH) Residential Treatment Levels I-IV (ASA) Residential Treatment Levels I-IV (CMH) Residential Treatment Levels I-IV (CSA) Short-Term Residential Treatment (AMH) Inpatient Detoxification (ASA) Inpatient Detoxification (CSA) Outpatient Detoxification (ASA) Outpatient Detoxification (CSA) Supportive Housing/Living (AMH) Supportive Housing/Living (ASA) Supportive Housing/Living (CMH) Supportive Housing/Living (CSA) Addiction Receiving Facility (ASA) Addiction Receiving Facility (CSA) Definitions Case Management (AMH) Case Management (ASA) Case Management (CMH) Case Management (CSA) Intensive Case Management (AMH) Intensive Case Management (CMH) Crisis Stabilization (AMH) Crisis Stabilization (CMH) Mobile Crisis Support (AMH) Mobile Crisis Support (ASA) Mobile Crisis Support (CMH) Mobile Crisis Support (CSA) Walk-in Crisis Support (AMH)-Determined by location code Walk-in Crisis Support (ASA)-Determined by location code Walk-in Crisis Support (CMH)-Determined by location code Walk-in Crisis Support (CSA)-Determined by location code FACT Team (AMH) FACT Team (ASA) Inpatient (AMH) Does Not Exist Does Not Exist Does Not Exist Medical Services (AMH) Medical Services (ASA) Medical Services (CMH) Medical Services (CSA) Medication-Assisted Treatment (ASA) Methadone Does Not Exist Outpatient Individual and Group Outpatient Individual and Group Outpatient Individual and Group Outpatient Individual and Group Billed under CCST Billed under CCST Billed Under Healthy Transitions Billed Under Healthy Transitions Do not contract Do not contract Residential Treatment Levels I-IV(AMH) Residential Treatment Levels I-IV (ASA) Residential Treatment Levels I-IV (CMH) Residential Treatment Levels I-IV (CSA) Short-Term Residential Treatment (AMH) Detox ASA - Not an ARF Detox CSA - Not a JARF OP Detox ASA OP Detox CSA Supportive Housing/Living (AMH) Supportive Housing/Living (ASA) Supportive Housing/Living (CMH) Supportive Housing/Living (CSA) Addiction Receiving Facility (ASA) Addiction Receiving Facility (CSA) AMH = Adult Mental Health ASA = Adult Substance Abuse CMH = Children's Mental Health CSA = Children's Substance Abuse 2 of 21

19 SERVICE - SUNCOAST REGION SUMMARY SunCoast Region Totals Charlotte County Collier County DeSoto County Number of Conties with Service Total Served Service/CC Number Served Service/CC Number Served Service/CC Number Served Case Management (AMH) 12 21, Case Management (ASA) 11, No 1 Case Management (CMH) 11 5, Case Management (CSA) No 5 Intensive Case Management (AMH) 1 6 Intensive Case Management (CMH) 0 0 Crisis Stabilization (AMH) 10 11, No 0 Crisis Stabilization (CMH) No 0 Mobile Crisis Support (AMH) Mobile Crisis Support (ASA) 2 0 No 0 No 0 0 Mobile Crisis Support (CMH) 2 1,01 Mobile Crisis Support (CSA) 1 0 Walk-in Crisis Support (AMH) 13 19, 1 83 No 0 Walk-in Crisis Support (ASA) 11 2,39 No Walk-in Crisis Support (CMH) 13, No 0 Walk-in Crisis Support (CSA) No 0 10 No 0 FACT Team (AMH) 9 1, No 0 FACT Team (ASA) 0 0 Inpatient (AMH) 0 11 Inpatient (ASA) 0 0 Inpatient (CMH) 0 0 Inpatient (CSA) 0 0 Medical Services (AMH) 13 23,182 1, Medical Services (ASA) 880 Medical Services (CMH) 12 2, Medical Services (CSA) Medication-Assisted Treatment (ASA) 1,199 Medication-Assisted Treatment (CSA) 0 0 Outpatient (AMH) 10 13, Outpatient (ASA) 11 5, Outpatient (CMH) 12 3, Outpatient (CSA) No 11 Recovery Support Provided by Certified Peer Recovery Specialists (AMH) Recovery Support Provided by Certified Peer Recovery Specialists (ASA) Recovery Support Provided by Certified Peer Recovery Specialists (CMH) 2 0 Recovery Support Provided by Certified Peer Recovery Specialists (CSA) 2 0 Recovery Support Provided by Paraprofessionals (ASA) 0 2,38 Not Contracted 123 Not Contracted 0 Not Contracted 0 Recovery Support Provided by Paraprofessionals (CSA) 0 6 Residential Treatment Levels I-IV(AMH) No 2 No 0 Residential Treatment Levels I-IV (ASA) 10 2, No 0 Residential Treatment Levels I-IV (CMH) 9 Residential Treatment Levels I-IV (CSA) No 0 No 0 Short-Term Residential Treatment (AMH) Inpatient Detoxification (ASA) 3 98 Inpatient Detoxification (CSA) 1 99 Outpatient Detoxification (ASA) Outpatient Detoxification (CSA) 0 0 Supportive Housing/Living (AMH) 6 1,88 No 30 No 122 No 0 Supportive Housing/Living (ASA) 0 83 Supportive Housing/Living (CMH) 0 0 Supportive Housing/Living (CSA) 0 0 Addiction Receiving Facility (ASA) 6, No 0 Addiction Receiving Facility (CSA) 3 3 Total 12,331 Total 6,10 Total 5,2 Total 321 AMH = Adult Mental Health ASA = Adult Substance Abuse CMH = Children's Mental Health CSA = Children's Substance Abuse 3 of 21

20 SERVICE - SUNCOAST REGION SUMMARY SunCoast Region Totals Number of Conties with Service Total Served Case Management (AMH) 12 21,138 Case Management (ASA) 11,250 Case Management (CMH) 11 5,3 Case Management (CSA) 96 Intensive Case Management (AMH) 1 6 Intensive Case Management (CMH) 0 0 Crisis Stabilization (AMH) 10 11,010 Crisis Stabilization (CMH) Mobile Crisis Support (AMH) Mobile Crisis Support (ASA) 2 0 Mobile Crisis Support (CMH) 2 1,01 Mobile Crisis Support (CSA) 1 0 Walk-in Crisis Support (AMH) 13 19, Walk-in Crisis Support (ASA) 11 2,39 Walk-in Crisis Support (CMH) 13,15 Walk-in Crisis Support (CSA) FACT Team (AMH) 9 1,863 FACT Team (ASA) 0 0 Inpatient (AMH) 0 11 Inpatient (ASA) 0 0 Inpatient (CMH) 0 0 Inpatient (CSA) 0 0 Medical Services (AMH) 13 23,182 Medical Services (ASA) 880 Medical Services (CMH) 12 2,63 Medical Services (CSA) Medication-Assisted Treatment (ASA) 1,199 Medication-Assisted Treatment (CSA) 0 0 Outpatient (AMH) 10 13,18 Outpatient (ASA) 11 5,23 Outpatient (CMH) 12 3,88 Outpatient (CSA) Recovery Support Provided by Certified Peer Recovery Specialists (AMH) Recovery Support Provided by Certified Peer Recovery Specialists (ASA) 1 0 Recovery Support Provided by Certified Peer Recovery Specialists (CMH) 2 0 Recovery Support Provided by Certified Peer Recovery Specialists (CSA) 2 0 Recovery Support Provided by Paraprofessionals (ASA) 0 2,38 Recovery Support Provided by Paraprofessionals (CSA) 0 6 Residential Treatment Levels I-IV(AMH) Residential Treatment Levels I-IV (ASA) 10 2,030 Residential Treatment Levels I-IV (CMH) 9 Residential Treatment Levels I-IV (CSA) 5 Short-Term Residential Treatment (AMH) Inpatient Detoxification (ASA) 3 98 Inpatient Detoxification (CSA) 1 99 Outpatient Detoxification (ASA) Outpatient Detoxification (CSA) 0 0 Supportive Housing/Living (AMH) 6 1,88 Supportive Housing/Living (ASA) 0 83 Supportive Housing/Living (CMH) 0 0 Supportive Housing/Living (CSA) 0 0 Addiction Receiving Facility (ASA) 6,80 Addiction Receiving Facility (CSA) 3 3 Total 12,331 Glades County Hardee County Hendry County Service/CC Number Served Service/CC Number Served Service/CC Number Served No 0 11 No 3 No 0 15 No 0 No 0 3 No 0 No 0 32 No 0 No 0 0 No 0 No 0 No 1 No 0 No 0 No 2 No No No No 0 No 0 No 0 12 No 0 No No 0 16 No No 0 No 1 No 1 Total 0 Total 601 Total AMH = Adult Mental Health ASA = Adult Substance Abuse CMH = Children's Mental Health CSA = Children's Substance Abuse of 21

21 SERVICE - SUNCOAST REGION SUMMARY SunCoast Region Totals Number of Conties with Service Total Served Case Management (AMH) 12 21,138 Case Management (ASA) 11,250 Case Management (CMH) 11 5,3 Case Management (CSA) 96 Intensive Case Management (AMH) 1 6 Intensive Case Management (CMH) 0 0 Crisis Stabilization (AMH) 10 11,010 Crisis Stabilization (CMH) Mobile Crisis Support (AMH) Mobile Crisis Support (ASA) 2 0 Mobile Crisis Support (CMH) 2 1,01 Mobile Crisis Support (CSA) 1 0 Walk-in Crisis Support (AMH) 13 19, Walk-in Crisis Support (ASA) 11 2,39 Walk-in Crisis Support (CMH) 13,15 Walk-in Crisis Support (CSA) FACT Team (AMH) 9 1,863 FACT Team (ASA) 0 0 Inpatient (AMH) 0 11 Inpatient (ASA) 0 0 Inpatient (CMH) 0 0 Inpatient (CSA) 0 0 Medical Services (AMH) 13 23,182 Medical Services (ASA) 880 Medical Services (CMH) 12 2,63 Medical Services (CSA) Medication-Assisted Treatment (ASA) 1,199 Medication-Assisted Treatment (CSA) 0 0 Outpatient (AMH) 10 13,18 Outpatient (ASA) 11 5,23 Outpatient (CMH) 12 3,88 Outpatient (CSA) Recovery Support Provided by Certified Peer Recovery Specialists (AMH) Recovery Support Provided by Certified Peer Recovery Specialists (ASA) 1 0 Recovery Support Provided by Certified Peer Recovery Specialists (CMH) 2 0 Recovery Support Provided by Certified Peer Recovery Specialists (CSA) 2 0 Recovery Support Provided by Paraprofessionals (ASA) 0 2,38 Recovery Support Provided by Paraprofessionals (CSA) 0 6 Residential Treatment Levels I-IV(AMH) Residential Treatment Levels I-IV (ASA) 10 2,030 Residential Treatment Levels I-IV (CMH) 9 Residential Treatment Levels I-IV (CSA) 5 Short-Term Residential Treatment (AMH) Inpatient Detoxification (ASA) 3 98 Inpatient Detoxification (CSA) 1 99 Outpatient Detoxification (ASA) Outpatient Detoxification (CSA) 0 0 Supportive Housing/Living (AMH) 6 1,88 Supportive Housing/Living (ASA) 0 83 Supportive Housing/Living (CMH) 0 0 Supportive Housing/Living (CSA) 0 0 Addiction Receiving Facility (ASA) 6,80 Addiction Receiving Facility (CSA) 3 3 Total 12,331 Highlands County Hillsborough County Lee County Service/CC Number Served Service/CC Number Served Service/CC Number Served 89 6,282 1, , , No 0 No 0 6 No 0 No 0 2,139 1,53 No No 0 0 No 0 No 0 0 No 0 No 1 0 No 0 No 0 0 No 0 1 1,3 2, , No ,38, Not Contracted 0 Not Contracted 26 Not Contracted 9 No No 3 1, ,19 No 9 9 No No 0 0 No 0 No 0 0 No 0 Not Contracted 0 Not Contracted 1,081 Not Contracted 5 Not Contracted 0 Not Contracted 0 Not Contracted 6 No No 0 0 No 0 No No 0 No 0 Lee 0 No Not Contracted 0 Not Contracted 0 Not Contracted 82 No 0 1, No Total 2,6 Total 2,059 Total 16,5 AMH = Adult Mental Health ASA = Adult Substance Abuse CMH = Children's Mental Health CSA = Children's Substance Abuse 5 of 21