Presentation to the Senate Committee on Health & Human Services June 16, The University of Texas Health Science Center at Houston (UTHealth)

Transcription

1 Prsntation to th Snat Committ on Halth & Human Srvics Jun 16, 2016 Th Univrsity of Txas Halth Scinc Cntr at Houston (UTHalth) Stphn Glazir, MBA, FACHE Chif Oprating Officr, UTHalth HCPC 1

2 Th UTHalth Harris County Psychiatric Cntr 276-bd acut car psychiatric hospital Scond largst acadmic psychiatric hospital in th country Joint ownrship btwn th stat and county Opratd and staffd by UTHalth Dpartmnt of Psychiatry Taching hospital Ovrviw Fundd primarily by th stat through a contract btwn UTHalth and Th Harris Cntr, th local mntal halth authority 2

3 Th UTHalth Harris County Psychiatric Cntr Spcialty Units & Programs Mood Disordrs Unit Comptncy Rstoration Unit Juvnil Sub-Acut Unit Child-Adolscnt Acut Unit Schizophrnia Unit Bipolar Unit Dual Diagnosis Unit Gro-psychiatry (Oldr Adult) Program Early Onst Program 3

4 Th UTHalth Harris County Psychiatric Cntr Facts & Figurs 8,800 admissions in 2015, with an avrag lngth of stay of 7.9 days 9,700 admissions projctd for 2016, with an avrag lngth of stay of 6.7 days Functionally full at all tims - w start ach day with a list patints waiting for a bd to opn Provids training for 480 mdical studnts, mor than 1,650 othr studnts (nursing, pharmacy, psychology, tc.), and 54 rsidnts and fllows ach yar 4

5 Th UTHalth Harris County Psychiatric Cntr UTHalth HCPC s Participation & Involvmnt in th Fornsic Mntal Halth Systm HCPC participats, along with th Harris Cntr and th HPD and Shriff s CIRT Tams, in th divrsion and tratmnt of mntal halth patints. HCPC also participats in trating fornsic patints by providing a 23-bd Comptncy Rstoration Unit. o Last fiscal yar this unit tratd 218 patints with an 87% rstoration prcntag and an avrag lngth of stay of 38 days. o Th Comptncy Rstoration Unit s Program Managr chairs th Harris County Comptncy Rstoration Ovrsight Committ which is comprisd of rprsntativs from th Misdmanor and Flony Courts, th District Attorny s Offic, th Public Dfndr s Offic, th Harris County Jail and th Harris Cntr. 5

6 Th UTHalth Harris County Psychiatric Cntr UTHalth HCPC s Participation & Involvmnt in th Fornsic Mntal Halth Systm W also participat on th Joint Committ on Accss and Fornsic Srvics and th Harris County Shriff s Mntal Halth Task Forc. Harris County has an ffctiv systm for idntifying and divrting individuals who rally do not blong in th fornsic systm into th mntal halth tratmnt systm. o Patints ar brought by CIRT officrs to th NruoPsychiatric Cntr for valuation, and if thy nd inpatint tratmnt, ar transfrrd to HCPC. o Th primary limitation of this systm is a lack of rsourcs, primarily a lack of bds. 6

7 Continuum of Car Gap Most svrly and prsistntly mntally ill patints nd to b tratd in a continuum of progrssivly lss intnsiv and lss rstrictiv forms of car Currntly thr is a gap in that continuum that causs ovr-utilization of th most xpnsiv forms of car (acut inpatint) That gap is also causing ovrutilization of hospital mrgncy rooms, psychiatric mrgncy srvics, law nforcmnt and jail srvics 7

8 Continuum of Car Gap Chronic rcidivism and rapid r-admissions to acut car hospitals ar two of th consquncs of this gap in th continuum of car This ovr rlianc on acut inpatint car drivs cost up and rsults in lss than optimal outcoms Statistic Cost at HCPC Supr-Utilizrs (4 + admissions pr yar) 1,244 Admissions $5,184,157 Rapid R-admittrs (r-admissions within 30 days) 10,207 Patint Days $5,384,229 Dischargs to shltrs 2,910 Dischargs 8

9 UTHalth HCPC Continuum of Car Campus M o r E x p n s Community Basd Short Trm Acut Inpatint Psychiatric 49 BEDS Short Trm Sub-Acut Patint 75 BEDS Hospital Basd - 25 ADULT ACUTE BEDS - 12 CHILD ACUTE BEDS - 12 ADOLESCENT ACUTE BEDS Rsidntial Tratmnt 100 BEDS Longr Trm Sub-Acut Patint (Approx 5% of population) L s S E x p n s Crisis Rspit Housing 25 BEDS Supportd Housing 50 BEDS Indpndnt Living with Outpatint Cas Managmnt Proposd nw bds: 299 Lss Rstrictiv Mor Rstrictiv 9

10 Closing th Gap Bttr patint outcoms Rducd dmand on law nforcmnt and jails Rducd dmand on th psychiatric mrgncy intak systm Cost savings from rducd utilization of highr lvl srvics apply towards lss rstrictiv options Rducd waits for bds for childrn and adolscnts Movmnt towards lss rstrictiv, lss costly, mor community-basd lvls of car Enabls patints to b tratd in thir own communitis closr to thir familis Infrastructur to mov towards valu-basd rimbursmnt Enabls valuation of clinical and conomic outcoms Rplicabl modl in urban aras to significantly rducd th dmand for typical stat hospital srvics Rducd utilization and fastr throughput for psychiatric patints in hospital 10 mrgncy rooms

11 Thank you from UTHalth Stphn Glazir, MBA, FACHE