Official: Reorganization of mental health leads to more services

BY DAVID HOTLE

Golden Triangle News Service

WASHINGTON ? While the time leading up to regionalization of mental health services in the state brought many concerns about the results, Keokuk and Washington Counties mental health and disability services director Bobbie Wulf said that when regionalization began on July 1, 2014, she embraced the concept.

Since regionalization, she said, several more mental health services have been offered. While July 1 was the official date of regionalization?s beginning, Wulf said the eight counties that make up Washington?s region had been working together for months to ensure the transition would be smooth. On Jan. 29, she said that regionalization primarily deals with administration and funding of mental health services, and patient care still operates on a local basis. The region includes Keokuk, Louisa, Henry, Jefferson, Van Buren, Des Moines, Lee and Washington counties.

?We have a wonderful relationship and partnership with each other,? Wulf said. ?Everyone has noticed statewide that we make a great group.?

She said there have been several changes in the previous year. Changes began in January 2014 with the implementation of the Affordable Care Act (ACA). Wulf said much of the region?s time in the beginning was to help provide people with an access and enrollment in the ACA, as well as mental health and substance abuse services.

During the same time, mental health services were seeing many changes that weren?t tied to regionalization, Hillcrest Family Services division director for southeast region Kristin Helm said. She said that all the changes seemed to fall into place in such a way that each benefited the other. She said that ACA and Medicaid provided patients with an avenue to access services that otherwise might not have been available.

Wulf said that many of the programs that have been built as a result of the regionalization have ?blossomed? and are doing more than they have ever done before.

Hillcrest services have been expanded to Henry and Louisa counties in March 2014, and will expand to Keokuk County in February. Emergency room support will be provided in Keokuk and Henry counties very soon. Fairfield already has a provider in its hospital.

Integrated health home services

Helm said that integrated health home (IHH) services is an initiative that bridges the gap between medical and mental health treatment, taking a holistic approach to care, Helm said. She said that a nurse, care manager, care coordinator and a peer support specialist work as a team to look at a patient?s total health and link a patient with resources and support. Many of the resources are funded through ACA. There are also services offered that give patients access to residential and vocational support, which allows the patients to be more independent.

Emergency Room treatment

Helm said that the emergency room project had been discussed for years, but was implemented when the region began. She said that a pilot version of the program had begun about two years ago, but had not been successful. She said that this program began April 1, 2014, in response to the shortage of mental health in-patient beds in Iowa. Wulf said that as a result of the shortage, sheriff?s deputies having to transport a patient for care might have had to take the patient as far as Sioux City or Council Bluffs for treatment.

?That got us thinking about how we could help with this process, to not only make it more conducive to the recipient who is going to the ER, but also alleviate some of the stress it was putting on the system,? Wulf said.

While the goal is still to route people having a mental health crisis to the mental health center, the emergency room program allows a mental health care professional to provide an assessment in the hospital, Helm said. The goal was to determine which patients needed to be hospitalized and which could go home with a next-day appointment.

Since the program began, hospitalizations have decreased. Since the program began, the program has served 63 patients. One individual was hospitalized for a substance abuse issue and 13 were hospitalized for mental health issues. Helm said 79 percent of the patients were able to remain in an outpatient status.

Hillcrest has a contract with the hospital to provide assessments from 8 a.m. to 9 p.m. Monday through Friday. Wulf said patients are also able to be linked to care within 48 hours of the assessment.

A crisis home has also been opened in Burlington to serve the region. Part of the requirements to get in, are to be evaluated in an emergency room by a mental health professional. The team hopes to open another crisis home in Fairfield, but the project has been delayed.

Urgent care services

Hillcrest offers a mental health crisis hotline at 1-855-800-1239. Helm said that counseling service is available 24 hours a day, every day. The Mental Health Clinics in Washington offers walk-in services for people or families in crisis. The clinic is at 2175 Lexington Blvd., and is open from 8 a.m. to 5 p.m. Monday through Friday. Its phone number is 653-6161.

Wulf said that the mental health department had determined that more patient openings were needed to be available due to the people accessing the emergency room. She said slots with therapists and doctors were open, allowing urgent care emergencies to be treated at the center.

Helm said that previously the idea was that the mental health center would be an outpatient center and people needing immediate help needed to go to a hospital. She said that the mental health facility has changed and wants to ?provide that front-line support.?