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In April 2020, Integral Care received a grant of $20,000 from All Together ATX to help people with mental illness, substance use disorder, and intellectual and developmental disabilities weather the storm of the COVID-19 pandemic. The funds will allow Integral Care to provide gift cards for groceries, assistance with rent and utilities, and help with prescription costs.

  • Integral Care will provide gift cards to HEB and Walmart so clients can purchase the food and supplies they need.
  • Clients who have lost work due to COVID-19 and are requesting financial assistance will provide a copy of their rent or utility bills and Integral Care will make a payment directly to the vendors.
  • Integral Care will cover the costs of prescriptions for established clients so they can continue their medications and stay healthy during this troubling time.

Through the All Together ATX grant program, our City leaders are using their nonprofit partners as a buffer against the worst impacts of the outbreak. They are relying on the expertise and experience of community-based institutions in the recovery effort that lies ahead. Integral Care is glad to be a part of this community-wide effort to help all members of our community weather the storm of COVID-19.

In April 2020, Integral Care received a $10,000 grant from the Alice Kleberg Reynolds Foundation that allows our intellectual and developmental disabilities and homeless services teams to provide short-term assistance to mitigate the negative impacts of the COVID-19 virus on the populations they serve.

 

In response to the COVID19 pandemic, Integral Care now provides most of its services via telehealth. However, many people experiencing homelessness do not own a phone and cannot access telehealth services. To ensure continuity of care, Integral Care is providing mobile phones to people experiencing homelessness. This means clients anywhere – even on the streets – can call in to a telehealth appointment and work with Integral Care staff to address their health needs. The grant will also allow Integral Care to deliver single occupancy tents and groceries to clients living on the street, allowing them to shelter in place and have their basic needs met.

 

Integral Care’s IDD Services Division provides people with intellectual and developmental disabilities the tools they need to live on their own while also offering extra help during times of crisis. Changes to grocery store and restaurant operations – including social distancing rules, modified schedules, and limited availability of certain products – may present unique challenges for this population. Staff have identified ten people with IDD who are currently struggling to get groceries, toiletries and cleaning supplies. The Alice Kleberg Reynolds Foundation grant allows staff to deliver groceries and other products during their regular visits throughout the shelter in place period.

Del Valle Independent School District (DVISD) received a Victims of Crime Act grant from the U.S. Department of Justice in the amount of $1,000,000.  DVISD contracted with Integral Care to expand its school-based mental health services. Integral Care has provided mental health services to students, families and staff in DVISD since 2013. With this grant, Integral Care will expand its services to nine elementary campuses and three alternative campuses, with a focus on supporting children and adults impacted by violent crime.

 

Integral Care will hire ten mental health professionals: six to serve students and four to provide support to family and school staff who are victims of crime. A program manager will provide oversight and supervise those providing direct mental health services. All staff will be trained to provide evidence-based psychotherapy that is trauma-informed and culturally competent.

In December 2019, Integral Care received a $523,413 grant from St. David’s Foundation to provide Mental Health First Aid (MHFA) training to 1,500 Central Texans annually for the next two years. MHFA is an evidence-based training that builds mental health literacy by teaching participants how to identify warning signs and symptoms of mental illness and apply a 5-step action plan to help individuals experiencing a mental health crisis.

 

St. David’s Foundation has supported Integral Care’s MHFA program since 2017. In 2018, Integral Care worked collaboratively with Bluebonnet Trails Community Services to provide MHFA training to 2,022 individuals in Travis, Williamson, and Bastrop Counties; last year, 2,059 individuals accessed MHFA training through Integral Care’s program.

 

Over the last several years, Integral Care has provided MHFA training to diverse audiences, including faith communities, nonprofit organizations, government agencies and departments, elected officials, and institutes of higher education. For this grant term, we plan to expand our outreach to focus on the private sector, increasing our community’s capacity to respond to a mental health crisis anywhere Central Texans live, learn, work, and play.

 

With a diverse corps of Mental Health First Aiders, we can reduce barriers to mental health care access throughout Central Texas. Building mental health literacy across our community – from nonprofit professionals and educators to business leaders and elected officials – helps to ensure that people living with mental illness and/or substance use disorder can get connected to the services they need.

In February 2020, Integral Care received a $25,000 grant award from the Montandon Charitable Trust to create a drop-in office space for 40 community-based staff in the Child and Family Services Division. This community workspace will offer opportunities for staff members to work in collaboration, sharing ideas and experiences that can help improve the services we provide to children with mental health, developmental, and behavioral challenges.

 

Staff who will utilize the drop-in space work with some of our highest need youth populations, including children enrolled in our Early Childhood Intervention (ECI) and Youth Empowerment Services (YES) Waiver programs. While community-based work is essential to meeting the needs of children and families in Early Childhood Intervention and YES Waiver programs, staff members face unique challenges to working outside a clinic.

 

Building a new drop-in office space is intended to increase staff engagement, build morale, and improve overall health outcomes for those we serve. When staff members have the opportunity to interact – whether in the break room, in a small meeting space, or with a visit to an adjacent cubicle, they can share their knowledge and work collaboratively to improve team performance.

In November, Integral Care received a $143,500 grant from the Meadows Foundation to renew the Healthy Transitions Program, a collaboration between Integral Care and The University of Texas at Austin that supports transition-age youth. Funding will allow Integral Care to hire four part-time, near-age peer support specialists who will serve as transition navigators for youth who are transitioning from Child and Family Services to Adult Behavioral Health services or young adults between the ages of 18 and 25 who are new to mental health services and engaging with Adult Behavioral Health services.

 

By connecting each youth with one of our trained, near-age peer support specialists, we anticipate that we will increase the number of individuals who attend their intake appointment with Adult Behavioral Health services and improve our retention rate for youth remaining in Adult Behavioral Health services.

 

As in Year One of the project, Integral Care will engage experts in the University of Texas at Austin Steve Hicks School of Social Work to train the young adult peer support providers in the developmental needs of transition-age youth, effective engagement skills, and fidelity to the young adult peer model.

Integral Care, the Local Mental Health and Intellectual and Developmental Disability Authority for Travis County, announced today the appointment of Travis County Sheriff Sally Hernandez to its Board of Trustees. The appointment was a result of Senate Bill 632, which promotes Local Mental Health Authority (LMHA) cooperation with the criminal justice system by directing all LMHAs to appoint a sheriff or sheriff’s representative to their local governing board as an ex officio non-voting member.

(more…)

In September, Austin City Council passed its 2020 budget, with several provisions aimed at improving services for individuals experiencing a mental health crisis. The budget includes new funding commitments for Integral Care’s Expanded Mobile Crisis Outreach Team (EMCOT), mental health clinicians embedded at the 911 call center, additional mental health training for 911 dispatchers, a telehealth tool for first responders, and a staffing increase for Austin Travis County Emergency Medical Services Community Health Paramedics. These programs have already shown promise in improving crisis systems in our community.

 

EMCOT, which is jointly supported by the City of Austin (60% of funding) and Travis County (40% of funding), co-responds with law enforcement and EMS to divert individuals from emergency departments, arrest, involuntary commitments, and jail. Since the inception of the program in 2013, EMCOT has served 7,214 individuals and provided training for 1,500 law enforcement officers, EMS, and school resource officers.

 

City funding will also continue Integral Care’s successful telehealth pilot with Austin Police Department, helping to ensure access to care for individuals experiencing a mental health crisis. If first responders recognize that an individual is having a mental health crisis, they can offer a telehealth option, allowing individuals to connect with a trained clinician to provide support. Clients who choose telehealth can speak with MCOT staff via iPad. Staff then provide assessment and triage, assist with safety planning, and link them to community resources such as the Judge Guy Herman Center for Mental Health Crisis Care or crisis residential care.

 

Starting in December, EMCOT team members will be stationed at the 911 Call Center, where mental health calls will be transferred by 911 call takers to EMCOT. This means quicker assessment and triage of a person’s situation and the level of care they need. Under the city’s new budget, EMCOT will add 4 full-time clinicians.

 

Integral Care appreciates our longstanding city and county collaboration to improve crisis services for all in our community

The Central Texas African American Family Support Conference provides opportunities to learn about mental health, intellectual and developmental disabilities, substance use disorder, co-occurring disorders and much more. The mission of the conference is to strengthen family and individual awareness of available behavioral and physical health care services through culturally sensitive education, supports, and partnerships.

Find out more about the conference here.
Join the Facebook group -> CLICK HERE

 

On September 27, Integral Care received a $10,000 grant from the Religious Coalition to Assist the Homeless (RCAH), a coalition of Austin-area faith communities that provides grant funds to social service providers to expand the capacity of local housing and shelter programs. Funding from RCAH will help Integral Care provide wraparound support services for the residents of Terrace at Oak Springs, our new permanent supportive housing community.

All Terrace residents have experienced chronic homelessness and live with mental illness, substance use disorder, and/or other chronic health conditions. In permanent supportive housing communities like Terrace at Oak Springs, offering flexible, voluntary support services can help individuals stay housed, build their self-sufficiency, and contribute to their communities. On-site wraparound services in the residential portion of the building will include case management, peer specialist support, benefits counseling, education, and job training/supported employment. Wraparound supports funded by RCAH will complement services provided through the 3000 Oak Springs Clinic, resulting in a holistic wellness and recovery approach for 50 residents.

As of December 17, 2019, 39 individuals have moved into their own apartments at Terrace at Oak Springs, all of whom can access wraparound support services.

Integral Care spoke with FOX 7 Austin about Post-traumatic Stress Disorder Awareness Month and the services we provide. Integral Care offers Mental Health First Aid training for Military Members, Veterans and their Families. Find out more here.

 

A home means recovery from homelessness, mental illness and substance use disorder. When people have a safe place to live, appropriate support services and the tools they need to achieve well-being, recovery begins and they can reach their full potential and contribute to their community.

Watch KVUE’s story on Integral Care’s Terrace at Oak Springs.

Texas Health and Human Services Commission has committed $1.9 million to support homeless services, including expanding shelter services and shelter redesign, increasing access to mental health and substance use services for families experiencing homelessness, and supporting clinic operations and the expansion of housing services at Terrace at Oak Springs. Set to open in summer 2019, this new permanent supportive housing community includes 50 fully furnished, single occupancy efficiency apartments and an onsite integrated health care clinic – 3000 Oak Springs Clinic. Features include onsite staffing 24 hours a day, onsite laundry facility, outdoor green space, community room with library, computers, and internal and external security cameras. Terrace at Oak Springs is modeled after other successful programs across the country and the first of its kind in Central Texas.

 

The 3000 Oak Springs location provides integrated primary health care and mental health care to residents of the apartment community. Services include counseling and case management, drug and alcohol treatment, exercise and nutrition programs, medication management and support, employment services, and assistance accessing benefits. Clinic services are also available to adults in the community who are eligible for Integral Care services. The clinic will be open 8 AM to 5 PM Monday through Friday, and will offer scheduled appointments and a limited number of walk-in appointments. Community members will be able to access clinic services through the same intake and assessment process that Integral Care uses for all of its services.

Episcopal Health Foundation has awarded Integral Care $1.5 million to expand our clinical services and implement a new financing and collaborative infrastructure. As our interdisciplinary care teams research new interventions in our clinics, we can demonstrate improved health outcomes and reduced costs of care to managed care organizations and develop a case for a value-based payment structure. Partnering with Episcopal Health Foundation will help us create the infrastructure for this new payment system while providing us flexibility to continue our clinical work by bridging funding streams.

 

Our new Integrated Practice Unit at Dove Springs, an expansion of services offered by Dell Medical School and Integral Care at the Bipolar Disorder Center at UT Health Austin, will serve as the pilot site for this initiative.  Later this year, Integral Care will bring this collaborative approach to yet another clinic – our 3000 Oak Springs Clinic, which is part of the forthcoming Terrace at Oak Springs permanent supportive housing community.

 

Integral Care’s integrative, team-based approach provides a strong foundation for implementing a value-based payment structure, which relies on collaboration and coordination throughout the cycle of care. By showing the improved health outcomes and reduced care costs of this care delivery model, we can collaborate with managed care organizations to create a value-based payment system that focuses on improving quality of care, rather than increasing quantity of services.

AUSTIN, Texas — Of the more than 7,000 people who experience homelessness in Travis County each year, many have complex health problems as diverse as heart disease and asthma. To help address these persistent challenges, Dell Medical School at The University of Texas at Austin, CommUnityCare Health Centers and Integral Care, Travis County’s mental health authority, are joining forces to launch an innovative, federally-funded mobile care team that serves homeless individuals where they are.

 

The collaboration, which is funded by a five-year, $2.3 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), will support homeless men and women who have a chronic medical condition along with serious mental illness and/or substance use disorder. The mobile, multidisciplinary team will be staffed by qualified health care providers who integrate comprehensive primary care, mental health care, substance use treatment, intensive case management, and wraparound services such as housing assistance and social programs enrollment into a continuum of care with one single team.

 

“Homeless Austinites living with multiple complex medical problems are among the most vulnerable and difficult to reach members of our community, but we believe that our innovative approach can work,” said Dell Med’s Tim Mercer, M.D., MPH, assistant professor in the departments of Population Health and Internal Medicine, who is the project director for this grant. Efforts to effectively treat this population require careful coordination among advocates and organizations working in Austin’s health ecosystem, he said.

 

“Our goal is to fill gaps in care by leveraging the existing strengths and infrastructure of the three collaborating organizations in a whole new way,” Mercer said. It’s also essential to coordinate efforts with other local organizations, such as the Ending Community Homelessness Coalition (ECHO), he added.

 

A 2017 Point-in-Time Count performed by ECHO found that 2,036 Austin residents experience homelessness on any given night, of whom 553 are chronically homeless, 345 have a substance use disorder and 519 experience serious mental illness. It also found that 61 percent of people experiencing homelessness access health care through an emergency room or not at all.

 

Meeting People Where They Are

 

One key design feature of the mobile model is that it allows the team to bring care to patients where they live, unlike the traditional model of requiring patients to seek services in clinics or hospitals to address their health needs.

 

“Normally the burden is entirely on the patient — they have to make appointments, figure out how to get a ride, go to the pharmacy, get their labs processed — they are constantly forced to jump through hoops,” said Audrey Kuang, M.D., clinical director of the homeless health care program at CommUnityCare and assistant professor in the departments of Internal Medicine and Population Health at Dell Med. “It’s tough enough for the average person, but for someone struggling with mental illness or chronically sick or worrying about their next meal, those hoops can be insurmountable obstacles,” she says.

 

Equipped with mobile medical supplies, laptops to access medical records on site, and well-honed “street medicine” engagement tactics, the team remains unfettered by the need for a building or an exam room to care for patients.

 

“We can meet with clients on the street, a park bench, under a bridge — wherever we need to be to serve them best,” says Kuang.

 

When more complex care is needed, the mobile team can also see patients in one of CommUnityCare’s 24 clinics or Integral Care’s four integrated mental and primary care clinics in Travis County.

 

The community-based mobile care team will consist of at least six health professionals, including:

 

  • A primary care physician or nurse practitioner
  • A mental health care psychiatrist or nurse practitioner
  • A licensed chemical dependency counselor
  • A nurse case manager
  • A qualified mental health professional case manager
  • A peer navigator

 

An important part of this community-based program is that it relies on the complementary strengths of the organizations involved. Integral Care has been providing outreach and recovery services to people experiencing co-occurring homelessness, mental illness and substance use disorder for over 20 years. Integral Care also partners with the Austin Police Department and Austin-Travis County EMS to connect individuals living on the street to housing, mental and primary health care and alcohol and drug treatment as part of the Homelessness Outreach Street Team. CommUnityCare, part of Central Health’s enterprise, provides primary care and standard case management services to the homeless as well. Dell Med’s population health experts will augment these existing resources through direct care, coordination among the partners, and research and evaluation efforts.

 

“We are excited to expand our partnership with Dell Med and CommUnityCare to further support our city’s homeless community,” said Darilynn Cardona-Beiler, director of adult behavioral health systems at Integral Care. “This grant allows us to bring our expertise together and innovate in a unique and effective way. Together, we’re meeting people where they are in the community — providing integrated primary care, mental health care and much needed substance use treatment on the streets of Austin.”

 

Measuring Success


In addition to serving as orchestrator of the project, researchers from Dell Med’s Department of Population Health will work to measure the success of the effort. Its data integration division will coordinate information from Integral Care’s and CommUnityCare’s electronic health systems and directly from patients to evaluate effectiveness and identify opportunities for improving and expanding this care model.

 

“By incorporating research into this project, we will be able to understand if this approach to caring for our city’s homeless works and can pay for itself, by reducing hospital and ER visits, for example, and if it can be scaled and replicated to improve the health of communities across the nation,” said William Tierney, M.D., professor and chair of Dell Med’s Department of Population Health.

The Chronicle’s year-end accounting of the best in Austin has named MCOT the “Best Mobile Mental Health Heroes” in the city. MCOT can respond to a mental health crisis whenever or wherever it occurs-and provide medication services and counseling for up to 90 days, with a goal of connecting individuals with the long-term resources they need to recover.
We are grateful to the Austin Chronicle for recognizing the work of this dynamic team. Full coverage is available here.

The HOST team is a partnership between Integral Care, the Austin Police Department, Emergency Medical Services, Downtown Austin Community Court and the Downtown Austin Alliance. An approved increase of funding will cover the cost of a certified peer specialist/peer recovery coach and allow more funding to address immediate needs, like obtaining official ID documents and bus passes.

Find out more in this report from KXAN.

“Mental health services in Austin ISD is an essential part of educating the whole child,” said Tracy Spinner, district director of health services. “We are thankful for dedicated partners like Integral Care who have stepped up to continue services for our students at 16 campus mental health centers. While we are one step closer to supporting our students, the need for additional funds is still present and we are continuing to meet with potential partners to fully fund these services.”

The Austin school board Monday night approved an agreement with Integral Care to keep 16 campus mental health centers open this school year. Read more in the Statesman.

U.S. News and World Report shined a spotlight on Integral Care’s integrated care services. The article features an Integral Care client who lives with bipolar and obsessive-compulsive disorders and benefits from integrated mental and physical health care as well as wellness services. Our client says, “It has really built me up to be a better woman.” The story also features our partners Dell Medical School and CommUnityCare.

Integral Care’s Systems Chief Medical Officer James Baker wrote an article for this month’s TexasMedicine about the ways our state can focus on prevention and early detection of mental illness.

 

By James G. Baker, MD, MBA

 

It is far too common in psychiatry for diagnosis to first come in a crisis visit to the emergency department, the equivalent of diabetes being first diagnosed as ketoacidosis. That is why I am very persuaded by the argument that we should focus on early detection and treatment in mental health, just as in other medical specialties.

 

What if our medical association and our local medical societies took the lead in the development and implementation of strategic population mental health initiatives across the state focused on early detection and intervention of mental illnesses? Our shared vision could be a statewide population mental health initiative with four parts:

 

Routine screening for depression, anxiety, and post-traumatic stress as a part of every outpatient clinic visit in Texas. Mental health screening could ― and should! ― be just as routine as temperature, pulse, and blood pressure screens for every adult in Texas, whether care is provided in the public or private sector. As an example, The University of Texas Southwestern’s Madhukar Trivedi, MD, has an iPad software program, VitalSIgn6, that screens for depression and can be modified to screen for other common mental health challenges.

 

Routine substance-use screening as part of physical exams for every teenager and adult in Texas. The NIDA Modified Assist (for adults) and the CRAFFT (for adolescents) are examples of quick, easy-to-use screening tools. Significant reductions in alcohol and substance use can result when screening is followed by a nurse or social worker offering brief, evidence-based intervention at the same doctor visit.

 

Easy access to evidence-based, first-episode psychosis treatment and research protocol for every newly diagnosed patients in Texas. Early and aggressive treatment in programs like RA1SE have been shown to improve markedly the outcome of patients with schizophrenia and other psychiatric disorders that include psychotic symptoms. Its availability currently is limited, but detection and early treatment are just as important with schizophrenia as they are with cancer.

 

Easy access to mental health first-aid training for everyone in Texas. Mental Health First Aid is a training course started in Australia 15 years ago that is now available statewide for anyone in the community, including first responders. The training reduces stigma, and, just like CPR, Mental Health First Aid has the potential to save lives. Our goal could be to train 750,000 people statewide.

 

Perhaps our medical association and local medical societies could partner with medical school departments of psychiatry, with local mental health authorities, and with local and statewide philanthropic organizations to demonstrate quick and quantifiable success in our four-part, population mental health initiative. Armed with that data, we could approach policymakers with strategies to improve access and quality of mental-health and substance-use services to everyone in our state, especially to the poor.

 

The potential impact on our patients and our communities ― and on each one of us ― is huge. As a mother, father, son, or daughter, you are just as likely to have family affected by mental health as by cancer ― up to one in three Texans has a mental health and/or substance use disorder. As a taxpayer, you help fund at least $1.4 billion in emergency department costs from mental illnesses presenting in crisis.

 

Each of us now knows that mental illness is medical illness, just like diabetes, cancer, or cardiovascular illness. And each of us knows that contemporary mental health care is rooted in science. Next, we must insist upon prevention, early intervention, and aggressive treatment for people who endure these potentially devastating disorders. When all that is required for early detection is a couple of questions asked while taking a pulse, then collectively we must insist that those questions get asked.

 

James G. Baker, MD, MBA, is a member of the Texas Medical Association Council on Science and Public Health. He also serves as associate chair of clinical integration and services in the Department of Psychiatry at The University of Texas at Austin Dell Medical School and as systems chief medical officer for integral care, the community mental health center for Austin and Travis County. Dr. Baker is a Distinguished Life Fellow of the American Psychiatric Association and a recipient of the National Alliance for the Mentally Ill Exemplary Psychiatrist Award as well as the Mental Health America of Greater Dallas Pamela Blumenthal Memorial Award.  

 

The commentary article was originally published on the Texas Medical Association’s website here as part of TMA Publication TexasMedicine February 2018.

Integral Care is now offering weekly Mental Health First Aid (MHFA) classes in Austin and Georgetown. MHFA is a one-day training that teaches people how to help someone who may be experiencing a mental health crisis or showing signs of mental illness or substance use disorder. Thanks to a grant from the St. David’s Foundation, no one will be turned away. However, a donation of $10 is welcome.

MHFA can save a life, just like CPR can save someone who can’t breathe or is having a heart attack. Register today.

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