Transparencies March - Integral Care

March

A Message From Our CEO

In many cases, individuals experiencing a mental health crisis are more likely to encounter law enforcement than get the healthcare services that they need. Individuals with serious psychiatric conditions including PTSD, schizophrenia and bipolar disorder often land in jail due to behavior exhibited or decisions made during a mental health crisis. According to the National Alliance on Mental Illness (NAMI), “2 million people with mental illness are booked into jails each year and nearly 15% of men and 30% of women booked into jails have a serious mental health condition”.

In Travis County, 36% of the current jail population are individuals experiencing mental illness or a co-occurring psychiatric and substance use disorder. Rather than involvement with the criminal justice system, these individuals need pathways to access treatment and get on the road to recovery.

In 2013, State Senator Joan Huffman sponsored Texas Senate Bill 1185, creating a pilot program in Harris County, which includes Houston. The law appropriated $5M annually to the county, with a 100% county match, to divert individuals with mental illnesses from jails. The goal was to reduce arrests and incarceration and increase access to housing and health and social services. Looking at the data collected, the initiative worked. It resulted in a reduction of the number of bookings for people enrolled in the program and 44.1% have had no further bookings into the Harris County Jail. Jail days were reduced by approximately 53 days per person, yielding a savings of 19,744 total jail days and an estimated $2,941,856.

Due to the success of pilot programs like this, the Texas Legislature passed Texas Senate Bill (SB) 292 during the last session. SB 292 is a grant program to reduce recidivism, arrest, and incarceration of individuals with mental illness. As required by the law, the local mental health authority (Integral Care in Travis County), the county and local hospital district (Central Health in Travis County) established a collaboration to apply for funding.

To ensure the effort reflected the needs of our community, the collaborative invited the City of Austin and Austin Police Department to join the effort. With input from a broad group of stakeholders, the collaborative submitted an application to establish a Forensic Assertive Community Treatment (FACT) Team. FACT is an evidence-based, intensive, multi-disciplinary, team-based intervention shown to reduce recidivism rates for people with serious mental illnesses and a pattern of over-utilizing law enforcement, jail, local emergency and hospital services. The $2.5 million grant will provide services for 90 individuals and include permanent supportive housing for 60 of the individuals in the program. Integral Care will build the team based on experience working with this population and operating a successful Assertive Community Treatment team.

Positive changes in the system are critical to ensure that individuals experiencing mental health issues get the support and services they need, rather than jail time. Initiatives like SB 1185 and SB 292 are significant examples of Texas communities making meaningful strides for this population.

David Evans

Chief Executive Officer

Program Recognition

Assertive Community Treatment

Integral Care’s Assertive Community Treatment (ACT) teams promote optimal health and wellness for individuals in Travis County with complex needs who frequently use emergency health services and/or interact with the criminal justice system. Our ACT teams provide intensive community-based treatment services to help individuals engage in ongoing and preventative healthcare, acquire and maintain stable housing and recover from substance use disorder. Two ACT teams, made up of 11 Integral Care staff each, currently serve 170 individuals in our community. The teams are comprised of:

Licensed clinical social workers and qualified mental health professionals who focus on mental health and general case management needs
A registered nurse and advanced practice nurse
A housing specialist
A drug and alcohol counselor
A peer support specialist
A forensic specialist who coordinates services and advocates for individuals involved in the criminal justice system.

Each team specializes in serving a particular population. The first ACT team, established 24 years ago, assists individuals with frequent and intensive psychiatric emergencies. Another team, established 4 years ago, focuses on individuals experiencing chronic homelessness, mental illness and chronic physical health conditions. This team uses the Housing First model, believing that permanent supportive housing is the first step to recovery. The FACT team will be a third team, helping those with a mental illness and/or substance use disorder who are also frequently involved with the criminal justice system.

The complexity of ACT client needs requires teams to be involved with all aspects of their care – from routine healthcare to help avoiding an endless cycle of emergency rooms, law enforcement involvement and incarceration. Data analysis of 109 ACT clients, 12 months prior to joining the ACT program and 12 months after joining, points to significant reduction in utilization of emergency services and inpatient psychiatric hospitalization – 30% fewer emergency room visits, 43% fewer 9-1-1 calls, 55% fewer inpatient hospitalizations and an overall cost savings of $1,080,420. That’s over $1M saved in health care system costs alone, not including savings from reduced arrests and jail time for these 109 individuals.

Our ACT teams help people regain and build basic life skills, as well as their health and well-being. Integral Care is proud of the longevity and success of this program, which is due to the hard work and commitment of our team members.

Partner Highlight

City of Austin

Integral Care, Downtown Austin Community Court and the Austin Police Department (APD) are longtime partners on initiatives to improve how our community responds to and supports individuals who experience mental illness and/or substance use disorder. The newly formed FACT team will work closely with APD to identify eligible individuals. People who are repeatedly in and out of the APD system will be connected directly to the FACT team.

Downtown Austin Community Court is a small problem-solving court that processes misdemeanors for the downtown area. The court, its case managers and community outreach team will take part in the coordination of care and treatment for individuals frequently seen in their court and served by the FACT team.

This builds on an already strong joint effort of jail diversion and recidivism reduction by APD, the Downtown Community Court and Integral Care. The Homelessness Outreach Street Team (HOST) has made a powerful impact since its launch in June 2016, as well as on-scene response by our Mobile Crisis Outreach Team with APD, which began in 2013. We look forward to working side by side with the city to support even better outcomes for people who have been in a revolving door with the criminal justice system.

Integral Care is grateful to the City of Austin and its many staff. Thank you for working every day to keep our community safe and connected to mental health care, so that everyone has the tools to reach their full potential.

TRANSPARENCIES

March

Program Recognition

Partner Highlight

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