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CARE Team Program Palm Beach County, Florida
Diana Stanley and Daniel Gibson
The Lord’s Place, Inc.
July 23, 2013
Programs:
• Supportive Housing
• Job Training and Employment
• Community Engagement
History: • Founded in 1979 • Grassroots agency focused on serving most vulnerable
Mission: The Lord’s Place is dedicated to breaking the cycle of homeless by providing innovative, compassionate and effective services to men, women, and children in our community
• Social Enterprises
• Re-entry Services
• Advocacy
• Case management
SERVING VULNERABLE PERSONS
Disabled/Medically Vulnerable 82%
History of Psychotropic Medications 52%
Severe & Persistently Mentally Ill (SPMI) 29%
Ex-Offender 53%
Chronically Homeless 55%
Substance Abuser 77%
LOCAL PROBLEM
Our participants encountered obstacles with the healthcare system. They reported:
• Long wait times for first and follow-up appointments
• Impersonal services
• Transportation problems
• Confusion over complex medications and diagnoses
• Poor access to services and preventative care
• Inability to pay for medications and co-pays
• Difficulty enrolling into health insurance
PERSONAL STORY
Ray’s journey from incarceration to The Lord’s Place
ASSERTIVE COMMUNITY TREATMENT (ACT) MODEL
Principles:
Client-focused Service mobility
Multidisciplinary team Staffings every day
Scaled to setting and budget
Components: • Psychiatry/Primary Care • Social Work • Nursing • Substance Abuse • Vocational Rehabilitation • Supportive Housing
• Psychopharmacological Treatment
• Individual Supportive Therapy
• Mobile Crisis Intervention • Supportive Employment
KEYS TO EFFECTIVE COLLABORATION
• Similar mission and values
• Funding not the motivating factor
• Capacity to serve targeted population
• Communication at all levels
• Trusted, proven track records
• Makes system more efficient
• Right time, right place
• Experts in each respective fields
• Flexibility and fluidity
LOCAL PARTNERSHIP & COLLABORATION
Genesis Community Health • Primary Healthcare • Psychiatric Services
Parent Child Center • Psychotherapeutic Services • Group facilitation
The Lord’s Place • Housing • Case Management • Job Training and Employment
CARE TEAM OVERVIEW
Principles:
• Assist those who are “stuck” • Return stabilized participants to community providers • Educate participants on health issues • Ensure comprehensive screening at outset
Screenings/Assessments:
• Drug and Alcohol • Mental Health • Psychosocial Evaluation • Post-Traumatic Stress Disorder
CARE TEAM IN ACTION
Photo: Staffing participants discuss a client’s progress at The Lord’s Place Men’s Campus on June 19, 2013
CARE TEAM CHALLENGES
• Silo Effect • Funding
• Creating the Team
• Communication • Discharge Planning
IMPACT OF CARE TEAM
• 508 residents assessed for medical and behavioral
health needs
• 95 residents received comprehensive services
• 75% decrease in emergency calls across residential
campuses
• 45% decrease in unsuccessful discharges for “high
psych need” residents
• 27% decrease in substance abuse relapses across
residential campuses
PERSONAL STORY
Patrick shares an update about his healthcare progress
https://www.dropbox.com/s/48nieq0xwpbmtqs/NAEH%202013%20Patrick%20Video%20No%20Titles-windows.wmv
CARE TEAM FUNDING
Pilot Project Grant United Way of Palm Beach County 120k per year (3yrs)
Expansion and Infrastructure Allegany Franciscan Ministries 145k per year (2yrs)
Sustainability Medicaid Fee for service
Private Funding Ongoing
CARE TEAM VISION
QUESTIONS?
Diana Stanley, Chief Executive Officer
Email: [email protected]
Phone: (561) 494-0125
Daniel Gibson, MSW, Chief Program Officer
Email: [email protected]
Phone: (561) 537-4670
THE LORD’S PLACE CONTACT INFORMATION
