VIRGINIA RESIDENTIAL PSYCHIATRIC TREATMENTVIRGINIA RESIDENTIAL PSYCHIATRIC TREATMENTASSOCIATION (“VRPTA”)ASSOCIATION (“VRPTA”)

Presentation to the Presentation to the House Health, Welfare and Institutions CommitteeHouse Health, Welfare and Institutions Committee

July 30, 2007July 30, 2007

Jim Council, Executive DirectorJim Council, Executive Director Kevin Burgess, ChairmanKevin Burgess, Chairman

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VRPTA formed in Spring 2007 to represent the educational, regulatory and legislative VRPTA formed in Spring 2007 to represent the educational, regulatory and legislative interests of residential psychiatric treatment facilities throughout the Commonwealth. interests of residential psychiatric treatment facilities throughout the Commonwealth. Its members provide the following mental health services:Its members provide the following mental health services:residential treatment for children ages 13 through 17 in a safe and secure residential treatment for children ages 13 through 17 in a safe and secure environment that will prepare these young people for a return to a home, a less environment that will prepare these young people for a return to a home, a less restrictive environment, or to independent living;restrictive environment, or to independent living;acute psychiatric and substance abuse services for children, adolescents and adults;acute psychiatric and substance abuse services for children, adolescents and adults;specialized care for young people with disabilities, injuries, lifelong illness, or other specialized care for young people with disabilities, injuries, lifelong illness, or other medical conditions;medical conditions;home-based services that offer intensive behavioral health intervention for children, home-based services that offer intensive behavioral health intervention for children, adolescents, adults and families;adolescents, adults and families;case management services to youth who are transitioning to or from intensive case management services to youth who are transitioning to or from intensive services; and, services; and, treatment of behavioral and emotional disorders, adolescent sexual offending, drug treatment of behavioral and emotional disorders, adolescent sexual offending, drug and alcohol abuse, and other issues that compromise productive daily functioning.and alcohol abuse, and other issues that compromise productive daily functioning.

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VRPTA Member organizationsVRPTA Member organizationsSubject to licensure and oversight of the Department of Mental Health, Mental Subject to licensure and oversight of the Department of Mental Health, Mental Retardation and Substance Abuse Services as well as compliance with regulations Retardation and Substance Abuse Services as well as compliance with regulations issued by the State Boards of Education, Juvenile Justice, DMHMRSAS and Social issued by the State Boards of Education, Juvenile Justice, DMHMRSAS and Social Services through the Office of Interdepartmental RegulationServices through the Office of Interdepartmental RegulationEmploy over 800 clinical, professional, and administrative staff (employees and Employ over 800 clinical, professional, and administrative staff (employees and contractors)contractors)Maintain facilities aggregating over 810 beds throughout the CommonwealthMaintain facilities aggregating over 810 beds throughout the CommonwealthFormed a partnership with The Jason Foundation, Inc, a national non-profit Formed a partnership with The Jason Foundation, Inc, a national non-profit organization dedicated to the prevention of youth suicide, under which members organization dedicated to the prevention of youth suicide, under which members voluntarily support the goals of JFI through the contribution of physical facilities, staff voluntarily support the goals of JFI through the contribution of physical facilities, staff time and assistance, and telecommunications support. time and assistance, and telecommunications support.

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Suicide ranks as the Suicide ranks as the THIRDTHIRD leading cause of death for ages 15-24 and leading cause of death for ages 15-24 and FOURTHFOURTH for for ages 10-14.ages 10-14.Each week in our nation, we lose approximately Each week in our nation, we lose approximately 100+100+ young people to suicide young people to suicideMore teenagers and young adults have died of suicide than from cancer, heart More teenagers and young adults have died of suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia and influenza, and chronic lung disease, AIDS, birth defects, stroke, pneumonia and influenza, and chronic lung disease disease COMBINEDCOMBINED..It’s a “Silent Epidemic”It’s a “Silent Epidemic”

JFIJFI is a nationally recognized provider of educational curriculums and training programs is a nationally recognized provider of educational curriculums and training programs for students, educators/youth workers, coaches and parents. JFI’s programs build an for students, educators/youth workers, coaches and parents. JFI’s programs build an awareness of the national health problem of youth suicide, educate participants in awareness of the national health problem of youth suicide, educate participants in recognition of “warning signs or signs of concern”, and provide information on recognition of “warning signs or signs of concern”, and provide information on identifying at-risk behavior and elevated risk groups, and direct participants to local identifying at-risk behavior and elevated risk groups, and direct participants to local resources to deal with possible suicidal ideation. JFI:resources to deal with possible suicidal ideation. JFI:Receives substantial funding from corporate AmericaReceives substantial funding from corporate AmericaHas a strong alliance with the National Football Coaches AssociationHas a strong alliance with the National Football Coaches AssociationHas Tennessee football coach Phillip Fulmer as its national spokesperson and Va. Has Tennessee football coach Phillip Fulmer as its national spokesperson and Va. Tech’s Frank Beamer as one of its state and regional ambassadorsTech’s Frank Beamer as one of its state and regional ambassadorsWas responsible for legislation in Tennessee making suicide risk identification Was responsible for legislation in Tennessee making suicide risk identification training part of teachers’ periodic recertification curriculumtraining part of teachers’ periodic recertification curriculum

Residential Treatment Providers Role in the Residential Treatment Providers Role in the Virginia Mental Health SystemVirginia Mental Health System

Who do we treat?Who do we treat?

Treatment ComponentsTreatment Components

Outcomes Outcomes

FinancingFinancing

FutureFuture

Who do we treat?Who do we treat?

Children ages 9-22 and their familiesChildren ages 9-22 and their families

Primary Psychiatric DiagnosisPrimary Psychiatric Diagnosis

60% State custody60% State custody

Victims of neglect, abuse, trauma.Victims of neglect, abuse, trauma.

Multiple treatment failures in outpatient, Multiple treatment failures in outpatient, hospitals, foster care.hospitals, foster care.

Mentally Retarded with an IQ of 35 or higherMentally Retarded with an IQ of 35 or higher

Behavior history putting self and others at risk Behavior history putting self and others at risk including sexual offenders, violent historyincluding sexual offenders, violent history

Treatment ComponentsTreatment Components

Clinical interventions including:Clinical interventions including:– PsychiatristsPsychiatrists– Psychologists (testing)Psychologists (testing)– Licensed Clinical SpecialistsLicensed Clinical Specialists– NursesNurses– Mental Health SpecialistsMental Health Specialists– Behavioral PlanningBehavioral Planning– DieticiansDieticians

Treatment ComponentsTreatment Components

Educational InterventionsEducational Interventions– Certified TeachersCertified Teachers– Special Education SpecialistsSpecial Education Specialists– Emotionally Disturbed SpecialistsEmotionally Disturbed Specialists– Teachers AidsTeachers Aids– SOL DirectedSOL Directed– Longer school yearLonger school year

OutcomesOutcomes

Decrease in psychiatric symptomsDecrease in psychiatric symptoms

Increase in patient behavioral stabilityIncrease in patient behavioral stability

70-80% discharges to lower level of care 70-80% discharges to lower level of care (home, foster care, group homes, (home, foster care, group homes, independent living)independent living)

Improvement in education levels Improvement in education levels

Decreased adjudication of mentally ill Decreased adjudication of mentally ill childrenchildren

FinancingFinancing

80% of revenue from State Medicaid 80% of revenue from State Medicaid ProgramProgramDecreased dependence on locality funding Decreased dependence on locality funding helps increase funding to preventative and helps increase funding to preventative and post discharge services (community post discharge services (community based)based)Work in tandem with Community Service Work in tandem with Community Service Boards to provide cost effective treatment Boards to provide cost effective treatment options. options.

Residential Treatment in Residential Treatment in Mental Health ContinuumMental Health Continuum

Acute CareAcute Care

Residential Treatment CenterResidential Treatment Center Group HomeGroup Home

Therapeutic Foster CareTherapeutic Foster Care Home Based ServicesHome Based Services

Intensive Outpatient ProgramIntensive Outpatient Program Outpatient TherapyOutpatient Therapy

FutureFuture

Collaboration with Commonwealth and local Collaboration with Commonwealth and local agencies in development of effective care agencies in development of effective care modelsmodelsDecreased need for “out of Commonwealth” Decreased need for “out of Commonwealth” placementsplacementsDecreased Length of Stay in out of home Decreased Length of Stay in out of home placement related to lack of step down placement related to lack of step down availabilityavailabilityAssist legislators and regulatory agencies in Assist legislators and regulatory agencies in establishment of mental health system that is establishment of mental health system that is both easy to access as well as effective in both easy to access as well as effective in clinical outcomes clinical outcomes