1 ~'a ~3a~3~9/~Ia COMMISSIONERS' COURT AGENDA REQUEST PLEASE FURNISH ONE ORIGINAL AND TEN (10) COPIES OF THIS REQUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT MADE BY: Linda Werlein MEETING DATE: March 23, 2009 OFFICE: Hill Country Community MHMR TIME PREFERRED: 10:30 AM SUBJECT: Presentation from Linda Werlein regarding the services provided by Hill Country Community MHMR Center. EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON) NAME OF PERSON ADDRESSING THE COURT: Linda Werlein ESTIMATED LENGTH OF PRESENTATION: IF PERSONNEL MATTER -NAME OF EMPLOYEE: Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter X51 and 552, Government Code, is as follows: Meeting scheduled for Mondays• THIS REQUEST RECEIVED BY: THIS RQUEST RECEIVED ON: ~:~~ PM previ~?as Tuesday @ .M. All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will be appreciated and contribute towards your request being addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners' Court. ~y ~. c c 'c d ~ ~U O ~ U ~ ~ - o TUB a~ c d v 0 L ~ ~ ~ ~ ~ 0 ~ ~ ca ~ x o ~U H_ S m. :5 ~~~. . a } :~:~. .w .~ :r L V Q~ U 2 A w .~ 3 O U r U 2 V ~.r" ^^ ~ L O Y///~ Y/ ~ ~~ ~I O .,.., ~"r di ~ MCI C~ .~ ~ ~ O ~::~ w`:. ~ x!"Y. y~.. `~ t..~ ~~ ,: ~. .:. x~~ .~:~~ ~F ~~ s ~; ... }- 5 L ~ -~^+ ~ ~ ~ V ~- OC ~ ._ _ ~ ._ ~ ~ :~ O ~V a~ ~~ ~ ~ ~ O ~ V " ~' cu ~ ~ O -~ V ~ O L .- d. ~ ~ o ~ ~ ~ ~ o ~ _ ~ O a~ ~ ~ U _ ~ ~ ~ - ~ - ~ ~ o ~ - U .~ '- ~ ~ i ~ ~ ~ ~ ~ ~ ~ .V ~ ~ s' ~ ~ ~ ._ ~ ~ ~ w ~ o - ~- U oo U a~ ~ ,~ ~ ~~ t w~.~. .~,- ,. ,~~ .~~: ~~~ ~; } Y. ~','•. ~' ~:~ . 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Hill Country Promoting lndependence, Community ntegration and Recovery by providinga hand up... Fax: ~ ~ -77~. 4. .. ~ . -- -- Community Integration and Recovery Hill Country Community MHIVIR Center 819 Water Street, Suite 300 Kerrville, TX 78028 Phone: (830) 792-3300 Fax: (830) 792-5771 Website: www.hillcountr~~.org Proudly Ser~~in; the residents of: Bandera, Blanco, Comal, Edwards, Gillespie, Hays, Kendall Kerr, Kimble, Kinney, Llano, Mason, Medina, Menard, Real, Schleicher, Sutton, Uvalde, and Val Verde Countries A Publication of Hill Country Community MHMR Center © 2009 2 Promoting Independence, e~ j Linda J. Werlein Executive Director ...Michael Smith Chief Operating Officer Dr. Kim James Medical Director Phyllis Guderian Director of Mental Health & Adolescent Substance Abuse Services Paula Paddock Director of Mental Retardation Janice Kennemer Director of Continuity of Care and TCOOMMI Services Kent Allen Director of Adult Substance Abuse Services, Mental Retardation Authority and Network Development Bill Nation Director of Utilization and Quality Management Scott Arrington Chief Financial Officer Sally Derr Director of Human Resources Connie Wunderlich Director of Support Services Ta b I e of Co ntents Executive Team .................................... 3 ......... ......... Message from Executive Director ................ .....4-5 Mission/Values .......................................... 6 ... ......... Board of Trustees .................................... 6 ...... ........ Service Area/Demographics ........................ ........7 Service Highlights ..............................................8-9 Mental Health Outcomes ....................................10 Directory of Services ..................................... ..... 11 . Financial Analysis .......................................... 12-14 Economic Impact ............................................. 15 .... Unduplicated Clients Served ........................ ......16 Years in Review Peer Support for Recovery .................................17 Hill Country Community MHMR Center Awarded $463,831 for ~~risis Stabilization Unit ...............................18-19 ~~-lill Country Consumers Bring The Spirit of Christmas ~:o Local Citizens ................................................20 David Weden a~, ~ ; Development Officer .Sharon Griffin ~' ; Executive Assistant/Board Liaison ~+ . z ~y ~- __ _ -_ __ ------ - -- ---- o .-~ ~_ - - - -- Message from Hill Countr~iCommunity MHMR Center Chief Executive Officer We are pleased to present our Bi-Annual Report for FY 2007 and 2008. In it you will find a snapshot of our agency that provided mental health, mental retardation, early childhood intervention and substance abuse services to more then 9,700 individuals on an annual basis. The report portrays a system that remains strong and continues to demonstrate innovation in our service de- livery despite the current economic challenges. Hill Country MHMR is designated to be the Mental Health Authority by the Texas Department of State Health Services (DSHS) and the Mental Retardation Authority by the Department of Aging and Disability Services (DADS) for our 19 county service area. Hill Country is also certified by DSHS as a community mental health center and designated as the single portal for admissions to the state hospitals. The Center is licensed by the following state agencies: (1) Teas Department of State Health Services, as a provider of substance abuse services and (2) Texas Department of Aging and Disability Services as a Home and Community Services provider. We are governed by a Board of Trustees who are appointed by and ac- ' countable to the 19 counties that are our sponsoring entities. The board has established a Citizen's Advi- sory Committee to ensure services are responsive to overall needs of the local communities. The Board of Trustees, Citizen's Advisory Committee, and Hill Country staff all work in tandem with other stakeholders in the community in order to provide mental health, mental retardation and substance abuse services across the life span to citizens throughout our nineteen county local service area. We provide timely, comprehensive community-based interventions to thousands of people, keeping them out of hospitals, jails, foster care and nursing homes. We continue to operate as a safety net for the poor' and uninsured with complex service needs, while setting national best practice standards in a variety of ser- vice areas. Our Adult Mental Health Services provides a full range of mental health treatment, rehabilita- tion and support services to people with mental illness, particularly those with severe and persistent mental illness. Additionally, we offer an array of services and supports designed to meet the needs of children experienc- ~~ ing severe emotional or social problems and their families. We offer services to persons with a diagnosis of mental retardation or pervasive developmental disorder. These inchzde programs funded by General Reve- nue, Medicaid, Private Pay, and Early Childhood Intervention (ECG). The Medicaid funded programs in- ~'~ dude Home and Community-Based Medicaid Waiver program (HCS), Texas Home Living Medicaid pro- gram (TxHmL), Service Coordination, and Psychosocial Rehabiliation. j _- - _____ ___ 'y'i: r',~m."'R"' ~~.•.T:-~'=;.~k~a1Rl!.,;n.-~1 ...,x -... ,@'f.. -. ~'~ -- --- O ~. ~~' ~" ' Agency Highlights • The Center's response to the Crisis Service Redesign initiative including establish- merit of a Mobil Crisis Outreach Team (MOOT) and up radin the Crisis Hotline to g g a hotline certified by the American Association of Suicidology; Working cooperatively with the Texas Department of State Health Services, local government entities, and local foundations to set the groundwork for the establish- ment of a local Hill Country Crisis Stabilization Unit scheduled to open in April of 2009; ~, • Over 750 individuals on an annual basis received mental retardation services through In-Home and Family Supports, Service Coordination, Texas Home Living, Sup- '~ ported Home Living and Day Habilitation; • Over 1,800 children below the age of three were served annually by Hill Country's Early Childhood Intervention program; • Recognized by the Texas Council of Community MHMR Centers as a Hero Among '~~ ~' Us for standing up for in times of human tragedy and always willing to assist indi- viduals during times of natural and manmade disasters; ', • Recognized by Texas Chapter of National Alliance on Mental Illness with the 2008 Above and Beyond Award for serving individuals during natural and manmade dis- asters; We are humbled by the kindness and compassion to help others less fortunate in our communities '~, that we witness are once again affirmed in our belief that individuals, organizations, and commu- nities must work together to promote the well being of our community by providing healthcare and social services. '~ On behalf of the Hill Country Board of Trustees and the Senior Leadership Team, we extend our ;heartfelt thanks to all our staff across the agency sites for providing outstanding service to our `~ '~~ customers and the communities we serve. You serve our customers with great distinction and :continue to make us proud of your commitment to Hill Country's mission and our values. ~', As we look ahead to future challenges and rewards, we are able to meet these challenges with 'confidence because we are a community center, operated by a local board that is appointed by lo- ' cal county officials, providing services based on local citizen input. We are proud to "promote 'independence, community integration and recovery" with our community partners and leaders. ~: Linda J. Werlein 'Executive Director ~- T ~ - Lo r~, ? 1 Mission Promoting Independence, Community Integration, and Recovery Values We are responsible first and foremost to the people we serve. We treat all people with respect and dignity. We foster an environment of integrity and trust. Responsible and creative use of resources allows us to provide the most effective and efficient services possible. We value personal uniqueness and acknowledge that people share needs, rights, desires, and capabilities. We understand our responsibility to educate people and maximize learning opportunities. With information and support, people have the opportunity to make informed personal choices and become more self-reliant. We recognize the importance of, and foster, family involvement in peoples' lives. We operate in partnership with the community, appreciating its uniqueness and strength. We strive for excellence, using continuous quality improvement. Quality is linked to customer satisfaction - both ultimately measured by our ability to meet the individual. requirements of people we serve. Commissioner John Kight Chairman Bandera ~< Kendall County Mr. Charles Blankenship Ms. Otila Gonzalez Vice Chairman Secretary Treasurer Hays County Val Verde County Other Bo:~rd Members: Judge Pat Tinley Kerr County Judge Herb Senne Kinney, Real & Uvalde Counties Judge Jim Barden Medina County Judge V4'ayne Brascom Blanco, Gillespie & Llano Counties Judge Nick Gallegos Mason, Edwards, Kimble, Menard, Schleicher, & Sutton Counties 0 Commissioner Donna Eccleston Corral County _. - - _- ~, Y,,_ _-~~~. ~..~ -.~.. .., ~ - ~ :...~~_~,_ ~ , .. ~ o ^ Locations of Mental Health Centers Boerne Kerrville Del Rio Llano Fredericksburg New Braunfels Hondo San Marcos Junction Uvalde Counties receiving Texas Correctional Office on Offenders with Medical and Mental Impairment Services Bandera Kendall Blanco Kerr Comal Uvalde Gillespie Val Verde Counties receiving. Early Childhood intervention Services Bandera `Kendall Mason Blanco Kerr Medina Comal Kimble Menard .Edwards Kinney Real Locations of Mental Retardation Centers Del Rio Llano Fredericksburg New Braunfels Devine San Marcos Kerrville Uvalde Proudly Serving the residents of: Bandera, Blanco, Com~>l, Edwards, Gillespie, Hays, Kendall Kerr, nimble, Kidney, Llano, Mason, Medina, Menard, Real, Schleicher, Sutton, Uvalde, and V<>I Verde Comities 2008 Estimated Population: Square Miles: 562,035 22,593 Age: Gender: Under 18 35.30% Female 50.77% 18 or older 64.70~o Male 49.23, Ethnicity: Black 2.75% Hispanic 35.87% White 59.20% Other 2.18% Number of Individuals Served in Fiscal Year 2008 (September 1, 2007 -August 31, 2008} Adult Mental Health 5,581 Children's Mental Health 1,051 Texas Correctional Office on Offenders with Mental or Medical Impairments 241 Mental Retardation 761 Early Childhood Intervention 1,846 Substance Abuse 242 --- _- _ - ~.. _. O - -- ~ Service Highlights on an Annual Basis ~_ i 9,400 total unduplicated persons served • Over 488,000 documented service events by staff and contract providers 15,393 hours of psychiatric and nursing services provided '' Mental Health Services Obtained certification of Crisis Hotline by American Association of Suicidology • Established Mobil Crisis Outreach Team in Hays County i !, . 40,640 hours of training sessions in independent living skills, problem solving, symptom man- agement, medication management, and vocational assistance to consumers with mental illness 1,550 hours of counseling services provided • 16,731 hours of Psychosocial Rehabilitation and Skills Training provided ', • $1.3 million in center purchased medications '; ,', • $3.2 million in free medications from drug companies provided to consumers with mental ill- "' !~;, Hess Mental Retardation (MR) Services '! • Over 310,000 hours of day habilitation, skills training, vocational training and supported home ' ~' living provided to consumers with mental retardation '' • 52 MR consumers provided staffed residential group-living care • 76 consumers provided supervised living in a family setting (foster care) ', ~I • 106 consumers provided Supported Home Living Services to enable them to stay in their own homes • 1,361 hours of nursing services provided to consumers with mental retardation Over 19,000 hours of Supported Home Living Services provided __.-- --- - - __ _ __ - -- -_ - -- - ~~ _~ _ ~t Service Highlights on an Annual Basis (cont.) Mental Retardation Authority Services • During FY07, 55 consumers were enrolled in Home and Community Based Services who had been on waiting list for 8.5 years • During FY08, 38 consumers were enrolled in Home and Community Base Services who had been on waiting list for 8 years 42 consumers were enrolled each year in the Texas Home Living Waiver Program ', 23 children received Permanency Planning Services each year to explore all possible options ~. of moving children from institutional setting and returning them to family setting ', s Preformed Community Living Options Information Process for 40 residents of Austin State School during FY08 `' Early Childhood Intervention Services Over 18,885 hours of speech, occupational, physical, or other developmental therapies, as- ' sessments, and service coordination provided to infants and toddlers with severe developmen- i ~: tal problems Substance Abuse Services ~I 242 individuals received Substance Abuse Services I i Y 17 Male Adolescents earned 3 or more high school credit hours during their 90 day residential' substance abuse program 5 Male Adolescents earned a total of 42.5 high school credit hours during their 90 day resi- dential substance abuse program • 6 Male Adolescents achieved the Honor Roll for their high school work during their .90 day residential substance abuse program - -_ -~ - ~, '~r ~, Resiliency & Disease Management Outcomes Hill Country Community MHMR Center '~ FY08 Adult Mental Health ~ Percentage of Target Outcomes Achieved by Dimension Rating _ __. ___ __--- I~ ~ 125% 120% 111/0 "~ -"~_~°~ - 107% 105°/ I 102% I . _ ..__ ! 100% ~ - ~ = ' ;ff,;- w }# r r' - ... - .. - ~ , - ~ K ° ,, 1 6o°i ~~ 1 40%~~ it 20% i Functioning Housing Instability Employment Criminal Justice Co-Occurring Substance Use ~ .a Hill Country Community MHMR Center FY08 Children's Mental He;~lth Percents a of Tar et Outcomes Achieved by Dimension Rating g g 140% ;__.______-130%__ ° _ ._._-____. _.._ __-_-_. _ __-_-._ __. .__-.__-- i 128/0 ° _ ______. - .."_._ _____ ___ 124% _- _..__ __. __~ 120% -I'~---: -- __ _ __ -__ 105/ 93% 100 % ', ~ . „~ ~ ,'' ~ - ~ 5 Y~,; I 3 ~ 60% - 40% j i 20% i i _._ _ - 0% _ _ _ _ , Functioning Problem Severity Juvenile Justice School Behavior Co-Occurring Substance Use -- _ -- __- - - -- - - - - - - ~~ I ` '''~ !~. ~~~ ~;' f I~~~~ :~ ' I O ~IRE~fipRY 4F SERVICES iHill Country Community Mental Health Meneal ReHardlat~ion Center rovid 'adults who have a mental illness such as schizophrenia, ma'or de p es mental health services for 'verely disabling mental disorders which require crisis resolution a pd so chid bipolar disorder, or other se- 'disturbances. dren with serious emotions! Crisis Services that provides mental health emergency support 24 hours a da . Adult/Children Outpatient Services are provided according to the Resilien y model for Texas Community Mental Health Centers. cY and Disease Management Service Coordination provides support and coordination of services. i Inpatient Services are provided through contracts with area state hos i p tols. !Mental Retardation Services rovide s Mental Retardation Services p pports for persons with mental retardation or autism in the indi- vidual, family, and foster homes as well as in alternative living residence sand group homes. Day Programs provides training to assist consumers to become em to living. p yed or to increase skills in daily Residential Services provides residential services in group homes de " ,:Supported Home Living offers support to eligible families in the signed for 3 to 4 people. ,require services in an institutional or residential setting. community setting who might otherwise ~~ ' Foster & Companion Care helps the consumer with daily living activitie i Respite -Emergency or planned short-term care and supervision. s .Service Coordination provides assistance for individuals and famiy :Community Supports provides independent living skills trainin to enh o access support services. Vocational Services provide an array of individualized sup ort gt ance community living. :that they choose. p hat enable people to participate in work In Home & Family Support provides small grants for families and individ r ''autism living at home, with disability related expenses. uals with mental retardation or !Texas Home Living Waiver Program provides essential services and su ort ages can continue to live with their families or in their own homes in thep ommuhat individuals of all n ity ECI is a statewide program for famil esrw hhcldihdorod Inbtervention (ECI) ,~ delays. It provides evaluations, at no cost to families, to dete mine eligibidlity andithe need forlopmental ~ ~ Families and profe:>sionals work together as a team to tan a ' p ppropriate services based on the unique istrengths and needs of the child and family. Services are provided in services. tings such as child care facilities, la y pthe home and in community set- p y groups and Mothers Da Out rograms. ,' j `' I ;Substance Abuse Services provides a sspe VtaedC aAdbus uSpa lent and ado ;~ program; adult ambulatory detoxification and male adolescent residential substan ~e abusentre tmen nt ~ ~ t. For more details go to "services" at the Hill Country Community MHMR Center ~ (htt website , ;' p~//www.hillcountry.org) `,I --- ,_ --- --- State 16% ~ocal/E'ee ~r Service 6~% G '' Fee for Service/Local Revenue f 'Medicaid Other Tota $9,537,045 5,334,114 $14,871,159 Medicaid ~~ „i_ ether 6% ~'. Analy:;is of Medicaid Revenue ', Medicaid Program Program Revenue Home & Community Based Services MR $7,193,490 Rehabilitative Services MH 996,119 ~! Case Management: ,'~, Mental Health MH 67,353 p '' Mental Retardation MR 231,583 ~I Early Childhood Intervention ECI 89,274 Card Services MH 304,436 Comprehensive Care Program ECI 23,748 '~'j Medicaid Administrative Claiming 631,042 ~' Total Medicaid Revenue For every $1 of State & Federal grant funding, Hill Country generates another $1.08 $9,537,045 # of Individuals Served'; 274 1,410 880 543 585 1,411 285 N/A O ' Summary of Expenditures Other, 2,,,., ~ s', r 'Personnel $17,930,215 ', `' Medications 4,647,648 Other 5,671,310 j ~~ ~~ Tota I $ 28, 249,17 3 ~; ~ ~~ Medicati rersonne i! ons, 16% I, 64% 4 t Patient ~-ssista n ce ~ --- -- - __.___ _ . _ ___. _~ _~._~_...________ _ __ ~~ Medications Received Medication Expenditures >~ FYOE~-FY08 FY06-FY08 . $3,500,000 -~----__-- ._.. _r_--_______~.__ _..~ ._ ._....___~ __ .._..___._-._ $3,282,996 $1600,D00 $1,568,344 .__.~ $ 3,000,000 L__a. _~._~ .~- -- _ _ _ _ y I' $1,550,000 I^- -_._ ._ m.,.._...~_ __. _ ~.~_ ' ' $1,500,000 ._... _: t~ cnn nnn ._..-~__.~ . __-_,~ 5~368.R36 - _ ~,. } $1,450,000 i, >~~ i " r.,,~`. I $1,400,000 $1,364,652 1 49 Ol $ ,3 ~ $1,350,000 ~ ,'' ', ;- I $1,300,000 $1,250,000 ~' ', $1,200,000 , ... _ . _ __- . fY06 fV01 fY08 ~I_._______.__..__..._._.~ __.v._. _,~_~,_,~. In FY08, for every $1 of Medication Expenditure Hill Country received $2.40 of Patient Assi stance Medication F; r _ _ __ _ _ ~1Lir 4•; Economic Impact: Return on Investment Current Numk~er of Employees: 472 Payroll Amount: $17,'930,215 Amount for Network of Contracted Providers: $ 1,'931,905 Current Number of Direct Service Contractors: Mental Retardation 79 Mental Health 15 Early Childhood Intervention 17 Audited Administrative Overhead Percentage: 11.03% In Kind: ~' S sites are provided cost-free by counties or local boards for Mental Health Clinics and Mental i~ ~, Retardation Centers. '~ Increased savings through the Patient Assistance Program (PAP) to just over $3.2 million. '', Received approximately $172,644 from our local Boards serving our 19 counties. 2008 Income: Local $ 3,578,520 7.64% State Allocated Funds $ 13,653,374 49.58% Earned Income $ 11,292,639 42.78% Total $ 28,524,533 Earned IncomE 40%_ ii ~~~i 1~ o ---- - - -- --- ----- o I --- --- - __ Undup licated Clients.Served i=Y2008 i ' ECI 72 35 422 62 61 9 ~I MH Adult 234 40 917 14 196 1,06 23 ' ~ , ~ MH Child 31 13 152 2 42 24 ~ 4 '. ' COOMMI 52 4 ubstance 9 2 2 91 ~ 1 1 buse I 'MR 14 3 111 45 160! 1 '~ otal 360 93 1,656. 16 436 2,127 39 1 - - -. ~ '~ ,~ ECI 162 14 10 45 15 173 , 9 MH Adult 998 80 43 219 38 470 24 MH Child 116 18 4 37 5 138' 3 '' TCOOMMI 62 ~~~ ~~~~ Substance 94 2 2 1 ~! Abuse ~ ~~ MR 72 3 11 40 2 63 ~ 2I, ~. Total 1,504 117 68 341 60 846 39 - - • ~' , ECI 13 7 2 ,846 MH Adult 45 16 18 352 432 146 5,581 MH Child 5 1 4 61 107 23 1,051 '~ TCOOMMI 2 45 36 1 241 ; i ~~ Substance 3 2 24 242 Abuse MR 5 1 1 89 110 10 761 I +: Total 70 18 23 647 687 216 9722 I , Peer Support for Recovery: A Compliment to Community Center Services "Peer support offers a unique learning opportunity for individuals who are motivated to establish and main- ;; taro their recovery and highest level of wellness living. Peer Support empowers individuals. It enables '~, people to develop the skills and willingness to set and accomplish real life goals and to establish and maintain recover from their illness. ', During a recent survey of a Peer Support Group at Hill Country, individuals noted the following positive aspects of their group: Feel like part of family and need to see them Couldn't talk to people prior to group Blessing to feel accepted in group Gives chance to get out of house This group has brought me out of house and now I do volunteer work and attend classes. ', "At Hill Country, we currently operate 8 Peer Support Groups, including a Depression and Bipolar Support Group and a Dual Disorder Support Group (mental health and substance addict~~on)" said Phyllis Guderian, ', Mental Health Director. "Each group is led by a facilitator that has received training regarding diagnosis, '~ medication, and wellness education tools. By providing training for Peer Facilitators, a continuity of ser- vice is established between clinic services and the Peer Support groups." Mrs. Guderian also noted that one '~; of the driving factors that helped Peer Support become an integral part of Hill Country's services is the ', commitment of the entire agency, from the Chief Executive Officer to the direct service worker, in under- ', standing the importance and need for Peer Support. Mrs. Werlein, Hill Country's Chief Executive Officer said, "Peer Support utilizes the most valuable re- ', source available, individuals who have recovered or are recovering from their illness. There is no substi- ?~ tute for the experience they have in dealing with their illness." '; As one of the Peer Support facilitators noted, through Peer Support, she can empower others with the tools that enable them to recover. "I work with people to help them build on their strengths and to learn signs and symptoms that occur prior to a crisis episode so they can reach out for help instead of going into cri- sis." I "That's what is all about," Werlein said, "people helping people lead productive and meaningful lives. ~; People helping each other recognize and overcome the symptoms of their illness as they recover." Hill Country Community MHPVIR Center Awarded $463,831 for Crisis Stabilization Unit 0 The Texas Department of State Health Services (DSHS) announced it is awarding $25 million in new ~~~ funding to 17 local mental health centers for community-based crisis mental. health services. Hill Country Community MHMR Center, headquartered in Kerrville, has been awarded $463,831 toward the operation ! `~ I' of a 16 bed Crisis Stabilization Unit. The money comes from an $82 million two-year appropriation from ~~~~,~~ ~ ~~,~ the Texas Legislature to improve how public mental health crisis services are provided statewide. ~~,' ~ ~~, "We appreciate the Legislature's commitment to developing a more effective response system for Texans ~'~~ ~~ dealing with mental health crises," said Dr. David Lakey, DSHS commissioner. "the additional money '~ = ', will help people get the best possible care in the best possible setting." A total of $21.4 million is being ~~ awarded to 14 community mental health centers for two-year projects that will establish or enhance psy- chiatric emergency service centers or for other facilities that provide alternatives to sending mentally ill patients to hospitals or jails if they can be treated efficiently in more appropriate settings. In regards to ', the $463,831 awarded to Hill Country, Representative Harvey Hilderbran stated, "I am excited about the I ` !, opportunity this funding in conjunction with HB 654 provides for our local community and I look forward ~` to the opening of the Crisis Stabilization Unit to be located in Kerrville." ', Mrs. Werlein, Chief Executive Officer of Hill Country, noted, "This is the culmination of five years of ', ~~ ', hard work by Representative Hilderbran, Hill Country, and local citizens. Representative Hilderbran ~', i fought long and hard to briing the Crisis Stabilization Unit, a new program, to our community. The Crisis Stabilization Unit to be operated by Hill Country will help ensure that civil psychiatric bed capacity re- mains available in our local community. This project would not have been successful without Represen- ', ', tative Hilderbran's backing and support and we are extremely grateful to him." The funding is part of an overall effort to increase access to crisis response services, reduce the need. for ', hospitalizations and provide alternatives to incarceration for those in mental health crises. Crises may in- ', dude situations in which people are, or believe they are, suicidal, a danger to others or having significant ~, deterioration due to a mental condition. Of the $82 million appropriation, DSHS also provided $21 million last fall to 38 local mental health cen- tors to help pay for the first year of crisis hotline improvements, mobile outreach units and other mental health crisis services. That money also is being used to develop additional crisis services, such as walk-in services, children's outpatiient services or residential services, or to pay for specially trained mental health ~~i~' ~j law enforcement officers. DSHS will provide $35 million next fiscal year for continuation of these local services. Of these funds, Hill Country Community MHMR Center received $310,809 last fall for the cur- '~, '' ''~, rent year and will receive `.63'70,809 next fall for crisis services. The Hill Country Crisis Stabilization Unit (CSU) is anticipated to open in April of 2009 and will provide 16 beds for individuals needing inpatient psychiatric services. The a-ddition of a Crisis Stabilization Unit I '~ in Kerrville, providing psychiatric, nursing, psychiatric rehabilitation, psychology and social work ser- '~~ vices, would allow the individuals to be served in an inpatient setting closer to their home community, assisting them to reach their individual outcomes as well as assuring continuity of services with the com- '~ I, munity mental health syste;m, and establishing an integrated model of psychiatric care in a rural setting. ~I. i ~ --- --- ---------- ------- --------- ~' In addition, offering a local community setting for inpatient psychiatric services helps incorporate the family .and community support in the individual's recovery, thus helping expedite their recovery process. '~ I 1 Mrs. Werlein, CEO of Hill Country, notes "The opening of the Hill Country Crisis Stabilization Unit will l be the culmination of five years of blood sweet and tears. It will serve as a model of not only a full con- tinuum of integrated mental health services provided in the local community, but of how the partnership ', of the state, local government entities, and private foundations and citizens can come together to serve I~ those most in need. While the opening of the unit will be a bright and glorious day, the impact the CSU ~! will make on the lives of the people we serve, will shine brighter and longer each and everyday in our lo- '~ !cal community." Floor Plan for Hill Country Crisis Stabilization Unit L ® o o ~- ~~ __ ,;- ~ ~ j 3 i i Y , ~f i -f' 'N ~~ • ~ i I i ~. __ L ___..: __ td 2.x._7 rf. ___ _- I ~ ___~ '. i _ ; ., , ,~ -ii ` ~ _ ~: ~~ ~" ::_ i~_ ,.. _ _ 15 E~ ~;; ; =- ,~ ,: Hill Country Consumers Bring The Spirit of Christmas to Loca I Citizens ~-: O t? i ~; . . .~ ~~ an Marcos -The consumers at the Scheib Opportunity Center in San Marcos truly know what makes the' ~ ~i pirit of Christmas come alive. Christmas caroling makes their holiday and everyone else that sees their erformance. In 2006, we began thinking about the idea of having Christmas carolers to help with commu- ication, self-esteem and community involvement of our consumers. Everyone knows the words to the ~~; :' ~ngs of the holiday, so why not tr}~ it? ~'~ IIIn October, we announced the opportunity ,' ~ Ito audition for caroler spots. Everyone, and ~, !I mean everyone, was going to have the ~, (chance to audition. For the entire first part of the month as you walked through the cen- ~~ter, you heard nothing but people practicing ~' ~~~ (the song they going to perform for their 'audition. It was Christmas in October. The ',auditions took three days. It was a sight to ',,behold and hear. It did not matter if you `' ':were non-verbal. If you could hum the ~„ ~~song, do gestures or just rock to the music, ''you received a chance to audition. The staff, then used a point system of 1 to 5, ~~°~. ',with 5 being the best, to determine who would be participate in the caroling group. ~_ ~_ .Everyone did extremely well at the auditions and no one received a low score. The points were tallied and ~ , '~, ;the moment they had all been waiting for arrived. T'he names were posted and the announcement was made '~, ',for them to go and see if they were named to the carolers. "Look out! !" They flocked around and searched ' ~I ithe list. The thrill and excitement was evident for those who were chosen. Even those who were not cho- . ~ ''~, sen maintained a positive attitude and said "maybe next year." In November, we began practicing. Practio ', ing everyday! ! We lined up shows for Monday and Wednesday evenings for people in the community. I ; I ;Everyone said "They rocked!!" They sang their hearts and souls out for every performance. They were ~, thrilled to share their talents with others. Even when they were tired, they never complained. The joy they ~~_ ' ~ ~~,experienced by sharing the holiday spirit carried them through and warmed their hearts. When the "tour'' ~ I ;was up, they were not sad because they were already looking forward to the next year which they knew', ~~ ~~would even be better. They were so right! ! We are now in our third year of performances and our "tour" grows every year. In 2007 we had an out standing year, but again at the end of the season they just wanted more for the next year. The year of 2008 'was magnificent! ! ! We did a total of nineteen shows in a three week period. Wow! ! ! We did three shows !, ~. '~ '' ~"on the road" in New Braunfels, Lockhart and Kerrville. They love going on the road. The recognition ~j ~I ~~they enjoyed the most was when they opened for the San Marcos City Council meeting. They led the , ;~ I 'Pledge of Allegiance and sang "We Wish You a Merry Christmas." They received a standing ovation, but ~ (for them, the best part was that they appeared on TV. Now, in their mind, they are stars. They have always j j ';been bright shining stars to us, and as a center we truly do shoot for the. stars in everything we do. _.,. .._ ~, ~..,.~ ,,., , ~ .,,.., . ~,-< , r~ _ _ _ _ - _ , , ~ ~ ~ HILL COUNTRY COMMUNITY MHMR CENTER Linda J. Werlein Isxecutivc Director 819 Watcr Strect, Suite 300 Kerrville, TX 78028 830-7)2-3300 work 830-377-313) cell Fax 830-89~-4330 E-mail Iwerlein(a?hillcountry~