Crisis services are required core services
IAC 331.397
Chapter 24
The Need for Crisis Services in
Iowa
• 25% of Iowans will have a diagnosable mental illness over the course of a year
• 6% of the population has a serious mental illness
• Suicide is the second leading cause of death for Iowa 15 to 24 year olds, and 25 to
44 year olds.
• Over an 8 years period of time 1,568 people committed suicide in rural counties
of Iowa, versus 1,382 in the state’s urban parts.
Community Participation in Development of Crisis
Plan
 Met 3 times with community
 Met 3 times with providers
 Met with the Regional Advisory Committee
 Three Regional Governing Board members participated in planning
Crisis Services Defined in the Code
1. Crisis screening
2. Assessment requirements
Already have in region
3. Twenty-three-hour crisis observation and holding
4.
5.
6.
7.
Wait to see if data
demonstrates a need
Twenty-four-hour crisis line
24 hour crisis response
Crisis stabilization residential/community based services
Mobile Crisis response
8. Warm line
New Service
Already have.
Need to expand
region wide
24 Hour Crisis Line and Warm Line
24 hour crisis line
• 24 hours per day.
• screened and counseled
• refer to the mobile crisis unit, other resources, or services if needed.
Warm line Peer response
• Short term
• Non directive support to assist the caller
Mobile Crisis Response. (Expansion)
Training will be provided using a nationally accredited model so the
same service is provided throughout the region.
How does it work?
1. A call comes in.
2. Dispatch will send provider to the scene.
Washington County Pilot
23 people received crisis services
2 went to the hospital
1 went to a detox facility
87% were diverted from the
hospital
3. Assessment will be completed to determine level of care needed.
4. Person will be stabilized at home, transferred to a crisis bed or
transported to the hospital.
Crisis Stabilization Services Residential and
Community (Expansion)
Residential short term beds:
• Goal is to stabilize the individual and return them to the community
• Stay up to five days.
• set up a place to live if needed,
• set up with community support services
• set up with psychiatrist and medications
Community:
• Goal is to stabilize the individual in their home.
• Services set up including but not limited to psychiatric, medication,
counseling, peer support and linkage to ongoing services.
Start with 4 beds with the ability to expand to 8 for the region if needed.
Warm
line
Crisis
Line
Mobile Crisis
Dispatch
Mobile Crisis staff goes to a location anywhere in the region and does the assessment
Outcome 1
Resolve the Crisis $
Outcome 2
Crisis Bed or stabilize in
home
place $$
Outcome 3
Hospitalization $$$
Crisis
Line
This is how most of
the region looks
today.
In a crisis situation
there is nowhere to
go except to the
most expensive
service(s).
Outcome 3
Hospitalization $$$
2014 regional costs following
hospitalization
$11,719,894.
Additional Costs to Expand Crisis Services
Service
Cost for
FY 2015
Warm Line
$30,880
Chat and Text
$107,354
Hotline
$130,511
Mobile Crisis
Coordination
$83,089
Mobile Crisis Service
$157,175
Crisis Stabilization
3 additional beds
$246,375
Total
$755,384
information and
education
service coordination
personal and
environmental support
general admin
crisis
Sustainability:
1. Decrease commitment and long term care costs.
Use the savings that comes from diversion to fund future crisis services.
10% diversion = $1,171,989.00 savings which pays for the service.
2. Medicaid will eventually fund part of the costs.
3. If necessary, drop the service. No current clients and no provider expansion.
prevention