Who We Are
The Heart of Texas Region MHMR Center is made up of caring professionals who are dedicated to helping individuals and families cope with mental illness, mental retardation, developmental delays, and emotional conflict. Currently we serve over 20,000 people each year in a six-county area. Read here for more...
News and Happenings
The Impact of Mobile Crisis Outreach Team (MCOT) on our Community
by Kristy Lohr, Program DirectorSince he was 18, J. has been on the streets. He has had no support, no steady food, no place to live, and nothing to call his own. He has been in and out of jail for minor misdemeanors such as trespassing and has been hospitalized 5 times for mental illness. He is now 24 years old. He just needs someone to invest in him.
T. is living in filth. Trash covers the floor of her house that once appeared nice. Her paranoia terrifies her and keeps her locked in a world of fear. She never dares to venture out of her home. She is a prisoner of her mental illness. She needs someone to penetrate her reality.
B. is a precious middle-aged woman. She lives in a home with no electricity in the middle of winter. There are 3 dead dogs in her back yard because she lacked the cognition to know to feed them. Her illness keeps her from seeing her own needs, let alone those of the dogs'. She needs someone to care enough to help her see.
M. just got out of Austin State Hospital. For the first time in his life he believes that he does in fact have a mental illness. He wants help, but does not know where to start. Is it too late? He has criminal charges pending for things he did before he went to the hospital. He's been evicted. His world is spinning. Can someone make it stop? Is there some one to really help him?
MCOT (Mobile Crisis Outreach Team) is a new state mandated program designed to go out into the community to aid individuals in mental health crisis. We meet people where they are--in their homes, on the streets, in the hospital, or in the shelters. We build a relationship with them in order to bridge the gap into treatment. We strive to meet the physical needs of people so that they are then more inclined to trust us with their deeper needs.
MCOT serves a number of functions. First, it serves as a step-down program from psychiatric hospitalization. We aid in reintegrating and working with individuals who no longer meet the criteria for hospitalization but still need intensive support. Second, we link individuals who do not qualify for MHMR services but are in situational crisis with other community providers. Third, we are available to the community for crisis assessments when individuals will not leave their homes to come to MHMR. Fourth, we are able to aid in admitting qualified individuals into MHMR services or into the hospital.
Our overarching goal is to engage clients in treatment with MHMR or other community providers in order to reduce hospitalizations and inappropriate jail bookings. Locally, MCOT has been operating since mid-December 2007. MCOT is currently staffed by two Licensed Professional Counselors, an RN, and three caseworkers. We provide services such as crisis assessments in the community, crisis housing support, daily medication monitoring, needs assessment, and relapse prevention. MCOT has received over 65 referrals covering all 6 counties. The referrals have come from entities such as law enforcement, adult protective services, The City of Waco, DePaul, Austin State Hospital, medical facilities, and from family members. Currently we have about 15 active cases and are receiving new cases almost daily. MCOT also has an after hours and weekend capability. We are able to utilize weekend ACT Team staff to aid in following up with MCOT clients on weekends and holidays. This allows in some cases for daily medication or quicker discharge from a psychiatric facility. MCOT has trained on-call workers that are able to respond to a crisis after hours by going to a secure location or with law enforcement to a client's home for assessment.
Do you remember the clients mentioned above?
J. is now in his very own apartment. He has social security income, food stamps, a bike, and more self-esteem than ever before. He is no longer forgotten. T. is now in a group home where she is able to receive medication monitoring, a safe environment, and security. She is no longer afraid. B. has electricity, support from a caseworker, and medical care that she previously lacked. She is no longer alone. M. has an apartment, daily medication monitoring, caseworkers advocating for him, and the support to build a new relationship with his children. M.’s world now makes sense.
As the saying goes, it only takes one to change one. One program is reaching out to the community to change lives one at a time. We are forging new ground in collaborating with other social service entities. We are loving people exactly where they are, but too much to leave them there.
Network Planning Process Underway
By Lisa BradfieldHOTRMHMR is launching a two year planning process called Local Planning and Network Development (LPND). This planning effort began when the 78th Legislative Session passed HB 2292 which stated that local MHMR centers must become the "Provider of Last Resort." Originally, the Provider of Last Resort language was thought to apply to mental retardation services only, but a clarification from the State Attorney General's Office indicated that the law also applied to Local Mental Health Authorities (i.e. HOTRMHMR). As a result, a coalition of MHMR Centers, advocacy groups and state agencies worked together as a Negotiated Rule Committee to define the specific requirements of the Provider of Last Resort law. The requirements were approved in the 80th Legislative Session and signed into law by the Governor. The recommendations from the Negotiated Rule Committee became law (Section 533.035 of the Texas Health and Safety Code) and the process for implementing the law is now called Local Planning and Network Development.
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Community Living Options Information Process (CLOIP)
By Carey Amthor
After two pieces of legislation, a scathing report from the Department of Justice about conditions at Lubbock State School, and ongoing lobbying by advocates across the state, Mental Retardation Authorities were given the responsibility for implementing the Community Living Options Information Process (CLOIP) to all residents of State Schools beginning January 1, 2008. CLOIP, very simply, is providing information about available services and supports in the community so that residents, their families and guardians can make informed choices about where the greatest quality of life, for the resident, is.
This process is not new. QMRPs at the State Schools and other ICF facilities have been implementing what has been called the Living Options to residents for years. What the DOJ report states and advocates loudly claim, however, is that employed staff at these facilities have a vested interest in keeping beds full, and thus have not done a good job presenting the Living Options. The proof, say advocates, is in the fact that very few residents of State Schools are referred for community placement in any given year.
Enter the MRA, an entity that can assure an unbiased explanation of supports and services to residents, their families and/or guardians. Because Heart of Texas has a State School in its service area - Mexia State School - our contract with the Department of Aging and Disabilities Services has been amended to give us the responsibility of implementing CLOIP to the 400+ residents of the facility, and to do so on an annual basis. The expectation is that 100% of those residents will be informed when they make their choice of where they want to live, and that we will provide representation at 100% of the annual staffings to assist the individual in explaining how and why they are making their choice. We have developed a new unit, with 4 Program Specialists, a Supervisor and a Support Staff to assure that we meet those contract requirements. Click here to learn more about the MRA...
My confidence is high that our implementation of this process will be exemplary. Melinda Bonds, who you may know as a Regional MH Supervisor, but who has many years of experience in Developmental Disabilities, will supervise the unit from the Mexia office. She is very excited to run with this challenge, and also very confident that the challenge will be met successfully. Whatever the outcome, adding 400+ clients to our programs within a day certainly makes for an interesting start to the new year!
New MH Crisis Services Funded
By Tom ThomasBased on an assessment of need at the state level with input from consumer groups, hospital administrators and law enforcement entities the Department of State Health Services (DSHS) sought legislative funding for additional crisis services for individuals with mental health issues. A two-year allocation of $82 million dollars was appropriated by the legislature for this biennium. State Health Services then established a plan for implementation that included distributing these funds through the local community mental health system with input from local communities regarding their specific needs. The local community centers were then charged with developing a community crisis services plan based on standards of care established by the Department of State Health Services, Texas Legislative Budget Board and with local community input.
The State Health Services mandated that at least two best practice services be provided in each community with the option of adding additional crisis services as funding allowed. The two mandated services are a Crisis Hotline and a Mobile Crisis Outreach Team (MCOT).
Based on funding provided by the State for the first year, the HOTRMHMR Center was able to add Crisis Hotline services, a Mobile Crisis Outreach Team and Walk-in Crisis services.
Hotline
The hotline is a continuously available telephone service staffed by trained and competent crisis counselors that provides information, screening and intervention, support, and referrals to callers 24 hours per day, 7 days per week. The number is 1-866-752-3451. Or click here for full contact information including TDD.
Walk-in Crisis Services
Walk-in Crisis Services are office-based outpatient services providing immediate screening and assessment and brief, intensive interventions focused on resolving a crisis and preventing admission to a more intensive level of care. These services are provided by the adult mental health program including Admissions, Mental Health caseworkers, and the MCOT staff.
In addition to these three new services the HOTRMHMR and the local community partners will maintain our local inpatient hospital contract with Providence Hospital (DePaul) as well as our Observation Unit (DePaul). These services will provide the cornerstone of our community crisis response system as we attempt to enhance our crisis services in the future.
