BEHAVIORAL HEALTH
TRANSPORT
An Update to
the 2007
EMSRB
Behavioral
Health Report
BEHAVIORAL/PSYCHIATRIC
DISORDER TRANSPORT
Why this report?
 Patients far away from home
 Law enforcement having to travel
 Ambulances having to transport and lacking reimbursement
Why now?
 Rural Health Community Forums (Sept. 2012)
 Mental health emergencies in the news
2007 EMS BEHAVIORAL HEALTH REPORT:
C H A LLE NG E S OF T RA NSPORTI NG BE H AVI ORAL H E A LT H
PAT IE NT S I N M I N N ESOTA
2007 Original Report
Community Behavioral Health
Hospitals (CBHHs)
•Newly implemented (2006)
MHA/DHS Psychiatric Bed
Tracking System
•Pilot project
Crisis Response Team
Model
•Alternative to ambulance transport
Present
Current utilization and capacity
•Status report
Expanded program
•Phases, additional providers
Covering more counties
•Governor’s Budget (2013)
Psychiatric Beds and Patients
Status of CBHHs
Mental Health Bed Tracking System
Mental Health Crisis Response
PSYCHIATRIC BEDS
2011
1,110 in-patient
psychiatric beds
500 in the nonmetro area
291 in the rural area
 (169 in 2007)
PSYCHIATRIC PATIENTS
Behavioral/Psychiatric Disorders
12.0%
10.0%
8.0%
% of all 911 emergency calls
6.0%
% of all interfacility medical
transports
4.0%
2.0%
0.0%
2006
2007
2008
2009
2010
Number of behavioral/psychiatric
disorder presentations and
transports have gone up
Psychiatric Bed Utilization
Status of CBHHs
Mental Health Bed Tracking System
Mental Health Crisis Response
COMMUNIT Y BEHAVIORAL HEALTH HOSPITALS
 10 state-operated CBHHs
 16 bed, acute mental health
inpatient treatment
 Illness management and
recover y ser vices
 Average length of stay
 CBHH: 19 days
 State hospital: 45 days
2006
COMMUNIT Y BEHAVIORAL HEALTH HOSPITALS
 Only 7 CBHHs today:
 Admitted 1,488 people in 2011
 95% of patients were from
non-metro Minnesota
 35 full-time equivalent staf f
 Operation/utilization
 Discharged in <20 days
 Persisting gap still exists
 Medical clearance required
CBHH Utilization
2011
2012
Licensed bed
capacity
69%
79%
Service capacity
84%
91%
Psychiatric Bed Utilization
Status of CBHHs
Mental Health Bed Tracking System
Mental Health Crisis Response
MENTAL HEALTH BED TRACKING SYSTEM
MHA/DHS, work
group origins
Mental health
service locator
 Inpatient
 Community based
services
Voluntary provider
participation
PSYCHIATRIC BED TRACKER
MENTAL HEALTH BED TRACKING SYSTEM
Successes
Limitations
 Keeps providers
accountable
 Currently lacks
evaluation
 Running Vermont
system
 Voluntary participation
 Contract with MHA
requires assessment
 Children’s non-acute
 Involvement with Mayo
Psychiatric Bed Utilization
Status of CBHHs
Mental Health Bed Tracking System
Mental Health Crisis Response
MENTAL HEALTH CRISIS RESPONSE
 41 providers across the
state
 Mobile and Residential
 2007: Governor’s Mental
Health Initiative
 MA funding only for face
to face
 Not for on-call/those not on
public programs
 Especially important for
Greater MN (less face-time)
MOBILE CRISIS RESPONSE TEAMS
 Are not everywhere:
 50 counties both mobile and
residential
Roseau
Kittson
Lake of
the
Woods
Marshall
 5 provide only mobile
 32 only offer residential
stabilization beds
 Mobile is proven more
effective
Adult
Mobile Mental Health
Crisis Providers
Beltrami
Red Lake
Polk
Norman
 4 new mobile crisis
response teams serving 16
additional counties and 2
tribes
5
1
Mahnomen
Cook
C
L
E
A
R
W
A
T
E
R
Itasca
Lake
St. Louis
3
2
Duluth*
Clay
Hubbard
Becker
Cass
W
A
D
E
N
A
Wilkin
Otter Tail
 2013: Governor’s budget
included $2 million
Koochiching
4
Pennington
Morrison
Todd
Grant
6
Pine
7
Mille
Lacs
K
A
N
A
B
E
C
Douglas
Benton
Traverse Stevens Pope
Stearns
Kandiyohi
Swift
Meeker
Wright
Chippewa
Lac qui
Parle
Hennepin
McLeod
10
Carver
Renville
Pipestone
Lyon
W
A
S
H
I
N
G
T
O
N
mobile teams that serve Mankato and
Duluth.
8
Scott
Sibley
9
Goodhue
Nicollet
Redwood
R
A
M
S
E
Y
Dakota
Yellow Medicine
11
Reservations in Minnesota:
1. Red Lake
2. White Earth
3. Leech Lake
4. Bois Forte/Nett Lake
5. Grand Portage
6. Fond du Lac
7. Mille Lacs
8. Shakopee Mdewakanton Sioux
9. Prairie Island
10. Upper Sioux
11. Lower Sioux
*Blue Earth County and St. Louis County have
C
H
I
S
A
G
O
Isanti
Sherburne
Anoka
Big
Stone
L
I
N
C
O
L
N
Carlton
Aitkin
Crow
Wing
Le Sueur
Rice
Wabasha
Brown
Murray
Cottonwood
Rock Nobles Jackson
Watonwan
Martin
Blue
Earth*
Waseca Steele Dodge
Olmsted Winona
Faribault Freeborn Mower
Fillmore
Houston
HOSPITALIZATION AFTER CRISIS
RESPONSE
CRISIS INTERVENTION TEAMS
 Training for law enforcement
 Police interactions with people living with mental illness
 National Alliance on Mental Illness
 Barbara Schneider Foundation
NEXT STEPS
More
beds
Decreased
transport
time?
Better way
of tracking
Better way
of
responding