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DEPARTMENT OF HUMAN SERVICES
MENTAL HEALTH SERVICES
PROGRAM MISSION: To
prevent psychiatric hospitalization and to promote mental and emotional
stability, recovery and optimum independent living of Arlington residents with
serious and persistent mental illness.
The programs in this continuum of care are described below.
-
Multidisciplinary
Team Services assist adults with serious and persistent mental illness
to assume their maximum level of functioning, minimize symptoms, reduce
frequency of hospitalizations and achieve a full life in the community. Services provided include initial and
ongoing assessment, case and care management services, specialized
psychological testing, and the prescription and monitoring of psychiatric
medication, psychosocial-educational groups, and family support and education. In addition, intra-agency services, such as
individual therapy, psychiatric medications and psychological testing are
provided to individuals served by the Aging and Disability Services Division
(Mental Retardation Bureau). Staff is
organized into two multidisciplinary teams, composed of case managers,
clinicians, psychiatrists, and residential support workers. Students from Masters and Ph.D. level
programs participate on the teams by providing direct clinical services under
the supervision of a licensed clinician.
Language specific services are available in French, Spanish and
Vietnamese. A new initiative this year
for the teams was the development of a new Young Adult Group for individuals
ages 18-25. The teams plan to expand
their work with young adults by collaborating with the Child and Family
Services Division for those individuals needing more intensive services to make
the transition from Child and Family Mental Health Services to Adult Mental
Health Services. Team clinicians work
closely with the discharge planners in the psychiatric hospitals, the Arlington
Detention Center and the Residential Program Center to ensure continuity of
services.
-
Program
of Assertive Community Treatment (PACT) Services promotes independent living in
the community for persons with the most severe and persistent mental
illness. Services are available 24
hours per day, seven days per week. A
multidisciplinary team provides outreach, intensive case management,
residential supports, substance abuse assessment and treatment, physical and
psychiatric assessments, prescriptions, monitoring of psychotropic medications,
employment assistance, crisis intervention, counseling, and linkage to
rehabilitation services. Close
collaboration with families and an array of community agencies is a hallmark of
PACT. All services are geared toward
increasing tenure in the community and stabilizing psychiatric symptoms and
improving the quality of life for identified high need, high-risk consumers.
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Clarendon House
Services is a Commission on Accreditation of Rehabilitation Facilities
(CARF)-accredited program that provides a wide range of psychosocial
rehabilitative services for adults with a serious mental illness. The Clarendon House program mission is to
promote the highest level of community integration and independence for each
participant and prevent psychiatric hospitalizations. The program focuses on helping each individual to develop the
ability to lead an independent and productive life. The program offers a work-oriented day program, outreach
services, medication services and education, supportive counseling, family
support, crisis intervention, vocational opportunities, case management and
support services. Within the Clarendon
House program there is a case management team.
The team consists of two full-time case managers and a part-time
consumer support services staff person.
This has resulted in a more integrated model of service delivery to the
members of the Clarendon House program.
The case management team provides comprehensive services, such as
assistance with housing resources, medical attention, financial entitlements,
clothing resources and numerous other services. The consumer support services staff person works very closely
with case management staff to provide intensive community based services in
order to keep those clients who are at risk of eviction, hospitalization or
otherwise having trouble maintaining stability in the community. Clarendon House continues to have an ongoing
agreement with the Northern Virginia Mental Health Institute. This agreement provides continuity of care
services for Arlingtonians who are currently in the hospital by allowing them
to attend the Clarendon House program prior to discharge.
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Employment
Services provide employment opportunities in the community for adults
experiencing a serious mental illness through an array of supportive,
comprehensive and integrated services based on individual choice. Job Avenue is a CARF-accredited program that
offers work preparation training, situational assessments, job development,
placement and training, and follow along services. Job Avenue staff also oversee enclave and individual placement
contracts with SOC Enterprises, Inc. and Mount Vernon Lee Enterprises, Inc., as
well as the Clarendon House Transitional Employment Program (TEP).
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Residential
Services promotes successful community living, fosters maximum independence
and prevents psychiatric hospitalization for adults with a serious mental
illness. Private vendors who assist in
the community stabilization process operate a continuum of services ranging
from highly intensive to supportive care.
These services include group homes; assisted living facilities, and
community alternatives for psychiatric emergencies. Crisis stabilization services provide short-term interventions
for persons experiencing acute psychiatric distress in a special
community-based setting. In addition,
transitional housing for homeless persons with serious mental illness, a
residential support program and an independent apartment program complete the
continuum of residential services. A
program goal is to increase stable residential opportunities through creative
public/private partnerships. A
cooperative agreement was established between the County and the Arlington
Partnership for Affordable Housing (APAH) to set aside three apartments for the
clients being served by the PACT Team.
This innovative program was developed using state funds and places
clients in affordable, safe, decent housing in integrated settings within the
community.
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Mental Health
Services Program Budget Summary
|
|
|
FY 2002
|
FY 2003
|
FY 2004
|
% Change:
|
|
|
Actuals
|
Adopted
|
Proposed
|
'03 to '04
|
|
Multidisciplinary
Teams
|
-
|
-
|
$1,204,391
|
-
|
|
PACT Team
|
-
|
-
|
830,929
|
-
|
|
Clarendon House
|
-
|
-
|
613,718
|
-
|
|
Employment
Services
|
-
|
-
|
231,222
|
-
|
|
Residential
Services
|
-
|
-
|
1,974,501
|
-
|
|
Total Expenditures
|
-
|
-
|
4,854,761
|
-
|
|
|
|
|
|
|
|
Revenues
|
-
|
-
|
2,879,779
|
-
|
|
Net Tax Support
|
-
|
-
|
$1,974,982
|
-
|
|
Mental Health Services
|
|
FY 2002
|
FY 2003
|
FY 2004
|
% Change:
|
|
Actuals
|
Adopted
|
Proposed
|
'03 to '04
|
|
Personnel
|
-
|
-
|
$2,661,738
|
-
|
|
Non-Personnel
|
-
|
-
|
472,515
|
-
|
|
Nonprofits
|
-
|
-
|
1,720,508
|
-
|
|
Total Expenditures
|
-
|
-
|
4,854,761
|
-
|
|
|
|
|
|
|
Fees
|
-
|
-
|
54,353
|
-
|
|
Medicaid
|
-
|
-
|
41,323
|
-
|
|
Medicare
|
-
|
-
|
2,000
|
-
|
|
Medicaid State Plan
Option
|
-
|
-
|
489,320
|
-
|
|
State Share
|
-
|
-
|
1,868,809
|
-
|
|
Federal Funds
|
-
|
-
|
20,333
|
-
|
|
LPACAP
|
-
|
-
|
373,641
|
-
|
|
Other Grants
|
-
|
-
|
30,000
|
-
|
|
Total Revenue
|
-
|
-
|
2,879,779
|
-
|
|
Net Tax Support
|
-
|
-
|
$1,974,982
|
-
|
|
|
|
|
|
|
Authorized FTEs
|
-
|
-
|
44.2
|
|
|
Funded FTEs
|
-
|
-
|
44.2
|
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PERFORMANCE MEASURES:
Multidisciplinary Team Objective: To decrease psychiatric symptoms and
improve functioning level of clients as measured by increased employment,
decreased need for psychiatric hospitalization and client satisfaction with
services.
|
FY 2001
Actual
|
FY 2002
Actual
|
FY 2003
Estimate
|
FY 2004
Estimate
|
FY 2004
Target
|
|
Mission Outcome Measures
|
|
|
|
|
|
|
Percentage of
consumers employed in any given month on average
|
N/A
|
40%
|
40%
|
40%
|
45%
|
|
Percent of
consumers hospitalized in any given month on average
|
N/A
|
1%
|
1%
|
1%
|
1%
|
|
|
|
|
|
|
|
Workload Measures
|
|
|
|
|
|
|
Total consumers
served
|
1,074
|
1,124
|
1,000
|
1,000
|
1,000
|
|
Number of consumers that
received case management services
|
655
|
691
|
600
|
600
|
600
|
|
|
|
|
|
|
|
Efficiency Measure
|
|
|
|
|
|
|
Number of days
between call for intake and the schedule for intake
|
N/A
|
7 days
|
7 days
|
7 days
|
7 days
|
|
Percent of
clients post intake, assigned to a case manager within 7 days
|
N/A
|
90%
|
90%
|
95%
|
97%
|
|
|
|
|
|
|
|
Quality/Customer
Satisfaction
|
|
|
|
|
|
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Percentage of
consumers satisfied with services received.
|
94%
|
90%
|
92%
|
92%
|
95%
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PACT Team Objective: To increase tenure in the community, improve
quality of life and foster community integration through the provision of
intensive and comprehensive services, as evidenced by 75 percent of consumers
not being hospitalized.
|
FY 2001
Actual
|
FY 2002
Actual
|
FY 2003
Estimate
|
FY 2004
Estimate
|
FY 2004
Target
|
|
Mission Outcome Measures
|
|
|
|
|
|
|
Number/percentage
of consumers employed
|
10/19%
|
8/16%
|
15/17%
|
20/25%
|
25/28%
|
|
Number/percentage
of consumers hospitalized post-admission to PACT
|
24/46%
|
25/37%
|
32/37%
|
33/37%
|
30/33%
|
|
Average length
of stay in psychiatric hospital (days)
|
18 days
|
7 days
|
7 days
|
7 days
|
6 days
|
|
Number/percentage
of consumers living in independent housing
|
45/86%
|
52/76%
|
68/80%
|
75/85%
|
77/85%
|
|
Number/percentage
of consumers in school
|
2/3%
|
5/9%
|
10/8%
|
12/15%
|
16/18%
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|
Workload Measures
|
|
|
|
|
|
|
Total consumers served
|
52
|
68
|
85
|
88
|
90
|
|
|
|
|
|
|
|
Efficiency Measure
|
|
|
|
|
|
|
Average number
of days from first contact to admission to PACT
|
15 days
|
10 days
|
7 days
|
6 days
|
6 days
|
|
|
|
|
|
|
|
Quality/Customer
Satisfaction
|
|
|
|
|
|
|
Percentage of
consumers responding to a survey who reported an increased quality of life
|
80%
|
80%
|
85%
|
88%
|
90%
|
|
|
|
|
|
|
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A high hospitalization
rate is typical of new PACT programs during the first three years of operation
as the team begins to provide services that stabilize people.
Clarendon House Objective:
To provide a comprehensive rehabilitation
program for individuals with serious mental illness in order to prevent
unnecessary psychiatric hospitalization and to assist them to gain the highest
level of independence and self-sufficiency in the community.
|
FY 2001
Actual
|
FY 2002
Actual
|
FY 2003
Estimate
|
FY 2004
Estimate
|
FY 2004
Target
|
|
Mission Outcome Measures
|
|
|
|
|
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Number and
percentage of members not hospitalized
|
105/85%
|
99/81%
|
115/88%
|
115/88%
|
126/90%
|
|
Average number
of days spent by members in psychiatric hospitals
|
33
|
31
|
20
|
20
|
20
|
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Total number
and percentage of employed members
|
44/35%
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31/25%
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60/43%
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60/43%
|
65/46%
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|
Percentage of
members who were employed and were not hospitalized
|
89%
|
94%
|
95%
|
95%
|
95%
|
|
Percentage of
members who had transitional employment and gained independent employment
|
28%
|
10%
|
30%
|
30%
|
30%
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Number and
percentage of members living independently
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50/40%
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67/55%
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70/52%
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70/52%
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75/54%
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Number and
percentage of members in college
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4/3%
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5/4%
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5/3%
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5/3%
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8/6%
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|
|
|
|
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Workload Measures
|
|
|
|
|
|
|
Total consumers
served
|
124
|
122
|
135
|
135
|
140
|
|
Number and
percentage of members receiving case management
|
107/86%
|
105/86%
|
110/81%
|
110/81%
|
115/82%
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Efficiency Measures
|
|
|
|
|
|
|
Percent of consumers who are placed in case management services within
30 days of referral
|
N/A
|
83%
|
85%
|
85%
|
85%
|
|
|
|
|
|
|
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Quality/Customer
Satisfaction
|
|
|
|
|
|
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Percent of
members responding to a survey who indicated that they were satisfied with
Clarendon house services
|
78%
|
78%
|
80%
|
85%
|
90%
|
|
Percent of
members responding to a survey who believe that the Clarendon House services
have prevented hospitalization
|
71%
|
85%
|
85%
|
85%
|
85%
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The Employment Services (Job
Avenue) Objective: To provide
successful employment opportunities in the community for adults experiencing a
serious mental illness through an array of supportive, comprehensive, and
integrated services based upon individual choice.
|
FY 2001
Actual
|
FY 2002
Actual
|
FY 2003
Estimate
|
FY 2004
Estimate
|
FY 2004
Target
|
|
Mission Outcome Measures
|
|
|
|
|
|
|
Number/percent
of all consumers served who obtained employment in the community
|
22/28%
|
24/30%
|
28/33%
|
28/33%
|
32/35%
|
|
Number of
consumers who were employed and hospitalized
|
1
|
2
|
2
|
2
|
2
|
|
Percentage of
consumers placed in employment within 90 days after receiving authorization
from DRS or goal establishment by consumer
|
N/A
|
40%
|
80%
|
80%
|
80%
|
|
Percentage of
consumers who remain employed 90 days post discharge
|
N/A
|
N/A
|
85%
|
85%
|
85%
|
|
|
|
|
|
|
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Workload Measures
|
|
|
|
|
|
|
Total number of
consumers served
|
79
|
79
|
85
|
85
|
90
|
|
Total number of SOC consumers
served
|
10
|
10
|
10
|
10
|
10
|
|
|
|
|
|
|
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Efficiency Measure
|
|
|
|
|
|
|
Percentage of
consumers who are scheduled for an intake evaluation within 45 days of
receiving a completed referral
|
N/A
|
85%
|
85%
|
85%
|
85%
|
|
|
|
|
|
|
|
Quality/Customer Satisfaction
|
|
|
|
|
|
|
Percentage of
consumers stating that they are satisfied with Job Avenue services
|
95%
|
95%
|
95%
|
95%
|
95%
|
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According
to Anthony, Howell and Denley in the American Psychologist journal, 15% of
people with serious mental illness are employed nationally.
Residential Services Objective: To assure community tenure (the absence of
psychiatric hospitalizations) and increase integration into the community for
95 percent of clients served in residential programs.
|
FY 2001
Actual
|
FY 2002
Actual
|
FY 2003
Estimate
|
FY 2004
Estimate
|
FY 2004
Target
|
|
Mission
Outcome Measures
|
|
|
|
|
|
|
Number/percent
of consumers who live in contractor group home or assisted living facility
who moved to a more independent living arrangement
|
4/11%
|
7/21%
|
10/26%
|
12/30%
|
12/30%
|
|
Number/percent
of consumers in contractor Community Living Program Services who maintain a
stable living situation
|
49/94%
|
49/96%
|
49/98%
|
54/98%
|
59/98%
|
|
Number/percent
of consumers in contractor homeless case management services who move to a
non-homeless status
|
50/72%
|
50/36%
|
70/52%
|
70/53%
|
99/72%
|
|
|
|
|
|
|
|
Workload Measures
|
|
|
|
|
|
|
Total
consumers served by:
|
|
|
|
|
|
|
Group homes
and assisted living facilities
|
39
|
33
|
41
|
40
|
40
|
|
Care (crisis
residence)
|
47
|
49
|
50
|
50
|
50
|
|
Contracted
Homeless case management
|
70
|
136
|
136
|
136
|
136
|
|
Community
living program
|
52
|
51
|
50
|
55
|
60
|
|
Transitional
housing
|
16
|
16
|
16
|
16
|
16
|
|
Project Hope
Apartments (APAH)
|
N/A
|
4
|
4
|
4
|
4
|
|
|
|
|
|
|
|
Quality/Consumer Satisfaction
|
|
|
|
|
|
|
Percentage of
consumers who report increased satisfaction in quality of life
|
94%
|
92%
|
95%
|
95%
|
95%
|
|
|
|
|
|
|
|
Efficiency
Measure
|
|
|
|
|
|
|
Percentage
of incident reports receiving appropriate response within 24 hours
|
N/A
|
89%
|
90%
|
95%
|
100%
|
|
