* The Rural East Texas Health Network

Who we are:

Anne Bondesen Project Director for the Rural East Texas Health Network

David Cozadd Director of Operations for the Burke Center

*The region we represent:Add map of area

* The lay of the land:12 Counties11,000 square milesPopulation - 370,000Rural communities (money & transportation issues)

Our local region, larger than 5 states*

Challenges

* Contributing challenges:

Funding cuts Limited healthcare resourcesRising costsGreater than 20% uninsuredSystem at capacity

*Shortage of Resources:Medically and Psychiatrically underserved areaHealth Care Professional ShortageMental Health Care Professional shortageNo other comprehensive providersLost inpatient beds locally and state-wideNo forensic psych beds available

* Burden placed on Hospitals and Law Enforcement

Long distances to resourcesHurricanes Katrina & Rita20% increase in hospitalizationsPsychiatric beds stay fullOverflow to hospitals and jailsHeavy workload on hospitals & law enforcement departmentsFrustrated and outraged

Nacogdoches, TX to Louisville, KY = 818 miles

An estimated travel time = 13 hours 36 minutes

Nacogdoches, TX to El Paso, TX = 820 miles

Estimated Driving Time = 13 hours 48 minutes*

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Addressing the Problem

* The Rural East Texas Health Network Created in 2006 through a federal HRSA Network Planning GrantIn 2007, received Mental Health Transformation grant through the Texas Health Institute.In 2008, received HRSA Network Development Grant

* Purpose of the RETHN:Line of communication between stakeholders

Line of communication between community and mental health provider

Educate community on issues and needs

Create a united voice working towards common goals

Provide a mechanism for collaborative problems solving

** RETHN Boards Local Advisory Boards Regional Board of Directors

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In 2007, our request proposal for funds for a regional Psychiatric Emergency Service Center (PESC)

Already organized and poised for actionNeed already identified25% financial match received from communitySupport letters from stakeholdersPledge from Temple Foundation

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The Results

* PESC established:Locked Extended Observation Unit: up to 48 hour observation, assessment, and interventionUnlocked Voluntary Residential Unit: up to two weeks stayStaffing?

* PESC - What we do:Accept people for evaluation 24/7Staff will screen for appropriatenessDo a comprehensive evaluationTelemedicineBegin to work quickly to alleviate symptoms and stabilizeMove to a lesser level of care within 48 hours (higher level in limited cases)Work to return people to their homes and community

* PESC - Who we serve:Persons 18 years of age or older ANDPersons coming from any of our 12 counties ANDPersons who have a mental illness ANDPersons who are in imminent danger of harming themselves or others due to their mental illness

* PESC - What we are not:We are not a hospitalWe are not a jailWe are not a drunk tank, detox facility or alcohol/drug treatment facilityWe are not a homeless shelterWe are not an Alzheimer or dementia treatment facility

* PESC implementation:Protocols and Procedures were createdTrainings were held across the regionOpened on December 8, 2008Opened in temporary location in Nacogdoches

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* New PESC in Lufkin:

Outcomes: Have admitted over 2,000 clients since opening in December 2008Reduction in time involvement by law enforcement and hospital emergency departmentsReduction in costsReduction in higher utilization of more intensive treatment resourcesLess intrusive care option for consumers

*Further progress in staying out of hospital emergency departmentsSubstance abuseContinuing adequate funding and resourcesCreating a new demand for outpatient treatmentMedication and transportation needsForensics

Continuing Challenges:

** Other projects: Telemedicine/conferencingWeb-site for RETHNPatient Information IndexMental Health Awareness

QUESTIONS

*David Cozadd: (936) 639-1141; davidc@burke-center.org

Anne Bondesen: (936) 465-0357; anneb@burke-center.org

Contact Information: