Collaborating to Increase Access  to Critical Care: Expansion of Extended Observation Unit March 19, 2019 Crisis  Respite Unit Transitional Housing Community  Services Residential (Ambulatory)  Detox Extended Observation  Unit Local  Psychiatric Hospital State  Hospital Extended Observation Unit – Collaboration BTCS EOU  Moves to GBHI 1 3 April 2017 EOU  Established BTCS awarded state funding  through HHSC to develop a  4‐bed Extended Observation  Unit at San Gabriel Crisis  Center ‐ Georgetown May 2018 September 2018 2 Renovation of 12‐Bed EOU  at GBHI completed and  fully staffed April 2018 September 2018 EOU Expansion  Initiated HB13 Funding  Application The legislative is developed  supporting an increased  number of EOU beds at  GBHI‐‐moving from 4 to 12  beds EOU Expansion  Completed 5 Commissioners approve  support  for HB 13 Application with  required local match– committing funding of  $42,750/month ($513,000/year) Professional shortage of RNs  and Psychiatrists leads to  collaboration between BTCS  and GBHI December 2015 Williamson County  Commits Local Match  Funding 4 To move forward with  expansion, EOU beds at  GBHI expand to 6 – awaiting  renovation of 12‐bed unit 6 Note:  Current funding agreement with Williamson County ends on September 30, 2019 Extended Observation Unit:   Admissions by County of Residence 3% 3% 2% 1% 0% 4% 4% 8% 12% 63% Williamson County ‐ 183 Bastrop County ‐ 34 Burnet County ‐ 22 Travis County ‐ 12 Other Counties ‐ 12 Lee County ‐ 9 Fayette County ‐ 8 Gonzales County ‐ 7 Guadalupe County ‐ 4 Caldwell County ‐ 1 Extended Observation Unit:  Referral Source 1% 1% 1% Emergency Room ‐ 146 20% BTCS Crisis Team ‐ 80 GBHI ‐ 58 50% Crisis Intervention Team ‐ 3 27% Other: CTTC ‐ 3 Mobile Outreach Team ‐ 2 Extended Observation Unit:                 Referring Emergency Rooms  (Williamson County Only) 2% St. David's Round Rock ‐ 27 9% 10% 28% Cedar Park RMC ‐ 25 Seton Williamson ‐ 24 St. David's Georgetown ‐ 10 Scott and White ‐ Round Rock ‐ 9 25% 26% Scott and White ‐ Taylor ‐ 2 Extended Observation Unit:                Referring Emergency Rooms                    (Non‐Wilco) 2% 6% St David’s ‐ Bastrop ‐ 15 4% Seton NW ‐ Travis ‐ 7 31% 8% Seton Highland Lakes ‐ Burnet ‐ 7 St. David’s ‐ Travis ‐ 5 Scott and White ‐ Burnet ‐ 5 10% Guadalupe RMC ‐ Guadalupe ‐ 4 St. Marks  ‐ Fayette ‐ 3 10% 15% 14% Dell Seton ‐ Travis ‐ 2 St. David’s ‐ La Grange ‐ 1 Extended Observation Unit:  Discharge Location 1% 0% 0% 2% 2% Home ‐ 215 CRU ‐ 63 21% PPB Higher Level of Care ‐ 5 SUD Treatment Centers ( 2 CTTC) ‐ 5 PES ‐ Integral Care ‐ 2 Jail ‐ 1 74% Shelter ‐ 1 Extended Observation Unit:  Length of Stay in Days by Month September 2018 – February 2019 4.98 4.88 4.57 4.56 4.42 4.41 September October November December January February Extended Observation Unit:  Length of Stay by Number of People September 2018 – February 2019 9+ Days 7‐8 Day 5‐6 Days 28 people 24 people 68 people 108 people 3‐4 Days 1‐2 Days 64 people Cost to Provide Wilco Residents  EOU Beds  $2,000,000 March 1, 2018 – February 28, 2019 Cumulative $1,800,000 Monthly $1,600,000 $1,400,000 DOLLARS $1,200,000 $1,000,000 $1,632,810 $1,473,283 $1,313,886 $800,000 $1,152,508 $1,008,617 $600,000 $860,459 $718,583 $400,000 $476,994 $581,994 $370,322 $200,000 $82,755 $0 $82,755 $171,311 $88,556 $264,687 $93,376 $161,378 $159,397 $159,527 $105,635 $106,672 $105,000 $136,589 $141,876 $148,158 $143,891 $2,500,000 Cost to Provide Wilco Residents  Private Psychiatric Beds AND EOU Beds  March 1, 2019 – February 28, 2019 Cumulative Monthly $2,000,000 DOLLARS $1,500,000 $2,084,965 $1,875,444 $1,673,468 $1,000,000 $1,469,583 $1,286,985 $1,096,992 $910,217 $737,619 $500,000 $595,119 $338,437 $460,947 $203,186 $0 $186,775 $189,993 $182,598 $203,885 $201,976 $209,521 $109,181 $135,251 $122,510 $134,172 $142,500 $172,598 0 Investment in the Extended Observation Unit  March 1, 2019 – February 28, 2019 Williamson County BTCS HHSC $1,150,19 6 43% $513,000  19% $1,027,21 5 38% Total Williamson County Residents Served  in the Extended Observation Unit  and Private Psychiatric Beds  March 1, 2018 – February 28, 2019 Extended  Observation  Unit (Adults) Adults Served ‐ Private Psych Hospitals  211 672 169 1,019 Unduplicated  Number Served   Youths Served ‐ Private  Psych Hospitals With appreciation for the Support  of the Williamson County Commissioners Court  and Our Community Partners Andrea Richardson, Executive Director Andrea.Richardson@bbtrails.org Monica Ochoa, Chief Executive Officer Monica.Ochoa@georgetownbehavioral.com