Efforts to Address Mental Illness, Substance Abuse and Homelessness: A One Stop Approach. July 22, 2010.

2. The Problem

3. The Crisis Care Center The Restoration Center Haven for Hope Homeless Campus The Purpose The Service The Value 1 2 3

4. Show me the DATA !!!

6. San Diego 529 high utilizers ran up a cost of $18 million dollars (2000-2003) including: $4 million for Emergency, Police, and Court $14 million for medical, ICU and surgery Impact San Diego SIP, Annals of Emergency Medicine, Vol 47, No.4:April 2006 15 chronic homeless inebriates (in eighteen months) cost $1.5 million The New Yorker Magazine, Million Dollar Murray, Issue 2006-02-13 and 20, 2006

7. The Case of Million Dollar Murray MILLION-DOLLAR MURRAY by MALCOLM GLADWELL The New Yorker Magazine, Issue of 2006-02-13 and 20, Posted 2006-02-06 News Release Emergency Departments See Dramatic Increase in People with Mental Illness Seeking Care Emergency Physicians Cite State Health Care Budget Cuts at Root of Problem American Psychiatric Association Hillarie Turner, 703-907-8536 June 2, 2004 hturner@psych.org Release No. 04-30 Sharon Reis 202-745-5103 Cost “ in one study, it had been concluded that one homeless person can cost the City and County about $200,000 in one year”. Philip F. Mangano, Executive Director of the United States Interagency Council on Homelessness (USICH), May 1, 2007. “ It cost us one million dollars not to do something about Murray,”

8. The Problem gets worse: Poor and or reduced funding Scant, limited and rationed services Reduction of State Hospital treatment beds The Problem

13. Total = 991 Total = 8,758 Crisis Care Center Data April 16, 2008 – March 31, 2009

15. Emergency Room utilization has dropped 40% since the inception of the Crisis Care Center. 40% of (7619 total seen at CCC) 3048 Persons diverted from the ER (in 2006 first year) X $1545 Cost Savings relative to ER Utilization $4,709,160 Source: Jean R. Setzer, Ph.D., University Health System Emergency Room Utilization (Medical Clearance) What Works

23. July 2010 Update

24. July 2010 Update

25. July 2010 Update

26. Combined CCC and Restoration Documented and Immediate Cost Avoidance $6,668,693 $5,174,599 $1,494,094 Total $385,522 $385,522 K. 0 Reduction in Jail Time for Competency Restoration on Bond and on Return $137,898 $137,898 J. 0 Reduction in Wait Time in Jail for Outpatient Competence/Wait Time for Restoration compared to Inpatient $255,055 $255,055 I. 0 Reduction in Competency Restoration Wait Time in Jail for Hosp Admission 5/08-3/09 $579,509 $371,350 H. $208,159 G. Mentally Ill Diverted from Magistration Facility $1,096,500 $774,000 F. $322,500 E. Mentally Ill Diverted from UHS ER Cost $1,795,200 $1,267,200 D. $528,000 C. Injured Prisoner Diverted from UHS ER $2,419,009 $1,983,574 B. $435,435 A. Public Inebriates Diverted from Detention Facility Direct Cost Avoidance Bexar County City of San Antonio Cost Category

27. Centralized Services Sites Crisis Center Restoration Center

31. Haven for Hope Campus http://havenforhope.org

32. Report run date: 7/20/2010 Haven For Hope Daily Counts Report 7-20-2010 109 2 Women 350 1 Men Total Today Campus Intakes 166 0 Children 116 0 Adults Total Today Family 741 3 Total Campus Intakes 1098 5 Total PCY Intakes Total Today PCY Intakes 1839 8 PCY+Campus Intakes 106 2 Women 294 3 Men Total Today Current Residents 138 0 Children 113 0 Adults Total Today Family

33. For additional information online Copies of this presentation and additional data on diversion initiatives can be found at: http://diversioninitiatives.net

34. The Center for Health Care Services Leon Evans, President/CEO The Center for Health Care Services Mental Health Authority www.chcsbc.org [email_address]