7/31/2010 10:16:29 AM
Located in south central Texas, Bexar County is a densely populated urban community with a large Hispanic population. Bexar County is included in the San Antonio Metropolitan Statistical Area (MSA) and was listed in 2006 as the sixth fastest growing county in the United States by Money Magazine.
The Bexar County Community Collaborative formed in 2000 when city leaders determined the mental health system was struggling to meet consumer demands. This service shortage placed a strain on both law enforcement and emergency rooms. Law enforcement officers often had to wait an average of 12 hours for an emergency room psychological evaluation of a detainee.
In response, County Judge John Specia, Jr. convened a broad group of stakeholders to address issues and identify solutions. Together, stakeholders developed short- and long-term strategies for crisis intervention training, jail diversion programs and a crisis “triage” center. The effort, known as the Center for Health Care Services (CHCS), has a proven track record of success.
An urban community, approximately 1.6 residents live in Bexar County. The county includes San Antonio, which has a significantly large minority population. Over half (57%) of county residents are Hispanic as compared to only one third (36%) of all Texans. The median household income in Bexar County ($38,800) is just slightly lower than that of Texas ($41,600) and 17% of the county population lives below the poverty level.
Bexar County has a diversified economy anchored by financial services, defense, health care and tourism. The county's number-one attraction, the Alamo, draws nearly 3 million tourists a year. In addition, trade with Mexico and Central America and agribusiness provide economic stability to the region. Area crops include corn, hay, oats, sorghum, and fruits and vegetables.
Workforce shortage issues center around obtaining resources, recruiting and maintaining staff.
The Bexar County Safety Net is a broad-based coalition comprised of mental health providers, law enforcement, judges, public and private hospital administrators, and youth and adult probation officers. The coalition meets on a regular basis to identify service gaps and community needs and discuss future projects. Project funding comes from Medicare and Medicaid reimbursement, public/private partnerships, grants, and in-kind contributions. CHCS total annual budget is $9 million.
Goal: To gather data from community mental health stakeholders to enable the Center for Health Care Services (CHCS) and other service providers to access to patient data in real time and improve treatment outcomes.
Plan: Data from the Center for Health Care Services, the University Hospital System, University of Texas Health Science Center at San Antonio, County Jail, Texas Department of State Health Services, and other community organizations will be stored in a secure, web-accessible warehouse and will be accessible by multiple sources.
CHCS will use the data to improve performance and treatment through 1) cost-benefit analyses and 2) clinical outcome assessments
.Consumer Involvement. Consumers will act in an advisory role during the development phase of the data warehouse system, consulting on issues such as consumer needs and privacy issues.
The Bexar County program will be included in a six-year, cost-benefit analysis, and identification of best practices in jail diversion programs. The report traces costs per event, start-up costs, and successful practices in Bexar County and other national communities.
Bexar County Safety Net has a proven track record of success working with community stakeholders to improve mental health and substance abuse services in the community. The program data has demonstrated the cost effectiveness of clinic treatment. Since the Center was established in 2000, the average wait time for a police officer to obtain a psychological evaluation for a detainee has dropped from approximately 12 hours to 20 minutes. The center has 23 observation beds and treats 500-600 consumers each month. The facility also has pharmacy services available on-site which enables staff to discharge consumers with medicines to support recovery.
Achieving the vision of a transformed Texas mental health system will take collaboration, innovation, and hard work. Each of the eight communities will collaborate with state partner agencies (TWG members), community stakeholders and consumers, and one another to craft solutions to their specific workforce and service challenges. On the path to transformation, these community collaboratives will learn lessons they will be able to share with other Texas communities seeking to transform their own mental health systems.
Leon Evans, President/CEO
Center for Health Care Services
3031 IH 10 West
San Antonio, TX
78201
levans@chcs.hhscn.org
210.731.1300