Mental/Dental/Emergency Room Diversion

GOAL:  Develop a community based vision to positively impact Mental and Dental health in Marion County by identifying existing resources and supporting a balanced portfolio of projects that promote long-term success while improving short-term outcomes in the acute care arena.

MENTAL WORK GROUP:

Target Population: Identify the population segments of individuals suffering from behavioral health issues who are unable to access services in order to maintain a stable quality of life.

Population Segments:

  • Underinsured
  • Showing up in ER
  • Addictions
  • Co-occurring disorders
  • Difficulty managing daily lives
  • Law Enforcement involvement
  • Elderly/Family Support

OBJECTIVE 1:  Leverage partnerships between Community Behavioral Health Centers and FQHC to enhance the capacity to expand needed behavioral health services in Marion County

1)  Action Step 1:    Set-up meetings w/ FQHC’s

  • Date due: March 16, 2016
  • Persons Responsible:  Tim Cowart & Stephen Quintyne
  • Status:  Done

2)  Action Step 2:    Research Partnership Models prior to meeting w/ FQHC’s

  • Date due: March 16, 2016
  • Persons Responsible:  Center’s Staff
  • Status:  In process, finalizing the model

3)  Action Step 3:

  • Meeting Agenda to Discuss Partnership
  • Recruit FQHC representatives to MH Workgroup
  • Discuss partnership models to determine ways to maximize available resources for local MH Services
  • Date due:  April 8, 2016
  • Persons Responsible:  Tim Cowart & Stephen Quintyne
  • Status:  Done

4)   Action Step 4:      Develop an action for working out a partnership agreement

  • Date due: April 29, 2016
  • Persons Responsible:  Tim Cowart & Stephen Quintyne

OBJECTIVE 2:  Perform a Community Impact Study (Hospitals, Sheriff Dept., Schools, Law Enforcement) to assess the estimated costs related to the inadequacies in the system.

1)  Action Step 1:  Reach out to WellFlorida and Public Policy Institute to see if one of these agencies can do a Community Impact Study.

  • Date due: March 31, 2016
  • Person Responsible:  Cheryl Amey
  • Status:  Delayed

2)  Action Step 2:  Develop Scope of Work for study requested outcomes.

  • Date due: April 29, 2016
  • Persons Responsible:  Workgroup

OBJECTIVE 3:  Facilitate community awareness and lobbying efforts through the mental health workgroup.

  • No Action Steps at this Time – Estimated Start Time – Summer 2016

OBJECTIVE 4: Incentive Programming/Provider Recruitment- establish recommendations to attract qualified staff to the area. 

1)  Action Step 1: Schedule a meeting w/ recruiters from various health agencies to develop a list of potential incentives

  • Develop contact list of invitees.
  • Date due:  March 9, 2016
  • Determine meeting date.
  • Date due:  March 9, 2016
  • Develop an agenda.
  • Date due:  March 9, 2016
  • Send out meeting invites.
  • Persons Responsible:  Workgroup
  • Status:  No activity

2)  Action Step 2: Identify Counties similar in demographics to Marion County.

  • Date due:  March 9, 2016
  • Person Responsible – Cheryl Amey
  • Status:  No activity

3)  Action Step 3:  Research similarities and differences in mental health resources.

  • Date due:  March 31, 2016
  • Status:  No activity

4)  Action Step 4: Research best practices in recruitment nationally.  What are people looking for other than money?

  • Date due:  March 31, 2016
  • Person Responsible – Stephen Quintyne
  • Status:  No activity

5) Action Step 5: Reach out to local colleges/universities (CF, Webster, UF) regarding best practices for retaining graduates to work locally.

  • Date due:  April 29, 2016
  • Person Responsible – Stephen Quintyne

DENTAL WORK GROUP:

OBJECTIVE 1:  Conduct thorough data collection to better understand the current dental health emergency demands per day in the emergency department.

1)  Action Step 1:  Meet with Dental Subgroup to identify potential to meet goal.

  • Date due:  March 4, 2016
  • Person Responsible:  Deanna Stentiford and subgroup
  • Status:  Done

2)  Action Step 2:  Compile data from target population to identify those visiting emergency department from Hospital District and Ocala Regional Medical Facility with the following information for the past six months:

  • Did party present for one or multiple issues
  • Time of day patient presented
  • Why did the patient go to the emergency room as opposed to a dental office?
  • How many patients presented in daytime hours?
  • How many patients presented in evening hours?
  • Demographics of patients that presented
  • Was the patient documented or non-documented?
  • Date due:  March 31, 2016
  • Responsible Party:  Deanna Stentiford, Scot Quintel, metrics subgroup

3)  Action Step 3:  Analyze research to determine ways to prevent returning visits to the emergency department.

  • Date due:  April 4, 2016
  • Responsible Party:  Dental Subgroup

OBJECTIVE 2:  Create an emergency divergent plan beginning with immediate care followed up with dental referral, preventative treatment and education.

1)  Action Step 1:  Review final grant opportunities for those receiving grant money for emergency divergent plans.

  • Date due:  April 7, 2016
  • Person Responsible:  Discussion for dental subgroup

2)  Action Step 2:  Invite members of other dental providers to join dental subgroup to ensure collaboration of entities.

  • Date due:  March 4, 2016
  • Responsible Party:  Deanna Stentiford
  • Status:  Done

3)  Action Step 3:  Outline potential referral system from emergency department for emergent care and preventive services.  Analyze research to determine ways to prevent returning visits to the emergency department.

  • Date due:  April 4, 2016
  • Responsible Party:  Sherrie Lewis
  • Status:  In process, in draft form

4)  Action Step 4:  Identify local dentists who would volunteer in dental clinics after initial referral.

  • Date due:  April 4, 2016
  • Responsible Party:  Dr. Amir, Ann Burnett, Deanna Stentiford
  • Status:  In process, contacts being made

5)  Action Step 5:  Identify documentations for referral process.

  • Date due:  April 4, 2016
  • Responsible Party:  Karen Hill
  • Status:  No activity

6)  Action Step 6:  Identify educational possibilities for patients using referral system.

  • Date due:  more discussion at April 4, 2016 meeting
  • Responsible Party:  Sherry Lewis
  • Status:  In process

7)  Action Step 7:  Create metric for measuring the effectiveness of emergency referral program.

  • Date due:  May5th, 2016
  • Responsible Party:  Subgroup discussion

OBJECTIVE 3:  Investigate and develop a voucher system to assist volunteer dentists to offer treatment in their private practices.

1)  Action Step 1:  Survey of dental professionals for input for an adequate amount of a voucher to reimburse for dental supply, interest in participation, number of patients they would accept into the practices.

  • Date due:  April 7, 2016
  • Person Responsible:  Dr. Amir
  • Status:  In process

2)  Action Step 2:  Identify steps needed for verification

  • Date due:  April 4, 2016
  • Responsible Party:  Donnie Mitchell
  • Status:  No activity

3)  Action Step 3:  Create metric for measuring the rate of voucher system utilization.

  • Date due:  May5th, 2016
  • Responsible Party:  Subgroup discussion

EMERGENCY DEPT. DIVERSION GROUP:

Target Population: Identify the population segments of individuals without the ability to pay who use the emergency room and who have non-emergency needs.

Population Segments:

  • Dental: Uninsured, underinsured, no ability to pay, adults, unemployed, homeless
  • Mental: Children and adults; individuals seeking medication, undiagnosed, seeking medical clearance, seeking social interaction

OBJECTIVE 1:  Dental – Develop the ability to track individuals returning regularly for patient services.

1) Action Step 1:  Meet with officials from hospital emergency departments to learn what patient information is gathered and can be shared with Heart of Florida for intervention purposes.

  • Date due: March 31, 2016
  • Person Responsible:  Scot Quintel
  • Status:  On hold

2)  Action Step 2:  Connect emergency room officials with Heart of Florida staff that will be providing dental service referrals.

  • Date due:  April 30, 2016
  • Person Responsible: Scot Quintel/ Dental sub-group

3)  Action Step 3:  Create schedule for data sharing on returning patients between initiative partners.

  • Date due:  April 30, 2016
  • Person Responsible:  Dental sub-group

4)  Action Step 4:  Create procedure for Heart of Florida staff to engage returning individuals in dental care and connect them to a dental home.

  • Date due: April 30, 2016
  • Person Responsible:  Dental sub-group

OBJECTIVE 2:  Dental – Create awareness of new or existing dental services so patients are routed properly for services.

1) Action Step 1:  Work with the Education Work Group to develop communication methods regarding new and appropriate dental services.

  • Person Responsible:  Scot Quintel
  • Status:  Waiting for capacity to be developed.

OBJECTIVE 3:  Mental – Creation of a “mental health pharmacy” enabling patients to meet their prescription needs.

1) Action Step 1:  Utilize 2-1-1 to identify which organizations provide assistance with mental health prescriptions.

  • Date due: March 15, 2016
  • Person Responsible:  Scot Quintel
  • Status:  Done

2) Action Step 2:  Meet with organizations providing prescription assistance to understand abilities, limitations and unmet needs.

  • Date due:  March 31, 2016
  • Person Responsible:  ED Diversion sub-group
  • Status:  In process, meetings taking place

3) Action Step 3:  Work with providers to create a plan to expand services and meet gaps in needs.

  • Date due:  May 15, 2016
  • Person Responsible:  ED Diversion sub-group

OBJECTIVE 2:  Mental – Build the capacity of mental health providers to perform medical clearance requirements for their patients.

1)  Action Step 1:  Develop an understanding of requirements and what is involved for mental health facilities to be able to provide their own medical clearance.

  • Date due:  March 30, 2016
  • Person Responsible: ED Diversion sub-group
  • Status:  In process

2)  Action Step 2:  Create a list of barriers, including resources needed, for mental health facilities to meet their own medical clearance needs.

  • Date due:  March 30, 2016
  • Person Responsible:  ED Diversion sub-group, Mental Health providers
  • Status:  No activity

3)  Action Step 3:  Create a plan for mental health providers to build the capacity to perform their own medical clearance.

  • Date due:  April 30, 2016
  • Person Responsible:  ED Diversion sub-group, Mental Health providers

4)  Action Step 4:  Identify sources of resources needed to accomplish the required capacity building.

  • Date due:  June 30, 2016
  • Person Responsible:  ED Diversion sub-group, Mental Health providers, MCHA Executive Committee