for Chatham County

A 24-hour behavioral health crisis center

5.3

Packet Pg. 14

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

 5.3

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Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

 5.3

Chatham Community Blueprint

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

1.3. Health
1.3.1. Vision: Chatham County has a culture of health including equal
access to quality and affordable healthcare, chronic disease prevention,
health inclusive policies and environmental design
1.3.2.1. Goal 1: Effectively address mental health by educating the public,
reducing stigma, increasing early prevention programs, removing gaps
and barriers, and increasing access to treatment particularly as it impacts
incarcerated individuals, children, and adolescents.
1.3.2.1.2 Strategy 2: Increase access to crisis services and increase
capacity of service providers to provide for those who lack resources.

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 5.3

Chatham Community Blueprint

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

1.4. Quality of Life
1.4.1. Vision: Chatham County citizens achieve a superior quality of life
within a safe, active and healthy environment inclusive of the areas
history, natural resources, public mobility and efficient government.
1.4.2.3. Goal 3: Develop local and regional collaboration among similar
organizations to improve the delivery of social services and to expand the
continuum of services
1.4.2.3.1. Strategy 1: Provide additional resources for the mentally ill
through a continuum of care facility rather than jail.

Packet Pg. 17
 5.3

Breaking the Cycle

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

Breaking the Cycle
Counties move to divert mentally ill from jail

County News: Hot Topics

National Association of Counties, May 1, 2017

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 5.3

Providing treatment for mental health crises:

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

A 24 hour
7 days a week
365 days a year
mental health crisis center

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 5.3

Packet Pg. 20

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

 5.3

What does a Behavioral Crisis Center Do?

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

Diverts people with mental illness from the hospital emergency room
Intercepts non-violent misdemeanor mentally ill offenders from jail

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 5.3

Behavioral Health Crisis Center BHCC

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

A Behavioral Health Crisis Center (BHCC) is a 24 hour crisis center contracted by the
Georgia Department of Behavioral Health and Developmental.
BHCCs were established by the General Assembly and are overseen by DBHDD.
They have the capacity to accept individuals in psychiatric crisis who present for
screening, assessment and evaluation by the appropriate practitioner.
They can make referrals to the next appropriate behavioral health level of care.
(Blueprint strategies: 1.3.2.1.3 and 1.4.2.1.1.)

A Behavioral Health Crisis Center (BHCC) provides three (3) distinct, but interrelated,
primary psychiatric crisis and substance detoxification services.
The main goal of a BHCC is avoiding unnecessary hospitalizations, and/or further
behavioral health decompensation.

Packet Pg. 22
 5.3

Behavioral Health Crisis Center

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

Three distinct primary psychiatric crisis and substance
detoxification services:

1. Walk-in crisis services center (24/7/365)

2. Temporary observation (up to 23 hours)
3. Crisis Stabilization (with an average length of stay: 5 days)

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General Comparison of CSU and BHCC
Crisis Stabilization Unit (CSU)
A residential facility with 10-30 beds
Ability to receive and evaluate if a bed is available
Access to Doctors who round daily
Staffed with nurses and Behavioral Health Tech
staff
Access to Community Pharmacy through the
Community Services Board.
5.3
Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).
Behavioral Health Crisis Center (BHCC)
Three distinct components
Crisis Services Center
MH urgent care center
Staffed 24/7 with Licensed MH professionals and Peer Staff
Access to a MD/APRN and nurse on site
Can provide support, counseling, triage and/or provide a Rx
Goal of treatment and diversion to the community outpatient system, but with access
to safe and secure triage rooms to assist with admission to inpatient if needed
Temporary Observation
Staffed with Nurses, BH Tech, Peer Support Staff, and access to Doctor/APRN on site
Active assessment and crisis de-escalation and planning for 23 hours.
Assessments could include physician, nursing, biopsychosocial, intake for out
patient if they are not enrolled, peer plan (wrap) with the goal of transferring to
outpatient treatment if possible
Ability to transfer to inpatient beds if needed
CSU (in addition to traditional CSU abilities)
Lower Ratio of staff to individual than traditional CSUs so that higher acuity can be
managed and include Peer Specialist
Pharmacy on site with the ability to have Stat or PRN medication
Recovery focused treatment and aftercare planning and coordination reduce
recidivism
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 5.3

Behavioral Health Crisis Center

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

Three pathways into the BHCC:

1. Walk-in: self-referred or family and friend referred

2. Agency referred (used just like an emergency room)
3. Police transported

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 5.3

Advantage of a BHCC

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

Community Benefits:
Less costly than a psychiatric hospital stay

Increased ability to divert individuals from Emergency Departments and Jails

Local capacity for receiving and evaluating means less travel and staff time for Law
Enforcement (reduced wait time not at the ED as much)
Increased capacity of the BHCC means an average of 15 hours shorter wait time for
evaluation compared to Emergency Rooms in areas with no BHCC
Increased staffing allows for a higher volume to be assessed and triaged locally versus
waiting on an available beds elsewhere in the state
Increased staffing allows for treatment of higher acuity individuals than in current
Crisis Stabilization Units

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 5.3

Advantage of a BHCC

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

Treatment Benefits:
Continuity of care:
Individuals served are able to have a warm transfer to case management, peer programs
and outpatient treatment and supports to assist with continued recovery efforts and
decrease recidivism
CSBs who operate a BHCC have access to treatment records for enrolled individuals and can
coordinate with the outpatient staff (GRAChIE!)

Right care at the right time:

A BHCC has the option of treating and referring, temporary observation or residential
stabilization. This allows for choice based on the true need and desire of the individual
seeking assistance.

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 5.3

Opening a BHCC in Chatham County

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

Location
Convenient to the community: self-referrals, family and friend referrals
A location that reduces round trip travel for law enforcement to allow quick return to patrol

Operating Costs
Chatham County Operating Cost Investment - $700k beginning in FY 2018-19
Operating a BHCC to meet the DBHDD guidelines is a $6,300,000 annual expense
An ongoing grant by Chatham County
Balance from DBHDD

Construction Purpose built

A purpose-designed and built BHCC building is required
Two have been built recently in Georgia in partnership with private investors
Partnership for construction of a purpose built facility for the BHCC:
Lease-purchase arrangement with the Community Service Board RFP

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 Potential effect for Detention Center from the mental health 5.3

interception capability of a Behavioral Health Crisis Center

Communication: Presentation on Behavioral Health Crisis Center (Dr. Mark Johnson).

A. Scenario 1
# people # people Avg days in Decrease in
diverted diverted jail per Number of jail Daily jail Annual cost avg daily
daily annually person days saved cost savings @ $70/day census

1 365 60 21,900 $ 70 $ 1,533,000 60

2 730 60 43,800 $ 70 $ 3,066,000 120

B. Scenario 2

# people # people Avg days in Decrease in

diverted diverted jail per Number of jail Daily jail Annual cost avg daily
daily annually person days saved cost savings @ $70/day census

1 365 90 32,850 $ 70 $ 2,299,500 90

2 730 90 65,700 $ 70 $ 4,599,000 180

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