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Innovation in Technology: Efficient Access to Quality
ServicesJennifer Armstrong, Director of Crisis Care Services- Centerstone of TN
Liam Barry, Director of IT Infrastructure-Centerstone of TN
Jennifer Smith, Team Lead, Northern Region Mobile Crisis- Centerstone of TN
Nation’s largest non-profit provider of community-based behavioral health services
Annually serves over 60,000 children, adolescents, adults, seniors and their families in Tennessee
Mission: To prevent and cure mental illness and addiction
Part of a national collaboration promoting the Zero Suicide Initiative
Centerstone
Crisis Center ◦ 9 local and national partners- crisis lines◦ Crisis Call Team◦ Crisis Follow-up Team (High Risk services
available across all crisis lines, BCBS grant, NSSP grant, GLS grant)
◦ Crisis Chat/Text Team- NSPL Crisis Chat, Hopeline Chat
◦ 25 masters level clinicians◦ AAS, CARF, CUSA, OES accredited◦ Team office: Nashville, TN.
Centerstone Crisis Services
Mobile Crisis Services- 3 regions across 21 counties
Crisis Management Strategies team- local and national training; critical incident response
Centerstone Crisis Services
Why?◦ 2009: Program cuts that reduced staff size from
15 to 6◦ 3600 total calls per month; crisis call services
only; 3 crisis lines managed◦ Per TDMH contract, must have 24/7 access to live
person: Centerstone Crisis Line and TN Statewide Crisis Line
◦ IT team research with current vendor (Cisco)- security, HIPAA concerns, etc..
Remote Services- Crisis Call Center
Equipment and Tools (approx. $2K per staff)• Laptop • Cisco Phone & Headset• Home Internet Connection• Cisco ASA • Battery Back-up• Private home office set up and monitored by IT
staff
Remote Services
Remote Services
Secure & Private Connection from Home to Office
Home Corporate Office
Centerstone uses a Cisco ASA – Model 5505 to secure the connection.
What is a Cisco ASA?
The Cisco ASA is a device that creates a private connection from one location to another.
• The connection (or tunnel) is secure and private• The tunnel is encrypted• Quick and easy to set up • The connection is monitored by our Network Operations center
The cost of an ASA is approximately $400.00.
What does ASA stand for?
ASA is simply a marketing term by Cisco. It’s an acronym for: Adaptive Security Appliance
Remote Services
Now what?◦ Cc-Modeler Professional Software:
Kooltoolz (www.kooltoolz.com) Workforce Management Improving Service Performace Projects needed staffing/where in meeting access
standards Utilizes call volume and staffing patterns Staffing truly by volume
Remote Services
Phase in: SLOWLY! Overnight, afterhours, then all day Daily IT correspondence; staff
communication and monitoring Shift in service:
Crisis intervention services only No I and R Afterhours functions for Centerstone of TN NSPL- relinquished regional services to
backup for TN only
Remote Services
Guidelines:
◦ Remote office must be set up in a private location in the home as assessed by IT staff.
◦ Access to an assigned Centerstone office location (all assigned sites must be within one hour of home office).
◦ Internet access provided by staff member.◦ Staff will use equipment issued and installed by
Centerstone Information Systems.◦ Must attend all clinical supervision and team meetings.
Remote Services
Emergency Back-up Plan:◦Service disruptions: Determine if back-up coverage is
warranted Utilize on-call staff Utilize back-up on-call staff as needed If outage exceeds 20 minutes,
relocation to assigned Centerstone location for completion of shift.
Remote Services
Monitoring and QA:
Remote Services:
Monitoring/QA:
Remote Services
Monitoring/QA:
Remote Services
Monitoring/QA:
Remote Services
Monitoring/QA:
Remote Services
Monitoring/QA:
Remote Services
Communication:
Remote Services
Pros◦ Right sized staffing◦ Built in emergency back-up plan◦ Staff retention◦ Same monitoring capabilities◦ Staff communication◦ Coverage nationally during disasters
Cons◦ Agent Status/Availability
Remote Services
Funded by Tennessee Department of Mental Health & TennCare (state Medicaid)
Overall contractual goal is to act as a diversionary resource to most appropriate, least restrictive setting
Response is to any location requested in 20 county catchment area
Centerstone’s Mobile Crisis
Seven county catchment area Average 250 assessments per month Response time average- 90 minutes Up to 98 miles roundtrip Average mileage per assessment- 54 miles
Mobile Crisis: The Northern Region
The beginning◦ 2012: Pilot project with HCA/TriStar and Cisco◦ Remote connection from laptop to cart placed
in ED using Movi/Jabber◦ Response time averaged 30 minutes◦ 1st six months averaged four assessments per
month Next steps
◦ 2013: Two more HCA affiliations◦ Cisco Movi/Jabber replaced with InTouch
equipment
Implementation of Televideo
Currently◦ Initial Assessment:
Emergency Department: iPad to ED cart via InTouch Centerstone O/P Clinics: iPad to iPad/laptop via Cisco 427 assessments to date Average response time to date- 27 minutes Evaluation component for client feedback
◦ Involuntary Hospitalization: 1st Certificate of Need 2nd Certificate of Need to RMHI
Implementation of Televideo
Contact Information:
◦ Jennifer Armstrong, LPC-MHSP [email protected]
◦ Liam Barry [email protected]
◦ Jennifer Smith, LMSW [email protected]
Questions?
