DMHAS: CRMHC Overview of Services

Capitol Region Mental Health Center

Overview of Services

Capitol Region Mental Health Center (CRMHC) is a community based mental health center, operated by the Connecticut Department of Mental Health and Addiction Services, which provides an array of innovative clinical and community support services to individuals with a psychiatric disability, in many cases with  co-occurring problems of substance abuse. 

 

In addition to the  function of providing individuals with behavioral  health services, CRMHC also collaborates with the Greater Hartford DMHAS-Funded Mental Health Programs that is comprised of 15 non-profit agencies located in Hartford and West Hartford.  These agencies work together to provide a comprehensive array of behavioral health services to nearly 3300 individuals and families.

 

Capitol Region Mental Health Center and the DMHAS-Funded Mental Health Programs serve adults with serious psychiatric disabilities or the co-occurring disorders of psychiatric illness and substance use, 18 years and older who reside in Hartford (Catchment Area 23), West Hartford, Farmington, Avon, Canton and Simsbury (Catchment Are 18).

Our mission is to partner with persons in recovery to ensure access to high quality and culturally competent person-centered behavioral healthcare services


CAPITOL REGION MENTAL HEALTH CENTER
TABLE OF ORGANIZATION

CLINICAL SERVICES

Acute Services Division

  • Mobile Crisis Team/Intake/Brief Treatment 
  • Inpatient Treatment Unit
  • HOPE Team (Homeless Services and Outreach)

Forensic Services Division

  • Jail Diversion
  • ASIST
  • CORP
  • Forensic Outpatient Services

Outpatient Services Division

  • General Psychiatry Unit
  • Co-occurring Disorders Unit
  • Medication Management Team
  • Deaf/Hard of Hearing Team

Young Adult Services Division

  • Young Adult Outpatient Services  
  • Hilltop Residential Program

MANAGED SERVICES DIVISION

  • DMHAS-Funded Mental Health Services Provider Relations 
  • Housing Services/Shelter Plus Care
  • Care Management

QUALITY MANAGEMENT DIVISION

  • Health Information Management
  • Information Technology
  • Performance Improvement
  • Professional Development

CRMHC RECOVERY AND COMMUNITY INTEGRATION

  • Community Support Team
  • Peer Support Center 

DESCRIPTION OF SERVICES

CLINICAL  SERVICES DIVISION

Mobile Crisis Team/Intake/Brief Treatment   (860-297-0999)
The Mobile Crisis Team provides seven day a week psychiatric crisis services.  These services include evaluations of individuals in psychiatric crisis at the Center and in the community (individuals' homes, jails, shelters, residential programs, hospital emergency rooms, nursing homes, and in other mental health facilities.) The Mobile Crisis Team assesses the individuals' need for services, and assists in resolving the crisis. In addition, assessment services are offered during normal working hours to assist clients in obtaining services at Capitol Region Mental Health Center or to refer clients for services to other area providers. 

 

Hours of Operation: 8:00 a.m. - Midnight, seven days a week

 

Inpatient Treatment  Unit:   (860-297-0995)
The Inpatient Treatment  Unit is a is a sixteen bed inpatient care unit which operates seven days a week, 24 hours a day. The major function of the program is to provide inpatient services to people from the CRMHC service area with a focus on those who are uninsured, who cannot obtain services from other providers, and are served by CRMHC.  This program provides a broad range of services including medication management, individual and group therapy, occupational therapy, and recreational interventions.  The average length of stay in this program is about 180 days. 

 

HOPE Team (Homeless Outreach and Positive/Participatory/Proactive/Preventative Engagement). )   (860-297-0999)

The Hartford Shelter Collaborative came together in 1998 and is a cooperative venture of emergency shelters, outreach providers, and the local mental health authority in Hartford, Connecticut, to coordinate and maximize the outreach services to the homeless in this city. The ultimate goal of the collaborative is to bring clinical services directly into the shelters and onto the streets and to assertively outreach in order to improve the quality of life for those homeless populations who have remained severely treatment resistant and who continually have fallen through the cracks of traditional and often fragmented systems. The primary conduit for the implementation of this collaboration was the formation of the Homeless Services H.O.P.E. Team (Homeless Outreach and Positive/Participatory/Proactive/Preventative Engagement).

 

This team is a group of clinicians specifically trained to integrate traditional systems and services at the street level while incorporating "state of the art" techniques from ongoing research in the area of outreach and engagement of the homeless.  The team emphasizes providing non-traditional options to clinical treatment in an effort to reach the chronic, treatment resistant populations with severe mental illness and/or substance abuse problems. Indeed, the very name of the team reflects the philosophy, values and principles of the collaborative and encompasses the belief that even the most chronic and difficult populations among the homeless are far from "hopeless" when services are customized and provided in ways that meet their unique needs.

Hours of Operation:

8:00 a.m. - 8:30 p.m. Monday-Thursday
8:00 a.m. - 4:30 p.m. Friday


 

OUTPATIENT SERVICES DIVISION

CO-Occurring/General Psychiatry/Medication Management Team

Provides outpatient clinical care  care for clients who have been diagnosed with a serious mental health disorder, and may also be dually diagnosed with mental health and substance abuse disorders, have severe trauma histories, behavioral or legal issues. Each team has a  Program Director  who oversees Licensed Senior Clinicians who supervise clinical staff. Teams provide ongoing support, maintenance medication, home visits and outreach, crisis intervention and stabilization; group-based and family treatment, advocacy, and psychotherapy to clients. The team uses the Integrated Dual Diagnosis Treatment model, a stagewise treatment approach geared to the client’s readiness to accept services. We use a team approach to provide comprehensive, intensive and continuous services to clients who have been resistant to traditional forms of treatment, are unable to maintain themselves in the community without support, and tend toward high utilization of inpatient services. These are interdisciplinary teams which include psychiatrists, licensed clinicians, psychotherapists, community support specialists, and  employment specialists.

The Outpatient Division also provides the following services: 

  • Clozaril clinics for all clients of the Center
  • Decanoate clinics for all clients of the Center’
  • Management of the Center’s medication rooms and medication policies and procedures
  • Management of the laboratory services and policies
Hours of Operation:  Monday-Friday 8:00-4:30

Deaf/Hard of Hearing Team

This program offers psychiatric services, case management, group and individual therapy, and a limited amount of psychosocial programming to clients who are deaf and/or hard of hearing. This program, which operates on a statewide basis, unlike other CRMHC programs, provides an essential service to deaf consumers who have difficulty finding appropriate services in most outpatient settings. Program staff are  fluent in American Sign language.

 

Hours of Operation: Monday-Friday 8:00-4:30


 

YOUNG ADULT SERVICES/FORENSIC SERVICES DIVISION

Young Adult Services/ Outpatient Team  

The Young Adult Services Division is an intensive, voluntary treatment program that provides specialized, age and developmentally appropriate supports for young people, many of whom are transitioning out of the DCF system of care, and are diagnosed with a major mental illness. It services young adults, ages 18-25, with complex psychiatric histories including but not limited to: behavioral dyscontrol and affective dysregulation, thought disorder, anxiety and impulse control disturbances associated with a number of major mental illnesses, psychosexual behavior issues, substance use disorders, pervasive developmental disorders,  persistent post-traumatic stress disorders with significant suicidal and/or self-injurious tendencies.  Many of these individuals often have experienced trauma, including persistent and profound neglect, physical and/or sexual abuse, and as a result, many suffer from complex post-traumatic stress disorders or symptoms.. The program uses a multidisciplinary team approach that provides age appropriate, culturally sensitive services with the focus of promoting recovery and assisting with the transition to adulthood. The treatment philosophy is based upon the premise that psychiatrically challenged young adults and their families can be assisted in achieving and maintaining stability if given appropriate support, guidance, education, treatment and skills.  This process is begun with a historically informed, age and developmentally sensitive assessment, culminating in diagnosis, active treatment and the use of positive skills and strength-based development-enhancing approaches.  The active involvement of the client, the client’s family and the community in the development and operationalization of the recovery oriented treatment plan is essential to a successful outcome. Services include acute, ongoing and long-term community-based psychiatric treatment, assertive outreach, recovery/ rehabilitation  supports, with the utilization of evidence based practices such as Integrated Dual Diagnosis Treatment(IDDT), Dialectical Behavioral Therapy(DBT) , Trauma Treatment and Assertive Community Treatment (ACT) services. 

Hours of Operation: Monday-Friday 8:00AM-8:30PM; Sat/Sun  8:00- 4:30PM  

The Hilltop Residential Program

The Hilltop Transitional Living Program is a supervised apartment program which is  staffed  24 hrs per day, 7 days a week. The services promote recovery by providing a  structured, safe, nurturing and  therapeutic environment to young adults, recognizing their abilities and talents. The staff assist the young adults in acquiring the necessary skills to attain the highest quality of independent life and by providing recovery and rehabilitative based interventions with a goal of independent living. The approximate length of stay is 18-24 months and services are based on an individualized recovery plan coordinated between the clinical YAS program and the residential program staff. Hilltop staff, a supervising nurse, a clinical social worker and mental health assistants, provide daily structure, support, psycho education, psychosocial , recreational activities and other rehabilitative services. A Clinical Psychologist and a Psychiatrist from the outpatient program also provide services to the Hilltop staff , including clinical supervision and consultation.   The focus of the program is for young adults to develop skills in the following areas: illness management and recovery, educational & vocational development, development of independent living skills and community integration.  

Hours of Operation:   Seven days a week,  24 hours per day

 

Forensic Services 

The Forensics Services Division provides behavioral health services, including consultation, screening , comprehensive assessment/evaluations and treatment to individuals involved with the Criminal Justice system. The primary focus is the identification of treatment needs and the delivery of appropriate treatment services, with a major emphasis on preventing or limiting criminal justice system involvement to the extent possible, and to promote individual and public safety. It includes the following Programs:

  • Advanced Supervision and Intervention Support Team (ASIST): Targets Pre Trial/Diversion, Post Sentence-Probation/Parole and Transitional Supervision individuals. Developed by the Court Support Services Division, CSSD, for Alternative to Incarceration. Provides intensive case management, individual and group based treatment to individuals with serious psychiatric and co-occurring disorders who are supervised by AIC. Non SMI are screened and referred to CSSD providers.
  • Connecticut Offender Re-Entry Program (CORP): Assists with reentry to the community of sentenced inmates with severe psychiatric and co-occurring disorders. Services are initiated 6-12 months before release, in the DOC facility. The individual must agree to participate in the program and the group treatment while still in the DOC facility.
  • Jail Diversion: Pre Trial / court based services for persons with serious psychiatric and co-occurring disorders, who are arrested on minor offenses. Primary function is to coordinate, refer to and monitor services for the diverted individuals.
  • Forensics Outpatient Services:
    • Psychiatric Security Review Board (PSRB): Services individuals that have been found not guilty by reason of insanity and are under the jurisdiction of the PSRB. Services start while the individuals are still receiving inpatient services at CVH and once transitional plans to discharge the individuals to the community and eventually obtain conditional release. Individuals receive the whole array of clinical case management services.
    • Outpatient Restoration: Pre Trial individuals are referred by the Judicial System for court ordered restoration to competency. The Office of Forensic Evaluation (OFE) conducts an initial evaluation to determine if the individual has a substantial probability of being restored to competency, in the least restrictive setting. The restoration process is intended to render a defendant competent to stand trial. Services include education and mental health services.
    • Interagency/Referral Program (OOC/DOC) :  Facilitates the referral of sentenced inmates with serious psychiatric and co-occurring disorders to appropriate community services after release. Individuals receive the whole array of clinical case management services.
    • Long Term Services:  Clinical case management services for individuals with serious psychiatric and co-occurring disorders who have been involved with the criminal justice system recurrently. Services are targeted to provide the individual with the skills and coping mechanisms in the community to prevent recidivism .
    • Brief Treatment: Clinical case management services for individuals with psychiatric and or co-occurring disorders that are currently involved with the criminal justice system and need brief treatment as part of diversion plan.  

Hours of Operation:  Monday-Friday 8:00-4:30


MANAGED SERVICES DIVISION  (860-297-0839)

The Managed Service Division works with the DMHAS funded affiliate agencies in the greater Hartford area to ensure strong linkage between these services and DMHAS-operated services.  These agencies provide a full range of clinical, residential, vocational, psychosocial rehabilitation and case management services to persons residing in Catchment areas 18 and 23 of the Department of Mental Health and Addiction Services.  Regular Provider Council meetings and annual individual operations meetings are held with the agencies.

 

The Managed Service Division has three units which, in addition to a variety of administrative functions, provide services to consumers, family members, funded providers and Capitol Region Mental Health Center staff:  Provider Contract Services, Care Management Services and Housing Services.

Provider Contract Services

This unit, which operates under the supervision of the Provider Contract Services Director, offers two functions to the clients and staff of CRMHC:

 

Money management- a voluntary program for persons receiving services who have difficulty managing their funds; a person can come to the Center on a scheduled basis to receive disbursements of their own money for spending, personal items, etc.

 

Vouchers – Through careful management of funds, Contract Services has been able to purchase vouchers for furniture, apartment set-up and groceries for disbursement to those people who meet eligibility criteria.  

 

Care Management Services

Care Management is generally defined as the process whereby overall care is improved and health care costs are managed by influencing decision-making around level of care and length of stay through careful assessment and oversight of both individual cases and the system of care.  Historically, most of our attention at CRMHC has been focused on Inpatient, Group Home, Respite and Supported Residential levels of care.  Additionally, CRMHC invests significant time and energy in addressing gridlock in the Emergency Departments of the two city hospitals. 

 

Care management staff chair and facilitate a weekly CRMHC meeting attended by all Clinical Program Directors, the Chief of Professional Services, and the Clinical Director.  50-100 clients identified as “in transition” are reviewed during this meeting.  The meeting tracks actions that must be accomplished for transition to occur and assigns the person responsible for the action.  The minutes are posted on the agency server so all clinicians have access.  Responses are expected the following week, if not sooner.  Additionally, openings are identified, wait lists triaged and admissions assigned.  In addition to the concrete functions, the working process of this meeting is useful for setting expectations and creating a positive change process.  For instance, we have successfully utilized  this meeting to advocate that admissions to group homes are not permanent placements. 

 

Care Management staff also  co-chair a regular meeting with staff from the two local Emergency Departments  attended by our CEO, Clinical Director, DMHAS Regional Manager, Inpatient Unit program director, Mobile Crisis, two state-wide UM staff as well as two other private LMHAs.  In addition to other processes, we review people “stuck” in the emergency departments and in the IOL Contract beds and frequently triage into our Inpatient Treatment Unit.    When people who are high utilizers of the EDs are identified, the internal clinical team is invited into this meeting and a case review is conducted with the purpose of decreasing presentations to the ED. 

 

Care management staff participate in a weekly state-wide UM review meeting at CVH that triages admissions to state hospital beds and reviews people state wide who are waiting in EDs, as well as a regularly scheduled CRMHC Inpatient Treatment Unit  Rounds meeting that reviews client issues,  potential discharges and admission.

 

Care management staff also facilitate monthly individualized meetings with private providers who provide high levels of residential care: Group Homes, Respite and high intensity supported housing programs.  Additionally, Care Management staff function as liaisons to both CVH and WFI and attend treatment planning meetings and facilitate the update  of clinical information.  Staff utilize the PND (an electronic documentation system at CRMHC) and two  separate UM Data Bases to track individual people and program census. 

 

This unit also provides the following assistance to consumers, family members and providers: 

Residential Referrals

Telephone (860) 297-0847

Hours of Operation:  Monday – Friday, 8:00 a.m. – 4:30 p.m. 

 

Housing Services

Housing Services assist persons receiving services to obtain housing and the finances to maintain that housing.   While various programs may be managed at different points in time, the two primary programs managed are:

  • The Bridge or HAF Fund – Offered through My Sisters Place, a grant-funded agency, this program offers loans to persons for security deposits and grants to persons to supplement other finances to ensure a safe, affordable residence. 
  • Shelter Plus Care – Shelter Plus Care is a grant program funded by the US Department of Housing and Urban Development, with the goal of providing housing subsidies and needed support services to homeless individuals with disabilities. Applicants must be referred by a case manager, and sponsored by one of the over 22 participating agencies involved in the Greater Hartford area. Eligibility is based on federal guidelines for homelessness, and one of the following targeted disabilities: serious mental illness, chronic substance abuse, a dual diagnosis of these two disabilities, or AIDS.  Participants in the program are not required to be Department of Mental Health and Addiction Services service recipients. 


QUALITY MANAGEMENT DIVISION (860-297-0975)

The role of the Quality Management Division is to provide support and assistance to other programs and services in the Center around development of performance improvement activities, education and training, technology initiatives, and other means of supporting and enhancing the clinical services of the agency.

Health Information Management

This department is responsible for the management of client information, storage and maintenance of clinical records, management of correspondence, auditing processes as well as entry of services into the DMHAS billing/service information. Also managed within this department is the Admissions process to the agency.

Information Technology

This department manages the development and maintenance of the agency’s computer network and electronic clinical information system, in conjunction with HIM. Staff in this department plan, develop, and execute new initiatives around technology, communication, databases, and other management of information, in addition to being responsible for managing on a day to day basis the physical network in terms of hardware/software support and development.

Quality Improvement

The ongoing process of performance improvement is managed by this staff who work with the various programs and services in the agency to develop QI projects, ongoing monitoring of clinical activities, review of incidents, oversight of the clinical incident review process, and other performance improvement activities.

Education and Training

Staff from this department oversee the education and training functions in the agency, in conjunction with the Human Resources Department. Among the responsibilities are managing the mandatory training activities of staff, developing training initiatives based on the competency assessment process, oversight of orientation of new employees, maintaining data on staff training activities, and other related functions.


CRMHC Recovery and Community Integration Services  

 

Community Support Team

The Community Support program  provides mental health rehabilitation services and supports necessary to assist the individual in achieving the highest degree of independent functioning. The service uses a team approach to provide intensive rehabilitative community support, crisis intervention, group and individual education, and skill building for activities of daily life. Most services are provided in the community with a goal of maximizing independence.  The program has two components: 

Community Support - community support specialists work with a designated group of clients on specific rehabilitation/recovery goals in order to assist them in building the skills and natural supports needed to live successfully in the community.  Most services are provided “in vivo”  in order to provide the teaching and support clients need in their natural settings.

 

Recovery Pathways - Recovery specialists work with clients on an as-needed basis to assist with various needs such as entitlements redetermination, housing issues, social needs, etc. This is mostly an office-based practice for shorter-term, defined needs.  Psychoeducational groups are led by Recovery Pathways staff.  

Hours of Operation:  Mon-Fri  8:00AM-6:30PM;  Evenings,  Weekends, and Holidays as needed.

Peer Support and Recovery Center

Peer Support and Recovery Center is a safe and inviting setting for people in recovery,   a place for people to meet and talk or investigate community integration .There is internet access to look for jobs or apartments or other community assets.  There are multiple opportunities for people in recovery to participate in self help groups such as NA, AA, Wellness Recovery Action Planning, Street Safety, and many other groups and activities. 

 

Peer staff participate as members of the clinical staff at CRMHC, and bring their voices of recovery to multiple committee, group, individual, and treatment settings throughout the organization and community.  The staff are individuals who can articulate their own recovery stories, where appropriate, and join to engage others in the journey to health and wellness.  They lead groups, help others find their own way to recovery, and articulate what may work for them in getting well.  This process involves complex and caring skills by Peer staff, who develop relationships with persons in recovery, families, and clinical staff.  

 

Peer staff are advocates for all persons in recovery, teaching empowerment and self advocacy.  Respect and skill teaching form the basis for much of the work in peer support, and the relationships that promote healing.  In this context, the work happens throughout the organization and community at all levels and in multiple settings.  Peer support staff increasingly focus on community integration work, as recovery moves outside the walls of the institution and into where people live and work.    Peer support staff are actively involved in CRMHC Multicultural Committee, Recovery Operational Plan, IDDT Committee and insuring  services are consistent with our Trauma Informed System of Care. Ongoing communication and information is provided to CRMHC Strategic Plan and Leadership by the Recovery Council, which meets every other week. Currently there are major identified projects of interest for the Council in the coming year, as well as the ongoing recovery focus for scheduled and planned events.  These scheduled events include the Day of Caring, Success Event, Holiday Event, and other events which are planned and coordinated by Peer Support staff and inclusive of all at  the agency.   

Grievance Resolution-Capitol Region Mental Health Center encourages all consumers who have a complaint or who wish to file a grievance to discuss the matter with the team clinician/case manager as a first step toward resolving the situation. Peer support staff has all been trained in advocacy skills, and are available to assist individuals in this areas.

 

However, it is also a consumer’s right to file a formal complaint or grievance by contacting the CRMHC Client Rights Officer, Carl Shields  at Tel: (860) 297-0826, or Glenn Woods at 297-0847.  Spanish speaking clients can call Maria Rivera at 293-6378.  Consumers may also contact the Joint Commission if their concerns cannot be resolved vie the normal channels.


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Content Last Modified on 4/5/2012 3:30:31 PM