LOUISIANA Community Mental Health Services Block Grant ...

prior to community residency. This time frame allowed adequate time for patients to apply for
benefits needed for community residency for their physical and behavioral health needs as well as
housing and specialty service needs. Community specialty services funded by the Department of
Health and Hospitals (DHH) included Assertive Community Treatment, Intensive Case Management,
and Therapeutic Residential Housing vouchers. OBH collaborates with several offices in order to
facilitate the transition from the hospital into the community. These offices include the:
Office of Medicaid -to facilitate access to benefits for patients exiting the intermediate
hospitals.
Office of Vital Records -to secure birth certificates as source documents to facilitate access to
housing programs and other entitlements.
Office for Citizens with Developmental Disorders (OCDD) -to identify those patients who
meet the criteria for community services provided by programs within that office.
The strategic COC process provided a framework for the successful discharge of patients to the
community. The Office of Behavioral Health COC plan includes a method of tracking discharged
clients for a follow up period of nine months to ensure successful discharge.
Through the Mental Health Redesign initiative, OBH is also developing and evaluating alternate
strategies and different service systems to support the forensic patient population in intermediate
care. Currently, the office provides forensic services to 235 individuals in the Feliciana Forensic
Facility that is affiliated with East Louisiana Mental Health System (ELMHS). As in other states, the
local court systems and the ever expanding population of forensic patients often place significant
pressures on state inpatient services. In fact, as this population expands and local judges often
control individuals‟ discharges, the forensic inpatient population comes to occupy aspects of the civil
hospital system. As a component of the Mental Health Redesign initiative, the Office of Behavioral
Health is creating alternative levels of care for a portion of the forensic inpatient population.
Increased capacity is being built in community-based forensic aftercare programming and Forensic
Assertive Community Treatment teams. Different levels of residential care, known as Secure
Forensic Facilities, are being developed for those individuals, who have reached some degree of
clinical stability and no longer require hospital-levels of care, but may not be eligible for release
through the courts.
In the event of crisis, hospitalization is a last resort, after community alternatives are tried and/or
ruled out prior to inpatient hospitalization in a state inpatient facility. Implementation of the
statewide Continuity of Care policy continues to enhance joint hospital-community collaboration
with the goals of improved outcomes post-discharge including reduced recidivism. They also address
the problems of acute and long term care; specifically assessing existing capacities and shortages
coupled with delivering appropriate acute care services.
Another avenue of care that has succeeded in reducing hospitalization rates is the Mental Health
Rehabilitation (MHR) program. MHR allows greater flexibility of services; and the ability to cover
additional services such as ACT and MST, which are consumer driven and recovery-focused. The
previously discussed move of the MHR program into the DHH Medicaid Office should improve the
availability of resources and flexibility to an even greater extent. Each OMH Region/ LGE also has
specific initiatives aimed at reducing hospitalization and/or shortening hospital stays.
Utilization of state hospital beds dropped significantly with the introduction of community-based
Mental Health Rehabilitation (MHR) services and the development of brief stay psychiatric acute
PART C LOUISIANA FY 2011 PAGE 122
SECTION III: ADULT PLAN – CRITERION 1
COMPREHENSIVE COMMUNITY-BASED MENTAL HEALTH SERVICES -- SYSTEM OF CARE & AVAILABLE SERVICES