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Overview
To provide an integrative crisis center that will be a single point of access for indigent and low-income persons in psychiatrically or medically compromised conditions due to mental health or substance abuse crisis.
The facility will provide short term medically monitored sobering, detoxification and sub-acute psychiatric stabilization services in a safe, caring, and therapeutic environment. It will effectively divert potential inpatient hospitalizations and/or incarcerations to a less restrictive but medically responsive environment. The program will provide linkages to long-term community resources as part of a seamless continuum of care and will serve residents of region IV of the State of Idaho.
Project Summary
A collaboration of Ada County, the cities of Boise, Eagle and Kuna, Idaho Health and Welfare, The United Way of Treasure Valley, the Boise City/Ada County Housing Authority, St. Alphonsus and St. Lukes Regional Medical Centers, and other non-profit organizations has committed to the development of a medically monitored community sobering, detoxification and subacute mental health facility.
The facility will open with a total of 26-beds and have the capacity to expand to a 48-bed capacity, and will be approximately 9,300 square feet. The site selected for the facility is located on approximately 1.7 acres, at 320 N. Allumbaugh St., Boise Idaho.
Funds to construct the facility were accumulated by grants received from City of Boise City (Community Development Block Grant) the Idaho Department of Health and Welfare, Ada County, Federal Appropriations, the United Way, and both St. Alphonsus and St. Lukes Regional Medical Centers for a total of $2.7 million for design and construction.
Under the current project scenario, the Housing Authority will oversee the design and construction of the facility and will be the owner and facility manager once construction has been completed..
Currently the Housing Authority is in the Design Phase of the project with Hummel Architects. Construction is targeted to commence soon after the standards being developed by the Idaho Department of Health and Welfare are reviewed by the appropriate entities. Operations of the facility are anticipated to begin within several months of construction.
Ada County has offered to serve as the administrator of the center contingent upon ongoing financial support of all the partners. Ada County is well suited to take on operational administration of the Center on behalf of the partnership. Ada County recognizes that the financial support of local units of government can only be year to year, but is confident that each of the partners understands that the ramifications of discontinuing funding will be to discontinue operation of the whole facility. Absence of an operational facility still results in costs being incurred by governmental units although in different programs or time periods.
The efforts to date in creating this facility have been extraordinary, and we look forward to seeing the benefits from our collective efforts. Presented in this proposal is a brief statement of need followed by a description of the project scope, operational guidelines, budget and a draft funding agreement.
Background
For the past decade, our region has recognized that there is no current medical facility to treat non-incarcerated, low-income individuals who suffer from either drug or alcohol withdrawal syndrome or voluntary mental health service needs. The costs to the community for not intervening are expensive hospital charges or even worse, incarceration. Medical stabilization is a necessary first step before effective treatment can occur and abstinence can be attained.
According to the Boise State University Center for Health Policy, an estimated 17,400 people in the Treasure Valley struggle with at least one chemical addiction. Private medical centers currently turn away 335 people monthly who are voluntarily seeking treatment, due to lack of resources. The availability of an 18-bed detox and 8-bed mental health Center will yield cost savings to state and local governments.
The costs of not intervening early to prevent incarceration are staggering. Ada County has recently completed a new $6 million, 82-bed medical facility at the Ada County jail to accommodate a growing inmate population with mental health and substance abuse medical needs. Ada County will spend $2 million annually to staff and operate this facility. In addition, Ada County spends $250,000 annually in support of the Idaho Department of Health and Welfare’s mobile crisis unit. This effort assists citizens with mental health needs in getting proper treatment prior to requiring hospitalization. It is clear that providing assistance to non-incarcerated, low-income individuals for mental health and substance abuse is a benefit to the communities it serves.
The anticipated scope of the Center is threefold:
- a sobering station that will act as a safe environment for people whose impairment due to alcohol intoxication is judged to put themselves and the greater community at risk
- an 18-bed detoxification facility whose average length of stay will be 3-to-5 days to stabilize chronic addict's/alcoholic's physical condition and to afford medically monitored care during this process
- an 8-bed, sub-acute psychiatric crisis stabilization unit of similar duration designed to address psychiatric instability and divert expensive, acute psychiatric hospitalization
Operating Concept
The Center will effectively unify the three services into an integrative healing facility that will be a single point of access for persons in psychiatric or medically compromised conditions due to mental health or substance abuse crises. It will provide:
- a uniform assessment process utilizing clinically valid assessment tools to determine medical risk of potential admissions and ascertain presenting needs
- treatment planning to address medical, psychiatric, psychosocial and other compelling precipitants in the plan of care
- administration of prescribed medications by qualified medical personnel
- a safe and healing milieu, including therapeutic and didactic group experience utilizing clinical protocols, emphasizing ‘edu-care’ (compassionate education), crisis management, symptoms management, and wellness in preparation for community re-entry
- linkage with appropriate community resources as part of a seamless continuum of care prior to discharge
Exhibit B illustrates the operating concept for the facility. The Boise City/Ada County Housing Authority (BC/ACHA) will own the land and the building. It is anticipated that the BC/ACHA will lease the building to an operating group consisting of the state of Idaho and local units of government under a joint powers operating agreement. Private nonprofit entities such as the hospitals that contribute funds for operations will participate through a steering committee. This steering committee will develop operating protocols in partnership with the Joint Powers group. Ada County will serve as the entity to formally accept and distribute funds on behalf of the Joint Powers group.
Annual Operating Budget
The facility will operate 24 hours per day, 7 days per week and will be fully staffed. The intent is that all programs associated with the facility will operate 24/7 as well. A summary of the anticipated operating revenues and expenses is presented in Exhibit A.
Anticipated Impact
- The center will serve an estimated 1,000 patients annually
- Indirect savings include enhancing the quality of life of impacted patients, their families, and their neighbors in the Treasure Valley area
- Associated reduction in crime rates and an improvement of public safety
- Reduction in the incidence of incarceration and use of the penal system
- The center will serve as the statewide model for public/private partnership to enhance the continuum of care and the delivery of critical care services to the community
EXHIBIT A
ANNUAL OPERATING REVENUES
State of Idaho, Region IV Department of Health and Welfare $900,000
Ada County $250,000
City of Boise $240,000
City of Meridian $ 52,000
City of Eagle $ 16,000
United Way of Treasure Valley $ 50,000
Saint Alphonsus Regional Medical Center $200,000
Saint Luke's Regional Medical Center $150,000
TOTAL REVENUE $1,858,000
ANNUAL OPERATING EXPENSES
Total Staffing Expenses $1,180,000
Total Other Operation Expenses $678,000
TOTAL DIRECT OPERATION COST $1,858,000
EXHIBIT B
Region IV Substance Abuse and Mental Health Crisis Center
Operational Diagram
Contact Information:
Boise City/Ada County Housing Authority
1276 River St. Suite 300
Boise, Idaho 83702
Deanna L. Watson, Executive Director (dwatson@bcacha.org) 208-287-1054
Richard Bouge, Development/Construction Manager (rbouge@bcacha.org) 208-287-1077
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