Humboldt County Mental Health Surge Capacity Presentation for County Disasters

1. Humboldt County Mental Health Surge Capacity Presentation for County Disasters Presented by: Amy Larum, RN, BSN, PHN Director of Nursing for the Mental Health Branch June 2009

2. Schematic of Services

3. Surge Capacity Plan • In the event of a disaster the surge capacity plan will be to utilize all available Mental Health Branch (MHB) staff. • MHB staff will report to the Rainbow Room at the Main Mental Health Complex for scheduling and assignment. • Licensed staff will be present to assess the needs of all presenting clients and refer each client to the appropriate level of care. • Routine, or basic services for non- emergencies will be suspended until the surge of clients reaches normal business levels. • Refills of medications will be continued by Licensed Vocational Nurses or Licensed Psychiatric Technicians to maintain the stability of existing clients.

4. Same Day Services • All clients presenting to Mental Health requesting services will be assessed by licensed Mental Health Branch staff to determine the level of services needed. • The Crisis line will be staffed with licensed or non-licensed personnel to triage calls and provide reassurance, referral to other departments or welfare checks, dependant upon law enforcement capacity. • All clients determined non-urgent or non-emergency will have an appointment scheduled to follow up with the appropriate department depending upon the clients individual needs, once surge capacity has subsided and normal business capacity is restored.

5. Medication Support • Clients open to medication support with basic needs will have medication refills completed by licensed vocational nurses or licensed psychiatric technicians on a first-come first-serve basis. • Regularly scheduled appointments will cease until surge capacity has subsided and the normal business capacity is restored. • All cancelled appointments will be rescheduled when surge capacity has subsided and the normal business capacity is restored.

6. Psychiatric Emergency Services(PES) • Bed capacity- 4 patients to each RN • 2 RN’s will be scheduled to work each shift, if staffing is available to accommodate surge capacity. • All staff normally assigned to PES will be available to work. (All time off requests will be suspended until surge capacity has subsided and the normal business capacity is restored). • Only patients who are: • suicidal with a plan and means; • homicidal with a plan and means; or, • gravely disabled due to a mental illness and are unable to provide food, clothing and shelter will be admitted to PES.

7. SempervirensPsychiatric Health Facility • Bed capacity – 16 Beds • All Mental Health Branch RN’s will be expected to be scheduled to work shifts in the PHF during a surge capacity event. • All staff normally assigned to Sempervirens will be available to work. (All time off requests will be suspended until surge capacity has subsided and the normal business capacity is restored). • In the event that the capacity reaches a census of 16, all efforts will be made to transfer patients to the nearest locked psychiatric hospital. • In the event that the capacity exceeds a census of 16 the California Department of Mental Health will be notified by phone.

8. Comprehensive Community Treatment (CCT) and Case Management • All Mental Health Branch staff will report to the Rainbow Room at the Main Mental Health Complex for scheduling and assignment. • All CCT and case managed clients will have contact with a Mental Health Branch staff member in person or by phone to determine needs and level of services required to maintain stability in the community. • Medication case management will be limited to medication module refills only.