Paint Valley ADAMH Board

394 Chestnut Street
Chillicothe, OH 45601
740-773-2283

Project Title
Assertive Community Treatment (ACT) Highland County
Grant Description
To create an Assertive Community Treatment team for the care and treatment of people with severe mental illnesses in Highland County
Focus Area
Severe Mental Illness
Region Served
Highland County, OH
Award Amount
$300,000
Year Awarded
2002
Grant Duration
24 months
Results All grant objectives were met:
  • Scioto Paint Valley Mental Health Center (SPVMHC) hired ACT team members, provided education, and developed policies and procedures for the team.
  • Over the course of the grant period, the ACT team served 69 clients. Of these 69, 21 were able to later transition to regular case management services, 9 moved out of the area, 4 dropped out of service, and 35 continue ACT services. Also, 91% (goal 80%) of ACT services are provided in the community as opposed to in SPVMHC's offices.
  • The ACT is sustained via increased Medicaid billing (59%), reduced use of crisis services (67%), and reduced hospitalization (56%). The Paint VAlley ADAMH Board is committed to providing additional funding for the team if needed.

The ACT team and an external evaluator evaluated the project outcomes:

  • Symptoms – Ohio Outcome data were collected on 50 clients of which 32 had at least two administrations. The mean scores show a reduction in symptom distress. This reduction is statistically significant. On the quality of life measure, the mean scores show a significant improvement.
  • Hospitalization – Prior to ACT, clients had a total of 41 hospitalizations and after ACT services, there were 18 hospitalizations. Based on an average length of stay of 3.5 days at $600 per day, the savings total $48,300.
  • Use of crisis services – Prior to ACT, clients received 178 hours of crisis services in 96 visits for a cost of $22,295. After ACT, clients received 46 hours of crisis services in 32 visits for a cost of $7,487. The savings total $14,808.
  • Housing stability – 52 out of 58 (89%) maintained current housing or moved to more independent housing during ACT services; 6 clients made moves to less desirable housing situations.
  • Vocational, volunteer, and educational activities  - not measured
  • Compliance with prescribed medication – not measured

SPVMHC did excellent work in establishing their ACT team. The client outcomes are very good. The ACT team is fully sustained with Medicaid billing, cost savings due to reductions in the use of crisis services and hospitalizations, and support from the Paint Valley ADAMH Board. Also, two of the team members made a formal presentation at the 2005 national ACT conference. The topic was implementing ACT services in a rural area.

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Project Title
CORE: Components of Recovery
Grant Description
To develop a strategic plan to improve services for adults with severe mental illnesses and for children classified as severely emotionally disabled
Focus Area
Severe Mental Illness
Region Served
Paint Valley service area
Award Amount
$127,179
Year Awarded
2000
Grant Duration
12 months
Results Paint Valley ADAMH Board hired a consultant to compare and contrast its current case management system with the Assertive Community Treatment (ACT) model of care and to make recommendations to improve the current services. The consultant failed to produce a useful report and the Board decided to do the planning work itself. The Board formed a leadership committee that included administrators, supervisors, case managers, consumers, and Board staff. Two supervisors on the leadership committee attended the 2001 ACT Conference and as a result were able to share useful information about the ACT model with the Committee. (The Health Foundation sponsored these individuals’ attendance at the ACT Conference.) The leadership committee used the Dartmouth Assertive Community Treatment Fidelity Scale to compare the current case management services with the ACT model. The committee agreed that current services were not intensive enough for adults with severe mental illnesses, especially since hospital admissions and suicides were increasing for this population in the Paint Valley service area. The leadership committee developed a business plan to implement two ACT teams, one in Highland County and one in Ross County.

The consultant compiled a report with extensive data from the needs assessment and made recommendations for the development of a system of care for children with behavioral health needs in the five-county area. A leadership committee made up of representatives from juvenile justice, mental retardation, schools, community action agencies, children’s services agencies, family and children first councils, parents, and the Paint Valley ADAMH Board will oversee the system of care. The Board submitted a grant application to the Substance Abuse and Mental Health Services Administration (SAMHSA) for implementation of the system of care. Paint Valley ADAMH Board intends to go forward with the system of care even if the federal proposal is not approved. Without federal money, the project will be on a smaller scale and extend over a longer time period.

The consultant then made recommendations for system improvement for greater employment opportunities for people with severe mental illnesses.

Mental health and vocational service providers, the Ohio Rehabilitation Services Commission (ORSC), Paint Valley ADAMH Board staff, and consumers took the consultant’s recommendations and developed a plan for improving employment services. Key elements of the plan include:
  • Contracting with a provider to develop additional capacity for vocational and employment services
  • Pursuing additional funding sources such becoming a vendor for the ORSC
  • Educating behavioral health staff, public officials, human service professionals, and the general public about the impact and importance of employment services for people with severe mental illnesses
  • Establishing a business advisory council to build networks and resources for employment
  • Developing an outcome measurement system for the vocational programs that includes how many consumers get and keep jobs

The Paint Valley ADAMH Board applied for a state grant to implement the vocational program.

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Project Title
Paint Valley's Improving Access to Children's Behavioral Health Services
Grant Description
To design and implement a strategic plan that increases access to mental and behavioral health services for school-age children.
Focus Area
School-Aged Children's Healthcare\Mental Health Intiative
Region Served
Ohio and Highland counties
Award Amount
$277,065.00
Year Awarded
2004
Grant Duration
36 months

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