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HomeMy WebLinkAboutOrdinance 6576 ORDINANCE NO. „ G s7 6 AN ORDINANCE APPROPRIATING REVENUE OF THE CITY FOR CONTRACTUAL 'SERVICES FOR DETOXIFICATION TREATMENTT PROVIDING A SEVERABILITY CLAUBSt MAKING THIS ORDINANCS CUMULATIVE OF PRIOR AP- PRDPRIATION ORDINANCES1 REPEALING ORDINANCES IN CONFLICT HERSWITHr AND PROVIDING AN EFFECTIVE DATE. HS IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF PORT WORTH, TZX&S t SECTION 1. That the Police Department of the City of Fort North shall be provided with such revenues as may be secured from the various sources included in Ordinance No. 6518 and in the Budget of the City Nanager, and in addition there is hereby appropriated the amount of Twenty Thousand Dollars ($20,000) of excess revenue and/or unappropriated surplus to be used to meet the requirements of the Police Department for contractual services for detoxification treatment. SECTION 2. That the City Manager of the City of Fort North is hereby authorised to contract for such detoxification treat- ment services. SECTION 3. Should any part, porti n, section or part of a seation of this ordinance be declared invalid or inoperative or void for any reason by a court of competent Jurisdiction, such de- aision, opinion or judgt shall in no way affect the remain- ing portions, parts, sections or parts of sections of this ordinance, wbich provisions shall be, remain and continue to be in full force and affect. SECTION 4. That this ordinance shall be cumulative of ordinance No. 6SIS, but all other ordinances and appropriatims for which provision has been heretofore made are hereby expressly repealed if in conflict with the pzovisions of this ordinance. SECTION S. That this ordinance shall take effect and be in Rill force and effect from and after the date of its passage, and it is so ordained. APPROVED AS TO FORK AND LSGALITYs City Attorney City of Fort Worth, Texas Mayor and Council Communication DATE NUMBER SUBJECT: Alcoholism Treatment Program PAGE R 10/26/71 G-1851 1of 3 Background 4' In January, 1969, the City Council appointed a study committee to review the c� existing conditions regarding alcoholism and the methods of incarceration, treatment and rehabilitation of persons arrested while intoxicated. Recom- mendations for improvement were requested of the committee. The committee was chaired by Dr. Edwin W. Guinn, then City Council member, and consisted of repre- sentatives from the medical profession, churches, groups which work with alco- holics and other concerned citizens. After several meetings of this committee, a report was submitted to the City Council on October 10, 1969 which outlined the problem and proposed alternative means of establishing a detoxification center. The report recommended that the City Council take the necessary steps to establish a center in Fort Worth for the treatment and rehabilitation of persons arrested for public drunkenness and of other persons suffering from the disease of chronic alcoholism. It was suggested by the committee that the center should be established and operated as a non-profit corporation chartered by the State of Texas with policy control and administration by a board of directors on which the City of Fort Worth would be represented. The City Council accepted the committee's report and the committee proceeded with the development of a non-profit corporation. Articles of incorporation and bylaws were developed and approved by the committee and in June, 1970 were submitted to the State of Texas. Approximately at this same time the Tarrant County Mental Health and Mental Re- tardation staff was developing a program for submission to the Federal Government for funding of a program aimed at achieving the same objectives as those devel- oped by the City Council study committee. After considerable Federal review and some modification of the program, the Tarrant County Mental Health and Mental Retardation Board received notification in July, 1971 of Federal approval of its program. This comprehensive, large-scale program was projected to cost in excess of $1,000,000 per year. The local share of the cost of this program was substantial. Working with officials from John Peter Smith Hospital and the City of Fort Worth, the Mental Health and Mental Retardation staff developed a modified program with annual expenditures reduced to $461,093. Utilizing the services of officials from various agencies, it was possible to reduce greatly the matching requirements for cash contributions. Mental Health Health and Mental Retardation Proposal On Monday, October 18, 1971, the Mental Health and Mental Retardation Board ap- proved the modified program, and subject to approval of the City of Fort Worth, will forward this program to the Federal Government for their review. This pro- gram provides for emergency medical service at John Peter Smith Hospital where a screening and disposition process will take place. Patients brought to the emergency room at the hospital will be seen by a physician where a decision will i DATE REFERENCE SUBJECT: PAGE NUMBER Alcoholism Treatment Program 2 3 10/26/71 G-1851 of be made to admit the patient to the hospital if medical attention is required, assign him to the Alcoholism Annex or return him to the City of Fort Worth jail. In each instance a physician will make a decision as to the treatment needed by the patients. An in-patient service will be provided in the Alco- holism Annex proposed to be located across the street from John Peter Smith Hospital. There will be twenty beds in this annex with facilities for both male and female patients. Patients will be admitted to this annex only if they do not require close medical attention. Some medical capabilities will be provided in the annex, but the facility will not be staffed and equipped to handle major medical complications. The primary focus of this program will be to initiate therapy with each patient for his recovery from alcoholism. Assist- ance in recovering from the physical side effects of alcoholism and any physi- cal injury may also be provided. As soon as a patient is admitted to the annex, efforts will be made to involve the patient in a multi-faceted treat- ment program and to increase the patient's motivation for recovery. A social therapist as well as three alcoholism specialists will work with the patients in attempting to solve the patient's alcoholism problems. The annex will have its own staff of clerical personnel, a cook and a janitor. While the patient is in the annex recovering from the physical effects of intoxification, he will also be visited by out-patient counselors who will attempt to establish a followup to the case, once the patient is released from the annex. The out-patient program, is anticipated to be the backbone of the comprehensive alcoholism treatment program. It will serve all of the patients entering the program and will provide a wide range of rehabilitation services anticipated to be needed by the patients. Out-patient clinics will be located in three different areas of the city. The followup counselors are also responsible for contacting the family of the patient and initiating and continuing a pro- gram of counseling support with each family. Intermediate care will be avail- able for those patients who do not need full time 24-hour in-patient care, but who are not able to function independently in the community without support and who need assistance in refining their vocational skills and obtaining em- ployment. Two halfway houses will be available under the program to provide this intermediate care. Advantages to the City of Fort Worth R Utilization of this program will provide several advantages to the City of Fort Worth. Facilities will be available for care of patients who are not sick enough to be admitted to the hospital but still necessitate some close atten- tion. Based upon a doctor's recommendation, these patients could be admitted to the alcoholism annex rather than being housed in the City of Fort Worth jail. Utilization of this facility will also provide the municipal court judges with a third alternative in disposition of individuals found guilty of public drunkenness. In addition to confining an individual in the jail or assigning him to the Fort Worth Rehabilitation Farm, the judge could decide, if space were available in the annex, that a person should be admitted to the program for rehabilitation. If this program is successful, it will greatly benefit the City of Fort Worth by breaking the apparent cycle of habitual alcoholics who are frequently arrested by City of Fort Worth police officers. Reducing the public drunkenness problem would greatly relieve police officers, thereby allowing them to devote more time to other police work. RATE RE gNCE SUBJECT: A PAGE NUER lcoholism Treatment Program 10/26/71 G-1851 3 of 3 Request for City Support The program as developed and approved by the Mental Health and Mental Retarda- tion Board provides for the contribution from the City of Fort Worth of around the clock police security for the Alcoholism Annex, which would require the services of five police patrolmen. In addition, a cash contribution from the City of Fort Worth of $20,000 has been requested to assist in meeting the local share of the cost of the program. It is anticipated that it will be January, 1972 before Federal approval is received and the program can actually be initiated. This corresponds with approximately the time of graduation of trainees in tht. present Police Academy, and it will be possible to assign five police officers to this unit without serious curtailment of other police activities. However, utilization of currently budgeted and authorized police personnel will reduce the number of policemen available for regular police work and if this program is continued into fiscal year 1972-72, it would be desirable to add five additional positions for this alcoholism program. Care- ful review will be given the results of' this program during its first year and if the results do not justify the expenditure, the desirability of continuing City participation in this program will be reevaluated. Recommendation It is recommended the City Council authorize the payment of $20,000 to the Mental Health and Mental Retardation Board in support of the Alcoholism Treatment Program and that a transfer be made from the contingency allowance (Account No. 001-90090) to the, Jail Operations (Account _No. 001-36506) for It is purpose. L/je I' SUBMITTED BY: DISPOSITION OUplCIL: PROCESSED BY PPROVSO ❑ OTHER (DESCRIBE) CITY SECRETARY A 4- GATE CITY MANAGER c) ATARRANT COUNTY MENTAL HEALTH AND MENTAL RETARDATION CENTER 600 TEXAS STREET TEL: 336-8788 FORT WORTH. TEXAS 76102 Toirt t.Duncan E Director �October 19 1971 _„�_..a BOARD OF TRUSTEES R.D.Alexander Mr. Roger Line City Manager Joe Day,Jr. Rev.L.L.Haynes City of Fort Worth P. O.Settle,Jr. 1000 Throckmorton Jim Stiff Ft. Worth , Texas 76102 Harry K. Werst Cortell K.Holsapple,M.D. Dear Mr. Line: John D.Lyon,M.D. Fernando G. 1'orgerson,Ph.D. The Tarrant County Mental Health and Mental Retardation Center Board of Trustees unanimously approved the enclosed comprehensive Alcoholism Treatment Program. SERVICES Inpatient We need at this time, the commitment from the city of Fort Worth to provide salaries in the amount of $45 ,000 and Outpatient a cash contribution of $20,000. Partial Inpatient Emergency The target date for commencing the program is early January. Education & Consultation Information & Referral I hope the Council will approve the funds and that the citizens Parent Counseling of Fort Worth will be pleased with the action. Day Care Sincerely yours, Crisis Intervention After Care Field Counseling Halfway House Tommie L. Duncan Executive Director Vocational Rehabilitation Graduate Student Training Youth Services Drug Abuse Information Alcoholic Treatment Information Infant Care Information TL D's gh Community Speakers COMPREHENSIVE ALCOHOLISM TREATMENT PROGRAM Emergency Services -.. ($1 ,650 New Staff) Inpatient Services Education, Training, and ($198,143 New Staff) Consultation Services ($40,425 New Staff) Outpatient Services Intermediate Care Services ($83,930 New Staff) ($22,605 New Staff) r COMPREHENSIVE ALCOHOLISM TREATMENT PROGRAM New Staff Salaries Matching Requirements Emergency $ 1 ,650 $ 330.00 TCMHMR Inpatient-Annex 198,143 39,628.00 TCMHMR Outpatient 83,930 16,786.00 TCMHMR Intermediate Care 22,605 4,521.00 Ho66&, Education, Training, and Consultation 40,425 8,085.00 T.C.C.A. $ 3461753 $ 69,350.00 TCMHMR Center Matching Requirements $ 56,744 ALCOHOLISM ANNEX - OPERATING EXPENSES Rent (5,000 sq. ft. @ $2.50/sq.ft. $12 ,500.00 Food (21 ,900 meals @ $1 .90) 41 ,600.00 Medications, dressings, etc. (approximately $6. per patient per day) 44,000.00 Janitorial Supplies 1 ,500.00 Laundry & Linen (Approximately $2 per patient per. day 14,600.00 Utilities, 2,500.00 Stationery, postage, office supplies 5,000.00 Insurance, Bonding, Auditing & Legal Fees 2,000.00 Maintenance & Repairs 1 ,200.00 TOTAL $124,900.00 A ti EMERGENCY The Emergency Services will be provided by the county hospital , John Peter Smith Hospital . Because of the nature of the disease, all emergency cases will first be seen at John Peter Smith Hospital where a screening and disposition process will be done, including all necessary laboratory tests and physical exam- inations. During regular working hours (weekdays 8:00 a.m. to 5:00 p.m. ) each patient will be seen first either in the Hospital 's Emergency Room and/or in the Hospital 's Psychiatric Ward. The attached chart indicates alternatives into and, out of the Hospital . The patient could go directly to the Psychiatric Ward. .i The patient could come directly to the Alcoholism Annex from which he would be taken to either the Emergency Room or the Psychiatric Ward. The patient could be brought directly to the Emergency Room and after screening by the physician on duty there could go to the Psychiatric Ward or to a Medical Ward in the Hospital. The patient could be brought by the police to the Emergency Room where he would be seen by a physician and sent to either the Psychiatric or a Medical Ward. If the patient arrives at the Hospital's Psychiatric Ward via any of these routes, the psychiatrist on the ward will evaluate the patient and admit him either to the Psychiatric Ward, a Medical Ward, or the Alcoholism Annex for inpatient treat- ment. If a patient is admitted to a Medical Ward, after the crisis is passed, a physician on that ward could admit him to the Annex. Thus, a physician's order (from either the Emergency, a Medical Ward, or the Psychiatric bard) will be required to admit a patient to the Alcoholism Annex. During weekends and nights a different procedure will be employed. All emergency cases will be brought to the John Peter Smith Hospital 's Emergency Room for screening and disposition. The patient can come directly to the Emergency a Emergency - 2 Room, or the patient could come first to the Alcoholism Annex and then be taken to the Emergency Room. The physicians staffing the Emergency Room will evalu- ate the patient and admit him either to the Psychiatric Ward, a Medical Ward, or the Alcoholism Annex for inpatient services. In each instance a physician will be making the decision as to the treat- ment needed by the emergency patient. Those patients who are admitted to the Psychiatric Ward would be those who have a psychosis or who are suspected to have some psychiatric disorder. Also, there would be some patients admitted to the Psychiatric Ward who have a psychiatric disorder and who also need close medical attention. There would be some patients who would need intensive medical super- vision but who were not suspected of having psychiatric disorder, and these patients would be admitted to one of the Hospital 's Medical Wards. The physician's decision that a patient needs close medical supervision (on a Medical Ward or on the Psychiatric Ward) would be based on the presence of such complications as un- consciousness, helplessness , withdrawal symptoms, delerium tremens , convulsions, injury, physical illness uncontrolled because of drinking, and malnutrition and dehydration. To assist the house staff of the Hospital 's Emergency Room, the three Alcoholism Specialists - Therapists of the Inpatient Program operated at the Alcoholism Annex will be assigned part of their time to the Emergency Room. They will assist the house staff in caring for the alcoholics in whatever way they can. To assure the coordination of these Emergency Services with the other four major components of the Comprehensive Alcoholism Treatment Program, ten percent of the Alcoholism Program Director's time will be assigned to the Emergency Service. He will be responsible for coordinating all the program components. Emergency - 3 If a patient has been admitted to the Psychiatric Ward or to a Medical Ward in the Hospital , he will remain there only as long as he needs close medical super- vision. As soon as the physician decides that he can be released from the Hospital , he can be admitted to the Alcoholism Annex for inpatient treatment or he can be discharged to go home. Hopefully, if the physician decides the patient does not need the inpatient treatment at the Alcoholism Annex, he will send the patient to the Annex on a referral basis so that the staff at the Annex can arrange for ot4c patient treatment and possibly placement in a halfway house. ti EMERGENCY Weekdays 8 a.m. - 5 p.m. (--Patient (--Patient - Alcoholism Annex E---Patient - Police Patent John Peter Smith Hospital John Peter Smith Hospital Outpatient Emergency Room Psychiatric Ward —OuC�ti ent Clinic Clinic (Screening and Disposition) --*Medical Ward Psychiatric Ward lcoholism Annex Weekends and Nights Patient Pa lent Pa lent Alcoholism Police Annex I I Patient JPSH Emergency Room Outpatient Clinic Outpatient Clinic (Screening and Disposition) Admit Admit Admit to to Psychiatric to Medical Alcoholism Ward Ward Annex - Inpatient EMERGENCY Alcoholism Program Director 10% ($15,000/yr.) 1 ,500.00 TOTAL $ 1 ,500.00 Employee Benefits (10%) 150.00 TOTAL STAFF SALARIES 1 ,650.00 1 r y i INPATIENT SERVICES - ALCOHOLISM ANNEX The Inpatient Treatment Program will be operated at the Alcoholism Annex located across the street from the John Peter Smith Hospital in a two-story building. Admission to the Alcoholism Annex will be by a physician's order only. As indicated on the attached chart, most of the entries into the Alcoholism Annex will be from the John Peter Smith Hospital. Either a psychiatrist from the Psychiatric Ward or a physician from a Medical Ward in the Emergency Room can admit a patient to the Alcoholism Annex. It will also be possible for a private physician and for the Program Physician to admit a patient to the Annex. There will be twenty beds at the Annex, and both male and female pa- tients will be accommodated. The physical facility will be renovated to fit the needs of the program and will be secure. Patients will be admitted. to this facility only if they do not require close medical attention. A patient in a medical crisis must be treated within the John Peter Smith Hospital . If necessary, a patient admitted to the Annex can be referred back to the hospital if he needs close medical supervision. Medical atten- tion will be provided at the Alcoholism Annex by a medical staff, but the facility will not be staffed and equipped to handle major medical compli- cations. The primary focus of this program will be to initiate therapy with each patient for his recovery from alcoholism. Assistance in recov- ering from the physical side affects of alcoholism and any physical injur- ies will also be provided. It is anticipated that the length of stay will average one week and may range from two days to three weeks. The Alcoholism Program Director will spend sixty percent of his time in the Inpatient Services. This person will have a Master's degree, or 5 Inpatient Services - Alcoholism Annex - 2 the equivalent, and will have the necessary experience and work training to implement, supervise, and coordinate the total Alcoholism Program. A Program Physician, an M.D. with experience in dealing with alcoholics and their treatment, will spend eighty percent of his time in the Inpatient Program. When he is on duty, it would be possible for him to see and evaluate a potential patient and make a disposition -- whether to admit him, discharge him, or send him to John Peter Smith, or to some other comnunity facility. The Program Physician will also provide the medical supervision of all the patients in the inpatient, outpatient, and intermediate care components of the Comprehensive Alcoholism Treatment Program and will offer to the staffs his consultation on the treatment programs appropriate for each patient. Also, a psychiatrist will be retained at five percent of full time to provide program and case consultation. A registered nurse will be at the facility 24 hours a day and will have the support of a nurse's aide and a security aide (a policeman dressed as a nurse's aide) 24 hours a day. As soon as a patient is admitted to the Alcoholism Annex, efforts will be made to involve the patient in a multi-faceted treatment program and to increase the patient's motivation for recovery. The primary thrust of the -treatment program will be supervised by an MSW Therapist who will spend forty percent of his time in the Inpatient Service (the other sixty percent of his time will be in the Outpatient and -the Intermediate Care Services). Three Alcoholism Specialists-Therapists will function in the Alcoholism Annex under the supervision of the MSW Therapist. (These Alcoholism- Therapists will function part of the time in the Emergency Room of John Inpatient Services - Alcoholism Annex - 3 Peter Smith Hospital to assist the staff there in dealing with alcoholics. This would also provide for continuity of care and coordination between the Emergency Services and the Inpatient Services.) These staff members will initiate .therapy programs for each patient and give support and guid- ance to the patients. In addition to their efforts the three Outpatient Counselors assigned to the Outpatient Services will make contact with the patients in the Alcoholism Annex so that a relationship between the Coun- selor can be cultivated as soon as possible. At the same time (while the patient is in the Alcoholism Annex) the six Follow-Up Counselors assigned to the Outpatient Services will contact the families of the patients and offer counseling, support, and guidance. There will be one executive secretary who will serve as the secretary to the Program Director and the Program Physician and who will be respon- sible for all the patients' records and major reports. Support staff of two clerks, a cook, *and a janitor will be provided. Most of the food will be supplied by transporting meals for the patients from the Hospital across the street. Thus the cost for food will be written in as a total sum in the operating expenses of the Alcoholism Annex. As soon as a patient has recovered from the physical side effects of alcoholism and a treatment program has been initiated, the patient's dis- position will be decided by a Patient Evaluation Team. This team will be composed of the Program Physician, the MSW Therapist, the Outpatient Coun- selor working with the patient, and perhaps the Alcoholism Program Direc- tor. This team will decide if the patient is ready to leave the Alcoholism Inpatient Services - Alcoholism Annex - 4 Annex Inpatient Services. If they decide he is ready, he can be discharged either to go home or to be placed in a halfway house. With either disposi- tion, continuing outpatient treatment will be scheduled at the Outpatient Clinic closest to the patient's residence. With most patients it is anti- cipated that intensive outpatient treatment efforts will be required. Also, the Follow-Up Counselors will continue to work closely with the family of the patient. :r a r. _,2 INPATIENT SERVICES - ALCOHOLISM ANNEX JPSH JPSH JPSH Psychiatric Ward Program Medical Ward Private Emergency Room (Psychiatrist) Physician (Physician) Physician (Physician) Alcoholism Annex Halfway House Home Outpatient Treatment Outpatient Treatment INPATIENT SERVICES - ALCOHOLISM ANNEX Alcoholism Program Director 60% ($15,000/yr. ) $ 9,000.00 Program Physician 80% ($25,000/y r. ) 20,000.00 Psychiatrist 5% ($3,000/y r. ) 1 ,500.00 4.2 Registered Nurses ($606.67/mo. ) 35,815.00 4.2 Nurses Aides ($355.33/mo. ) 17,907.00 4.2 Security Aides 40,500.00 ~` 3 Alcoholism Specialists - Therapists ($7,200/yr. ) 21 ,600.00 MSW Therapist 40% ($10,000/yr. ) 4,000.00 1 Executive Secretary - Records Librarian ($550/mo. ) 6,600.00 2 Clerks ($435.00/mo. ) 10,440.00 1 .4 Cook ($420.00/mo. ) 7,056.00 1 .4 Janitor ($340.00/mo.) 5,712.00 TOTAL $180,130.00 Employee Benefits (10%) 18,013.00 TOTAL STAFF SALARIES $198,143.00 t { OUTPATIENT SERVICES f E f i The Outpatient Program is anticipated to be the backbone of the Com- prehensive Alcoholism Treatment Program. It will serve all the patients entering the comprehensive program through any of the components and will provide the wide range of rehabilitation services anticipated to be needed I by the patients in the program. The Central Outpatient Clinic will be located at the Alcoholism Annex and will be supervised by an MSW therapist (forty-five percent of his time will be assigned to the Outpatient Ser- vices, and the other fifty-five percent will be assigned to the Inpatient and Intermediate Care Services. Many patients would come to the Outpa- tient Program from the Inpatient Program at the Alcoholism Annex, but entry into the Outpatient Program can be direct, that is, a patient who does not need inpatient services can be scheduled straightaway in the Out- patient Program. Some could come directly to the Outpatient Program from John Peter Smith Hospital 's Psychiatric Ward, the Emergency Room, or a Medical Ward. (See the attached chart.) To assist the outpatient staff and to coordinate all facets of the Comprehensive Alcoholism Treatment Program, the Alcoholism Program Direc- tor will spend twenty percent of his time in Outpatient Services. The Program Physician will spend ten percent of his time in the Outpatient Services offering patient supervision and staff consultation. A psychi- atrist will be retained at five percent of full time to provide program and case consultation when needed. The clinical staff located in the Al- coholism Annex will support both the Inpatient and Outpatient Services' staffs. Outpatient Services - 2 In addition to the Central Outpatient Clinic located at the Alcohol- ism Annex, there will be an Outpatient Clinic located in each of the three catchment areas served by the alcoholism program. Most of the patients will first be seen at the Central Outpatient Clinic and then be assigned to the satellite Clinic closest to his residence. However, it would be possible for a patient to be treated in a satellite Clinic without pass- ing first through the Central Clinic. In each of the three satellite Outpatient Clinics there will be a fulltime Outpatient Counselor and two fulltime Follow-Up Counselors. The Outpatient Counselor will be responsible for the case management of each patient, that is, he will contact the patient as soon as the patient en- ters the system (probably at the Inpatient Service) and establish a rela- tionship with the patient and begin a treatment program. He will be res- ponsible for continuing with the patient throughout his treatment program. The Follow-Up Counselors will be responsible for contacting the family of the patient and initiating and continuing a program of counseling and sup- port with each family. One of the two Follow-Up Counselors assigned to each satellite Outpatient Clinic will work closely with the Outpatient Counselor at that Outpatient Clinic, forming a team. The other Follow-Up Counselor will work closely with the outpatient counselors located at the y Community Action Agency's neighborhood centers in the catchment areas (these CAA counselors are currently funded by a grant from the Office of Economic Opportunity). Thus a second team of CAA outpatient counselor and Follow-up Counselor will be formed for the catchment area. (See at- tached map.) Outpatient Services - 3 These teams in each catchment area will provide the many rehabilita- tion services needed by the patients and will provide the necessary counsel- ing to the families. All of the Counselors will include home visits to patients and families as a major aspect of their activities. Also, these staff members will function actively within their neighborhood areas to publicize the services and help available to alcoholics and their famil- ies and to assist in educating the public about the disease of alcoholism. These staff members will be encouraged to use aggressive outreadh tactics. OUTPATIENT SERVICES JPSH (Psychiatric Ward Inpatient - Patient or Emergency Room Alcoholism Annex or Medical Ward) Central Outpatient Clinic at Alcoholism Annex -Outpatient Clinic --6 CAA FWSMH Clinic Centers Private Outpatient Treatment LO --Northside Outpatient Clinic CAA Centers Patient C. --Stop Six Out atient Clinic or Mosier Valley CAA Center ...� � .w-.����y��is •:. VV Haw IVII "At IBM ` MEMO ..'i r"-"'.' �`` -. 11 °, -^r 3� �, 1 :, ► /k -yam. ors 4es4 =LIS ►� :� l�a / e I + II k= q a� i * :,• y Ili `M /�- �/' F,1,� ;;�/►r,� _ ` • I� .� � .dI f IIII€� ,�, 11¢ i�'Iu ,T -®IY! 1 L, TQ. .uue • J �'t'/Ea d°��,c`r5'J I 'op ...... lt� `��\•:,`.'I�MOM � �ii- r � � k� •'il .11 nr{ �y 1 v s�._u•!a�C7C _ r il ,. �.':. IYInN a,.edR`�► III! 1� �'� -el . ----- _ - - �; MR. 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OUTPATIENT SERVICES Alcoholism Program Director 20% ($15,000/yr. ) $ 3,000.00 Program Physician 10% ($25,000/yr. ) 2,500.00 Psychiatrist 5% ($30,000/y r. ) 1 ,500.00 -1 Outpatient Coordinator - MSW Therapist 45% ($10,000/yr. ) 4,500.00 3 Outpatient Counselors ($7,200/yr.) 21 ,600.00 6 Follow-Up Counselors ($7,200/yr. ) 43,200.00 TOTAL $76,300.00 Employee Benefits (10%) 7,630.00 TOTAL STAFF SALARIES $83,930.00 INTERMEDIATE CARE - HALFWAY HOUSES Intermediate Care will be available for those patients who do not need full-time, twenty-four hour inpatient care but who are not able to function independently in the community without structured support and who need assistance in refining their vocational skills and obtaining employment. Two halfway houses will be available to provide this inter- mediate care. Both are located in the central part of Fort Worth and are older residences converted for this purpose. The men's has a capacity of thirty, and the women's, ten. It will be possible fora client to stay in this component of the Comprehensive Alcohol Treatment Program up to approximately 4 months , although. it is hoped that he will be able to function without this support after approximately one to two months. Both halfway houses are currently in operation to a limited degree as boarding facilities; no counseling staff is provided now, and there is no treatment or therapy program offered. The atmosphere in both houses is comfortable and relaxed. The programs of these halfway houses will be upgraded in order to provide the services necessary for the Intermediate Care component of the Alcoholism Treatment Program and to qualify for rating as a Class I facility by the Texas Rehabilitation Commission. The physical space will be checked, and any necessary renovations will be made to meet the following standards. The living space for each client will be adequately large and comfortable; there will be offices available that are private and large enough for counseling; the dining room will be able to accommodate all residents at one time; the living areas will be large and will be furnished adequately for indoor leisure time activities; and k Intermediate Care - Halfway Houses - 2 there will be adequate first-aid supplies and fire precautions. Room and board will be available to all clients. A cook and relief cook are currently employed. Supervised living will also be provided and is described as the following: "to provide parental influence with regard to appropriate dress , personal hygiene, manners, etc. ; to assign housekeeping duties; to see that house rules are adhered to; to be appraised of activities of all clients and to know their where- abouts at all times; to notify proper authorities in case of emergency and to take immediate action when necessary." For these purposes two house managers, one for the women's house and one for the men's house, and a Director of Halfway Houses will be employed. Personal - social adjustment will be an important part of the therapeutic program offered and consists of the following: "a formalized program of training to assist the individual to acquire personal habits, attitudes and values and social interaction skills that will enable him to function effectively and to integrate his total personality to his environment; particular emphasis to be placed on his emotional reactions to his disability, his education, his vocational and social experiences, and his attitude toward total adjustment." Each client will receive at least five hours a week of individual attention for these objectives. The Outpatient Counselor who is responsible for the case management of the client will be active in this respect, and a psychologist and a social worker will spend some time in individual and group sessions with all the clients to improve the personal and social adjustment of each. Thus, competent and qualified staff will be available to assure that this service is provided. Intermediate Care - Halfway Houses - 3 Work adjustment is another service to be provided and consists of the following: "a formalized program whose basic purpose is to aid the individual in adjusting to the psychological and social demands of a work setting; this service to include the locating, obtaining, and main- taining of gainful employment commensurate with the client's ability; to consist of utilization of work and the work environment to enable the individual to experience the employer - employee relationship in a productive environment with the aim of helping the individual adapt to work situations rather than for the development of job skills." The Vocational Rehabilitation Courtesy Counselor will function in both the halfway houses to provide this service with the support of the halfway houses' staffs. To assure coordination between this program and all the other services of the Comprehensive Alcoholism Treatment Program, the Alcoholism Program Director will devote five percent of his time to the Intermediate Care Program. Individual counseling and group counseling will be offered in the helfway houses by the psychologist and the social worker who will be operating in all the components of the Comprehensive Alcoholism Treat- ment Program with part of their time assigned to the Immediate Care Program, thus insuring continuity of care. Medical supervision of the clients will be provided by the Program Physician who will check the medication of any of the clients that might be receiving and who will be at the halfway houses a specified period of time each week. Any medical emergency that might arise will not be handled at the halfway house, but the client will be immediately transferred to the John Peter Intermediate Care - Halfway Houses - 4 Smith Hospital for attention. Transportation except in emergencies will be provided via the public transportation facilities which are readily accessible to both halfway houses. S i I INTERMEDIATE CARE - Patient JPSH JPSH Medical Alcoholism annex- tpati*nt P yoiatric. Ward Ward Inpatient Cling i (any I of 4) h Halfway } Houses (2) (And Outpati nt Treatment) Home and Job . (And Outpatient Treatment) r r - n' S.r i INTERMEDIATE CARE - HALFWAY HOUSES Alcoholism Program Director 5% ($15,000/yr.) $ 750.00 Program Physician 10% ($25.,000/y r.) 2,500.00 PsycholMist 20% ($12,000/yr. ) 2,,400.00 MSW Therapist 15% (Outpatient Coordinator) ($10,000/yr.) 1 ,500.00 Director of Halfway Houses ($8,400/yr.) 8,400.00 Halfway House Manager - men ($2,500/yr.) 2,500.00 Halfway House Manager - women ($2,500/yr.) 2,500.00 TOTAL $20,550.00 Employee Benefits (10%) 2,055.00 TOTAL STAFF SALARIES $ 221605.00 Y • J � EDUCATION, TRAINING AND CONSULTATION SERVICES To capitalize on the expertise of an existing agency, the Education, Training, and consultation Program will be administered by the Tarrant County Council on Alcoholism who is already engaged in such activities. Staff employed through this grant will 'be assigned to the Council offices and provide the services as herein described. An Education, Training, and Consultation Coordinator will provide program direction and administrative responsibility for a vigorous program of ed- ucation, training, and consultation, and this person will be a psychologist wit?1' experience in such activities and will spend eighty percent of his time in this component (the other twenty percent of his time is allocated to the Intermediate Care Service). It will also be the responsibility of the Coordinator to utilize the staff employed in the various Comprehensive Alcoholism Treatment Program com- ponents to assist in the planned program of education , training, and consultation services. In addition, two Education, Training, and Consultation Specialists will be employed to provide education and training not only to the staffs in all components of the total Comprehensive Alcoholism Treatment Program, but also to community groups and agencies. Support staff of two secretaries will be provided to handle all the clerical and reporting procedures. The Education, Training, and Consultation Coordinator will be responsible for working with clergymen through organized religion. He will arrange and conduct workshops and seminars for community clergymen and ministerial students and will provide consultation to individual clergymen about the problems and techniques of pastoral counseling for the alcoholic and his family. The Coordinator will develop liaison with the public school system for the development of training institutes for school teachers and administrators. The Education, Training and Consultation Services - 2 influence of the school system is identified as a strategic and potent force in community and family life. The potential of the school system for the prevention and control of alcoholism consequently will be given high priority in education, training, and consultation services. Additional activities will include the provision of sery ices to public welfare personnel , public health nurses, and other health and social welfare personnel . An initial goal of the Education, Training, and Consultation Program- will be s to give adequate publicity to the inauguration of this new comprehensive treatment program and to stimulate appropriate utilization of the various elements of service. This will be achieved through use of the mass media and operation of a speaker's bureau. Close coordination and utilization of the staffs of the Outpatient Clinics will assist in achieving these goals. i Although this program has public relations implications, this service is viewed as a program of prevention with both long and short range goals rather than one that seeks merely to project a favorable public image of the Comprehensive Alcoholism Treatment Program. It is anticipated that prior to the opening of each service element, there will be a two week intensive inservice training and orientation program for the staff of each service element. The development of a program to meet the inservice training will be the responsibility of the Education, Training, and Consultation Coordinator. This inservice staff training program will be interdisciplinary. Students from the Brite Divinity School of Texas Christian University and the Southwestern Baptist Theological Seminary, as well as graduate students from Education, Training and Consultation Services - 3 the University of Texas at Arlington Graduate School of Social Work, are expected to be placed in the various service elements of the Comprehensive Alcoholism Treatment Program as part of their graduate training. Graduate student placements have mutual benefits in that they provide assistance and stimulation to both staff and clients in the services while the students receive training and thus contribute to the pool of professional manpower trained to work in alcoholism programs. M EDUCATION, TRAINING, AND CONSULTATION SERVICES Alcoholism Program Director 5% ($15,000/yr.) $ 750.00 Education, Training & Consultation Coordinator (Psychologist) 80% ($12,000/yr. ) 9,600.00 2 Education, Training & Consultation Specialists ($8,400/yr. ) 16,800.00 2 Secretaries ($4,800/yr. ) 9,600.00 TOTAL $ 36,750.00 Employee Benefits (10%) 3,675.00 TOTAL STAFF SALARIES $ 40,425.00