The Continuum of Care Model

The Continuum of Care model for mental health services for adults was an off-shoot of a 2001 Community Access Program grant to UTMB and its 21-member community coalition from the Health Resource Services Administration (HRSA) to improve access to health care for all residents of Galveston County. At the time that the $1.9 million grant became operational, the need for additional mental health services was evident but very little funding was available to enhance mental health care. Therefore, a mental health task force was developed to further study the issue and members made application for a second HRSA grant that was awarded to the coalition in 2005.

Under the second grant, Gulf Coast Center (GCC), the mental health authority for Galveston and Brazoria counties, worked with UTMB and partners to develop a virtual mental health network designed to expedite treatment, reduce crisis episodes, streamline referrals, boost enrollment in entitlement programs and most importantly, implement comprehensive, communitywide case management for GCC clients who had fallen off the patient rolls.

The program placed five case managers throughout the communities in Federally Qualified Healthcare Centers, jails, faith-based organizations, hospitals, emergency rooms, and free clinics; and launched two, two-person mobile response teams (MRTs) on the road in both counties. In a single year of operation, the case managers:

  • Recorded over 5,200 encounters with patients and case management of nearly 2,300 clients
  • Recorded over 1,300 patient encounters by MRTs
  • Enrolled 354 clients in entitlement programs
  • Ensured over 75 percent of appointments made for clients were kept
  • Introduced telepsychiatry in Brazoria County for near-crisis intervention and ensure 86 percent of appointments were kept
The impact of these programs was to decrease unnecessary visits to local emergency rooms. When the federal government cut HRSA funding resulting in the elimination of year two funding of the mental health grants, UTMB, realizing the cost-savings potential of the program stepped in to provide transition dollars to keep the program in operation until additional funds could be obtained. At present, the program is funded in part by the Meadows Foundation of Dallas as additional funders are sought. Sustainability will likely come through ER cost-avoidance. The State of Texas has realized the success of the model and mandated the implementation of crisis response MRTs throughout Texas.