Frontier Health’s careful management of resources serves more than 73,000 clients in 2009

During a recession there is usually a spike in first-time mental health needs in the community and Frontier Health’s CEO confirms seeing an increased demand for mental health services.

“A fluctuating economy, lost jobs, closing businesses, and other stressors can result in family struggles,” said E. Doug Varney, President and CEO of Frontier Health. “We’ve seen people who never needed services before face depression or other issues and we’re here to help.”

In 2009 Frontier Health helped more than 73,000 adults, children, and adolescents at its 63 sites and within its more than 85 programs in Northeast Tennessee and Southwest Virginia.During Fiscal 2009, there were 32,111 open outpatient cases.

Of those Frontier Health clients, 47 percent of Frontier Health clients have an income at or below 100 percent of the federal poverty level. Of available Tennessee Department of Mental Health and Developmental Disabilities Behavioral Health Safety Net funds, 99.6 percent were fully utilized and this year over-utilized for clients who sought care.

Frontier Health provides mental health, substance abuse, vocational rehabilitation, recovery, and intellectual and developmental disabilities services. The continuum of community programs include services for victims of domestic violence and AIDS, 24/7 crisis response services, interpreter services for hearing impaired, and residential services for individuals with mental illness and/or state custody issues. To provide those services, Frontier’s 1,011 employees traveled 1,728,418 miles during Fiscal 2009 to provide those services in a 12,000-square-mile 12-county coverage area.

The staff of 1,011 employees includes psychiatrists, psychologists, licensed clinical social workers, licensed professional counselors, licensed marriage and family therapists, and other professionals. Frontier Health provides services in Carter, Greene, Hancock, Hawkins, Johnson, Sullivan Unicoi, and Washington counties in Tennessee; and Lee, Scott, Wise counties, the city of Norton and Bristol/Washington County, Virginia.

...”A fluctuating economy, lost jobs, closing businesses and other stressors can result in family struggles….We’ve seen people who never needed services before face depression and other issues and we’re here to help,” said Doug Varney, President and CEO of Frontier Health.

Through careful management during this recession Frontier did not cut any of its workforce, managed to serve a more than 73,000 clients with mental health needs, and found innovative ways to fund services through grants, state programs etc.

“We manage our resources and keep the administrative costs at about half the industry standard,” said Varney. “We recognize our services are vital to the communities we serve and pay attention to small things,” said Varney.

New innovations and expanded programs were begun in the last year to cope with increased demand for services. During 2009, Frontier Health opened the only Tennessee Crisis Stabilization Unit east of Knoxville, provided more than $32.5 million in subsidized care, purchased a new Weber City location for Scott County Behavioral Health Services, and in 2010 will open a new recovery program in Greeneville, TN.

Frontier Health opened the first Crisis Stabilization Unit (CSU) in Northeast Tennessee serving 10 counties: Carter, Cocke, Greene, Hancock, Hamblen, Hawkins, Johnson, Unicoi, Washington and Sullivan. The Johnson City CSU is a voluntary, mental health unit for adults 18 and older who are experiencing a mental health emergency. Referrals are made by Frontier’s Mobil Crisis Response team through an initial screening, assessment and triage.

“Instead of transporting clients in need of stabilization away from our region, we are able to address their mental health crisis at home,” Varney said. “Once stabilized, our CSU helps clients continue needed treatment and referrals to resources, treatment and services within our communities.”

CSUs are a cost-effective way for communities to offer intensive, 24-hour mental health treatment in a less-restrictive setting than a psychiatric hospital or other treatment resources for a minimum 72-hour stay. “A main goal of the CSU is to divert clients, when clinically appropriate, from psychiatric inpatient hospitalizations and unnecessary incarcerations stemming from their behavioral health conditions,” said Cindra Jones, TDMHDD.

The Greeneville recovery program is set to open in the spring. The psychiatric rehabilitation program is for people with physical, mental, and/or emotional disabilities and provides vocational and job readiness training, employment placement, job coaching and Recovery Education Center Services.

To help provide the $32.5 million in subsidized care, Frontier Health utilized diversified funding sources, foundations, grants, fees and also support from area United Way agencies and local governments for individuals —most with no ability to pay.

On an ongoing basis to meet increase demand for services Frontier Health works with legislators in Tennessee and Virginia to pass legislation to address emerging needs and tackle health care gaps and evolving social problems. This includes further development of a region-wide electronic health record through CareSpark.

School based mental health services are provided in Elizabethton, Greeneville, Johnson City, Kingsport, Carter, Johnson, Unicoi and Washington counties through grant funding and contracts that place counselors in area schools to provide individual and group services for children and their families. The program in Elizabethton increased from 18 hours to 42 hours per week to provide mental health services. This has allowed 100 percent increase in student contact in that school system.

In Kingsport, two additional counselors and a system wide social worker were added at the elementary schools. This occurred through a federal Elementary Counseling Grant that was awarded to Kingsport City Schools. All of the elementary school now have access to a mental health counselor who can provide screening and early intervention for students who may need some assistance.

A Johnson City Schools Safe Schools and Healthy Students $8.2 million federal grant, the HEROES project, provided 17 new Frontier Health staff positions in the schools in addition to other services developed through the Johnson City Juvenile Court and the Johnson City Police Department. These staff provide programs to address bullying, early alcohol and drug use and develop resources for parents who need assistance. School-based mental health services have been expanded in all of the schools and there are additional parenting resources available. This school, court, law enforcement, mental health collaboration has a management team that directs activities of the HEROES project.

Project BASIC, funded by Tennessee Department of Mental Health and Developmental Disabilities, is provided in Carter, Greene, Hancock Hawkins and Unicoi counties. The program helps students develop appropriate expressions of feelings, social skills, conflict resolution and problem-solving skills in the classroom. This program has been used as a model for some of the school-based grants that have been received in the region.

Through a School-Based Mental Health Liaison Grant, Frontier Health received funding for two counselors in Washington County Schools who provide school-based mental health services. In the current school year those services were expanded with a half-time position at Unicoi County High School in Unicoi County and at Happy Valley High School in Carter County. These staff works with the school systems to identify students who are in need of additional help. In all of these school-based programs, consultation and direct intervention with bullying and alcohol and drug use prevention is a priority.

Ideally, all of these school-based programs assist families in having access to mental health services for their children. Through these programs, staff can also assist parents in finding the help they may need.

Frontier Health has also partnered with the Children’s Advocacy Center in Mosheim to provide the STARS program. This early intervention program helps preschool children with severe behavior problems. The program teaches parents and children social skills, conflict resolution, parenting strategies and problem-solving skills.