Receiving Center

• The Receiving Center is a short-term outpatient community environment staffed with mental health professionals to help individuals resolve an immediate psychiatric crisis.

Receiving Center services are for individuals capable of resolving an immediate psychiatric crisis and discharge with outpatient treatment referrals.  

Receiving Center staff do not facilitate inpatient hospital psychiatric admissions.

• UNI has teamed up with Salt Lake County and Optum Health SLCo to provide free crisis response and hospital diversion programs that aim to keep all our family members, friends, and neighbors safe.

• The community crisis service programs are designed to provide community members with a full range of options to help solve the crisis in the best setting possible.

• Our team of professionals are highly trained in mental health crisis management and suicide prevention.

The Receiving Center is a recovery- focused environment with peer support and clinical staff to help individuals regain a sense of hope, choice and empowerment.

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DEFINITIONS OF CRISIS• “People are in a state of crisis when they face an obstacle to an

important life goal - an obstacle that is, for a time, insurmountable by the use of customary methods of problem-solving.” (Caplan, 1961)

• “…an upset in equilibrium at the failure of one’s traditional problem-solving approach which results in disorganization, hopelessness, sadness, confusion, and panic.” (Lillibridge and Klukken, 1978)

• “…crisis is a perception or experience of an event or situation as an intolerable difficulty that exceeds the persons current resources and coping mechanism.”(James and Gilliland, 2001)

WHAT IS THE RECEIVING CENTER?

• The Receiving Center is a short-term (up to 23 hours) secure center providing therapeutic crisis management for individuals.

• An assessment based on strengths and psychiatric needs will be provided.

• The staff will work with guests on a wellness recovery/discharge plan.

• The Receiving Center is staffed by advance practice nurses, physician assistants, social workers, certified peer specialists, and psychiatric technicians.

• The Receiving Center is not the next step to an inpatient

admission, nor does it house individuals until an

inpatient bed is available.

• The program is intended to defer guests from emergency room visits, and inpatient admissions.

THE UNI RECEIVING CENTER (RC)….• ….is an innovative program funded by Salt Lake County Medicaid Dollars providing a

short-term stay based upon a psychiatric need in a secure crisis center.

• The RC is designed to offer a safe, supportive and welcoming environment to both voluntary and involuntary individuals. It recognizes each person as a guest and provides the critical time needed to work through his or her crisis.

• Treatments include therapeutic crisis management, strength-based assessment and processing utilizing peer specialists, screenings to determine health-care needs, behavioral health assessment by a licensed mental health professional, medication discussions, safety, security and assistance in discharge planning which includes community resource referrals.

• The RC acts as the primary receiving facility for law enforcement officers and EMS personnel in Salt Lake County.

• Treatment is based upon a wellness recover model.

RECEIVING CENTER CONTINUED…• We accept clients from MCOT, Crisis Line, CAC, Police, and EMS, Agencies

in the community and all Emergency Rooms throughout Salt Lake County.

• We serve the Medicaid (Optum), Uninsured, and Low income population who live in Salt Lake County, with the exception of MCOT referrals.

• We have space for 6 individuals, our priority are individuals with Medicaid (Optum), and Unfunded.

• We do accept individuals who have private insurance, but will need to be considered case by case.

• Patients are not admitted for medications to be started or altered.

RC CONTINUED…• Individuals who are agitated and combative must be calm before they are admitted to

the Receiving Center. – If they are not already in an Emergency Room they will need to go to one first, before staffing with

Receiving Center Clinicians. Individuals who are detoxing from Alcohol or Benzodiazepines, as well as, any other drug unless, the medical provider is consulted and they are willing to accept the patient.

• While in the Receiving Center, a clinical Social Worker, and Advanced Practitioner will meet with the guest to help identify their needs and goals.

• Pt will also receive crisis counseling, and medication reviews (medications are not prescribed and are not started while in the Receiving Center).

• Pt will also have the opportunity to work with a Peer Specialist, on safety planning, and coping skills. – In addition, depending on the milieu there will be impromptu groups held during the daytime hours.

ACCOMMODATIONS

The RC is considered “Bedded Outpatient”, which is extremely different from inpatient units. There are no private rooms with beds, no television, personal items are not allowed (cell phones, wallets, etc.), there is no smoking, and guests may be voluntary or involuntary.

The main living room is where most guests will sleep, either on a couch or a recliner, depending on how many guests are present and what is available.

There is a private bathroom with a shower if guests would like shower and change into scrubs.

There is a small refrigerator with meals and juice/milk/water . We ask that guests be respectful and only take one meal as there is limited quantities and more guests may arrive throughout the day and night and be in need of a hot meal.

(If guests are here at breakfast, lunch and dinner times, the meals will be provided from the kitchen and brought the RC)

There are two private assessment room for one-on-one therapy, assessment, and evaluation by licensed providers (social worker and medical providers).

LIVING ROOM STYLE MILIEU• It is important to let potential guests

know that there are not private rooms to sleep in, nor are there beds. This is an outpatient short term (23 hours or less) crisis center.

• Guests can sleep on a couch or a recliner depending on how full the unit is already. (first come, first served).

• Both males and females share the living space and sleep in the same living room. There are cameras and guests are kept safe with frequent (every 15 minutes) wellness checks for guest safety and medical monitoring.

GUIDELINES FOR RECEIVING CENTER GUEST• Individuals need to have a psychiatric diagnosis and be in crisis.

– (Homelessness is not a crisis)

• Psychiatric diagnosis.

• Must be at least 18 years of age.

• Medically stable

• Individuals need to be able to ambulate and care for the ADLS on their own.

• Willing to come to work on a discharge

treatment plan for outpatient treatment

• Be calm and cooperative

POTENTIAL UNI-RC PATIENTS • Psychiatric complaints:

– Suicidal– Homicidal– Depression– Anxiety– Auditory/Visual hallucinations– Paranoia

EXCLUSION CRITERIA PRESENT?• Age: under 18

• Blood glucose: under 80 or over 150 mg/dl

• Any abnormal vital signs?– Temperature above 38 degrees• Heart rate above 130

• Systolic BP under 90 or over 180 mm Hg

• RR under 10/minute

• Medication or drug overdose

• Traumatic injuries requiring medical attention

• Uncontrolled or acute medical conditions

• Clinically apparent acute alcohol or drug intoxication

• Actively withdrawing from drugs or alcohol (we do not accept patients detoxing from benzo’s and alcohol)

BEHAVIORAL EXCLUSION PRESENT?• Physically combative

– Needing chemical or physical restraint– Aggressive toward staff, self, or others (both physically and verbally)

EMT or Paramedic judgment that the patient needs a higher level of intervention or that the RC would be an inappropriate setting for the patient given their current presentation.

TO MAKE A REFERRAL RC ADMISSION, WHEN CALLED BY EMS/ GOLD CROSS, PLEASE PROVIDE THE FOLLOWING:• EMS must speak with the medical

provider on shift.• Salt Lake County Residency Status

and funding• Correct Spelling of legal first and last

name of patient• DOB (must by at least 18 years old)• Living situation• Presenting problem- brief

explanation of situation • Medical Issues-acute, chronic,

current/history

• Medications- what are they taking? • Do they have the medications with

them?• Are there barriers to getting their

medications?• Substance Abuse current/history• At risk for withdrawal/detox issues?• SI/HI, is there plan or intent, any

self-harm.• Behavioral presentation

(experiencing AH/VH? What are they saying? What are they doing?)

AFTER A REFERRAL IS MADE….• After a referral is made please

allow the RC time to staff the potential patient the other members of the treatment team (medical provider and social worker).

• After a decision has been made the decision will be relayed to EMS.

• If the patient is accepted please give an ETA so the RC can make arrangements for the patient’s arrival.

• If the decision has been made to divert to the closest ED it is based on the clinical information given, acuity of the patient, availability at the RC at that time, and what is in the patient’s best interest.

• If the decision has been made to come directly to the RC please inform the patient of the Receiving Center’s Policy (no beds, no smoking, and no TV)

• Up to 23 hrs.

• It is not a gateway to inpatient admission.

WHAT MAKES A “GOOD” REFERRAL?

• Salt Lake County Residency Status, that is 18 years or older.

• In a crisis, emotional, SI/HI, with/without a plan or intent.

• Behavioral presentation (experiencing AH/VH and is able to control their behavior, they are calm and cooperative, or easily redirect able)

• Medications? They have them with them or are able to have them brought to the RC.

• Guest has been to the RC in the past and has been appropriate.

REPEAT GUESTS THAT WERE DENIED• Many guests request coming to the RC several days in a row, or several

times a month. Acceptance of a known guest is not guaranteed and each encounter is treated differently.

• Reasons why a known guest would not be accepted:– Previous behavior in the RC was inappropriate– Guest was verbally, physically abusive to staff or other guests– Guest did not participate in the process/refused services or help– Guest was not forthcoming as to what drugs, alcohol use was present– Uncontrolled medical conditions not reported and not addressed– Guest using services inappropriately (using RC as the shelter, wanting food/drink

due to lack of funding, wanting their medications for free without obtaining or filling their current prescriptions, demanding laundry services)

ADDITIONAL INFORMATION THAT MAY BE HELPFUL:

REFERRAL SOURCES AT A GLANCE• Referrals come from a variety of

sources in the community.

• Walk in-self referral, friend, family members

• Emergency Rooms

• Out patient providers

• Residential treatment/providers

• MCOT/Crisis Line/Text line

• Law Enforcement

• EMS

REFERRAL SOURCES by MONTH

Count of PATIENT NAME (Last, First) Column Labels

Row Labels 7 Grand Total

Emergency Room 77 77

Inpatient 11 11

SELF/FAMILY 10 10

Outpatient Provider 5 5

Residential Provider 4 4

MCOT 4 4

Crisis Line 3 3

Law Enforcement 2 2

Grand Total 116 116

WHAT TO EXPECT WRAP UP….• 1. Individuals commit to being

respectful and behaviorally appropriate;

• 2. Smoking is prohibited• 3. Individuals surrender cell phones, all

valuables, personal items and medications. These items will be returned upon discharge

• 4. Individuals need to bring their own medications

• 5. Medications are not prescribed. Individuals are referred to outpatient providers

• 6. Beds or private rooms are notavailable. Individuals sleep on futon couches or recliners

• 7. Once admitted individuals are not allowed to leave the unit until discharge

• 8. Individuals agree to participate in individual and group therapy

• 9. If staff feel an individual is behaviorally inappropriate for the Receiving Center community environment they can be asked to leave

• 10. Visitors are not allowed • 11. Individuals may be asked to

shower and change into scrubs• 12. Staff will help facilitate discharge

transportation which may include bus tokens, cab vouchers, van ride, etc.

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ALWAYS call before coming to ensure space is available.

801-587-7988•