Cornerstone Montgomery

Intensive and specialty servicesthis program provides residential rehabilitation, residential crisis and assertive community treatment. Residential rehabilitation provides general and intensive level housing for up to 224 consumers. The mission of the program is to assist people realize their own goal of living as independently as possible by providing training, supervision and assistance in the skills of community living. The program uses evidence based practice models such as dbt (dialectical behavioral therapy), itcod (integrated treatment of co-occurring disorders) and imr (illness management and recovery) to help consumers move to less intensive levels of residential rehab supports. Staffing at the different sites ranges from drop-in to twenty-four hours per day. As we slowly come out of covid, we continue to have staffing issues and increased vacancies. Residential crisis provides a community-based residential alternative to inpatient hospitalization with intensive 24 hours per day staff supervision to help people in psychiatric crisis become stabilized and return to normal life routines as quickly as possible. We served 204 consumers with three houses in fy22 and more than half of the community referrals came from hospitals. A stay in this program costs the state one third of an inpatient hospital visit and research shows this model to be equally effective. During the covid-19 pandemic we continued to take in hospital and community referrals for those in need of our assistance. Covid had a huge impact upon referrals to this program, but that has improved over the last year. Staffing was impacted by turnover, recruitment challenges, and we continue to have occasional covid exposure and covid infection where we need to put holds on intakes until the infection is cleared. This year we renovated two of the houses with state community bonds. This also impacted revenue.the assertive community treatment (act) team is an intensive evidence based treatment model which combines outpatient mental health and psychiatric rehabilitation services out in the community. It provides assertive outreach, treatment and support to adults who have not been successful in more traditional forms of outpatient treatment. Service provision is mobile and provided in the individual's natural environment (i.e. Home, street, shelters, etc.). This is considered the highest level of care provided to clients in a communitybased setting. The team is composed of therapists, addiction specialists, vocational specialists, peer counselor, psychiatrist and nurses and can serve up to 200 consumers. This year close to 180 clients were served, with 45 gaining housing. Covid to have an impact on staffing by turnover, recruitment challenges, covid exposure and covid infection.

Clinical and medical services outpatient mental health clinics provide outpatient psychiatric therapy and medication services to approximately 1,000 individuals in the community. The program is organized to provide continuity and integrated care with other providers including pcp, specialty, and other behavioral health services as well as telehealth. It offers individual and group treatment modalities. The program uses evidence base practice interventions such as family psycho-education, dialectic behavioral therapy, and integrated treatment for co-occurring disorders. In addition, the individual therapy, group therapy and medication services are available to anyone in the community in need of such services. Covid meant that we had to pivot to almost 100% telehealth services. We are slowly increasing the number of in person services this year, but most continue to be virtual. Covid continues to have an impact on staffing by turnover, recruitment challenges and client caseloads (we have lost at least 300 clients). Integrated health services department oversees the health home program, a state medicaid program to improve the somatic health of people with serious mental health problems. Health homes tracks health data and to support clients with chronic somatic conditions such as diabetes, hypertension or a high bmi by linking them to medical care and supporting them in activities that promote wellness. Covid affected this program with the staffing issues in rrp that impacted the health homes billing.

Community services community services encompass our vocational, transition aged youth, day and supported living programs.vocational services include vocational assessment and planning, supported employment job search and coaching services, work adjustment training, job placement and employee support services. The program helped a total of 634 consumers look for, find and maintain employment in fy22 with 341 being employed, including 182 new job placements. The employment rate of this program is more than three times the national average of employment for people with disabilities. Covid affected this program with clients who were exposed or became ill and were unable to work. Clients were not as active with job seeking. Covid continued to have an impact on staffing by turnover, recruitment challenges, covid exposure and covid infection. We have not regained the capacity or employment numbers that were lost. Transition age youth services are also provided under the umbrella of the vocational programs. The career transition program provides a unique combination of mental health, career/vocational and educational resources to assist students and their families and young adults in identifying and obtaining necessary resources to assist in a successful transition from school to work or post-secondary academic environments. The career academic psychiatric-rehabilitation services provides a combination of supported education and supported employment services to young adults age 18-25 post high school to assist them in achieving their employment and academic goals. These teams served 148 consumers with 73 employed and 49 new job placements in fy22. This program also includes 12 rrp beds and a new prp team with 16 clients. Covid continues to have an impact on staffing by turnover, recruitment challenges, covid exposure and covid infection. Day programs (foundations) provide outpatient rehabilitation training, seminars and social/recreational activities to assist people in developing independent living skills and community integration skills. Anyone in any of the psychiatric rehabilitation programs is eligible to participate in the day programs. Most skill development and recovery activities are provided in a group setting and consumers have significant input into classes and activities. Covid dramatically affected this program because we stopped providing in person groups. We did return to limited in person groups during this year, with some success and plan to increase that over the next year. Covid continues to have an impact on staffing by turnover, recruitment challenges, covid exposure and covid infection. Supported living services provide counseling and independent living skills training to people living in their own homes in the community. The program is organized to assist people to live as independently as possible through counseling, skill development and other support and assistance on a drop in" basis. This program also provides evidence-based practices in dbt, itcod and imr. Covid continues to have an impact on staffing by turnover, recruitment challenges, covid exposure and covid infection.