Issue 19: API 2000 Community Implementation Process

Goal: Ensure that integrated, community-based services are implemented and maintained to accommodate a smaller Alaska Psychiatric Institute.

Discussion

As Alaska's only state psychiatric hospital, Alaska Psychiatric Institute has played a key role in the mental health services in Alaska. The need for a new building for API was identified over ten years ago. Initially conceived as a 114-bed facility, the size of the planned facility has been dictated more by financial constraints rather than underlying service needs. Concurrently, consumers and advocates have maintained that comprehensive, integrated community services can significantly reduce the number of beds needed at Alaska Psychiatric Institute.

In January, 1997, a state-funded study presented several scenarios for a downsized Alaska Psychiatric Institute. A follow-up study in October, 1997 examined the considerations and steps necessary to implement a 54-bed hospital model. The report concluded that the 54-bed model is both desirable and affordable, and outlined the essential elements of the API Community Implementation Plan. The Plan shifts public hospital resources and maximizes third party revenues to build comprehensive community services which are closer to home and in less restrictive environments. Alaska Psychiatric Institute's 54 beds will be used to serve clients whose needs cannot be effectively addressed at the community level.

A project structure with broad-based stakeholder involvement is now being established to guide the development of services under the Community Implementation Plan. It is estimated that the phase-in process for community based services under the Plan will take a minimum of two years.

Actions

281. The Alaska Mental Health Board will ensure that enforceable agreements are in place regarding needed community services to complement a smaller Alaska Psychiatric Institute.
Responsible party: Alaska Mental Health Board

282. The Alaska Mental Health Board, the Alaska Mental Health Trust Authority and the Department of Health and Social Services will ensure that the Community Implementation Plan includes the following elements:

a. A single point of entry system for behavioral health emergencies in the Anchorage area.

b. Enhanced acute-care diversion services in South Central Alaska including 23-hour crisis stabilization, crisis respite, designated evaluation and treatment beds, and residential detoxification services for dually diagnosed clients.

c. Enhanced assisted living and/or nursing home services and psychiatric consultation for persons with long-term care needs.

d. A plan for addressing the inpatient/residential care needs of adolescents with an emphasis on community based alternatives to the adolescent unit at Alaska Psychiatric Institute.

e. A detailed budget plan for financing the phase-in of community-based services and managing the transfer of resources from Alaska Psychiatric Institute to the community.

283. The Alaska Mental Health Board, the Alaska Mental Health Trust Authority and the Department of Health and Social Services will ensure that all major stakeholders are represented in the community implementation process and that any deviations from the Plan are developed through stakeholder consensus whenever possible.
Responsible party (actions 2-3): Alaska Mental Health Board, Department of Health and Social Services, Alaska Mental Health Trust Authority