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Annual Report
Proudly Serving Central Texans Since 1997
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Dear Friends,
In the blink of an eye, we raced through another year. For Bluebonnet Trails Community Services, fiscal year 2023 has been a year of bold transformation. Informed by our experiences and practices during a worldwide pandemic, our evolution has been defined by recognizing, respecting and guiding a new normal – a new way of working, new opportunities meeting local needs, and new avenues opening access to care. Despite extraordinary circumstances including a strategic expansion of our system of care among significant staffing shortages, this Bluebonnet Trails Community Services Team persisted and remained vigilant and determined. Within our Annual Report, we acknowledge and celebrate accomplishments benefiting the lives of the persons in our care as well as our community partners in service alongside us.
We are encouraged, optimistic and positioned for success. To be secured through an intelligent use of resources, the future is filled with promise. Together with colleagues throughout our communities, we deploy a strong strategic plan enhancing collaboration, thoughtfully filling gaps within our continuum of care, developing resources fortifying and sustaining our system of care, and recognizing the staff and partners this Annual Report intentionally celebrates.
As we continually refine the Bluebonnet Trails Community Services system of care, we acknowledge the challenges ahead and we embrace the promise that the future holds. Inspired by the resiliency of the persons we are privileged to serve and the commitment of our staff and community partners, we plan for the future. With gratitude for the dedication and governance of our Board of Trustees and the extraordinary investments of our county and state officials, we will lead the way in providing what Central Texas babies, children, adolescents and adults deserve – healthy and fulfilled lives.
Purposefully, strategically and boldly, we move forward,
Andrea Richardson, Chief Executive Officer
Supporting our vision for
healthy
fulfilled
and
lives,
Bluebonnet Trails Community Services Board and Staff assure access to a comprehensive array of services strengthening individuals and families throughout a lifetime.
During fiscal year 2023 (September 1, 2022 - August 31, 2023), the Center operated thirty-two offices, residential settings, campus-based programs, transitional home and program sites.
2023
Fiscal Year
32
Center-Operated
Office & Program Sites
24
Independent School District Locations
18
Substance Use Outpatient Locations
14
Integrated Health Care Locations
5
24/7 Crisis Facilities
39,907
Central Texans
Served
Counties Served with IDD Services as a Local Intellectual
and Developmental Disability Authority
Counties Served with Mental Health Services as a Local Mental Health Authority
8
8
Austin
201
646
Independent Contractors
Employees
6
9
Counties Served with
Early Childhood
Intervention Services
Counties Served with
Substance Use Treatment Services
10
30
Counties Served with
Autism Treatment
Counties Served with Outreach, Screening, Assessment & Referral (OSAR) connecting Central Texans to substance use treatment
San Antonio
Comparing Demographics of Employees and Persons Served
Employee %
Persons Served %
Age
Gender
Race
[Services Provided in FY23]
[Location of Service]
53%
2%
3%
7%
36%
Justice Settings
Schools
Crisis/
Healthcare Facilities
BTCS Clinics
Homes/
Community
[Babies, Children & Adults]
Served in FY23
[Training Provided]
BTCS hosted 27 Mental Health First Aid trainings during FY23
270
Community Members Trained in
Youth Mental Health First Aid
158
Community Members Trained in
Adult Mental Health First Aid
Program Highlights
Crisis Services
Crisis Continuum of Care
1,146
Persons Served
through our PPB Program
6
Contracted Hospitals
Criminal Justice Diversion
The Substance Abuse and Mental Health Services Administration (SAMHSA) Sequential Intercept Model is a framework for diverting individuals with mental and substance use disorders from the justice system. The following illustrates program expansion, achievements and new initiatives this fiscal year at each intercept.
The BTCS 988 Back-Up
Answering Center expands to serve all 254 Texas counties
Renovation is completed
for a Seguin Youth Therapeutic Respite center
BTCS applies for Youth Crisis Outreach Team (YCOT) grant funding
Intercept 0
Community Services
Grant-funded MH Deputies coordinate treatment for 232 individuals in lieu of arrest
911 Mental Health Dispatch project records 135 EMS/Fire/Police diversions
BTCS is selected for a Pre-Arrest Diversion Collaborative
& Early Diversion Grant
Intercept 1
Law Enforcement
BTCS partners with Guadalupe County
to establish a Mental Health Docket,
serving 21 persons
The Williamson County Felony
Mental Health Docket graduates
its 21st successful participant
Intercept 2
Initial Court Hearings
Initial Detention
BTCS partners with Williamson County and HHSC to open a Jail-Based Competency Restoration Program
The Jail Diversion Team works to divert
290 people out of jail, including 17
persons with an IDD
Intercept 3
Jails/Courts
The Outpatient Competency Restoration Program successfully transitions 7 persons from jail into the community
The BTCS Care Coordination Team
makes 127 follow-ups to support
transition from jail to home
Intercept 4
ReEntry
The BTCS TCOOMMI Program serves 735
adults on parole or probation, maintaining
a recidivism rate of 10.3%.
The Forensic Assertive Community Treatment Team serves 87 persons with
a recidivism rate of 2%.
Intercept 5
Community
Corrections
Substance Use
Disorder Services
Narcan Distribution:
The WilCo EMS CHP public education team and BTCS partnered to provide 1,240 boxes of life-saving Narcan to the public in 2023, including schools, public buildings, and community
service
organizations.
Nurse-led Expanded Substance Use Disorder Training and Education Program (NExSTEP):
This grant funds Texas A&M School of Nursing family nurse practitioners (FNP) at BTCS locations and includes $25,000
to support nursing
students.
Harm Reduction Partnership:
Williamson County EMS Community Health Paramedics (CHP) partnered with BTCS in 2022 to refer those who have experienced an opioid overdose to treatment. BTCS
has successfully
engaged 32%.
Services for Youth:
BTCS established partnerships in FY23 with Williamson and Guadalupe County Juvenile Probation and the Williamson County Juvenile Detention Center to deliver substance use disorder services
to youth.
Primary Care
Total Served
Since 2008, BTCS has partnered to
increase access to integrated healthcare in our communities.
Working alongside Community Health Centers of South Central Texas (CHCSCT) and Texas A&M School of Nursing (TAM-SON), we offer primary care at 14 BTCS locations.
1,281
Individuals Served at:
- Bastrop
- Bastrop ISD
- Elgin ISD
- Gonzales
- Lockhart
- Seguin
2,491
Individuals Served at:
- Cedar Park
- Georgetown
- Giddings
- Jarrell ISD
- La Grange
- Marble Falls
- Round Rock
- Taylor
Texas Child Health Access Through Telemedicine (TCHATT) Program
BTCS proudly participates in the TCHATT Program that partners with participating school districts to provide mental health services to students while at school at no cost.
TCHATT offers students referred by Dell Medical School up to 3 teletherapy and/or telepsychiatry services with a licensed provider from BTCS. Ninety-two percent of students referred through TCHATT transitioned into ongoing services with BTCS:
17%
33%
25%
17%
Counseling
Medication Management
Case Management
Intellectual and Developmental Disability or Autism Services
Successes
Timeline
SEPTEMBER 2022
- Our La Grange Clinic achieves the Rural Health Clinic designation (seal at right), enabling BTCS to receive enhanced reimbursement for primary care
- BTCS launches its Staff Sergeant Parker Gordon Fox Suicide Prevention grant program serving veterans and family members in Williamson and Guadalupe counties
- The Texas Health and Human Services Commission (HHSC) notifies BTCS of selection for a Multisystemic Therapy (MST) contract award
- SAMHSA notifies BTCS of selection for a four-year Certified Community Behavioral Health Clinic – Improvement and Advancement grant
- HHSC awards BTCS a $3.9 million contract to operate a 988-back-up answering center
OCTOBER 2022
- The BTCS Parents as Teachers (PAT) program in Bastrop earns endorsement as a PAT Blue Ribbon Affiliate (logo at left)
- The Diversion Center in Georgetown expands capacity from 5 to 8 beds
- BTCS celebrates our mighty IDD Enrichment Center Team as the Schulenburg day program comes to an end
November 2022
- Jonathan Lemuel, Director of Forensic Services, joined a panel of experts to present on the topic, “Developing Outpatient Competency Restoration & Jail-Based Competency Restoration Programs” at the 2022 Judicial Summit on Mental Health
- BTCS and the Williamson County Assistant District Attorney presented to the Williamson County Bar Association on BTCS services and the Felony Mental Health Docket process
December 2022
- Our extraordinary staff quickly respond to a pipe burst at the San Gabriel Crisis Respite Unit in Georgetown during the Winter Storm, causing temporary relocation while the unit underwent repair and renovation
- The Family Health Clinic at Jarrell ISD was also temporarily relocated by our resilient primary care team to our Taylor Clinic after the site experienced considerable damage during the Winter Storm
January 2023
- The St. David’s Foundation extends funding for the BTCS Parents as Teachers program (photo of team members at right) for two additional years
- BTCS and Guadalupe County Juvenile Services enter into a partnership agreement to provide therapeutic services to at-risk youth referred to Juvenile Services
- BTCS joins stakeholders in Guadalupe County led by Judge Kirsten Legore to begin a Mental Health Docket serving persons with misdemeanor criminal offenses
FEBRUARY 2023
- The Diversion Center in Georgetown expands to full capacity, from 8 to 10 beds
- BTCS participates in the “End Overdose Texas Rally and Advocacy Day" at the Texas Capitol, distributing 200 “You NarCan Save Lives” flyers
MArch 2023
- BTCS is awarded $315,099.54 in American Rescue Plan Act of 2021 (ARPA) Funds to expedite determination of intellectual disability assessments, enabling families to access services more quickly
- BTCS receives a certificate from HHSC upon achieving a score of 98% to re-certify the center as a Texas Certified Community Behavioral Health Clinic (T-CCBHC) through July 2026
- The Cedar Park City Council unanimously supports an agreement between BTCS and the Cedar Park Police Department integrating BTCS crisis workers into their Mental Health Unit
- The Seguin Adult Crisis Respite Unit relocates into a newly renovated 10-bed unit on the Seguin Center Campus; meanwhile, renovation begins in the former space to prepare for a Youth Therapeutic Respite Program
- BTCS adds a second State Hospital Step-Down Transitional Home in Georgetown
April 2023
- The Multisystemic Therapy Program begins providing services to youth and families
- BTCS provides testimony before the Texas House Higher Education Committee Hearing and Senate Finance Committee
- BTCS is awarded Williamson County ARPA funding supporting additional access to private psychiatric hospitalization for Williamson County residents experiencing an acute mental health crisis
MAy 2023
- The BTCS 988 Back-Up Answering Center begins taking calls for Texas
- BTCS receives notice of award for a Capital Area Metropolitan Planning Organization transportation grant
- Samsung Austin Semiconductor awards $10,000 to BTCS (ceremony pictured at right) to fund summer camp scholarships and annual memberships to the Boys & Girls Club for Taylor residents
- The BTCS State Hospital Step Down Program team contributes to HHSC’s poster presentation at the National Council for Mental Wellbeing’s 2023 National Conference (NatCon) in Los Angeles, CA
june 2023
- The Texas A&M School of Nursing receives a Health Resources and Services Administration grant for a Nurse-led Expanded Substance Use Disorder Training and Education Program; this award funds family nurse practitioners (FNP) to serve in BTCS integrated clinic locations and includes a $25,000 sub-award to support at least 1 FNP student and 1 bachelor-level nursing student per semester
- The BTCS Diversion Center team leads a presentation titled, “Diversion Center Model: Law Enforcement and LMHA Partnership” at the 2023 Texas Council Conference in Houston, Texas
- The Texas Council honors former BTCS Board of Trustees Chair, Hartley Sappington (pictured at left) with Honorary Lifetime Membership, In Memoriam at their 2023 annual conference
- BTCS’s UnitedHealthcare Strengthening Quality in Texas Community Program proposal is fully funded for $100,000 to improve healthcare access for persons with IDD and data infrastructure/reporting
july 2023
- BTCS executes its first Jail-Based Competency Restoration contract with HHSC making the program operational within the Williamson County Jail in August (unit pictured at right)
- BTCS and Williamson County Juvenile Probation execute an agreement for BTCS to provide substance use disorder individual and group services to youth
- BTCS is selected by HHSC to participate in a statewide Pre-Arrest Diversion Learning Collaborative alongside criminal justice and law enforcement partners in Burnet and Fayette Counties
august 2023
- BTCS visits a temporary evacuation center to offer services to families impacted by a brush fire causing destruction to an apartment complex in Cedar Park
- Service Dogs, Inc. agrees to place a fully trained facility dog named Daisy with BTCS First Responder Peer, Chris Orton (pictured at left). Read more here.
- BTCS is invited by HHSC to co-present during a National Council for Mental Wellbeing Center of Excellence for Integrated Health Solutions discussion hour on the topic, “State Innovations to Improve Integrated Care”
- The new 10-bed Youth Therapeutic Respite Program in Seguin passes its pre-operational HHSC site visit and begins accepting referrals in September 2023
In the Media
New Grants and Funding Awards
Certified Community Behavioral Health Clinic - Improvement and Advancement Grant
The Substance Abuse & Mental Health Services Administration (SAMHSA) awards BTCS with a four-year $4,000,000 CCBHC-IA Grant supporting the following projects:
- Behavioral health crisis workers embedded in the Cedar Park Police Department
- A specialized care coordinator for persons with co-occurring substance use disorders
- A jail-based clinician serving persons with co-occurring IDD
- School- and field-based crisis follow-up clinicians
- Electronic health record software for documenting primary care services and 911 calls
Transportation Grants
Texas Department of Transportation (TxDOT)
BTCS was awarded $133,895 in grant funds through the Federal Transit Administration (FTA) 5310 Enhanced Mobility for Seniors and Individuals with Disabilities Program for Fiscal Year 2024, enabling us to continue purchasing transportation for individuals in services.
Capital Area Metropolitan Planning Organization (CAMPO)
On May 11, 2023, BTCS received notice of continued funding from CAMPO in the amount of $294,189 for an additional two-year project period.
Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program
Guadalupe and Williamson Counties
$750,000
In Fiscal Year 2023, BTCS implemented a Department of Veterans Affairs grant program providing community outreach, training, screening, referral, peer support, case management, and equine-assisted therapy. The program team enrolled and served 39 Veterans and their family members with suicide risk factors.
Withdrawal Management
Program Funding
In April 2023, Williamson County partnered with BTCS to open a 4-bed withdrawal management unit at the San Gabriel Crisis Center in Georgetown by investing $862,000 over the next two years to support the cost of nursing staff.
The unit opened on September 25, 2023 to help adults safely withdraw from opioids, alcohol and benzodiazepines.
New Programs
MultiSystemic Therapy
(MST) Program
MultiSystemic Therapy is a highly structured treatment approach backed by research and designed to reduce youth criminal activity, substance use and antisocial behavior through community-based, family-driven care accessible 24/7.
April 2023
Program Start Date
Caldwell, Gonzales and
Guadalupe Counties
Counties Served
18
Families Served
Youth Therapeutic Respite Program Expansion
Joining our Round Rock Youth Therapeutic Respite (YTR) program in operation since June 2022, BTCS opened a second YTR program in Seguin on September 27, 2023.
The previous adult Crisis Respite Unit in Seguin was renovated to serve children and includes a classroom, outdoor sanctuary with playscape, and therapy space.
BTCS becomes a 988 Back-Up Answering Center in Partnership with Texas HHSC & Avail Solutions
This expansion ensures more 988 calls from Texans are answered by a call center based in Texas, with knowledge of community resources and how to access local supports.
BTCS began taking calls as a 988 statewide back-up center on May 1, 2023, and answered 2,236 calls through the end of fiscal year 2023.
988 Calls Handled by BTCS in FY23
1,281
653
226
76
May
June
July
Aug
Vocational Apprenticeship Program
The BTCS Vocational Apprenticeship Program, available in Caldwell and Guadalupe Counties, allows participants with intellectual, developmental and/or mental health challenges to earn a wage while completing apprenticeships in real work environments, learning skills to gain and maintain competitive, integrated jobs.
In June 2023, the first participant was paired with an apprenticeship site in Seguin, with a second apprentice slated to begin in October 2023. Additionally, 4 individuals attended social skills classes in FY23 as BTCS developed other apprenticeship opportunities in the community.
See What's Coming in Fiscal Year 2024!
The BTCS Strategic Planning Process:
The Strategic Plan leads to new programs!
Our Strategic Priorities
I. Supporting
Transition-Age Youth
in Achieving Life Goals
II. Responding to
Homelessness in
our Communities
III. Advancing our Response to an
Aging Population
IV. Retaining and Recruiting an
Excellent Staff
New Programs
Early Diversion
SAMHSA Grant
This 5-year grant funds Multi-Disciplinary Response Teams to deploy alongside our law enforcement partners in Caldwell, Gonzales and Guadalupe Counties. The project will increase pre-booking jail diversions and access to services.
Youth Crisis Outreach
Team (YCOT)
BTCS will launch its first YCOT in FY24, funded through a competitive grant awarded by HHSC. This specialized team will respond 24/7 to address the immediate crisis needs of youth and families involved with DFPS, offering access to intensive short-term, follow-up care. The YCOT model includes Family Partners and Youth Peer Specialists who will use lived experience to come alongside the caregiver and youth to inspire hope.
TX - Rapid Access
Texas HHSC was awarded a TX-Rapid Access Grant through the National Association of State Mental Health Program Directors and will be partnering with BTCS and the University of Texas Health Science Center in San Antonio to promote same day/rapid access to behavioral health care for crisis prevention and follow-up care. This $158,413 award will fund Peer Specialists and Family Partners to serve in Burnet and Bastrop Counties as well as our Youth Therapeutic Respite programs.
Expansion of State
Hospital Step Down Homes
Through a grant awarded by HHSC, BTCS will add a transitional home in Bastrop County to increase capacity for stepping persons out of the state hospital and into the community. BTCS is seeking to expand eligibility for the program to include persons discharging from community hospitals, including psychiatric, medical, and emergency departments, who have not stabilized in other settings. This includes persons with IDD in need of a long-term transitional setting.
Parenting Awareness and Drug Risk Education Services (PADRES)
BTCS is proud to launch its first substance use prevention program, funded by HHSC. The PADRES Program will offer substance use awareness and coordination services to decrease the effects of substance use within the family while increasing access to community resources and education. The program will serve parents of children under the age of 6; expectant parents with past or current substance use involvement; or any parent or child living with someone using substances. Participants must reside in the 30 counties that make up Region 7. For more information, please visit our website.
Our Valued Board Members
Our dedicated Board of Trustees volunteers their time and talents in governing our system of care through challenging and difficult decisions as well as through celebrations of innovation and growth. Each member offers knowledge from the perspective of their home county along with a unique voice guiding the vision, mission, values and goals of the Center. Over half (54.5%) of members have lived experience as a person or family member with a mental health, intellectual or developmental diagnosis.
Roxanne Nelson
Burnet County, Board Chair
Tom Bonn
Caldwell County, Board Vice Chair
Barbara Bogart
Bastrop County, Board Secretary
Shirley Hester
Guadalupe County
John Raeke
Gonzales County
Michael York
Lee County
Shannon McBride
Fayette County
Frank Saenz
Williamson County
Ex-Officio Members
Sheriff Calvin Boyd
Burnet County Sheriff's Office
Since September 2019
Sheriff Arnold Zwicke
Guadalupe County Sheriff's Office
Since September 2019
Sheriff Mike Gleason
Williamson County Sheriff's Office
Since September 2022
