Our Lady of Peace residential center smoothes transition from inpatient psychiatric care to home and community Patty Farrell calls her son's progress "amazing."
"Steven is a much happier young man," she said. "He loves greeting people at the front door, and now we can even take him home regularly for trial visits."
Steven, 15, lives in Malcolm House, one of two psychiatric residential treatment facilities managed by Our Lady of Peace psychiatric hospital in Louisville, Ky. The two new homes, built side by side near Sts. Mary & Elizabeth Hospital, provide 24-hour care, treatment and education for as many as 18 children with dual diagnoses of psychiatric disorder and another disability such as autism, brain injury or mental retardation.
Malcolm House opened May 4, followed by LaSalle House on Aug. 17. They share a common backyard with a playground and picnic tables. Donations helped to pay for the $2.1 million project, and Kentucky Medicaid payments of $262 per resident per day pay for part of the cost of running the homes. (That amount rises 2.22 percent every two years.)
The homes have a combined staff of 30, including nurses, mental health workers, residential coordinators, a behavioral analyst and a licensed clinical social worker. The dual-diagnosis homes are the first of their kind in Kentucky.
Our Lady of Peace, founded by the Sisters of Charity of Nazareth in 1951, is the nation's largest provider of inpatient psychiatric care for children and adolescents. Our Lady of Peace and Sts. Mary & Elizabeth are among the five hospitals of Louisville-based Jewish Hospital & St. Mary's HealthCare. Formed in 2005, Jewish Hospital & St. Mary's HealthCare is a joint venture between Denver-based Catholic Health Initiatives and Jewish Hospital HealthCare Services.
Steven, a 6-foot-tall boy with limited verbal skills, was diagnosed with autism and bipolar disorder. He is the third of four children of Patty and Joe Farrell, who live in Brandenburg, Ky., about 35 miles from Louisville.
His mother said Steven had been in and out of Our Lady of Peace for treatment, but the returns home became too jarring for the family. They resisted giving up custody of their son — a requirement for many group homes — and took him to one near Chicago before hearing about plans for the new program much closer to home.
Steven entered Malcolm House shortly after it opened. Recently, he began attending classes through the Jefferson County Public Schools, the Louisville-area district. The homes send some of their residents to area schools. Jefferson teachers also give classes at the homes.
Patty Farrell said the intense program structure at Malcolm House has been the key for her son.
"Steven communicates with the staff spontaneously and, to me, that's just awesome," she said. "They've been able to get him to follow a routine. They are teaching him what he needs to make the transition to home."
That is the whole idea, said Jennie Hulette, program director of the two homes and an assistant vice president at Our Lady of Peace. Hulette said the hospital had been working for more than a decade to develop a "step-down" format that could help young people move from inpatient hospital treatment back to their homes.
"The challenges these kids have are twofold," Hulette said. "They have psychiatric issues, lots of behavioral issues. And, because of limited development, they aren't able to cope with those underlying psychiatric issues. Some of these kids have been in hospitals for a very long time. We are working with teens who, through treatment, can transition to a lower level of care."
Our Lady of Peace had been working on this idea since it obtained a state certificate of need in 1999. The Kentucky legislature cleared the way for such homes with an amendment to the state Medicaid code in 1992, but the daunting challenges and expense of providing intensive care to children with dual diagnoses required years of planning.
Three years ago, planners chose open ground in a neighborhood just two blocks from Sts. Mary & Elizabeth Hospital. Hulette said neighbors welcomed the idea, and the Malcolm and LaSalle homes were designed to blend into the block. Builders broke ground on July 20, 2007.
Each home has beds for nine residents ranging in age from 12 to 17. Each home has a kitchen, a dining area and a classroom, and each has workers on duty around the clock.
The staff prepares an individual discharge plan for each resident. Staff members teach the children basic communication skills, life skills such as doing laundry and skills in social interaction. They take the children to parks, restaurants and other public settings. When a child is ready, he or she is enrolled in an appropriate Jefferson County school.
On Aug. 27, the program had its first graduate, a 14-year-old boy with diagnoses of bipolar disorder and mild mental retardation. He has moved to a foster home. On his discharge day, the staff hosted a party for him, complete with a cookie cake bearing his name and cards and a banner honoring his achievement.
Hulette said the boy had accomplished the goals of his discharge plan. "It was designed to help him control his behavior when experiencing difficult emotions," she said. "He learned how to take care of himself, how to prepare a meal, do his laundry and keep his room. He was excited about going to the foster home. And he loved his party!"