Washington City Orphan Asylum, doing business as Hillcrest Children and Family Center, proposes to implement the Hillcrest Assisted Outpatient Treatment (AOT) Project in Washington, DC to support adults with severe mental illness (SMI), including those with co-occurring substance use disorder, who meet DC-specific criteria for AOT. Within this broader population, the project will focus in particular on serving vulnerable populations including communities of color, transitional-age youth (ages 18-24), justice-involved adults, individuals experiencing homelessness or unstable housing, and those with chronic health conditions and/or disabilities. Hillcrest plans to serve 55 unduplicated individuals each year for a total of 220 individuals served over four years. The Psychiatric Institute of Washington - a short-term, inpatient care facility that includes crisis stabilization - and the Superior Court of the District of Columbia will join Hillcrest staff as part of the AOT Management Team, whose purpose is to coordinate the project's development, implementation, and evaluation, including regular review of AOT participants’ status and strategy sessions to develop and review procedures for fulfilling civil court orders and address challenges as they arise. The goals and objectives are as follows:
Goal #1: Increase the capacity of Hillcrest staff to serve civilly committed individuals with SMI through the establishment of a formal AOT program.
• Objective 1.1: By July 30, 2025, and every year thereafter through July 30, 2028, 100% of staff who will work with civilly committed individuals will have received forensic mental health training.
• Objective 1.2: By July 30, 2025, increase the number of civilly committed individuals served by Hillcrest from an average of 12-15 to 55, maintaining this minimum average every year thereafter through July 30, 2028.
Goal #2: Improve the whole health of civilly committed individuals served by Hillcrest, as evidenced by improved health and social outcomes.
• Objective 2.1: By July 30, 2028, decrease the number of hospitalizations and Emergency Department visits by civilly committed individuals seen by Hillcrest by an average of 5% annually.
• Objective 2.2: By January 30, 2025, establish an AOT steering committee comprised of community partners that address health and social disparities (e.g., jails, shelters), and add one additional partner each year thereafter through July 30, 2028.