Joint Finance Committee Hearing - PowerPoint Presentation

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Joint Finance Committee HearingFiscal Year 2016Gerard Gallucci, M.D. MHSActing Division Director February 26, 2015

Department of Health and Social ServicesDivision of Substance Abuse and Mental Health Slide2

DSAMHThe Single State Agency for prevention and treatment services for substance use, mental health and gambling conditionsProvides services regardless of ability to payOrganizational structure consists of the Central Office/Administration, the Delaware Psychiatric Center (DPC), and a variety of community mental health, substance use disorder, and gambling services Slide3

Accomplishments FY 14USDOJ Settlement AgreementDE has met substantial compliance in all but three of the of the Settlement Agreement Targets. There are three targets that have met partial compliance: 30% Reduction of Bed Days, Risk Management and Fidelity of ACT Teams. 356 Mental Health Screeners, including Emergency Department Physicians and other behavioral health professionals have been trained/certified & are in a variety of settings. They provide first level assessment services regarding an individual’s need for involuntary hospitalization or referral to other services.

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Accomplishments FY 14USDOJ Settlement AgreementThe Mobile Crisis Teams (NCC & Kent/Sussex) continue to exceed their response time target (1 hour) & average 45 minutes per call.There are a variety of housing options for clients with Serious and Persistent Mental Illness:State Rental Assistance Voucher(SRAP) and 811 Project Demonstration Program both are partnerships with Delaware State Housing Authority

Supervised Apartment ProgramGroup Homes

Transitional Housing

Crisis Beds (3 to 5 days)

Resource/Respite beds

The Peer Programs throughout the state continue to expand . Peer supports are now provided as part of a new Problem Solving Court in New Castle County. Slide5

AccomplishmentsA Medicaid & DSAMH partnership facilitated revisions in the Delaware Medicaid State Plan to expand federal funding for behavioral health services. Slide6

AccomplishmentsSubstance Abuse System Re-Design is underway.The American Society of Addiction Management (ASAM) guidelines have been adopted to guide services, level of care determinations, and expected outcomes.Contracts for the re-designed Comprehensive Behavioral Health Outpatient Treatment Programs have been finalized. This model will provide a better coordination of care throughout an individual’s journey to recovery.Contracts for the re-designed Withdrawal Management Programs are being finalized.Slide7

Residential SUD ServicesCurrently DSAMH contracts for 78 beds on the Governor Bacon Campus (Gateway).The program must be relocated as the campus will be used for other purposes.This has allowed for us to re-think and re-design our residential treatment programs.Slide8

Residential SUD ServicesThe re-design and additional funding in the FY ‘16 GRB will result in:47 beds (for men) will be moved to a renovated facility on the Delaware Hospital for the Chronically Ill campus.3-16 bed treatment facilities across the state.These programs will serve a total of 63 males and 32 women. Increase of 17 beds.Slide9

Sober Living Residential BedsFormerly known as half-way houses.These programs offer recovery supports in addition to housing.Currently we have 60 beds and have requested funding for 60 more in FY ‘16.We continue to explore another intermediate treatment level (Recovery Residence Level 3) of treatment homes to add to the treatment continuum. Slide10

Young Adult Residential Opiate Treatment ProgramCurrently one program in operation providing 15 beds.Expansion in FY ‘15 to 16 beds.With the funding proposed in the GRB, we would add a second program for 16 beds.Slide11

AccomplishmentsAnother Medicaid & DSAMH partnership resulted in CMS approval of the new PROMISE program, to leverage additional federal funding to provide an array of services to individuals residing in the community, who have Serious and Persistent Mental Illness and/or other diagnostic criteria.Slide12

PROMISE Promoting Optimal Mental Health for Individuals through Supports and EmploymentSlide13

PROMISE - Its GoalsTo provide an array of community based services. To meet the USDOJ requirement that individuals be provided mental health services in the most appropriate setting.To ensure that the services provided to individuals through PROMISE meet the individual’s needs.To ensure that the health and safety of PROMISE participants are maintained.

To both leverage federal funding and to assure that the services provided are value based and cost effective in meeting the individuals needs.Slide14

PROMISE — Services and Supports

PROMISE will offer individually-tailored, community-based, and recovery-oriented mental health services to help individuals live independently in the community:

Care

Management

Individual Employment Supports

Short-Term

Small Group Supported Employment

Financial Coaching

Benefits

Counselling

Peer

Support

Non-Medical Transportation

Community-

Based

Residential

Supports

,

Excluding

Assisted Living

Nursing

Community Psychiatric Support and Treatment

Psychosocial Rehabilitation

Respite

Independent Activities of

Daily Living/Chore

Personal

Care

Community

Transition

ServicesSlide15

Community Treatment TeamsSlide16

Crisis Walk-In CenterSlide17

Crisis CallsSlide18

US DOJ Settlement Agreement Housing Vouchers Generated By YearSlide19

FY ‘14 Peer Support Services – Contacts

Note: Numbers include phone and in-person contacts (including walk ins). Contacts are duplicative across

clientsSlide20

Supported EmploymentSlide21

DPC Annual Average Daily CensusFY 2008 – FY 2014

Delaware Health and Social ServicesSlide22

Reallocation of Resources from Facility-Based to Community: Efficiencies

DSAMH FY ‘15 Expenditures

DSAMH FY

‘10

ExpendituresSlide23

FY ‘16 Governor’s Recommended BudgetSubstance Use DisorderWithdrawal Management* $ 750.0Sober Living Residential Programs $ 935.0Young Adult Residential Treatment/Opiate $1,150.0Residential Treatment $ 800.0

Subtotal $3,635.0One-Time Funds $ 815.0 T

otal $4,450.0

*

Additional $950.0 structurally transferred to DSAMH for Withdrawal Management

from

the Office of Management & Budget

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FY ‘16 Governor’s Recommended BudgetUSDOJ RequirementsAssertive Community Treatment (ACT) $ 954.0Crisis Services $ 760.0Targeted Case Management $

100.0Supported Employment $ 100.0Housing Vouchers $1,125.0

Peer

Supports

$

175.0

Total

$3,214.0Slide25

Thank you very much for your continued support Behavioral Health (MH/SA) is essential to overall healthPrevention Works

Treatment is EffectivePeople do Recover