Fiscal Year 2016 Gerard Gallucci MD MHS Acting Division Director February 26 2015 Department of Health and Social Services Division of Substance Abuse and Mental Health DSAMH The Single State Agency for prevention and treatment services for substance use mental health and gambling ID: 698601
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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.
Slide4
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