Upload
brad-hollinsworth
View
216
Download
1
Tags:
Embed Size (px)
Citation preview
Joint Finance Committee HearingFiscal Year 2016
Gerard Gallucci, M.D. MHSActing Division Director
February 26, 2015
Department of Health and Social Services
Division of Substance Abuse and Mental Health
Delaware Health and Social Services
DSAMH• The Single State Agency for prevention and treatment
services for substance use, mental health and gambling conditions
• Provides services regardless of ability to pay
• Organizational 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
Delaware Health and Social Services
Accomplishments FY 14USDOJ Settlement Agreement
• DE 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.
Delaware Health and Social Services
Accomplishments FY 14USDOJ Settlement Agreement
• The 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 Program Group 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.
Delaware Health and Social Services
Accomplishments
• A Medicaid & DSAMH partnership facilitated revisions in the Delaware Medicaid State Plan to expand federal funding for behavioral health services.
Delaware Health and Social Services
Accomplishments
•Substance 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.
Delaware Health and Social Services
Residential SUD Services
• Currently 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.
Delaware Health and Social Services
Residential SUD Services
The 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.
Delaware Health and Social Services
Sober Living Residential Beds• Formerly 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.
Delaware Health and Social Services
Young Adult Residential Opiate Treatment Program
• Currently 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.
Delaware Health and Social Services
Accomplishments
• Another 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.
Delaware Health and Social Services
PROMISE
Promoting Optimal Mental Health
for Individuals through Supports
and Employment
Delaware Health and Social Services
PROMISE - Its Goals• To 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.
Delaware Health and Social Services
PROMISE — Services and SupportsPROMISE 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 TransitionServices
Delaware Health and Social Services
Community Treatment Teams
TCM ACT ICM Wait List0
200
400
600
800
1000
1200
1400
1600
251
864
470
41
701
806
618
34
1093
1403
199153
FY 2012
FY 2013
FY 2014
Delaware Health and Social Services
Crisis Walk-In Center
FY14 Jul-14 Aug-14 Sep-1476
77
78
79
80
81
82
83
78.7
81.281.8
82.4
Hospital Diversion RatesFY 14 and 1st Quarter FY 15
RRC Diversion RateLinear (RRC Diversion Rate)
Nu
mb
er o
f C
lien
ts
Delaware Health and Social Services
Crisis Calls
Jul-14 Aug-14 Sep-14 Oct-14 Nov-140
500
1000
1500
2000
2500
3000
SUD Calls
Crisis Calls
Delaware Health and Social Services
US DOJ Settlement Agreement Housing Vouchers Generated By Year
0
50
100
150
200
250
FY11 FY12 FY13 FY14 FY15
Num
ber o
f Clie
nts
HUD Housing ChoiceVouchers
CRISP
SRAP Vouchers
Grandfathered
Delaware Health and Social Services
FY ‘14 Peer Support Services – Contacts
Trauma Peers, 1687
Community Peers, 7307
DPC Peers, 1276
Mental Health Court Peers, 224
Note: Numbers include phone and in-person contacts (including walk ins). Contacts are duplicative across clients
Delaware Health and Social Services
Supported Employment
FY 12 FY 13 FY 14 FY 15 (Target)
0
200
400
600
800
1000
1200
238
569663
1100
Clients Receiving Supported Em-ployment Services FY 12 to FY 15 (Tar-get)Linear (Clients Receiv-ing Supported Em-ployment Services FY 12 to FY 15 (Target))N
um
ber
of
Cli
ents
DPC Annual Average Daily CensusFY 2008 – FY 2014
Delaware Health and Social Services
FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 20140
50
100
150
200
250232
204 200
162
146136
112.6775
Nu
mb
er
of
Clie
nts
Delaware Health and Social Services
Reallocation of Resources from Facility-Based to Community: Efficiencies
DSAMH FY ‘15 ExpendituresDSAMH FY ‘10 Expenditures
41%
57%
3%
Delaware Psychiatric Center
Community Services
Community Mental Health Inpatient
27%
71%
2%
Delaware Psychiatric Center
Community Services
Community Mental Health Inpatient
Delaware Health and Social Services
FY ‘16 Governor’s Recommended Budget
Substance Use DisorderWithdrawal Management* $ 750.0
Sober Living Residential Programs $ 935.0
Young Adult Residential Treatment/Opiate$1,150.0
Residential Treatment $ 800.0
Subtotal $3,635.0
One-Time Funds $ 815.0
Total $4,450.0
*Additional $950.0 structurally transferred to DSAMH for Withdrawal Management from the Office of Management & Budget
Delaware Health and Social Services
FY ‘16 Governor’s Recommended Budget
USDOJ Requirements• Assertive Community
Treatment (ACT) $ 954.0• Crisis Services $ 760.0• Targeted Case Management $
100.0• Supported Employment $
100.0• Housing Vouchers
$1,125.0• Peer Supports $ 175.0
Total$3,214.0