assessing and planning for behavioral health transformation l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Assessing and Planning for Behavioral Health Transformation PowerPoint Presentation
Download Presentation
Assessing and Planning for Behavioral Health Transformation

Loading in 2 Seconds...

play fullscreen
1 / 24

Assessing and Planning for Behavioral Health Transformation - PowerPoint PPT Presentation


  • 274 Views
  • Uploaded on

Assessing and Planning for Behavioral Health Transformation. Texas Mental Health Transformation Grant An Overview of the Assessment and Comprehensive Plan Dave Wanser Ph.D., Deputy Commissioner Texas Department of State Health Services.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Assessing and Planning for Behavioral Health Transformation' - EllenMixel


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
assessing and planning for behavioral health transformation

Assessing and Planning for Behavioral Health Transformation

Texas Mental Health Transformation Grant

An Overview of the

Assessment and Comprehensive Plan

Dave Wanser Ph.D., Deputy Commissioner

Texas Department of State Health Services

transformation drivers assessment of texas bh indicators
Transformation Drivers:Assessment of Texas BH indicators
  • Prevalence of behavioral health disorders: 2,578,424
    • SMI and SED in the population: ~1,552,543 (57% adults)
    • Substance Abusers who would seek treatment: ~ 1,025,881

(2005)

    • 2,149 Texans committed suicide (2002)
    • 9,992 Texas were hospitalized for attempting (2002)
  • Economic Cost to Texas of Behavioral Health Problems:
  • Mental Illness: $16.6 billion(2003)
  • Alcohol and Drug Abuse: $25.9 billion(2002)
transformation drivers assessment of agency bh indicators
Transformation Drivers:Assessment of Agency BH indicators

HHSC:

    • 1/3 of all Texas children were enrolled in Medicaid in 2005 (~2.1 million).
    • Mental health needs are the most frequent reason children and youth are referred to local CRCG interagency planning teams.

DFPS:

    • 38,522 investigative cases were confirmed abuse and/or neglect.
    • Parental substance abuse contributes to an estimated 1/3 – 2/3 of cases.

DADS:

    • 22% of older adults have mental disorder that is not part of the normal aging process
    • ~17% of older adults abuse alcohol or drugs.
    • Older adults have the highest suicide rates.

DARS:

  • Percentage of people served in Vocational Rehabilitation with disabilities that interfered with their employment: 19% mental/emotional; 16% cognitive; and 7% substance abuse.
transformation drivers assessment of agency bh indicators4
Transformation Drivers:Assessment of Agency BH indicators

DSHS:

  • Current system able to serve ~10% of those in need.
  • State Mental Hospitals have had a 55% increase in admissions since 1996, with shorter lengths of stay. Forensic commitments are increasing.
  • 25% in MH and 20% in SA services had a Co-occurring Disorder.

TJPC/TYC:

  • 26.5% of juveniles supervised by probation departments were mentally ill..
  • High risk youth comprise 43% of TYC population (4% chemically dependent; 48% serious emotional disturbances; 11% were sex offenders; 17% capital and serious violent offenders; 1% mental retardation)

TDCJ/TCOOMI:

  • Typical adult offender is 36.3 years old; has IQ of 90.7 (normal = 100); a history of academic failure; an average schooling of 10th grade but tests at grade 7.6; low self-esteem including no confidence about finding employment; no vision for a productive future; has compulsive behavior; is defensive or has a negative attitude; has difficulty with relationships and difficulty controlling anger; and, escapes from reality through drug or alcohol abuse before and after incarceration.
transformation drivers assessment of agency bh indicators5
Transformation Drivers:Assessment of Agency BH indicators

TEA:

  • Annual student drop out rates for African-American were 5.4%, Hispanic were 6.1%, and White were 2.5%.
  • In high school, more than 1 in 5 African-American (21.9%) and Hispanic (23.5%) students in 9th grade did not advance to 10th grade.
  • In elementary school, African-American and Hispanic students were almost twice as likely to be retained in a grade level as White students.

TWC:

  • 15,013 adults and 190 youth were served by the Project Re-integration of Offenders work program.

ORCA:

  • Hispanic population doubling in nonmetropolitan/rural areas by 2040.
  • More aged 65 and older in rural vs. urban counties (15.5% to 9%).
  • Higher poverty rates and lower income levels in rural vs. urban counties.
  • Health care professional shortages in rural areas.
transformation drivers assessment of agency bh indicators6
Transformation Drivers:Assessment of Agency BH indicators

TDHCA

  • 25% of homeless individuals suffer from a serious mental illness.
  • More than 65,000 persons with disabilities did not have predictable means of shelter in 1999.
  • An SSI recipient would have to pay 98.3% ($536) of his/her $545 monthly payment to rent a one-bedroom apartment in Texas.

VHA

  • 27,000 Texas Reservists have fought in Iraq or Afghanistan.
  • In 2005, 1,667,370 veterans resided in Texas, 22.49% had accessed VHA services.
  • If trends continue, half of all returning vets will have a brain injury.
  • About 25% of returning veterans asked for help for mental health disorders.
  • 485,092 patients in the VA health system had substance use disorder (2002).
  • Veterans with substance use disorders accounted for approximately 12% of VA patients and about 25% of total expenditures - $4.2 billion.
driving transformation client matching
Driving Transformation:Client Matching
  • Agency collaboration has allowed investigation into shared clients.
    • TDCJ and DSHS
      • Matches TDCJ data to Mental Health CARE System
    • Co-Occurring Children’s Policy Academy
      • Matched children in HHSC (Medicaid), Mental Health, Texas Youth Commission, Texas Juvenile Probation Commission.
      • Matched children in the Department of Family and Protective Services and the Texas Education Agency.
tdcj and mental health matching
TDCJ and Mental Health Matching

These numbers reflect offenders who have received services in the public mental health system and does not include those not diagnosed or who have not received care in the public system. A recent study indicates 40% of offenders have a mental health disorder.

children s policy academy hhsc mh tyc and tjpc matching
Children’s Policy AcademyHHSC, MH, TYC, and TJPC Matching

Reflects the number of shared clients among the four agencies.

Of 213,427 total children in the agencies, at least 12% are served by two agencies, 2% by three agencies, and about 1% by all four agencies.

It is entirely possible that any or all of those 165 children are each a $1 million dollar child.

slide10

A Greater Percentage of Victims of Child Abuse/Neglect with Juvenile Justice Contact had Criminal History in their Family, had a Behavior Problem, and/or had a Substance Abuse Issue

>

>

>

Source: DFPS Child Protective Services and TYC client databases, from Ruggiero, K.M., and Mason, M. (2006). The role of behavioral health services among

youth in Texas at risk for juvenile justice involvement: Multi-agency data-matching project for the Policy Academy on Co-Occurring Substance Abuse and Mental Health Disorders. Austin, TX.

but less than half received behavioral health services funded by the state
But Less Than Half Received Behavioral Health Services Funded by the State

Source: DFPS Child Protective Services, DSHS Mental Health and Substance Abuse, HHSC Child Medicaid, and TYC client databases, from Ruggiero, K.M., and Mason, M. (2006). The role of behavioral health services among youth in Texas at risk for juvenile justice involvement: Multi-agency data-matching project for the Policy Academy on Co-Occurring Substance Abuse and Mental Health Disorders. Austin, TX.

slide12

A Greater Percentage of Victims of Child Abuse/Neglect with a Behavior Problem had an Earlier Disciplinary Problem Identified by TEA - Mostly Student Misconduct

Source: FY2003 DFPS-TEA Data-Match, TEA, October 2006.

driving transformation in the current system challenges
Driving Transformationin the Current System: Challenges

Stigma

Lack of Public Understanding

Lack of Provider Understanding

Employment and Housing

Education and Training Needed

Veterans and Families

Large numbers in Texas

BH problems high after return

Need for PTSD services/training

Coordinated approach for families

Rural Needs

Access to Care Difficulty

Workforce Shortages

Housing Shortages

Transportation Issues

Older Population

Increasing

More Rural

Complex Medical Needs

Undiagnosed Mental Disorders

Substance Use Increasing

Allow to Age at Home

Family Involvement in Care

Children and Youth

Increasing

Changing Demographics

Justice and Protective Services

Medicaid Increases

Dropouts

Need Systems of Care

Family Involvement in Care

Demographic Shifts

Hispanic Majority by 2040

Culturally Appropriate Services

School Dropout Rates

Less Education = Less Income

More Un- and Underinsured

Multilingual Workforce

driving transformation in the current system needs
Driving Transformationin the Current System: Needs

Under-funded System

47th in per capita Funding

Need exceeds Service Supply

Operating Costs Increasing

Transportation Cost

Medicaid Reimbursement

Lack of Service Coordination

Crisis Services Redesign

Improve Jail Diversion

Evidence Based Practice Use?

Coordinate Services in the State

Earlier Identification of Need

Workforce Issues

Training Needed

Recruit to rural areas

College/University collaboration

New service delivery models

Multilingual workers needed

Fewer Entering the Field

Ability to Screen, Assess, Refer

Consumer Oriented

Define Consumer Driven

Different Agency Rules

System Difficult to Navigate

Support for Peer Models

System that works for Youth

Use of Technology

Agencies Share Clients

Data Sharing/Integration

Expand Current Use

Use of EHRs

HIPAA translation

transformation objectives
Transformation Objectives

Current System

Transformed System

Population-based;

early intervention

Persons receiving services

Coordinated care;

“no wrong door”

Agency “silos”

Piecemeal, fragmented

training

Well-defined workforce

development / training

infrastructure

Data Compartments

Data – sharing and

coordination

Consumer and family

member involvement

Consumer and family

driven - system

Persons falling through

agency “cracks”

Seamless continuity

of care

recognizing that transformation
Recognizing that Transformation …
  • is an evolving process which takes time
  • will focus on pivotal issues and opportunities
  • will be based on a learning process, requiring adjustments and refinement
  • requires major shifts in organizational “cultures”
  • will be based on partnerships - consumers, family members, providers and local, state, federal levels of government
new freedom goals texas
New Freedom Goals - Texas

Goal 1

Mental Health is Essential to Health

Goal 4

Early Screening, Assessment, Referral

Goal 2

Care is Consumer and Family Driven

Goal 5

Excellent Care is Delivered

Goal 3

Eliminate Disparities in Services

Goal 6

Increase Use of Technology

what s next
What’s Next?
  • Continue Dialogue and Inclusion of Voices
  • Four Initial Workgroups Developed:

Adults, Youth, Technology, Workforce

  • Leverage Immediate Opportunities
  • Research and Evaluate Longer Term Activities
  • Prioritize Efforts
slide24
The Present System

Fragmented, confusing to navigate, inadequate services that frustrate recovery….

A Transformed System

Consumer-driven, coordinated ‘no wrong door’ quality services supporting recovery …