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Subsidy Allocations Discussion. Future Department of Mental Health & A ddiction Services January 3, 2013. Agenda. Summary of meeting materials Brief overview of work products assigned at last meeting Parameters for our work going forward Potential models for allocation strategies

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Subsidy allocations discussion

Subsidy Allocations Discussion

Future Department of Mental Health & Addiction Services

January 3, 2013


  • Summary of meeting materials

  • Brief overview of work products assigned at last meeting

  • Parameters for our work going forward

  • Potential models for allocation strategies

  • Identify next steps

    • Meeting dates

    • Agenda for next meeting

Assignments from 12 11 12
Assignments from 12/11/12

Accountability is important!

Data analyses assigned
Data Analyses Assigned

  • Per capita comparison of all non-federal general subsidy (both AOD and MH). What we did:

    • GRF + Fund 475 = $80.7 million

    • GRF less medication + Fund 475 = $71.4 million

    • GRF only = $76.6 million

    • GRF less medication = $67.3 million

  • Attachment 1 Scenarios contain overviews of each of these approaches and related data

Data analyses assigned 2
Data Analyses Assigned, 2

  • Per capita comparison of general AOD subsidy (federal and non-federal). What we did:

    • GRF + Fund 475 + SAPT block grant = $47.9 million

    • See attachment 1 scenarios

  • Per capita comparison of ALL general subsidy (federal and non-federal)

    • GRF + Fund 475 + SAPT and MH block grants

    • See attachment 1 scenarios

Parameters going forward
Parameters Going Forward

  • Goal: a shared, succinct allocations plan prior to budget deliberations

  • Taking into account the 12/11 discussion, certain decisions must be reached before work can proceed at a meaningful pace

    • Disposition of existing money

    • Disposition of new money (if applicable)

    • Inputs related to disposition

Parameters existing money
Parameters: Existing Money

  • Remains allocated to the community currently receiving it

    • No moderate redistribution of x%

    • We examined possibilities but ultimately determined that redirection is not pragmatic

    • Sets aside 53 individual allocation histories without attempting redress

    • Ohio decision regarding Medicaid expansion/no expansion will have impacts that vary among communities

Parameters existing money 2
Parameters: Existing Money, 2

  • No redirection enables the field to focus on the future rather than disagree about the current or past

  • Let’s not spend time now contemplating how a subsidy reduction would be handled

    • Block grant strategy, if/when reduction occurs, will be vetted with the field.

    • Transparency & timeliness are important philosophies for the new department

Parameters new money
Parameters: New Money

  • This is where we articulate the vision

  • Need a model that anyone can explain

    • Can be scaled based on resource availability

    • Focus our work here

  • Enables us to recognize that all communities would benefit from additional resources, but that targeted investments may be more helpful when taking into account specific needs

Parameters allocation inputs
Parameters: Allocation Inputs

  • For any new, additional appropriation in Continuum of Care line item

  • Propose to use per capita as a core data element, but perhaps use in a variety of ways, e.g.:

    • Straight per capita

    • Per capita as comparative factor between communities in the existing funding level

    • Other?

Parameters allocation inputs 2
Parameters: Allocation Inputs, 2

  • Per capita is not a panacea, but it is:

    • Immediately available

    • Objective

    • Clear & understandable

  • For future biennia, as new timely & relevant information is available, it would be possible to re-open discussions about inputs; however, no commitment now to absolutely do so.

Potential allocation models
Potential Allocation Models

  • Caveats & reminders…These are for discussion to obtain feedback and identify next steps

    • Other concepts are welcome

    • Two funding scenarios run for each model, merely to demonstrate how it works. These amounts are completely arbitrary!

  • Will walk through each model, respond to questions, and discuss all models at the end

Potential model 1
Potential Model #1

  • Allocate any additional amounts on a straight per capita basis

    • See attachment for Model #1, which contains two hypothetical scenarios to demonstrate impacts at various funding levels

    • Questions?

Potential model 2
Potential Model #2

  • Allocate 60% of any new appropriation in the same manner that DMH allocated the $619k in the MBR (i.e., targeted to “per capita disparity” boards.) 

  • Allocate the other 40% in a straight per capita to all boards

  • See attachment for Model #2

  • Questions?

Potential model 3
Potential Model #3

  • Allocate 75% of the new amounts in a straight per capita to all boards

  • With the other 25%, establish a “pool” that MHA will use to make targeted investments to incentivize collaboration, augment an area that experiences a specific problem, focus on a specific policy topic, etc. Process would be established (this month.)

  • See attachment for Model #3; Questions?

Potential model 4
Potential Model #4

  • Allocate 50% of any new appropriation in the same manner that DMH allocated the $600k in the MBR (i.e., targeted to “per capita disparity” boards.) 

  • 25% to all boards via straight per capita

  • 25% to a pool that MHA would distribute as described in Model #3

  • See attachment for Model #4; Questions?


  • Pros and cons of each model?

  • Other concepts folks would like to see that are NOT reflected in one of these models?

  • Are there any models here that are more preferred than others?

    • Goal: narrow to 1-2 and modify those for our next discussion

  • Any other constructive feedback?

Parking lot issues
Parking Lot Issues

  • At logical point in January, we still need to address/discuss:

    • Provider specific subsidies for AOD

    • Community medication logistics

    • Topics of concern to 6 boards with single focus

    • Hot spots approach for FYs 14/15

    • Reporting in the new environment for MOE

Next steps
Next Steps

  • Meetings scheduled: January 10, 16, 24

    • 10am – 12pm

    • Same location and call-in available

    • Meetings will be canceled if not needed

  • Agenda for January 10th

  • Other assignments?