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  1. Department of Health and Social ServicesDivision of Substance Abuse and Mental Health Joint Finance Committee Hearing Fiscal Year 2014 Kevin A. Huckshorn PhD, RN, CADC Division Director Thursday, February 21, 2013

  2. 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, the Delaware Psychiatric Center (DPC), & community mental health, substance abuse , and gambling services

  3. Accomplishments FY10 - FY13 • US DOJ Settlement Agreement • DHSS/DSAMH successfully negotiated a USDOJ Settlement Agreement signed July 15, 2011 • Worked with community partners to evaluate use of involuntary commitment and provide training on ADA/Olmstead Decision • Managed 6 Requests for Proposals to launch DSAMH system transformation (USDOJ agreement) • Launched 4 new Peer Programs with 1400 client contacts in FY 13; an increase of almost 300% since FY 09. • Have met all USDOJ requirements to date

  4. Accomplishments FY10 – FY13 • Housing • New RFP for a 3rd party housing management agency to manage the funds and housing of 102 units with a potential to support 187 clients. • Increased the number of Oxford Houses from 10 to 42in just 3 years, while saving $60,000 in costs • Opened two3-bedroom transitional step-down houses for persons leaving DPC. • Total of 302 SRAP vouchers “in the pipeline” for persons with mental illness who are homeless (FY12 to date)

  5. Efficiencies FY10 – FY13 • Performance Improvement • Implemented a comprehensive Performance Improvement (PI) Department at DPC thru re-deployment of staff. Focus is on safety, client rights, abuse/neglect & quality standardsof care • Hired two Utilization Review RNs to work in private hospitals and DPC to monitor use and costs of inpatient care

  6. Efficiencies FY10 - FY13 • Delaware Psychiatric Center Additional Efficiencies • Implemented the Pyxis Medication Delivery System • Maintained full Joint Commission Accreditation and CMS certification • Implemented quarterly Town Hall meetings for families & staff • Created and deployed a Geriatric-Psych Outreach Team to prevent unnecessary admissions and readmissions

  7. Efficiencies FY10 – FY13 • Leveraging Federal Resources • Secured $14 million in federal grants to: • Implement Trauma Informed Care statewide • Expand Peer Service providers statewide • Implement large expansion of substance abuse prevention services across the lifespan

  8. Efficiencies FY13Services by County– Diversion Courts

  9. Efficiencies FY10 – FY13 • Community Services– Detoxification and Co-Occurring Services • Re-engineering of Ellendale to ensure that Kent/Sussex citizens haveaccess to detox services while offsetting $1.6 million in costs of USDOJ mandates • Implemented new Ambulatory Detox program statewide that has helped to reduce need for inpatient services • Launched co-occurring screening and assessment statewide

  10. Efficiencies FY10 - FY13 • Delaware Psychiatric Center (DPC) – Discharge of Long Term Clients and “Right Sizing” • Added 18 bed acute care unit through long term discharges • Closed the 32 bed psychiatric nursing home in May 2010, with the successful discharge of 32 clients to more appropriate settings • DPC FY13 Average Daily Census (ADC) through January was 143 vs. 232 in FY08. January ADC was 135.

  11. DPC Performance Measures 2008 to 2012 • Seclusion: 62.5% ↓ * • Restraint: 96.2% ↓ • Emergency Med. Administration: 52.9% ↓ * • Contraband: 48.9% ↓ • Sexual Encounters: 75.0% ↓ • Suicide Attempts: 88.9% ↓ * reflects change in persons served to “acute care” and the discharge of “Long Stay”

  12. Total FTE Reduction from DPC:105 Total Budget Reduction in DPC: $7,346.2 Reallocation of ResourcesCommunity Investment FY10 - FY13

  13. DPC ADC vs. Community Svcs

  14. Reallocation of Resources from Institution to Community: Efficiencies DSAMH FY13 Budget

  15. FY 14 Governor’s Recommended Budget • $3,527.0Community Placements • $800.00 Supported Housing

  16. Thank you very much. Kevin Huckshorn PhD, RN, CADC Melissa Smith, MA Nana Odoi, PhD 302-255-9398