Department of Mental Health and Substance Abuse Services Budget Hearing. November 24, 2014

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Phyllis Katrina Riley
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1 Department of Mental Health and Substance Abuse Services Budget Hearing November 24, 2014

2 Customer-Focused Government Goals RMHI Goals Improving Services Educational Goals Key Operational Goals Actively work with RMHI leadership continuing efforts to improve outcomes for patient care while containing cost. Strengthen and improve community mental health and substance abuse services. Educating Tennesseans and working to improve their understanding of mental health and substance abuse issues and getting people to early intervention services. Strategic Initiatives Lead in partnership with State agencies and community partners to prevent and treat the prescription drug abuse epidemic in Tennessee. Reduce and more effectively intervene and treat Tennesseans that abuse controlled substances. Mental Health & Substance Abuse Services 2

3 TDMHSAS Successes Regional Mental Health Institutes Substance Abuse Services Mental Health Services Clinical/Administrative Processes Improved LEAN event admissions process Standardization of best practices Systems transformation Promoting community alternatives Lakeshore Closure Memphis Mental Health Institute reorganization Prescription for Success Low cost/high impact programs Lifeline Oxford House Community Coalitions Recovery Courts General public and healthcare providers education and prevention Collaboration with other state agencies Expanded housing Redesign of children s crisis services Discretionary grants Suicide prevention initiatives Veteran issues Addressing initial serious psychiatric episodes Mental Health & Substance Abuse Services 3

4 TDMHSAS Successes Savings from investing in some key programs: Substance abuse treatment services saved Tennessee taxpayers approx. $340,038,600 in monetary benefits to society in FY 2013 Crisis services saved Tennessee taxpayers approx. $53,205,844 in psychiatric hospital services avoided in FY TDMHSAS funded community mental health prevention services saved Tennessee taxpayers approx. $45,369,005 in increased productivity, and reduced health care, criminal justice, and social services costs in FY Mental Health & Substance Abuse Services 4

5 TDMHSAS Challenges Available resources to address the critical needs of Tennesseans accessing public mental health and substance abuse services. Workforce shortages Increase demand for inpatient psychiatric beds (private and public sector) Changing public policy for drug related offenses. Finding resources for technology investments: 1) Electronic Medical Records (EMR) 2) Telehealth 3) Automated Medication Dispensing (Pyxis) 4) Next Gen Staffing Mental Health & Substance Abuse Services 5

6 FY Budget Mental Health and Substance Abuse Services 6

7 Revenue Sources Millions $350 $300 $250 $200 $150 $43 $46 $58 $64 $47 $62 $100 $203 $204 $196 $50 $0 Actual FY14 Estimated FY15 Requested FY16 State Appropriations Federal Revenue Other Revenue Mental Health and Substance Abuse Services 7

8 Proposed Reduction Plan Priority Category Reduction Description 1. Program & Operations Reduces budgeted professional services, supplies and other non-personnel costs closer to actual expenditure State Savings $200, Program & Operations Elimination of 7 vacant positions in the central office $315, Program & Operations Reduce the funding available for forensic evaluations $1,000, Program Elimination Elimination of Assisted Outpatient Therapy Program $125, Program & Operations Reduction of funding for private inpatient uninsured services $510, Program Elimination Elimination of Juvenile Court Screenings Funding $20, Program Elimination 8. Program Elimination 9. Program Elimination Elimination of adolescent outpatient substance abuse services Elimination of adolescent day/evening treatment services statewide Elimination of support for all 45 peer support centers statewide. Reduction submitted in previous years. $190,000 $1,219,000 $4,523,600 TOTAL $8,103,900 Mental Health and Substance Abuse Services 8

9 State Dollar Savings By Program Total Reductions = $8,103,900 Administrative Services Division, $515,900 Community Mental Health Services, $6,179,000 Community Substance Abuse Services, $1,409,000 Mental Health and Substance Abuse Services 9

10 Proposed Cost Increases Increase Total State Federal Other Positions Lifeline Peer Program Continuation - Recurring Mental Health Family Support Adult Program $525,000 $525, $119,600 $119, Total Cost Increases $644,600 $644,600 $0 $0 0 Mental Health and Substance Abuse Services 10

11 Request Summary State Appropriations (in millions) $203.9 $ $8.1 $0.6 Base Budget Reductions Increases Total Request Mental Health and Substance Abuse Services 11

12 Request Summary Authorized Positions 1,875 1, Base Budget Reductions Increases Total Request Mental Health and Substance Abuse Services 12

13 Authorized Positions 2,642 2,276 2,245 1,903 1,880 1,875 1,868 FY10 FY11 FY12 FY13 FY14 FY15 Requested FY16 Mental Health and Substance Abuse Services 13

14 Regional Mental Health Institutes Mental Health and Substance Abuse Services 14

DEPT: Behavioral Health Division UNIT NO. 6300 FUND: General 0077. Budget Summary

DEPT: Behavioral Health Division UNIT NO. 6300 FUND: General 0077. Budget Summary 2 Budget Summary Category 2014 Budget 2014 Actual 2015 Budget 2016 Budget 2016/2015 Variance Expenditures 1 Personnel Costs $71,051,105 $68,846,318 $63,170,918 $61,866,902 ($1,304,016) Operation Costs