In 2013 over 15,000 Jackson County residents received mental health care supported by the Jackson County community mental health fund.

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1 About Us The Jackson County Community Mental Health Fund (Levy) is a payer of last resort for mental health care in Jackson County. The Levy makes grants to charitable, non-profit mental health organizations who provide care to children, families and people in need. Without Levy funding many would have nowhere else to turn. Thirty-five agencies received grants in For more information please visit: Report The Mental Health Levy works with grantee agencies to make this report possible. Limited demographic information 1 is collected to better understand who the Levy served. We use a web-based system as a simple way to collect information from nearly every grantee agency, accounting for 99% of Levy service recipients. 2 Information about the agencies and their grants was combined with participant age, race, gender, zip code, insurance status, and language. In Brief In 2013 over 15,000 Jackson County residents received mental health care supported by the Jackson County community mental health fund. 3 People who used Levy-funded services tend to live in distressed communities. When comparing Levy participants to the Jackson County population: Latinos and Asians are under-represented in Levy services Caucasians are under-represented in Service Area 3, Kansas City s traditional East Side. African Americans are under-represented in Service Area 5, which includes Independence and northern Blue Springs. Consistent with Missouri Medicare and Medicaid rules, adults aged were about half as likely to have health insurances, as compared with children and seniors. In contrast to state population data, African Americans served by the Levy were somewhat more likely to be insured than Caucasians.

2 Persons Served by Zip Code Jackson County s four state-designated Service Areas are shown on the adjacent map. They are 2: TMC-BH; 3:Swope Health Services; 4: Rediscover; 5: CMHS. The number of residents participating in Levy-funded services is color-coded had more than 1,000 Levy participants , 64052, 64055, 64106, 64111, and had Levy participants. For comparison, another map shows substantiated child abuse and neglect 4 which provides a geographic indicator of communities in distress. Levy utilization reflects a similar pattern of utilization. 5

3 Participants by Race, Service Area 2 6 N=4158 Agencies located within the TMC-Catchment Area are listed in the box. A comparison of Levy participant demographics versus County population shows some general similarities, along with important differences. There was a much lower percentage of Latinos among Levy participants as compared with the general population. There was a much higher percentage of Caucasians among Levy participants as compared with the general population. Asians are 3% of the general population, but <1% of levy Participants.

4 Participants by Race: Service Area 3 6 Agencies located within the Swope Health Services Catchment Area are listed in the box. A comparison of Levy participant demographics versus County population shows several differences. Caucasians comprise half the population, but less than one-fourth of Levy participants. African-Americans comprise a much higher proportion of Levy clients as compared with the general population. Latinos comprise 6% of the population but <1% of Levy participants. Asians comprise 2% of the population but <1% of Levy participants.

5 Participants by Race: Service Area 4 6 Agencies located within the Rediscover Catchment Area are listed in the box. Levy participant demographics versus County population are similar. There was a slightly lower percentage African Americans among Levy participants as compared with the general population. The percentage of Latino participants (2%) was less than half the percentage in the general population (5%). Biracial and multiracial residents comprised 3% of the population but less than 1% of service participants.

6 Participants by Race: Service Area 5 6 Agencies located within the Comprehensive (CMHS) Catchment Area are listed in the box. Again, the Levy service and County populations are similar, in fact the percentage of Caucasians served was identical to the County population. Among the differences: The percentage of African American participants in Levy services (5%) was less than half the percentage population (12%). Latinos were 6% of the general population, but 2% of levy Participants.

7 Preferred Language The language preferred by Levy participants in their mental health services and at home are presented in the adjoining tables. Spanish is by far the most frequently identified non-english service language, indicated for about 4% of participants (587 of 15,059 responses). Those responses are arranged by grantee in a separate table. Almost three-fourths (73%) of Spanish language services were provided by Mattie Rhodes Center. Because of the large number of unknowns this finding should be considered preliminary. 7

8 Age Groups by Grant Program The number and percentage of service participants by grant program, within general age groups is shown in the chart. Adults age comprised large majorities of service participants in Consumer Services, Forensic, Domestic/Sexual Violence and Safety Net funding programs. Young adults ages were about one-fifth of persons served in all categories except Consumer Services. The largest number of young adults served was 1,333 in Safety Net. As expected the largest percentages of participants under 18 were served in Children and Families and Education and Vocational grant categories. Very few persons age 65+ were served with Levy funds because seniors qualify for Medicare. Seniors in the Children and families category are believed to be custodial grandparents.

9 Age and Gender within Safety Net Safety Net is the largest funding program, accounting for about 69% of persons served. As age increases, so does the percentage of female participants. Five transgender persons were reported.

10 Gender by Program This breakdown appears very similar to results from last year. Forensic and Consumer Services grants served a majority of male participants, but the majorities of male participants in Safety Net and Children & Families grants were greater by only a few percentage points. More than 80% of domestic violence participants were female. Gender of education and vocational grant participants were evenly divided.

11 Forensic Services Clients by Race All Levy-funded clients in court or jail-based (Forensic) mental health are shown by race. The large number reported as unknown makes it difficult to estimate a reliable breakdown or draw meaningful conclusions.

12 Corrections Clients by Race TMC-BH served all persons who received Levy-funded mental health services in the Regional Correctional Center (RCC) or Jackson County Detention Center (JCDC). The race of the majority was reported as unknown.

13 Mental Health Court Clients by Race Legal Aid provides legal defense services in Kansas City Municipal Mental Health Court. Most clients were African-American. Monitoring services provide a bridge between the courts and Community Mental Health Centers. Swope Health and TMC-BH serve most clients in Kansas City Municipal Court; again, Most clients were African-American. Comprehensive Mental Health Services (CMHS) and ReDiscover Mental Health Services serve most clients in the Jackson County mental health court (Eastern and Southern parts of the county). Large majorities of their clients were identified as Caucasian. Percentages of Latinos and Hawaiian/Pacific Islanders were low, with the greatest representation in providers who concentrate in the southern and eastern parts of the county.

14 Insurance Status by Race Being insured is defined as having insurance at some time during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqualification rules, application delays and spend down requirements mean that a person s status can shift throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. There is wide variation in the insurance status of each group. Because of the large number of unknowns for Latinos we cannot draw meaningful conclusions for this group. The percentage of uninsured Caucasians (51%) was larger than the percentage of uninsured African Americans (42%) served by the Levy. In contrast, for the general Missouri population the uninsured rates are 13% and 21% for Caucasians and African Americans, respectively. 8

15 Insurance Status by Age Being insured is defined as having insurance at some time during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqualification rules, application delays and spend down requirements mean that a person s status can shift throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. A comparison of insurance status between age groups shows several differences. As expected participants 18 years and younger, and over 65 had the highest rates of being insured (66% and 74% respectively). We believe this is due to eligibility for Medicaid and Medicare. Insurance rates of adults in all three groups were very similar; more than half were uninsured. More detailed views of insurance status for each grant program are provided in the Supplemental Analyses below. 9

16 Insurance Status by Age for Safety Net Program Being insured is defined as having insurance at some time during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqualification rules, application delays and spend down requirements mean that a person s status can shift throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. For Safety Net, the pattern of insurance status is very similar to the overall comparison above. This is as expected since Safety Net comprises such a large part of those data. Children and seniors have a much higher level of coverage than adults ages

17 Insurance Status by Age for Children and Families Programs Being insured is defined as having insurance at some time during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqualification rules, application delays and spend down requirements mean that a person s status can shift throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. Children and Families participants also reflect the pattern of higher insurance coverage for children and seniors, but with a notable presence of unknowns. Among adults the lowest rate of coverage is for persons

18 Insurance Status by Age for Forensic Programs Being insured is defined as having insurance at some time during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqualification rules, application delays and spend down requirements mean that a person s status can shift throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. Forensic clients had notably low rates of insurance coverage, with at least two-thirds uninsured in all age groups.

19 Insurance Status by Age for Domestic/Sexual Violence Programs Being insured is defined as having insurance at some time during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqualification rules, application delays and spend down requirements mean that a person s status can shift throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. Participants in Domestic/Sexual Violence services reflected the overall pattern, in which children and seniors have a much higher level of coverage than adults Adult subgroups appeared very similar, with coverage in the 42% to 47% range.

20 Insurance Status by Age for Education and Vocation Programs Being insured is defined as having insurance at some time during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqualification rules, application delays and spend down requirements mean that a person s status can shift throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. Education and Vocational clients had the lowest reported rate of insurance coverage overall. Children in alternative schools evidenced lower coverage that children in other groups. This may be evidence of family distress and lack of access to mainstream resources.

21 Insurance Status by Age for Consumer Services Programs Being insured is defined as having insurance at some time during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqualification rules, application delays and spend down requirements mean that a person s status can shift throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. Consumer Services participants evidenced high insurance coverage. Family advocacy and benefits management are among the grantee agencies in this category.

22 Notes 1. Limited health information is obtained for temporary use, and is located only on protected IT servers. It is used to create an unduplicated set of participants for aggregate analysis of demographics. Identifying data are permanently removed once the unduplicated data set has been created. Domestic violence agencies provide placeholder information in lieu of identifiable data. No identifiable data is archived. 2. Information not included in the 9/23/14 report: One consumer services agency provides telephone warm line services and we permit them not to request demographic information from callers (n~1,200). The agency submits aggregate information, which is not included here. Two agencies reported demographics well past the deadline and their data are not included in all charts. The number of individuals not included is small (n < 50). Agencies with Pilot grants are not included in this report because the funding program has a different reporting deadline. Those data will be included in the 2014 report. 3. Service participants can be served by more than one agency. Unless otherwise indicated client counts delineate enrollments as opposed to specific (unduplicated) individuals. Charts in the report are prepared from a live database, which receives updates from reporting grantee agencies. Charts were prepared over a six-week period and the total number in charts varies slightly. 4. Source: Local Investment Commission (LINC). 5. The map of Levy utilization under-reports Latinos, because of the large number of unknown zip codes for Latinos submitted by one agency. 6. A majority of persons represented in the figure are served by the mental health center indicated. Most agencies listed in the box are likely to provide Levy-funded services to County residents from both within and outside the state-designated catchment (service) area. 7. The option for users to submit unknown responses to the participant language in year-end report will be eliminated in future reporting years. 8. Source: Kaiser Family Foundation, State Health Facts, Uninsured rates for the non-elderly by race/ethnicity. See: kff.org/uninsured/state-indicator/ rate-by-ethnicity/ 9. Invalid ages (not shown in charts) were caused by data entry error, where a two digit year was entered (entering 72' instead of 1972'). These errors will be prevented in future reporting years. The number/percentage of invalid age was extremely small (table ). Grant Program Invalid Age Safety Net 123 Children and Families 1 Forensic 2 Domestic/Sexual Violence 11 Education and Vocation 3 Consumer Services 19