In 2014 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: kson co u n t ycare s.o rg 2014 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 2014 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 insurance, as compared with children and seniors Demographic Report 1

2 rv 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 p cipa ng in Levy-funded services (in 2013) is color-coded had more than 1,000 Levy p cipants , 64052, 64055, 64106, 64111, and had Levy p cipants. For comparison, another map shows substan ated child abuse and neglect 4 which provides a geographic indicator of commun u lization re ects a similar p ern of u liza on. s in distress. Levy 2014 Demographic Report 2

3 Participants by Race, Service Area 2 5 Agencies located within the TMC-Catchment Area are listed in the box. A comparison of Levy p cipant demographics versus County popu on shows some general simi es, along with important d erences. There was a much lower percentage of nos among Levy p cipants as compared with the general popu on. There was a much higher percentage of Caucasians among Levy par cipants as compared with the general popula on. Asians are 3.2% of the general popu on, but only 1.3% of levy Par cipants Demographic Report 3

4 Participants by Race: Service Area 3 5 Agencies located within the Swope Health Services Catchment Area are listed in the box. A comparison of Levy p County popula on shows several d erences. Caucasians comprise half the popu on, but just roughly one-fourth of Levy p cipants. African-Americans comprise a much higher propo on of Levy clients as compared with the general popu on. nos comprise 5.8% of the popu on but only 2.4% of Levy p cipants. Asians comprise 1.8% of the popula on but <1% of Levy p cipants. cipant demographics versus 2014 Demographic Report 4

5 Participants by Race: Service Area 4 5 Agencies located within the Rediscover Catchment Area are listed in the box. Levy par cipant demographics versus County popula on are similar. There was a higher percentage African Americans among Levy p cipants as compared with the general popu on. The percentage of no p cipants (2.6%) was just over half the percentage in the general popula on (5%). Biracial and mu racial residents comprised 2.5% of both the popula on of service par cipants Demographic Report 5

6 Participants by Race: Service Area 5 5 Agencies located within the Comprehensive (CMHS) Catchment Area are listed in the box. Levy service and County popula ons are similar, in fact the percentage of Caucasians served was iden cal to the County popul on. Among the d erences: The percentage of African American p cipants in Levy services (11.3%) was more than double the percentage popu on (5.2%). nos were 6.1% of the general popula on, but 10.1% of Levy Pa cipants Demographic Report 6

7 Participants by Race: Jackson County, Missouri Levy Total (N=16,863) 0.4% 0.2% 0.6% 3.7% 5.4% County Total (N=698,248) 0.2% 2.3% 1.6% 0.4% 8.2% 47.5% 23.0% 42.2% 64.3% The percentage of African American s served by Levy funding is nearly double that of the total County population (42.2% and 23.0% respectively). Caucasians are underrepresented in the Levy-served population compared with County data (47.5% Levy versus 64.3% County). Latinos are also underrepresented in the Levy-served population by a significant amount (5.4% Levy versus 8.2% County). Although smaller than the populations of the above-mentioned groups, the Asian population appears to be very underrepresented in the Levy-served population (0.6% Levy versus 1.6% County) The very small populations of Native Americans/Alaskan and Hawaiian/Pacific Islanders appear to be represented very proportionally. Multi-racial individuals are represented by approximately 50% higher in the Levy population (3.7% Levy versus 2.3% County) Demographic Report 7

8 Preferred Language Language Preferred MH Svc Use at Home Language Preferred MH Svc Use at Home Agency Spanish Preferred Arabic Lakota 0 1 Mattie Rhodes 281 Banjuni 1 1 Mbai 1 1 Samuel Rodgers 78 Burmese Nepali CAPA 34 Chinese 3 3 Refused Family Conservancy 29 Chukese 1 1 Russian 2 2 DeLaSalle 28 Creole 1 1 Sango 3 3 TMC-BH 22 Deaf - Does Not Sign 1 1 Sign 4 3 MOCSA 20 East India/Pakistan 0 1 Somali Spofford 18 English Spanish ReDiscover 10 French 5 3 Swahili 7 7 KC Care Clinic 9 Italian 0 1 Tagalog 0 1 Rose Brooks 9 Kaba 1 2 Unknown CMHS 5 Kabyle 0 1 Vietnamese 2 1 Hope House 5 Karen Jewish Family Services 4 Karenni 2 2 BFMA 2 Khran 1 1 Jewish Vocational Services 2 Kiganda 1 1 restart 2 Kinyarwanda 6 6 Goodwill 1 Kirundi 3 3 Legal Aid 1 Kunama 1 1 Swope 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 3.3% of participants (561 of 16,780 responses). Those responses are arranged by grantee in a separate table. 50% of Spanish language services were provided by Mattie Rhodes Center Demographic Report 8

9 Preferred Language Jewish Vocational Services Language # Language # Arabic 7 Kinyarwanda 6 Banjuni 1 Kirundi 3 Burmese 29 Kunama 1 English 2 Mbai 1 French 3 Nepali 14 Kaba 1 Sango 3 Karen 13 Somali 18 Karenni 2 Spanish 2 Khran 1 Swahili 7 Kiganda 1 Vietnamese 1 In 2014 Jewish Vocational Services gave a very detailed breakdown of their clients language preferences, showing considerable diversity and thus significantly increasing the number of reported languages. It would be interesting to get this degree of detail from other agencies in future years Demographic Report 9

10 Age Groups by Grant Program The number and percentage of service p cipants by grant program, within general age groups is shown in the chart. Adults age comprised large majo es of service p cipants in Consumer Services, Forensic, Do c/sexual Violence and Safety Net funding programs. Young adults ages were less than one- h of persons served in all categories except Forensic Services. The largest number of young adults served was 1,262 in Safety Net. As expected the largest percentages of par cipants under 18 were served in Children and Families and Educ on and Voc onal grant categories. Very few persons age 65+ were served with Levy funds because seniors qualify for Medicare Demographic Report 10

11 Age and Gender within Safety Net (n=11,538) Safety Net is the largest funding program, accounting for about 69% of all persons served by the Levy. As age increases, so does the percentage of female participants. Four transgender persons were reported Demographic Report 11

12 Gender by Program Enrollment (N=16,622) This breakdown shows some differences from last year. Forensic and Consumer Services grants served a majority of male participants like last year, but males in Safety Net and Children & Families grants no longer comprised the majority of participants. More than 80% of domestic violence participants were female. Gender of Education and Vocational grant participants were evenly divided with a slightly higher number of males. This breakdown shows 16,622 participants because some persons were enrolled in more than one program Demographic Report 12

13 Forensic Services Clients by Race (n=752) All Levy-funded clients in court or jail-based (Forensic) mental health programs are shown by race Demographic Report 13

14 Corrections Clients by Race (n=297) TMC-BH served all persons who received Levy-funded mental health services in the Regional Correctional Center (RCC) or Jackson County Detention Center (JCDC) Demographic Report 14

15 Mental Health Court Clients by Race (n=407) 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. The other agencies shown provide monitoring services, which is a bridge. 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 majori es of their clients were iden ed as Caucasian. Percentages of nos and Hawaiian/Pac Islanders were low, with the greatest represent on in providers who concentrate in the southern and eastern parts of the county. CMHS had 1 Latino participant, ReDiscover had none, and neither agency had Hawaiian/Pacific Islanders Demographic Report 15

16 Insurance Status by Race (N=16,622) Being insured is d ned as having insurance at some me during the year. Insurance includes private insurance, Medicaid, Medicare and TriCare. Medicaid eligibility/disqu on rules, applic on delays and spend down requirements mean that a person s status can sh throughout the year. Mental Health Levy is a last resort payer when these other types of coverage are unavailable. Because of the large number of unknowns for L nos we cannot draw meaningful conclusions for this group, however they appear to have a much lower rate of insurance coverage. African Americans have only a slightly lower uninsured rate than whites. The percentage of uninsured Caucasians (47.2%) was less than the percentage of uninsured African Americans (49%) served by the Levy. Other groups have a small sample size. In comparison, for the general Missouri popu on the uninsured rates are 13% and 21% for Caucasians and African Americans, respec vely Demographic Report 16

17 Insurance Status by Age (N=16,622) (N=16,662) 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. The 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 (66.7% and 71.8% 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 Demographic Report 17

18 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. The 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 Demographic Report 18

19 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. The 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. Among adults the lowest rate of coverage is for persons Demographic Report 19

20 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. The 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; more than four-fifths of adults under 65 were uninsured Demographic Report 20

21 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. The 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 46% to 49% range Demographic Report 21

22 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. The 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 Demographic Report 22

23 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. The Mental Health Levy is a last resort payer when these other types of coverage are unavailable. Consumer Services participants evidenced the highest insurance coverage of all grant categories. Family advocacy and benefits management are among the grantee agencies in this category Demographic Report 23

24 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. 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 time and the total number in charts may vary. 4. Source: Local Investment Commission (LINC). Notes 5. 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. 6. 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/ 2014 Demographic Report 24