5 Agency Presentation - Part IV of IV (pages 223-281) - DSS FY15 Friday, January 24, 2014 9:03 AM NOTE: This is Part IV of IV of the Agency Presentation (Pages 223-281) Behavioral Health Human Services Center Division of Community/Correctional Behavioral Health Informational Boards
Behavioral Health ub tan abu e di order • It i comm n for p ople to have co-occurring m ntal health and ub tance abu e condition • Beha ioral health treatment i mo t effective when ervice are integrated and provided inrnltaneou ly in the lea t re tricti e en ironment What is a "Severe Mental Illness"? • Severe mental illne include both a diagno able mental di order and functional impainnent that ignificantly interfere with daily living • Mood Di order • 9.5% of th population in a gi en year • Bipolar di ord r major depre ive di order dy thymic di order • ften co-occur v ith anx_iety di order and ub tance abuse • chizophrenia • 1.1 % of the population in a gi en year • ften appear in late adolescence or early adulthood Pa c- 22
Behavioral Health Prevalence: Mental Disorders: • An estimated 26.2 °/o of Americans 18 and older - about 1 in 4 adults - experience a diagnosable mental disorder in a given year • Apprnx. 1 in 10 children have a diagnosable mental disorder in a given year • Although mental disorders are widespread in the population, about 1 in 17 people experience a severe mental illness Prevalence: Substance Abuse Disorders: • 2011 ational Survey on Drug Use and Health • Estimated 20.6 million per ons (8 % of the population age 12 or old r) had ubstance dependence or abuse diagnosis • Of the 20.6 million, 2.6 million were cla sified with dependence or abu e of alcohol and illicit drug and 14 .1 million with only alcohol Pa e 223
Behavioral Health Behavioral Health Reorganization: • Executive order in 2011 by Governor Daugaard moving behavioral health services from DH S to DSS • Division of Mental Health, Division of Alcohol & Dr ug Abu e, Human Services Center • Purpose was to create a more integrated approach and opportunities to: • Le erage exi ting re ource • Streamline variou proce e to minimize red tape • Change the law to upport effective ervice delivery • Crea te d two new divisions and a program • Di i ion of Community Beha ioral Health • Divi ion of Conectional Behavioral Health • Prevention Program Pa e 224
Behavioral Health Behavioral Health Workgroup: • E tabli bed in 2011 by Governor Daugaard after reorganization of behavioral health ervice • reated to guide the long-term vision of the behavioral health y tern • Workoroup Goals • Increa e acce s to erv 1ce tlu·oughout the tate • Build the capa ity of lo al co 1111mmitie to upp01t behavioral health erv 1ce • Develop a trntegic tatewide prevention plan • Con ider the role of the Hmnan Se1vice Center • Workgroup Subcommittee • ommit:ment La, • Essential Ser ice • eriatri erv1ce • Prevention e1vices For more information visit http: ds .. sd.gOl bcha , ioralhea//hse11·i<:es inde.r.asp Pa c - 25
Behavioral Health Behavioral Health Regions -- eaLE FOURCHE RGlS RAPl>CITY Page 226
Department of Social Services DSS String FamlUes • SHIii ak1ta's Foundation and aur Future Human Services Center (HSC) Pa c _ 27
Human Services Center Who We erve: • Individuals age 12 to end of life who are unable to be erved by other providers • Ale re tricti e environment i not an option for care • Voluntary and involuntary admi sions ervices Provided: • Licensed pecialty ho pital, tate' only public p ychiatric ho pital • Adult & adole cent inpatient p ychiatric treatment • Adult & adole ent inpatient ubstance abu e treatment • eriatric p ychiatric treatment (nur ing facility) • omt order d competency valuation and r toration Page 229
Human Services Center General $32.959.982 1.3% FY14 Major Budget Area FTE Federal Total General Other HS C Administration 57.0 $3,152,340 $967,760 Sl86 ,323 S-1 ,306,423 so lnpaD0111 Psychmtn: Treaunem 266 0 Sl 1,040,765 S-1 ,359,459 Sl S, 400,224 so Inpatient Substance Abuse Treatme nt 48.0 $2,135,6 51 $688,795 Sl ,824,446 so Genatrx: 91.0 $3,980,035 Sl , 188 ,959 S S, 168,994 er\lCCS C linital Ser\'.,Cs $2,810 ,7 44 55.5 SS ,456,160 S742,2 19 S9 ,009,123 Faciky Opcrauons 48 .5 $3,848,977 Sl , 561 ,004 SI00 ,748 S S.5 10 ,729 so so Bond PaymclllS 0.0 $3.346,054 $3 ,346,054 TotalBSC 566.0 $32,959,982 Sll,576 , 721 Sl ,029,290 $45,565,993 Personal Scr\'iccs 566.0 $23 , 515 , 953 $9,222,051 S49l ,335 S33 , l90 ,339 0 p eratmsz E."'P='c 0.0 $9,384,029 52 ,354,670 S536,955 $1 2.275,654 Total RSC 566.0 $32,959,982 Sll ,576, 721 Sl ,029,290 $45,565,993 Page 230
Human Services Center FYl 4 Funding Sources Medicaid & CHIP 51.31% Medicare 47.92% National School Lunch 0.77% D OC Pharmacy 44.96% H C Ot h er 27.89% Prescription Dru2 Pl an 23.75% Medical Faculty 3.40% Page 231
Human Services Center ervice Delivery: • Each patient is a signed a p ychiatrist who is re pon ible for coordination of treatment • Treatment teams are used to plan, implement and evaluate treatment and include: • Patient and hi /her family and/or ignificant other • P ychiatri t •Nur e • So ial Worker • Discharge plannino and arranoements for aftercare P ag e 232
Human Services Center HSC Staffing: Total HSC Budgeted Full Time Equivalent Staff - 566.0 FTE • • Nurses - 98.0 FTE • Coun elors - 81.5 TE • M ntal Health T chnicians/ Aides - 17 6. 5 TE • ocial Worker - 16.0 FTE • Medical Profes ional - 25.5 FTE • Facility Operations - 48.5 FTE • Admini tration - 57.0 FTE • Other - 63 .0 FTE • TuI" nov e1· Rate • FY 13 percent of direct care staff 25.4% • SFY13 percent of total turnover 21.4% Pa ge 233
Human Services Center HSC Admini tration: Gene r al Fede r al Otner Tota l FTE Funds Fund s Funds Funds ! 54,306,423 ! FY1 4 Bu dget 57 0 Sl ,152,340 S967,760 S186,323 • Admini trative Service to operate HS • Administration • Business Office • Warehou e • Admi sion • Medical Records • Utilization Review • Education • Support Service Page 234
Human Services Center Admissions: • 1,821 admis ion in FY13 • Adults • Voluntary admi ion (not court or board ordered) - 20% • Involuntary admi ion - 0% • Ty pe of admi ion • Adult acute - 1 365 individual • Adult ub tance abuse - 1 4 individual • Adole cent p y hiatri - 215 individual • Adolescent sub tance abuse - 57 indi iduals • Primary Diagnosis at time of admission: • Depre ive Di order - 19.25% • chizophrenic Di order - 1 .05% • pi odic Mood Di order - 16.44% • Alcohol Dependence Syndrome- 7.34% • All other diagno i - 38.92% • FY13 average o t per day: $4 74.4 7 P ag e 23
Human Services Center Inpatient P ychiatric Treatment: General Fede r al Other Tota l FTE F unds Fund s Funds Fund s ! S15, 400 224 ! FY14 Budget 266 0 S11 , 040 765 $4 , 359 ,4 59 SO • Psychiahic Tr eat ment (SFY13) • Adult ervices • Acute rv1c - 6 b d • SFY 13 erage length of tay - 13 day • SFY13 A erage total co t per day: $524.40 • Long Tenn Service - 66 bed • FY13 A erage length of tay- 152 da y • Y13 A erage total cost per day: $400.34 • Adolescent ervice - 54 bed • Acute Intermediate and ong Term • SFY13 A erage length of tay - 36 day • SFY13 A erage total o t per day: $507.18 • School op rated on ite for youth - appro ed educational program P ag e 236
Human Services Center Inpatient Substance Abuse Treatment: Genera l Fede r al other To tal fTE F unds Funds Funds F unds S2 . 824 ,446 ! ! FY1 4 Bu d ge t 480 52,135, 651 5688,795 SO • Substance Abu e Treatment ( FY13) • Adult Services - 24 Beds • SFY13 Average length of tay - 26 days • SFY13 Average total co t per day: $445.76 • Adolescent Services - 20 Beds • Accredited by ommi ion on Accreditation of Rehabilitation Facilitie (CARF) • SFY13 Average length of tay - 68 day • FYI 3 Average total co t per day: $489 .39 Page 237
Human Services Center G Gene ral Federal Tota l Olher F1E Funds Fun<ls Fund s Fund s 55 ,168994 I ! so FY 14 Budget 91 0 $3 , 980 , 035 $1.1 88 ,959 • Ge 1i atric P ychiatric Treatment - 69 b d • 5- tar rated nur ing facility • SFY13 Average length of tay in - 283 day • SFY13 Average total o t per day: $457.05 • Working with community nur ing facilitie to de elop the capacity to erve individual with dementia and chall nging beha ior in the community • HS consulting team to pro ide psychiatric review/con ultation to nur ing facilitie • Training to community nur ing facilitie P ag e 238
Human Services Center Clinical Services: Gene raJ Federal Other To tal ne Funas FurldS Funos Fu nos 59 , 009 ,123 I I 55.5 $5 ,456,1 60 $2,810,744 S742,219 FY14 Budget • Provide medical ervices on site whenever possible • ur mg • Laboratory • Specialty Clinic • Radiology • Dental • peech Therapy • Medical ervices • Psychology • Pharmacy Page 239
Human Services Center Facility Operations: Genera l Fede ral Other Tota l rn Funas Funas Funas Fu n as I S5,510, n9 I FY14 suaoet 48.5 SJ ,848,977 S 1. 561,004 s100.74s • Plant Operations • Laundry • Custodial • ec mity • Food Service • U e Department of Con-ection tru tie for labor • HS C provide meal for tru tie Page 240
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