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So .. YOURE NE W T O BE HAVIORAL HE AL T H F INANCE ? - - PDF document
So .. YOURE NE W T O BE HAVIORAL HE AL T H F INANCE ? - - PDF document
So .. YOURE NE W T O BE HAVIORAL HE AL T H F INANCE ? CBHAA Whe re to F ind Re so urc e s to Assist in Unde rsta nding F unding So urc e s Be ha viora l He a lth F unding History CBHAA Co unty He a lth F unding
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Re a lig nme nt – Wha t It Is
Conc e pt
Re a lig nme nt – to a djust two o r mo re c o mpo ne nts o f
re spo nsib ility
T
ra nsfe rs o r “re a lig ns” funding re spo nsib ility b y shifting a g re a te r sha re o f c o st to the c o untie s
1991/ 92 Re a lig nme nt
CBHAA
1991 Re a lig ne d Prog ra ms
CBHAA
AB 8 County He a lth Se rvic e s L
- c a l He a lth Se rvic e s
Ca lifornia Childre n’s Se rvic e s Indig e nt He a lth Ca lWORKs E mployme nt Se rvic e s County Se rvic e s Bloc k Gra nt In- Home Supportive Se rvic e s F
- ste r Ca re
CWS Adoptions County Sta biliza tion Subve ntions County Juve nile Justic e Subve ntions (AB 90) Me nta l He a lth
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1994- 95 E a rly a nd Pe riodic Sc re e ning , Dia g nosis a nd T re a tme nt (E PSDT )
E
PSDT ha s b e e n a re q uire me nt o f the Me dic a id Pro g ra m sinc e its inc e ptio n in 1966
T
he fe de ra l Omnib us Budg e t Re c o nc ilia tio n Ac t o f 1989 (OBRA ‘ 89) e xpa nde d the b e ne fit to inc lude d dia g no stic a nd tre a tme nt se rvic e s ne e de d to “c o rre c t o r a me lio ra te de fe c ts, physic a l a nd me nta l illne ss a nd c o nditio ns disc o ve re d b y sc re e ning se rvic e s, whe the r o r no t suc h se rvic e s we re c o ve re d unde r the Me dic a id Sta te Pla n.”
A 1993 la wsuit a g a inst the sta te De pa rtme nt o f He a lth Se rvic e s fo r no t
suffic ie ntly c o mplying with fe de ra l la w re sulte d inc re a se d a va ila b ility o f Sta te Ge ne ra l F unds to fina nc e Me di-Ca l spe c ia lty me nta l he a lth se rvic e s to c hildre n a nd a do le sc e nts.
Co unty me nta l he a lth pla ns pa id a 50% ma tc h, pursua nt to 1991
Re a lig nme nt, until it re a c he d its a djuste d fisc a l ye a r 1994-95 b a se line o f e xpe nditure s fo r spe c ia lty me nta l he a lth se rvic e s.
I
n 2002, in a n e ffo rt to e nsure tha t c o untie s ha d a n “inc e ntive ” to c o ntro l c o sts, a n a dditio na l 10% c o unty sha re o f c o st o n g ro wth in the E PSDT pro g ra m wa s impo se d.
CBHAA
1995- 98 Me di- Ca l Spe c ia lty Me nta l He a lth Consolida tion
F ro m 1995 thro ug h 1998 the sta te c o nso lida te d F e e -F
- r-Se rvic e (F
F S) a nd Sho rt-Do le pro g ra ms into o ne “c a rve o ut” spe c ia lty me nta l he a lth ma na g e d c a re pro g ra m unde r a Me dic a id 1915(b ) “F re e do m o f Cho ic e ” wa ive r. Unde r the c o nso lida tio n, a ll Me di-Ca l b e ne fic ia rie s we re re q uire d to a c c e ss the ir spe c ia lty me nta l he a lth se rvic e s thro ug h the c o unty Me nta l He a lth Pla n (MHP). Upo n c o nso lida tio n the sta te De pa rtme nt o f He a lth Ca re Se rvic e s tra nsfe rre d the funds it ha d b e e n spe nding unde r the F F S syste m fo r impa tie nt psyc hia tric a nd o utpa tie nt physic ia n a nd psyc ho lo g ist se rvic e s to c o unty MHPs. Additio na l c o sts fo r inc re a se s in Me di-Ca l b e ne fic ia ry c a se lo a ds a nd COL As b e yo nd the b a se a llo c a tio n fo r c o nso lida tio n, we re to b e pa id fo r with c o unty 1991 Re a lig nme nt.
CBHAA
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2004 Me nta l He a lth Se rvic e s Ac t (MHSA)
Re ve nue s a re vo la tile a nd funding is no t g ua ra nte e d Ca sh flo w va rie s sig nific a ntly during e a c h fisc a l ye a r E xpe nditure s must b e c o nsiste nt with a n a ppro ve d pla n F unds must b e spe nt within a spe c ifie d time fra me (g e ne ra lly, thre e (3) ye a rs) F unds distrib ute d o n a mo nthly b a sis (W&I Co de Se c tio n 5892(j)(5)) Co untie s a re re spo nsib le fo r e nsuring c o mplia nc e with W&I Co de Se c tio n 5892(a ) 20% fo r Pre ve ntio n & E a rly I nte rve ntio n pro g ra ms Ba la nc e fo r Co mmunity Se rvic e s & Suppo rts (Syste m o f Ca re ) 5% o f to ta l funding utilize d fo r I nno va tive pro g ra ms
CBHAA
Me nta l He a lth Se rvic e s Ac t (MHSA)
F unds must b e de po site d in a fund whic h inte re st e a rne d re ma ins in the fund to b e use d fo r MHSA e xpe nditure s Be g inning in F Y 2008/ 09, c o untie s c a n a nnua lly de dic a te up to 20% o f the a ve ra g e o f the ir 5-ye a r to ta l o f MHSA funds to the Prude nt Re se rve , Ca p/ T e c h o r WE T pro g ra ms/ pro je c ts Ma y use up to 5% o f to ta l a nnua l MHSA re ve nue s fo r pla nning a nd suppo rting Co nsume rs, fa mily me mb e rs, sta ke ho lde rs a nd c o ntra c to rs in the lo c a l pla nning pro c e ss
CBHAA
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2011 Re a lig ne d Prog ra ms
CBHAA
F
- ste r Ca re
CWS Adoptions Adult Prote c tive Se rvic e s Child Abuse Pre ve ntion, Inte rve ntion & T re a tme nt (CAPIT ) Wome n a nd Childre n’s Re side ntia l T re a tme nt Drug Me di- Ca l Non- Drug Me di- Ca l Drug Court Me nta l He a lth E PSDT Ma na g e d Ca re L a w E nforc e me nt
- T
ria l Court Se c urity
- Distric t Attorne y & Public De fe nde r
- Juve nile Justic e
- Community Corre c tions
- L
- c a l Public Sa fe ty Subve ntions
Inte rse c tion of Re a lig nme nt Prog ra ms
CBHAA
Adult Prote c tive Se rvic e s Child Abuse Pre ve ntion, Inte rve ntion & T re a tme nt (CAPIT ) Wome n a nd Childre n’s Re side ntia l T re a tme nt Drug Me di- Ca l Non- Drug Me di- Ca l Drug Court E PSDT Ma na g e d Ca re L a w E nforc e me nt
- T
ria l Court Se c urity
- Distric t Attorne y & Public De fe nde r
- Juve nile Justic e
- Community Corre c tions
- L
- c a l Public Sa fe ty
Subve ntions F
- ste r Ca re
CWS Adoptions Me nta l He a lth AB 8 County He a lth Se rvic e s L
- c a l He a lth Se rvic e s
Ca lifornia Childre n’s Se rvic e s Indig e nt He a lth Ca lWORKs E mployme nt Se rvic e s County Se rvic e s Bloc k Gra nt In- Home Supportive Se rvic e s County Sta biliza tion Subve ntions County Juve nile Justic e Subve ntions (AB 90)
1991 Re a lig nme nt 2011 Re a lig nme nt SHARE D
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Gra nts
- Community Me nta l he a lth Se rvic e s Bloc k Gra nt (MHBG)
Pro vide s g ra nt funds to e sta b lish o r e xpa nd a n o rg a nize d c o mmunity-b a se d syste m o f c a re fo r pro viding no n-T itle XIX me nta l he a lth se rvic e s to c hildre n with se rio us e mo tio na l disturb a nc e s (SE D) a nd a dults with se rio us me nta l illne ss (SMI).
- Pr
- je c ts for Assista nc e in T
r a nsition from Home le ssne ss (PAT H) F unds c o mmunity b a se d o utre a c h, me nta l he a lth a nd sub sta nc e a b use re fe rra l/ tre a tme nt, c a se ma na g e me nt a nd o the r suppo rt se rvic e s, a s we ll a s a limite d se t o f ho using se rvic e s fo r the ho me le ss me nta lly ill.
- Substa nc e Abuse Pre ve ntion & T
r e a tme nt (SAPT ) Bloc k Gr a nt F unds to pre ve nt a nd tre a t sub sta nc e a b use ta rg e ting po pula tio n a nd se rvic e a re a s inc luding pre g na nt wo me n a nd wo me n with de pe nde nt c hildre n, intra ve no us drug use rs, tub e rc ulo sis se rvic e s, e a rly inte rve ntio n se rvic e s fo r HIV/ AI Ds a nd prima ry pre ve ntio n se rvic e s.
- Othe r Gra nts
T ria g e , No Pla c e L ike Ho me , e tc …..
CBHAA
Othe r F unding Sourc e s
Drug Me di-Ca l Org a nize d De live ry Syste m (ODS) Wa ive r Sta te Ge ne ra l F unds Co ntra c ts Ca lWORK s Co urt F e e s & Co sts (SUDS) E sta te F e e s – Pub lic Administra to r/ Gua rdia n Priva te I nsura nc e Me dic a re Clie nt F e e s (UMDAP & SUDS Sliding F e e )
CBHAA
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De live ring Se rvic e s T hroug h Multiple F unding Sourc e s
Know the re quire me nts a nd limita tion of your funding sourc e
Re a d the c o ntra c t Whe n in do ub t c o nta c t yo ur lia iso n fo r the spe c ific funding so urc e
F
unding Hie ra rc hy Priva te (I nsura nc e ) L
- c a l (F
e e s, Ge ne ra l F und) Sta te Ge ne ra l F und Sta te (Re a lig nme nt) F e de ra l (F e de ra l Gra nts, Me di-Ca l)
CBHAA
Informa tion to Support F ina nc ia l De c ision Ma king
- Me a ning ful Da ta
Go o d da ta is ne c e ssa ry fo r so und de c isio n ma king
- Community Ne e d
Wha t a re the ne e ds o f the c o mmunity
- Histor
y In b o th te rms o f re ve nue a nd se rvic e de live ry
- Antic ipa te d Outc ome s
Will the a ntic ipa te d o utc o me b e wo rth the inve stme nt
- Susta ina bility
Will the d e c isio n b e susta ina b le into the future in te rms o f re ve nue , pro g ra m a nd sta ffing .
CBHAA
SLIDE 9
Annua l Ups a nd Downs of F isc a l Ma na g e me nt
- Ja nua ry 10th: Sta te b udg e t to L
e g isla ture
- Ja nua ry: Mid-Ye a r Pro je c tio ns due
- F
e brua ry 1st: All pro po se d sta tuto ry c ha ng e s (tra ile r b ills) ne c e ssa ry to imple me nt the Sta te
b udg e due
- F
e brua ry: Annua l Budg e t Pa c ka g e sub mitte d to CAO
- Ma rc h – Ma y: Budg e t me e ting s
- Ma y: Sta te Budg e t Re vise
- June 15: Sta te L
e g isla ture pa sse s Budg e t Bill
- June : Budg e t sub mitte d to BOS a nd fo r pub lic re vie w
- July – Se pte mbe r: L
- c a l Annua l Budg e t Appro va l Pro c e ss
- Oc tobe r: Audito r-Co ntro lle r dra ft a djustme nts to b a la nc e a do pte d b udg e t
- July – Se pte mbe r: L
- c a l Co unty Prio r Ye a r E
nd Clo sing
- De c e mbe r 1st: L
- c a l Ado pte d Budg e t sub mitte d to Sta te Co ntro lle r
- De c e mbe r: Co st Re po rting a nd Re ve nue & E
xpe nditure Re po rts (BH & SUDS)
CBHAA
Re sourc e s for Dire c tors a nd F isc a l Sta ff
- Ca lifo rnia Be ha vio ra l He a lth Administra to rs Asso c ia tio n
- Ca lifo rnia Institute fo r Be ha vio ra l He a lth So lutio ns
- http:/ / www.c ib hs.o rg /
- Ca lifo rnia Sta te Asso c ia tio n o f Co untie s (CSAC)
- http:/ / www.c o untie s.o rg /
- Ce nte r fo r Me dic a re & Me dic a id Se rvic e s (CMS)
- https:/ / www.c ms.g o v/
- Co unty Be ha vio ra l He a lth Dire c to rs Asso c ia tio n o f Ca lifo rnia (CBHDA)
- http:/ / www.c b hda .o rg /
- De pa rtme nt o f He a lth Ca re Se rvic e s (DHCS)
- http:/ / www.dhc s.c a .g o v/ Pa g e s/ de fa ult.a spx
- Co unty Custo me r Se rvic e s Se c tio n (Me dCCC)
- Me dCCC@ dhc s.c a .g o v
- Sub sta nc e Ab use a nd Me nta l He a lth Se rvic e s Administra tio n (SAMHSA)
- https:/ / www.sa mhsa .g o v/
- Othe r Co unty Dire c to rs a nd F
isc a l Sta ff
- Inde pe nde nt Co ntra c to rs
CBHAA
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