Transcript No Slide Title

Children’s Mental Health Services
Part 1
DSHS Legislative Appropriation Request(s) for
Children's Mental Health Services
for FY2008-FY2009
BASE REQUEST
(Assumes 10% Reduction)
Mental Health Services for Children
(Goal 2, Objective 2, Strategy 2)
Funding Source
FY2008
FY2009
Biennium
General Revenue Funds
$38.3 Million
$38.3 Million
$76.6 Million
Federal Funds
$18.4 Million
$18.4 Million
$36.8 Million
$56.8 Million
$56.8 Million
$113.6 Million
Total
Source: Texas Department of State Health Services FY2008-2009 Legislative Appropriations Request, http://www.dshs.state.tx.us/budget/lar/StrategysRequests.pdf, pp.
51-53, Retrieved 10/30/06.
Note: Totals subject to rounding error.
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RESTORATION OF BASE FUNDING
Mental Health Services for Children
(Goal 2, Objective 2, Strategy 2)
Funding Source
FY2008
FY2009
Biennium
General Revenue Funds
$4.3 Million
$4.3 Million
$8.6 Million
Federal Funds
$4.0 Million
$4.0 Million
$8.0 Million
$8.3 Million
$8.3 Million
$16.6 Million
Total
Source: Texas Department of State Health Services FY2008-2009 Legislative Appropriations Request, http://www.dshs.state.tx.us/budget/lar/Exceptstratallocation.pdf,
p. 17, Retrieved 10/31/06.
Note: Totals subject to rounding error.
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EXCEPTIONAL ITEM REQUEST (HHSC)
Eliminating the Waiting List for
DSHS-Funded Children’s Community Mental Health Services
FY2008
GR
All
Allocated
Funds
Keep Pace with
Population Growth
$.66 Million
Reduce Waiting List
Options
Total
FY2009
Biennium
GR
All
Allocated
Funds
GR
All
Allocated
Funds
$.66 Million
$1.3 Million
$1.3 Million
$2.0 Million
$2.0 Million
$.56 Million
$.56 Million
$1.1 Million
$1.1 Million
$1.7 Million
$1.7 Million
$1.2 Million
$1.2 Million
$2.4 Million
$2.4 Million
$3.6 Million
$3.6 Million
Source: Texas Department of State Health Services Waiting List Summary Document Submitted to HHSC, 07/27/06.
Note: Totals subject to rounding error.
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EXCEPTIONAL ITEM REQUEST (DSHS)
Mental Health Community Services (Crisis Redesign)
FY2008
GR
All
Allocated
Funds
Mental Health
Services for Adults
$20.4 Million
Mental Health
Services for Children
Biennium
GR
All
Allocated
Funds
GR
All
Allocated
Funds
$20.4 Million
$40.8 Million
$40.8 Million
$61.1 Million
$61.1 Million
$7.1 Million
$7.1 Million
$14.1 Million
$14.1 Million
$21.2 Million
$21.2 Million
$27.5 Million
$27.5 Million
$54.9 Million
$54.9 Million
$82.3 Million
$82.3 Million
Options
Total
FY2009
Source: Texas Department of State Health Services FY2008-2009 Legislative Appropriations Request, http://www.dshs.state.tx.us/budget/lar/Exceptstratallocation.pdf, p.
48-50, Retrieved 11/01/06.
Note: Totals subject to rounding error.
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REQUEST SUMMARY
Children’s Mental Health Services
FY2008
FY2009
Biennium
Funding
Source
Requested
Dollars
Number
Served
Requested
Dollars
Number
Served
Requested
Dollars
Number
Served**
Base Request
$56.8 Million
20,706
$56.8 Million
20,706
$113.6 Million
41,412
Restoration of
Base Funding
$8.3 Million
1,533
$8.3 Million
1,533
$16.6 Million
3,066
Eliminating
Waiting List
$1.2 Million
241
$2.4 Million
483
$3.6 Million
483
Crisis Services
Redesign*
$7.1 Million
3,184
$14.1 Million
3,202
$21.2 Million
6,386
$73.4 Million
25,664
$81.6 Million
25,924
$155.0 Million
51,347
Total
*Not counted in provider performance targets.
** Not necessarily unduplicated.
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Part 2
The Projected Number of Children to be Served if
the DSHS Legislative Appropriation Requests
Are Actually Funded
BASE REQUEST & RESTORATION OF BASE FUNDING
Mental Health Services for Children
(Goal 2, Objective 2, Strategy 2)
Projected Number of Children to be Served
30,000
25,000
22,239
22,239
FY2008
FY2009
20,000
15,000
10,000
5,000
0
Source: Texas Department of State Health Services FY2008-2009 Legislative Appropriations Request, http://www.dshs.state.tx.us/budget/lar/StrategysRequests.pdf, pp.
51-53, Retrieved 10/30/06, and http://www.dshs.state.tx.us/budget/lar/Exceptstratallocation.pdf, p. 17, Retrieved 10/31/06.
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EXCEPTIONAL ITEM REQUEST (HHSC):
Eliminating the Waiting List for
DSHS-Funded Children’s Community Mental Health Services
Projected Number of Children to be Served
600
Keep Pace with Population Growth
483
Reduce Waiting List
400
Total
241
200
130
260
223
111
0
FY2008
FY2009
Source: Texas Department of State Health Services Waiting List Summary Document Submitted to HHSC, 07/27/06.
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EXCEPTIONAL ITEM REQUEST (DSHS)
Mental Health Community Services (Crisis Redesign)
Mental Health Services for Children (Goal 2, Objective 2, Strategy 2)
Projected Number of Children to be Served
4,000
3,184
3,202
FY2008
FY2009
3,000
2,000
1,000
0
Sourrce: DSHS Mental Retardation and Behavioral Health Outpatient Warehouse (MBOW), Consumers Served with Crisis at Admit, run 9/19/06.
Note: Estimates based on number of children served in crisis service package in FY06 adjusted for population growth (1.17% over biennium).
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Part 3
The Extent to Which the Appropriation Request(s)
in Part 2 Would Properly Serve the Total Number
of Children Who Are in Need of Receiving
Mental Health Services
PENETRATION RATE:
Mental Health Services for Children and
Eliminating the Waiting List for
DSHS-Funded Children’s Community Mental Health Services
Measure
FY2008
FY2009
Estimated Number of Children with
Mental Illness in Texas
778,557
789,617
Projected Number of Children to be
Served with Appropriation Request(s)
22,480
22,722
Estimated Percent Served with
Appropriation Request(s)
2.9%
2.9%
Source: Texas Department of State Health Services FY2008-2009 Legislative Appropriations Request, http://www.dshs.state.tx.us/budget/lar/StrategysRequests.pdf, pp.
51-53, Retrieved 10/30/06; Texas Department of State Health Services Waiting List Summary Document Submitted to HHSC, 07/27/06.
Note: Estimated Number of Children with Mental Illness in Texas assumes 11.8% of Texas projected population under age 18 from U.S. Census Bureau,
http://www.census.gov/population/projections/SummaryTabB1.pdf, Retrieved 10/30/06.
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Part 4
The Number of Children Served by
DSHS-Funded Community Mental Health
Centers and the State Mental Health
Hospitals for the
Last Two Fiscal Years
NUMBERS ACTUALLY SERVED:
DSHS-Funded Community Mental Health Centers
and State Mental Health Hospitals
Projected Number of Children to be Served
DSHS-Funded Community Mental Health Centers
State Mental Health Hospitals
35,000
27,666
28,000
22,998
21,000
14,000
7,000
2,051
1,951
0
FY2005
NOTE: Although the
number of children
receiving DSHSfunded community
mental health
services has been
increasing (FY2005FY2006), the number
projected for FY2008FY2009 in Part 2 is
lower based on
implementation of
the Resiliency and
Disease Management
model that was
designed to provide
more intensive
services to a slightly
reduced population.
FY2006
Source: DSHS-Funded Community Mental Health Centers = DSHS Mental Retardation and Behavioral Health Outpatient Warehouse (MBOW), LBB
RDM Served.
State Mental Health Hospitals = DSHS Client Assignment and Registration System (CARE), 10/30/06.
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Part 5
Putting all this in context
Greater Percentage of Victims of Child Abuse/Neglect
(as confirmed by Department of Family and Protective Services in FY2003)
with Juvenile Justice Contact
Had Criminal History in their Family, Had a Behavior Problem,
and/or Had a Substance Abuse Issue
WITH
Texas
Youth
Commission
Contact
(n = 176)
WITHOUT
Texas
Youth
Commission
Contact
(n = 12,155)
1. Youth’s Family Members Had Been Victims/Perpetrators of Domestic Violence/Abuse
61.4%
58.3%
2. Youth’s Family Members Had Criminal History
66.5%
3. Youth’s Family Members Had Difficulty Dealing with Stress
68.8%
66.4%
4. Youth’s Family Members Had Substance Abuse Problems
47.7%
39.6%
5. Youth Had Lack of Extended Family Support
11.9%
15.2%
6. Youth Had Behavior Problem
60.8%
7. Youth Had Mental Health Issue
12.5%
8. Youth Had Substance Abuse Issue
19.3%
RISK INDICATOR
>
>
47.6%
18.3%
5.8%
>
3.3%
Source: DFPS Child Protective Services and TYC client databases, from Ruggiero, K.M., and Mason, M. (2006). The role of behavioral health services among
youth in Texas at risk for juvenile justice involvement: Multi-agency data-matching project for the Policy Academy on Co-Occurring Substance Abuse and Mental
Health Disorders. Austin, TX.
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But Less Than Half Received
Behavioral Health Services Funded by the State
RISK INDICATOR
Percent
With
Behavioral Health Services
2. Youth’s Family Members Had Criminal History
35.9%
6. Youth Had Behavior Problem
38.3%
8. Youth Had Substance Abuse Issue
41.2%
Source: DFPS Child Protective Services, DSHS Mental Health and Substance Abuse, HHSC Child Medicaid, and TYC client databases, from Ruggiero,
K.M., and Mason, M. (2006). The role of behavioral health services among youth in Texas at risk for juvenile justice involvement: Multi-agency datamatching project for the Policy Academy on Co-Occurring Substance Abuse and Mental Health Disorders. Austin, TX.
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A Greater Percentage of Victims of Child Abuse/Neglect
(as confirmed by DFPS in FY2003) with a Behavior Problem
Had an Earlier Disciplinary Problem Identified by TEA
— Mostly Student Misconduct
100%
FY2003 DFPS Confirmed Victims of Child Abuse/Neglect in General (N = 13,152)
FY2003 DFPS Confirmed Victims of Child Abuse/Neglect with a Behavior Problem (N = 2,406)
75%
56.9%
51.7%
50%
42.8%
37.1%
32.5%
25%
30.9%
24.0%
16.8%
0%
1999-2000
2000-2001
2001-2002
2002-2003
Source: FY2003 DFPS-TEA Data-Match, TEA, October 2006.
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A Vicious Cycle?
Parental Involvement
with
Criminal Justice System
May Become
a Parent
TEA
Earlier
Discipline Problem
(Student Misconduct)
Youth
Behavior
Problem
DFPS
Youth
Youth
Substance Abuse
Issue
Juvenile Justice
Contact
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Data-Sharing Implications
 Children with serious emotional disturbances (including co-occurring)
have the highest rate of school failure, and are at extreme risk for
injury, death, employment and housing problems, criminal justice
involvement, and increased state costs due to poorer treatment
outcomes (Pennell et al., 2003).
 Therefore, it is imperative that State agencies create data systems that
integrate child data to better understand child outcomes and to
identify intervention points.
 Through the use of a data warehouse, State agencies can provide
child data to be matched using tested algorithms to produce the
greatest likelihood of integration between datasets.
 Once matched, de-identified data sets can be created to answer
questions that unmatched data sets cannot address.
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