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FY 2016 Combined Behavioral Health Assessment and Plan A

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FY 2016 Combined Behavioral Health Assessment and Plan A PAGE 1 LOUISIANA FY 2016 Combined Behavioral Health Assessment and Plan A. Framework for Planning B. Planning Steps C. Environmental Factors and Plan PAGE 2 A. Framework for Planning – Mental Health and Substance Abuse Prevention and Treatment The Office of Behavioral Health (OBH) is the state program office within the Department of Health and Hospitals (DHH) responsible for managing and delivering the services and supports necessary to improve the quality of life for citizens with mental illness and addictive disorders. The agency oversees contractors in the provision of specialized behavioral health services provided in both hospital and community-based treatment settings for both Medicaid and non-Medicaid eligible populations. OBH was created by Act 384 of the 2009 Legislative Session which directed the consolidation of the offices of addictive disorders and mental health into the Office of Behavioral Health effective July 1, 2010 in order to streamline services and better address the needs of people with co-occurring mental illness and addictive disorders. The Department’s work in implementing Act 384 was guided by stakeholders and leaders in the behavioral health field from across Louisiana who participated in the Office of Behavioral Health Implementation Advisory Committee. The mission of OBH is to lead the effort to build and provide a comprehensive, integrated, person-centered system of prevention and treatment services that promote recovery and resilience for all citizens of Louisiana. OBH assures public behavioral health services are accessible, have a positive impact, are culturally and clinically competent and are delivered in partnership with all stakeholders. The OBH FY 2014 budget is $272,888,963. The total appropriation for the OBH Community Budget is $143,668,100. The following tables provide additional budgetary information, including a breakdown of federal funding for behavioral health services. OFFICE OF BEHAVIORAL HEALTH APPROPRIATION FOR FY 13-14 BUDGET SUB-ITEM TOTAL(S) % of TOTAL Community Budget Central Office $ 44,015,908 16.1% Community Behavioral Health Centers $29,403,179 10.8% Community Social Service Contracts $42,540,994 15.6% Community Total $115,960,081 42.5% Hospital Budget Central Louisiana State Hospital $35,973,405 13.2% Eastern Louisiana Mental Health System $113,819,740 41.7% PAGE 3 Hospital Total $149,793,145 54.9% State Office Administration $6,915,008 2.5% State Office Total $6.915.088 25 % Auxiliary Auxiliary $20,000 0.00007% Auxiliary Total $20,000 0.00007% TOTAL $325,287,253 100% HOSPITAL SYSTEM FY2014 Total Adult/Child State Hospital Beds (a) 691 State General Funds ($) 88,249,183 Federal Funds ($) 57,289,848 NOTES: (a) Total represents funded beds for adult intermediate care, adult forensic, adult acute, Transitional Forensic and Community Homes. COMMUNITY SYSTEM FY2014 Community Behavioral Health Centers 45 State General Funds ($) 15,437,573 Federal Funds ($) 3,906,477 Community Behavioral Health Contract State General Funds ($) 21,377,528 Federal Funds ($) 8,182,846 PAGE 4 OBH Authorized Table of Organization (T.O.) Personnel Positions FY 2013 FY 2013 FY 2014 Office of Behavioral Health Reductions Classified Unclassified T.O. T.O. Administration Administration 44 -0 44 41 3 TOTAL - Administration 44 0 44 41 3 Community Central Office 41 0 41 41 0 Community Behavioral 202 -202 0 0 0 Health Centers TOTAL –Community 243 -202 41 41 0 Hospitals Central Louisiana State 163 123 286 283 3 Hospital Eastern Louisiana Mental 1018 3 1021 1014 7 Health System Southeast Louisiana Hospital 563 -563 0 0 7 TOTAL - Hospitals 1744 -437 1307 1290 17 TOTAL - OBH 2031 -639 1392 1372 20 Evolution toward Local Governing Entities In June of 2014, the OBH completed its portion of a legislative mandate for the Department of Health and Hospitals (DHH) to transition the Louisiana mental health, addictive disorder, and developmental disability healthcare system from a centrally controlled set of regions to a system of independent healthcare districts or locally controlled authorities. ACT 373, passed during the 2008 Louisiana Legislative Session, required all DHH regions convert to Local Governing Entities (LGE). The LGEs were required to complete a readiness criteria process that demonstrated their capability to assume the responsibility for high quality service delivery and good governance. This process included the establishment of local governing boards that provided ongoing support and advice, while serving as vehicles for community coordination. Members of the Governing Boards PAGE 5 are appointed by the Governor, and the bylaws require that membership is reflective of the population of the region. These LGEs, classified as either a district or authority, have a contractual agreement with DHH. The LGEs are local umbrella agencies that administer the state-funded mental health, addictive disorder, and developmental disability services in an integrated system within their localities. The LGE model affords opportunity for greater accountability and responsiveness to local communities since it is based on local control and authority. Each LGE is administered by an executive director who reports to a local governing board of directors of community and consumer volunteers. All LGEs remain part of the DHH departmental organizational structure, but not in a direct reporting line with OBH. With the transition to LGEs and the presence of the Louisiana Behavioral Health Partnership, the role of OBH changed from direct operational service delivery to one of providing resources and assistance that enable the LGEs to carry out service delivery. OBH is also responsible for providing assistance in setting policy, establishing minimum standards for the operation of the service system, establishing reasonable expectations for service utilization and outcomes, and developing mechanisms statewide for measuring these outcomes. In addition, OBH ensures that the LGE service system is well coordinated with those services that continue to be operated by the State (primarily the State-operated psychiatric hospitals). In addition, OBH continues to provide technical assistance and guidance to the LGEs to ensure federal Block Grant requirements are met. LGEs must maintain Regional Advisory Councils (RACs), officially linked to the State Behavioral Health Advisory Council, in order to qualify to receive Block Grant funding. To assist the reader in understanding the State behavioral health care system, a listing and map of Louisiana that illustrates the geographic locations of the Local Governing Entities (LGEs) and a description of each are below. DHH Administrative Local Governmental Entities (LGEs) Region or District/Authority Parishes Metropolitan Human Services District: MHSD (formerly Region 1 - established July 1, 2004) Orleans, Plaquemines, St. is comprised of the New Orleans metropolitan area and two civil parishes to the south of Orleans Bernard Parish. Ascension, East Baton Rouge, Capital Area Human Services District: CAHSD (formerly Region 2 - established July 1, 1997) East Feliciana, Iberville, Pointe encompasses the Baton Rouge metropolitan area and six surrounding parishes. Coupee, West Baton Rouge, West Feliciana South Central Louisiana Human Services Authority: SCLHSA (formerly Region 3 - Assumption, Lafourche, St. established July 1, 2010) includes seven parishes in the bayou country of coastal Louisiana with Charles, St. James, St. John the Houma as the regional hub. Baptist, St. Mary, Terrebonne Acadiana Area Human Services District: AAHSD (formerly Region 4 – established July 1, Acadia, Evangeline, Iberia, 2012) is comprised of seven parishes in the Acadiana area with Lafayette serving as the regional Lafayette, St. Landry, St. hub. Martin, Vermillion Imperial Calcasieu Human Services Authority: ImCal (formerly Region 5 – established July Allen, Beauregard, Calcasieu, 1, 2014) encompasses five southwestern parishes, including coastal Cameron. Lake Charles is Cameron, Jefferson Davis the hub of this Region. Central Louisiana Human Services District: CLHSD (formerly Region 6 – established July 1, Avoyelles, Concordia, 2014) contains eight central Louisiana parishes that border Mississippi in the East and Texas on Catahoula, Grant, LaSalle, the West. With the exception of Rapides, this Region is very rural in nature. Alexandria is the Rapides, Vernon, Winn regional hub. Northwest Louisiana Human Services District: NLHSD (formerly Region 7 –established July Bienville, Bossier, Caddo, 1, 2014) comprises the predominantly rural Northwest area of the state, including nine parishes. Claiborne, Desoto, Shreveport-Bossier City is the major metropolitan complex. This is an agricultural area but Natchitoches, Red River, contains most of the state’s heavy manufacturing business. Sabine, Webster Northeast Delta Human Services Authority: NEDHSA (formerly Region 8 –established July Caldwell, East Carroll, 1, 2014) comprises the Northeast corner of the state, known as the Delta region. Monroe is the Franklin, Jackson, Lincoln, PAGE 6 hub of this Region, which encompasses 12 parishes, most of which are the poorest in the state in Madison, Morehouse, Ouachita, per capita income. This Region is dominated by agriculture and light industry. Richland, Tensas, Union, West Carroll Florida Parishes Human Services Authority: FPHSA (formerly Region 9 - established July Livingston, St. Helena, St. 1, 2004) is comprised of the five parishes in the Florida Parishes area. This area borders Tammany, Tangipahoa, Mississippi on the north
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