1. Delaware Health and Social Services Department of Health and Social Services Division of Substance Abuse and Mental Health Joint Finance Committee Hearing Fiscal Year 2015 Kevin A. Huckshorn PhD, RN, CADC Division Director February 27, 2014

2. Delaware Health and Social Services DSAMH The Single State Agency for prevention and treatment services for substance use, mental health and gambling conditions Provides services regardless of ability to pay Organizational structure consists of the Central Office, the Delaware Psychiatric Center (DPC), and a variety of community mental health, substance use disorder, and gambling services

3. Delaware Health and Social Services Accomplishments FY 13 – FY 14 USDOJ Settlement Agreement 1.DE has met all of the Settlement Agreement Targets to date. 2.200 Mental Health Screeners have been trained/certified & are in a variety of settings. They provide first level assessment services regarding need for involuntary hospitalization or other services. 3.The Mobile Crisis Teams (NCC & Kent/Sussex) continue to exceed their response time target (1 hour) & average 41 minutes per call. 4.A DMMA & DSAMH partnership facilitated revisions in the Delaware Medicaid State Plan: a 1115i Demonstration Waiver, and the new PROMISE Program. 5.We developed new housing options for clients who require interim housing when released from hospitals or in crisis: a) resource beds, b) transitional housing, c) 3-5 day crisis beds 6.We continue to solicit feedback from service providers/customers through monthly meetings, quarterly forums, and one to one interviews conducted by Peers and other DSAMH staff

4. Delaware Health and Social Services Accomplishments FY 13 - FY 14 Mobile Crisis −An average of 42 responses per month for FY 14. Now a full statewide service. Trauma Informed Care –Screened 1,240 for history of trauma with follow up when necessary. Crisis Intervention Teams (CIT) –Launched statewide project with DE Law Enforcement/MHA/NAMI; training launch in May. Oxford Houses –48 houses, 323 beds, 15% vacancy rate. (As of November 2013) TASC –TASC has received over 13,000 referrals in the past 12 months for services statewide.

5. Delaware Health and Social Services Accomplishments DE Substance Abuse System Re-org DSAMH/DHSS & Governor’s Office started working with state legislators and community stakeholders mid FY 14 to re-design this system of care. A more current evidence-based philosophy of care has been chosen that includes the provision of individualized services and supports directed by a public health model for chronic disease management. The American Society of Addiction Management (ASAM) guidelines will be adopted to guide service & funding decisions, level of care decisions, and expected outcomes. Next step? A March 2014 conference of statewide Substance Use Disorder leaders and other experts to develop a Delaware 3-year plan.

6. Delaware Health and Social Services FY 15 Governor’s Recommended Budget USDOJ/DPC Settlement Assertive Community Treatment (ACT)$1,650.0 Crisis Services$1,240.0 Targeted Case Management$ 300.0 Supported Employment$ 100.0 Housing Vouchers*$ 0.0 Peer Supports*$ 325.0 Total$3,615.0 *Housing Vouchers to be supported with $750.0 from FY 14 Housing Continuing appropriation. $50.0 from FY 14 Housing Continuing appropriation to Peer Supports.

7. Delaware Health and Social Services Assertive Community Treatment Teams (ACT)

8. Delaware Health and Social Services Crisis Walk-In Center

9. Delaware Health and Social Services Targeted Care Management (TCM)

10. Delaware Health and Social Services Supported Employment

11. Delaware Health and Social Services Peer Support Services Trauma PeersCommunity PeersDPC PeersTotals Total Contacts1157505214507659 Number of Peers12161341 Avg # of Contacts/Peer96.4315.8111.5186.8

12. Delaware Health and Social Services US DOJ Settlement Agreement Housing Vouchers Issued By Year

13. Delaware Health and Social Services DPC Performance Measures 2010 to 2013 Seclusion use 87.5% Restraint use 73.6% Contraband 31.6% Suicide Attempt 100%

14. Delaware Health and Social Services Reallocation of Resources from Institution to Community: Efficiencies DSAMH FY14 Expenditures DSAMH FY 10 Expenditures

15. Delaware Health and Social Services Thank you very much for your incredible support these last 5 years. Kevin Huckshorn PhD, RN, CADC; Director Melissa Smith, MA; Deputy Director Darlene Plummer; Senior Fiscal Administrative Officer 302-255-9398 Behavioral Health (MH/SA) is essential to overall health Prevention Works Treatment is Effective People do Recover