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Maggie Labarta, PhD President/CEO April 27, 2011
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Among the most prevalent disorders
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Brain disorders, highly treatable 60-80% improvement, compared to 40-60% for heart disease Mental illnesses cause more premature death and disability than most other conditions, second only to heart disease Account for 25% of disability recipients Cost over $317 billion annually for lost productivity, health care and disability payments Impact of mental health and substance abuse in Alachua County One in four are affected by a mental illness = 61,750 One in 17 has a serious, potentially disabling illness = 22,230
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The system of care capacity is inadequate Florida ranks 49 th in funding for behavioral health, 35 th for substance abuse Un-met need: 58% of adult mental health 82% children’s mental health 85% children’s substance abuse 93% adult substance abuse of disorders Only 46% of the care being provided is covered through private insurance Last year, Meridian provided $1.6 million in uncompensated care and still had to turn away 815 from all catchment areas, 309 in Alachua County who requested treatment because no payment source was available
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Return on investment Community TreatmentWithout Community Treatment Crisis Stabilization per Day $300 Emergency Room visit $2,887 Detox per day $274 Hospital per day $2,000 Average annual cost – substance abuse treatment $2,400 Average Annual prison Cost $55,000 Average annual cost – mental health treatment $1,551 Average State hospital bed $112,000 per year $28,000 for 3-month admission
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Meridian is a non-profit community mental health and substance abuse treatment provider Part of the safety net providing Emergency and crisis support services The region’s only public receiving facility Collaborative solutions to community problems Emergency room and hospital overutilization Jail diversion Homeless services Services to the uninsured
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Part of the area’s high quality healthcare system Accredited Council on Accreditation of Rehabilitation Facilities American Association of Suicidology Licensed Agency for Healthcare Administration Department of Children and Families Drug Enforcement Agency
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Served almost 30,000 across ten counties 14,574 in treatment programs 16,000 through outreach and prevention services Part of the area’s economy Employ over 500 individuals, 387 in Alachua County Provide $22 million in salaries and benefits Purchase goods and services totaling $8.3 million in the local communities
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p Jail Diversion Homeless Educational Success Uninsured Employment
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Forensic Services
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Effective use of resources
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4,569 seen year to date Comparable to 4,554 at the same point in FYE2010 Most prevalent problems Mood disorders (depression, bi-polar) – 2,335 Psychotic Disorders – 567 Substance Use Disorders - 415 PTSD/Anxiety – 304 ADHD - 333 Turned away 100 due to lack of capacity or lack of payor source Typically increases in last quarter as state funds are depleted 84% are at or below Federal Poverty 98% are at or below 300% Federal Poverty and receive discounted services
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Ability to braid funds maximizes county, state, federal and private revenues Each piece is essential to maintaining the whole Federal State Insurance Client Fees Donations Medicaid Medicare Contracts
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Medicare Psychiatric Treatment Counseling Commercial Insurance Psychiatric Treatment Counseling CSU – some companies only Detox seldom Medicaid Psychiatric Treatment Counseling CSU – some companies only Rehabilitation Case Management Peer Supports State and County Psychiatric Treatment Counseling CSU – some companies only Rehabilitation Case Management Vocational Peer Supports Housing
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Most clients need more than one service, often not all allowed by the primary payor Once a client is admitted, they are offered all medically necessary services regardless of availability of funding Typically results $1.6- $3 million per year in uncompensated care Medical HousingRehab
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Fees/ Insurance/ Medicaid/ Medicare StateCounty Comprehensive Care
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State and federal funds require local match Meridian’s match amount is specified within contract with DCF Varies year-to-year depending on how state and federal dollars are allocated to us from DCF “Local match” Local fee and county funds Counties responsible
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Apportion required match Calculate catchment area population Calculate each county’s percent Distribute share of match accordingly Project funds from all eligible sources = “earned match" Client fees Insurance Contracts County special service contracts School contracts Request County Commission funding Match required less earned match Remaining amount to be asked of county BOCC
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2010 required match: $2,638,678 or $5.06 per capita Alachua County 50% of catchment area, $1,301,640 in match Current match eligible contribution $795,561 BOCC contract $430,000 Court Services Contracts (estimated current year) Match deficit $76,000
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Alachua County Fiscal YearNumber Served % changePer Capita Funding Total Funding Value of Services Cost Per Person Served County Per Person Served FYE 20075,042 $3.62$899,383$13,111,15 8 $2,600$178 FYE 20085,4878.83%$3.58$904,929 $13,758,791 $2,508$165 FYE20095,7254.34%$3.54$883,956$14,043,82 5 $2,453$154 FYE20105,7620.65%$3.14795,561$11,064,88 4 $1,920$138 FYE2011 Estimate* 5,935 3.00% $3.09 $695,561 GR /$100,000 (CHOICES) $134 5% Reduction $2.93$755,783
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Focus on Evidence Based Practices
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Co-occurring treatment Evidence based assessment – GAIN Solution focused therapy Group treatment Trauma informed care Wellness Prevention
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Mental Health MeridianRegionState AdultDays in Community348353347 Days of Work (SMI)312833 Days in Community (Forensic)281240295 ChildSED Days in Community352 350 SED School Attendance91.61%92.49%91.49% ED Days in Community357362360
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Substance Abuse MeridianRegionState AdultSuccessful Completion57.14% 61.54% %Change in Employment 7%9%15% ChildSuccessful Completion46.67%52.93%69.11% Stable Housing100%92%96%
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Forensic Services – Forensic Specialist Team (MIWG) Arrests went from 1.93 to.75, on average in the first year and jail days from 117 to 53 jail days. In year 2, arrests remained lower,.70 on average and jail days to 48, on average.
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Forensic Diversion Team (CJMHSAG) – The number of arrests and incarcerations decreased for all groups, though it was the most significant for the clients who successfully completed treatment (42% decrease in arrests and 51% decrease in incarcerations). The number of jail days significantly increased by 86% for the non-engaged group of clients) -
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Questions ?
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