1. Waterville Rotary Club Presentation by Thomas J. McAdam, Chief Executive Officer With Clinics in:  Waterville  Augusta  Skowhegan  Winthrop September 28, 2009

2. Mission To promote the well-being of children, adults and families who experience mental illness, emotional difficulties or behavioral challenges.

3. Mental Health Care is Healthcare

4. KBH Agency Snapshot Employees321 Annual Revenue (Current Fiscal Year) $21,818,706 Persons Served11,785 (FYE June 09) Communities Served by Zip Code 129

6. KBH Total Service Growth 2003-2009

7. Why People Call KBH Depression / Mood Disorder43% Anxiety14% Behavior14% Alcohol or Drugs 9% Marital / Family 7% Anger 5% Major Mental Illness 3% All Other 5% 100%

9. Where Our Clients Come From Catchment Area Augusta32% Skowhegan20% Waterville32% Winthrop13% Out of Catchment 3% 100%

10. Where Our Clients Come From

11. Helen Keller “Although the world is full of suffering, it is full also of the overcoming of it.”

12. Disease Prevalence in Maine Diabetes.6% Cancer 5.4% Heart Disease 7.6% Mental Health19.0%

13. Surgeon General Report on Mental Health One in five Americans has a diagnosable mental health issue during the course of a year Mental Health is fundamental to overall health Mental Health disorders are real Mental Health disorders are treatable

14. Mental Illness and Poverty

15. According to the World Health Organization Mental illness is the leading cause of ill-health and disability worldwide

16. Chicken and Egg Does Poverty Cause Mental Illness or Does Mental Illness Cause Poverty? 2005 Research – increasingly strong evidence that socioeconomic status is indeed a very important dimension of mental illness, though not the only dimension.

17. Causes Many causal links between poverty and mental illness, particularly depression People living in poverty face more threatening events, entrapping life events, poor social connections, poor self-image, loss of control over life

18. Findings Schizophrenia more likely to pull people into poverty (.05%) Depression more likely to be caused by poverty (some say twice as high) This does not dismiss the biological component of mental illness (personal responsibility vs. biological)

19. Creates a Cycle If a person has had mental illness, they have a much higher chance of becoming ill again Having a mental illness causes additional stress such as loss of self confidence, loss of status, loss of job, homelessness, rejection by the community, criticism, rejection, etc…

20. Hippocrates “Healing is a matter of time, but it is sometimes also the matter of opportunity.”

21. Summary If you have a serious mental illness, you are more likely to live in poverty If you live in poverty, you are more likely to develop a mental illness

22. But, what about the money…??

24. Who pays for healthcare in Maine? Employer52.5% Individual 4.8% Medicaid (MaineCare)18.8% Medicare13.5% Other Public 1.3% Uninsured 9.1% 100%

25. MaineCare Funding for Mental Health Care FY09 Adult Mental Health$241,405,695 Child & Family Services$325,506,858* Office of Substance Abuse$ 54,343,147 TOTAL$621,255,700 * Includes Child Welfare

26. MaineCare in Maine Total Maine Population1,316,456 Kennebec County 120,017 Somerset County 51,377 MaineCare Enrollment FY08 344,307

27. How is MaineCare Funded? A Good Deal for Maine Federal Match74% Maine General Fund Tax Revenue26% (Current increase because of federal stimulus bill)

28. “How do you guys know this stuff works?” Ken Fletcher, State Rep., Winslow At KBH, we: Measure Evaluate Act

30. Into the Future TABOR Healthcare Reform

31. What We Need in Central Maine Preserving the Safety Net Adequate Outpatient (Community- Based) Services Adequate Crisis Funding Correct Number of Hospital Beds by Community

32. Thank you Waterville Rotary Board Members Involved & Interested Community Members