Children’s Mental Health Services

Children’s Mental Health Services

Part 1DSHS Legislative Appropriation Request(s)

for Children's Mental Health Services

for FY2008-FY2009

3

BASE REQUEST (Assumes 10% Reduction)Mental Health Services for Children

(Goal 2, Objective 2, Strategy 2)

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.

Funding Source FY2008 FY2009 BienniumGeneral Revenue Funds

$38.3 Million $38.3 Million $76.6 Million

Federal Funds $18.4 Million $18.4 Million $36.8 MillionTotal $56.8 Million $56.8 Million $113.6 Million

4

RESTORATION OF BASE FUNDING Mental Health Services for Children

(Goal 2, Objective 2, Strategy 2)

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.

Funding Source FY2008 FY2009 BienniumGeneral Revenue Funds

$4.3 Million $4.3 Million $8.6 Million

Federal Funds $4.0 Million $4.0 Million $8.0 MillionTotal $8.3 Million $8.3 Million $16.6 Million

5

EXCEPTIONAL ITEM REQUEST (HHSC)Eliminating the Waiting List for

DSHS-Funded Children’s Community Mental Health Services

Source: Texas Department of State Health Services Waiting List Summary Document Submitted to HHSC, 07/27/06.Note: Totals subject to rounding error.

Options

FY2008 FY2009 Biennium

GR

All Allocated

Funds GR

All Allocated

Funds GR

All Allocated

Funds

Keep Pace withPopulation Growth $.66 Million $.66 Million $1.3 Million $1.3 Million $2.0 Million $2.0 Million

Reduce Waiting List $.56 Million $.56 Million $1.1 Million $1.1 Million $1.7 Million $1.7 Million

Total $1.2 Million $1.2 Million $2.4 Million $2.4 Million

$3.6 Million $3.6 Million

6

EXCEPTIONAL ITEM REQUEST (DSHS)Mental Health Community Services (Crisis Redesign)

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.

Options


GR

All Allocated

Funds GR

All Allocated

Funds GR

All Allocated

Funds

Mental Health Services for Adults $20.4 Million $20.4 Million $40.8 Million $40.8 Million $61.1 Million $61.1 Million

Mental Health Services for Children

$7.1 Million $7.1 Million $14.1 Million $14.1 Million $21.2 Million $21.2 Million

Total $27.5 Million

$27.5 Million

$54.9 Million

$54.9 Million

$82.3 Million

$82.3 Million

7

REQUEST SUMMARYChildren’s Mental Health Services

*Not counted in provider performance targets.** Not necessarily unduplicated.

Funding Source


Requested Dollars

NumberServed

Requested Dollars

NumberServed

Requested Dollars

NumberServed**

Base Request $56.8 Million 20,706 $56.8 Million 20,706 $113.6 Million 41,412Restoration 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

Total $73.4 Million 25,664 $81.6 Million 25,924 $155.0 Million 51,347

Part 2The Projected Number of Children to be

Served if the DSHS Legislative Appropriation Requests

Are Actually Funded

9

BASE REQUEST & RESTORATION OF BASE FUNDING

Mental Health Services for Children(Goal 2, Objective 2, Strategy 2)

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.

Projected Number of Children to be Served

22,239 22,239

0

5,000

10,000

15,000

20,000

25,000

30,000

FY2008 FY2009

10

EXCEPTIONAL ITEM REQUEST (HHSC):Eliminating the Waiting List for

DSHS-Funded Children’s Community Mental Health Services


130

260

111

223241

483

0

200

400

600

FY2008 FY2009

Keep Pace with Population GrowthReduce Waiting ListTotal

Source: Texas Department of State Health Services Waiting List Summary Document Submitted to HHSC, 07/27/06.

11

EXCEPTIONAL ITEM REQUEST (DSHS)Mental Health Community Services (Crisis Redesign)

Mental Health Services for Children (Goal 2, Objective 2, Strategy 2)

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).


3,184 3,202

0

1,000

2,000

3,000

4,000

FY2008 FY2009

Part 3The 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

13

PENETRATION RATE:Mental Health Services for Children and

Eliminating the Waiting List for DSHS-Funded Children’s Community Mental Health

Services

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.

Measure FY2008 FY2009Estimated 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%

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

15

NUMBERS ACTUALLY SERVED:DSHS-Funded Community Mental Health Centers

and State Mental Health Hospitals


22,998

27,666

2,051 1,9510

7,000

14,000

21,000

28,000

35,000

FY2005 FY2006

DSHS-Funded Community Mental Health CentersState Mental Health Hospitals

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.

NOTE: Although the number of children receiving DSHS-funded community mental health services has been increasing (FY2005-FY2006), the number projected for FY2008-FY2009 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.

Part 5

Putting all this in context

17

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

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.

RISK INDICATOR

WITHTexasYouth

CommissionContact(n = 176)

WITHOUTTexasYouth

CommissionContact

(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% 47.6%

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% 18.3%

7. Youth Had Mental Health Issue 12.5% 5.8%

8. Youth Had Substance Abuse Issue 19.3% 3.3%

>

>

>

18

But Less Than Half Received Behavioral Health Services Funded by the State

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 data-matching project for the Policy Academy on Co-Occurring Substance Abuse and Mental Health Disorders. Austin, TX.

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%

19

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

16.8%24.0%

30.9%37.1%

32.5%

42.8%

51.7%56.9%

0%

25%

50%

75%

100%

1999-2000 2000-2001 2001-2002 2002-2003

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)

Source: FY2003 DFPS-TEA Data-Match, TEA, October 2006.

20

Parental Involvementwith

Criminal Justice System

YouthBehaviorProblem

YouthSubstance Abuse

Issue

May Becomea Parent

A Vicious Cycle?

DFPSYouth

Juvenile Justice Contact

TEAEarlier

Discipline Problem(Student Misconduct)

21

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.

Documents

Children’s Mental Health Services