Sonja Gaines, Associate CommissionerOffice of Mental Health CoordinationHealth and Human Services Commission

October 15, 2015

Texas Mental Health Moving

in the Right Direction: A

Year in Review

1

Office of Mental Health CoordinationOffice of Mental Health Coordination (MHC) created by the 83rd Regular

Session:

• Provides broad oversight-public mental health policy in Texas

• Coordinating the policy and delivery of mental health services

throughout the State of Texas.

• The office of MHC shall consult and coordinate with other state

agencies, local governments and other entities to ensure a strategic,

statewide approach to mental health.

Vision: To ensure that Texas has a unified approach to the delivery of

behavioral health services that allows all Texans to have access to care

at the right time and place.

Texas Mental Health

Moving in the Right Direction

2

A Year in Review: MH Coordination3

Cross Agency Mental Health Liaison Workgroups

Representation across all state agencies that impact mental health- meet

monthly to improve cross agency coordination, collaboration, reduce duplication

and improve efficiency and replicate best practices.

Texas Education Agency: Established a cross agency workgroup to address the

Behavioral Health needs of school aged children. Outcomes are Mental Health

First Aid training by TEA, expansion of the anti-stigma community conversations toseveral regional education centers across Texas.

MH First Aid Training Initiative: 2000 staff trained across Commission, 28 new

trainers trained cross agency to expand MHFA statewide. Currently developing a

reporting structure for all HHS System agencies to quantify outcomes as well as a

timeline for 2016 trainings.

Immigration and Refugee Affairs - to address current barriers to identifying and

addressing the mental health needs of refugees in Texas. Current activities involvestrengthening community collaborations and developing a brief, uniform MH

screening to be used at intake.

Continued A Year in Review

SB58 Carve-in: Moved TCM and MH Rehabilitation to Managed Care

model focused on integrated care

DSRIP Projects through the 1115 Waiver -Approximately 400 projects focus

on behavioral health across Texas; focus on rapid access to care, Peer

services ,telemedicine, concentrated efforts to support unique populations

such as IDD, enhanced integrated health projects, SUD and MH

MH Awareness Campaign-Provided consultation and recommended

direction related to the Mental Health Awareness Campaign, instrumental

in solicitation of stakeholder feedback and the utilization of Texas 2-1-1 as

the identified call center for the initiative, facilitated expansion across

agencies.

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Agency Focused BH Initiatives:

• DFPS: CANS Assessment, staffing, improved agency collaboration

• DARS: MHFA-more than 1000 trained, awareness and relations

• DADS: Crisis Services Implementation

• DSHS: MH Campaign, MHFA, 84th Session - $200 Million, NorthSTAR transition, Performance

Measures; New Co-occurring MH/Substance Abuse Planning federal grant; new early

childhood grant focused on social-emotional development strategies

• Medicaid: MDCD Medical Policy,SB58,MH Excellence Grant, Re-Enrollment, Peer Services

• Social Services: Refugee Program , 211 Support and enhancements, CRCG- MH training

• TEA: USAC Group, MHFA, MH Campaign

• TJJD: Data Project, MHFA, troubleshoot, webinars, training

• Texas Veterans Commission: Staff Training, Veteran Grant

• University of Texas - The Institute for Excellence in Mental Health: System of Care

Framework implementation for children’s mental health

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SG Coordination Matrix (SGCM)

PopulationsJuvenile

JusticeVeteran

Foster

Child

Legally

BlindRefugee Homeless

Goal Re-Entry Community

IntegrationPermanency

Independent

Living

Obtain

Employment

Safe and

Affordable

Housing

Barriers Untreated

MH/SUD

Singular

Focused

Programs

Lack of cross

agency

coordination

Staff lack

training, tools &

expectations

Challenged

Business

Relations

Drivers FundingPerformance

Expectations

Contract

Agreements

Available

Resources

Service

Connections

Additional

Complexities

English Prophecy/

CulturePhysical Disability Economics Transportation Geography

Uncoordinated

Care

Inpatient,

Criminal Justice,

Suspension

Economic Impact Long waitlists Co-Morbidity Confusing

What Does Effective Coordinated

Care Look Like?Coordinated care is the fusing and linking of key aspects

of care and support systems to address a common and

compelling need.

• Should be seamless to individual

• Use of technologies, peers and stakeholders

• Leveraging of funding and resources

• Culturally and Linguistically responsive

• It is intentional and well thought out

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Texas Mental Health

Moving in the Right Direction

2015 HHS Cross Systems Summit

Resources you

can use today8

9http://mentalhealthtx.org/

Mental Health Texas Website: Offer a one-stop

web based resource point

for Texas residents in need

of immediate mental

health information and

resources to find basic

mental health information

and direction.

http://www.hhsc.state.tx.us/hhsc_projects/omh/docs/cabhi.pdf 10

2015 Cross Agency BH Initiatives: Inventory of cross-agency MH

Initiatives to address gaps,

reduce duplication and establish

cross agency reporting.

http://www.hhsc.state.tx.us/hhsc_

projects/omh/docs/cabhi.pdf

Texas Veterans Phone App

• March 2014, HHSC launched a free mobile application designed to be used by veterans, active duty personnel, military families, and service providers for quick portable access to crisis lines, online resources, personal connections with local/regional veterans, and assistance with services.

• Offers access to: Veterans Crisis Line, Hotline for Women Veterans, Connect with Texas Veterans, Texas Veterans Hotline, and the Texas Veterans Portal.

Texas Veterans Portal (TVP)

• A resource for veterans, their families, and survivors: the Texas Veterans

Commission (TVC) manages the website, which includes helpful

information from many government agencies regarding assistance,

services, and benefits.

• HHSC coordinates with TVC to ensure that all state agency websites

include the portal.

• HHSC is working with county governments to include the portal in their

websites.

HHS Veterans Services and Initiatives:

Connecting Veterans to Resources11

84th Legislative BH Impact: Update on HHS SB 200: HHSC Consolidation Bill

• Mental health & substance abuse services consolidated into HHSC by 9/1/16

• State Hospitals consolidated into HHSC by 9/1/17

• ECI moves to TWC-9/1/16

• DSHS will retain public health functions

BH Advisory Committees Transformation

• SB 200 directed the Executive Commissioner to establish in rule, advisory

committees to consider issues and solicit public input

o Across major areas of HHS System

o Including behavioral health

• DSHS Sunset Commission report directed HHS to establish an

Enterprise-wide behavioral health advisory committee

• SB 200 and SB 277 abolished in statute certain advisory

committees

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Approved Statewide Behavioral Health

• HB 1, Art. 9, Section 10.04, 84th Legislative Regular Session created the

Statewide Behavioral Health Strategic Plan and Coordinated Expenditures

with the purpose of a detailed plan to coordinate these programs and

services to eliminate redundancy, utilize best practices in contracting

standards, perpetuate identified, successful models for mental health and substance abuse treatment, ensure optimal service delivery, and identify

and collect comparable data on results and effectiveness.

Texas Veterans Initiative, SB 55• The 84th Texas Legislature passed Senate Bill 55, by Senator Nelson, to

establish a pilot program and a grant program at HHSC, to support

veterans and their family’s mental health through grant projects around

Texas.

• Appropriated $20 million for 2016-17 to HHSC to enhance community

mental health services and treatment to veterans and their families.

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• MH Excellence Grant – selection of sites

• 1115 Waiver renewal

• YES Waiver Expansion - including the use of wraparound as an

intensive care coordination approach

• Medicaid Re-enrollment requirements

Touching on Managed Care :

• SB58-Medicaid Medical Policy Changes

• Review/changes in performance measures - Sunset language14

Community Center Impacts

• The strategic planning process will result in better

coordination and collaboration across state agencies

• Increase in BH focused policy changes across state agencies

• Improved data that outlines the need to focus on enhanced BH

services across systems

• Improved coordination across agencies and stakeholders to

address BH needs-distribution of resources and ID gaps

• Focus on Integrated Health across disciplines

• Changes in leadership at the state level

• The Vision starting to become a reality!

• Moving towards a unified approach to BH services across

state agencies that allows all Texans to gain access to care

at the right time and place.

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Future Predictions