Thomas F. BestDeputy Assistant Commissioner

Division for Mental Health and Substance AbuseDepartment of State Health Services

The 84th Legislature and Substance Abuse Services:Funding, New Programs, and Behavioral Health Integration

Need Met for Substance Abuse Treatment Services

2

SUD Population Below 200% FPL Served in

DSHS-Funded Substance Abuse Treatment Programs

(including NorthSTAR) 4

38,9775.87% Need Met

Texas Adults 2013Texas Population 18

and older1

19,406,207

8.07% of Texas Adults with

Alcohol or Illicit Drug

Dependency or Abuse (SUD) 2

1,566,081

Sources:1 US Census Bureau: Annual Estimates of the Resident Population by Single Year of Age and Sex for the United States, States, and Puerto Rico Commonwealth: April 1, 2010 to July 1, 2013: 2013 Population Estimates2 2012-2013 NSDUH State Estimates of Substance Use and Mental Disorders3 Based on column – ABODILAL: Illicit Drug or Alcohol Abuse or Dependency, National Survey on Drug Use, 20134 Texas Department of State Health Services, Mental Health and Substance Abuse, Office of Decision Support, 06/18/15

42.42% of Texas Population 18+ with SUD Below 200%

Federal Poverty Level (FPL) 3

664,331

Need Met for Substance Abuse Treatment Services

3

Texas Youth 2013

SUD Population Below 200% FPL Served in

DSHS-Funded Substance Abuse Treatment Programs

(including NorthSTAR) 4

5,6046.35% Need Met

Texas Population Aged from 12 to 171

2,321,185

6.68% of Texas Population aged from 12 to 17 live with SUD

155,0552

Sources:1 US Census Bureau: Annual Estimates of the Resident Population by Single Year of Age and Sex for the United States, States, and Puerto Rico Commonwealth: April 1, 2010 to July 1, 2013: 2013 Population Estimates2 2012-2013 NSDUH State Estimates of Substance Use and Mental Disorders3 From Column ABODILAL: Illicit Drug or Alcohol Abuse or Dependency, National Survey of Drug Use, 20134 Texas Department of State Health Services, Mental Health and Substance Abuse, Office of Decision Support, 06/18/15

56.92% of Texas Population 12-17 with SUD Below

200% Federal Poverty Level (FPL) 3

88,257

Sunset Legislation

4

SB 200: HHSC Consolidation Bill• Mental health & substance abuse services

consolidated into HHSC by September 1, 2016.• State Hospitals consolidated into HHSC by

September 1, 2017.• DSHS will retain public health functions.

SB 202: DSHS Sunset Bill• Originally contained several elements related to

behavioral health services. Final version was almost exclusively specific to DSHS Regulatory Licensing.

• Some behavioral health elements of the filed version of SB 202 were moved to SB 1507.

SB 1507

DSHS to hire a forensic director to address issues with delivery of forensic services in the state (population changes, service availability, waitlists, etc.)

Convenes a forensic work group

DSHS to re-allocate inpatient mental health beds

DSHS, with input from the court of criminal appeals and the Forensic Director, will develop and maintain a training curriculum for judges and attorneys.

Outreach, Screening, Assessment andReferral (OSAR) Services

Requires DSHS to contract with local mental health authorities for OSAR services.

Local mental health authorities may subcontract with substance abuse or behavioral health providers for OSAR services.

Local mental health authorities are required to develop an integrated service delivery model that utilizes historical substance abuse providers when feasible.

5

Substance Abuse Funding

Substance Abuse funding increased 5.6% from the nearly $308 million for the FY 14-15 biennium

‘New Money’ received to expand youth prevention and neonatal prevention services

6

Youth Substance Abuse Prevention($7.8 million/biennium)

DSHS-funded substance abuse prevention providers offer services in 173 ofthe 254 Texas counties (68 percent), with 81 counties receiving no services.

Several of these are high-risk counties, comprised of rural midsized cities, military populations, and border communities.

This funding is expected to serve:

DSHS Exceptional Item

Program Type Youth AdultsYouth Prevention Universal 132,420 30,060Youth Prevention Select 10,692 2,736Youth Prevention Identified 7,236 1,744

Totals 150,348 34,540

7

Neonatal Abstinence Syndrome($11.2 million/biennium)

Screening and Outreach• $1.3 million will increase work to engage high risk populations through street

outreach efforts to target 1,111 women.

Intervention and Treatment• $2.9 million to increase the number of women served through existing

Pregnantand Postpartum Intervention (PPI) programs by 2,417.

• $5 million will be used for 635 Opioid Substitution Therapy slots.

Specialized Programs• $1.5 million will support one residential treatment pilot program available to

approximately 171 pregnant women using opioids in need of stabilization and specialized services.

• $500,000 to expand the Mommies program to 560 families in the five counties with highest incidence and costs for NAS cases: Bexar, Dallas, Harris, Tarrant, and Nueces.DSHS Exceptional Item

8

Community-Based Crisis and Treatment Facilities Review

• Comprehensive review of contract funding requirements and standards governing crisis and treatment facilities (MH&SA)

• Requires identification of best practices and unnecessary barriers

• Report (December 1, 2016) to include a summary of review and recommendations for statutory or regulatory changes

DSHS Rider 809

State Hospitals

The State Hospital Long-term Plan• Expanded access through purchase of local beds• Pursuit of academic partnerships• Addressed workforce issues• Begin repairing / replacement of aging state

hospitals

Substance abuse services in state hospitals and continuity of care

10

Behavioral Health ConditionsIncrease Costs

*Presented by SAMHSA at NASADAD 2015 Annual Meeting

Vision for the Future

Integration of behavioral health and physical health

Access to substance abuse treatment

Trauma-informed care

Continuity of care (including nursing homes and youth and families in the DFPS system.

Collaboration with other agencies, universities, and non-profits

12

Questions