Alameda County Behavioral Health AB 109 Funding Proposal FY 19/20
Image-based presentation outlines AB 109 clients receiving services, mental health modalities, and clients served by modality from FY 16/17 to FY 18/19 in Alameda County Behavioral Health. Details include case management, crisis services, hospital care, outpatient treatment, residential programs, subacute services, and transitional case management in collaboration with Santa Rita Jail.
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Alameda County Behavioral Health AB 109 Funding Proposal, FY 19/20 Alameda County Behavioral Health AB 109 Funding Proposal, FY 19/20 Community Corrections Fiscal & Procurement Meeting March 10, 2020 Karyn L. Tribble, PsyD, LCSW, Alameda County Behavioral Health Director 1
AB 109 Clients Receiving ACBH Services FY 16/17 to FY 18/19 AB 109 Clients Receiving ACBH Services FY 16/17 to FY 18/19 1,800 1,600 1,400 557 372 1,200 399 1,000 800 600 1,129 1,090 864 400 200 0 FY 16/17 FY 17/18 SUD FY 18/19 MH 2
Mental Health Services for AB 109 Clients Mental Health Services for AB 109 Clients Case Management: Case Management: Intensive case management programs, including full service partnerships and service teams Crisis Services: Crisis Services: Crisis response program services Hospital: Hospital: Psychiatric emergency in-patient services Outpatient: Outpatient: Non-intensive case management outpatient treatment services, including wellness centers and Level 3 providers Residential: Residential: Crisis residential treatment programs Subacute: Subacute: Twenty-four hour intensive treatment programs Transitional Case Management: Transitional Case Management: Intensive reentry-focused case management program incorporating pre-release discharge planning services in Santa Rita Jail 3
Number & Percent of Services by Mental Health Modality for AB 109 Clients, FY 18/19 Number & Percent of Services by Mental Health Modality for AB 109 Clients, FY 18/19 Crisis, 145, 1% Transitional Case Management, 1,480, 9% Hospital, 2,960, 19% Case Management , 3,547, 23% Outpatient, 3,855, 24% Subacute, 880, 6% Residential, 2,907, 18% 4
AB 109 Clients Served by Mental Health Modality, FY 16/17 to FY 18/19 AB 109 Clients Served by Mental Health Modality, FY 16/17 to FY 18/19 400 351 350 350 300 250 221 206 200 164 150 118 108 92 89 83 100 72 71 67 67 48 44 43 50 24 10 6 5 0 Crisis Services Hospital Outpatient Residential Subacute Case Transitional Case Management Management 16-17 17-18 18-19 5
AB 109 Clients with Fewer Psychiatric Hospitalizations After Case Management Enrollment AB 109 Clients with Fewer Psychiatric Hospitalizations After Case Management Enrollment Case Management Case Management Clients With Prior Clients With Prior Hospitalizion Hospitalizion Hospitalized Less Hospitalized Less After Case After Case Management Management Hospitalized Hospitalized Same After Case Same After Case Management Management Hospitalized Hospitalized More After Case More After Case Management Management Fiscal Year Fiscal Year 2015 2016 2016 2017 2017 2018 46 54 42 59% 59% 61% 61% 69% 69% 20% 19% 12% 22% 20% 19% 6
AB 109 Clients without Readmission to Psychiatric Emergency Services AB 109 Clients without Readmission to Psychiatric Emergency Services No No % without % without Admission Admission within 30 within 30- -days Re Re- -Admission Admission Clients Clients Fiscal Year Fiscal Year PES Clients PES Clients Re Re- -Admission Admission Clients Clients days 2015 2016 283 78 205 72% 72% 2016 2017 2017 2018 325 260 83 76 242 184 74% 74% 71% 71% 7
Substance Use Disorder Services for AB 109 Clients Substance Use Disorder Services for AB 109 Clients Criminal Justice Care Management: Criminal Justice Care Management: Assessment, referrals, and intensive care management to facilitate ongoing treatment and service coordination Withdrawal Management/Sobering: Withdrawal Management/Sobering: Management of symptoms and complications of substance withdrawal i.e. detoxification Narcotics Treatment Program: Narcotics Treatment Program: Opioid medication assisted treatment Outpatient: Outpatient: Treatment & case management services Recovery Residences: Recovery Residences: Sober living environments to support outpatient SUD services Residential: Residential: Intensive SUD treatment in 24-hour living support setting 8
Number & Percent of Services by SUD Modality for AB 109 Clients, FY 18/19 Number & Percent of Services by SUD Modality for AB 109 Clients, FY 18/19 Residential, 4,126, 9% Withdrawal Management/Sobering, 1,836, 4% Recovery Residences , 5,479, 12% Outpatient, 7,804, 17% Narcotics Treatment Program, 25,941, 58% 9
AB 109 Clients Served by SUD Modality FY 16/17 to FY 18/19 AB 109 Clients Served by SUD Modality FY 16/17 to FY 18/19 300 257 250 215 200 173 156 151 143 150 131 130 118 101 100 73 65 48 47 50 28 0 Withdrawal Narcotics Treatment Program Outpatient Recovery Residences Residential Management/Sobering FY 16/17 FY 17/18 FY 18/19 10
AB 109 Client SUD Outcomes, FY 17/18 AB 109 Client SUD Outcomes, FY 17/18 Percent of clients connected to Percent of clients connected to services within 14 days of referral: services within 14 days of referral: 86% of clients had at least 2 treatment sessions within 30 days of admission 80% of Recovery Residence 89% of Residential Treatment 74% of Outpatient 71% of clients (152) were successfully discharged 11
ACBH AB 109 FY 18/19 Actual Costs ACBH AB 109 FY 18/19 Actual Costs Leveraged Leveraged Revenue Revenue 1,497,874 1,142,078 1,224,604 Government Government Cost Cost 1,460,917 Service Type Service Type Total Cost Total Cost CBO Cost CBO Cost MH In Custody MH Out of Custody SUD Out of Custody Intensive Case and Care Management Training and Consultation ACBH Administrative Cost Total Total 2,958,791 2,864,314 2,009,877 1,661,691 1,661,691 785,273 785,273 60,545 0 3,242,942 14,200 271,275 $11,361,399 1,473,858 1,624,061 1,624,061 14,200 14,200 145,023 0 271,275 $1,937,760 $5,338,414 $4,085,225 $4,085,225 12
ACBH AB 109 CBO FY 18/19 Costs ACBH AB 109 CBO FY 18/19 Costs Actual Cost Approved Funding $4,085,225 $2,900,000 Funding Shortfall $1,185,225 1,185,225 13
ACBH AB 109 CBO FY 19/20 Funding Request ACBH AB 109 CBO FY 19/20 Funding Request Funding Shortfall Recovery Residence (22 beds) $ 408,997 $1,185,225 Request for Additional Ongoing CBO Funding Request for Additional Ongoing CBO Funding $1,600,000 $1,600,000 14
