Community Mental Health Centers in Kentucky - Providing Essential Services

SMI TASK FORCE Steve Shannon KARP, Inc. June 15, 2021 1

Community Mental Health Centers 14 Community Mental Health Centers (CMHCs) Serve Approximately 175,000 individuals annually Employ 8,000 people therapists, direct support professionals, physicians, accountants, lawyers Led by 300+ voluntary board members CMHCs Make All KY Communities Better! 2

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The Community Mental Health Act President Kennedy October 31, 1963 This federal legislation created the opportunity for states to establish a network of CMHCs. Kentucky passed enabling legislation in 1964 KRS 210.370 485 CMHCs are creatures of the KY General Assembly The CMHC network was established in KY by 1966 and all 120 counties were included KY was first to complete the network President Kennedy: A Good Job, Well Done! 4

Definition of SMI SAMHSA Definition: SMI is defined as being over 18 years old, within the past year had a diagnosable mental, behavioral, emotional disorder that causes serious functional impairment in one or more life activities. Kentucky Definition: Individual is over 18 years old, has a diagnosis of (1) Schizophrenia Spectrum (2) Bipolar and Related Disorders, (3) Depressive Disorders, or (4) Trauma and Stressor Related Disorders, impact on daily life and a duration of at least two-years. Definitions are not the same but include age, a diagnosis, impact on functional activities and a timeframe. In 2020 the CMHCS served and supported approximately 43,000 individuals diagnosed with SMI. Approximately 25% of individuals served and supported 1.4% of all Kentucky Adults If folks are not seen at a CMHC, they do not disappear. They are seen at ERs, Jails, Homeless Shelters, Streets, Alone, or Worse. 5

CMHC Services Assertive Community Treatment Targeted Case Management Comprehensive Community Support Services Peer Support Services Supported Employment Services Therapeutic Rehabilitation Program Social Club Drop-In Centers Crisis Stabilization Units & Mobile Crisis Services Medication Administration Individual Therapy Group Therapy 6

Challenges & Opportunities Challenges Stigma Relationship with Medicaid MCOs are a significant challenge to individuals accessing services and CMHCs being reimbursed. Pay for MCO approved services provided to MCO members. During the COVID-19 Pandemic, telehealth was greatly expanded, we appreciate CHFS, Medicaid and DBH for their support of telehealth. Opportunities Certified Community Behavioral Health Centers Medicaid Waiver for Adults with SMI 7

Certified Community Behavioral Health Center CCBHC are designed to provide a comprehensive range of mental health and substance use disorder services. Nine Required Services 1. Crisis mental health services including 24-hour mobile crisis teams, emergency crisis intervention and crisis stabilization 2. Screening, assessment, and diagnosis 3. Patient-centered treatment planning 4. Outpatient mental health and substance use disorder services 5. Primary care screening and monitoring 6. Targeted case management 7. Psychiatric rehabilitation services 8. Peer support services and family support services 9. Services for members of the armed services and veterans Seven Counties, NorthKey, Pathways and New Vista are the four (4) CMHCs in the process of becoming CCBHCs by a go-live date of October 1, 2021. The goal is all fourteen (14) CMHCs have this opportunity 8

SMI Waiver Interim Health, Welfare & Family Services Testimony June 3, 2019 1915 (c), 1915 (i) or 1115 waiver Needed Services Residential Options Supported Employment A good, safe home and a good job not a very high bar! Kentucky Can Do Better Kentucky Must Do Better! 9