Provide statewide leadership, direction and oversight for services to help Texans prevent mental health or substance abuse problems, build resiliency and facilitate recovery in their home or community.
Fiscal Year 2008 Budget (total funding)
Community Mental Health Services: $482,316,409
Mental Health Hospital Services: $373,730,280
Substance Abuse Services: $164,575,118
Division includes 11 state hospitals, and has service contracts with 39 mental health centers, and 270 substance abuse providers.
Full-Time Positions
7,734
Substance Abuse Prevention, Intervention, and Treatment Services
Substance Abuse Prevention, Intervention, and Treatment Services
Inpatient Psychiatric Services (State Hospitals)
Community-Based Mental Health Services
Projects for Assistance in Transition from Homelessness (PATH)
NorthSTAR – Community-Based Mental Health, Substance Abuse and Co-Occurring Services
South Texas Health Care System
Texas Center for Infectious Disease (TCID)
Primary Prevention
HIV Early Intervention and Outreach
Outreach, Screening, Assessment and Referral Services (OSAR)
Tobacco Prevention and Control
Pregnant and Post-partum Intervention for Women (PPI)
Detoxification
Detoxification
Intensive and Supportive Residential (adult and youth)
Outpatient (adult and youth)
Opioid Replacement Therapy
Co-Occurring Psychiatric and Substance Abuse Disorders (COPSD) Services
Specialized Female Services
Changing trends in drug use patterns
Cost pressures on treatment providers
Workforce development
Availability of specialized services
Ensuring a continuum of care
Alcohol is the primary drug of abuse in Texas
Alcohol is the primary drug of abuse in Texas
Of particular concern is heavy consumption of alcohol, or binge drinking, which is defined as drinking five or more drinks at one time. In 2008, 12 percent of all secondary students said that when they drank, they usually drank five or more beers at one time, and 13 percent reported binge drinking of liquor
In 2008, 27 percent of all clients admitted to publicly funded treatment programs had a primary problem with alcohol
Increase in inhaling heroin—not just “Cheese” (heroin+Tylenol PM) but use of other diphenhydramine products such as Benedryl to produce powder from the Tar.
Increase in inhaling heroin—not just “Cheese” (heroin+Tylenol PM) but use of other diphenhydramine products such as Benedryl to produce powder from the Tar.
Problems with inhaled heroin continue to increase, especially among youths and young adults.
Suboxone (buprenorphine + naloxone) as treatment option for young heroin clients.
Proportion of Black crack users continues to decrease.
Decreased availability and increased price due to late 2008 gang moratorium and Colombians not fronting cocaine on consignment to Mexican traffickers.
Methamphetamine availability down and price up.
Methamphetamine availability down and price up.
Mexican limits on importation of pseudoephedrine have dropped from 140 tons in 2005 to 12 tons in 2007
Small meth labs starting up again
magnitude of the substance abuse and mental health problem on the Border is of serious concern.
Concern that people in need of substance abuse and mental health services will become more “closeted” and afraid to ask for help due to repercussions related to the safety of their families and/or immigration issues.
Increasing numbers of youth involved in drug trafficking and fewer options for them. Choosing whether or not to become involved in drugs and gangs is less a “choice” and instead a decision based on threats and fear.
Clinical Management Behavioral Health System (CMBHS)
Access to Recovery (ATR)
Texas Recovery Initiative (TRI)
Licensure
CMBHS will:
CMBHS will:
Integrate clinical management tool for Substance Abuse and Mental Health service providers
Capture demographic, service and clinical data for Substance Abuse and Mental Health clients
Track service utilization and client progress
Facilitate State and Federal reporting requirements
All Mental Health & Substance Abuse Treatment providers contracted with DSHS’ Mental Health and Substance Abuse division.
All Mental Health & Substance Abuse Treatment providers contracted with DSHS’ Mental Health and Substance Abuse division.
CMBHS will serve as a connection point to other publicly-funded behavioral health service systems and related programs.
Clients will not currently have direct access to information in CMBHS. A future expansion may provide this service.
CMBHS will replace BHIPS, DSHS’ legacy system for managing substance abuse treatment.
CMBHS will replace BHIPS, DSHS’ legacy system for managing substance abuse treatment.
CMBHS is web-based. Providers need only a computer with Internet access to use the system.
Training began earlier this month, with rollout to providers by region.
Helpdesk services will be available to all CMBHS users.
Efficient, seamless administrative and clinical processes for gathering, updating, and sharing client information.
Efficient, seamless administrative and clinical processes for gathering, updating, and sharing client information.
Convenient and accessible from any computer that has a browser and Internet connection, allowing access from almost any location.
Free of charge to community Mental Health and Substance Abuse treatment providers who provide services under contract to DSHS.
A person seeking services will experience more streamlined intake, admission, assessment, diagnosis, treatment plan development, treatment and discharge processes by:
A person seeking services will experience more streamlined intake, admission, assessment, diagnosis, treatment plan development, treatment and discharge processes by:
Reducing time for staff to perform administrative tasks and gather basic client information
Using a single process that assesses a person’s need for mental health and/or substance abuse treatment
Creating a single client record that can be shared, eliminating need to create and maintain multiple client records
Allowing access to previous health records that can help identify what types of treatment have been most effective in the past and facilitate current treatment plans.
CMBHS will begin an incremental rollout to Substance Abuse and NorthSTAR providers beginning in August.
CMBHS will begin an incremental rollout to Substance Abuse and NorthSTAR providers beginning in August.
Region 7 Substance Abuse Providers, 08/10/09
Region 6 Substance Abuse Providers, 09/08/09
NorthSTAR Substance Abuse Providers, 10/05/09
Region 3 Substance Abuse Providers, 11/02/09
Region 5 Substance Abuse Providers, 12/01/09
(CMBHS Release One Deployment Continued)
(CMBHS Release One Deployment Continued)
Region 4 Substance Abuse Treatment Providers, January 2010
Region 2 Substance Abuse Treatment Providers, February 2010
Region 11 Substance Abuse Treatment Providers, March 2010
Region 9 Substance Abuse Treatment Providers, April 2010
Region 10 Substance Abuse Treatment Providers, May 2010
Region 8 Substance Abuse Treatment Providers, June 2010
Region 1 Substance Abuse Treatment Provider, July 2010
Voucher issued to client rather than contract with provider
30 participating drug courts in 13 counties
Second ATR Meth Grant awarded 2007
$13.5 million for three years
Federal target 6,038 clients
Focus on methamphetamine use
Partnership with Governor’s Office/Criminal Justice Division
The Texas Recovery Initiative (TRI)
The Texas Recovery Initiative (TRI)
Partnership between DSHS and the substance abuse treatment and recovery communities
Identify opportunities and methods for improving the quality and effectiveness of services provided to adult population
Process to date has included a series of community meetings, creation of a task force and the presentation of a set of summary findings for service improvement and recommendations
Emphasize integration in all efforts.
Make public health messages readily available to individuals seeking recovery.
Expand existing infrastructure through peer case management at the treatment level, community recovery services at the OSAR level and seek additional funding for additional wrap-around ancillary services to support recovery.
Chemical Dependency Treatment Facility Licensure Rules, TX Administrative Code, Chapter 448 are under review for revision
Chemical Dependency Treatment Facility Licensure Rules, TX Administrative Code, Chapter 448 are under review for revision
A stakeholder meeting for input and feedback on the preliminary revised Chapter 448 draft was held in Austin on July10th
Input from that meeting is being used to revise the rules draft
The subsequent revised Ch. 448 rules draft is expected to be available today (7/31):
The subsequent revised Ch. 448 rules draft is expected to be available today (7/31):
Recovery Support and Service Coordination Services
OSAR Expansion
Services for Persons with Co-occurring Mental Illness
Medication Assisted Treatment
Article IX, Sec. 17.15 of SB 1
Article IX, Sec. 17.15 of SB 1
Sec. 17.15. Medicaid Substance Abuse Treatment. Out of funds appropriated above in Goal B, Medicaid, the Health and Human Services Commission shall, beginning January 1, 2010, provide coverage for comprehensive substance abuse treatment services under Medicaid to persons who are at least 21 years of age, have a substance abuse disorder, and otherwise qualify for Medicaid. The commission may delay implementation pending federal approval. The commission shall analyze data relating to the provision of those treatment services and provide the data to the Legislative Budget Board in a format and at times requested by the Legislative Budget Board. The commission may not provide those treatment services if the Legislative Budget Board determines that the treatment services have resulted in an increase in overall Medicaid spending.
All Medicaid recipients in Texas
All Medicaid recipients in Texas
Traditional fee for service delivery system and managed care
Clinical assessment, residential levels of care, ambulatory detox, case mgt, outpatient, medication assisted treatment are being reviewed by HHSC and DSHS
Benefits must be approved by CMS prior to implementation
The rider may allow some greater flexibility in terms of benefit array, timeliness for cost effectiveness study.
The rider may allow some greater flexibility in terms of benefit array, timeliness for cost effectiveness study.
HHSC (lead agency) and DSHS are co-managing roll out. There are standing workgroups to address the implementation issues, which include:
decisions of IT systems, service delivery system (fee for service vs. managed care), benefit design/medical policy and CMS approval of benefits, utilization management, provider education, recruitment and enrollment in Medicaid, recipient education, staffing/oversight, how it will relate with and the effect on the SAPT block grant and DSHS provider contracts, and cost effectiveness evaluation component.
HHSC and DSHS have been meeting regarding questions on IT systems, benefit design and provider network.
HHSC and DSHS have been meeting regarding questions on IT systems, benefit design and provider network.
Tentative implementation date:
Around April-May 2010
Detailed project plan:
There are many moving parts and interdependencies in this plan. There will be frequent updates to the provider community to keep all apprised.
HB 1232 - The Department of State Health Services shall establish a local behavioral health intervention pilot project for children in Bexar County.
HB 1232 - The Department of State Health Services shall establish a local behavioral health intervention pilot project for children in Bexar County.
HB 2196 - The executive commissioner of the Health and Human Services Commission shall establish a workgroup to recommend best practices in policy, training, and service delivery to promote the integration of health and behavioral health services in this state.
SB 1325 - relating to the creation of a mental health intervention program for military veterans.
HB 1233 - relating to the court-ordered administration of psychoactive medication to certain criminal defendants.
Texas Education Agency (TEA)
Texas Education Agency (TEA)
Education Service Centers (ESC) - expanding role of School Health Specialist to include MH promotion and substance abuse prevention efforts
Legislative direction to implement tobacco education program in schools
Drug Demand Reduction Advisory Committee (DDRAC)
Drug Demand Reduction Advisory Committee
(DDRAC)
The DDRAC was legislatively mandated to develop a comprehensive statewide strategy with recommendations to reduce drug demand in Texas.
The DDRAC was legislatively mandated to develop a comprehensive statewide strategy with recommendations to reduce drug demand in Texas.
16 state agencies must participate in effort, as well as 5 at-large members from different geographical areas within the state.
3 Subcommittees: Workforce, Continuity of SA Services/ Data Sharing & Media/Communications
Remove exclusion clause for medical expenses from Uniform Individual Accident and Sickness Policy Provision Law
Remove exclusion clause for medical expenses from Uniform Individual Accident and Sickness Policy Provision Law
Statewide public smoking ban
Prescription Drug Monitoring
Mandate comprehensive alcohol and other drug reduction strategies targeting college students
Support the recruitment and retention of quality service providers in the field of substance abuse prevention and treatment
To develop a strong workforce and provide a holistic approach to substance abuse and mental health service delivery:
To develop a strong workforce and provide a holistic approach to substance abuse and mental health service delivery:
• Shift the focus from the number of people receiving services to the specific services urgently needed to reduce drug demand in Texas.
• Recruit and train a professional workforce to fully meet the service needs and provide appropriate training and tools.
Southwest Center for the Application of Prevention Technologies
DSHS
Rationale:
Rationale:
• Texas has an urgent need for qualified and well-supported behavioral health professionals across disciplines.
• The reported annual staff turnover for Texas substance abuse programs was 42% and program directors report ongoing difficulty filling their open positions.
• Quality service providers in the field of substance abuse prevention and treatment specializing in criminal justice populations are also decreasing and difficult to recruit.
Increase the number of substance abuse programs in higher education institutions
Increase the number of substance abuse programs in higher education institutions
Stimulus funding for health care should include behavioral health
Establish an internship program with local institutions of higher education
Make LCDC training a part of the TRI
Target veterans to receive assistance to be trained as substance abuse professionals
Unique opportunity for attendees to gain a greater understanding of the unique challenges facing the border region because of the demand for drugs in the United States
As of today, there have been 9,903 drug war related deaths at the US/Mexico Border
Source: UC San Diego Transborder Institute
Speakers include:
Speakers include:
Jane Maxwell, Ph.D., UT Addiction Technology Transfer Ctr.
Chilo Madrid, Ph.D., Aliviane NO-AD, Inc.
Luis Flores, SCAN, Inc.
Michael Hanson, Border Patrol, Operation Detour
Guillermo Valenzuela, Director of International and Border Affairs for U.S. Congressman Silvestre Reyes, Chairman of the House Select Committee on Intelligence
Sergio Nogueira, CEO of Mexican Association of Rehabilitation of Alcoholics and Addicts
Simon F. Sotelo, Executive Director, Quad Counties Council on Alcohol and Drug Abuse
Mission: To reduce youth drug use in Texas by distributing research-based media messages created by the Partnership for a Drug-Free America and supplementary marketing materials developed specifically for Texas.
Mission: To reduce youth drug use in Texas by distributing research-based media messages created by the Partnership for a Drug-Free America and supplementary marketing materials developed specifically for Texas.
Alliance Support
Alliance Support
1-877-9-NO-DRUG Hotline
Red Ribbon Rally (October 15!)
Children’s Activity Book
Children’s Activity Book
Currently producing bilingual activity book for ages 5-7
PSA Distribution Changes
Moving towards digital PSA distribution
New Drug-Free Texas Website
Working with Partnership National to syndicate content
Will allow for daily updates by DSHS and PDFT
2009 marks the 20th Anniversary of Recovery Month, which aims to:
2009 marks the 20th Anniversary of Recovery Month, which aims to:
highlight societal benefits of substance abuse treatment
laud the contributions of treatment providers
promote the message that recovery is possible
encourage citizens to help expand and improve availability of effective treatment
educate public on substance abuse, addiction is a treatable disease and recovery possible
reduce and eventually eliminate public stigma associated with substance abuse and recovery
Rallies will be hosted in:
Rallies will be hosted in:
San Antonio
Dallas
Houston
El Paso
More much more information on Recovery Month can be found at:
http://www.recoverymonth.gov
On behalf of the citizens of Texas, thank you for all of the work you do!
On behalf of the citizens of Texas, thank you for all of the work you do!
