LifeWays Community Mental Health Millage Proposal

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1 LifeWays Community Mental Health Millage Proposal May 2017 We must do more to provide access to mental health for everyone.

2 Mental Health Code charge to LifeWays To provide a comprehensive array of mental health services appropriate to conditions of individuals who are located within its geographic service area, regardless of an individual's ability to pay. Those services, at a minimum, are: Crisis stabilization and response including a 24-hour, 7-day per week, crisis emergency service that is prepared to respond to persons experiencing acute emotional, behavioral, or social dysfunctions, and the provision of inpatient or other protective environment for treatment. Identification, assessment, and diagnosis to determine the specific needs of the recipient and to develop an individual plan of services. Planning, linking, coordinating, follow-up, and monitoring to assist the recipient in gaining access to services.

3 Mental Health Code charge to LifeWays, continued Specialized mental health recipient training, treatment, and support, including therapeutic clinical interactions, socialization, and adaptive skill and coping skill training, health and rehabilitative services, and pre-vocational and vocational services. Recipient rights services. Mental health advocacy. Prevention activities that serve to inform and educate with the intent of reducing the risk of severe recipient dysfunction. Any other service approved by the Michigan Department of Health and Human Services.

4 Why a Mental Health Millage? LifeWays Community Mental Health of Jackson and Hillsdale Counties has experienced an unprecedented reduction in funding, which impacts our ability to serve the uninsured and underinsured in our communities. Critical programming and services to our most vulnerable citizens are being reduced, and in some cases, discontinued.

5 $6,000, DECLINE OF GENERAL FUND TO LIFEWAYS $5,000, $4,000, $3,000, $2,000, $4,834, $4,381, $3,205, $1,493, $1,493, $1,000, $

6 General Fund Breakdown Spendown Service 19% FY 16 Residential Services 13% Inpatient 9% Internal Providers 21% External services 38%

7 $2,000,000 General Fund Expenditures $1,800,000 $1,600,000 $1,400,000 $1,200,000 $1,000,000 $800,000 $600,000 $400,000 $200,000 $0 Residential Services Inpatient External services Internal Providers Spendown Service Grants FY 13 FY 14 FY 15 FY 16

8 Unmet Need

9 # of Services Reduction in Services Provided in Jails Total Services Provided in Jails by Provider by Fiscal Year YTD LifeWays Integro

10 Consumers General Fund Consumers by County HILLSDALE JACKSON OUT OF COUNTY

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12 Community Health Assessments Jackson The rate of those reporting being diagnosed by their provider with depression: 26%. The rate of anxiety has increased since 2008 (10%) to 24% in About 59% of residents reported feeling worried, tense, or anxious in the past 30 days. Published by Jackson Health Improvement Organization

13 How This Proposal was Developed Consultation with Ottawa County CMHSP (Community Mental Health Service Program): first in the state to pass a Mental Health millage. Community Needs Assessment: identified gaps in mental health services across the counties. Reduction in state General Fund monies to LifeWays over the past three years. Discussions with community stakeholders around gaps in treatment. Polling of community to evaluate level of support for a mental health millage. Survey of consumers, guardians, and family members.

14 Ballot Proposal Access to Mental Health Treatment for Uninsured/ Underinsured Supports to Jails Supports to Law Enforcement Social Support/Enrichment Services Supports to School System Guardianship Needs

15 Unmet Behavioral Health Needs FY (Fiscal Year) 2016: 1,476 individuals were not able to be served by LifeWays. Services to be provided to meet the need: Case Management Psychiatric Services Peer Operated Services Outcomes: Decrease in Emergency Utilization Improved Mental Health of Population

16 Jail Services Since 2015 there has been an 82% reduction in mental health services to our local jails. LifeWays could reinstate the services that were provided prior to 2015, which were: Counseling; and Crisis Interventions. Potential numbers to be served: 1,000 annually Outcome: Stabilization of mental health needs of individuals in local jails.

17 Law Enforcement Crisis Intervention Team Each year, 2 million jail bookings involve a person with mental illness. Approximately 15% of men and 30% of women in local jails have a serious mental illness; 1 in 4 people killed in officerinvolved shootings has a serious mental illness. These numbers just begin to show some of the relationships and consequences of a sad truth: With our failing mental health system so inadequate, law enforcement agencies have increasingly become de facto first responders to people experiencing mental health crisis. LifeWays would like to partner with local law enforcement on Crisis Intervention Team (CIT) programs. This is an innovative first responder model of police based crisis intervention with the community mental health service program. Source:

18 Enrichment Center Funding is needed to expand the grassroots programs that have been developed to provide the social and community access needed for people with intellectual developmental disabilities. Key findings of needs survey that was administered to individuals, families, and guardians: 76% would like to see more activities or programs; 30% report feeling lonely; and 65% are spending 98% of their time in their homes. Current challenges to accessing grassroots programs is transportation, so a portion of the funding will cover transportation. Outcomes

19 School Services The Michigan Profile for Healthy Youth (MiPHY) data shows that in Jackson County: 19.83% of students seriously considered attempting suicide during the past 12 months % of students felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities during the past 12 months. Services Sources of Strength mental health programs and suicide prevention for youth in schools. Expand Trauma Training for teachers and administrators. Prioritize at-risk schools in both counties.

20 Mental Health Funding Request is for a.50 mill for Jackson, which would generate $2,117,914 annually in Mental Health Millage funding that will not replace or supplant Medicaid or State General Fund dollars. Funding will be used to provide community-based mental health safety net services not funded by Medicaid or State General Fund dollars.

21 Taxpayer Impact in Jackson Approx Value of Home Taxable Value of Property.5 Mill Annual Increase Approximate Monthly Cost Approximate Weekly Cost $50,000 $25,000 $12.50 $1.04 $0.24 $100,000 $50,000 $25.00 $2.08 $0.48 $150,000 $75,000 $37.50 $3.12 $0.72

22 Community Surveys LifeWays contracted with EPIC MRA to survey 500 registered voters who reside within the two constituent counties; 300 interviews were completed in Jackson County and 200 in Hillsdale County. Respondents were screened to include registered voters who indicated that they voted in the 2014 November election, the 2012 November election, voted in both elections, or were too young to have voted in either election. The primary purpose for the survey was to measure potential community support for establishing a millage to provide funding for mental health programs and services in Jackson and Hillsdale Counties, many of which were cut by State of Michigan budget cuts. The interviews were conducted August 16 through August 18, Sampling error is plus or minus 4.4%.

23 Key Findings In Jackson County, 71% said that the need for mental health services was a major problem that must be urgently addressed (cited by 37%), or it was an important, but not a major, problem (cited by 34%). 53% majority in Jackson County said there is too little funding to provide quality mental health treatment for people diagnosed with mental illness. On the initial question asking voters if they would vote yes or no to establish a one-half mill property tax levy to fund mental health programs and services for 20 years, a 64 to 25% majority in Jackson County said they would vote yes, including 59% directly voting yes and 5% leaning yes.

24 Key Findings Top reasons cited for voting yes were: mental health and services are important/needed (cited 36% in Jackson); funding is needed (13% in Jackson); know someone/family members suffering from mental illness who would benefit (13% in Jackson); and reasonable cost (10% in Jackson). Top reasons cited for voting no included: tax increase/taxes too high (26% in Jackson County); wasteful spending (19% in Jackson); more funding not needed (14% in Jackson); mental illness used as a crutch and/or misdiagnosed (12% in Jackson); other priorities first education, crime, drugs (11% in Jackson).

25 Level of Support for Millage Proposal Strongest support: The expansion of the grassroots programs that have already been developed to provide the social and community access needed for people with intellectual development disabilities. 74% majority in Jackson County Develop a crisis mobile ride-along program with law enforcement and to implement a program to create, promote, support and sustain more effective interactions among law enforcement, mental health care providers, people with mental illness and their families. 71% majority in Jackson County

26 Level of Support for Millage Proposal Restoring programs that were provided to people who are uninsured so that the same level of programs and services provided to people with Medicaid are offered to the uninsured. 63% majority in Jackson County Restore counseling services provided to prisoners at the jail, which were eliminated because of budget cuts. 51% majority in Jackson County

27 How Will We Assure Accountability? Evidence-based and Best Practices will be implemented whenever possible. Programs will be evaluated on an ongoing basis to assess success or failure in achieving agreed upon measurable goals and outcomes. We will work with community partners to assure greatest needs are being met and collaborate with existing services and programs. Annual Reports to the County Commissions on numbers served by programs and outcomes achieved.

28 Community Advantages The value and vitality of a community rests on the overall health of its citizens. Quality behavioral health benefits the community and also helps to retain and attract families to Jackson County. It allows us to put our dollars into our community and maintains our community s investment.

29 Why Now This is our opportunity to do the right thing. A dedicated millage will create sustainable, predictable, and flexible funding to support mental health safety net services. With the ongoing reduction of funding, this is a potential source that allows for prevention services and services to meet the needs of the uninsured. To assure the most vulnerable citizens in Jackson county receive appropriate and adequate treatment, services, and supports. To be a leader in innovation and collaboration.

30 What Happens if the Millage Fails? LifeWays will have less dollars to serve the same amount of people. Services and supports could be reduced for many people and discontinued for some. Individuals may not get the level of service they need to improve or stay out of crisis, the hospital, or jail. The elimination of all prevention services and reduced ability to provide health care safety net services. The standard of service that Jackson County citizens have come to expect will decrease.

31 Millage Timeline April 2016: Mental Health Millage proposed to LifeWays Board of Directors. May 2016: Mental Health millage proposed to Jackson & Hillsdale County Commissions. August 2016: Jackson and Hillsdale County Citizens polled (64% of Jackson respondents and 62% of Hillsdale respondents supported a ballot proposal for a 0.50 Mill for mental health services). November 2016: Resolution adopted by LifeWays Board. January 2017: Formal request to Board of Commissioners to support the millage. January 2017: Friends of LifeWays formed and Facebook page established. January 2017: FAQ document published; public presentations scheduled. February May 2017: Public presentations scheduled and completed. May 2017: Election

32 Ballot Language, Jackson County For the purpose of providing mental health services for Jackson County residents, shall the Constitutional limitation upon the total amount of taxes which shall be assessed in one (1) year upon all property within the County of Jackson, Michigan, be increased, and shall the County be authorized to levy, up to 0.50 mill ($0.50 per $1,000 of Taxable Value) for a period of twenty (20) years, 2018 through 2037, inclusive? If approved and levied in full, this millage will raise an estimated 2,117,914 for providing funds for mental health services in the first calendar year of the levy based on taxable value. If approved and levied, in accordance with State law a portion of the millage may be distributed to the Downtown Development Authorities of the City of Jackson, the Villages of Grass Lake and Springport, and the Townships of Blackman and Leoni; the Local Development Finance Authorities of the Village of Parma and the Township of Blackman; and the Brownfield Redevelopment Authority of the City of Jackson.