Service Array, Needs, and Gaps FY16-17 Silvia Quintana Chief Executive Officer squintana@bbhcflorida.org 1
ROLE OF BBHC AS THE BROWARD MANAGING ENTITY Broward Behavioral Health Coalition, Inc. (BBHC) was created in 2011 and was selected by the Florida Department of Children and Families (DCF) as Broward County s Managing Entity (ME) for mental health and substance abuse services. The purpose of the ME is to provide the administration, management, support and oversight of DCF-funded behavioral health services in Broward County. 2
BROWARD BEHAVIORAL HEALTH COALITION VISION Ensuring a responsive and compassionate behavioral healthcare experience for people in our community. MISSION To advocate and ensure an effective and efficient behavioral health system of care is available in Broward County. VALUES Consumer driven, cultural competence, compassionate service, efficient management, innovative system, fiscal integrity. 3
Substance Abuse and Mental Health Program Funding Total Annual Operating Budget: $51,278,662 FY 2016-2017 Operational Cost, 2,330,272, 4.6% Children Substance Abuse, 5,428,153, 11% Adult Mental Health, 25,374,186, 49% Other: Adult/Child Prevention, $1,523,400 Adult Substance Abuse, 14,730,856, 26.4% Children Mental Health, 3,415,195, 7% 4
PREVENTION FUNDING FY15-16 Adult and Children Prevention Services Contracted to the United Way $1,523,400 5
BBHC Unique Clients FY 15-16 by program and population type 14000 12000 10000 13171 10751 8000 6000 4000 2000 2756 2270 0 AMH ASA CMH CSA 6
HOMELESS SERVED BY BBHC NETWORK 3500 3000 2500 2722 3168 2000 1848 1500 1000 500 0 Actual Year To Date Projected FY 14-15 FY 15-16 FY 15-16 2 7
SERVICE TYPES FUNDED Addiction Receiving Facility (ARF, JARF) Aftercare Assessment Case Management Care Coordination Team Clubhouse Consumer Drop-In Centers Crisis Stabilization Crisis Support Mobile Crisis Team Central Receiving Center Day/Night Treatment Detoxification FACT (Florida Assertive Community Treatment) Family Intervention Team First Episode Team Incidental / Flexible Funds Information and Referral In-Home / On-Site Intervention Medical Services Multi-Disciplinary Forensic Team Outpatient Outreach Prevention Recovery and Peer Support Services Residential Respite Supported Employment / Education Supportive Housing / Living Transition to Independence Process (TIP) 8
EMERGENCY SERVICES Children and adult Mobile Crisis Team provided by Henderson Behavioral Health Juvenile Addiction Receiving Facility (detoxification) provided by Fort Lauderdale Hospital Adult Addiction Receiving Facility (detoxification secured) provided by Fort Lauderdale Hospital Crisis Support and Crisis Stabilization Unit (Baker Act) provided Fort Lauderdale Hospital (Adults and Children) Crisis Stabilization provided by Henderson Behavioral Health and Broward Health (Adults only) Residential Detoxification Adults Provided by BARC Inpatient Detoxification for Pregnant Woman provided by Memorial Health Systems Inpatient Mental Health provided by Memorial Health Systems Outpatient Detoxification provided by Memorial Health Systems (Adults) 9
CHILDREN RESIDENTIAL SERVICES Residential Level 1 (secured) Substance Abuse and Mental Health Services Residential Mental Health services provided by Statewide Inpatient Psychiatric Programs (evaluation and prior authorization required) Residential Substance Abuse level 2 provided by Covenant House 10
ADULT RESIDENTIAL SERVICES Short-term Residential Treatment will be provided by Citrus Health Network Residential level 1 (Secured) Forensic Residential Level 1 (not secured) provided by Henderson Behavioral Health and Gulf Coast Residential Level 2 provided by Henderson Behavioral Health, Archways, Banyan Health System, House of Hope Co-occurring Substance Abuse and Mental Health Residential Level 2 for women and their children provided by Susan B. Anthony Residential Level 2 Substance Abuse BARC Only Residential Level 3 and 4 Provided by Gulf Coast, House of Hope, Archways 11
CHILDREN/YOUTH NON-RESIDENTIAL SERVICES Henderson Behavioral Health Banyan Health Systems Broward Sheriff s Office (Juvenile Assessment Center) Camelot Community Care Inc. Gulf Coast Jewish Family and Community Services Kids in Distress (Infant Mental Health) Our Children, Our Future Smith Mental Health Associates, Inc. SunServe South Florida Wellness Network 12
ADULT NON-RESIDENTIAL SERVICES Archways Henderson Behavioral Health Banyan Health Systems Broward County Elderly/Veterans Services Gulf Coast Jewish Family and Community Services Susan B. Anthony House of Hope Broward Sheriff s Office Memorial Health Systems The Chrysalis Center South Florida Wellness Network Broward Regional Health Planning Council SunServe Care Resource 13
ADULTS, CHILDREN AND FAMILIES SUPPORT SERVICES Peer support services, training, and advocacy for adult and children provided by South Florida Wellness Network Peer support services, advocacy and Drop-In Center services for Adults provided by 9 Muses at Mental Health Association, the Rebel Center at Memorial Health Care systems, and Silver Impact. Clubhouse employment services provided by Foot Print to Success Supported Employment and Supported Education services provided by Foot Print to Success and Susan B. Anthony Supported Housing Services provided by Broward Housing Solutions and Henderson Behavioral Health. 14
EVIDENCE-BASED PRACTICES (EBP) EBPs are scientifically proven strategies for successful outcomes. BBHC is committed to optimal quality of care services. A key strategy for enhancing the clinical expertise available in our provider network is the provision of EBP training opportunities. Motivational Interviewing Wellness Recovery Action Planning (WRAP) including Facilitator Training Mental Health First Aid Adult and Youth Trauma Focused Cognitive Behavioral Therapy (TF CBT) Children Trauma Incident Reduction (TIR) Therapy for Adults and Youth Transition to Independence Process (TIP) for transition age Youth 14-29 Moral Reconation Therapy (MRT) criminal justice involved youth and adults Crisis Intervention Team (CIT) Training for Law Enforcement Permanent Supportive housing IPS Supported Employment/Education TMACT for FACT Teams Critical Time Intervention (CTI) for Care Coordination Locus and CALocus level of care assessment 15
NEW INITIATIVES Housing Initiative: Supported Housing Teams Maternal Addiction Program Family Engagement Program Power of Peers Care Coordination Teams Supported Employment Teams One Community Partnership 2 (OCP2) CLAS Standards 16
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HOUSING INITIATIVE CHARTER RECOMMENDATIONS Broward County Charter, Section 1.04: Citizen s Bill of Rights Protection of Human Rights Recommendation: Charter should include protections for two classes: Persons experiencing Homelessness Gender identity (LGBTQI community) Peer Supports Persons with lived experience bring effective ways to engage and assist others in their recovery through interventions that are evidence-based through SAMHSA. Peer Specialists have requirements for specialized training and Florida certification board credentialing to ensure the individual meets the necessary level of competency for the hired position. In lieu of case managers, when appropriate, peer support specialists can provide the necessary support to households who are engaged in their maintaining their stability and enhancing their quality of life. Recommendation: Broward County should implement a peer support workforce initiative in two ways: Hiring formerly homeless individuals to staff the homeless helpline. Hiring Peer Specialists for the Permanent Supportive Housing programs in an effort to graduate individuals who have attained housing stability; this in turn provides the opportunity for new program participants to access Case Management more rapidly. 18
Affordable Housing & Affordable Workforce Housing Tourist driven economy where 35% of renters spend more than 50% of their income in rent Not in my back yard culture in cities and neighborhoods Lack of vouchers for sustainable affordable housing for individuals experiencing substance abuse and mental health disorders who may or may not be experiencing homelessness Recommendation: Encourage developers and utilize funds to construct or rehab single room occupancy (SRO) or similar units for individuals with disabling conditions. Broward County should advocate for receiving fair-share of Sadowski funds. HUD-Funded Continuum of Care HUD programs only serve literally homeless households and households fleeing domestic violence, excluding other categories of homeless Persons with substance abuse and mental health disorders may not be significantly chronic enough on the VI-SPDAT to access permanent supportive housing Recommendation: Expand the supports and funding to households who are at-risk or meet alternate definitions of homeless, providing early intervention services to break the cycle. 19
TYPICAL RESIDENTIAL DISCHARGES Children Residential Treatment Facility, 9 Supportive Housing, 1034 Not Available or Unknown, 1305 ALF, 123 Correctional Facility, 269 Crisis Residential, 12 Dependent Living nonrelatives, 1730 State Hospital, 61 Nursing Home, 20 Independent Living with Relatives, 4137 Dependent Living with relatives, 4986 Foster Home, 41 Independent Living non-relatives, 2400 DJJ, 33 Group Home, 370 Homeless, 934 Independent Living Alone, 4798 20
PRIORITY NEEDS/GAPS - FUNDING NEEDS Housing for all populations, in particular youth: Permanent, supported housing that is not linked to a voucher, Transitional housing and Emergency Beds and Assisted Living Facilities, FAR-certified Sober Homes Peer Support Expansion and need Family Peer Specialists Family Supports Parent therapy, parenting skills, certified behavioral analysts, trauma therapy, etc. Short-Term Residential Treatment (SRT)- extended crisis program Case Management supplemental rate to support low Medicaid rates Training and specialized treatment for LGBTQ Training for Evidence-Based Practices, including expansion of TIP, MRT, Motivational Interviewing, CTI Stipends for Adult Consumers to reduce barriers and participate in leadership opportunities Intensive Residential Treatment of individuals with charges of sex offenses, arson, and violent crimes/ Criminal Justice-Involved Individuals Residential and Outpatient Treatment for those with eating disorders. Primary Care-Behavioral Health Integration including Dental Care 21
FY 16-17 LEGISLATIVE REQUEST SUBMITTED BY DCF FOR BBHC Children Community Action Team (CAT) Team (60 clients): $750,000 multidisciplinary teams that treat and provide support to families and keep children and youth at home and divert them from institutionalization (Child Welfare, SIPP, and Juvenile Justice). Reentry Program for criminal justice involved (75 clients): $500,000 Additional FACT Team (100 Adults): $2.2 million Short Term Residential Treatment program (20 beds): $2.2 million Peer Support Services (50 clients): $225,000 Supportive Housing Project/Flexible Funds (60 clients): $500,000 22
Contact: squintana@bbhcflorida.org 23