Department of Behavioral Health & Developmental Disabilities

Joint Appropriations CommitteeBudget Presentation

Chair: Sen. Jack HillChair: Rep. Terry England

Budget PresentationAFY2017 – FY2018

Commissioner Judy FitzgeraldJanuary 17, 2017

1Georgia Department of Behavioral Health and Developmental Disabilities

Presentation Package Contents

DBHDD Overview & Summary Vision: People We Serve Mission: Provider Network Progress

• ADA Settlement Agreement• Agency Accomplishments

AFY 2017 – FY2018 Budget Changes

Capital Budget

Agency Challenges & Opportunities

2Georgia Department of Behavioral Health and Developmental Disabilities

Vision Statement: Easy access to high-quality care that leads to a life of recovery and independence for the people we serve.

People We Serve:

Behavioral Health: Mental Illness

Behavioral Health: Addictive Diseases

Intellectual & Developmental Disabilities

All Georgians are touched by these populations

Department of Behavioral Health & Developmental Disabilities

3Georgia Department of Behavioral Health and Developmental Disabilities

Mission Statement: Leading an accountable and effective continuum of care to support Georgians with behavioral health challenges, and intellectual and developmental disabilities in a dynamic health care environment.

Since 2012 ongoing efforts to overhaul our service delivery system

Department of Behavioral Health & Developmental Disabilities

4Georgia Department of Behavioral Health and Developmental Disabilities

Increasing Accountability in the Provider Network: Behavioral Health

1. Redesign of the Provider Network 3 Tiers, with service definitions and standards

2. Development of Key Performance Indicators Access to Services, Crisis Management, Substance Use

Treatment & Support, Administration & Fiscal Structure, Accreditation, Housing Access, and others

3. Transformation of Financial Infrastructure Fee for Service Cost Based Reimbursement

4. ASO: Georgia Collaborative Allows DBHDD to apply managed care strategies in

the public system Measure & improve access, quality, and efficiency

5Georgia Department of Behavioral Health and Developmental Disabilities

Increasing Accountability in the Provider Network: Intellectual & Developmental Disabilities

1. Overhaul of Support Coordination and Intensive Support Coordination

2. Transform the Transition Process (hospital to community)

3. Office of Health & Wellness (clinical oversight)

4. Proposed Budget Changes Resulting from the Residential Cost Study

6Georgia Department of Behavioral Health and Developmental Disabilities

FY2017 Current Budget

State Federal & Other Total

DBHDD Total 1,032,094,308$ 172,858,006$ 1,204,952,314$

Community 705,683,415$ 130,233,111$ 835,916,526$

Hospital 287,473,215$ 28,868,136$ 316,341,351$

Administration 35,306,770$ 4,400,746$ 39,707,516$

Transportation 2,600,000$ 7,336,971$ 9,936,971$

Attached Agencies 1,030,908$ 2,019,042$ 3,049,950$

7Georgia Department of Behavioral Health and Developmental Disabilities

Program State Funds Federal & Other Total

Administration 37,906,770$ 11,737,717$ 49,644,487$

Adult Addictive 46,239,763$ 44,689,134$ 90,928,897$

Adult Developmental Disab. 299,377,970$ 55,940,753$ 355,318,723$

Adult Forensics 97,337,649$ 26,500$ 97,364,149$

Adult Mental Health 365,254,047$ 12,949,048$ 378,203,095$

C&A Addicitve 3,307,854$ 7,928,149$ 11,236,003$

C&A Developmental Disab. 8,983,665$ 3,588,692$ 12,572,357$

C&A Forensic 6,472,393$ -$ 6,472,393$

C&A Mental Health 50,274,665$ 10,409,515$ 60,684,180$

Direct Care/Support Svcs 115,672,145$ 13,573,041$ 129,245,186$

Substance Abuse Prevention 236,479$ 9,996,415$ 10,232,894$

Attached Agencies 1,030,908$ 2,019,042$ 3,049,950$

Total Department 1,032,094,308$ 172,858,006$ 1,204,952,314$

Department of Behavioral Health & Developmental DisabilitiesFY 2017 Current Budget

8Georgia Department of Behavioral Health and Developmental Disabilities

$424,851,380 $445,155,586

$570,364,256 $600,209,302

$638,832,851 $665,788,715 $678,739,100

$705,683,415

$244,436,102

$284,733,044 $286,668,079 $300,643,235

$279,606,372 $264,956,051 $271,294,298

$287,473,215

$-

$100,000,000

$200,000,000

$300,000,000

$400,000,000

$500,000,000

$600,000,000

$700,000,000

$800,000,000

FY2010Appropriation

FY2011Appropriation

FY2012Appropriation

FY2013Appropriation

FY2014Appropriation

FY2015Appropriation

FY2016Appropriation

FY2017Appropriation

Community & Hospital BudgetsState Funds Appropriation

FY2010 - FY2017

Community

Hospitals

9Georgia Department of Behavioral Health and Developmental Disabilities

O N G O I N G C O M P L I AN C E

ADA Settlement Update

10Georgia Department of Behavioral Health and Developmental Disabilities

ADA Settlement Update: Past & Current

➢Achieved compliance with the majority of original elements

➢Total Funding Received (over the original Settlement period, FY12 – FY16): $171.5M

11Georgia Department of Behavioral Health and Developmental Disabilities

12Georgia Department of Behavioral Health and Developmental Disabilities

ADA Settlement Update: Elements of the Extension

➢The state has negotiated a two year extension to address a few remaining elements

❖ Transition of individuals with IDD from Hospitals

❖ Waivers for individuals with IDD

❖ Community Oversight of individuals with IDD

❖ Mental Health Supported Housing

13Georgia Department of Behavioral Health and Developmental Disabilities

AFY2017 & FY2018 BUDGET CHANGES

Agency Budget Requests

14Georgia Department of Behavioral Health and Developmental Disabilities

FY2017 & FY2018: Agency Budget Priorities

Ensuring Easy Access to High Quality Care

Crisis Services

NOW & COMP Waivers

Forensic Services

Mental Health Housing Services

15Georgia Department of Behavioral Health and Developmental Disabilities

STATE FUNDS CHANGES STATE

Statewide Adjustments

1 Merit System Assessments ($158,102) $5,421

2 Merit Based Pay Adjustments - $13,084,066

3 ERS Adjustments - $194,925

4 TRS Adjustments - $87,184

5 DOAS Self Insurance - ($216,560)

6 SHBP – Board of Regents - $14,661

7 FMAP Rate Changes - ($4,000,000)

TOTAL (158,102) $9,169,697

AFY2017 FY2018

16Georgia Department of Behavioral Health and Developmental Disabilities

STATE FUNDS CHANGES STATE

DBHDD Budget Changes

1 Adult DD – 250 New Waivers(6 Months Funding in AFY2017, Annualized in FY2018)

$6,054,113 $12,108,226

2 Adult DD – 250 New Waivers(6 Months Funding in FY2018, Annualized in FY2019)

- $6,054,113

3 Adult DD – Annualize 100 Waivers(6 Months Funding Already Received for FY2017, Annualization Needed for FY2018)

- $1,096,912

4 Adult DD – Annualize the Comp Rate Increase - $11,762,894

5 Adult MH – Supported Housing(Initial Funding in AFY2017, Annualized in FY2018)

$6,133,276 $7,756,876

6 Adult MH – Behavioral Health Crisis Center - $6,000,000

7 BIPP Restoration - $10,731,835

TOTAL $12,187,389 $55,510,856

AFY2017 FY2018

40 Bed Forensic Unit at GRHA (This will be an AFY2018 Request)

$4,338,452

17Georgia Department of Behavioral Health and Developmental Disabilities

STATE FUNDS

Department of Behavioral Health & Developmental DisabilitiesTotal Proposed Net Change

Agency Budget Requests $12,029,287 $64,680,553

Department of Behavioral Health & Developmental DisabilitiesFinal Proposed Budget

DBHDD Agency Budget $1,044,123,595 $1,096,774,861

AFY2017 FY2018

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BUILDING OUR FUTURE

Capital Budget

19Georgia Department of Behavioral Health and Developmental Disabilities

CAPITAL FUNDS CHANGES for FY2018 STATE

Capital Funds

1 Savannah Treatment Mall – 20 Year Bonds $5,085,000

2 Hospital Major Improvements & Renovations – 20 Year Bonds

$5,000,000

3 Hospital Sustainment and Repairs – 5 Year Bonds $2,000,000

Total $12,085,000

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AGENCY CHALLENGES & OPPORTUNITIES

FY2018 & Beyond

21Georgia Department of Behavioral Health and Developmental Disabilities

Looking Ahead: Behavioral Health & IDD

Clinical Workforce Recruitment & Retention

Core BH Funding

Georgia’s population has increased by an estimated 9.5% from FY07 – FY17

Core Outpatient Services’ funding has not kept pace

Continued investment is needed to move Georgia toward national averages

BHCC & CSU Statewide Coverage

Prioritize the IDD Planning List

Maintain provider rate structure that attracts and retains quality providers in Georgia

22Georgia Department of Behavioral Health and Developmental Disabilities

Looking Ahead: Addictive Diseases, Forensic Services, & Housing

AD Capacity Enhancements aligned with Strategic Priorities

Forensic Services Improvements

Community & Secure

Aging population with nursing home level of care needs

Increase mental health supported housing capacity

Working co-operatively with our sister agencies to help meet the needs of Georgia’s citizens

“Easy access to high quality care that leads to a life of recovery and independence for the people we serve.”