FY 2017-FY 2018 Needs Assessment Data Report · Data update for needs identified in FY 2017 and FY...

FY 2017-FY 2018 Needs Assessment Data Report

Data update for needs identified in FY 2017 and FY 2018

Ellen Omohundro, Ph.D., 12/13/2018 Office of Research

Table of contents

2 Ellen Omohundro, Ph.D., 12/13/2018

Office of Research

The needs assessment process 3

Process for needs assessment reports 4

Mental health needs overview 6 Crisis services statewide map 7 Crisis stabilization units for adults and children 8 Housing for individuals with mental health or co-occurring disorders 10 Reliable transportation to and from treatment and recovery/support services 12

Substance abuse services needs overview 16 Recovery and transitional housing for individuals with substance abuse disorders 17 Increase residential and detox beds including adolescent residential programs 21 Increase programs for at-risk youth 22

The needs assessment process


Office of Research

Process for needs assessment reports

4

FY 2017 and FY 2018 needs identified

December 2018 FY 2017 and FY

2018 7/1/2016 – 6/30/2018

Needs assessment report for FY 2017 and FY 2018 needs

TDMHSAS data collection

FY 2017 and FY 2018 7/1/2016 – 6/30/2018

• Regional Planning and Policy Councils and the Statewide Committees (Adult, Children’s and Consumers Advisory Board) identified needs in FY 2017 and FY 2018.

• TDMHSAS collected data for FY 2016- FY 2018. • “FY 2017 and FY 2018 Needs Assessment Data Report” covers

trends over time for needs identified in FY 2017 and FY 2018.


FY 2017 and FY 2018 Mental Health Needs

5 Ellen Omohundro, Ph.D., 12/13/2018 Office of Research

Mental health needs overview

1. Expand Crisis Stabilization Units (CSUs) and inpatient beds for adults and children

– Regions 1, 2, 5, 6, 7 and Children’s Committee

2. Increase appropriate and affordable housing for persons with mental illness and co-occurring disorders

– Regions 1, 2, 3, 4 and Children’s Committee

3. Increase reliable transportation to and from treatment and recovery support services

– Regions 3, 6 and Adult Committee

4. Increase Peer Recovery Services and Specialists – Region 3, Adult Committee and Consumer Advisory Board

6

Identified mental health (MH) needs in FY 2017 and FY 2018


MH need 1: Crisis Services Statewide Map

7

Data source: Office of Crisis Services and Suicide Prevention, TDMHSAS


MH need 1: Crisis stabilization units (CSUs) for adults & children

Data source: See more at: https://www.tn.gov/behavioral-health/need-help/crisis-services/mental-health-crisis-services/crisis-stabilization-units--csu-.html

8

CSU LOCATIONS Frontier Health: Johnson City, TN 877-928-9062 (Region 1)

Helen Ross McNabb: Knoxville, TN 865-541-6958 (Region 2)

Volunteer Behavioral Health: Cookeville, TN 800-704-2651 (Region 3 & 5)

Volunteer Behavioral Health: Chattanooga, TN 800-704-2651 (Region 3)

Mental Health Cooperative: Nashville, TN 615-726-0125 (Region 4)

Pathways of Tennessee: Jackson, TN 731-541-8330 (Region 6)

Alliance Healthcare Services: Memphis, TN 901-577-9400 (Region 7)

Cherokee Health Systems: Morristown, TN 423-586-5074 or 1-855-602-1082 (toll-free) (Region 2)

CSUs

Intensive short-term

stabilization 24/7/365

Counseling and support

Mental illness and substance

abuse education

Medication management

and administration

Stress management

counseling

Individual treatment plan


https://www.tn.gov/behavioral-health/need-help/crisis-services/mental-health-crisis-services/crisis-stabilization-units--csu-.html

MH need 1: Crisis stabilization units (CSUs) for adults

9

Data source: Office of Crisis Services and Suicide Prevention, TDMHSAS


17,504 17,135

17,421 17,682

18,100

FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Walk-in assessments

69% 66% 67% 68% 70%

0%

20%

40%

60%

80%

100%

FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Average occupancy rate

3.2 2.8 2.9 3.1 3.1

0

1

2

3

4

FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Average length of stay in days

10,216 10,320 10,580

9,730 9,799

FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Number of admissions to CSUs

MH need 2: Housing for individuals living with mental health or co-occurring disorders

10

Data source: Office of Housing and Homeless Services, TDMHSAS


Creative Homes Initiative (CHI): New housing opportunities

2,150

960 767

FY 2016 FY 2017 FY 2018

61 70

57

FY 2016 FY 2017 FY 2018

Creative Affordable Housing Program: New housing opportunities

1,034 2,636 2,505

2,427

2,024 2,293 3,461

4,660 4,798

FY 2016 FY 2017 FY 2018

Community support Inpatient support

Targeted Transitional Support Program: Consumers served

Creating Homes Initiative (CHI): partners with local communities to educate, inform, and expand quality, safe, affordable and permanent housing options for people with mental illness and co-occurring disorders. Notes: (1) Housing vouchers decreased during FY 2017 and FY 2018; (2) Some funding sources did not provide funding to the same providers in consecutive years; (3) Regional Housing Facilitator positions have experienced several vacancies between FY 2017 and FY 2018; all vacancies have since been filled

Creating Affordable Housing Program: supports the CHI, and is a supplemental funding grant awarded to community-based provider agencies to provide and maintain quality, affordable and safe permanent housing for people experiencing mental illness or co-occurring disorders.

Targeted Transitional Support Programs: (Community Targeted Transitional Support and Inpatient Targeted Transitional Support) provide specific, temporary financial assistance that help consumers successfully transition to independent living in the community by providing funding for rental deposits and assistance, utility deposits and assistance, vision and dental care, and other needs.

1,335

1,747

675 51%

1,665 95%

0

500

1,000

1,500

2,000

FY 2016 FY 2017

Referred to mental health servicesAttained mental health services

265

1,658

113 43%

944 57%

0

500

1,000

1,500

2,000

FY 2016 FY 2017

Referred to housingAttained housing

MH need 2: Projects for Assistance in Transition from Homelessness (PATH) includes linkage to mental health, substance abuse and housing services

11

Data source: Projects for Assistance in Transition from Homelessness Data Exchange, FY2016-FY 2017 (FY 2018 data not available at this time).


6,246

3,775

2,019 32%

2,433 64%

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

FY 2016 FY 2017

ContactedEnrolled

PATH Consumers

Mental Health Services Substance Abuse Services

Housing Services

127

251

88 69%

158 63%

0

100

200

300

FY 2016 FY 2017

Referred to substance abuse treatmentAttained substance abuse treatment

MH need 3: Increase reliable transportation to and from treatment and recovery services

12

• January 1, 2018: non-emergency transportation was added to the Behavioral Health Safety Net (BHSN) of Tennessee as a Pilot Project.

• The service provides transportation for BHSN of TN enrollees for the purpose of accessing treatment and recovery services covered by BHSN of TN.

• Mode of transportation used will be determined by the enrollee’s BHSN of TN provider.

• Eleven months of data (Jan-Nov 2018) show that there were over 10,000 services provided to over 2,800 individuals. There was an average of 4 service units per client for this service during this time period.

• The pilot project will be evaluated through June 2019.

Data source: TDMHSAS BHSN


MH need 3: BHSN transportation to and from treatment and recovery services added in 2018

13

Approved modes of transportation for the BHSN of TN include: • BHSN of TN contracted provider vehicles to transport; • Public transportation such as buses or taxis services; • BHSN of TN providers contracting with community transportation vendors; • Reimbursement to enrollees for gasoline; • Reimbursement to others, such as family, friends, and neighbors for transport; • BHSN of TN contracted provider staff may use their personal vehicles if the following

conditions are met: (a) staff must have a class D license with an F endorsement, and (b) staff must have a copy of their current full coverage vehicle insurance on file at the agency.

Transportation is reimbursable based on the following three criteria:

• there is no other payment source for this service; • the BHSN of TN enrollee has no other reliable transportation alternative; and • enrollees must be receiving another BHSN of TN service as transportation is not a stand-alone

service.

Data source: TDMHSAS BHSN


MH need 4: Increase Peer Recovery Services and Specialists

14

• The RMHI Peer Engagement Program places Certified Peer Recovery Specialists (CPRSs) employed by the Tennessee Mental Health Consumers’ Association (TMHCA) in each of the four RMHIs.

• The CPRSs provide peer support both inside and outside of the hospital, maintaining a caseload of individuals that they assist in the community after discharge which includes providing help with overall autonomy and resources such as insurance, housing, and employment overall autonomy.

• In FY 2018, the CPRSs provided peer support to 276 individuals in the community following discharge from an RMHI.

• The CSU Peer Link program places CPRSs employed by the Tennessee Mental Health Consumers’ Association (TMHCA) in Crisis Stabilization Units. This program was expanded in FY2019 so that all 8 CSU’s now offer peer support services.

• Peer staff in Region 3’s nine Peer Support Centers regularly offer the following evidence-based wellness curricula to individuals with mental illness to help address health disparities:

– Chronic Disease Self-Management Program – Diabetes Self-Management Program – Chronic Pain Self-Management Program – Tobacco Free Workshop – Well Body Workshop – Whole Health Action Management (WHAM)

Data source: Office of Consumer Affairs and Peer Recovery Services


FY 2017 and FY 2018 Substance Abuse Needs

15 Ellen Omohundro, Ph.D., 12/13/2018 Office of Research

1. Increase recovery housing for individuals with substance abuse disorders – Regions 1, 2, 3, 4, 5 and Adult Committee

2. Increase transitional housing for individuals with

substance abuse disorders – Regions 1, 2, 3, 5, 6 and Adult Committee

3. Increase residential and detox beds including

adolescent residential programs – Regions 2, 4, 5, 6, 7 and Children’s Committee

4. Increase programs for at-risk youth – Regions 1, 3, 7 and Children’s Committee

Identified substance abuse services (SAS) needs in FY 2017 and FY 2018:

Substance abuse services needs overview


Office of Research

SAS need 1: Increase appropriate recovery and transitional housing for individuals with addiction and/or co-occurring diagnosis leaving treatment

• Oxford House – The Oxford House Housing Program (OHHP) is one through which Oxford

House International, a non-profit umbrella organization for all Oxford Houses, develops statewide networks of self-run, self-supported recovery homes.

• Transitional Housing – housing that is required on a transitional basis to support the service

recipient during his or her treatment and/or recovery phase. – must be community based, safe, and drug and alcohol free. – the service must be governed or staffed to assure a safe and drug free

environment. – facilities must meet all local housing codes, TDMHSAS licensure rules (if

applicable), and have adequate liability insurance. – Transitional housing was added to Opioid State Targeted Response

Addiction Recovery Program in Year 2


Office of Research


18

• Oxford Houses across the State of Tennessee have a total capacity of 507 beds available for individuals with addiction and/or co-occurring diagnosis.

Data source: Division of Substance Abuse Services, TDMHSAS & oxfordhouse.org

89 163

248

328

435 507

0

200

400

600

Dec 31 Dec 31 Dec 31 Dec 31 Dec 31 Jun 30

2013 2014 2015 2016 2017 2018

Capa

city

(bed

s)

Oxford House Capacity




Office of Research

Map Legend

Counties with Oxford Houses 78 Number of houses

Follow this link for the Oxford Houses of Tennessee – Directory: http://www.oxfordhouse.org/pdf/tn_directory_listing.pdf

507 – Total capacity of Oxford Houses in Tennessee

http://www.oxfordhouse.org/pdf/tn_directory_listing.pdf


Office of Research

Addiction Recovery Program agencies that have transitional housing

• Buffalo Valley • Cocaine Alcohol Awareness Program • CrossBRIDGE, Inc. • Downtown Memphis Ministries DBA • E & C Housing/Grandpa's House • Father's House Mission • FOCUS Group Prison Ministries • Fresh Start Center • Greater Faith Community Action Corp • Hope Center Ministries • Hope of East Tennessee • Journey With Jesus • Life Changers • Lighthouse Mission Ministries • M.I.N.C. • Mending Hearts • Next Door Inc. • PATCH

• Phases, Inc. • Philadelphians Prison Ministries • Phoenix Rising • Recovery Community Inc. • Room in the Inn • Synergy Foundation, Inc. • Teen Challenge of Memphis • Tennessee Valley Teen Challenge • Transitions Halfway Ministries • Trinity Community Coalition • Turning Point Recovery Residence • Urban Family Ministries CDC • Wade Harvest Ministries • Warrior Centers • Welcome Home Ministries • Women Ablaze Ministries • WOW Transition House Inc. • Young Women's Christian Association

Funding increased from $400,000 in FY 2018 to $800,000 in FY 2019 for medically managed withdrawal management (Level IV).

SAS need 3: Increase residential and detox beds including adolescent residential programs

21

Data source: Division of Substance Abuse Services, TDMHSAS

Detox Type FY 2016 FY 2017 FY 2018

Crisis detox 1,911 2,237 2,075

Level IV detox 130 124 220

Total 2,041 2,361 2,295


SAS need 4: Increase programs for at-risk youth

22

*For more information, see https://www.tn.gov/behavioral-health/article/Crisis-Detoxification Data sources: Office of Licensure, Division of Administrative and Regulatory Services; Division of Substance Abuse Services, TDMHSAS

For adolescents who have a primary or secondary alcohol or other drug abuse or dependency diagnosis or co-occurring substance use and psychiatric diagnosis, treatment is available. For youth in need of substance abuse treatment, adolescent services are available through: • Residential services: provided in a residential setting and include treatment

sessions as well as education (funding for residential services has fluctuated over the past four years).

• Outpatient services: regularly-scheduled sessions of usually fewer than nine hours each week.*

Dotted line = projection


856 697 695 700

0

200

400

600

800

1000

FY 2016 FY 2017 FY 2018 FY 2019

Adolescent treatment (Outpatient, Day/Evening, Residential Treatment)

Number served

https://www.tn.gov/behavioral-health/article/Crisis-Detoxification





SAS need 4: Increase programs for at-risk youth

o Substance Abuse Prevention Coalitions (46 county coalitions) Universal interventions – designed to reach entire groups or

populations Community based strategies that focus on reducing:

o Non-medical pain reliever use o Binge and underage drinking o Underage tobacco use

o Tennessee Prevention Network (25 providers) Selective interventions- programming targeting at-risk populations

o Evidence-based individual based strategies

Indicated interventions – target individuals who show signs of being at risk for a substance use disorder

o Evidence-based individual based strategies


Office of Research

FY 2017-FY 2018 Needs Assessment Data Report · Data update for needs identified in FY 2017 and FY...

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