MHMR of Nueces County Behavioral & Developmental Health Services

1. MHMR of Nueces CountyBehavioral & Developmental Health Services Our Mission: “Working Together for Better Lives” December 2011

2. What is MHMR? • Designated by the IRS as a “Unit of Local Government” • Created in 1969 by the Texas Health and Safety Code • 1 of 39 MHMR Centers in Texas • Sponsored by Nueces County Commissioner’s Court • Governed by a local Board of Trustees • Designated by the Texas Dept. of State Health Services as the “Local Authority” for Nueces County • Designated by the Tx. Dept. of Aging and Disability Services as the “Local Authority” for Nueces County • A provider of services for adults and children with mental illness, intellectual and developmental disabilities • 1 of 6 nationally accredited MHMR Centers in Texas

3. Board of Trustees • Vicki Garza, Chair • Carlos Vargas, Vice Chair • Dr. Tony Diaz, Treasurer • Nova Shields, Secretary • John Jackson (former Chair) • Linda Fallwell-Stover • Abel Alonzo • Harvey Salinas • John Kelley • Appointed by Nueces County Commissioner’s Court

4. Foundation Board of Directors • Tim Clower, Chair • Eve Layman, Ph.D., Vice-Chair • John Fantuzzo • Jimmy Rodriguez • Lamont Taylor • Incorporated May 1991 with the purpose to: • Assist and support the Center in raising funds to further its mission, and • Serve as a 501c3 non-profit corporation. Recognition as a non-profit of this type enables the Center to qualify for more grants, as some philanthropic foundations will not fund an entity receiving government revenue.

5. Donation Received • The Emmord Family Trust documents MHMR is to receive 40% of residual interest in the trust, and includes undivided interest in the mineral and royalties in two tracts of land in Goliad County. • MHMR’s Board of Trustees and Foundation Board approved investing 60% of donation received; and developing plan to spend 40% for services, programs and future fundraising (including establishing ongoing giving campaign)

6. Mental Health Services for Adults • Eligibility Criteria (unless otherwise specified in grant program) • Diagnosis of schizophrenia, bipolar disorder, major depression • Schizophrenia—severe brain disorder, lifelong illness; research suggests its caused by combination of genetic factors, inherited genes, & environmental factors. Can be successfully managed with medication, psychiatric care and support. • Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior. • Impact on major areas of functioning, such as work, interpersonal relations, or self care. • Major Depression –long periods of sadness, feeling hopeless, sleep disturbances, social withdrawal, appetite changes, loss of interest, thoughts of death/suicide • 15% of individuals with severe Major Depression die by suicide • Workers average 27 lost workdays per year

7. Mental Health Services • Bi-Polar Disorder--Mood disorder with alternating periods of manic episodes and major depressive episodes; genetic and environmental influences • Elevated risk of suicide • Workers average 65 lost workdays per year Services focus on “recovery” and achieving outcomes and improvements in employment, housing, substance abuse, crisis avoidance, avoiding hospitalizations and re-arrests. Recent study (Dembling) reported individuals with severe mental illness dies 19 years prematurely. The average death for the severely mentally ill population was 52 years versus the 72 years for the general population. Contributing factors: suicide; poor health habits such as smoking, obesity, alcohol abuse; presence of diseases such as heart disease and diabetes which may be undiagnosed and untreated; unavailability of services; high risk of accidental death, homelessness; victims of violence.

8. Mental Health Services for Children • Children (under age 18) with emotional and behavioral problems • Eligibility not driven by diagnosis; common diagnoses include anxiety disorders, depression, ADHD, conduct disorder • 1 in 5 children have a mental health disorder • Caused by biology and environment • Many symptoms and distress associated with childhood mental health disorders can be alleviated with appropriate treatment and support • Suicide is the 4thleading cause of death for teenagers ages 10-14 and the 3rd leading cause of death for teenagers ages 15-19 Services focus on achieving outcomes in improved school behavior, substance abuse avoidance, avoiding re-arrest and overall functioning ; and family education and support.

9. Intellectual & Developmental Disability Services • Adults and children diagnosed with intellectual & developmental disabilities: • Sub-average general intellectual functioning accompanied by limitations in communication, self-care, home living, social/interpersonal skills, work, leisure, health, safety ; or • Pervasive Developmental Disorders, including Autism spectrum disorders • Characterized by severe and pervasive impairment in areas of development: social interaction skills, communication skills. • Manage contracts to provide vocational training and employment opportunities with Corpus Christi Army Depot, Army Reserve, Tx Dept of Transportation • Advocacy organizations promote changing from “Mental Retardation” to “Intellectual & Developmental Disabilities”— “Ban the R Word” • Services focus on achieving outcomes and supporting the individual and family to achieve their dreams in employment, housing, education, independent living, reduced need for institutional care, reduced instances of abuse/neglect/exploitation.

10. Early Childhood Intervention Services • Contract with the Texas Dept. of Assistive and Rehabilitative and Services to serve infants/toddlers from birth to age 3 diagnosed with medical conditions and or developmental delays in areas of speech, gross and fine motor skills, auditory and vision, nutritional development. • Services provided in natural environment and treatment strategies are developed so families can provide intervention during routine daily activities. • Services focused on promoting achievement of family outcomes, promote development and learning, provides support to families and decrease the need for costly special programs.

11. FY 2011 Service Data • Persons served -- 9,990 Mental Health Services for Adults: 5,672 Mental Health Services for Youth: 1,042 Early Childhood Intervention Services: 1,538 Intellectual & Developmental Disability Services: 1,738 Services include: • Information & Referral * Screening /Assessment * Crisis Hotline • Case Management * Mobile Crisis Outreach * Medication Services • Counseling * Respite * Vocational Training • Employment Support * Therapy * Psychological Services • Support Services * Skills Training/Rehabilitation * Home and Community Services • Court assistance for involuntary commitments to hospitals * Peer Support • Transition to and from public school * Housing Support • Psychiatric Rehabilitation/skills training * Nutrition • Medication * Day Habilitation * Support for Veterans

12. Highlights in FY 2011 • Received Corpus Christi Independent School District’s “Partner of the Year” award for offering students in their last two years of public school, the opportunity to work on our CCAD janitorial contract. Many students retain their job post-graduation. • Recognized as “Best of the Best” for 2011 • Reduced Workers Compensation costs $90,000 from FY 2010

13. FY 2012 Budget (current) • Revenue: $16,877,102 • Expense: $17,002,102 • Board approved $125,000 from reserves for vehicle replacement & computer upgrades • Local Funds: • $969,129 from Nueces County Hospital District • $ 54,000 from City of Corpus Christi • Revenue reduced $737,408 from 2011 (primarily state general revenue , slight reductions in some grant revenue and a decrease in all Medicaid reimbursement rates) • 47 Sources of Revenue • 292 Employees • Eliminated 22 vacant positions last year

14. Current Issues • Promotion of Crisis Hotline and Mobile Crisis Outreach services to reduce arrests and emergency room visits for psychiatric issues • Continue contract with Naphcare to provide psychiatric services in the jail • In partnership with County Judge, Sheriff, District Attorney & local stakeholders, submitted funding application to Texas Dept. of State Health Services for Outpatient Competency Restoration program • With reductions in state general revenue and reduced Medicaid reimbursement rates, considering starting waiting list for state-funded services • Preparing for impact of Health care reform as an employer and as a health care provider; need enhanced business/administrative functions around billing private insurance, collections, managing denials and appeals • Increase Foundation Board membership • Accreditation visit from The Joint Commission expected May 2012