Substance Abuse and Mental Health

1. Substance Abuse and Mental Health Presentation to the FADAA/Florida Council 2011 Annual Conference August 25, 2011 David A. Sofferin Assistant Secretary Substance Abuse and Mental Health

2. Department Strategic Vision

3. SAMH Program OfficeVision • Implement 3 Managing Entities (MEs) Statewide by December 1, 2011 • Implement SAMH Finance and Service Accountability Management System • Redirect Services Funding Toward Evidence-based Practice By July 1, 2013 (SA, MH, and Co-occurring) • Metrics And Performance Driven Decision-making • Reduce Duplicative Administrative Structure • Mental Health Redesign • Continue Integration with Primary Health Care • Continue Integration with Child Welfare

4. Reorganization of the Substance Abuse and Mental Health Office Clint Rayner Consumer & Stakeholder Senta Goudy Suicide Prevention • State Operated State Mental Health Treatment Facilities • Privatized State Mental Health Treatment Facilities • Sexually Violent Predator Program • Performance Improv./CQI (metrics, data decision making) • Policy (integrated, policy decisions) • Substance Abuse Services (Science to Services – EBPs, Standards) • Mental Health Services • Contracts • Finance • Data

5. SAMH Reorganizaton • Goal: Increase quality of care for individuals and families with substance abuse and mental health disorders while addressing budget cuts • Began July 2011 • Staff cut by more than 50% • Required comprehensive review of SAMH roles and responsibilities • Created six (6) regional systems of care-closed circuit SAMH offices

6. SAMH Alignment with Healthcare Marketplace • Implementation Of Managing Entities (MEs) Statewide • Redirect Services Funding Toward Evidence-based Practice • Increased Focus on Metrics and Performance Driven Decision-making • Integrated SAMH Headquarters Program Consistent with Co-Occuring Model • Increased Use of Technology – E Therapy, Telehealth Technology

7. SAMH Challenges • Prescription drug abuse continues to increase in Florida – an average of 7 persons die every day • There remains great unmet needs for SAMH Services • The rate of adverse childhood experiences is high – Family Safety served 36,000 (of those, 18,700 in out of home care) • State economic concerns is expected to impact numbers of persons needing services and our ability to help them • Siloed funding

8. Importance of Metrics Individual Level • Florida uses SAMH Information System (SAMH) to collect, maintain, and report client-level data on approximately 400,000 persons State Level • SAMHIS database provided info on performance outcome data, as required for Legislative funding. Federal Level • SAMHIS database major source for integrated SAMH Block Grant

9. Core QuestionsSAMHIS Data System • Who Receives • What Services • From Whom • Where • At What Costs • To Achieve What • Outcomes?

10. Managing Entity Background • In the past, DCF has managed as many as 535 Community Provider Contracts • In 2008, the Legislature passed a law (394.9082, F.S.) authorizing DCF to implement Managing Entities (MEs) • Today, there are three MEs operating • Suncoast - 1 contract / $138M • Southern - 1 contract / $77M • Circuit 1 - 1 contract / $27M • DCF manages three (3) contracts instead of 172 • There are four (4) Regions without MEs totaling 254 contracts / $296.6M • Procurement / Contracting process complicated and confusing • Prescriptive not Outcomes / Results Focused • High administrative fees

11. Mental Health Redesign • Civil • Forensic