Fiscal Year 2004 Proposed Budget

Proposed Budget Contents | Section H Contents | Behavioral Healthcare Contents | Submit Comments

DEPARTMENT OF HUMAN SERVICES
BEHAVIORAL HEALTHCARE DIVISIONAL MANAGEMENT

PROGRAM MISSION: To provide leadership and management to divisional programs that promote recovery, independence, and community integration for persons with serious mental illness and substance abuse problems.

In FY 2002, the Division of Mental Health and Substance Abuse undertook a review of all adult programming to ensure that services are organized according to best practice models and in the most effective and efficient manner to meet the needs of the consumer populations served. The outcome of the organizational review was a new more integrated model for mental health and substance abuse services, including a new Medical Services Unit and Dual Diagnosis programming for those individuals with both serious mental illness and substance dependence, and a new community outreach and prevention unit within Substance Abuse Services. A new "front door" unit, Client Services Entry, has also been created for all individuals entering Mental Health and Substance Abuse Services to ensure comprehensive assessments, treatment and appropriate linkages. The Division of Mental Health and Substance Abuse services was renamed the Division of Behavioral Healthcare as of the beginning of FY 2003 to better reflect the integration of services. Full implementation of the new organizational structure will continue during FY 2003 and into FY 2004.

The objective of divisional management is to provide leadership for services in the context of the County vision and departmental mission, effectively manage divisional resources, ensure compliance with all local, state, federal and grant requirements, provide information technology and management support for management information systems, assess needs and evaluate performance, and ensure collaboration with community partners, vendors, and consumers and their families. An important function of divisional management is to provide staffing support to and implement the policies of the Arlington Community Services Board (CSB), an 18-member board appointed by the Arlington County Board as required by the Code of Virginia. The CSB provides oversight to all mental health, mental retardation and substance abuse services in the Department, regardless of what Division the service is provided in, and the Behavioral Healthcare Division Chief serves as the Executive Director for the CSB. Divisional management also serves as the liaison between the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) and the related programs in the Department of Human Services.

The following chart provides a summary of the budget for the Behavioral Healthcare Division. Expenditures are shown by broad program area.

The budget for Divisional Management includes expenditures that directly support the programs of the Division, but are budgeted centrally in administration and not allocated to the program level. In the reorganization, 4.8 FTEs administrative support staff, who provide direct administrative support to the client service programs in the areas of word processing, data entry, reception, telephone coverage, and client record maintenance, were reallocated among programs within mental health and substance abuse services. Other administrative staff in the Division are the Division Chief/ACSB Executive Director; three Management Specialists supporting the CSB, state licensing, reporting, and training functions; three information technology positions supporting the Anasazi automated behavioral healthcare system; and Management and Budget Analyst, Records Assistant, Administrative Technician, Administrative Assistant, and two Accounting Assistants responsible for fiscal management, financial processing, and records management. Two positions were allocated to divisional management for a Compliance Officer and Quality Assurance position. State-mandated data collection and cost reimbursement procedures for this Division are among the most complex in the human services arena. The Divisional management budget also includes $500,678 in program expenses that directly support the service activities of the Division, including telephones and utilities ($104,211), postage ($6,200), rental and repair of buildings ($116,637), automation ($189,415), equipment rental and repair ($11,764), security ($32,100) and other miscellaneous expenditures ($40,351).

SIGNIFICANT BUDGET HIGHLIGHTS:

• Because of state budget cuts affecting mental health, mental retardation and substance abuse funding, revenue was reduced in Divisional management ($86,570); the corresponding expenditure reductions, however, were taken elsewhere in the Division.

• Most of the decrease in non-personnel costs reflects the elimination of the state requirement for Performance Outcome Measurement reporting, which involves a loss of state grant funding of $31,927. Telephone charges were reduced by $12,728 based on actual usage.

• State share revenue is reduced due to the state budget cuts noted above. In FY 2002 the actual revenue received was $244,369, however this revenue was inadvertently credited to other mental health, mental retardation, and substance abuse programs within the Department.

• In FY 2003 the reduction in FTEs reflects a reallocation of an Administrative Assistant (1.0 FTE) to the Mental Retardation Bureau in Aging and Disability Services. In FY 2004 the reduction in FTEs reflects a reallocation of administrative support staff (4.8 FTEs) to programs in mental health and substance abuse services and the reallocation of 2.0 FTEs from mental health services (non-direct service positions) to Divisional Management to provide a Compliance Officer and Quality Assurance position.

PERFORMANCE MEASURES:

• FY 2001 third party reimbursements received includes back billings for prior years.

The reorganization of the Division has resulted in significant changes in the organization of Mental Health Services within approved FTE's and normal expenditure increases in the Division. Below is a combined Mental Health budget summary including Client Services Entry, Medical Services, Mental Health Services, and Dual Diagnosis Services. This summary shows total expenditures and revenues in FY 2002 and FY 2003 for the old organizational structure, and total expenditures and revenues for FY 2004 for the new organizational structure. Following the summary is a breakdown of program budget summaries for the old organizational structure and the new organizational structure.

SIGNIFICANT BUDGET HIGHLIGHTS:

• Due to state budget cuts affecting mental health, mental retardation and substance abuse service funding, the expenditure budget was reduced by $480,290 across a variety of mental health services. $460,290 of the cuts were restored using LPACAP funds. The remaining cut is elimination of $20,000 in consulting funds.

• Non-personnel expenses decreased due to the reduction in consulting funds noted above ($20,000), partially offset by a reallocation of $14,884 transferred from Substance Abuse to Medical Services to consolidate all medical services within one work unit.

• Non-profit expenses increased due to additional funds from the Virginia Department of MHMRSAS for residential services for the seriously mentally ill of $34,930, and the addition of 2% merit and liability insurance increases for Community Residences, Inc. of $45,061.

• Inter-departmental credit decreases due to reorganization within the Behavioral Healthcare Division. Beginning in FY 2004, all Detention Facility programs are reflected in the Substance Abuse section of the budget. This credit in previous years represents personnel cost only for the Mental Health Jail program (2.0 FTEs) and offsets the non-personnel budget.

• Fee increase reflects 1% adjustment for inflationary growth. DHS staff and the Arlington Community Services Board are undergoing a comprehensive review of all mental health, mental retardation and substance abuse service client fees, and will be developing a new fee scale based on current service costs. The review will be completed by early February.

• State share decreased by $327,187 due to state budget cuts; additional funds of $34,930 were received for residential services, representing a net loss of $292,257.

• LPACAP increased to offset the state cuts, which funded direct and contractual supportive residential services, and psychiatric medical services.

• The FTE increase reflects the net effect of internal Divisional reorganization as follows:

• 3.1 FTE Mental Health Therapist II transferred from the Substance Abuse Services (1.0 FTE) to consolidate homeless case management, (1.5 FTE) to Dual Diagnosis Services, (0.6 FTE) to Medical Services.

• 2.0 FTEs Mental Health Therapist II was reallocated from Mental Health to Substance Abuse Services to consolidate Jail Services.

• 1.0 FTE Mental Health Therapist III was reallocated from Mental Health to Substance Abuse Services for Prevention Services.

• 1.0 FTE Office Supervisor II transferred from Divisional Management to Client Service Entry.

• 3.0 FTEs Administrative Assistant III from Divisional Management to (1.0 FTE) Medical Services, and (2.0 FTE) Mental Health Services.

• 1.8 FTEs Word Processor and Records Assistant IV From Divisional Management to Client Service Entry.

• 2.0 FTEs Mental Health Therapist III reallocated to Divisional Management for Quality Assurance and Compliance.

• 1.0 FTE Mental Health Supervisor reallocated to Divisional Management for Administrative Trainer.

Below is a program budget summary that reflects the prior organization structure of Mental Health Services:

The new more integrated model for Mental Health Services includes a new Medical Services Unit and Dual Diagnosis programming for those individuals with both serious mental illness and substance dependence, and a new client services entry "front door" unit for all individuals entering Mental Health and Substance Abuse Services to ensure comprehensive assessments, treatment and appropriate linkages. Mental Health Services programs continue to include an array of outpatient treatment services, community-based programs, and residential services. The program budget summary for the new organizational alignment is below, and these programs are described in more detail in the next four program narratives.

Proposed Budget Contents | Section H Contents | Behavioral Healthcare Contents