Fiscal Year 2004 Proposed Budget

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DEPARTMENT OF HUMAN SERVICES
CHILD AND FAMILY MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT SERVICES

PROGRAM MISSION: To promote the emotional/psychological well being of children and families, develop their capacity for healthy, adaptive functioning, and prevent the progression of mental health and substance abuse disorders by providing accessible, high quality therapeutic services to families with the most severe or persistent impairments or the most limited resources.

Services are targeted for families of children and adolescents with serious emotional disturbance as well as those at risk due to trauma or parental impairment. Services are also targeted for families of adolescents experiencing substance abuse problems and of children who have been negatively impacted by the substance abuse of a parent or caretaker. Services include:

• Assessment: diagnostic mental health and substance abuse evaluation, psychological testing, psychiatric/medication evaluation.

• Outpatient Treatment: individual, group or family therapy, medication monitoring, psychoeducation, urinalysis monitoring, limited respite services; specialized assessment and treatment for youth with sexually inappropriate or aggressive behaviors.

• Professional Consultation and Care Coordination: consultation and collaboration provided to other child-serving agencies and community providers to increase awareness of mental health and substance abuse treatment needs of children and families and to develop effective interagency strategies for prevention and management.

To expand the continuum of care for children's mental health and substance abuse treatment, more intensive services are provided when weekly outpatient treatment is insufficient in bringing about stability within the home or community. These alternative treatment models are used to prevent the out-of-home placement for the most seriously impaired youth and for those returning to the community from residential or hospital care. Services are short-term and intensive and include:

• Intensive Home-based Services: mental health therapy provided in the home for several hours per week; case management and coordination with other providers.

• Substance Abuse Intensive Outpatient Services and Residential Services: two to five days per week of substance abuse-specific services and time limited residential services provided through contract; case management and aftercare for the adolescent and family to support reintegration into the community.

SIGNIFICANT BUDGET HIGHLIGHTS:

• Because of state budget cuts affecting funding for the Department of Human Services, $39,227 in funding for non-mandated services was eliminated; funding was restored, however, using LPACAP revenue.

• The decrease in personnel costs, non-personnel costs, FTEs and net tax support is due to the reallocation of FTEs during a reorganization within Child and Family Services. 1.0 FTE was reallocated to Child and Family Substance Abuse Prevention and 2.0 FTEs to the In-Home Services Team. In addition, the FY 2004 proposed budget reflects elimination of 1.0 FTE funded by the SABRE grant which terminated in FY 2003, and the reallocation of a position from Mental Retardation Services in the Aging and Disability Services Division to create a Child Psychiatrist position funded by reallocating non-personnel contract funds to establish the full-time position. Aging and Disability Services will fund 30% (0.3 FTE) of this position with 0.7 FTE in this program.

• The decrease in fees is to bring the budgeted amount more in line with prior year's actuals. FY 2002 actuals include fees collected for both In-Home Services and Child and Family Mental Health. In-Home Service fees appear in a separate narrative in FY 2004, but could not be differentiated in the prior year actuals.

• The decrease in state share revenue is due to the termination of the SABRE Grant.

• 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.

PERFORMANCE MEASURES:

Child and Family Mental Health Objective: To improve the level of functioning and/or reduce symptoms in 75 percent of clients provided services.

• Total consumers served reflects only clients for whom face-to-face services have been provided (screening/assessment, treatment, case management, psychoeducation, psychological testing)and for whomindividual clinical records have been opened. The total number of family members participating in face-to-face services is not reflected.

• Benefit from services is determined by clients meeting all or most of service plan goals and/or an increase in level of functioning on standardized assessment scale, i.e. Global Assessment of Functioning Scale (Diagnostic and Statistical Manual of Disorders, Fourth Edition – DSM IV R).

• Internal standards derived from Sizing Components of Care, Sheila Pires; A System of Care for Children. Youth with Severe Emotional Disturbances; Beth Stroul, Robert Friedman, CASSP Technical Assistance Center, Center for Child Health and Mental Health Policy. This monograph describes a model system of care for children and adolescents with emotional disturbances, endorsed by the National Institute of Mental Health and Substance Abuse/Mental Health Services Administration.

Proposed Budget Contents | Section H Contents | Child and Family Services Contents