Department of Mental Health and Addiction Services,

A Healthcare Service Agency

At a Glance

PATRICIA A. REHMER, MSN Commissioner

Ezra Griffith M.D., Acting Medical Director

Established - 1995 [1]

Statutory authority - CGS Sec. 17a-450

Central office - 410 Capitol Avenue, 4th Floor,

P.O. Box 341431

Hartford, CT 06134

Number of employees (full and part-time) - 3,693

Recurring operating expenses - $701,082,785

Organizational structure -

The organizational structure of the Department of Mental Health and Addiction Services (DMHAS) emphasizes results-based accountability through the Offices of the Commissioner, Medical Director, Chief Financial and Operating Officer, Affirmative Action, Education/Training, Evaluation/Quality Management and Improvement, Forensic Services, Healthcare Finance, Healthcare Systems, Human Resources, Information Systems, Legal/Ethics Compliance, Legislation and Policy, Military Support Services, Multicultural Affairs, Planning Analysis/Support, Prevention and Health Promotion, Recovery Community Affairs, Safety Services, Statewide Services, and Young Adult Services.

Mission

DMHAS is a healthcare service agency responsible for health promotion, and the prevention and treatment of mental health and substance use disorders in Connecticut. The single overarching goal of DMHAS is promoting and achieving a quality-focused, culturally responsive, and recovery-oriented system of care. The mission of DMHAS is to improve the quality of life for Connecticut residents by providing an integrated network of comprehensive, effective and efficient mental health and addiction services that foster self-sufficiency, dignity and respect.

Statutory Responsibility

While DMHAS' prevention and health promotion services serve all Connecticut citizens, its mandate is to serve adults (18 years and over) with mental health and/or substance use disorders, who lack the financial means to obtain such services on their own. DMHAS also provides collaborative programs for individuals with special needs, such as persons with co-occurring mental health and substance use disorders, people in the criminal justice system, those with problem gambling disorders, pregnant women with substance use disorders, persons with traumatic brain injury, National Guard/Reserve members and their families, and young adult populations transitioning out of the Department of Children and Families.

Public Service

DMHAS continually works to enhance the effectiveness of our services, including ongoing compliance with the highest national standards of behavioral healthcare through accreditation by the Joint Commission across all its state-operated facilities. DMHAS’ Division of Healthcare Systems is charged with integrating mental health and addiction services, enhancing service access and continuity of care, and ensuring quality service delivery and compliance with applicable state and federal regulations. Healthcare Systems focuses on quality improvement, through on-site monitoring visits to contracted treatment agencies, desk audits of compliance with utilization and outcome/performance measures, and focus groups with individuals served. Quality and performance is also measured through the DMHAS Division of Evaluation, Quality Management, and Improvement. The division is charged with establishing performance measures, collecting and reviewing performance data, developing and disseminating provider report cards, and ensuring annual consumer satisfaction surveys are completed.

Improvements/Achievements 2009-10

In addition to the Department’s overarching goal of building a Value-Driven, Recovery-Oriented System of Care, DMHAS measures its accomplishments in terms of progress made toward achievement of its four targeted goals. Each of the goals is presented below, followed by a few examples of the many initiatives DMHAS is pursuing to fulfill these goals.

1. Improved Service System— Providing a Comprehensive Array of Services that Promote Health, Economic Opportunity, Social Inclusion and Sustain Stability in Individuals’ Lives.

• Military Support Program (MSP). Expanded the MSP statewide clinical panel to 400 clinicians who have been trained to provide outpatient counseling services to Connecticut National Guard/Reserve members and their families; and Embedded 25 licensed clinicians, who serve as a visible and familiar resource through provision of valuable behavioral health information and as the key point of contact for timely access to services, within 23 National Guard units that have been or will soon be affected by deployment(s) in Operations Enduring and Iraqi Freedom.

• Alternative to Incarceration/Reduction in Recidivism. Continued training law enforcement personnel on working effectively with persons with psychiatric disorders, with 755 officers from over 60 departments trained since 2004; and Implemented the Residential Supports Program, which provides housing case management to individuals with behavioral health disorders involved in the criminal justice system to improve their ability to live successfully in the community.

• Access to Recovery (ATR) Program. Continued to provide clinical and recovery support services to the most vulnerable populations with substance use disorders. Innovative clinical treatment such as Buprenorphine Treatment, Co-occurring Residential Treatment, and Co-occurring Intensive Outpatient Treatment were heavily utilized throughout the grant year. Recovery support services such as housing assistance, case management and transportation were utilized by the majority of recipients.

• Cultural Competence/Health Disparities. Secured funding from the Connecticut Health Foundation, in collaboration with the Yale Program for Recovery and Community Health, to develop and test a cultural competence system change intervention; Completed qualitative study in which 25 focus groups were conducted to explore experience of consumers/individuals in recovery with care and the ways in which culture was incorporated into care or not; and Submitted two articles for publication, one addressing health disparities in inpatient mental health settings and the other summarizing findings from the qualitative study discussed above.

• Community Living Opportunities. Developed new community living services and supports to transition individuals across the DMHAS inpatient service system who were clinically ready for community living, resulting in thirty-eight (38) individuals being discharged to the community with these new resources.

• Community Support Program (CSP)/Recovery Pathways (RP). Initiated conversion of mental health case management to CSP/RP services, which will result in increased focus on skill building interventions and activities, facilitating connections to the individual’s community recovery supports, and emphasizing the individual’s choices, goals and recovery path.

• Prevention/Health Promotion Strategies. Improved data quality and increased use of environmental strategies across DMHAS-funded prevention programs; Supported a State Epidemiological Outcomes Workgroup to review state and community substance abuse data, track data trends and generate information to strengthen prevention efforts; and Reduced minors’ access to tobacco by conducting inspections of tobacco outlets, increasing community awareness programs, and providing multiple mechanisms for public input into DMHAS’ tobacco prevention activities and plan.

2. Quality of Care Management—Managing by Outcomes, Expanding Continuing Care Recovery and Effective Service Models.

• Veterans Jail Diversion Program. Established jail diversion and trauma recovery services for veterans in the Norwich/New London Courts. The planning process focused on substantive systems integration that resulted in a unifying memorandum of agreement signed by 29 agencies representing multiple systems, including judicial, law enforcement, state agencies, veteran administration, Vet centers, Department of Defense, and community providers.

• Co-Occurring Disorders. Converted 10 beds at DMHAS’ Southwest CT Mental Health System facility to a co-occurring enhanced inpatient program for individuals with severe mental illnesses and substance use disorders; Added 8 agencies (4 Local Mental Health Authorities and 4 chemical maintenance programs) to the DMHAS Co-Occurring Improvement Collaborative for a total of 30 DMHAS-operated and funded agencies actively working to increase their capacity to serve individuals with co-occurring disorders; Collaborated with Department of Social Services and providers to complete a new policy for integrated treatment of adults with co-occurring disorders served in Medicaid Enhanced Care Clinics; and Received a SAMHSA Science/Service Award for exemplary implementation of an evidence-based intervention, Integrated Dual Disorder Treatment, at DMHAS’ CT Mental Health Center’s Hispanic Clinic for Latinos/as.

• Supported Education. Expanded the provision of Supported Education Services to individuals with prolonged mental illness across DMHAS’ five behavioral health regions; and Formed the Supported Education Advisory Committee, to identify educational needs for persons in the DMHAS system and to develop collaborative approaches to supporting students with behavioral health disorders.

· Employment Supports. Assisted 11,000 Individuals in Recovery to become employed; Implemented an innovative addictions employment model in partnership with the Alcohol and Drug Recovery Center and the Connecticut Community for Addiction Recovery, that developed meaningful employment for 50% of the 358 program participants; and Secured vocational training, through the federally funded Access to Recovery Program, for more than 1,000 persons across the State.

· Women’s Service’s Practice Improvement Collaborative. Continued to implement gender responsive programming and trauma-informed care in seventeen (17) of DMHAS’ Women and Children programs. Expansion efforts are underway to replicate this initiative at other provider sites.

· Mental Health Waiver. Provided intensive Home and Community services to individuals residing in nursing homes or who are at-risk of entering nursing homes, resulting in approximately 50 individuals successfully living in the community; and Diverted over 90 individuals from entering nursing homes and discharged over 60 individuals to less restrictive settings.

• Recovery Specialist Voluntary Program. Maximized use of resources across DMHAS, the Department of Children and Families, and the Judicial Branch through this joint initiative that intervenes with families in crisis, improves safety, and increases permanency of children removed from their homes due to parental substance abuse.

• Ease System Gridlock/Alternative to Hospitalization (ATH) Program. Continued the ATH Program, which diverts individuals with substance use disorders who present in emergency departments and decreases number of admissions to acute inpatient mental health services; and Implemented the Disposition Team Program to assist providers with expediting timely and successful discharge plans for individuals admitted to acute inpatient psychiatric care. Both are examples of DMHAS’ reinvestment strategy, which identifies innovative and cost-effective approaches and reinvests savings to further support a recovery-oriented system.

• Consumer Surveys. Received over 25,000 Consumer Surveys indicating that the majority of individuals are satisfied with services provided or funded by DMHAS.

• Provider Report Cards. Implemented Provider Report Cards, as a provider performance management tool that includes key outcome data at both the agency and program level.

• Projecto Nueva Vida (Project New Life). Selected by the Community Defined Evidence Project as one of the six top culturally competent programs in the U.S., Projecto Nueva Vida enhances treatment opportunities for Latinos/Latinas with behavioral health conditions.  

3. Workforce and Organizational Effectiveness– Investing in People who Provide Consumer-friendly, High Quality Services.

· Veterans Resource Representative Training Program. Trained 150 DMHAS clinicians in the clinical needs of returning veterans; health care services, eligibility criteria, key points of contact and referral methods for accessing services through the U.S. Department of Veterans Affairs and Vet Center systems; and state and federal veterans benefits in order to improve clinicians’ ability assist veterans in treatment and service planning.

· Information Systems. Implemented a new web-based provider data system that is in full compliance with the federal National Outcome Measures; Upgraded the DMHAS state-operated behavioral health information system to Avatar, which is a superior cost-effective, HIPAA compliant solution; Initiated the upgrade of DMHAS’ file, print and email services from Novell to Microsoft, the State of Connecticut enterprise standard; and Procured for a prevention data system that collects and manages substance abuse prevention services data and supports performance-based outcome measurement.

• Project for Addictions Cultural Competence Training Project (PACCT). Continued to address workforce issues through the PACCT Program, a workforce development program designed to increase the number of minorities working in the addictions field, which resulted in 13 participants being hired or promoted within the addiction field.

• Prevention Workforce Development. Trained over 728 participants on a variety of prevention topics; and Provided professional development opportunities for two undergraduates who aspired to be substance abuse prevention specialists through the federal Center for Substance Abuse Prevention Fellowship Program.

4. Resource Base–Creating a Resource Base to Support Service Goals, Expansions and Fiscally Sound Investments in Workforce, Technology and Information Through Emphasis on Collaboration and Excellence in Communication.

· Collaborations and Partnerships. DMHAS takes pride in the many interagency initiatives and public/private and academic collaborations that improve care for thousands of people in Connecticut. Examples include: Cultivated respectful alliances with 29 distinct agencies representing several systems in launching the federally funded Connecticut Jail Diversion and Trauma Services Initiative; and Partnered with the Department of Social Services, Department of Labor, Workforce Investment Boards, Bureau of Rehabilitation Services, and DMHAS employment providers on a Medicaid Infrastructure Grant-funded pilot employment program focused on promoting workforce development opportunities for tenants of supportive housing. Additional collaborations can be found on the DMHAS website at www.dmhas.state.ct.us.

• Grants Development. Partnered with state agencies, providers, recovery communities, and academics in developing approximately $20M in new proposals currently pending federal review; Awarded a 5-year $11.5 million federal grant to help achieve a targeted decrease in alcohol consumption by youth ages 12-17 and 18-20; and Awarded a two-year $375,000 grant to enhance the Connecticut Statewide Healthy Campus Initiative, a coalition of representatives from college campuses, state departments, and community organizations across the state who began meeting in an effort to change aspects of campus and community environments that contributed to high-risk drinking and other drug use.

• Housing Development. Continued to house 900 formerly homeless individuals and their families with mental health and substance use disorders through a $10M federal HUD grant; Increased our supportive housing inventory by adding nearly 50 units; Funded four new supportive housing projects, in coordination with the Interagency Committee on Supportive Housing; and Expanded Housing Assistance Fund to two additional populations, young adults entering the DMHAS system and clients of the forensic unit.

Information Reported as Required by State Statute

Affirmative Action Annual Plan. DMHAS annually prepares and submits its Affirmative Action Plan to the Connecticut Commission on Human Rights and Opportunities each January 30^th for approval.

Connecticut Alcohol and Drug Policy Council. On or before January 15^th of each year, the Council, Co-Chaired by DMHAS, is required to submit a report to the Governor and the General Assembly that evaluates substance abuse prevention and treatment services and the policies pertaining to these programs and services.

Allocation of Federal Funds by Department. DMHAS is charged with reporting its findings regarding the disposition of allocations on or before January 1^st of each year to the Governor and the General Assembly along with the Department’s recommendations pertaining to executive and legislature action(s) as it finds beneficial to the public interest.

Substance Abuse Treatment Programs for Pregnant Women and Their Children. On or before November 13^th, annually, DMHAS is required to submit a report to the joint standing committee of the General Assembly detailing treatment availability for pregnant women.

---

[1]Merging the former Department of Mental Health (established 1953) with the Addiction Services component of the Department of Public Health and Addiction Services.