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Mental health check: Dallas County Commissioners push for stronger mental health care
Dallas County Commissioner John Wiley Price led the team of stakeholders for a press conference on the heels of the Newtown, Conn., shootings, requesting Texas legislators to heed the critical need for funding facing the county's mental health and substance abuse treatment programs.
Price, who is Sunnyvale's commissioner, was joined by newly elected Commissioner for Precinct 1 Dr. Theresa Daniel and state Senator Royce West, along with other county leaders. With extensive experience in public affairs and in program evaluation and accountability with DISD, Daniel will co-chair the Dallas County Behavioral Health Leadership team.
"I look forward to learning more and being a part of this critical committee in Dallas County," Daniel said.
The recent tragedy in Newtown, Conn., shocked the nation and has renewed the debate about gun control in America. According to Dr. E. Fuller Torrey, president of Treatment Advocacy Center, 50 percent of these incidents have been carried out by persons with a severe and persistent mental illness.
The Dallas County Behavioral Health Leadership Team (BHLT) joins other stakeholders in urging the Texas Legislature to focus not on gun control as a response to the Newtown and prior tragedies, but on the need for adequate mental health and substance abuse funding across the state and specifically in Dallas County and the rest of the NorthSTAR service area, which also includes Collin, Rockwall, Navarro, Kaufman, Hunt and Ellis Counties. The Dallas County BHLT was created by the Dallas County Commissioners Court on Jan. 11, 2011, to be the single point of accountability, planning, oversight and funding coordination for all Dallas County mental health and substance abuse services and funding streams.
The BHLT, led by Price, evolved from a task force created in September 2009 and includes broad representation from consumers, service providers, advocates and other stakeholders.
In 2010, Texas spent $38.99 per person on mental health services, compared to the national average of $125 per person. Texas ranks 49th among the states in mental health funding, ahead of only Idaho. This low level of funding has hit Dallas County and the surrounding six NorthSTAR counties particularly hard, according to Dallas County officials. In 1999, there were 12,000 adults and children who received services in the NorthSTAR area. In 2011, that number had increased to 73,125.
Funding has not kept up with the increase in need, officials added. In 1999, NorthSTAR was funded at $2,500 per year per person served; in 2011, the per-year, per-person average had dropped to $1,534. Outside the NorthSTAR region, the average funding per person served in 2011 was $3,559.
NorthSTAR now serves 24 percent of the statewide population needing mental health and substance abuse services, but it receives only 13 percent of the statewide funding.
The NorthSTAR system is also facing barriers to full participation in the Medicaid 1115 Transformation Waiver currently being implemented in Texas. This "1115 Waiver" provides a new mechanism to increase federal funds matching for services and is expected to make significant additional funding available. Due to the unique managed-care arrangement, the seven NorthSTAR counties were not allowed to participate in the 1115 Waiver at the same level as the rest of the state.
The NorthSTAR system was implemented in 1999 as a pilot program of integrated funding and managed care delivery of mental health and chemical dependency services to adults and children. NorthSTAR is comprised of Collin, Dallas, Rockwall, Navarro, Kaufman, Hunt, and Ellis counties and combines local, state and federal funding into a single program budget. Medicaid and medically indigent individuals are eligible for mental health and chemical dependency services provided by a single behavioral health organization (BHO), Value Options, which manages a network of providers located throughout the NorthSTAR region.
The NorthSTAR program is governed by the North Texas Behavioral Health Authority (NTBHA), with members appointed by the Commissioners Courts of participating counties.
The Dallas County BHLT joins other stakeholders in calling for increased funding for mental health and substance abuse services statewide, including funding for transitional and permanent supportive housing for persons with serious mental illness, and other programs that promote recovery and reduce repeat offenses.
"The state's investment in funding for treatment of mental health and substance abuse disorders more than pays for itself in reduced costs and increased revenues and produces excellent returns on the commitment of public resources," said economist Ray Perryman.