Alabama Department of Mental Health Improves Care While Saving Tax-Payer Money

By: Terry Mitchell, Alabama Department of Mental Health

MONTGOMERY (Governor’s Office) –Over the past five years, the Alabama Department of Mental Health (ADMH) has aggressively made decisions to sustain a tradition of excellence and to provide important services to the consumers they serve. ADMH has taken innovative actions to avoid cutting services to consumers while shifting services to a less costly level of care.

ADMH has successfully managed during years of decreased funding by streamlining operations and improving efficiencies. To accomplish this, the department accelerated plans to close the last developmental center and three mental illness facilities in order to shift services to a more cost-effective system with a primary focus on community-based treatment, reducing the cost.

Given the decrease in operational functions due to facility closures, the Central Office budget and overall staffing levels underwent an extensive review in July 2012. As a result of the review, Central Office expenses were reduced and more savings were realized as every effort was made to “right size” the department.

Prevention – Funding Less Costly Services Now to Prevent More Costly Services in the Future

For individuals who struggle with substance abuse, the field of prevention science has produced effective strategies similar to those developed with other chronic health conditions. The expanded funding request addresses those areas of prevention that are a high priority. Prevention efforts support safer schools and communities, better health outcomes, and increased productivity. These programs include:

Assertive Crisis Prevention Strategies
Child and Adolescent Services including school-based services
Peer Support Services
Public Awareness and education

For individuals with intellectual disabilities, the focus is continuing to shift services to a more integrated setting in the community including:

Transitioning from sheltered workshop settings to focusing on time-limited, prevocational and employment support
Seeking grant funding to demonstrate new models for housing and employment
Expanding existing work models including Project Search and Project Gate

Prevention is the best approach to realize additional savings rather than incurring the costs related to treatment. For example, ADMH will focus on additional programs that deliver substance prevention rather than additional funds spent on addiction treatment which will result in long-term savings. The programs that treat addictions may charge an additional rate for services which will fund substance abuse prevention. Similarly, the initiatives that treat the mentally ill before they require inpatient treatment will save money. Prevention is the key to avoiding one of the most expensive services the department offers. Further integration of individuals with intellectual and developmental disabilities into “stay at home” environments is far less expensive than institutional or congregate care. These measures are more incremental and long-term but will lead to savings over a period of time.

Operational Efficiencies and Consolidation

Going forward, ADMH has a vision for a “One Campus” plan to consolidate all services into a single campus. Currently, there are four major facilities leased by ADMH as well as several smaller regional offices around the state. There are three treatment facilities in Tuscaloosa: Bryce Hospital, Taylor Hardin Secure Medical Facility and Mary Starke Harper Center for Geriatric Care. ADMH’s Central Office is located at RSA Union in Montgomery. The One Campus plan will combine all assets in Tuscaloosa to the new Bryce Campus. A new, larger secured medical facility would eliminate the number of Not Guilty by Reason of Insanity (NGRI) patients in local jails waiting for treatment. In addition, a similar facility would be included in the building plan to house those prisoners with serious mental illness or serious substance abuse challenges. Estimates show that one-third of the state’s prison population has mental illness or substance abuse issues. The Harper Center for Geriatric Care is the last of the facilities in Tuscaloosa that remains on the traditional campus of the University of Alabama. A new geriatric center would be included in the “One Campus” plan. Both, the Harper Center and Taylor Hardin require more maintenance due to their age, the newest of which is more than 35 years old.

The “One Campus” plan will consolidate the functions of maintenance, food services, information technology and security resulting in long-term cost savings. The management efficiency of consolidation will also save dollars, as well as improve the delivery of services. This plan will take approximately ten years to complete and will require the coordination of multiple agencies and institutions within the state.

More information about the Alabama Department of Mental Health can be found at their website: http://mh.alabama.gov/.

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