Missouri Department of Mental Health FY 2021 Budget Governor Recommends Book 1

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by  Missouri Department of Mental Health

FY 2021 BUDGET
MISSOURI DEPARTMENT OF
GOVERNOR
MENTAL
RECOMMENDS
HEALTH
Departmentwide &
Office of Director
(Book 1 of 3)
January 2020

DEPARTMENT OF MENTAL HEALTH
FY 2021 GOVERNOR RECOMMENDS
TABLE OF CONTENTS
DEPARTMENT INFORMATION
Department Overview ..................................................................................................................................................................... 1
Department Placemat ..................................................................................................................................................................... 2
State Auditor’s Report, Oversight and Evaluations and MO Sunset Act Reports ........................................................................... 5
SUPPLEMENTAL REQUESTS
Increase – Overtime Compensation ................................................................................................................................................. 7
Increase – Crisis Counseling Grant................................................................................................................................................... 14
Increase – Children’s Residential Rate Rebase Equity Adjustment .................................................................................................. 18
Increase – MO DD Council Authority Shortfall...................................................................................................................................... . .2..4.. .........
Increase – Provider Tax Shortfall................................................................................................................................. 31
SUPPLEMENTAL TOTALS ........................................................................................................................................................... 40
DEPARTMENT TOTALS .............................................................................................................................................................. 41
DEPARTMENTWIDE
Increase – FY 2021 Pay Plan ............................................................................................................................................................ 45
Increase – FY 2020 Cost-to-Continue Pay Plan ................................................................................................................................ 131
Increase – FY 2020 Cost-to-Continue Market Adjustment Pay Plan ................................................................................................ 218
Increase – Mileage Reimbursement ................................................................................................................................................ 245
Increase – FMAP Adjustment .......................................................................................................................................................... 283
Increase – Above and Beyond Performance Incentives ................................................................................................................... 289
Increase – DMH Utilization Increase ............................................................................................................................................... 292
Increase – Increased Medical Care Costs......................................................................................................................................... 302
Increase – Increased Food Costs ...................................................................................................................................................... 322
Increase – Crisis Counseling Grant................................................................................................................................................... 341
DEPARTMENT OF MENTAL HEALTH
FY 2021 GOVERNOR RECOMMENDS
TABLE OF CONTENTS
OFFICE OF DIRECTOR
Core – Director’s Office ................................................................................................................................................................... 346
Core – Mileage Reimbursement ...................................................................................................................................................... 356
Core – Overtime .............................................................................................................................................................................. 361
Core – ITSD ADA Federal Transfer Section ...................................................................................................................................... 370
Core – Operational Support ............................................................................................................................................................ 375
Core – Staff Training ........................................................................................................................................................................ 387
Core – Refunds ................................................................................................................................................................................ 398
Core – Abandoned Fund Transfer ................................................................................................................................................... 407
Core – Mental Health Trust Fund .................................................................................................................................................... 412
Core – Federal Funds ....................................................................................................................................................................... 417
Core – Housing Assistance ............................................................................................................................................................... 422
Core – Medicaid Payments Related to State Operated ICF/IID UPL Claim Payments ..................................................................... 432
Core – Intergovernmental Transfer/Disproportionate Share Payments ........................................................................................ 437
Core – General Revenue Transfer Section....................................................................................................................................... 442
Increase – CCBHO Earnings Federal Transfer .................................................................................................................................. 447
Core – IGT DMH Medicaid Transfer................................................................................................................................................. 450
Core – DSH Transfer ........................................................................................................................................................................ 455
Core – Legal Expense Transfer ........................................................................................................................................................ 460
OPERATING BUDGET TOTAL – Office of Director ................................................................................................................. 465
DIVISION OF BEHAVIORAL HEALTH - ALCOHOL AND DRUG ABUSE
Core – Administration ..................................................................................................................................................................... 467
Core – Prevention and Education Services ...................................................................................................................................... 478
Increase – First Responders Comprehensive Addiction & Recovery Act Grant ................................................................................ 495
Core – Treatment Services .............................................................................................................................................................. 500
Increase – CSTAR Opioid Treatment Access Cost-to-Continue ........................................................................................................ 520
Increase – DBH Medication Assisted Treatment (MAT) .................................................................................................................. 525
Increase – CSTAR Treatment Access Cost-to-Continue.................................................................................................................... 532
Core – Compulsive Gambling Treatment ........................................................................................................................................ 538
DEPARTMENT OF MENTAL HEALTH
FY 2021 GOVERNOR RECOMMENDS
TABLE OF CONTENTS

Core – Substance Awareness Traffic Offender Program (SATOP) ................................................................................................... 546
OPERATING BUDGET TOTAL – Division of ADA .................................................................................................................... 558

DIVISION OF BEHAVIORAL HEALTH - COMPREHENSIVE PSYCHIATRIC SERVICES

Core – Administration ..................................................................................................................................................................... 560
Core – Facility Support .................................................................................................................................................................... 573
Core – Adult Community Programs ................................................................................................................................................. 582
Increase – Certified Community Behavioral Health Organizations (CCBHO)................................................................................... 606
Increase – Certified Community Behavioral Health Organizations (CCBHO) Regional Certification ............................................... 615
Increase – Eastern Region Community Access to Care .................................................................................................................... 624
Core – Civil Detention Legal Fees .................................................................................................................................................... 628
Core – Forensics Support Services (FSS) .......................................................................................................................................... 633
Core – Youth Community Programs (YCP) ...................................................................................................................................... 643
Increase – Children’s Residential Rate Rebase Equity Adjustment Cost-to-Continue ..................................................................... 659
Increase – MO Healthy Transitions (MO TAY-LER) Grant ................................................................................................................ 665
Core – Medications.......................................................................................................................................................................... 670
Increase – DBH Increased Medication Costs ................................................................................................................................... 679
Core – Mental Health Trauma Treatment for Children ................................................................................................................... 694
Core – Adult Inpatient Facilities ...................................................................................................................................................... 703
Increase – Fulton State Hospital SORTS Ward Expansion Cost-to-Continue ................................................................................... 807
Core – State Operated Children’s Facility ........................................................................................................................................ 813
OPERATING BUDGET TOTAL – Division of CPS ..................................................................................................................... 831

DIVISION OF DEVELOPMENTAL DISABILITIES

Core – Administration ..................................................................................................................................................................... 833
Core – Habilitation Center Payments .............................................................................................................................................. 846
Increase – DD Provider Tax Shortfall ............................................................................................................................................... 854
Core – Community Programs .......................................................................................................................................................... 863
Increase – Dual Diagnosis Transitions from State Hospitals ........................................................................................................... 900
Increase – DD Rate Standardization ................................................................................................................................................ 909
DEPARTMENT OF MENTAL HEALTH
FY 2021 GOVERNOR RECOMMENDS
TABLE OF CONTENTS

Increase – Eliminate DD Waitlist ..................................................................................................................................................... 917
Increase – DD Market Based Rate Adjustment ............................................................................................................................... 924
Increase – DD Case Management Privatization .............................................................................................................................. 932
Increase – Southeast Autism Diagnosis Evaluations ....................................................................................................................... 954
Core – Community Support Staff .................................................................................................................................................... 963
Increase – DD Regional Office Staffing ............................................................................................................................................ 976
Core – Developmental Disabilities Act (DDA) .................................................................................................................................. 987
Increase – MO DD Council Authority Shortfall................................................................................................................................. 998
Core – Provider Assessment Transfer Section................................................................................................................................. 1004
Core – Regional Offices ................................................................................................................................................................... 1012
Core – State Operated Services ....................................................................................................................................................... 1051
Increase – Optimistic Beginnings Conversion .................................................................................................................................. 1114
Core – Tuberous Sclerosis Complex ................................................................................................................................................ 1123
OPERATING BUDGET TOTAL – Division of DD ......................................................................................................................1128

GLOSSARY ...............................................................................................................................................................................1130
Missouri Department of Mental Health
Department Overview
The Missouri Department of Mental Health was first established as a cabinet-level state agency by the Omnibus State Government Reorganization
Act, effective July 1, 1974.
State law provides three principal missions for the department: (1) the prevention of mental disorders, developmental disabilities, substance use,
and compulsive gambling; (2) the treatment, habilitation, and rehabilitation of Missourians who have those conditions; and (3) the improvement of
public understanding and attitudes about mental disorders, developmental disabilities, substance use disorder, and compulsive gambling.
The seven-member Missouri Mental Health Commission serves as the principal policy advisory body to the department director. The department is
composed of three divisions: the Division of Behavioral Health, the Division of Developmental Disabilities and the Division of Administrative
Services, as well as seven support offices.
DMH serves approximately 170,000 Missourians annually through state-operated facilities and contracts with private organizations and individuals.
The seven state-operated psychiatric facilities include inpatient psychiatric care for adults and children, as well as sex offender rehabilitation and
treatment services. In addition, four habilitation centers, three community waiver programs, one community-based crisis program, five regional
offices and six satellite regional offices serve individuals with developmental disabilities. Other services are purchased from a variety of privately
operated programs statewide through approximately 1,300 contracts managed annually by DMH.
1

MISSOURI MISSOURI DEPARTMENT OF
MENTAL
HEALTH
Department of Mental Health
12/2019 Version 4.0
We will support recovery, independence, and self-sufficiency of
ASPIRATION
Missourians with mental illness, substance use disorders and
developmental disabilities.
THEMES
Increase Increase Use of
Advance Supports
Employment Rates Building Technology Among
for Substance Use Strengthen DMH and
Among DMH Community DMH Populations,
Recovery and Contracted
Populations, Systems of Positive Fostering Increased
Decrease Opioid Workforce
Fostering Self- Behavior Supports Levels of
Deaths
Sufficiency Independence
Recovery Employment Behavior Independence Workforce Development
• Expand • Expand • Create and • Promote • Implement training
INITIATIVES
Community- Employment implement a Technology First and protocols for
based prevention First initiative new model for concept to IDD staff response to
efforts to address • Increase individuals with populations and patient/client
opioid epidemic employment complex MI-DD contractors violence
• Promote training opportunities conditions • Increase the • Develop skilled
workforce through
and education through Justice • Expand Tools of number of
DMH Academies,
programs for Reinvestment Choice Training contracted
trainings, and the
providers Initiative and usage technology
Missouri Way
addressing opioid • Increase number • Increase local providers
• Expand/develop
misuse of businesses provider • Develop
efforts to increase
• Expand trained in capacity through Implementation
staff retention
Medication First Autism friendly ECHO Autism framework for
through mentoring
treatment model practices Technology First
programs 2
MISSOURI MISSOURI DEPARTMENT OF
MENTAL
HEALTH
Department of Mental Health
12/2019 Version 4.0
• Overdose • Number • Trainings • Techfest • .• Number of
MEASURES
trainings; authorizations; completed; participants; trainings;
naloxone percent agencies podcast protocol
boxes employed competent; participants; fidelity
distributed • JRITP individuals webinar • Number of
• ECHO employed impacted participants programs;
Sessions; totals • Number of • Number of participants in
number of • Number of agencies providers programs
providers businesses competent; • Percent of steps • Staff retention
• Generation Rx number of completed
curriculum individuals
competent
• Number of
providers
3