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Print Version (PDF format)
SECTION G -- HUMAN SERVICES
BEHAVIORAL HEALTHCARE SERVICES
MENTAL HEALTH
SERVICES
PROGRAM MISSION:
To prevent psychiatric hospitalization and to promote mental and
emotional stability, recovery and optimum independent living of Arlington
residents with serious and persistent mental illness.
The programs in
this continuum of care are described below.
-
Community
Support Team Services assist adults with serious and persistent mental
illness to assume their maximum level of functioning, minimize symptoms, reduce
frequency of hospitalizations and enhance their recovery. Services provided include initial and
ongoing assessment, case and care management services, individual therapy,
specialized psychological testing, psychosocial-educational groups, and family
support and education. In addition, intra-agency
services, such as individual therapy, consultation and psychological testing
are provided to individuals served by the Aging and Disability Services
Division (Mental Retardation Bureau).
Staff is organized into two teams, composed of case manager/therapists,
clinical psychologists and residential support workers. Nurses and psychiatrists from the Psychiatric
Services unit are linked with each team. Students from Masters and Ph.D. level
programs participate on the teams by providing direct clinical services under
the supervision of a licensed clinician.
Team clinicians work closely with the Client Services Entry unit and discharge
planners in the psychiatric hospitals, the Arlington County Detention Center (ACDF)
and the Residential Program Center (RPC) to ensure continuity of services.
-
Program
of Assertive Community Treatment (PACT) Services promotes independent living in
the community for persons with the most severe and persistent mental
illness. Services are available 24
hours per day, seven days per week. A multidisciplinary
team provides outreach, intensive case management, residential supports,
substance abuse assessment and treatment, physical and psychiatric assessments,
prescriptions, monitoring of psychotropic medications, employment assistance,
crisis intervention, counseling, and linkage to rehabilitation services. Close collaboration with families and an
array of community agencies is a hallmark of PACT. All services are geared toward increasing tenure in the community,
stabilizing psychiatric symptoms and improving the quality of life for
identified high need, high-risk consumers.
-
Clarendon House is
a Commission on Accreditation of Rehabilitation Facilities (CARF)-accredited
program that provides a wide range of psychosocial rehabilitative services for
adults with serious mental illness. The
Clarendon House program mission is to promote the highest level of community
integration and independence for each participant and prevent psychiatric
hospitalizations. The program focuses
on helping each individual to develop the ability to lead an independent and
productive life. Services include a
work-oriented day program, outreach, medication and education, supportive
counseling, family support, crisis intervention, vocational opportunities, case
management and support services. To
better integrate service delivery, there is a case management team within the
psychosocial staff to provide comprehensive services, including assistance with
housing resources, medical attention, financial entitlements, clothing
resources and numerous other services.
Clarendon House has an agreement with the Northern Virginia Mental
Health Institute to provide continuity of care services for Arlingtonians who
are currently in the hospital by allowing them to attend the Clarendon House
program prior to discharge.
-
Employment
Services provide employment opportunities in the community for adults experiencing
serious mental illness, through an array of supportive, comprehensive and
integrated services based on individual choice. Job Avenue is a CARF-accredited program that offers work
preparation training, situational assessments, job development, placement and
training, and follow-along services.
Job Avenue staff also oversee enclave and individual placement contracts
with SOC Enterprises, Inc. and Mount Vernon Lee Enterprises, Inc., as well as
the Clarendon House Transitional Employment Program (TEP). The Job Avenue is
approved by the Social Security Administration to be part of the Employment
Network Program through the Ticket -to-Work Initiative.
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Residential
Services promotes successful community living, fosters maximum independence
and prevents psychiatric hospitalization for adults with serious mental
illness. Private vendors who assist in
the community stabilization process operate a continuum of services ranging
from highly intensive to supportive care.
These services include group homes, assisted living facilities, and
community alternatives for psychiatric emergencies. Crisis stabilization services provide short-term interventions in
a special community-based setting for persons experiencing acute psychiatric
distress. Other components include
transitional housing for homeless persons with serious mental illness, a
residential support program and a supported independent apartment program.
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Program Budget
Summary
|
|
FY 2004
|
FY 2005
|
FY 2006
|
% Change:
|
|
Actuals
|
Adopted
|
Proposed
|
'05 to '06
|
|
Community Support
|
$1,486,939
|
$1,612,519
|
$1,569,124
|
-3%
|
|
Clarendon House
|
690,057
|
567,622
|
580,504
|
2%
|
|
PACT Team
|
692,465
|
686,367
|
707,610
|
3%
|
|
Residential
Services
|
1,903,389
|
2,158,005
|
2,204,621
|
2%
|
|
Employment
Services
|
188,268
|
270,788
|
272,425
|
1%
|
|
Project Resilience
|
1,083,268
|
-
|
-
|
-
|
|
Total Expenditures
|
6,044,386
|
5,295,301
|
5,334,284
|
1%
|
|
|
|
|
|
|
Revenues
|
4,642,767
|
3,001,849
|
3,445,234
|
15%
|
|
Net Tax Support
|
$1,401,619
|
$2,293,452
|
$1,889,050
|
-18%
|
-
Project Resilience was a federally-funded program which
provided crisis assistance counseling during FY 2002 through FY 2004.
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Mental Health
Services
|
|
FY 2004
|
FY 2005
|
FY 2006
|
% Change:
|
|
Actuals
|
Adopted
|
Proposed
|
'05 to '06
|
|
Personnel
|
$3,637,332
|
$2,806,374
|
$2,775,040
|
-1%
|
|
Non-Personnel
|
463,390
|
298,938
|
344,812
|
15%
|
|
Nonprofits
|
1,943,665
|
2,189,989
|
2,214,432
|
1%
|
|
Total Expenditures
|
6,044,386
|
5,295,301
|
5,334,284
|
1%
|
|
|
|
|
|
|
Fees
|
56,937
|
54,353
|
65,800
|
21%
|
|
Medicaid Clinic
Option
|
12,426
|
41,323
|
6,520
|
-84%
|
|
Medicare
|
34,066
|
2,000
|
31,705
|
1485%
|
|
State Share
|
2,439,014
|
2,406,756
|
2,662,030
|
11%
|
|
Medicaid State
Plan Option
|
751,175
|
489,320
|
627,131
|
28%
|
|
Federal Grants
|
61,370
|
8,097
|
52,048
|
543%
|
|
Other Grants
|
1,287,779
|
-
|
-
|
-
|
|
Total Revenues
|
4,642,767
|
3,001,849
|
3,445,234
|
15%
|
|
Net Tax Support
|
$1,401,619
|
$2,293,452
|
$1,889,050
|
-18%
|
|
|
|
|
|
|
Authorized FTEs
|
40.8
|
40.8
|
40.9
|
|
|
Funded FTEs
|
40.8
|
40.8
|
40.9
|
|
SIGNIFICANT BUDGET HIGHLIGHTS:
-
Increase in non-personnel is primarily
due to transfer of funding from nonprofits for PACT supportive client funds
($29,000) and recurring costs for an additional county vehicle for the
Community Support Teams ($19,168). The
vehicle will be transferred during FY 2005 to the Behavioral Healthcare
Division from Aging and Disability Services.
-
Increase in nonprofits is due to
the net effects of a 3% increase for vocational contracts ($3,045) additional expenses
related to the federal PATH grant ($43,951), salary and utilities increases for
residential service providers ($28,372) and reallocations within the division
to non-personnel.
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Increase in fees
($11,447) primarily due to an increase in projected adult mental health client
revenues.
-
Decrease in Medicaid
Client Option revenues ($34,803) due to reallocating revenues to other programs
within Mental Health as a result of the recent reorganization.
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Increase in Medicare revenues ($29,705) due to higher
than budgeted FY 2003 and FY 2004 revenues.
-
State share revenues increased based on current year's
allocation.
-
Increase in Medicaid State Plan Option revenues is due
to higher than budgeted FY 2003 and FY 2004 revenues.
-
Federal grants increased due to new PATH revenue
($43,951).
-
Increase of 0.1 FTE is due to net impact of
administration decentralization.
PERFORMANCE MEASURES:
Community Support Team
|
FY 2002 Actual
|
FY 2003 Actual
|
FY 2004 Actual
|
FY 2005 Estimate
|
FY 2006 Estimate
|
FY 2006 Goal
|
|
Mission Outcome Measures
|
|
|
|
|
|
|
|
Percent of
consumers employed monthly
|
40%
|
39%
|
38%
|
39%
|
40%
|
40%
|
|
Percent of
consumers hospitalized monthly
|
1%
|
1%
|
1%
|
<1%
|
<1%
|
0%
|
|
|
|
|
|
|
|
|
Customer Measure
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|
|
|
|
|
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Percent of
consumers satisfied with services received
|
90%
|
96%
|
99%
|
99%
|
99%
|
99%
|
|
|
|
|
|
|
|
|
Workload Measures
|
|
|
|
|
|
|
|
Total consumers
served
|
1,124
|
1,024
|
1,023
|
1,100
|
1,100
|
1,150
|
|
Number of consumers who received
case management services
|
691
|
613
|
622
|
625
|
650
|
650
|
|
|
|
|
|
|
|
|
Efficiency Measures
|
|
|
|
|
|
|
|
Percent of
clients (post intake) assigned to a case manager within 7 days
|
90%
|
95%
|
83%
|
95%
|
95%
|
95%
|
PACT Team
|
FY 2002 Actual
|
FY 2003 Actual
|
FY 2004 Actual
|
FY 2005 Estimate
|
FY 2006 Estimate
|
FY 2006 Goal
|
|
Mission Outcome Measures
|
|
|
|
|
|
|
|
Number/percent
of consumers employed
|
8/12%
|
10/13%
|
24/28%
|
26/29%
|
30/32%
|
33/33%
|
|
Number/percent
of consumers hospitalized post-admission to PACT
|
25/37%
|
22/29%
|
29/34%
|
28/31%
|
27/28%
|
26/26%
|
|
Number/percent
of consumers living in independent housing
|
52/76%
|
68/91%
|
82/95%
|
86/96%
|
91/96%
|
97/97%
|
|
Number/percent
of consumers in school
|
5/9%
|
6/8%
|
6/7%
|
7/8%
|
9/9%
|
10/10%
|
|
|
|
|
|
|
|
|
Customer Measures
|
|
|
|
|
|
|
|
Percent of consumers responding to a survey who
reported an increased quality of life
|
80%
|
94%
|
95%
|
95%
|
95%
|
98%
|
|
Percent of consumers satisfied with
services received
|
N/A
|
96%
|
95%
|
95%
|
95%
|
98%
|
|
|
|
|
|
|
|
|
Workload Measure
|
|
|
|
|
|
|
|
Total consumers served
|
68
|
75
|
86
|
90
|
95
|
100
|
Clarendon House
|
FY 2002 Actual
|
FY 2003 Actual
|
FY 2004 Actual
|
FY 2005 Estimate
|
FY 2006 Estimate
|
FY 2006 Goal
|
|
|
|
|
|
|
|
|
Mission
Outcome Measures
|
|
|
|
|
|
|
|
Number/percent
of members not hospitalized
|
99/81%
|
110/86%
|
115/86%
|
116/86%
|
116/86%
|
122/87%
|
|
Total number/percent
of employed members
|
31/25%
|
37/30%
|
64/48%
|
65/48%
|
66/49%
|
70/50%
|
|
Percent of employed
members who were not hospitalized
|
94%
|
84%
|
95%
|
95%
|
95%
|
95%
|
|
Number/percent
of members in Transitional Employment
|
9/3%
|
9/7%
|
10/7%
|
10/7%
|
10/7%
|
15/11%
|
|
Number/percent of
members living independently
|
67/55%
|
70/55%
|
75/56%
|
75/56%
|
78/58%
|
84/60%
|
|
Number/percent of members in college
|
5/4%
|
5/4%
|
5/3%
|
5/4%
|
5/4%
|
7/5%
|
|
|
|
|
|
|
|
|
Customer
Measures
|
|
|
|
|
|
|
|
Percent of members responding to a survey who
indicated that they were satisfied with Clarendon House services
|
78%
|
77%
|
80%
|
80%
|
85%
|
90%
|
|
Percent of members responding to a survey who state
they are more independent as a direct result of the program
|
73%
|
85%
|
85%
|
85%
|
85%
|
90%
|
|
Percent of members responding to a survey who
believed that the Clarendon House services have prevented hospitalization
|
85%
|
85%
|
85%
|
85%
|
85%
|
90%
|
|
|
|
|
|
|
|
|
Workload
Measures
|
|
|
|
|
|
|
|
Total consumers
served annually
|
122
|
128
|
133
|
135
|
135
|
140
|
|
Average daily
attendance
|
50/40%
|
51/40%
|
51/38%
|
60/44%
|
60/44%
|
63/45%
|
Number/percent of members attending social club functions
|
73/60%
|
78/60%
|
74/56%
|
85/63%
|
85/63%
|
90/64%
|
|
Number/percent of members receiving case
management
|
105/86%
|
109/82%
|
115/86%
|
117/87%
|
119/88%
|
126/90%
|
|
|
|
|
|
|
|
|
Efficiency
Measure
|
|
|
|
|
|
|
|
Percent of consumers who are placed in case management
services within 30 days of referral
|
83%
|
85%
|
100%
|
100%
|
100%
|
100%
|
|
|
|
|
|
|
|
Employment Services (Job Avenue)
|
FY 2002 Actual
|
FY 2003 Actual
|
FY 2004 Actual
|
FY 2005 Estimate
|
FY 2006 Estimate
|
FY 2006 Goal
|
|
Mission Outcome Measures
|
|
|
|
|
|
|
|
Number of all
consumers served who obtained employment in the community
|
24
|
24
|
47
|
50
|
55
|
66
|
|
Number of employed
consumers who were hospitalized
|
2
|
2
|
1
|
2
|
2
|
1
|
|
Percent of consumers placed in employment within 90 days
after receiving authorization from Va. Dept. of Rehabilitative Services (DRS)
or goal established by consumer
|
40%
|
73%
|
60%
|
70%
|
80%
|
85%
|
|
Percent of DRS consumers who remain in job
for 90 days
|
40%
|
54%
|
40%
|
50%
|
55%
|
60%
|
|
|
|
|
|
|
|
|
Customer Measure
|
|
|
|
|
|
|
|
Percent of consumers responding to a survey stating
that they are satisfied with Job Avenue services
|
95%
|
100%
|
95%
|
95%
|
95%
|
95%
|
|
|
|
|
|
|
|
|
Workload Measures
|
|
|
|
|
|
|
|
Total number of consumers served
|
79
|
84
|
102
|
105
|
105
|
110
|
|
Total number of
consumers served through Sheltered Occupational Center (SOC)
|
10
|
10
|
13
|
13
|
13
|
14
|
|
|
|
|
|
|
|
|
Efficiency Measures
|
|
|
|
|
|
|
|
Percent of
consumers who are scheduled for an intake evaluation within 45 days of
receiving a completed referral
|
0%
|
0%
|
36%
|
85%
|
85%
|
90%
|
|
Total clients authorized by DRS to receive supported employment
services
|
15
|
11
|
9
|
20
|
25
|
30
|
|
Number/percent of clients receiving situational assessments paid by DRS
|
6/40%
|
4/36%
|
3/33%
|
8/40%
|
11/44%
|
15/50%
|
|
Number/percent of clients receiving job development
paid by DRS
|
10/67%
|
7/64%
|
6/67%
|
14/70%
|
18/72%
|
23/77%
|
-
According
to Anthony, Howell and Denley in the American Psychologist journal, 15% of
people with serious mental illness are employed nationally.
Residential Services
|
FY 2002 Actual
|
FY 2003 Actual
|
FY 2004 Actual
|
FY 2005 Estimate
|
FY 2006 Estimate
|
FY 2006 Goal
|
|
Mission Outcome Measure
|
|
|
|
|
|
|
|
Number/percent of consumers from group homes or assisted
living who moved to more independent living
|
7/21%
|
11/29%
|
4/13%
|
10/29%
|
15/38%
|
20/40%
|
|
|
|
|
|
|
|
|
Customer Measure
|
|
|
|
|
|
|
|
Percent of consumers who report increased
satisfaction in quality of life
|
92%
|
92%
|
95%
|
95%
|
97%
|
100%
|
|
Percent of ACCESS consumers who report satisfaction with client confidentiality
|
N/A
|
N/A
|
N/A
|
95%
|
100%
|
100%
|
|
|
|
|
|
|
|
|
Workload Measures
|
|
|
|
|
|
|
|
Total
consumers served by:
|
|
|
|
|
|
|
|
Group homes
and assisted living facilities
|
33
|
38
|
31
|
35
|
40
|
50
|
|
Contracted
homeless case management
|
136
|
139
|
149
|
149
|
150
|
150
|
|
Supported
living program
|
51
|
51
|
34
|
43
|
50
|
50
|
|
Transitional
housing
|
16
|
16
|
14
|
16
|
16
|
16
|
|
Project Hope Apartments (APAH)
|
4
|
4
|
5
|
6
|
6
|
6
|
|
Hospital
diversion
|
45
|
40
|
52
|
60
|
60
|
60
|
|
Milestones
Program (Shelter Plus Care)
|
N/A
|
N/A
|
1
|
9
|
15
|
15
|
|
|
|
|
|
|
|
|
Efficiency
Measure
|
|
|
|
|
|
|
|
Percent
of incident reports receiving appropriate response within 24 hours
|
89%
|
90%
|
95%
|
95%
|
100%
|
100%
|
|
Percent
of incident reports responded to by the residential coordinator within 24
hours
|
89%
|
90%
|
95%
|
95%
|
100%
|
100%
|
|
|
