January 14, 2011
QUESTIONS FOR THE DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICE (DMHAS) COMMISSIONER NOMINEE
By: Nicole Dube, Associate Analyst
COMMISSIONER OF MENTAL HEALTH AND ADDICTION SERVICES (CGS § 17A-451)
The commissioner establishes and enforces standards for the treatment of people with psychiatric disabilities, substance abuse disabilities, or both in public and private facilities; may investigate the serious injury or unexpected death of anyone who received treatment within one year of the occurrence; and is responsible for developing and implementing state mental health and substance abuse plans.
1. 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.” How does DMHAS go about fulfilling this mission? How is the current state budget situation affecting the department's ability to meet its responsibilities?
2. DHMAS has undertaken significant work to transform the state's behavioral health system to one based on recovery and co-occurring disorder treatment strategies. What are the key components of a recovery-oriented system of care? Because recovery is highly individualized, how do you define and measure it? How does this system continue to move forward within the constraints of the current state budget?
3. Under the federal Patient Protection and Affordable Care Act (federal health care reform law), the Medicaid program will play an increasing role in the financing and delivery of mental health and substance abuse services. Can you please describe how DHMAS has worked with the Department of Social Services (DSS) to convert the State Administered General Assistance Behavioral Health program to the Medicaid Low-Income Adult program? What steps were taken to ensure that participants were properly informed and assisted through this transition?
4. The federal health care reform law also contains provisions aiming to integrate primary and behavioral health care, including increasing access to medical homes for individuals with mental health and substance abuse disorders. What initiatives has the department undertaken to achieve this integration?
5. How is DHMAS otherwise working to understand and actively participate in the implementation of federal health care reform efforts? What efforts is DHMAS undertaking to ensure that behavioral health is included in all aspects of the state's health care reform implementation?
6. Please describe DHMAS' initiatives that help divert and discharge people with serious mental illness from long-term care facilities into the community.
7. DMHAS' mandate is to serve adults (18 years and older) with mental health and substance abuse disorders who lack the financial means to obtain such services on their own. How does DMHAS work with the Department of Children and Families to assure that children with mental health problems will receive the services they need when they turn age 21? Are these efforts sufficient? What can be done to improve the process?
8. DMHAS and DSS have begun to place some community mental health services under the Medicaid rehabilitation option (MRO) program. How many MRO services are currently offered? Do you anticipate adding any more services in the future?
9. Does DMHAS or its private providers have any problems finding sites for group homes? How does DMHAS work with communities in the siting process? Can the legislature do anything to make siting easier?
10. For the past few years, DMHAS administered a Military Support Program that provides a range of behavioral health services to the state's service members, veterans, and their families. How has this initiative worked so far? Do you anticipate expanding or changing the program?
11. Please describe the department's efforts to re-align mental health case management services to a standardized Community Support Program and a less intensive case management service, Recovery Pathways.
12. What measures does DMHAS use to gauge its success or determine in what areas it most needs improvement?