Budget Act Conference Report

The 2008 Budget Act was unprecedented in recent memory in its attention to mental health issues.

Here is language on Mental Health from the Conference Report on the Continuation, Capital and Expansion Budgets FY 08-09 http://www.ncga.state.nc.us/sessions/2007/budget/2008/conferencecommitteebudgetreport.pdf

R = Recurring Funds; NR = Non-Recurring [one-time] funds; all figures in millions

o New Local Psychiatric Inpatient Capacity - $8.12 R - the State-paid share of new local psychiatric inpatient capacity (beds/bed days).

o Clinical Staffing Ratios at Psychiatric Hospitals - $7.28 R - for 107 positions at the State's psychiatric hospitals: 7 psychiatrists, 1 Medical MD, 40 RNs, 34 LPNs, 25 Health Care Techs

o Walk-In Crisis and Immediate Psychiatric Aftercare $4.46 R; $1.65 NR - funding to Local Management Entities (LMEs) for walk-in crisis and immediate psychiatric aftercare. Also provides funding for the purchase of telepsychiatry equipment - to support 30 psychiatrists and related support staff. Of these funds, $1,650,000 shall be used for telepsychiatry equipment to be owned by the LMEs and shall be distributed across the State according to need determined by the Department.

o Mobile Crisis Intervention Teams - $4.655 R; $1.1 NR - operating subsidies to 30 mobile crisis teams state-wide. Also provides start-up funding for 11 crisis teams to bring the total number of teams state-wide to 30.

o Recruitment and Workforce Development: $1.27 R - for recruitment and workforce development initiatives at State facilities, including psychiatrist loan repayment, increased recruitment efforts, and expansion of the Psychiatry Nurse Practitioner scholarship program. Funding for each item is as follows: Psychiatrist Loan Repayment Program in Office of Rural Health - $868,519; Expansion of Recruitment and Advertising Funding for Difficult-to-Recruit Positions - $277,000; Psychiatric Nurse Practitioner Scholarship Program at UNC School of Nursing - $125,000; Additionally, $500,000 NR is included for sign-on bonuses for hard-to recruit Registered Nurse positions at the State's psychiatric institutions in the Statewide Reserves Section of this report.

o Dorothea Dix Hospital Overflow Unit $5,212,166 NR; 96.85 positions - for the Dorothea Dix Hospital Overflow Unit, a 60-bed unit to remain open on the Dorothea Dix campus after the opening of the new Central Regional Hospital. Total requirements for this item are $10,731,103 with $4,767,760 in receipts from Wake County and $751,177 in Medicaid receipts. The 60-bed unit will be staffed with a total of 174.75 FTEs, of which 77.9 will be funded by Wake County receipts and 96.85 are funded by State appropriation and Medicaid receipts. Position classifications & number of FTEs for all 174.75 positions: Physician III-B (psychiatrists) (7.75) – 1 Physician IV-B (psychiatrist supervisor) ; 0.5 Physician III-A (medical MD); 1 Psychiatric Unit Administrator II; 1.5 Senior Psychologist; 3 Physician Extender II; 1 Nurse Supervisor B; 37 RNs; Nurse B (4); 66 Health Care Technicians; 6.5 Clinical Social Worker; 1 Social Work Supervisor; ; 1 Pharmacy Technician; 1 Clinical Dietitian I; 1.5 Occupational Therapist I; 2.5 Therapeutic Recreational Specialist I; 9 Rehabilitation Therapists; 0.5 Advocate I; 1 Word Processor IV; 1 Personnel Technician III (1); 4 Office Assistant IV; 1 Utilization Review Nurse; 1 Patient Relations Representative V(usually, this is for the admitting office); 1.5 Medical Records Assistant IV; 1 Floor Maintenance Assistant; 8.5 Housekeeper; 1 Kitchen Manager; 1 Food Services Supervisor; 3 Cook I; 6 Food Services Assistant; 1 Diet Clerk

o Clinical and Operational Enhancements of State Facilities $1.8 R; $0.05 NR; 19.00 positions - to improve training and supervision of direct care staff, for monitoring of State facilities, for pharmacy management, and for information technology and accounting positions: Clinical Nurse Specialists (2 at each of the three psychiatric hospitals and one at each Alcohol and Drug Abuse Treatment Center); 9 Nurse Cs; State-Operated Services Compliance Team: 4 Mental Health Program Manager IIs; 1 Mental Health Program Manager I (1) - $57,666; Clinical Policy Section: 1 Pharmacy Manager III ; 1 HEARTS Training Coordinator; DHHS Controller's Office: 1 , Accounting Technician IV, 1 Accounting Technician III; Longleaf Neuro-Medical Center; 1 Technology Support Technician;

o Resident Furnishings $0.61 R; $1.02 NR in receipts for replacing resident furnishings in poor condition in State mental health facilities.

o Realignment of Mental Health Trust Fund Funding for Housing Initiative - realignment [cut from this line] $2.0 NR - Realigns unallocated funding from the Mental Health Trust Fund to the Housing Trust Fund to continue the MH/DD/SA Housing Initiative.

o Continuing the MH/DD/SA Housing Initiative - Housing Trust Fund 7.0 NR - Provides $7,000,000 in non-recurring funding ($2,000,000 of which is realigned from the Mental Health Trust Fund) for the financing of additional independent- and supportive-living apartments for people with disabilities. The apartments shall be affordable to those with incomes at the Supplemental Security Income (SSI) level. The funds for this item are located in the Housing Finance Agency section of this report.

o Continuing the MH/DD/SA Housing Initiative - Operating Cost Subsidy - $1.0 R - Provides funding for operating cost subsidies for independent- and supportive-living apartments for individuals with disabilities. The apartments shall be affordable to those with incomes at the SSI level.

o Julian F. Keith ADATC Pharmacy $0.47 R; 4.00 positions - Provides funding for four positions to create a pharmacy program at the Julian F. Keith Alcohol and Drug Abuse Treatment Center (ADATC) to serve the expanded acute treatment beds. The Substance Abuse Prevention and Treatment Block Grant includes $70,000 for one-time start-up costs associated with the pharmacy. Position classifications, number of FTEs: 1 Pharmacy Manager I; 1 Clinical Pharmacist; 2 Pharmacy Technician

o Early Intervention for Autism $1.875 R - Provides funding for services for children ages 0-10 with autism (i.e., autism early intervention), as follows: $625,000 to the Autism Society of NC for training and collaboration with model programs and community agencies to increase availability of autism early intervention services. $1,250,000 for DHHS to contract directly for three model programs of early intervention services.

o Supportive Services for HUD 811 Projects $0.13 R; $0.155 R - Provides funding for on-going operations and start-up expenses to support 6 two-bedroom and 19 one-bedroom apartments financed through the United States Department of Housing and Urban Development.

o Program Service Funding for Group Homes $0.2 R - Provides funding for on-going program service funding for two group homes under development by the Mental Health Association in N.C., Inc.

o Traumatic Brain Injury Services $1.0 R - Provides funding for the provision of traumatic brain injury (TBI) services.