Secretary Greenstein Announces Next Critical Phase of Behavioral Health Consolidation
Says integrated care stands to benefit Louisiana residents 

Wednesday, Feb. 16, 2011  |  Contact: Lisa R. Faust (225) 342-7913 or (225) 252-3579 (cell)

BATON ROUGE - Today, Louisiana Department of Health and Hospitals (DHH) Secretary Bruce D. Greenstein announced a major step forward in the state's plan to improve services for Louisiana residents struggling with mental illness and addictive disorders. In accordance with Act 384 of the 2009 Regular Session, which directed the consolidation of the offices of addictive disorders and mental health into the Office of Behavioral Health (OBH), DHH is integrating regional offices to more effectively and efficiently deliver services.

"I am very proud of the progress that has been made in this plan to provide a 'no wrong door' approach to serve individuals with mental illness and addictive disorders, which are often co-occuring," Secretary Greenstein said. "We are moving away from a fragmented system that forced people through too many hoops to get the care they needed. I, like most Louisianians, believe the people of our state deserve a system that better supports our residents' needs while using the taxpayer resources in the most efficient manner possible."

Research indicates co-occurring disorders have a high prevalence rate in the general population, with 42.7 percent of individuals with a twelve-month addictive disorder having had at least one twelve-month mental disorder and 14.7 percent of individuals with a twelve-month mental disorder having had at least one twelve-month addictive disorder. Further, individuals with serious mental illness have been shown to be at a higher risk for developing a substance abuse disorder, specifically 47 percent of individuals with schizophrenia also had a substance abuse disorder and 61 percent of those with bi-polar disorder also had a substance abuse disorder, according to the research. Individuals with co-occurring mental and substance disorders have complex needs that often impact every aspect of their lives, and have more severe psychiatric symptoms, repeated hospitalizations and a variety of legal and social problems.

Following a legislative mandate to streamline services and better address the needs of people with co-occurring mental illness and addictive disorders, DHH combined administrative functions of the former Office of Addictive Disorders (OAD) and Office of Mental Health (OMH) into one office, OBH, at the start of this fiscal year. The department anticipates savings of $12 million for next fiscal year as a result of this physical merger. As the next critical step toward a fully integrated approach for behavioral health, DHH is now consolidating offices in five of the state's nine service regions. Such integration is already in place in four other state service regions, where local governing entities (LGEs) known as human services districts or human services authorities already operate. DHH's goal is to establish such LGEs in each region to make services more effective and efficient for recipients, better leverage revenue sources, bring local governance and decision-making to these entities and improve overall health outcomes.

By combining OAD's and OMH's administrative functions and appropriate clinical services in each region, OBH will be able to pursue best practices that maximize available professionals to serve people with co-occurring disorders, while ensuring individualized treatment for those suffering from a distinct mental illness or addictive disorder. The consolidation, expected to be mostly complete by April 1, also will allow OBH to use available state, federal and grant funding more efficiently.

DHH's work in implementing Act 384 was guided by stakeholders and leaders in the behavioral health field from across Louisiana who sat on the department's Office of Behavioral Health Implementation Advisory Committee.

"I am so pleased to see DHH continuing to move forward with implementation of the advisory committee's recommendations to consolidate addictive disorder and mental health services," said Rubye Noble, Chairwoman of the Behavioral Health Implementation Advisory Committee. "We are all impacted by the effects of these disorders on our communities, and I am confident that by improving the way in which we deliver services to individuals with mental illness, addictive disorders and co-occuring conditions, every Louisianian will benefit tremendously."

Sen. Fred Mills, who co-sponsored Act 384 when he served in the House of Representatives said, "In 2009, the Louisiana Legislature recognized the need for a comprehensive behavioral health system. Today, I'm pleased to see we are taking a major step forward in that process. By finalizing the consolidation of mental health and addictive disorders services, our state will provide more meaningful care at a lower cost - a win for everyone."

Sen. Mike Walsworth, who co-sponsored the OBH legislation, said, "I applaud the Department of Health and Hospitals for its diligence in implementing our Legislation. Change can always be difficult, but all of the research tells us that this kind of long overdue change is moving our state in the right direction from a fragmented system to one of integrated care for those who need it most."

The integration of the regional offices will take place in the following DHH administrative regions: Region 4 (Acadiana); Region 5 (Southwest Louisiana); Region 6 (Central Louisiana); Region 7 (Northwest Louisiana); and Region 8 (Northeast Louisiana). Due to duplication of administrative and some clinical functions caused by the current fragmented system and the increase of the use of private providers and contractors under the new system, the consolidations will result in the physical move of some clinic locations and the reduction in 161 state positions.