DELAWARE ADA SETTLEMENT FACT SHEET

Overview

• The agreement provides relief for more than 3,000 individuals unnecessarily institutionalized in Delaware’s State-operated psychiatric hospital or in state-funded private psychiatric facilities and people at risk of needless institutionalization because of a lack of community supports;
• The agreement will transform Delaware’s mental health system from one reliant on expensive, institutional care to one focused on cost-effective community-based services;
• The agreement provides for community services that promote recovery and independence and will enable individuals to live, work, and participate fully in community life.

Relief in Settlement Agreement

• Crisis System
  • Will serve as the “front door” to the mental health system and divert individuals from unnecessary hospitalization and involvement with the criminal justice system
  • Goal of crisis system is to reduce hospitalization by 50% by the end of the agreement
  • Full range of crisis services:

    - Crisis walk-in centers (2)

    - Mobile crisis teams (capacity to respond to any crisis within 1 hour)

    - Crisis stabilization services (14 day limit)

    - Peer run crisis apartments (4)

    - Statewide crisis hotline

• Intensive Case Supports
  • Full range of intensive case management supports to meet varying levels of need:

    - Assertive Community Treatment teams (11 teams, serving approximately 1100 people)

    - Intensive case management teams (4 teams, serving approximately 800 people)

    - Targeted case management (25 case managers, serving approximately 875 people)

• Integrated Supported Housing
  • Vouchers or subsidies for 650 people, with guarantee to anyone in need in the target group;
  • All new housing is supported housing with no more than 20 percent of people with disabilities per building.
• Other community supports
  • Supported employment (1100 people)
  • Rehabilitation services including education, substance abuse services (1100 people)
  • Family and peer supports (1000 people)
• Additional provisions
  • Discharge planning process including community providers beginning upon admission;
  • Statewide quality management system with qualitative and quantitative measures;
  • Monitor with capacity to hire staff to assist in the implementation and to conduct reviews;
  • All service providers must have linguistic and cultural competence.

Fiscal Impact

• The agreement will rebalance Delaware’s mental health system from one reliant on state-funded institutional care to one focused on Medicaid-reimbursable community-based services;
• The agreement will help the state leverage additional federal dollars, significantly expanding the total available funds for mental health services;
• A reduction in inpatient care by half and reinvestment of that money, with Medicaid’s match, into community services will lead to a more than doubling of funding for community services.