1) Community-based mental healthcare services are more effective than institutional care by allowing for greater family involvement, being less restrictive, and producing better outcomes at a lower cost. 2) Integrating community-based services helps with early detection and treatment of mental health issues while reducing hospitalization needs and helping patients live successfully in their communities. 3) Studies show that average monthly spending per person for home and community-based services is much lower than for institutional care like nursing homes.

1. Community Care Based Services Leon Evans President and Chief Executive Officer The Center for Health Care Services Mental Health and Substance Abuse Authority Bexar County San Antonio, Texas [email_address] Maximizing Efficiency and Treatment Effectiveness NAMI Utah State Conference 2010 Salt Lake City

3. Community Mental Health Philosophy “ You get better outcomes when treatment is nearer to families, jobs and communities”. Leon Evans Philosophy

8. This could save money in the long term, provide economic benefits, and better serve state residents. 4. Cutting home and community based services may violate the Supreme Court’s Olmstead decision. States must have a plan for placing individuals with disabilities in the least restrictive care setting. http://www.familiesusa.org/assets/pdfs/long-term-care/Five-Good-Reasons.pdf 3. Cutting home and community based services runs counter to consumer preferences. Most consumers who need long-term care prefer to remain in their homes or in the community. Four Good Reasons (cont) Families USA 2010 (original source listed 5 Reasons, see link)

10. Texas Department of Criminal Justice MHMR Match Statistics October, 2007 *Represents all Clients served since 1985, including those whose diagnosis is no longer eligible for MHMR Source: Texas Correctional Office on Offenders with Mental and Medical Impairments 17.40% 12.65% 25.41% 26.78% % of Total Population 115,373 54,727 19,763 40,883 # of Care Matches* 662,775 432,359 77,755 152,661 Total TDCJ Population Total Probation Parole C.I.D.

11. Collaboration: It’s an unnatural act between… … two or more unconsenting adults.

18. Involuntary Outpatient Commitment Program Pre IOPC Program Post 79% Reduction in Bed Day Use, Post Program First Year Evaluation

21. The Center for Health Care Services Leon Evans, President/CEO The Center for Health Care Services Mental Health Authority 210 731-1300 www.chcsbc.org [email_address]