RD123 - Department of Behavioral Health and Developmental Services Discharge Assistance Program Performance Review - February 2014

Executive Summary:
Across the Commonwealth today, the Discharge Assistance Program (DAP) is an integral part of the discharge planning process. The DAP provides supplemental funding to assist individuals who have been discharged from state behavioral health facilities with reintegrating into their communities. The DAP allows these individuals to exit state hospitals and resume their lives in the community. (*1)

The Office of the State Inspector General's (OSIG) review of the DAP revealed the following:

i. The Department of Behavioral Health and Developmental Services (DBHDS) lacked documentation to support the DAP fund allocation methodology, as well as the current allocation of DAP funds to Community Services Boards (CSBs) and Regional Utilization Management Committees (regions).

ii. The DBHDS' DAP reporting requirements for CSBs and regions were inadequate.

iii. The DBHDS' audits of DAP funds were inadequate.

iv. The DBHDS lacked a documented strategy, including objectives, goals, and adequate performance measures, for the DAP.

v. The definition of discharge ready used by facility staff and community providers was misaligned.

vi. Most CSBs did not prepare an estimate of DAP plan costs until a willing community provided has been located.

vii. Insufficient community capacity existed to allow for the timely discharge of individuals from state-operated behavioral health facilities.

viii. The process of scrubbing, employed to identify unused DAP funds, is a best practice.

During this review, DBHDS took significant steps to address many of the issues identified in this report; however, additional steps remain that will, if undertaken, continue to enhance the efficiency, effectiveness, and economy of the DAP.
(*1) Throughout the state's public sector system of care, the acronym "DAP" is used as a surrogate for "discharge assistance planning," "discharge assistance project," or "discharge assistance program." When the acronym DAP is used in this Report, it means "discharge assistance program" and includes the actual appropriation and the state, regional, and local programming intended to assist individuals transitioning from state-operated facilities to return to their communities.