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CALIFORNIA’S DEPARTMENT OF MENTAL HEALTH TRANSITIONING INTO THE NEW DEPARTMENT OF STATE HOSPITALS

New DMH Structure to Enhance Treatment, Safety and Fiscal Management

On December 7, 2011, the California Department of Mental Health announced the blueprint to establish the new Department of State Hospitals and reforms to the DMH structure designed to improve the mental hospital system in California.

“We are making the changes that are long overdue,” said DMH Acting-Director, Cliff Allenby. “Earlier this year, we brought in a team of experts who worked closely with administrative, clinical, and operations staff to develop an action plan to enhance care, increase safety measures, and improve the fiscal management of our state mental hospitals.”

New policies and investments are underway to increase safety. Installation of a new alarm system at Napa State Hospital is nearing completion. Funding for similar systems at Metropolitan and Patton State Hospitals will be requested for next year’s budget. Atascadero State Hospital is in the process of implementing an Enhanced Treatment Unit pilot. If successful in reducing patient acuity and aggression, this model of care will be replicated in other facilities.

“We remain committed to providing appropriate treatment for patients in a safe environment and in a fiscally responsible manner,” added DMH Acting-Chief Deputy Director, Kathy Gaither. “Throughout the year, we listened to employees, management, mental health advocates and experts to get their recommendations which are reflected in the plan unveiled today.”

The blueprint plan calls for streamlining administrative policies, procedures and reporting by staff to increase focus on the provision of care while maintaining full compliance with federal standards. Inflexible system-wide rules regulating how care is provided in hospitals will be replaced with treatment decisions made by individual units based on patient needs.

Using best practices from hospital administrators and clinicians, the Department is setting system-wide standards for purchasing, information technology, fiscal management, and contracting to ensure state dollars are used efficiently and effectively. Department leadership is working with state partners from California’s Correctional Health Services and the private sector to adopt better business practices. Staff and leadership at each hospital are also recommending creative solutions to provide quality services in an efficient and effective manner.

The new structure also provides flexibility to hospitals to target staffing based upon patient need and thereby reduces the use of costly overtime and contract staff - the two single biggest drivers of increased hospital spending. With new streamlined procedures and flexible treatment options reducing workload, the department will modify aggregate staffing ratios based on acuity and patient need – higher staffing ratios for units with higher acuity and aggression, lower ratios for more stable patients. Staffing ratios will provide appropriate care and treatment as well as safety for patients and staff.

Specifically, the new DSH structure will be implemented at California’s five mental health hospitals: Metro, Atascadero, Napa, Coalinga and Patton, along with two psychiatric programs at Vacaville and Salinas Valley state prisons.

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