Performance Details
Department of Revenue - Mental Health Trust Operations
Mission
The mission of the Alaska Mental Health Trust Authority is to administer the Alaska Mental Health Trust as a perpetual trust and to ensure a comprehensive and integrated mental health program to improve the lives of beneficiaries.
Core Services
- Spend Trust income to improve the lives and circumstances of Trust beneficiaries.
- Provide leadership in advocacy and planning around beneficiary related issues.
- Manage Trust cash and non-cash assets.
- Ensure funding of a comprehensive integrated mental health program.
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Performance Detail
| A: Result - Beneficiary Quality of Life: Increase quality of life for Trust beneficiaries through Trust funding and partnering. |
| A1: Core Service - Spend Trust income to improve the lives and circumstances of Trust beneficiaries. |
Target #2: Report annually the total number of beneficiaries and family members served.
Funded Trust Projects with Services to Beneficiaries
Analysis of results and challenges: Trust authority grant projects may be awarded in a fiscal year, however they may not end in that same fiscal year, or grant data may not be available until well after the reporting deadline. The analyses for this measure is based upon the best available data. This is typically from projects that ended in the fiscal year prior to the current OMB reporting period. So, for the FY19 OMB report, the best available data is for Trust projects that ended in FY18. For Trust projects that ended during FY 2018, 26,164 beneficiaries and family members were served or impacted through MHTAAR and Authority Grant projects. This is a 13.01% decrease from FY 2017, where 30,078 beneficiaries and family members were served or impacted through Trust projects. Even though there was a decrease in the overall number of beneficiaries served from FY 2017 to FY 2018, there was a 15.85% increase in the number of professionals trained (14,201 in FY 2018 from 12,258 in FY 2017) and a significant 62.55% increase in the number of individuals served through outreach and education efforts (38,767 in FY 2018 from 23,849 in FY 2017). This large increase is likely contributed to three projects that either did not occur during FY 2017 or had a change in scope from FY 2017 to FY 2018. One of the three projects that ended during FY 2018 provided training and educational opportunities for individuals and families who work with or provide care for Trust beneficiaries (Alaska Association for Infant and Early Childhood Mental Health’s Infant and Early Childhood Mental Health Training Hub). The other two projects that lead to the marked increase during FY 2018 supported outreach and/or educational efforts (Anchorage Library Foundation’s Anchorage Public Library User Survey and Challenge Alaska’s Land Acquisition of the Keil Center for Adaptive Sports, Therapeutic Recreation and Education). When comparing these numbers, it is important to note that the number of grants and types of projects that are funded vary from year to year, thus contributing to the variance in the number of individuals served. In total, 79,132 individuals received some type of training, service, and/or were impacted as a result of the Trust’s efforts through projects that ended in FY 2018; an overall increase of 19.5% from FY 2017. |
Target #3: 60% of direct service projects will provide direct beneficiary improvement information.
% Direct Service Projects Reporting Outcomes
Analysis of results and challenges: Trust authority grant projects may be awarded in a fiscal year, however they may not end in that same fiscal year, or grant data may not be available until well after the reporting deadline. The analyses for this measure is based upon the best available data. This is typically from projects that ended in the fiscal year prior to the current OMB reporting period. So, for the FY19 OMB report, the best available data is for Trust projects that ended in FY18. Out of the 169 projects that ended in FY 2018, 53 were categorized as Direct Service projects. Of these 53 projects (44 Authority Grants + 9 MHTAAR projects), 43 (97.7%) Authority Grant projects and 9 (100%) MHTAAR projects reported direct beneficiary improvements in quality of life. The percentage reporting direct impacts to beneficiaries’ quality of life for grants that ended in FY 2018 was slightly higher than the percentage reported for FY 2017 for both Authority Grants and MHTAAR projects. Though the numbers are slightly higher than in FY 2017, as always, we will continue to encourage our grantees to report specific outcome data that demonstrates beneficiary improvements in quality of life through participation in Trust funded projects. |
Target #4: In The Trust's statewide Public Opinion Survey conducted every other year, a good proxy for the level of public awareness is that at least 70% of the public "knows where to find services" for a Trust beneficiary. Analysis of results and challenges: The Trust Public Opinion Survey, historically administered every other year, was last administered in FY2014. Due to resource and staffing issues, the survey has not occurred since. We are in the process of exploring the future implementation and use of this survey. |
| B: Result - Systems Change: Create change in the beneficiary service system lasting beyond temporary Trust interventions and resources. |
| B1: Core Service - Provide leadership in advocacy and planning around beneficiary related issues. |
Target #1: Report major system changes related to beneficiaries in each focus area that are likely to continue beyond Trust funding.
Number of systems changes likely to continue beyond Trust funding
Analysis of results and challenges: In FY2019, the Trust, as an active participant, facilitator or funder, engaged in or supported significant systems change related activities. FY2019 Systems changes reported: Non-Focus Area Related Systems Change – Comprehensive Integrated Mental Health Program Plan 1. The Trust, in collaboration with the DHSS, Statutory Advisory boards, and key partners, developed and implemented the Comprehensive Integrated Mental Health Program plan. Improvements included a life span focus, including prevention as an emphasis, and engaging in a formal public comment process. The last version sunset in 2011. In the next year focus will be upon developing an action plan for implementation, and performance metrics for monitoring progress. Non-Focus Area Related Systems Change – Medicaid Reform 2. 1115 Substance Use Disorder waiver: The Trust’s financial investment in, and staff collaboration with, the DHSS’s Medicaid reform efforts resulted in the Centers for Medicare and Medicaid Services (CMS) approval of an 1115 Substance Use Disorder (SUD) waiver component of the Section 1115 Behavioral Health demonstration waiver. Additionally, a waiver of the Institutions for Mental Diseases (IMD) exclusion rule for SUD services was approved. Approval of the Mental Health component of the 1115 waiver application is anticipated in FY20. Non-Focus Area Related Systems Change - Behavioral health 3. Behavioral health crisis stabilization: The Trust in partnership with DHSS is working to evaluate and provide a plan for enhancing the current BH crisis response system to more adequately meet the needs of our beneficiaries. 4. Alaska Suicide Prevention Council: The Trust worked with the Alaska Suicide Prevention Council, Senator Kawasaki and key stakeholders to introduce Senate Bill 10, which asked the legislature to extend the life of the Council through 2027. This is strategic for Trust beneficiaries as the Council is the only statewide advocacy and awareness group that can advise the Governor and Legislature on suicide prevention matters within the state. This bill was signed into law. Non-Focus Area Related Systems Change - Workforce Development 5. The program officer position who oversees healthcare workforce development continues to collaborate with stakeholder partners in efforts to recruit and retain a stable workforce. The Trust worked with the DHSS, the SHARP Council and Senator Wilson on introducing Senate bill 93 which would expand the current SHARP 1 student loan repayment program to include more service areas and healthcare positions around the state. One of the best recruitment and retention tools is offering student loan repayment contracts for health care professionals in organizations that serve at least 30% Trust beneficiaries. This bill was signed into law. Non-Focus Area Related Systems Change – Prevention and Early Childhood Intervention 6. Trust staff continued to engage with advisory boards as well as key state and agency partners to identify critical areas of opportunity related to prevention and early childhood intervention for beneficiaries and families. Research continues highlight the prenatal and early childhood periods as having the greatest Return on Investment for beneficiary related intervention. Ongoing strategic planning and investment framework development continues with advisory boards and partners into FY20. Housing and Long Term Services and Support 7. The Trust continued to fund Housing and Homeless Service Coordinators for three communities in Alaska, Anchorage, Juneau and Fairbanks. The partnership with the municipalities and city boroughs is to coordinate local housing and homeless services that assist persons experiencing homelessness in these core communities that experience the highest rates of homelessness in our state by coordinating the communities housing resources and social service programs to end the problems related to homelessness. Funding analysis, reduction of impediments to fair housing, elimination of barriers, coordinated emergency services and housing and community project development are all strategies to for better coordination between services and prioritization of resources to the most vulnerable. 8. Developmental Disability (DD) Vision Collaborative – The Trust continued to sponsor the statewide collaborative process to refine and implement a shared vision of support for Alaskans with developmental disabilities. Input gathered from over 200 stakeholders from across the state helped to develop a shared vision of support for Alaskans with developmental disabilities. DD systems “thought leaders” met regularly as a steering committee to guide next steps in implementing the vision for a comprehensive and person-directed service delivery system for beneficiaries with intellectual and developmental disabilities. Vision: “Alaskan’s share a vision of a flexible system in which each person directs their own supports, based on their strengths and abilities, toward a meaningful life in their home, their job and their community. This vision includes supported families, professional staff and services available throughout the state now and into the future.” Legislation including language from the vision passed unanimously during the 2018 legislative session (SB 174) and signed into law by Governor Walker in August 2018. 9. The Trust provided partner funding in collaboration with DHSS to implement a state level Intellectual and Developmental Disability (IDD) program survey, the National Core Indicators. In FY19 a staff survey was conducted with providers and in FY20 the in-person survey will be completed with people receiving IDD services to evaluate quality and impact of those services from their perspective. Focus Area - Beneficiary Employment and Engagement 10. Peer Support Workforce– The Trust, DHSS and statewide partners worked with a contractor to develop a multi-year pro-forma to anticipate training and credentialing needs related to the emerging peer support workforce. Peer support workers provide key recovery supports for people with behavioral health needs and offer the unique lens and skills developed through their own lived experience. Recommendations from the pro-forma were analyzed by DHSS leadership in late 2018/early 2019 and the decision was made to proceed with training, credentialing, and awareness/promotion to professionalize and standardize the peer support workforce. The Trust continues to be a primary funding and advocacy partner in this systems effort. 11. Individualized Placements and Supports (IPS) Employment Model Replication – The Trust continued to support DHSS efforts to expand beneficiary access to the IPS employment model statewide. The IPS model is an evidence-based practice that helps people with serious mental illness and substance use disorders to find and maintain work in competitive, integrated jobs of their choice. The model is based on 8 principles; Focus on competitive employment, eligibility is based on client choice, integration of rehabilitation and mental health services, attention to worker preferences, personalized benefits counseling, rapid job search, systematic job development, and time-unlimited and individualized support. 12. Pre-Employment Transition Services (Pre-ETS) – The Trust continued to partner with the Department of Labor/Division of Vocational Rehabilitation and other stakeholders to increase beneficiary youth access to Pre-ETS opportunities. Pre-ETS supports include: Job Exploration Counseling; Post-Secondary Counseling; Self-Advocacy Instruction; Work-Based Learning Experiences; and Workplace Readiness Training. These supports are available to any student with a disability between the ages of 14-21. Trust funds augment and increase flexibility of approximately $1.5 million federal dollars annually, allowing school districts and community partners to actively engage beneficiary youth in Pre-ETS opportunities, including job training and skill development, in their home communities Focus Area - Disability Justice 13. The Alaska Justice Information Center (AJiC) is a partnership between the Trust and the University of Alaska Anchorage. The mission of AJiC is to compile, analyze, and report on criminal justice topics to policy makers and practitioners in order to improve public safety, to increase criminal justice system accountability, and to reduce recidivism. Work has continued in expanding the Pew-MacArthur Results First initiative (RFI) through development of a behavioral health emphasis. The AJiC continues to forge relationships with justice related organizations and stakeholders to further the development of its integrated data platform to provide timely criminal justice related information to policy makers. |
| C: Result - Cash & Non-cash Asset Development: Maximize payout in perpetuity. |
| C1: Core Service - Manage Trust cash and non-cash assets. |
Target #1: Report annual payout rate and maintain reserve balances @ 400% of payout to ensure beneficiary services despite market variations.
Budget Reserve Balance (as % total payout) at Year End
Analysis of results and challenges: In FY19, The Trust continued to maintain the annual payout rate at 4.25%, and maintained budget reserves sufficient to maintain beneficiary related programming. The Trust’s budget reserve account at the end of FY19 is at 567% of year-end payout. This is a decrease from FY18 when the budget reserve balance was 778% of total payout. In FY19 financial performance was within anticipated rates which allowed us to maintain prudent budget reserves. |
| D: Result - Fulfill Mission: Ensure the Trust’s mission is fulfilled via strong stakeholder relations and efficient use of funds. |
| D1: Core Service - Ensure funding of a comprehensive integrated mental health program. |
Target #1: Via the new Stakeholders Survey done every other year to improve scores to above median on 1) “your impression of the Trust?” 2) “to what extent has the Trust affected public policy?” 3) "how clearly do you understand the Trust's goals?"
Stakeholder Survey responses about The Trust (scale is 1 to 7, with 7 being "strongly positive")
Analysis of results and challenges: There are no updated Stakeholder Survey results to present for FY19; the last survey occurred in FY15, calendar year 2014. While we did not implement the formal Stakeholder survey in FY19, the Trust engaged in an extensive stakeholder feedback process to inform the development of the Trust’s FY20-21 budget recommendations, and monitor our performance. Feedback received showed favorable impressions of the Trust, and understanding of the Trust’s goals. We continue to evaluate the use of the Stakeholder survey as a measure in coming fiscal years. |
Target #2: Report Trust administrative overhead as a % of total expended income.
Trust Admin as % of Total Funding Available
Analysis of results and challenges: The Trust Authority administrative overhead authorization for FY18 was 13.4% of the total available funding for the fiscal year. While this is a slight increase from FY17, when the administrative overhead was 12.3%, the administrative overhead has remained stable overtime. The increase in administrative overhead cost relates to increases in personnel related to program, planning and grants related services. Periodic review of the philanthropy field for foundations similar to The Trust indicate the average range of administrative expense continues to be approximately 12-15% of the total available funding. |
Target #3: Report the percentage of Trust grant agreements processed in less than 30 days.
% Trust grant agreements processed in < 30 days
Analysis of results and challenges: Approximately 211 Authority Grant agreements were completed and executed in FY19, of which 210 or 99.5% of the projects executed within the 30-day target. For FY19, the percentage of projects completed and executed in under 30 days after approval increased when compared to FY18, and previous years. Trust grants staff engage in on-going process improvement activities to streamline the grants administration process to reduce any barriers to timely execution. In exploring the root cause of the delay, the variation in percentage of grant agreements processed from year to year continues is attributed to the readiness of grantees to initiate their projects after Trustee approval. |
Current as of December 18, 2019