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.
- 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.
|Mission Results||Core Services|
|Mission Results||Core Services|
|Mission Results||Core Services|
|Mission Results||Core Services|
|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 State fiscal year, however they may not end in that same fiscal year, or grant data may not be available until well after the OMB 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 FY18 OMB report, the best available data is for Trust projects that ended in FY17.
When comparing these numbers, it is important to note that the number of grants and types of projects funded vary from year to year, thus contributing to the variance in the number of individuals served. For Trust projects that ended in FY 2017, there were 30,078 beneficiaries and family members served or impacted through MHTAAR and Authority Grant projects. This is a 14.7% decrease from FY 2016, when there were 35,247 beneficiaries and family members served or impacted through Trust projects. In addition to a decrease in the overall number of beneficiaries served from FY 2016 to FY 2017, there was a 28.9% decrease in the number of professionals trained (12,258 in FY 2017 from 17,234 in FY 2016). There was a 77.5% decrease in the number of individuals served through outreach and education efforts (23,849 in FY 2017 from 105,772 in FY 2016). This decrease is due primarily to two projects that were included in the FY 2016 data, but were not included in FY 2017. These two projects ending in FY 2016 helped to increase statewide outreach efforts: the United Way of Mat-Su’s Be Positive Community Norms campaign and the Anchorage Park Foundation’s 100 Stone project. In total, 66,185 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 2017; an overall decrease of 58.2% from FY 2016.
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 FY18 OMB report, the best available data is for Trust projects that ended in FY17.
Out of the 183 projects that ended in FY 2017, 58 were categorized as Direct Service projects. Of these 58 projects (47 Authority Grants + 11 MHTAAR projects), 40 (85%) Authority Grant projects and 10 (91%) MHTAAR projects reported direct beneficiary improvements in quality of life. The percentage reporting direct impacts to beneficiaries’ quality of life for FY 2017 was slightly lower than the percentage reported for FY 2016 for both Authority Grants and MHTAAR projects. Though the numbers are only slightly lower than in FY 2017, 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, typically 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 evaluating 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 FY2018, the Trust, as an active participant, facilitator or funder, engaged in or supported significant systems change related activities. As Trust staff levels have returned to normal, we anticipate the number of systems changes will increase in the future.
FY2018 systems changes reported:
Non Focus Area Related Systems Change – Criminal Justice Reform and Reinvestment
1. A member of the Alaska Criminal Justice Commission, the Trust continues to participate in the development of key reforms to Alaska’s criminal justice system. The Trust chairs the Commission’s Behavioral Health Standing Committee. The charge of the committee is to identify opportunities where closer collaboration between Alaska’s criminal justice and behavioral health systems in law or practice could reduce the overrepresentation of people with behavioral health disorders in the justice system, enhance public safety, promote both offender rehabilitation and a more cost effective and efficient criminal justice system. The Commission outlined its substantive and technical recommendations to the legislature in the fall of 2017.
Non Focus Area Related Systems Change – Medicaid Reform
2. The Trust’s $10,000,000 investment in Medicaid Reform supported DHSS progress in drafting a Section 1115 Behavioral Health Demonstration Waiver application to the Centers for Medicare and Medicaid Services (CMS). The application submitted in January of 2018 led to initiation of negotiations between DHSS and CMS in March of 2018. Additionally, DHSS released the Request for Proposal for an Administrative Services Organization in 2018. Trust contractual funding provided support to DHSS in moving this work forward.
Non Focus Area Related Systems Change - Workforce Development
3. A program officer position added to the Trust staff will oversee the development of workforce related issues that occur within all the systems change and focus areas. As the behavioral health and healthcare systems across Alaska undergo expansion and change, it is increasingly important to have a strong Trust presence to helping collaborate and coordinate these changes in respect to a growing workforce.
Focus Area - Beneficiary Employment and Engagement
4. Peer Support Workforce– the Trust, DHSS and statewide partners participated in the BRSS TACS Policy Academy (Bringing Recovery Supports to Scale Technical Assistance Center) sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). BRSS TACS advances effective recovery supports and services for people with mental or substance use disorders and their families. Through technical assistance and a broad stakeholder meeting in late 2017, Alaska’s peer support leaders developed three workgroups to enact systems change related to the state’s peer support workforce (certification, collaboration, and education/advocacy). The workgroups worked through FY18 to develop key recommendations that will be presented to DHSS leadership in Fall 2018.
5. Individualized Placements and Supports (IPS) Employment Model Replication – the Trust supported DHSS efforts to train and provide technical assistance to agencies pursing the IPS model. The IPS model is an evidence-based practice that helps people with serious mental illness to work in regular jobs related to their work preferences. This 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. Trust staff participated in a Spring 2018 IPS fidelity review for the state’s first successful implementation of the model and continues to work with DHSS and partners to further replicate the model statewide for improved beneficiary employment outcomes.
Focus Area - Disability Justice
6. 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. In FY18, AJiC, in partnership with the Pew-MacArthur Results First initiative (RFI), released a report, Alaska Results First Initiative Adult Criminal Justice Program Benefit Cost Analysis. This report analyzes the extent Alaska’s adult criminal justice programs are performing to expectation and the levels of return on investment. Additionally, 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.
7. The Trust in partnership with the Public Defender Agency, the University of Alaska Anchorage Justice Center and Alaska Legal Services Corporation continues its support of a pilot project in Bethel, the Holistic Defense Pilot, addresses civil and criminal legal needs of beneficiaries simultaneously and in a holistic joint approach, improving individual outcomes and reducing costs to the criminal justice system.
8. The Trust in partnership with the Alaska Court System, Mat-Su Health Foundation, and other private foundations launched a pilot therapeutic court, the Palmer Families with Infant and Toddlers court (FIT Court). The court’s primary goals are to achieve family permanency within twelve months, reunifying young children with their families of origin. The FIT Court seeks to reduce repeat child maltreatment by building strong supports around the family. Involvement promotes child safety by encouraging wrap-around recovery services for parents and custodians.
Focus Area - Housing & Long Term Support and Services
9. 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.
10. Forget-Me-Not Manor, a Trust supported housing first project, in Juneau completed its six-month evaluation of its permanent supportive housing program. The evaluation has shown a dramatic decrease in emergency services usage, corrections stays and sleep off center usage. There is compelling information to redirect funds to housing to serve people who benefit from permanent supportive housing programs.
11. Trust staff participated with key stakeholders and partners to help the Fairbanks community implement a rapid rehousing program for families.
12. 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.
13. As part of the DD Vision Collaborative, the Trust in partnership with the Division of Senior and Disabilities Services funded the National Core Indicator to obtain data to assist in the development of a new vision for the DD system services. The collaborative worked to explore and evaluate IDD services both at the individual agency level and at the State program level. Work has begun to ensure these processes are coordinated and reflected in how forms, procedures and policies develop.
Focus Area - Substance Abuse Prevention and Treatment
14. The Trust funded capital costs for two primary providers of substance abuse treatment in Anchorage/Matsu valley communities. Funding supported expanded outpatient treatment capacity for one provider in the Matsu Valley, while the second organization constructed a new residential treatment center in Eklutna, Alaska.
|C: Result - Cash & AMP; 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 FY18, 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 FY18 is at 778% of year-end payout. This is an increase from FY17 when the budget reserve balance was 597% of total payout. The Trust benefited from a strong financial performance that allowed us to maintain prudent budget reserves. We do not anticipate future growth at the same rate.
|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 FY18; the last survey occurred in FY15. We are evaluating the continued use of the Stakeholder survey as a measure in coming fiscal years.
While we did not implement the formal Stakeholder survey in FY18, the Trust initiated an extensive stakeholder feedback process to inform the development of the Trust’s FY20 budget recommendations, and monitor our performance. Feedback received showed favorable impressions of the Trust, and understanding of the Trust’s goals.
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, 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 179 Authority Grant agreements were completed and executed in FY18, of which 176 or 98.3% of the projects executed within the 30-day target. For FY18, the percentage of projects completed and executed in under 30 days after approval increased when compared to FY17.
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 July 19, 2019