Louisiana Behavioral Health Needs Assessment

Opportunity

HSRI worked with Louisiana’s Office of Behavioral Health and partners with the Technical Assistance Collaborative (TAC) to fulfill the requirements of a consent agreement the state reached with the U.S. Department of Justice (DOJ). The goal was to ensure that Louisiana’s services to people with mental illness are provided in the most integrated setting appropriate to their needs.

Approach

The initial project

Following a finding by the DOJ that the State of Louisiana unnecessarily relies on nursing facilities to serve adults with serious mental illness, instead of serving them in the most integrated setting appropriate to their needs as required by the Americans with Disabilities Act, the State and the DOJ reached a settlement agreement. The settlement had two primary goals:

• To divert people with serious mental illness away from inappropriate nursing facility placements by requiring comprehensive evaluations and services designed to enable them to live in community-based settings; and
• To identify people with serious mental illness who have been admitted to nursing facilities but are able to and would like to transition to the community, and provide them with transition and discharge planning and community-based services.

Expanding the focus

The Office of Behavioral Health decided to expand this effort into an overall needs assessment of the entire public behavioral health service system. The expanded focus included people with serious mental illness generally (rather than just those at-risk for inappropriate placements) as well as people with substance use disorder, and it included an assessment of inpatient treatment services and home and community-based waiver services in addition to outpatient and crisis services. HSRI contracted with the Technical Assistance Collaborative, DOJ’s Subject Matter Expert, to conduct a comprehensive needs assessment and make recommendations for Louisiana to meet these goals.

Project reports

A preliminary report for the purposes of informing the FY 2021 budget process identified gaps in the current service system and provided projections on expected utilization and costs for key services, based on analyses of qualitative and quantitative data conducted to date.

A final report with detailed recommendations including potential barriers and challenges, facilitating resources, strategies for success and requirements of implementation and sustainability was completed in February 2021. The final report included a background description of the needs assessment process, data analyses that were conducted, protocols for key informant interviews, focus groups, and other descriptive material.

Impact

The project promoted a system that serves people with behavioral health disorders in the most integrated setting appropriate to their needs, to honor the principles of self-determination and choice, and to provide quality services in integrated settings.