Service Area Strategic Plan
5/20/2013   5:25 pm
Department of Behavioral Health and Developmental Services (720)
Biennium:
Service Area 1 of 1
Facility Administrative and Support Services (720 498 00)
Description

Facility Administrative and Support Services consist of general management and direction, computer services, food and dietary services, housekeeping services, linen and laundry services, physical plant services, power plant operations, and training and education services. These functions support the overall mission of each state hospital and training center. Facility administration and support services provide the foundation for the provision of quality behavioral health and developmental services in an inpatient environment.
Background Information
Mission Alignment and Authority
  • Describe how this service supports the agency mission
    Facility Administrative and Support Services support the mission of the Department by providing the administrative framework that promotes quality patient or resident care in a safe and clean environment. Each of the components of this service area accomplishes this in a different way but the general focus is the same regardless of the support service. General management and direction and computer services activities support quality inpatient care by providing leadership, assuring compliance with administrative and financial requirements, and supporting an overall facility environment that is safe and conducive to quality treatment or habilitation. Food and dietary services, housekeeping services, and laundry and linen services provide for an environment that is safe, sanitary, and healthy for patients or residents and state facility staff. Physical plant services and power plant services serve to provide a safe and healthy environment by ensuring that buildings are free of dangerous hazards and comfortably heated and cooled, and by ensuring that preventive maintenance is performed on a regular basis. Training and education services ensure that all facility staff are properly trained and possess the latest tools for providing quality care to patients and residents. All of these functions, taken together, serve to help the Department achieve its vision of consumer-focused services and supports that promote consumer self-determination, empowerment, recovery, resilience, health, inclusion, and participation in all aspects of community life.
  • Describe the Statutory Authority of this Service
    Chapter 3 of Title 37.2 of the Code of Virginia establishes the Department of Behavioral Health and Developmental Services.
    • § 37.2-304 outlines the duties of the Commissioner, including supervising and managing the Department and its state facilities, including facility administrative and support services.

    Chapter 7 of Title 37.2 of the Code of Virginia authorizes the Department to perform certain functions related to the operation of state facilities, including facility administrative and support services.
    • § 37.2-703 authorizes the Commissioner to prescribe a system of records, accounts, and reports of how money is received and disbursed and of consumers admitted to or residing in each state facility;
    • § 37.2-704 authorizes the Commissioner to receive and expend social security and other federal payments for consumers in state facilities; and
    • §§ 37.2-717 through 37.2-721 direct the Department to investigate and determine which consumers or parents, guardians, conservators, trustees, or other persons legally responsible for consumers are financially able to pay for care; to assess or contract with such individuals to recover expenses; and to pursue payment of such expenses.
Customers
Agency Customer Group Customer Customers served annually Potential annual customers
Individuals receiving inpatient services provided on state hospital medical/surgical units Adults served in state hospitals 4,725 5,748
Individuals receiving inpatient services provided on state hospital medical/surgical units Children and adolescents served in state hospitals 581 764
Individuals civilly committed to the Virginia Center for Behavioral Rehabilitation (VCBR) Individuals meeting SVP criteria and civilly committed to the Virginia Center for Behavioral Rehabilitation (VCBR) 150 300
Individuals receiving state training center services and supports Individuals served in state training centers 1,386 1,500
Individuals with active criminal justice system involvement receiving secure forensic services Individuals with active criminal justice system involvement who require secure forensic services 1,472 1,766
Individuals receiving inpatient services provided by Hiram Davis Medical Center Patients at Hiram Davis Medical Center 122 150
Older adults (65 and older) receiving state hospital services Senior adults (65 and older) receiving services in state hospitals 701 785
State facility employees State facility employees 9,091 10,000

Anticipated Changes To Agency Customer Base
The development of more community services may decrease state facility census and may lessen the demand for facility administrative and support services.
Partners
Partner Description
Community services boards and behavioral health authority (CSBs): The Department provides state and federal funds to the 40 CSBs to support the provision of behavioral health and developmental services and supports.
Department of Accounts: This agency provides accounting and processing services for each state facility along with policy guidance, financial reporting guidance and payroll expertise. Each state facility performs its own accounting and finance functions, but relies upon the Department of Accounts to serve as its policy arm.
Department of General Services: This agency provides guidance regarding state facility physical plant services and building maintenance.
Department of Health: This agency provides overall sanitation standards and regulates these standards particularly as they relate to facility food services operations.
Department of Human Resource Management: This agency provides policy guidance to Human Resource officers at each state facility.
Department of Medical Assistance Services: This agency provides reimbursement to each state facility for Medicaid eligible patients or residents. Medicaid reimbursement accounts for 43 percent of the state facility budgets.
Department of Planning and Budget: The Department of Planning and Budget provides budget planning and finance expertise to the Department overall and each facility. This technical relationship helps each state facility to achieve its mission.
Department of Rehabilitative Services: This agency provides guidelines for addressing accessibility issues in state facility buildings.
Departmental Central Office: The central office provides oversight and internal auditing functions related to all state facilities. It also provides reimbursement services involving the billing and collection of third party reimbursement. This revenue represents a large part of most state facility budgets.
Other regulatory agencies: These include agencies such as the Department of Environmental Quality (boiler inspections) and the local Fire Marshall (building safety).
Products and Services
  • Factors Impacting the Products and/or Services:
    o The workforce of state facilities is aging just as the state workforce in general. This is particularly true of the facility workforce for facilities in rural areas where staff turnover is less than in more urban areas. Recruitment and retention of the facility workforce of the future will be a challenge.

    o New requirements in Governor’s Executive Orders and changes in regulations from external agencies such as DOA, DHRM, DPB, DGS, and additional workload requirements, often unfunded, from federal or state agencies could affect state facility administrative and support services. Changes in the Department's regulations related to human rights also could affect state facility administrative and support services.

    o Individuals with more complex and severe medical disabilities will place additional demands on facility support services such as special diets, additional laundry services, more frequent housekeeping, and specialized safety and security.

    o The continuing economic downturn affecting the Commonwealth has significantly limited the ability of state facilities to hire the number of staff needed to accomplish the objectives of the service.

    o As state facilities are replaced, administration and support needs will change as a result of the new acreage and new facility structure and the configuration of buildings and units (e.g., building layout, number of units, energy and technological processes).

    o Facility administrative and support services also may be affected by the rapidly changing healthcare environment, annual increases in health care costs, facility relationships with VITA and implementation of technological changes such as the electronic health record, and future potential outsourcing of state facility administrative and support functions.

    o Facility building renovation needs driven by building code changes and aging capital equipment also could affect state facility administrative and support functions.
  • Anticipated Changes to the Products and/or Services
    o Potential further consolidations of administrative functions and administrative service sharing across facilities to achieve administrative efficiencies or cost reductions.

    o Continuing efforts to reduce the energy consumed by modernizing the energy delivery systems, improving laundry operations, and using renewable energy sources.

    o Potential privatization of specific services.
  • Listing of Products and/or Services
    • Administrative leadership and regulatory compliance
    • Information technology support
    • Food services for state facility patients and residents
    • Housekeeping services to ensure a clean and safe environment
    • Linen and laundry services
    • Physical plant services, including building maintenance and security services
    • Power plant operations
    • Employee training and education services
Finance
  • Financial Overview
    This service area is funded with 48 percent general funds and 52 percent non-general funds. Non-general funds are derived from the collection of fees from Medicaid, Medicare, private insurance, private payments, and Federal entitlement programs related to indirect services costs of patient care. Less than one-half percent of total non-general funds are federal grant funds for the National School Lunch, National School Breakfast, and the Virginia Department of Agriculture and Consumer Services Federal Food Distribution programs.

    Note: The information on the following tables is presented at the service area level. However, funding by fund source is appropriated at a higher program level. This results in the allocation of the non-general fund amounts to the various service areas within the program level in accordance with reasonable allocation methodology. This methodology has been applied and is represented in these amounts.
  • Financial Breakdown
    FY 2011    FY 2012
      General Fund     Nongeneral Fund        General Fund     Nongeneral Fund  
    Base Budget $81,673,162 $85,528,121    $81,673,162 $85,528,121
    Change To Base -$2,415,707 $0    -$2,415,707 $0
               
    Service Area Total   $79,257,455  $85,528,121     $79,257,455  $85,528,121 
Service Area Objectives
 
  • Provide efficient and effective administration and support to inpatient services provided within each state hospital and training center.
    Objective Description
    Efficient and effective administration and support services must be in place if state facilities are to provide quality services in a safe and healthy environment.
    Alignment to Agency Goals
    • Agency Goal: Align administrative and funding incentives and organizational processes to support and sustain quality individually-focused care, promote innovation, and assure efficiency and cost-effectiveness.
    • Agency Goal: Assure that services system infrastructure and technology efficiently and appropriately meet the needs of individuals receiving publicly funded behavioral health and developmental services and supports.
    • Agency Goal: Obtain sufficient numbers of professional, direct care, administrative, and support staff with appropriate skills and expertise to deliver quality care.
    Objective Strategies
    • Continue to adhere to Prompt Payment Act, small purchase care usage, Payline participation, direct deposit participation regulatory and compliance requirements.
    • Comply with all HIPAA Privacy and Security Rule requirements.
    • Adhere to Health Department regulations pertaining to state facility food services operations, overall sanitation, and cleanliness.
    • Adhere to all safety regulations as prescribed by the local Fire Marshall pertaining to building safety.
    • Adhere to all safety regulations as prescribed by the Department of Environmental Quality pertaining to boiler inspections.
    • Procure equipment so that proper state facility maintenance and support activities occur and safety and effective services are not compromised.
    • Develop a succession-planning process for each facility that includes communication and recruitment strategies, identifies anticipated vacancies, determines critical positions, establishes current and future competencies, creates leadership transition/development activities, and evaluates succession management.
    • Continue to assess opportunities for additional energy savings projects, modernize facility energy delivery systems, and use renewal energy sources.
    Link to State Strategy
    • nothing linked
    Objective Measures
    • Prompt Payment Act compliance rate
      Measure Class:
      Other
      Measure Type:
      Outcome
      Measure Frequency:
      Annual
      Preferred Trend:
      Maintain

      Frequency Comment: Fiscal year

      Measure Baseline Value:
      95
      Date:
      6/30/2005

      Measure Baseline Description: The Department achieved 95 % compliance across all state facilities

      Measure Target Value:
      100
      Date:
      6/30/2012

      Measure Target Description: The Department achieved 95 % compliance across all state facilities

      Data Source and Calculation: Source: Department of Accounts prompt payment compliance reports Calculation: Divide the number of state facilities that have met the 95% compliance rate by the total number of state facilities.

    • The daily cost to serve patients and residents in state facilities
      Measure Class:
      Productivity
      Measure Frequency:
      Quarterly
      Preferred Trend:
      Maintain
      Measure Baseline Value:
      534.41
      Date:
      6/30/2008

      Measure Baseline Description: Direct per diem expenses for patients/residents in FY 08.

      Measure Target Value:
      534.41
      Date:
      6/30/2012

      Measure Target Description: Direct per diem expenses for patients/residents.

      Data Source and Calculation: Total expenses incurred for state facility services year to date divided by the number of days that patients and residents reside in state facilities year to date. This measure will be calculated quarterly, recognizing factors that may produce spikes in quarterly per diem rates, which include purchases of inventoried items such as pharmaceuticals, food purchases, and energy raw materials such as fuel oil and natural gas. Purchase of these items, when incurred, will increase per diem costs in that period then reduce per diem costs in subsequent periods. Facility census patterns also will influence per diem costs.


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