Ohio Department of Mental Health and Addiction Services Budget Overview

On February 7th, 2023, Director Lori Criss presented an overview of budget priorities for the Department of Mental Health and Addiction Services (OhioMHAS). Soon after, she testified in the Ohio House of Representatives Finance Committee to present executive budget recommendations. In the previous fiscal year, the largest line-item expense was Subsidies and Shared Revenue, which consisted of 44.9 percent of the budget. The second largest expense was Personnel, which added up 32.8 percent of the budget. This increase was due to the increased support of federal and General Revenue Funding to provide support for harm reduction, early intervention, treatment, and recovery supports. The overall total amount spent in FY2022 was $905,140,259, with a 10.7% change for FY2023-2024. For FY2023, federal funding represents 24.3 percent of the recommended budget. For FY2024, this funding represents 22.5 percent of the budget.

The recommended state budget this biennium includes $16 million dedicated to recruiting and retaining Forensic Evaluators that conduct court-ordered evaluations.

The recommended state budget this biennium includes $16 million dedicated to recruiting and retaining Forensic Evaluators that conduct court-ordered evaluations. This need is partially because of the growing population of Ohioans involved with the criminal justice system who suffer from mental illness. The budget also contains recommendations for $20.5 million to improve community recovery and treatment for Ohio adults living with mental illness. We previously published on budget priorities by department and the goals for the department this biennium. In addition to these priorities, there are several outcomes from the previous biennium noted in the budget.

  • Mobile crisis services have been made available in 43 counties, serving well over 29,000 Ohioans, with plans to expand these services to 22 other counties.
  • Mobile Response Stabilization Services (MRSS) became Medicaid charged service, which has helped over 4,500 adults and youth across the state.
  • The Department of Medicaid worked closely with OhioMHAS to implement OhioRISE to support multi system needs. My colleague Tara Britton previously wrote about how this MSY support aligns with the work that we do here at Community Solutions.
  • Ohio expanded the 988 Suicide and Crisis Lifeline call center capacity. This has helped ensure that every county has coverage and calls that route through the new three-digit lifeline.
  • The Multi-System Adult Project rolled out in 2021. This service aids residents who need treatment and recovery services that are involved in multiple systems of care. Examples of these systems include criminal justice, homelessness and developmental disabilities.

Funding Sources

The largest funding source in FY2022 was the General Revenue Fund (GRF). This made-up 54 percent of the budget. About 65 percent of this source was used to support six regional hospitals in the state. The second largest funding was federal grants. This amount consisted of $274.3 million of the budget in FY2022. Federal funds through OhioMHAS will be spread across the state to bolster harm reduction, treatment, recovery, early intervention and high-quality prevention.

988 Suicide and Crisis Response Funding

Previous work at Community Solutions has highlighted the funding disparity for 988. Allocations for 988 have been identified as a major priority this biennium, especially because it is an increasingly relied upon service, which is evident from the reported growth in the previous biennium. From August 2021 to August 2022, Ohio saw a 109 percent increase in the number of calls by lifeline providers, a 603 percent increase in text demand and a 201 percent increase in chat demand. 988 funding for FY2024 is recommended at $20.7 million, and this increases to $25.8 million in FY2025, with a 24.8 percent change.

FundALI NameFY2023FY2024% changeFY2025%Change
GRF988 Suicide and Crisis Response$0$20,701,661N/A$25,831,02024.8%

Early Childhood Mental Health Counselors and Consultation

This line item was one of the programs shifted to the proposed Department of Children and Youth. The goal of this program is to increase the number of childhood mental health providers and increase the number of youths screened for mental health issues. These providers will work to improve the life skills and development of children and reduce provider stress, turnover and burnout.

FundALI NameFY2023FY2024% changeFY2025%Change
GRFEarly Childhood Mental Health Counselors and Consultation$1,250,000$0N/A$024.8%

Prevention and Wellness

Prevention and early identification programs make up a large portion of services to mitigate the impact of adverse behavioral health impacting Ohioans. OhioMHAS used COVID relief funding in the past to invest in a large range of suicide prevention programs in the Governor’s 2020 Suicide Prevention Plan. General Revenue Funding for this item will work to help scale strategies for private and public partnerships with local Alcohol, Drug Addiction, and Mental Health (ADAMHS) boards, public health districts, community, and business partners. This funding will also increase the number of Ohioans that are credentialed to promote resiliency and reduce stigma in communities and schools. This will be targeted toward at-risk populations such as youth aged 10-24, men aged 25-29, veterans, Black Ohioans and Ohioans from Appalachia.

FundALI NameFY2023FY2024% changeFY2025%Change
GRFPrevention
and Wellness
$4,868,659$13,868,659184.9%$13,868,6590%

Continuum of Care Services

Continuum of care supports community mental health initiatives. This also includes investments in Mobile Response Stabilization Services (MRSS), Adult Wellness, and OhioStart. These programs will expand what is referred to as the Crisis Contiuum, which works to Connect, Respond, Stabilize, and Thrive.

FundALI NameFY2023FY2024% changeFY2025%Change
GRFContinuum of Care Services$89,914,846$106,214,84618.1%$106,214,8460%

Statewide Treatment and Prevention

This line item had an increased appropriation which would build Ohio’s transitional step-down housing and develop the State of Ohio Action for Resiliency Network (SOAR Network). The SOAR Network works to develop, evaluate and implement mental health addiction prevention, recovery and treatment. The SOAR network will also utilize the expertise of researchers and clinicians in Ohio’s academic medical centers to target core issues of mental health as well.

FundALI NameFY2023FY2024% changeFY2025%Change
GRFStatewide Treatment and Prevention$22,843,950$162,799,190612.7%$22,799,190-86.0%

OhioRISE Support

This line item works to support pediatric behavioral workforce development. Within this plan is to improve infrastructure at health care facilities and expand access to pediatric behavioral health services. This includes OhioRISE psychiatric residential treatment facilities. This is aligned with our budget priority for utilizing state funding to fill in gaps of care. Below is the proposed funding for pediatric behavioral health:

FundALI NameFY2023FY2024% changeFY2025%Change
5CV3ARPA Pediatric Behavioral Health$16,550,000$50,000,000202.1%$0-100.0%

Budget by Line Item

Below are the Redbook budget recommendations for the entire agency. Stay up to date with Community Solutions as we continue our coverage on the state budget, and our state budget priorities.

Fund GroupALI Name
FY2023
FY2024
FY2025
GRFProgram Support and Operations$19,438,426
$54,807,151
$57,100,151
GRF
Resident Trainees
$450,000
$450,000
$450,000
GRF
Family and Children First
$0
$0
$0
GRFPrevention and Wellness$4,868,659 $13,868,659 $13,868,659
GRF
Hospital Services
$270,845,778
$318,588,247
$344,258,948
GRF
Mental Health Facilities Lease Rental Bond Payments
$27,400,000
$25,875,000
$22,625,000
GRF
Continuum of Care Services
$89,914,846
$106,214,846
$106,214,846
GRF
Criminal Justice Services
$19,805,937
$30,044,829
$30,044,829
GRF
Addiction Services Partnership with Corrections
$34,409,472
$0
$0
GRF
Recovery Housing
$3,000,000
$5,000,000
$5,000,000
GRF
Specialized Docket Support
$10,250,000
$11,269,340
$11,269,340
GRF
Community Innovations
$15,500,000
$11,000,000
$11,000,000
GRF
Court Costs
$1,000,000
$0
$0
GRF
Residential State Supplement
$16,000,000
$24,000,000
$24,000,000
GRF
Early Childhood Mental Health Counselors and Consultation
$1,250,000
$0
$0
GRF
Appalachian Children Coalition
$1,250,000
$0
$0
GRF
988 Suicide and Crisis Response
$0
$20,701,661
$25,831,020
GRF
Medicaid Support
$1,587,246
$1,618,364
$1,650,415
2320
Family and Children First
$0
$0
$0
4750
Statewide Treatment and Prevention
$22,843,950
$162,799,190
$22,799,190
4850
Mental Health Operating
$9,000,000
$15,000,000
$15,000,000
5AU0
Behavioral Health Care
$10,010,000
$17,500,000
$17,500,000
5CV1
COVID Response - Mental Health
$0
$0
$0
5CV3
COVID Mental Health Impacts
$5,000,000
$0
$0
5CV3
ARPA Pediatric Behavioral Health
$16,550,000
$50,000,000
$0
5CV3
Crisis Infrastructure Expansion
$90,000,000
$0
$0
5HC8
MHA Home and Community Based Services
$85,000,000
$0
$0
5JL0
Problem Gambling and Casino Addiction
$6,093,655
$7,000,000
$7,000,000
5T90
Problem Gambling Services
$2,000,000
$2,320,000
$2,320,000
5TZ0
Stabilization Centers
$6,000,000
$6,000,000
$6,000,000
5TZ0
ADAMHS Boards
$11,000,000
$11,000,000
$11,000,000
5VV0
Transcranial Magnetic Stimulation Pilot
$6,000,000
$6,000,000
$0
6320
Community Capital Replacement
$350,000
$350,000
$350,000
6890
Education and Conferences
$75,000
$75,000
$75,000
1490
Hospital Operating Expenses
$16,000,000
$16,000,000
$16,000,000
1490
Operating Expenses
$5,500,000
$7,350,000
$7,350,000
1510
Ohio Pharmacy Services
$100,857,237
$105,755,000
$106,955,000
4P90
Community Mental Health Projects
$250,000
$250,000
$250,000
3240
Medicaid/Medicare
$20,004,753
$20,000,000
$20,000,000
3A60
Federal Miscellaneous
$0
$0
$0
3A70
Social Services Block Grant
$7,700,000
$8,000,000
$8,000,000
3A80
Federal Grants
$5,500,000
$5,500,000
$5,500,000
3A90
Mental Health Block Grant
$38,854,897
$45,940,000
$45,940,000
3B10
Community Medicaid Legacy Support
$5,699,914
$4,000,000
$4,000,000
3G40
Substance Abuse Block Grant
$85,766,164
$86,000,000
$86,000,000
3H80
Demonstration Grants
$16,808,236
$16,000,000
$16,000,000
3HB1
State Opioid Response
$111,026,079
$113,000,000
$113,000,000
3HQ0
Governor's Emergency Education Relief - Mental Health Coordination
$0
$0
$0
3N80
Administrative Reimbursement
$1,000,000
$1,000,000
$1,000,000