Given the resources and time necessary to implement these recommendations, we also recommend that the Legislature require DSH to provide additional justification for its budget requests during the development and implementation of the new budgeting process. ![]() Second, we recommend that the Legislature direct DSH to use the updated information to develop its budget and staffing requests based on expected changes in the number and acuity (or level of care) of its patient population, as well as make adjustments to its budget if the actual population differs from its projections. First, we recommend the Legislature require the department to establish or update several key components used to develop its budget to ensure that they are accurate and adequate. In view of the above findings, we make several recommendations to improve the DSH budgeting process. Specifically, we find that (1) the department has a large amount of funded beds that are not used (2) the level of staff needed to operate DSH facilities is unclear (3) the budgeting methodology used by the department creates poor incentives for it to operate efficiently and (4) other state departments have more transparent, updated, and efficient budgeting processes than DSH. Based on our review, we find that the current DSH budgeting process has several shortcomings. The department then requests adjustments to the base budget to account for projected increases or decreases in the patient population during the budget year.ĭSH’s Budgeting Process Has Several Shortcomings. In determining how much funding to request for the upcoming fiscal year, DSH uses the amount of funding it received in the state budget for the current year as a base budget or starting point. This includes funding for both clinical and nonclinical staff, as well as non–staff costs (such as food and clothing). The state provides about $1.6 billion in funding to the Department of State Hospitals (DSH) to provide inpatient treatment to mental health patients in the eight DSH facilities.
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