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File #: 2019-1355   
Type: Consent Calendar Item Status: Agenda Ready
File created: 8/26/2019 In control: Health Services
On agenda: 9/24/2019 Final action:
Title: Mental Health Services Act 2019-2020 Program and Expenditure Plan and Annual Update for 2017-2018
Department or Agency Name(s): Health Services
Attachments: 1. Summary Report

To: Board of Supervisors of Sonoma County

Department or Agency Name(s): Department of Health Services

Staff Name and Phone Number: Bill Carter, 565-5157

Vote Requirement: Majority

Supervisorial District(s): Countywide




Mental Health Services Act 2019-2020 Program and Expenditure Plan and Annual Update for 2017-2018



Recommended Action:

Recommended action

Adopt the Mental Health Services Act 2019-2020 Program and Expenditure Plan and Annual Update for 2017-2018



Executive Summary:

In November 2004, California voters approved Proposition 63, the Mental Health Services Act. The Act imposes a one percent income tax on personal income in excess of $1 million. Much of the funding is provided to counties to fund mental health programs consistent with their local plans. As required by California Welfare and Institutions Code Section 5847, each county mental health program must prepare and submit a three-year program and expenditure plan and annual update, adopted by the county board of supervisors, to the Mental Health Services Oversight and Accountability Commission and the California Department of Health Care Services within 30 days of adoption.

Mental Health Services Act funded programs provide a full array of services in communities throughout Sonoma County, with a focus on wellness and recovery. The Department’s Behavioral Health Division, along with community partners, have created a behavioral health system that is peer, client, and family member driven, is culturally responsive and linguistically appropriate, and promotes a vision in which recovery is possible.



This item recommends Board adoption of the Mental Health Services Act 2019-2020 Program and Expenditure Plan and Annual Update for 2017-2018 (MHSA Report). The Plan can be accessed at the following location:

The Mental Health Services Act provides funding to expand community mental health services in five components, each of which addresses specific goals for priority populations, key community mental health needs, and age groups that require special attention. The MHSA Report is organized in the context of these five funding components:

1.                     Community Services and Supports - Provides enhanced mental health services for Seriously Emotionally Disturbed children and youth and Seriously Mentally Ill adult populations.

2.                     Prevention and Early Intervention - Programs that prevent mental illnesses from becoming severe and disabling, emphasizing improvement on timely access to services for underserved populations.

3.                     Innovation - Novel, creative and/or ingenious mental health practices/approaches that are expected to contribute to learning, which are developed within communities through a process that is inclusive and representative, especially of unserved and underserved individuals.

4.                     Capital Facilities and Technological Needs - Works towards the creation of facilities that are used for the delivery of Mental Health Services Act services to mental health clients and their families, or for administrative offices. Funds may also be used to support an increase in peer-support and consumer-run facilities, development of community-based settings, and the development of a technological infrastructure for the mental health system to facilitate the highest quality and cost-effective services and supports for clients and their families.

5.                     Workforce Education and Training - The goal of the Workforce Education and Training component is to develop a diverse workforce. Clients and families/caregivers are given training to help others by providing skills to promote wellness and other positive mental health outcomes. They are able to work collaboratively to deliver client-and family-driven services, provide outreach to unserved and underserved populations, as well as services that are linguistically and culturally competent and relevant, and include the viewpoints and expertise of clients and their families/caregivers.

The MHSA Report includes outcomes for 2017-2018 and the plan and budget for 2019-2020. The Annual Update section of the report provides a description of Mental Health Services Act-funded programs, clients served, and program performance outcome data for 2017-2018. The report also includes an Expenditure Plan, which provides a listing of all programs for which Mental Health Services Act funding is being proposed in fiscal year 2019-2020 and identifies the proposed expenditures for each type of funding. The Plan Update section of the report provides a description of any planned changes to programs and services for 2019-2020 (in relation to the previously adopted Mental Health Services Act Three-Year Integrated Plan for 2017-2020).

The MHSA Report reflects input from the community during the original extensive integrated planning process, as well as ongoing feedback from stakeholders from a number of venues, including Mental Health Board meetings. In compliance with state requirements, on July 19, 2019, the Department posted the Mental Health Services Act 2019-2020 Program and Expenditure Plan and Annual Update for 2017-2018 for a 30-day public review and comment period. On August 21, 2019 at the end of the review period, the Mental Health Board conducted a public hearing, providing the community an opportunity to give more input in the development of the report. Many service providers reported on the activity of their Mental Health Services Act-funded programs and shared stories of recovery and support from clients or family members.

Strategic Plan Alignment - This administrative function supports the County’s goal of supporting overall health and the Department’s goal of strengthening the behavioral health infrastructure.


Prior Board Actions:

On January 8, 2019 the Board adopted the Mental Health Services Act Update for 2018-2019 and Annual Update for 2016-2017.


Fiscal Summary


FY 19-20 Adopted

FY 20-21 Projected

FY 21-22 Projected

Budgeted Expenses




Additional Appropriation Requested




Total Expenditures




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Narrative Explanation of Fiscal Impacts:

The fiscal year 2019-2020 Mental Health Services Plan expenditures reflect what has been submitted to the state in the fiscal year 2019-2020 Mental Health Services Act Expenditure Plan. The plan expenditures are consistent with the Behavioral Health Division budget approved by the Board during June 2019 budget hearings. Of the $28,472,672, $18,004,675 is funded by Mental Health Services Act revenue. The balance of the expenditures are funded by General Fund, Federal Financial Participation, Realignment, and Whole Person Care. The General Fund consists of $192,590 of un-claimable retirement, which will be used to fund Community Services and Supports and Prevention and Early Intervention services, and $1,162,239 add-back funded by Graton Mitigation, which will fund Community Services and Supports services. Estimated expenditures for fiscal years 2020-2021 and 2021-2022 have not been determined. Expenditures for these fiscal years will be addressed in future Mental Health Services Act Expenditure Plans.


Staffing Impacts:




Position Title (Payroll Classification)

Monthly Salary Range (A-I Step)

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Narrative Explanation of Staffing Impacts (If Required):






Related Items “On File” with the Clerk of the Board:

Mental Health Services Act 2019-2020 Program and Expenditure Plan and Annual Update for 2017-2018