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
Title:
Title
Mental Health Services Act Three-Year Integrated Program and Expenditure Plan for 2020-2023 and Annual Program Report for 2018-2019
End
Recommended Action:
Recommended action
Adopt the Mental Health Services Act Three-Year Integrated Program and Expenditure Plan for 2020-2023 and Annual Program Report for 2018-2019.
end
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 plan and annual report, 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, with a focus on wellness and recovery, in communities throughout Sonoma County. 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. The Department’s integrated planning process works to strengthen and enhance existing services funded by the Act, with the goal of increasing access and reducing disparities to behavioral health services for all residents of Sonoma County. In alignment with the Board’s Safety Net priorities focused on behavioral health, implementation of the 2020-2023 Mental Health Services Act Three-Year Integrated Plan includes efforts to strengthen cross-department and community coordination aimed at addressing gaps in the behavioral health system and the goal of ensuring a comprehensive system of coordinated care.
Discussion:
This item recommends Board adoption of the 2020-2023 Mental Health Services Act Three-Year Integrated Program and Expenditure Plan and Annual Report for FY 2018-2019. The Plan can be accessed at the following location:
http://sonomacounty.ca.gov/Health/Behavioral-Health/News/Draft-MHSA-FY-20-23-Three-Year-Plan-Posted/
Mental Health Services Act provides funding to expand community mental health services with five different components. The Annual Report for fiscal year 2018-2019 reports on programs and activities within the following five components as outlined in the Mental Health Services Act:
1. Community Services and Supports - Focus on the transformation of services provided to individuals with serious mental illnesses and youth with serious emotional disturbances. Community Services and Supports are community based, focused on recovery, culturally competent, and include consumers and family members in treatment service provision. Component services are voluntary and are primarily full-service partnerships. Full-service partnerships provide wraparound-type services to help the most severely mentally ill clients and their families, twenty-four hours a day, seven days a week. These wraparound services include treatment, case management, transportation, housing, crisis intervention, education, vocational training and employment services, as well as socialization and recreational activities, based upon the individual needs for successful treatment outcomes.
2. Innovation - Focus on implementing new service models that will create collective learning across the system. Innovation Programs are defined as novel, creative, and/or ingenious mental health practices or approaches that are expected to contribute to learning, which are developed within communities through a process that is inclusive and representative of unserved and underserved individuals. The Innovation component allows counties the opportunity to try out new approaches that can inform current and future mental health practices/approaches and contributes to learning rather than having a primary focus on providing a service. Innovation projects are subject to one-time funding with time limitations to assess and evaluate their efficacy and are time-limited with one-time funding.
3. Prevention and Early Intervention - Focus on a broad continuum of prevention and early intervention services. The intent of the Prevention and Early Intervention programs is to engage individuals before the development of serious mental illness or serious emotional disturbance, or to alleviate the need for additional or extended mental health treatment. These programs are provided in places where mental health services are not traditionally given, such as schools, community centers, and faith-based organizations.
4. Workforce, Education and Training- Provides funding to improve and build the capacity of the mental health workforce to meet the needs of unserved and underserved populations, and provide linguistically and culturally relevant services.
5. Capital Facilities and Technology Needs- Provides funding for building projects and increasing technological capacity to improve mental health service delivery.
The 2020-2023 Mental Health Services Act Three-Year Integrated Program and Expenditure Plan and Annual Report for 2018-2019 includes outcomes of the prior year and the budget for the upcoming year. In Sonoma County, all five components have been implemented with ongoing programs and services. The Annual Update provides information on each of the five Mental Health Services Act components including a description of Mental Health Services Act-funded programs, clients served, and program performance outcome data. The Mental Health Services Act Annual Report also includes an Expenditure Plan and Work Plans, which provide a listing of all programs for which Mental Health Services Act funding is being proposed in fiscal year 2020-2021 and identifies the proposed expenditures for each type of funding.
In compliance with state requirements, on April 27, 2020 the Department posted the 2020-2023 Mental Health Services Act Three-Year Integrated Program and Expenditure Plan and Annual Report for 2018-2019 for a 30-day public review and comment period. On May 27, 2020, at the end of the review period, the Mental Health Board conducted a virtual public hearing, providing the community an opportunity to give more input in the development of the Integrated Plan. Over 55 community members and stakeholders attended the public hearing with approximately 10 people taking the opportunity to address the Mental Health Board. Many community members shared their experience as a client or family member in a Mental Health Services Act-funded program. They shared stories of recovery and support and were thankful for the services they received. A number of the Department’s community partners reported on the activity of their programs and also expressed their appreciation for the funding and their collaborative relationship with the Department of Health Services, Behavioral Health Division.
The Three-Year Integrated Program and Expenditure Plan and Annual Report includes detailed information about the Capacity Assessment conducted in 2019 that reflects input from the community on the community program planning process and feedback from stakeholders. The Plan includes changes in the programs or services being funded by the Mental Health Services Act.
The Sonoma County 2016-2019 MHSA Capacity Assessment found that Sonoma County’s public mental health system was, overall, well setup with the appropriate services at suitable capacity for the population. Consumers were by-in-large satisfied with the services they received and providers were dedicated to supporting consumers’ recovery. With appropriate programs and committed providers, Sonoma County’s mental health system has a strong foundation which the Department of Health Services is continuing to build upon.
Despite these strengths, the capacity assessment found some challenges and barriers within the system identifying opportunities for improvement. The priorities identified through the capacity assessment with extensive stakeholder input include the following:
1. Providing additional treatment opportunities for Underserved Populations
2. Increase utilization review
3. Integrate Peer Providers
4. Increase Stakeholder Participation (particularly Stakeholders with lived mental health experience)
Mental Health Services Act regulations requires counties submit and get approval of a Three-Year Integrated Plan for all funded services. In Sonoma County, all five components have been implemented with ongoing programs and services. Detailed information on programs and services for each of the five components is provided in the Plan and the Annual Report including a description of funded programs, clients served, program performance outcome data, and cost.
The Three-Year Integrated Program and Expenditure Plan and Annual Report includes no significant changes in the programs or services being funded. Rather, it continues the programs and services developed with community input and continued community support. Any difference in the numbers contained in the Three-Year Integrated Program and Expenditure Plan and subsequent Annual Updates are due to the Three-Year Integrated Plan containing the Department’s best estimates at the time the Plan was presented at the public hearing conducted by the Mental Health Board on May 27, 2020 prior to the adoption of the County’s fiscal year 2020-2021 budget.
The Mental Health Services Act states that five percent of the total funding for each county mental health program for Part 3 (commencing with Section 5800), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) of this division, shall be utilized for innovative programs in accordance with Sections 5830, 5847, and 5848. The FY 2020-2021 Mental Health Services Act Plan provides overviews of the seven proposed innovation projects listed below. The total cost for these projects is $2,519,634.
- ACCESS (Accessing Coordinated Care and Empowering Self Sufficiency) Sonoma - Integrated Case Management System: Diversion Cohort
- Early Psychosis Learning Health Care Network: Elizabeth Morgan Brown One Mind ASPIRe Program of Sonoma County
- Diversion Transitional Housing
- Instructions Not Included (INI) - Dads Matter
- New Parent TLC
- Collaborative Care Enhanced Recovery Project (CCERP)
- Nuestra Cultura Cura Social Innovations Lab
Prior Board Actions:
On September 24, 2019 the Board adopted the 2019-2020 Mental Health Services Act Program and Expenditure Plan Update and Annual Report for 2019-2020.
Fiscal Summary
|
Expenditures |
FY 19-20 Adopted |
FY 20-21 Projected |
FY 21-22 Projected |
|
Budgeted Expenses |
28,472,672 |
30,405,931 |
|
|
Additional Appropriation Requested |
|
2,519,634 |
|
|
Total Expenditures |
28,472,672 |
32,925,565 |
|
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
1,354,829 |
420,382 |
|
|
State/Federal |
27,117,843 |
32,505,183 |
|
|
Fees/Other |
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|
|
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Use of Fund Balance |
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Contingencies |
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Total Sources |
28,472,672 |
32,925,565 |
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Narrative Explanation of Fiscal Impacts:
The FY 2020-2021 Mental Health Services Act Plan presented here provides funding information for all Mental Health Services Act programs and services. Total FY 2020-2021 expenditures are $32,925,565. This amount includes additional appropriations of $2,519,634 for innovation projects, which will be requested via the consolidated budget adjustments process following approval of the plan.
Mental Health Service Act provides $22,858,695 of funding to cover the expenditures. Funding is available as a result of Proposition 63, the Mental Health Services Act, passed by California voters in November 2004. The Act imposes a 1 percent income tax on personal income in excess of $1 million.
The balance of the expenditures are covered by a combination of general fund, realignment, federal financial participation and Whole Person Care.
The amount for FY 2021-2022 has not been determined and will be addressed in future Mental Health Service Act Expenditure Plans.
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Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
None
Related Items “On File” with the Clerk of the Board:
None