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 Annual Program Update and Expenditure Plan for 2021-2022 and Annual Program Report for 2019-2020
End
Recommended Action:
Recommended action
Adopt the Mental Health Services Act 2021-2022 Program and Expenditure Plan and Annual Update for 2019-2020.
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 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.
Discussion:
This item recommends Board adoption of the Mental Health Services Act 2021-2022 Program and Expenditure Plan and Annual Update for 2019-2020 (MHSA Report). The Plan can be accessed at the following location:
https://sonomacounty.ca.gov/Health/Behavioral-Health/Mental-Health-Services-Act/
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 2019-2020 and the plan and budget for 2021-2022. 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 2019-2020. The report also includes an Expenditure Plan, which provides a listing of all programs for which Mental Health Services Act funding is being proposed to the state for fiscal year 2021-2022 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 2021-2022 (in relation to the previously adopted Mental Health Services Act Three-Year Integrated Plan for 2020-2023).
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 Services Act Steering Committee, Stakeholders, and Mental Health Board meetings. In compliance with state requirements, on October 4, 2021, Department staff posted the Mental Health Services Act 2021-2022 Program and Expenditure Plan and Annual Update for a 30-day public review and comment period. On November 4, 2021 at the end of the review period, the Mental Health Board hosted 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 June 9, 2020, the Board adopted the Mental Health Services Act Three-Year Plan for 2020-2023 and Annual Update for 2018-2019.
On January 8, 2019 the Board adopted the Mental Health Services Act Update for 2018-2019 and Annual Update for 2016-2017.
Fiscal Summary
|
Expenditures |
FY 21-22 Adopted |
FY 22-23 Projected |
FY 23-24 Projected |
|
Budgeted Expenses |
$37,593,459 |
|
|
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$37,593,459 |
0 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
$2,135,762 |
|
|
|
State/Federal |
$35,379,131 |
|
|
|
Fees/Other |
$78,566 |
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$37,593,459 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
A Summary of Sonoma County’s Mental Health Services Act (MHSA) estimated funding and expenditures for FY 2021-2022 is included in Attachment 1 - Mental Health Services Act 2021-2022 Program and Expenditure Plan and Annual Update for 2019-2020.
The MHSA estimated funding and expenditures in the FY 2021-2022 Department of Health Services Adopted Budget approved during June Budget Hearings were $37,593,459.
Of the $37,593,459 estimated total expenditures in the FY 2021-2022 Department of Health Services Adopted Budget, $22,526,976 is funded by Mental Health Services Act revenue. The balance of the expenditures are funded by the following:
- $8,443,138 in Medi-Cal Federal Financial Participation (FFP)
- $1,669,071 in Mental Health 1991 Realignment (of which $1,420,356 is from the $3 million in 1991 Realignment transfer from Human Services Department Social Services Subaccount to the Department of Health Services Mental Health Subaccount)
- $4,954,274 in Other Funding as follows:
o $2,135,762 in General Fund ($2 million for Mobile Support Team Expansion (MST) allocated during the FY 20-21 Budget Hearings in September 2020, $36,005 from the FY 21-22 distribution of the General Fund contribution and $99,757 for un-claimable retirement)
o $1,062,815 in Whole Person Care funding
o $1,544,131 in federal funding (non-FFP)
o $78,566 in Other
Expenditures are expected to change as the projects funded by MHSA operate. Updated expenditures for Fiscal Year 2022-23 will be submitted in next year’s report and subsequent reporting.
|
Staffing Impacts: |
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|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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|
|
|
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Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - Mental Health Services Act 2021-2022 Program and Expenditure Plan and Annual Update for 2019-2020
Related Items “On File” with the Clerk of the Board:
None