To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera, 707-565-4774
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Mental Health Services Act Program and Expenditure Plan Update for FY 2022-2023 with FY 2020-2021 Annual Report
End
Recommended Action:
Recommended action
Adopt the Mental Health Services Act 2022-2023 Program Plan Update & Expenditure Plan and the Annual Program Report for 2020-2021.
end
Executive Summary:
In November 2004, California voters approved Proposition 63, the Mental Health Services Act (MHSA). 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 (DHCS) 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 Behavioral Health Division within the Department of Health Services (DHS or “The Department”), 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 enclosed MHSA Annual Program Report includes outcomes for 2020-2021 and the plan and budget for 2022-2023. The draft MHSA FY 22-23 Annual Plan Update and Expenditure Plan and Program Report for FY 20-21 was posted and emailed for public review on April 15, 2022. Also, virtual meetings were conducted to present to Stakeholders for review and receive feedback.
Discussion:
DHS recommends Board adoption of the Mental Health Services Act 2022-2023 Program Plan Update and Expenditure Plan and Annual Update for 2020-2021 (MHSA Report). The Plan is provided as Attachment 1 to this report.
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 Annual Program Report includes outcomes for 2020-2021 and the plan and budget for 2022-2023. The Annual Program Report section provides a description of Mental Health Services Act-funded programs, clients served, and program performance outcome data for 2020-2021. The report also includes an FY 2022-2023 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 2022-2023 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 2022-2023 (in relation to the previously adopted Mental Health Services Act Three-Year Integrated Plan for 2020-2023).
Summary of Services provided by Program in Fiscal Year 2021-22:
|
Program |
Community Members Served (FY 2020-21) |
Total Number of Encounters (FY 2020-21) |
Community Members Receiving Outreach (FY 2020-21) |
|
Prevention and Early Intervention (PEI) |
20,585 |
19,803 |
20,149 |
|
Community Services and Supports (CSS) |
8,809 |
38,272 |
16,510 |
|
Total Community Members |
29,394 |
58,075 |
36,659 |
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 April 15, 2022, Department staff posted the Mental Health Services Act 2022-2023 Program and Expenditure Plan and Annual Update for a 30-day public review and comment period. On May 17, 2022 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 MHSA-funded programs and shared stories of recovery and support from clients or family members. After the Board of Supervisors reviews and approves the FY 22-23 MHSA Program and Expenditure Plan and Annual Update the revised and approved plan will be posted for at least 30 days followed by a public hearing hosted by the Mental Health Board.
In addition to Attachment 1, the MHSA Report is available at the following site:
<https://sonomacounty.ca.gov/health-and-human-services/health-services/divisions/behavioral-health/about-us/mental-health-services-act>
Prior Board Actions:
On December 7, 2021, the Board adopted the Mental Health Service Act Program Plan Update and Expenditure Plan for 2021-2022 and Annual Program Report for 2019-2020.
On June 9, 2020, the Board adopted the Mental Health Services Act Three-Year Plan for 2020-2023 and Annual Program Report for 2018-2019.
On January 8, 2019 the Board adopted the Mental Health Services Act Update for 2018-2019 and Annual Program Report for 2016-2017.
Fiscal Summary
|
Expenditures |
FY 22-23 Adopted |
FY 23-24 Projected |
FY 24-25 Projected |
|
Budgeted Expenses |
$28,257,224 |
|
|
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$28,257,224 |
0 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$28,257,224 |
|
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$28,257,224 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
A Summary of Sonoma County’s Mental Health Services Act (MHSA) estimated funding and expenditures for FY 2022-2023 is included in Attachment 1 - Mental Health Services Act 2022-2023 Program and Expenditure Plan and Annual Program Report for 2020-2021.
The MHSA estimated funding and expenditures in the FY 2022-2023 DHS Adopted Budget approved during June Budget Hearings were $28,257,224.
The MHSA Expenditure Plan shows an ending fund balance of $36.5 million, which is less than the Fund Balance Memo in the 2022-23 Adopted Budget. The Department has approximately $9.5 million in funds approved by the Board of Supervisors for future obligations removed from unspent fund balance in the MHSA Expenditure Plan.
Expenditures are expected to change as the projects funded by MHSA operate through the fiscal year. Updated expenditures for Fiscal Year 2023-2024 will be submitted in next year’s report and subsequent reporting.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - Mental Health Services Act Program and Expenditure Plan Update for FY 2022-2023 with FY 2020-2021 Annual Report
Related Items “On File” with the Clerk of the Board:
None