Santa Clara CountySanta Clara CountyMental Health Services Act PlanningMental Health Services Act Planning

CSS Three-Year Plan

CSS Plan Celebration &CSS Plan Celebration &Implementation LaunchImplementation Launch January 27, 2006January 27, 2006

Department of Mental Health SCVHHS

Welcome!Welcome!

CSS Plan OverviewCSS Plan Overview

Implementation Phase Implementation Phase OverviewOverview

Thank You!Thank You!

MHSA (aka Proposition MHSA (aka Proposition 63)63)

1% tax on taxable personal income over $1 million to 1% tax on taxable personal income over $1 million to be deposited into a Mental Health Services Fund be deposited into a Mental Health Services Fund (MHSF) in State Treasury(MHSF) in State Treasury

Administered by State Department of Mental HealthAdministered by State Department of Mental Health

Oversight by 16-Member Accountability CommissionOversight by 16-Member Accountability Commission

Distributed to Counties Via Current State-County Distributed to Counties Via Current State-County ContractContract

$300 Est. Million in FY05; $700 Million Est. in FY06$300 Est. Million in FY05; $700 Million Est. in FY06

Phased in approach to implementation, beginning Phased in approach to implementation, beginning with Planning and Expanded Service componentswith Planning and Expanded Service components

Counties currently submitting first component Counties currently submitting first component funding requestsfunding requests

Overview of Overview of MHSA ComponentsMHSA Components

SSix phased-in components completed through a state and local stakeholder involved process:

1. Community Program Planning (5%)

2. Community Services and Supports (50%)

3. Capital and Information Technology (10%)*

4. Education and Training (10%)*

5. Prevention and Early Intervention (20%)*

6. Innovation (5%)*

*requirements and allocation method undetermined

Plan Approved by the Plan Approved by the Board of SupervisorsBoard of Supervisors

Community Services & Supports Community Services & Supports PlanPlan

Santa Clara: $13.4 Million x 3 yrs Santa Clara: $13.4 Million x 3 yrs 51%+ in Full Service Partnerships51%+ in Full Service Partnerships 49% System Development/Outreach & Engagement49% System Development/Outreach & Engagement 20+ Specific Age-Based Work Plans20+ Specific Age-Based Work Plans Subject to DMH approval Subject to DMH approval Each distinct program must be approved/deniedEach distinct program must be approved/denied Approval expected for initial plans by April 2006Approval expected for initial plans by April 2006

Board of Supervisors

State Dept. ofMental Health

BOS Committees(HHC, CSFC, PSJC)

County ExecutiveSCVHHS Exec. Dir

MHSA StakeholderLeadership Committee

Work Group & Strategy Teams

Children & Youth

0-15 Years

Work Group & Strategy Teams

Older Adults60+ Years

Work Group & Strategy Teams Transition Age

Youth16-25 Years

Work Group & Strategy Teams

Adults26-59 Years

Community Stakeholder Forums, Focus Groups, and Consumer Engagement Groups, Surveys, Meetings

Cultural Competency

Wellness and Recovery

Evidenced Based Practices

MHSA Vision & Requirements

FocusGroup

FocusGroup

FocusGroup

FocusGroup

FocusGroup

Accountability Commission

Mental Health Board

Project Management

Team

Santa Clara CountyMHSA Planning

Structure

Ethnic Community Advisory

Committees

Ethnic Community Advisory

Committees

Plan RequirementsPlan Requirements

The Three-Year CSS The Three-Year CSS PlanPlan

Identify Community

Concerns for All Ages

Determine Unmet Need &

Disparities

Identify Specific

Populations for Focus

Identify strategies to Meet

Need

1 2 3 4

$13.4 Million per year 20 Program Work

Plans

Planning PhasePlanning PhaseAccomplishmentsAccomplishments

Inreach and Outreach CampaignInreach and Outreach Campaign March through June March through June 2005–2005– 10,000 voices of input!10,000 voices of input!

Work GroupsWork Groups drafted concerns and potential focal drafted concerns and potential focal populations;populations;

Ethnic Community Advisory CommitteesEthnic Community Advisory Committees formed and formed and providing ongoing input;providing ongoing input;

Strategy TeamsStrategy Teams researched and identified key strategies researched and identified key strategies for nine focal populations;for nine focal populations;

Stakeholder Leadership CommitteeStakeholder Leadership Committee - - endorsed draft endorsed draft plan recommendations from Work Groups, Strategy Teams, plan recommendations from Work Groups, Strategy Teams, and Ethnic Community Advisory Teamsand Ethnic Community Advisory Teams

Three Three Public HearingsPublic Hearings sponsored by the Mental Health sponsored by the Mental Health Board in November 2005Board in November 2005

Board of Supervisors approvedBoard of Supervisors approved CSS Plan for state CSS Plan for state submission in Decembersubmission in December

Focal PopulationsFocal PopulationsDefined Per Defined Per RequirementsRequirements

Children 0 - 15Children 0 - 151.1. Zero to Five Years High RiskZero to Five Years High Risk2.2. Foster Care YouthFoster Care Youth3.3. Juvenile Justice Involved YouthJuvenile Justice Involved Youth4.4. Underserved Seriously Emotionally DisturbedUnderserved Seriously Emotionally Disturbed

Transition Age Youth 16 - 25Transition Age Youth 16 - 255.5. First Time PsychosisFirst Time Psychosis6.6. Sixteen to 25 Years Aging Out of Child SystemsSixteen to 25 Years Aging Out of Child Systems

Adults 26 - 59Adults 26 - 597.7. Jail Involved/Homeless/Dual Diagnosed SMIJail Involved/Homeless/Dual Diagnosed SMI8.8. Underserved/Un-served SMIUnderserved/Un-served SMI

Older Adults 60+Older Adults 60+9.9. High Risk/Homebound SMI SeniorsHigh Risk/Homebound SMI Seniors

Disparities in Disparities in Unmet NeedUnmet Need

Latino, Asian and American Indian underserved Latino, Asian and American Indian underserved among all agesamong all ages

Latino, African American and American Indian over-Latino, African American and American Indian over-represented in CJS, un-housed, and foster care with represented in CJS, un-housed, and foster care with greater need (prevalence) and underservedgreater need (prevalence) and underserved

Refugee, immigrant and monolingual greater need Refugee, immigrant and monolingual greater need and less servedand less served

LGBTQ greater need and less servedLGBTQ greater need and less served

Developmentally disabled greater need and less Developmentally disabled greater need and less servedserved

Overview of Overview of Proposed Work PlansProposed Work Plans

Children 0-15Children 0-15

C-01 Full Service PartnershipsC-01 Full Service Partnerships – 30 slots; – 30 slots; est. $20K per year per child, with up to 30% to est. $20K per year per child, with up to 30% to support stable living/housing; emphasis on Latino, support stable living/housing; emphasis on Latino, African American, and American Indian juvenile African American, and American Indian juvenile justice involved and youth without insurance. justice involved and youth without insurance.

C-02 Zero to Five System C-02 Zero to Five System DevelopmentDevelopment -to develop inter-agency -to develop inter-agency infrastructure to support 0-5 year olds, includes infrastructure to support 0-5 year olds, includes planning; screening/assessment design; training of planning; screening/assessment design; training of specialists; family support and system navigation specialists; family support and system navigation for monolingual Latino and Vietnamese families.for monolingual Latino and Vietnamese families.

Children 0-15Children 0-15

C-03 Behavioral Health System C-03 Behavioral Health System DevelopmentDevelopment – System-wide – System-wide implementation of improved screening, implementation of improved screening, assessment and best practice models of assessment and best practice models of treatment; specialized access and care treatment; specialized access and care management of juvenile justice and foster care management of juvenile justice and foster care populations. Emphasis on underserved Latino, populations. Emphasis on underserved Latino, Asian, African American, American Indian Asian, African American, American Indian youth and families.youth and families.

Transition Age Youth Transition Age Youth 15 – 25 Years 15 – 25 Years

T-01 Full Service PartnershipsT-01 Full Service Partnerships – 30 slots; – 30 slots; est. $20K per year per youth, with up to 30% to est. $20K per year per youth, with up to 30% to support stable living/housing; emphasis on Latino, support stable living/housing; emphasis on Latino, African American, and American Indian exiting African American, and American Indian exiting juvenile justice and foster care systems. juvenile justice and foster care systems.

T-02 Behavioral Health System T-02 Behavioral Health System DevelopmentDevelopment System-wide implementation of System-wide implementation of improved screening, assessment and best practice improved screening, assessment and best practice models of treatment; specialized access and care models of treatment; specialized access and care management of youth child-serving systems. management of youth child-serving systems. Emphasis on underserved Latino, Asian, African Emphasis on underserved Latino, Asian, African American, Native American youth and families.American, Native American youth and families.

Transition Age Youth Transition Age Youth 15 – 25 Years 15 – 25 Years

T-03 Crisis & Drop-In Services and T-03 Crisis & Drop-In Services and

SupportsSupports safe, non-stigmatizing access to safe, non-stigmatizing access to mental health and basic services.mental health and basic services.

T-04 Education PartnershipT-04 Education Partnership – Integrated – Integrated “middle college” and community college support to “middle college” and community college support to improve school success of youth with mental improve school success of youth with mental health concerns.health concerns.

Adults 26-59Adults 26-59

A-01 Full Service PartnershipsA-01 Full Service Partnerships – 75 slots; – 75 slots; est. $20K per year per client, with up to 30% to est. $20K per year per client, with up to 30% to support stable living/housing; emphasis on Latino, support stable living/housing; emphasis on Latino, African American, Asian and American Indian, African American, Asian and American Indian, homeless, institutionalized, and frequent ER users homeless, institutionalized, and frequent ER users with severe mental illness. with severe mental illness.

A-02 Behavioral Health Recovery A-02 Behavioral Health Recovery ServicesServices – to redesign county adult outpatient – to redesign county adult outpatient services to include consumer and family support services to include consumer and family support staff; add support and case management staff; staff; add support and case management staff; and to introduce best practice strategies and align and to introduce best practice strategies and align and establish therapeutic caseload size. and establish therapeutic caseload size.

Adults 26-59Adults 26-59

A-03 Jail Aftercare and Recovery ServicesA-03 Jail Aftercare and Recovery Services – – (($2.5 M$2.5 M proposed to satisfy Jail Task Force solution proposed to satisfy Jail Task Force solution #15)#15) for criminal justice involved mentally ill:for criminal justice involved mentally ill:

Full Service PartnershipsFull Service Partnerships - 75 slots; est. $20K - 75 slots; est. $20K per year per client, with up to 30% to support per year per client, with up to 30% to support stable living/housing; emphasis on Latino, African stable living/housing; emphasis on Latino, African American, and American Indian;American, and American Indian;

Enhanced Treatment CourtEnhanced Treatment Court – 60 slots for case – 60 slots for case management and service linkage;management and service linkage;

Dual-Diagnosis After Care TreatmentDual-Diagnosis After Care Treatment – 125 – 125 slots for medication and case management slots for medication and case management services;services;

Expanded Housing OptionsExpanded Housing Options – 75 beds; – 75 beds; Transitional Housing Units (THU) Transitional Housing Units (THU)

Adults 26-59Adults 26-59

A-04 Adult Urgent Care and Crisis A-04 Adult Urgent Care and Crisis SupportSupport – Establishes urgent care and mobile – Establishes urgent care and mobile crisis response in north, central and south crisis response in north, central and south county regions.county regions.

A-05 Consumer and Family Self-Help A-05 Consumer and Family Self-Help SupportSupport- Establishes Director of Consumer - Establishes Director of Consumer Affairs and Director of Family Support and Affairs and Director of Family Support and Education, in addition to expanded consumer Education, in addition to expanded consumer and family self-help with focus on unserved and and family self-help with focus on unserved and underserved ethnic and cultural communities. underserved ethnic and cultural communities.

Older Adults Older Adults 60+60+

OA-01 Full Service PartnershipsOA-01 Full Service Partnerships – 25 slots; – 25 slots; est. $20K per year per client, with up to 30% to est. $20K per year per client, with up to 30% to support stable living/housing; emphasis on those support stable living/housing; emphasis on those in or at risk of homelessness, institutionalization, in or at risk of homelessness, institutionalization, incarceration; physical and emotional harm.incarceration; physical and emotional harm.

OA-02 Behavioral Health ServicesOA-02 Behavioral Health Services – – System-System-wide implementation of improved screening, wide implementation of improved screening, assessment and best practice models of assessment and best practice models of treatment; specialized access and care treatment; specialized access and care management of older adults; expanded service to management of older adults; expanded service to senior day programs.senior day programs.

Older Adults Older Adults 60+60+

OA-03 Senior Mobile Assessment & OA-03 Senior Mobile Assessment & OutreachOutreach-- Provides specialized mobile Provides specialized mobile assessment and outreach services to shut-in and assessment and outreach services to shut-in and homebound mentally ill seniors, many of whom homebound mentally ill seniors, many of whom are experiencing concurrent medical and are experiencing concurrent medical and substance abuse problems; focus on monolingual substance abuse problems; focus on monolingual seniors.seniors.

OA-04 Senior Family and Caregiver SupportOA-04 Senior Family and Caregiver Support – Provides culturally appropriate family and – Provides culturally appropriate family and caregiver support and education to those caring caregiver support and education to those caring for mentally ill seniors.for mentally ill seniors.

Crosscutting Crosscutting Strategies Strategies

State requirements allow up to 6 State requirements allow up to 6 months ($6.7 million) of FY06 months ($6.7 million) of FY06 funds to be used for one-time funds to be used for one-time expenses over three years. These expenses over three years. These funds are proposed to support funds are proposed to support several age-based plans in addition several age-based plans in addition to several cross-cutting initiatives.to several cross-cutting initiatives.

Crosscutting Crosscutting Strategies Strategies

HO-01 – Housing Options – HO-01 – Housing Options – Establishes $4 million fund to develop housing options in collaboration with Office of Affordable Housing with $2 million MHSA and $2 million from County. Upon State approval of this proposal, MHD and OAH will jointly design expenditure plan with assistance of housing experts, and will bring back to BOS for approval. Objective will be to leverage these funds in order to maximize the establishment of ongoing permanent housing for the mentally ill in Santa Clara County.

Crosscutting Crosscutting StrategiesStrategiesHousing Component SummaryHousing Component Summary Full Service Partnerships (C-01, T-01, A-01, Full Service Partnerships (C-01, T-01, A-01,

A-03 and OA-01)A-03 and OA-01). . Est. $2-3 MillionEst. $2-3 Million (30% of annual (30% of annual resources) will go to securing and maintaining stable resources) will go to securing and maintaining stable permanent living for clients. permanent living for clients.

MHSA Housing Fund (HO-01) - MHSA Housing Fund (HO-01) - $4 Million$4 Million to to

develop permanent housing resources.develop permanent housing resources.

Jail Aftercare & Recovery (A-03) - Jail Aftercare & Recovery (A-03) - $625,000$625,000 for for 75 Transition Housing Units dedicated to jail 75 Transition Housing Units dedicated to jail aftercare. Length of stay and provider requirements aftercare. Length of stay and provider requirements will be determined through collaboration with Jail will be determined through collaboration with Jail Task Force members.Task Force members.

Crosscutting Crosscutting StrategiesStrategies FH-01 – Community & Family Outreach FH-01 – Community & Family Outreach

and Engagement Initiative –and Engagement Initiative – to develop to develop culturally competent outreach and culturally competent outreach and engagement strategies to underserved engagement strategies to underserved populations.populations.

HC-01 – Behavioral & Primary Health HC-01 – Behavioral & Primary Health Care PartnershipCare Partnership – to establish pilot – to establish pilot program to improve primary care service program to improve primary care service access for clients of the mental health access for clients of the mental health system.system.

Crosscutting Crosscutting Strategies Strategies

EE-01 – Education, Employment, and Self-EE-01 – Education, Employment, and Self-Sufficiency Services - Sufficiency Services - to develop to develop comprehensive education, employment and comprehensive education, employment and benefit assistance system for all clients of the benefit assistance system for all clients of the system.system.

ST-01 – Regional Survivors of Torture ST-01 – Regional Survivors of Torture Treatment ServicesTreatment Services – to establish regionally – to establish regionally available specialty treatment services for Bay available specialty treatment services for Bay

Area refugee survivors of torture.Area refugee survivors of torture.

Implementation Implementation ApproachApproach

ImplementationImplementationImplementationImplementation

Training

Program

DataBudge

t Info

ChildreChildrenn

TAYTAY

AdultsAdults

SeniorsSeniors

Full Service Partnerships

System Development

Outreach and Engagement

Jan 2006

Sep 2006

Jun 2006

ImplementationImplementation

TrainingTraining

– All system stakeholders will be offered All system stakeholders will be offered training on new program groups (Full training on new program groups (Full Service, System Development, Outreach & Service, System Development, Outreach & Engagement) by the Engagement) by the MHD Training TeamMHD Training Team. .

– Training to continue through RFP process Training to continue through RFP process and provider selection. and provider selection.

– Ongoing annual Ongoing annual Learning Partnership Learning Partnership Training Plan Training Plan will be developed.will be developed.

ImplementationImplementation

Program RequirementsProgram Requirements

– A A Program Requirements TeamProgram Requirements Team will will develop program requirements for develop program requirements for each group of programs by age group each group of programs by age group (Full Service, System Development, (Full Service, System Development, Outreach & Engagement)Outreach & Engagement)

– Requirements will be included in Requirements will be included in RFP’s, county program descriptions, RFP’s, county program descriptions, policies and procedurespolicies and procedures

ImplementationImplementation

Outcomes Data and TechnologyOutcomes Data and Technology

– All new programs will have state and All new programs will have state and county outcomes requirements county outcomes requirements defined, communicated and managed defined, communicated and managed by a by a Data and Technology TeamData and Technology Team for for each group of programs (Full Service, each group of programs (Full Service, System Development, Outreach & System Development, Outreach & Engagement)Engagement)

ImplementationImplementation

Budget and Fiscal Budget and Fiscal ManagementManagement

– A MHD A MHD Budget and Fiscal TeamBudget and Fiscal Team will will develop, monitor and manage develop, monitor and manage program budgets and budget program budgets and budget reports throughout the reports throughout the implementation process. implementation process.

ImplementationImplementation

Stakeholder CommunicationStakeholder Communication

– MHD will develop a MHD will develop a Communication Communication PlanPlan to ensure ongoing information to ensure ongoing information flow to staff, providers, system flow to staff, providers, system partners, Mental Health Board and partners, Mental Health Board and county and state leadership. county and state leadership.

Tentative TimelineTentative Timeline(Calendar Regularly Updated on Website)(Calendar Regularly Updated on Website)

January 27January 27 -- Launch Implementation PhaseLaunch Implementation Phase

February 24February 24 -- Potential Provider OrientationPotential Provider Orientation

Feb 27 - Mar 2 Feb 27 - Mar 2 -- Full Service Partnership TrainingFull Service Partnership Training

March 17March 17 -- Full Service Partnership RFP ReleasedFull Service Partnership RFP Released

March 29March 29 -- Mandatory Vendor ConferenceMandatory Vendor Conference

May 3May 3 - - Full Service Partnership Proposals DueFull Service Partnership Proposals Due

Late MayLate May -- Full Service Partnership Contract AwardsFull Service Partnership Contract Awards

JuneJune -- Contract Negotiations/DevelopmentContract Negotiations/Development

JulyJuly -- Full Service Partnership Contracts Full Service Partnership Contracts

BeginBegin

Contact InfoContact Info

Nancy Pena, Ph.D., Director, MHD, 408-885-5783

Bruce Copley, Deputy Director, MHD 408-885-5773

Tiffany Ho, M.D., Medical Director, MHD, 408-885-5781

Sheila Yuter, MHSA Coordinator, 408-885-3885

Maria Fuentes, Ethnic Services Manager, 408-885-5775

Santa Clara County MHD Website www.sccmhd.org

State Dept. Mental Health website www.dmh.ca.gov

Thank You!