santa clara county planning kickoff mental health services act

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1 Santa Clara County Santa Clara County Planning Kickoff Planning Kickoff Mental Health Services Act Mental Health Services Act Department of Mental Health January 26, 2005 January 26, 2005

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Santa Clara County Planning Kickoff Mental Health Services Act. January 26, 2005. Department of Mental Health. Welcome on Behalf of…. Board of Supervisors County Executive SCVHHS Executive Director Mental Health Director Mental Health Board Consumers & Providers. - PowerPoint PPT Presentation

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1

Santa Clara CountySanta Clara CountyPlanning KickoffPlanning Kickoff

Mental Health Services Mental Health Services ActAct

Department of Mental Health

January 26, 2005January 26, 2005

2

Welcome on Behalf of…Welcome on Behalf of…

Board of SupervisorsBoard of Supervisors

County ExecutiveCounty Executive

SCVHHS Executive DirectorSCVHHS Executive Director

Mental Health DirectorMental Health Director

Mental Health BoardMental Health Board

Consumers & ProvidersConsumers & Providers

3

Meeting ObjectivesMeeting Objectives

Orient Stakeholders to MHSA Orient Stakeholders to MHSA

Engage Stakeholders in Planning Engage Stakeholders in Planning ProcessProcess

Overview Planning ProcessOverview Planning Process

Obtain Stakeholder Input Obtain Stakeholder Input

4

AgendaAgenda

1.1. Overview - MHSA RequirementsOverview - MHSA Requirements

2.2. DMH Vision & Transformation DMH Vision & Transformation

ExpectationsExpectations

3.3. Local Planning Process & TimelinesLocal Planning Process & Timelines

4.4. Brief Overview of SCVHHS MHDBrief Overview of SCVHHS MHD

5.5. Stakeholder Input to Vision & Stakeholder Input to Vision &

InvolvementInvolvement

6.6. Next Steps and ClosureNext Steps and Closure

5

Purpose of the Purpose of the Mental Health Mental Health

Services Act (MHSA)Services Act (MHSA)

The stated purpose of the The stated purpose of the Mental Health Services Act Mental Health Services Act

is to “expand mental is to “expand mental health services” in health services” in

CaliforniaCalifornia

6

MHSA FundingMHSA Funding

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

Is used to expand, not supplant services; can Is used to expand, not supplant services; can “not be “not be used to supplant existing state or county funds used to supplant existing state or county funds utilized to provide mental health services.”utilized to provide mental health services.”

7

MHSA is IntendedMHSA is Intended toto

Introduce effective new service models that promote well-being, recovery and self-help

Introduce prevention and early intervention to prevent negative impact of serious mental illness

Enhance human resource, technology and capital infrastructure of current system

Reduce stigma and change negative social perceptions of mental illness

Correct fragmentation and inadequate funding

8

Current Situation in Current Situation in CaliforniaCalifornia

Estimates (Year 2000) are that over 1,000,000 adults, older

adults, and children/youth living at or below 200% of poverty in California are in need of treatment.

The public system provides an estimated 460,000 persons with services indicating we would need to more than double capacity to

meet the needs of those who rely on public services.

9

Mental Health Mental Health Prevalence DataPrevalence Data

Research indicates prevalence of mental illness in US is 8.55% (adjusted for age and ethnicity).

This equals 145,000 Santa Clara County residents, with 26,639 living at 200% or below of poverty.

Current SCC MH system serves 18,000 year, with less than 10,000 ongoing

10

MHSA in PerspectiveMHSA in Perspective

CA public system had $3.1 Billion in expenditures in FY 2001/02.

MHSA is projected to provide $700 Million in new revenue in FY 2005/06 with est. 50% going to direct service expansion.

Initial Full Year Will Increase Direct Services by 15%

SCC share between $17 - $30 Million, depending on DMH allocation method.

11

MHSA MHSA Overview of Plan Overview of Plan

ComponentsComponents

12

Nine Categories of Nine Categories of ExpendituresExpenditures

1.1. Local PlanningLocal Planning

2.2. Services to ChildrenServices to Children

3.3. Services to Adults & Older Adults Services to Adults & Older Adults

4.4. Innovative Programs (within 1&2)Innovative Programs (within 1&2)

5.5. Prevention and Early InterventionPrevention and Early Intervention

6.6. Education and TrainingEducation and Training

7.7. Capital and Technology DevelopmentCapital and Technology Development

8.8. State Planning and AdministrationState Planning and Administration

9.9. Prudent Local ReservesPrudent Local Reserves

13

Initial Funding FY04-05Initial Funding FY04-05

FY04-05 funds (est. $300 Million)FY04-05 funds (est. $300 Million)

45% - Education and Training (DMH 45% - Education and Training (DMH fund)fund)

45% - Capital Facilities Technology 45% - Capital Facilities Technology (DMH fund)(DMH fund)

5% - Local Planning (to counties)5% - Local Planning (to counties)

5% - State Implementation (to DMH 5% - State Implementation (to DMH Admin)Admin)..

14

Distribution of Funds inDistribution of Funds inFY06, FY07 and FY08FY06, FY07 and FY08Est. $600 – 700 MillionEst. $600 – 700 Million

10% - Education & Training10% - Education & Training

10% - Capital and Technology 10% - Capital and Technology

50% - Children, Adult, Senior Services50% - Children, Adult, Senior Services

5% - Innovative Programs5% - Innovative Programs

20% - Prevention and Early 20% - Prevention and Early InterventionIntervention

5% - State Administration5% - State Administration

15

Distribution of Funds After 07-Distribution of Funds After 07-0808

Est. $700-800 Million Est. $700-800 Million No longer designated percentage to No longer designated percentage to

specific categories. specific categories.

May be used for:May be used for:

Services for children, adults and older adults Services for children, adults and older adults

Technological needs and capital facilitiesTechnological needs and capital facilities

Human resource needsHuman resource needs

A prudent reserve to ensure that services do A prudent reserve to ensure that services do not have to be reduced in years in which not have to be reduced in years in which revenues are below previous years. revenues are below previous years.

16

Local PlanningLocal Planning

$12.7 Million (5%) FY05 funds go to counties for planning as outlined by DMH.

Each county is to receive $75,000 plus county share of the statewide prevalence of mental health need for those living at or below 200% of poverty.

Santa Clara County will receive $302,000 for planning (project management, provider and stakeholder training, needs assessment)

17

Expansion of Expansion of Direct Service SystemDirect Service System

First Phase of Funding – FY06First Phase of Funding – FY06

Children and Transition Children and Transition Age Age YouthYouth

Emphasis on effective intervention models

County implementation of wraparound

Must address Transition Age Youth Current definitions of eligible populations

18

Expansion of Expansion of Direct Service SystemDirect Service System

First Phase of Funding – FY06First Phase of Funding – FY06

Adults and Older AdultsAdults and Older Adults

Recovery focus, consumer-operated services, attention to culturally competent services

Focus on AB2034 – wrap style for hard-to-serve

MIOCR-type programs effective with criminal justice populations

Attention to dual diagnosed population

19

Innovative ProgramsInnovative Programs5% in FY065% in FY06

Included as part of system of care expansion

Includes increased access to underserved groups

Increased and better outcomes

Promotion of interagency collaboration and increased access to services

20

Implementation ofImplementation ofPrevention & Early Prevention & Early

InterventionInterventionProbable 2Probable 2ndnd Phase – FY06 Phase – FY06

Prolonged suffering Homelessness Removal of children

from their homes

Includes outreach, access, reduction of Includes outreach, access, reduction of stigma, reduction of stigma, reduction of

discrimination. discrimination.

Emphasis on reducing negative Emphasis on reducing negative outcomes of:outcomes of:

Plan Requirements expected before 7/05

Suicide Incarcerations School

failure/dropout Unemployment

21

Implementation of Implementation of Education and TrainingEducation and Training

Implementation TBDImplementation TBD

Includes staff needs assessment by counties

Five-year education and training plan by state

Educational stipends and forgiveness loans and other strategies to increase the size of the mental health work force

Education and curriculum development to “retrain” and increase staff capability, create regional partnerships

22

Implementation of Human Implementation of Human Technology and Capital Technology and Capital

ProjectsProjects Implementation TBDImplementation TBD

DMH to establish requirements for DMH to establish requirements for counties to apply for funding for counties to apply for funding for information service and capital information service and capital projectsprojects

23

State Department of State Department of Mental HealthMental Health

Vision of a Vision of a Transformed SystemTransformed System

24

DMH Proposed IntentDMH Proposed Intent

Build long-term vision of Build long-term vision of transformation of the current transformation of the current mental health system mental health system

Initiate phased-in multiple Initiate phased-in multiple plan components which will plan components which will eventually be integratedeventually be integrated

25

Letter to Stakeholders Letter to Stakeholders DMH Director Steve DMH Director Steve

Mayberg Mayberg

“To… expend funds made available

through this initiative to transform the

current mental health system in

California …This will not be “business as

usual”. Eventually access will be easier,

services more effective and out-of-home

and institutional care will be reduced.”

26

DMH: Vision Statement DMH: Vision Statement Includes Improvements in:Includes Improvements in:

Consumer and Family Participation Consumer and Family Participation and Involvementand Involvement

Programs and ServicesPrograms and Services

Community PartnershipsCommunity Partnerships

Cultural CompetenceCultural Competence

Outcomes and AccountabilityOutcomes and Accountability

27

DMH: Key Source DMH: Key Source DocumentsDocuments

President’s New Freedom Commission President’s New Freedom Commission on Mental Health Reporton Mental Health Report

Institute of Medicine’s Institute of Medicine’s Crossing the Crossing the Quality ChasmQuality Chasm Report Report

California Planning Council’s California Planning Council’s Master Master PlanPlan

Little Hoover Commission ReportsLittle Hoover Commission Reports

Reports of the Select Committee of Reports of the Select Committee of the California Legislaturethe California Legislature

28

Santa Clara County Santa Clara County PlanningPlanning

29

Santa Clara County Santa Clara County MHSAMHSA

Planning Process Planning ProcessBroad based stakeholder process

Stakeholder Leadership Committee to:

Review Development of PlanReview Development of Plan Facilitate Stakeholder Facilitate Stakeholder InvolvementInvolvement

Educate CommunityEducate Community Advise Board of SupervisorsAdvise Board of Supervisors

30

Board of Supervisors

State Dept. ofMental Health

BOS Committees(HHC, CSFC, PSJC)

County ExecutiveSCVHHS Exec. Dir

MHSA StakeholderLeadership Committee

Data, Technology,

Budget Work Group

Prevention & Early

InterventionWork Group

Children’s System of Care Work

Work Group

Adult/Older Adult

System of Care Work Group

Community Stakeholder Forums, Focus Groups, and Consumer Engagement Groups

Readiness Forums Readiness Forums Readiness Forums Readiness Forums

FocusGroup

FocusGroup

FocusGroup

FocusGroup

FocusGroup

Accountability Commission

Mental Health Board

Project Management

Santa Clara CountyMHSA Planning

Structure

31

SCC Planning ProcessSCC Planning Process Monthly Stakeholder Leadership Monthly Stakeholder Leadership

Meetings for:Meetings for:• Information and Status ReportsInformation and Status Reports• Input from Broad CommunityInput from Broad Community• Readiness ForumsReadiness Forums

Work Group Meetings:Work Group Meetings:•Child, Adolescent, Young Adult SOCChild, Adolescent, Young Adult SOC•Adult and Older Adult SOCAdult and Older Adult SOC•Prevention and Early InterventionPrevention and Early Intervention•Data, Infrastructure and Human Data, Infrastructure and Human

ResourcesResources

Regular Reports Board and Board Regular Reports Board and Board Committees and Mental Health BoardCommittees and Mental Health Board

32

Local Planning ProcessLocal Planning ProcessPartial List of StakeholdersPartial List of Stakeholders

• Mental Health Department (chair)Mental Health Department (chair)

• County Executive’s Office (co-chair)County Executive’s Office (co-chair)

• Mental Health Board (co-chair)Mental Health Board (co-chair)

• Mental Health Self-Help Centers Mental Health Self-Help Centers

• MHD Office of Consumer MHD Office of Consumer Empowerment Empowerment

• National Alliance for the Mentally Ill National Alliance for the Mentally Ill

• Association of Mental Health Association of Mental Health Contract Agencies Contract Agencies

• Non-AMHCA mental health providersNon-AMHCA mental health providers

• Labor OrganizationsLabor Organizations

• Foster Care Association Foster Care Association

• Parents Helping Parents Parents Helping Parents

• Department of Alcohol and Drug Department of Alcohol and Drug Services Services

• Public Health Department Public Health Department

• VMC Acute Psychiatric Services VMC Acute Psychiatric Services

• Custody Health ServicesCustody Health Services

• Valley Medical Center Valley Medical Center

• Office of the Public GuardianOffice of the Public Guardian

• Police Chief Association Police Chief Association

• SCC Sheriff SCC Sheriff

• Department of Social Services Department of Social Services

• Probation Department Probation Department

• Superior Court Superior Court

• District Attorney’s Office District Attorney’s Office

• Public Defender’s Office Public Defender’s Office

• County Office of Education County Office of Education

• School District Superintendents School District Superintendents

• First Five Commission First Five Commission

• Council on Aging Council on Aging

• Office of Affordable Housing Office of Affordable Housing

• Domestic Violence Council Domestic Violence Council

• School Linked Services School Linked Services

• United Way United Way

• Interfaith Council Interfaith Council

• Silicon Valley Council of Non-Silicon Valley Council of Non-profitsprofits

• San Andreas Regional CenterSan Andreas Regional Center

33

Planning RequirementsPlanning Requirements

Consumer and Family Centered Consumer and Family Centered

Broad Stakeholder InvolvedBroad Stakeholder Involved

“ “Transformation” DesignedTransformation” Designed

Reflective of MHSA and DMH VisionReflective of MHSA and DMH Vision

Inclusive of Practice Proven Service ModelsInclusive of Practice Proven Service Models

Improved Cultural CompetenceImproved Cultural Competence

Improved Outcomes & AccountabilityImproved Outcomes & Accountability

Reduced InstitutionalizationReduced Institutionalization

Reduced StigmaReduced Stigma

34

Planning PhasesPlanning Phases Engagement and CommitmentEngagement and Commitment

Invite Stakeholder InvolvementInvite Stakeholder Involvement Share Intent and VisionShare Intent and Vision Motivate and Include In PlanningMotivate and Include In Planning

Learning and AssessmentLearning and Assessment Learn Current SystemLearn Current System Learn Needs of Consumers, Stakeholders, CommunityLearn Needs of Consumers, Stakeholders, Community Learn Best Practice Strategies to Meet NeedsLearn Best Practice Strategies to Meet Needs

Prioritization and PlanningPrioritization and Planning Establish Local Mission, Values & Transformation Establish Local Mission, Values & Transformation

ObjectivesObjectives Prioritize Local NeedsPrioritize Local Needs Select Most Effective Strategies to Meet Local NeedsSelect Most Effective Strategies to Meet Local Needs

ImplementationImplementation Obtain State ApprovalObtain State Approval Select Local ProvidersSelect Local Providers Initiate, Monitor and Evaluate ServicesInitiate, Monitor and Evaluate Services

35

Initial Timeline EstimatesInitial Timeline Estimates

January 2005

State Final Requirements for Planning FundsBOS Approves Planning ProcessCounty Launches Local Stakeholder Planning ProcessProject Management Contractor Selected

February 2005February 2005Project Management Plan CompletedProject Management Plan Completed

County SubmitsCounty Submits Planning ProposalState Publishes Implementation Requirements for First PhaseReadiness Forum on Cultural CompetencyStatus Report to Stakeholder Leadership Committee

36

Initial Timeline EstimatesInitial Timeline Estimates

March–June 2005March–June 2005State Finalizes MHSA Implementation RequirementsCounty Completes Adult & Child SOC Expansion PlansMental Health Board Holds Public Hearing on PlanCounty Submits FY06 Community Services Expansion

PlanCounty Initiates Local Planning of other Program Areas

July-Dec 2005July-Dec 2005State Approves Community Services Expansion PlanState Allocates Service Expansion FundingState/County Finalize FY06 Performance ContractCounty Implements Expanded ServicesCounty Continues Planning in Other Expenditure Areas

37

Current Public Mental Current Public Mental Health SystemHealth System

38

SCC Mental Health SystemSCC Mental Health SystemCurrent MandatesCurrent Mandates

There are 4 primary target populations served by current public mental health systems:

1)   Individuals served involuntarily under LPS,2)   Eligible Special Education students,3)   Eligible Medi-Cal beneficiaries,4)   Eligible poor and uninsured

MHSA will expand direct services to #3 & #4

MHSA will introduce prevention & early intervention to all populations

39

SCC Mental Health System SCC Mental Health System OverviewOverview

FY05 Budget $190 MillionFY05 Budget $190 Million Services to 18,000 UnduplicatedServices to 18,000 Unduplicated Four Divisions of ServicesFour Divisions of Services

Adult & Older AdultAdult & Older AdultChildren & FamiliesChildren & FamiliesAcute Emergency & InpatientAcute Emergency & InpatientCustody Adult Mental HealthCustody Adult Mental Health

40

Stakeholder InputStakeholder Input

To VisionTo Vision

To PlanningTo Planning

41

Next Steps and ClosureNext Steps and Closure