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Mental Health Services Act 101

Rules and Regulations

Galen Main

County of Marin

Behavioral Heath and Recovery Services

ABOUT

1967: State mental hospitals emptied

Historical context

  • California led the nation in deinstitutionalizing mental illness
  • Promise of community care
  • Promise never fulfilled
  • One year after the law went into effect, the number of mentally ill people in the criminal-justice system doubled
  • More than 50,000 individuals with severe mental illness lived on the streets of California

MHSA

Championed by consumers and family members, Proposition 63, the Mental Health Services Act (MHSA) was passed by California voters in November 2004.

1% tax on all personal income over $1M

Core Principles

Values

MHSA Values

Community Collaboration

Client Driven

Family Driven

Cultural Competence

Wellness, Recovery & Resilience Focused

Integrated Service Experience

MHSA Funding Distribution

19%

5%

DIVING DEEPER

76%

note: interest is allocated according to these same percentages

Prevention & Early Intervention

Prevention and Early Intervention

“Prevent mental illness from becoming severe and disabling”

and improve “timely access for under-served populations

Moves to a “help first” rather than

“fail first” strategy

51% of PEI funds for Youth

Goal to intervene earlier or prevent the onset of serious mental illness

Required to spend 51% of PEI funds on

youth between ages 0 and 25, because:

  • half of all mental disorders start by age 14
  • three-fourths start by age 24

PEI funds revert to the state if not spent within 3 years (including the year the revenue came to the county)

Three Year Reversion

SB 1004 - Wiener

Mental Health Services Act: prevention and early intervention. (Amended: 8/20/2018). Would require the MHSOAC, on or before January 1, 2020, to establish priorities for the use of prevention and early intervention funds and to develop a statewide strategy for monitoring implementation of prevention and early intervention services, including enhancing public understanding of prevention and early intervention and creating metrics for assessing the effectiveness of how prevention and early intervention funds are used and the

outcomes that are achieved.

Pending Legislation

Program Types

PEI focuses on reducing negative outcomes that may result from untreated

mental illness, such as suicide, incarceration, school failure or drop out,

unemployment, homelessness, prolonged suffering, and removal of children

from the family home.

Outcomes

key MHSA-intended PEI outcomes:

increased recognition of and response to early signs of mental illness; increased access to

treatment for people with serious mental illness; improved timely access to

services for underserved communities with persons at risk of or with a mental

illness; reduced stigma associated with either being diagnosed with a mental

illness or seeking mental health services; and reduced discrimination against

people with mental illness.

INNOVATION

MHSOAC controls funding approval, Goals include:

increase access to underserved groups

increase the quality of services

promote interagency collaboration

increase access to services

Important to contribute to learning--by design, not all INN projects will be successful

Community Services and Supports

Community Services and Supports

Up to a total of 20% of the CSS allocation can be transferred to any combination of these 3 categories

Funding Options

Up to an additional 5% can be allocated to Community Program Planning

Prudent Reserve

The MHSA authorizes a county to maintain a prudent reserve to ensure that services do not have to be significantly reduced in years in which revenues are below the average of previous years.

In order to spend the Prudent Reserve the State has to send a letter to the counties indicating that the economic conditions warrant tapping into the Prudent Reserve. The State has not authorized use of the PR since the last economic downturn.

SB 192

New Legislation

New guidlines set the PR maximum amount at 33% of the past 5 years' average CSS allocation

~$2.337M for Marin, approximetly $162K above our current PR of $2.175M

The WET

component aims to:

train more people to remedy the shortage of qualified individuals who provide services to address severe mental illness

promote employment of mental health clients and their family members in the mental health system

increase the cultural competency of staff and workforce development programs

WET

Capital Facilities and Technological Needs

CFTN

Funding for Capital Facilities is to be used to acquire, construct, and/or renovate facilities that provide services and/or treatment for those with severe mental illness or that provide administrative support to MHSA funded programs.

Funding for Technological Needs is to be used to fund county technology

projects with the goal of improving access to and delivery of mental health

services

Community Program Planning example costs:

CPP

  • Child care for community forums or focus groups
  • Facilitators and interpreters
  • Food for community planning events
  • Transportation subsidies for consumers/family members
  • Room rentals
  • Technology needs for meetings

51% of CSS allocation must go toward Full-Service Partnerships (FSP)

Funding Requirements

CSS funding reverts to the State if not spent within 3 years

Full Service Partnerships (FSPs)

FSPs

FSPs consist of a service and support delivery system for the public mental health system’s hardest to serve clients, as described in Welfare and Institutions Code (WIC) Sections 5800 et. seq. (Adult and Older Adult Systems of Care) and 5850 et. seq. (Children's System of Care).

FSPs provide wrap-around or “whatever it takes” services to clients.

General System Development

System Development

  • funds are used to improve programs, services, and supports for clients consistent with the MHSA target populations

  • services may include client and family services such as peer support, education and advocacy services, and mobile crisis teams.

  • programs also promote interagency and community collaboration and services, and develop the capacity to provide values-driven, evidence-based and promising clinical practices.

  • This funding may only be used for mental health services and supports to address mental illness or emotional disturbance.

Outreach and Engagement

Outreach and Engagement

Activities are specifically aimed at reaching populations who are unserved or underserved. The activities help to engage those reluctant to enter the system and provide funds for screening of children and youth.

Examples of organizations that may receive funding include:

  • racial ethnic community-based organizations,
  • mental health and primary care partnerships,
  • faith-based agencies,
  • tribal organizations, and
  • health clinics.

TIMELINE

3 Year Plan

FY 17/18

FY 18/19

FY 19/20

July 1, 2020

2018

Community Program Planning

FY 20/21

3 Year Plan

TIMELINE

TEAM PROFILES

Marin County Behavioral Health & Recovery Services

Wider Mental Health Services Act Team

Chandrika Zager, LCSW, MPH

Cesar Lagleva, LCSW

Galen Main, MSW

Veronica Alcala

Jei Africa, PsyD, MSCP, CATC-V

Kristen Gardner,

MPH, MA

Mental Health Services Act Coordinator

Ethnic Services Manager & WET Coordinator

Administrative Services Technician

Director, Behavioral Health and Recovery Services

Prevention & Early Intervention Coordinator

Growing Roots Innovation Project Coordinator (contractor)

  • MHSA Advisory Committee
  • Cultural Competency Committee
  • TAY Advisory Council
  • WET Steering Committee
  • Mental Health Board
  • Prevention and Early Intervention Provider Committee
  • Alcohol and Other Drug Advisory Board
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