BEHAVIORAL HEALTH AND RECOVERY SERVICES DIVISION MHSA Advisory Committee Meeting

January 25, 2017

1:30 to 3:00 p.m.

AGENDA

1:30 Welcome, Introductions and Announcements

1:40 Review of Meeting Notes

1:50 Director’s Report

2:05 MHSA Community Planning Update

2:20 MHSA Advisory Committee Input

2:40 Review of MHSAAC Role / Committee Attendance

3:00 Adjourn

Next Meeting Date: February 22, 2017 1:30 – 3:00, 20 N. San Pedro, Pt. Reyes Conf. Room

 

BEHAVIORAL HEALTH AND RECOVERY SERVICES DIVISION MHSA Advisory Committee Meeting

December 13, 2016 20 N. San Pedro Rd., Conf. Room Pt. Reyes

12:30 to 2:00 p.m.  

 

AGENDA

12:30 Welcome, Introductions and Announcements

12:45 Director’s Report

1:00 MHSA Community Planning Update

1:10 Finance Projections for MHSA/ Current Program Funding

1:35 Program Review Tool Trial Run

2:00 Adjourn

Next Meeting Date:   January 25, 2017, 1:30 – 3:00,    20 N. San Pedro Road, Pt. Reyes Conf. Room

MHSA Advisory Committee 12/13/16 – 20 N. San Pedro Rd., Conf. Room Pt. Reyes

12:30 – 2:00 pm

12/27/2016 Page 1 of 4

In Attendance: Mary Roy, Kristen Gardner, Gustavo Goncalves, Mark Parker, Marisa Smith, Barbara Coley, Karin Jinbo, Vinh Q. Luu, Kay Browne, Lynn Murphy, Laura Taylor, Sandra Ponek, Suzanne Tavano, Suzanne Sadowsky, Carol Kerr, Brain Slattery, Victoria A. Sanders, Sandra Fawn, Amira Mostafa, Maya Gladstern

Next Meeting: – January 25, 2017. 1:30 – 3:00 20 N. San Pedro Road, Pt. Reyes Conf. Room

Topic Discussion

Welcome Introductions and Announcements

Maya is in discussion with Community Action Marin to transition the Enterprise Resource Center to a consumer run non-profit under the new MHSA 3yr plan. Consumer run means consumer staff, throughout the organization including the Board of Directors are comprised of at least 51% Consumers. San Rafael PD - Jan 27th point in time homeless count –Eric Petersen is seeking volunteers to go out and do a thorough count of homeless individuals living in Marin. epetersen@marincounty.org. (Fed and State use this data when making decisions on funding.) 2017 BHRS Calendar – If you would like to distribute and collect donations for the Calendar, please contact Gustavo Goncalves ggoncalves@marincounty.org Donations will go towards consumer scholarships to attend “Celebrate the Uncelebrated”.

Director’s Report

The requested return of $1.4 million Housing Funds from CALHFA – the check is in the mail and the 3-year clock to expend the funds before they are subject to reversion will start as soon as we are in receipt of the funds. CBHDA Update – The association provided an ‘Initial Impact Analysis: Potential Repeal of the Affordable Care Act.’ (view attachment). Medi-Cal funds may be impacted by the new federal administration. Cures Act (view attachment) was passed on the federal level. It addresses Behavioral Health and Substance Use and enables the federal government to fund these services, although this would allow for the appropriation of funds it does not currently have any funds attached. 10% of the SAMHSA block grant is recommended to go towards First Episode of Psychosis (FEP). BHRS is actively seeking and exploring ways to increase the funds available for FEP services.

MHSA Advisory Committee 12/13/16 – 20 N. San Pedro Rd., Conf. Room Pt. Reyes

12:30 – 2:00 pm

12/27/2016 Page 2 of 4

MHSA Community Planning Update

MHSA 3 Year planning has completed the community meeting forums. More focus groups are under way as well as Key informant interviews. Handout Includes – Questions which we are exploring, completed focus groups, upcoming focus groups and completed community meetings. (View attachment)

Finance Projections for MHSA/ Current Program Funding

CSS ~$1,143,000 Unallocated - We don’t know whether the grants, which fund community crisis response team will continue funding these services beyond FY 17/18. Throughout the Community Planning Process, these services have received strong support and requests for expansion. If these grants sunset, consideration will be given to utilizing the unallocated CSS funds to continue these essential services. This can be accomplished through creating a contingency budget within the upcoming 3 Year Plan. PEI - ~$95,000 Unallocated - although there may be an increase in funding from the previous years there are other expenses, such as the required tracking and data collection, required by the Mental Health Services Act Oversight and Accountability Commission, that increase in cost. INN - ~$517,000 Unallocated, which will be addressed through a separate planning process. MHSA – is based on taxation and therefore we base the budget on projections to fund programs and services. - Unexpected funds are held by Marin County and do not revert to the state, as long as they are expended within the mandated timelines.

MHSAAC Member Recruitment

Are we still recruiting members? Possibility of Kerry Pierson’s return to the Advisory Committee

MHSA Advisory Committee 12/13/16 – 20 N. San Pedro Rd., Conf. Room Pt. Reyes

12:30 – 2:00 pm

12/27/2016 Page 3 of 4

Program Review Tool Trial Run

Utilize an FSP evaluation review tool to assess a current FSP program (STAR). (View attachments) Using the Program Review Tool how will we operationalize program assessment? Rating Scale – request for demographics of who is being served throughout these programs. Reviewing programs is a difficult and nuanced task. Data analysis will be brought to the MHSAAC to raise questions regarding that data so that the MHSAAC can have a better picture of what is happening amongst these programs.

Over 50% of CSS funds must be allocated to FSPs There should be a comparison between the year before enrollment and the year following to be able to evaluate the effectiveness of the service in FSP programs, identify the racial composition of those served by program, and how many dropped out v. graduated from the programs. The folks who created the form are not present today. Advisory Committee:

Have BHRS analyze the DATA

Possibly only request information about programs being considered and not all MHSA programs

If the research isn’t available what do we ask about grassroots programs to evaluate the effectiveness of the proposed approach?

Should we review RFPs before going through the reviewing process?

We have the option to advocate for continuing, closing or improving programs.

Using an online survey – we will query stakeholders about the priorities for funding from a list of possibilities identified through the MHSA Planning Process.

The MHSAAC with consider gaps identified within the continuum of care and provide input regarding the priorities. Outcome: Overwhelming majority of the MHSAAC voted to look at condensed program data and identify gaps within a continuum rather than to review each program separately.

MHSA Advisory Committee 12/13/16 – 20 N. San Pedro Rd., Conf. Room Pt. Reyes

12:30 – 2:00 pm

12/27/2016 Page 4 of 4

Acronym Legend

PAF – Partnership Assessment Form KET – Key Event Tracking CSS – Community Support Services PEI – Prevention and Early Intervention INN – Innovation CFTN – Capital Facilities and Technological Needs WET – Workforce, Education and Training AOD – Alcohol and Other Drugs FSP – Full Service Partnerships

MHSA Advisory Committee Meeting Notes

November 15th, 2016

12:30 – 3:00pm

20 N. San Pedro Road, Point Reyes Conference Room

Next Meeting Date: December 13th 12:30 – 2pm

Advisory committee members present: Sandra Fawn, Amira Mostafa, Lynn Murphy, Vinh Q Luu, Karin Jinbo, Maya Gladstern, Heather Richardson, Carol Kerr, Laura Kantowski, Sandra Ponek, Gail Theller, Robert Reiser, Sandra Ramirez-Griggs, Kay Browne, Lisa Peacock Compton.

Non-committee participants present: Kristen Gardner, PEI/INN Coordinator, Mary Roy, MHSA Three Year Community Planning, Gustavo Goncalves BHRS Administration

Announcements: Committee Updates:

New Members

New MHSA Advisory Committee members Amira Mostafa from Tamalpais High School, Lynn Murphy San Rafael Police Department, Karin Jinbo Novato Unified School District, Kay Brown, Family Member were welcomed to the Committee.

At the request of Gail Theller, Kerry Pierson attended today’s meeting after giving his resignation as a committee member. Gail expressed her concerns that Kerry’s resignation was motivated by a finance department policy change which didn’t take into concern the difficulty caused to consumer members who may not have a bank account to cash the checks. The committee urges Administration to find an alternate method for individuals for whom the policy change causes a hardship.

The Committee expressed their gratitude to Kerry for his contribution to the committee.

MHSA Three Year Planning Process:

The MHSAAC elected to have this meeting conducted using the same process as the Community Meetings. This allowed them to have the same experience as the community and allowed them to provide input into the areas of inquiry undertaken in this 3 Year Planning Process.

A PowerPoint Presentation on understanding MHSA was developed, which provides committee members a basic understanding of MHSA, it’s purpose, central concepts, component parts, and funding structure.

Housing

In a recent meeting with the Board of Supervisors, the top two needs for the county were identified as, increasing the number of mental health hospital beds available and permanent housing.

Housing has been addressed as countywide problem and it is not something that BHRS can resolve alone. In order to address the housing shortage the community, developers, contractors, and the county need to invest into housing.

Recently, a SLE for women was about to open when the landlord ultimately decided not to lease the property due to pressures from neighbors and stigma. There are concerns over potential decreases in property values. Political pressures were also identified as a potential barrier. Housing is clearly a multi-faceted problem. MHSAAC members pointed out that there are groups already working on the housing problem, i.e. Marin Environmental Housing Consortium. MEHC meet Nov. 16th at 5:30pm.

A potential guest speaker, Ashley Mcantyre was identified. MHSAAC members expressed interest in having a presentation on housing and homelessness. (McAntyre when Ms. McAntyre returns from maternity leave)

Programs in Sonoma County have been toured as possible models for Marin. A motel was converted as a permanent housing facility in a high crime neighborhood. The motel was converted into a 108-bed permanent housing facility. The new housing ultimately improved the crime rates in that community.

Meeting Location:

Some individuals have expressed concerns over the meeting location, parking, and possible transportation stipends. MHSAAC member proposed moving to the Wellness Campus on Kerner or an alternate location with better parking near Home Depot in San Rafael.

For now MHSAAC meetings will continue at 20 NSP. Efforts will be made to accommodate the needs of new members.

Rating Scale Review and Utilization:

A new scale was designed to be used as a tool to review program proposals and existing programs. This tool would serve to provide an equitable means of reviewing established programs and their grass root counterparts and hopefully assist with monetary decisions.

MHSA Planning Progress, next steps and input:

We are currently awaiting our fiscal department’s forecasting of the MHSA funds that will be available within this 3 Year Planning Cycle.

A discussion was held on how to best approach and assess the many different programs. Do we, focus based on age, MHSA service category etc.? An overview of the MHSA planning process was given. Currently, the planning process is aimed at identifying community needs by reaching out to key informants, focus groups, and hosting 3 community meetings. This process will lead to the development of a draft plan. Committee Members will continue to be informants in the process. When a

MHSAAC will have an opportunity to review existing programs.

MHSAAC members wanted to discuss

Barriers, gaps

Explore PEI Priorities for funding Reaching underserved

Suicide Integrating AOD and MH Trauma care Housing

Review funding streams

The goal is to complete focus group interviews by mid December (ERC, Marin Advocates for MH, Staff Policy Forum, Latino Providers, Consumers, Adult Providers, Vietnamese, LGBTQ Adults, LGBTQ Youth, Latino, West Marin, FEP, Suicide Prevention, Family Members etc. .)

Next Meeting Goals

Provide MHSA service categories with the corresponding programs..

Our goal is to have a draft plan completed, posted for 30 Day Public Review and Comment and sent to the Board of Supervisors for final approval by July 1..

The committee suggested setting clear expectations regarding conflict of interest.

The committee requested that total funding and unallocated funds be identified for planning.

Discuss the roles of MHSAAC Members:

Meeting Adjourned

Community Services and Supports (CSS) Community Services and Supports – Component Budget FY2014-15 through FY2016-17

COUNTY OF MARIN ▪ MENTAL HEALTH AND SUBSTANCE USE SERVICES DIVISION MHSA FY2016-2017 ANNUAL UPDATE

MHSA Community Services and Support (CSS)

Three-Year Plan (FY2014-2015 through FY2016-2017)

Program FY14-15 FY15-16 FY16-17 Total

FSP-01 Youth Empowerment Services (YES) $649,227 $649,227 $649,227 $1,947,682

FSP-02 Transitional Age Youth (TAY) Program $446,773 $446,773 $446,773 $1,340,318

FSP-03 Support and Treatment After Release (STAR) $519,644 $519,644 $519,644 $1,558,933

FSP-04 Helping Older People Excel (HOPE) $688,527 $688,527 $688,527 $2,065,581

FSP 04 -Helping Older People Excel-Intensive Community Treatment $159,990 $159,990 $159,990 $479,970

FSP- 05 Odyssey (Homeless) $1,138,543 $1,138,543 $1,138,543 $3,415,630

FSP 05 Odyssey (Homeless) Step Down Recovery Program $144,492 $144,492 $144,492 $433,476

SDOE-01 Enterprise Resource Center (ERC) $347,387 $347,387 $347,387 $1,042,161

SDOE 01-ERC -Step Up Program- New $254,942 $254,942 $254,942 $764,826

SDOE-04 Southern Marin Services (SMSS) $277,729 $277,729 $277,729 $833,188

SDOE-07 Adult System of Care (ASOC) $801,460 $801,460 $801,460 $2,404,380

SDOE-08 - Co-Occurring Capacity $347,409 $347,409 $347,409 $1,042,227

SDOE-09 - Crisis Continuum of Care $0 $600,000 $600,000 $1,200,000

Subtotal $5,776,124 $6,376,124 $6,376,124 $18,528,372

MHSA Coordinator $140,986 $140,986 $140,986 $422,958

Ethnic Services Manager $88,000 $88,000 $88,000 $264,000

Administration and Indirect $900,767 $990,767 $990,767 $2,882,301

Operating Reserve $159,750 $129,798 $129,798 $389,394

Total $7,035,675 $7,725,675 $7,725,675 $22,487,025

FY14-15 FY15-16 FY16-17 Total %

County $2,673,259 $2,718,552 $2,718,552 $8,110,363 36%

Contract Provider $3,331,851 $3,886,559 $3,886,559 $11,104,968 49%

Administration $900,767 $990,767 $990,767 $2,882,300 13%

Operating Reserve $129,798 $129,798 $129,798 $389,394 2%

Total $7,035,675 $7,725,675 $7,725,675 $22,487,025 100%

Full Service Partnership (FSP) 64.87% 58.77% 58.77%

System Development Outreach and Engagement (SDOE) 35.13% 41.23% 41.23%

Total 100.00% 100.00% 100.00%

Prevention and Early Intervention (PEI) Prevention and Early Intervention – Component Budget FY2014-15 through FY2016-17

COUNTY OF MARIN ▪ MENTAL HEALTH AND SUBSTANCE USE SERVICES DIVISION MHSA FY2016-2017 ANNUAL UPDATE 82

MHSA Prevention and Early Intervention (PEI)

Three-Year Plan (FY2014-2015 through FY2016-2017)

Program FY14-15 FY15-16 FY16-17 Total

PEI-1 Early Childhood Mental Health Consultation - ECMH $230,000 $230,000 $230,000 $690,000

PEI-2 Triple P (Positive Parenting Program) Marin $55,000 $62,000 $62,000 $179,000

PEI-4 Transition Age Youth (TAY) PEI $140,000 $160,000 $160,000 $460,000

PEI-5 Latino Community Connection $199,000 $204,000 $204,000 $607,000 PEI-6 Integrated Behavioral Health in

Primary Care $180,000 $180,000 $180,000 $540,000 PEI -7 Older Adult Prevention and Early

Intervention $100,000 $100,000 $100,000 $300,000 PEI-11 Vietnamese Community

Connection $53,000 $53,000 $53,000 $159,000 PEI-12 Community and Provider PEI

Training $45,000 $95,000 $85,000 $225,000 PEI-18 School Age Prevention and

Early Intervention Programs $205,000 $310,000 $310,000 $825,000 PEI-19 Veteran's Community

Connection $25,000 $60,000 $60,000 $145,000 PEI-20 Statewide Prevention and Early

Intervention $111,536 $175,000 $205,000 $491,536

Subtotal $1,343,536 $1,629,000 $1,649,000 $4,621,536

Evaluation $0 $0 $40,000 $40,000

PEI Coordinator $64,900 $64,900 $74,000 $203,800

Administration and Indirect $211,265 $254,085 $264,450 $729,800

Operating Reserve $27,799 $15,000 $63,565 $106,364

Total $1,647,500 $1,962,985 $2,091,015 $5,701,500

FY14-15 FY15-16 FY16-17 Total %

County $25,000 $60,000 $60,000 $145,000 2.5%

Contract Provider $1,383,436 $1,673,900 $1,673,900 $4,731,236 83%

Administration $244,265 $244,265 $244,265 $732,795 13%

Operating Reserve $27,799 $27,799 $36,871 $92,469 1.5%

Total $1,680,500 $2,005,964 $2,015,036 $5,701,500 100%

Workforce, Education and Training (WET) Workforce, Education and Training – Component Budget FY2014-15 through FY2016-17

COUNTY OF MARIN ▪ MENTAL HEALTH AND SUBSTANCE USE SERVICES DIVISION MHSA FY2016-2017 ANNUAL UPDATE

MHSA Workforce, Education and Training (WET)

Three-Year Plan (FY2014-2015 through FY2016-2017)

Program FY14-15 FY15-16 FY16-17 Total

1) System-wide Dual Diagnosis Training

$7,472.00 $24,310.00 $54,654.71 $86,436.71

2) Family Member Focus Training $3,900.00 $0 $0 $3,900.00

3) Scholarships for Underserved Consumers & Family Members

$7,586.22 $68,719.00 $78,000.00 $154,305.22

4) Community Based Organization (CBO) Intern Stipends

$0 $0 $50,000.00 $50,000.00

5) Training Initiatives $5,281.00 $23,099.07 $80,000.00 $108,380.07

6) Peer Mentoring $8,982.00 $22,234.00 $80,000.00 $111,216.00

7) MHSUS Intern Stipends $109,632.00 $152,000.00 $194,368.00 $456,000.00

8) WET Coordination $30,000.00 $0 $0 $30,000.00

9) California Institute for Mental Health-Training

$0 $5,348.00 $10,500 $15,848.00

Total $172,853.22 $295,710.07 $547,522.71 $1,016,086.00

One-Time Funding Sources:

Prior Year Unspent WET Funds (Actual) $164,086

Prior Year Unspent CSS Funds $852,000

TOTAL $1,016,086

Capital Facilities and Technological Needs (CFTN)

Capital Facilities and Technological Needs – Component Budget FY2014-15 through FY2016-17

COUNTY OF MARIN ▪ MENTAL HEALTH AND SUBSTANCE USE SERVICES DIVISION MHSA FY2016-2017 ANNUAL UPDATE

MHSA Capital Facilities and Technological Needs (CFTN)

Three-Year Plan (FY2014-2015 through FY2016-2017)

Program FY14-15 FY15-16 FY16-17 Total Description of Project

Practice Management $151,252 $66,507 $68,011 $285,770

Enhancements will allow for further upgrades to the Practice Management system to meet federal and state requirements and increases the systems capability for analytics, data outcome reports, and interoperability.

Scanning $69,507 $55,968 $56,230 $181,705

This component involves the implementation of a scanning application which is fully integrated with the MHSUS electronic health record. Adding scanning capability will allow authorized staff at any work station to to have access to documentation necessary for quality care.

E-Prescribing $40,400 $37,343 $37,735 $115,478

E-Prescription program for county psychiatrists and mental health nurse practitioners through a web-based program that interfaces with the County's electronic health record. The E-Prescription program RxNT now allows for secure prescribing of controlled Rx's.

Electronic Health Record Upgrade $298,091 $185,344 $73,286 $556,721

System upgrade to meet Federal and State Meaningful Use guidelines. Additionally completes the remaining electronic forms/documents in CG and provides for expanded hardware to provide emergency back up in the event of a system failure

Consumer Family Empowerment $149,221 $72,055 $73,494 $294,770

Expansion to existing resources at the Enterprise Resource Center, the county consumer drop-in center. Provides computers and connectivity in county contracted consumer residential sites and dedicated paid consumer staff time for training and IT support.

Behavioral Health Information Crosswalk $142,081 $20,494 $20,494 $183,069

Furthers the integration efforts of MHSUS (AOD/MH) by reducing duplication and improve care coordination and interoperability between systems within our electronic health records and data sharing capabilities.

Total $850,552 $437,711 $329,250 $1,617,513

One-Time Funding Sources

Prior Year Unspent CFTN Funds $709,500

Prior Year Unspent CSS Funds $908,013

Total $1,617,513

EXHIBIT B

MARIN COUNTY BEHAVIORAL HEALTH AND RECOVERY SERVICES

MHSA PLANNING ESTIMATES SUMMARY- DRAFTFY 17/18, 18/19 and 19/20

Updated: 11/09/2016

I. CSS 2017-18 2018-19 2019-20 TOTAL

Estimated - 3- Year Average Marin County MHSA

Allocation $9,202,872 $9,202,872 $9,202,872 $27,608,616

CSS Programs Currently Funded (FY 16/17) $7,725,675 $7,725,675 $7,725,675 $23,177,025

WET Programs Currently Funded $333,333 $333,333 $333,334 $1,000,000

Unallocated Funds $1,143,864 $1,143,864 $1,143,863 $3,431,591

Total CSS Funds Available $9,202,872 $9,202,872 $9,202,872 $27,608,616

II. PEI 2017-18 2018-19 2019-20 TOTAL

Estimated - 3- Year Average Marin County MHSA

Allocation $1,996,433 $1,996,433 $1,996,433 $5,989,299

PEI Programs Currently Funded (FY 16/17) $1,900,500 $1,900,500 $1,900,500 $5,701,500

Unallocated Funds $95,933 $95,933 $95,933 $287,799

Total PEI Funds Available $1,996,433 $1,996,433 $1,996,433 $5,989,299

III. INN 2017-18 2018-19 2019-20 TOTAL

Estimated - 3- Year Average Marin County MHSA

Allocation $517,765 $517,765 $517,765 $1,553,295

INN Programs Currently Funded (FY 16/17) (Note:

Existing INN funded programs will not be funded with

INN funds in the next 3-year plan) $0 $0 $0 $0

Unallocated Funds $517,765 $517,765 $517,765 $1,553,295

Total Estimated INN Revenues - County $517,765 $517,765 $517,765 $1,553,295

Full Service Partnerships Outcomes

Support and Treatment After Release (STAR)

1

Mental Health Services Act Advisory Council Marin County Three Year Plan FY17-20

Program Rating Form

__ CSS Scoring 1 = Not at all/no contribution NA = Not applicable __ PEI 2 = Somewhat DK = Do not know __ WET 3 = Neutral __ CFTN 4 = Significant contribution 5 = Important contribution Program Name: _________________________ Criteria Score Recommendation In alignment with MHSA purpose Do not fund Targets un/underserved population Fund at lesser level Fills an identified gap Fund at same level Community priority (define – i.e.; as determined in 3 year Planning process including community, staff, providers, etc.)

Fund at higher level

In alignment with Three Year Plan goals Evidence of effectiveness Cost effective

TOTAL NOTES (i.e. Pros/cons)

Program Name: _________________________ Criteria Score Recommendation In alignment with MHSA purpose Do not fund Targets un/underserved population Fund at lesser level Fills an identified gap Fund at same level Community priority Fund at higher level In alignment with Three Year Plan goals Evidence of effectiveness Cost effective

TOTAL NOTES (i.e. Pros/cons)

Program Name: _________________________ Criteria Score Recommendation In alignment with MHSA purpose Do not fund Targets un/underserved population Fund at lesser level Fills an identified gap Fund at same level Community priority Fund at higher level In alignment with Three Year Plan goals Evidence of effectiveness Cost effective

TOTAL NOTES (i.e. Pros/cons)