County of OrangeMental Health Services Act

Steering Committee Meeting

February 4, 2008

        

Steering CommitteeDecisions 2008

Kate PavichKate Pavich

MHSA CoordinatorMHSA Coordinator

MHSA Local & State Updates

Mark RefowitzMark Refowitz

BHS DirectorBHS Director

Distribution of Funds (DMH Notice 07-25)

75% will be distributed upon approval of the Plan and execution of an MHSA Agreement

25% will be distributed upon submission of the Local Cash Flow Statement and the annual Revenue and Expenditure Report

Distribution of Funds (DMH Notice 07-25)

Start of FY

Submission of Documentation to DMH

Prudent Reserve (DMH Notice 07-25)

Each county must maintain 50% of the most recent annual approved CSS funding by July 1, 2010

Sources for the Prudent Reserve Unexpended Funds Counties not expected to reduce services below FY

07-08 levels to fund reserve If cannot reach 50% by July 1st should use future

increases in planning estimates before expanding services

Unexpended Funds (DMH Notice 07-25)

DMH requires an annual Plan update that indicates the utilization of unspent funds

Unused Funds Can Be Used For Service consistent with the approved Plan Prudent Reserve

Sustainability (DMH Notice 07-25)

Counties must submit a Plan to justify the sustainability of programs that are funded through the Planning Estimate

Factors DMH will look at Interest Current and Projected Costs Cost of Living Increases Anticipated Revenues Impact of Higher Levels of Care

2005-06 CSS One-Time (DMH Notice 07-25)

DMH will no longer approve and fund the use of 2005-06 CSS funds for activities funded through other components (Capital Facilities, Technology, WET) after June 30, 2008.

Counties that spend their entire FY 2005-06 Planning Estimate on approved services (including one-time funds and/or the prudent reserve) will not be subjected to the June 30, 2008 reversion.

Estimated Growth Funds 2008-09

$8 Million Total Allocation

$6.8 Million: Programs

$1.2 Million: Administration (15%)

HCA Recommendations for Growth Funds Program Adjustments

Maintain Age Allocation for $6.8 million CYS: $1,380,400TAY: $1,271,600Adult: $3,196,000Older Adult: $952,000

Allocation by Age

Statewide Programs No provision for Statewide Programs in

MHSA

Counties may work together or individually to fund Statewide Programs

Joint Powers Agreement

One county administers these funds

Statewide Programs - Housing $33 million for Orange County

County must Assign funds to California Housing Finance Agency (CalHFA)

Submit a plan for each program Follow approval process with CalHFA

Cannot access funds directly

Statewide Programs - PEI

PEI ServiceAnnual

AllocationYears

Dedicated

Suicide Prevention $14 million Four Years

Stigma and Discrimination Reduction $20 million Four Years

Training, Technical Assistance, and Capacity Building

$12 million Four Years

Ethnically and Culturally Specific Programs and Interventions

$15 million Four Years

Student Mental Health Initiative $30 million Two Years

Statewide Programs – WET

Workforce Education and TrainingCalifornia Social Work Education Center

(CalSWEC) Pays stipend for 2nd year social work studentsRegional Partnerships

In the future, there may be statewide programs for other components as well

Money for Statewide Projects

Housing must be assigned to CalHFA Money for other statewide projects must

be assigned to the fiscal agent designated by the State

Must give the dollars back to the State for statewide projects

CSS One-Time Funding Update(DMH Notice 07-21)

Update of our Three-Year Program and Expenditure Plan was reviewed by DMH

DMH has approved $1,339,300 in Additional One-Time Funding Augmentation

Used to Expand Local Mental Health Services

Capital Facilities & Technology Update

Kate PavichKate Pavich

MHSA CoordinatorMHSA Coordinator

What is a Capital Facility?

A building secured to a foundation

Permanently affixed to the ground

Used for delivery of MHSA services

Used for administrative offices

Allowable Use of MHSA Funds

Acquire buildings Acquire and build

upon land Construct buildings Renovate buildings

Examples of Expenditures

Purchase/renovate a building for: Use as a clinic, clubhouse, wellness and

recovery center, or for a building that serves clients in a less restrictive setting and reduces the need for institutionalization and/or incarceration

Vocational, educational and recreational MHSA services to individuals and families

Proposed Use of Funds

The Health Care Agency is currently exploring using Capital Facilities funds to develop the Interim Care Facility building in Orange.

401 S. Tustin Avenue, Orange CA

Architect-Engineer Assessment

Review of building/site conditions and code/ordinance requirements

Remodeling of the existing facility is “highly impractical” due to mold conditions, termite damage, roofing issues and problems with earthquake compliance

Demolition of site was recommended and using new construction

Proposed Programs

Crisis Residential

Wellness Center

Vocational Training/Education

Crisis Residential Program

Crisis Residential Treatment

An alternative to hospitalization for acute and chronic mentally ill persons

Voluntary program Services provided 24/7 15 bed facility Ages 18-59 both males and females Average length of stay is 14 days

A Wellness Center

Wellness Center

Service system to support clients and increase self-reliance by providing:

Socialization and life skills Assistance with benefits Education and job training Recreation and exercise Recovery groups

Vocational Training/Education

Vocational Training/Education

Provide education and support to consumers including pre-employment classes, job coaches, and peer mentors

Promote the employment of mental health consumers within the mental health system

Educate and train all individuals who provide mental health services

Stakeholder Process

Supported Employment Services were approved by stakeholders for our 3 Year CSS plan

Stakeholders have provided input regarding use of MHSA funds for Workforce Education and Training

Consumer Action Advisory Committee has expressed their support for developing a third building at the 401 S. Tustin site for vocational training

Proposed Program

Use Capital Facilities Funds for a Vocational Training and Education building

Allocation for FY 2007-08

Capital Facilities/Technology allocation was previously expected to be $8 million

Steering Committee previously voted to support using 80%of the funds for Capital Facilities and 20% for Technology

Current Allocation

Expect our allocation to be $28,308,300.

Proposed projects using: 80% Capital Facilities ($22.6 million)

20% Technology ($5.6 million)

Split of Allocation

80% Capital Facilities 20% Technology

Keep same percentage with increased allocation

Workforce Education and TrainingCasey Dorman, Ph.D.

OCHCA/BHS Training Coordinator

Aim Addressing identified occupational

shortages in both county mental health and private organizations providing community based public mental health services Vietnamese, Spanish, Farsi, Korean speaking

staffConsumer/Family Member StaffMasters and Bachelors level staff in above

categories

Aim Education and training for all individuals who

provide or support public mental health services. This is education and training that contributes to developing and maintaining a culturally competent workforce, to include consumers and family members, who are capable of providing consumer- and family-driven services that promote wellness, recovery and resilience, and lead to measurable, values-driven outcomes.

Funding Original County Allocation:

$8.2 million $652,000 Early Implementation (planning, positions

and programs) 3 year allocation but 10 years to spend

Additional County Allocation $8.2 million Spend on needs identified during original planning

process 10 years to spend

Planning

Timeline – for submission of original allocation October 2007- February 2008 Stakeholder meetings End of February 2008 Completed Plan March- April 2008

Public Comments MHB, Steering Committee, BOS

May 2008 – Submission of Plan July 2008 DMH Approval of Plan

Stakeholder Process 25 Separate Stakeholder meetings with over

300 attendees Consumers/Family member groups High Schools, Community Colleges Undergrad and Graduate Programs County staff Contract Agency Providers Other County Agencies Representatives of Underserved Groups Many of the meetings included paid

consumer/family member consultants Nearly 100 separate proposals

Plan Development Advisory Committee – Evaluates Proposals and Formulates

Plan NAMI Client Network Undergrad representative Grad School representative Latino Clinic Asian-Pacific Islander Clinic Adult Mental Health Contract Provider Children’s Mental Health Contract Provider County Behavioral Health Staff Paid Consumer/Family Member Consultants

Ways To Use Workforce Education and Training Funds

Workforce Staffing Support Training and Technical Assistance Mental Health Career Pathway

Programs Residency, Internship Programs Financial Incentive Programs

Proposed Use of Funds

Workforce StaffingBehavioral Health Services Training

Department Consumer Support positions – three positions,

two for Adult mental health and one for Children and Youth Services

Proposed Use of Funds

Career PathwaysMental Health Paraprofessional Training

Program (Continuation of the Pacific Clinics/Santa Ana College program. Currently funded with one-time money – After next year continue at 25 students per year)

Proposed Use of Funds

Training and Technical AssistanceMental Health Training for Law Enforcement

Officers (continuation of the Golden West College program about to be developed using one-time money – for first two years will train 500 officers per year and after the first two years training 250 officers per year)

Proposed Use of Funds Training and Technical Assistance

Recovery Education Institute Based on the model of the Recovery Education Center at

Recovery Innovations in Phoenix, AZ. There will be requirements that the teaching and administrative staff have consumer/family member backgrounds.

To provide training in life skills necessary to prepare someone to begin a career path to join the mental health workforce, e.g.

Relapse prevention Medication management Finding a social group Computer skills Job interviewing

Proposed Use of Funds

Training and Technical AssistanceConsumer/family member training of the

mental health workforceHalf-time deaf or deaf culture trainer to

provide staff training and outreach to the deaf community

Proposed Use of Funds

Residency/Internship Programs Funding for Approximately 12 FTE Internship

Supervisors in County and Contract Agency Clinical sites to allow greater use of students and attract bilingual/bicultural interns who may later join our workforce.

Funding for 1 Supervisor of an intern who is deaf or a member of the deaf culture

Child Psychiatry Resident Supervision Community Psychiatry Fellowship Program through

UCI Dept. of Psychiatry

Proposed Use of Funds

Financial Incentive Programs Support for County and Contract Agency Employees

who are Part-time MSW Students through a 20/20 program that pays salaries for staff while they are doing fieldwork placement

Stipends and Scholarships for bilingual/bicultural (including deaf and signing) or consumer/family member graduate students in Social Work, MFT, Psychology

Stipends, Scholarships, and 20/20 programs for Undergraduate students in Human Services, Social Work , Psychology, Nursing

Further Planning Currently Proposed Programs account for about

¾ of WET funds expected Many more proposals we are still evaluating,

including High School Academies Community College Certificate Program Benefits Training Training on evidence-based interventions Cultural Competence Training Others

Prevention and Early Intervention

Alan Albright, MFT

        October 12, 2007

PLANNING PROCESS

10/22/07: Approval of Orange County’s Request for Funding for Community Program Planning $2,029,700

11/14/07: PEI Subcommittee established

12/07-6/07?:Collect and analyze data from various service sectors and community groups, ETC. in order to assess current community capacity, resources, and needs.

PEI CONTACT AND PRESENTATIONS

03/13/07: Mental Health Board Children’s Committee 03/16/07: OCDE 03/23/07: SSA and Probation 04/06/07: OCDE 04/09/07: NAMI 05/23/07: Early Childhood Social Emotional Health

System Development 06/04/07: CalOptima 07/19/07: Children’s Services Coordination Committee 08/16/07: Children’s Services Coordination Committee 08/17/07: Orange County Criminal Justice Coordinating

Council 10/12/07: MHSA Steering Committee 10/16/07: MHSA CAAC (cont.)

10/22/07: Orange County TAY Conference 200710/22/07: Orange County TAY Conference 2007 10/23/07: OCDE Mental Health Collaboration Meeting 10/23/07: OCDE Mental Health Collaboration Meeting

(SELPA) (SELPA) 11/07/07: OC Safe From The Start Advisory Council11/07/07: OC Safe From The Start Advisory Council 11/08/07: Mental Health Board Study Meeting11/08/07: Mental Health Board Study Meeting 11/09/07: Developmental Pathways Leadership Committee11/09/07: Developmental Pathways Leadership Committee 11/13/07: California Department of Education (CDE),11/13/07: California Department of Education (CDE), 11/14/07: MHSA Steering Committee PEI Subcommittee11/14/07: MHSA Steering Committee PEI Subcommittee 11/14/07: San Clemente Human Affairs Committee Forum 11/14/07: San Clemente Human Affairs Committee Forum 11/16/07: Alcohol & Drug Abuse Advisory Board11/16/07: Alcohol & Drug Abuse Advisory Board 11/27/07: 211OC11/27/07: 211OC 12/03/07: Children and Youth Services All Contract 12/03/07: Children and Youth Services All Contract

Providers Meeting Providers Meeting 12/03/07: Orange County Congregation Community 12/03/07: Orange County Congregation Community

Organization Organization 12/05/07: Anaheim Family Justice Center 12/05/07: Anaheim Family Justice Center

FOCUS GROUPS AND STAKEHOLDER MEETINGS 11/19/07: Juvenile Bench Officers 12/19/07: Juvenile Justice Commission 01/08/08: Coordinating Nurses 01/08/08: Children and Families Commission Grantees 01/09/08: Project ACCESS 01/14/08: Anaheim Union High School District School

Counselors 01/15/08: Community Action Advisory Committee 01/15/08: ADAS Contract Providers 01/16/08: Ombudsman Regional Coordinators 01/17/08: Children’s Services Coordination Committee 01/28/08: Post Partum Depression Work Group 01/28/08: Council on Aging 01/29/08: APS Social Services (cont.)

FOCUS GROUPS AND STAKEHOLDER MEETINGS 01/30/08: South County Seniors 01/31/08: Anaheim Family Justice Center 01/31/08: ADEPT 01/31/08: Mission Hospital Senior Advisory Committee

MORE TO COME…

PEI SURVEY RESPONSE

Mailed to over 2,000 organizations and community members Distributed at meetings throughout OC E-mailed announcement and link to online surveys

TO DATE:

ORGANIZATIONAL =193 COMMUNITY = 494 Print = 110 Print = 287 Online = 83 Online = 207

PEI PLANNING STEPS REMAINING

• Continue to collect community input

• Present to Steering Committee

• Draft PEI Plan

• Review and approval by MHSA Steering Committee

• Public Hearing and Mental Health Board

• Board of Supervisors

• Dept. Of Mental Health and MHSOAC

STAY INVOLVED

• Encourage regional focus groups and stakeholder meetings

• For community and organizational on-line surveys and more information, go to :

  http://www.ochealthinfo.com/mhsa/pei/