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MHSA Steering Committee

March 2, 20091:00 p.m. – 4:00 p.m.

Delhi Community Center

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Sharon Browning

Welcome

3

Patty Rogers andTony Delgado

Full Service Partnerships (FSPs)

Data as of January 31, 2009

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Adult FSPs: Capacity Capacity 560

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Adult FSPs: Capacity Capacity 560

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Adult FSPs: Age Range

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Adult FSPs: Ethnicity

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Adult FSPs: Residential Domain

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Adult FSPs: Education 11% of the 485 enrolled members are attending school

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Adult FSPs: Employment 8% of 485 members enrolled have Paid Employment

11Data from FSP Monthly Outcome Report

Adult FSPs: Residential Domains

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5%Section 8

26% Subsidized

12%Shelter Plus

Care

94% Housed

Data from FSP Monthly Outcome Report

Adult FSPs

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Residence - Living IndependentlyNovember 2008 - January 2009

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Residential - HospitalizationsNovember 2008 - January 2009

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8

8.5

9

9.5

10

10.5

11

11.5

12

12.5

November December January

Residential - IncarcerationNovember 2008 - January 2009

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EducationNovember 2008 - January 2009

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Paid EmploymentNovember 2008 - January 2009

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Older Adult Full Service Partnership

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OASIS: Capacity Total Orange County Older Adult FSP

Capacity: 150

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Older Adult FSP: Age Range Total Enrolled: 80

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Older Adult FSP: Education 10% of the 80 enrolled members

are attending school

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Older Adult FSP: Employment 1.25 % of 80 members enrolled

23Data from the FSP Monthly Outcome Report

OASIS: Residential Domain January 2009

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Children and Youth Full Service Partnerships

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All: Ethnicities

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TAY: Ethnicities

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Children: Ethnicities

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TAY: Residential

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TAY: Education/Employment

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Mental Health Statistical Improvement Program (MHSIP)California Quality of Life Scales (CA-QOL)

Youth Services Survey for Families (YSS-F)

Adult Surveys

Child/Youth Surveys

Survey Period: May 2008

Consumer Perception Surveys

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Consumer Perception Surveys Required by the State Department of Mental Health

Administered twice annually, in May and November

Each data collection period is for two weeks

The survey is offered to all consumers who attend outpatient mental health services during the survey period

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Completed by adult consumersAsks consumers to rate program qualityFive point scale:

Domain Sample ItemGeneral Satisfaction I like the services that I received here.Perception of Access Services were available at time that were

good for me.Perception of Quality andAppropriateness

Staff here believe that I can grow, change, and recover.

Perception of Participation In Treatment Planning

I felt comfortable asking questions about my treatment and medication.

Perception of Outcomeof Services

I deal more effectively with daily problems.

Perception of Functioning I do things that are more meaningful to me.

Perception of SocialConnectedness

I am happy with the friendships I have.

1: Strongly disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly agree

Mental Health Statistical Improvement Survey (MHSIP)

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Completed by adult consumersAsks consumers to rate the quality of their lives.Seven point scale:1: Terrible 2: Unhappy 3: Mostly dissatisfied 4: Mixed 5: Mostly satisfied 6: Pleased 7: Delighted

DomainSample Item: How do you feel about …

Living Situation ... the living arrangements where you live?

Daily Activities & Functioning

... the way you spend your spare time?

Family ... the way you and your family act toward each other?

Social Relations ... the things you do with other people?

Safety ... how safe you are where you live?Health ... your health in general?

California Quality of Life Survey (CA-QOL)

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Completed by parent/guardian of youth and children.Asks family to rate the quality of program services.Five point scale: 1: Strongly disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly agreeMeasures seven domains.

Domain Sample ItemGeneral Satisfaction Overall, I am satisfied with the services my

child received.Perception of Access Services were available at times that were

convenient for us.Perception of Cultural Sensitivity Staff were sensitive to my cultural/ethnic

background.Perception of Participation inTreatment Planning

I helped to choose my child’s services.

Perception of Outcome of Services

My child is better at handling daily life.

Perception of Functioning My child is better able to do things he or she wants to do.

Perception of Social Connectedness

I am comfortable talking about my child’s problems.

Youth Services Survey for Families (YSS-F)

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Older Adults

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Mostly Satisfied

Mixed

Satisfied

Older Adult: CA-QOL

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Strongly Agree

Agree

Neutral

Older Adult: MHSIP

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Adults

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Pleased

Mostly satisfied

Mixed

Adult: CA-QOL

40

Strongly Agree

Agree

Neutral

Adult: MHSIP

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Transitional Age Youth (TAY)

42

Mostly satisfied

Pleased

Mixed

TAY: CA-QOL

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Strongly Agree

Agree

Neutral

TAY: MHSIP

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Children and Youth

45

Strongly Agree

Agree

Neutral

Youth YSS-F

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FSP Success Stories:“Consumer Perspective”

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Questions?

48

Mark Refowitz

Local/State Updates

49

Mike Geiss

MHSA Fiscal Update

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MHSA Fiscal Update Revenue Sources Component Funding Planning Estimates Revenue Projections Policy Considerations

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Mental Health Services Act (MHSA) Overview

The MHSA created a 1% tax on income in excess of $1 million to expand mental health services

Approximately 1/10 of one percent of tax payers are impacted by tax Approximately 20,000 – 30,000 tax

returns

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MHSA Revenue Sources Five sources of deposits into State MHS

Fund 1.76% of all monthly personal income tax (PIT)

payments (Cash Transfers) Not just millionaires

Annual Adjustment based on actual tax returns Settlement between monthly PIT payments and

actual tax returns Based on actual tax returns from two years prior

Interest income (posted quarterly) Excess State Administration (unauthorized and

unexpended) Reverted funds

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MHSA Revenue Sources

$$$Reverted Funds (twice a year)

$$Excess Admin (annually)

$$$$$Interest (quarterly)

$$Annual Adjustment (annually)

$$$$$$$$$$$$$Cash Transfers (monthly)

Deposits into Fund

        JulyAprilJanOctJuly

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MHSA Component Funding In accordance with Welfare & Institutions

Code Section 5892, deposits into the State Mental Health Services Fund are dedicated to specific components.

Prior to making the distribution to components, up to 5% is made available for State Administration

Balance of funds (95%) distributed to each component based on the fiscal year in which the deposits are posted on a cash basis

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MHSA Component Funding

Component FY05-06 through FY07-08 FY08-09

WET (WIC 5892(a)(1)) 10% 0%

Cap/Tech (WIC 5892(a)(2)) 10% 0%

PEI (WIC 5892(a)(3))a/ 20% 20%

CSS (WIC 5892(a)(5))a/b/ 60% 80%

Funding for Each Non-Administrative Component

a/ 5% of total funding for PEI and CSS must be utilized for innovative programs (WIC 5892(a)(6))b/ Beginning in FY08-09, CSS funds may be used for WET, Cap/Tech and a local prudent reserve subject to a 20% limit (WIC 5892(b))

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MHSA Planning Estimates Funds are made available to each

County through Planning Estimates Planning Estimates represent the

maximum funding for each County Established by component, published

by DMH

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MHSA Planning Estimates Planning Estimates

MHSA Government Partners recommend the Global/Aggregate Planning Estimates for local services to respective organizations

Meet following the close of the fiscal year and analyze amounts deposited, distributed and committed for each component during the fiscal year

Establish Global/Aggregate Planning Estimates for subsequent fiscal year

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MHSA Planning Estimates Generally, Planning Estimates are not

based on estimated revenues Future year increases are based on actual

revenues received in prior years Distributions are on a cash basis (i.e.,

sufficient revenues are in the State MHS Fund at the start of the fiscal year for distributions for the entire fiscal year)

Long term sustainability is considered based on recent economic data

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MHSA County Distributions Distribution of funds is contingent upon

a fully executed MHSA Agreement and submission of required reports Counties receive 75% of approved plan

amount upon plan approval or at start of fiscal year whichever is later

Balance provided when required reports are submitted. (Cash Flow Statement and Revenue and Expenditure Report)

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MHSA Revenue Projections Cash Transfers based on Department of Finance

estimate through FY 2009-10 (January 2009) Cash Transfers after FY 2009-10 will change based on

Legislative Analyst’s Office estimates of change in PITs (November 2008)

Relatively slow growth Department of Finance estimate of Annual

Adjustment through FY 2011-12 (January 2009) Capital Gains will be a significantly smaller portion of

PITs in future based on LAO estimates (November 2008)

Interest Income unchanged from FY 2009-10 due to lower fund balance and lower interest rates

Proposed redirection of MHAS funds to EPSDT in FY 2009-10 and 2010-11 can be absorbed within existing deposits

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Historical and Estimated MHSA Revenues (Cash Basis-Millions of Dollars)

04/05 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13

Cash Transfers $169.5 $894.6 $935.1 $983.9 $831.0 $837.0 $866.0 $903.0 $957.0

Annual Adjustment $83.6 $0.0 $0.0 $423.7 $438.4 $529.0 $150.0 $50.0 $100.0

Interest $0.7 $11.2 $49.2 $94.4 $60.8 $27.4 $25.0 $25.0 $25.0

Total $253.8 $905.8 $984.3 $1,502.0 $1,330.2 $1,393.4 $1,041.0 $978.0 $1,082.0

Actual EstimatedFiscal Year

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Historical and Estimated MHSA Revenues (Cash Basis-Millions of Dollars)

$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

03/04 04/05 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13

Fiscal Year

Cash TransfersAnnual AdjustmentInterestTotal

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Historical and Estimated MHSA Planning Estimates (Millions of Dollars)

04/05 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13

Planning $12.7

CSS $317.3 $320.5 $518.2 $650.0 $900.0 $750.0 $725.0 $750.0

PEI $115.0 $232.6 $330.0 $220.0 $185.0 $190.0

WET $100.0 $110.0

CFTN $345.0 $108.4

INN $71.0 $71.0 $66.2 $49.4 $46.5

Total $12.7 $317.3 $320.5 $1,078.2 $1,172.0 $1,301.0 $1,036.2 $959.4 $986.5

Fiscal YearActual Estimated

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Orange County Historical and Estimated MHSA Planning Estimates

a/ (Millions of Dollars)

04/05 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13

Planning $0.6

CSS $25.5 $25.8 $37.6 $52.2 $72.6 $60.5 $58.5 $60.5

PEI $9.8 $19.7 $27.7 $18.5 $15.5 $15.9

WET $8.3 $8.9

CFTN $28.3 $8.9

INN $5.8 $5.8 $5.4 $4.0 $3.8

Total $0.6 $25.5 $25.8 $84.0 $95.5 $106.1 $84.4 $78.0 $80.2

Fiscal YearActual Estimated

a/ Excludes State Administered projects (CSS MHSA Housing Program and PEI)

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MHSA Fiscal Policy Considerations FY 2009-10 represents one-time spike in

available funding Prudent Reserve (CSS only) Local cash management because of 3 year

reversion Opportunity to evaluate MHSA in terms of

overall mental health system fiscal integration Increase in Medi-Cal Decrease in Realignment

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Kate Pavich

MHSA Updates

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MHSA Updates CSS Plan Update Client Forum: Healing Trauma –

“We Can Do It” Recovery Arts

“I Am” by Keith Torkelson

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Public WorkshopCalifornia Strategic Plan for Mental health

Stigma and Discrimination ReductionSOUTHERN CALIFORNIA

Thursday, March 19, 2009 1:00 p.m.- 4:00 p.m.Holiday Inn Orange County Airport– Santa Ana

2726 Grand Ave., Santa Ana, CA 92705(Located parallel to the 55 Freeway and Accessible by Bus

Routes 59, 72, 74, and 213 Express Route)To Register Contact:

nugarte@ccp.csus.edu

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Capital Facilities Capital Facilities Project Proposal

Approved by the Board of Supervisors January 13, 2009

Sent to the Department of Mental Health

January 21, 2009 DMH will reply within 60 days of submission

- initial review of the proposal has occurred

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401 S. Tustin St.

“Trees” by Theresa Boyd

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Architecture and Planning Architectural Designer presented

floor, fabric, and carpet treatments Green Components:

Carpet Tile: 100% recycled backing Furniture Fabric: 100% recycled

polyester and low impact nylon Flooring and Cabinetry: Constructed of

formaldehyde free bamboo which is a rapidly regenerative source of wood

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401 S. Tustin St. TimelineCEQA Compliance Complete April 14Construction Documents Complete April 28 100% Cost Estimate Complete June 30 Plans Ready for Permit Issue August 18 Advertise for Bids September 30Award Construction Contract December 29

Construction Start January 27

Construction Complete February 22

2009

2010

2011

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Next Steering Committee Meeting

Monday April 6, 20091:00 p.m. – 4:00 p.m.

Delhi Community Center 505 East Central, Santa Ana, CA

92707