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The Mental Health Services Act (MHSA): What Aging Services Providers Need to Know Aging Services of California Annual Conference May 5, 2010 Lin Benjamin, MSW, MHA Geriatric Mental Health Specialist California Department of Aging (916) 928-7890; lbenjamin@aging.ca.gov. Presentation Agenda.

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Presentation Agenda

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  1. The Mental Health Services Act (MHSA):What Aging Services Providers Need to KnowAging Services of California Annual ConferenceMay 5, 2010Lin Benjamin, MSW, MHAGeriatric Mental Health SpecialistCalifornia Department of Aging(916) 928-7890; lbenjamin@aging.ca.gov

  2. Presentation Agenda Description of Proposition 63/MHSA MHSA Core Principles MHSA Stakeholder Process MHSA Funding Components Collaboration Among Older Adult Service Providers Resource Information

  3. Description of Prop 63/MHSA California voters’ ballot initiative (November 2, 2004) 1% tax on personal income in excess of $1M Became effective as statute on Jan 1, 2005, as the Mental Health Services Act (MHSA) http://www.dmh.ca.gov/Prop_63/MHSA/docs/Mental_Health_Services_Act_Full_Text.pdf Six MHSA Funding Components Community Services & Supports (CSS) Prevention and Early Intervention (PEI) Workforce Education and Training (WET) Innovation Capital Facilities & Technology Housing

  4. Description of Prop 63/MHSA • Policy Guidelines developed for each funding component defines how MHSA funds can be used • Funding is allocated to County Mental Health Departments for each component on a 3-year basis (Moving towards an Integrated Plan) • Requires a Community Planning Process involving stakeholders to identify community needs and develop County Plans for state approval http://www.dmh.ca.gov/Prop_63/MHSA/Community_Planning/default.asp • Non-Supplantation Policy • No MHSA funds can be used to fund mental health services that were in existence prior to Prop 63

  5. Description of Prop 63/MHSA Requires counties to fund a Prudent Reserve to be used when revenue declines to maintain stability of MHSA programs/services State Administrative Funds 5% of MHSA funds are used for state MHSA administrative activities of the Department of Mental Health (DMH), the Mental Health Services Oversight and Accountability Commission (MHSOAC) and the California Mental Health Planning Council (CMHPC) State-level Interagency Partners receive MHSA funding from DMH through Memorandum of Understanding (includes California Department of Aging) http://www.dmh.ca.gov/Prop_63/MHSA/State_Interagency_Partners.asp

  6. MHSA Core Principles Transform the public mental health system Reach Un-served and Under-served populations across the lifespan (Children & Youth, Transition-Age Youth, Adults, Older Adults), including Racially, Ethnically and Culturally Diverse Populations Develop services that Promote Wellness and Recovery Reduce Disparities in Access and Outcomes Are Consumer & Family Driven; Culturally & Linguistically Competent, Result from Community Collaboration, Provide an Integrated Service experience

  7. MHSA Stakeholder Process MHSA County Plan Development and Approval Process: Community Planning Process County MHSA Steering/Advisory Committee (prioritize proposals) County DMH Writes County MHSA Plan 30 Day Public Comment Period and Public Hearing County Mental Health Board Approval County Board of Supervisors Approval Submit County MHSA Plan to CA DMH or MHSOAC for State Review/Approval for Funding County DMH Implements MHSA Plan (RFPs) County DMH Submits Annual Update to CA DMH for Approval/Funding

  8. MHSA Funding Components Community Services and Supports (CSS) Mental health services to address Serious Mental Illness (SMI) in adults/older adults and Serious Emotional Disturbance (SED) in children. Full Service Partnerships – Services for specific age groups that provide “whatever it takes” to prevent negative outcomes (hospitalization, institutionalization, homelessness, suicide, school failure, out of home placement, etc) Older Adult Full Service Partnerships (February, 2009) http://cmhda.org/go/LinkClick.aspx?fileticket=IcWmQ9fKR4Q%3d&tabid=169 http://www.dmh.ca.gov/Prop_63/MHSA/Community_Services_and_Supports/default.asp

  9. MHSA Funding Components Prevention and Early Intervention (PEI) Prevent onset of SMI/SED Prevent mental illness from becoming severe and disabling MHSA PEI Policy Guidelines for County PEI Plans require allocation of 51% (minimum) of PEI funds for ages 0-25 and must serve all age groups Small counties are excluded from these PEI requirements (<200,000 population)

  10. MHSA Funding Components Prevention and Early Intervention (PEI) (cont.) County PEI Plans Must Address Key Community Needs: Disparities in Access Psycho-social impact of trauma At-Risk Children, Youth and Young Adult Populations Stigma and Discrimination Suicide Risk

  11. MHSA Funding Components Prevention and Early Intervention (PEI) (cont.) County PEI Plans Must Target Priority Populations: Trauma Exposed Individuals Individuals Experiencing Onset of Serious Psychiatric Illness Children & Youth in Stressed Families Children & Youth at Risk for School Failure Children & Youth at Risk of or Experiencing Juvenile Justice Involvement

  12. MHSA Funding Components Workforce Education & Training (WET) Statewide Five-Year WET Plan Promote post-secondary education strategies to prepare future public mental health workforce and address workforce shortages http://www.dmh.ca.gov/Prop_63/MHSA/Workforce_Education_and_Training/docs/MHSA_FiveYearPlan_5-06-08.pdf County Three-Year Expenditure WET Plan Complete a county mental health workforce needs assessment to identify workforce shortages (by discipline, diversity issues) Provide training to build skills and capacity of existing public mental health workforce (professionals, consumers, families) and system partners http://www.dmh.ca.gov/DMHDocs/docs/notices07/07-14_Enclosure1A.pdf Regional WET Plans http://www.cimh.org/Services/MHSA/Workforce-Education-Training.aspx

  13. MHSA Funding Components • Innovation • Establish creative approaches to mental health services that promote recovery, resilience and reduce disparities in access and outcomes • Introduce a new mental health practice • Implement a promising community practice that advances mental health service delivery, increases quality of services, improves outcomes, promotes interagency collaboration and new learning • http://www.dmh.ca.gov/Prop_63/MHSA/Innovation/default.asp

  14. MHSA Funding Components Capital Facilities and Technology To ensure the infrastructure necessary for the expansion and transformation of the public mental health system Capital Facilities: Treatment, service and administrative facilities http://www.dmh.ca.gov/Prop_63/MHSA/Capital_Facilities/default.asp Technology: Electronic health records, information/data systems, local priorities http://www.dmh.ca.gov/Prop_63/MHSA/Technology/default.asp

  15. MHSA Funding Components • MHSA Housing • Develops permanent supportive housing for persons with SMI/SED • http://www.dmh.ca.gov/Prop_63/MHSA/Housing/default.asp

  16. MHSA Statewide PEI Projects California Strategic Plan on Suicide Prevention http://www.dmh.ca.gov/Prop_63/MHSA/Prevention_and_Early_Intervention/docs/CDMH_ExSummary_Web.pdf http://www.dmh.ca.gov/Prop_63/MHSA/Prevention_and_Early_Intervention/docs/SuicidePreventionCommittee/FINAL_CalSPSP_V9.pdf http://www.dmh.ca.gov/PEIStatewideProjects/SuicidePrevention.asp California Strategic Plan on Stigma & Discrimination Reduction http://www.dmh.ca.gov/PEIStatewideProjects/StrategicPlan.asp Student Mental Health Initiative http://www.dmh.ca.gov/PEIStatewideProjects/StudentMentalHealthInitiative.asp California Strategic Plan on Reducing Ethnic and Cultural Disparities http://www.dmh.ca.gov/PEIStatewideProjects/ReducingDisparities.asp http://www.dmh.ca.gov/Multicultural_Services/default.asp

  17. Collaboration Among Older Adult Service Providers MHSA provides opportunity to develop older adult mental health services Older adult service providers/advocates must participate in the MHSA stakeholder process to ensure that MHSA funds the development of older adult mental health services Promote development of collaborative and integrated service models (health, mental health, substance use, care management, support services)

  18. Collaboration Among Older Adult Service Providers Mental Health Senior Peer Counseling/Peer Counseling Programs Home & Community-Based Aging Services Network- Area Agencies on Aging (Older Americans Act programs), Multipurpose Senior Services Programs, Adult Day Health Care, Independent Living Centers, Aging and Disability Resource Centers, Public Guardian Alcohol/Substance Abuse Primary Care, Hospitals, Home Health Social Services-Adult Protective Services, In Home Supportive Services Senior Housing Providers Family Caregiver Programs Ethnic & Cultural Brokers Faith-Based Organizations Educational Institutions Legal Mental Health & Aging Coalitions

  19. Collaboration Among Older Adult Service Providers • Opportunities to Promote Older Adult Mental Health Service Development • California Department of Aging MHSA PEI Plan Review Summary Report(Handout) • California Mental Health Directors Association (CMHDA) Older Adult System of Care Committee WET Issue Paper(Handout) • Promote geriatric mental health training of public mental health workforce and system partners working with older adults with mental health needs • http://cmhda.org/go/Committees/OlderAdultSystemofCareCommitteeOASOC/OASOCDocuments.aspx

  20. Resource Information California Department of Mental Health (DMH) MHSA Home Page/List-Serve: http://www.dmh.ca.gov/Prop_63/MHSA/default.asp http://www.dmh.ca.gov/Prop_63/MHSA/Apps/subscription/default.asp Link to County Mental Health Departments to determine MHSA stakeholder activities: http://www.dmh.ca.gov/docs/CMHDA.pdf County MHSA Plans and Annual Updates: http://www.dmh.ca.gov/Prop_63/MHSA/County_Plans_and_Updates.asp http://www.dmh.ca.gov/DMHDocs/docs/notices08/08-28.pdf MHSA Resource Information: http://www.dmh.ca.gov/Prop_63/MHSA/Related_Resources.asp Statewide PEI Projects - Policy Guidelines http://www.dmh.ca.gov/DMHDocs/docs/notices10/10-06_PEIGuidelines.pdf

  21. Resource Information • Mental Health Services Oversight and Accountability Commission (MHSOAC) http://www.dmh.ca.gov/MHSOAC/default.asp • Monthly Commission meetings; Commission Committee meetings • County PEI Plans Approved by MHSOAC http://www.dmh.ca.gov/MHSOAC/Prevention_and_Early_Intervention.asp • MHSA Fast Factshttp://www.dmh.ca.gov/MHSOAC/docs/FastFacts_General_MHSAwFinalChgs-3-8-10.pdf • PEI Fast Facts http://www.dmh.ca.gov/MHSOAC/docs/FastFacts_PEI_Final-3-8-10.pdf • Prop 63 Funding Fast Facts http://www.dmh.ca.gov/MHSOAC/docs/Fast_Facts_Prop_63_funding--Revised_03-8-10.pdf

  22. Resource Information California Mental Health Directors Association (CMHDA)http://www.cmhda.org/go/Home.aspxr MHSA Information http://cmhda.org/go/MentalHealthServicesAct.aspx California Counties Transforming Local Mental Health Systems Publication (Description of County CSS-Funded Programs) http://cmhda.org/go/MentalHealthServicesAct/CommunityServicesSupports/CSSCompendium.aspx Older Adult System of Care Committee Documents Workforce Education and Training (WET) Issue Paper http://cmhda.org/go/Committees/OlderAdultSystemofCareCommitteeOASOC/OASOCDocuments.aspx Older Adult Full Service Partnerships (February, 2009) http://cmhda.org/go/LinkClick.aspx?fileticket=IcWmQ9fKR4Q%3d&tabid=169

  23. Resource Information California Institute of Mental Health (CiMH)www.cimh.org California Mental Health Directors Association (CMHDA) Older Adult System of Care Conference (2009) http://www.cimh.org/Learning/Conferences-Training/Handouts/2009/Older-Adults.aspx MHSA training activities Mental health training resources

  24. Resource Information • California Mental Health Planning Council (CMHPC) http://www.dmh.ca.gov/Mental_Health_Planning_Council/default.asp • Committees • http://www.dmh.ca.gov/Mental_Health_Planning_Council/Meetings.asp • California Mental Health Planning Council Master Plan • http://www.dmh.ca.gov/Mental_Health_Planning_Council/Master_Plan.asp

  25. Resource Information California Department of Aging (CDA) http://www.aging.ca.gov/ California State Plan on Aging (2009-2013) http://www.aging.ca.gov/legislation/California_State_Plan_on_Aging_AoA_2009-2013_06-30-2009.pdf Statistics and Demographics http://www.aging.ca.gov/stats/default.asp Resource Links http://www.aging.ca.gov/links/related_links.asp California Commission on Aging http://www.ccoa.ca.gov/

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