California Mental Health Services Authority (CalMHSA) California Quality Improvement Coordinators March 21, 2012 Monterey, California Presented By: Wayne Clark, PhD President, CalMHSA 1

CalMHSA—On a Mission Mission The mission of CalMHSA is to provide member counties a flexible, efficient, & effective administrative/fiscal structure focused on collaborative partnerships & pooling efforts in: Development & Implementation of Common Strategies & Program Fiscal Integrity, Protections, & Management of Collective Risk Accountability at State, Regional & Local Levels Vision CalMHSA serves California Counties and Cities in the dynamic delivery of mental health and supportive services. A nationally recognized leader, CalMHSA inspires the service community through its commitment to results and values. Successful statewide and regional programs enable the voice of many to be heard. Purpose Promoting Efficiency, Effectiveness and Enterprise among Counties and Cities

CalMHSA—JPA Agreement/Purpose Counties join CalMHSA through a JPA Agreement that specifies their purpose is to jointly develop and fund mental health services and educational programs. Such Programs May Include, But Are NOT Limited To, the Following: Addressing Suicide Prevention Ethnic/Cultural Outreach Stigma/Discrimination Reduction Related to Mental Illness Student Mental Health/Workforce Training and Education Training, Technical Assistance, and Capacity Building Provision of Necessary Administrative Services 3

www.CalMHSA.org We recently updated our website – it should become more and more user friendly to local constituencies over the coming months and can be used as a place to stay up to date on all issues related to PEI programs

CalMHSA—Membership 42 members, serving 89.6% of the state’s population.

Statewide PEI Programs Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) Statewide Programs: In eight months, CalMHSA went from Implementation Work Plan approval to releasing Requests for Proposals, awarding contracts, and has completed 25 contracts for the distribution and delivery of services of $130 million in funds! Might want to add that there are now more funds received that CalMHSA will be determining how to spend in the coming months – roughly $10-12Million

PEI Statewide Initiatives Three Initiative/Program Areas: Suicide Prevention Stigma and Discrimination Reduction Student Mental Health Programs conclude June 30, 2014 Statewide Evaluation

Suicide Prevention – Approved Programs Provider 1 Suicide Prevention Network Program Didi Hirsch Community Mental Health Services 2 Regional Local Suicide Prevention Capacity Building Program A Ventura, San Bernardino, Riverside, Orange, San Diego, Imperial & Los Angeles B San Luis Obispo, Santa Barbara & Kern Transitions Mental Health Association C Monterey & Santa Cruz Family Services Agency of the Central Coast D Marin, Sonoma, Napa, Lake, Mendocino & Solano Family Services Agency of Marin E San Francisco, Santa Clara, San Mateo & Contra Costa San Francisco Suicide Prevention F Sacramento, El Dorado, Placer, Yolo, Sutter/Yuba, Amador, Butte, Colusa, Glenn, Trinity, Humboldt, Siskiyou , Tuolumne, Calaveras & Modoc Institute on Aging Center G Fresno, Madera, Merced & Stanislaus Kings View 3 Social Marketing AdEase 4 Suicide Prevention Training Workforce Enhancement Program LivingWorks Suicide Prevention (SP) Initiative uses a full range of strategies from Prevention to Early Intervention across the lifespan and across diverse backgrounds to prevent suicide There are Four Program Areas: Statewide Suicide Prevention Network Regional and Local Suicide Prevention Capacity Building Program Social Marketing Training and Workforce Enhancement For individual counties providing this powerpoint – match your specific region to the provide write up handout entitled “Key Activites”. This is modeled in this example for Orange Co.

Suicide Prevention – Intended Outcomes Increase # of accredited suicide prevention programs/call lines Reduce disparities in the availability, accessibility and quality of services for age, gender, region and racial, ethnic and cultural groups that have been historically underserved Increase # of articles and air time that media devotes to suicide prevention and improve adherence to suicide reporting guidelines Increase # of informed individuals of warning signs and how to seek appropriate and available help Increase # of local suicide survivor groups that have access educational and relevant suicide prevention materials that are age, region, gender and culturally and linguistically appropriate. Provide statewide training for recognition and referral of suicide warning signs that are culturally competent and age appropriate. Improve delivery of services by integrating crisis intervention systems, including physical health, mental health, substance abuse, aging and long term care, social services, first responders and emergency hotlines

Stigma & Discrimination Reduction (SDR) Approved Programs Provider 1 Strategies for a Supportive Environment Program 1 Stigma & Discrimination Reduction Consortium Adele James, (Interim) Program Manager 2 Social Marketing Runyon, Saltzman & Einhorn 3 Capacity Building United Advocates for Children & Families 2 Values, Practices and Policies Program 1 Resource Development Mental Health Association of San Francisco 2 Partnering with Media and the Entertainment Industry Entertainment Industries Council, Inc 3 Promoting Integrated Health Community Clinics Initiative 4 Promoting Mental Health in the Workplace Second release of RFP; responses due February 15, to be awarded April 12, 2012 5 Reducing Stigma and Discrimination in Mental Health and System Partners National Alliance on Mental Health 3 Promising Practices Program 4 Advancing Policy to Eliminate Discrimination Program Disability Rights California Of note, similar to the Suicide Prevention contractors, all of the listed contractors are required, as part of a deliverable to work with CalMHSA to ensure that local efforts are leveraged and there is collaboration – including how and when to contact local county staff.

Stigma & Discrimination Reduction – Intended Outcomes Increased availability of age, gender, region and culture/language specific anti-stigma programs to create widespread understanding of mental health challenges and suicide risk and prevention. Measurable reduction in public stigma towards people with mental health challenges by employers, landlords, law enforcement, mental health and health care staff, and school and college personnel Measurable increase in understanding of mental health challenges and suicide risk and prevention strategies on the part of trained personnel, community gatekeepers and peer-to-peer support providers.

Student Mental Health – Approved Programs Provider California State University California State University Office of the Chancellor California Community Colleges California Community Colleges Office of the Chancellor University of California Regents of the University of California Statewide K-12 California Department of Education Regional K-12 California County Superintendents Educational Services Association The Student Mental Health Initiative (SMHI) promotes and applies strategies to strengthen student mental health statewide across K-12 educational systems and through institutions of higher education. The purpose of the University and College Student Mental Health Programs (UC-SMHP, CSU-SMHP and CCC-SMHP) is to implement training, peer-to-peer support and suicide prevention within the University of California (UC), California State University (CSU) and California Community Colleges (CCC). The Student Mental Health Programs should prioritize capacity building and infrastructure development to benefit all students throughout all campuses of the three respective higher education institutions Campus-Based Mental Health Programs Mental Health Promotion Programs Peer to Peer Support Activities Suicide Prevention Programs Referral and Linkage The purpose of the Statewide Kindergarten to Twelfth Grade Student Mental Health Program (K-12 SMHP – Statewide) is to provide school-based programs, systems and policy developments, education and training and technical assistance in schools districts. The long-term goal is that programs will be established in each of California's eleven superintendent regions. State level activities for training will involve developing or enhancing existing evidence-based trainings to be more culturally and linguistically appropriate which would allow schools or other community organizations to implement the training at the local level; technical assistance to support program development and implementation through the provision of resources on best practices, convening to exchange and share information and lessons learned and access to on‐site consultation to increase the effectiveness of SMHI‐funded programs; training for those personnel, like teachers, most likely to first identify potential mental health needs; use of appropriate youth peer‐to‐peer strategies; a continuum of prevention and early intervention services for schools and their districts

Student Mental Health - Outcomes Improved relationships between school systems, foster care systems and county mental health departments Increased access to and awareness of services, increased linkages with community resources Increased collaboration among the higher education to improve student mental health Increased identification of early signs of mental illness Increased school attendance, or performance Reduced incidents of suicide or suicide attempts Reduced stigma and discrimination

Draft Implementation Work Plan Amendment Since the CalMHSA Implementation Work Plan was approved by the Mental Health Services Oversight and Accountability Commission (MHSOAC) in February 2011, 13 new counties and cities beyond those included in the original work plan have elected to participate in CalMHSA PEI statewide projects. To date, new participation has resulted in an additional $7.7 million of assigned program funds for redistribution into new communities.

Draft Implementation Work Plan Amendment Principles for Funding Allocations The primary principles driving the allocation of additional program funds are: Implement PEI projects in an expeditious manner. Strengthen local and regional capacity by ensuring new CalMHSA participants are included in funded activities. Maintain overall consistency in the proportion of funds allocated to Suicide Prevention 25%; Stigma and Discrimination Reduction 37.5%; and Student Mental Health 37.5%. Consider the unique characteristics of communities participating in CalMHSA, including local factors such as capacity, population, and setting (rural, suburban, urban). DMH Information Notices No.: 08-25 and 10-06, “The goal… is to ensure that California maintains the significant and intended investment in the three program areas as originally intended.”

Draft Implementation Work Plan Amendment Recommendations Suicide Prevention (SP): Increase by approximately $1.9M (25% of $7.7M). Regional Local Capacity Building Programs: As new communities participate in CalMHSA, many regional SP providers are being asked to serve additional counties and/or cities. Augment regional programs to serve an expanded geographic and/or racial/ethnic/cultural and underserved population.

Draft Implementation Work Plan Amendment Recommendations Student Mental Health Initiative (SMHI):­ Increase by approximately $2.9M (37.5% of $7.7M). Higher Education: California Community Colleges (CCC): SMHI Higher Education funds were allocated equally to each system. The CCC serves a student population that is 6 to 11 times that of the California State University and University of California.

Draft Implementation Work Plan Amendment Recommendations Stigma and Discrimination Reduction (SDR): This amendment will set aside approximately $2.9M (37.5% of $7.7M) for Work Plan Amendment #2 (planned for Fall 2012). Nine out of 10 SDR projects are in the initial stages of implementation; the other project (SDR Program 2, Component 4) has been re-released for bid. It is recommended that program enhancements be delayed until Work Plan Amendment #2, so that they can be informed by implementation data.

PEI Statewide Evaluation Invests up to $10 million to implement a complex multi- phase evaluation of all programs individual and collective impact to capitalize on the unique statewide investment in Student Mental Health, Suicide Prevention and Stigma and Discrimination Reduction. To evaluate if the strategies of PEI Statewide Projects are effective in Preventing Suicides Improving Student Mental Health and Reducing Mental Health Stigma and Discrimination

PEI Statewide Evaluation Key objectives include: Establishing baselines and community indicators Conducting thorough program evaluations Identifying innovative programs for replication Promoting continuous quality improvement efforts

PEI Statewide Evaluation Statewide Evaluation Experts (SEE): SEE Launched in March 2012 SEE represents 20 experts that support and guide PEI Statewide Projects Evaluation effort SEE members will liaison with CalMHSA program partners, as needed, to ensure support and success in evaluation

Any Questions?

Finance Summary Implementation Plan Budget $129,399,879 (from January 27, 2011 MHSOAC approved Work Plan) $129,399,879 Program Funds Received 9/20/2011 $135,716,145 Program Funds Receivable as of 9/20/2011 $375,680 Program Dollars Expended through 9/20/2011 $1,500,000 Planning Dollars Expended Since 7/1/2009 $2,243,437 Total Program Funds Assigned $136,090,825

CalMHSA — We’re Here to Answer Questions John Chaquica, CPA, MBA, ARM Executive Director, CalMHSA George Hills Company (916) 859-4824 (CalMHSA Office) john.chaquica@georgehills.com Ann Collentine, MPPA Program Director, CalMHSA George Hills Company (916) 859-4806 (CalMHSA Office) ann.collentine@georgehills.com Stephanie Welch, MSW Program Manager, CalMHSA George Hills Company (916) 859-4816 (CalMHSA Office) stephanie.welch@georgehills.com Wayne Clark, PhD Director, County of Monterey, Department of Behavioral Health President, CalMHSA (916) 859-4829 or (916) 859-4820 (CalMHSA Office) clarkww@co.monterey.ca.us 24