1 Santa Clara County 2 nd Stakeholder Meeting Mental Health Services Act Santa Clara County 2 nd Stakeholder Meeting Mental Health Services Act Department of Mental Health February 25, 2005

2 Meeting Objectives Inform Stakeholders of Work to Date on MHSA Overview of Planning Process & Timeline Obtain Stakeholder Input to Community Engagement and Stakeholder Training Needs Launch Assessment Phase Launch Assessment Phase

3 Agenda 1.Welcome & Agenda Review 2.Introduction of MIG Consultants 3.Recap Kickoff Meeting & Summary of Stakeholder Input 4.Approach to Assessment Phase 5.Planning Timeline & Milestones 6.Stakeholder Input Next Steps and Closure

4 Recap of Kickoff Meeting

5 MHSA Funding  1% tax on taxable personal income over $1 million to be deposited into a Mental Health Services Fund (MHSF) in State Treasury  Administered by State Department of Mental Health  Oversight by 16-Member Accountability Commission  Distributed to Counties Via Current State-County Contract  $300 Million in FY05; $700 Million Est. in FY06  Is used to expand, not supplant services; can “not be used to supplant existing state or county funds utilized to provide mental health services.”

6 Nine Categories of Expenditures 1.Local Planning 2.Services to Children 3.Services to Adults & Older Adults 4.Innovative Programs (within 1&2) 5.Prevention and Early Intervention 6.Education and Training 7.Capital and Technology Development 8.State Planning and Administration 9.Prudent Local Reserves

7 Initial Funding FY04-08  FY04-05 funds (est. $300 Million) 45% - Education and Training (DMH fund) 45% - Education and Training (DMH fund) 45% - Capital Facilities Technology (DMH fund) 45% - Capital Facilities Technology (DMH fund) 5% - Local Planning (to counties) 5% - Local Planning (to counties) 5% - State Implementation (to DMH Admin). 5% - State Implementation (to DMH Admin).  FY06, FY07 and FY08 (est. $600 – 700 Million) 10% - Education & Training 10% - Capital and Technology 50% - Children, Adult, Senior Services 5% - Innovative Programs 5% - Innovative Programs 20% - Prevention and Early Intervention 5% - State Administration 5% - State Administration

8 SCC Planning Process  Monthly Stakeholder Leadership Meetings for: Information and Status ReportsInformation and Status Reports Input from Broad CommunityInput from Broad Community Readiness ForumsReadiness Forums  Work Group Meetings: Child, Adolescent, Young Adult SOC Child, Adolescent, Young Adult SOC Adult and Older Adult SOC Adult and Older Adult SOC Prevention and Early Intervention Prevention and Early Intervention Data, Infrastructure and Human Resources Data, Infrastructure and Human Resources  Regular Reports Board and Board Committees and Mental Health Board

9 Board of Supervisors State Dept. of Mental Health BOS Committees (HHC, CSFC, PSJC) County Executive SCVHHS Exec. Dir MHSA Stakeholder Leadership Committee Data, Technology, Budget Work Group Prevention & Early Intervention Work Group Children’s System of Care Work Work Group Adult/ Older Adult System of Care Work Group Community Stakeholder Forums, Focus Groups, and Consumer Engagement Groups Cultural CompetencyReadiness ForumsRecovery/Self HelpReadiness Forums Focus Group Focus Group Focus Group Focus Group Focus Group Accountability Commission Mental Health Board Project Management Team Santa Clara County MHSA Planning Structure

10 Local Planning Process Partial List of Stakeholders Mental Health Department (chair)Mental Health Department (chair) County Executive’s Office (co-chair)County Executive’s Office (co-chair) Mental Health Board (co-chair)Mental Health Board (co-chair) Mental Health Self-Help CentersMental Health Self-Help Centers MHD Office of Consumer EmpowermentMHD Office of Consumer Empowerment National Alliance for the Mentally IllNational Alliance for the Mentally Ill Association of Mental Health Contract AgenciesAssociation of Mental Health Contract Agencies Non-AMHCA mental health providersNon-AMHCA mental health providers Labor OrganizationsLabor Organizations Foster Care AssociationFoster Care Association Parents Helping ParentsParents Helping Parents Department of Alcohol and Drug ServicesDepartment of Alcohol and Drug Services Public Health DepartmentPublic Health Department VMC Acute Psychiatric ServicesVMC Acute Psychiatric Services Custody Health ServicesCustody Health Services Valley Medical CenterValley Medical Center Office of the Public GuardianOffice of the Public Guardian Police Chief Association SCC Sheriff Department of Social Services Probation Department Superior Court District Attorney’s Office Public Defender’s Office County Office of Education School District Superintendents First Five Commission Council on Aging Office of Affordable Housing Domestic Violence Council School Linked Services United Way Interfaith Council Silicon Valley Council of Non-profits San Andreas Regional Center

11 Planning Phases  Engagement and Commitment  Invite Stakeholder Involvement  Share Intent and Vision  Lay Out Planning Landscape  Learning and Assessment  Learn Current System  Learn Needs of Consumers, Stakeholders, Community  Learn Best Practice Strategies to Meet Needs  Prioritization and Planning  Establish Local Mission, Values & Transformation Objectives  Prioritize Local Needs  Select Most Effective Strategies to Meet Local Needs  Implementation  Obtain State Approval  Select Local Providers  Initiate, Monitor and Evaluate Services

12 Input From Stakeholders To Date

13 Input From 84 Consumers Our Needs – Top 10 1.Self-Help ExpansionN = 30 2.Transportation N = 29 3.Job Training & PlacementN = 27 4.Sensitivity Training ( MH Staff & Police) N = 26 5.Peer Support (counseling, case mgmt.) N = 21 6.Outreach (Elderly, Homeless, Unserved) N = 16 7.Recreation/Socialization (with Peers) N = 13 8.Education on Diagnosis (to Clients and Families) N = 12 9.Consumer Provider PositionsN = Redesign of SystemN = 11

14 Input From 40 Dept. Managers What Transformation Means to Us:  Vision  Consumer Gains  Improved Services  Staff Improvements “Two years from now we will have a new, Innovative, noticeable change” in access, involvement, and freedom from stigma In better practices and improved quality in knowledge & skill, awareness & inclusion, morale & attitude, & in effectiveness of interventions.

15 What Transformation Means to 200+ County Staff  A Vision: “A holistic approach to mental health incorporating medicine, rehabilitation & recovery”  A Process: “Improving existing services to best meet client and community needs”  Results: Prevention, early intervention, improved access, improved collaboration and integrated services

16 Input From 236 Stakeholders 1/26/05  What in the DMH Vision is Important to Us? Service Scope N = 66Service Scope N = 66 Service Collaboration N = 50Service Collaboration N = 50 Evidenced Based/Promising Practices N = 33Evidenced Based/Promising Practices N = 33 Results for Accountability and N = 33 to Improve ServicesResults for Accountability and N = 33 to Improve Services Client Centered Programs N = 31Client Centered Programs N = 31 Service Quality N = 28Service Quality N = 28 Partnering Mechanisms N = 28Partnering Mechanisms N = 28

17 Input From Stakeholder 1/25/05 Kickoff  Did you Like Meeting Format? Yes =125 No = 3  Did you Like the Presentation? Yes =126 No = 3  Did you Like the Interactive Exercise? Yes =102 No = 17 - Not enough time - Too hard to process each table - Thanks for trying & modifying

18 Next Steps in Engagement  Finalize Engagement Strategies and Survey for In-Reach to Bring the Voice of 5,000 Consumers and Families into the plan.  Finalize Engagement Strategies and Survey for Outreach to Stakeholders and Community Members to Bring the Voice of 5,000 Stakeholders and Community Members into the plan.

19 Initiating Assessment Phase

20 The Approach– Lifespan Framework Determine and Prioritize Local Mental Health Needs Across Lifespan Prevention Early Intervention Intervention All Citizens Across Lifespan Citizens in need Unmet Need Current Public MH System

21 The Approach – Lifespan Framework Children, Youth and Young AdultsChildren, Youth and Young Adults years years 12 – 17 years 18 – 25 years Adults and Older Adults 26 – 35 years 36 – 50 years 51 – 65 years 65 + years

22 Population SizePopulation Size Geographic DistributionGeographic Distribution Ethnicity and ImmigrationEthnicity and Immigration GenderGender AgeAge Service UtilizationService Utilization Prevalence InfoPrevalence Info Risk & Special PopulationsRisk & Special Populations Unmet NeedUnmet Need Stakeholder InputStakeholder Input Developmental Group Describe: For Each Developmental Group Describe: The Approach – Lifespan Framework

23 For Each Developmental Group For Each Developmental Group Assess Each Transformation Area:  Consumer & Family Involvement  Community Partners  Programs & Services  Cultural Competency  Accountability and Outcomes Where Are We? Assess Strengths & Weaknesses in each area Where Do We Want to Be? Determine Transformation Objectives in each area The Approach – Lifespan Framework

24 Early Intervention The Approach – Lifespan Framework Developmental Group Strategies to Transform Current System Strategies to Increase Services Strategies for Early Intervention & Prevention Prevention Intervention For All Ages

25 The Approach Establish Common Goals for All Ages Establish Common Goals for All Ages Health & Well Being Stability in Home, Family & Social Relations Success in School/Work Meaningful Activity Safe From Harming or Being Harmed in Community Examples of System Outcome Objectives  Health Insurance  Health Visits  Health Status  Suicide  Stable Living  # Placements  DV Incidents  School Attendance  Graduations  Work stability  CJS Recidivism  Days incarcerated  Victims of Crime  CJS Diversions

26 The Approach Establish System Structure and Stakeholder Involvement Individual & Family Provider Services System Policy and Management Stakeholders System Performance: Expectations & Results Provider Performance: Expectations & Results Client Level Outcomes: Expectations & Results

27 The Approach Demonstrate process quality and favorable outcomes Who Do We Serve? What Are We Trying to Change? What Practices Do We Employ and Why? How Do We Insure Quality of Practices? How Do We Measure Results? What Results Do We Achieve?

28 Planning Process & Timeline Overview

29 Stakeholder Input Plan to Plan Outreach Engagement Strategies Outreach Survey

30 Meeting Schedule Work Group Interest Meeting Evaluation Closure