Santa Clara County Mental Health Services Act Planning CSS Plan Celebration & Implementation Launch January 27, 2006 Santa Clara County Mental Health Services Act Planning CSS Three-Year Plan CSS Plan Celebration & Implementation Launch January 27, 2006 Department of Mental Health SCVHHS

Welcome! CSS Plan Overview CSS Plan Overview Implementation Phase Overview Implementation Phase Overview Thank You! Thank You!

MHSA (aka Proposition 63)  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 Est. Million in FY05; $700 Million Est. in FY06  Phased in approach to implementation, beginning with Planning and Expanded Service components  Counties currently submitting first component funding requests

Overview of MHSA Components S Six phased-in components completed through a state and local stakeholder involved process: Community Program Planning (5%) Community Services and Supports (50%) Capital and Information Technology (10%)* Education and Training (10%)* Prevention and Early Intervention (20%)* Innovation (5%)* *requirements and allocation method undetermined

Plan Approved by the Board of Supervisors  Community Services & Supports Plan  Santa Clara: $13.4 Million x 3 yrs  51%+ in Full Service Partnerships  49% System Development/Outreach & Engagement  20+ Specific Age-Based Work Plans  Subject to DMH approval  Each distinct program must be approved/denied  Approval expected for initial plans by April 2006

Board of Supervisors State Dept. of Mental Health BOS Committees (HHC, CSFC, PSJC) County Executive SCVHHS Exec. Dir MHSA Stakeholder Leadership Committee Work Group & Strategy Teams Children & Youth 0-15 Years Work Group & Strategy Teams Older Adults 60+ Years Work Group & Strategy Teams Transition Age Youth Years Work Group & Strategy Teams Adults Years Community Stakeholder Forums, Focus Groups, and Consumer Engagement Groups, Surveys, Meetings Cultural Competency Wellness and Recovery Evidenced Based Practices MHSA Vision & Requirements Focus Group Focus Group Focus Group Focus Group Focus Group Accountability Commission Mental Health Board Project Management Team Santa Clara County MHSA Planning Structure Ethnic Community Advisory Committees

Plan Requirements The Three-Year CSS Plan Identify Community Concerns for All Ages Determine Unmet Need & Disparitie s Identify Specific Populations for Focus Identify strategies to Meet Need 1234 $13.4 Million per year 20 Program Work Plans

Planning Phase Accomplishments Inreach and Outreach Campaign March through June 2005– 10,000 voices of input! Inreach and Outreach Campaign March through June 2005– 10,000 voices of input! Work Groups drafted concerns and potential focal populations; Work Groups drafted concerns and potential focal populations; Ethnic Community Advisory Committees formed and providing ongoing input; Ethnic Community Advisory Committees formed and providing ongoing input; Strategy Teams researched and identified key strategies for nine focal populations; Strategy Teams researched and identified key strategies for nine focal populations; Stakeholder Leadership Committee - endorsed draft plan recommendations from Work Groups, Strategy Teams, and Ethnic Community Advisory Teams Stakeholder Leadership Committee - endorsed draft plan recommendations from Work Groups, Strategy Teams, and Ethnic Community Advisory Teams Three Public Hearings sponsored by the Mental Health Board in November 2005 Three Public Hearings sponsored by the Mental Health Board in November 2005 Board of Supervisors approved CSS Plan for state submission in December Board of Supervisors approved CSS Plan for state submission in December

Focal Populations Defined Per Requirements Children Zero to Five Years High Risk 2.Foster Care Youth 3.Juvenile Justice Involved Youth 4.Underserved Seriously Emotionally Disturbed Transition Age Youth First Time Psychosis 6.Sixteen to 25 Years Aging Out of Child Systems Adults Jail Involved/Homeless/Dual Diagnosed SMI 8.Underserved/Un-served SMI Older Adults High Risk/Homebound SMI Seniors

Disparities in Unmet Need Latino, Asian and American Indian underserved among all ages Latino, Asian and American Indian underserved among all ages Latino, African American and American Indian over- represented in CJS, un-housed, and foster care with greater need (prevalence) and underserved Latino, African American and American Indian over- represented in CJS, un-housed, and foster care with greater need (prevalence) and underserved Refugee, immigrant and monolingual greater need and less served Refugee, immigrant and monolingual greater need and less served LGBTQ greater need and less served LGBTQ greater need and less served Developmentally disabled greater need and less served Developmentally disabled greater need and less served

Overview of Proposed Work Plans

Children 0-15 C-01 Full Service Partnerships – 30 slots; est. $20K per year per child, with up to 30% to support stable living/housing; emphasis on Latino, African American, and American Indian juvenile justice involved and youth without insurance. C-01 Full Service Partnerships – 30 slots; est. $20K per year per child, with up to 30% to support stable living/housing; emphasis on Latino, African American, and American Indian juvenile justice involved and youth without insurance. C-02 Zero to Five System Development - to develop inter-agency infrastructure to support 0-5 year olds, includes planning; screening/assessment design; training of specialists; family support and system navigation for monolingual Latino and Vietnamese families. C-02 Zero to Five System Development - to develop inter-agency infrastructure to support 0-5 year olds, includes planning; screening/assessment design; training of specialists; family support and system navigation for monolingual Latino and Vietnamese families.

Children 0-15 C-03 Behavioral Health System Development – System-wide implementation of improved screening, assessment and best practice models of treatment; specialized access and care management of juvenile justice and foster care populations. Emphasis on underserved Latino, Asian, African American, American Indian youth and families. C-03 Behavioral Health System Development – System-wide implementation of improved screening, assessment and best practice models of treatment; specialized access and care management of juvenile justice and foster care populations. Emphasis on underserved Latino, Asian, African American, American Indian youth and families.

Transition Age Youth 15 – 25 Years T-01 Full Service Partnerships – 30 slots; est. $20K per year per youth, with up to 30% to support stable living/housing; emphasis on Latino, African American, and American Indian exiting juvenile justice and foster care systems. T-01 Full Service Partnerships – 30 slots; est. $20K per year per youth, with up to 30% to support stable living/housing; emphasis on Latino, African American, and American Indian exiting juvenile justice and foster care systems. T-02 Behavioral Health System Development System-wide implementation of improved screening, assessment and best practice models of treatment; specialized access and care management of youth child- serving systems. Emphasis on underserved Latino, Asian, African American, Native American youth and families. T-02 Behavioral Health System Development System-wide implementation of improved screening, assessment and best practice models of treatment; specialized access and care management of youth child- serving systems. Emphasis on underserved Latino, Asian, African American, Native American youth and families.

Transition Age Youth 15 – 25 Years T-03 Crisis & Drop-In Services and Supports safe, non-stigmatizing access to mental health and basic services. T-03 Crisis & Drop-In Services and Supports safe, non-stigmatizing access to mental health and basic services. T-04 Education Partnership – Integrated “middle college” and community college support to improve school success of youth with mental health concerns. T-04 Education Partnership – Integrated “middle college” and community college support to improve school success of youth with mental health concerns.

Adults A-01 Full Service Partnerships – 75 slots; est. $20K per year per client, with up to 30% to support stable living/housing; emphasis on Latino, African American, Asian and American Indian, homeless, institutionalized, and frequent ER users with severe mental illness. A-01 Full Service Partnerships – 75 slots; est. $20K per year per client, with up to 30% to support stable living/housing; emphasis on Latino, African American, Asian and American Indian, homeless, institutionalized, and frequent ER users with severe mental illness. A-02 Behavioral Health Recovery Services – to redesign county adult outpatient services to include consumer and family support staff; add support and case management staff; and to introduce best practice strategies and align and establish therapeutic caseload size. A-02 Behavioral Health Recovery Services – to redesign county adult outpatient services to include consumer and family support staff; add support and case management staff; and to introduce best practice strategies and align and establish therapeutic caseload size.

Adults A-03 Jail Aftercare and Recovery Services – ( $2.5 M proposed to satisfy Jail Task Force solution #15) for criminal justice involved mentally ill: A-03 Jail Aftercare and Recovery Services – ( $2.5 M proposed to satisfy Jail Task Force solution #15) for criminal justice involved mentally ill:  Full Service Partnerships - 75 slots; est. $20K per year per client, with up to 30% to support stable living/housing; emphasis on Latino, African American, and American Indian;  Enhanced Treatment Court – 60 slots for case management and service linkage;  Dual-Diagnosis After Care Treatment – 125 slots for medication and case management services;  Expanded Housing Options – 75 beds; Transitional Housing Units (THU)

Adults A-04 Adult Urgent Care and Crisis Support – Establishes urgent care and mobile crisis response in north, central and south county regions. A-04 Adult Urgent Care and Crisis Support – Establishes urgent care and mobile crisis response in north, central and south county regions. A-05 Consumer and Family Self-Help Support - Establishes Director of Consumer Affairs and Director of Family Support and Education, in addition to expanded consumer and family self-help with focus on unserved and underserved ethnic and cultural communities. A-05 Consumer and Family Self-Help Support - Establishes Director of Consumer Affairs and Director of Family Support and Education, in addition to expanded consumer and family self-help with focus on unserved and underserved ethnic and cultural communities.

Older Adults 60+ OA-01 Full Service Partnerships – 25 slots; est. $20K per year per client, with up to 30% to support stable living/housing; emphasis on those in or at risk of homelessness, institutionalization, incarceration; physical and emotional harm. OA-01 Full Service Partnerships – 25 slots; est. $20K per year per client, with up to 30% to support stable living/housing; emphasis on those in or at risk of homelessness, institutionalization, incarceration; physical and emotional harm. OA-02 Behavioral Health Services – System-wide implementation of improved screening, assessment and best practice models of treatment; specialized access and care management of older adults; expanded service to senior day programs. OA-02 Behavioral Health Services – System-wide implementation of improved screening, assessment and best practice models of treatment; specialized access and care management of older adults; expanded service to senior day programs.

Older Adults 60+ OA-03 Senior Mobile Assessment & Outreach- Provides specialized mobile assessment and outreach services to shut-in and homebound mentally ill seniors, many of whom are experiencing concurrent medical and substance abuse problems; focus on monolingual seniors. OA-03 Senior Mobile Assessment & Outreach- Provides specialized mobile assessment and outreach services to shut-in and homebound mentally ill seniors, many of whom are experiencing concurrent medical and substance abuse problems; focus on monolingual seniors. OA-04 Senior Family and Caregiver Support – Provides culturally appropriate family and caregiver support and education to those caring for mentally ill seniors. OA-04 Senior Family and Caregiver Support – Provides culturally appropriate family and caregiver support and education to those caring for mentally ill seniors.

Crosscutting Strategies State requirements allow up to 6 months ($6.7 million) of FY06 funds to be used for one-time expenses over three years. These funds are proposed to support several age-based plans in addition to several cross-cutting initiatives. State requirements allow up to 6 months ($6.7 million) of FY06 funds to be used for one-time expenses over three years. These funds are proposed to support several age-based plans in addition to several cross-cutting initiatives.

Crosscutting Strategies HO-01 – Housing Options – HO-01 – Housing Options – Establishes $4 million fund to develop housing options in collaboration with Office of Affordable Housing with $2 million MHSA and $2 million from County. Upon State approval of this proposal, MHD and OAH will jointly design expenditure plan with assistance of housing experts, and will bring back to BOS for approval. Objective will be to leverage these funds in order to maximize the establishment of ongoing permanent housing for the mentally ill in Santa Clara County.

Crosscutting Strategies  Housing Component Summary  Full Service Partnerships (C-01, T-01, A-01, A-03 and OA-01). Est. $2-3 Million (30% of annual resources) will go to securing and maintaining stable permanent living for clients.  MHSA Housing Fund (HO-01) - $4 Million to develop permanent housing resources.  Jail Aftercare & Recovery (A-03) - $625,000 for 75 Transition Housing Units dedicated to jail aftercare. Length of stay and provider requirements will be determined through collaboration with Jail Task Force members.

Crosscutting Strategies FH-01 – Community & Family Outreach and Engagement Initiative – to develop culturally competent outreach and engagement strategies to underserved populations. FH-01 – Community & Family Outreach and Engagement Initiative – to develop culturally competent outreach and engagement strategies to underserved populations. HC-01 – Behavioral & Primary Health Care Partnership – to establish pilot program to improve primary care service access for clients of the mental health system. HC-01 – Behavioral & Primary Health Care Partnership – to establish pilot program to improve primary care service access for clients of the mental health system.

Crosscutting Strategies EE-01 – Education, Employment, and Self- Sufficiency Services - to develop comprehensive education, employment and benefit assistance system for all clients of the system. EE-01 – Education, Employment, and Self- Sufficiency Services - to develop comprehensive education, employment and benefit assistance system for all clients of the system. ST-01 – Regional Survivors of Torture Treatment Services – to establish regionally available specialty treatment services for Bay Area refugee survivors of torture. ST-01 – Regional Survivors of Torture Treatment Services – to establish regionally available specialty treatment services for Bay Area refugee survivors of torture.

Implementation Approach

ImplementationImplementation Training Program DataBudget InfoChildren TAY Adults Seniors Full Service Partnerships System Development Outreach and Engagement Jan 2006 Sep 2006 Jun 2006

Implementation Training Training –All system stakeholders will be offered training on new program groups (Full Service, System Development, Outreach & Engagement) by the MHD Training Team. –Training to continue through RFP process and provider selection. –Ongoing annual Learning Partnership Training Plan will be developed.

Implementation Program Requirements Program Requirements –A Program Requirements Team will develop program requirements for each group of programs by age group (Full Service, System Development, Outreach & Engagement) –Requirements will be included in RFP’s, county program descriptions, policies and procedures

Implementation Outcomes Data and Technology Outcomes Data and Technology –All new programs will have state and county outcomes requirements defined, communicated and managed by a Data and Technology Team for each group of programs (Full Service, System Development, Outreach & Engagement)

Implementation Budget and Fiscal Management Budget and Fiscal Management –A MHD Budget and Fiscal Team will develop, monitor and manage program budgets and budget reports throughout the implementation process.

Implementation Stakeholder Communication Stakeholder Communication –MHD will develop a Communication Plan to ensure ongoing information flow to staff, providers, system partners, Mental Health Board and county and state leadership.

Tentative Timeline (Calendar Regularly Updated on Website) January 27 - Launch Implementation Phase January 27 - Launch Implementation Phase February 24 - Potential Provider Orientation February 24 - Potential Provider Orientation Feb 27 - Mar 2 -Full Service Partnership Training Feb 27 - Mar 2 -Full Service Partnership Training March 17-Full Service Partnership RFP Released March 17-Full Service Partnership RFP Released March 29-Mandatory Vendor Conference March 29-Mandatory Vendor Conference May 3- Full Service Partnership Proposals Due May 3- Full Service Partnership Proposals Due Late May-Full Service Partnership Contract Awards Late May-Full Service Partnership Contract Awards June-Contract Negotiations/Development June-Contract Negotiations/Development July-Full Service Partnership Contracts Begin July-Full Service Partnership Contracts Begin

Contact Info Contact Info Nancy Pena, Ph.D., Director, MHD, Bruce Copley, Deputy Director, MHD Tiffany Ho, M.D., Medical Director, MHD, Sheila Yuter, MHSA Coordinator, Maria Fuentes, Ethnic Services Manager, Santa Clara County MHD Website State Dept. Mental Health website Thank You!