Mental Health Services Act Plan Update FY 2021-2022
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Mental Health Services Act
Plan Update FY 2021-2022
Presented by:
Colleen Chawla, Director, Alameda County Health Care Services Agency
Dr. Karyn Tribble, PsyD, LCSW Director, Alameda County Behavioral Health
Tracy Hazelton, MPH MHSA Division Director, Alameda County Behavioral Health
Alameda County Board of Supervisors’ Health Committee
June 14, 2021
MHSA Plan Update Presentation Highlights
Presentation Purpose: Presenting program and fiscal updates from the MHSA FY
21/22 Plan Update with the goal of the Health Committee recommending this
document to be moved to the full Board of Supervisors calendar for approval per
Welfare and Institutions Code Section (WIC §) 5847.
Presentation Highlights:
•Review of MHSA Regulations and Approval Process
•Program Outcome examples
•Fiscal Overview FY 21/22
•FY 21/22 Program Changes
2
Mental Health Services Act
The Mental Health Services Act (MHSA) emphasizes Transformation of the Mental
Health System and Improving the Quality Of Life for people living with mental illness
and those at-risk for mental illness and/or mental health challenges.
• In 2004, California voters passed Proposition 63, know as the Mental Health
Services Act.
• Funded by 1% tax on individual incomes over $1 million.
• Services must be voluntary.
• Non-supplantation: MHSA may not replace existing program funding or be used
for non-mental health programs.
3
MHSA Regulations
Component Regulations
• 76% of the annual allocation must be spent in this component area
Community Services & Supports (CSS)
• At least 50% must be spent on “Full Service Partnership clients”
• 19% of the total allocation must be spent in the PEI component
Prevention & Early Intervention (PEI)
• >50% must be spent on activities that serve clients age 25 or younger
• 5% of total allocation must be spent on INN
• Must be spent on one-time innovative projects that address a “learning
Innovative Programs (INN)
question” with duration of no longer than 5 years
• Must be approved by MHSOAC before funds can be spent
Workforce Education & Training (WET),
• Can choose to add up to 20% of previous 5-year allocation average to CFTN, WET
Capital Facilities /Technological Needs
or the Prudent Reserve. Funds must be transferred from CSS component.
(CFTN), Prudent Reserve (PR)
Community Program Planning Process • Counties are required to conduct a Community Program Planning Process (CPPP)
(CPPP) every three years in relation to their Three-Year MHSA Plan.
4MHSA Three Year Plan/Plan Update Process
• Alameda County’s Three Year Plan:
County mental health programs shall prepare and submit a Three- • FY 20/21-22/23
Year Program and Expenditure Plan (Plan) and Annual Updates for
• FY 21/22 is the 2nd year of our
MHSA programs and expenditures. Three Year Plan.
The Mental Health Board shall conduct a public hearing on the • 30 day public comment period: April
draft Three-Year Plan/Plan Update at the close of the 30-day 15, 2021-May 17, 2020 at 5pm
public comment period. • MH Board Hearing: May 17th 2021
Plans and Annual Updates must be adopted by the county
• BOS Health Committee June 14, 2021
Board of Supervisors (BOS) and submitted to the Mental
• Full BOS
Health Services Oversight and Accountability Commission
• For INN projects MHSOAC Approval
(MHSOAC) within 30 days after Board of Supervisor adoption.
5Full Service Partnership (FSP) Program Highlights, FY 19/20
Full Service Partnership (FSP) programs are Number of FSPs: 13
designed for individuals who’ve been
diagnosed with a severe mental illness (SMI) or Number of FSP slots: 1,045
serious emotional disturbance (SED) and • 40 in children
would benefit from an intensive service • 150 in TAY
program.
• 700 in adult
The foundation of FSPs is doing “whatever it • 300 Homeless focus
takes” to help individuals on their path to • 200 Forensic focus
recovery and wellness. • 200 Adult-general
Unique to FSP programs are a low staff to client • 100 in older adult
ratio, a 24/7 crisis availability and a team Total Budget: $31.2M
approach that is a partnership between mental
health staff and consumers. Estimated Amount of Budget Spent: $21.66 (70%)
6Full Service Partnership (FSP) Program Highlights, FY 19/20
How Much Did We Do?
Race/Ethnicity
FSP Clients Served 4%
1,141
1200
1,026 1,076 36%
1000
812
800
600
33%
400
19%
200
8%
0
FY 17/18 FY 18/19 FY 19/20 FY 20/21 Asian African American
Latino White
Other/Unknown
7Full Service Partnership (FSP) Program Highlights, FY 19/20
How Well Did We Do? (Quality of Service)
71%
Average of 4+ Visits w/in a month
56%
91%
No Gaps in Service over 30 Days
96%
71%
Follow up w/in 5 Days of Crisis Episode
76%
0% 20% 40% 60% 80% 100% 120%
FY 19/20 FY 18/19
8Full Service Partnership (FSP) Program Highlights, FY 19/20
Is Anyone Better Off?? (Program Impact)
FSP Outcomes Based on 1 Year of Service
43%
Increase in Stable Housing 41%
36%
64%
Reduction in Incarceration Events 62%
68%
88%
Reduction in Acute Crisis Days 75%
67%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
FY 19/20 FY 18/19 FY 17/18
9Full Service Partnership (FSP) Program Highlights,
FY 19/20
Is Anyone Better Off? Incarceration Data
Overall More than half of all age groups served during FY 19/20 had a decrease in the number of
incarcerations, for those clients who received one year of service.
10Prevention and Early Intervention (PEI) Program Highlights FY 19/20
Prevention in mental health aims to reduce the incidence, prevalence, and
recurrence of mental health disorders and their associated disability. Preventive
interventions are based on modifying risk exposure and strengthening the coping
mechanisms of the individual.
Number of people served and/or reached through outreach contacts: 82,812 (9%
increase from FY 18/19) 33% of services aimed at Children and TAY, 27% Adults, 10%
Older Adults, 29% unknown.
Diversity Focus: 52% of PEI funding is focused on ethnic and cultural communities.
Total Budget: $17.07M
Estimated Amount of Budget Spent: $15.26M (89%)
11Prevention and Early Intervention (PEI) Program Highlights FY 19/20
Trend Data from Underserved Ethnic/Language Programs (UELP) Evaluations
Increased Understanding of 91%
MH 88%
Better Able to Acess 88%
Resources 78%
Better Able to Handle a Crisis 83%
79%
70% 75% 80% 85% 90% 95%
FY 19/20 FY 18/19
12Prevention and Early Intervention (PEI) Program Highlights FY 19/20
Provided 230 Early Childhood mental health Outreach & Consultation sessions to promote
social/emotional growth of children in preschool settings.
Reached 362 youth and young adults through the Suicide Prevention Teen Text Line
and 12,824 through community education presentations/trainings.
Conducted 300 Afrocentric healing circles were provided to enhance the health and
wellness of over 1,300 African Americans.
Provided MH resources and access & linkage to 10,937 youth in 14 School Districts (268 schools)
through Coordination of Service Teams (COST).
13MHSA FY 21/22 Fiscal Overview Highlights
MHSA Funding Estimates (in millions)
Source All Components CSS PEI INN WET CFTN
Unspent funds from prior 64.37 41.69 1.43 18.91 0 2.33
FYs
State Allocation FY 21/22 97.59 74.17 18.54 4.02 -- --
Transfer to WET/CFTN 12.39 (12.39) 3.40 8.99
Available Funding 161.96 103.47 19.98 23.79 3.40 11.31
Projected Expenditures 136.07 96.40 15.96 8.99 3.40 11.31
Carryover Funds 25.89 7.07 4.02 14.80 0 0
*The above budget does not include the Prudent Reserve, estimated to be $14.59M in FY 21/22
14MHSA FY 21/22 Fiscal Overview Highlights
Fiscal Year MHSA Allocation Budget % of Budget
Alameda County Amount Spent
(millions)
18/19 72.09 $104.30 78%
19/20 65.69 $128.08* 82%
20/21 91.00** $132.22 92%+
21/22 97.59** $136.07 --
*Large increase in FY 19/20 to increase funding for homeless focused services and to reduce
carryover amount so as to provide as much funding as possible into the community.
**Estimate Allocation.
+Estimate based on three quarters of fiscal data.
15Carryover Overview
$14.8M (57%) of FY 21/22 carryover (25M) will be in the Innovation (INN)
component:
• INN projects take approximately 12-18 months to develop and launch.
• INN projects are pilot projects where an idea is to be tested for a maximum of 5
years.
• 2-step approval process (County and State).
• Multiple INN ideas are currently being vetted and developed; COVID-19 initially
delayed this process.
16Carryover Overview continued…
Currently expenditures are higher than the annual MHSA revenue from the state.
Carryover is needed to cover the gap between expenditures and revenue.
• The annual carryover amount continues to decrease. ACBH is working to align
the budget with the revenue from the state.
•Reasons for carryover:
• Time it takes to implement an INN project;
• Contractors underspending;
• Project delays;
• Staff vacancies, and
• Historical revenue fluctuations.
17MHSA Plan Changes FY 21/22
• New Mental Health Urgent Care pilot Project-East County
• New Pediatric Care Coordination Pilot through the Alameda Health Consortium
(AHC)
CSS
• Expansion of MH supports in the Collaborative Courts
• Transformation of the Service Team Model
• Continued Development of two Re-entry Treatment Teams
PEI • Trauma Support Groups for youth in Albany Unified
INN • Augmentation to the Community Assessment & Treatment Team (CATT) INN budget
• New African American Focused TAY Academic and Career Pathway Pilot Project
WET/CFTN • Asian and Pacific Islander (API) Graduate Student Internship Program
• Replacement of the old ACBH billing system
18MHSA Website www.ACMHSA.org
For more information, contact our MHSA Staff at MHSA@acgov.org.
19Comments and Questions
Tracy.Hazelton@acgov.org
www.ACMHSA.org
MHSA@acgov.org
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