MHSA Three-year Program and Expenditure Plan 2014-15 – 2016-17

1. MHSA Three-year Program and Expenditure Plan2014-15 – 2016-17 Presentation to the MHSA Planning Stakeholder Steering Committee February 24, 2014

2. Discussion Outline • 3-Year Program and Expenditure Planning Process • Planning Purpose • Methodology • Timeline and Meeting Schedule • Proposed Guidelines and Planning Implications • Integrating Ongoing Feedback and Program Directions • DRAFT PEI Program Guidelines • Program Plans reflective of Performance Measures • Key Research Questions

3. 3-Year Program and Expenditure Planning Process Part I

4. Planning Purpose (1) • County mental health programs shall prepare and submit a Three-Year Program and Expenditure Plan (WIC 5847) that addresses each MHSA component. • Counties shall create one plan, incorporating all MHSA components, and make expenditure projections for each component per year. • Budgets shall be submitted for FY2014-15, FY 2015-16, and FY2016-17.

5. Mental Health Services Act • Community Services and Supports (CSS) • Prevention and Early Intervention (PEI) • Innovation (INN) • Workforce Education and Training (WET) • Capital Facilities and Technological Needs (CFTN)

6. Planning Purpose (2) • Engage consumers, family members, community partners in a discussion to ensure meaningful stakeholder involvement in developing: • Mental Health Policy • Program Planning • Implementation • Monitoring • Quality Improvement • Evaluation • Budget Allocations

7. Methodology • Leverage Existing, Current Information • Recent Discussion Groups – 20 in 2013 • BHS Strategic Plan • Ongoing Partner Feedback • Other Strategic Opportunities • Affordable Care Act • Other Federal and State Opportunities • Update Information • Community and Stakeholder Discussion Groups • Outcome Data and Performance Indicators

8. Timeline and Meeting Schedule • February • Review guidelines • Develop planning methodology • Notify Stakeholders • March • Collate recent data to inform discussion • Conduct meetings to gather stakeholder input • Review findings and proposed plan directions • April • Draft 3-Year Program and Expenditure Plan • Share with Stakeholders and Post for 30-day Review • MAY • Convene Public Hearing on the Plan

9. Questions? End of Part I

10. Proposed Guidelines and Planning Implications Part II

11. Integrating Ongoing Feedback and Program Directions • Incorporate the Key Themes and Planning Directions that Stakeholders have emphasized in recent years: • Develop new and enhanced services for the prevention, early intervention, and treatment of mental health illnesses. • Continue to emphasize the integration of mental health and substance abuse services. • Ensure that individuals with mental health disorders, including co-occurring substance use disorders have access to a range of residential and acute treatment services. • Improve services!

12. Improving Services • WIC 5848 states that Plans shall include reports on the achievement of performance outcomes for MHSA services • Improve Services – as demonstrated by outcomes achieved • Reduce prolonged suffering • Improved access and linkage to services • Improved access to services for underserved populations • Demonstrate prudent use of expenditures to achieve outcomes for individuals with mental illness

13. DRAFT PEI Program Guidelines • DRAFT PEI Program Guidelines www.cmhda.org/go/committees/MHSA-committee-handouts • (under December 2013) • Proposes new guidelines on the use of PEI funds • Anticipate approval of guidelines soon • Includes new directions on use of funds, required performance measures, and program evaluation • More use of evidence based practices • Must demonstrate service criteria • Less funding for broad, universal, prevention programs

14. Required PEI Strategies • Intervene early in the onset of a mental illness • Required • Increase recognition of early signs of mental illness amongst designated first responders • Recommended • Additional strategies • Reduce risks related to mental illness • Stigma and discrimination reduction programs • Suicide prevention programs

15. Annual Report • All programs must demonstrate and report on: • Fidelity to an evidence based- or promising-practice • Specific criteria to program inclusion • The unduplicated number served or first responders trained • The number referred for services followed up on a referral, and who participated at least once in the referred service • The length of time an individual remained engaged in the services referred to • Interval between onset of symptoms and referral for services • Interval between referral to services and engagement in services • All indicators measured by age, gender, race, etc.

16. Program Plans Reflective of Performance Measures • DRAFT PEI Guidelines offer a Framework • Anticipate similar guidelines for CSS funding • The new 3-Year program and expenditure will incorporate Draft PEI Guidelines and Stakeholder Input for the use of performance measures • Strategic Objective – Develop a standardized set of outcomes for services and performance-based quality improvement processes

17. Key Planning Strategies • Leverage all available funds, including Medi-Cal • Use MHSA dollars to leverage additional state and federal resources • Move towards more evidence based and promising practices • Measure and evaluate program effectiveness • Leverage and expand use of technology • Invest in workforce training and development

18. Key Research Questions • What should we know about current services • What works well? • What services are missing, or not distributed well? • What are the recommendations to improve services? • Who should we be considering for new or enhanced services • What specific criteria should guide program enrollment into full service partnership and early intervention programs? • Who should we train as first responders? • What risk factors do we need to target to prevent mental illnesses?

19. Additional Recommendations? End of Part 2

20. NEXT Steps

21. Next Steps: how you can Help • Advertise and distribute meeting information • Convene planning meetings • Encourage additional discussions • Incorporate written feedback and suggestions

22. Contact Information Kayce Rane kaycerane@ranecd.com 925-876-0760 www.sjmhsa.net