Mental Health Services Act Steering Committee

1. Mental Health Services ActSteering Committee July 7, 2008 1:00 – 4:00

2. Consumer Perspective MHSA Newsletter: Recovery Connections

4. MHSA Participation By Tho Be

5. Kites: By Margarita Noguera

6. Mark Refowitz Local/State Updates

7. Kate Pavich MHSA/Capital Facilities Update

9. 1. Framework and Goal Support • Briefly describe how the County plans to use Capital Facilities and/or Technological Needs Component funds to support the programs, services and goals implemented through the MHSA

10. Allowable Costs • To purchase a building for use as a wellness and recovery center and office space • To purchase a building where vocational, educational and recreational services are provided and where the County is the owner of record • To purchase a building for short-term crisis residential care to avoid hospitalization and allow for a quick return to the family/community

11. County Property:401 S. Tustin Avenue, Orange

12. New Facilities • Crisis Residential program to serve as an alternative to hospitalization for acute and chronic mentally ill persons • Wellness/Peer Support Center to offer clients assistance with benefits, socialization, self-reliance, and recovery • Vocational Training to provide education and employment support to consumers and their families

13. Tustin Avenue Campus • Three 7,500 square foot buildings • Green belts, walkways, and outdoor activity areas • Architects to incorporate “green” construction including lighting, flooring, building materials, transportation and use of recycling

14. 1. Framework and Goal Support • Briefly describe how you derived the proposed distribution of funds

15. Split of Allocation 80% Capital Facilities 20% Technology ($22.6 million) ($5.6 million)

16. 2. Stakeholder Involvement • Provide a description of stakeholder involvement in identification of the County’s Capital Facilities and/or Technological Needs Component priorities along with a short summary of the Community Program Planning Process and any substantive recommendations and/or changes as a result of the stakeholder process.

17. Stakeholder Process • Training and workshops from local and national experts on system transformation, recovery-based planning, and creating a recovery culture • Consumer Action Advisory Committee advises MHSA Office on development of programs; participated in eleven meetings regarding capital facilities and technology; toured the Tustin facility and unanimously supported the development of the site for MHSA programs

18. Wellness Center Planning Committee Identified a list of components that should be included in a wellness recovery center • Nourishing culture • Green facility • A safe place that is non-discriminatory • Peer staffing • Advisory board made up of at least 51% consumers

19. Steering Committee • 62 member committee composed of community members, consumers, and family members that represent a diverse cross-section of the community – reviewed 6 presentations on Capital Facilities and Technological Needs

20. Stakeholder Meetings • Workforce Education and Training (WET) meetings discussed using the property for a Recovery Education Institute and a vocational training program • Capital Facilities and Technology Advisory Board met regarding programs to be housed on the property, creating a timeline, and determining the spilt of funds • Mental Health Board presentations and Public Hearing

21. 3. Capital Facilities Needs North Orange County – 401 S. Tustin • Centrally located with easy access for public transportation • Has Conditional Use Permit to allow residential program on site • Property can accommodate three 7,500 sq. ft. buildings with green belts and outdoor activity areas South Orange County – to be determined

22. 4. Technological Needs • Electronic Health Record (EHR) – plans to implement an EHR “lite” system • By end of 2008 will have accomplished the Practice Management phase with the implementation of scheduling. • Build the Clinical Data Management component to create clinical assessments, treatment plans, and progress notes on line.

23. Component Proposal Timeline

24. Project Schedule • Feasibility Study Phase • Programming Phase: data collection/staff interviews • Schematic Design Phase: preliminary design development drawings

25. Alan Albright Prevention and Early Intervention Coordinator

26. Develop universal and selective interventions and programs to help prevent the development of serious emotional or behavioral disorders and mental illness. Provide “short–duration”, “low-intensity” interventions to avoid more extensive mental health services or to prevent a mental health problem from getting worse. Create PEI interventions that are distinct from Community Services and Support services. Engage persons prior to the development of SMI or SED. Alleviate the need for additional mental health treatment and/or transition to extended mental health treatment. Through the Prevention and Early Intervention (PEI) component, the MHSA provides funding to:

27. KEY TO TRANSFORMATION: HELP FIRST • “To facilitate accessing supports at the earliest possible signs of mental health problems and concerns, PEI builds capacity for providing mental health early intervention services at sites where people go for other routine activities (e.g., health, education, community organizations).”(DMH PEI Guidelines Sept. 2007, page 2)

28. PEI PROJECTS • Each PEI project should be designed to address one or more PEI Key Community Mental Health Need:• Disparities in Access to Mental health Services • Psychosocial Impact of Trauma • At-Risk Children, Youth, and Young Adult Populations• Stigma and Discrimination• Suicide Risk • and one or more PEI Priority Population: • Underserved Cultural Populations • Individuals Experiencing the Onset of Serious Psychiatric Illness• Trauma Exposed• Children/Youth in Stressed Families• Children/Youth at Risk of School Failure• Children/Youth at Risk of Juvenile Justice Involvement

29. PEI County Plans will address all age groups, however, a minimum of 51% of the overall County PEI budget must be dedicated to individuals who are between the ages of 0-25. PEI PRIORITY AGE

30. NON-SUPPLANTATION • Funds must be used for programs authorized in Section 5892 of the W&I Code. • Funds cannot be used to replace other state or county funds required to be used to provide mental health services in fiscal year 2004-05 (the time of enactment of the MHSA). • Funds must be used on programs that were not in existence in the county at the time of enactment of the MHSA (new programs) or to expand the capacity of existing services that were being provided at the time of enactment of the MHSA (11/02/04).

31. ALLOWABLE EXPENSES • Personnel (such as mental health professionals, culturally/linguistically competent family liaisons, program managers) • Operating costs (such as curricula and other educational materials, supplies, travel, equipment and facilities rental) • Subcontracts (such as professional services for training or program evaluation)

32. NON-ALLOWABLE EXPENSES • Filling gaps in treatment and recovery services for individuals who have been diagnosed with a serious mental illness or serious emotional disturbance • Capital projects or housing • Technology projects • Workforce Education and Training activities (as described in the Workforce Education and Training Component – Proposed Three Year Program and Expenditure Plan Guidelines) in the following categories: • Mental Health Career Pathway Programs • Residency, Internship Programs • Financial Incentive Programs • Broad social marketing campaigns (State-administered projects will support this activity) • Development of new training curricula (State-administered projects will support this activity)

33. ORANGE COUNTY’S PEI PLANNING PROCESS • Community Information • http://www.ochealthinfo.com/mhsa/pei/ • Community Input: • Regional Focus Groups and Stakeholder Meetings • Community and Organizational Surveys • Recommended Planning Partners • Underserved Communities • Education • Client and Family Member Organizations • Mental Health Providers • Health • Social Services • Law Enforcement

34. COMMUNITY AND STAKEHOLDER PRIORITIES Ten most frequently identified PEI program/service needs: 1. Culturally competent outreach/engagement, care coordination, information/referral, follow-up assistance, consultation targeting at-risk populations (e.g., 211/mobile/senior center I&R/”Friendly Visitor”, ER/hospital, MD-based, etc.) 2. PEI/mental health early intervention/counseling/ support groups/substance abuse/trauma resources for children, teens, parents, care givers, spouses, seniors, military families in community/home-based, school, primary care, and culturally competent settings. 3. Culturally competent PEI/mental health training/ education for professionals (schools, health, law enf., faith-based, SSA, caregivers, etc.)

35. COMMUNITY AND STAKEHOLDER PRIORITIES 4. Community information / education / training / stigma reduction campaigns (culturally competent media / community / web-based) 5. Community-based assessment/ screening /early identification at various service sites for all individuals / ages 6. Volunteer / mentor / peer counselor resources for children, TAY, adults, parents, and seniors

36. COMMUNITY AND STAKEHOLDER PRIORITIES 7. School-based PEI / mental health / family-focused resources (screening / early identification, PBIS, SARB resources, etc.) 8. PEI-focused / community-based socialization, after school, arts, recreational, life skills, nutritional resources, etc. 9. Culturally competent parenting resources, classes, education, information 10. OC-based suicide hotline, crisis services, warm line services, resources

38. Next Steps

39. Kimari Phillips Community & Organizational Surveys Involving OC MH Consumers & Providers in the Prevention & Early Intervention Planning Process

40. Data Collection Methods • Surveys (online & printed) • Organizational • Community (Spanish, Vietnamese, English) • Stakeholder Meetings • Focus Groups

41. Survey Measures • A collaborative team from OCHCA’s: • Behavioral Health Services • Quality Mgmt – Planning & Research • Two comprehensive surveys for OC: • Organizational Providers • Community/Consumers

42. Survey Dissemination • Mailed over 3,000 surveys to OC organizations and community members • Handed out over 5,000 surveys throughout OC at meetings, clinics, community based organizations, etc. • E-mailed announcements regarding the online surveys (including a hyperlink for easy access)

43. Mail & E-mail Distribution: • CBOs & Family/Senior Resource Centers • City & County Offices • Law Enforcement & Legal Services • Educational Institutions • Faith-based Organizations • Financial Institutions & Foundations • Housing & Transportation Agencies • Medical, Mental Health, & Social Services • Utility Companies & Media

44. Surveys Received to Date Community (n = 1,329) • 78% Print (n = 1035) • 22% Online (n = 294) • 85.5% English (n = 1136) • 11.4% Spanish (n = 152) • 3.1% Vietnamese (n = 41) Organizational (n = 380) • 74% Print (n = 281) • 26% Online (n = 99)

45. General Types of Respondents • MH Providers/Advocates • Non-MH Providers & Other Government Agencies • Interested Community Members and MH Consumers

46. Information Gathered from OC Community Members/Consumers • Satisfaction with amount & accessibility of PEI services in OC • Demographic info (age, gender, race/ethnicity, annual household income, ZIP code) • Opinions regarding: • Populations in greatest need of PEI in OC • Priority PEI issues in OC communities • Most effective settings for identifying OC residents with a need for PEI services • Best approaches for addressing PEI in OC

47. Preliminary Data Analysis Results Community PEI Survey Orange County

48. Race/Ethnicity of Community Respondents (n=426)

49. Age & Gender of Community Respondents • Average Age (n=420) • 45.2 years (15-89 yrs) • Gender (n=432) • 71.1% Female • 28.9% Male

50. Average Annual Household Income