Kern County Mental Health

1. Kern County Mental Health CARF - Presentation

2. State Department of Mental Health • The State Department of Mental Health has oversight over an almost $2.2 billion public mental health budget, approximately 8,244 positions and provides services in the following four broad areas: • System leadership for state and local county mental health departments. • System oversight, evaluation and monitoring. • Administration of federal funds. • Operates four state hospitals and an Acute Psychiatric Program.

3. California State Mental Health Organization Chart

4. Kern County Mental Health Organization Chart

5. California State & Kern County Roles • The basic provisions for the government of California counties are contained in the California Constitution and the California Government Code. • A county is the largest political subdivision of the state having corporate powers. • The California Constitution recognizes two types of counties: general law counties and charter counties. • Kern County is a general law county meaning the adherence to state law as to the number and duties of county elected officials. Kern County

6. County Powers • The California Constitution authorizes a county to make and enforce local ordinances that do not conflict with general laws. A county also has the power to sue and be sued, purchase and hold land, manage or dispose of its properties, and levy and collect taxes authorized by law. • The powers of a county can only be exercised by the Board of Supervisors. Additionally, the Board must follow the procedural requirements in the statutes or its actions will not be valid. • However, where the law does not specifically prescribe a method for accomplishing a task, the county may adopt any reasonably suitable means.

7. Kern County Board of Supervisors • The Board of Supervisors is both the legislative and the executive authority of the county. It also has quasi-judicial authorities: • Executive Role – Sets county priorities; oversees most county departments and programs, annually approves their budgets; controls all county property; appropriates and spends money on programs meeting residents’ needs. • Supervision of County Officials. • County Litigation. • Relationship to the Civil Grand Jury – A valuable tool to audit county programs and provide constructive recommendations for improvement. • Joint Powers Agreement/Joint Powers Agency-Authority • Legislative Role – May act by resolution, board order, or ordinance. • County Revenue Authority • Quasi-Judicial Role – May settle claims made against the county and may examine and audit the accounts of all county officers as they relate to the management and disbursement of funds.

8. Kern County Mental Health Revenue Sources Amounts in Millions

9. Revenue Sources - Definitions • MediCal – FFP • FFP – This is money the Federal Government makes available to Kern County for the implementation of the Medicaid program.

10. Revenue Sources - Definitions • EPSDT (Early Periodic Services Diagnosis & Treatment) • EPSDT – This is money the State of California makes available to Kern County as a match for Federal MediCal (Medicaid) monies for the expansion of children’s services.

11. Revenue Sources - Definitions • Realignment • Realignment is money from State Sales Tax used by the County to match Federal MediCal monies and pay for indigent services. • Managed Care • Managed Care is state money made available for the counties transition into managed care and pay for hospitalization in a State institution or in a hospital with an approved TAR (Treatment Authorization Request). Any monies remaining after paying for hospitalization may be used at the county’s discretion.

12. Revenue Sources - Definitions • CalWORKs/Other • CalWORKs is an acronym standing for California Work Opportunity and Responsibility to Kids. This is our State’s name for the Federal TANF program or Temporary Assistance for Needy Families which was created by the Welfare Reform Law of 1996. • California’s CalWORKs was approved and became effective on November 26, 1996. TANF replaced what was commonly known as AFDC (Aid to Families with Dependent Children) and the JOBS (Job Opportunities and Basic Skills Training) programs. • TANF provides assistance and work opportunities to needy families by granting states the federal funds and wide flexibility to develop and implement their own welfare programs.

13. Revenue Sources - Grants • Mental Health • Bakersfield Emergency Shelter Grant $ 22,332 • Kern Co. Emergency Shelter Grant $ 75,000 • Children’s System of Care $700,000 • AB 2034 (8 mo. Allocation) $971,250 • Path – Supportive Housing $175,000 • Path – Homeless Grant $ 31,013 • Substance Abuse Mental Health Services Agency $629,377 • Jail Link $460,357 • Individual Self Sufficiency Program $119,207 • Specialized Treatment Offenders Program $ 51,722 • HUD Help $282,088 • HUD Rural Homes $209,474

14. Revenue Sources - Grants • Substance Abuse • Perinatal Substance Abuse Treatment $57,034 • Friday Night Live Mentoring $27,500 • Friday Night Live Kids Expansion $50,000 • Drug Court Partnership $132,185

15. Vendor – Catholic Charities Diocese of Fresno 525 18th Street, Bakersfield, CA 93301 Contract Term: October 1, 2000 Through June 30, 2001 Contract Amount $120,600 Representative Payee Services Substitute Payee Information

16. Substitute Payee Responsibilities • Catholic Charities is a consumer fiduciary representative insuring continuation of benefits through filing of necessary documents, monitoring consumer files, and communicating with agencies, payor sources (Social Security Administration, State Disability, County General Assistance, Veterans Administration, etc.), vendors, the Mental Health Department or other parties as required to ensure continuation of financial and/or medical benefits, shelter or other resources. • Maintains a ledger and controlling account detailing all transactions, maintains documents, receipts, paid bills, canceled checks, bank statements. Provides KCMH with monthly reports delineating deposits/expenditures by consumer.

17. Substitute Payee Responsibilities • Catholic Charities establishes a budget detailing anticipated living expenses and appropriate expected expenditures. Funds are dispersed per budget ensuring monies are spent on consumer’s behalf and for his/her benefit only. • Catholic Charities currently serves 330 consumers with 400 consumers being the maximum. • Provides budgeting and bank services training based on consumer’s ability. • Participates in long-term planning, in conjunction with the Mental Health Case Manager, toward the goal of achieving independent financial management for the consumer.

18. Risk Management – Malpractice Insurance • Elements of the Risk Management Process: • Exposure Identification • Risk Evaluation • Risk Control • Risk Funding • Risk Management Administration • Malpractice Insurance: • Limits • $25,000,000 Each Occurrence or Wrongful Act Limit or a Combination of Occurrence and Wrongful Act. • $20,000,000 Aggregate, where applicable. • Coverage – This comprehensive liability program protects against most legal liabilities arising out of the operations of the County for such activities as public liability, automobile liability, products damage, contractual liability, non KMC enterprise fund malpractice, and public officials’ errors and omissions.