County of Orange Mental Health Services Act Steering Committee Meeting February 4, 2008

1. County of Orange Mental Health Services Act Steering Committee Meeting February 4, 2008

3. Steering CommitteeDecisions 2008 Kate Pavich MHSA Coordinator

6. MHSA Local & State Updates Mark Refowitz BHS Director

7. 75% will be distributed upon approval of the Plan and execution of an MHSA Agreement 25% will be distributed upon submission of the Local Cash Flow Statement and the annual Revenue and Expenditure Report Distribution of Funds (DMH Notice 07-25)

8. Distribution of Funds (DMH Notice 07-25) Submission of Documentation to DMH Start of FY

9. Each county must maintain 50% of the most recent annual approved CSS funding by July 1, 2010 Sources for the Prudent Reserve Unexpended Funds Counties not expected to reduce services below FY 07-08 levels to fund reserve If cannot reach 50% by July 1st should use future increases in planning estimates before expanding services Prudent Reserve (DMH Notice 07-25)

10. Unexpended Funds (DMH Notice 07-25) • DMH requires an annual Plan update that indicates the utilization of unspent funds • Unused Funds Can Be Used For • Service consistent with the approved Plan • Prudent Reserve

11. Counties must submit a Plan to justify the sustainability of programs that are funded through the Planning Estimate Factors DMH will look at Interest Current and Projected Costs Cost of Living Increases Anticipated Revenues Impact of Higher Levels of Care Sustainability (DMH Notice 07-25)

12. DMH will no longer approve and fund the use of 2005-06 CSS funds for activities funded through other components (Capital Facilities, Technology, WET) after June 30, 2008. Counties that spend their entire FY 2005-06 Planning Estimate on approved services (including one-time funds and/or the prudent reserve) will not be subjected to the June 30, 2008 reversion. 2005-06 CSS One-Time (DMH Notice 07-25)

13. Estimated Growth Funds 2008-09 • $8 Million Total Allocation • $6.8 Million: Programs • $1.2 Million: Administration (15%)

14. HCA Recommendations for Growth Funds • Program Adjustments • Maintain Age Allocation for $6.8 million • CYS: $1,380,400 • TAY: $1,271,600 • Adult: $3,196,000 • OlderAdult: $952,000

15. Allocation by Age

16. Statewide Programs • No provision for Statewide Programs in MHSA • Counties may work together or individually to fund Statewide Programs • Joint Powers Agreement • One county administers these funds

17. Statewide Programs - Housing • $33 million for Orange County • County must Assign funds to California Housing Finance Agency (CalHFA) • Submit a plan for each program • Follow approval process with CalHFA • Cannot access funds directly

18. Statewide Programs - PEI

19. Statewide Programs – WET • Workforce Education and Training • California Social Work Education Center (CalSWEC) • Pays stipend for 2nd year social work students • Regional Partnerships • In the future, there may be statewide programs for other components as well

20. Money for Statewide Projects • Housing must be assigned to CalHFA • Money for other statewide projects must be assigned to the fiscal agent designated by the State • Must give the dollars back to the State for statewide projects

21. CSS One-Time Funding Update(DMH Notice 07-21) • Update of our Three-Year Program and Expenditure Plan was reviewed by DMH • DMH has approved $1,339,300 in Additional One-Time Funding Augmentation • Used to Expand Local Mental Health Services

22. Capital Facilities & Technology Update Kate Pavich MHSA Coordinator

23. A building secured to a foundation Permanently affixed to the ground Used for delivery of MHSA services Used for administrative offices What is a Capital Facility?

24. Acquire buildings Acquire and build upon land Construct buildings Renovate buildings Allowable Use of MHSA Funds

25. Examples of Expenditures Purchase/renovate a building for: • Use as a clinic, clubhouse, wellness and recovery center, or for a building that serves clients in a less restrictive setting and reduces the need for institutionalization and/or incarceration • Vocational, educational and recreational MHSA services to individuals and families

26. Proposed Use of Funds • The Health Care Agency is currently exploring using Capital Facilities funds to develop the Interim Care Facility building in Orange.

27. 401 S. Tustin Avenue, Orange CA

28. Architect-Engineer Assessment • Review of building/site conditions and code/ordinance requirements • Remodeling of the existing facility is “highly impractical” due to mold conditions, termite damage, roofing issues and problems with earthquake compliance • Demolition of site was recommended and using new construction

29. Proposed Programs • Crisis Residential • Wellness Center • Vocational Training/Education

30. Crisis Residential Program

31. Crisis Residential Treatment • An alternative to hospitalization for acute and chronic mentally ill persons • Voluntary program • Services provided 24/7 • 15 bed facility • Ages 18-59 both males and females • Average length of stay is 14 days

32. A Wellness Center

33. Wellness Center Service system to support clients and increase self-reliance by providing: • Socialization and life skills • Assistance with benefits • Education and job training • Recreation and exercise • Recovery groups

34. Vocational Training/Education

35. Vocational Training/Education • Provide education and support to consumers including pre-employment classes, job coaches, and peer mentors • Promote the employment of mental health consumers within the mental health system • Educate and train all individuals who provide mental health services

36. Stakeholder Process • Supported Employment Services were approved by stakeholders for our 3 Year CSS plan • Stakeholders have provided input regarding use of MHSA funds for Workforce Education and Training • Consumer Action Advisory Committee has expressed their support for developing a third building at the 401 S. Tustin site for vocational training

37. Use Capital Facilities Funds for a Vocational Training and Education building Proposed Program

38. Allocation for FY 2007-08 • Capital Facilities/Technology allocation was previously expected to be $8 million • Steering Committee previously voted to support using 80%of the funds for Capital Facilities and 20% for Technology

39. Current Allocation Expect our allocation to be $28,308,300. Proposed projects using: • 80% Capital Facilities ($22.6 million) • 20% Technology ($5.6 million)

40. 80% Capital Facilities 20% Technology Split of Allocation Keep same percentage with increased allocation

41. Workforce Education and Training Casey Dorman, Ph.D. OCHCA/BHS Training Coordinator

42. Aim • Addressing identified occupational shortages in both county mental health and private organizations providing community based public mental health services • Vietnamese, Spanish, Farsi, Korean speaking staff • Consumer/Family Member Staff • Masters and Bachelors level staff in above categories

43. Aim • Education and training for all individuals who provide or support public mental health services. This is education and training that contributes to developing and maintaining a culturally competent workforce, to include consumers and family members, who are capable of providing consumer- and family-driven services that promote wellness, recovery and resilience, and lead to measurable, values-driven outcomes.

44. Funding • Original County Allocation: • $8.2 million • $652,000 Early Implementation (planning, positions and programs) • 3 year allocation but 10 years to spend • Additional County Allocation • $8.2 million • Spend on needs identified during original planning process • 10 years to spend

45. Planning • Timeline – for submission of original allocation • October 2007- February 2008 Stakeholder meetings • End of February 2008 Completed Plan • March- April 2008 • Public Comments • MHB, Steering Committee, BOS • May 2008 – Submission of Plan • July 2008 DMH Approval of Plan

46. Stakeholder Process • 25 Separate Stakeholder meetings with over 300 attendees • Consumers/Family member groups • High Schools, Community Colleges • Undergrad and Graduate Programs • County staff • Contract Agency Providers • Other County Agencies • Representatives of Underserved Groups • Many of the meetings included paid consumer/family member consultants • Nearly 100 separate proposals

47. Plan Development • Advisory Committee – Evaluates Proposals and Formulates Plan • NAMI • Client Network • Undergrad representative • Grad School representative • Latino Clinic • Asian-Pacific Islander Clinic • Adult Mental Health Contract Provider • Children’s Mental Health Contract Provider • County Behavioral Health Staff • Paid Consumer/Family Member Consultants

48. Ways To Use Workforce Education and Training Funds • Workforce Staffing Support • Training and Technical Assistance • Mental Health Career Pathway Programs • Residency, Internship Programs • Financial Incentive Programs

49. Proposed Use of Funds • Workforce Staffing • Behavioral Health Services Training Department • Consumer Support positions – three positions, two for Adult mental health and one for Children and Youth Services

50. Proposed Use of Funds • Career Pathways • Mental Health Paraprofessional Training Program (Continuation of the Pacific Clinics/Santa Ana College program. Currently funded with one-time money – After next year continue at 25 students per year)