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Health and Human Services Agency recommending the Board:
1) Adopt El Dorado County’s Mental Health Services Act (MHSA) Three-Year Program and Expenditure Plan, covering Fiscal Year (FY) 2023-24 through FY 2025-26, which will become effective July 1, 2023; and
2) Authorize the implementation of the MHSA Three-Year Program and Expenditure Plan through June 30, 2026.
FUNDING: State Mental Health Services Act funds, with expenditure offsets from other Federal, State and Local Funding Sources.
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DISCUSSION / BACKGROUND:
In 2004, California voters passed Proposition 63, the Mental Health Services Act (MHSA). MHSA imposes a one (1) percent tax on personal income in excess of $1,000,000. The funds from the tax are distributed to California counties and are intended to transform the Mental Health System into one that is consumer and family driven, is recovery-oriented, accessible and culturally competent, and offers services appropriate for the population that is served.
The MHSA requires counties to prepare a three-year program and expenditure plan, known as the MHSA Three-Year Program and Expenditure Plan and to prepare annual updates, known as Annual Updates. The MHSA Plans and Updates are to be developed with input from local stakeholders, including adults and older adults with severe mental illness; families of children, adults and older adults with mental illness; providers of services; law enforcement agencies; educational agencies; social services agencies; veterans and representatives from veteran organizations; providers of substance use disorder services; and health care organizations. This public planning process is utilized to provide an opportunity for stakeholders and interested parties to discuss mental health policy, program planning, implementation, monitoring, quality improvement, evaluation, and budget allocations.
The MHSA established five (5) components that address specific goals for priority populations and key community mental health needs. The components are Prevention and Early Intervention (PEI), Community Services and Supports (CSS), Innovation (INN), Workforce Education and Training (WET), and Capital Facilities and Technology Needs (CFTN).
On May 9, 2023, HHSA’s Behavioral Health Division staff presented the draft FY 2023-24 through 2025-26 MHSA Plan to the Board of Supervisors (File ID 23-0591).
HHSA is recommending the Board adopt El Dorado County’s MHSA Three-Year Program and Expenditure Plan, covering FY 2023-24 through FY2025-26, which will become effective July 1, 2023. Since this presentation, due to collective input from the community and shareholders as well as through new information due to the contract development process, minor changes were made to this draft MHSA Plan to include updated language for clarification, and minimal formatting and grammar corrections. The only substantial changes to the MHSA Three Year Program and Expenditure Plan draft were to increase the budgeted cost per FY for three (3) service categories funded through the MHSA Prevention and Early Intervention Component, as follows:
1. The Latino Outreach Project was changed from the initial planned budget per FY from $300,000 to $400,000 to allow for increased staffing cost by the Contractor providing services (FY 2023-24, FY 2024-25 and FY 2025-26); and
2. The Primary Project was changed from the initial planned budget per FY from $245,000 to $253,000, to allow for increased staffing cost by the Contractor providing services (FY 2023-24, FY 2024-25, and FY 2025-26).
3. Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, and Asexual or Allied (LGBTQIA) Community Education Project was changed from the initial planned budget per FY from $50,000 to $100,000 to allow for increased staffing cost by the Contractor providing services (FY 2023-24, FY 2024-25 and FY 2025-26).
Per the changes above, the MHSA Plan Total Budget for PEI Projects increased from $5,986,900 to $6,144,900.
The finalized MHSA Three-Year Program and Expenditure Plan is attached (Attachment A) to this agenda item, along with a copy showing all redlined changes (Attachment B).
Approval of the MHSA Three-Year Program and Expenditure Plan will ensure that HHSA continues to provide MHSA programs and services as required in the existing MHSA Plan and Three-Year Plan Update, as well as provide the direction of focus for HHSA with regards to future Behavioral Health services and projects.
ALTERNATIVES:
Failure to adopt the MHSA Three-Year Program and Expenditure Plan will not only result in an inability to provide continuity of care for clients currently receiving MHSA-funded services from contracted vendors, but will also result in HHSA being out of compliance with the requirements of the MHSA, which includes adoption of a Three-Year Program and Expenditure Plan.
PRIOR BOARD ACTION:
1) 05/09/23. 23-0591, MHSA FY 2023-24 - FY 2025-26 Plan Presentation and Update
2) 08/30/22, 22-0832, HHSA 2022-2023 MHSA Plan Update
3) 07/19/22, 22-1046, Approval of 2022-2023 Suicide Prevention Strategic Plan
4) 06/22/21, 21-0713, HHSA MHSA Plan Update 2021-22
5) 06/09/20, 20-0446, HHSA MHSA FY 2020-21 - FY 2022-23 Plan Approval
6) 06/25/19, 19-0936, HHSA MHSA Plan Update FY 2019-20
7) 06/26/18, 18-0874, HHSA MHSA FY 2018-19 Annual Update
8) 06/20/17, 17-0551, HHSA MHSA FY 2017-18 - FY 2019-20 Three-Year Program and Expenditure Plan
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
HHSA Social Services, El Dorado County Office of Education, El Dorado County Probation Department, Library Services, and Sheriff’s Office
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
MHSA revenue and expenditures were included in the FY 2023-24 Recommended HHSA Budget and will be included in future year budget requests. Additional revenue sources that offset the MHSA expenditures have also been budgeted. Adjustments to the MHSA FY 2023-24 Budget will be made in the Adopted Budget revisions to align budget with the approved MHSA Plan. There is no Net County Cost associated with the MHSA program.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT:
Healthy Communities; Improved health, well-being, and self-sufficiency of El Dorado County communities, residents, and visitors.
CONTACT
Olivia Byron-Cooper, MPH, Interim Director, Health and Human Services Agency