MENTAL HEALTH AND SUBSTANCE USE SERVICES DIVISION. MHSA Three Year Program and Expenditure Plan for FY14-15 through FY16-17 Amendment Overview

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MENTAL HEALTH AND SUBSTANCE USE SERVICES DIVISION MHSA Three Year Program and Expenditure Plan for FY14-15 through FY16-17 Amendment Overview 1. Youth Empowerment Services (YES) Full Service Partnership (FSP) CSS Component Due to a decline in juvenile probation referrals into the YES FSP, the service is being reformulated to make this FSP a co-occurring (mental health and substance abuse) service and expanding the referrals into the program beyond juvenile probation. A Children s mental health strategic planning effort is underway to guide changes with the program. Language has been added to identify the use of Flex Funding which was not included in the original Program Description. The Flex Funding budget is being amended for FY14-15 through FY16-17 to continue at the same level as FY13-14. The additional flex funds adjustment is coming out of Operating Reserve. The below language has been updated to reflect the changes. Program Description - Amended The YES model is a MHSA CSS supportive, strengths based model with the goal of meeting youth and families in their homes and in the community. The services incorporate a wraparound philosophy, focusing on working as a team to help families identify their needs and implement ways to address them successfully. The YES program provides culturally appropriate mental health services, intensive case management, and psychiatric care, as well as collaboration with partner agencies (i.e., education, probation, drug court, etc.) to facilitate integrated care and ongoing family support. The Full Service Partnership model includes the whatever it takes philosophy which includes creative strategizing to maintain stability for clients and their families which is supported by Flex Funding which can be used, for example, to support housing during a short term emergency. Flex Fund decisions are made by the wraparound team and must be in support of the mental health goals of the child and family as described in the Treatment Plan. Outcomes Expected and Evaluation - Amended YES program objectives include decreasing arrests, decreasing school suspensions and increasing school attendance and performance. Too little data has been collected to draw meaningful conclusions regarding homelessness and hospitalizations. Because the number of youth in this program each year is small for purposes of statistical analysis outcomes have been calculated to include all participants over the course of this program, adding each year s data. However, the YES supervisor and Children s Mental Health Program Manager will be working with the staff to decide on one or two of these data points to track changes year to year so as to be able to focus on areas where there could be program improvement. We are currently researching a new outcome measure to use in our programs so as to be able to measure the effectiveness of services. ly, the programs uses the Child Behavioral Check List (CBCL) but it is lengthy and many parents find it overwhelming to complete so we are hoping to find a valid 1

instrument that will be less challenging to use and we hope to be implementing this by the summer of 2015 as well. 1. FSP-01 Youth Empowerment Services (YES) FSP-01 Youth Empowerment Services (YES) $639,227 $639,227 $639,227 $1,917,681 Proposed Amendment FSP-01 Youth Empowerment Services (YES) $649,227 $649,227 $649,227 $1,947,681 Adjustment $10,000 $10,000 $10,000 $30,000 2. Co-Occurring Capacity CSS Component The Co-Occurring Capacity Program is currently made up of three (3) different programs, Co-Occurring, Alliance in Recovery (AIR) and Tobacco Cessation. The Tobacco cessation funding in the Co-Occurring section of the CSS budget needs to be updated so that the allocation is $35,000 versus $30,000. The tobacco cessation program was added to the MHSA Three Year Plan due to strong feedback at the public hearing and there was a miscommunication with the county fiscal department about the final allocation. There are no language changes to the program description, only the $5,000 budget adjustment below. This budget adjustment is coming out of Operating Reserve. 2. SDOE-08 - Co- Occurring Capacity Co-Occurring $50,000 $50,000 $50,000 $150,000 AIR $262,409 $262,409 $262,409 $787,227 Tobacco $30,000 $30,000 $30,000 $90,000 Total $342,409 $342,409 $342,409 $1,027,227 Proposed Amendment Co-Occurring $50,000 $50,000 $50,000 $150,000 AIR $262,409 $262,409 $262,409 $787,227 Tobacco $35,000 $35,000 $35,000 $105,000 Total $347,409 $347,409 $347,409 $1,042,227 Adjustment $5,000 $5,000 $5,000 $15,000 3. Adult System of Care (ASOC) Expansion CSS Component In the ASOC Proposed Expansion section of the MHSA Three Year Plan there was language around increased short-term housing funding for at-risk clients in order to help them keep their housing in the community. The below language has been updated to reflect process change in how short term client support and housing assistance funds are used. There is no budget impact. Short-Term Client Support and Housing Assistance - Amended CSS FY2011-12 one-time funds were approved through FY2013-14 to create a Housing Assistance Fund for the ASOC to provide short-term housing assistance funding to assist at-risk clients of the Adult Intensive Case Management team to successfully access and/or maintain appropriate housing 2

in the community. Experience with this funding over the past 2-3 years has revealed the need to broaden its use to address other, equally critical client needs. The Adult Intensive Case Management team will use this funding as a pool of flexible funds to support clients and purchase needed goods and services, including emergency and short-term transitional housing, medications, and transportation, that cannot be otherwise obtained. This fund will be used to assist 40 clients annually. 3. ASOC - No Budget Amendment 0 0 0 0 4. Helping Older People Excel (HOPE) CSS Component The ACASA program needs a budget adjustment to support an increase from.10 FTE to.20 FTE ($16,045 reduction to operating reserve) to support the program needs. No language will be changed, only the below budget adjustment. This budget adjustment is coming out of Operating Reserve. 4. FSP-04 Helping Older People Excel (HOPE) FSP-04 Helping Older People Excel (HOPE) $672,482 $672,482 $672,482 $2,017,446 Proposed Amendment FSP-04 Helping Older People Excel (HOPE) $688,527 $688,527 $688,527 $2,065,581 Adjustment $16,045 $16,045 $16,045 $48,135 5. Capital Facilities and Technological Needs (CFTN) CFTN Component Based on technology needs the CFTN budget is being realigned to support the actual personnel, hardware and software needs to support the MHSUS system of care infrastructure. This budget adjustment does not require any additional funding. 5. CAPITAL Facilities and Technological Needs (CFTN) Practice Management $393,083 $32,775 $32,775 $458,633 Scanning $113,134 $4,600 $4,600 $122,334 E-Prescribing $46,952 $37,715 $37,715 $122,382 Electronic Health Record Upgrade $464,030 $119,347 $4,347 $587,724 Consumer Family Empowerment $126,110 $39,790 $39,790 $205,690 Behavioral Health Information Crosswalk $120,750 $0 $0 $120,750 Total $1,264,059 $234,227 $119,227 $1,617,513 Proposed Amendment Practice Management $151,252 $66,507 $68,011 $285,770 Scanning $69,507 $55,968 $56,230 $181,705 E-Prescribing $40,400 $37,343 $37,735 $115,478 Electronic Health Record Upgrade $298,091 $185,344 $73,286 $556,721 Consumer Family Empowerment $149,221 $72,055 $73,494 $294,770 Behavioral Health Information Crosswalk $142,081 $20,494 $20,494 $183,069 Total $850,552 $437,711 $329,250 $1,617,513 3

MHSA COMMUNITY SERVICES AND SUPPORT CSS) 3 YEAR PLAN (FY 2014-2015 Through FY 2016-2017) CURRENT Program FY14-15 FY15-16 FY16-17 Total FSP-01 Youth Empowerment Services (YES) $639,227 $639,227 $639,227 $1,917,682 FSP-02 Transitional Age Youth (TAY) Program $446,773 $446,773 $446,773 $1,340,318 FSP-03 Support and Treatment After Release (STAR) $519,644 $519,645 $519,645 $1,558,933 FSP-04 Helping Older People Excel (HOPE) $672,482 $672,482 $672,482 $2,017,446 FSP 04 -Helping Older People Excel-Intensive Community Treatment $159,990 $159,990 $159,990 $479,970 FSP- 05 Odyssey (Homeless) $1,138,543 $1,138,543 $1,138,543 $3,415,630 FSP 05 Odyssey (Homeless) Step Down Recovery Program $144,492 $144,492 $144,492 $433,476 SDOE-01 Enterprise Resource Center (ERC) $347,387 $347,387 $347,387 $1,042,161 SDOE 01-ERC -Step Up Program- New $254,942 $254,942 $254,942 $764,826 SDOE-04 Southern Marin Services (SMSS) $277,729 $277,729 $277,729 $833,188 SDOE-07 Adult System of Care (ASOC) $801,460 $801,460 $801,460 $2,404,380 SDOE-08 - Co- Occurring Capacity $342,409 $342,409 $342,409 $1,027,227 SDOE-09 - Crisis Continuum of Care $0 $600,000 $600,000 $1,200,000 Subtotal $5,745,079 $6,345,079 $6,345,079 $18,435,237 MHSA Coordinator $140,986 $140,986 $140,986 $422,958 Ethnic Services Manager $88,000 $88,000 $88,000 $264,000 Administration and Indirect $896,110 $986,110 $986,110 $2,868,329 Operating Reserve $165,500 $165,500 $165,500 $496,500 Total $7,035,675 $7,725,675 $7,725,675 $22,487,025 FY14-15 FY15-16 FY16-17 Total % County $2,698,048 $2,698,049 $2,698,049 $8,094,147 36% Contract Provider $3,276,017 $3,876,017 $3,876,017 $11,028,050 49% Administration $896,110 $986,110 $986,110 $2,868,329 13% Operating Reserve $165,500 $165,500 $165,500 $496,500 2% Total $7,035,675 $7,725,675 $7,725,675 $22,487,025 100% Full Service Partnership (FSP) 64.77% 58.65% 58.65% System Development Outreach and Engagement (SDOE) 35.23% 41.35% 41.35% Total 100.00% 100.00% 100.00% 4

MHSA COMMUNITY SERVICES AND SUPPORT (CSS) 3 YEAR PLAN (FY 2014-2015 Through FY 2016-2017) PROPOSED AMENDMENT Program FY14-15 FY15-16 FY16-17 Total FSP-01 Youth Empowerment Services (YES) $649,227 $649,227 $649,227 $1,947,682 FSP-02 Transitional Age Youth (TAY) Program $446,773 $446,773 $446,773 $1,340,318 FSP-03 Support and Treatment After Release (STAR) $519,644 $519,644 $519,644 $1,558,933 FSP-04 Helping Older People Excel (HOPE) $688,527 $688,527 $688,527 $2,065,581 FSP 04 -Helping Older People Excel-Intensive Community Treatment $159,990 $159,990 $159,990 $479,970 FSP- 05 Odyssey (Homeless) $1,138,543 $1,138,543 $1,138,543 $3,415,630 FSP 05 Odyssey (Homeless) Step Down Recovery Program $144,492 $144,492 $144,492 $433,476 SDOE-01 Enterprise Resource Center (ERC) $347,387 $347,387 $347,387 $1,042,161 SDOE 01-ERC -Step Up Program- New $254,942 $254,942 $254,942 $764,826 SDOE-04 Southern Marin Services (SMSS) $277,729 $277,729 $277,729 $833,188 SDOE-07 Adult System of Care (ASOC) $801,460 $801,460 $801,460 $2,404,380 SDOE-08 - Co- Occurring Capacity $347,409 $347,409 $347,409 $1,042,227 SDOE-09 - Crisis Continuum of Care $0 $600,000 $600,000 $1,200,000 Subtotal $5,776,124 $6,376,124 $6,376,124 $18,528,372 MHSA Coordinator $140,986 $140,986 $140,986 $422,958 Ethnic Services Manager $88,000 $88,000 $88,000 $264,000 Administration and Indirect $900,767 $990,767 $990,767 $2,882,301 Operating Reserve $129,798 $129,798 $129,798 $389,394 Total $7,035,675 $7,725,675 $7,725,675 $22,487,025 FY14-15 FY15-16 FY16-17 Total % County $2,673,259 $2,718,552 $2,718,552 $8,110,363 36% Contract Provider $3,331,851 $3,886,559 $3,886,559 $11,104,968 49% Administration $900,767 $990,767 $990,767 $2,882,300 13% Operating Reserve $129,798 $129,798 $129,798 $389,394 2% Total $7,035,675 $7,725,675 $7,725,675 $22,487,025 100% Full Service Partnership (FSP) 64.87% 58.77% 58.77% System Development Outreach and Engagement (SDOE) 35.13% 41.23% 41.23% Total 100.00% 100.00% 100.00% 5

MHSA CAPITAL FACILITIES AND TECHNOLOGICAL NEEDS 3-YEAR PLAN (FY 2014-2015 THROUGH FY 2016-2017) CURRENT PROPOSED AMENDMENT Program FY14-15 FY15-16 FY16-17 Total FY14-15 FY15-16 FY16-17 Total Practice Management $393,083 $32,775 $32,775 $458,633 $151,252 $66,507 $68,011 $285,770 Scanning $113,134 $4,600 $4,600 $122,334 $69,507 $55,968 $56,230 $181,705 E-Prescribing $46,952 $37,715 $37,715 $122,382 $40,400 $37,343 $37,735 $115,478 Electronic Health Record Upgrade $464,030 $119,347 $4,347 $587,724 $298,091 $185,344 $73,286 $556,721 Consumer Family Empowerment $126,110 $39,790 $39,790 $205,690 $149,221 $72,055 $73,494 $294,770 Behavioral Health Information Crosswalk $120,750 $0 $0 $120,750 $142,081 $20,494 $20,494 $183,069 Total $1,264,058 $234,227 $119,227 $1,617,513 $850,552 $437,711 $329,250 $1,617,513 One-Time Funding Sources Prior Year Unspent CFTN Funds $709,500 Prior Year Unspent CSS Funds $908,013 One-Time Funding Sources Prior Year Unspent CFTN Funds $709,500 Prior Year Unspent CSS Funds $908,013 Total $1,617,513 Total $1,617,513 6