what’s up in california: new funding sources for mental health services

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Whats Up in California: New Funding Sources for Mental Health Services. National Alliance to End Homelessness Annual Conference July 18, 2006 Presentation by: Alecia Hopper Jonathan Hunter Public Policy Coordinator California Program Director - PowerPoint PPT Presentation

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  • Whats Up in California: New Funding Sources for Mental Health Services

    National Alliance to End HomelessnessAnnual ConferenceJuly 18, 2006Presentation by:Alecia HopperJonathan HunterPublic Policy Coordinator California Program DirectorMental Health Association Corporation for Supportiveof San FranciscoHousing

    Moderated by: Karen Gruneisen, Managing Attorney, HomeBase

    Mental Health Association of San Francisco

  • Focus on:Mental Health Services Act (Proposition 63)Governors Initiative to End Chronic Homelessness

    Mental Health Association of San Francisco

  • Part I:

    Mental Health Services Act

    Mental Health Association of San Francisco

  • History In California1968: state mental hospitals emptiedCalifornia led the nation in deinstitutionalizing mental illnessPromise of community carePromise never fulfilledCurrently, tens of thousands are without caremore than 50,000 individuals with severe mental illness live on the streets of California

    Mental Health Association of San Francisco

  • BackgroundDarrell Steinberg,Assemblyman, Sacramento

    AB 34/AB2034 (1999)Created integrated servicesmodelImportance of what was measured - cost savings

    Mental Health Association of San Francisco

  • Why an Initiative?In spite of clearly documented offsetting savings, the Legislature has been unwilling to expand programs

    Strong public support36 year unfulfilled promise of community programs

    Mental Health Association of San Francisco

  • This initiative is funded by...1% tax on taxable personal incomes over $1 millionTaxpayers earning $1.5 million would pay a tax of $5000Deductible from federal income taxesIs this tax fair?This tax is a small portion of what these taxpayers saveCalifornia Property Taxes and recent federal tax cuts

    Mental Health Association of San Francisco

  • How does Prop. 63 affect the State Budget?Existing Entitlements are ProtectedState cant reduce funding or shift costs to countiesFunds must be used to expand not supplant servicesEstimated $500 million savings for State General Fund in criminal justice system, emergency rooms and welfareLA County jail is the largest mental health care provider in California

    Mental Health Association of San Francisco

  • What does Prop. 63 do?The Mental Health Services Act became law effective January 1, 2005Provides almost 1 Billion per year to counties$1.1 and 1.2 billion for 05/06 Estimated between $1.2 and 1.3 billion for 06/07 Uses allocation formulaOffers mental health care to children, transitional age youth, adults, seniorsCovers uninsured, and those whose insurance coverage has run out

    Mental Health Association of San Francisco

  • MHSA Fund Allocation FY 05/06-FY 07/08Education/Training = 10%

    Capital Facilities/Technology = 10%

    State Imp/Adm.= 5%

    Local Plan= 0%

    Prevention/Early Intervention= 20%

    CSS= 55%(5% of Prev & CSS for innovative programs)

    Mental Health Association of San Francisco

  • Five Funding Areas1) Prevention and Early Intervention 20% of fundingThis component will support the design of programs to prevent mental illnesses from becoming severe and disabling, with an emphasis on improving timely access to services for underserved populations.Emphasis on reducing: SuicideIncarcerationsSchool failures or dropoutsProlonged sufferingHomelessnessRemoval of children from their homes

    Mental Health Association of San Francisco

  • Five Funding Areas2) Community Services and Support (CSS)50% of fundingThe CSS are the programs, services, and strategies that are being identified by each county through its stakeholder process to serve unserved and underserved populations, with an emphasis on eliminating racial disparity.At least 51% of $ must be spent on wrap-around whatever it takes services based on AB34 program (see http://www.ab34.org/)The remaining $ are spent as determined by the County based on an intensive public stakeholder process

    Mental Health Association of San Francisco

  • Five Funding Areas3) Education and Training10% of FundingThis component will target workforce development programs to remedy the shortage of qualified individuals to provide services to address severe mental illnesses.State will create planEducational stipends, loan forgiveness and other strategies to increase the mental health workforce

    Mental Health Association of San Francisco

  • Five Funding Areas4) Capital and Information Technology10% of fundingThis component will address the capital infrastructure needed to support implementation of the Community Services and Supports programs. It includes funding to improve or replace existing IT systems and for capital projects to meet program infrastructure needs.

    Mental Health Association of San Francisco

  • Five Funding Areas5) Innovative Programs5% of the fundingThe goal of this component is to develop and implement promising and proven practices designed to increase access to services by underserved groups, increase the quality of services and improve outcomes, and to promote interagency collaboration.

    Mental Health Association of San Francisco

  • MHSA Fund Allocation Years 5+State Imp/Adm. = 5%

    Prevention and Early Intervention*= 20%

    CSS= 75%- (5% of Prev. & CSS for innovative programs)

    Local Planning up to 5% of local funds

    NOTE: Capital Facilities is no longer a set aside but counties can choose to devote CSS funds to meet capital needs on an ongoing basis! Maximum of 20% can be dedicated to Capital / IT, Education and Training (ie Human Resources) and Prudent Reserve

    *Amount for Prevention and EarlyIntervention can be increased in specific circumstances.

    Mental Health Association of San Francisco

  • Stakeholder ProcessStakeholder: a person or an organization that feels they have an active interest in the outcome of an issue or topic. clients, family members, county mental health departments, mental health providers, schools, social services, law enforcement and others. Intensive on going local and state-wide stakeholder processIn San Francisco over 70 community meetings held to create CSS planState DMH holds on-going meetings, conference calls, email updates, etc.

    Mental Health Association of San Francisco

  • Oversight and Accountability CommissionResponsible for Oversight of the MHSA16 members-- All appointed by governorAttorney General Superintendent of Public InstructionChairperson of the Senate Health and Human Services Committee Chairperson of the Assembly Health Committee Two persons with a severe mental illnessa family member of an adult or senior with a severe mental illness a family member of a child who has or has had a severe mental illnessa physician specializing in alcohol and drug treatmenta mental health professionala county Sheriffa Superintendent of a school districta representative of labor organizationan employer with less than 500 employees an employer with more than 500 employeesa health care services plan or insurer

    Mental Health Association of San Francisco

  • Oversight and Accountability CommissionLaw requires counties to develop three year plans Plan must be developed with local stakeholders and receive state approvalReviewed and renewed on a yearly basisWorks with State DMH to develop policies that will transform the mental health system in California

    Mental Health Association of San Francisco

  • Reasons for OptimismPurpose is to transform the mental health system, not business as usual

    Shifts the system from fail first to help first by focusing funds specifically on prevention and early intervention

    Funds are continuously appropriated

    Funds are not tied to medical necessity - local creativity results

    Cultural competence in service delivery is fostered

    Mental Health Association of San Francisco

  • More Reasons for OptimismCommunities articulate the link between recovery and permanent housing and fund housing

    Unprecedented consumer and family involvement brings much expertise

    New roles emerging for seasoned stakeholders

    Helps to reduce mental health stigma

    Increases the political voice of the mental health community

    Mental Health Association of San Francisco

  • Part II:Governors Initiative to End Chronic Homelessness (GHI)

    Mental Health Association of San Francisco

  • GHI, Phase I: New Capital Dollars!!A New Funding Program was established by the Governor in 2005 to target housing funds to projects serving people who are severely mentally ill and chronically homeless Note: the State is NOT using the HUD definition of chronically homeless but individual projects may use the more restrictive HUD definition if they are leveraging HUD fundsThis program funding is comprised of:$40 million in MHP (Multifamily Housing Program-Prop 46)$2 million in MHSA (from State administrative dollars)

    Mental Health Association of San Francisco

  • GHI, Phase I: More than Housing FundIn addition to this housing fund, the Governor:Created the State Interagency Council on HomelessnessProvided funds for the Council to develop a Ten Year Plan to End Chronic Homelessness;Provided MHSA funds to provide training to counties on building collaboratives to develop supportive housing

    Mental Health Association of San Francisco

  • GHI, Phase I: Application ProcessThese housing funds are available by applying to the State Department of Housing and Community DevelopmentThe application form and process is similar to the States existing Multifamily Housing ProgramThe application process opened on January 16, 2006 and the deadline for submitting an appl