1. CMHDA Update for NAMI Leadership Institute: County Implementation of MHSA in the New Environment August 18, 2011

2. List of Major 2011-12 State Budget Actions of interest to Community Mental Health  Per AB 100, $862 million in MHSA being used instead of SGF for Medi-Cal and Special Education Students. Also removed “state approval” of MHSA plans, streamlined fund distributions to counties, and decreased state admin. expenditures.  Per AB 118, “Realignment 2011” specifies the programs and account structure. AB 109 specifies public safety realignment.  The AB 3632 mandate on county MH is now permanently repealed.  Medi-Cal functions are being transferred to DHCS.

3. What Has Changed for MHSA  State administers the Mental Health Services Fund (MHSF), issues regs.  County MHSA plans must include local stakeholder process, 30-day review, approval by local MH Board  MHSA statute and regulations still in effect  $861 million loss in 2011- 12  DMH/OAC does not approve plans  MHSA state admin. cap is now 3.5%  Funds distributed monthly as deposits are made into the MHS Fund STAYED THE SAMECHANGES

4. 2011 Public Safety Realignment  Funding Source (~$5.5 billion/year)  1.0625% of existing sales tax revenue  Continuously appropriated to counties  Account Structure for FY 2011-12 at state and county levels  Eight accounts, nine subaccounts  One account is a “Mental Health Account”  Intent language that new allocation formulas to be developed for 2012-13, forward.

5. Realignment Funding for Mental Health 2011-122012-13 (Forward) EPSDT0 (AB 100)$629 million Medi-Cal MH Managed Care 0 (AB 100)$183.7 million 1991 Community MH Realignment $1.083 billion $1.119 billion  Since AB 100 is providing MHSF in 2011-12, Medi-Cal Specialty Mental Health not realigned until 2012-13.  Only the funding source for 1991 community mental health realignment is changing. Funds will be deposited monthly. The 2011-12 amount is 5.9% higher than would be anticipated without the 2011 Public Safety Realignment.

6. AB 109 Criminal Justice Realignment  Effective October 1, 2011.  Statewide $354.3 million available in FY 2011-12 for “Local custody” of non-non-non offenderss, as well as “Post-release community supervision” for adults paroled out of state prison.  Each count has a Community Corrections Partnership (CCP) to recommend to the Board of Supervisors an implementation plan.  Led by Chief Probation Officer.  CCP must include the county mental health director  Meetings are subject to the Brown Act’s posting and open meeting requirements.

7. Other Health/Social Services Reductions that will affect MH Consumers  More Medi-Cal co-pays on doctor and ER visits, and prescriptions. Soft cap on doctor visits. Provider rate cuts to doctors, pharmacies, hospitals.  Eliminate Adult Day Health Care.  SSI/SSP grants are now at federal minimum levels.  Reductions to IHSS totaling $486 million