1. PRESENTATION TO THE MHSA PLANNING STAKEHOLDER STEERING COMMITTEE FEBRUARY 24, 2014 MHSA THREE-YEAR PROGRAM AND EXPENDITURE PLAN 2014-15 – 2016-17

2. DISCUSSION OUTLINE I.3-Year Program and Expenditure Planning Process A.Planning Purpose B.Methodology C.Timeline and Meeting Schedule II.Proposed Guidelines and Planning Implications A.Integrating Ongoing Feedback and Program Directions B.DRAFT PEI Program Guidelines C.Program Plans reflective of Performance Measures D.Key Research Questions

3. 3-YEAR PROGRAM AND EXPENDITURE PLANNING PROCESS PART I

4. PLANNING PURPOSE (1) County mental health programs shall prepare and submit a Three-Year Program and Expenditure Plan (WIC 5847) that addresses each MHSA component. Counties shall create one plan, incorporating all MHSA components, and make expenditure projections for each component per year. Budgets shall be submitted for FY2014-15, FY 2015-16, and FY2016-17.

5. MENTAL HEALTH SERVICES ACT Community Services and Supports (CSS) Prevention and Early Intervention (PEI) Innovation (INN) Workforce Education and Training (WET) Capital Facilities and Technological Needs (CFTN)

6. PLANNING PURPOSE (2) Engage consumers, family members, community partners in a discussion to ensure meaningful stakeholder involvement in developing: Mental Health Policy Program Planning Implementation Monitoring Quality Improvement Evaluation Budget Allocations

7. METHODOLOGY Leverage Existing, Current Information Recent Discussion Groups – 20 in 2013 BHS Strategic Plan Ongoing Partner Feedback Other Strategic Opportunities Affordable Care Act Other Federal and State Opportunities Update Information Community and Stakeholder Discussion Groups Outcome Data and Performance Indicators

8. TIMELINE AND MEETING SCHEDULE February Review guidelines Develop planning methodology Notify Stakeholders March Collate recent data to inform discussion Conduct meetings to gather stakeholder input Review findings and proposed plan directions April Draft 3-Year Program and Expenditure Plan Share with Stakeholders and Post for 30-day Review MAY Convene Public Hearing on the Plan

9. QUESTIONS? END OF PART I

10. PROPOSED GUIDELINES AND PLANNING IMPLICATIONS PART II

11. INTEGRATING ONGOING FEEDBACK AND PROGRAM DIRECTIONS Incorporate the Key Themes and Planning Directions that Stakeholders have emphasized in recent years: Develop new and enhanced services for the prevention, early intervention, and treatment of mental health illnesses. Continue to emphasize the integration of mental health and substance abuse services. Ensure that individuals with mental health disorders, including co-occurring substance use disorders have access to a range of residential and acute treatment services. Improve services!

12. IMPROVING SERVICES WIC 5848 states that Plans shall include reports on the achievement of performance outcomes for MHSA services Improve Services – as demonstrated by outcomes achieved Reduce prolonged suffering Improved access and linkage to services Improved access to services for underserved populations Demonstrate prudent use of expenditures to achieve outcomes for individuals with mental illness

13. DRAFT PEI PROGRAM GUIDELINES DRAFT PEI Program Guidelines www.cmhda.org/go/committees/MHSA-committee-handouts (under December 2013) Proposes new guidelines on the use of PEI funds Anticipate approval of guidelines soon Includes new directions on use of funds, required performance measures, and program evaluation More use of evidence based practices Must demonstrate service criteria Less funding for broad, universal, prevention programs

14. REQUIRED PEI STRATEGIES Intervene early in the onset of a mental illness Required Increase recognition of early signs of mental illness amongst designated first responders Recommended Additional strategies Reduce risks related to mental illness Stigma and discrimination reduction programs Suicide prevention programs

15. ANNUAL REPORT All programs must demonstrate and report on: Fidelity to an evidence based- or promising-practice Specific criteria to program inclusion The unduplicated number served or first responders trained The number referred for services followed up on a referral, and who participated at least once in the referred service The length of time an individual remained engaged in the services referred to Interval between onset of symptoms and referral for services Interval between referral to services and engagement in services All indicators measured by age, gender, race, etc.

16. PROGRAM PLANS REFLECTIVE OF PERFORMANCE MEASURES DRAFT PEI Guidelines offer a Framework Anticipate similar guidelines for CSS funding The new 3-Year program and expenditure will incorporate Draft PEI Guidelines and Stakeholder Input for the use of performance measures Strategic Objective – Develop a standardized set of outcomes for services and performance-based quality improvement processes

17. KEY PLANNING STRATEGIES Leverage all available funds, including Medi-Cal Use MHSA dollars to leverage additional state and federal resources Move towards more evidence based and promising practices Measure and evaluate program effectiveness Leverage and expand use of technology Invest in workforce training and development

18. KEY RESEARCH QUESTIONS What should we know about current services What works well? What services are missing, or not distributed well? What are the recommendations to improve services? Who should we be considering for new or enhanced services What specific criteria should guide program enrollment into full service partnership and early intervention programs? Who should we train as first responders? What risk factors do we need to target to prevent mental illnesses?

19. ADDITIONAL RECOMMENDATIONS? END OF PART 2

20. NEXT STEPS

21. NEXT STEPS: HOW YOU CAN HELP Advertise and distribute meeting information Convene planning meetings Encourage additional discussions Incorporate written feedback and suggestions

22. CONTACT INFORMATION Kayce Rane kaycerane@ranecd.com 925-876-0760 www.sjmhsa.net