1. 1 CMHS Block Grant Peer Reviews Ann Arneill-Py, PhD, Executive Officer CA Mental Health Planning Council California Mental Health Planning Council April 21, 2010

2. 2 CMHS Block Grant Community Mental Health Services Block grant appropriated at approximately $400M annually Community Mental Health Services Block grant appropriated at approximately $400M annually CA receives approximately $54M annually CA receives approximately $54M annually

3. 3 CMHS Block Grant Type of Allocation Amount Base Allocation $36.6M Dual Diagnosis Set-aside 8.1M 8.1M Children’s System of Care 4.0M 4.0M Integrated Service Agency 2.0M 2.0M Human Resources Project 200,000 Co-occurring Disorders 340,000 Homeless Programs 300,000 COJAC Support 20,000 20,000 DMH Administration 2.7M 2.7M

4. 4 Planning Council Mandate Review and comment on Block Grant application and implementation report Review and comment on Block Grant application and implementation report Advocate for persons with serious mental illnesses and children with serious emotional disturbances Advocate for persons with serious mental illnesses and children with serious emotional disturbances Monitor, review, and evaluate not less than once each year, the allocation and adequacy of mental health services in the State Monitor, review, and evaluate not less than once each year, the allocation and adequacy of mental health services in the State

5. 5 Peer Review Mandate Title XIX, Part B, Subpart I Title XIX, Part B, Subpart I Section 1943, Additional Requirements Section 1943, Additional Requirements In general – A funding agreement for a grant under section 1911 or 1921 is that the State involved will In general – A funding agreement for a grant under section 1911 or 1921 is that the State involved will –(A) For the fiscal year for which the grant involved is provided, provide for an independent peer review to assess the quality, appropriateness, and efficacy of treatment services provided in the State to individuals under the program involved; and –(B) Ensure that, in the conduct of such peer review, not fewer than 5 percent of the entities providing services in the State under such program are reviewed (which 5 percent is representative of the total population of such entities);

6. 6 Peer Reviews Peer reviews have not been conducted since 2004 Peer reviews have not been conducted since 2004 DMH has asked the Planning Council to conduct these reviews DMH has asked the Planning Council to conduct these reviews The Executive Committee authorized the Quality Improvement Committee to implement this project The Executive Committee authorized the Quality Improvement Committee to implement this project

7. 7 Memorandum of Understanding (MOU) MOU being negotiated with DMH regarding the conduct of these peer reviews MOU being negotiated with DMH regarding the conduct of these peer reviews DMH to provide applications DMH to provide applications Review written reports and comment Review written reports and comment Develop corrective action plans, if needed Develop corrective action plans, if needed Provide travel funds Provide travel funds CMHPC to comply with federal statute CMHPC to comply with federal statute Develop protocol Develop protocol Conduct site visit Conduct site visit Provide written report within 90 days Provide written report within 90 days Have county make presentation at QIC meeting Have county make presentation at QIC meeting

8. 8 Peer Review Team One consumer One consumer One family member One family member One provider/professional or consumer related advocate One provider/professional or consumer related advocate 2 Planning Council staff 2 Planning Council staff 1 county mental health department quality improvement staff person 1 county mental health department quality improvement staff person

9. 9 Site Review Agenda Team Meeting Team Meeting Entrance Conference Entrance Conference One program review in the morning One program review in the morning One program review in the afternoon One program review in the afternoon Team meeting in the morning to develop findings Team meeting in the morning to develop findings Exit conference Exit conference

10. 10 Review Protocol Have there been any revisions to the program description? If so please describe. Have there been any revisions to the program description? If so please describe. What staff are providing services? Please specify in full time equivalent positions. What staff are providing services? Please specify in full time equivalent positions. How does the program serve the target population; e.g., Children and Youth, Transition Age Youth, Adults, and Older Adults.? Please specify the number of clients served. How does the program serve the target population; e.g., Children and Youth, Transition Age Youth, Adults, and Older Adults.? Please specify the number of clients served. What collaborative efforts with other County programs have been undertaken with CMHS- funded services? What collaborative efforts with other County programs have been undertaken with CMHS- funded services?

11. 11 Review Protocol Are the approved measurable objectives being met? What progress has there been towards meeting the approved program objectives? If there are problems, what has been or needs to be done to resolve the issue? Are the approved measurable objectives being met? What progress has there been towards meeting the approved program objectives? If there are problems, what has been or needs to be done to resolve the issue? What are the results of the program evaluation as described in the approved application? If a problem was identified, what action was planned or taken to resolve it? What are the results of the program evaluation as described in the approved application? If a problem was identified, what action was planned or taken to resolve it? Does this program have a role in reducing racial/ethnic/cultural disparities in your county? Does this program have a role in reducing racial/ethnic/cultural disparities in your county? What barriers have you encountered? What means have been used to eliminate any identified barriers? What barriers have you encountered? What means have been used to eliminate any identified barriers? What special gains or service reforms have occurred as a direct result of the County’s SAMSHA grant program? What special gains or service reforms have occurred as a direct result of the County’s SAMSHA grant program?

12. 12 Client Focus Group What part of this program do you think is the most helpful to you? What part of this program do you think is the most helpful to you? How involved are you in helping to develop your treatment plan and setting your goals? How involved are you in helping to develop your treatment plan and setting your goals? What goals are most important for you, and how do your services help you get there? What goals are most important for you, and how do your services help you get there? How is this program helping you “recover” from the problems that brought you here? How is this program helping you “recover” from the problems that brought you here?

13. 13 Client Focus Group Do you consider yourself to be a part of a certain culture, such as ethnicity, age, or religion? Is the staff respectful of this when they talk to you or assist you in your plans? Do you consider yourself to be a part of a certain culture, such as ethnicity, age, or religion? Is the staff respectful of this when they talk to you or assist you in your plans? Are you receiving community-supported services in preparing you for transition to independent living; e.g. employment, housing, education? Are you receiving community-supported services in preparing you for transition to independent living; e.g. employment, housing, education? What do you recommend for improving services here? What do you recommend for improving services here?

14. 14 Staff Focus Group Please tell us about the program. How is the program staffed? Who is served? How are potential consumers identified? How is assessment conducted? How do you develop treatment plans? What services do you provide? Please tell us about the program. How is the program staffed? Who is served? How are potential consumers identified? How is assessment conducted? How do you develop treatment plans? What services do you provide? What are the program’s strengths/successes and what are the program’s challenges? From the perspective of management? Supervisor? Line staff? What are the program’s strengths/successes and what are the program’s challenges? From the perspective of management? Supervisor? Line staff? What interagency involvement is there? How successful is collaboration? What strategies are used to facilitate collaboration? Management? Line staff? What interagency involvement is there? How successful is collaboration? What strategies are used to facilitate collaboration? Management? Line staff? How are staff trained? Is there any training regarding specific treatment approaches or treatment philosophy? What kind of training is provided regarding Cultural competency? How is Cultural Competency training incorporated into service delivery? Do staff receive any specific training on Recovery principles? Describe. How are Recovery principles incorporated into service delivery? How are staff trained? Is there any training regarding specific treatment approaches or treatment philosophy? What kind of training is provided regarding Cultural competency? How is Cultural Competency training incorporated into service delivery? Do staff receive any specific training on Recovery principles? Describe. How are Recovery principles incorporated into service delivery?

15. 15 Staff Focus Group What does success look like for the program’s consumers? Please provide some examples. What are the greatest challenges for obtaining this success? What are the programs greatest strengths in helping consumers succeed? What does success look like for the program’s consumers? Please provide some examples. What are the greatest challenges for obtaining this success? What are the programs greatest strengths in helping consumers succeed? If we asked consumers what they thought about the program, what would they tell us? What would be the program’s greatest challenges from their perspective? What would be the program’s greatest strengths? If we talked to consumers, what would they say about cultural competency? About the focus on recovery? If we asked consumers what they thought about the program, what would they tell us? What would be the program’s greatest challenges from their perspective? What would be the program’s greatest strengths? If we talked to consumers, what would they say about cultural competency? About the focus on recovery?

16. 16 Assistance from Planning Council Members Peer reviews will be conducted in February/March, August/September, November/December Peer reviews will be conducted in February/March, August/September, November/December Quality Improvement Committee does not have sufficient members to staff all the peer reviews Quality Improvement Committee does not have sufficient members to staff all the peer reviews Will be asking for volunteers from Planning Council to participate in reviews Will be asking for volunteers from Planning Council to participate in reviews