DATE: May 7, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Fresno County Mental Health Services Act Annual Update 2024-2025
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Department of Behavioral Health Director to execute and submit the Fresno County Mental Health Services Act Annual Update 2024-2025 to the California Department of Health Care Services and the California Mental Health Services Oversight and Accountability Commission.
REPORT
Approval of the recommended action will allow the Department of Behavioral Health to submit the Fresno County Mental Health Services Act (MHSA) Annual Update 2024-2025 to the California Department of Health Care Services (DHCS) and the California Mental Health Services Oversight and Accountability Commission (MHSOAC) by June 30, 2024. The MHSA Annual Update is required per Welfare & Institutions Code (W&IC), section 5847. The section describes the Annual Update process, whereby the County outlines the MHSA-funded programs and services according to community stakeholder input and the Community Program Planning Process (CPPP), per Title 9, California Code of Regulations (CCR), sections (§§) 3300 and 3200.060. The programs and services are provided to behavioral health clients, their family members and target populations throughout the County, with no increase to Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Your Board may choose not to approve the MHSA Annual Update; however, this action would prevent the County from having any spending authority related to its MHSA funds in FY 2024-2025 and all MHSA-funded services would halt until an Annual Update is approved. This would result in failure to adhere to the required statutes. Additionally, non-approval may place some MHSA funds at risk of reversion to DHCS as the funds are subject to expenditure time limits. Further, if your Board recommends significant changes to the plan, the Department will be required to re-engage the community through a stakeholder process and submit the changes for 30-day public comment, further delaying the submission of the plan.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. MHSA funding allows for full reimbursement of direct and indirect program and service costs. The projected funds for the Annual Update were included in the previously approved FYs 2023-2026 Three-Year Plan. Your Board approved the plan on June 30, 2023. The recommended Annual Update updates the projected budgets as follows:
FYs 2023-2024 through 2025-2026
FY 2023-2024: $ 106,615,403
FY 2024-2025: $ 85,582,420
FY 2025-2026: $ 85,582,420
TOTAL $277,779,883
DISCUSSION:
The Department is required to submit a new Three-Year Plan every three years and annual updates yearly for approval by the governing body, your Board, before submission to DHCS.
The proposed Annual Update was completed with significant input from the community. Counties are required to develop their plans through a CPPP (Title 9, CCR, §§ 3200.060 and 3300) which includes robust and meaningful stakeholder engagement.
In Fall 2023, the Department hosted two in-person community forums with Spanish and Hmong interpretation. The Department also hosted a virtual community forum livestreamed on Facebook and Youtube. The plan was posted for a 30-day Public Comment period from February 16, 2024 through March 18, 2024. A Public Hearing was held on March 20, 2022.
The Department’s current MHSA Three-Year Plan was developed to focus on sustainability of services and the implementation of the California Advancing and Innovating Medi-cal (CalAIM). The recommended Annual Update supports that commitment. The Department will continue to engage in improvement activities, including program evaluations to ensure the continued provision of high-quality and outcomes-driven services to residents of the County in a coordinated manner.
This annual update does not take any action related to Proposition 1. The Department posted the draft of this annual update for 30-day Public Comment on February 16, 2024, which occurred before election day on March 5, 2024. The Department has complied with all statutory requirements for this Annual Update, and the components of Proposition 1 are not material to this update.
OTHER REVIEWING AGENCIES:
On March 20, 2024, the Behavioral Health Board held a public hearing. On the same date, the Behavioral Health Board voted unanimously to support the Fresno County MHSA Annual Update 2024-2025 and recommended it for presentation to your Board for final approval.
REFERENCE MATERIAL:
BAI #49, June 20, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - MHSA Annual Update 2024-2025
CAO ANALYST:
Ron Alexander