DATE: June 20, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Fresno County Mental Health Services Act Three-Year Plan 2023-2026
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Department of Behavioral Health Director to execute and submit the Fresno County Mental Health Services Act Three-Year Plan 2023-2026 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 adopt a new three-year plan necessary to render services funded through the Mental Health Services Act (MHSA) and to submit the Fresno County MHSA Three-Year Plan 2023-2026 to the California Department of Health Care Services (DHCS) and the California Mental Health Services Oversight and Accountability Commission (MHSOAC) by June 30, 2023. The MHSA Three-Year Plan is required per Welfare & Institutions Code (W&IC), section 5847. The section describes the Three-Year Plan 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 persons served needing behavioral health services, 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 Three-Year Plan; however, this action would prevent the County from having any spending authority related to its MHSA funds in FY 2023-2024 and all MHSA-funded services would halt until a new Three-Year Plan 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 new 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 and allows the county to use MHSA as a match from other state and federal funding. This Three-Year Plan projects expenditures for the next three fiscal years; however, these projections may change. Any changes will be described in future Annual Updates. The recommended Three-Year Plan describes the projected budgets as follows:
FYs 2023-2024 through 2025-2026
FY 2023-2024: $112,820,708
FY 2024-2025: $ 96,527,375
FY 2025-2026: $ 96,527,375
TOTAL $305,875,458
DISCUSSION:
The Department is required to submit a new Three-Year Plan every three years and annual updates yearly for approval by your Board, before submission to DHCS.
The proposed Three-Year Plan 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 2022, the Department hosted fifteen in-person community planning meetings in English, Spanish, and Hmong; participated in ten community gatherings; conducted sixteen key informant interviews across different sectors; and received 384 survey responses from members of the public. In addition, the Department held a follow-up session on March 29, 2023. The plan was posted for a 30-day Public Comment period from March 17, 2023, through April 17, 2023. A Public Hearing was held on April 19, 2023.
This 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 Department will continue to engage in improvement activities, including third party program evaluations to ensure the continued provision of high-quality and outcomes-driven services to residents of the County in a coordinated manner.
OTHER REVIEWING AGENCIES:
On April 19, 2023, the Behavioral Health Board also reviewed and supported adoption of the plan in its monthly in-person public meeting. On the same date, the Behavioral Health Board voted unanimously to accept the Fresno County MHSA Three-Year Plan and recommended it for presentation to your Board for final approval.
REFERENCE MATERIAL:
BAI #37, April 13, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - MHSA Three-Year Plan 2023-2026
CAO ANALYST:
Ron Alexander