DATE: April 13, 2021
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Submission of the Fresno County Mental Health Services Act Three-Year Plan for 2020-2023 and Annual Update 2019-2020
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Department of Behavioral Health to submit the MHSA Three-Year Plan 2020-2023 and Annual Update 2019-2020 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 Mental Health Services Act (MHSA) Three-Year Plan and Annual Update to the California Department of Health Care Services (DHCS) and the California Mental Health Services Oversight and Accountability Commission (MHSOAC) by March 31, 2021. The MHSA Three-Year Plan is required per Welfare & Institutions Code (W&IC), section 5847. This section also describes the Annual Update process, whereby the County outlines the MHSA-funded programs and services according to community stakeholder input and the Community Planning Process (CPP per Title 9, California Code of Regulations, 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 Three-Year Plan and Annual Update; however, it would result in failure to adhere to the required statutes and would delay the Department’s efforts to provide needed behavioral health services in the community. Additionally, non-approval may place 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, as part of the stakeholder process, further delaying the submission of the plan.
FISCAL IMPACT:
There is no increase in Net County Cost associated with this recommended action. MHSA funding allows for full reimbursement of direct and indirect program and service costs. The FY 2018-2019 program and service costs ($58,337,985) are detailed in the FY 2019-2020 Annual Update. The Annual Update was included in the previously approved FYs 2017-2020 Three-Year Plan. The 2020-2023 Three-Year Plan describes projected funding as follows:
FYs 2020-2021 through 2022-2023 Three-Year Plan
FY 2020-2021: $ 93,031,436
FY 2021-2022: $ 87,092,102
FY 2022-2023: $ 87,489,285
TOTAL $267,612,823
As part of the Three-Year Plan, amendments to existing programs and new proposed programs would be brought to your Board for approval prior to implementation. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2019-20 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
The Department is required to submit a new Three-Year Plan every three years and annual update for approval by the governing body, your Board, before submission to DHCS.
The proposed Three-Year Plan and Annual Update were completed with significant input from the community. Counties are required to develop their plans through a Community Program Planning Process (CPPP) (Title 9, California Code of Regulations, § 3200.060 and 3300) which includes robust and meaningful stakeholder engagement.
From November 2019 to December 2019, the Department held 20 in-person community forums across the County, which included locations outside of metro-Fresno (such as San Joaquin, Coalinga, Mendota, Selma) and four virtual community forums. The forums were advertised online, in print media, and through in-person engagement at community events. The forums were open to the community at large, and interpreters were available at every forum. The Department hosted public forums on weekends, evenings, and at various community locations to increase accessibility. Several population-specific forums were held, including but not limited to, providers, first responders, faith leaders, individuals served, families/caregivers, Transition-Aged Youth, Hmong-speakers, and Spanish-speakers. In addition to these public forums, the Department conducted 19 cross-sector Key Informant Interviews to elicit input from advocates and leaders outside of the Behavioral Health field, whose constituents and individuals served would be impacted by the proposed plan. Finally, from October 2019 to December 2019, over 650 Community Needs Surveys were collected from community members during the CPPP.
The Department hosted three virtual follow up sessions the week of November 30 through December 4, 2020. The plan was posted for a 30-day Public Comment period from December 18, 2020 through January 22, 2021. Three Public Hearings were held the week of January 18 through January 22, 2021. The Behavioral Health Board approved the plan on January 20, 2021.
The COVID-19 pandemic affected both the services provided by the Department and the funding available through MHSA. The plan was due June 30, 2020; however, the County obtained an extension approval from the DHCS to complete the plan in a manner informed by current fiscal projections.
The Department’s proposed MHSA Three-Year Plan was developed to focus on sustainability over the next three years. The Department will continue to engage in improvement activities, including program evaluations to ensure the continued provision of high-quality services to residents of the County in a coordinated manner.
OTHER REVIEWING AGENCIES:
On January 20, 2021, the Behavioral Health Board held a public hearing simultaneously hosted virtually on WebEx, Facebook, and YouTube. On the same date, the BHB voted unanimously to accept the Fresno County MHSA Three-Year Plan for 2020-2023 and the Annual Update 2019-2020 and recommend it for presentation to your Board for approval.
REFERENCE MATERIAL:
BAI #36, June 18, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - MHSA Three-Year Plan 2020-2023 & Annual Update 2019-2020
CAO ANALYST:
Sonia M. De La Rosa