DATE: July 7, 2020
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Approval to Proceed with Proposed Innovation Programs
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Department of Behavioral Health to move forward with next planning steps in the development of proposed Innovation programs.
REPORT
Approval of the recommended action will allow the Department of Behavioral Health to move forward with next planning steps for three Innovation (INN) programs and secure Mental Health Services Act (MHSA) INN funds which were subject to reversion. The INN programs were previously included in the Department’s approved 3-year expenditure plan and annual updates for FY 17/18, 18/19, and 19/20. The INN programs were recently presented to Mental Health Services Oversight and Accountability Commission (MHSOAC) and were approved with the contingency of local Board of Supervisor approval to move forward with next steps.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department would revert INN funds back to the California Department of Health Care Services (DHCS) which would be detrimental to the Department’s efforts to provide behavioral health services in the community.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. Programs will be fully funded with MHSA INN funds. The total funding for the three INN programs is $6,927,000.
INN Program Year 1 Year 2 Year 3 Total
The Lodge $1,399,333 $1,400,333 $1,400,334 $4,200,000
Handle with Care Plus+ $502,140 $511,897 $512,963 $1,527,000
Project RideWell $386,391 $388,187 $454,422 $1,200,000
Your Board previously approved of the proposed INN programs. Agreements for the proposed programs would be brought to your Board for approval at a later date 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:
MHSA’s INN component provides California Counties the opportunity to test, pilot, adapt or study ideas to develop new best practices. Five percent (5%) of each county’s MHSA budget is required to be set aside for INN programs. Legislation requires local Counties to revert (return) funds to the State that have not been encumbered within the required 3-year timeframe for the primary MHSA programs. INN programs need to be presented to the MHSOAC for approval in order to be implemented with INN funding.
On December 5, 2017, your Board approved the Department’s MHSA FY 2017-18 through FY 2019-20 Three-Year Program and Expenditure Plan. The Lodge was one of the identified INN programs in the plan.
On November 8, 2018, your Board approved of the Department’s FY 2017-18 Annual Report which included the Transportation Application (a.k.a. Project RideWell), and Response to Kids and Families Experiencing Stress & Trauma (a.k.a. Handle with Care Plus+) as new proposed INN programs, which were identified through the Community Planning Process and on-going system gap analysis.
On June 18, 2019, your Board approved of the Department’s FY 2018-19 Annual Report which provided an update to all three programs. Concept papers had been submitted to MHSOAC or were in the process of being developed.
The Lodge is short-term lodging driven by peer support services to individuals with a severe mental illness whom are experiencing or at risk of homelessness. The intent of The Lodge is to gain insight through a pilot research project on what can enhance and increase engagement of individuals who are homeless or at risk for homelessness, with the onset of an early or severe mental illness and who are not engaging in care due to being in the precontemplation stage of change.
Project RideWell seeks to create a user-friendly ride request application for smart devices that can be used by individuals served and service providers throughout Fresno County to access a range of behavioral health services including psychiatric appointments, assessments, intake, counseling sessions, group sessions, as well as non-clinical activities, such as relapse prevention services, wellness activities, family functions, didactical trainings, and greater opportunity for peer involvement in programs and work groups.
Handle with Care Plus+ seeks to create a cross sector program that will respond to children and families immediately after a trauma or stressful life event occurs. The focus is to provide early support, screen and assess children for early indicators of mental health symptoms, empower the family with the tools they need to cope and recover, and connect children and families to any additional necessary resources.
All three INN programs were vetted through a stakeholder process. Per regulations, plans were drafted for each program and were posted for a 30-day public posting/comment period. The required 30-day public review and comment period began with the posting of the drafts on the County’s MHSA website from March 2, 2020 through April 2, 2020. Notifications were sent out to various list serves about the posting. A virtual public hearing was conducted on April 3, 2020 via YouTube, which was shared on the Department’s page. The plans were reviewed and approved by the Behavioral Health Board on April 9, 2020. MHSOAC also posted the plans for statewide public comment.
Each of the INN plans have an independent evaluation component as required by INN regulations. These evaluations will be used to inform the County of the effectiveness of the projects, their viability, and provide data information decision making with regards to the future of any of the projects.
On May 28, 2020, pursuant to INN regulations, the Department presented the three INN programs to MHSOAC for approval prior to expending INN funds. Approval was granted with the contingency of formal local Board adoption/approval to move forward with next planning steps for the proposed INN programs.
With your Board’s approval, the Department would secure funds for all three programs. The Department would have three (3) years to expend the funds, and the three (3) year time clock would start when the Department begins delivering services or when funds are first spent, whichever happens first. Once the programs are ready for implementation, the Department would return to the Board at a later date for agreement approval. Updates to the programs will be included in future Department MHSA Annual Updates.
REFERENCE MATERIAL:
BAI #36, June 18, 2019
BAI #27, November 6, 2018
BAI #5, December 5, 207
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - The Lodge Program Plan
On file with Clerk - Handle with Care Plus+ Program Plan
On file with Clerk - Project RideWell Program Plan
CAO ANALYST:
Ronald W. Alexander