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COUNTY OF SAN MATEO
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Inter-Departmental Correspondence
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Health Department
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DATE:
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October 1, 2008
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BOARD MEETING DATE:
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October 7, 2008
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Charlene A. Silva, Director of Health
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Louise Rogers, Director, Behavioral Health and Recovery Services
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SUBJECT:
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Agreement with State Department of Mental Health for Mental Health Services Act Funding
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RECOMMENDATION:
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Adopt a Resolution authorizing the President of the Board to execute a superseding Agreement with the State Department of Mental Health for Mental Health Services Act funding for the term July 1, 2004 through June 30, 2009, for a maximum allocation of $22,133,849.
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VISION ALIGNMENT:
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Commitment: Ensure basic health and safety for all.
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Goal 8: Help vulnerable people—the aged, disabled, mentally ill, at-risk youth and others—achieve a better quality of life.
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The Agreement contributes to this commitment and goal by providing funding for mental health services as described in the approved San Mateo County Mental Health Services Act (MHSA) Three-Year Plan.
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Behavioral Health and Recovery Services (BHRS) provides a range of services to promote wellness and recovery and to support consumers remaining in the lowest possible level of care. The provision of intensive case management is one established level of care. The Full Service Partnership (FSP) services provided through this Agreement contribute to this measure.
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Performance Measure:
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Measure
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Adult FSP clients maintained at current or lower level of care.
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BACKGROUND:
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On November 8, 2005, your Board approved submission of the San Mateo County MHSA Community Services and Supports (CSS) Three-Year Plan (Plan) to the State Department of Mental Health (DMH). The Plan was the result of a comprehensive planning process that was designed to facilitate meaningful participation of a broad range of stakeholders including members of historically unserved and underserved populations. The formal planning process included participation by several hundred stakeholders and outreach to over 1,000 community members. DMH approved the Plan on March 30, 2006. On February 6, 2007, your Board approved an Agreement with DMH that approves MHSA funding in the amount of $15,216,213 for the term March 1, 2006 through June 30, 2008. On January 29, 2008, your Board approved a superseding Agreement with DMH that revised the term to July 1, 2004 through June 30, 2008, and increased the maximum MHSA funding amount to $17,760,871.
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On July 22, 2008, your Board approved a modification to the Agreement extending the term through June 30, 2009. Following submission of that modification to the State, DMH determined that a new Agreement for FY 2008-09 would be required and did not sign the modification. The new Agreement was received from DMH on September 2, 2008.
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DISCUSSION:
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This superseding Agreement with DMH provides funding for FY 2004-09. Funding will be used to support eight program strategies organized into three expenditure categories: outreach and support, system transformation strategies, and FSP services. Fifty percent of the funding is required to be directed to FSP services, which are comprehensive services for the highest risk individuals. In San Mateo County FSP services have been implemented for youth, for transition-age youth, and for adults and older adults. Other services that have been implemented include: Pathways, a mental health court; expansion of primary care based mental health services; expansion of senior-focused services; expansion of services for children, youth, and adults; hiring and training consumer and family members to serve as peer counselors; cultural competence training and grant projects for focused resource and materials development; development of effective treatment for co-occurring disorders including a three-year training plan for mental health and alcohol and other drug treatment providers; and subsidized housing for clients who are receiving FSP services.
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New funding is included in the Agreement for the Capital Facilities and Information Technology component of the MHSA. BHRS submitted a proposal to DMH for Information Technology, which was approved on July 22, 2008. The Information Technology plan will partially fund a new integrated business and clinical information system as well as ongoing technical support. This system will replace the legacy system currently used by BHRS, and the clients and families it serves. Largely because most BHRS facilities are leased, capital facilities projects that fit the State parameters for this funding have not yet been identified.
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The present Agreement has been reviewed and approved by County Counsel and Risk Management. The County Manager approved a waiver of the three-year term limit. Under the terms of this Agreement DMH may make unilateral modifications to respond to variances in available State funding, to provide additional planning funds, to implement new services in our approved Plan, or to expand services already implemented.
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FISCAL IMPACT:
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The term of the Agreement is July 1, 2004 through June 30, 2009. This maximum approved amount is $22,133,849. The BHRS FY 2008-09 Adopted Budget includes MHSA funding in the amount of $8,950,200, which includes rollover and anticipated annual growth funds. There is no Net County Cost associated with this Agreement.
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