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Mental Health Services Act
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> California Issues > Mental Health Services Act
Latest Update: April 17, 2008 The passage of Proposition 63 (now known as the Mental Health Services Act or MHSA) in November 2004, provides the first opportunity in many years for the California Department of Mental Health (DMH) to provide increased funding, personnel and other resources to support county mental health programs and monitor progress toward statewide goals for children, transition age youth, adults, older adults and families. The Act addresses a broad continuum of prevention, early intervention and service needs and the necessary infrastructure, technology and training elements that will effectively support this system. The MHSA is funded by a 1% tax on taxable personal incomes that exceed $1 million. Statewide, the Act was projected to generate approximately $254 million in fiscal year 2004-05, $683 million in 2005-06 and increasing amounts thereafter. Under the Act’s provisions, funding, which may not be used to supplant existing services, will be made annually to counties to accomplish the following:
Revenue is placed in the Mental Health Services Fund and administered by DMH for allocation to counties. Some funding must also be set aside for statewide initiatives. The Act also calls for the establishment of the Mental Health Services Oversight and Accountability Commission (MHSOAC) to ensure that the Act is implemented in accordance with the will of the voters. The Act directs DMH to solicit broad public input on implementation issues and to provide leadership to counties as they use this new revenue stream to transform California’s mental health system. Prior to receiving funds, each county must develop and submit a three-year implementation plan to DMH for approval. To provide for an orderly implementation of MHSA, DMH has planned for sequential phases of development for each component of the Act. An extensive stakeholder process is being employed to inform the state’s implementation efforts. Program Components: Capital Facilities and Technology (CFT): Includes facility development and electronic health records. Community Services and Supports (CSS): Includes county plans for expansion of recovery-oriented treatment services and permanent supportive housing. Innovation: Includes county plans for innovative programs that increase access to services, quality of outcomes, and interagency collaboration. Prevention and Early Intervention (PEI): Includes county plans for prevention and early intervention services and statewide initiatives in stigma reduction and suicide prevention. Workforce, Education and Training (WET): Includes both county plans and statewide initiatives for workforce development. CPCA continues to monitor MHSA implementation and participate in the DMH state stakeholder process to advocate on behalf of community clinics and health centers. Planning for the local implementation of the CSS, PEI and WET components is currently underway. CPCA has been working closely with the CPCA Mental Health Task Force to share information and discuss advocacy strategies to maximize health centers’ abilities to participate in their local planning process. CPCA has focused advocacy efforts in the following areas: Prevention and Early Intervention In September, the Department of Mental Health (DMH) released the Mental Health Services Act (MHSA) Proposed Guidelines for the Prevention and Early Intervention Component of the Three-Year Program and Expenditure Plan for Fiscal Years 2007-08 and 2008-09. In short, Prevention and Early Intervention (PEI) funding is to be used to prevent mental health problems or to intervene early with relatively short duration and low intensity approaches to achieve intended outcomes. The purpose of the proposed guidelines is to set forth guidelines and criteria for the release of PEI funds to counties. These proposed guidelines cover the period of Fiscal Years 2007-08 and 2008-09, for the initial implementation of the PEI component. Overall, CPCA was pleased with the changes made by DMH to the draft guidelines that were released for public comment in July (dated 7-16-07). We believe these changes should help safeguard the involvement of community-based organizations and agencies, such as community clinics and health centers, as counties develop their plans for PEI programs. Foremost, CPCA is supportive of the added requirement that the PEI plans strengthen and build upon the local community-based mental health and primary care system, specifically including community clinics and health centers. Member clinics and consortia are encouraged to contact their local County Mental Health Department as soon as possible in order to get involved in the local planning process. There is no deadline for component submission. The statute provides for review and approval of county plans by the Mental Health Services Oversight and Accountability Commission (MHSOAC) to ensure compliance with the Proposed Guidelines. CPCA has weighed in on multiple occasions with the MHSOAC to ensure that the process for review and approval of local plans is transparent and includes sufficient opportunities for stakeholder involvement. Overall, CPCA is pleased with the final review process adopted by the MHSOAC in November. However, the MHSOAC has made it clear that the only concerns that will be entertained at the state level with be those that have already been raised at the local level. It is critical that clinics and consortia document any efforts to raise concerns with the planning process at the local level (via written comments) in order to allow CPCA to point to these efforts in instances where members have been excluded when bringing these concerns forward at the state-level. Per the request of the CPCA Mental Health Task Force, CPCA has developed a tool kit to provide member clinics and consortia with additional resources to assist them in maximizing their involvement in the local planning process. To access the CPCA Tool Kit for Local PEI Planning, click here. Click here to access the PEI guidelines and all other related PEI documents.
Workforce, Education and Training In July, DMH released the Proposed Guidelines for the Workforce, Education & Training (WET) Component of the Three-Year Program and Expenditure Plan for fiscal years 2006-07, 2007-08 and 2008-09. The overall goal of the WET component is to develop and maintain a competent and diverse workforce capable of effectively meeting the mental health needs of the public. Counties have been encouraged to develop on-going planning and monitoring stakeholder committees, and to use and augment these groups as needed for the particular planning and oversight expertise needed for the WET component. There is no deadline for component submission. The statute provides for review and approval of county plans by the California Mental Health Planning Council (CMHPC) to ensure compliance with the Proposed Guidelines. Member clinics and consortia interested in participating in the local WET planning process are encouraged to contact their local County Department of Mental Health as soon as possible. Additionally, much of the WET planning will take place at the regional level through the California Institute for Mental Health (CIMH)-led Regional Partnerships. For more information about how to get involved in one of the Regional Partnerships, please contact Molly Brassil at mbrassil@cpca.org. To access the Proposed Guidelines for the Education and Workforce Component of the Three-Year Program and Expenditure Plan, click here. Capitol Facilities and Technological Needs In March 2008, DMH released the Proposed Guidelines for Counties to submit their Capital Facilities and Technological Needs Project Proposals of the Three-Year Program and Expenditure Plan of the Mental Health Services Act. Capital Facilities and Technological Needs (CFT) is one of the five components of the Mental Health Services Act (MHSA) and part of a broad continuum that will eventually all be part of a comprehensive, integrated approach to community mental health services and supports. The CFT component will support efforts to acquire and develop land and/or construct or renovate buildings and create cost-effective improvements to data processing and communications to support the mental health programs and services to be provided through Community Services and Supports (CSS) and Prevention and Early Intervention (PEI).
According to the guidelines, Capital Facility expenditures must result in a capital asset which increases the County Department of Mental Health’s infrastructure on a permanent basis and must result in an expansion of the capacity/access of existing services or the provision of new services. However, the guidelines also assert that counties may utilize Capital Facilities funds to renovate buildings that are privately owned if the building is dedicated and used to provide MHSA services (Enclosure 2, Page 2). Additionally, counties may develop Technological Needs Projects that may benefit more than only mental health provided that revenues from other funding sources are included so that the net cost to the MHSA is reflective of the benefit received by mental health (Enclosure 3, Page 10).
Planning for the local implementation of the CFT component is currently underway. Member clinics and consortia are encouraged to contact their local County Mental Health Department as soon as possible in order to get involved in the local planning process. There is no deadline for component submission. If you experience problems with locating the designated MHSA coordinator(s) in your county(ies), please contact Molly Brassil. Additionally, it should be noted that contracting protocols vary greatly by county and that health centers may need to begin to make arrangements to ensure compliance with county requirements if looking to receive CFT funds. CPCA will continue to work closely within a coalition of community mental health advocates to monitor the implementation of this component in order to ensure maximum inclusion of community-based organizations to the full extent of the law.
To access the guidelines and other and resources related to the CFT component, click here. Innovations The MHSA stipulates that 5 percent of the total funding for each county mental health program for both Community Services and Supports and Prevention and Early Intervention shall be utilized for innovative programs after approval of the proposed programs by the MHSOAC. CPCA has continued to monitor the work of the MHSOAC’s Innovations Committee and elevate health center issues via the participation of a community health center provider as a Committee member. In November the Innovation Committee released the Innovation Resource Paper (dated 11/8/2007) that provides principles and criteria that are to inform DMH in drafting guidance to counties for local planning. CPCA is overall pleased with the recommendations outlined in the Resource Paper and hope that they will ensure community clinic inclusion in the local planning process. Cultural and Linguistic Competence Technical Resource Group CPCA was invited to participate as a member of the MHSOAC’s Cultural and Linguistic Technical Resource Group and has utilized the opportunity to further promote primary and mental health integration as a strategy for reducing disparities in access to care for minority communities. For questions about any of the components or for assistance in navigating your local process, please contact Molly Brassil at mbrassil@cpca.org or (916) 440-8170, ext. 207. DMH Resources County Mental Health Departments Contact List Mental Health Services Act-full text DMH Letter re MHSA Non-Supplantation MHSA Oversight & Accountability Commission MHSOAC Adopted PEI Review Tool MHSOAC Goals, Procedures & Rules of Operation MHSOAC Report on Co-occurring Conditions MHSOAC Work Plan January 2007 through June 2008 Community Services & Supports CSS Implementation Study Phase I CSS Implementation Study Phase II Prevention & Early Intervention PEI Budget and Planning Worksheets PEI Glossary of Acronyms, Terms & Definitions PEI Program Expenditure Plan Proposed Guidelines CPCA Guide to Navigating PEI Resource Materials PEI Resource Materials with Clinic Highlights PEI Planning Estimates for FY 07-08 and 08-09 Workforce, Education & Training Workforce Education & Training Program Expenditure Plan Proposed Guidelines MHSOAC Position Paper – Education & Training MHSA & Regional Partnerships Description Workforce Education & Training Regional Roundtables: Discussions Summary Capital Facility & Technology Proposed Guidelines for CFT Component Proposal Proposed Guidelines for Capital Facilities Project Proposal Proposed Guidelines for Technological Needs Project Proposal Innovation Innovation Committee Recommendations MHSOAC Innovation Resource Paper 11-19-07 Advocacy Efforts Chesbro Letter to DMH re Draft PEI Guidelines 7-16-07 CPCA Comments on the DMH Presentation to MHSOAC 10-27-06 CPCA Comments on the MHSOAC PEI Committee Proposal dated 10-22-06 CPCA Comments to DMH on PEI Draft Guidelines dated 7-16-07 CPCA MHSA Education & Training Comments 3-19-07 DMH Response to CPCA Comments to E&T Draft Guidelines 8-21-07 MHSA Community Partners Coalition Letter 11-14-07 Underserved Advocates Coalition Letter to DMH 8-9-07 CPCA Comments on Draft WET 5-Year Plan 3-6-08 Advocacy Resources CPCA Mental Health & CCHCs Fact Sheet CPCA MHSA PEI Guidelines Local Planning Process Overview Presentation CPCA Integrated Behavioral Health Care Brief Integrated Behavioral Health Resources Behavioral Health Primary Care Integration, Mauer 2006 Mind-Body Reunited, American College of Mental Health Administration President’s New Freedom Commission on Mental Health, Final Report General Mental Health Resources Substance Abuse and Mental Health Services Administration California Institute of Mental Health California Mental Health Directors Association California Council of Community Mental Health Agencies National Council for Community Behavioral Healthcare The California Network of Mental Health Clients National Alliance on Mental Illness California Cultural and Linguistic Competence Technical Resource Group
Per the request of the CPCA Mental Health Task Force, CPCA has created a tool kit to provide member clinics and consortia with additional resources to assist them in maximizing their involvement in the local planning process for the PEI component of MHSA.
To access CPCA’s Tool Kit for Local PEI Planning, click here. *If you experience difficulty downloading the large document, please contact Molly Brassil at mbrassil@cpca.org or (916) 440-8170 to request a hard copy. Planning for the local implementation of the both CSS, PEI & WET components are currently underway. Member clinics and consortia are encouraged to contact their local County Mental Health Department as soon as possible in order to get involved in the local planning process. There are no deadlines for component submission. For questions or for further assistance in navigating your local process, please contact Molly Brassil at mbrassil@cpca.org or (916) 440-8170, ext. 207.
Copyright ©2005 California Primary Care Association. Contact information and legal disclaimers.
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