Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: San Mateo County Mental Health Services Act Annual Update FY 2024-2025
RECOMMENDATION:
title
Adopt a resolution authorizing the approval and submission of the San Mateo County Mental Health Services Act Annual Update for Fiscal Year 2024-2025 to the State Mental Health Services Oversight and Accountability Commission and the Department of Health Care Services.
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BACKGROUND:
In 2004, California voters passed Proposition 63, known as the Mental Health Services Act (MHSA), which made additional state funds available to expand and transform behavioral health services. Since 2006, MHSA resources and expenditures have been approved by this Board as part of the larger County Health budget. State legislation requires that the MHSA Three-Year Program and Expenditure Plan and subsequent Annual Updates be approved by the County’s Board of Supervisors.
On September 12, 2023, this Board approved the MHSA Three-Year Program and Expenditure Plan FY 2023-24 through FY 2025-26 and Annual Update FY 2023-24.
On April 3, 2024, the Behavioral Health Commission held a public hearing and voted to close a 30-day public comment on the MHSA Annual Update FY 2024-25. Behavioral Health and Recovery Services (BHRS) is now recommending approval of the Update by this Board of Supervisors.
DISCUSSION:
The MHSA Annual Update is intended to describe any changes to the programs and expenditures plans to the MHSA Three-Year Plan, previously approved by this Board, and report on annual program outcomes.
The MHSA Three-Year Plan included several priority strategies and plans to spend down the unanticipated revenue and one-time revenue increase due to delayed tax filings, as well as a projected and unprecedented annual adjustment to the MHSA revenue. The Plan’s priorities and strategies included addressing behavioral health workforce capacity; expanding access to services for youth and the Chinese community; and strengthening the behavioral health crisis continuum of care and increases to Full Service Partnerships (FSP), including the new Community Assistance, Recovery and Empowerment Courts FSP and FSP housing resources. FSP programs are evidence-based and incorporate a “whatever it takes” approach to supporting adults living with serious mental illness and children and youth living with serious emotional disturbance, in achieving their individual recovery goals and needs. A one-time spend plan included “big-ticket” items such as 1) housing developments; 2) capital facilities purchases; 3) technology needs; and 4) system transformation projects.
For this current MHSA Annual Update FY 2024-25, the strategies set forth in the MHSA Three-Year Plan will continue as planned and includes proposed increases to the ongoing budget for the sustainability of core BHRS services such as the Serenity House, which supports individuals experiencing a behavioral health crisis, and the Bipolar Disorder Early Assessment and Management, which supports youth and young adults in experiencing the onset of bipolar spectrum or mood disorder with psychotic features.
The FY 2024-25 MHSA proposed budget can be found on Appendix 3 of this MHSA Annual Update.
The agreement and resolution have been reviewed and approved by County Counsel as to form.
A client is considered "maintained at the current or lower level of care" if, during the fiscal year, they did not have a new admission to a higher level of care or had one or more new admissions to a program with the same or lower level of care. One of the many BHRS programs funded by the MHSA is its FSP program described above. It is anticipated that 75% of FSP clients shall be maintained at a current or lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of FSP clients maintained at a current or lower level of care |
73% 297 of 409 clients* |
75% 335 of 446 clients* |
*Based on data through 5/1/2024
EQUITY IMPACT:
MHSA funded programs and services positively impact marginalized communities, especially cultural, racial, and ethnic communities struggling with severe mental health and substance use conditions. These funded programs provide direct treatment and recovery supports (e.g., FSPs, Pathways Program, California Clubhouse, Lived Experience Academy etc.), elevating the importance of providing culturally responsive services. Such culturally responsive services include Cultural Humility 101 trainings for staff and contracted providers, Multi-Cultural Organizational Development, and Trauma-Informed Systems. These offerings include prevention and early intervention programming tailored to engaging marginalized cultural and racial communities (e.g., Pride Center, Cariño Project, Health Ambassador Program, etc.). Marginalized communities are also engaged in the planning and prioritizing of MHSA funding through the MHSA Three-Year Plan development. Over 400 community members of diverse racial, ethnic, and cultural backgrounds (Asian Indian/South Asian 5%, Chinese 7%, Filipino 5%, Black/African American, 4% Hispanic/Latino 19%, Native Hawaiian or Pacific Islander 2%, White/Caucasian 43%) participated in planning via surveys, community input sessions, key interviews, and a 30-day public comment process. A total of 642 stipends were provided to clients and/or family members in FY 2022-23 through the ongoing participation in the MHSA Steering Committee, the BHRS Office of Consumer and Family Affairs, and the BHRS Office of Diversity and Equity programming including the Health Equity Initiatives.
FISCAL IMPACT:
BHRS estimates receiving $69,672,317 in MHSA funding, including interest, in FY 2023-24. BHRS anticipates MHSA funding including interest for FY 2024-25, of $58,142,860. Funds that are not yet allocated through our internal planning process or Request for Proposals to the community are held in a Trust Account. This Account is also used to manage the fluctuations in funding that occur from year to year, as well as to support maintenance of effort and cost increases for current programs. There is no Net County Cost associated with this annual update.