Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lisa Mancini, Interim Director, Behavioral Health and Recovery Services
Subject: Amendment to the San Mateo County Mental Health Services Act Annual Update for FY 2022-23
RECOMMENDATION:
title
Adopt a resolution authorizing the approval of an amendment to the San Mateo County Mental Health Services Act Annual Update for FY 2022-23 and submission 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 expenditures have been approved by the Board as part of the larger County Health budget. State legislation requires that an MHSA Three-Year Program and Expenditure Plan (Three-Year Plan), subsequent MHSA Annual Updates and any amendments be approved by this Board.
The Behavioral Health Commission held a public hearing and closed a 30-day public comment on December 7, 2022, on the proposed amendment to the MHSA Annual Update for FY 2022-23 and is recommending approval by this Board.
On August 4, 2020, this Board approved the MHSA Three-Year Plan for FY 2020-23 and the Annual Update for FY 2020-21. The subsequent MHSA Annual Updates for FY 2021-22 and FY 2022-23 were approved by this Board on September 14, 2021, and July 12, 2022, respectively.
DISCUSSION:
The MHSA Annual Update for FY 2022-23, approved by this Board, included strategies for $16.9 million in funding to development of supportive housing units within affordable housing developments under the Department of Housing and other one-time expenditures. Ongoing budget increases were primarily allocated to support Full Service Partnership (FSP) rate increases and expanded services, a core and required component of the MHSA. FSP programs are evidence-based and incorporate a “whatever it takes” approach to support adults living with serious mental illness and children and youth living with serious emotional disturbance, in achieving their individual recovery goals and needs.
At this time, it is necessary to amend the MHSA Annual Update for FY 2022-23 to include the following additional proposed plans and expenditures:
1. El Camino Property Purchase - this property purchase is being proposed for approval to use one-time MHSA funds in the amount of $3,755,500.
The 2191-2195 El Camino Real (El Camino) building in San Mateo was originally identified by the San Mateo County Human Services Agency and recommended to San Mateo County Health, Behavioral Health, and Recovery Services (BHRS) division to support much needed services for the target population housed at the Stone Villa Inn, which is contiguous to the building and a component of the County’s Functional Zero Homeless Campaign. A proposal was provided to this Board, to authorize the purchase of the El Camino property using a short-term loan from the General Fund. MHSA funds are being proposed in this amendment to pay the General Fund loan this current FY 2022-23. The on-site support services will be provided by California Clubhouse and Voices of Recovery. California Clubhouse is a community-based socialization and economic inclusion model focused on restoration of personhood from patient-hood. Voices of Recovery is a peer-led model that provides wellness, advocacy, and support services for individuals seeking long-term recovery from addiction and substance abuse.
2. Innovation (INN) Project Plans - four INN Project Plans that meet State requirements for use of the INN funding are being proposed for approval. While the services are targeted to begin FY 2023-24, this proposed amendment will allow for the use of MHSA INN funds in the amount of $35,000 this current FY 2022-23 for BHRS administrative and procurement activities. Once BHRS receives approval from the State, Requests for Proposal will be issued.
o Adult Residential In-Home Support Element (ARISE). Total amount proposed: $1,235,000 for four years ($990,000 in services, $145,000 for administrative costs, and $100,000 for independent evaluations of the project). The ARISE program creates a model for residential in-home services to support clients with a serious mental illness (SMI) and/or substance use disorder (SUD) who are at risk of losing their housing. Residential in-home support workers will be recruited and provided with specialized training for working with SMI and/or SUD clients in collaboration with a peer support staff and occupational therapist.
o Mobile Behavioral Health Services for Farmworkers. Total amount proposed: $1,815,000 for five years ($1,455,000 in services, $215,000 for BHRS administrative costs, and $145,000 for independent evaluations of the project). The program will provide direct behavioral health mobile services and wraparound resources in Spanish to farmworkers and their families. It integrates cultural arts practices as a pathway for engaging farmworkers and their families with formal clinical behavioral health services spanning prevention, early intervention, treatment, and recovery.
o Music Therapy for Asians and Asian Americans. Total amount proposed: $940,000 for four years ($755,000 in services, $110,000 for administrative costs, and $75,000 for independent evaluations of the project). This project will provide music therapy as a culturally responsive approach for Asian/Asian Americans to reduce stigma, increase behavioral health literacy, and promote linkages to behavioral health services and build protective factors to prevent behavioral health challenges and crises.
o Recovery Connection Drop-in Center. Total amount proposed $2,840,000 for five years ($2,275,000 in services, $340,000 for BHRS administrative costs, and $225,000 for independent evaluations of the project). This center will provide drop-in services for individuals with substance use challenges or co-occurring substance use and mental health challenges at all stages of their recovery, from pre-contemplative to maintenance and enhancement. The Recovery Connection will center around evidence-based Wellness Recovery Action Plan programming, use a peer support model, provide linkages as needed and serve as a training center to expand capacity countywide.
The resolution has been reviewed and approved by the County Attorney 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. It is anticipated that 85% of FSP clients be maintained at a current or lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2021-22 Actual |
FY 2022-23 Estimated |
|
Percentage of FSP clients maintained at a current or lower level of care |
84% 387 of 460 clients |
82% 322 of 395 clients* |
*Projected based on data through 12/23/22
FISCAL IMPACT:
BHRS received $56,620,000 in MHSA funding in FY 2021-22. BHRS anticipates MHSA revenue for FY 2022-23 of $47,110,000. Funds that are not yet allocated through the internal planning process or Request for Proposals to the community are held in a Trust Account. The latter 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 plan.