Mental Health Services Act Steering Committee

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Mental Health Services ActSteering Committee

• July 7, 2008
• 100 400

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Consumer Perspective

• MHSA Newsletter
• Recovery Connections

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(No Transcript)
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MHSA Participation

• By Tho Be

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Kites By Margarita Noguera
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Mark Refowitz

• Local/State Updates

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Kate Pavich

• MHSA/Capital Facilities Update

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(No Transcript)
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1. Framework and Goal Support

• Briefly describe how the County plans to use
  Capital Facilities and/or Technological Needs
  Component funds to support the programs, services
  and goals implemented through the MHSA

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Allowable Costs

• To purchase a building for use as a wellness and
  recovery center and office space
• To purchase a building where vocational,
  educational and recreational services are
  provided and where the County is the owner of
  record
• To purchase a building for short-term crisis
  residential care to avoid hospitalization and
  allow for a quick return to the family/community

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County Property401 S. Tustin Avenue, Orange
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New Facilities

• Crisis Residential program to serve as an
  alternative to hospitalization for acute and
  chronic mentally ill persons
• Wellness/Peer Support Center to offer clients
  assistance with benefits, socialization,
  self-reliance, and recovery
• Vocational Training to provide education and
  employment support to consumers and their families

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Tustin Avenue Campus

• Three 7,500 square foot buildings
• Green belts, walkways, and outdoor activity areas
• Architects to incorporate green construction
  including lighting, flooring, building materials,
  transportation and use of recycling

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1. Framework and Goal Support

• Briefly describe how you derived the proposed
  distribution of funds

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Split of Allocation

• 80 Capital Facilities 20 Technology
• (22.6 million) (5.6 million)

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2. Stakeholder Involvement

• Provide a description of stakeholder involvement
  in identification of the Countys Capital
  Facilities and/or Technological Needs Component
  priorities along with a short summary of the
  Community Program Planning Process and any
  substantive recommendations and/or changes as a
  result of the stakeholder process.

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Stakeholder Process

• Training and workshops from local and national
  experts on system transformation, recovery-based
  planning, and creating a recovery culture
• Consumer Action Advisory Committee advises MHSA
  Office on development of programs participated
  in eleven meetings regarding capital facilities
  and technology toured the Tustin facility and
  unanimously supported the development of the site
  for MHSA programs

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Wellness Center Planning Committee

• Identified a list of components that should
• be included in a wellness recovery center
• Nourishing culture
• Green facility
• A safe place that is non-discriminatory
• Peer staffing
• Advisory board made up of at least
• 51 consumers

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Steering Committee

• 62 member committee composed of community
  members, consumers, and family members that
  represent a diverse cross-section of the
  community reviewed 6 presentations on Capital
  Facilities and Technological Needs

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Stakeholder Meetings

• Workforce Education and Training (WET) meetings
  discussed using the property for a Recovery
  Education Institute and a vocational training
  program
• Capital Facilities and Technology Advisory Board
  met regarding programs to be housed on the
  property, creating a timeline, and determining
  the spilt of funds
• Mental Health Board presentations and Public
  Hearing

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3. Capital Facilities Needs

• North Orange County 401 S. Tustin
• Centrally located with easy access for public
  transportation
• Has Conditional Use Permit to allow residential
  program on site
• Property can accommodate three 7,500 sq. ft.
  buildings with green belts and outdoor activity
  areas
• South Orange County to be determined

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4. Technological Needs

• Electronic Health Record (EHR) plans to
  implement an EHR lite system
• By end of 2008 will have accomplished the
  Practice Management phase with the implementation
  of scheduling.
• Build the Clinical Data Management component to
  create clinical assessments, treatment plans, and
  progress notes on line.

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Component Proposal Timeline
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Project Schedule

• Feasibility Study Phase
• Programming Phase data collection/staff
  interviews
• Schematic Design Phase preliminary design
  development drawings

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Alan Albright

• Prevention and Early Intervention Coordinator

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Through the Prevention and Early Intervention
(PEI) component, the MHSA provides funding to

• Develop universal and selective interventions and
  programs to help prevent the development of
  serious emotional or behavioral disorders and
  mental illness.
• Provide shortduration, low-intensity
  interventions to avoid more extensive mental
  health services or to prevent a mental health
  problem from getting worse.
• Create PEI interventions that are distinct from
  Community Services and Support services.
• Engage persons prior to the development of SMI or
  SED.
• Alleviate the need for additional mental health
  treatment and/or transition to extended mental
  health treatment.

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KEY TO TRANSFORMATION HELP FIRST

• To facilitate accessing supports at the earliest
  possible signs of mental health problems and
  concerns, PEI builds capacity for providing
  mental health early intervention services at
  sites where people go for other routine
  activities (e.g., health, education, community
  organizations).(DMH PEI Guidelines Sept. 2007,
  page 2)

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PEI PROJECTS

• Each PEI project should be designed to address
  one or more PEI Key Community Mental Health
  Need Disparities in Access to Mental health
  Services Psychosocial Impact of Trauma
  At-Risk Children, Youth, and Young Adult
  Populations Stigma and Discrimination
  Suicide Risk
• and one or more PEI Priority Population
  Underserved Cultural Populations Individuals
  Experiencing the Onset of Serious
• Psychiatric Illness Trauma
  Exposed Children/Youth in Stressed Families
  Children/Youth at Risk of School Failure
  Children/Youth at Risk of Juvenile Justice
  Involvement

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PEI PRIORITY AGE

• PEI County Plans will address all age groups,
  however, a minimum of 51 of the overall County
  PEI budget must be dedicated to individuals who
  are between the ages of 0-25.

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NON-SUPPLANTATION

• Funds must be used for programs authorized in
  Section 5892 of the WI Code.
• Funds cannot be used to replace other state or
  county funds required to be used to provide
  mental health services in fiscal year 2004-05
  (the time of enactment of the MHSA).
• Funds must be used on programs that were not in
  existence in the county at the time of enactment
  of the MHSA (new programs) or to expand the
  capacity of existing services that were being
  provided at the time of enactment of the MHSA
  (11/02/04).

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ALLOWABLE EXPENSES

• Personnel (such as mental health professionals,
  culturally/linguistically competent family
  liaisons, program managers)
• Operating costs (such as curricula and other
  educational materials, supplies, travel,
  equipment and facilities rental)
• Subcontracts (such as professional services for
  training or program evaluation)

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NON-ALLOWABLE EXPENSES

• Filling gaps in treatment and recovery services
  for individuals who have been diagnosed with a
  serious mental illness or serious emotional
  disturbance
• Capital projects or housing
• Technology projects
• Workforce Education and Training activities (as
  described in the Workforce Education and Training
  Component Proposed Three Year Program and
  Expenditure Plan Guidelines) in the following
  categories
• Mental Health Career Pathway Programs
• Residency, Internship Programs
• Financial Incentive Programs
• Broad social marketing campaigns
  (State-administered projects will support this
  activity)
• Development of new training curricula
  (State-administered projects will support this
  activity)

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ORANGE COUNTYS PEI PLANNING PROCESS

• Community Information 
• http//www.ochealthinfo.com/mhsa/pei/
• Community Input
• Regional Focus Groups and Stakeholder Meetings
• Community and Organizational Surveys
• Recommended Planning Partners
• Underserved Communities
• Education
• Client and Family Member Organizations
• Mental Health Providers
• Health
• Social Services
• Law Enforcement

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COMMUNITY AND STAKEHOLDER PRIORITIES

• Ten most frequently identified PEI
  program/service needs
• 1. Culturally competent outreach/engagement,
  care coordination, information/referral,
  follow-up assistance, consultation targeting
  at-risk populations (e.g., 211/mobile/senior
  center IR/Friendly Visitor, ER/hospital,
  MD-based, etc.)
• 2. PEI/mental health early intervention/counseli
  ng/ support groups/substance abuse/trauma
  resources for children, teens, parents, care
  givers, spouses, seniors, military families in
  community/home-based, school, primary care, and
  culturally competent settings.
• 3. Culturally competent PEI/mental health
  training/ education for professionals (schools,
  health, law enf., faith-based, SSA, caregivers,
  etc.)

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COMMUNITY AND STAKEHOLDER PRIORITIES

• 4. Community information / education / training
  / stigma reduction campaigns (culturally
  competent media / community / web-based)
• 5. Community-based assessment/ screening /early
  identification at various service sites for all
  individuals / ages
• 6. Volunteer / mentor / peer counselor resources
  for children, TAY, adults, parents, and seniors

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COMMUNITY AND STAKEHOLDER PRIORITIES

• 7. School-based PEI / mental health /
  family-focused resources (screening / early
  identification, PBIS, SARB resources, etc.)
• 8. PEI-focused / community-based socialization,
  after school, arts, recreational, life skills,
  nutritional resources, etc.
• 9. Culturally competent parenting resources,
  classes, education, information
• 10. OC-based suicide hotline, crisis services,
  warm line services, resources

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Next Steps
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Kimari Phillips

• Community Organizational Surveys
• Involving OC MH Consumers Providers
• in the
• Prevention Early Intervention
• Planning Process

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Data Collection Methods

• Surveys (online printed)
• Organizational
• Community (Spanish, Vietnamese, English)
• Stakeholder Meetings
• Focus Groups

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Survey Measures

• A collaborative team from OCHCAs
• Behavioral Health Services
• Quality Mgmt Planning Research
• Two comprehensive surveys for OC
• Organizational Providers
• Community/Consumers

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Survey Dissemination

• Mailed over 3,000 surveys to OC organizations and
  community members
• Handed out over 5,000 surveys throughout OC at
  meetings, clinics, community based organizations,
  etc.
• E-mailed announcements regarding the online
  surveys (including a hyperlink for easy access)

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Mail E-mail Distribution

• CBOs Family/Senior Resource Centers
• City County Offices
• Law Enforcement Legal Services
• Educational Institutions
• Faith-based Organizations
• Financial Institutions Foundations
• Housing Transportation Agencies
• Medical, Mental Health, Social Services
• Utility Companies Media

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Surveys Received to Date

• Community (n 1,329)
• 78 Print (n 1035)
• 22 Online (n 294)
• 85.5 English (n 1136)
• 11.4 Spanish (n 152)
• 3.1 Vietnamese (n 41)
• Organizational (n 380)
• 74 Print (n 281)
• 26 Online (n 99)

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General Types of Respondents

• MH Providers/Advocates
• Non-MH Providers Other Government Agencies
• Interested Community Members and MH Consumers

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Information Gathered from OC Community
Members/Consumers

• Satisfaction with amount accessibility of PEI
  services in OC
• Demographic info (age, gender, race/ethnicity,
  annual household income, ZIP code)
• Opinions regarding
• Populations in greatest need of PEI in OC
• Priority PEI issues in OC communities
• Most effective settings for identifying OC
  residents with a need for PEI services
• Best approaches for addressing PEI in OC

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Preliminary Data Analysis Results

• Community PEI Survey
• Orange County

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Race/Ethnicity of Community Respondents (n426)
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Age Gender of Community Respondents

• Average Age (n420)
• 45.2 years (15-89 yrs)
• Gender (n432)
• 71.1 Female
• 28.9 Male

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Average Annual Household Income
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Community Opinions Regarding Priority
Populations for PEI in OC(Averages on a 5-point
scale, where 1Very Low Need, 5Very High Need)
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Community Opinions Regarding Priority
Goals/Needs for PEI in OCReduction of
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Community Opinions Regarding Effective Settings
for Identifying OC Residents Needing PEI Services
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Community Opinions RegardingBest
Approaches/Strategies for Addressing PEI in OC
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There are enough existing PEI resources and
services in OC. (n436 public responses,
average1.87 on a 5-point scale, where 1Strongly
Disagree, 5Strongly Agree)
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There is enough information available about how
to find and access existing PEI resources and
services in OC. (n432 public responses,
average1.97 on a 5-point scale, where 1Strongly
Disagree, 5Strongly Agree)
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Sample of Community Respondent Suggestions for OC
PEI Services (Related to Provider Needs)

• Focus on a strength-based model instead of
  pathology and symptoms
• More training opportunities for employees
• Funding should provide for safe placement of MI
• Needs to be a way to keep MI in Tx on meds
• Support community infrastructure non-profits
  which provide referrals and public education
• Increase number of small, short-term triage
  centers where law enforcement can drop off pts
• Need to support existing programs while trying to
  expand services to at risk populations

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Sample of Community Respondent Suggestions for OC
PEI Services (Related to Consumer Needs)

• Need for on-site technical assistance in schools,
  especially in all preschools child care centers
• More counselors free counseling at school sites
• More accessible services for single parents/kids
• Advertise on TV, radio, local papers, etc.
• Training for family members of newly diagnosed
• Bilingual services in South OC are severely
  limited
• More housing options (with SUPPORT) for MI
• Ability to see a professional sooner once a
  referral is made. Weve been waiting over 6
  months.

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Information Gathered from Organizational
Providers in OC

• Types of organizations serving OC community
• Populations, ages numbers served in OC
• Types of PEI services provided
• Annual budget and percent allocated to PEI
• Priority goals for PEI in OC
• Satisfaction with number of PEI resources
  amount of info to find/access PEI services in OC
• PEI resources needed by OC providers
• How OC can best deliver PEI svcs to underserved

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Preliminary Data Analysis Results

• Organizational PEI Survey
• Orange County

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Types of Respondent Organizations (Potential
PEI Partners)
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Provider Opinions Regarding Priority Goals/Needs
for PEI in OCReduction of
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There are enough existing PEI resources and
services in OC. (n372 provider responses,
average1.72 on a 5-point scale, where 1Strongly
Disagree, 5Strongly Agree)
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There is enough information available about how
to find and access existing PEI resources and
services in OC. (n377 provider responses,
average1.85 on a 5-point scale, where 1Strongly
Disagree, 5Strongly Agree)
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PEI Resources Needed by Respondent Organizations
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Strategies to Reach Underserved Groups with PEI
Services
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Sample of Organizational Respondent Suggestions
for OC PEI Services (Related to Provider Needs)

• Full partnership between public/private providers
• Bring services to the people at school, work,
  home, malls, EDs, government offices (e.g., DMV,
  HCA)
• Web-based Efforts to Outcomes tracking system
• Promote more screening at clinics doctor
  offices
• Keep funding Family Resource Centers
• Administer assessment tool at school enrollment
• Attention to alcohol and drug abuse Tx community
• Ongoing education for educators, med providers,
  etc
• Involve leaders from faith-based communities

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Sample of Organizational Respondent Suggestions
for OC PEI Services (Related to Consumer Needs)

• Community education seminars by area
  professionals
• More groups for DV, anger mgmt, coping skills,
  etc
• More culturally/linguistically sensitive services
  staff
• TV ads with information for parents teens
• More drop-in centers available for homeless
• Services for underserved workforce in South OC,
  e.g., some areas with up to 90 Hispanic
  residents
• Increase awareness of early signs of MH problems
• Increase accessibility to low-cost
  counseling/referral
• Tx for the whole individual (physical
  psychological)

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Next Steps (July 08)

• Continue analyzing survey data (including surveys
  received by 6/30/08)
• Report findings to BHS re
• Public opinions re priority populations,
  settings, issues goals for PEI in OC
• Satisfaction ratings for amount and accessibility
  of PEI resources/services in OC
• Suggested PEI goals, strategies, settings,
  approaches, etc. for reaching those in need

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For more information regarding methods used for
data collection, preliminary analyses, or this
summary of results

• Contact
• Kimari Phillips, MA, CHES
• Research Analyst, OC Health Care Agency
• Office of Quality Management
• Planning Research
• [phone]
• kphillips_at_ochca.com

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Sharon Browning

• Review of
• Steering Committee Guidelines

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Role of the Steering Committee

• Be fully educated about the status of State MHSA
  funding availability and requirements and the
  status of OC MHSA program implementation.
• Support the Countys ability to meet both state
  funding requirements and Orange County funding
  needs.
• Make timely, effective decisions that maximize
  the amount of funding secured by Orange County
  and preclude Orange County from losing funding
  for which it is potentially eligible.

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Role of the Steering Committee

• Ensure that funding is allocated to services for
  identified needs and priorities.
• Support and ensure the proper implementation of
  Orange Countys MHSA approved plan for each MHSA
  component and the MHSA Integrated Plan, when it
  is developed.
• Remain informed about Stakeholder Focus Group and
  Community Advisory meetings and the
  recommendations made by members of these groups.

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Decision-Making

• Decisions will be made via consensus.
• Consensus is defined as agreement of all
  committee members or the decision will not move
  forward.
• A yes means that the decision will be actively
  supported or at a minimum nothing will be done to
  undermine the success of the decision.
• A no means that the proposed decision cannot
  move forward.
• The goal in effective consensus decision-making
  is to find ways to say yes wherever possible
  and to say no only when absolutely necessary
  and when prepared to stop the proposed decision
  as stated from moving forward.

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Decision-Making

• Only those representatives officially designated
  to participate in decision-making by their
  organization may participate in
  discussions/decisions and sit at the Committee
  tables.
• There will be time for Public Comment at the end
  of each meeting. Each comment should be limited
  to three minutes.

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Break
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Sharon Browning

• PEI Planning Guidelines

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Planning Guidelines

• PEI Vision Statement
• Purpose of the PEI Planning Process
• Key PEI Community Mental Health Needs
• PEI Priority Populations
• Planning Structure

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Guiding Principles

• Difference Between CSS and PEI
• Age Distribution of Funding
• PEI Transformational Concepts
• Non-Supplantation Requirement

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Planning Process

• Review Needs Assessment Data
• Workgroup, PEI Sub Committee, and HCA Staff Draft
  Recommendations
• HCA Staff Presents Recommendations to the
  Steering Committee
• Steering Committee discuss recommendations
• Make suggestions for changes, if needed
• Come to consensus on final recommendations

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Next Steering Committee Meeting

• Monday, August 4, 2008 100-400 PM
• at
• Delhi Community Center
• 505 East Central, Santa Ana, CA 92707