Santa Clara County
Mental Health Services Act Planning
CSS Three-Year Plan
A Presentation to the
Board of Supervisors
December 13, 2005
Department of Mental Health
SCVHHS
Overview of
MHSA Components
Six phased-in components completed
through a state and local stakeholder
involved process:
1.
Community Program Planning (5%)
2.
Community Services and Supports (50%)
3.
Capital and Information Technology (10%)*
4.
Education and Training (10%)*
5.
Prevention and Early Intervention (20%)*
6.
Innovation (5%)*
*requirements and allocation method undetermined
Current Plan
Before the Board
 Community Services & Supports Plan

Santa Clara: $13.4 Million x 3 yrs

Broad stakeholder process required

51%+ in Full Service Partnerships

49% System Development/Outreach

Public Hearing hosted by Mental Health Board

Subject to DMH approval

Each distinct program must be approved/denied
Santa Clara County
State Dept. of
Mental Health
Accountability
Commission
MHSA Planning
Structure
Board of
Supervisors
Mental Health
Board
BOS Committees
(HHC, CSFC, PSJC)
County Executive
SCVHHS Exec. Dir
MHSA Stakeholder
Leadership Committee
Ethnic Community
Advisory
Committees
Focus
Group
Work Group &
Strategy Teams
Transition Age
Youth
16-25 Years
Work Group &
Strategy Teams
Children &
Youth
0-15 Years
Work Group &
Strategy Teams
Adults
26-59 Years
Project
Management
Team
Work Group &
Strategy Teams
Older Adults
60+ Years
Community Stakeholder Forums, Focus Groups, and
Consumer Engagement Groups
Focus
Group
Cultural
Competency
Wellness and
Recovery
Focus
Focus
Group
Group
Evidenced Based
Practices
MHSA Vision &
Requirements
Ethnic Community
Advisory
Committees
Focus
Group
Plan Requirements
The Three-Year CSS Plan
1
2
3
Identify
Community
Concerns for
All Ages
Determine
Unmet
Need
Identify
Specific
Populations
for Focus
4
Identify
strategies
to Meet
Need
Stakeholder Process

Major Inreach and Outreach Campaign
regarding Critical Concerns and needs from
March through June – 10,000 voices have
been heard through meetings and surveys!

Stakeholder Leadership Committee convened and endorsed critical concerns,
focal populations & draft plan
recommendations from Work Groups,
Strategy Teams, and Ethnic Community
Advisory Teams
Most Frequently
Noted Concerns

Across all Age Groups
–
–
–
–
–
–
–
–
–
In trouble with the law, incarceration
Concurrent substance abuse
Abuse, neglect, violence, trauma
Sadness, depression, loneliness, isolation
Poverty, homelessness, inadequate housing
Failing school & jobs, meaningless activities
Concurrent medical problems
Institutionalization, hospitalization
Problems with family and peers
Focal Populations
Defined Per Requirements
Children
1.
2.
3.
4.
Zero to Five Years High Risk
Foster Care Youth
Juvenile Justice Involved Youth
Underserved Seriously Emotionally Disturbed
5.
6.
First Time Psychosis
Sixteen to 25 Years Aging Out of Child Systems
Transition Age Youth
Adults
7.
8.
Jail Involved/Homeless/Dual Diagnosed SMI
Underserved/Un-served SMI
9.
High Risk/Homebound SMI Seniors
Older Adults
Estimates of Unmet
Need

Based on 200% of poverty population by prevalence
estimates (FY03 service data)
AGE
Fully
Served
Served
Underserved
Unserved*
0-15
250
4,147
751
3,159
16-25
137
3,891
1,302
1,172
26-59
52
11,608
2,517
3,977
60+
2
2,410
285
622
Total
441
22,056
4,855
8,930
(2%)
(100%)
(22%)
* Understated estimate of public need (closer to 300% of poverty) and prevalence among
certain populations (e.g. 8.5% general population vs. 50+% in jail, foster care, juvenile
justice)
Disparities in
Unmet Need



Latino, Asian and American Indian underserved among
all ages
Latino, African American and American Indian overrepresented in CJS, un-housed, and foster care with
greater need (prevalence) and less served
Refugee, immigrant and monolingual greater need and
less served

LGBTQ greater need and less served

Developmentally disabled greater need and less served
Overview of
Recommendations
Children 0-15

C-01 Full Service Partnerships

C-02 Zero to Five System Development -
– 30 slots;
est. $20K per year per child, with up to 30% to
support stable living/housing; emphasis on Latino,
African American, and American Indian juvenile
justice involved and youth without insurance.
to develop inter-agency infrastructure to support 0-5
year olds, includes planning; screening/assessment
design; training of specialists; family support and
system navigation for monolingual Latino and
Vietnamese families.
Children 0-15

C-03 Behavioral Health System
Development – System-wide implementation of
improved screening, assessment and best practice
models of treatment; specialized access and care
management of juvenile justice and foster care
populations. Emphasis on underserved Latino, Asian,
African American, American Indian youth and
families.
Transition Age Youth
15 – 25 Years

T-01 Full Service Partnerships – 30 slots; est. $20K
per year per youth, with up to 30% to support stable
living/housing; emphasis on Latino, African American, and
American Indian exiting juvenile justice and foster care
systems.

T-02 Behavioral Health System Development
System-wide implementation of improved screening,
assessment and best practice models of treatment;
specialized access and care management of youth childserving systems. Emphasis on underserved Latino, Asian,
African American, Native American youth and families.
Transition Age Youth
15 – 25 Years

T-03 Crisis & Drop-In Services and Supports
safe, non-stigmatizing access to mental health and basic
services.

T-04 Education Partnership – Integrated “middle
college” and community college support to improve
“school success” of youth with mental health concerns.
Adults 26-59

A-01 Full Service Partnerships

A-02 Behavioral Health Recovery Services
– 75 slots; est.
$20K per year per client, with up to 30% to support
stable living/housing; emphasis on Latino, African
American, Asian and American Indian, homeless,
institutionalized, and frequent ER users with severe
mental illness.
–
to redesign county adult outpatient services to include
consumer and family support staff; add support and case
management staff; and to introduce best practice
strategies and align and establish therapeutic caseload
size.
Adults 26-59

A-03 Jail Aftercare and Recovery Services – ($2.5 M
proposed to satisfy Jail Task Force solution #15) for
criminal justice involved mentally ill:
 Full Service Partnerships - 75 slots; est. $20K per
year per client, with up to 30% to support stable
living/housing; emphasis on Latino, African American,
and American Indian;
 Enhanced Treatment Court – 60 slots for case
management and service linkage;
 Dual-Diagnosis After Care Treatment – 125 slots for
medication and case management services;
 Expanded Housing Options – 75 beds; Transitional
Housing Units (THU)
Adults 26-59

A-04 Adult Urgent Care and Crisis Support –
Establishes urgent care and mobile crisis response in
north, central and south county regions.

A-05 Consumer and Family Self-Help SupportEstablishes Director of Consumer Affairs and Director
of Family Support and Education, in addition to
expanded consumer and family self-help with focus
on unserved and underserved ethnic and cultural
communities.
Older Adults 60+

OA-01 Full Service Partnerships – 25 slots; est.
$20K per year per client, with up to 30% to support
stable living/housing; emphasis on those in or at risk
of homelessness, institutionalization, incarceration;
physical and emotional harm.

OA-02 Behavioral Health Services – System-wide
implementation of improved screening, assessment
and best practice models of treatment; specialized
access and care management of older adults;
expanded service to senior day programs.
Older Adults 60+

OA-03 Senior Mobile Assessment & OutreachProvides specialized mobile assessment and outreach
services to shut-in and homebound mentally ill
seniors, many of whom are experiencing concurrent
medical and substance abuse problems; focus on
monolingual seniors.

OA-04 Senior Family and Caregiver Support –
Provides culturally appropriate family and caregiver
support and education to those caring for mentally ill
seniors.
Support Staff

2.0 Full Service Coordinators

1.0 Training Director

2.0 Q.I./U.M. Coordinators

1.0 Utilization Management Analyst

1.0 Cultural Competency Coordinator
Crosscutting
Strategies

State requirements allow up to 6
months ($6.7 million) of FY06 funds to
be used for one-time expenses over
three years. These funds are proposed
to support several age-based plans in
addition to several cross-cutting
initiatives.
Crosscutting
Strategies

HO-01 – Housing Options –
 Establishes $2 million fund to develop housing
options in collaboration with Office of
Affordable Housing. Upon State approval of this
proposal, MHD and OAH will jointly design
expenditure plan with assistance of housing
experts, and will bring back to BOS for
approval. Objective will be to leverage these
funds in order to maximize the establishment of
ongoing permanent housing for the mentally ill
in Santa Clara County.
Crosscutting
Strategies
 Housing Component Summary
 Full Service Partnerships (C-01, T-01, A-01, A-03
and OA-01). Est. $2-3 Million (30% of annual resources)
will go to securing and maintaining stable permanent living
for clients.
 MHSA Housing Fund (HO-01) - $2 Million to develop
permanent housing resources.
 Jail Aftercare & Recovery (A-03) - $625,000 for 75
Transition Housing Units dedicated to jail aftercare. Length
of stay and provider requirements will be determined
through collaboration with Jail Task Force members.
Crosscutting
Strategies

FH-01 – Community & Family Outreach
and Engagement Initiative – to develop
culturally competent outreach and engagement
strategies to underserved populations.

HC-01 – Behavioral & Primary Health Care
Partnership – to establish integrated pilot
primary care services for clients of the mental
health system.
Crosscutting
Strategies

EE-01 – Education, Employment, and SelfSufficiency Services - to develop
comprehensive education, employment and
benefit assistance system for all clients of the
system.

ST-01 – Regional Survivors of Torture
Treatment Services – to establish regionally
available specialty treatment services for Bay
Area refugee survivors of torture.
Total CSS Funding Allocations
FY06 – FY08
Age 16-25
$4.9m
13%
Age 26-59
$17.4m
46%
Age 0-15
$3.8m
10%
Admin
$3.4m
9%
Age 60+
$3.8m
10%
Cross Cutting
$4.6m
12%
FY09 and Beyond



Following initial Three-Year Plan County
will submit renewal plan
Increased revenues expected in future
years to finance one-time initiatives and
expand strategies to further populations
MHD may revise strategies depending
on outcomes achieved with DMH
approval
Timeline

October 28th -
Leadership Committee Endorsed Plan

November 29-30th - Public Hearings

December 5th -
Mental Health Board Endorsed Plan

December 7th -
Proposed Plan to HHC

December 13th –
Proposed Plan to BOS

December 30th –
Final Plan to State DMH

January – April –
RFP Process, Training, Start-Up

April – Jan 07 –
Implementation of Programs