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Overview
In November 2004, Proposition 63 was passed and has become the Mental Health Services Act (MHSA). The MHSA is intended to change the public mental health system into a more effective, culturally competent, consumer/family driven system, with a focus on recovery and choice. The funding comes from a 1% tax on California residents with earned incomes of over $1 million a year. In order to gain approval by the State Department of Mental Health, each County's planning process must meet specific requirements including extensive community and consumer input. There are several components to the MHSA that will be rolled out over the next few years: Community Services & Supports; Capital Facilities & Information Technology; Early Intervention & Prevention; Workforce Education & Training; and Innovative Programs.
Counties are beginning to implement the first major component, Community Services & Supports. By State regulation, the majority of the new Community Services & Supports funds must be spent on providing intensive services to a relatively small group of consumers who will be offered Full Service Partnerships. Full Service Partnership combines the notion of fully "wrapping services around" an individual or family with "whatever it takes" to clear the way for each individual to achieve his/her own recovery. A lesser amount of funds are available to strengthen the overall infrastructure of the mental health system, or Systems Development Strategies.
Contra Costa County held a community planning process in 2005. Community members were chosen to participate on Stakeholder Planning Groups for four target age groups. Consumers and family members were surveyed, and data about needs was gathered. Stakeholder Planning Groups identified specific populations to be served within the four age groups of children, transition-aged youth, adults, and older adults. Key elements of Contra Costa's MHSA program are that it is person-centered, guided by a recovery vision; culturally competent; and consumer/family-driven. Contra Costa will be taking a Housing First approach-which recognizes that consumers are more responsive to interventions, services and support after they are in their own housing, rather than while living in emergency or temporary/transitional facilities. Contra Costa's plan provides rental assistance for Full Service Partner enrollees, along with one-time funding for future, permanent supportive housing.
Contra Costa's Initial Programs
- Children: The population to be served is children in Far East County with repeated failure in learning environments including childcare, preschool, school, and home, and who are from families at or below 300% of the poverty level and not eligible for other funding sources. A total of 100 children and their families will be served in the next two years. Far East County was chosen as the initial service area because there are currently limited mental health services in the community. Two 24-hour per day/7 days per week (24-7) teams will provide one-stop availability of services including crisis stabilization, care management, community and school linkages, housing if needed, and other community services and supports as needed to enhance resiliency. Services are individualized, based on the wrap-around philosophy of community-based services. This is a Full Service Partnership program.
- Transition Aged Youth: The target population is youth, aged 16-25, living in the West County area, with serious emotional disturbances or serious mental illness, who are homeless or at imminent risk of homelessness. 135 transition-aged youth will be served in the next two years. Supported housing is central to this progressive recovery-based program. A 24-7 service team will conduct outreach and engagement, and personal service coordination which may include educational and vocational supports, wellness recovery peer programs, substance abuse treatment, and financial counseling. The team will link consumers with other services and resources to support community integration. This is a Full Service Partnership Program.
- Adults to Age 60: West County adults with serious mental illness, who are homeless or at serious risk of homelessness, and who are not currently being served by County Outpatient Mental Health Services will be eligible for the Adult Full Service Partnership. 150 adults will be served in the next two years. Supported housing is central to this progressive recovery-based program. Two 24-7 service teams will conduct outreach and engagement, and personal service coordination which may include educational and vocational supports, wellness recovery peer programs, substance abuse treatment, financial counseling, and will serve as liaisons to the justice system. The team will link consumers with other services and resources to support community integration.
- Older Adults Program: The Older Adult program will serve seniors throughout the county with three regional teams that will provide outreach, engagement and on-going services to the most imperiled seniors in the county. Services will be both home and clinic-based. Clinic-based services will be integrated with primary care to allow for combined medical and psychiatric care in the same visit. This core structure will allow expansion for more comprehensive services and increased service volume in the future. It is anticipated that 425 clients will be assessed in the first year with 225 of those clients becoming active for ongoing care management services. This program is a Systems Development Strategy.
Systems Development Strategies
Additionally, funds have been allocated to support strengthening the infrastructure of the existing service delivery system of Contra Costa Mental Health. This includes:
- Expanding the Office for Consumer Empowerment to have a stronger consumer leadership training program, SPIRIT, and to provide stipends for training placements. The Office for Consumer Empowerment (OCE) works to empower consumers to play an active role in transforming our mental health system.
- Hiring of a Wellness Nurse to develop a physical wellness program to support consumers to be in charge of their wellness and to manage the physical effects of medications.
- Hiring of Peer Benefits Advocates to work with consumers and family members.
- Hiring of Bilingual Family Partners for Children's Services and hiring of additional Adult Family Coordinators for Adult Services.
- Coordinated planning efforts around Transportation and Co-occurring Mental Health/Substance Abuse treatment; and Division-wide staff training.
For further information:
www.cchealth.org/services/mental_health/ (click on Mental Health Services Act) or contact Kimberly Mayer, MHSA Project Manager at kmayer@hsd.cccounty.us; or at 925-957-5132.
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