Loading...
HomeMy WebLinkAboutMINUTES - 10072014 - D.8RECOMMENDATION(S): ACCEPT the recommendation of the Behavioral Health Services Director to adopt the draft Mental Health Services Act (Proposition 63) Three Year Program and Expenditure Plan, Fiscal Years 2014/15 through 2016/17. AUTHORIZE and DIRECT the Chair of the Board of Supervisors to send a letter to that effect to the Mental Health Services Oversight and Accountability Commission (MHSOAC) to inform the MHSOAC of their approval of the adoption of this plan. FISCAL IMPACT: Adoption of the Mental Health Services Act Three Year Program and Expenditure Plan, Fiscal Years 2014-2015 through FY 2016/17 assures continued MHSA funding for Fiscal Years 2014/2015 through 2016/2017 in the amount of $127,844,238. BACKGROUND: Proposition 63 was passed by California voters in the November 2004 election. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 10/07/2014 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor Contact: Cynthia Belon, 957-5501 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: October 7, 2014 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: D.8 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:October 7, 2014 Contra Costa County Subject:Mental Health Services Act (Proposition 63): Three Year Program and Expenditure Plan for Fiscal Years 2014/15 through 2016/17 BACKGROUND: (CONT'D) Now known as the Mental Health Services Act (MHSA), the legislation provides public mental health systems by imposing an additional one percent tax on individual, but not corporate, taxable income in excess of one million dollars. There are a total of five MHSA components which have been rolled out over time by the State Department of Mental Health with the goal of creating a better program of mental health services and supports in California’s public mental health systems. The five components include: Community Services and Support; Prevention and Early Intervention; Workforce Education and Training; Capital Facilities and Technology Needs; and Innovation. There are multiple programs operated within each component. This is a state mandated program under Welfare & Institutions Code. CLERK'S ADDENDUM Speakers: Lauren Rettagliata, resident of Danville; Teresa Pasquini, resident of El Sobrante; Douglas Dunn, resident of Antioch; Peter Mantas. CONTINUED the matter to October 28, 2014. ATTACHMENTS MHSA Three Year Plan Letter of Approval       Contra Costa County  Mental Health Services Act           Three Year Program and Expenditure Plan  Fiscal Years 2014 – 15 through 2016 ‐ 17      1    Introduction We are pleased to present Contra Costa County Mental Health’s (CCMH) integrated Mental Health Services Act (MHSA) Three Year Program and Expenditure Plan. This plan starts July 1, 2014, and integrates the components of Community Services and Supports, Prevention and Early Intervention, Innovation, Workforce Education and Training, and Capital Facilities/Information Technology. This Plan describes county operated and contract programs that are funded by MHSA, what they will do, and how much money will be set aside to fund these programs. Also, the plan will describe what will be done to evaluate their effectiveness and ensure they meet the intent and requirements of the Mental Health Services Act. California approved Proposition 63 in November, 2004, and the Mental Health Services Act became law. The Act provides significant additional funding to the existing public mental health system, and combines prevention services with a full range of integrated services to treat the whole person. With the goal of wellness, recovery and self- sufficiency, the intent of the law is to reach out and include those most in need and those who have been traditionally underserved. Services are to be consumer driven, family focused, based in the community, culturally and linguistically competent, and integrated with other appropriate health and social services. Funding is to be provided at sufficient levels to ensure that counties can provide each child, transition age youth, adult and senior with the necessary mental health services, medications and support set forth in their treatment plan. Finally, the Act requires this Three Year Plan be developed with the active participation of local stakeholders in a community program planning process. Thus the Mental Health Services Act not only provides additional funding, but also provides a philosophical framework for the entire Behavioral Health System to successfully provide care to those whose needs are greatest. 2    Table of Contents Introduction…………………………………………………………………………………..1 Vision…………………………………………………………………………………………3 The Community Program Planning Process…………………………………………….4 The Plan…………………………………………………………………………………….16 - Community Services and Supports (CSS)…………………………………….. 16 - Prevention and Early Intervention (PEI)…………………………………………30 - Innovation (INN)……………………………………………………………………42 - Workforce Education and Training (WET)………………………………………47 - Capital Facilities/Information Technology (CF/TN)…………………………….51 The Budget…………………………………………………………………………………54 Evaluating the Plan………………………………………………………………………..58 Acknowledgments…………………………………………………………………………60 Appendices - Mental Health Service Maps………………………………………………….....A-1 - Program and Plan Element Profiles…………………………………………….B-1 - Glossary………………………………………………………………………...…C-1 - Certifications, Funding Summaries…………………………………………..…D-1 - Public Comment and Hearing…………………………………………………...E-1 - Board Resolution………………………………………………………………….F-1 Note. Program and plan element profiles and a glossary section are included in the Appendices to provide more information regarding a specific program or plan element, and to assist in better understanding terms that are used. The electronic version of this document utilizes hyperlinks, in which the reader may click on a term or title and have immediate access to the information. The Table of Contents also utilizes hyperlinks, whereby the reader can click on the page number and have immediate access to the desired section. To return, click on the program title, or glossary term. 3    Vision The Mental Health Services Act serves as a catalyst for the creation of a framework that calls upon members of our community to work together to facilitate change and establish a culture of cooperation, participation and innovation. We recognize the need to improve services for individuals and families by addressing their complex behavioral health needs. This is an ongoing expectation. We need to continually challenge ourselves by working to improve a system that pays particular attention to individuals and their families who need us the most, and may have the most difficult time accessing care. During this past year we asked our consumers, their families and our service providers to describe mental health care that works best. The following elements emerged: Access. Programs and care providers are most effective when they serve those with mental health needs without regard to Medi-Cal eligibility or immigration status. They provide a warm, inviting environment, and actively and successfully address the issues of transportation to and from services, wait times, availability after hours, services that are culturally and linguistically competent, and services that are performed where individuals live. Capacity. Care providers are most appreciated when they are able to take the time to determine with the individual and his or her family the level and type of care needed and appropriate, coordinate necessary health, mental health and ancillary resources, and then are able to take the time to successfully partner with the individual and his or her family to work through the mental health issues. Integration. Mental health care works best when health and behavioral health providers, allied service professionals, public systems such as law enforcement, education and social services, and private community and faith-based organizations work as a team. Effective services are the result of multiple services coordinated to a successful resolution. We honor this input by envisioning a system of care that supports independence, hope, and healthy lives by making accessible behavioral health services that are responsive, integrated, compassionate and respectful. Cynthia Belon, L.C.S.W. Behavioral Health Services Director 4    The Community Program Planning Process The County has utilized the community program planning process to 1) identify issues related to mental illness that result from a lack of mental health services and supports, 2) analyze mental health needs, and 3) identify priorities and strategies to meet these mental health needs. In 2006 CCMH completed its first community program planning process under MHSA, and received funding for the Community Services and Supports component of the Act. The Prevention and Early Intervention component was approved in 2010, and the remaining components of Workforce, Education and Training, Innovation, Capital Facilities and Information Technology soon followed. Additional programs and services were incrementally approved and added each succeeding year as service needs were identified by means of the community program planning process. CCMH has consolidated all of these components into a single Plan, and its current MHSA funded programs and services are included in the Fiscal Year 2013-14 Plan Update. In addition to the above community program planning processes, CCMH continues to provide support and seeks counsel from an active stakeholder body, entitled the Consolidated Planning Advisory Workgroup (CPAW). Over the years these stakeholder representatives have provided input to the Mental Health Director as each MHSA component was developed and implemented. For the upcoming Three Year Plan CPAW has recommended that the Plan provide a more comprehensive approach that links MHSA funded services and supports to prioritized needs, evaluates their effectiveness and fidelity to the intent of the Act, and informs future use of MHSA funds. Thus the Plan can provide direction for continually improving not only MHSA funded services, but also influencing the County’s entire Behavioral Health System. Overview. With one million residents Contra Costa County is comprised of three distinct regions in the West, Central and Eastern parts of the county. It is estimated that potentially 60,000 of these individuals may be adults who have a serious mental illness, or are children and youth who have been diagnosed with a serious emotional disorder. Many of these individuals are faced with the compounding debilitating effects of poverty; the daily struggle with the basic necessities of food, clothing, employment, transportation, health care and a safe place to live. With the addition of MHSA funded services and supports CCMH now provides services to approximately 20,000 individuals who have a serious mental illness or serious emotional disturbance, and who cannot afford private mental health treatment. This ranks Contra Costa County’s 5    performance for providing services to this potentially eligible population in the top 25% of counties throughout the state. However, it is reasonable to conclude that the County will continue to operate in an environment where there are more people in need of public mental health services than there are resources to meet this need. It is within this context that the community program planning process was initiated in Fiscal Year 2013-14 in order to inform the direction of this Plan. Assessment of Need. During the months of September and October of 2013 Contra Costa County Mental Health initiated an assessment of need process in order to provide a preliminary identification of issues related to mental illness, and to assess mental health needs. Staff conducted a series of site visits to interview both individuals who provide services and individuals who receive services. These consumers, their families and mental health professionals were considered “key informants” who could provide a preliminary assessment of public mental needs throughout the county. A stratified sampling of 25 CCMH programs were selected to ensure representation from 1) all three regions of the county, 2) all four age groups (children, transition age youth, adults and older adults, 3) both county and contract operated services, and 4) all types of services, to include clinics, full service partnership programs, housing programs, wellness and recovery centers, prevention and early intervention programs, and CCMH administrative staff. The method for participation was small group discussions that were supplemented by surveys in English and Spanish that could be completed and mailed in by individuals who either chose to provide written input, or were not available for scheduled discussions. The agenda for the group discussions and format for the written surveys were the same; namely, the participants were asked to discuss 1) what the program, service provider or agency does well, 2) what the program, service provider or agency needs to improve upon, and 3) what needed mental health services and supports are missing. Over 300 consumers, family members, line staff, supervisors and senior staff actively participated in the discussions and/or completed surveys. Host agency staff arranged for consumers and family members to participate with them (in some cases separately) in the discussions, although all individuals were considered stakeholders without designation of affiliation during the discussions. A summary of the discussions and surveys was completed for each of the 25 sites, and the detailed results of this preliminary needs assessment was made available for the subsequent consumer, family member and service provider focus groups and the community forums that were conducted in January through March of 2014. 6    Focus Groups and Community Forums. Resource Development Associates (RDA) was contracted with to provide independent facilitation of the focus group and community forum phases of the community program planning process. Individuals with lived mental health consumer experience co-facilitated these group discussions with RDA staff in order to foster a safe environment for individuals to freely discuss issues they may not otherwise feel comfortable discussing. Focus Groups. 232 consumers and family members and 50 service providers met in small groups, provided their perceptions of priority mental health needs, and suggested ideas to address these needs. Eighteen consumer and family focus groups were conducted in all three regions of the County, with recruitment to each age group, underserved communities, persons experiencing homelessness, persons monolingual in Spanish, and individuals identifying as lesbian, gay, bi-sexual, transgender, or questioning their sexual identity. Four service provider focus groups were conducted, covering all geographic regions. RDA developed reports with participant feedback on strengths, gaps, barriers and proposed solutions for service access, quality, and sufficiency of services. Community Forums. Approximately 150 members of the public participated in three community forums that were held in the western, central and eastern parts of the county. RDA presented the accumulated input from the needs assessment and focus group events, and solicited additional feedback. Finally, RDA presented the results of the needs assessment, focus groups and community forums to the Consolidated Planning Advisory Workgroup, with the Mental Health Commission invited to attend. This event was also open to the public, and all in attendance were invited to provide input. The full preliminary needs assessment report and Resource Development’s subsequent report on the community program planning process can be found at: http://cchealth.org/mentalhealth/pdf/2014-0417-CCMHSA-Consoildated-Report.pdf . . Results. The following are broad themes taken from these detailed reports that enable informed decision-making regarding program direction and evaluation efforts. Stakeholders participating in the community program planning process identified the following significant shortfalls as priority needs, and weighed in on strategies to improve access to services, quality and levels of service provided, integration of effort, accountability, and stakeholder participation in planning and evaluation. Each theme includes a cross reference of where relevant program or plan elements are contained in the Plan. This Plan’s chapter on Evaluating the Plan outlines a process by which each 7    of the funded programs and plan elements will be assessed for the extent to which they address these needs. Access.  Getting to and from services. The cost of transportation and the County’s geographical challenges make access to services a continuing priority. Flexible financial assistance with both public and private transportation, training on how to use public transportation, driving individuals to and from appointments, and bringing services to where individuals are located, are all strategies needing strengthening and coordinating. o Relevant program/plan elements: Transportation assets and flexible funds to assist consumers get to and from services are included in supports provided in Full Service Partnerships. MHSA purchased vehicles to augment children, adult and older adult county operated clinic transportation assets, and additional staff are being hired through MHSA funding to drive consumers to and from appointments. A proposed Innovation Component program is being developed to provide a comprehensive, multi-faceted approach to transportation needs.  Navigating the system. Mental health and its allied providers, such as primary care, alcohol and other drug services, housing and homeless services, vocational services, educational settings, social services and the criminal justice system provide a complexity of eligibility and paperwork requirements that can be defeating. Just knowing what and where services are can be a challenge. Easy access to friendly, knowledgeable individuals who can ensure connection to appropriate services is critical. Suggested strategies include expanding the system navigation capacity by use of trained peer and family partners (both paid and volunteer), strengthening system emphasis on active collaboration among service providers, and improving timely response and efficiency of the County’s telephone access line. o Relevant program/plan elements: Family partners are stationed at the children’s county operated clinics to assist family members participate in wraparound services. Clinicians are stationed at adult operated clinics to assist consumers with rapid access and connectivity to services. The Women Embracing Life and Learning (WELL) program in the Innovation component has a public health nurse assist participants navigate health and behavioral health resources. The Workforce Education and Training Component contracts with NAMI to provide family to family training. Outside the scope of this Plan Behavioral Health Services has focused attention on improving the County’s Access Line as a single source of entry to mental health, alcohol and other drugs, and homeless services. 8     Cultural/linguistic appropriate outreach and engagement. Focus groups underscored that mental health stigma and non-dominant culture differences continue to provide barriers to seeking and sustaining mental health care. Emphasis should continue on recruiting and retaining cultural and linguistically competent service providers (especially psychiatrists), training and technical assistance emphasis on treating the whole person, and the importance of providing on-going staff training on cultural specific treatment modalities. Also, culture-specific service providers providing outreach and engagement should assist their consumers navigate all levels of service that is provided in the behavioral health system. Transition age youth, to include lesbian, gay, bi- sexual, transgender and questioning youth, who live in at-risk environments feel particularly vulnerable to physical harassment and bullying. Stakeholders continued to emphasize MHSA’s role in funding access to all levels of service for those individuals who are poor and not Medi-Cal eligible. o Relevant program/plan elements: Prevention and Innovation programs provide outreach and engagement to individuals and underserved populations who are at-risk for suffering the debilitating effects of serious mental illness. These programs are culture specific, and will be evaluated by how well they assist individuals from non-dominant cultures obtain the cultural and linguistically appropriate mental health care needed. The full service partnership programs in the Community Services and Supports component are to provide bi-lingual staff on their teams. The training and technical assistance category of the Workforce Education and Training component utilizes MHSA funding to sensitize service providers to the issues impacting cultural awareness and understanding, and mental health access and service delivery for underserved cultural and ethnic populations. Capacity.  Serve those who need it the most. Through MHSA funding the County has developed designated programs for individuals with serious mental illness who have been deemed to be in need of a full spectrum of services. These are described in the full service partnership category of the Community Services and Supports component. In spite of these programs stakeholders report that a number of individuals who have been most debilitated by the effects of mental illness continue to cycle through the most costly levels of care without success. Strategies put forth are to enact Assembly Bill 1421 (Laura’s Law), or to adapt elements of the law that more assertively applies a comprehensive, multi- disciplinary service response, such as that described in the assisted out-patient treatment model. Also, stakeholders recommended that full service partner 9    programs develop outcome data that could help determine and improve the level to which the most severely disabled are served. o Relevant program/plan elements: The County is studying the feasibility of implementing or adapting Assembly Bill 1421, or Laura’s Law, with the accompanying assisted out-patient treatment model. Planning efforts are taking place outside the MHSA community program planning process, as there are potential costs to the County outside of mental health treatment. At the time a proposal and budget is put forth for Board of Supervisor consideration, the impact, if any, on reduction or elimination of other mental health funded programs will be assessed. For Fiscal Year 13-14 two new full service partnership programs for transition age youth and adults were started in the Eastern part of the county. Their impact should be felt in the coming three years. The chapter entitled Evaluating the Plan describes a comprehensive program and fiscal review process that includes addressing whether programs serve those who need the service and achieve the outcomes that have been agreed upon.  Crisis response. Response to crisis situations occurring in the community needs to be improved for both adults and children. Crisis response now primarily consists of psychiatric emergency services located at the Contra Costa Regional Medical Center (CCRMC). There is fewer more appropriate and less costly alternatives. Suggested strategies include implementing the much anticipated crisis residential facility and assessment and recovery center being built and co- located with the CCRMC), developing mobile crisis teams, improving partnership with law enforcement, and building coordinated follow-up and support for individuals and their families after a crisis event. Stakeholders emphasized that crisis response from mental health providers needs to be available outside normal business hours. o Relevant program/plan elements: In addition to the implementation of the crisis residential facility and assessment and recovery center, CCMH has applied to the California Health Facilities Financing Association for state MHSA funding for a mobile, multi-disciplinary team for adults and older adults to be first responders to a psychiatric emergency occurring in the community. Seneca Family of Agencies contracts with the County as part of the Children’s Services full service partnership program, and provides a mobile response team for coordinating crisis support activities on behalf of youth and their families.  Housing and Homeless Services. The chronic lack of affordable housing make this a critical factor that affects the mental health and well-being of all individuals with limited means. However, it is especially deleterious for an individual and his/her family who are also struggling with a serious mental illness. Stakeholders 10    suggested a range of strategies that would increase housing availability, such as increasing transitional beds, housing vouchers, supportive housing services, permanent housing units with mental health supports, staff assistance to locate and secure housing in the community, and coordination of effort between Homeless Services and Contra Costa Mental Health. o Relevant program/plan elements: Unfortunately, sufficient affordable housing for all consumers of CCMH is beyond the financial means of the County’s Behavioral Health Services budget. It is estimated that up to 3,800 individuals in the County are homeless on any given night. However, the MHSA funded Housing Services category of the Community Services and Supports component is coordinating staff and resources with Homeless Services of the Behavioral Health Division in order to improve and maximize the impact of the number of beds and housing units available, shorten wait times, and improve mental health treatment and life skills supports needed for consumers to acquire and retain housing. In addition, evaluation efforts will focus attention on efforts to improve the overall quality of housing and supports, and to seek opportunities to move housing units within county boundaries.  Assistance with meaningful activity. Stakeholders underscored the value of engaging in meaningful activity as an essential element of a treatment plan. Youth in high risk environments who are transitioning to adulthood were consistently noted as a high priority. For pre-vocational activities, suggested strategies include providing career guidance, assistance with eliminating barriers to employment, and assistance with educational, training and volunteer activities that improve job readiness. Stakeholders highlighted the need for better linkage to existing employment services, such as job seeking, placement and job retention assistance. For daily living skills, suggested strategies include assistance with money and benefits management, and improving health, nutrition, transportation, cooking, cleaning and home maintenance skill sets. o Relevant program/plan elements: The prevention component lists a number of programs providing outreach and engagement to transition age youth. Approved for plan development in the Innovation component is a new and different pattern of service that will expand Contra Costa Vocational Services capacity to provide more pre-vocational services to enable greater access to existing employment services. Resource planning and management specialists, or money managers, are being added to the three adults clinics to assist consumers better manage financial and in-kind resources. All full service partnership programs are to provide money management services. Approved for plan development 11    in the Innovation component are the addition of peer and family partners to provide health and wellness coaching.  Children in-patient beds. In-patient beds and residential services for children needing intensive psychiatric care are not available in the county, and are difficult to find outside the county. This creates a significant hardship on families who can and should be part of the treatment plan, and inappropriately strains care providers of more temporary (such as psychiatric emergency services) or less acute levels of treatment (such as Children’s’ clinics) to respond to needs they are ill equipped to address. Additional funding outside the Mental Health Services Fund would be needed to add this resource to the County, as in-patient psychiatric hospitalization is outside the scope of MHSA.  Supporting family members and significant others. Critical to successful treatment is the need for service providers to partner with family members and significant others of loved ones experiencing mental illness. Stakeholders continued to underscore the need to provide families and significant others with education and training, emotional support, and assistance with navigating the system. o Relevant program/plan elements: Children’s Services utilizes family partners to actively engage families in the therapeutic process, and is implementing the evidence based practices of multi-dimensional family therapy and multi-systemic therapy, where families are an integral part of the treatment response. Adult Services provides family advocacy services out of their Central Adult Mental Health Clinic. In the Prevention and Early Intervention Component the County provides clinicians dedicated to supporting families experiencing the juvenile justice system due to their adolescent children’s involvement with the law. Five Prevention programs provide family education designed to support healthy parenting skills. Project First Hope provides multi-family group therapy and psycho- education to intervene early in a young person’s developing psychosis. Two Innovation programs, Rainbow Community Center and Community Violence Solutions, have a family support component. The Workforce Education and Training Component describes NAMI’s Family-to Family training, where emotional support and assistance with how to navigate the system is provided.  Support for peer and family partners. CCMH was acknowledged for hiring individuals who bring lived experience as consumers and/or family members of consumers. Their contributions have clearly assisted the County to move toward a more client and family member directed, recovery focused system of care. However, these individuals have noted the high incidence of turnover among their colleagues due to exacerbation of mental health issues brought on by work 12    stressors, and lack of support for career progression. Individuals in recovery who are employed need ongoing supports that assist with career progression, and normalizes respites due to relapses. o Relevant program/plan elements: CCMH has received state MHSA funding to strengthen its certification training for consumers who are preparing for a service provider role in the behavioral health system. These funds are to expand the curriculum to include preparing family members as well, provide ongoing career development and placement assistance, and develop ongoing supports for individuals with lived experience who are now working in the system. This is described in the Workforce Education and Training Component. Also included in this component are additional funds to provide scholarships for employees to concurrently obtain bachelors and master’s degrees and enable upward mobility.  Care for homebound frail and elderly. Services for older adults continue to struggle with providing effective treatment for those individuals who are homebound and suffer from multiple physical and mental impairments. Often these individuals cycle through psychiatric emergency care without resolution. o Relevant program/plan elements: The Prevention and Early Intervention component describes a contract agency and a county operated plan element to provide services designed to support isolated older adults. The Innovation component describes a project in development that would train and field in-home peer support workers to engage older adults who are frail, homebound and suffer from mental health issues.  Intervening early in psychosis. Teenagers and young adults experiencing a first psychotic episode are at risk for becoming lifelong consumers of the public mental health system. Evidence based practices are now available that can successfully address this population by applying an intensive multi-disciplinary, family based approach. A suggested strategy is to expand the target population now served by Project First Hope from youth at risk for experiencing a psychotic episode to include those who have experienced a “first break”. o Relevant program/plan elements: The Early Intervention category of the Prevention and Early Intervention component describes Project First Hope. This county operated program recently completed its first year in operation. Consideration will be given for expansion to youth experiencing a first psychotic break, should the program demonstrate success and funds be available. 13    Integration.  Between levels of care. Levels of care range from in-patient hospitalization to intensive case management to therapy and medication to self-care recovery services. Stakeholders (both care providers and receivers) consistently cited the difficulty in moving from one level of care to another. Consumers often cited the disincentive to getting better, as it meant loss of care altogether. Consumers and their families indicated that this system inattention to level of care movement often interfered with the important work of minimizing or eliminating the level of psychotropic medications needed to maintain recovery and wellness. Often a “meds only” service response was not responsive to appropriate lower levels of medication and/or psychosocial support alternatives. Care providers indicated that they faced the choice of either ending service or justifying continuance of a more intensive level of care than was needed. Continuity of care from a more intensive to a less intensive level and vice-versa need to be improved. Suggestions included using contracts and memorandums of understanding as a means of incentivizing professionals at different care levels to collaborate and facilitate the process of recovery. o Plan Response. This is a system-wide emphasis that affects all programs and plan elements. The chapter entitled Evaluating the Plan describes the method by which every program and plan element will be evaluated as to the degree to which it meets the needs of the community and/or population. The degree to which there is successful integration between levels of care will be addressed in each written report, with program response and plan(s) of action required where attention is needed.  Between service providers. Integrating mental health, primary care, drug and alcohol, homeless services and employment services through a coordinated, multi-disciplinary team has been proven effective for those consumers fortunate to have this available. Often cited by consumers and their families was the experience of being left on their own to find and coordinate services, and to understand and navigate the myriad of eligibility and paperwork issues that characterize different service systems. Also cited was the difficulty of coordinating education, social services and the criminal justice systems to act in concert with the behavioral health system. Suggested strategies were to emphasize and normalize system collaboration and navigation as an expected service from the most senior leaders down through managers to service providers. Also recommended was to add paid and volunteer peer and family partners to facilitate both care providers working together and assist care receivers to navigate these systems. 14    o Plan Response. The Plan funds a number of multi-disciplinary teams that models effective integration of service providers for select groups of clients. However, this is a system issue that affects all programs and plan elements. The chapter entitled Evaluating the Plan describes the method by which every program and plan element will be evaluated as to the degree to which it communicates effectively with its community partners. The degree to which there is successful communication, cooperation and collaboration will be addressed in each written report, with program response and plan(s) of action required where attention is needed. Accountability and Stakeholder Participation. The stakeholder community has requested CCMH to provide more transparent and ongoing program and fiscal information and decision-making in order to better understand what is working well, what needs to improve, and what needs to change in order to address identified priority needs. This would enable a better working partnership in planning, implementation and evaluation between consumers, their families, service providers, and administration. o Plan Response. The chapter entitled Evaluating the Plan outlines a comprehensive program and fiscal review of every MHSA funded program and plan element that will be conducted in the next three years. These reviews and written reports will provide a transparent means for better aligning resources with needs on an ongoing basis. Also, during Fiscal Year 2013-14 a prototype monthly program and budget report was developed to provide an ongoing means of program and fiscal communication between administration and stakeholders. The community program planning process surfaced many program ideas that are not articulated in the above listed broad themes. This input is welcomed and is contained in the reports prepared by Resource Development Associates and staff conducting the needs assessment. This information will be considered and utilized, as appropriate, as programs are evaluated for responsiveness to the needs of the community. The Consolidated Planning Advisory Workgroup has recognized their role to support full stakeholder participation in all committees supported by Contra Costa Mental Health, and to facilitate active sharing among committees of program and fiscal information, workgroup progress and decision-making. 15    Summary. This year’s community program planning process has resulted in the identification of current and ongoing mental health service needs, and provides direction for MHSA funded programs to address these needs over the next three years. It also informs planning and evaluation efforts that can influence how and where MHSA resources can be directed in the future. The full complement of MHSA funded programs and plan elements described in this document are the result of current as well as previous community program planning processes. Thus this year’s planning process builds upon previous ones. It is important to note that stakeholders did not restrict their input to only MHSA funded services, but addressed the entire public mental health system. The MHSA Three Year Program and Expenditure Plan operates within the laws and regulations provided for the use of the Mental Health Services Fund. The Budget chapter also addresses funding constraints. Thus the Three Year Plan contained herein does not address all of the prioritized needs identified in the community program planning process, but does provide a framework for improving existing services and implementing additional programs as funding permits. The following Plan and Budget chapters contain programs and plan elements that are funded by the County’s MHSA Fund, and will be evaluated by how well they address the Three year Plan’s Vision and identified needs as prioritized by the Community Program Planning Process. 16    The Plan Community Services and Supports Community Services and Supports is the component of the Three-Year Program and Expenditure Plan that refers to service delivery systems for mental health services and supports for children and youth, transition age youth (ages 16-25), adults, and older adults (over 60). Contra Costa County Mental Health utilizes MHSA funding for the categories of Full Service Partnerships and General System Development. First approved in 2006 with an initial State appropriation of $7.1 million Contra Costa’s budget has grown incrementally to $31.5 million annually in commitments to programs and services under this component. The construction and direction of how and where to provide funding began with an extensive and comprehensive community program planning process whereby stakeholders were provided training in the intent and requirements of the Mental Health Services Act, actively participated in various venues to identify and prioritize community mental health needs, and developed strategies by which service delivery could grow with increasing MHSA revenues. The programs and services described below are directly derived from this initial planning process, and expanded by subsequent yearly community program planning processes, to include current year. Full Service Partnerships Contra Costa Mental Health both operates and contracts with mental health service providers to enter into collaborative relationships with clients, called full service partnerships. Personal service coordinators develop an individualized services and support plan with each client, and, when appropriate, the client’s family to provide a full spectrum of services in the community necessary to achieve agreed upon goals. Children (0 to 18 years) diagnosed with a serious emotional disturbance, transition age youth (16 to 25 years) diagnosed with a serious emotional disturbance or serious mental illness, and adults and older adults diagnosed with a serious mental illness are eligible. These services and supports include, but are not limited to, crisis intervention/stabilization services, mental health treatment, including alternative and culturally specific treatments, peer support, family education services, access to wellness and recovery centers, and assistance in accessing needed medical, substance abuse, housing, educational, social, vocational rehabilitation and other community 17    services, as appropriate. A qualified service provider is available to respond to the client/family 24 hours a day, 7 days a week to provide after-hours intervention. In order to provide the full spectrum of needed services the County makes available a variety of services that may be provided outside the particular agency who enters into a full service partnership agreement with a client. These additional services are included here as part of providing the full spectrum of services in the Full Service Partnership category. These services are utilized by full service partners on a pro-rated basis in order to direct as required by statute the majority of Community Services and Supports funds to those individuals who need services from a full service partnership. The following full service partnership programs are now established: Children. The Children’s Full Service Partnership Program is comprised of four elements, 1) personal services coordinators, 2) multi-dimensional family therapy for co- occurring disorders, 3) multi-systemic therapy for juvenile offenders, and 4) county operated children’s clinic staff. 1) Personal Service Coordinators. Personal service coordinators are part of a program entitled Short Term Assessment of Resources and Treatment (START). Seneca Family of Agencies contracts with the County to provide personal services coordinators, a mobile response team, and three to six months of short term intensive services to stabilize the youth in their community and to connect them and their families with sustainable resources and supports. Referrals to this program are coordinated by County staff on a countywide assessment team, and services are for youth and their families who are experiencing severe stressors, such as out-of-home placement, involvement with the juvenile justice system, co-occurring disorders, or repeated presentations at the County’s Psychiatric Emergency Services. 2) Multi-dimensional Family Therapy (MDFT) for Co-occurring Disorders. Lincoln Center contracts with the County to provide a comprehensive and multi-dimensional family-based outpatient program for adolescents with a mental health diagnosis who are experiencing a co-occurring substance abuse issue. These youth are at high risk for continued substance abuse and other problem behaviors, such as conduct disorder and delinquency. This is an evidence based practice of weekly or twice weekly sessions conducted over a period of 4-6 months that target the youth’s interpersonal functioning, the parents’ parenting practices, parent-adolescent interactions, and family communications with key social systems. 3) Multi-systemic Therapy (MST) for Juvenile Offenders. Community Options for Families and Youth (COFY) contracts with the County to provide home-based multiple therapist-family sessions over a 3-5 month period. These sessions 18    are based on nationally recognized evidence based practices designed to decrease rates of anti-social behavior, improve school performance and interpersonal skills, and reduce out-of-home placements. The ultimate goal is to empower families to build a healthier environment through the mobilization of existing child, family and community resources. 4) Children’s Clinic Staff. County clinical specialists and family partners serve all regions of the County, and contribute a team effort to full service partnerships. Clinical specialists provide a comprehensive assessment on all youth deemed to be most seriously emotionally disturbed. The team presents treatment recommendations to the family, ensures the family receives the appropriate level of care, and family partners helps families facilitate movement through the system. The Children’s Full Service Partnership Program is summarized below: Program/Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Personal Service Coordinators Seneca Family Agencies Countywide 45 562,915 Multi- dimensional Family Therapy Lincoln Center Countywide 60 874,417 Multi-systemic Therapy Community Options for Family and Youth Countywide 66 650,000 Children’s Clinic Staff County Operated Countywide Support for full service partners 798,488 Total 171 $2,885,820 Transition Age Youth. Eligible youth (ages 16-25) are individuals who are diagnosed with a serious emotional disturbance or serious mental illness, and experience one or more of the risk factors of homelessness, co-occurring substance abuse, exposure to trauma, repeated school failure, multiple foster care placements, and experience with the juvenile justice system. Fred Finch Youth Center contracts with the County to serve West and Central County. This program utilizes the assertive community treatment model as modified for young adults that includes a personal service coordinator working in concert with a multi-disciplinary team of staff, including peer and family mentors, a psychiatric nurse practitioner, staff with various clinical specialties, to include co-occurring substance disorder and bi-lingual capacity. In addition to mobile mental health and psychiatric services the program offers a variety of 19    services designed to promote wellness and recovery, including assistance finding housing, benefits advocacy, school and employment assistance, and support connecting with families. Youth Homes contracts with the County to serve Central and East County. This program emphasizes the evidence based practice of integrated treatment for co- occurring disorders, where youth receive mental health and substance abuse treatment from a single treatment specialist, and multiple formats for services are available, to include individual, group, self-help and family. The Transition Age Youth Full Service Partnership Program is summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Transition Age Youth Full Service Partnership Fred Finch Youth Center West and Central County 90 1,400,642 Transition Age Youth Full Service Partnership Youth Homes Central and East County 40 665,000 Total 130 $2,065,642 Adult. Adult Full Service Partnerships provide a full range of services to adults over the age of 18 who are diagnosed with a serious mental illness, are at or below 300% of the federal poverty level, and are uninsured or receive Medi-Cal benefits. Five contractors to the County currently provide full service partnerships, and utilize the assertive community treatment model. This is a self-contained mental health model of treatment made up of a multi-disciplinary mental health team, including a peer specialist, who work together to provide the majority of treatment, rehabilitation, and support services that clients use to achieve their goals. Rubicon Programs contracts with the county to provide full services partnerships for West County clients through its Bridges to Home program. Anka Behavioral Health takes the lead in providing full service partnership services to Central County. The Hume Center contracts with the County to provide full service partnerships for East County, while Familias Unidas and Community Health for Asian Americans contracts with the County to provide the lead on full service partnerships for West County’s Hispanic and Asian populations, respectively. Anka Behavioral Health additionally serves those adults who have been charged with non-violent felonies or misdemeanors, and who experience a serious mental illness/serious emotional disturbance. The Behavioral Health Court Program is a 20    collaboration with Contra Costa Superior Court, Sheriff’s Department, District Attorney’s Office, Public Defenders Office, and the Probation Department to prevent incarceration and to assist individuals receive the health and mental health care needed. The Adult Full Service Partnership Program is summarized below: Program/Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Bridges to Home Rubicon Programs West County 75 928,813 Full Service Partnership Community Health for Asian Americans West County 20 123,422 Full Service Partnership, Behavioral Health Court Anka Behavioral Health Central County Countywide 50 30 768,690 Full Service Partnership Familias Unidas West County 30 207,096 Full Service Partnership Hume Center East County 60 907,493 Total 265 $2,935,514 Additional Services Supporting Full Service Partners. The following services are utilized by full service partners, and enable the County to provide the required full spectrum of services and supports. Adult Mental Health Clinic Support. Contra Costa Mental Health has dedicated clinicians and nursing staff at each of the three adult mental health clinics to provide support, coordination and rapid access for full service partners to health and mental health clinic services as needed and appropriate. Program/Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated FSP Support, Rapid Access, Wellness Nurses County Operated West, Central, East County Support for Full Service Partners 1,794,059 Total $1,794,059 21    Wellness and Recovery Centers. Recovery Innovations contract with the County to provide wellness and recovery centers situated in West, Central and East County to ensure the full spectrum of mental health services is available. These centers offer peer-led recovery-oriented, rehabilitation and self-help groups, which teach self- management and coping skills. The centers offer wellness recovery action plan (WRAP) groups, physical health and nutrition education, advocacy services and training, arts and crafts, and support groups. Program/Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Recovery and Wellness Centers Recovery Innovations West, Central, East County 200 875,000 Total 200 $875,000 Crisis Residential Program. For Fiscal Year 2013-14 the County is contracting with Telecare to operate a recently constructed MHSA financed 16 bed residential facility. This is a voluntary, highly structured treatment program that is intended to support seriously mentally ill adults during a period of crisis and to avoid in- patient psychiatric hospitalization. It will also serve consumers being discharged from the hospital and long term locked facilities that would benefit from a step-down from institutional care in order to successfully transition back into community living. Services are designed to be up to a month in duration, are recovery focused with a peer provider component, and will be able to treat co-occurring disorders, such as drug and alcohol abuse. The Crisis Residential Program is summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Crisis Residential Program Telecare Countywide 200 2,017,019 Total 200 $2,017,019 MHSA Housing Services. MHSA funded housing services supplements that provided by CCMH and the County’s Homeless Services Division, and is designed for those low income adults with a serious mental illness or children with a severe emotional disorder and their families who are homeless or at imminent risk of being homeless. The program provides affordable housing, and is comprised of five elements, 1) supportive housing, 2) augmented board and care facilities, 3) temporary shelter beds, 4) permanent housing units, and 5) a centralized county operated coordination team. 22    1. Supportive Housing. Shelter, Inc. contracts with the County to provide a master leasing program, in which adults or children and their families are provided tenancy in apartments and houses throughout the County. Through a combination of self-owned units and agreements with landlords Shelter, Inc. acts as the lessee to the owners and provides staff to support individuals and their families move in and maintain their homes independently. In addition to Shelter, Inc., Bonita House is proposing to develop a supportive housing program, entitled the “Knightsen Farm”, in the Eastern part of the County. As a result of stakeholder support a $220,000 placeholder in the annual housing services budget has been added, while feasibility and program design are determined. 2. Augmented Board and Care. The County contracts with a number of licensed board and care providers and facilities to provide additional staff care to enable those with serious mental illness to avoid institutionalization and enable them to live in the community. Of these 26 augmented board and care providers, seven were added due to MHSA funding. 3. Temporary Shelter Beds. The County’s Homeless Services Division operates a number of temporary bed facilities in West and Central County for transitional age youth and adults. In 2010 CCMH entered into a Memorandum of Understanding with the Homeless Services Division that provides additional funding to enable up to 109 individuals with a serious mental illness per year to receive temporary emergency housing for up to four months. 4. Permanent Housing Units. Having participated in a specially legislated state run MHSA Housing Program through the California Housing Finance Agency (CalHFA) the County, in collaboration with many community partners, embarked on a number of one-time capitalization projects to create 50 permanent housing units for individuals with serious mental illness. These individuals receive their mental health support from Contra Costa Mental Health contract and county service providers. The sites include Villa Vasconcellos in Walnut Creek, Lillie Mae Jones Plaza in North Richmond, The Virginia Street Apartments in Richmond, Tabora Gardens in Antioch, Robin Lane apartments in Concord, Ohlone Garden apartments in El Cerrito, Third Avenue Apartments in Walnut Creek, Garden Park apartments in Concord, and scattered units throughout the County operated by Anka Behavioral Health. 5. Coordination Team. Mental Health Housing Services Coordinator and staff work closely with County’s Homeless Services Division staff to coordinate referrals and placements, facilitate linkages with other Contra Costa mental health programs and services, and provide contract monitoring and quality control. 23    The allocation for MHSA Housing Services is summarized below: Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Supportive Housing Shelter, Inc. Countywide 128 1,663,668 Supportive Housing Bonita House Countywide To be determined 190,000 (estimated) Augmented Board and Care Crestwood Central County 26 beds 411,653 Augmented Board and Care Devines West County 6 beds 4,850 Augmented Board and Care Modesto Residential Countywide 7 beds 120,000 Augmented Board and Care Oak Hill East County 8 beds 21,120 Augmented Board and Care Pleasant Hill Manor Central County 16 beds 30,000 Augmented Board and Care United Family Care (Family Courtyard) West County 48 beds 271,560 Augmented Board and Care Williams Board and Care Home West County 12 beds 30,000 Augmented Board and Care Woodhaven Central County 5 beds 13,500 Shelter Beds County Operated Countywide 109 beds 1,672,000 Permanent Housing County Operated Countywide 50 units One time funding allocated Coordination Team County Operated Countywide Support to Homeless Program 457,958 Total *** $4,886,309 *** It is estimated that up to 700 individuals per year will receive temporary, supported or permanent housing by means of MHSA funded Housing Services. 24    General System Development General System Development is the service category in which the County uses Mental Health Services Act funds to improve the County’s mental health service delivery system for all clients who experience a serious mental illness or serious emotional disturbance, and to pay for mental health services for specific groups of clients, and, when appropriate, their families. Since the Community Services and Supports component was first approved in 2006 programs and plan elements included herein have been incrementally added each year by means of the community program planning process. These services are designed to support those individuals who need services the most. Funds are now allocated in the General System Development category for the following programs and services designed to improve the overall system of care: Older Adult Mental Health Program. First implemented in 2008 there are now two programs serving the older adult population over the age of 60, 1) Intensive Care Management, and 2) IMPACT (Improving Mood: Providing Access to Collaborative Treatment). 1) Intensive Care Management. Three multi-disciplinary teams, one for each region of the County provide mental health services to older adults in their homes, in the community, and within a clinical setting. The primary goal is to support aging in place and to improve consumers’ mental health, physical health and overall quality of life. Each multi-disciplinary team is comprised of a psychiatrist, a nurse, a clinical specialist, and a community support worker. The teams deliver a comprehensive array of care management services, linkage to primary care and community programs, advocacy, educational outreach, medication support and monitoring, and transportation assistance. 2) IMPACT. IMPACT is an evidence-based practice which provides depression treatment to older adults in a primary care setting who are experiencing co- occurring physical health impairments. The model involves short-term (8 to 12 visits) problem solving therapy and medication support, with up to one year follow-up as necessary. MHSA funded mental health clinicians are integrated into a primary treatment team. 25    The Older Adult Mental Health Program is summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Intensive Care Management County Operated Countywide 237 3,189,600 IMPACT County Operated Countywide 138 370,479 Total 375 $3,560,079 Children’s Wraparound Support. The County’s Wraparound Program, in which children and their families receive intensive, multi-leveled treatment from the County’s three children’s mental health, were augmented in 2008 by family partners and mental health specialists. Family partners are individuals with lived experience as parents of children and adults with serious emotional disturbance or serious mental illness who assist families with advocacy, transportation, navigation of the service system, and offer support in the home, community, and county service sites. Family partners participate as team members with the mental health clinicians who are providing treatment to children and their families. Mental Health Specialists are non-licensed care providers who can address culture and language specific needs of families in their communities. These professionals arrange and facilitate team meetings between the family, treatment providers and allied system professionals. Children’s Wraparound Support is summarized below: Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Wraparound Support County Operated Countywide Supports Wraparound Program 2,161,974 Total $2,161,974 Assessment and Recovery Center. The County has recently completed construction on a separate building near the Contra Costa Regional Medical Center that will house an Assessment and Recovery Center. This county operated mental health treatment program for both children and adults will be co-located with a primary care site, and will be utilized to divert adults and families from the psychiatric emergency services (PES) located at the Regional Medical Center. Through a close relationship with Psychiatric Emergency Services children and adults who are evaluated at PES can quickly step down to the services at the Assessment and Recovery Center if they do not need hospital level of care. The Assessment and Recovery Center will also allow for urgent same day appointments for individuals who either are not open to the Contra Costa Mental Health System of Care, or have disconnected from care after being seen previously. 26    The allocation for the Assessment and Recovery Center is summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Assessment and Recovery Center County Operated Countywide To be Determined 2,750,000 Total $2,750,000 Liaison Staff. Contra Costa Mental Health partners with the Regional Medical Center to provide two Mental Health Clinical Specialists who assist with mental health treatment planning and transitioning clients from in-patient hospitalization at the Regional Center to an appropriate treatment plan of mental health care in the community. In addition, two Community Support Workers, individuals with lived experience as consumers of mental health services, are assigned to Psychiatric Emergency Services in order to assist individuals experiencing a psychiatric crisis connect with services that will support them in the community. The allocation for the Liaison Staff is summarized below: Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Liaison Staff County Operated Countywide Hospital Support 513,693 Total $513,693 Clinic Support. The Community Program Planning Process that supported the 2012-13 MHSA Plan Update recommended adding County positions to supplement clinical staff implementing treatment plans at the three adult clinics and three children’s clinics. These are: 1) Resource Planning and Management. Dedicated staff at the three adult clinics assist consumers with money management and the complexities of eligibility for Medi-Cal, Medi-Care, Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) benefits. One money management specialist is allocated for each clinic, and work with and are trained by financial specialists. 2) Transportation Support. The Community Program Planning Process identified transportation to and from clinics as a critical priority for accessing services. Toward this end one-time MHSA funds were utilized in Fiscal Years 2013-14 and 14-15 to purchase additional county vehicles to be located at the clinics. Community Support Workers, one for each adult clinic, are being added to the three clinics to be dedicated to the transporting of consumers to and from appointments. 27    3) Evidence Based Practices. Clinical Specialists, one for each Children’s clinic, are being added to provide training and technical assistance in adherence to the fidelity of treatment practices that have an established body of evidence that support successful outcomes. The allocation for Clinic Support Staff are as follows: Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Resource Planning and Management County Operated Countywide Clinic Support 617,465 Transportation Support County Operated Countywide Clinic Support 213,693 Evidence Based Practices County Operated Countywide Clinic Support 370,479 Total $1,201,637 Forensic Team. Authorized for Fiscal Year 2011-12 four clinical specialists were funded by MHSA to join a multi-disciplinary team that provides mental health services, alcohol and drug treatment, and housing services to individuals with serious mental illness who are on probation and at risk of re-offending and incarceration. These individuals were determined to be high users of psychiatric emergency services and other public resources, but very low users of the level and type of care needed. This team works very closely with the criminal justice system to assess referrals for serious mental illness, provide rapid access to a treatment plan, and work as a team to provide the appropriate mental health, substance abuse and housing services needed. The allocation for mental health clinicians on the Forensic Team are as follows: Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Forensic Team County Operated Countywide Support to the Forensic Team 493,973 Total $493,973 Quality Assurance and Administrative Support. In 2008 the County first added needed positions via MHSA funding to perform various administrative support and quality assurance functions for statutory, regulatory and contractual compliance, as well as management of quality of care protocol. County staff time and funding to support the community program planning process are also included here. Utilizing the state’s allowance guide of 15% of total MHSA budget for this support element, the County’s total percentage has varied from 12.3% in Fiscal Year 2009-10 to 10.3% for 28    the upcoming year. County positions have been incrementally justified, authorized and added each year as the total MHSA budget has increased. The following functions and positions are summarized below: 1) Quality Assurance. Function Position(s) Yearly Funds Allocated Utilization Review 3 370,473 Medication Monitoring 1 89,843 Clinical Quality Management 3 370,473 Clerical Support 4 345,884 Total $1,176,673 2) Administrative Support. Function Position(s) Yearly Funds Allocated Project and Program Manager 5 757,210 Clinical Coordinator 2 213,902 Planner/Evaluator 2 260,400 Family Service Coordinator 1 105,205 Administrative and Financial Analyst 3 327,336 Clerical Supervisor 1 96,876 Clerical Support 5 390,310 Community Planning Contract 100,0000 Total $2,251,239 29    Community Services and Supports (CSS) Component Yearly Program and Expenditure Summary Full Service Partnerships Number to be Served: 576 17,459,363 Children 2,885,820 Transition Age Youth 2,065,642 Adults 2,935,514 Adult Clinic Support 1,794,059 Wellness and Recovery Centers 875,000 Crisis Residential Center 2,017,019 MHSA Housing Services 4,886,309 General System Development 14,109,268 Older Adults 3,560,079 Children’s Wraparound Support 2,161,974 Assessment and Recovery Center 2,750,000 Liaison Staff 513,693 Clinic Support 1,201,637 Forensic Team 493,973 Quality Assurance 1,176,673 Administrative Support 2,251,239 Total $31,568,631 30    Prevention and Early Intervention Prevention and Early Intervention is the component of the Three-Year Program and Expenditure Plan that refers to services designed to prevent mental illnesses from becoming severe and disabling. This means providing outreach and engagement to increase recognition of early signs of mental illness, and intervening early in the onset of a mental illness. Programs in this component are designed to 1) reduce risk for negative outcomes related to untreated mental illness for groups whose risk of developing a serious mental illness is significantly higher than average; 2) prevent relapse for individuals in recovery from a serious mental illness; 3) reduce the stigma and discrimination related to mental illness; and 4) prevent suicide. All of the programs contained in this component help create access and linkage to mental health treatment, with an emphasis on outreach and engagement to those populations who have been identified as traditionally underserved. First approved in 2009, with an initial State appropriation of $5.53 million Contra Costa’s Prevention and Early Intervention budget has grown incrementally to $7.86 million annually in commitments to programs and services. The construction and direction of how and where to provide funding for this component began with an extensive and comprehensive community program planning process that was similar to that conducted in 2005-6 for the Community Services and Support component. Underserved and at risk populations were researched, stakeholders actively participated in identifying and prioritizing mental health needs, and strategies were developed to meet these needs. The programs and services described below are directly derived from this initial planning process, and expanded by subsequent yearly community program planning processes, to include current year. Prevention Prevention programs provide outreach and engagement to individuals and underserved populations who are at-risk for suffering the debilitating effects of serious mental illness, and educate the community as to the adverse effects that stigma and discrimination have on persons experiencing mental illness. The County provides dedicated staff and contracts with community based organizations to 1) reduce the risk of developing a serious mental illness, 2) prevent relapse of individuals in recovery, 3) reduce stigma and discrimination, 4) prevent suicide, and 5) administratively support and evaluate MHSA funded prevention and early intervention programs. 1) Reducing risk of developing a serious mental illness. This category includes a) providing outreach and engagement to underserved communities, b) 31    supporting at-risk youth, c) supporting healthy parenting skills, d) integrating primary care and mental health care for adults, and e) providing outreach and support to isolated older adults. a. Eight agencies contract with the County to provide outreach and engagement to underserved communities. 1. Asian Community Mental Health provides culturally-sensitive education and access to mental health services for immigrant Asian communities, especially the Southeast Asian and Chinese population of Contra Costa County. Staff provide outreach, medication compliance education, community integration skills, and mental health system navigation. Early intervention services are provided to those exhibiting symptoms of mental illness, and participants are assisted in actively managing their own recovery process. 2. The Center for Human Development serves the primarily African American population of Bay Point in Eastern Contra Costa County. Services consist of culturally appropriate education on mental health issues through support groups and workshops. Participants at risk for developing a serious mental illness receive assistance with referral and access to County mental health services. In addition, the Center for Human Development provides mental health education and supports for gay, lesbian, bi-sexual, and questioning youth and their supports in East County to work toward more inclusion and acceptance within schools and in the community. 3. Jewish Family and Children’s Services of the East Bay provides culturally grounded, community-directed mental health education and navigation services to refugees and immigrants of all ages in the Latino, Afghan, Bosnian, Iranian and Russian communities of Central and East County. Outreach and engagement services are provided in the context of group settings and community cultural events that utilize a variety of non-office settings convenient to individuals and families. 4. La Clinica de la Raza reaches out to at-risk Latinos in Central and East County to provide behavioral health assessments and culturally appropriate early intervention services to address symptoms of mental illness brought about by trauma, domestic violence and substance abuse. Clinical staff also provide psycho- 32    educational groups that address the stress factors that lead to serious mental illness. 5. Lao Family Community Development provides a comprehensive and culturally sensitive integrated system of care for Asian and Southeast Asian adults and families in West Contra Costa County. Staff provide comprehensive case management services, to include home visits, counseling, parenting classes, and assistance accessing employment, financial management, housing, and other service both within and outside the agency. 6. The Native American Health Center provides a variety of culturally specific methods of outreach and engagement to educate Native Americans throughout the County regarding mental illness, identify those at risk for developing a serious mental illness, and help them access and navigate the human service systems in the County. Methods include an elder support group, a youth wellness group, a traditional arts group, talking circles, Positive Indian Parenting sessions, and Gatherings of Native Americans. 7. Rainbow Community Center provides a community based social support program designed to decrease isolation, depression and suicidal ideation among members who identify as lesbian, gay, bisexual, transgender, or who question their sexual identity. Key activities include reaching out to the community in order to engage those individuals who are at risk, providing mental health support groups that address isolation and stigma and promote wellness and resiliency, and providing clinical mental health treatment and intervention for those individuals who are identified as seriously mentally ill. 8. The Building Blocks for Kids Collaborative, located in the Iron Triangle of Richmond, train family partners from the community with lived mental health experience to reach out and engage at-risk families in activities that address family mental health challenges. Individual and group wellness activities assist participants make and implement plans of action, access community services, and integrate them into higher levels of mental health treatment as needed. 33    The allocation for these prevention activities are summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Underserved Communities Asian Community Mental Health Countywide 50 130,000 Underserved Communities Center for Human Development East County 230 133,000 Underserved Communities Jewish Family and Children’s Services Central and East County 350 159,699 Underserved Communities La Clinica de la Raza Central and East County 4,000 256,750 Underserved Communities Lao Family Community Development West County 120 169,926 Underserved Communities Native American Health Center Countywide 150 213,422 Underserved Communities Rainbow Community Center Countywide 1,210 220,507 Underserved Communities Building Blocks for Kids West County 1,200 198,057 Total 7,310 $1,481,361 b. Five agencies contract with the County to provide outreach and engagement to support at-risk youth, while the County provides clinicians dedicated to supporting families experiencing the juvenile justice system. 1. The James Morehouse Project at El Cerrito High School, a student health center that partners with community based organizations, government agencies and local universities, provides a range of youth development groups designed to increase access to mental health services for at-risk high school students. These on-campus groups address coping with anger, violence and bereavement, factors leading to substance abuse, teen parenting and caretaking, peer conflict and immigration acculturation. 2. The New Leaf program at Martinez Unified School District provides career academies for at-risk youth that include individualized learning plans, learning projects, internships, and mental health education and counseling support. Students, school staff, parents and community partners work together on projects designed to 34    develop leadership skills, a healthy lifestyle and pursuit of career goals. 3. People Who Care is an after school program serving the communities of Pittsburg and Bay Point that is designed to accept referrals of at-risk youth from schools, juvenile justice systems and behavioral health treatment programs. Various vocational projects are conducted both on and off the program’s premises, with selected participants receiving stipends to encourage leadership development. A licensed clinical specialist provides emotional, social and behavioral treatment through individual and group therapy. 4. The RYSE Center provides a constellation of age-appropriate activities that enable at-risk youth in Richmond to effectively cope with the continuous presence of violence and trauma in the community and at home. These trauma informed programs and services include drop-in, recreational and structured activities across areas of health and wellness, media, arts and culture, education and career, technology, and developing youth leadership and organizing capacity. The RYSE Center facilitates a number of city and system-wide training and technical assistance events to educate the community on mental health interventions that can prevent serious mental illness as a result of trauma and violence. 5. STAND! Against Domestic Violence is a prevention program that utilizes established curricula to assist youth successfully address the debilitating effects of violence occurring both at home and in teen relationships. Fifteen week support groups are held for teens throughout the County, and teachers and other school personnel are assisted with education and awareness with which to identify and address unhealthy relationships amongst teens that lead to serious mental health issues. 6. Within the County operated Children’s Services five mental health clinicians support families who are experiencing the juvenile justice system due to their adolescent children’s involvement with the law. Three clinicians are out-stationed at juvenile probation offices, and two clinicians work with the Oren Allen Youth Ranch. The clinicians provide direct short-term therapy and coordinates appropriate linkages to services and supports as youth transition back into their communities. 35    The allocation for these prevention activities are summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Supporting Youth James Morehouse Project West County 300 94,200 Supporting Youth New Leaf Central County 46 220,079 Supporting Youth People Who Care East County 200 203,594 Supporting Youth RYSE West County 2,000 460,119 Supporting Youth STAND! Against Domestic Violence Countywide 1,270 122,734 Supporting Youth County Operated Countywide 300 500,000 Total 4,116 $1,600,726 c. Five agencies contract with the County to provide prevention programs designed to support healthy parenting skills. 1. The Child Abuse Prevention Council of Contra Costa provides a 23 week curriculum designed to build new parenting skills and alter old behavioral patterns, and is intended to strengthen families and support the healthy development of their children. The program is designed to meet the needs of Spanish speaking families in East and Central Counties. 2. Contra Costa Interfaith Housing provides on-site services to formerly homeless families, all with special needs, at the Garden Park Apartments in Pleasant Hill, the Bella Monte Apartments in Bay Point, and Los Medanos Village in Pittsburg. Services include pre-school and afterschool programs, such as teen and family support groups, assistance with school preparation, and homework clubs. These services are designed to prevent serious mental illness by addressing domestic violence, substance addiction and inadequate life and parenting skills. 3. The Counseling Options Parenting Education (COPE) Family Support Center utilizes the evidence based practices of the Positive Parenting Program to help parents develop effective skills to address common child and youth behavioral issues that can lead to serious emotional disturbances. Targeting families residing in underserved communities this program delivers in English and 36    Spanish a number of seminars, training classes and groups throughout the year. 4. First Five of Contra Costa, in partnership with the COPE Family Support Center, takes the lead in training families who have children up to the age of five. First Five also partners with the COPE Family Support Center to provide training in the Positive Parenting Program method to mental health practitioners who serve this at-risk population. 5. The Latina Center serves Latino parents and caregivers in West Contra Costa County by providing culturally and linguistically specific twelve-week parent education classes to high risk families utilizing the evidence based curriculum of Systematic Training for Effective Parenting (STEP). In addition, the Latina Center trains parents with lived experience to both conduct parenting education classes and to become Parent Partners who can offer mentoring, emotional support and assistance in navigating social service and mental health systems. The allocation for these prevention activities are summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Supporting Families Child Abuse Prevention Council Central and East County 120 118,828 Supporting Families Contra Costa Interfaith Housing Central and East County 170 64,526 Supporting Families Counseling Options Parenting Education Countywide 228 225,000 Supporting Families First Five Countywide (numbers included in COPE) 75,000 Supporting Families Latina Center West County 300 102,080 Total 818 $585,434 d. The County’s primary care system staffs the new Concord Health Center II, which integrates primary and behavioral health care. Two mental health clinicians are funded by MHSA to enable a multi-disciplinary team to provide an integrated response designed to prevent the onset of serious functional impairment among adults visiting the clinic for medical services. 37    The allocation for this prevention activity is summarized below: Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Supporting Adults County Operated Central County To be determined 246,986 Total $246,986 e. One contract agency and one county operated plan element provide prevention services designed to support isolated older adults. 1. Lifelong Medical Care provides isolated older adults in West County opportunities for social engagement and access to mental health and social services. A variety of group and one-on-one approaches are employed in three housing developments to engage frail, older adults in social activities, provide screening for depression and other mental and medical health issues, and linking them to appropriate services. 2. The Senior Peer Counseling Program within the Contra Costa Mental Health Older Adult Program engages volunteer peer counselors to reach out to older adults at risk of developing mental illness by providing home visits and group support. Two clinical specialists support the efforts aimed at reaching Latino and Asian American seniors. The volunteers receive extensive training and consultation support. The allocation for this prevention activity is summarized below: Program/Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Supporting Older Adults Lifelong Medical Care West County 115 118,970 Supporting Older Adults County Operated Countywide 225 370,479 Total 340 $489,449 2) Preventing relapse of individuals in recovery. Following the internationally recognized clubhouse model, the Putnam Clubhouse provides peer-based programming for adults throughout Contra Costa County who are in recovery from a serious mental illness. This structured, work focused programming helps individuals develop support networks, career development skills, and the self-confidence needed to sustain stable, productive and more independent lives. Features of the program provide respite support to family 38    members, peer-to-peer outreach, and special programming for transition age youth and young adults. The allocation for this prevention activity is summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Preventing Relapse Putnam Clubhouse Countywide 278 468,440 Total 278 $468,440 3) Reducing stigma and discrimination. The Contra Costa Behavioral Health Services Office for Consumer Empowerment (OCE) provides leadership and staff support to a number of initiatives designed to a) reduce stigma and discrimination, b) develop leadership and advocacy skills among consumers of behavioral health services, c) support the role of peers as providers, and d) encourage consumers to actively participate in the planning and evaluation of MHSA funded services. a. Staff from the OCE support a number of activities designed to educate the community in order to raise awareness of the stigma that can accompany mental illness. The PhotoVoice Empowerment Program enables consumers to produce artwork that speaks to the prejudice, discrimination and ignorance that people with behavioral health challenges face. The Wellness Recovery Education for Acceptance, Choice and Hope (WREACH) Speaker’s Bureau forms connections between people in the community and people with lived mental health and co-occurring experiences, using face to face contact by providing stories of recovery and resiliency and current information on health treatment and supports. Other related activities include producing videos, public service announcements and educational materials. b. The OCE facilitates Wellness Recovery Action Plan (WRAP) groups by providing certified leaders and conducting classes throughout the County, and supports ongoing support groups in partnership with the Contra Costa chapter of the National Alliance for the Mentally Ill (NAMI). These groups include a writer’s group and a self-help group led by NAMI certified facilitators. c. The Service Provider Individualized Recovery Intensive Training (SPIRIT) is a college accredited recovery oriented, peer led classroom and experiential-based program for individuals with lived mental health experience. This classroom and internship experience leads to a certification for individuals who successfully complete the program, and 39    is accepted as the minimum qualifications necessary for employment within Contra Costa Behavioral Health in the classification of Community Support Worker. Participants learn peer counseling skills, group facilitation, Wellness Action Plan (WRAP) development, wellness self-management strategies and other skills needed to gain employment in peer provider positions in both county operated and community based organizations. The OCE offers monthly group peer support and training for those individuals who are employed by the County in various peer and family support roles. d. The Committee for Social Inclusion is an ongoing alliance of committee members that work together to promote social inclusion of persons who receive behavioral health services. The Committee is project based, and projects are designed to increase participation of consumers and family members in the planning, implementation and delivery of services. Current efforts are supporting the integration of mental health, alcohol and other drug, and homeless services within the Behavioral Health Services Division. In addition, OCE staff assist and support consumers and family members in participating in the various planning committees and sub-committees, Mental Health Commission meetings, community forums, and other opportunities to participate in planning processes. The allocation for this prevention activity is summarized below: Program County/Contract Region Served Yearly Funds Allocated Stigma Reduction County Operated Countywide 692,988 Total $692,988 4) Preventing Suicide. There are three plan elements that augment the County’s efforts to reduce the number of suicides in Contra Costa County; a) augmenting the Contra Costa Crisis Center, b) dedicating a clinical specialist to support the County’s adult clinics and psychiatric emergency services, and c) supporting a suicide prevention committee. a. The Contra Costa Crisis Center provides services to prevent suicides by operating a certified twenty four hour suicide prevention hotline. The hotline connects with people when they are most vulnerable and at risk for suicide, enhances safety, and builds a bridge to community 40    resources. Staff conduct a lethality assessment on each call, provide support and intervention for the person in crisis, and make follow up calls (with the caller’s consent) to persons who are at medium to high risk of suicide. MHSA funds enable additional paid and volunteer staff capacity, most particularly in the hotline’s trained multi-lingual, multi- cultural response. b. The County fields a mental health clinical specialist to augment the psychiatric emergency services unit and the adult clinics for responding to those individuals identified as at risk for suicide. This clinician receives referrals from psychiatrists and clinicians of persons deemed to be at risk, and provides a short term intervention and support response, while assisting in connecting the person to more long term care. c. A multi-disciplinary, multi-agency Suicide Prevention Committee has been established, and has published a countywide Suicide Prevention Strategic Plan. This ongoing committee will now oversee the implementation of the Plan by addressing the strategies outlined in the Plan. These strategies include i) creating a countywide system of suicide prevention, ii) increasing interagency coordination and collaboration, iii) implementing education and training opportunities to prevent suicide, iv) implementing evidence based practices to prevent suicide, and v) evaluating the effectiveness of the County’s suicide prevention efforts. The allocation for this prevention activity is summarized below: Program/Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Suicide Prevention Contra Cost Crisis Center County wide 25,000 292,850 Suicide Prevention County Operated County wide 50 123,493 Suicide Prevention County Supported County wide N/A Included in PEI administrative cost Total $416,343 5) Administrative support and evaluation of prevention and early intervention programs. Two program managers and two planner/evaluator positions have 41    been allocated by the County to provide administrative support and evaluation of programs and plan elements that are funded by MHSA. The allocation for this activity is summarized below: Plan Element County/Contract Region Served Yearly Funds Allocated Administrative Support County Operated Countywide 123,493 Planning/Evaluation County Operated Countywide 246,986 Total $370,479 Early Intervention Early intervention means services that provide treatment and other interventions to address and promote recovery and related functional outcomes, and to mitigate the negative outcomes that result from untreated mental illness. The County operated First Hope Program serves youth who are at risk for, or show early signs of psychosis. Referrals are accepted from all parts of the County, and through a comprehensive assessment process young people, ages 12-25, and their families are helped to determine whether First Hope is the best treatment to address the psychotic illness and associated disability. A multi-disciplinary team provides intensive care to the individual and their family, and consists of psychiatrists, mental health clinicians, occupational therapists and employment/education specialists. These services are based on the Portland Identification and Early Referral (PIER) Model, and consists of multi-family group therapy, psychiatric care, family psycho-education, education and employment support, and occupational therapy. The allocation for this program is summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated First Hope County operated Countywide 100 1,685,607 Total 100 $1,685,607 Prevention and Early Intervention (PEI) Component Yearly Program and Expenditure Summary Prevention 6,352,206 Early Intervention 1,685,607 Total $8,037,813 42    Innovation Innovation is the component of the Three Year Program and Expenditure Plan that funds new or different patterns of service that contribute to informing the mental health system of care as to best or promising practices that can be subsequently added or incorporated into the system. The innovative programs for Contra Costa Mental Health are developed by an ongoing community program planning process that is sponsored by the Consolidated Planning Advisory Workgroup through its Innovation Committee. These innovative programs accomplish one or more of the following objectives; i) increase access to underserved groups, ii) increase the quality of services, to include better outcomes, iii) promote interagency collaboration, and iv) increase access to services. The following programs have been approved, implemented and funds are allocated for each year of the Three Year Plan : 1) Mental Health and Social Supports for Lesbian, Gay, Bi-sexual, Transgender, Questioning (LGBTQ) Consumers. Rainbow Community Center has contracted with the County to continue to develop a behavioral/mental health model to serve youth, TAY and adult consumers who identify themselves as lesbian, gay, bi-sexual, transgender or questioning their sexual identity or gender. Previously, this program worked to identify unmet needs and tested the effectiveness of various modes of engagement, assessment and service provision, and developed best practices for engaging and serving LGBTQ consumers and broadening and strengthening their social supports (peers, family, schools, faith communities). A key component of the project included building learning collaboratives of local community members and organizations who worked to improve linkage and care services for LGBTQ community members in schools, faith communities, and service provider settings. The project developed proposed models of LGBTQ counseling, support groups, youth and TAY development activities, and specialty mental health services tailored to meet needs of LGBTQ community members. Three categories of interventions will be sustained with future funding in order to inform the mental health system of care as to best practices and to assist in replication: i) promote inclusive climates with faith communities and service providers, ii) individual counseling (clinic and school-based) and support group services to promote healthy LGBTQ identity development, iii) specialty mental health services for consumers who have been 43    marginalized and have a serious mental illness, and iv) development of evaluation methodology for school and agency-based mental health services. The counseling and mental health programs have begun to serve TAY and adults and older adults as well as youth. 2) Women Embracing Life and Learning (WELL). This project is a collaboration between Contra Costa Mental Health, Public Health Nursing and the Women, Infant and Child (WIC) program. This new pattern of service integrates a coordinated approach to addressing perinatal and post- partum depression among women in order to improve health outcomes and prevent serious mental illness. The Central County WIC office screens for symptoms of depression, refers women at risk to the multi-disciplinary team, and the team provides one-on-one and group counseling, medication support as appropriate, and referral and linkage to additional treatment as needed. 3) Trauma Recovery Project. The County is providing staff to lead trauma recovery groups within the County’s adult mental health clinics for individuals who are both suffering from post-traumatic stress disorder (PTSD) and are receiving mental health services for a serious mental illness. The groups adhere to the trauma recovery group practice for treatment of PTSD. This is a promising practice that utilizes cognitive restructuring, and seeks to reduce involuntary hospitalizations and psychiatric emergency services for this at-risk population. 4) Reluctant to Rescue. Community Violence Solutions contracts with the County to provide outreach and engagement to exploited youth who engage in street socialization, commercial sex work or survival sex. Staff adapt their outreach to engaging youth where they are located, providing safe, accessible drop-in centers, and providing mental health and support services. This project is developing promising practices to identify exploited and at-risk youth, coordinate with and educate public entities, such as law enforcement, and mobilize resources to assist youth leave exploited situations. The allocation for these programs are summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Supporting LGBTQ Youth Rainbow Community Center Countywide 125 420,187 Women Embracing Life and County Operated Central County 50 194,652 44    Learning (WELL) Trauma Recovery Project County Operated Central County 40 123,493 Reluctant to Rescue Community Violence Solutions West, East County 40 126,000 Administrative Support County Countywide Innovation Support 121,773 Total 255 $1,019,495 The following concepts have been designated to be Innovation Projects, and are on track to be fully developed, approved and implemented during the next three years: o Wellness Coaches. Individuals who have experience as a consumer and/or family member of the mental health system will be trained to provide mental health and health wellness coaching to recipients of integrated health and mental health services within Contra Costa Mental Health. These peer providers will be part of the County’s Behavioral Health Services integration plans that are currently in development. Upon determination of location and organizational role within the county operated system of care these positions will be filled and receive training specific to the skill sets needed to improve health and wellness outcomes for consumers. o Vocational Services for Unserved Mental Health Consumers. The community program planning process has placed an urgent priority on the County providing pre-vocational and employment services to a large number of mental health consumers who are not currently receiving this service. An analysis indicates that Contra Costa Vocational Services currently partners with the California Department of Rehabilitation to provide a “place and train” model of employment services. This model screens applicant for readiness to enter competitive employment, and then provides job placement and supported employment services to facilitate job retention. However, a large number of individuals who need training, education and other pre-employment services are being screened out. A new and innovative model is being developed to combine a “train and place” approach with the existing “place and train” approach in order to serve a larger number of consumers who represent a broader spectrum of readiness for employment. 45    o Partners in Aging. Older adults who are frail, homebound and suffer from mental health issues experience higher rates of isolation, psychiatric emergency interventions, and institutionalization that could be prevented. An Innovation Project is being developed that would train and field in-home peer support workers to engage older adults who have been identified by Psychiatric Emergency Services as individuals who need additional staff care in order to avoid repeated crises, engage in ongoing mental health treatment, increase their skills in the activities of daily living, and engage appropriate resources and social networks. o Overcoming Transportation Barriers. Transportation challenges provide a constant barrier to accessing mental health services. A comprehensive study was completed via the County’s community program planning process, and a number of needs and strategies were documented. Findings indicated a need for multiple strategies to be combined in a systemic and comprehensive manner. These strategies include training consumers to independently navigate public transportation, providing flexible resources to assist with transportation costs, educating consumers regarding schedules, costs and means of various modes of public transportation, transport consumers to and from mental health appointments and develop shuttle routes, accommodate special transportation needs, and create a centralized staff response to coordinate efforts and respond to emerging transportation needs. During this Three Year Plan an Innovation Project will be developed to address these needs and provide a means to inform the overall mental health system of care regarding solutions for improving transportation access to mental health care. The above concepts have been recommended by the Innovation Committee for development and submittal to the Mental Health Services Oversight and Accountability (MHSOAC) for approval. They are a result of recommendations from previous community program planning processes. Additional concepts for Innovation Projects will be entertained and vetted through the Innovation Committee on an ongoing basis. These submitted concepts will be consistent with the priorities of this year’s community program planning process. The Mental Health Services Act states that five percent of a County’s budget will be for Innovation Projects. In order to meet this five percent requirement additional funds will be set aside for the emerging projects listed above, as well as new concepts that are brought forward, should funds be available. 46    Innovation (INN) Component Yearly Program and Expenditure Summary Programs Implemented 1,019,495 Funds allocated for emerging programs 1,000,000 Total $2,019,495 47    Workforce Education and Training Workforce Education and Training is the component of the Three Year Program and Expenditure Plan that includes staff development through education and training, workforce activities including career pathway development, and financial incentive programs for current and prospective Contra Costa Mental Health employees, and contractor agency staff. The purpose of this component is to develop and maintain a diverse mental health workforce capable of providing consumer and family-driven services that are compassionate, culturally and linguistically responsive, and promote wellness, recovery and resilience across healthcare systems and community-based settings. The County’s Workforce, Education and Training Component Plan was developed and approved in May 2009, with subsequent yearly updates. The following represents funds and activities allocated for the next three fiscal years in the categories of 1) Workforce Staffing Support, 2) Training and Technical Assistance, 3) Mental Health Career Pathway Programs, 4) Residency, Internship Programs, and 5) Financial Incentive Programs. 1) Workforce Staffing Support. A Workforce Education and Training Coordinator and an administrative support staff person are designated to develop and coordinate all aspects of this component. This includes conducting a yearly workforce needs assessment, coordinating education and training activities, acting as an educational and training resource by participating in the Greater Bay Area Regional Partnership and state level workforce activities, providing staff support to County sponsored ongoing and ad-hoc workforce workgroups, developing and managing the budget for this component, applying for and maintaining the County’s mental health professional shortage designations, applying for workforce grants and requests for proposals, coordinating intern placements throughout the County, and managing the contracts with various training providers and community based organizations who receive funding for graduate level interns. The County’s funding allocation for this category is summarized below: Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Administrative Support County Operated Countywide N/A 184,426 Total $184,426 2) Training and Technical Assistance. Various individual and group staff trainings will be funded that support the values of the Mental Health Services Act. As a 48    part of the MHSA community program planning process and training surveys stakeholders identified the need for training to increase knowledge related to cultural communities, such as disadvantaged populations, and the lesbian, gay, bi-sexual, transgender communities, and those who question their sexual identity. Additionally, stakeholders expressed the need to develop activities to reduce stigma. In response the County will host a variety of culture-specific training events focused on cultural groups, such as Asian Americans, Latinos, and African Americans. In addition, the following specific contracts will be let out; i) payment for a Contra Costa College instructor to support the County’s SPIRIT training for consumers and family members who are preparing for a career in mental health service, ii) payment to the Contra Costa National Alliance on Mental Illness (NAMI) to provide Family-to-Family training in both English and Spanish that assists families support their loved ones navigate the public mental health system, iii) training for law enforcement officers to respond safely and compassionately to crisis situations involving consumers. The County’s funding allocation for this category is summarized below: Plan Element County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Staff Training Various vendors Countywide To be determined 84,000 SPIRIT Contra Costa College Countywide 40 11,000 Family to Family NAMI Countywide 48 20,000 Law Enforcement Various Countywide 70 5,000 Total $120,000 3) Mental Health Career Pathway Programs. Funding is annually allocated to enable a designated Contra Costa County high school to develop and deliver a mental health class curriculum and provide stipend work experiences. By introducing high school students to mental health through this curriculum, students increase their knowledge of mental health concepts and potential careers in the public mental health system. Staff assist students connect with colleges that support a career ladder in the public mental health system. Contra Costa Mental Health has successfully created a number of peer and family provider positions in its system of care, and, through its SPIRIT program has recruited and prepared individuals with lived experience for entry level 49    positions as peer providers. However, the County’s assessment of workforce needs has determined that these individuals could benefit from ongoing support and assistance with career development and advancement through the system. Also, training is needed for individuals with lived experience as a family members for entry to enter the workforce as a family provider. Toward this end the County applied for and received a $436,386 grant through the statewide workforce, education and training funds administered by the Office of Statewide Health Planning and Development. These funds are to expand the curriculum to include training to be a family provider, supporting ongoing career development and placement assistance, and developing ongoing supports for individuals with lived experience who are now working in the system. The County’s funding allocation for this category is summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated High School Academy Contra Costa Unified School District Countywide 15 14,500 Total $14,500 4) Residency, Internship Programs. Contra Costa County supports internship programs which place graduate level students in various county operated and community based organization locations. Particular emphasis is put on the recruitment of individuals who are bi-lingual and/or bi-cultural, and individuals with consumer and/or family member experience. CCMH provides funding to enable up to 75 graduate level students to participate in paid internships in both county operated and contract agencies that lead to licensure as a Marriage and Family Therapist (MFT), Licensed Clinical Social Worker (LCSW), Clinical Psychologist and Mental Health Nurse Practitioner. These County financed internships are in addition to the state level workforce education and training stipend programs that are funded by the California Office of Statewide Health Planning and Development. This state funded stipend program requires that participants commit to working in community public mental health upon graduation. The County’s assessment of workforce needs has determined that a combination of state and locally financed internships has enabled the County and its contractors to keep pace with the annual rate of turnover of licensed staff. Recruitment and retention of psychiatrists remain a challenge for Contra Costa County. Toward this end the County is seeking state level workforce, education and training funds to develop a psychiatric residency relationship with the 50    University of California at San Francisco to enable psychiatrists to complete their final year of residency within the County’s mental health system of care. The County’s funding allocation for this category is summarized below: Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Graduate Level Internships County Operated Countywide 25 169,945 Graduate Level Internships Contract Agencies Countywide 50 100,000 Total 75 $269,945 5) Financial Incentive Programs. Contra Costa Mental Health offers a scholarship program for employees seeking upward mobility through obtaining a bachelor or master’s degree. A portion of educational expenses is covered under this program for eligible staff in exchange for a two year service obligation in the public mental health system. The County also participates in the state level workforce, education and training funded Mental Health Loan Assumption Program. Administered by the Office of Statewide Health Planning and Development, this program makes annual payments of up to $10,000 to an educational lending institution on behalf of an employee who has incurred debt while obtaining education. The recipient is required to work in the public mental health system for each year (up to five years) in a capacity that meets the employer’s workforce needs. For current year eight individuals were enrolled in the program. The County plans to maximize the impact of this retention strategy by incrementally increasing the number of awards provided yearly for county and contract agency employees who work in the Contra Costa Mental Health system of care. Program County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Bachelor/Master Degree Scholarships County Operated Countywide 10 50,000 Total 10 $50,000 Workforce Education and Training (WET) Component Yearly Program and Expenditure Summary WET Component 638,871 Total 638,871 51    Capital Facilities/Information Technology The Capital Facilities/Information Technology component of the Mental Health Services Act enables counties to utilize MHSA funds on a one-time basis for major infrastructure costs necessary to i) implement MHSA services and supports, and ii) generally improve support to the County’s community mental health service system. The County completed an extensive community program planning process related to capital facility outlays and information technology needs, and received approval from the State in 2010 to spend up to $10 million, $6 million for an electronic health record system specific to mental health needs, and $4 million for construction of a facility to house an Assessment and Recovery Center. In the fiscal year 2011-12 MHSA Plan Update the construction of a 16 bed crisis residential facility (Hope House) was approved and added as a Capital Facilities project. This was funded by transferring $3 million from the County’s Prudent Reserve. 1) Electronic Health Records System. The electronic health record system, as proposed in 2010, intended to transform the current paper and location-based system with an electronic system where clinical documentation could be centralized and made accessible to all members of a consumer’s treatment team, with shared decision-making functionality. It would replace the existing claims system, where network providers and contract agencies would be part of the system and be able to exchange their clinical and billing information with the County. The proposed system would allow doctors to submit their pharmacy orders electronically, and permit sharing between psychiatrists and primary care physicians to allow knowledge of existing health conditions and drug inter- operability. It would also allow consumers to access part of their medical record, make appointments, and electronically communicate with their treatment providers. Since approval for this project was obtained in 2010, Contra Costa Health Services, to include Contra Costa Regional Medical Center, the ambulatory care clinics and the Contra Costa Health Plan converted existing systems to an integrated electronic medical record system, entitled EPIC. This conversion of the larger health care system initiated an analysis to determine the feasibility of using the EPIC system for behavioral health services. The analysis indicated significant functionality gaps in the clinical documentation and billing for specialty mental health services, as it utilized a different billing format. To close the gap would require significant development efforts by EPIC system staff. Consequently the decision was made to purchase and implement a new system 52    specifically for Behavioral Health Services. This new system will have the capacity to communicate and share information with EPIC and other systems currently in use by contract providers and other entities involved in the treatment and care of clients. Selection of a preferred vendor has occurred; however, to date a contract has not been signed. The project is scheduled to be completed in two years. As per the 2010 proposal, funding from the County’s Health Services Department would be sought for any costs that exceed the originally approved $6 million. Ongoing County staff costs allocated for this project are summarized below: Project County/Contract Region Served Number to be Served Yearly Yearly Funds Allocated Administrative Support County Operated Countywide N/A 849,936 Total $849,936 2) Construction of an Assessment and Recovery Center. An extensive community program planning process completed in 2010 supported the construction of a new facility that would house an Assessment and Recovery Center. This 6,000 square foot building will house a mental health treatment program for both children and adults, will be co-located with a primary care site, and will be utilized to divert adults and children and their families from the psychiatric emergency services (PES) located at the Regional Medical Center. In addition to the clinical treatment areas business and operations support were included, such as parking, housekeeping and a staff lounge. The building was completed in spring of current year, with start of services projected by end of June. 3) Construction of Hope House. The 16 bed crisis residential treatment facility (Hope House) was completed in March of 2014, and is located on a hillside above the Contra Costa Regional Medical Center. It is intended to help mental health consumers avoid hospitalization, as well as to assist in the transition from hospitals or long term care facilities back to the community. It provides round- the-clock, recovery focused services that encourages successful transition back to the community. Telecare has contracted with the County to begin services in April 2014. 53    Capital Facilities/Information Technology (CF/TN) Component Yearly Program and Expenditure Summary CF/TN Component 849,936 Total $849,936 54    The Budget The following tables represent a Mental Health Services Act yearly funding summary by component: Fiscal Year 2014/15 A.Estimated FY 2014/15 Available Funding CSS PEI INN WET CF/TN 1.Estimated unspent funds from prior fiscal years 16,250,578 10,572,630 3,314,376 2,043,384 4,054,864 2. Estimated new FY 14/15 funding 28,060,615 7,015,154 1,846,093 3. Transfers in FY 14/15 4.Estimated available funding for FY 14/15 44,311,193 17,587,784 5,160,469 2,043,384 4,054,864 B.Estimated FY 14/15 Expenditures 30,068,631 8,037,813 2,019,495 638,871 849,936 Fiscal Year 15/16 A.Estimated FY 2015/16 Available Funding CSS PEI INN WET CF/TN 1.Estimated unspent funds from prior fiscal years 14,242,562 9,549,971 3,140,974 1,404,513 3,204,928 2. Estimated new FY 15/16 funding 24,219,250 6,054,813 1,593,372 3. Transfers in FY 15/16 55    4.Estimated available funding for FY 15/16 38,461,812 15,604,784 4,734,346 1,404,513 3,204,928 B.Estimated FY 15/16 Expenditures 31,568,631 8,037,813 2,019,495 638,871 849,936 Fiscal Year 16/17 A.Estimated FY 2016/17 Available Funding CSS PEI INN WET CF/TN 1.Estimated unspent funds from prior fiscal years 6,893,181 7,566,971 2,714,851 765,642 2,354,992 2. Estimated new FY 16/17 funding 24,758,147 6,189,537 1,628,825 3. Transfers in FY 16/17 4.Estimated available funding for FY 16/17 31,651,328 13,756,507 4,343,677 765,642 2,354,992 B.Estimated FY 16/17 Expenditures 31,568,631 8,037,813 2,019,495 638,872 849,936 C.Estimated funds available for FY 17/18 82,697 5,718,694 2,324,182 126,771 1,505,056 Prudent Reserve: $7,125,250 Budget Analysis. 1. Total funding commitments for the Community Services and Supports (CSS) and Prevention and Early Intervention (PEI) components currently exceed estimated revenues for each of the three fiscal years of this plan. Unspent funds from prior fiscal years will be utilized to meet funding commitments to sustain this level of 56    programming. It is estimated that there will be sufficient unspent funds from prior years and estimated new revenues such that funds from the prudent reserve will not be utilized. This is based upon the following assumptions: a. Revenue estimates from the State MHSA Fund and federal financial participation from the Medi-Cal program actualize at or above the above estimated levels. b. No significant funding obligations for additional programs or plan elements are added. Any MHSA funding commitments for new or expanded programming should also consider corresponding program reductions or eliminations. 2. Estimated funds available for Fiscal Year 2017-18 indicate that funding commitments will need to equal estimated funding revenues at some point during the next Three Year Program and Expenditure Plan (Fiscal Years 2017-20). 3. The Mental Health Services Act requires that 20% of the total new funding for the County go for the PEI component. The balance of new funding is for the CSS component. From the total of CSS and PEI components, five percent of the total new funding is to go for the Innovation (INN) component, and is to be equally divided between the CSS and PEI allotment. The estimated new funding for each fiscal year reflects this distribution. 4. The County may set aside up to 20% of its total allocation of new funding for the Workforce, Education and Training (WET) component, Capital Facilities, Information Technology (CF/TN) component and a prudent reserve. For this three year period the County is not allocating any new funding for these areas, as the existing balances are estimated to be sufficient to fund estimated expenditures. However, it is anticipated that continuation of part or all of the existing WET programs for the next three year period (FY 2017-20) will require use of new funding. 5. The MHSA requires that counties set aside sufficient funds, entitled a prudent reserve, to ensure that services do not have to be significantly reduced in years in which revenues are below the average of previous years. The County’s prudent reserve balance through June 30, 2017 is estimated to be $7,125,250. This figure is in addition to the estimated available funds. 6. For the CF/TN component it is projected that the combined one-time costs of the construction of the Assessment and Recovery Center, Hope House and the implementation of a mental health electronic record system will utilize the entire component fund balance by the end of this three year period. The remaining one-time transfers from the CF/TN component that are made to pay for these projects are not depicted in the above table, but will be reflected in subsequent Plan Updates. Any costs that are incurred above the total funds set aside for 57    these three projects will be considered separately as a new and additional funding obligation. 7. Significant changes in revenues or funding commitments, such as program additions and reductions, and staff cost of living adjustments, or increases in costs of doing business due to inflation will be reflected in subsequent plan updates. 58    Evaluating the Plan Contra Costa Mental Health is committed to evaluating the effective use of funds provided by the Mental Health Services Act. Toward this end a comprehensive program and fiscal review process has been developed to a) improve the services and supports provided, b) more efficiently support the County’s MHSA Three Year Program and Expenditure Plan, and c) ensure compliance with statute, regulations and policies. During the next three years each of the over 85 contract and county operated programs and plan elements receiving MHSA funds will undergo a program and fiscal review. This will entail interviews and surveys of individuals both delivering and receiving services, review of data, case files, program and financial records, and performance history. Key areas of inquiry include:  Delivering services according to the values of the Mental Health Services Act.  Serving those who need the service.  Providing services for which funding was allocated.  Meeting the needs of the community and/or population.  Serving the number of individuals that have been agreed upon.  Achieving the outcomes that have been agreed upon.  Assuring quality of care.  Protecting confidential information.  Providing sufficient and appropriate staff for the program.  Having sufficient resources to deliver the services.  Following generally accepted accounting principles.  Maintaining documentation that supports agreed upon expenditures.  Charging reasonable administrative costs.  Maintaining required insurance policies.  Communicating effectively with community partners. Each program or plan element will receive a written report that addresses each of the above areas. Promising practices, opportunities for improvement, and/or areas of concern will be noted for sharing or follow-up activity, as appropriate. The emphasis will be to establish a culture of continuous improvement of service delivery, and quality feedback for future planning efforts. 59    In addition, a monthly MHSA Financial Report will be generated that will depict funds budgeted versus spent for each program and plan element included in this Plan. This will enable ongoing fiscal accountability, as well as provide information with which to engage in sound planning. 60    Acknowledgements We acknowledge that this document is not a description of how Contra Costa Mental Health has delivered on the promise provided by the Mental Health Services Act. It is, however, a plan for how the County can continually improve upon delivering on the promise. We have had the honor this past year to meet many people who have overcome tremendous obstacles on their journey to recovery. They were quite open that the care they received literally saved their life. We also met people who were quite open and honest regarding where we need to improve. For these individuals, we thank you for sharing. We would also like to acknowledge those Contra Costa stakeholders, both volunteer and professional, who have devoted their time and energy over the years to actively and positively improve the quality and quantity of care that has made such a difference in people’s lives. They often have come from a place of frustration and anger with how they and their loved ones were not afforded the care that could have avoided unnecessary pain and suffering. They have instead chosen to model the kindness and care needed, while continually working as a team member to seek and implement better and more effective treatment programs and practices. For these individuals, we thank you, and feel privileged to be a part of your team. The MHSA Staff A‐1    Mental Health Service Maps Mental Health Services Act funded programs and plan elements are only a portion of the total funding that supports public mental health services provided by Contra Costa County employees and staff employed by contractors. The backbone of the CCMH system of care is its three county operated Children’s and three county operated Adult clinics that serve the Western, Central and Eastern regions of the county. The following six service maps provide a visual picture, or architecture, of the constellation of types of Contra Costa Mental Health’s programs, and thus enable the viewer to see the inclusion of MHSA funded services as part of the entire system of care.   Outpatient Services Contractor: Seneca Center At Riverview Middle School (MDUSD) At: Liberty Alternative Education Campus and Freedom H.S. (LUHSD) At: 2 Junior High Schools:  Belair  Fred Finch Mental Health Enhanced Classroom(s) Outpatient School Wide Mental Health Services Contractor Fred Finch At: 1 High School Mount Diablo HS and 2 Jr. HS Belair El Dorado Contractor Lincoln Child Center At 6 Elem. Schools  Highlands,  Stoneman,  Parkside,  Heights,  Foothills, and  Willow Cove and 2 Junior High Schools  Hillview, and  Central Contractor Seneca Center At: 1 Middle School Riverview Middle School (MDUSD) MDUSD = Mount Diablo Unified School District PUSD = Pittsburg Unified School District LUHSD = Liberty Union High School District Outpatient Services Contractor: La Cheim At: Antioch Juvenile Probation Services Address: 202 Glacier Dr., Martinez Population Served: Children & TAY  Juvenile Hall  Orin Allen Youth Rehabilitation Facility  Regional Probation Liaisons School Based Program Unit County-Wide Assessment Team Address: 2425 Bisso Ln. #235, Concord Population Served: Children & TAY West County Children’s Mental Health Clinic Address 303 41st Street Richmond, CA Population Served Children & Transition Age Youth Services: Psychiatric Services Outpatient Services Parent Partners Parent Project Street Soldiers Teach One Reach One Wrap Around Services Cognitive Behavioral Therapy Dialectical Behavior Therapy Trauma Focused Cognitive Behavioral Therapy Triple P Parenting NA/AA Contracted Psychiatric Hospitals: John Muir Behavioral Health; Herrick Hospital; BHC Sierra Vista; BHC Heritage Oaks; St. Helena Hospital – Vallejo; St. Helena Hospital – St. Helena Start FSP Seneca Countywide WEST COUNTY CHILDREN’S MENTAL HEALTH SERVICES Provider’s Network Organizational Carrie McCluer & Associates (Crockett) Individual (32) Countywide Services Contracted Psychiatric Hospitals School Based Programs Community Services & Supports (CSS) Programs Prevention & Early Intervention Programs: Building Blocks for Kids (Richmond) The James Morehouse Project (El Cerrito) The Latina Center (Richmond) Native American Health Center (Richmond) RYSE (Richmond STAND! (Richmond) Prevention & Early Intervention Programs System of Care Community Based Organizations Providers Network Child & Family Services Address: 2425 Bisso Ln. #235, Concord Population Served: Children & TAY  Emergency Foster Care  Child & Family Mental Health Services  Social Services Child Assessment Unit  Spirit of Caring Hospital & Residential Unit Address: 2425 Bisso Ln. #280, Concord Population Served: Children & TAY  Local and National Case Management  Hospital Liaison  TBS Services Coordination TBS Providers  COFY  Youth Homes  Fred Finch  La Cheim SenecaCommunity Health for Asian Americans Richmond Thunder Road Countywide * WCCUSD = West Contra Costa Unified School District Contractor: YSB * At: 3 Elementary Schools: Washington, Harbour Way, Transitional Learning 4 Middle Schools: Crespi, Pinole, Portola, and Hercules 4 High Schools: El Cerrito, Richmond, Pinole Valley, and Hercules * YSB – Youth Services Bureau Outpatient School Wide Mental Health Services at WCCUSD SchoolsContractor: Seneca At 3 Elementary Schools: Highland, Sheldon, and Tara Hills 2 Middle Schools:Pinole, and Transitional Learning Center (WCCUSD) Contractor: La Cheim At: La Cheim School -Richmond (NPS) Unbundled Day Treatment Contractor: Community Health for Asian American At: 2 Elementary Schools: Lincoln and Nystrom 2 Middle Schools: Helms and LoVonya DeJean 3 High Schools: El Cerrito, Kennedy, and Richmond Contractor: Y Team At: 1 Elementary School: Nystrom Elementary 4 Middle Schools Crespi, Helms, Portola, LoVonya and DeJean and 4 High Schools: De Anza, El Cerrito, Kennedy, and Richmond Contractor: Bay Area Community Resources (B.A.C.R.) At: 6 Elementary Schools: Grant, Harbor Way,Lincoln, Nystrom, Peres, and Stege BACR Richmond La Cheim Richmond Familias Unidas Richmond Mobile Response Team Seneca Countywide Early Childhood Mental Health Richmond Head Start RichmondLincoln (Multi-Dimensional Family Therapy Countywide COFY (Multi-Systemic Therapy) Countywide CVS San PabloContractor: Seneca At: Kennedy High School (WCCUSD) Youth Services Bureau Richmond A-2 West County Adult Mental Health Clinics Address 2523 El Portal Dr. #103, San Pablo Population Served Adults & Older Adults TAY Services: Assessments Case Management Psychiatric Services Crisis Intervention Housing Services Benefits Assistance Recovery Innovations (Consumer-Run Community Center) Address: 256 24th St., Richmond Augmented Board and Care Homes: Devine’s Home (San Pablo) Ducre’s Residential Care (Richmond) Family Courtyard (Richmond) God’s Grace (Hayward) Hailey’s Care (El Sobrante) Williams Board and Care (Richmond) Yvonne’s Home Care (Richmond) Contracted Psychiatric Hospitals: John Muir Behavioral Health; Herrick Hospital; BHC Sierra Vista; BHC Heritage Oaks; St. Helena Hospital – Vallejo; St. Helena Hospital – St. Helena. WEST COUNTY ADULT MENTAL HEALTH SERVICES ANKA Programs, Inc. (Multi Service Center) Address: 1515 Market St., San Pablo Provider’s Network Organizational Amador Institute (Antioch) Family Stress Center (Antioch) Psychotherapy Institute of Ind., Fam. & Comm. Development (Antioch) The Lucas Center (Pittsburg) YWCA (Antioch) Individual (35) Prevention & Early Intervention Programs: Asian Community Mental Health (Richmond) Building Blocks for Kids (Richmond) Lao Family Community Development (San Pablo) The Latina Center (Richmond) Native American Health Center (Richmond) RYSE (Richmond Rubicon, Inc. (Bridges to Home-Adult FSP) Address: 2500 Bissell Ave., Richmond Countywide Services Contracted Psychiatric Hospitals Providers Network Long-term Care Providers System of Care Community Based Organizations Prevention & Early Intervention Programs Augmented Board & Care HomesCountywide Long-term Care Providers (IMDs/MHRCs): California Psychiatric Transitions; Crestwood; Canyon Manor; Creekside MH Rehab. Ctr.; Telecare; Idylwood Convalescent Fred Finch (TAY FSP) Address: 2523 El Portal Dr., San Pablo Familias Unidas (Adult FSP) Address:205 39thStreet, RichmondFamily Institute of Pinole Address: 668 Quinan Street #100, Pinole Conservatorship/Guardianship Address: 1111 Ward St., Martinez Transition Services Forensic Services Vocational Services Anka - Nierika House (Crisis Residential Facility) Address: 1959 Solano Way, Concord Crestwood (The Bridge Board & Care) Pathways Transitional Residential Our House Board & Care Older Adult Services Nevin House Address: 3215/3221 Nevin Ave, Richmond Community Health for Asian Americans (Bridges to Home-Adult FSP) Address: A-3 MDUSD = Mount Diablo Unified School District PUSD = Pittsburg Unified School District LUHSD = Liberty Union High School District Outpatient Services Contractor: Seneca Center At Riverview Middle School (MDUSD) At: Liberty Alternative Education Campus and Freedom H.S. (LUHSD) At: 2 Junior High Schools:  Belair  Fred Finch Mental Health Enhanced Classroom(s) Outpatient School Wide Mental Health Services Contractor Fred Finch At: 1 High School Mount Diablo HS and 2 Jr. HS Belair El Dorado Contractor Lincoln Child Center At 6 Elem. Schools  Highlands,  Stoneman,  Parkside,  Heights,  Foothills, and  Willow Cove and 2 Junior High Schools  Hillview, and  Central Contractor Seneca Center At: 1 Middle School Riverview Middle School (MDUSD) Outpatient Services Contractor: La Cheim At: Antioch Juvenile Probation Services Address: 202 Glacier Dr., Martinez Population served:  Juvenile Hall  Orin Allen Youth Rehabilitation Facility  Regional Probation Liaisons School Based Program Unit County-Wide Assessment Team Address: 2425 Bisso Ln. #235, Concord Population Served: Children & TAY Central County Children’s Mental Health Clinic Address 2425 Bisso, Ste. 200 Concord, CA 94520 Population Served Children & Transition Age Youth Services: Head Start Program Psychiatric Services Outpatient Services Parent Partners Parent Project PIP Program Wrap Around Services Cognitive Behavioral Therapy Dialectical Behavior Therapy Trauma Focused Cognitive Behavioral Therapy Triple P Parenting Contracted Psychiatric Hospitals: John Muir Behavioral Health; Herrick Hospital; BHC Sierra Vista; BHC Heritage Oaks; St. Helena Hospital – Vallejo; St. Helena Hospital – St. Helena Start FSP Seneca Countywide Population: ChildrenCENTRAL COUNTY CHILDREN’S MENTAL HEALTH SERVICES Provider’s Network Organizational Hiawatha Harris-Pathways to Wellness (Pleasanton) Jewish Family Stress (Walnut Creek) Touchstone Counseling Services (Pleasant Hill) YWCA (Antioch) Individual (70) Countywide Services Contracted Psychiatric Hospitals School Based Programs Seneca Mobile Response Team Countywide Community Services & Supports (CSS) Programs Prevention & Early Intervention Programs: Child Abuse Prevention Council (Concord) Contra Costa Crisis Center (Walnut Creek) Contra Costa Interfaith Housing (Walnut Creek) Center for Human Development (Pleasant Hill) C.O.P.E. Family Support Center La Clinica de la Raza (Concord) New Leaf (Martinez) Rainbow Community Center (Concord) STAND! (Concord) Prevention & Early Intervention Programs System of Care Community Based Organizations Providers Network Child & Family Services Address: 2425 Bisso Ln. #235, Concord Population Served: Children & TAY  Emergency Foster Care  Child & Family Mental Health Services  Social Services Child Assessment Unit  Spirit of Caring Hospital & Residential Unit Address: 2425 Bisso Ln. #280, Concord Population Served: Children & TAY  Local and National Case Management  Hospital Liaison  TBS Services Coordination TBS Providers  COFY  Youth Homes  Fred Finch  La Cheim Seneca La Clinica de la Raza Oakley Community Health for Asian Americans Antioch Thunder Road Countywide MDUSD = Mount Diablo Unified School District CCCOE = Contra Costa County Office of Education NPS = Non Public School; AUHSD = Acalanes Union High School District Outpatient School Wide Mental Health Services At: Mt.Diablo/ Olympic/Alliance High Schools (MDUSD) Sunrise Elmntry (MDUSD) At: Marchus School – Elementary Grades (CCCOE) Unbundled Day Treatment Contractor: Families First At: Mount Diablo High School (MDUSD) Contractor: La Cheim At: La Cheim School - Antioch (NPS ) Mental Health Enhanced Classroom(s) 3 Classrooms Contractor: Seneca At: Pleasant Hill Middle School (MDUSD) At: Campolindo High School (AUHSD) At: Marchus School Middle School Class (CCCOE) Contractor: Fred Finch At: Mt. Diablo High School Contractor: Seneca At: Olivera High School COFY (Multi-Systemic Therapy) Countywide Lincoln (Multi-Dimensional Family Therapy) Countywide Youth Services Bureau Concord At: Belair JH (MDUSD) El Dorado JH (MDUSD) A-4 Central County Adult Mental Health Clinics Address 1420 Willow Pass Rd., Concord Population Served Adults & Older Adults TAY Services: Assessments Case Management Psychiatric Services Crisis Intervention Housing Services Benefits Assistance Recovery Innovations (Consumer-Run Community Center) Address: 2975 Treat Blvd., Walnut Creek Augmented Board and Care Homes: Cayce Retirement Home (Concord) CC’s Adult Residential Care Home (Concord) Concord Hill (Concord) Concord Royale (Concord) Crestwood Wellness (Concord) Delly’s Care Home (Concord) Happy Home (Concord) Lark Lane Adult Residential Facility (Concord) Margarita’s Villa of Care (Concord) Modesto Residential Pleasant Hill Manor (Pleasant Hill) Scenic View (Martinez) Woodhaven Home (Concord) Contracted Psychiatric Hospitals: John Muir Behavioral Health; Herrick Hospital; BHC Sierra Vista; BHC Heritage Oaks; St. Helena Hospital – Vallejo; St. Helena Hospital – St. Helena. CENTRAL COUNTY ADULT MENTAL HEALTH SERVICES ANKA Programs, Inc. (Multi Service Center) Address: 1121 Detroit Ave., Concord Conservatorship/Guardianship Address: 1111 Ward St., Martinez Provider’s Network Organizational Amador Institute (Antioch) Family Stress Center (Antioch) Psychotherapy Institute (Antioch) STAND (Antioch) The Lucas Center (Pittsburg) YWCA (Antioch) Individual (73) Prevention & Early Intervention Programs: Child Abuse Prevention Council (Concord) Contra Costa Clubhouses (Concord) Contra Costa Crisis Center (Walnut Creek) Contra Costa Interfaith Housing (Walnut Creek) Center for Human Development (Pleasant Hill) C.O.P.E. Family Support Center (Concord) Jewish Family & Children’s Svcs (Walnut Creek) La Clinica de la Raza (Concord) Rainbow Community Center (Concord) STAND! (Concord)Countywide Services Contracted Psychiatric Hospitals Providers Network Long-term Care Providers System of Care Community Based Organizations Prevention & Early Intervention Programs Augmented Board & Care HomesCountywide Long-term Care Providers (IMDs/MHRCs): California Psychiatric Transitions; Crestwood; Canyon Manor; Creekside MH Rehab. Ctr.; Telecare; Idylwood Convalescent Transition Services Clayton Way (TAY Transitional/Independent Housing) Forensic Services Vocational Services Anka - Nierika House (Crisis Residential Facility) Address: 1959 Solano Way, Concord Crestwood (The Bridge Board & Care) Pathways Transitional Residential Our House Board & Care Older Adult Services Nevin House Address: 3215/3221 Nevin Ave, Richmond Assessment and Recovery Center Address: Rainbow Community Center (Counseling Program) Address: 2118 Willow Pass Rd., Concord ANKA Bridges to Home and Behavioral Health Court Address: 1410 Danzig Plaza, Concord Telecare Corporation Hope House (Crisis Residential Facility) Address: 300 Ilene St., Martinez A-5 Juvenile Probation Services Address: 202 Glacier Dr., Martinez Population Served: Children & TAY  Juvenile Hall  Orin Allen Youth Rehabilitation Facility  Regional Probation Liaisons School Based Program Unit County-Wide Assessment Team Address: 2425 Bisso Ln. #235, Concord Population Served: Children & TAY East County Children’s Mental Health Clinic Address 3501 Lone Tree Way, #200 Antioch, CA 94509 Population Served Children & Transition Age Youth Services: Head Start Program Psychiatric Services Outpatient Services Parent Partners Parent Project Wrap Around Services Cognitive Behavioral Therapy Dialectical Behavior Therapy Trauma Focused Cognitive Behavioral Therapy Triple P Parenting Contracted Psychiatric Hospitals: John Muir Behavioral Health; Herrick Hospital; BHC Sierra Vista; BHC Heritage Oaks; St. Helena Hospital – Vallejo; St. Helena Hospital – St. Helena Start FSP Seneca Countywide Population: ChildrenEAST COUNTY CHILDREN’S MENTAL HEALTH SERVICES Provider’s Network Organizational Amador Institute (Antioch) YWCA (Antioch) Individual (65) Countywide Services Contracted Psychiatric Hospitals School Based Programs Mobile Response Team Seneca Countywide Community Services & Supports (CSS) Programs Outpatient Services Contractor:Seneca Center At Riverview Middle School (MDUSD) Contractor: Lincoln At: 1 Elementary School Learning Academy (PUSD) Contractor: Lincoln At: 2 Junior High Schools:  Central J.H. Hillview Mental Health Enhanced Classroom(s) Outpatient School Wide Mental Health Services Contractor Lincoln At: 1 High School Pittsburg HS Contractor Lincoln Child Center At 6 Elem. Schools  Highlands,  Stoneman,  Parkside,  Heights,  Foothills, and  Willow Cove (All PUSD) Contractor Seneca Center At: 1 Middle School Riverview Middle School (MDUSD) MDUSD = Mount Diablo Unified School District PUSD = Pittsburg Unified School District LUHSD = Liberty Union High School District Prevention & Early Intervention Programs: Center for Human Development (Bay Point) Contra Costa Interfaith Housing (Pittsburg) La Clinica de la Raza (Pittsburg) People Who Care (Pittsburg) STAND! Prevention & Early Intervention Programs System of Care Community Based Organizations Providers Network Outpatient Services Contractor: La Cheim At: Antioch Child & Family Services Address: 2425 Bisso Ln. #235, Concord Population Served: Children & TAY  Emergency Foster Care  Child & Family Mental Health Services  Social Services Child Assessment Unit  Spirit of Caring Hospital & Residential Unit Address: 2425 Bisso Ln. #280, Concord Population Served: Children & TAY  Local and National Case Management  Hospital Liaison  TBS Services Coordination TBS Providers  COFY  Youth Homes  Fred Finch  La Cheim SenecaLa Clinica Oakley Community Health for Asian Americans Antioch Thunder Road Countywide Lynn Center Antioch & Countywide Lincoln (Multi-Dimensional Family Therapy) Countywide COFY (Multi-Systemic Therapy) Countywide Head Start CVS AntiochA-6 East County Adult Mental Health Clinics Address 2311 Loveridge Rd. Pittsburg, CA 94565 Population Served Adults & Older Adults TAY Services: Assessments Case Management Psychiatric Services Crisis Intervention Housing Services Benefits Assistance Recovery Innovations (Consumer-Run Community Center) Address: 2400 Sycamore Drive, Antioch Augmented Board and Care Homes: Blessed Care Home (Pittsburg) Johnson Care Home (Antioch) Menona Drive Care Home (Antioch) Oak Hills Residential Facility (Pittsburg) Paraiso Home (Oakley) Springhill Home (Pittsburg) Contracted Psychiatric Hospitals: John Muir Behavioral Health; Herrick Hospital; BHC Sierra Vista; BHC Heritage Oaks; St. Helena Hospital – Vallejo; St. Helena Hospital – St. Helena. EAST COUNTY ADULT MENTAL HEALTH SERVICES ANKA Programs, Inc. (East County Shelter & Multi Service Center) Address: West 4th St., Antioch Provider’s Network Organizational Family Stress Center (Antioch) Psychotherapy Institute of Ind., Fam. & Comm. Development (Antioch) STAND (Antioch) The Lucas Center (Pittsburg) YWCA (Antioch) Individual (63) Prevention & Early Intervention Programs: Center for Human Development (Bay Point) Contra Costa Interfaith Housing (Pittsburg) La Clinica de la Raza (Pittsburg) Countywide Services Contracted Psychiatric Hospitals Providers Network Long-term Care Providers System of Care Community Based Organizations Prevention & Early Intervention Programs Augmented Board & Care HomesCountywide Long-term Care Providers (IMDs/MHRCs): California Psychiatric Transitions; Crestwood; Canyon Manor; Creekside MH Rehab. Ctr.; Telecare; Idylwood Convalescent Conservatorship/Guardianship Address: 1111 Ward St., Martinez Transition Services Forensic Services Vocational Services Anka - Nierika House (Crisis Residential Facility) Address: 1959 Solano Way, Concord Crestwood (The Bridge Board & Care) Pathways Transitional Residential Our House Board & Care Older Adult Services Nevin House Address: 3215/3221 Nevin Ave, Richmond Youth Homes (TAY FSP) Address: 2213 Buchanan Rd., Antioch Portia Bell Hume Behavioral Health and Training Center (Adult FSP) Address: 555 School St., Pittsburg A-7 B‐1    Program and Plan Element Profiles Anka Behavioral Health, Inc. Point of Contact: Chris Withrow, Chief Executive Officer. Contact Information: 1850 Gateway Boulevard, Suite #900, Concord CA 94520, (925)-825–4700, cwithrow@ankabhi.org 1. General Description of the Organization Anka’s mission is to eliminate the impact of behavioral health problems for all people. Anka serves more than 15,000 individuals annually and employ nearly 1,000 professional, specialized staff members. Anka’s philosophy is to treat the whole person by fully integrating care of both mind and body, always using clinically- proven, psycho-social models designed to promote health and wellness while containing costs. 2. Program: Adult Full Service Partnership - CSS The Adult Full Service Partnership (FSP) joins the resources of Anka Behavioral Healthcare and Costa County Mental Health Services, and utlize the assertive community treatment model. Anka’s FSP program also includes the Behavioral Health Court Program, which collaborates with Contra Costa Superior Court, Contra Costa Sheriff’s Department, Contra Costa Health Services Division, Contra Costa Adult Mental Health, Contra Costa District Attorney’s Office, Contra Costa Public Defenders Office, Contra Costa Probation Department and Anka Behavioral Health, Inc. It also includes collaborative services with the Contra Costa Adult Forensic Team to case manage consumers who are on Contra Costa County Probation. The program serves adults who reside in Contra Costa County, who have been charged with non-violent felonies or misdemeanors, and who experience a serious mental illness/serious emotional disturbance. a. Scope of Services: Services use an integrated multi-disciplinary team approach, based on a modified Assertive Community Treatment (ACT) model of care. Services include outreach and engagement, case management, outpatient mental health services, including services for individuals with co-occurring mental health and alcohol and other drug problems, crisis intervention, medication support, housing support, flexible funds, vocational services, educational services, and recreational and social activities. Anka staff are available to consumers on a 24/7 basis. b. Target Population: Adults over the age of 18 in West and Central County who are diagnosed with a serious mental illness, are at or below 300% of the federally defined poverty level, and are uninsured or receive Medi-Cal benefits. c. Payment Limit: $768,690 B‐2    d. Number served: In FY12/13 Anka was part of the Bridges to Home (BTH), a collaborative made up of two programs, BTH West and BTH Central. Together, BTH West and Central served 185 Individuals (target 155 individuals). BTH Central served 78 individuals. e. Outcomes: Below are the FY 12/13 outcomes for Bridges to Home Central.  Reduction in incidence of psychiatric crisis*  Reduction of the incidence of restriction* Pre- and post-enrollment utilization rates for 87 Bridges to Home Central County participants enrolled in the FSP program during FY 12-13. No. pre- enrollment No. post- enrollment Rate pre- enrollment Rate post- enrollment % change PES episodes 338 331 0.455 0.390 - 14.3 Inpatient episodes 64 35 0.076 0.050 - 34.2 Inpatient days 458 272 0.524 0.372 -29.0 * Data on service utilization were collected from the county’s internal billing system, PSP. To assess the effect of FSP enrollment on PES presentations and inpatient episodes, this methodology compares clients’ monthly rates of service utilization pre-enrollment to clients’ post-enrollment service utilization rates. Using PES usage as an example, the calculations used to assess pre- and post-enrollment utilization rates can be expressed as: ( No.of PES episodes during pre- enrollment period)/(No.of months in pre- enrollment period) =Pre-enrollment monthly PES utilization rate ( No.of PES episodes during post-enrollment period)/(No.of months in post- enrollment period) =Post-enrollment monthly PES utilization rate B‐3    Asian Community Mental Health Services (ACMHS) Point of Contact: Pysay Phinith Contact Information: Asian Family Resource Center (AFRC), 12240 San Pablo Ave, Richmond, Ca. (510) 604-6200 Pysayp@acmhs.org 1. General Description of the Organization ACMHS provides multicultural and multilingual services, empowering the most vulnerable members of our community to lead healthy, productive and contributing lives. 2. Program: Building Connections (Asian Family Resource Center) - PEI a. Scope of Services: Asian Family Resource Center (AFRC) in Richmond provides comprehensive, culturally-sensitive and appropriate education and access to Mental Health Services to Asian and Pacific Islanders immigrant and refugee communities, especially the Southeast Asian and Chinese population of Contra Costa County. AFRC employs multilingual and multidisciplinary staff from the communities which they serve, including bilingual/bicultural peer navigators for mental health outreach, engagement, system navigation, and stigma reduction. Staff provides the following Prevention and Early Intervention activities: community outreach, home visits to senior housing sites, medication compliance education, community integration skills, older adult care giving skills, basic financial management, survival English communication skills, travel training, health and safety education and computer education, mental health workshops, structured group activities on topics such as, coping with adolescents, housing issues, aid cut-off, domestic violence, criminal justice issues, health care and disability services, and health and mental health system navigation. Services are aimed at assisting consumers in actively managing their own recovery process. b. Target Population: Asian and Pacific Islanders immigrants and refugees (especially Chinese and Southeast Asian population) in Contra Costa County c. Payment Limit: $130,000 d. Number served: For FY 12/13: 67. To be served: 50 high risk and underserved community members. e. Outcomes:  All of the 67 program participants received system navigation support for mental health treatment, Medi-Cal benefits, and other essential benefits.  72% of program participants increased their knowledge of mental health resources and benefits available.  83% of program participants reported that system navigation support was very helpful.  88% improved level of self-care. B‐4    Building Blocks for Kids (BBK) Point of Contact: Jennifer Lyle. Contact Information: 310 9th Street, Richmond, Ca 94804, (510) 232-5812 jlyle@bbk-richmond.org 1. General Description of the Organization Building Blocks for Kids Richmond Collaborative is a place-based initiative with the mission of supporting the healthy development and education of all children, and the self-sufficiency of all families, living in the BBK Collaborative zone located in downtown Richmond, California. The Collaborative consists of member residents, member organizations, and working groups that work toward community change in the area of wellness and health, education, and community engagement. 2. Program: One Family at a Time (PEI) a. Scope of Services  Community Building: Community Engagement and Advocacy Teams (CEAT) o Training of 30 resident leaders in advocacy work who in turn will provide coaching for other residents. Consists of four intensive sessions plus monthly follow ups o Identify and build advocacy for community needs with emphasis on health, mental health, and education issues o Help families create the change that they want to see in the community  System Navigation Support o Support groups for English and Spanish speaking mothers o Facilitate relationships with providers, increase capacity for culturally competent service provision o Provide training to create trauma informed supportive support services  Parent Partners in Elementary Schools. Parent Partners work with families of children that are referred by teachers, school administrators, and collaborative member organizations. b. Target Population: Children and Families in the Iron Triangle, Richmond c. Payment Limit: $198,057 d. Number served: For FY 12/13: 1015 Individuals (includes outreach and education events). To be served: 300 families e. Outcomes:  20 families received intensive support from Community Engagement and Advocacy Team (CEAT) around identifying and advocating for children’s mental health needs and accessing services.  90% of surveyed parents (140) reported an increased understanding of mental health related topics and increased comfort discussing these topics.  The CEAT membership increased by 38 over the fiscal year of 12/13  A core of 43 residents attended at least 75% of all public events. B‐5    Center for Human Development (CHD) Point of Contact: Elaine Prendergast Contact Information: 901 Sunvalley Blvd., Suite 220, Concord, Ca 94520 (925) 687- 8844 elaine@chd-prevention.org 1. General Description of the Organization Center for Human Development (CHD) is a community-based organization that offers a spectrum of services for at-risk youth, individuals, families, and communities in the Bay Area. Since 1972 CHD has provided wellness programs and support aimed at empowering people and promoting positive growth. Volunteers work side- by-side with staff to deliver quality programs in schools, clinics, and community sites throughout Contra Costa as well as nearby counties. CHD is known for innovative programs and is committed to improving the quality of life in the communities it serves. 2. Program: African American Wellness Program and Youth Empowerment Program, PEI a. Scope of Services:  Wellness Program. Provide mental health outreach and engagement, as well as system navigation support to a minimum of 150 individuals in Bay Point, Pittsburg, and surrounding communities. Increase client emotional wellness, reduce client stress and isolation, and link clients to community resources in a culturally competent manner. Key activities include culturally appropriate education on mental health topics through mind, body, and soul support groups and community health education workshops, outreach at community events, and navigation assistance for culturally appropriate mental health referrals.  Youth Empowerment Program. Provide strength-based educational support services that build on youths’ assets and foster their resiliency to a minimum of 80 unduplicated LGBTQ youth and their allies in Antioch, Pittsburg, and surrounding East County communities. Key activities include, a) two weekly educational support groups that promote emotional health and well-being, increase positive identity and self-esteem, and reduce isolation through development of concrete life skills, b) a leadership group that meets a minimum of twice a month to foster community involvement, and c) referrals to culturally appropriate mental health services. b. Target Population: Wellness Program: African American residents (East County) at risk of developing serious mental illness. Youth Empowerment Program: LGBTQ youth in East County c. Payment Limit: $133,000 d. Number served: For FY 12/13: 248 served in Wellness Program. Numbers not available for Youth Empowerment Program. B‐6    e. Outcomes: Wellness Program.  94% of program participants reported that they were more comfortable to address mental health related issues.  94% of participants were able to point to at least one stress management tool they use.  94% of participants reported that they are now able to access mental health support when needed.  100% of participants reported that they were able to apply information learned to help others. B‐7    Child Abuse Prevention Council (CAPC) Point of Contact: Carol Carillo Contact Information: 2120 Diamond Blvd #120, Concord, Ca 94520 capccarol@sbcglobal.net 1. General Description of the Organization The Child Abuse Prevention Council has worked for many years to prevent the maltreatment of children. Through providing education programs and support services, linking families to community resources, mentoring, and steering County- wide collaborative initiatives, CAPC has led Contra Costa County’s efforts to protect children. It continually evaluates its programs in order to provide the best possible support to the families of Contra Costa County. 2. Program: The Nurturing Parenting Program, PEI a. Scope of Services: The Child Abuse Prevention Council of Contra Costa provides an evidence-based curriculum of cultural, linguistic, and developmentally appropriate parent education classes to Spanish speaking families in East County and Central County’s Monument Corridor. CAPC provides four classes for 15 parents each session and approximately 15 children each session who are 0-12 years of age. The 22 week curriculum will immerse parents in ongoing training designed to build new skills and alter old behavioral patterns intended to strengthen families and support the healthy development of their children in their own neighborhoods. b. Target Population: Latino children and their families in Central and East County. c. Payment Limit: $118,828 d. Number served: For FY 12-13: 126 e. Outcomes: 1. Four 22 week classes in Central and East County serving 70 children/youth and 56 parents. 2. All parent participants completed pre- and post-tests. All parents improved their scores on five parenting measures (appropriate expectations, empathy, discipline, self-awareness, empowerment). B‐8    Community Health for Asian Americans. Point of Contact: Kenneth Kim and Sean Kirkpatrick, Co-Interim Executive Directors. Contact Information: 207 37th Street, Richmond, CA 94805, (510)-233–7555, Kenneth.Kim@chaaweb.org , Sean.Kirkpatrick@chaaweb.org 1. General Description of the Organization Community Health for Asian Americans (CHAA) is a non-profit organization committed to improving the quality of life for marginalized communities with special focus on Asian and Pacific Islander (API) communities in the Bay Area. CHAA's mission is to provide community-driven behavioral health services, family support, youth development and advocacy for the historically underserved API communities in the Bay Area. 2. Program: Adult Full Service Partnership (FSP) - CSS The Adult Full Service Partnership is a collaborative program that joins the resources of Community Health for Asian Americans (CHAA) and Contra Costa County Behavioral Health Services. a. Scope of Services  Services will be provided using an integrated team approach, based on a modified Assertive Community Treatment (ACT) model of care. Services include: o Outreach and engagement o Case management o Outpatient Mental Health Services, including services for individuals with co-occurring mental health & alcohol and other drug problems o Crisis Intervention o Collateral o Medication support (may be provided by County Physician) o Housing support o Flexible funds o Vocational Services o Educational Services o Recreational and Social Activities o Transitional Employment Program o Contractor must be available to consumer on 24/7 basis b. Target Population: Adults over the age of 18 in West and Central County who are diagnosed with a serious mental illness, are at or below 300% of the federally defined poverty level, and are uninsured or receive Medi-Cal benefits. c. Payment Limit: $123,422 d. Number served: In FY12/13 CHAA was part of the Bridges to Home (BTH) collaborative. Bridges to Home served 185 Individuals. e. Outcomes: B‐9     Reduction in incidence of psychiatric crisis*  Reduction of the incidence of restriction* Table 1. Pre- and post-enrollment utilization rates for 77 Bridges to Home West County participants enrolled in the FSP program during FY 12-13. No. pre- enrollment No. post- enrollment Rate pre- enrollment Rate post- enrollment % change PES episodes 160 151 0.271 0.223 - 17.7 Inpatient episodes 29 26 0.039 0.036 - 7.7 Inpatient days 253 218 0.334 0.282 - 15.6 * Data on service utilization were collected from the county’s internal billing system, PSP. To assess the effect of FSP enrollment on PES presentations and inpatient episodes, this methodology compares clients’ monthly rates of service utilization pre-enrollment to clients’ post-enrollment service utilization rates. Using PES usage as an example, the calculations used to assess pre- and post-enrollment utilization rates can be expressed as: ( No.of PES episodes during pre- enrollment period)/(No.of months in pre- enrollment period) =Pre-enrollment monthly PES utilization rate ( No.of PES episodes during post-enrollment period)/(No.of months in post- enrollment period) =Post-enrollment monthly PES utilization rate B‐10    Community Options for Families and Youth, Inc. Point of Contact: Julie Sievenpiper, Program Manager Contact Information: 1910 Olympic Boulevard, Suite 200, Walnut Creek, CA 94596, (925)-943-1794, j.sievenpiper@cofy.org 1. General Description of the Organization Community Options for Families and Youth (COFY) is a multi-disciplinary provider of mental health services. COFY’s mission is to work with youth whose high-intensity behaviors place them at risk of hospitalization or residential treatment. Their mental health clinicians work collaboratively with caregivers, educators and social service professionals to help exasperated families restore empathic relationships and maintain placement for their children. 2. Program: Multisystemic Therapy (MST) – Full Service Partnership (FSP) - CSS Multisystemic Therapy (MST) in an intensive family and community based treatment that addresses the multiple determinants of serious anti-social behavior. The MST approach views individuals as being surrounded by a network of interconnected systems that encompasses individual, family, and extra familial (peers, school, community) factors. Intervention may be necessary in any one or a combination of these systems, and using the strengths of each system to facilitate positive change. The intervention strives to promote behavioral change in the youth’s natural environment. Family sessions are provided over a three to five month period. These sessions are based on nationally recognized evidence based practices designed to decrease rates of anti-social behavior, improve school performance and interpersonal skills, and reduce out-of-home placements. The ultimate goal is to empower families to build a healthier environment through the mobilization of existing child, family and community resources. a. Scope of Services: Services include but are not limited to outreach and engagement, case management, outpatient mental health services, crisis intervention, collateral services, flexible funds. COFY staff must be available to consumer on a 24/7 basis. b. Target Population: Children 12 to 17 who have a serious emotional disturbance or serious mental illness, and have been identified as a juvenile offender or are at risk of involvement with Probation due to delinquent behavior. Services are county-wide. c. Payment Limit: $650,000 d. Number served: Program began in FY 13/14. Number to be served: 66. e. Outcomes: Because the program began in FY 13/14, there are no outcomes to report at this time. COFY will report on reduction in incidence of restriction, arrests, incarceration. B‐11    Community Violence Solutions Point of Contact: Cynthia Peterson, Director of the Rape Crisis Center. Contact Information: 2101 Van Ness Street, San Pablo, CA 94806, (510)-307-4121, cpeterson@cvsolutions.org 1. General Description of the Organization Community Violence Solutions (CVS) is dedicated to working in partnership with the community to end sexual assault and family violence through prevention, crisis services, and treatment. Formerly called Rape Crisis Center, CVS was founded by the Greater Richmond Interfaith Program in 1974. Since then, CVS has expanded its services to all of Contra Costa and Marin Counties. 2. Program: Reluctant to Rescue (Innovation) The intent of this project is to “increase the quality of services, including better outcomes”. Community Violence Solutions (CVS) named the project “Reluctant to Rescue” because it recognized the highly complex dynamic situations that often prevent the “rescue” of youth victimized by sexual exploitation. Through this project, CVS is exploring the effectiveness of various service modalities by addressing two of its operating assumptions. First, commercially sexually exploited (CSEC) youth are nearly always traumatized sexual assault victims; yet, exploited youth do not always see themselves as victims and, as a result, often do not respond to the same approaches as other sexual assault victims. Interventions might be more effective if they: a) assisted youth in recognizing the physical risks and health problems associated with the sex trade and b) addressed the youth’s ability to earn a living through paid job training. Addressing trauma and other psychosocial issues may need to occur later in the intervention. Second, the ways and reasons youth enter a situation of exploitation are often not same reasons they remain in this “work”. Therefore, interventions should address these changes. Staff adapt their outreach to engage youth where they are located, providing safe, accessible drop-in centers, and providing mental health and support services. This project is developing promising practices to identify exploited and at-risk youth, coordinate with and educate public entities, such as law enforcement, and mobilize resources to assist youth leave exploited situations. a. Scope of Services: The project recognizes youth as experts in their own experiences and relies on their feedback and expressions of need to inform the development of services and multiple service routes. Accordingly, the project initially approaches the issue of sex for pay with respectful inquiry instead of specific ideas of intervention and service. Youth share information through guided interviews and focus groups. The proposed project seeks to gain detailed information directly from the youth in order to help develop interventions that address complex motivations for entering and continuing in sexual exploitation. B‐12    CVS utilizes the youth-generated information to inform curriculum development and intensive training with a core group of CSEC parents, guardians, and foster parents who are open to increasing their skills and willing to care for these challenging and challenged youth. CVS coordinates all aspects of the project and, as appropriate, brings community partners in to deliver specific services requested by youth. Two drop-in centers are staffed and respond to needs of youth expressed in the qualitative data collected during Phase I of the project. CVS contracts with specific individuals and/or other agency providers to serve identified needs. b. Target Population: Sexually exploited youth (ages 16 to 25 years) and youth at risk of sexual exploitation. c. Annual Payment Limit: $159,390 d. Number served: For FY 12/13: 62 youth e. Outcomes:  Reduction in incidence of incarceration  Reduction in depression symptoms To determine if the program may have resulted in changes in the above outcomes, data for these outcomes will be tracked annually using the Children and Adolescent Needs and Strengths Assessment (CANS). Baseline measurements were taken during Fiscal Year 2012/2013. At baseline, the CANS indicated that 100% of the youth participating in the program reported having experienced incarceration. At baseline, the CANS also indicated that 91% of the youth participating in this program showed evidence of depression, with 73% presenting with moderate to severe symptoms. B‐13    Contra Costa County Behavioral Health – County-Operated Mental Health Services Act Housing Services Point of Contact: Sandy Rose, Mental Health Housing Services Coordinator Contact Information: 1340 Arnold Drive, Suite 200, Martinez CA 94553. (925)-957- 5143. Sandy.Rose@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The County-operated MHSA Housing Services operates within Contra Costa Mental Health’s Adult System of Care, and partners closely with the Homeless Program. 2. Program: Homeless Programs -- Temporary Shelter Beds The County’s Homeless Services Division operates a number of temporary bed facilities in West and Central County for transitional age youth and adults. In 2010, CCMH entered into a Memorandum of Understanding with the Homeless Services Division that provides additional funding to enable up to 109 individuals with a serious mental illness per year to receive temporary emergency housing for up to four months. a. Target Population: Individuals who are severely and persistently mentally ill or seriously emotionally disturbed, and are homeless. b. Total MHSA Portion of Budget: $1,672,000 c. Number Served in FY 12/13: 109 beds fully utilized for 365 days in the year. Program: Permanent Housing Having participated in a specially legislated MHSA Housing Program through the California Housing Finance Agency the County, in collaboration with many community partners, the County completed a number of one-time capitalization projects to create 50 permanent housing units for individuals with serious mental illness. These individuals receive their mental health support from Contra Costa Mental Health contract and county service providers. The sites include Villa Vasconcellos in Walnut Creek, Lillie Mae Jones Plaza in North Richmond, The Virginia Street Apartments in Richmond, Tabora Gardens in Antioch, Robin Lane apartments in Concord, Ohlone Garden apartments in El Cerrito, Third Avenue Apartments in Walnut Creek, Garden Park apartments in Concord, and scattered units throughout the County operated by Anka Behavioral Health. a. Target Population: Individuals who are severely and persistently mentally ill or seriously emotionally disturbed and are homeless or at risk of homelessness. b. Total MHSA Portion of Budget: One Time Funding Allocated c. Number Served in FY 12/13: 50 units. Program: Coordination Team B‐14    Mental Health Housing Services Coordinator and staff work closely with County’s Homeless Services Division staff to coordinate referrals and placements, facilitate linkages with other Contra Costa mental health programs and services, and provide contract monitoring and quality control. a. Target Population: Individuals who are severely and persistently mentally ill or seriously emotionally disturbed and are homeless or at risk of homelessness. b. Total FTE: 4.0 FTE c. Total MHSA Portion of Budget: $457,958 d. Number Served in FY 12/13: Support to MHSA Housing Services and the Homeless Program. B‐15    Contra Costa County Behavioral Health – Forensics Services Point of Contact: David Seidner, Adult Mental Health Supervisor Contact Information: 1330 Arnold Drive, Suite 143, Martinez CA 94553. (925)-957- 5138. David.Seidner@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The Forensic Services team operates within Contra Costa Mental Health’s Adult System of Care, and works closely with Adult Probation. 2. Program: Forensic Services The Forensics Services team is a multidisciplinary team comprised of mental health clinical specialists, registered nurses, alcohol and other drugs specialists, homeless benefits specialists, and community support workers. The purpose of the team is to engage and offer voluntary services to participants who are seriously and persistently mentally ill and are involved in the criminal justice system. Forensic Services hosts office hours at the three regional probation offices to enhance the opportunity for screening and service participation. The co-located model allows for increased collaboration among the participants, service providers, and Deputy Probation Officers. b. Scope of Services. Authorized for Fiscal Year 2011-12 four clinical specialists were funded by MHSA to join Forensics Services Team. These clinicians provide services to individuals who were determined to be high users of psychiatric emergency services and other public resources, but very low users of the level and type of care needed. This team works very closely with the criminal justice system to assess referrals for serious mental illness, provide rapid access to a treatment plan, and work as a team to provide the appropriate mental health, substance abuse and housing services needed. c. Target Population: Individuals who are seriously and persistently mentally ill who are on probation and at risk of re-offending and incarceration. d. Budget: $493,973 e. MHSA-Funded Staff: 4.0 Full-time equivalent f. Number Served in FY 12/13: 138 cases were opened. Future MHSA Plans will report on number screened as well as number of cases opened. g. Outcomes: The Forensics Team will report on the following outcomes in future MHSA Plans:  Percentage of clients screened who are opened by the Forensics Team  Percentage of clients who are opened by the Forensics Team who receive a first appointment at the mental health clinic B‐16    Contra Costa County Mental Health – Assessment and Recovery Center Point of Contact: To Be Determined Contact Information: 25 Allen Street, Martinez CA 94553. 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The Assessment and Recovery Center operates within Contra Costa Mental Health, and is jointly operated by the Children’s and Adult System of Care. 2. Program: Assessment and Recovery Center The Assessment and Recovery Center (ARC) is meant to serve several purposes in Contra Costa Behavioral Health Services’ system of care, including diverting children and adults from Psychiatric Emergency Services (PES). Through a close relationship with PES, the goal will also be to allow children and adults who are evaluated at PES to quickly step-down to the ARC if they do not need hospital level of care. The ARC will offer urgent same-day appointments for individuals who are not open to the Contra Costa Mental Health System, or who have disconnected from care after previously being seen. The County has recently completed construction on a separate building near the Contra Costa Regional Medical Center that will house the Assessment and Recovery Center. This county operated mental health treatment program for both children and adults will be co-located with a primary care site. The ARC is scheduled to be operational in the Summer of 2014. a. Target Population: Children and adults who are being diverted from PES or who require urgent same day appointments. b. Total Budget: $2,750,000 c. Staff: To Be Determined d. Number Served: To Be Determined e. Outcomes: To Be Determined   B‐17    Contra Costa County Mental Health – Central County Adult Mental Health Clinic Point of Contact: Guillermo Cuadra, Mental Health Program Manager Contact Information: 1420 Willow Pass Rd., Ste. 200, Concord, CA 94520, (925)- 646-5480, Guillermo.Cuadra@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The Central Adult Mental Health Clinic operates within Contra Costa Mental Health’s Adult System of Care, and provides assessments, case management, psychiatric services, crisis intervention, housing services and benefits assistance. Within the Adult Mental Health Clinic are the following MHSA funded programs and plan elements: 2. Plan Element: Adult Full Service Partnership Support - CSS Contra Costa Mental Health has dedicated clinicians staff at each of the three adult mental health clinics to provide support, coordination and rapid access for full service partners to health and mental health clinic services as needed and appropriate. Plan Element: Clinic Support - CSS General Systems Development strategies are programs or strategies that improve the larger mental health system of care. These programs and strategies expand and enhance the existing service structure to 1) assist consumers in obtaining benefits they entitled to, educate consumers on how to maximize use of those benefits and manage resources, and 2) provide transportation support for consumers and families. a. Clinic Target Population: Adults aged 18 years and older who live in Central County, are diagnosed with a serious mental illness and are uninsured or receive Medi-Cal benefits. b. Total Number served by clinic: For FY 12-13: Approximately 3,610 Individuals. Program: Suicide Prevention Pilot - PEI A Mental Health Clinical Specialist provides routine follow up care and linkage services for Central County clients who access Psychiatric Emergency Services and are at risk for suicide. In addition, the clinician provides comprehensive assessment as well as group and individual therapy for suicidal patients at Concord Adult Mental Health. a. Target Population: Clients at risk of suicide. b. Total Budget: $123,493 c. Staff: 1 Full time equivalent d. Number Served: 41 e. Outcomes:  Decrease in Suicide Rate (among clients open to Concord Adult Mental Health)  Increase in Cognitive Behavioral Therapy Participation Program: Women Embracing Life and Learning (WELL) - INN B‐18    WELL is a collaboration between Contra Costa Mental Health Services, Public Health Nursing and the Women Infant and Child (WIC) project. It is integrating perinatal/postpartum depression services into the services currently provided at the Central County WIC office. The target population consists of mothers who receive services from the Central County WIC office who screen positive for perinatal and/or post-partum depression. The goals of the project are to learn: 1) which elements of the collaboration are most/least effective and why; 2) if the collaboration leads to an increase in awareness about mental health services and a decrease in the mothers’ perception of stigma associated with depression; and 3) improved health outcomes for the women participating in the collaboration. a. Target Population: Low income mothers with perinatal/postpartum depression. b. Total Budget: $194,652 c. Staff: 2.62 Full time equivalent d. Number Served: Program began in FY 12/13. e. Outcomes: The WELL Project strives to accomplish the following outcomes: • A decrease in psychiatric symptoms • A decrease in mental health stigma To determine if the program may have resulted in changes in the above outcomes, data for these outcomes will be compared before and after program participation. The baseline data will be derived from participants at enrollment, and the post data will be derived from participants at graduation or upon dropping out from the program. Data related to psychiatric symptoms will be obtained from the PHQ-9 and the Edinburgh Postnatal Depression Scale. Data related to mental health stigma will be obtained from a measurement tool that will be determined. Program: Trauma Recovery Project - INN The Trauma Recovery Project is piloting the use of a Trauma Recovery Group with consumers diagnosed with co-occurring Post-Traumatic Stress Disorder (PTSD) and schizophrenia, schizoaffective disorder, bipolar disorder and/or cluster B personality disorders who receive mental health services at the county-operated adult mental health clinics. The goals of the project are to determine: 1) if offering this group to consumers will improve mental health outcomes and promote recovery; 2) how peer providers can support the group; and 3) if the group is effective among various cultural populations, particularly Spanish-speaking populations and transition age youth. a. Target Population: Consumers diagnosed with co-occurring Post-Traumatic Stress Disorder (PTSD) and schizophrenia, schizoaffective disorder, bipolar disorder and/or cluster B personality disorders. b. Budget: $123,493 B‐19    c. Staff: 1.5 Full-time equivalent d. Number Served: 30 e. Outcomes: The Trauma Recovery Project aims to achieve the following outcomes: • A decrease in the rate of psychiatric emergency admissions • A decrease in the rate of acute psychiatric admissions and hospitalization days To determine if the group may have resulted in changes in the above outcomes, data for these outcomes was compared before and after group participation. The baseline data was derived from participants one year before enrollment, and the post data was derived from participants enrolled in the group during FY 2012-2013. Table 1. Pre- and post-enrollment utilization rates for 30 Trauma Recovery Group participants enrolled in FY 2012-2013. No. pre- enrollmen t No. post- enrollmen t Rate pre- enrollmen t Rate post- enrollmen t % chang e PES admissions 11 8 0.0306 0.0222 - 27.45% Hospitalization s 5 3 0.0139 0.0083 - 40.29% Hospitalization days 36 20 0.1000 0.0556 - 44.40% Note. Pre-enrollment data is from the calendar year before each participant’s enrollment in the group. Post-enrollment data is from FY 2012-2013. B‐20    Contra Costa Mental Health – Central County Children’s Mental Health Clinic Point of Contact: Jan Cobaleda-Kegler, Mental Health Program Manager Contact Information: 2425 Bisso, Ste. 200, Concord, CA 94520, (925)-521-5707, Jan.Cobaleda-Kegler@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The Central Children’s Mental Health Clinic operates within Contra Costa Mental Health’s Children’s System of Care, and provides psychiatric and outpatient services, family partners, and wraparound services. Within the Adult Mental Health Clinic are the following MHSA funded plan elements: 2. Plan Element: Clinic Support - CSS General Systems Development strategies are programs or strategies that improve the larger mental health system of care. These programs and strategies expand and enhance the existing service structure to assist consumers in the following areas:  Family Partners and Wraparound Facilitation. The family partners assist families with advocacy, transportation assistance, navigation of the service system, and offer support in the home, community, and county service sites. Family partners support families with children of all ages who are receiving services in the children. Family partners are located in each of the regional clinics for children and adult services, and often participate on wraparound teams following the evidence-based model.  A Clinical Specialist in each regional clinic who provides technical assistance and oversight of evidence-based practices in the clinic.  Support for full service partners. a. Target Population: Children aged 17 years and younger, who live in Central County, are diagnosed with a serious emotional disturbance or serious mental illness, and are uninsured or receive Medi-Cal benefits. b. Number served by clinic: For FY 12/13: Approximately 810 Individuals. B‐21    Contra Costa County Mental Health – East County Adult Mental Health Clinic Point of Contact: Beverly, Fuhrman, Mental Health Program Manager Contact Information: 2311 Loveridge Rd., Pittsburg, CA 94565, (925)-431-2621, Beverly.Fuhrman@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The East Adult Mental Health Clinic operates within Contra Costa Mental Health’s Adult System of Care, and provides assessments, case management, psychiatric services, crisis intervention, housing services and benefits assistance. Within the Adult Mental Health Clinic are the following MHSA funded programs and plan elements: 2. Plan Element: Adult Full Service Partnership Support - CSS Contra Costa Mental Health has dedicated clinicians at each of the three adult mental health clinics to provide support, coordination and rapid access for full service partners to health and mental health clinic services as needed and appropriate. Plan Element: Clinic Support - CSS General Systems Development strategies are programs or strategies that improve the larger mental health system of care. These programs and strategies expand and enhance the existing service structure to assist consumers in 1) obtaining benefits they entitled to, educate consumers on how to maximize use of those benefits and manage resources, and 2) provide transportation support for consumers and families. a. Clinic Target Population: Adults aged 18 years and older who live in Central County, are diagnosed with a serious mental illness and are uninsured or receive Medi-Cal benefits. b. Total Number served by clinic: For FY 12-13: Approximately 2,960 Individuals. B‐22    Contra Costa Mental Health – East County Children’s Mental Health Clinic Point of Contact: Eileen Brooks, Mental Health Program Manager Contact Information: 3501 Lone Tree Way, #200, Antioch, CA 94509, (925)-427- 8545, Eileen.Brooks@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The Central Children’s Mental Health Clinic operates within Contra Costa Mental Health’s Children’s System of Care, and provides psychiatric and outpatient services, family partners, and wraparound services. Within the Adult Mental Health Clinic are the following MHSA funded plan elements: 2. Plan Element: Clinic Support - CSS General Systems Development strategies are programs or strategies that improve the larger mental health system of care. These programs and strategies expand and enhance the existing service structure to assist consumers in the following areas:  Family Partners and Wraparound Facilitation. The family partners assist families with advocacy, transportation assistance, navigation of the service system, and offer support in the home, community, and county service sites. Family partners support families with children of all ages who are receiving services in the children. Family partners are located in each of the regional clinics for children and adult services, and often participate on wraparound teams following the evidence-based model.  A Clinical Specialist in each regional clinic who provides technical assistance and oversight of evidence-based practices in the clinic.  Support for full service partners. a. Target Population: Children aged 17 years and younger, who live in Central County, are diagnosed with a serious emotional disturbance or serious mental illness, and are uninsured or receive Medi-Cal benefits. b. Number served by clinic: For FY 12/13: Approximately 890 Individuals. B‐23    Contra Costa County Mental Health – West County Adult Mental Health Clinic Point of Contact: Matthew Luu, Mental Health Program Manager Contact Information: 2523 El Portal Drive, San Pablo, CA 94806, (510)-215-3700, Matthew.Luu@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The East Adult Mental Health Clinic operates within Contra Costa Mental Health’s Adult System of Care, and provides assessments, case management, psychiatric services, crisis intervention, housing services and benefits assistance. Within the Adult Mental Health Clinic are the following MHSA funded programs and plan elements: 2. Plan Element: Adult Full Service Partnership Support - CSS Contra Costa Mental Health has dedicated clinicians at each of the three adult mental health clinics to provide support, coordination and rapid access for full service partners to health and mental health clinic services as needed and appropriate. Plan Element: Clinic Support - CSS General Systems Development strategies are programs or strategies that improve the larger mental health system of care. These programs and strategies expand and enhance the existing service structure to 1) assist consumers in obtaining benefits they entitled to, educate consumers on how to maximize use of those benefits and manage resources, and 2) provide transportation support for consumers and families. a. Clinic Target Population: Adults aged 18 years and older who live in Central County, are diagnosed with a serious mental illness and are uninsured or receive Medi-Cal benefits. b. Total Number served by clinic: For FY 12-13: Approximately 2,720 Individuals. B‐24    Contra Costa County Mental Health – West County Children’s Mental Health Clinic Point of Contact: Chad Pierce, Mental Health Program Manager Contact Information: 303 41st St Richmond, CA 94805, (510)-374-7208, Chad.Pierce@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The Central Children’s Mental Health Clinic operates within Contra Costa Mental Health’s Children’s System of Care, and provides psychiatric and outpatient services, family partners, and wraparound services. Within the Adult Mental Health Clinic are the following MHSA funded plan elements: 2. Plan Element: Clinic Support - CSS General Systems Development strategies are programs or strategies that improve the larger mental health system of care. These programs and strategies expand and enhance the existing service structure to assist consumers in the following areas:  Family Partners and Wraparound Facilitation. The family partners assist families with advocacy, transportation assistance, navigation of the service system, and offer support in the home, community, and county service sites. Family partners support families with children of all ages who are receiving services in the children. Family partners are located in each of the regional clinics for children and adult services, and often participate on wraparound teams following the evidence-based model.  A Clinical Specialist in each regional clinic who provides technical assistance and oversight of evidence-based practices in the clinic.  Support for full service partners. a. Target Population: Children aged 17 years and younger, who live in Central County, are diagnosed with a serious emotional disturbance or serious mental illness, and are uninsured or receive Medi-Cal benefits. b. Number served by clinic: For FY 12/13: Approximately 1,492 Individuals. B‐25    Contra Costa Crisis Center Point of Contact: Rhonda James Contact Information: P.O. Box 3364 Walnut Creek, Ca 94598 RhondaJ@crisis-center.org 1. General Description of the Organization The mission of the Contra Costa Crisis Center is to keep people alive and safe, help them through crises, and connect them with culturally relevant resources in the community 2. Program: Suicide Prevention Crisis Line a. Scope of Services: Contra Costa Crisis Center provides services to prevent suicides throughout Contra Costa County by operating a nationally certified 24-hour suicide prevention hotline. The hotline lowers the risk of suicide at a time when people are most vulnerable, enhances safety and connectedness for suicidal individuals, and builds a bridge to community resources for at-risk persons. Key activities include: answering local calls to toll-free suicide hotlines, including a Spanish-language hotline; assisting callers whose primary language isn’t English or Spanish through use of a tele- interpreter service; conducting a lethality assessment on each call consistent with national standards; making follow-up calls to persons (with their consent) who are at medium to high risk of suicide; and training all crisis line staff and volunteers in ASIST (Applied Suicide Intervention Skills Training). As a result of these service activities: 95 percent or more of people who call the crisis line and are assessed to be at medium to high risk of suicide will still be alive one month later; the Crisis Center will continuously recruit and train crisis line volunteers to a minimum pool of 25 multilingual/culturally competent individuals within the contract year, and the number of hours that a minimum of one Spanish-speaking counselor is on duty will be 80 per week. In partnership with County Mental Health, Contra Costa Crisis Center co-chairs the Suicide Prevention Committee. b. Target Population: Contra Costa County residents in crisis. c. Payment Limit: $292,850 d. Number served: 30,582 e. Outcomes:  Calls were answered in both English and Spanish 16 hours each day and in English with Spanish tele-interpreter back up during late night/early morning hours 8 hours per day.  Average response time was 6.6 seconds and call abandonment rate was 1.9 (losing less than half of industry standard number of calls).  Lethality assessments were provided for 100% of callers rated mid to high level risk. 828 follow-up phone calls were provided to 230 callers.  41 new volunteers were trained and added to the line. B‐26    Contra Costa Interfaith Housing (CCIH) Point of Contact: Louise Bourassa Contact Information: 3164 Putnam Blvd. Ste C, Walnut Creek, CA 94597 (925) 944- 2244 Louise@ccinterfaithhousing.org 1. General Description of the Organization Contra Costa Interfaith Housing strives to provide permanent, affordable housing and vital support services to homeless and at-risk families and individuals in Contra Costa County. CCIH believes that every family in Contra Costa County should have secure housing and the dignity of self-sufficiency. CCIH helps provide living conditions for children that support their development into productive and healthy members of the community. 2. Program: Strengthening Vulnerable Families a. Scope of Services: Contra Costa Interfaith Housing provides on-site, on-demand, and culturally appropriate delivery of an evidence-based Strengthening Families Program to help formerly homeless families, all with special needs, at the Garden Park Apartments in Pleasant Hill to improve parenting skills, child and adult life skills, and family communication skills. This program is designed to help families stabilize, parents achieve the highest level of self-sufficiency possible, and provide early intervention for the youth in these families who are at risk for ongoing problems due to mental illness, domestic violence, substance addiction, poverty and inadequate life skills. Key activities include: family support, support for sobriety, academic 4-day-per-week homework club, support for families of children aged birth to 5, teen support group, and community building events. Further, CCIH provides an Afterschool Program and mental health and case management services at two sites in East Contra Costa County: Bella Monte Apartments in Bay Point and Los Medanos Village in Pittsburg, and at one site in Concord: Lakeside Apartments. These complexes offer permanent affordable housing to low-income families. b. Target Population: Formerly homeless families c. Payment Limit: $65,526 d. Number served: 238 e. Outcomes:  At Garden Park Apartments o 85% of youth attended 75% of afterschool programming or more. 93% of participants improved in at least two academic goals. o 74% of families improved at least in one area of self-sufficiency. o 77% of families achieved progress on self-created goals.  At Los Medanos and Bella Monte Apartments: B‐27    o 96% of 30 families engaged in case management services were able to resolve the issues for which they sought help. o 81% of afterschool program participants improved in four or more benchmarks. B‐28    Counseling Options Parent Education (C.O.P.E.) Point of Contact: Cathy Botello Contact Information: 2280 Diamond Blvd #460, Concord, Ca 94520. (925) 689-5811 cathy.botello@copefamilysupport.org 1. General Description of the Organization C.O.P.E.S.’s mission is to prevent child abuse, provide comprehensive services in order to strengthen family relationships and bonds, empower parents, encourage healthy relationships, and cultivate nurturing family units to encourage an optimal environment for the healthy growth and development of parents and children through parent education. 2. Programs: Triple P Positive Parenting Education and Support (PEI) a. Scope of Services: In partnership with community based organizations and County Mental Health, C.O.P.E. delivers Positive Parenting Program classes for parents of children age 6 – 17 and (partnering with First Five) for parents of children age 0 – 5 . Parenting classes include classes for parents with special needs children, parents with anger in parenting, parents coping with stress and marital conflict. All classes are available in Spanish and/or English as needed. C.O.P.E. provides management briefings and orientation meetings to partner agencies, organizes trainings to build and maintain a pool of practitioners, provides pre-accreditation training to trainees, and provides clinical and peer support for practitioners. b. Target Population: Contra Costa County parents of children and youth with identified special needs. c. Payment Limit: $225,000 (6 – 17), through First Five: $75,000 (0 – 5). d. Number served: For FY 12/13: 327 (6 – 17) and 243 (0 – 5). e. Outcomes:  Completed 21 parent education classes for parents of children age 6 – 17  Completed 17 parent education classes for parent of children age 0 – 5  Pre and Post Test show improvements in measures of parenting style (laxness, over-reactivity, and hostility), decrease of depression/anxiety measures, and decrease in frequency of child problem behavior, improvement in child adjustment behavior and caregivers level of stress about these behaviors.  In partnership with First Five, C.O.P.E. organized trainings for 19 new practitioners in two levels of Triple P (Group and Teen trainings).  Provided seven weeks of pre-accreditation training and one Learning Community retreat.  Added eight new community agencies and staff trained in Triple P Positive Parenting.   B‐29    Crestwood Behavioral Health, Inc. Point of Contact: Sylvia Ward, Program Director for The Pathway. Contact Information: 550 Patterson Boulevard, Pleasant Hill, CA 94523. (925) 938- 8050. 1. General Description of the Organization The mission at Crestwood Healing Center is to partner with Contra Costa County clients, employees, families, business associates, and the broader community in serving individuals affected by mental health issues. Together, they enhance quality of life, social interaction, community involvement and empowerment of mental health clients toward the goal of creating a fulfilling life. Clients are assisted and encouraged to develop life skills, participate in community based activities, repair or enhance primary relationships, and enjoy leisure activities. Being supportive, compassionate and inclusive increases motivation and commitment. 2. Program: The Pathway Program (Mental Health Housing Services - CSS The Pathway Program provides psychosocial rehabilitation for 16 clients who have had little, if any, previous mental health treatment. The program provides intensive skills training to promote independent living. Many clients complete their high school requirements, enroll in college or are participating in competitive employment by the end of treatment. a. Scope of Services  Case management.  Mental health services.  Medication management.  Crisis intervention.  Adult residential. c. Target Population: Adults aged 18 years and older who live in Central County, are diagnosed with a serious mental illness and are uninsured or receive Medi- Cal benefits. b. Annual MHSA Payment Limit: $ 411,653 c. Number served: For FY 12/13: 16 beds available. d. Outcomes: To be determined.   B‐30    Desarrollo Familiar, Inc. Point of Contact: Lorena Huerta, Executive Director. Contact Information: 205 39th Street, Richmond, CA 94805, (510)–412–5930, LHuerta@Familias-Unidas.org . 1. General Description of the Organization Familias Unidas exists to improve wellness and self-sufficiency in Latino and other communities. The agency accomplishes this by delivering quality mental health counseling, service advocacy, and information/referral services. Familias Unidas programs include: mental health, education and prevention, youth development, and wrap-around services. 2. Program: Familias Unidas – Full Service Partnership - CSS Familias Unidas provides a comprehensive range of services and supports in Contra Costa County to adults with serious emotional disturbance/serious mental illness who are homeless or at serious risk of homelessness. Services are based in West Contra Costa County. a. Scope of Services  Services are provided using an integrated team approach, based on a modified Assertive Community Treatment (ACT) model of care. Services include: o Outreach and engagement o Case management o Outpatient Mental Health Services, including services for individuals with co-occurring mental health & alcohol and other drug problems o Crisis Intervention o Collateral services o Medication support (may be provided by County Physician) o Housing support o Flexible funds o Contractor must be available to the consumer on a 24/7 basis b. Target Population: Adults between the ages of 26 and 59 in West County who are diagnosed with a serious mental illness, are homeless or at imminent risk of homelessness, are at or below 300% of the federally defined poverty level, and are uninsured or receive Medi-Cal benefits. c. Payment Limit: $ 207,096 (this includes Federal Financial Participation, FFP) d. Number served: For FY 12/13: 37 Individuals . e. Outcomes: For FY 12/13:  Reduction in incidence of psychiatric crisis  Reduction of the incidence of restriction B‐31    Table 1. Pre- and post-enrollment utilization rates for 55 Familias Unidas participants enrolled in the FSP program during FY 12-13. No. pre- enrollment No. post- enrollment Rate pre- enrollment Rate post- enrollment % change PES episodes 33 28 0.073 0.042 - 42.5 Inpatient episodes 10 2 0.020 0.005 - 75.0 Inpatient days 49 13 0.094 0.035 - 62.8 * Data on service utilization were collected from the county’s internal billing system, PSP. To assess the effect of FSP enrollment on PES presentations and inpatient episodes, this methodology compares clients’ monthly rates of service utilization pre-enrollment to clients’ post-enrollment service utilization rates. Using PES usage as an example, the calculations used to assess pre- and post-enrollment utilization rates can be expressed as: ( No.of PES episodes during pre- enrollment period)/(No.of months in pre- enrollment period) =Pre-enrollment monthly PES utilization rate ( No.of PES episodes during post-enrollment period)/(No.of months in post- enrollment period) =Post-enrollment monthly PES utilization rate B‐32    Divines Home Point of Contact: Maria Riformo. Contact Information: 2430 Bancroft Lane, San Pablo, CA 94806. 1. Program: Augmented Board and Cares – MHSA Housing Services - CSS The County contracts with Divines Homes, a licensed board and care provider, to provide additional staff care to enable those with serious mental illness to avoid institutionalization and enable them to live in the community. a. Scope of Services  Augmented residential services. d. Target Population: Adults aged 18 years and older who live in Central County, are diagnosed with a serious mental illness and are uninsured or receive Medi- Cal benefits. b. Annual MHSA Payment Limit: $ 7,200 c. Number served: For FY 12/13: 6 beds available. d. Outcomes: To be determined. B‐33    First Five Contra Costa Point of Contact: Wanda Davis Contact Information: 1486 Civic Ct, Concord Ca 94520. (925) 771-7300 wdavis@firstfivecc.org 1. General Description of the Organization The mission of First 5 Contra Costa is to foster the optimal development of children, prenatal to five years of age. In partnership with parents, caregivers, communities, public and private organizations, advocates, and county government, First Five supports a comprehensive, integrated set of sustainable programs, services, and activities designed to improve the health and well-being of young children, advance their potential to succeed in school, and strengthen the ability of their families and caregivers to provide for their physical, mental, and emotional growth. 2. Programs: Triple P Positive Parenting Program - (PEI) a. Scope of Services: First Five Contra Costa and Contra Costa Behavioral Health jointly fund the Triple P Positive Parenting Program that is provided to parents of 0 to 5 children, as well as the Triple P training necessary to maintain a network of Triple P practitioners in the County. Among other duties, First Five Contra Costa provides classes, helps identify 0-5 Triple P trainees, provides support for trainees to develop their skills, and provides technical assistance and support to sub-contractors to identify sites for classes and gather data. b. Target Population: Contra Costa County parents of at risk 0 – 5 children. c. Payment Limit: $75,000 d. Number served: For FY 12/13: 243 Parents (included in C.O.P.E. numbers) e. Outcomes:  17 classes throughout the County for 243 parents with parent satisfaction rate of 99%.  Improvement of parenting skills and reduction in perceived problem behaviors  Triple P training for new instructors  Learning community for Triple P instructors. B‐34    First Hope – Contra Costa County Mental Health Point of Contact: Phyllis Mace, Mental Health Program Supervisor Contact Information: 1034 Oak Grove Rd, Concord, CA 94518 (925) 681-4450 Phyllis.Mace@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The First Hope program operates within Contra Costa Mental Health’s Adult System of Care. 2. Program: First Hope: Early Identification and Intervention in Psychosis - PEI a. Service Plan The mission of the First Hope program is to reduce the incidence and associated disability of psychotic illnesses in Contra Costa County through: 1) Early Identification of young people between ages 12 and 25 who are showing very early signs of psychosis and determined to be at risk for developing a serious mental illness. 2) Engaging and rapidly treating those identified as “at risk”, while maintaining progress in school, work and social relationships. 1) Outreach and community education with the goal of identifying all young people in Contra Costa County who would benefit from early intervention services. Program components include assessment, family-aided assertive community treatment, psycho-education and multi-family groups, medication management, and supported education and employment services. b. Target Population: 12-25 year old transition age youth and their families c. Total Budget: $1,685,607 d. Staff: 13.5 Full time equivalent multi-disciplinary staff e. Number served: For calendar year 2013:  Outreach Education: 2,640, plus presence at 4 Health Fairs, Conferences  Screenings: 253  Assessments: 98  Clients enrolled: 40 f. Outcomes:  Help clients manage prodromal symptoms  Help clients maintain progress in school, work, relationships  Prevent development of psychotic illnesses  Reduce necessity to access psychiatric emergency serves/ inpatient care Long Term Public Health Outcomes:  Reduce conversion rate from prodromal symptoms to schizophrenia  Reduce incidence of psychotic illnesses in Contra Costa County. B‐35    Fred Finch Youth Center Point of Contact: Fanshen Thompson, LCSW, Program Director Contact Information: 2523 El Portal Drive, Suite 201, San Pablo, CA 94806, (510)– 439–3130, ext. 111, fanshenthompson@fredfinch.org 1. General Description of the Organization Fred Finch Youth Center (FFYC) seeks to provide innovative, effective, caring mental health and social services to children, young adults, and their families that allows them to build on their strengths, overcome challenges, and live healthy and productive lives. FFYC serves children, adolescents, young adults, and families facing complex life challenges. Many have experienced trauma and abuse; live at or below the poverty line; have been institutionalized or incarcerated; have a family member that has been involved in the criminal justice system; have a history of substance abuse; or have experienced discrimination or stigma. 2. Program: Contra Costa Transition Age Youth Full Service Partnership - CSS Fred Finch Youth Center is the lead agency that joins resources with the Contra Costa Youth Continuum of Services, The Latina Center and Contra Costa Mental Health to provide a full service partnership program for transition age youth. a. Scope of Services  Services will be provided using an integrated team approach, based on a modified Assertive Community Treatment (ACT) model of care. The team includes a personal service coordinator working in concert with a multi- disciplinary team of staff, including peer and family mentors, a psychiatric nurse practitioner, staff with various clinical specialties, to include co- occurring substance disorder and bi-lingual capacity. Services include: o Outreach and engagement o Case management o Outpatient Mental Health Services, including services for individuals with co-occurring mental health & alcohol and other drug problems o Crisis Intervention o Collateral o Medication support (may be provided by County Physician) o Housing support o Flexible funds o Money Management o Vocational Services o Contractor must be available to consumer on 24/7 basis b. Target Population: Young adults ages 16 to 25 years with serious mental illness or serious emotional disturbance. These young adults exhibit key risk factors of homelessness, limited English proficiency, co-occurring substance abuse, exposure to trauma, repeated school failure, multiple foster-care or family- B‐36    caregiver placements, and experience with the juvenile justice system and/or Psychiatric Emergency Services. FFYC serves Central and West County. c. Payment Limit: $1,400,642 d. Number served: For FY 12/13: 90 Individuals. e. Outcomes: For FY 12/13:  Reduction in incidence of psychiatric crisis: participants will experience a net reduction in their Psychiatric Emergency Services utilization rate of at least 40% when the annual utilization rate for clients’ most recent 12 months of service, or total number of months if a client has been enrolled for less than 12 months, is compared to the pre-enrollment rate. * Seventy-seven Fred Finch TAY FSP participants were included in this analysis. Clients were excluded if they did not have sufficient pre-enrollment data or if they transferred to a different FSP program during the fiscal year. The pre-enrollment rate for PES utilization for these 77 clients was 0.110 visits per person, per month. During the post-enrollment time period, this rate decreased by 41% to 0.065 visits per person, per month.  Reduction of the incidence of restriction: participants will experience a net reduction in their inpatient utilization rate of at least 60% when the annual utilization rate for clients’ most recent 12 months of service, or total number of months if a client has been enrolled for less than 12 months, is compared to the pre-enrollment rate.* Seventy-seven Fred Finch TAY FSP participants were included in this analysis. Clients were excluded if they did not have sufficient pre-enrollment data or if they transferred to a different FSP program during the fiscal year. The pre-enrollment rate for inpatient utilization for these 77 clients was 0.056 episodes per person, per month. During the post-enrollment time period, this rate decreased by 71% to 0.016 episodes per person, per month. * Data on service utilization were collected from the county’s internal billing system, PSP. To assess the effect of FSP enrollment on PES presentations and inpatient episodes, this methodology compares clients’ monthly rates of service utilization pre-enrollment to clients’ post-enrollment service utilization rates. Using PES usage as an example, the calculations used to assess pre- and post-enrollment utilization rates can be expressed as: ( No.of PES episodes during pre- enrollment period)/(No.of months in pre- enrollment period) =Pre-enrollment monthly PES utilization rate ( No.of PES episodes during post-enrollment period)/(No.of months in post- enrollment period) =Post-enrollment monthly PES utilization rate  B‐37    James Morehouse Project at El Cerrito High, YMCA East Bay Point of Contact: Jennifer Rader Contact Information: 540 Ashbury Ave, El Cerrito, Ca 94530 (510) 231-1437 jenn@jmhop.org 1. General Description of the Organization The James Morehouse Project works to create positive changes in the El Cerrito High School community through health services, counseling, academic support and the arts. Founded in 1999, the James Morehouse Project assumes youth have the skills, values and commitments to make positive change happen in their own lives and the life of the school community. The James Morehouse Project partners with community and government agencies, local providers and universities. Program: James Morehouse Project (JMP) - PEI a. Scope of Services: The James Morehouse Project, the school health center at El Cerrito High School, provides services that increase access to mental health/health services and a wide range of innovative youth development programs for 300 multicultural youth in West Contra Costa County. JMP provides a wide range of innovative youth development programs through an on-campus collaborative of community-based agencies, local universities and County programs. Key activities designed to improve students’ well- being and success in school include: Alcohol and Other Drug Use/Abuse Prevention; JMP Leadership Class(anger and violence); Arts/Spoken Word (students at risk of school failure); Bereavement Groups (loss of a loved one); Skittles (queer youth of color); Discovering the Realities of Our Communities (DROC – environmental and societal factors that contribute to substance abuse); Peer Conflict Mediation; Immigrants Acculturation; Social Skills Group for youth on autism spectrum. b. Target Population: At-risk students at El Cerrito High School c. Payment Limit: $94,200 d. Number served: For FY 12/13: 355 e. Outcomes:  19% of 300 youth participating in youth development programs cross- participated in substance abuse prevention programs and/or clinical mental health services in 2012-2013.  37 students referred for violent/disruptive behavior were enrolled in youth development programs in 2012-2013.  79% of participating students increased their scores across a range of resiliency factors.  74% of 300 participating students reported an increase in well-being after participation in JMP programs in 2012-2013 B‐38    Jewish Family and Children’s Services(JFCS) Point of Contact: Razia Iqbal Contact Information: 1855 Olympic Blvd. #200, Walnut Creek, Ca 94596 (925) 927- 2000 riqbal@jfcs-eastbay.org 1. General Description of the Organization Jewish Family and Children's Services is one of the oldest and largest family service institutions in the United States. Today, JFCS serves 76,000 people annually with the research based social services designed to strengthen individuals, families, and the community. As a problem-solving center for residents of several Bay Area counties, JFCS strives to be a lifeline for children, families, and older adults facing life transitions and personal crises. 2. Program: Community Bridges. a. Scope of Services: JFCS provides culturally grounded, community-directed mental health education and navigation services to 350-400 refugees and immigrants of all ages in the Latino, Afghan, Bosnian, Iranian, Iraqi, and Russian communities of central and East Contra Costa County. Prevention and early intervention-oriented program components include culturally and linguistically accessible mental health education, early assessment and intervention for individuals and families, and health and mental health system navigation assistance. Services are provided in the context of group settings and community cultural events, as well as with individuals and families, using a variety of convenient non-office settings, such as schools, senior centers, and client homes. In addition, the program includes mental health training for frontline staff from JFCS/East Bay and other community agencies working with diverse cultural populations, especially those who are refugees and immigrants. b. Target Population: Immigrant and refugee families of Contra Costa County at riskfor developing a serious mental illness. c. Payment Limit: $159,699 d. Number served: For FY 12/13: 475 e. Outcomes:  268 clients received individual counseling and system navigation support.  42 Mental Health Education Groups (attendance ranging between 8 and 72), covering a wide range of topics including parenting, cultural adjustment of immigrants, hoarding, early signs of mental illness.  Cross cultural mental health training series aimed at helping service providers (20 to 41 per training) understand importance of cross cultural issues. B‐39    Juvenile Justice System – Supporting Youth (Contra Costa Mental Health) Point of Contact: Daniel Batiuchok Contact Information: 202 Glacier Drive, Martinez, Ca 94553 (925) 957-2739 Daniel.Batiuchok@hsd.cccounty.us 1. General Description of the Organization The Behavioral Health Services Division of Contra Costa Health Services combines Mental Health, Alcohol & Other Drugs and Homeless Program into a single system of care. The staff working to support youth in the juvenile justice system operate within Contra Costa Mental Health’s Children’s System of Care. 2. Program: Mental Health Probation Liaisons and Orin Allen Youth Ranch Clinicians - PEI County mental health clinicians strive to help youth experiencing the juvenile justice system become emotionally mature and law abiding members of their communities. Services include screening and assessment, consultation, therapy, and case management for inmates of the Juvenile Detention Facility and juveniles on probation, who are at risk of developing or struggle with mental illness or severe emotional disturbance. a. Scope of Services  Mental Health Probations Liaisons engage youths on probation and at risk of getting on probation, many of them transitioning out of juvenile detention. The liaisons provide mental health screenings, short term therapy, as well as warm hand offs to service providers within the community or County Mental Health. Liaisons also conduct court ordered assessments of mental status, risk and protective factors, and treatment needs, and contribute to placement recommendations. The liaisons also provide much needed linkages between the juvenile justice system, the educational system, and the community, by consulting to Student Absence Review Boards, educational staff, and community gatekeepers regarding at risk youth. In addition, liaisons provide parenting education support to parents of juveniles.  Clinicians at the Orin Allen Youth Ranch, a non-locked sentencing facility, assess youth for need of mental health services and provide these if needed. Services include crisis support, individual and family counseling, anger management training, help with developing effective communication skills, trauma –focused cognitive behavioral therapy, support with overcoming gang involvement, and parenting education support for parents of residents of the Ranch. Youth receive warm hand-offs to community resources upon discharge. b. Target Population: Youth in the juvenile justice system in need of mental health support c. Total Budget: $500,000 B‐40    d. Staff: 5 Mental Health Clinical Specialists: 3 probation liaisons, 2 clinicians at the Ranch e. Number served: For calendar year 2013: 302 f. Outcomes:  Help youth address mental health and substance abuse issues that may underlie problems with delinquency  Increased access to mental health services and other community resources for at risk youth  Decrease of symptoms of mental health disturbance  Increase of help seeking behavior; decrease stigma associated with mental illness. B‐41    La Clinica de la Raza Point of Contact: Leslie Preston and Nancy Facher Contact Information: La Clinica Monument, 2000 Sierra Rd, Concord, 94518. (510) 535-6200 nfacher@laclinica.org 1. General Description of the Organization With 31 sites spread across Alameda, Contra Costa and Solano Counties, La Clínica delivers culturally and linguistically appropriate health care services to address the needs of the diverse populations it serves. La Clínica is one of the largest community health centers in California. 2. Program: Vias de Salud and Familias Fuertes (PEI) a. Scope of Services:  Vías de Salud (Pathways to Health) serves Latinos residing in Central and East County with: a) 3,000 screenings for mental health risk factors; and b) 1,000 assessment and early intervention services provided by a Behavioral Health Specialist to identify risk of mental illness or emotional disturbance; and c) psycho-educational groups facilitated by a social worker for 68 adults to address isolation, stress, communication and cultural adjustment.  La Clinica implements Familias Fuertes (Strong Families), to educate and support Latino parents and caregivers living in Central and East County in the healthy development of their children and youth. Project activities include: 1) Screening for risk factors in youth ages 0-18 (1,000 screenings), 2) 250 assessment and/or parent coaching sessions provided to parents/caretakers of children ages 0-18; and 3) 48 parents/caretakers participating in parent education and support groups. The group utilizes the evidence based and culturally relevant curriculum entitled Los Niños Bien Educados. b. Target Population: Contra Costa County Latino residents at risk for developing a serious mental illness. c. Payment Limit: Vias de Salud: $144,139. Familias Fuertes: $112,611. d. Number served: For FY 12/13 Vias de Salud provided 4,425 screenings, 1,217 behavioral health consultations, 83 clients participated in groups. To be served: 3000 screenings, 1000 BH consultations, 68 clients to participate in groups. Familias Fuertes: 1109 screenings, 279 BH consultations, 157 parent group participants. To be served: 1,000 screenings, 250 BH consultations, 48 parent group participants. e. Outcomes: Vias de Salud - 100% of Participants of support groups reported reduction in isolation, 100% of Participants of support groups reported decrease in anxiety and/or depression. Familias Fuertes - 100% of parents reported increased knowledge about positive family communication, 96% of parents reported improved skills, behavior, and family relationships. B‐42    LAO Family Community Development Point of Contact: Kathy Chao Rothberg Contact Information: 1865 Rumrill Blvd. Suite #B, San Pablo, Ca 94806, (510) 215- 1220 KRothberg@lfcd.org 1. General Description of the Organization Lao Family Community Development, Inc. (LFCD) assists diverse refugee, immigrant, limited English, and low-income U.S. born community members in achieving long-term financial and social self-sufficiency. Lao Family delivers linguistically and culturally appropriate services using an integrated service model that addresses the needs of the entire family unit, with the goal of achieving self- sufficiency in one generation. 2. Program: Health and Well-Being for Asian Families - PEI a. Scope of Services: Lao Family Community Development, Inc. provides a comprehensive and culturally sensitive Integrated service system approach for Asian and South East Asian adults. The program activities includes comprehensive case management and educational workshops and support groups. LFCD provides outreach, education, and support to develop problem solving skills, and increase families emotional well-being and stability. When necessary LFCD staff provides support in accessing needed health and mental health services. The staff provides a client centered, family focused, strength based case management and planning process, to include home visits, brief counseling, parenting classes, advocacy and referral to other in-house services such as employment services, financial education, and housing services. These services are provided in client homes and other community based settings as well as the offices of Lao Family Community Development in San Pablo. b. Target Population: South Asian and South East Asian Families at risk for developing serious mental illness. c. Payment Limit: $169,926 d. Number served: For FY 12/13: 126, To be served: 120 Individuals e. Outcomes:  100% of program participants created a mental health related personal goal.  95% of program participants achieved at least one of their stated goal.  100% of program enrollees participated in at least one peer support group.  Overall decrease of social isolation among program participants. B‐43    Lifelong Medical Care Point of Contact: Kathryn Stambaugh Contact Information: 2344 6th Street, Berkeley, Ca 94710 (510) 981-4156 kstambaugh@lifelongmedical.org 1. General Description of the Organization Lifelong Medical Care provides health and social services to underserved people of all ages by creating models of care for the elderly, people with disabilities and families. It advocates for continuous improvements in the health of communities. 2. Program: Senior Network and Activity Program (SNAP) and Elderly Learning Community (ELC) - PEI a. Scope of Services: Lifelong Medical Care provides isolated older adults in West Contra Costa County with opportunities for social engagement and linkage to mental health and social services. A variety of group and one-on-one approaches are employed to provide opportunities for socialization that appeal to different groups of seniors, and reach out to those most reluctant to participate in social activities. The Senior Network and Activity Program (SNAP) is provided in three housing developments that lack on-site services. These activities include regular on-site socials (three per month for residents of each site), quarterly outings, and outreach to invite participation in group activities that develop rapport with residents. Services include screening for depression and isolation and information and referral services. The Elders Learning Community provides engagement, learning and social activity services to at least ten frail seniors. The expected impact of these services includes 1) reducing isolation and promoting feelings of wellness and self-efficacy, 2) increasing trust and reducing reluctance to revealing unmet needs or accepting support services, and 3) improving the quality of life by reducing loneliness and promoting friendships and connections with others. b. Target Population: Seniors in low income housing projects at risk for developing serious mental illness.. c. Payment Limit: $118,970 d. Number served: For FY 12/13: 147 e. Outcomes:  52% of SNAP participants and 100% of ELC participants completed at least one long-term project.  On average, in course of program involvement, SNAP participants improved scores on assessment tool. (less depressed, more motivated); 92% of ELC improved their morale while attending program.  100% of SNAP and ELC participants reported decrease of isolation.  96% of SNAP and 100% of ELC participants reported being either very satisfied or satisfied with their experiences in SNAP and ELC. B‐44    Lincoln Child Center. Point of Contact: Christine Stoner-Mertz, CEO Contact Information: 1266 14th St, Oakland CA 94607, (510) 273-4700 chrisstoner@lincolnchildcenter.org 1. General Description of the Organization Lincoln Child Center was founded in 1883 as the region's first volunteer-run, non- sectarian, and fully integrated orphanage. As times and community needs evolved, Lincoln's commitment to vulnerable children remained strong. In 1951, Lincoln began serving abused, neglected and emotionally challenged children. Today, as a highly respected provider of children's services, Lincoln has a continuum of programs to serve challenged children and families throughout the Bay Area. Their community based services include early intervention programs in the Oakland and Pittsburg School Districts aimed at stopping the cycle of violence, abuse and mental health problems for at-risk children and families. 2. Program: Multi-Dimensional Family Therapy (MDFT) – Full Service Partnership CSS Multidimensional Family Therapy (MDFT), an evidence-based practice, is a comprehensive and multi-systemic family-based outpatient program for youth and adolescents with co-occurring substance use and mental health disorders who may be at high risk for continued substance abuse and other problem behaviors, such as conduct disorder and delinquency. Working with the youth and their families, MDFT helps youth develop more effective coping and problem solving skills for better decision making, and helps the family improve interpersonal functioning as a protective factor against substance abuse and related problems. Services are delivered over 4 to 6 months, with weekly or twice-weekly, face-to-face contact, either in the home, the community or in the clinic. a. Scope of Services  Services include but are not limited to: o Outreach and engagement o Case management o Outpatient Mental Health Services o Crisis Intervention o Collateral Services o Group Rehab o Flexible funds o Contractor must be available to consumer on 24/7 basis b. Target Population: Children ages 11 to 19 years in West, Central and East County experiencing co-occurring serious mental health and substance abuse disorders. Youth and their families can be served by this program. c. Payment Limit: $874,417 B‐45    d. Number served: Program began in FY 13/14, with 60 to be served. e. Outcomes: Because the program began in FY 13/14, there are no outcomes to report at this time. Lincoln Child Center will report on the outcomes listed below in the upcoming MHSA Plans.  Reduction in severity of psychiatric symptoms: of youth who completed the program with a history of or current substance use issues at intake, at least 70% at discharge will have reduced drug use or maintained abstinence per drug screens and GAIN Q3 as compared to intake data.  Consumer Satisfaction: of the youth who completed the program, 90% or greater of clients and caregivers will report satisfaction with services on the Consumer Satisfaction Surveys at discharge. B‐46    LTP CarePro, Inc (Pleasant Hill Manor). Point of Contact: Tony Perez. Contact Information: 40 Boyd Road, Pleasant Hill CA, 94523. 1. Program: Augmented Board and Cares – MHSA Housing Services - CSS The County contracts with LTP CarePro, Inc., a licensed board and care provider, to provide additional staff care to enable those with serious mental illness to avoid institutionalization and enable them to live in the community. a. Scope of Services  Augmented residential services. b. Target Population: Adults aged 18 years and older who live in Central County, are diagnosed with a serious mental illness and are uninsured or receive Medi- Cal benefits. c. Annual MHSA Payment Limit: $ 30,000 d. Number served: For FY 12/13: 16 beds available. e. Outcomes: To be determined. B‐47    Modesto Residential Living Center, LLC. Point of Contact: Dennis Monterosso. Contact Information: 1932 Evergreen Avenue, Modesto CA, 95350. (209)530-9300. info@modestoRLC.com 1. Program: Augmented Board and Cares – MHSA Housing Services - CSS The County contracts with Modesto Residential Living Center, a licensed board and care provider, to provide additional staff care to enable those with serious mental illness to avoid institutionalization and enable them to live in the community. a. Scope of Services  Augmented residential services. b. Target Population: Adults aged 18 years and older who lived in Contra Costa County, are diagnosed with a serious mental illness and are uninsured or receive Medi-Cal benefits, and accepted augmented board and care at Modesto Residential Living Center. c. Annual MHSA Payment Limit: $ 120,000 d. Number served: For FY 12/13: Capacity of 7 beds, average of 2 beds filled each month. e. Outcomes: To be determined. B‐48    Native American Health Center (NAHC) Point of Contact: Michael Dyer Contact Information: 2566 MacDonald Ave, Richmond, 94804 (510) 232-7020 MichaelD@nativehealth.org 1. General Description of the Organization The Native American Health Center serves the California Bay Area Native Population and other under-served populations. NAHC has worked at local, state, and federal levels to deliver resources and services for the urban Native American community, to include medical, dental, behavioral health, diabetes, obesity, substance abuse prevention, HIV/HCV care coordination and prevention services. 2. Program: Native American Wellness Center - PEI a. Scope of Services: NAHC provides weekly group sessions and quarterly community events for youth, adults, and elders to develop partnerships that bring consumers, families, community members and mental health professionals together and build a community that reflects the history and values of Native American people in Contra Costa County. Activities include elders support groups, youth wellness groups (including suicide prevention and violence prevention activities), traditional arts groups (beading, quilting, arts & crafts), and quarterly cultural events. Family communication activities include weekly Positive Indian Parenting sessions, talking circles that improve communications skills and address domestic violence, trauma and historical trauma, and Gathering of Native Americans to build a sense of belonging and cohesive community. Family members who need supplemental treatment for mental health and substance abuse problems will be referred to appropriate agencies. Mental Health Education/System Navigator Support will include quarterly cultural competency trainings for public officials and other agency personnel, referrals to appropriate services with follow-up, and educational sessions about Contra Costa County’s service system. b. Target Population: Native American residents of Contra Costa County (mainly west region) who are at risk for developing a serious mental illness. c. Payment Limit: $213,422 d. Number served: For FY 12/13: 126 e. Outcomes: a. 57% of program participants increased social connectedness within a twelve month period. b. 64% of program participants increased family communications. c. 100% of participants that engaged in referrals and leadership training increased their ability to navigate the mental health/health/education systems. B‐49    New Leaf Program – Vincente High School - Martinez Unified School District Point of Contact: Carol Adams Contact Information: 614 F Street Martinez, Ca 94553 CAdams@martinezusd.net 1. General Description of the Organization The New Leaf Leadership Academy strives to educate students in a holistic manner by providing high school students in grades 9-12 an educational experience that supports their academic, social, and emotional growth through place-based and classroom learning. 2. Program: New Leaf Leadership Academy at Vicente High School - PEI a. Scope of Services: The New Leaf Leadership is an alternative high school program that provides "career academies" which include individualized learning plans, place-based learning projects, career mentorships and internships for at-risk high school students in Martinez of all cultural backgrounds. Key activities include: service-learning projects, career preparation and internships where students, school staff, parents and community partners work together on projects, all derived from California standards-based curricula. Goals include achieving a high school diploma, transferable career skills and certification, acceptance into a college or post-high school training program, strong leadership skills and the development of the assets necessary for holistic, sustainable living. All students at New Leaf receive focused education about mental health concepts that decreases stigma attached to mental illness and help seeking. All students enrolled in Vicente High School and Briones School have access to a licensed psychotherapist for individual and group counseling as well as an internship coordinator who provides support for obtaining paid as well as intern opportunities. Staff at New Leaf are developing a curriculum aimed at implementing New Leaf practices in other High Schools in Contra Costa. b. Target Population: At-risk high school students in Central County c. Payment Limit: $220,079 d. Number served: For FY 12/13 : 51 New Leaf e. Outcomes:  87 students at Vicente High School received psychological services.  76% of test participants improved score on Developmental Asset Profile.  81% of students achieved 4 out of 6 goals of Individual Success Plan.  73% of identified students improved on discipline referrals (goal: 70%).  59% of identified students improved their attendance rates.  69.23% of students earned required amount of credits (goal: 70%). B‐50    Oak Hills Residential Facility. Point of Contact: Rebecca Lapasa. Contact Information: 141 Green Meadow Circle, Pittsburg, CA 94565. 1. Program: Augmented Board and Cares – MHSA Housing Services - CSS The County contracts with Oak Hills Residential Living Center, a licensed board and care provider, to provide additional staff care to enable those with serious mental illness to avoid institutionalization and enable them to live in the community. a. Scope of Services  Augmented residential services. b. Target Population: Adults aged 18 years and older who live in Eastern Contra Costa County, are diagnosed with a serious mental illness and are uninsured or receive Medi-Cal benefits. c. Annual MHSA Payment Limit: $ 21,120 d. Number served: For FY 12/13: 8 beds. e. Outcomes: To be determined. B‐51    Office for Consumer Empowerment (Contra Costa Mental Health) Point of Contact: Susan Medlin Contact Information: 1340 Arnold Drive #200, Martinez, Ca 94553 (925) 957-5104 Susan.Medlin@hsd.cccounty.us 1. General Description of the Organization The Office for Consumer Empowerment is a County operated program that supports the entire Behavioral Health System, and offers an range of trainings and supports by and for individuals who have experience receiving mental health services. The goals are to increase access to wellness and empowerment knowledge for consumers of the Behavioral Health System. 2. Program: Reducing Stgma and Discrimination – PEI a. Scope of Services  The Mental Health Service Provider Individualized Recovery Intensive Training (SPIRIT) is a recovery-oriented, peer led classroom and experientially based college accredited program that prepares individuals to become providers of service. Certification from this program is a requirement for many Community Support Worker positions in Contra Costa Mental Health. Staff provide instruction and administrative support, and provide ongoing support to graduates who are employed by the County.  The Wellness Recovery Education for Acceptance, Choice and Hope (WREACH) Speaker’s Bureau develops individuals with lived mental health and co-occurring experiences to effectively present their recovery and resiliency stories in various formats to a wide range of audiences, such as health providers, schools, law enforcement, and other community groups.  Staff lead and support the Committee for Social Inclusion. This is an alliance of community members and organizations that meet regularly to promote social inclusion of persons who use behavioral health services. The committee guides projects and initiatives designed to reduce stigma and discrimination, and increase inclusion and acceptance in the community.  Staff provides outreach and support to consumers and family members to enable them to actively participate in various committees and sub – committees throughout the system. These include the Mental Health Commission, the Consolidated Planning and Advisory Workgroup and sub- committees, and Behavioral Health Integration planning efforts. Staff provides mentoring and instruction to consumers who wish to learn how to participate in community planning processes or to give public comments to advisory bodies.  Staff partner with NAMI Contra Costa certified facilitators to offer self-help groups for people diagnosed with mental illness who want to get support and share experiences in a safe environment. B‐52    b. Target Population: Consumers of public mental health services and their families; the general public. c. Total MHSA Funding: $692,988 d. Staff: 6.5 full-time equivalent staff positions. e. Outcomes:  Increased access to wellness and empowerment knowledge and skills by consumers of mental health services.  Decrease stigma and discrimination associated with mental illness.  Increased acceptance and inclusion of mental health consumers in all domains of the community. B‐53    Older Adult Mental Health (Contra Costa Mental Health) Point of Contact: Heather Sweeten-Healy, Mental Health Program Manager Contact Information: 2425 Bisso Lane, Suite 100, Concord, CA 94520, (925)-521- 5655, Heather.Sweeten-Healy@hsd.cccounty.us 1. General Description of the Organization The Older Adult Mental Health Clinic is in the Adult System of Carew and provides mental health services to Contra Costa’s senior citizens, ranging from preventive care and outreach to under-served at risk communities, problems solving short term therapy, to intensive care management for severely mentally ill individuals. 2. Program: Intensive Care Management Teams - CSS The Intensive Care Management Teams (ICMT) provide mental health services to older adults in their homes, in the community and within a clinical setting. Services are provided to Contra Costa County residents with serious psychiatric impairments who are 60 years of age or older. The program provides services to those who are insured through MediCal, dually covered under MediCal and MediCare, or uninsured. The primary goal of these teams is to support aging in place as well as to improve consumers’ mental health, physical health, and overall quality of life. Additionally, the teams provide services to those who are homeless, living in shelters, or in residential care facilities. There are three multi-disciplinary Intensive Care Management Teams, one for each region of the county. Program: Improving Mood Providing Access to Collaborative Treatment (IMPACT) - CSS IMPACT is an evidence-based practice which provides depression treatment to individuals over age 60 in a primary care setting. The IMPACT model prescribes short-term (8 to 12 visits) Problem Solving Therapy and medication support with up to one year of follow-up as necessary. Services are provided by a treatment team consisting of licensed clinicians, psychiatrists, and primary care physicians in a primary care setting. The target population for the IMPACT Program is adults age 60 years and older who are at 300% or below of the Federal Poverty Level, are insured by MediCal, MediCal and MediCare, or are uninsured. The program focuses on treating older adults with late-life depression and co-occurring physical health impairment, such as cardio-vascular disease, diabetes, or chronic pain. Program: Senior Peer Counseling - PEI This program reaches out to isolated and depressed older adults in their home environments and links them to appropriate community resources in a culturally competent manner. In addition, both the Latino and Chinese Senior Peer Counseling Programs are recognized as a resource for these underserved populations. This program serves older adults age 55 and older who are experiencing aging issues such as grief and loss, multiple health problems, B‐54    loneliness and depression and isolation. Emphasis is on serving underserved cultural communities, especially Latino and Asian older adults. a. Target Population: Depending on program, Older Adults aged 55 or 60 years and older experiencing serious mental illness or at risk for developing a serious mental illness. b. Total Budget: Intensive Care Management - $3,189,600; IMPACT - $370,479; Senior Peer Counseling - $370,479. c. Staff: 26 Full time equivalent multi-disciplinary staff. d. Number served: For FY 12/13: ICMT served 237 individuals; IMPACT served 138 Individuals; Senior Peer Counseling Program served 237 individuals. e. Outcomes: Changes in Level of Care Utilization System (LOCUS) scores, reductions in Psychiatric Emergency Service visits, reductions in hospitalizations, decreased Patient Health Questionnaire (PHQ-9) scores, reduced isolation. B‐55    People Who Care (PWC) Children Association Point of Contact: Conny Russell Contact Information: 2231 Railroad Ave, Pittsburg, 94565 Ph: (925) 427-5037 Pwc.cares@comcast.net 1. General Description of the Organization People Who Care Children Association provides educational, vocational and employment training programs to children ages 12 through 21 years old. Many are at risk of dropping out of school and involved with, or highly at risk of entering, the criminal juvenile justice system. The mission of the organization is to empower children to become productive citizens by promoting educational and vocational opportunities, and by providing training, support and other tools needed to overcome challenging circumstances. 2. Program: PWC Afterschool Program (PEI) a. Scope of Services: Through its After-school Program, People Who Care (PWC) Children Association will provide work experience for 200 multicultural at risk youth residing in the Pittsburg/Bay Point and surrounding East Contra Costa County communities, as well as, programs aimed at increasing educational success among those who are either at-risk of dropping out of school, or committing a repeat offense. Key activities include job training and job readiness training, mental health counseling (screening for mental health problems, individual, group, and family therapy), as well as civic and community service activities. b. Target Population: At risk youth with special needs in East Contra Costa County c. Payment Limit: $203,594 d. Number served: For FY 12/13: 205 e. Outcomes:  54% of youth program participants showed improved youth resiliency factors (self- esteem, relationship, and engagement).  74% of program participants reported that they have a caring relationship with an adult in the community or at school during their program participation.  70% of program participants showed an increase in school attendance during their program participation.  82% of participants did not re-offend during they participation in the program.  94% of participants increased their ‘green jobs’ related knowledge and skills. B‐56    Portia Bell Hume Behavioral Health and Training Center. Point of Contact: Chris Celio, Acting Department Manager. Contact Information: 2555 School Street, Pittsburg, CA 94565, (925)–586–7811, ccelio@humecenter.org 1. General Description of the Organization The Hume Center's mission is to provide high quality, culturally sensitive and comprehensive behavioral health care services and training. The agency strives to promote mental health, reduce disparities and psychological suffering, and strengthen communities and systems in collaboration with the people most involved in the lives of those served. The Hume Center is committed to training behavioral health professionals to the highest standards of practice, while working within a culture of support and mutual respect. 2. Program: Adult Full Service Partnership - CSS The Adult Full Service Partnership is a collaborative program that joins the resources of The Hume Center and Contra Costa County Behavioral Health Services. a. Scope of Services  Services will be provided using an integrated team approach, based on a modified Assertive Community Treatment (ACT) model of care. Services include: o Outreach and engagement o Case management o Outpatient Mental Health Services, including services for individuals with co-occurring mental health & alcohol and other drug problems o Crisis Intervention o Collateral o Medication support (may be provided by County Physician) o Housing support o Flexible funds o Vocational Services o Educational Services o Recreational and Social Activities o Contractor must be available to consumer on 24/7 basis b. Target Population: Adults over the age of 18 in East and Central County who are diagnosed with a serious mental illness, are at or below 300% of the federally defined poverty level, and are uninsured or receive Medi-Cal benefits. c. Payment Limit: $907,493 d. Number served: Services began FY 13/14. B‐57    e. Outcomes: Because the program began in FY 13/14, there are no outcomes to report at this time. The Hume Center will report on the outcomes listed below in the upcoming MHSA Plans.  Decrease incidence of restriction: decrease in hospital utilization.  Positive Client Satisfaction. B‐58    Putman Clubhouse Point of Contact: Tamara Hunter, Clubhouse Director Contact Information: 3024 Willow Pass Rd #230, Concord Ca 94519, (510) 926- 0474 tamara@putnamclubhouse.org 1. General Description of the Organization Putnam Clubhouse provides a safe and welcoming place where participants (called members) build on personal strengths instead of focusing on illness. Members learn and improve vocational and social skills, while working together to run all aspects of the Clubhouse, to include clerical, cooking, governance and fundraising. 2. Program: Preventing Relapse of Individuals in Recovery - PEI a. Scope of Services: The Putnam Clubhouse provides peer-based programming for adults throughout Contra Costa County in recovery from psychiatric disorders, helping them to develop the support networks, vocational skills, and self- confidence needed to sustain stable, productive, and more independent lives. Services include work-ordered day programming that helps members gain pre- vocational skills, social skills, healthy living skills, and help with access to career development options within the greater community. Assistance and support is provided with navigating the system of care and accessing services. Putnam Clubhouse helps members with goal setting (including educational and vocational goals), building advocacy and media skills, and provides recreational, and respite services for family members. In collaboration with the Office of Consumer Empowerment, Putnam Clubhouse hosts Career Corner, an online blog that focuses on all aspects of vocational rehabilitation for mental health consumers in Contra Costa County. Putnam Clubhouse increases family wellness by reducing stress related to care-giving, provides family member respite through Clubhouse programs for new and existing participants, and supports Clubhouse members in gaining independence through Clubhouse participation. b. Target Population: Contra Costa County residents with identified mental illness and their families. c. Payment Limit: $468,440. d. Number served: For FY 12/13: 278 members. e. Outcomes:  278 unduplicated members engaged in 44,762 program hours.  90% of families (members and their families) completing annual survey reported an increase in personal mental, physical, and emotional well- being.  100% of family members surveyed reported Clubhouse activities provided them with respite care, and that their family member showed increased independence. B‐59     Program participants showed decrease of hospitalizations and out-of- home placements (in terms of number of episodes and days of hospitalization) since becoming members.  100% of members choosing employment as a goal in their career plans were referred to appropriate employment resources, applied for job, or had job interview within three months.  92% of members who used the Career Development Unit services reported that they were satisfied or very satisfied with services related to employment and educations. B‐60    Rainbow Community Center (RCC) Point of Contact: Ben-David Barr Contact Information: 2118 Willow Pass Rd, Concord, Ca 94520. (925) 692-0090 Ben@rainbowcc.org  General Description of the Organization The Rainbow Community Center of Contra Costa County (RCC) builds community and promotes well-being among Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQ) people and our allies.  Programs: 1. Outpatient Behavioral Health (INN), 2. Pride and Joy (PEI), 3. LGBTQ Youth Support (PEI), 4. Inclusive Schools (PEI) a. Scope of Services: 1) Outpatient Services: RCC provides outpatient behavioral health services for the lesbian, gay, bisexual, transgender, and questioning (LGBTQ) communities. RCC works with consumers to develop a healthy and un-conflicted self-concept by providing individual, group, couples, and family counseling, as well as case management. Counseling and case management services are available in English, Spanish, and Vietnamese. Onsite support is available in Tagalog. 2) Pride and Joy: Three tiered support services (Tier One: outreach, isolation reduction and awareness building, Tier Two: support groups for clients with identified needs, Tier Three: individual counseling and system navigation support for clients with higher level of need) aimed at the LGBTQ community of Contra Costa County, particularly LGBTQ seniors, people living with HIV, and community members with unrecognized health and mental health disorders. 3) Youth Development: Three tiered services (see above) aimed at LGBTQ youth as a particularly vulnerable population. Services are provided both on-site as well as school based. 4) Inclusive Schools: Community outreach and organization involving school leaders, staff, and students to build acceptance of LGBTQ youth in Contra Costa County schools, families, and faith communities. b. Target Population: LGBTQ community of Contra Costa County (mainly Central and East) who are at risk of developing serious mental illness. c. Payment Limit: $420,187 for Innovation program; $220,507 for PEI programs. d. Number served: For FY 12/13: 1) Outpatient Services: 128; 2) PEI total served is 730 in-person participants with the following breakdowns: Pride and Joy: 558 in-person participants (includes 147 LGBTQ seniors and 150 HIV+ people); 3) Youth Development: 172 participants; 4) Inclusive Schools: This is a new PEI project for this fiscal year and the data will be available for FY13/14 in the year- end report. PEI outreach services also include 1,500 subscribers to online weekly newsletter and social media sites. Weekly newsletter promoted county services such as Access Line, Suicide Help lines, and RCC support services. B‐61    e. Outcomes: Outpatient Clinic:  128 individuals received one on one services (counseling and case management). Prevention and Early Intervention:  213 agency participants completed PHQ9 depression screenings and baseline data for LGBTQ assessment instrument being developed by the organization.  110 unduplicated youth attended onsite drop-in programming and 62 received school based and individual support services.  147 seniors participated in luncheons, support groups, and counseling. 95 seniors on agency call list received two wellness check-in calls per month.  558 individuals attended support groups and outreach events.  Participants made over 9,000 visits to the agency in FY13. Youth visits = 2169; Senior visits = 868 ; all visits = 9433. B‐62    Recovery Innovations Point of Contact: Hillary Bowers, Recovery Services Administrator Contact Information: 2975 Treat Blvd., Suite C8, Concord, CA 94518, (925)–363– 7290, Hiliary.Bowers@recoveryinnovations.org 1. General Description of the Organization Founded by Eugene Johnson in 1990 as META Services, an Arizona non-profit corporation, Recovery Innovations developed and provided a range of traditional mental health and substance abuse services for adults with long term mental health and addiction challenges. In 1999, Recovery Innovations began pioneering an innovative initiative: the creation of the new discipline of Peer Support Specialist. Now, 13 years later, this experience has transformed the Recovery Innovations workforce to one in which Peer Support Specialists and professionals work together on integrated teams to deliver recovery-based services. The Recovery Innovations experiences had a global impact on the mental health field serving as a demonstration that recovery from mental illness and/or addiction is possible. Based on this transformation experience, Recovery Innovations operates recovery-based mental health services in 21 communities in five states and New Zealand and has provided recovery training and transformation consultation in 27 states and five countries abroad. 2. Program: Recovery Innovations Wellness and Recovery Centers - CSS Recovery Innovations provides wellness and recovery centers situated in West, Central and East County to ensure the full spectrum of mental health services is available. Wellness and Recovery Centers are made up of individuals embarking on or expanding their recovery journey. Staff of well-trained peers who have experienced their own recovery success share what they have learned and walk alongside each person. The clients of Wellness and Recovery Centers learn to identify personal strengths and develop personalized wellness plans that incorporate their hopes and dreams for the future. Each participant partners with a Recovery Coach who understands the challenges and is standing alongside ready to offer support. These centers offer peer-led recovery-oriented, rehabilitation and self-help groups, which teach self-management and coping skills. The centers offer wellness recovery action plan (WRAP) groups, physical health and nutrition education, advocacy services and training, arts and crafts, and support groups. a. Scope of Services: o Peer and Family Support o Personal Recovery Planning using the seven steps of Recovery Coaching o Workshops, Education Classes and Community-Based Activities using the nine dimensions of wellness; physical, emotional, intellectual, social, spiritual, occupational, home/community living, financial, recreation/leisure o Community Outreach and Collaboration B‐63    o Assist participants to coordinate medical, mental health, medication and other community services o Wellness Recovery Action Plan (WRAP) classes o Family Education and Support Programs o Breakfast/Lunch meals during weekdays for participants b. Target Population: Adult mental health participants in Contra Costa County. Recovery Innovations services will be delivered within each region of the county through Wellness and Recovery Centers located in Antioch, Concord and San Pablo. c. Payment Limit: $875,000 d. Number served: Program began in FY 13/14 with a 6 month contract. Number to be served yearly: 200. e. Outcomes: Because the program began in FY 13/14, there are no outcomes to report at this time. Recovery Innovations will report on the outcomes listed below in the upcoming MHSA Plans. • Increase in meaningful activity: 90% participants with a Wellness plan. • Increase in quality of life: Recovery Assessment Scale scores B‐64    Rubicon Programs, Inc. Point of Contact: Jane Fischberg, President and Executive Director. Contact Information: 2500 Bissell Avenue, Richmond, CA 94804, (510)–231–3987, janef@rubiconprograms.org 1. General Description of the Organization Rubicon’s mission is to prepare very low-income people to achieve financial independence and to partner with people with mental illness on their journey of recovery. Since 1973, Rubicon has provided employment, housing, mental health, and other supportive services to individuals who are very low-income, especially people who are homeless or have mental illness. Based in Richmond, California, Rubicon Programs offers services throughout Contra Costa and Alameda counties. 2. Program: Bridges to Home – Full Service Partnership - CSS The Adult Full Service Partnership (FSP) Bridges To Home (BTH) is a collaborative program that joins the resources of Rubicon Programs and Contra Costa Mental Health. a. Scope of Services  Services will be provided using an integrated multi-disciplinary team approach, based on a modified Assertive Community Treatment (ACT) model of care. Services include: o Outreach and engagement o Case management o Outpatient Mental Health Services, including services for individuals with co-occurring mental health & alcohol and other drug problems o Crisis Intervention o Collateral o Medication support (may be provided by County Physician) o Housing support o Flexible funds o Vocational Services o Educational Services o Recreational and Social Activities o Contractor must be available to consumer on 24/7 basis b. Target Population: Adults over the age of 18 in West County who are diagnosed with a serious mental illness, are at or below 300% of the federally defined poverty level, and are uninsured or receive Medi-Cal benefits. c. Payment Limit: $928,813 d. Number served: For FY 12/13: In FY12/13 BTH was made up of two programs, BTH West and BTH Central. BTH West and Central served 185 Individuals combined. e. Outcomes: Below are the FY 12/13 outcomes for Bridges to Home. B‐65     Reduction in Psychiatric Crisis o 2013 Bridges to Home participants experienced a 41% overall reduction in hospital days (comparing total time in program to the same length of time prior to program entry (1654 pre-program hospital days compared to 972 in-program hospital days) o 74% of 2013 Bridges to Home participants who experienced any pre- program hospital days experienced fewer hospital days while in program (50 of 68 participants)  Reduction in Severity of Psychiatric Symptoms o 44% of 2013 Bridges to Home participants experienced reduced severity of psychiatric symptoms over the last year, as measured by change in LOCUS scores. The average change was 2.84 (on a point scale of 32).  60% of 2013 Bridges to Home participants maintained or reduced severity of psychiatric symptoms over the last year as measured by change in LOCUS scores. The average change for this group was 2.08 (on a point scale of 32).  Average LOCUS score was 24 (with 32 representing highest severity of symptoms), confirming that this is an extremely high- need population (recommended for Residential Treatment/Full Service Partnerships).  Improved Quality of Life o 81% of 2013 Bridges to Home participants who entered the program homeless have obtained stable housing (91 of 113 homeless participants). The average time to stabilize housing was 119 days. o 87% of all 2013 Bridges to Home participants currently maintain stable housing (158 of 181 participants; this includes participants who were homeless at entry and those who were already in supportive housing). B‐66    RYSE Center Point of Contact: Kanwarpal Dhaliwal Contact Information: 205 41st Street, Richmond. CA 94805 (925) 374-3401 Kanwarpal@rysecenter.org 1. General Description of the Organization RYSE is a youth center in Richmond that offers a wide range of activities, programs, and classes for young people including media arts, health education, career and educational support, and youth leadership and advocacy. RYSE operates within a community mental health model and employs trauma informed and healing centered approaches in all areas of work, including one-on-one, group and larger community efforts. 2. Program: Supporting Youth - PEI. a. Scope of Services: 1) Trauma Response and Resilience System: develop and implement trauma informed training series for key system partners, facilitate development of a community response to violence and trauma, evaluate impact of trauma informed practice, provide critical response and crisis relief for young people experiencing acute incidents of violence. 2) Health and Wellness: support young people (ages 13 to 21) from the diverse communities of West County to become better informed (health services) consumers and active agents of their own health and wellness, and foster healthy peer and youth-adult relationships. Activities include mental health counseling and referral, outreach to schools, workshops and ‘edutainment’ activities, youth assessment and implementation of partnership plans (Chat it Up Plans). 3) Inclusive Schools: Facilitate collaborative work with West Contra Costa schools and district aimed at making WCC schools an informed and accepting environment for LGBTQ students. Activities include assistance in provision of LGBT specific services, conducting organizational assessments, training for adults and students, engaging students in leadership activities, and providing support groups at target schools. etc. b. Target Population: West County Youth at risk for developing serious mental illness. c. Payment Limit: $460,119 d. Unique Number served: For FY 12/13: 1): 458 2): at least 800 3): 300 e. Outcomes:  142 members completed wellness plans; an estimated 300 members participated in at least 2 program activities aimed at supporting healthy peer relationships, community engagement, and leadership; at least 519 unique members participated in one on site activity. B‐67     At least 200 members participated in structured, multi-session on site programs.  97% of member survey participants feel “safer just as safe at RYSE than other places”; 54% of survey participants feel “a lot safer” at RYSE than other places.  Survey members strongly endorsed sense of belonging and experience of success at RYSE.  Survey participants strongly endorsed positive quality of relationships to peers and adults at RYSE.  74% of survey participants reported increased comfort with participation in programs that offer mental health support services.  66% of survey participants reported that they have a better understanding of LGBTQ identity. B‐68    Seneca Family of Agencies Point of Contact: Jessica Donohue, Program Supervisor Contact Information: 2351Olivera Road, Concord, CA, 94520, (925)–808–8724, jessica_donohue@senecacenter.org 1. General Description of the Organization Seneca Center for Children and Families is a leading innovator in the field of community-based and family-based service options for emotionally troubled children and their families. With a continuum of care ranging from intensive residential treatment, to in-home wraparound services, to public school-based services, Seneca is one of the premier children’s mental health agencies in Northern California. 2. Program: Short Term Assessment of Resources and Treatment (START) - Full Service Partnership - CSS Seneca Family of Agencies (SFA) provides an integrated, coordinated service to youth who frequently utilize crisis services, and may be involved in the child welfare and/or juvenile justice system. START provides three to six months of short term intensive services to stabilize the youth in their community, and to connect them and their families with sustainable resources and supports. The goals of the program are to 1) reduce the need to utilize crisis services, and the necessity for out-of-home and emergency care for youth enrolled in the program, 2) maintain and stabilize the youth in the community by assessing the needs of the family system, identifying appropriate community resources and supports, and ensuring their connection with sustainable resources and supports, and 3) successfully link youth and family with formal services and informal supports in their neighborhood, school and community. a. Scope of Services  Services include: o Outreach and engagement o Linkage o Case management o Plan development o Crisis Intervention o Collateral o Flexible funds o Contractor must be available to consumer on 24/7 basis b. Target Population: The target population for the program includes youth 18 years and under with a history of multiple psychiatric hospitalizations and crisis interventions, imminent risk of homelessness, who have a serious mental illness and/or are seriously emotionally disturbed, and are not being served, or are being underserved, by the current mental health system. Youth in the program can be Medi-Cal eligible or uninsured. c. Payment Limit: $ 562,915 B‐69    d. Number served: Contract began in 2013 and served 32 youth. e. Outcomes: Because the program began in FY 13/14, there are no outcomes to report at this time. Seneca will report on the outcomes listed below in the upcoming MHSA Plans.  Increase meaningful activity: successful linkage to the services introduced by the START program.  Reduction in severity of psychiatric symptoms: changes in client Children and Adolescent Level of Care Utilization System (CALOCUS) scores. B‐70    Shelter, Inc. Point of Contact: Timothy O’Keefe, Executive Director . Contact Information: 1815 Arnold Dr. Martinez, CA, 94553, (925)-335-0698, timo@shelterincofccc.org 1. General Description of the Organization The mission of Shelter, Inc. is to prevent and end homelessness for low-income residents of Contra Costa County by providing resources that lead to self-sufficiency. Shelter, Inc. was founded in 1986 to alleviate the County's homeless crisis, and its work encompasses three main elements, 1) prevent the onset of homelessness, including rental assistance, case management, and housing counseling services, 2) ending the cycle of homelessness by providing 3 to 24 months of housing in combination with supportive services, such as job training, educational services, health care, and counseling, and 3) providing affordable housing for nearly 250 low- income households, including such special needs groups as transition-age youth, people with HIV/AIDS, and those with mental health disabilities. 2. Program: Supportive Housing - CSS Shelter, Inc. provides a master leasing program, in which adults or children and their families are provided tenancy in apartments and houses throughout the County. Through a combination of self-owned units and agreements with landlords Shelter, Inc. acts as the lessee to the owners and provides staff to support individuals and their families move in and maintain their homes independently. Housing and rental subsidy services are provided to residents of the County who are homeless and that have been certified by Contra Costa Mental Health as eligible. The objective program is to create housing opportunities that are affordable and safe and promote housing stability among MHSA consumers. a. Scope of Services.  Provide services in accordance with the State of California Mental Health Service Act Housing Program, the County Behavioral Health Mental Health Division’s Work Plan, all State, Federal and Local Fair Housing Laws and Regulations, and the State of California’s Landlord and Tenants Laws.  Provide consultation and technical support to Contra Costa Mental Health with regard to services provided under the housing services and rental subsidy program.  Utilize existing housing units already on the market to provide immediate housing to consumers through master leasing and tenant based services.  Acquire and maintain not less than 109 master-leased housing units throughout Contra Costa County.  Negotiate lease terms and ensure timely payment of rent to landlords.  Leverage housing resources through working relationships with owners of low income housing within the community. B‐71     Integrate innovative practices to attract and retain landlords and advocate on behalf of consumers.  Leverage other rental subsidy programs including, but not limited to, Shelter Plus Care and Section 8.  Reserve or set aside units of owned property dedicated for MHSA housing.  Ensure condition of leased units meet habitability standards by having Housing Quality Standard (HQS) trained staff conduct unit inspections prior to a unit being leased and annually as needed.  Establish maximum rent level to be subsidized with MHSA funding to be Fair Market Rent (FMR) as published by US Department of Housing and Urban Development (HUD) for Contra Costa County in the year that the unit is initially rented and for each year thereafter.  Provide quality property management services to Consumers living in master leased and owned properties.  Maintain property management systems to track leases, occupancy, and maintenance records.  Maintain an accounting system to track rent and security deposit charges and payments.  Conduct annual income re-certifications to ensure consumer rent does not exceed 30% of income minus utility allowance. The utility allowance used shall be in accordance with the utility allowances established by the prevailing Housing Authority for the jurisdiction that the housing unit is located in.  Provide and/or coordinate with outside contractors and Shelter, Inc. maintenance staff for routine maintenance and repair services and provide after-hours emergency maintenance services to consumers.  Ensure that landlords adhere to habitability standards and complete major maintenance and repairs.  Process and oversee evictions for non-payment of rent, criminal activities, harmful acts upon others, and severe and repeated lease violations.  Work collaboratively with full service partnerships around housing issues and provide referrals to alternative housing options.  Attend collaborative meetings, mediations and crisis interventions to support consumer housing retention.  Provide tenant education to consumers to support housing retention. b. Target Population: Consumers eligible for MHSA services. The priority is given to those who are homeless or imminently homeless and otherwise eligible for the full service partnership programs. c. Annual Payment Limit: $1,663,668. d. Number served: For FY 12/13: Shelter, Inc. served 112 consumers . FY 14/15 Target: 128 consumers. B‐72    e. Outcomes: Shelter, Inc. will report on the following outcomes in future MHSA Plans.  Quality of life: housing stability. o 80% of MHSA Consumers residing in master leased housing shall remain stably housed for 24 months or longer. o 90% of MHSA Consumers residing in Shelter, Inc. owned property shall remain stably housed for 16 months or longer. B‐73    STAND! For Families Free of Violence Point of Contact: Sharon Turner Contact Information: 1410 Danzig Plaza #220, Concord, Ca 94520 SharonT@standffov.org 1. General Description of the Organization STAND! For Families Free of Violence is a community based organization committed to promoting safe and strong families. STAND pursues a well-rounded and community-wide approach to eliminating family violence. In addition to providing a complete spectrum of prevention, intervention, and treatment programs, STAND! enlists the efforts of local residents, partners, and institutions, all of whom are striving to stop domestic violence and child abuse. STAND! is a founding member of the "Zero Tolerance for Domestic Violence Initiative", a cross-sector organization working for ten years to help solve domestic violence, sexual assault and children exposed to violence. Program: “Expect Respect” and “You Never Win With Violence” - PEI. a. Scope of Services: STAND! provides services to address the effects of teen dating violence/domestic violence and help maintain healthy relationships of at-risk youth throughout Contra Costa County. STAND! uses two evidence-based, best-practice programs: “Expect Respect” and “You Never Win with Violence” to directly affect the behaviors of youth to prevent future violence and enhance positive mental health outcomes for students already experiencing teen dating violence. Primary prevention activities include educating middle and high school youth about teen dating through the ‘You Never Win with Violence’ curriculum, and providing school personnel, service providers and parents with knowledge and awareness of the scope and causes of dating violence. The program strives to increase knowledge and awareness of the tenets of a healthy dating relationship. Secondary prevention activities include supporting youths experiencing, or at-risk for, teen dating violence by conducting 20 gender-based, 15- week support groups. Each school site has a system for referring youth to the support groups. As a result of these service activities, youth experiencing, or youth who are at-risk for, teen dating violence will demonstrate an increased knowledge of 1)the difference between healthy and unhealthy teen dating relationships, 2) an increased sense of belonging to positive peer groups, 3) an enhanced understanding that violence does not have to be “normal”, and 4) an increased knowledge of their rights and responsibilities in a dating relationship. b. Target Population: Middle and high school students at risk of dating violence c. Payment Limit: $122,734 d. Number served: For FY 12/13 : 1326 e. Outcomes:  You Never Win With Violence presentations: 691 students (46% of target) B‐74     Expect Respect support groups: 522 students (209% of target)  81 Adults received educational presentations on effects of domestic violence on children and dynamics of teen dating violence.  32 new participants participated in the Youth Against Violence Leadership program. B‐75    Telecare Corporation Point of Contact: Chris Roach, Program Director Contact Information: 1080 Marina Village Parkway, Suite 100, Alameda, CA 94501, (510) 337-7950 croach@telecarecorp.com 1. General Description of the Organization Telecare Corporation was established in 1965 in the belief that persons with mental illness are best able to achieve recovery through individualized services provided in the least restrictive setting possible. Today, they operate over 70 programs staffed by more than 2,500 employees in California, Nebraska, North Carolina, Oregon, Texas, New Mexico, Pennsylvania and Washington, and provide a broad continuum of services and supports, including Inpatient Acute Care, Inpatient Non-Acute/Sub- Acute Care, Crisis Services, Residential Services, Assertive Community Treatment (ACT) services, Case Management and Prevention services. 2. Program: Hope House Crisis Residential Facility - CSS Telecare Corporation operates Hope House, a voluntary, highly structured 16-bed Short-Term Crisis Residential Facility (CRF) for adults between the ages of 18 and 59. Hope House is serves individuals who require crisis support to avoid hospitalization, or are discharging from the hospital or long-term locked facilities and need step-down care to transition back to community living. The focus is client- centered and recovery-focused, and underscores the concept of personal responsibility for the resident's illness and independence. The program supports a social rehabilitation model, which is designed to enhance an individual's social connection with family and community so that they can move back into the community and prevent an inpatient stay. Services are recovery based, and tailored to the unique strengths of each individual resident. The program offers an environment where residents have the power to make decisions and are supported as they look at their own life experiences, set their own paths toward recovery, and work towards the fulfillment of their hopes and dreams. Telecare’s program is designed to enhance client motivation to actively participate in treatment, provide clients with intensive assistance in accessing community resources, and assist clients develop strategies to maintain independent living in the community and improve their overall quality of life. The program’s service design draws on evidence- based practices such as Wellness Action and Recovery Planning (WRAP), motivational interviewing, and integrated treatment for co-occurring disorders. a. Scope of Services Services include: o Individualized assessments, including, but not limited to, psychosocial skills, reported medical needs/health status, social supports, and current functional limitations within 72 hours of admission. o Medical assessment within 24 hours of admission. B‐76    o Treatment plan development with 72 hours of admission. o Therapeutic individual and group counseling sessions on a daily basis to assist clients in developing skills that enable them to progress towards self-sufficiency and to reside in less intensive levels of care. o Crisis intervention and management services designed to enable the client to cope with the crisis at hand, maintaining functioning status in the community, and prevent further decompensation or hospitalization. o Medication support services, including provision of medications, as clinically appropriate, to all clients regardless of funding; individual and group education for consumers on the role of medication in their recovery plans, medication choices, risks, benefits, alternatives, side effects and how these can be managed; supervised self-administration of medication based on physician’s order by licensed staff; medication follow-up visit by a psychiatrist at a frequency necessary to manage the acute symptoms to allow the client to safely stay at the Crisis Residential Program, and to prepare the client to transition to outpatient level of care upon discharge. o Co-occurring capable interventions for substance use following a harm reduction modality. o A comprehensive weekly calendar of activities, including physical, recreational, social, artistic, therapeutic, spiritual, dual recovery, skills development and outings. o Peer services, including development of WRAP plans. o Engagement of family in treatment, as appropriate. o Assessments for involuntary hospitalization, when necessary. o Discharge planning and assisting clients with successful linkage to community resources, such as outpatient mental health clinics, substance abuse treatment programs, housing, full service partnerships, physical health care, and benefits programs. o Follow-up with client and their mental health service provider following discharge to ensure that appropriate linkage has been successful. o Daily provision of meals and snacks for residents. o Transportation to services and activities provided in the community, as well as medical and court appointments. b. Target Population: Adults ages 18 to 59 who require crisis support to avoid psychiatric hospitalization, or are discharging from the hospital or long-term locked facilities and need step-down care to transition back to community living. c. Payment Limit: $2,017,019.00 d. Number served: Program began in FY 13/14. Number to be served yearly: 200. e. Outcomes: Because the program began in FY 13/14, there are no outcomes to report at this time. Telecare will report on the outcomes listed below:  Reduction in severity of psychiatric symptoms: Discharge at least 90% of clients to a lower level of care.  Consumer Satisfaction: Maintain an overall client satisfaction score of at least 4.0 out of 5.0. B‐77    The Latina Center Point of Contact: Esther Wong, 3701 Barrett Ave #12, Richmond, Ca 94805 (510) 233-8595 Contact Information: miriamrwong@gmail.com 1. General Description of the Organization The Latina Center is an organization of and for Latinas that strive to develop emerging leaders in the San Francisco Bay Area through innovative training, support groups and leadership programs. The mission of The Latina Center is to improve the quality of life and health of the Latino Community by providing leadership and personal development opportunities for Latina women. 2. Program: Familias Fuertes - PEI a. Scope of Services: The Latina Center (TLC) provides culturally and linguistically specific parenting education and support to at least 300 Latino parents and caregivers in West Contra Costa County that 1) supports healthy emotional, social and educational development of children and youth ages 0-15, and 2) reduces verbal, physical and emotional abuse. The Latina Center enrolls primarily low- income, immigrant, monolingual/bilingual Latino parents and grandparent caregivers of high-risk families in a 12-week parenting class using the Systematic Training for Effective Parenting (STEP) curriculum or PECES in Spanish (Padres Eficaces con Entrenamiento Eficaz). Parent Advocates are trained to conduct parenting education classes, and Parent Partners are trained to offer mentoring, support and systems navigation. TLC provides family activity nights, creative learning circles, cultural celebrations, and community forums on parenting topics. b. Target Population: Latino Families and their children in West County at risk for developing serious mental illness. c. Payment Limit: $102,080 d. Number served: 305 e. Outcomes:  During impact survey 100% of parent participants were able to provide examples of increased parenting skills.  Upon three months follow up, a sample of 80 parents reported increased confidence in their parenting skills (target: 30)  75 of parent participants were Latino Fathers (goal: 60)  271 of parent participants set personal goals for creating change in their parenting (goal: 240)  283 parents were able to identify 1 – 3 individuals for peer support. B‐78    United Family Care, LLC (Family Courtyard). Point of Contact: Julian Taburaza. Contact Information: 2840 Salesian Avenue, Richmond CA, 94804. 1. Program: Augmented Board and Care Housing Services - CSS The County contracts with United Family Care, LLC , a licensed board and care provider, to provide additional staff care to enable those with serious mental illness to avoid institutionalization and enable them to live in the community. a. Scope of Services  Augmented residential services. b. Target Population: Adults aged 18 years and older who live in Western Contra Costa County, are diagnosed with a serious mental illness and are uninsured or receive Medi-Cal benefits. c. Annual MHSA Payment Limit: $ 271,560. d. Number served: For FY 12/13: 48 beds available. e. Outcomes: To be determined. B‐79    Williams Board and Care Home. Point of Contact: Frederick Williams. Contact Information: 4229 Taft Street, Richmond, CA 94804. 1. Program: Augmented Board and Care - Housing Services - CSS The County contracts with Williams Board and Care Home, a licensed board and care provider, to provide additional staff care to enable those with serious mental illness to avoid institutionalization and enable them to live in the community. a. Scope of Services  Augmented residential services. b. Target Population: Consumers eligible for MHSA services. c. Annual MHSA Payment Limit: $ 30,000 d. Number served: For FY 12/13: 12 beds available. e. Outcomes: To be determined. B‐80    Woodhaven. Point of Contact: Milagros Quezon. Contact Information: 3319 Woodhaven Lane, Concord, CA 94519. 2. Program: Augmented Board and Care - Housing Services - CSS The County contracts with United Family Care, LLC , a licensed board and care provider, to provide additional staff care to enable those with serious mental illness to avoid institutionalization and enable them to live in the community. f. Scope of Services  Augmented residential services. g. Target Population: Consumers eligible for MHSA services. h. Annual MHSA Payment Limit: $ 13,500 i. Number served: For FY 12/13: 5 beds available. j. Outcomes: To be determined. B‐81    Youth Homes, Inc. Point of Contact: Stuart McCullough, Executive Director Contact Information: 2025 A Sherman Drive, Pleasant Hill, CA 94523, (925)–933– 2627, stuartm@youthhomes.org 1. General Description of the Organization Youth Homes, Inc. is committed to serving the needs of abused and neglected children and adolescents in California's San Francisco Bay Area. Youth Homes provides intensive residential treatment programs and community-based counseling services that promote the healing process for seriously emotionally abused and traumatized children and adolescents. 2. Program: Transition Age Youth Full Service Partnership - CSS Youth Homes implements a full service partnership program using the Integrated Treatment for Co-Occurring Disorders model (also known as Integrated Dual Disorders Treatment – IDDT). This model is a recognized evidence based practice in which the Substance Abuse and Mental Health Services Administration (SAMHSA) has created a tool kit to support implementation. Integrated Treatment for Co- Occurring Disorders is an evidence-based practice for treating clients diagnosed with both mental health and a substance abuse disorders. Through Integrated Treatment for Co-Occurring Disorders, consumers receive mental health and substance abuse treatment from a single “integrated treatment specialist” so consumers do not get lost in the health care system, excluded from treatment, or confused by going back and forth between separate mental health and substance abuse programs. It is not expected that all full service partners will be experiencing a substance use issue; however, for those who have co-occurring issues, both disorders can be addressed by one single provider. a. Scope of Services  Services include: o Outreach and engagement o Case management o Outpatient Mental Health Services, including services for individuals with co-occurring mental health & alcohol and other drug problems o Crisis Intervention o Collateral o Medication support (may be provided by County Physician) o Housing support o Flexible funds o Money Management o Vocational Services o Contractor must be available to consumer on 24/7 basis B‐82    b. Target Population: Young adults ages 16 to 25 years with serious emotional disturbance/serious mental illness, and who are likely to exhibit co-occurring disorders with severe life stressors and are from an underserved population. Services are based in East Contra Costa County as well as Central Contra Costa County. c. Payment Limit: $665,000. d. Number served: Program began in FY 13/14. Number to be served 40. e. Outcomes: Because the program began in FY 13/14, there are no outcomes to report at this time. Youth Homes will report on the outcomes listed below in the upcoming MHSA Plans.  Increase in age appropriate meaningful activity.  Positive Client Satisfaction.   C‐1    Glossary Assembly Bill 1421. AB 1421, also known as Laura’s Law, enacted in 2002, would create an assisted outpatient treatment program for any person who is suffering from a mental disorder and meets certain criteria. The program would operate in counties that choose to provide the services. Adoption of this law enables a court, upon a verified petition to the court, to order a person to obtain and participate in assisted outpatient treatment. The bill provides that if the person who is the subject of the petition fails to comply with outpatient treatment, despite efforts to solicit compliance, a licensed mental health treatment provider may request that the person be placed under a 72-hour hold, based on an involuntary commitment. The law would be operative in those counties in which the county board of supervisors, by resolution, authorized its application and made a finding that no voluntary mental health program serving adults, and no children’s mental health program, would be reduced as a result of the implementation of the law. Assertive Community Treatment (ACT). Assertive Community Treatment is an intensive and highly integrated approach for community mental health service delivery. It is an outpatient treatment for individuals whose symptoms of mental illness result in serious functioning difficulties in several major areas of life, often including work, social relationships, residential independence, money management, and physical health and wellness. Its mission to promote the participants' independence, rehabilitation, and recovery, and in so doing to prevent homelessness, unnecessary hospitalization, and other negative outcomes. It emphasizes out of the office interventions, a low participant to staff ratio, a coordinated team approach, and typically involves a psychiatrist, mental health clinician, nurse, peer provider, and other rehabilitation professionals. Assisted Outpatient Treatment (AOT). Assisted Outpatient Treatment is the delivery of mobile, community-based care by multidisciplinary teams of highly trained mental health professionals with staff-to-client ratios of not more than one to ten, and additional services, as specified, for adults with the most persistent and severe mental illness. AOT involves a service and delivery process that has a clearly designated personal services coordinator who is responsible for providing or assuring needed services. These include complete assessment of the client’s needs, development with the client of a personal services plan, outreach and consultation with the family and other significant persons, linkage with all appropriate community services, monitoring of the quality and follow through of services, and necessary advocacy to ensure each client receives those services which are agreed to in the personal services plan. AOT is cited as part of Assembly Bill 1421, or Laura’s Law. Augmented Board and Care. Board and care facilities licensed by the State also contract with Contra Costa Mental Health to receive additional funding to provide a therapeutic environment and assist residents gain their independence through recovery and wellness activities. Extra staff time is devoted to creating a home-like atmosphere, C‐2    often with shared housekeeping activities, and provide or coordinate a variety of therapeutic, educational, social and vocational activities. Persons who experience severe and persistent mental illness are eligible. Behavioral Health System (BHS). This term refers to the grouping of Contra Costa Mental Health, Homeless Services, and Alcohol and Other Drug Services under one division of the Health Services Department. Capital Facilities/Information Technology (CF/TN). Capital Facilities and Information Technology is the title of one of five components of the Mental Health Services Act. This component enables a county to utilize MHSA funds for one-time construction projects and/or installation or upgrading of electronic systems, such as mental health records systems. Case Management. Case Management refers to a service in which a mental health clinician develops and implements a treatment plan with a consumer. This treatment plan contains a diagnosis, level of severity, agreed upon goals, and actions by the consumer, the case manager, and other service providers to reach those goals. The mental health clinician provides therapy and additionally takes responsibility for the delivery and/or coordination of both mental and rehabilitation services that assist the consumer reach his/her goals. Clinical Specialist. Clinical Specialist, in the context of this document, refers to a licensed or registered intern in the specialties of social work, marriage and family therapy, psychology, psychiatric nurse practitioner, licensed professional clinical counselor, or psychiatrist. A Clinical Specialist is capable of signing a mental health consumer’s treatment plan that can enable the County to bill Medi-Cal for part of the cost to deliver the service. Clubhouse Model. The Clubhouse Model is a comprehensive program of support and opportunities for people with severe and persistent mental illness. In contrast to traditional day-treatment and other day program models, Clubhouse participants are called "members" (as opposed to "patients" or "clients") and restorative activities focus on their strengths and abilities, not their illness. The Clubhouse is unique in that it is not a clinical program, meaning there are no therapists or psychiatrists on staff. All participation in a clubhouse is strictly on a voluntary basis. Members and staff work side-by-side as partners to manage all the operations of the Clubhouse, providing an opportunity for members to contribute in significant and meaningful ways. A Clubhouse is a place where people can belong as contributing adults, rather than passing their time as patients who need to be treated. The Clubhouse Model seeks to demonstrate that people with mental illness can successfully live productive lives and work in the community, regardless of the nature or severity of their mental illness. C‐3    Community Forum. In this context a community forum is a planned group activity where consumers, family members, service providers, and representatives of community, cultural groups or other entities are invited to provide input on a topic or set of issues relevant to planning, implementing or evaluating public services. Community Program Planning Process. This a term used in regulations pertaining to the Mental Health Services Act. It means the process to be used by the County to develop Three-Year Expenditure Plans, and updates in partnership with stakeholders to 1) identify community issues related to mental illness resulting from lack of community services and supports, including any issues identified during the implementation of the Mental Health Services Act, 2) Analyze the mental health needs in the community, and 3) identify and re-evaluate priorities and strategies to meet those mental health needs. Community Services and Supports (CSS). Community Services and Supports is the title of one of five components funded by the Mental Health Services Act. It refers to mental health service delivery systems for children and youth, transition age youth, adults, and older adults. These services and supports are similar to those provided in the mental health system of care that is not funded by MHSA. Within community services and supports are the categories of full service partnerships, general system development, outreach and engagement, and project based housing programs. Consolidated Planning Advisory Workgroup (CPAW). CPAW is an ongoing advisory body appointed by the Contra Costa Mental Health Director that provides advice and counsel in the planning and evaluation of services funded by MHSA. It is also comprised of several sub-committees that focus on specific areas, such as stigma reduction, homelessness, and services to the four age groups. It is comprised of individuals with consumer and family member experience, service providers from the County and community based organizations, and individuals representing allied public services, such as education and social services. Consumers. In this context consumers refer to individuals and their families who receive behavioral health services from the County, contract partners, or private providers. Consumers can be also referred to as clients, participants or members. Contra Costa Mental Health (CCMH). CCMH is one of 58 counties, the City of Berkeley, and the Tri-Cities area East of Los Angeles legislatively empowered to engage in a contract, or Mental Health Plan, with the state to perform public mental health services. This enables Contra Costa County to utilize federal, state, county and private funding for these mental health services. The Mental Health Services Act is one source of state funding. CCMH is divided into a Children’s System of Care and an Adult and Older Adult System of Care. C‐4    Co-occurring Disorders. Co-occurring disorders refers to more than one behavioral and/or medical health disorder that an individual can experience and present for care and treatment. Common examples are an individual with a substance abuse disorder coupled with a mental health diagnosis, or a developmental disability, such as autism, coupled with a thought disorder. Cultural Competence. Cultural competence means equal access to services of equal quality is provided, without disparities among racial/ethnic, cultural, and linguistic populations or communities. Employment Services. Employment Services is a continuum of services and supports designed to enable individuals to get and keep a job. It includes 1) pre-vocational services, such as removing barriers to employment, 2)employment preparation, to include career counseling and education, training and volunteer activity support, 3) job placement, to include job seeking, placement assistance and on-the-job training, and 4) job retention, to include supported employment. EPIC system. Epic is a nationwide computer software company that offers an integrated suite of health care software centered on a database. Their applications support functions related to patient care, including registration and scheduling; clinical systems for doctors, nurses, emergency personnel, and other care providers; systems for lab technicians, pharmacists, and radiologists; and billing systems for insurers. Evidence Based Practices. This term refers to treatment practices that follow a prescribed method that has been shown to be effective by the best available evidence. This evidence is comprised of research findings derived from the systematic collection of data through observation and experiment, and the formulation of questions and testing of hypotheses. Family Partners. Also referred to as Parent Partners, this professional brings lived experience as a family member of an individual with a serious mental illness to their provision of services. They often participate as a member of a multi-disciplinary team providing mental health treatment, and assist families understand, acquire and navigate the various services and resources needed. Family-to-Family Training. Family-to-Family is an educational course for family, caregivers and friends of individuals living with mental illness. Taught by trained volunteer instructors from the National Alliance for the Mentally Ill it is a free of cost twelve week course that provides critical information and strategies related to caregiving, and assists in better collaboration with mental health treatment providers. C‐5    Federal Poverty Level. This is a total household income amount that the federal government provides an annual guideline that defines whether individuals are living above or below the poverty level. For example, a family of four is determined to live under the poverty level if their total income in 2014 is $23,850. Focus Groups. In this context focus groups are a means for a small group (usually 8- 15) of individuals to provide input, advice and counsel on practices, policies or proposed rulemaking on matters that affect them. Often these individuals are grouped by similar demographics or characteristics in order to provide clarity on a particular perspective. Forensic. In this context this is a term that is connected to individuals involved in the legal court system. Public mental health services utilizing this term identify individuals with mental health issues also involved in the court system. Full Service Partnership (FSP). Full service partnership is a term created by the Mental Health Services Act as a means to require funding from the Act to be used in a certain manner for individuals with serious mental illness. Required features of full service partnerships are that there be a written agreement, or individual services and supports plan, entered into with the client, and when appropriate, the client’s family. This plan may include the full spectrum of community services necessary to attain mutually agreed upon goals. The full spectrum of community services consists of, but is not limited to, mental health treatment, peer support, supportive services to assist the client, and when appropriate the client’s family, in obtaining and maintaining employment, housing, and/or education, wellness centers, culturally specific treatment approaches, crisis intervention/stabilization services, and family education services. Also included are non-mental health services and supports, to include food, clothing, housing, cost of health care and co-occurring disorder treatment, respite care, and wrap-around services to children. The County shall designate a personal service coordinator or case manager for each client to be the single point of responsibility for services and supports, and provide a qualified individual to be available to respond to the client/family 24 hours a day, seven days a week. The Full Service Partnership category is part of the Community Services and Supports (CSS) component of the Mental Health Services Act. At least 50% of the funding for CSS is to go toward supporting the County’s full service partnership category. General System Development. This is a term created by the Mental Health Services Act, and refers to a category of services funded in the community services and supports component, and are similar to those services provided by community public mental health programs authorized in the Welfare and Institutions Code. MHSA funded services contained in the general system development category are designed to C‐6    improve and supplement the county mental health service delivery system for all clients and their families. Greater Bay Area Regional Partnership. Regional partnership means a group of County approved individuals and/or organizations within geographic proximity that acts as an employment and education resource for the public mental health system. These individuals and/or organizations may be county staff, mental health service providers, clients, clients’ family members, and any individuals and/or organizations that have an interest in developing and supporting the workforce of the public mental health system. The Greater Bay Area Regional Partnership refers to an ongoing effort of individuals and/or organizations from the twelve county greater California bay area region. IMPACT (Improving Mood: Providing Access to Collaborative Treatment). This refers to an evidence based mental health treatment for depression utilized specifically for older adults, and is provided in a primary care setting where older adults are concurrently receiving medical care for physical health problems. Up to twelve sessions of problem solving therapy with a year follow up is provided by a licensed clinical therapist, with supervision and support from a psychiatrist who specializes in older adults. The psychiatrist assesses for and monitors medications as needed, and both the clinician and psychiatrist work in collaboration with the primary care physician. Innovation (INN). Innovation is the component of the Mental Health Services Act that funds new or different patterns of service that contribute to informing the mental health system of care as to best or promising practices that can be subsequently added or incorporated into the system. These innovative programs accomplish one or more of the following objectives; i) increase access to underserved groups, ii) increase the quality of services, to include better outcomes, iii) promote interagency collaboration, and iv) increase access to services. All new Innovation programs shall be reviewed and approved by the Mental Health Services Oversight and Accountability Commission. The Act states that five per cent of a County’s revenues shall go for Innovation. Iron Triangle. This term refers to the central area of the city of Richmond that is bordered on three sides by railroad tracks. The communities within this area have a high number of households living below the poverty level, and have a high need for social services, to include public mental health. Laura’s Law. See Assembly Bill 1421. Lesbian, Gay, Bi-sexual, Transgender, Questioning (LGBTQ). Persons in these groups express norms different than the heterosexism of mainstream society, and often experience stigmatism as a result. Lesbian refers to women whose primary emotional, romantic, sexual or affectional attractions are to other women. Gay refers to men whose primary emotional, romantic, sexual or affectional attractions are to other men. C‐7    Bi-sexual refers to men or women whose primary emotional, romantic, sexual, or affectional attractions are to both women and men. Transgender is a term that includes persons who cross-dress, are transsexual, and people who live substantial portions of their lives as other than their birth gender. People who are transgender can be straight, gay, lesbian or bi-sexual. Questioning refers to someone who is questioning their sexual and/or gender orientation. Licensed Clinical Specialist. In this context the term licensed clinical specialist is a County civil service classification that denotes a person meeting minimum mental health provider qualifications, to include possessing a license to practice mental health treatment by the California Board of Behavioral Sciences (BBS). An intern registered by BBS also qualifies. A licensed clinical specialist or registered intern can sign mental health treatment plans that qualify for federal financial participation through the Medi- Cal program. Medi-Cal. Medi-Cal is California’s version of the federal Medi-Caid program, in which health and mental health care can be provided by public health and mental health entities to individuals who do not have the ability to pay the full cost of care, and who meet medical necessity requirements. The federal Medi-Caid program reimburses states approximately half of the cost, with the remainder of the cost provided by a variety of state and local funding streams, to include the MHSA. Mental Health Career Pathway Program. Mental Health Career Pathway Programs are education, training and counseling programs designed to recruit and prepare individuals for entry into and advancement in jobs in the public mental health system. These programs are a category listed as part of the workforce education and training component of the Mental Health Services Act. Mental Health Commission (MHC). The County’s Mental Health Commission are individuals, often with lived experience as a consumer and/or family member of a consumer, who are appointed as representatives of the County’s Board of Supervisors to provide 1) oversight and monitoring of the County’s mental health system, 2) advocacy for persons with serious mental illness, and 3) advise the Board of Supervisors and the mental health director. Mental Health Loan Assumption Program (MHLAP). This is a program that makes payments to an educational lending institution on behalf of an employee who has incurred debt while obtaining an education, provided the individual agrees to work in the public mental health system for a specified period of time and in a capacity that meets the employer’s workforce needs. The MHLAP is funded by the Mental Health Services Act in the workforce education and training component. C‐8    Mental Health Services Act (MHSA). Also known as Proposition 63, the Mental Health Services Act was voted into law by Californians in November 2004. This program combines prevention services with a full range of integrated services to treat the whole person, with the goal of self-sufficiency for those who may have otherwise faced homelessness or dependence on the state for years to come. The MHSA has five components; community services and supports, prevention and early intervention, innovation, workforce education and training, and capital facilities and technology. An additional one percent of state income tax is collected on incomes exceeding one million dollars and deposited into a Mental Health Services Fund. These funds are provided to the County based upon an agreed upon fair share formula. Mental Health Services Act (MHSA) Three Year Program and Expenditure Plan. Each County prepares and submits a three year plan, which shall be updated at least annually and approved by the County’s Board of Supervisors. The plan will be developed with local stakeholders by means of a community program planning process, and will include programs and funding planned for each component, as well as providing for a prudent reserve. Each plan or update shall indicate the number of children, adults and seniors to be served, as well as reports on the achievement of performance outcomes for services provided. Mental Health Services Oversight and Accountability Commission (MHSOAC). The Mental Health Services Oversight and Accountability Commission was established by the MHSA to provide state oversight of MHSA programs and expenditures, and is responsible for annually reviewing and approving each county mental health program for expenditures pursuant to the components of Innovation and Prevention and Early Intervention. Mental Health Professional Shortage Designations. This is a term used by the federal Human Resource Services Administration to determine areas of the country where there is a verified shortage of mental health professionals. These geographical areas are then eligible to apply for a number of federal programs where financial incentives in recruiting and retention are applied to address the workforce shortage. Money Management. This is a term that refers to services that can encompass all aspects of assisting an individual plan and manage financial benefits and resources. It can include counseling on the interplay of work and other sources of income on Medi- Cal, Medicare, Social Security Disability Income (SSDI), and Supplemental Security Income (SSI). It can include becoming a conservator of funds for an individual who has been deemed to be unable to manage their own funds. Multi-dimensional Family Therapy (MDFT). MDFT is an evidence based comprehensive and multi-systemic family-based outpatient or partial hospitalization C‐9    program for substance-abusing adolescents, adolescents with co-occurring substance use and mental disorders, and those at high risk for continued substance abuse. Treatment is delivered in a series of 12 to 16 weekly or twice weekly 60 to 90 minute sessions. Treatment focuses on the social interaction areas of parents and peers, the parents’ parenting practices, parent-adolescent interactions in therapy, and communications between family members and key social systems, such as school and child welfare. Multi-systemic Therapy (MST). MST is an evidence based mental health service that is a community-based, family driven treatment for antisocial/delinquent behavior in youth. The focus is on empowering parents and caregivers to solve current and future problems, and actively involves the entire ecology of the youth; family, peers, school and the neighborhood. National Alliance on Mental Illness (NAMI). NAMI is the National Alliance on Mental Illness, the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need. NAMI is the foundation for hundreds of NAMI State Organizations, NAMI Affiliates and volunteer leaders who work in local communities across the country to raise awareness and provide essential and free education, advocacy and support group programs. Needs Assessment. In this context needs assessment means that part of the community program planning process where the mental health services and supports needs of the community are identified and assessed. This includes identifying populations, age groups and communities that remain unserved, underserved or inappropriately served. Office of Statewide Health Planning and Development (OSHPD). The Office of Statewide Health Planning and Development (OSHPD) is a state department that assists California improve the structure and function of its healthcare delivery systems and promote healthcare accessibility. OSHPD is the state entity responsible for the implementation of various MHSA state level funded workforce education and training programs, such as the mental health loan assumption program, psychiatric residency programs, and several graduate stipend and internship programs. Outreach and Engagement. In this context outreach and engagement is a MHSA term that is a community services and support category, and a category in which prevention and early intervention services can be provided. Services are designed to reach out and engage individuals in mental health care who have a serious mental illness, or are C‐10    at risk of developing a serious mental illness. These are individuals who have not sought services in a traditional manner due to cultural or linguistic barriers. Peer Provider. This is a term that refers to a professional who brings lived experience as a mental health consumer to their provision of services. They often participate as a member of a multi-disciplinary team providing mental health treatment, and assist consumers and their families understand, acquire and navigate the various services and resources needed. Perinatal Depression. Perinatal depression is depression that occurs during pregnancy and up to twelve months after giving birth. It can be caused by changes in hormones during pregnancy and after having a baby. It can also be caused by the many stresses of being a new mother. Postpartum depression, or depression after delivery, is different from post-partum “blues,” which peak three to five days after delivery and usually end within two weeks after the baby’s birth. A woman with perinatal depression has symptoms that last two weeks or longer. Personal Service Coordinators. Personal service coordinators, also known as case managers, refers to a mental health clinician who develops and implements an individual services and support plan with an individual diagnosed with a serious mental illness, and who is part of a full service partner program under the MHSA. This plan contains a diagnosis, level of severity, agreed upon goals, and actions by the consumer, the personal services coordinator, and other service providers to reach those goals. The personal service coordinator provides therapy, and additionally takes responsibility for the delivery and/or coordination of both mental health and rehabilitation services that assist the consumer reach his/her goals. PhotoVoice Empowerment Program. The County sponsors classes designed to enable individuals to create artwork consisting of a photograph and a personally written story that speak to or represent the challenges of prejudice, discrimination and ignorance that people with behavioral health challenges face. These artworks are then displayed in the community to educate, raise awareness and reduce stigma. Portland Identification and Early Referral (PIER) Model. This is an evidence based treatment developed by the PIERS Institute of Portland, Maine. It is an early intervention program for youth, ages 12-25 who are at risk for developing psychosis. It is a multi-disciplinary team approach consisting of a structured interview to assess risk for psychosis, multi-family group therapy, psychiatric care, family psycho-education, supported education and employment, and occupational therapy. Positive Parenting Program. The Triple P Positive Parenting Program is an evidence based practice designed to increase parents’ sense of competence in their parenting C‐11    abilities. It is a multilevel system of family intervention that aims to prevent severe emotional and behavioral disturbances in children by promoting positive and nurturing relationships between parent and child. Improved family communication and reduced conflict reduces the risk that children will develop a variety of behavioral and emotional problems. Post-traumatic Stress Disorder (PTSD). Post-traumatic stress disorder (PTSD) is an emotional illness that that is classified as an anxiety disorder, and usually develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience. PTSD sufferers re-experience the traumatic event or events in some way, tend to avoid places, people, or other things that remind them of the event (avoidance), and are exquisitely sensitive to normal life experiences (hyper arousal). Prevention and Early Intervention (PEI). Prevention and Early Intervention is a term created by the Mental Health Services Act, and refers to a component of funding in which services are designed to prevent mental illnesses from becoming severe and disabling. This means providing outreach and engagement to increase recognition of early signs of mental illness, and intervening early in the onset of a mental illness. Twenty percent of funds received by the Mental Health Services Act are to be spent for prevention and early intervention services. Pre-vocational Employment Services. These are services that enable a person to actively engage in finding and keeping a job. Often the services remove barriers to employment services, such as counseling on how working affects benefits, stabilizing medications, obtaining a driver’s license or general education diploma, and resolving immigration or other legal issues. Prudent Reserve. This is a term created by the Mental Health Services Act, and refers to a County setting aside sufficient MHSA revenues in order to ensure that services do not have to be significantly reduced in years in which revenues are below the average of previous years. Psychiatric Emergency Services (PES). The psychiatric emergency services unit of Contra Costa County is located next door to the Emergency Room of the Regional Medical Center in Martinez. It operated 24 hours a day, seven days a week, and consists of psychiatrists, nurses and mental health clinicians who are on call and available to respond to individuals who are brought in due to a psychiatric emergency. Persons who are seen are either treated and released, or admitted to the in-patient psychiatric hospital ward. Psychiatric Residency. Physicians who specialize in psychiatry complete a four year residency program at one of several schools of psychiatry, such as that located at the University of California at San Francisco. This is essentially a paid work study C‐12    arrangement, where they practice under close supervision and concurrently take coursework. At the final residency year the psychiatrist can elect to work in a medical setting, teach, do research, or work in a community mental health setting. Serious Mental Illness (SMI). Adults with a serious mental illness are persons eighteen years and older who, at any time during a given year, have a diagnosable mental, behavioral, or emotional disorder that meet the criteria of the Diagnostic and Statistical Manual, and the disorder has resulted in functional impairment which substantially interferes with or limits one or more major life activities. Seriously Emotionally Disturbed (SED). Children from birth up to age eighteen with serious emotional disturbance are persons who currently or at any time during the past year have had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual and results in functional impairment which substantially interferes with or limits the child's role or functioning in family, school, or community activities. Service Provider Individualized Recovery Intensive Training (SPIRIT). SPIRIT is a recovery oriented, peer led classroom and experiential-based , college accredited educational program for individuals with lived experience as a consumer of mental health services. It is sponsored by Contra Costa Mental Health and Contra Costa Community College, and successful completion satisfies the minimum qualifications to be considered for employment by the County as a Community Support Worker. Stakeholders. Stakeholders is a term defined in the California Code of Regulations to mean individuals or entities with an interest in mental health services, including but not limited to individuals with serious mental illness and/or serious emotional disturbance and/or their families, providers of mental health and/or related services such as physical health care and/or social services, educators and/or representatives of education, representatives of law enforcement, and any organization that represents the interests of individuals with serious mental illness and/or serious emotional disturbance and/or their families. Stigma and Discrimination. In this context these terms refer to the negative thoughts and/or behaviors that form an inaccurate generalization or judgment, and adversely affects the recovery, wellness and resiliency of persons with mental health issues. These thoughts and behaviors can include any person who has an influence on a person’s mental health well-being, to include the person experiencing the mental health issue. Substance Use Disorder. A substance use disorder is a disorder in which the use of one or more substances leads to a clinically significant impairment or distress. Although C‐13    the term substance can refer to any physical matter, substance abuse refers to the overuse of, or dependence on, a drug leading to effects that are detrimental to the individual's physical and mental health, or the welfare of others. The disorder is characterized by a pattern of continued pathological use of a medication, non-medically indicated drug or toxin which results in repeated adverse social consequences related to drug use, such as failure to meet work, family, or school obligations, interpersonal conflicts, or legal problems. Supported Employment. Supported employment is a federal vocational rehabilitation term that means competitive work for individuals with the most significant disabilities that occurs in integrated work settings, or settings in which individuals are working toward competitive work. Such work is consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individuals. Supported employment usually means that a professional support person, or job coach, assists the individual in a competitive work setting until assistance is no longer needed. Supportive Housing. Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives. Supportive housing is widely believed to work well for those who face the most complex challenges—individuals and families confronted with homelessness and who also have very low incomes and/or serious, persistent issues that may include substance abuse, addiction or alcoholism, mental illness, HIV/AIDS, or other serious challenges to a successful life. Supportive housing can be coupled with such social services as job training, life skills training, alcohol and drug abuse programs, community support services, such as child care and educational programs, and case management to populations in need of assistance. Supportive housing is intended to be a pragmatic solution that helps people have better lives while reducing, to the extent feasible, the overall cost of care. Systematic Training for Effective Parenting (STEP). Systematic Training for Effective Parenting (STEP) is a parent education program published as a series of books developed and published by the psychologists Don Dinkmeyer Sr., Gary D. McKay and Don Dinkmeyer Jr. The publication was supplemented by an extensive concept for training and proliferation. STEP has reached more than four million parents and has been translated into several languages. It provides skills training for parents dealing with frequently encountered challenges with their children that often result from autocratic parenting styles. STEP is rooted in Adlerian psychology and promotes a more participatory family structure by fostering responsibility, independence, and competence in children; improving communication between parents and children; and helping children learn from the natural and logical consequences of their own choices. C‐14  Transition Age Youth (TAY). Transition Age Youth is a term meaning individuals who are between the age of 16 years and 25 years of age. Specific mental health programs that address this age group are in the adult system of care, and were designed to assist in the transition of services from the children’s system of care, where individuals stop receiving services at 18. Workforce Education and Training (WET). Workforce Education and Training is a term created by the Mental Health Services Act, and refers to the component of the MHSA that funds programs and service that assist in the recruitment and retention of a skilled and culturally competent mental health workforce. Wellness Recovery Action Plan (WRAP). The Wellness Recovery Action Plan, or WRAP, is an evidence-based practice that is used by people who are dealing with mental health and other kinds of health challenges, and by people who want to attain the highest possible level of wellness. It was developed by a group of people who have a lived experience with mental health difficulties and who were searching for ways to resolve issues that had been troubling them for a long time. WRAP involves listing one’s personal resources and wellness tools, and then using those resources to develop action plans to use in specific situations. Wraparound Services. Wraparound services are an intensive, individualized care management process for children with serious emotional disturbances. During the wraparound process, a team of individuals who are relevant to the well-being of the child or youth, such as family members, other natural supports, service providers, and agency representatives collaboratively develop an individualized plan of care, implement this plan, and evaluate success over time. The wraparound plan typically includes formal services and interventions, together with community services and interpersonal support and assistance provided by friends and other people drawn from the family’s social networks. The team convenes frequently to measure the plan’s components against relevant indicators of success. Plan components and strategies are revised when outcomes are not being achieved. Wellness Recovery Education for Acceptance, Choice and Hope (WREACH). The WREACH Speaker’s Bureau is sponsored by Contra Costa Behavioral Health Services, and is designed to reduce the stigma that consumers and family members often face in the workplace, behavioral and physical health care systems, and in their communities. The WREACH program forms connections between people in the community and people with lived mental health and co-occurring disorders experiences by providing opportunities for sharing stories of recovery and resiliency, and sharing current information on health treatment and supports. Workshops are held to teach people and their families how to write and present their recovery and resilience stories. These C‐15  individuals are then connected with audiences that include behavioral health providers, high school and college staff and students, law enforcement, physical health providers and the general community. Three-Year Program and Expenditure Plan and Annual Update County/City Certification Final (07/26/2013) MHSA COUNTY COMPLIANCE CERTIFICATION County/City: ____________________________ ☐ Three-Year Program and Expenditure Plan ☐ Annual Update Local Mental Health Director Name: Telephone Number: E-mail: Program Lead Name: Telephone Number: E-mail: Local Mental Health Mailing Address: I hereby certify that I am the official responsible for the administration of county/city mental health services in and for said county/city and that the County/City has complied with all pertinent regulations and guidelines, laws and statutes of the Mental Health Services Act in preparing and submitting this Three-Year Program and Expenditure Plan or Annual Update, including stakeholder participation and nonsupplantation requirements. This Three-Year Program and Expenditure Plan or Annual Update has been developed with the participation of stakeholders, in accordance with Welfare and Institutions Code Section 5848 and Title 9 of the California Code of Regulations section 3300, Community Planning Process. The draft Three-Year Program and Expenditure Plan or Annual Update was circulated to representatives of stakeholder interests and any interested party for 30 days for review and comment and a public hearing was held by the local mental health board. All input has been considered with adjustments made, as appropriate. The annual update and expenditure plan, attached hereto, was adopted by the County Board of Supervisors on _________________________. Mental Health Services Act funds are and will be used in compliance with Welfare and Institutions Code section 5891 and Title 9 of the California Code of Regulations section 3410, Non-Supplant. All documents in the attached annual update are true and correct. ______________________________________ ________________________________ Local Mental Health Director (PRINT) Signature Date D-2 County:Contra Costa Date:April 17, 2014 A B C D E F Community Services and Supports Prevention and Early Intervention Innovation Workforce Education and Training Capital Facilities and Technological Needs Prudent Reserve A. Estimated FY 2014/15 Funding 1.Estimated Unspent Funds from Prior Fiscal Years 16,250,578 10,572,630 3,314,376 2,043,384 4,054,864 2.Estimated New FY2014/15 Funding 28,060,615 7,015,154 1,846,093 3.Transfer in FY2014/15a/0 4.Access Local Prudent Reserve in FY2014/15 0 5.Estimated Available Funding for FY2014/15 44,311,193 17,587,784 5,160,469 2,043,384 4,054,864 B. Estimated FY2014/15 MHSA Expenditures 30,068,631 8,037,813 2,019,495 638,871 849,936 C. Estimated FY2015/16 Funding 1.Estimated Unspent Funds from Prior Fiscal Years 14,242,562 9,549,971 3,140,974 1,404,513 3,204,928 2.Estimated New FY2015/16 Funding 24,219,250 6,054,813 1,593,372 3.Transfer in FY2015/16a/0 4.Access Local Prudent Reserve in FY2015/16 0 5.Estimated Available Funding for FY2015/16 38,461,812 15,604,784 4,734,346 1,404,513 3,204,928 D. Estimated FY2015/16 Expenditures 31,568,631 8,037,813 2,019,495 638,871 849,936 E. Estimated FY2016/17 Funding 1.Estimated Unspent Funds from Prior Fiscal Years 6,893,181 7,566,971 2,714,851 765,642 2,354,992 2.Estimated New FY2016/17 Funding 24,758,147 6,189,537 1,628,825 3.Transfer in FY2016/17a/0 4.Access Local Prudent Reserve in FY2016/17 0 5.Estimated Available Funding for FY2016/17 31,651,328 13,756,507 4,343,677 765,642 2,354,992 F. Estimated FY2016/17 Expenditures 31,568,631 8,037,813 2,019,495 638,871 849,936 G. Estimated FY2016/17 Unspent Fund Balance 82,697 5,718,694 2,324,182 126,771 1,505,056 H. Estimated Local Prudent Reserve Balance 1. Estimated Local Prudent Reserve Balance on June 30, 2014 7,125,250 2. Contributions to the Local Prudent Reserve in FY 2014/15 0 3. Distributions from the Local Prudent Reserve in FY 2014/15 0 4. Estimated Local Prudent Reserve Balance on June 30, 2015 7,125,250 5. Contributions to the Local Prudent Reserve in FY 2015/16 0 6. Distributions from the Local Prudent Reserve in FY 2015/16 0 7. Estimated Local Prudent Reserve Balance on June 30, 2016 7,125,250 8. Contributions to the Local Prudent Reserve in FY 2016/17 0 9. Distributions from the Local Prudent Reserve in FY 2016/17 0 10. Estimated Local Prudent Reserve Balance on June 30, 2017 7,125,250 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Funding Summary a/ Pursuant to Welfare and Institutions Code Section 5892(b), Counties may use a portion of their CSS funds for WET, CFTN, and the Local Prudent Reserve. The total amount of CSS funding used for this purpose shall not exceed 20% of the total average amount of funds allocated to that County for the previous five years. MHSA Funding D-3 County:Contra Costa Date:April 17, 2014 A B C D E F Estimated Total Mental Health Expenditures Estimated CSS Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding FSP Programs 1.Children 2,885,820 2,885,820 2.Transition Age Youth 2,065,642 2,065,642 3.Adult 2,935,514 2,935,514 4.Adult Mental Health Clinic Support 1,794,059 1,794,059 5.Wellness and Recovery Centers 875,000 875,000 6.Crisis Residential 2,017,019 2,017,019 7.MHSA Housing Services 4,886,309 4,886,309 8.0 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 Non-FSP Programs 1.Older Adult Mental Health Program 3,560,079 3,560,079 2.Children's Wraparound Support 2,161,974 2,161,974 3.Assessment and Recovery Center 1,250,000 1,250,000 4.Liaison Staff 513,693 513,693 5.Clinic Support 1,201,637 1,201,637 6.Forensic Team 493,973 493,973 7.Quality Assurance and Administrative Support 1,176,673 1,176,673 8.Administrative Support 2,251,239 2,251,239 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 CSS Administration 0 CSS MHSA Housing Program Assigned Funds 0 Total CSS Program Estimated Expenditures 30,068,631 30,068,631 0 0 0 0 FSP Programs as Percent of Total 58.1% FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Community Services and Supports (CSS) Component Worksheet Fiscal Year 2014/15 D-4 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Community Services and Supports (CSS) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated CSS Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding FSP Programs 1.Children 2,885,820 2,885,820 2.Transition Age Youth 2,065,642 2,065,642 3.Adult 2,935,514 2,935,514 4.Adult Mental Health Clinic Support 1,794,059 1,794,059 5.Wellness and Recovery Centers 875,000 875,000 6.Crisis Residential 2,017,019 2,017,019 7.MHSA Housing Services 4,886,309 4,886,309 8.0 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 Non-FSP Programs 1.Older Adult Mental Health Program 3,560,079 3,560,079 2.Children's Wraparound Support 2,161,974 2,161,974 3.Assessment and Recovery Center 2,750,000 2,750,000 4.Liaison Staff 513,693 513,693 5.Clinic Support 1,201,637 1,201,637 6.Forensic Team 493,973 493,973 7.Quality Assurance and Administrative Support 1,176,673 1,176,673 8.Administrative Support 2,251,239 2,251,239 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 CSS Administration 0 CSS MHSA Housing Program Assigned Funds 0 Total CSS Program Estimated Expenditures 31,568,631 31,568,631 0 0 0 0 FSP Programs as Percent of Total 55.3% Fiscal Year 2015/16 D-5 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Community Services and Supports (CSS) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated CSS Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding FSP Programs 1.Children 2,885,820 2,885,820 2.Transition Age Youth 2,065,642 2,065,642 3.Adult 2,935,514 2,935,514 4.Adult Mental Health Clinic Support 1,794,059 1,794,059 5.Wellness and Recovery Centers 875,000 875,000 6.Crisis Residential 2,017,019 2,017,019 7.MHSA Housing Services 4,886,309 4,886,309 8.0 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 Non-FSP Programs 1.Older Adult Mental Health Program 3,560,079 3,560,079 2.Children's Wraparound Support 2,161,974 2,161,974 3.Assessment and Recovery Center 2,750,000 2,750,000 4.Liaison Staff 513,693 513,693 5.Clinic Support 1,201,637 1,201,637 6.Forensic Team 493,973 493,973 7.Quality Assurance and Administrative Support 1,176,673 1,176,673 8.Administrative Support 2,251,239 2,251,239 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 CSS Administration 0 CSS MHSA Housing Program Assigned Funds 0 Total CSS Program Estimated Expenditures 31,568,631 31,568,631 0 0 0 0 FSP Programs as Percent of Total 55.3% Fiscal Year 2016/17 D-6 County:Contra Costa Date:April 17, 2014 A B C D E F Estimated Total Mental Health Expenditures Estimated PEI Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding PEI Programs - Prevention 1.Underserved Communities 1,481,361 1,481,361 2.Supporting Youth 1,600,726 1,600,726 3.Supporting Families 585,434 585,434 4.Supporting Adults 246,986 246,986 5.Supporting Older Adults 489,449 489,449 6.Preventing Relapse 468,440 468,440 7.Stigma Reduction 692,988 692,988 8.Suicide Prevention 416,343 416,343 9.Administrative support /Planning/Evaluation 370,479 370,479 10.0 PEI Programs - Early Intervention 11.First Hope 1,685,607 1,685,607 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 PEI Administration 0 PEI Assigned Funds 0 Total PEI Program Estimated Expenditures 8,037,813 8,037,813 0 0 0 0 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Prevention and Early Intervention (PEI) Component Worksheet Fiscal Year 2014/15 D-7 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Prevention and Early Intervention (PEI) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated PEI Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding PEI Programs - Prevention 1.Underserved Communities 1,481,361 1,481,361 2.Supporting Youth 1,600,726 1,600,726 3.Supporting Families 585,434 585,434 4.Supporting Adults 246,986 246,986 5.Supporting Older Adults 489,449 489,449 6.Preventing Relapse 468,440 468,440 7.Stigma Reduction 692,988 692,988 8.Suicide Prevention 416,343 416,343 9.Administrative support /Planning/Evaluation 370,479 370,479 10.0 PEI Programs - Early Intervention 11.First Hope 1,685,607 1,685,607 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 PEI Administration 0 PEI Assigned Funds 0 Total PEI Program Estimated Expenditures 8,037,813 8,037,813 0 0 0 0 Fiscal Year 2015/16 D-8 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Prevention and Early Intervention (PEI) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated PEI Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding PEI Programs - Prevention 1.Underserved Communities 1,481,361 1,481,361 2.Supporting Youth 1,600,726 1,600,726 3.Supporting Families 585,434 585,434 4.Supporting Adults 246,986 246,986 5.Supporting Older Adults 489,449 489,449 6.Preventing Relapse 468,440 468,440 7.Stigma Reduction 692,988 692,988 8.Suicide Prevention 416,343 416,343 9.Administrative support /Planning/Evaluation 370,479 370,479 10.0 PEI Programs - Early Intervention 11.First Hope 1,685,607 1,685,607 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 PEI Administration 0 PEI Assigned Funds 0 Total PEI Program Estimated Expenditures 8,037,813 8,037,813 0 0 0 0 Fiscal Year 2016/17 D-9 County:Contra Costa Date:April 17, 2014 A B C D E F Estimated Total Mental Health Expenditures Estimated INN Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding INN Programs 1.Supporting LGBTQ Youth 420,187 420,187 2.Perinatal Depression Treatment 194,652 194,652 3.Trauma Recovery Project 123,493 123,493 4.Reluctant to Rescue 159,390 159,390 5.Administrative Support 121,773 121,773 6.Emerging programs 1,000,000 1,000,000 7.0 8.0 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 INN Administration 0 Total INN Program Estimated Expenditures 2,019,495 2,019,495 0 0 0 0 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Innovations (INN) Component Worksheet Fiscal Year 2014/15 D-10 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Innovations (INN) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated INN Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding INN Programs 1.Supporting LGBTQ Youth 420,187 420,187 2.Perinatal Depression Treatment 194,652 194,652 3.Trauma Recovery Project 123,493 123,493 4.Reluctant to Rescue 159,390 159,390 5.Administrative Support 121,773 121,773 6.Emerging programs 1,000,000 1,000,000 7.0 8.0 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 INN Administration 0 Total INN Program Estimated Expenditures 2,019,495 2,019,495 0 0 0 0 Fiscal Year 2015/16 D-11 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Innovations (INN) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated INN Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding INN Programs 1.Supporting LGBTQ Youth 420,187 420,187 2.Perinatal Depression Treatment 194,652 194,652 3.Trauma Recovery Project 123,493 123,493 4.Reluctant to Rescue 159,390 159,390 5.Administrative Support 121,773 121,773 6.Emerging programs 1,000,000 1,000,000 7.0 8.0 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 INN Administration 0 Total INN Program Estimated Expenditures 2,019,495 2,019,495 0 0 0 0 Fiscal Year 2016/17 D-12 County:Contra Costa Date:April 17, 2014 A B C D E F Estimated Total Mental Health Expenditures Estimated WET Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding WET Programs 1.Administrative Support 184,426 184,426 2.Staff Training 84,000 84,000 3.SPIRIT 11,000 11,000 4.Family to Family 20,000 20,000 5.Law Enforcement 5,000 5,000 6.High School Academy 14,500 14,500 7.Graduate Level Internships 269,945 269,945 8.Bachelor/Master Degree Scholarships 50,000 50,000 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 WET Administration 0 Total WET Program Estimated Expenditures 638,871 638,871 0 0 0 0 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Workforce, Education and Training (WET) Component Worksheet Fiscal Year 2014/15 D-13 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Workforce, Education and Training (WET) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated WET Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding WET Programs 1.Administrative Support 184,426 184,426 2.Staff Training 84,000 84,000 3.SPIRIT 11,000 11,000 4.Family to Family 20,000 20,000 5.Law Enforcement 5,000 5,000 6.High School Academy 14,500 14,500 7.Graduate Level Internships 269,945 269,945 8.Bachelor/Master Degree Scholarships 50,000 50,000 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 WET Administration 0 Total WET Program Estimated Expenditures 638,871 638,871 0 0 0 0 Fiscal Year 2015/16 D-14 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Workforce, Education and Training (WET) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated WET Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding WET Programs 1.Administrative Support 184,426 184,426 2.Staff Training 84,000 84,000 3.SPIRIT 11,000 11,000 4.Family to Family 20,000 20,000 5.Law Enforcement 5,000 5,000 6.High School Academy 14,500 14,500 7.Graduate Level Internships 269,945 269,945 8.Bachelor/Master Degree Scholarships 50,000 50,000 9.0 10.0 11.0 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 WET Administration 0 Total WET Program Estimated Expenditures 638,871 638,871 0 0 0 0 Fiscal Year 2016/17 D-15 County:Contra Costa Date:April 17, 2014 A B C D E F Estimated Total Mental Health Expenditures Estimated CFTN Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding CFTN Programs - Capital Facilities Projects 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 CFTN Programs - Technological Needs Projects 11.Electronic Health Records System - Administrative Support849,936 849,936 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 CFTN Administration 0 Total CFTN Program Estimated Expenditures 849,936 849,936 0 0 0 0 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Capital Facilities/Technological Needs (CFTN) Component Worksheet Fiscal Year 2014/15 D-16 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Capital Facilities/Technological Needs (CFTN) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated CFTN Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding CFTN Programs - Capital Facilities Projects 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 CFTN Programs - Technological Needs Projects 11.Electronic Health Records System - Administrative Support849,936 849,936 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 CFTN Administration 0 Total CFTN Program Estimated Expenditures 849,936 849,936 0 0 0 0 Fiscal Year 2015/16 D-17 County:Contra Costa Date:April 17, 2014 FY 2014-15 Through FY 2016-17 Three-Year Mental Health Services Act Expenditure Plan Capital Facilities/Technological Needs (CFTN) Component Worksheet A B C D E F Estimated Total Mental Health Expenditures Estimated CFTN Funding Estimated Medi- Cal FFP Estimated 1991 Realignment Estimated Behavioral Health Subaccount Estimated Other Funding CFTN Programs - Capital Facilities Projects 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 CFTN Programs - Technological Needs Projects 11.Electronic Health Records System - Administrative Support849,936 849,936 12.0 13.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 CFTN Administration 0 Total CFTN Program Estimated Expenditures 849,936 849,936 0 0 0 0 Fiscal Year 2016/17 D-18   E‐1        PUBLIC COMMENT PUBLIC HEARING MHSA Three Year Program and Expenditure Plan Fiscal Years 2014-17  E-2 E-3 The Commission will provide reasonable accommodations for persons with disabilities planning to participate in Commission meetings. Contact the Executive Assistant at 925-957-5140 at least 48 hours prior to the meeting. AGENDA I. 6:15 Call to Order / Introductions II. 6:20 Opening Comments by the Mental Health Commission (MHC) Chair A. Review of authority for Public Hearing [Welfare & Institutions Code 5848(a)(b)]. A draft plan and update shall be prepared and circulated for review and comment for at least 30 days to representatives of stakeholder interests and any interested party who has requested a copy of the draft plans. The Mental Health Commission shall conduct a public hearing on the draft plan and annual updates at the close of the 30-day comment period. The Mental Health Commission shall review the adopted plan or update and make recommendations to the county mental health department for revisions. B. Review of Public Hearing purpose To confirm and complete the process. III. 6:30 Fiscal Years 2014-2017 Mental Health Services Act (MHSA) Three Year Program and Expenditure Plan – Warren Hayes, MHSA Program Manager The Plan is available for review at: cchealth.org/mentalhealth/pdf/2014-mhsa-3- year-plan.pdf IV. 6:45 Public Comment On Plan Members of the public may comment on any item of public interest within the jurisdiction of the Mental Health Commission. Public Comment cards are available on the table at the back of the room. Please turn them in to the Mental Health Commission’s Executive Assistant. In the interest of time and Contra Costa County’s Mental Health Commission Hosts a PUBLIC HEARING On the Fiscal Years 2014-2017 Mental Health Services Act Three Year Program and Expenditure Plan Thursday, June 12, 2014  6:15 – 7:45 p.m. County Administration Building 651 Pine Street, Room 101, Martinez E-4 equal opportunity, speakers are requested to observe a 3-minute maximum time limit (subject to change at the discretion of the Chair). In accordance with the Brown Act, if a member of the public addresses an item not on the Agenda, no response, discussion, or action on the item may occur except for the purpose of clarification. V. 7:10 Commissioner Comments Members of the Commission may comment on any item of public interest within the jurisdiction of the Mental Health Commission. Commissioner Comment cards are available at your seat. Please turn them in to the Mental Health Commission’s Executive Assistant. In the interest of time and equal opportunity, speakers are requested to observe a 3-minute maximum time limit (subject to change at the discretion of the Chair). In accordance with the Brown Act, if a member of the public addresses an item not on the Agenda, no response, discussion, or action on the item may occur except for the purpose of clarification. VI. 7:15 Develop List of Comments and Recommendations to the County Mental Health Administration (MHA) and to the Board of Supervisors (BOS). Action Item VII. 7:45 Adjourn Public Hearing Any disclosable public records related to an open session item on a regular meeting agenda and distributed by the staff to a majority of the members of the Mental Health Commission less than 96 hours to that meeting are available for public inspection at 1340 Arnold Drive, Ste. 200, Martinez during normal business hours. E-5 E‐6    MENTAL HEALTH COMMISSION MHSA 2014-2017 PUBLIUC HEARING 6.12.2014 MINUTES – 1st Draft Agenda Item Discussion Action/ Follow-up I. Call to Order and Introductions Mental Health Chairperson Sam Yoshioka called the meeting to order at 6:25 p.m. Commissioners Present: Louis Buckingham, District III Jerome Crichton, District III Jack Feldman, District V Dave Kahler, District IV (Left at 7:00) Peggy Kennedy, District II Carole McKindley-Alvarez, District I Colette O’Keeffe, District IV Teresa Pasquini, District I Lauren Rettagliata, District II Gina Swirsding. District I (4:55) Sam Yoshioka, District IV Commissioners Absent: Peggy Black, District V Evelyn Centeno, District V Karen Mitchoff, BOS Repr. Non-Commissioners Present: Stan Baraghin, Consumer Hillary Bowers, Recovery Innovations Lia Bristol, Supv. Mitchoff’s Office Lisa Bruce, OCE Yolana Cruz, OCE Doug Dunn, NAMI Warren Hayes, MHSA Program Manager Gerogette Howington, Family member Kimberly Krisch, OCE Gerold Loenicker, MHA Erin McCarty, MHA Susan Medlin, OCE Joe Partansky, Guest Roberto Roman, OCE Karen Shuler, MHC Executive Assistant Interpreters for sign language, Spanish and Vietnamese II. Opening Comments by the A. Review of authority for Public Hearing [Welfare & Institutions Code 5848(a)(b)]. A draft plan and update shall be prepared and circulated for review E‐7    MHC Chair and comment for at least 30 days to representatives of stakeholder interests and any interested party who has requested a copy of the draft plans. The Mental Health Commission shall conduct a public hearing on the draft plan and annual updates at the close of the 30-day comment period. The Mental Health Commission shall review the adopted plan or update and make recommendations to the county mental health department for revisions. B. Review of Public Hearing purpose To confirm and complete the process. Sam commented that he questioned the W&I Code statute that was referred to above as being the authority for the Public Hearing process and the Mental Health Commission’s involvement in that process. But after reading the portion cited, he found it was accurate as stated above. He then turned the meeting over to MHSA Program Manager Warren Hayes for the introduction to the Public Comments.. III. Fiscal Years 2014-2017 Mental Health Services Act (MHSA) Three Year Program and Expenditure Plan – Warren Hayes, MHSA Program Manager The Plan is available for review at: cchealth.org/mentalhealth/pdf/2014-mhsa-3-year- plan.pdf Warren stated that Contra Costa Mental Health is pleased to present the draft Mental Health Services Act (MHSA) Three Year Program and Expenditure Plan for fiscal years 2014 through 2017. We welcome your input this evening. This Three Year Plan proposes to set aside $41.6 million annually to fund over 80 programs and plan elements. No new programs are proposed. Yearly projected expenditures includes $30 million for Community Services and Supports, $8 million for Prevention and Early Intervention, $2 million for Innovation, $600,000 for Workforce Education and Training, and $850,000 for Capital Facilities and Information Technology. The budget analysis indicates that expenditures will exceed revenues for the next three years, and predicts that sufficient unspent funds from previous years are available in each component to sustain this level of programming for this three year period. That is, assuming that there are no significant new funding commitments. The Plan proposes to evaluate all programs and plan E‐8    elements during the next three year period in order to determine whether each MHSA funded program or plan element meets the letter and intent of MHSA, supports the prioritized needs identified in our recently completed community program planning process, meets the agreed upon outcomes, and is cost effective. The Plan also proposes to establish a monthly MHSA financial report in the format provided in this Three Year Plan in order to enable better fiscal accountability, transparency and communication. Finally, this Three Year Plan format and narrative style has been changed from previous years. It contains a Mental Health Director’s vision that is linked to our community program planning process, crosswalks our stakeholder’s prioritized needs to relevant parts of the Plan, provides mental health service maps, program and plan element profiles, and a glossary of terms used in the Plan. Significant events leading up to today include:  April 18 - posting the needs assessment and community engagement process reports.  April 21 - sending the first draft of the Plan to the Mental Health Commission, Consolidated Planning and Advisory Workgroup, and other interested parties.  May 1 and May 8 - meeting with the Consolidated Planning and Advisory Workgroup and the Mental Health Commission for discussion of the Plan.  May 12 - posting the second draft of the Plan for the 30 day Public Comment period.  June 5 - responding to input received on the first draft. Tomorrow we will respond to the input received during the public comment period, as well as input received this evening. This written response will be included in the Plan that is sent to the Board of Supervisors for consideration. IV. Public Comment on Plan 1) Joe Partansky re: Council on Mentally Ill Offenders. There was discussion as to whether or not he could distribute a flyer he had brought. The Executive Assistant will send out the flyer to attendees tomorrow. (See attached flyer.) He said he hopes that the MHSA Plan allows for efforts at reducing the number of mentally ill juveniles and adults in the court system. 2) Douglas Dunn re: Laura’s Law. (See attached Scan and e-mail flyer Friday to Commissioners and all attendees. E‐9    notes.) He asked that the $2.5-$2.75 million in identified CSS funding for a full 45 person Laura’s Law program be included in the 2014-2017 MHSA Plan that the Board of Supervisors finally approve. Until then, he said he personally and the NAMI-CC Board of Directors cannot recommend approval of the 2014-2017 MHSA Plan. Note: The Chair allowed Doug’s comments to go beyond the 3-minutes time limit. Peggy reminded the Chair that anyone else commenting needed to be allowed the same time (8 minutes). The Chair said time was not a problem. 3) Stan Baraghin re: his experiences being 5150’d. He said he objects to Laura’s Law. 4) Yolanda Cruz re: Laura’s Law and Behavior Health Court. She spoke about her experience being 5150’d and taken to jail instead of a hospital when she had a mental break. She said the Behavior Health Court has helped her. These programs help and they do need to get funded. She said she is for Laura’s Law because you can get the help you need. V. Commissioner Comments 1) Gina responded to the Public Comment Doug made about Laura’s Law despite being told response was not allowed during Public Comment except for purpose of clarification. The Chair allowed her to continue her comments about her opinion of Laura’s Law. 2) Jerome said he wants to find out about how MHSA can make more funds available for the Behavior Health Court. If the Plan increases BHC from 18 to 30 clients per year, it would necessitate additional staff. Especially on the cusp of Laura’s Law, can the provision be made to expand and adequately staff it? 3) Carole had questions regarding specifics in Plan to raise client levels from 18 to 30. Warren said he visited the BHC and spoke to clients and the judge. The BHC is mandated and only accepts individuals who violate the law. The mandated part is they are given the option of staying in jail or participating in treatment. MHSA only funds the portion where the court system and County staff, the clinicians, who are not funded by MHSA but are really active – the case managers. When an individual needs services from one of our contractors – in this case it is ANKA – he asks E‐10    questions about how many people ANKA currently gets involved with and right now it’s miniscule. But he left the 30 in the Plan. This was done before cuts started being made. He added there isn’t a lot of specificity around ANKA and the behavioral Health Court mainly because it isn’t very active. 4) Teresa explained that the Commission had voted to get additional information on behalf of the Criminal Justice Committee and discuss it at the next MHC meeting. She said she’s concerned about specifics about the funds being requested and the number of clients being served. She is confused about how we can have a Plan where the program doesn’t have to provide specifics. How are we accepting that the costs given are what it actually costs? 5) Jerome said there are currently 15 clients and 1 Mental Health Clinical Specialist. What does that represent? How is this being thought out? Who and in what way is putting this together? What forethought has been given to the connection between funding and the staffing? Warren spoke about the contractural process. The benchmark for the staff-client ratio for FSP is 1 to 12-15. Part of the impetus for MHSA doing an in depth evaluation is asking if they delivered what was originally negotiated and is it right right now? We did a comprehensive review of ANKA. 6) Carole asked if there was a way for more information in the Plan. Warren: We can’t come up with what we haven’t been provided. Is there a means in the Plan to get you the information? 7) Peggy: In the next round, next time there should be an evaluation attached to each of the programs – an outcomes report evaluation adapted to each program. 8) Gina: Find out how much money is left over they still have floating around. Warren: Method to determine projections needed. How is program actually trending? 9) Lauren: Innovation pp. 42-43. Didn’t see timeframe in Plan. Partnership/Collaboration component is also missing. Explanation of funds allocated for emerging programs. 10) Carole: Innovation programs have not been well E‐11    thought out. The Plan needs to be well-thought-out. Warren: Timeframe for Innovation Program has not been set. 11) Lauren said we need to know what the timeframes are for the Innovative Programs. Warren said they are being proposed to be funded for the next 3 years. 12) Carole asked how are Innovation Programs audited or reviewed. Warren: They will be included with all the others and get the same treatment – actually get a lot more scrutiny from the Innovation Committee. 13) Teresa: Have concerns, heard anecdotal information about Crestwood, and wonders about outcomes (Crestwood). She questions what $850,000 for IT is going to be spent on. Says Warren is a hero for his efforts. She said she is still not able to support this Plan. There are too many loose ends. The ARC budget needs to be explained. Is MHSA paying for staffing? There needs to be clarity. Cannot support it because there is no accommodation for Laura’s Law. Warren:  Regarding Crestwood, this Plan is an Augmented Board and Care – outcomes is how many beds they provide, but it needs to be outcomes relating to funds that are augmenting the board and care. As part of our evaluation process, we will need to have outcomes that will satisfy our need to know what they are doing with their funds.  The money for IT was a number given to him by Finance and represents the County operated staff that has been in place to provide the planning for the contract this is being negotiated. He feels the figure will be lower. They have not agreed on a contract yet to do this.  When he got here, in order to get Board approval for the staffing pattern at the ARC, they had to point to a funding source and it was MHSA. A number of clinical specialties can be eligible for federal funding, so how much MHSA funds depends on the staffing pattern.  He is not part of the Laura’s Law process. It is still ongoing. If Laura’s Law is approved and MHSA funds are an issue, an update can be E‐12    provided. He asked that they not be lumped together because it’s not known how the Laura’s Law discussion is going to go. VI. Develop list of comments and recommendations to the County Mental Health Administration and to the Board of Supervisors 1) If the Plan increases BHC from 18 to 30 clients per year, it would necessitate additional staff. Especially on the cusp of Laura’s Law, can the provision be made to expand and adequately staff it? 2) Is there a way for more specifics to be included in the Plan (like ANKA and the BHC)? Without deliverables, how can we vote? 3) In the next round, next time there should be an evaluation attached to each of the programs – an outcomes report evaluation adapted to each program. 4) Find out how much money is left over they still have floating around. 5) Innovation pp. 42-43. Didn’t see timeframe in Plan. Partnership/Collaboration component is also missing. Explanation of funds allocated for emerging programs. 6) Innovation programs have not been well thought out. The Plan needs to be well-thought-out. 7) Questions about what $850,000 for IT is going to be spent on. The ARC budget needs to be explained. Is MHSA paying for staffing? There needs to be clarity. Sam called for a motion to be made to send all the questions and comments and recommendations made during this Public Hearing to the Mental Health Administration and to the Board of Supervisors.  Jerome made the motion and Carole seconded. There was no further discussion. By a vote of 9-0-1, the motion passed. Motion to forward list of comments and recommendations to MHA and BOS, Passed 9-0-1. Yes (9): Louis Jerome Jack Peggy K. Carole Colette Teresa Lauren Sam No (0) Abstain (1): Gina Absent (4) Evelyn Dave Peggy B. Supv. Mitchoff VII. Adjourn Public Hearing The meeting adjourned at 7:45 p.m. Respectfully Submitted, Karen Shuler, Executive Assistant Contra Costa County Mental Health Commission E‐13    Contra Costa Mental Health Administration Responses to Public Comments, Public Hearing and Mental Health Commission Comments/Recommendations PUBLIC COMMENT a. Comment. Page 4 - Though an acronym index is provided in the second paragraph, CCMH is used without it being defined. To make the Plan reader friendly, the first time an acronym is used please spell it out. Response. The Contra Costa Mental Health (CCMH) administration agrees that the first time an acronym is used that it should be spelled out, and acknowledges that CCMH was first used without it being spelled out. Contra Costa Mental Health is first spelled out on page 1 – Introduction. The acronym “CCMH” will be inserted on page 1 to inform the reader that this stands for Contra Costa Mental Health. b. Comment. On Pages 8 & 9 Laura's Law is mentioned. At least, persons with a serious mental illness that keeps them from treatment do make the pages of the Plan. I will count this a good first step. Response. As stated in the Three Year Plan, the County is studying the feasibility of implementing or adapting Assembly Bill 1421, or Laura’s Law. c. Comment. Housing and Homeless Services. There are new studies out that show that it is less expensive to house someone with a serious mental illness than it is to leave them homeless. So instead of the sentence that begins "Unfortunately . . ." Maybe calling our county to a more forward thinking position at providing housing is needed. Response. The sentence reads, “Unfortunately sufficient affordable housing for all consumers of CCMH is beyond the financial means of the County’s Behavioral Health Services budget.” This statement is within the scope of this document, and provides context for subsequent statements that identify plans for better coordinating staff and resources in order to improve and maximize the impact of the number of beds and housing units available. Advocacy for more funding for additional affordable housing is beyond the scope of this document. However, it is not outside the scope of individuals who are dedicated to advocating for this issue. d. Comment. Children Wraparound Support - page 25. Do any of these funds qualify for federal reimbursement? Response. These MHSA funds pay for staff participating in the Children’s Wraparound Program, such as family partners, who are not qualified to sign treatment plans that generate federal reimbursement funds. All staff who are able to generate revenue, such as licensed clinicians, are funded by a combination of non-MHSA, non-federal funds, such as realignment dollars, and federal financial participation. E‐14    e. Comment. Assessment and Recovery Center and Liaison Staff - page 25- 26. Do any of these positions qualify for funds for federal reimbursement? Response. For the Assessment and Recovery Center - the potential for part of the mental health service costs to be offset by other funding sources is being determined, such as federal financial participation through Medi-Cal, and cost offsets on selected mental health positions due to the Center being certified as a federally qualified health center. Each potential funding source and its rules for reimbursement will materially affect the potential program and staffing pattern utilized at the center. Any realized cost offsets will affect the total amount of MHSA funds needed, and subsequently affect the projected MHSA funds budgeted for the Center. For the Liaison Staff – these positions either do not qualify for cost offsets, such as Medi-Cal reimbursement (Community Support Workers), or are performing duties that do not qualify for cost offsets (Mental Health Clinical Specialists). f. Comment. Can the Forensic Team positions qualify for AB 109 Funds? Response. No, the MHSA funded positions that are part of the Forensic Team do not qualify for AB 109 funds. g. Comment. Pages 28-29 are hard to track. There is a Family Service Coordinator, but what about the three positions that are at each of the Clinics, East, West and Central? Response. The Family Service Coordinator position resides at CCMH headquarters, and performs a county wide role that provides non-direct service functions that are administrative in nature. Any direct service positions housed in clinics are part of the respective clinics’ staff and would not be included on the administrative support list. h. Comment. Page 33, New Leaf Program Martinez Unified School District. Since each of the at-risk youths is under an individualized education plan (IEP) as noted on page 33, would not the cost of this program be the responsibility of the state and federal government? Response. The program as designed does not fit within the parameters of funding responsibility for either the state or federal educational systems. i. Comment. Page 36 & 37, the Concord Health Center. Would not the two mental health clinicians be paid for through reimbursement of Medi-Cal and federal funds. Would this be a federally qualified health center? Response. The Concord Health Center referenced in the draft should be more correctly entitled the Concord Health Center II, and this change will be made in the final Plan. This clinic has been certified as a federally qualified health center. However, MHSA funds these two positions because they do not qualify for cost offsets, as the positions are filled by Licensed Marriage and Family Therapists. However, the two mental health clinicians could potentially generate federal E‐15    financial participation through Medi-Cal reimbursement. j. Comment. Since County personnel is very familiar with how the Plan is implemented, they do not need to keep flipping back and forth to the section labeled Plan on page 16, and the Program and Plan Element Profiles on page B- 1. But the average stakeholder and citizen does. Has it ever been considered to put all of the Adult FSP Profiles together under the Plan portion that deals with that, and all the Prevention and Early Intervention Profiles under that part of the Plan that they deal with? I don't know if I am clearly getting my point across here, but it seems disjointed the way it is now laid out. It also makes it easier for one to follow the funding if the detail given in the Profile of the agency is under each Plan element. Response. Yes, it was considered to group the program profiles with the Plan. This format has been used in previous years. Feedback from stakeholders indicated that this was cumbersome as well, as they had to navigate through extensive verbiage and sort out current with proposed information. Once the Plan is adopted by the Board of Supervisors the electronic copy of the Plan will contain hyperlinks that will enable the reader to toggle back and forth between the Plan and Program Profiles where and when they feel the need. The adopted hard copy will contain labeled tabs to assist the reader easily navigate this version as well. We apologize for the current inconvenience. k. Comment. Some Programs such as Crestwood & Modesto LLC do not have outcomes. These are not new programs. How can they still be receiving funds if they do not have outcomes? Response. Currently the outcomes for Crestwood and Modesto LLC have been the number of beds available for consumers experiencing a serious mental illness who are or have been receiving services from CCMH. Contra Costa Mental Health agrees that board and care facilities that receive additional, or augmented, funding should have mutually agreed upon outcomes that account for the additional funds received. The Evaluating the Plan section of the Three Year Plan outlines a methodology to determine if the program achieves the outcomes that have been agreed upon. Additional outcomes for augmented board and care facilities will be determined with these programs as they undergo a program and fiscal review, and these outcomes will be incorporated in their contract as well as reflected in future Plan Updates. PUBLIC HEARING a. Comment. I hope that the Plan allows for efforts at reducing the number of mentally ill juveniles and adults in the court system. Response. The Three Year Plan funds a number of programs and plan elements that provide mental health services to this population in order to reduce the number of mentally ill juveniles and adults in the court system. Specifically, multi-systemic therapy for juvenile offenders, clinicians out-stationed at juvenile probation offices, clinicians working with the Oren Allen Youth Ranch, the E‐16    Behavioral Health Court, and the forensic team, who work with individuals with serious mental illness who are on probation and at risk of re-offending and incarceration. b. Comment. I am a family member whose family has suffered because no program like Laura’s Law was in place. Enacting Laura’s Law would prevent individuals who are seriously mentally ill from being placed in locked facilities. The cost savings would reverse the trend of more and more of the County’s mental health budget going to paying for locked facility costs. This would ease the pressure for MHSA funds to pay for out-patient mental health costs. As a representative of NAMI we cannot support the MHSA Three Year Plan without it including funding for Laura’s Law. c. Comment. I am a consumer who has been arrested, locked up and mistreated by the law many times. I have handcuff scars to prove it. I am against Laura’s Law because it violates my rights. d. Comment. I am a consumer who was in jail for six months before being given the opportunity to participate in Behavioral Health Court as an alternative to jail. I received excellent mental health treatment, meet monthly with the judge, and my life has turned around. I didn’t know I had a mental illness until I got treatment. I am for Laura’s Law if it is run like the County’s Behavioral Health Court. Response. The implementation of Laura’s Law has not yet been decided by the County. Should the County wish to proceed in this direction, program and funding issues need to be resolved, such as program design, court, public defender, and law enforcement participation, size of population to be served, budget and funding sources needed for sustainability, and any cost savings to the County. For use of MHSA funds for financing the mental health treatment portion of the implementation, a determination will need to be made whether the proposed program design meets the General Standards (CCR 9 CA ADC Section 3320) for use of MHSA funds, and whether a finding is made that no voluntary mental health program serving adults and no children’s mental health program will be reduced as a result of the implementation of this article (WIC 5 Section 5349). Page 8 and 9 of the Three Year Plan describes the introduction of potential implementation of Laura’s Law, and the process for achieving resolution. Additional language would be premature, given the status of community input and planning efforts. Should the Board of Supervisors recommend that MHSA funds be utilized to implement Laura’s Law, this new program will be added to the Three Year Plan, or will be included as a Plan Update, should this Three Year Plan be in place. A community program planning process will be required prior to use of MHSA funds for implementing Laura’s Law (CCR 9 CA ADC Section 3300), and Board of Supervisor approval is required. E‐17    MENTAL HEALTH COMMISSION COMMENTS/RECOMMENDATIONS a. Comment. I am opposing Laura’s Law on the grounds that it violates consumers’ civil rights. The whole police and court experience is demeaning, overwhelming, and exposing for persons with mental illness. Assisted out-patient treatment is good, however, and should be funded. I am upset that the discussions and work groups so far are dominated by those people who are for Laura’s Law, and different perspectives are not allowed to be voiced. Response. See above response. b. Comment. The Three Year Plan calls for Anka to serve 30 consumers a year as a Full Service Partner provider for those consumers who are participating in the Behavioral Health Court. The Behavioral Health Court is an excellent program. Can this number be increased to 40, and adequate funding provided? Response. The Behavioral Health Court is part of the criminal justice system, where the County provides most of the funding outside Contra Costa Mental Health and MHSA funding. As the lead funder, the County determines the total population capacity to be served. Presently the Behavioral Health Court has approximately 15 active participants who participate for up to two years. Given this scope of service, it would be difficult for Anka to provide full service partner services to more than 30 individuals a year who are participating in the Behavioral Health Court. As stated in the plan, every MHSA program and plan element will undergo a comprehensive program and fiscal review during the Three year Plan. This annual projected number will be examined during Anka’s review and adjusted, if appropriate. c. Comment. I support the Three Year Plan’s section on conducting a program and fiscal review of each MHSA program and plan element. I would recommend that in the next Three year Plan the results of these reviews be included as part of describing the performance and outcomes of these programs and plan elements. Response. CCMH Administration agrees, and will incorporate this recommendation in the next Three year Plan. d. Comment. We need to know how much money is left over after expenditures are made. Response. The Evaluating the Plan section states that a monthly MHSA Financial Report will be generated that will depict funds budgeted versus spent E‐18    for each program and plan element included in this Plan. This will provide ongoing information, and enable sound planning for unspent funds. e. Comment. The Innovation section of the Plan should be better thought out. Specifically,  In the Innovation section of the Plan it does not say how long the listed Innovation Projects will last. Response. All of the listed Innovation Projects will last for the duration of the Three Year Plan. This will be clarified in the final version of the Three Year Plan forwarded to the Board of Supervisors. The Mental Health Services Oversight and Accountability Commission (MHSOAC) has approval authority for all Innovation Projects, and, until very recently, has remained silent on duration of Innovation Projects. The MHSOAC recently published the first draft of state regulations pertaining to the Innovation component, and are proposing a limit of four years, with the potential of extending a project an additional year.  The MHSOAC web site states that how the project addresses partnership and collaboration should be articulated. Response. This particular web site lists the topics that an Innovation Project proposal should contain as part of its submittal process to the MHSOAC for approval. All approved CCMH Innovation project proposals as described in the Plan have completed this multi-page detailed checklist of requirements, to include addressing partnership and collaboration. The proposals were fully vetted by the Innovation Committee of the Consolidated Planning and Advisory Workgroup (CPAW). Including the full proposals in the Plan was not considered appropriate, instead the Plan provides a summary of the concept, with a program profile in Appendix B. Innovation project proposals are available upon request.  How are Innovation projects monitored and evaluated? Response. Innovation projects are closely monitored by the Innovation sub- committee of the Consolidated Planning and Advisory Workgroup. Innovation projects will be evaluated utilizing the same methodology for evaluating all programs and plan elements as outlined in the Three Year Plan.  Explain the funds allocated for emerging programs. E‐19    Response. The Mental Health Services Act requires that five percent of funds go for Innovation. For Contra Costa County this is approximately $2 million, which is the yearly budgeted amount for the Plan. $1,019,495 is committed to existing approved projects. The remaining $1 million is set aside for the four Innovation project concepts that have been vetted and recommended by the Innovation sub- committee and CPAW, and approved and included in previous Plan Updates. These concepts have yet to be developed into full proposals with detailed budgets for MHSOAC consideration. It would be premature to provide specificity for these concepts, as they have yet to be developed. f. Comment. I cannot support the Three Year Plan again this year because there are too many loose ends; specifically,  There are no realistic numbers for persons served or outcomes (deliverables) for some programs, such as Anka and Crestwood. Can we get more specifics to be included in the Plan? Response. Appendix B of the Three Year Plan provides a program profile of every MHSA funded program that is included for funding in the Plan. Each program profile contains a scope of services, target population, current year payment limit, number to be served, and a listing of fiscal year 2012-13 outcomes. CCMH contract monitors are responsible for determining this information with the program, and ensuring compliance. Anka provides this specificity of deliverables. Crestwood is an augmented board and care operator where outcomes are currently defined as number of beds available for consumers experiencing a serious mental illness who are or have been receiving services from CCMH. Contra Costa Mental Health agrees that board and care facilities that receive additional, or augmented, funding should have mutually agreed upon outcomes that account for the additional funds received. The Evaluating the Plan section of the Three Year Plan outlines a methodology to determine if the program achieves the outcomes, or deliverables, that have been agreed upon. Additional outcomes for augmented board and care facilities will be determined with these programs as they undergo a program and fiscal review, and these outcomes will be incorporated in their contract as well as reflected in future Plan Updates.  What is the yearly $850,000 for Information Technology used for? Response. In the Capital Facilities/Information Technology section, the Electronic Health Records System is explained, as is its current status. The County is currently in negotiations with a vendor to develop and implement a new system specifically for Behavioral Health Services. This as yet determined cost will be funded by a one-time allocation to this component that was enacted in a previous year community program planning process. The $849,936 yearly cost E‐20    budgeted in this Plan is to pay for county operated staff to provide administrative support for this project. The vendor contract cost will be shared as it becomes available.  The mental health staffing budget and MHSA’s share of this cost for the George Miller Wellness Center has not been determined. Response. The not to exceed $2.75 million in total ongoing costs for the Center was proposed to the County and accepted, as MHSA funding was determined to be available at the time. From project approval to the recent opening of the primary care element, the potential for part of the mental health service costs to be offset by other funding sources is being determined, such as federal financial participation through Medi-Cal, and cost offsets on selected mental health positions due to the Center being certified as a federally qualified health center. Each potential funding source and its rules for reimbursement materially affects the potential program and staffing pattern utilized at the Center. Resolving these mental health program and staffing issues will provide specificity on program detail and amount needed from the MHSA fund.  Laura’s Law needs to be approved and funded. Response. See above responses to potential Laura’s Law implementation. ContraCostaCounty The Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, California 94553-1293 John Gioia, 1st District Candace Andersen, 2nd District Mary N. Piepho, 3rd District Karen Mitchoff, 4th District Federal D. Glover, 5th District David Twa Clerk of the Board and County Administrator (925) 335-1900 July 8, 2014 Mental Health Services Oversight and Accountability Commission 1300 17th St., Suite 1000 Sacramento, CA 95811 E-mail: mhsoac@mhsoac.ca.gov Dear Mental Health Services Oversight and Accountability Commission: Enclosed you will find the Mental Health Services Act (MHSA) Three Year Program and Expenditure Plan for Fiscal Years (FY) 2014/2015 through 2016/2017 as required. The Draft MHSA Three Year Program and Expenditure Plan for FYs 2014/2015 through 2016/2017 was posted for the required 30 day public review and comment period from May 12, 2014 through June 12, 2014. The MHSA Three Year Program and Expenditure Plan for FYs 2014/2015 through 2016/2017 was adopted by the Contra Costa County Board of Supervisors on July 8, 2014. Please note that we are not currently seeking Mental Health Services Oversight and Accountability Commission (MHSOAC) approval for the new Innovation projects listed in the Plan but intend to do so at a later date. The descriptions contained therein are meant to inform our stakeholders in regards to our intentions for the three-year period and are not intended to receive approval from the MHSOAC at this time. As required, we have enclosed one hard copy with original signature, and one electronic copy that is a single document in PDF format, for submission. If you have any questions on this request, please contact: Cynthia Belon, LCSW, Behavioral Health Services Director, 925- 957-5201, or Cynthia.Belon@hsd.cccounty.us. Thank you. Sincerely, Karen Mitchoff, District IV Chair of the Contra Costa County Board of Supervisors Enclosure: Contra Costa County Adopted MHSA Three Year Program and Expenditure Plan for FYs 2014/2015 through 2016/2017