HomeMy WebLinkAboutMINUTES - 12202005 - D.3 j)
TO: BOARD OF SUPERVISORS Contra
FROM: William Walker, M.D., Health Services Director 1
� - -- .Costa
DATE: December 20, 2005 ' r" �
County
Z SUBJECT: Adoption of the Three-Year Community Services and Supports Plan under
the Mental Health Services Act(Proposition 63)
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
Adopt the Community Services and Supports Plan under the Mental Health Services Act (Proposition
63)for fiscal years 2005-2006;2006-2007;and 2007-2008.
FISCAL IMPACT:No County funds are required. Contra Costa's allocation of funding from the State
(� Department of Mental Health for the Community Services and Supports Component of the Mental
Health Services Act is$7,121,500 annually for the first three years.Over the first three years of this new
funding,approximately 60%will be contracted out and 40%will be used for County-operated services.
BACKGROUND:
In November 2004, California voters passed Proposition 63,now known as the Mental Health Services
\p Act, intended to transform the public mental health system. The revenues are generated from an
( additional one percent tax on individuals whose incomes exceed one million dollars annually. As stated
in the legislation and State Department of Mental Health regulations, there are six components of the
.� Mental Health Services Act:, Community Planning; Community Services and Supports; Capital
�C Information and Technology; Education and Training; Prevention and Early Intervention; and
Innovation.
0
The Community Services and Supports component represents the first substantial infusion of funds
`Q under the Mental Health Services Act. In conjunction with State Department of Mental Health
�J guidelines, Contra Costa Mental.Health has conducted an extensive community planning process for the
past year to write the Community Services and Supports Plan.Over 1,100 people have participated in the
planning process that included six community forums; 55 targeted focus groups with consumers,family
members providers and staff; several hundred surveys; and Stakeholder Planning groups. The four
Stakeholder Planning groups—Children; Transition Age Youth; Adults; and Older Adults—included
required stakeholders: consumers; family members; providers of services; Employment & Human
Services; law enforcement; and education, plus other community members. The four Stakeholder
Planning Groups met over a four-month period from April through July 2005. Each group was charged
with coming up with recommendations for priority populations, services and strategies for the new
funding. From these recommendations, Contra Costa Mental Health developed the Draft Community
Services and Supports Plan. An advisory group of Stakeholders reviewed the Draft Plan and gave input
before it was released for public comment. / �/�
CONTINUED ON ATTACHMENT: _t YES SIGNATURE: 4I 1 W.tl" '4 «J7
RECOMMENDATION OF COUNTY ADMINISTRATOR _RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON O APPROVE AS RECOMMENDED OTHER
� —_—G It/—..
VOTE OF SUPERVISORS 1 HEREBY CERTIFY THAT THIS 1S A TRUE`
AND CORRECT COPY OF AN ACTION TAKEN
UNANIMOUS(ABSEN i AND ENTERED ON THE MINUTES OF THE -
BOARD OF SUPERVISORS ON THE DATE
AYES: NOES: SHOWN.
ABSENT: ABSTAIN:
ATTESTEp
CONTACT: JOHN,SWEETEN.CLERK OF THE BOARD
OF SUPERVISORS AND COUNTY
ADMINISTRATOR
CC: DmmaWigand(957-5111
I health Services Administration
HD IIL Se ices(Con
tracts) r
BY PUN
Page Two
Prop 63
In order to receive Community Services and Supports funding, County Mental Health systems must
submit a three-year plan that demonstrates broad input and community collaboration. The guidelines
require counties to use a complex logic model that looks at community issues resulting from a lack of
untreated mental illness and prioritize the most unserved and underserved consumers and family
members. The plan must also be updated annually. (The State Department of Mental Health has not yet
released guidelines or funding allocations for the other components of the Mental Health Services Act).
As required under Welfare & Institutions Code 5835, the Contra Costa Mental Health Commission
conducted a public hearing on the Draft Community Services and Supports Plan on December 7, 2005.
The Mental Health Commission adopted the Final Plan on December 13'h, 2005. Following adoption of
the plan by the Board of Supervisors, it will be submitted to the State Department of Mental Health for a
three-month review process. Pending approval by the State Department of Mental health, new programs
will begin start-up in April 2006. Any delays in the approval process will push back this date
accordingly.
ADDENDUM TO D.3.
DECEMBER 20, 2005
On this day the Board CONSIDERED adopting the Community Services and Supports
Plan on Proposition 63, the Mental Health Services Act, as recommended by the Mental
Health Commission and the Health Services Department.
After a summation of the background to adopt a three-year Community Services and
Supports Plan under the Mental Health Services Act(Proposition 63)presented by Donna
Wigand, Mental Health Director, the Chair asked the public for comments.
The following individuals presented testimony urging the Board to expand the definition
of homelessness to include those at risk of being homeless:
Herb Putnam,National Alliance for the Mentally III NAMI;
Ann Perridge-Heavey,NAMI;
Barbara Hall NAMI;
Julie Boucher, San Pablo resident;
Vera K. Se,NAMI;
Anne Perridge-Heavey NAMI;
Liz Callahan, (Contractors;Alliance).
The following individuals did not wish to speak but left their comments urging the Board
to expand the definition of homelessness to include those at risk of being homeless.
Maria Overby, Lafayette resident;
Barbara Hall NAMI;
Art Honegger, Incoming President, NAMI.
Supervisor Glover expressed grave concern on the limited amount of money to serve the
population.
Supervisor DeSaulnier suggested changing the recommendation to add"those in serious
risk of being homeless". He suggested adding at the end of the recommendation "those
without shelter who are unserved':
Supervisor Gioia noted it would be important for the Board to provide input on new
funds coming in to the County for Proposition 63 and thinks the Board may need to do a
workshop to have a greater understanding of how the programs works.
Supervisor Gioia drew the Boards attention to the executive summary under leverage of
additional funding under the new services to be provided over the first three year period,
and noted approximately 60%would be contracted out to the community and 40% would
be County operated, and said the Board did not recommend this.
1
Supervisor Gioia said the Board should look at expanded services, where the County's
Mental Health Division could submit and compete against community providers. He
suggested removing the provision of the 60/40, and went on to say the County is not
required under State law to decide today who will perform these services.
Supervisor Gioia asked how this could be done with flexibility and reiterated the County
did not want to lock into 60/40 of the funds.
Ms. Wigand responded the County was not locked in,but that they were required to give
the State Department of Mental Health an estimate.
Supervisor Gioia said he would like to see the County meet the needs of the Act and went
on to say to have a competitive process would be good for the County.
Supervisor Gioia asked Ms. Wigand to explain on leveraging other funding sources of the
Act and noted the importance of having great school-based mental health services,
especially in those communities that can access Early and Periodic Screening,
Diagnostic, and Treatment money. Supervisor Gioia noted 95 percent federal and state
dollars; 5 percent local dollars, and remarked "so $1 m of our money yields $19m; I can't
think of a better investment".
Ms. Wigand noted concerns by the Board about the process written into the Act and said
this was not intended to regulate the Board. She went on to say Mental Health Services
would apply for the prevention/early intervention money.
Supervisor Gioia asked Ms. Wigand to talk about the intervention that would be the
opportunity for the school-based Mental Health Services.
Ms, Wigand responded there were opportunities in the innovation part as well.
Supervisor Gioia asked Ms. Wigand to suggestl language that would meet the State's
needs with maximum flexibility on who will provide the services, if the Board did not
decide today.
Ms. Wigand responded there would be some core roles held in-house and done by the .
County and there would be a competitive RFP,process for the balance of the dollars.
Ms. Wigand noted that at least two thirds of the Community Services and Supports
funding would be contracted out and 100% of the capital/IT dollars would be contracted.
Supervisor said the County needs to let Sacramento know the County has a huge Mental
Health population that is not being served. Addressing Ms. Wigand, Supervisor Piepho
said she would like to see some review or discussion on the RFP process to make sure the
County is constantly reviewing and looking into current program providers to see
whether they are the best the County can get.
2
Chair Uilkema said she is aware of the cumbersome nature of the State process and
expressed her wish to adopt the Community Services and Support funding on this day.
She addressed the Board on their concerns on amending the language, concerned if the
Board were to approve this item, the language could in anyway inhibit the Board from
either continuing to explore or becoming more active in the annual review process.
Ms. Wigand responded this would work and the Adult stakeholder group could
reconvene after the first of the year. She went on to say they would send their first
annual update in July 2006.
Supervisor DeSaulnier recognised part of the language under the 60/40 being a guideline,
and commented it was at least two thirds. He suggested staff have the Adult Stakeholder
group review the language.
The Board of Supervisors took the following action by unanimous decision:
ADOPTED staff's recommendation with an amendment to add the language in the adult
portion that reads: Those without shelter who are unserved.... to add "those at serious
risk of becoming homeless".
3
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CONSIDERWKH
--- Honorable Supervisor De Saulnier,
I wish to address the agenda item D.3 which stands
for Discussion Item 3 for Tuesday Dec.20th; which is ,
the MRSA, Contra Costa County Plan. I would hope that
written comments, e-mails, phone calls, and all
communications from constituents are important.
I ask that my written comments be entered into the
written record of the Bd of Suprv. meeting, and
announced at the meeting.
Comments: 1. The Plan does Not serve those adult
consumers that are living with aging family members, ;
who are at risk-of-homelessness, who live anywhere in
Contra Costa County nor does it help those in
long-term hospitalized care obtain independent living.
i
2 . The Plan does NOT serve the
aging 60+ consumers, whose population will dwindle
through death, before they receive any services;which
is only planned for in the third year.
3 . I want you to be aware that j
the Mental Health Dept. followed the letter of the
Mental Health Services Act, but not the Spirit of what
was meant to be accomplished in our community.
4. I would hope that the
upcoming sections of the MHSA for IT, Prevention &
Outreach, and the other section on Innovative Programs i
will receive adequate input from Family members,
consumers, and all cultural groups with equal voice.
These programs should serve unserved and underserved
consumers and families countywide.
Thank you for your thoughtful consideration,
Veronica Vale
Family member & Consumer on Stakeholder Group, CISC
group, Advocate
>cc: +�
> Clerk of the Board
CONSIDER WIN
--- Honorable Supervisor De Saulnier,
I wish to address the agenda item D.3 which stands
for Discussion Item 3 for Tuesday Dec.20th; which is
the MRSA, Contra Costa County Plan. I would hope that
written comments, e-mails, phone calls, and all
communications from constituents are important.
I ask that my written comments be entered into the
written record of the Bd of Suprv. meeting, and
announced at the meeting.
Comments: 1. The Plan does Not serve those adult
consumers that are living with aging family members,
who are at risk-of-homelessness, who live anywhere in
Contra Costa County nor does it help those in
long-term hospitalized care obtain independent living.
2 . The Plan does NOT serve the
aging 60+ consumers, whose population will dwindle
through death, before they receive any services which
is only planned for in the third year.
3. I want you to be aware that
the Mental Health Dept. followed the letter of the
Mental Health Services Act, but not the Spirit of what
was meant to be accomplished in our community.
4. I would hope that the
upcoming sections of the MHSA for IT, Prevention &
Outreach, and the other section on Innovative Programs
will receive adequate input from Family members,
consumers, and all cultural groups with equal voice.
These programs should serve unserved and underserved
consumers and families countywide.
Thank you for your thoughtful consideration,
Veronica Vale
Family member & Consumer on Stakeholder Group, CISC
group, Advocate
>cc:
> Clerk of the Board
--- Honorable Supervisor De Saulnier,
I wish to address the agenda item D.3 which stands
for Discussion Item .3 for Tuesday Dec.20th; which is
the MHSA, Contra Costa County Plan. I would hope that
written comments, e-mails, phone calls, and all
communications from constituents are important.
I ask that my written comments be entered into the
written record of the Bd of Suprv. meeting, and
announced at the meeting.
Comments : 1. The Plan does Not serve those adult
consumers that are living with aging family members,
who are at risk-of-homelessness, who live anywhere in
Contra Costa County nor does it help those in
long-term hospitalized care obtain independent living.
2. The Plan does NOT serve the v
aging 60+ consumers, whose population will dwindle
through death, before they receive any services;which
is only planned for in the third year.
3. I want you to be aware that
the Mental Health Dept. followed the letter of the
Mental Health Services Act, but not the Spirit of what
was meant to be accomplished in our community.
4 . I would hope that the
upcoming sections of the MHSA for IT, Prevention & ✓
Outreach, and the other section on Innovative Programs
will receive adequate input from Family members,
consumers, and all cultural groups with equal voice.
These programs should serve unserved and underserved
consumers and families countywide.
Thank you for your thoughtful consideration,
(Veronica Vale
Family member. & Consumer on Stakeholder Group, CISC
group, Advocate
>CC:
> Clerk of the Board
Page 1 of 1
Herbert B. Putnam
From: <SK11 DER@aol.com>
To: <putnamsherbbev@msn.com>
Sent: Sunday, December 18, 2005 9:12 PM
Subject: My email to Federal Glover
Herb:
As I am unable to make Tuesday's meeting, I sent the following to Glover:
Dear Federal:
I want to go on record as opposing the Mental Health Division's Adult plan. The definition of eligible persons is
much too restrictive, especially considering a couple million bucks is planned for this effort.
We have so many more consumers on a knife edge, and if any had been serviced even one time by the
"system"they would be ineligible. What a wasteful use of precious tax dollars.
Thank you for your consideration of my comments, and for entering them in the written proceedings of your
December 20 Board meeting.
Sincerely,
Art Honegger
Incoming president
NAMI Contra Costa
12/19/2005
2005 �
ANNUAL REPORT
of the
� CONTRA COSTA
�i COUNTY
MENTAL HEALTH
� COMMISSION
Presented to the
Contra Costa County
Board of Supervisors
December 6, 2005
December 6, 2005
Contra Costa County Board of Supervisors:
Supervisor John Gioia, District I
Supervisor Gayle Uilkema,District H
Supervisor Mary Nejedly-Piepho,District III
Supervisor Mark DeSaulnier, District IV
Supervisor Federal Glover,District V
In accordance with the Board Advisory Body Procedures Resolution No. 2002/377,this Annual
Report for the year 2005 is presented to the Contra Costa County Board of Supervisors on
Tuesday, December 6,2005.
Respectfully Submitted,
Karen Shuler, Executive Assistant
Contra Costa County Mental Health Commission
Advisory Body Name: Contra Costa County Mental Health Commission
Meeting TimefLocation: 4'h Thursday of the month from 4:30-6:30 p.m.
Concord Police Department Community Room
1350 Galindo Street,Concord,CA
Chairperson: Scott Singley;Bobbie J.Arnold(Vice Chairperson)
Stan'Person: Karen Shuler,Executive Assistant
Reporting Period: January-December 2005
L Activities
A. Foremost in the activities of the Commission was involvement in the planning process for the
implementation of the Mental Health Services Act:
a. Conducted 6 Community Forums to receive public input
b. Participated on each of the four Stakeholder Planning Groups
c. Participated on the Mental Health Services Act Planning Team
d. Participated on the Stakeholder Advisory Team
e. Conducted the Mental Health Services Act Public Hearing to receive final comments from
the public on the draft plan.
B. Performed three site visits
a. Crestwood Residential Care Facility,Pleasant Hill
b. Mt.Diablo Pavilion,Concord
c. Martinez Jail Facility,Martinez
C. Actively supported the excellent work of Mental Health Vocational Services.
D. Actively campaigned to keep our clients within our own County
E. Actively opposed the budget cuts to Health Services
F. Supported Summit Center and Chris Adams Center when the programs appeared to be in danger of
being but from the County budget.
G. Tracked the impact on care for seniors following the closing of the geriatric psychiatric unit at Contra
Costa Regional Medical Center.
H. Supported S11840,the California Health Insurance Reliability Act.
L Remained informed of issues surrounding AB3632 and SB619
J. Heard reports from:
a. Elizabeth Stallings,Administrator of Mt.Diablo Pavilion,on their programs for transitional
age youth
b. Helene Schwarzenberger,a parent who had concerns over the lack of Medicare services
available to clients
c. Cindy Mataraso,Administrator of Crestwood Residential Care Facility,responding to
questions about their program
d. Dennis Hamilton,a client of Mental Health Vocational Services,regarding help he received
from their program
e. Representatives from the Multidisciplinary Forensics Task Force,on their work of
collaboration between law enforcement agencies
f. Dr.Wendy Eberhardt,Psychiatrist,on how psychiatric services are delivered at the
Richmond Health Clinic
g. Dr.Nancy Ebbert,Chief Psychiatrist,on the integration and coordination of services at the
Richmond Health Center following the closing of the El Cerrito Clinic and the geriatric
clinics
h. Dr.Robert Sessler,Director of Aging&Adult Program of Employment and Human
Services,addressed the Long Term Care Integration Project.
L Bill Oye,Dean of Student Life at Diablo Valley College on supported education.
IL Accomplishments
A. Developed a Law Enforcement Referral Card,for use as a pilot program by Brentwood Police
Department
B. Requested that the Board of Supervisors issue a Proclamation declaring the Month of May 2005 be
declared"Mental Health Awareness Month"
C. Requested that the Board of Supervisors issue a Proclamation declaring the Week of October 2-8,
2005 be declared"Mental Illness Awareness Week"
D. Members of the Mental Health Commission participated as active members on the California
Mental Health Planning Council,the California Association of Local Mental Health
Boards/Commissions,and the Contra Costa County Mental Health Coalition.
III. Attendance/Representation
A. A quorum was achieved at all eleven of the scheduled meetings of the Mental Health Commission in
2005. Members of the Commission:
a. Bobbie J.Arnold,District I Member-at-Large Female African-American
b. Geet Gobind,District IH Consumer Representative Female East Asian
c. Lisa Honegger,District V Consumer Representative Female Caucasian
d. David Kahler,District IV Member-at-Large Male Caucasian
e. Judy McCahon,District IH Family Member Female Caucasian
E Kathi McLaughlin,District H Consumer Representative Female Caucasian
g. Cynthia Miller,District H Member-at-Large Female Caucasian
h. Bettye J.Randle,District I Consumer Representative Female African-American
L Lisa Ronan,District IV Consumer Representative Female Caucasian
j. Daniel L.Rurin,District V Family Member Male Caucasian
k. Scott Singley,District III Member-at-Large Male Caucasian
L Karen Sloma,District IV Family Member Female Caucasian
m. Diane Soto,District V Member-at-Large Female Caucasian
n. Robert Torres,District II Family Member Male Hispanic
Board of Supervisors Representative to the Mental Health Commission:
Supervisor Mark DeSaulnier
Supervisor John Gioia(alternate)
Vacancies on the Commission:
District I Family Member
IV. Training/Certification
A. Commissioners attended several Mental Health Services Act conference sponsored by the California
Institute for Mental Health(CEM H)
B. Attended the California Mental Health Advocacy for Children and Youth Annual Conference
C. Attended the Rose Jenkins Conference
V. Proposed Work Plan/Obiectives for Neat Year
A. If the State Department of Mental Health approves Contra Costa County's Mental Health Services
Act Plan,the Commission will be actively involved in the implementation of the Plan,as well as in
beginning the process for continued annual Plan implementations
B. Advocacy will continue for.
a. A separate children's psychiatric unit
b. Court services for mental health clients
c. Continued dispersal of law enforcement referral cards to additional law enforcement
agencies
d. A separate geriatric psychiatric inpatient unit
e. Creation of the position of Older Adult Mental Health Program Chief
f. Mobile Mental Health Clinics
g. Mental Health support groups throughout the County
h. Keeping clients in the County and bring them home from out-of-county placement.
SUMMARY REPORT FOR THE
2005 MENTAL HEALTH COMMISSION ANNUAL REPORT
ADULT& TRANSITIONAL AGE YOUTH CON W TTEE
Diane Soto, Chairperson
2005 Focus Goal
• Planning for the Implementation of the Mental Health Services Act
Guest Speakers
• Elizabeth Stallings from Mt Diablo Pavilion spoke about their programs for
transitional age youth.
• Helene Schwarzenberger spoke about her concerns about the lack of Medicare
services available to clients.
• Cindy Mataraso, Administrator of Crestwood Residential Care Facility, responded to
questions about Crestwood that resulted from the site visit.
• Dennis Hamilton, a client of Mental Health Vocational Services, shared his
experience in getting help from MH Vocational Services.
• Bill Oye, Dean of Student Life, Diablo Valley College, on supported education.
Regular Reports
• Victor Montoya, Adult/Older Adult Program Chief
• John Hollender, Mental Health Vocational Services
Issues Addressed (In addition to those listed as Focus Goals)
• Due to the new designation of transitional age seniors, changed the name of the
Committee from Transitional Age& Adult Programs Review Committee to Adult
and Transitional Age Youth Committee.
• The Committee received a request for support of the Clubhouse Model.
• Actively supported the work of Mental Health Vocational Services.
Accomplishments
• Critically involved in the formulation of the Contra Costa County's implementation
of the Mental Health Services Act.
• Conducted a site visit to Crestwood Residential Care Facility and forwarded to the
Commission a favorable report.
• Conducted a tour of the Mt. Diablo Pavilion and forwarded to the Commission a
favorable report.
• Worked with Mental Health Administration, Contra Costa Health Services and Mt.
Diablo Pavilion in keeping our clients in County.
MISC.
• Nominated Terri Gilotti, Sheryl Wiseman and Robert McKinnon of the Central
County Young Adult A Team to receive P Annual Mental Health Commission
Awards from the Adult& Transitional Age Youth Committee.
SUMMARY REPORT FOR THE
2005 MENTAL HEALTH COMMISSION ANNUAL REPORT
CHILDRENS COMMITTEE
Kathi McLaughlin, Chairperson
2005 Focus Goal
• Planning for the Implementation of the Mental Health Services Act
Guest Speakers
• Donna Wigand, Mental Health Director to give an overview of the Mental Health
Services Act.
Regular Reports
• Vern Wallace, Children's Mental Health Program Chief
• Juvenile Systems Planning Advisory Committee
Issues Addressed (In addition to those listed as Focus Goals)
• Received updates on AB3632.
• Reviewed the Virginia Commission on Youth materials to see if some evidence-
based practices could be incorporated into our County.
• Began a process of adding student commissioners to the Mental Health
Commission.
• Discussed the implementation of a teen suicide prevention program in our County
schools.
• Received updates on the progress of SB679.
• Expressed support of Summit Center and Chris Adams Center when the programs
were in danger of being cut from the budget.
Accomplishments
• Critically involved in the formulation of the Contra Costa County's implementation
of the Mental Health Services Act.
• Conducted a Public Hearing to discuss the Mental Health Services Act as it pertains
to children's services.
Misc.
• Members attended the California Mental Health Advocacy for Children and Youth
(CMHACY) Conference.
• Members attended the Rose Jenkins Conference.
• Nominated Arlette Merritt of Early Childhood Mental Health, Elree Langford of
Lynn Center and John Jones of We Care as individuals, and Jewish Family and
Children's Services of the East Bay to receive the 3`d Annual Mental Health
Commission Awards from the Children's Committee.
SUMMARY REPORT FOR THE
2005 MENTAL HEALTH COMMISSION ANNUAL REPORT
CRDIWAL JUSTICE COMMITTEE
Judy McCahon and Karen Sloma, Co-Chairpersons
2005 Focus Goal
• Planning for the Implementation of the Mental Health Services Act
Regular Reports
• Victor Montoya, Adult/Older Adult Program Chief
Multidisciplinary Forensics Task Force
Issues Addressed (In addition to those listed as Focus Goals)
• Improvement of interaction between law enforcement agencies and the mental
health administration.
• How to develop a volunteer plan to serve as liaisons between jail personnel and
internees and their families.
Accomplishments
• Outlined a plan to address concerns expressed by law enforcement agencies in their
responses to a survey sent out by the Committee in 2004.
• Developed a Law Enforcement Referral Card, with the intention of using the City of
Brentwood as a pilot program to distribute the cards.
• Conducted a site visit to the Martinez Jail facility.
Misc.
• Viewed POST Training video on"Recognizing Mental Illness: A Proactive
Approach"
• Nominated Nierika House and Candace Kunz-Tao to receive P Annual Mental
Health Commission Awards from the Criminal Justice Committee.
SUMMARY REPORT FOR THE
2005 MENTAL HEALTH COMMISSION ANNUAL REPORT
OLDER ADULTS COMMITTEE
Bettye J. Randle, Chairperson
2005 Focus Goal
• Planning for the Implementation of the Mental Health Services Act
Guest Speakers
• Dr. Wendy Eberhardt, Richmond Mental Health Clinic
• Dr. Nancy Ebbert, Chief Psychiatrist
• Robert Sessler, Director of Aging&Adult Program of Employment and Human
Services
Regular Reports
• Victor Montoya, Adult/Older Adult Program Chief
• Bette Wilgus, Aging and Adult Services
• Senior Services Review Task Force
Issues Addressed (In addition to those listed as Focus Goals)
• The impact on care for seniors following the closing of the geriatric psychiatric
inpatient unit at CCRMC.
• The need for better integration and coordination of services at the County
Healthcare Clinics.
• Concern raised over clients being detained over 72 hours without assessment at
Doctors Hospital
Accomplishments
• Critically involved in the formulation of the Contra Costa County's implementation
of the Mental Health Services Act.
• Forwarded to the Commission a letter in support of SB840, the California Health
Insurance Reliability Act.
Misc.
• Nominated Mt. Diablo Adult Day Health Center and Rosalind J. Brown of A Way
Home, Inc. to receive P Annual Mental Health Commission Awards from the Older
Adult Committee.
EXHIBIT 1: PROGRAM AND EXPENDITURE PLA! FACE SHEET
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MENTAL HEALTIi SERVICES3 ACTrd SA)
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`THREE"YEAR PROGRAM+and`EXPENDIT , PLAN
z x ' COMM[JNITY SERVICES AND Si1PPORTS Y s ,
"` t Fiscal Years-2005 06,x2006 07, andti2007 08. ��
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County: Contra Costa Date: December 21, 2005
County Mental Health Director:
Donna M. Wigand, LCSW
Print d Name
r
S gnature
Date: December 21, 2005
Mailing Address: Contra Costa Mental Health Administration
1340 Arnold Drive, Suite 200
Martinez, CA 94553
Phone Number: 925-957-5111 Fax: 925-957-5156
E-mail: dwigand@hsd.co.contra-costa.ca.us
Contact Person: Kimberly Mayer, MSSW
925-957-5132
Phone:
925-957-5156
Fax:
E-mail: kmayer@hsd.co.contra-costa.ca.us
a
a
CONTRA COSTA
HEALTH SERVICES
Mental Health Division
PROPOSITION 63
MENTAL HEALTH SERVICES ACT
a
Community Services and Supports
Final Three-Year Plan
December 2005
a
CONTRA COSTA HEALTH SERVICES
Mental Health Division
Proposition 63: Mental Health Services Act
Community Services and Supports Plan
December 2005
Executive Summary
Overview
In November 2004, California voters approved Proposition 63, the Mental Health
Services Act (MHSA), intended to "transform the public mental health system." The
revenues are generated from an additional one percent tax on individuals whose
incomes exceed one million dollars annually. Statewide, it is projected that these
revenues will exceed approximately $600 to $750 million annually.
The population to be helped under MHSA is defined as adults and older adults who
have been diagnosed with or who may have a serious and persistent mental illness, and
children and youth who have been diagnosed with or who may have serious emotional
Q disorders, and their families. According to the MHSA, the essential elements under a
transformed mental health system include community collaboration, cultural
competence, client/family driven services, a wellness focus and integrated services.
The MHSA consists of six components that are being rolled out overtime by the State
Department of Mental Health (DMH) with the goal of creating a better program of mental
health services and supports in California's public mental health system. These
components are:
■ Community Planning
• Community Services and Supports (the focus of this executive summary and
draft plan)
■ Capital and Information Technology
• Education and Training
■ Prevention and Early Intervention
■ Innovation
The overall anticipated outcomes under MHSA-funded programs include:
■ Equity and access for unserved populations through culturally sensitive and
effective services
■ Meaningful use of time and capabilities (school, work, social, and community
activities)
Executive Summary: Community Services and Supports Plan, December 2005
Page 1 of 9
r
■ Reduced homelessness and increased access to safe and adequate permanent
housing
■ A network of supportive relationships
■ Timely access to needed help, including times of crisis TM
x
■ Reduction in incarceration to jails and juvenile hall
■ Reduction in involuntary services and institutionalization, and fewer out-of-home '
placements
1 The Community Services and Supports (CSS) component represents the first
f substantial infusion of funds under the MRSA. In order to receive CSS funding, county
mental health systems must submit a three-year plan that demonstrates broad input and
community collaboration. The guidelines also require counties to use a complex logic r
model that looks at community issues resulting from a lack of untreated mental illness `
and prioritize the most unserved and underserved consumers and family members. The
plan must also be updated annually. Programs funded under the MHSA must be
voluntary in nature, where people chose the services and supports they want and need.
Under the MHSA, county mental health systems will receive a percentage of available
funds based on a complex formula developed by DMH. Contra Costa's allocation for the
first year of Community Services and Supports (CSS) funding is $7.1 million. This r
amount.is significantly less that the County had originally anticipated, and represents
approximately 6% of the Mental Health Division's annual budget. While this initial
amount of funding is inadequate to transform the county's mental health system, it
serves as a starting point as we develop new services and strategies for the most
unserved and underserved mental health consumers and family members. We also
believe the planning process and level of community collaboration that has taken place
over the last ten months is also the beginning of our transformation process.
DMH has not yet released guidelines or funding allocations for the other components of
the MHSA: Capital and Information Technology; Education and Training; Prevention
and Early Intervention; and Innovation. We anticipate that these additional strategies
and funding sources will contribute to a transformed public mental health system.
Public Planning Effort
The MHSA requires each county to incorporate broad public input into the planning
process for developing programs and strategies with the new funding. Over 1,100
individuals have participated in Contra Costa's MHSA Planning effort, which began in
December 2004 with the formation of the Consumer Involvement Steering Committee.
Input has been gathered through several methods including Stakeholder Planning
Groups, community forums, targeted focus groups, and recommendations from the
general.public. We also solicited input on the planning process from the Mental Health
Coalition, an umbrella organization that includes: The Contractors Alliance of Contra
Executive Summary: Community Services and Supports Plan, December 2005
Page 2 of 9
QCosta; Local 1; Contra Costa Network of Mental Health Clients; NAMI; and the Mental
Health Commission.
Under the MHSA, broad input includes the active participation of mental health
consumers and family members, plus other required stakeholders: providers of
services, social services (Employment & Human Services in Contra Costa), education
and law enforcement. In addition to the required stakeholders, Contra Costa Mental
Health also invited participation from a range of human service providers.
During February and March 2005, 260 people participated in two trainings for potential
stakeholders. Following the trainings interested individuals applied to be on one of the
four Stakeholder Planning groups: Children's, Transition Age Youth (TAY), Adults and
Older Adults. These four age groups are determined by MHSA guidelines. A team of
five including a consumer, family member, the Mental Health Division's Ethnic Service's
Coordinator, a Program Chief and the chair of the Mental Health Commission selected
the four Stakeholder Planning Groups. The Stakeholder Planning groups also included
participants from the Mental Health Coalition as described previously.
From April through July, a total of 90 individuals participated in the four Stakeholder
Planning Groups, with each workgroup meeting a total of nine times (36 meetings total).
The meetings were open to the public, and minutes published on the Health Services
web site: www.cchealth.ora. During spring 2005 the Contra Costa Mental Health
Commission hosted six community forums throughout the county. Consultant Steve
Ekstrom of The Results Group facilitated all 36 Stakeholder Planning meetings, along
with the six community forums. (An advisory group of Stakeholders, selected by each
Planning Group, continues to work with Contra Costa Mental Health on this plan and its
implementation).
As part of the planning process, we also conducted 55 targeted focus groups in a
variety of community settings (county clinics, community-based organizations and other
agencies), including groups with monolingual Latino and Southeast Asian consumers
and family members. Focus groups were conducted by a team that included staff,
consumers and family members. We also conducted focus groups with consumers who
are placed out of county in contracted facilities. In addition to the community forums
and focus groups, we received feedback through surveys from family members and
consumers, including Spanish-speaking consumers. Surveys were conducted in several
locations throughout the county. Beyond survey and focus groups, any individual or
organization could submit a recommendation for CSS through a form that was
published on our web site.
Types of Funding Available
There are three types of funding available under CSS:
Executive Summary: Community Services and Supports Plan, December 2005
Page 3 of 9
■ Full Service Partnership Funds—Designed to provide all necessary services and
supports for designated populations, or "whatever it takes" that will be served in
the first three years. CSS guidelines require that counties expend the majority of
their funds in the first three years on Full Service Partnerships. Focus is on
unserved consumers.
• ; System Development Funds—Dedicated to improving services and infrastructure
for the overall mental health system, including those identified under Full Service 11
Partnerships. System Development funds are more restrictive than Full Service
E
Partnership funds.
■ Outreach and Engagement Funds—Designed to reach out to consumers who
may need services but are unserved or underserved. Can be used in conjunction
with programs funded with Full Service Partnership and System Development
resources. `
d
Since the final guidelines for CSS were not released until August 2005 and the lengthy
public planning process required, DMH is giving counties some flexibility in the first year
of funding (FY 2005-06), recognizing the need for startup funding, one-time costs and
the need to capitalize some expenses. DMH expects a three-month review process for
each county's plan once submitted (which should be late December or early January forIR
Contra Costa). With the exception of this Executive Summary, the CSS Plan is written
in accordance to strict guidelines as developed by DMH. DMH encourages counties to
"start smart and start small" with all new programs.
What We Learned in the Planning Process
The number one issue identified from all of our public input was the need for a full range
of housing; including emergency, transitional, and long term housing options for mental
health consumers. Using input from community forums, focus groups, surveys, county
data sources and their individual or agency's experiences, the major community issues
identified by each Stakeholder Planning Group are listed in the table below. Those
issues which have been selected to be the focus of MHSA services over the next three
years are identified with an asterisk (*).
Our programs emphasize the recovery vision, including personal recovery goals.
Recovery builds on the idea of the community support system, emphasizing improved
quality of and access to support services, such as linkages to vocational training,
education and supportive housing. Recovery also emphasizes that while individuals
may not be able to have full control over their symptoms they can have full control over
their lives.
Note: With the exception of the Older Adults program (which will be countywide),
services are targeted in specific regions of the county for this initial three-year start-up
Executive Summary: Community Services and Supports Plan, December 2005
Page 4 of 9
0 period. It is our intent to eventually make available all of these services throughout the
county, pending additional MHSA funding, plus leveraging of other funding sources.
Community Issues Identified in the Public Planning Process
Children[Youth TAY Adults Older Adults
1. Failure in Learning 1. Homelessness* 1. Homelessness* 1. Unnecessary Loss of Functioning*
Environments*
(Includes: Frequent hospitalizations,
(Includes: School Failure) frequent emergency medical care,
inability to work, inability to manage
independence, involuntary care and
institutionalization
2. Out-of-Home 2. Incarceration 2. Isolation Isolation
Placements
3. Involvement in child 3. Hospitalization or 3. Inability to Work
welfare or juvenile justice Involuntary Care
lsystems
Full Service Partnerships
Children: The Children's Stakeholder Planning Group selected: Unserved children, 0 —
18 years of age, who have a history of repeated failure in learning environments,
including home, childcare, preschool and school, and who are from families who are at
or below 300% of poverty. Priority within this population is to be given to those children
who show one or more of the following risk factors: multiple foster care or family
caregiver placements; limited English proficiency; high-risk parents or community;
populations whose cultural differences have historically precluded them from MH
services; trauma, substance abuse; experience with the juvenile justice system; and
visits to Psychiatric Emergency Services (PES).
Far East County was selected for initial implementation because there are currently no
comprehensive mental health and support services for this population based in that
area (besides home visits) and travel to the nearest County operated service site, other
than health care, can take up to one hour. This area is culturally diverse with a large
number of Spanish-speaking community members. Additionally, it is the fastest growing
area of Contra Costa County and will double in population over the next seven to ten
years. A comprehensive service infrastructure is badly needed.
Services to be provided will include the creation of two regionally based 24 hour/7 day a
week Active Community Supports and Services Teams. These interagency,
interdisciplinary, ethnically diverse community response teams will provide crisis
stabilization, short-term case planning and problem resolution, family resource
Executive Summary: Community Services and Supports Plan, December 2005
Page 5 of 9
Fdevelopment, community linkage and advocacy, educational linkages and long-term
case management. Innovative elements layered onto this enhanced "wraparound"
approach include blended multilingual teams comprised of CBO and County staff,
transportation aides, family partners, teen peer mentors, a co-occurring disorders
specialist and a family law specialist. Services are designed to be strength-based and
family focused. The program will also develop a community roundtable of child-serving
agencies in Far East County. Over three years, Contra Costa has budgeted
approximately $4.7 million in MHSA funding for Children's services. This includes
services and housing supports.
Transition Age Youth: The Transition Age Youth (TAY) Stakeholder Planning Group
selected: Transition age youth, 16-25 years of age, with serious emotional disturbance
or serious and persistent mental illness, who are homeless or at imminent risk for
homelessness. While the Stakeholder Planning Group did not specify sub-criteria for
prioritizing selection of participants, they did acknowledge that the systems supports
and services required to fully serve this population must have the ability to address the
high likelihood of the following risk factors and conditions within the population: dual
diagnosis (SED or mental illness with alcohol and other drug problems); psychosis;
exposure to violence; under education; immigrant status; non-English speaking; LGBT;
juvenile justice system involvement; living with parents who are seriously mentally ill;
jobless; history of 5150s; in or has been in foster care system; and unable to get
appropriate medications. Y
West County was selected as the initial geographic target area because of the extreme
need and the extreme shortage of targeted services for TAY I this area. 47% of the
county's homeless population is located in or near Richmond. While there is much to be
done to build a stronger system of supports and services in West County for this
population, it Was felt that a baseline of existing services was available.
The TAY program emphasizes person-centered service planning and a recovery vision
that links supports and opportunities for personal development. Services to be provided
include the formation of Integrated Service Teams that will include Outreach
Workers/Personal Services Coordinators, Clinicians, Family Coordinators, Community
Support Workers, supported educational and vocation services, a consumer financial
specialist and a co-occurring specialist (alcohol and other drugs). The teams will
include county and contracted staff. Linkages to medical and psychiatric care will be
available. Teams will be available on a 24/7 basis to Full Service Partners. Over three
years, Contra Costa has budgeted approximately $5.2 million for transition age youth. }
This includes services and housing supports.
Adults: The Adult Stakeholder Planning Group selected: Adults with serious and
persistent mental illness who are homeless without shelter. This target population was
later amended to include those" at serious risk of homelessness." They further
emphasized that FSPs should be countywide and culturally diverse. Additional risk
Executive Summary: Community Services and Supports Plan, December 2005
Page 6 of 9
factors which may be taken into account in prioritizing who will receive FSP services
include: alcohol and other drug abuse or dependency; serious medical issues; limited
English proficiency; history of incarceration or institutionalization.
As with the TAY Group, West County was selected as the initial geographic target area
because of the extreme need and extreme shortage of targeted services for adults in
this area. It was also recognized that, while TAY have vastly different needs for
services and supports than Adults, some activities could be conducted jointly for the two
population groups. For example, both groups require an intense focus on development
of new—although separate—emergency, transitional and long term housing options.
Services to be provided include the establishment of two new Integrated Service Teams
that will include outreach workers, Personal Service Coordinators, Family Coordinators,
clinicians, peer/consumer staff and a co-occurring specialist. Teams will conduct
outreach and counseling in the field, and will link with the County's multi-service center
for the homeless. Medical and psychiatric care will be offered, and access to alcohol
and drug treatment will be available. Jail and court liaisons will also be available to
support the program. Teams will be available on a 24/7 basis to Full Service Partners.
Over three years Contra Costa has budgeted approximately $7.4 million for adults. This
includes services and housing supports.
Housing Program: As discussed previously, the number one issue identified from our
community planning process was the need for a full range of housing, including
emergency, transitional, and long term housing options. Housing is the backbone of our
new programs for Adults and TAY. It is the Program's goal to move all Full Service
Partners into long term housing at each consumer's own pace, with supports provided
at the desired by each consumer. The process of moving into long-term supported
housing may include movement through an emergency shelter, residential drug
treatment and/or transitional housing along the way.
Overall, our Housing Program—in partnership with the TAY and Adult Programs—will
build on existing services and strategies as outlined in the County's Ten Year Plan to
End Homelessness, including the County Health Services Public Health Homeless
Program. This also includes the County's Homeless Services' Health, Housing and
Integrated Services Network (HHISN). We also anticipate further expansion of the
Housing Program with the addition of Capital Funding under the MHSA (which has not
yet been released by DMH).
Housing services, offering priority to TAY and adult Full Service Partners, includes
emergency shelter beds, transitional living, a 16-bed residential treatment facility for
psychiatrically disabled adults with secondary drug and alcohol disorders, and long-
term, master-leased, scattered site supportive housing. Using MHSA funds, we will
purchase a 5-bedroom modular home to provide emergency/short term shelter for up to
10 homeless young adults aged 18-25 that will be operated through the Homeless
Executive Summary: Community Services and Supports Plan, December 2005
Page 7 of 9
Program with additional FSP supports. MHSA funds will also be used to create new
services at the Pittsburg Youth Campus located in East County.
As discussed previously, counties are given flexibility the first year of funding for one-
time costs (due to the lengthy public planning process required, and the three-month
review period by DMH). Accordingly, we have budgeted funds to capitalize rent .
subsidies over the first three-year period. We have also budgeted CSS funds.for future
housing opportunities (pending approval by DMH). Over three years we have budgeted
approximately $7 million for housing—included as part of the services and supports for
children, transition age youth, adults and older adults. The majority of these funds are
in one-time costs in FY 2005-06 that we will capitalize over the first three-year period.
Systems Development
Older Adults: The Older Adult Stakeholder Planning Group identified its priority
population as: Seriously disabled consumers, 60 years of age and up, from unserved
ethnic populations in the county who are living in the community without adequate
supports and resources (including inadequate insurance). They further stated that
serious disability is characterized as having complex presentations, e.g. a serious
mental illness with other factors as serious medical problems.
Contra Costa Health Services currently has no specialized geriatric mental health
services. The new Older Adult Program will establish an integrated service delivery
structure that currently does not exist for seniors. The centerpiece of the program is a
system of three multidisciplinary outreach teams (including county and CBO staff) that 3'
will serve three geographic regions of Contra Costa—East, West and Central County.
Each team will include a geropsychiatrist who will see patients in both primary care ,
settings and in their home environments. The program will include partnerships with u'
Contra Costa Health Services' Division of Hospital and Clinics, and the'Contra Costa
Health Plan (CCHP). It will also provide linkages to CCHPs plan for Acute and Long
Term Care Integration Program (ALTCI).
Y
Services for older adults begin in the third year of MHSA funding (FY 2007-08). This
lengthy start-up time is necessary due to the planning efforts required to coordinate
services within three divisions of Health Services and to build on the strategies of
ALTCI. We have budgeted approximately $1.7 million for older adults, including services
and housing supports.
Additional Systems Development Strategies:
Increasing Consumer/Family Staff: In addition to the consumer and family member
positions that will be created for the new programs, Contra Costa Mental Health will hire
additional consumer and family staff as follows: the Office for Consumer Empowerment
will add staff and increase consumer training programs; we will add consumer/peer
Executive Summary: Community Services and Supports Plan, December 2005
Page 8 of 9
Obenefits advocates to assist consumers and family members; we will add bilingual
Family Partners in our Children's Mental Health system.
Planning: During the planning process there were several areas that we received input
on and were explored but need additional time and resources in order to fully develop.
We will put together planning strategies for the following areas to improve outcomes for
consumers and family members: Co-occurring Disorders (Mental Health/Alcohol &
Other Drugs); Transportation; and, Transformation Training (including training on
cultural competency)for staff and contractors. Consumers and family members will
participate in these planning processes.
Physical Wellness/Recovery: We will pilot a wellness program with adult mental
health consumers in one of our clinics.
Leveraging of Additional Funding
Counties are encouraged to use MHSA funds to leverage other funding sources,
including Medi-Cal. Contra Costa's Draft Plan includes projected Medi-Cal revenue. Per
DMH: "Although counties are encouraged to maximize other funding sources whenever
possible, for counties to be innovative and transformative, funds requested under the
MHSA should not be driven by the goal of maximizing Medi-Cal reimbursement." Of the
new services to be provided over the first three-year period, the majority of funds will be
J contracted out to the community and the remaining will be county-operated. In addition
to new services, the majority of the funds for the housing program will also be spent in
the community on master-leased, scattered-site supportive housing.
Conclusion
The public mental health system in California has been seriously underfunded for
decades. The Mental Health Services Act offers the beginning of a long overdue
solution to provide better outcomes for children, adults and families who require mental
health services, and to do so in a way that enhances recovery and resiliency for
consumers and family members. Transforming an entire system is a tall order; it will not
happen overnight. However, we believe the plan we have developed for this first
component of MHSA is a starting point. We look forward to working with our community
to create the quality mental health services that our residents deserve.
a
Executive Summary: Community Services and Supports Plan, December 2005
Page 9 of 9
Contra Costa Health Services
Mental Health Division
PROPOSITION 63
MENTAL HEALTH SERVICES ACT
Community Services and Supports Plan
Three-Year Plan
December 2005
Table of Contents
PART I: COUNTY/COMMUNITY PUBLIC PLANNING PROCESS
AND PLAN REVIEW PROCESS...........................................................................1
Section I: Planning Process........................................................................................1
Section II: Plan Review .............................................................................................16
n PART II: PROGRAM AND EXPENDITURE PLAN REQUIREMENTS...............................20
/ Section I: Identifying Community Issues Related to Mental Illness and
Resulting from Lack of Community Services and Supports......................20
Section II: Analyzing Mental Health Needs in the Community...................................25
Section III: Identifying Initial Populations for Full Service Partnerships......................29
Section IV: Identifying Program Strategies.................................................................34
Section V: Assessing Capacity..................................................................................34
Section VI: Workplans and Timeframes......................................................................41
PART III: REQUIRED EXHIBITS........................................................................................43
Exhibit 2: Program Work Plan Listing.......................................................................43
Exhibit 3: Full Service Partnerships Population — Overview.....................................46
Exhibit 4: Work Plan Summary.................................................................................48
Exhibit 5: Budgets and Budget Narratives................................................................56
Justification for One-Time/Unspent Funds .............................................188
Exhibit 6: Quarterly Progress Report......................................................................189
Exhibit 7: Cash Balance Quarterly Report..............................................................192
a
i
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County
Mental Health Services Act
Community Services & Supports
Three-Year Program and Expenditure Plan
November 2005
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PART I. COUNTY/COMMUNITY PUBLIC PLANNING PROCESS AND
PLAN REVIEW PROCESS
Section I. Planning Process
Overview:
Contra Costa Mental Health has led a community-wide planning process that is
unprecedented in its scope. Over 1,100 consumers, providers, family, and community
members have had the opportunity to provide meaningful input into the process and
product. Visits to Contra Costa Mental Health's web site rose from under 50 a month
before the MHSA process, to a grand total of 4,400 during the peak planning period.
Participation and involvement has been great.
Mechanisms have been established for continuing stakeholder participation into the
future as we implement the services and strategies included in our Community Services
and Supports Plan. A description of how our process was comprehensive and
representative, including how it involved consumers and families in a meaningful way is
described below. This is broken down by stage of the process. As required by the State
Department of Mental Health (DMH) Contra Costa Mental Health (CCMH) submitted its
"Plan-to-Plan, or Community Program Plan, in March 2005. This plan was approved
unconditionally by DMH and has been the guideline for all planning activities from
January through November 2005.
1.1.1. Meaningful Involvement of Consumers and Families
Contra Costa Mental Health actively involves consumers and family members in day-to-
day operations, treatment planning, policy decisions and overall management of our
ongoing work. The Coordinator for our Office for Consumer Empowerment (OCE) and
our Adult/Family Coordinator report directly to the Mental Health Director and are part of
her executive staff. OCE works closely with Contra Costa's Mental Health Consumer
Concerns, the nation's second oldest consumer-run organization. We employ
consumer providers in three of our adult clinics, along with Family Partners in our
children/adolescent clinics. All of the above mentioned groups and individuals have
been instrumental in engaging consumers and family members in the planning process
for Community Services and Supports (CSS).
0
MHSA Community Supports and Services Final Plan, December 2005
Following passage of Proposition 63, the OCE formed the Consumer Involvement
Steering Committee (CISC). The CISC was formed in November 2004 and is made up
of approximately 16 individuals representing consumer providers (county mental health
staff), Mental Health Consumer Concerns (MHCC) and the Contra Costa Network of
Mental Health clients (the Network). Each organization was asked to nominate three
individuals to participate. The CISC developed a mission statement that reads:
The Consumer Involvement Steering Committee ensures broad consumer
involvement in the Planning Process for the implementation of the Mental Health
Services Act in Contra Costa County. 1) We will strive to gather input with
representation of all consumer stakeholders. 2) We will formulate
recommendations and advocate for implementation of these recommendations in
our county's plan.
3
A list of CISC's membership and workplan is included here as Attachment 1. OCE staff
and CISC members are part of our overall MHSA Planning Team. CISC meets monthly.
Outreach to Those in Organized Groups
Outreach to solicit stakeholder participation and to gain broad planning input and
involvement from consumers and family members and other stakeholders in organized .
groups was conducted in a variety of ways. The goals of this outreach were to gain
participation in the stakeholder planning process and/or to gain input on needs and
services through a variety of community forums, focus groups and surveys. While
outreach for these activities is described briefly in this section, more detailed
descriptions of who actually participated in the stakeholder planning, data collection
forums, focus groups and surveys is provided in "Data Collection and Community Input"
below.
■ The Office for Consumer Empowerment (OCE) offered three trainings on the MHSA
in December at the consumer community centers operated by Mental Health
Consumer Concerns. OCE Coordinator, Sharon Kuehn, also serves as part of
Contra Costa Mental Health's MHSA Planning Team (and is part of the Division's f
Executive Staff).
• Outreach to family members included the regular support groups facilitated by Gloria
Hill, CCMH's Adult/Family Coordinator, offered in West and Central Contra Costa.
In addition, Family Partners in Children's Mental Health held community meetings for
interested parents of children in the system to encourage participation in the
community forums and overall planning process.
The local chapter of the National Alliance for the Mentally III.(NAMI) is part of our <`
Contra Costa Mental Health Coalition (the Coalition) that was involved in the design
of the planning process. In addition to NAMI, the Coalition included the Contractors'
Alliance of Contra Costa County (which includes mental health, substance abuse
and other human service providers); the Mental Health Commission; Local 1 (the
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MHSA Community Supports and Services Final Plan, December 2005
labor union that represents the majority of our clinical staff); and the Contra Costa
Network of Mental Health Clients (The Network). The Coalition has been in
existence for over ten years. All members of The Coalition were encouraged to
participate in the planning process. The Mental Health Director meets with the
Coalition when requested. CCMH met with the Coalition in late January 2005 to get
input on the planning process.
• We conducted staff focus groups in our county-operated clinics. We also conducted
focus groups with some specialized staff, including those who work with the
developmentally delayed.
• Outreach & publicity for each of the community forums was handled through the
Health Services Department's Community Education & Information Unit. Efforts
included "blast" faxing announcements to over 400 community—based organizations
throughout the county, Public Service Announcements (PSAs) to local media outlets
including Spanish-language radio stations, and through the CCMH website:
www.cchealth.org. The Contra Costa Times and its affiliate publications also ran
listings of the meetings, and ran two stories during the first six months of 2005.
Targeted mailings were also conducted to community based organizations,
contractors and other interested parties.
Outreach to Consumers & Family Members Not In Organized Groups
Outreach to solicit stakeholder participation and to gain broad planning input and
involvement from consumers and family members who are not in organized groups was
conducted in a variety of ways. The goals of this outreach were to gain participation in
the stakeholder planning process and/or to gain input on needs and services through 6
community forums, 55 focus groups and 377 surveys (as discussed in detail in "Data
Collection and Community Input" below).
Outreach efforts to those not in organized groups included:
• CCMH had originally planned to contract out a substantial portion of outreach as well
as all focus groups and surveys to a broad range of culturally diverse community
based organizations. However, the length of time involved in the contracting process
and the need to recruit participants and gather data for the Stakeholder Planning
Groups by June made this impossible. This led to the creation of an internal
outreach team that included Mental Health Consumer Concerns (CBO). See the
next paragraph for a more detailed discussion of this. CCMH was able to contract
with seven community-based agencies that work with specific ethnic populations to
educate their communities about the MRSA planning process and to conduct
approximately 11 of the focus groups and surveys in appropriate languages and
settings. These community-based agencies were:
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MHSA Community Supports and Services Final Plan, December 2005
o Familias Unidas -- Conducted groups with monolingual Spanish consumer and
family members, with seniors, adults; teens and other family members. Also
conducted a focus group with their staff.
o Asian Community Health Services (ACMHS) and Asian Pacific
Psychological Services (APPS) -- Conducted focus groups with consumers
and family members in Vietnamese, Lao and Mien. Groups included teens,
adults 'and older adults.
o Community Clinic Consortium of Contra Costa—Conducted surveys with
consumers (predominantly Spanish-speaking) who are seen in three community
health clinics (through subcontracts): Brookside Community Health Center in
West county, Planned Parenthood in Central county and La Clinica de la Raza
in East County.
CCMH formed an internal outreach team that included mental health staff,
consumers, family members, the Ethnic Services Coordinator, the OCE Coordinator
and a Patients Rights Advocate (from Mental Health Consumer Concerns)to reach
out to a wide variety of"known locations" where we might reach consumers and
family members. These included county clinics, board and care homes, skilled
nursing facilities, homeless shelters, service provider offices and several out-of-
county facilities including IMDs (Institutes for Mental Disease) and MHRCs (Mental
Health Rehabilitation Facilities), where Contra Costa consumers are placed. This
out-of-county effort was one of the more enlightening parts of our process for both
q staff and consumers; we view it as a key step in our transformation process. Many
consumers had never been asked, "What do you want?" or "What do you need?"
Most were used to having county staff focusing on the consumer's clinical issues.
We also conducted focus groups and surveys in the county jail (Martinez Detention
Facility), with adults and young adults in county homeless shelters, with the youth in
the county's Independent Living Skills Program (ILSP).
• The CISC conducted outreach to individuals through a series of surveys and focus
groups (described in detail in "Data Collection and Community Input" below). They
worked in collaboration with the Community Clinic Consortium of Contra Costa a
group of community-based organizations (CBOs) that provide physical health care to
low-income and Medi-Cal recipients. The majority of their clients are Latino and
include many monolingual individuals. Many of their mental health consumers
receive only medication through the clinics. We contracted with the Community
Clinic Consortium to conduct surveys in English and Spanish at three clinics:
Brookside in West County, Planned Parenthood in Central County and La Clinica de
la Raza in East County. t
• CCMH's Family Partners, who are parents of children who are (or have been)
consumers in the public mental health system, engaged in outreach for the MHSA in
partnership with local school districts, other child-serving agencies, and with parents
of children who are consumers in our system. This included parents of adolescents
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MHSA Community Supports and Services Final Plan, December 2005
who are in the Chris Adams and Summit Centers -- residential treatment programs
attached to our juvenile hall.
• We did surveys and focus groups with consumers who are currently in the Contra
Costa Regional Medical Center's Psych in-patient unit.
■ We conducted focus groups with female consumers whose children are involved
with the child welfare system. We also conducted focus groups at Ujima Family
Recovery Services, a perinatal substance abuse treatment program that serves
women with co-occurring substance abuse and metal health issues, and their
children. The majority of the women in the Ujima group were also involved in the
child welfare system.
• As stated above, outreach & publicity for each of the community forums was
handled through the Health Services Department's Community Education &
Information Unit. Efforts included "blast" faxing announcements to over 400
community—based organizations throughout the county, Public Service
Announcements (PSAs) to local media outlets including Spanish-language radio
stations, and through the CCMH website: www.cchealth.org. The Contra Costa
Times and its affiliate publications also ran listings of the meetings, and ran two
stories during the first six months of 2005. Targeted mailings were also conducted
to community-based organizations, contractors and other interested parties.
1.1.2. Comprehensive and Representative Nature of the Planning Process
Design of the Planning Process .
CCMH formed a MHSA Planning Team in December 2004 with a group of staff that
includes managers, consumers, family members and providers of services. We continue
to meet weekly. Planning for the MHSA included our local Mental Health Coalition (the
Coalition), a group of several organizations including Local 1 (county clinical providers
union), the Contractor's Alliance of Contra Costa County (an affiliation of approximately
30 community based organizations that contract with the county's Health and
Employment & Human Services Departments), the Contra Costa branch of the National
Alliance for the Mentally III (NAMI), the Contra Costa Network of Mental Health Clients
(The Network), the Contra Costa County Mental Health Commission, and the Consumer
Involvement Steering Committee (described earlier). The Mental Health Coalition was
formed over ten years ago and serves as a unifying voice advocating for mental health
funding and services in Contra Costa. The Coalition also included many of the required
stakeholders, and several members participate in our Stakeholder Workgroups.
With these groups, CCMH designed a comprehensive, involved, stakeholders planning
process. Contra Costa's request for Community Program Planning funds was approved
on first review with no comments or contingencies.
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MHSA Community Supports and Services Final Plan, December 2005
Outreach, Education and Selection of Stakeholders
CCMH's outreach, education and selection of Stakeholders followed its original plan
closely. A series of letters, emails, and phone calls were issued inviting all required and
other interested parties to attend an Orientation and Training for Potential Stakeholders.
Outreach
Using the guidelines in DMH Letter 5-01 (list of organization/types)we invited the
required stakeholders: Consumers, family members, mental health providers,
social service providers (known as Employment & Human Services Division in
Contra Costa), education and law enforcement. In addition to the required
stakeholders, we invited a range of groups and individuals from divisions of the
County Health Services Department: Public Health, Alcohol & Other Drugs, and
the Contra Costa Regional Medical Center. We also solicited participation from
housing programs, homeless programs, advocacy groups (including NAMI), faith-
based groups, foster care programs, child welfare, First Five, Vocational
Rehabilitation, domestic violence programs, local Special Education Local Plan
Areas (SELPAs), senior services, and others.
r Assistance in outreach was provided by the Mental Health Division's Disparities
Work Group and community-based organizations working with traditionally
unserved and underserved groups.
Education
Potential stakeholders were requested to think of themselves as delegates to the
planning process, committing to look at the overall picture of the needs of mental
health consumers and family members in the county, and not just their own
personal or professional agenda.
Two two-hour "Orientations for Potential Stakeholders" were held for a total of
260 people in February and March 2005. The first training was videotaped by
Contra Costa Television (CCN) and made available on video or DVD to anyone
interested. Those who attended the planning sessions were asked to consider
their availability to participate fully in Stakeholder Planning Groups and were
given applications to apply. Applicants were asked to commit to fully
participation in a series of 7 planning meetings at approximately two-week
intervals that were scheduled from April until June 2005
Some additional recruitment was conducted with targeted individuals or groups
who had not attended the orientations. In order to comply with DMH regulations
that all potential stakeholder be trained, we made a DVD and video of the training
available to a few individuals.
3' $
The content of the orientation/training included the history of MHSA, the
organizational structure for statewide implementation of MHSA funds, DMH
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MHSA Community Supports and Services Final Plan, December 2005
requirements for planning processes and release of funds, and Contra Costa
County's own planning process.
Additional training for stakeholders selected for the four Stakeholder Planning
Groups (described below) was conducted at the first meeting of each group.
This included a review of the Act, planning requirements, and how the planning
process would work. We also extensively reviewed the DMH Requirements for
Community Services & Supports, covering the logic model, community issues,
etc. When the CSS guidelines were revised in May we went back to the
Stakeholder Planning Groups and went over the changes.
In addition to the trainings, we provided each member of the four planning groups
with a library of articles and information related to the mental health and the
specific age group. Resources included the articles listed on the DMH Web
Page under "Resource Listing," along with other information recommended by
our consumer staff. Additional resources provided to Stakeholders included the
data from our Needs Assessment on services provided, penetration rates,
demographic data and needs of our overall system. We also encouraged sharing
of appropriate data from stakeholders, i.e., there were staff from the county's
Homeless Program in Public Health who provided specific data on the homeless
population.
Selection of Stakeholders
After the training; a total of 155 applications for participation in the four
Stakeholder Planning Groups were received. A small team, made up of a Mental
Health Commissioner, consumer, family member, Mental Health Disparities Work
Group Chairperson and a Mental Health Manager reviewed the applications and
selected membership for the four Stakeholder Planning Groups using the criteria
originally defined in its proposal to DMH for planning funds. They included:
✓ Ensuring participation of required stakeholders
✓ Ensuring a broad-based group that reflects the ethnic and geographic
diversity of Contra Costa
✓ Ensuring inclusion of individuals who have experience working with the
specific populations
While the original plan was to create four Stakeholder Planning Groups
(Children, Transitional Age Youth, Adult and Older Adult) with 20 members each
for a total of 80 stakeholders, it was necessary to enlarge the groups to achieve
the desired diversity. The total number of selected stakeholders ended up at 90.
Of this group, 25 individuals identified themselves as consumers and/or family
members. A list of Stakeholders and some of their characteristics is included as
an Attachment..
A consumer staff member and a mental health manager from Contra Costa
Mental Health were also assigned to support each group as an informational
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MHSA Community Supports and Services Final Plan, December 2005
resource. Their role was to answer any technical questions, i.e., explaining
Medi-Cal regulations or service delivery practices, etc.
• Attachment 2 : Letter of invitation to Stakeholder Orientation/Training
• Attachment 3 : List of those who attended trainings with affiliations and
demographic descriptions (as known)
• Attachment 4 : Agenda/Outline of Stakeholder Orientation/Training
• Attachment 5 : Application to be a Stakeholder/Planner
• Attachment 6: List of Stakeholders and some characteristics
4 Data Collection and Community Input
Contra Costa's community input process exceeded its original plans. More forums and
focus groups were conducted than originally envisioned. More completed surveys were
returned than originally imagined. The outreach effort for participation in these activities
was great. Details of these efforts are provided below.
Community Forums
Six Community Forums, hosted by the Mental Health Commission, were conducted
by consultant Steve Ekstrom of The Results Group. The six forums were carried out
in six different geographic areas of the county (5 supervisorial districts with 2 forums
in one larger district). Five forums had originally been envisioned.
The purpose of the forums was to offer community residents the opportunity to voice
their ideas on the MHSA. Professional translators familiar with ASL and Spanish
(threshold language) were on hand at each forum with an additional LaoNietnamese
translator available for the West county forum, The primary concerns and needs
expressed varied greatly from location to location. For example, at the second
community forum in Martinez, several parents of adult consumers expressed their
concerns about the lack of supportive housing and other services. In the Antioch
forum, the participants were much more focused on the lack of services for children
and adolescents, especially in Far East County. In West County, there was a
stronger turnout from consumers, in addition to family members, and several faculty
from the West Contra Costa Unified School District. Attendance at the forums was
low at the beginning but grew with each successive event; the final community forum
in EI Cerrito drew approximately 75 people.
Outreach & publicity for each of the community forums was handled through the
Health Services Department's Community Education & Information Unit. Efforts
included "blast" faxing announcements to over 400 community-based organizations
throughout the county, Public Service Announcements (PSAs) to local media.outlets
including Spanish-language radio stations, and through the CCMH website:
www.cchealth.org. The Contra Costa Times and its affiliate publications also ran
listings of the meetings, and ran two stories during the first six months of 2005.
Targeted mailings were also conducted to community-based organizations,
contractors and other interested parties.
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MHSA Community Supports and Services Final Plan, December 2005
Attendance at the community forums included family members (especially family
members of adult consumers), advocates, CBOs, consumers, and other community
groups and individuals.
Surveys
A series of written surveys were distributed in Spanish and English through mental
health service outlets throughout the county. Consumers involved with CISC
assisted in the design of the surveys. The purpose of the surveys was to provide
opportunity for consumers and family members to voice their needs and concerns as
part of the planning process. Of the four surveys, one was for mental health
consumers in general, one was for mental health consumers currently residing in
mental health rehabilitation centers, one was for family members of adults in the
mental health system, and one was for family members of children in the mental
health system.
Survey distribution sites included: County Mental Health and Child Mental Health
clinics, Napa State Hospital, Crestwood Pleasant Hill, Crestwood Fremont,
Crestwood Manor, Crestwood Healing Center, Crestwood Health Center, Brookside
Community Health Center, Planned Parenthood, La Clinica de La Raza, Board and
Care Homes, Kirker Center, Agape House, Seneca Center, Mt. Diablo Day Health,
John Muir Hospital Family Support Group, Family-to-Family Groups in Danville and
Concord, EI Cerrito Royale Family Support Group, NAM) Support Groups, New
Hope Adolescent Support Group, Foster Care Parents, Seneca — Oak Grove, We
Care —Antioch, San Ramon & Concord. Surveys were also distributed at MHSA
consumer trainings through Mental Health Consumer Concerns.
A total of 377 completed surveys were returned to CCMH and were analyzed by
Steve Hahn-Smith, PhD, Planning and Evaluation Coordinator. Consumers and
community members who submitted completed surveys above were given $5 gift
cards for Safeway to acknowledge their participation. Residents in rehabilitation
facilities received funds in their trust accounts.
Focus Groups
A total of 55 targeted focus groups were conducted to gain additional input on issues
and priorities for MHSA planning. CCMH's Disparities Work Group and consumers
involved in CISC assisted in the development of focus group questions to assure
appropriate probing of key issues. Outreach for these groups was discussed earlier
in this Section. Most of these focus groups were conducted by a team of CCMH
professionals and family and consumer staff. Eleven focus groups were contracted
out to agencies in the community with relationships and cultural/language capacities
to reach ethnic and non-English speaking sub-populations, and were conducted in
languages other than English. 43 focus groups or 78% of all focus groups were
made up entirely of consumers or their families. Nearly 300 individuals are
estimated to have provided input through this effort. A list of all focus groups is
included as an Attachment to this section.
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MHSA Community Supports and Services Final Plan, December 2005
As outlined in Contra Costa's Request for Planning Funds, a Request for Interest
(RFI) was published on our web site to community based organizations (CBOs) and
other groups in the community who were engaged with "hard to reach" sectors of the
community, focusing on monolingual Spanish and Southeast Asian consumers and
family members. These included cultural groups, groups with language capacities
for non-English or Spanish speaking residents (primarily Asian), immigrants, and
others who are traditionally unserved or underserved by CCMH. Those selected to
receive funds to conduct focus groups conducted their own outreach, provided
incentives, and provided written summaries of the findings of the groups As
discussed previously, our original intent was to contract out all of the focus groups
and surveys to CBOs, however, due to time constraints we wound up forming an
outreach team in-house for the majority of the work.
$15 Safeway gift certificates were provided to focus group participants to
i acknowledge their contribution to the project. Residents of IMDs/Long Term Care
facilities received $15 in their trust accounts. Where appropriate or necessary,
refreshments, childcare and transportation were also provided.
Analysis of Findings
The open-ended content of the community forums and focus groups was quite rich.
Summaries of each group were compiled and distributed. Stakeholders were
encouraged to read them all. Additionally, data were analyzed by Nancy Frank of
Nancy Frank & Associates and the most common themes were presented in a table
format. Cautions were made to alert Stakeholders and community members that the
summary tables were to be used as companion pieces to full summaries of each
group — and not as a stand alone piece.
Community Services and Supports Recommendations
As a tool to elicit suggestions from any member of the community or organization, a
"Community Services & Supports Recommendations" form was developed. It was
publicized on the CCMH web site and sent out to community-based organizations.
We received approximately 25 recommendations with a variety of suggestions for
programs and services. Most of the recommendations advocated for specific funding
for specific agencies and/or programs. Some recommended the expansion of
consumer-run centers. Recommended services included supportive housing (all
types); increases in services for ethnic populations; increase in services for
consumers with co-occurring mental health/substance abuse problems; Clubhouse
Model; working farm; increase in school-based mental health services; 211
telephone line; mobile crisis; integrated mental health and healthcare services, etc.
A list of all groups/individuals who submitted recommendations and their ideas is
included in the attachments.
Other Opportunities for Information and Input
In addition to all of the community input opportunities listed above, Prop. 63 Project
Manager Kimberly Mayer was available by phone and by email to answer individual
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MHSA Community Supports and Services Final Plan, December 2005
concerns and questions from anyone throughout the process. Her availability and
contact information was included on the County web page for Prop 63 planning as
well as on other outreach and informational materials. Karen Shuler, Executive
Assistant to the Mental Health Commission, also responded to emails and phone
calls about the planning process. We also used our web site for individuals to ask
questions, and to be added to our electronic and USPS mailing for meetings and
events. Data on web site hits is included here as an Attachment.
Detailed information about events, opportunities for input, the planning process and
minutes of meetings were also posted on the County's Health Services Website
(www.cchealth.org).
Attachment 7: Summary of all community forums, focus groups and surveys with
locations of focus groups and forums listed
Attachment 8: Flyer, notes from Community Forums
Attachment 9: Focus group questions (English/Spanish)
Attachment 10: Summary of CSS recommendations & form
Attachment 11: Summary of web site hits
Stakeholder Planning Process and Recommendations
As described earlier, four Stakeholder Planning Groups (Children, TAY, Adults and
Older Adults)were established to make recommendations to the Director of the Mental
Health Division. Recommendations were to: Identify Full Service Populations for the
first three years of MHSA implementation, and prioritize services needed throughout the
community.
All Stakeholder meetings were facilitated by Steve Ekstrom of The Results Group.
Having a highly skilled and neutral facilitator assured the effectiveness and integrity of
the process. Stakeholder meetings were open to the public and minutes of each
meeting were distributed to all Stakeholders (not just those in the specific age grouping)
and published on the CCMH website within a few days of each meeting. Transportation
reimbursement was made available to any Stakeholder needing assistance.
The first Stakeholder meeting for each group consisted of another two-hour, more
detailed and more up-to-date training about MHSA, and the assignments of the
Stakeholder Groups. This training was conducted by Mental Health staff.
Because of the concern for a holistic approach and the artificial divides between the four
specified Stakeholder groups, an additional intergenerational meeting was held for all
interested Stakeholders from all planning groups. This meeting addressed frustrations,
overlaps and concerns about how the planning process could/should look at whole
families. Twenty-seven Stakeholders attended this meeting. Minutes of this meeting
were also distributed and posted on the web site.
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MHSA Community Supports and Services Final Plan, December 2005
Each of the four Stakeholder Groups met 9 times (36 meetings total) rather than the
originally envisioned 7 times. The 9th meeting for each group included a face-face
meeting to present and discuss findings with Donna Wigand, Director of CCMH. .
Attachment 12: Minutes from Stakeholder and intergenerational meetings
Attachment 13: Recommendations from Stakeholder Planning Groups
Advisory Committee
As the Stakeholder planning process neared completion, it became evident that
continued involvement of Stakeholders was both desirable and needed as Stakeholder
a recommendations were honed down into a fundable package for MHSA funds. Each
Stakeholder Group nominated up to four of its members to an ongoing Advisory Group
that has continued to advise CCMH as it developed its plan. In October CCMH
distributed a working draft of the plan to the Advisory Groups, and met with them to get
feedback. This proved to be extremely valuable; their specific input and ideas have
been incorporated into the Draft and Final Plans.
Input on Plan and Revisions
CCMH emailed the Advisory Members a draft of the plan and budget information in
October. We met with the Adult and TAY Advisory Groups together. Separate meetings
were held with the Children's and Older Adults Advisory Groups. Overall, all the
Advisory Groups were supportive of the plan.
Comments from the Adult and TAY groups focused around specific recovery language
in the plan. There were some concerns that we had not emphasized person-centered
planning enough in the plan. While we were clear that the recovery focus was definitely
a program emphasis, the narrative needed to be strengthened to clearly identify this
information. In the full Adult Stakeholder Planning group, one of the recommendations
(from July) was that the County should "contract out" all of the new program design for
the Adult CSS funds as a means of getting the most innovative programs, and have the
decisions for new contracts made by another entity (i.e., another county). One member
of the Adult Stakeholder Advisory group though that we should go forward with this
idea, however, we explained this was not feasible as the County cannot delegate
responsibility for our own programs to another County. The remaining Advisory
members agreed with CCMH on this point, and eventually, the individual stakeholder
who questioned this point also agreed that that process was not doable.
The Children' group was supportive of the plan, and gave us specific feedback on data
we could use to strengthen the case for using Far East County as a starting point for
Full Service Partnerships.
The Older Adults Advisory Group was supportive of the plan, however, were
disappointed that the new program will not begin until Year 3 of the program. We
explained the rationale for this: funds are limited; this is a collaboration of several
partners; working with the ALTCI planning group will be very important so that we do not
duplicate efforts.
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MHSA Community Supports and Services Final Plan, December 2005
Plans for Ongoing Input
CCMH will continue to work with the Advisory Stakeholders through the plan review
process and implementation. At the final meeting with each Stakeholder Planning group
in July, CCMH requested that the individuals on each of the Advisory Stakeholder
groups commit to continuing their involvement until the CSS plan was approved. At that
point, continued Advisory Stakeholder involvement will be requested to continue
through implementation. If any members feel they cannot commit to additional time, we
will go back to the full stakeholder planning groups for replacement members. We
believe the ongoing involvement of Stakeholders in our planning and implementation
process will also be helpful for the annual plan review that will be required by DMH.
1.1.3. Responsibilities and Roles in Planning Process
Overall Responsibility
As Mental Health Director, Donna M. Wigand, LCSW has the overall responsibility for
planning and implementation of the MHSA.
Organizational Responsibility
Kimberly Mayer, MSSW, is a Mental Health manager and has overall organizational
responsibility for the planning process. This includes working closely with the Director,
facilitating weekly planning meetings, working with consultants on the project and
overseeing all of the tasks and processes necessary to plan and implement the MHSA.
Responsibility For Ensuring Involvement of Unserved/Underserved Groups
Sharon Kuehn, OCE Coordinator, is responsible for ensuring outreach to unserved and
unserved groups. Gloria Hill, Adult/Family Coordinator is also working on outreach to
this population. Kathy Davison, Family Partner, works to outreach to parents and family
members of children and adolescents.
Responsibility For Ensuring Ethnically Diverse Stakeholders
Lisa V. Booker, RN, was named Ethnic Services Coordinator in July 2005. She serves
as chair of the Mental Health.Disparities Work Group, and as Technical Assistance
Coordinator for Children's Mental Health. Lisa is a member of the MHSA Planning
Team and helped to ensure the inclusion of an ethnically diverse set of stakeholders.
Use Of Consultants In Community Program Planning
Steve Ekstrom, MA is a senior partner with The Results Group. Mr. Ekstrom facilitated
all of our community forums, stakeholder orientations and Stakeholder Planning
Groups. He also is part of our MHSA Planning Team.
Grace Boda, MPP, a fiscal consultant for the Mental Health Division, is also assisting
with planning. Her role is to assist with training of the Stakeholders, developing outreach
to mental health staff and contractors. She is a member of the MHSA Planning Team
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MHSA Community Supports and Services Final Plan, December 2005
Nancy Frank, MPH, Principal of Nancy Frank and Associates has been hired to write
the final MHSA Community Services and Supports Plan. She has also assisted in the
analysis of focus group and community forum data. She is a member of the MHSA
Planning Team.
MHSA Planning Team
When we began our internal MHSA Planning in December 2004, we started with a small
team of people. As we moved forward with the process, it was necessary to add
participants to the group. The role of the planning team is to assist with all areas of the
planning process. Our team includes consumer providers and family members, along
with line staff, managers and program chiefs. The team meets weekly. Two of our key
consultants, Steve Ekstrom and Nancy Frank, also attended the weekly planning
meetings as necessary.
List of all Staff and Consultants Involved in MHSA Program Planning and Time
Spent To-Date
Contra Costa County Mental Health Division
Staff Participation in MHSA Planning Process
January.-October, 2005
Estimated Actual
Name Title Time Time
Donna M. Wigand, LCSW Mental Health Director 45% 45%
Kimberly Mayer, MSSW Program Manager 80% 80%
Office for Consumer Empowerment
Sharon Kuehn Coord 35% 50%
Steve Hahn-Smith, PhD Research & Evaluation Coordinator. 30% 35%
Office for Consumer Empowerment,
Jay Mahler Staff 35% 35%
Lisa V. Booker, RN Ethnic Services Coordinator 15% 30%
Karen Pratt Adult Mental Health Program Manager 5% 30%
Beth Lucas Research Assistant 20% 20%
Victor Montoya Adult Mental Health Chief 5% 20%
Suzanne Tavano, PhD, RN Clinical Services Chief 5% 15%
Vern Wallace, MFT Children's Mental Health Chief 5% 15%
Gloria Hill Adult Family Coordinator 10% 10%
Children's Mental Health Program ;
Sandra Marsh Manager 5% 6%
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MHSA Community Supports and Services Final Plan, December 2005
Mental Health Commission Executive
Karen Shuler Assistant 5% 5%
Kathy Davison Children's Mental Health Family Partner 5% 5%
Nancy Ebbert, MD Chief Psychiatrist 5% 5%
David Cassell, LCSW Quality Improvement Coordinator 5% 5%
John Allen Adult Mental Health Program Manager 5% 5%
Stacey Tupper Administrative Services Analyst 5% 2%
Sherry Bradley, MPA Operations Manager 5% 3%
Children's Mental Health Program
Rich Weisgal, MFT Manager 5% 2%
Children's Mental Health Contract
Helen Kearns Manager 5% 0%
Grace Boda, MPP Consultant Trainer 15% 15%
Steve Ekstrom, MA Consultant Facilitator 20% 30%
Nancy Frank, MPH Consultant, Planner/Writer 20% 20%
Jana Drazich Finance Manager 5% 10%
A ore Riaunda Accountant III 5% 5%
1.1.4. Stakeholder, Staff and Other Training
Stakeholder Training
As described earlier, Stakeholder training began with a wider group before the actual
Stakeholder Planning Groups were formed. Two 2-hour trainings were offered for all
interested parties as a pre-requisite to applying to be a member of one of the four
Stakeholder Planning Groups.
Two two-hour orientations/training were held for a total of 260 people. The first training
was videotaped by Contra Costa Television (CCTV) and made available on DVD and
videotape to anyone interested. Those who attended the planning sessions were asked
to consider their availability to participate fully in Stakeholder Planning Groups and were
given applications to apply. Applicants were asked to commit to fully participation in a
series of 7 planning meetings at approximately two-week intervals. We also requested
that the prospective Stakeholders think of themselves as delegates and planners for the
entire county; not just their specific interest. Trainirigs covered the overview of MHSA
including the recovery vision.
Once 90 Stakeholder Planners were selected from the 155 applications received, the
first meeting of each of the 4 Stakeholder Planning Groups consisted of another training
15
MHSA Community Supports and Services Final Plan, December 2005
session which included a more up-to-date training about MHSA, the role and activities
of the State DMH, and the assignments of the Stakeholder Groups. These trainings
were conducted by Mental Health staff Kimberly Mayer, Steve-Hahn Smith and
consultant Grace Boda. As discussed previously, we trained extensively on the DMH
requirements for Community Services and Supports, covering the logic model and
program strategies. We also provided a resource library for all individuals on the
Stakeholder Planning Groups with background information on mental health issues and
other pertinent information.
Again, as mentioned earlier, each Stakeholder Group had two CCMH staff members
(including a consumer) assigned to the group to provide technical assistance and
ongoing education to the group. This included bringing information on such issues as
the range of current services, laws and eligibility regulations to the group upon request.
41 Staff Training
CCMH engaged in a variety of activities to educate mental health staff about the MHSA.
CCMH began training for all of its managers and supervisors in February. We also
conducted trainings at regular staff meetings, including: Children's Lead Staff; Adult
Lead Staff and Clerical Lead Staff. Some managers and line staff also attended the two-
hour Orientation and Training for Potential Stakeholders held in February. Managers
directly involved in the planning of the MHSA also attend CMHDA and DMH stakeholder
meetings.
Line staff received training through regular staff meetings. Additionally, training on
MHSA was provided at focus groups for staff and mental health providers. Nine focus
groups were held for CCMH direct staff and two additional groups included community
providers. An estimated 90 staff participated in focus groups. We also provided regular
updates through all-employee emails.
Board of Supervisors
In January 2005, Donna M. Wigand, Mental Health Director, made a presentation to the
Board of Supervisors to give an overview of the planning process. We also ensured that
our CAD's office was up-to-date on the planning process. This was very important
during the budgeting process for FY 2005-2006; our Board of Supervisors understood
the non-supplantation rule when planning for any reductions in the Health Services
Department.
Section Il.. Plan Review
1.11.1. Distribution of Draft Plan
The Draft Plan was made available through a number of methods. These include:
■ The Draft Plan, along with an Executive Summary (available in English, Spanish
and Vietnamese) was posted on our web site: www.cchealth.org. The date and
location of the public hearing was included in the web site announcement.
zr
16 ='
t.
MHSA Community Supports and Services Final Plan, December 2005
■ Copies of the Draft Plan were distributed to all 27 Contra Costa Public Libraries.
A copy was also available in the Mental Health Administration office.
■ CCMH mailed hard copies of the draft plan to all members of the Mental Health
Commission and Stakeholder Planning groups.
■ Contra Costa Health Service' Community Education & Information Unit "blast"
faxed a press release to 400 media outlets and community based agencies.
■ CCMH sent an announcement of the plan to approximately 200 individuals on
our email and regular mailing lists.
■ On November 15th, CCMH had a meeting with all Mental Health managers and
supervisors to review the draft plan. We also emailed all Mental Health staff the
link to the web site, plus a copy of the Executive Summary.
■ The week of October 31, CCMH had meetings with the MHSA Stakeholder
Planning Groups to discuss and gain input on the Draft Plan.
■ On November 17 we held a two-hour study/training session with Mental Health
Commission at their regular meeting.
■ At their November meeting, the Consumer Input Steering Committee reviewed
the draft and made comments, which they relayed to the Office for Consumer
Empowerment.
■ Mental Health Director Donna M. Wigand presented an overview of the plan at
the November NAMI Contra Costa meeting.
■ The Contra Costa Times and its affiliates ran a front-page article on the draft plan
(which also featured Alameda's plan) on November 21, 2005. (Attachment 18)
■ Radio station KCBS featured an interview with Kimberly Mayer, MHSA Planning
Manager, on November 22.
■ A media advisory was sent November 30tH as reminder for the December 7th
public hearing.
Overall, from November 4th through December 6th, we distributed 250 hard copies of the
entire draft plan. During the same time period our web site had over 900 hits on the
draft plan — an average of approximately 30 hits per day.
1.11.2. Documentation of Public Hearing
An announcement and agenda for our Public Hearing is included as Attachment 17.
Announcement of the public hearing was included in all media and hard copy
dissemination of the Plan. Information on how to provide input on the Plan in ways
other than at the public hearing was also included.
During the public hearing, interpreters were available to translate in American Sign
Language, Spanish and Vietnamese. The public hearing was recorded by CCTV for a
permanent record.
17
MHSA Community Supports and Services Final Plan, December 2005
1.11.3. Summary and Analysis of Substantive Input from the Public
During the 30-day public comment period we received approximately 20 comments by
email, letter and phone. At the December 7th public hearing, approximately 50 people
attended, and 24 made comments. We also received three additional written comments
during the meeting. Public comments and suggestions covered the following areas of
the plan:
■ Older Adult Program: Three people spoke in support of the Older Adult plan, but
opposed the timing of the plan, and want it rolled out earlier than Year 3 of MHSA
funding. The Contra Costa County Advisory Council on Aging submitted a letter
reflecting those comments.
■ Transition Age Program: One individual spoke against the TAY portion of the
program, feeling that it did not adhere to the recommendations of the TAY
Stakeholder Planning Group, and that services were spread too thin. Another
person spoke in favor of the TAY program and was very interested in further
development of the Community College aspect of the program.
■ Housing Program: The Homeless Continuum of Care Advisory Board expressed
strong support for the housing program and the overall draft plan, especially
master-leased, scattered site housing and integrated service teams. Another
individual expressed the need for more licensed facilities for mental health
consumers.
■ Children's Program: The Chair of the County's Children's System of Care Policy
Council spoke in strong support of the Children's Program and the overall draft
plan.
■ Adult Program: Six individuals from NAM[ Contra Costa spoke advocating for a
more inclusive definition of homelessness for the Adult Program to include those
,at imminent risk" of homelessness, who may not be on the streets, but who are
coming out of facilities, or are adult consumers living with their aging parents and
are very underserved. Several in this group also supported the development of a
"Clubhouse Model" under MHSA funding.
This issue represents a continuation of divided opinions within the Adult
Stakeholder Planning group, which very narrowly chose the "pure homeless"
definition over a more inclusive definition. CCMH understands this critical issue,
and also honors the work of the Stakeholder Planning Group. Based on this
input, CCMH recommended a careful review of the program and criteria for
inclusion —with Stakeholder input— as part of the first annual plan review
which will begin soon.
18 '
MHSA Community Supports and Services Final Plan, December 2005
However, the Contra Costa County Board of Supervisors, in approving the plan,
stipulated that the eligibility criteria for Adult FSPs be broadened to include those
"at serious risk for homelessness" (see Substantive Changes below).
Other comments:
o Mental Health Consumer Concerns (MHCC) advocated for further expansion
of its community centers, and submitted a letter outlining their requests. A
second speaker representing MHCC commented on the need for consumer-
operated transportation.
o Three comments were made by members of the CISC, advocating for more
participation in the final draft of the plan, and for a strong recovery vision in all
MHSA programming.
o One individual commented on the lack of programs in California for adults
with serious mentally illness and asked why we don't have programs that
exist on the East Coast.
o One individual commented on the need for expansion of the WRAP program,
and that Tender Loving Care workers (consumer program) should be bonded.
o The Contractors' Alliance had concerns over the systems development area
of the plan, and was concerned CCMH was building capacity for the County
and not CBOs.
o One individual commented that we need supports for mothers to keep
custody of their children.
1.11.4. Substantive Changes to Plan Based on Community Input
CCMH did not make substantive changes to the plan or program design based on
community input at the public hearing. However, during the public comment period we
made extensive edits to the narrative to clarify specific sections, improve syntax and
grammar, improve the clarity of the recovery philosophy we are guided by, and
generally strengthened our overall proposal. We made some minor changes to the
budget, and added a detailed budget narrative. Also, based on information posted in
November on the "Frequently Asked Questions" portion of the MHSA Web Page (DMH),
we formatted the narrative and exhibits to reflect the most recent information. The
Contra Costa Mental Health Commission adopted the final plan on December 13, 2005.
The Contra Costa County Board of Supervisors was presented with the Plan for its
approval on December 20. Several members of NAMI spoke again at this meeting
about the need to house those adults with psychiatric disabilities who are at very
serious risk of homelessness —e.g.: currently being discharged from institutions or living
with family members who are aging and can no longer be in the caretaker role. In
response to this, one member of the Board of Supervisors suggested a language
amendment to the eligibility definition of the Adult Full Service Partnership, and the rest
of the Board of Supervisors agreed. This language adds those "at serious risk for
homelessness." This change has been made in the definition of the target population
throughout the remainder of this document.
19
MHSA Community Supports and Services Final Plan, December 2005
Part II. PROGRAM AND EXPENDITURE PLAN
Section I. Community Issues Related to Mental Illness and Resulting from
Lack of Community Services and Supports
11.1.1. Major Community Issues Identified Through Community Planning Process
The major community issues identified by each Stakeholder Planning Group are listed
in the table below. Those which have been selected to be the focus of MHSA services
over the next three years are identified with an asterisk (*).
Community Issues Identified in the Public Planning Process
Children/Youth TAY Adults Older Adults
1. Failure in Learning 1. Homelessness* 1. Homelessness* 1. Unnecessary Loss of Functioning*
Environments*
(Includes: Frequent hospitalizations,
(Includes: School Failure) frequent emergency medical care,
inability to work, inability to manage
independence, involuntary care and
institutionalization
. Out-of-Home 2. Incarceration 2. Isolation 2. Isolation*
Placements
3. Involvement in child 3. Hospitalization or 3. Inability to Work
welfare or juvenile justice Involuntary Care
Isystems
All four stakeholder groups received training and technical assistance on the logic
model used in the Community Service and Supports guidelines. This included an
overview of the DMH's requirements to identify Full Service Partnerships and System
Development Strategies.
1.1.2. Factors.or Criteria Leading to Selection of Starred (*) Issues
Selection of Children's Issues
The Children's Stakeholder Planning Group identified many issues before selecting
its priority issue (above). This included a review of community input from surveys,
focus groups and community meetings (included as Attachment 7 to this plan) as
well as existing utilization and demographic data. Issues were prioritized through
facilitated discussion. It was generally agreed that many critical issues identified in
the brainstorming phase of the discussion (including family problems, involvement
with child welfare or juvenile justice systems, and out-of-home placement) would
manifest themselves in the more visible issue of ability to function in learning
environments. The Children's Stakeholder Planning Group wrote:
20
;r
MHSA Community Supports and Services Final Plan, December 2005
Reductions in funding to children's mental health services over the last several
years have created a critical situation. Existing services are limited and many
have long waiting lists. It is in this context that we plan for the MHSA.
When it becomes obvious to health and other professionals, and possibly to
parents/caregivers, that a child or adolescent is having problems functioning
safely and productively in his/her home, learning environment and/or community,
t it can be assumed that the child has serious social, emotional or physical needs
that are inadequately met. Healthy functioning and reasonable growth in the
home and in the learning environment are the best indicators that a child will
develop into a healthy and productive young adult.
When health professionals and educators assist families in meeting the social,
emotional and physical needs of their children, the community in general is a
happier and healthier place for all of us.
It is important to note that the Stakeholder Group refined DMI-I's issue of "school
failure" to recognize that, especially for younger children, many learning
environments are not specifically schools. The concept was broadened to include
these additional learning environments.
Selection of Transition Age Youth Issues
As with the Children's Group, the Transition Age Youth Stakeholder Planning Group
reviewed existing data and community input and identified pivotal issues which they
viewed as not only of primary importance, but as the visible results of secondary
issues such as school failure and out-of-home placement. The group wrote:
There are three core issues: homelessness, incarceration and
hospitalizationrnvoluntary.care. These are difficult to separate as involvement in
any one can lead to involvement in another. Then a ripple effect occurs. Youths
who are homeless, incarcerated and/or hospitalized stand a very good chance of
having difficulty in regular school settings or holding a job. Additionally, the
likelihood of being placed in foster care or a group home is increased.
Selection of Adult Issues
As with the other groups, the Adult Stakeholders Planning Group recognized that a
few pivotal issues were the most primary and most visible manifestations of mental
illness in the population as well as other key community issues such as
incarceration, substance abuse and family problems. They wrote:
The goal for adults with serious mental illnesses should be "greater membership
in society."But due to a lack of appropriate integrated services at the time people
need them, the major impacts on adults with serious psychiatric disabilities are:
An inability to financially support themselves or access benefits, ,
• Isolation due to the effects of mental illness and discrimination, and
Homelessness or inappropriate housing.
21
MHSA Community Supports and Services Final Plan, December 2005
Any one of these can initiate a cycle that leads to the others. Common outcomes
are incarceration and/or institutionalized care without integrated services and a
continuum of supports.
While the Adult Stakeholder Group ultimately selected the "homeless without
shelter' population for Full Service Partnerships, there was major discussion within
the group, especially among those who advocated for services for those who may
not be without shelter- yet. This includes those who are at imminent risk for
homelessness: Consumers being discharged from institutions, jails or hospitals, and
consumers in unstable housing. It came down to a vote within the group with a slim
majority voting for those "without shelter." The portion of the group that wanted a
broad definition of homelessness also created a "Minority Report" that was given to
the Mental Health Director at the final Stakeholder Planning Group meeting,
advocating for the more inclusive population.
(Note: As stated earlier, the definition of the Adult FSP was broadened to include "at
serious risk of homelessness" by the Board of Supervisors on December 20th. This
broadened definition has been included in the balance of this Plan.)
Selection of Older Adult Issues
The Older Adult Stakeholder Planning Group reviewed existing data and identified
many issues before selecting its priority issues. Additional issues included: In-crisis,
complex presentation, in the community without supports and resources (variation
on isolated), in institutions without supports and resources, homeless, resistant to
treatment and/or recovery, uninsured or underinsured, no employment or meaningful
activity. In selecting the starred issues, the Planning Group wrote:
For older adults with serious mental illnesses, there is a dynamic between
"unnecessary loss of ability to function"(lack of resources available that results in
a downward spiral) and "isolation."Either of these two issues can stimulate the
other, and they are exacerbated by lack of transportation, lack of case
management services, language barriers, and discrimination based on
age/race/alternative life styles. From isolation/unnecessary loss of ability to
function follows a cascade of secondary problems such as: inability to attend to
health care needs; inability to care for one's self, inability to work, substance
abuse; and hopelessness. Common outcomes of this pattern are
institutionalization and homelessness.
Unnecessary loss of ability to function is not a specific category mentioned in the
MHSA but was identified as critical by the Stakeholder Planning Group. It can be
viewed as a "Super' category that includes several MHSA categories including:
frequent hospitalizations, frequent emergency medical care, inability to work, inability
to manage independence, involuntary care and institutionalization.
22
MHSA Community Supports and Services Final Plan, December 2005
1.1;3. Racial, Ethnic and Gender Disparities Within Selected Community Issues
Children
The Children's FSP focuses on youth with SED, without any medical insurance, who
have experienced failure in their learning environments. We know that these f
children are more likely to be lower income. At present, CCMH serves 8.2% of the
population of families with children who live in poverty. Of this lowest income served
population, African Americans and Whites are most highly served and Asians/Pacific
Islanders and Latinos are the most underserved at 3.7% and 4.4% respectively.
We know from experience that children who experience homelessness are more
r likely to have serious emotional disturbances. This may be, in part, from the
experience of homelessness itself. It may also be because risk factors that
contribute to homelessness (e.g.: low income, low education, substance abuse,
parental psychiatric disabilities) also contribute to SED in children.
We also know that children who enter the foster care system are more likely to have
j SED. As with homelessness, we know that the risk factors that led them into the
foster care system are some of the same risk factors for SED. As with
homelessness, we know that the experience of foster care itself can (in some
j instances) lead to SED. '
Finally, we know that older children with SED are more likely to enter the juvenile
justice system. And that children who enter the juvenile justice system are more
likely to have or develop SED. A snapshot of youth in juvenile hall on a single day in
October, 2005 shows that 89% are male. 54% are African American, 25% are
Latino, and 18% are White.
Transition-Age Youth
The TAY FSP focuses on youth with SED, who are homeless or at imminent risk of
homelessness. We know that these youth are low income. They are more likely to
be gay/lesbian or questioning their sexual identity. Many have aged out of the foster
care system with few supports and inadequate education and life skills. The
population is disproportionately of color. Many have experienced episodes of ;
homelessness before.
We know from experience that youth who experience homelessness are more likely
to have serious emotional disturbances. This may be, in part, from the experience of
homelessness itself. It may also be because risk factors,that contribute to
homelessness (e.g.: low income, low education, entrance into child welfare and
criminal justice systems, substance abuse, parental psychiatric disabilities, parental
substance abuse) also contribute to SED in youth.
2005 Data from Homeless Encampment Outreach efforts conducted by Contra
Costa County Homeless Services shows that, of 4,578 contacts with homeless
individuals, 34% were under the age of 25. Those in encampments (clustered in
23
MHSA Community Supports and Services Final Plan, December 2005
open areas within the county) are the most chronically homeless, with 71% having
been homeless for more than a year.
We know that children who enter the foster care system are more likely to have or
develop SED. As with homelessness, we know that the risk factors that led them
into the foster care system are some of the same risk factors for SED. As with
homelessness, we know that the experience of foster care itself can (in some
instances) lead to SED.
Adults
The Adult FSP focuses on seriously mentally ill adults who are homeless without
shelter or at serious risk of homelessness. Many will be chronically homeless
adults. Many have aged out of the foster care system with few supports and
inadequate education and life skills. The population is disproportionately of color.
Some of these individuals are homeless-because of their mental illness. Some have
come out of jail into homelessness. The mentally ill are also more likely to go to jail.
2005 Data from Homeless Encampment Outreach efforts conducted by Contra
Costa County Homeless Services shows that, of 4,578 contacts with homeless
individuals, 71% had been homeless for more than a year, with 23% homeless for
more than 5 years. 55% of those contacted were White, 31% were African
American, and 11% were Latino. When compared to countywide census data
(2000) data, we see that African Americans are significantly over represented in the
chronically homeless population.
Lower education is a factor in homelessness. Homeless Encampment Data also
shows that 26% of the homeless do not have a high school diploma or equivalent—
compared to 13% countywide. 80% of these homeless individuals do not have a
college degree — compared to 57% countywide.
Of mental health clients served by Project Hope — a homeless outreach program,
85% reported substance abuse, 53% of whom reported abusing alcohol.
Older Adults
Older adults have complex factors contributing to and/or complicating mental illness.
Older adults become increasingly isolated in their homes. This can exacerbate
mental illness, and make it harder to find support or treatment. Declining health can
also exacerbate and/or mask mental illness. Declining health can lead to multiple
hospitalizations and or institutionalization. Repeated hospitalizations or
institutionalization can lead to loss of one's home. Additionally, the increased
number of medications taken by older adults can create behavioral disturbances that
are difficult to diagnose or treat.
Older adults are at increased risk of dementia — recognized as a physical/medical
problem rather than a mental illness. Because of this physical definition, it is treated
in medical settings and reimbursed as a medical event. But dementia is difficult to
differentiate from mental illness and mental health care is often not provided —even
24
MHSA Community Supports and Services Final Plan, December 2005
when co-occurring. To overcome this, physical and mental health diagnosis and
treatment need to be jointly provided.
Co-Occurring Developmental and Psychiatric Disabilities
In our focus group process, we learned more about the gap in services and limited
partnerships with agencies and organizations that provide services to the population
with the co-occurring issues of developmental and psychiatric disabilities. Experts
who participated in this focus group were quite clear regarding recent studies
showing the increased prevalence of mental disorders among the developmentally
disabled who also experience significant stigma, discrimination, and higher t'
frequency of trauma. The need to further explore the data and collaborate further a
a
with DD-focused organizations to develop culturally relevant services was raised.
LGBT Population
Lesbians, gays, bisexuals and transgender persons cross almost all age groups.
j Their characteristics and their needs are complex. Within this population, there are
many dynamics to consider when offering programming — such as the differing
mental health needs of ethnically specific LGBT communities and the complexity of
the issue of the "Down Low" dynamic where stigma affects the health of the general
community. The needs of the HIV/AIDS-infected LGBT consumer must also be
considered. In order to better,serve youth, focus groups suggested a greater
presence in the schools.
Section II. Analyzing Mental Health Needs in the Community
11.11.1. Estimates of Unserved Populations
Contra Costa Mental Health has developed a very rough estimate of the prevalence of
SMI and SED in the population using formulas developed by Dr. Charles Holzer and
used in the state of Georgia's Mental Health Gap Analysis.', These estimates are
included as Attachment 14. In order to estimate the numbers of unserved individuals,
numbers of consumers with open cases in July, 2004, are then subtracted from the
Holzer—based estimates.
While these prevalence estimates were helpful as a starting point in determining the
unserved population, there are serious limitations to these estimates. We know that
these figures underestimate the unserved population based on:
200% of Poverty Level -- Contra Costa County has a high cost of living, especially
for housing, and incomes are relatively higher to compensate for this high cost of
living. Basing the prevalence estimates on 200% of the federally designated poverty
level threshold is likely too conservative because many individuals and families earn
more than the 200% of poverty level but are still in need of publicly funded mental
h ttp://www.apshealthcare.comlpublicprogramslgeorgialerolgeorgia.htm
25
MHSA Community Supports and Services Final Plan, December 2005
health services. Using a 300% of poverty level criteria would have been more
realistic in this county.
2000 Census Data -- Prevalence estimates are derived from Census 2000 figures
and a general growth rate of 5.8% was applied to all groups, regardless of gender,
race, age, or income. In this county, as well as most counties in California, the
growth rate varies tremendously by sub-population. For example, the growth rate of
the Latino population is much higher than for most other groups, but this is not taken
into account in the adjusted prevalence estimates. Adjusting the prevalence
estimates for differential growth rates would have been more realistic in this county.
Household Surveys to Estimate Prevalence -- The prevalence estimates were
based on surveys of households from national surveys. A large number of
individuals, literally thousands, who are in need of services are not included in this
sample simply because they do not live in households. This includes the homeless
and institutionalized populations. Adjusting the prevalence estimates to include this
population would give a more realistic picture of the unserved population.
In any event, until better estimates are available, we based our unserved population on
the difference between the estimates provided by DMH and the actual cases in the
Contra Costa County Mental Health Plan, The MHSA planning efforts used this
information as a starting point and a point of reference, but not solely as the basis for
determining the unserved population.
Children through Age 17
Analysis of tables shows that just over half (52%) of the youth in the county estimated to
have SED are unserved. The younger the youth, the more likely he/she is to be
unserved —with 85% of the estimated 1,822 of 0-5 year-olds unserved and 7% of 12-17
year-olds unserved. These data include the lower end of the TAY population grouping.
Whites, Pacific Islanders and Native American have the lowest rates of unserved youth
(8%), 26% of Blacks/African American youth, 77% of Hispanic youth, and 84% of Asian
youth are unserved.
Transition Age Youth (18 and Older), Adults and Older Adults
As with youth, just over half(54%) of the adults in the county estimated to have SMI are
unserved. Older adults (65+) are most likely to be unserved (85% unserved) while 45-
54 year-olds appear to be the least unserved (7% unserved). The next largest
unserved groups are the youngest adults including transitional-age youth, with 72% of
18-20 year-olds and 71% of 21-24 year-olds estimated to be unserved.
Pacific Islanders, Native Americans and those of "Other" races, while very low in overall
estimated prevalence, appear to be fully served. Less than half of Whites and
Blacks/African Americans are unserved (44% and 39% respectively). The most
seriously unserved populations appear to be Asians (67% unserved) and Hispanics
(76% unserved).
26
YE
y
MHSA Community Supports and Services Final Plan, December 2005
11.11.2. Fully Served and Under/Inappropriately Served Populations
The tables below provide estimates of the number of people currently being served by
CCMH -whether they are being fully served or not-by age, race/ethnicity and gender.
These figures are then contrasted against county data. a
Chart A: Service Utilization by Race/Ethnicity
�.b
Underserved or
C.h1ldrenand Yauth Inappropriately County Poverty County
to�' ea1:8 Full Served Served Total Served Po ulation Population
MALE FEMALE MALE FEMALE # % # % # % ;
TOTAL 619 425 2477 1700 5221100.0% 63187100.0% 262706100.0%
RACE/ETHNICITY
` African American 209 143 834 573 1759 33.7% 14791 23.4% 29601 11.3%
5
Sian Pacific 3
Islander 24 17 97 67 205 3.9% 5492 8.7% 29832 11.4%
>t' Latino 1 131 901 525 3601 1106 21.2% 25082 39.7% 72809 27.7%
,Y Native American 4 3 18 121 37 0.7% 201 0.3% 1816 0.7%
White 226 155 904 620 190 36.i5%j 14224 22.5% 1153211 43.9%
b
Other 25 17 99 681 2091 4.0%1 33971 5.4% 133271 5.1%
Underserved or County
x 'ATlAciultst ' Inappropriately Poverty County
A e41 1€ X59 .
Fully Served Served Total Served Po ulation Population
i¢ MALE FEMALE MALE FEMALE # % # % # %
100.0% 100.0%
TOTA 957 894 15420 5064 12334 100.0% 89808 598758
u RACE/ETHNICITY
frica American 216 202 1223 1143 2784 22.6% 14576 16.2% 54940 9.2%
Wan Pacific
Islander 46 43 259 242 590 4.8% 9288 10.3% 83754 14.0%
Latino 137 128 779728 1773. 14.4% 25417 28.3% 126373 21.1
Native American 7 6 38 135 86 0.7% 453 0.5% 4485 0.7% '
hite 1492 460 12788 12605 16344 51.4% 36176 40.3% 1316507 52.9%
Other 159 55 1333 1311 757 6.1% 3898 4.3% 112699 2.1
�M
ij
f
y
27 y:
$1
v
;..rt .. r -� • � . 4ti�4;{.'N a.o n �3�R}
x F s
MHSA Community Supports and Services Final Plan, December 2005
r Underserved or
OlderAdult
Inappropriately Count y PovertCount
.Fy A`eCl 6Q+`t Full Served Served Total Served Population Population
MALE FEMALE MALE FEMALE # % # % # %
TOTAL 45 77 253 436 811 100.0% 31554 100.00157202100.0%
RACE/ETHNICITY
African American 7 12 40 69 129 15.9% 5121 16.2% 11461 7.3%
Sian Pacific
Islander 4 8 25 43 79 9.7% 3263 10.3% 18127 11.5%
Latino 5 9 29 50 92 11.3% 8930 28.3% 13321 8.5%
Native American 0 1 2 3 6 0.7% 159 0.5% 860 0.5%
.White 241 42 1381 238 443 54.6% 12711 4.3% 111548 71.0%
Other 1 31 61 191 3362 7.6% 1370 4.3% 188 1.2%
11.11.3. Ethnic Disparities in the Fully Served, Underserved/Inappropriately Served
Populations
Ethnic Disparities in All Four Age Groupings
The data provided in these charts is consistent with our analysis of unserved
populations discussed by age group in Section 1.1.3 above. In summary, we can see
that in comparison with the low-income population in the county—which is the
population most heavily served by CCMH, Latinos are consistently the most significantly
underserved population across age groups. Asians are the second most under
represented group. Many unserved individuals are monolingual Spanish speaking.
11.11.4. Objectives Related to Need For/Provision Of Culturally and Linguistically
Competent Services
The extensive outreach and data collection effort conducted as part of this MHSA
planning process identified a number of specific barriers to care in Contra Costa County
including some related to cultural and linguistic competencies. Related barriers were
identified as:
1. Not enough linguistically and/or culturally/ethnically diverse staff
2. Not enough culturally appropriate/culturally specific services and interventions
3. Lack of integration of mental health outreach and services with existing ethnic
communities, agencies and faith-based organizations
4. Difficult location of services — often far from lower income, ethnically diverse
neighborhoods.
5. Lack of culturally/linguistically based outreach efforts
6. Lack of staff trained to be sensitive to different cultures
The Contra Costa County Mental Health Division's Updated Cultural Competence Plan
(3/2004) also identifies many of these same barriers and has already established, as its
own goals, to:
28
MHSA Community Supports and Services Final Plan, December 2005
1. Improve linguistic access
2. Implement training and related activities on cultural and linguistic competence
and diversity, which will foster broad organizational growth and change
3. Further develop an organizational climate that values consumer, family and
-
employee diversity and addresses health disparities
Specific objectives addressing cultural/linguistic competency to be embedded in all
MHSA programs will mirror the goals of our Cultural Competency Plan and focus on the
direct service activities of outreach and engagement, as well as service delivery. Our
MHSA objectives are: f
To hire linguistically and culturally diverse staff whenever possible;
1. To focus outreach efforts on traditionally unserved and underserved ethnic
w communities in a culturally and linguistically competent manner;
2. To collaborate widely with community-based organizations that provide
services to primarily ethnically and racially diverse populations;
f 3. To geographically locate efforts in the communities being served whenever
possible; and
4. To remain informed and open to culturally specific treatment modalities that
F
address the needs of diverse consumers and families.
is
1 Section III. Initial Populations for Full Service Partnerships
j
111.1. Identification of Populations for Full Service Partnerships
Community stakeholder groups reviewed input from demographic analyses of the
county, community forums, focus groups and surveys. Using these data as well as the
great expertise that they brought to the table, the groups arrived at clear definitions of
Initial Populations for Full Service Partnerships.
Following this process, the MHSA Planning Team (described in Section 1.1.2 above) met
in two, full-day retreats and follow-up workgroups to plan how to operationalize services
to the FSP target populations identified by Stakeholders. This planning resulted in the
selection of geographic target areas for each FSP program except Older Adults (see
explanation below) and a 3-year start-up service plan.
Clearly defined geographic targeting in the start-up phase of each FSP was decided
upon because of the extensive size of the county, the level of funding for CSS, as well
as the extremely varied populations and service availability from area to area of the
county. Contra Costa County commonly uses this regional model for service planning
and delivery (East, West and Central County). The MHSA Planning Team envisions
that all new Full Service Partnerships and all new services will be expanded to serve all
regions of the county in the future.
Criteria for selection of geographic target areas for FSP start-up included
29
MHSA Community Supports and Services Final Plan, December 2005
• High need for services
Low availability of mental health services
Availability of at least some necessary related community-based services to
facilitate development of a network for community supports
Based on Stakeholder and MHSA Planning Team recommendations, the groups
selected to be fully served in the first three years are:
Children in Far East County (Brentwood, Discovery Bay, Knightsen, Bethel Island,
Oakley, and Byron)
The Stakeholder Planning Group selected: Unserved children, 0-18 years of age,
who have a history of repeated failure in learning environments including
home, childcare, preschool and school and who are from families who are at
or below 300% of the poverty level and not eligible for other funding sources.
Priority within this population is to be given to those children who show one or more
of the following risk factors:
• Multiple foster care or family caregiver placements
• Limited English proficiency
• High-risk parents or community
• Populations whose cultural differences have historically precluded them from
MH services
• Out-of-norm trauma
• Substance abuse
• Experience with the juvenile justice system
• PES visits
Far East County was selected for initial implementation because there are currently
no comprehensive mental health-focused care management and support services
for this population based in that area (besides home visits) and travel to the nearest
County operated service site, other than health care, can take up to one hour. This
area is culturally diverse with a large number of Spanish-speaking community
members. Additionally, it is the fastest growing area of Contra Costa County and will
double in population over the next seven to ten years. A comprehensive service
infrastructure is badly needed.
Transition Age Youth in West County (All area west of Martinez. Includes cities of
Richmond, San Pablo, EI Cerrito, Pinole, Hercules and Rodeo)
Transition age youth, 16-25 years of age, with serious emotional disturbance
or serious and persistent mental illness, who are homeless or at imminent risk
of homelessness.
30
MHSA Community Supports and Services Final Plan, December 2005
While the Stakeholder Planning Group did not specify sub-criteria for prioritizing
selection of participants, they did acknowledge that the system supports and
services required to fully serve this population must have the ability to address the
high likelihood of the following risk factors and conditions within the population:
Dual diagnoses
Psychoses
• Exposure to violence (community, domestic)
Under-educated
• Immigrant status
Non-English speaking
. LGBT
• In the juvenile justice system
• Living with parents who are seriously mentally ill
• Jobless
History of 5150s
In, or has been in, foster care system
• Unable to get appropriate medications
West County was selected as the initial geographic target area because of the
extreme need and extreme shortage of targeted services for TAY in this area. 47%
of the county's homeless population is located in or near Richmond. While there is
much to be done to build a system of supports and services in West County for this
population, it was agreed felt that a baseline of existing.services was available.
Adults in West County (All area west of Martinez. Includes cities of Richmond,
San Pablo, EI Cerrito, Pinole, Hercules and Rodeo)
The Adults Stakeholder Planning Group selected Adults with serious and
persistent mental illnesses who are homeless without shelter as its FSP. The
Board of Supervisors later added: `or those at serious risk of homelessness."
Stakeholders further emphasized that FSPs should be countywide and culturally
diverse, and that every effort should be made to treat homeless families as a unit
without breaking them up. Additional risk factors, which may be taken into account
to help prioritize who will receive FSP services, were identified as:
Alcohol and other drug abuse and dependency
Serious medical issues
Limited English proficiency
• History of incarceration or institutionalization
As with the TAY Group, West County was selected as the initial geographic target
area because of the extreme need and extreme shortage of targeted services for
adults in this area. It was also recognized that, while TAY have vastly different
needs for services and supports than Adults, some activities could be conducted
jointly for the two population groups. For example, both groups would require an
31
MHSA Community Supports and Services Final Plan, December 2005
intense focus on development of new (although separate) emergency, transitional
and long term housing options.
Older Adults Countywide for Systems Development Effort in Years 1-3
The Older Adult Stakeholder Planning Group identified its potential Full Service
Population as: Seriously disabled consumers, 60 years of age and up, from
unserved ethnic populations in the county who are living in the community
without adequate supports and resources (including inadequate insurance).
They further stated that serious disability is characterized as having complex
presentations, e.g., a serious mental illness with other factors such as serious
medical problems.
The MHSA Planning Team, however, found that this target population was not a
strong group for early implementation of FSP because:
1) This is a hidden population and their geographic distribution in the county is not
known (yet), and
2) There are almost no supports and services in the community around which to
build an FSP.
Rather, the MHSA Planning Team identified a critical set of supports and services
that need to be developed countywide to begin to identify this highly isolated
population and to begin to provide supports to them. Additionally, with consideration
being given to adding 20,000-30,000 aged, blind or disabled MediCal beneficiaries
to the Contra Costa Health Plan through the Acute & Long Term Care Integration
Project (ALTCI), the number of older adults entering the county's system of care
could rise dramatically.
It was agreed that the initial years would be spent developing this core set of
community outreach, supports and services, identifying these isolated elders and
their situational characteristics, and beginning to meet some of their needs. By Year
5 or 6 of the MHSA, Contra Costa would be ready to implement a Full Service
Partnership for this population.
Systems Development Activities for Older Adults are described more fully in Exhibit
4 of this Plan. Teams of Outreach workers, therapists, geropsychiatrists and nurses
will be based in existing county primary care clinics for greater coordination with
medical care. They will reach out into the differing communities through contracts
with community-based agencies who naturally serve those communities.
Assessment and care coordination services will be provided.
Additionally, the group recognized that an occasional Older Adult would be
homeless and could need immediate and intense supports and services. In these
few instances, in these few start-up years, these Older Adults could be included in
32
MHSA Community Supports and Services Final Plan, December 2005
the Adult Full Service Partnership for housing supports and 24-hour access but
would be managed on a daily basis by the Older Adult Team.
t
111.2. Factors Considered in Selection of Initial Populations
The factors that were considered and criteria established that led to selection of the
initial three populations for the first three years are clearly stated in Section 111.1. above.
To reiterate here:
Each Stakeholder Planning Group reviewed needs and demographic data about the
target age group they were examining. They established definitions for their FSPs and
most included additional situational characteristics to consider when prioritizing services
within their populations group, or to consider when developing services for their
population group.
The MHSA Planning Team then considered geographic targets for start-up FSPs for
each age group. This was done with the clear recognition that the ultimate goal is to
expand the availability of FSP to all areas of the county.
Criteria for selection of initial geographic targets for FSPs were:
• High need for services
• Low availability of services
• Availability of at least some necessary related community-based services to
facilitate development of a network for community supports
After much review, development of an FSP for Older Adults was postponed until a
future year in order to spend the time developing core outreach, identification, and
service elements countywide.
111.3. Reduction of Ethnic Disparities
M
As stated earlier, Latinos and Asians are consistently underrepresented in the CCMH
service population. Latinos and African Americans are consistently over represented in
the Homeless population, as well as those in foster care and the criminal justice system
—whose service needs are disproportionately high.
Each of the initial FSP populations will be focusing on culturally and linguistically
competent outreach and services for communities of color— especially Latinos and
Asians. Within Asian populations, we will be emphasizing Filipinos and Laotians.
Reducing the mental health service disparity will be achieved through culturally
competent outreach that is embedded within the communities we are seeking to serve,
increased cultural and,linguistic capabilities among provider staff through targeted
hiring, and increased training to all staff on issues of stigma and cultural competency.
33
MHSA Community Supports and Services Final Plan, December 2005
Additionally, the existing Mental Health Disparities Work Group, working with the
Consumer Involvement Steering Committee, including community-based organizations
that serve diverse communities, will be designing a workplan for each of the three
regions of Contra Costa County that focused on involvement/engagement of grass roots
community leaders, natural healers, and community-based organizations in ethnically
and culturally diverse populations. The goal will be to identify cultural brokers within the
communities that could become active participants of the Mental Health Disparities
Work Group. This group will then take on a more active role in establishing themselves
as an advisory forum to help inform on the needs of these populations.
With these groups, quarterly roundtable discussion that are ethnically and culturally
appropriate in their presentation would take place in each region of the county—
continuing the concept of Community Forums begun as part of the MHSA planning
process. Mental Health Cultural Brokers from these regions would facilitate the
roundtable discussions in partnership with a staff representative from the Disparities
Work Group. These roundtable discussion will aid in the continual analysis of the
community health needs of ethnically and culturally diverse populations, trust could be
further established, and there would be a direct venue where feedback and ideas could
be exchanged.
Section IV. Program Strategies
All key strategies selected for implementation with MHSA funs are listed by the State as
�1 accepted strategies. These strategies are summarized in Exhibit 4 (Program Work Plan
Summary) and listed in more detail in Program Narratives.
Section V. Service Provider Capacity
V.I. Organization and Service Provider Strengths and Limitations to Meet the
Needs of Racially and Ethnically Diverse Populations
V.2. Direct Service Provider Strengths and Limitations to Meet the Needs of
Racially and Ethnically Diverse Populations
Contra Costa's organizational and service provider assessment, done as part of its Plan
for Culturally Competent Specialty Mental Health Services. An analysis of those data
for both all staff and providers exclusively includes:
Race/Ethnicity
County Mental Health Division Staff
County staff are quite diverse with 43% of all staff identifying as non-White. There
are proportionately more Asian/Pacific Islander and White staff relative to the
population served, and proportionately fewer Hispanic and African American staff
relative to the population served. A similar patter holds true when looking at only
direct service staff.
34
i
MHSA Community Supports and Services Final Plan, December 2005
Race/Ethnicity of Population and County Staff
Likely to Open
Need Cases
Services July,2004 All Staff Direct Staff Interpreters
n=16.373 n=7855 n=385 n=239 N=36
Hispanic 32% 16% 12% 11% 69%
Asian/PI 9% 6% 10% 11% 8%
1 Black 18% 25% 19% 18% 6%
White 36% 47% 57% 59% 17%
Native American <1% 1% 0% 0% 0
Mixed/Other 5% 5% 2% 1% 0
1 '
The difference between staff race/ethnicity and the population likely to need services
is much more dramatic. Using the Holzer Model (see earlier footnote), we can see
that Latinos/Hispanics are highly underrepresented among staff(11% of direct staff
compared to 32% of the population likely to need services). Staffing is comparable
to the "likely to need" population for Blacks and is slightly higher for Asian/Pacific
K Islanders. There is a much higher rate of Whites among direct staff than in the
"likely to need" population (59% compared to 36%).
Contractors
The ethnicity of staff at contracting provider organizations is similar to county staff.
Again, there is over representation of Asian/Pacific Islander and White staff relative
to the population served, and there is an under representation of Latino/Hispanic
and African American staff. This pattern holds for direct service staff as well.
Looking at direct service staff, we see again that there is higher representation of
Whites and Asians among staff when compared to the client population and the
"likely to need services" population, and lower representation of Blacks and
Hispanics among staff.
35
MHSA Community Supports and Services Final Plan, December 2005
Race/Ethnicity of Population and Contracting Staff2
Likely to Need Open Cases July,
Services 2004 All Staff Direct Staff
n=16.373 N=7855 N=1755 N=1285
Hispanic 32% 16% 12% 12%
sian/PI 9% 6% 10% 9%
Black 18% 25% 16% 14%
White 36% 47% 58% 61%
Native American <1% 1% <1% <1%
Mixed/Other/NA 5% 5% 4%u 4%
Language Capacity
County Mental Health Division Staff
Mental Health Division staff have a relatively extensive language capacity,
particularly among direct service and support staff however some adjustments are
needed to match the population. 109 staff or approximately 25% of all staff speak
some other language in addition to English. 72 of these staff are direct service staff.
The dominant non-English language spoken by county staff is Spanish — a threshold
language in Contra Costa County. This is followed by Tagalog, Farsi, and Chinese.
62 staff and 38 direct service staff speak Spanish. 9 staff(5 direct service) speak a
Filipino dialect. To the gaps in linguistic capacity, a variety of interpreter services
are utilized by CCMH including Cyracom, California Translation International (CTI),
and EDI. While it is more ideal and certainly the objective of CCMH to have
linguistic capacity of staff match the needs of the consumer population, virtually any
linguistic need can be met using these resources (Attachment 16, Interpreter
Services Utilization). Interpreter services are primarily Spanish and ASL (American
Sign Language) at present. The number of interpreters available to CCMH is due to
increase through the efforts of the Department of Health Disparities Committee.
Unfortunately, the population data necessary to conduct a Holzer-based analysis of
unserved populations is not available by language spoken. While MHSA services
will not be limited to those who are MediCal eligible, we do have MediCal eligibility
data available by language and it does provide a starting point for an analysis of the
unserved by language. At best, however, this will undercount the unserved
population and will skew is slightly as we know that the Spanish speaking population
is overrepresented in the MediCal population.
If we use an average rate of 9% of the low income MediCal population in the county
as "likely to need mental health services (Holzer report), and apply it to groups
speaking the more prominent languages, we see the following:
Z Note: Data from contracting providers is based on less than a 100%survey response,so particular groups may be
over-or under-represented.
36
MHSA Community Supports and Services Final Plan, December 2005
Languages Spoken by Population, Staff and Interpreters
Likely to Need MediCal Eligible
Services 2004 All Staff Direct Staff Interpreters
n=4.094 n=109 n=72 n=37
Spanish 57% 82% 57% 53% 92%
Farsi 1% 2% 3% 4% 3%
Vietnamese 2% 4% 1% 1% 3%
Chinese Langs. 1% NA 3% 4% 0%
Lao 1% 2% 1% 0% 3%
Filipino Dialect NA 0% 8% 7% 0%
Other 37% 8% 28% 31% 0%
The large proportion of clients whose language is unknown makes these data difficult to
interpret. However, we can see that while there is a reasonable distribution of staff who
speak non-English languages, the sheer numbers of staff speaking those languages is
probably low in relation to the population likely to need services.
Contractors
Mental Health Contractors also have a diverse language capacity. Again, however,
some adjustments are needed to match the population. Among contracting agencies
who responded to an annual survey , 61 staff speak some language other than English.
21 of these staff are direct service staff. Again, the large number of Other/Unknown
entries make the data difficult to analyze. However, the dominant non-English language
spoken by contractors is Spanish, followed by Chinese and Lao.
Again, it is important to remember that this analysis is based on the MediCal population
and certainly undercounts the unserved population slightly and over represents the
Spanish Speaking population.
Languages Spoken by Population and Contracting Staff 2
Likely to Need Services MediCal Eligible 2004 All Staff Direct Staff
n=4.094 n=61 n=21
Spanish 57% 82% 46% 14%
Farsi 1% 2% 2% 5%
Vietnamese 2% 4% 1% 0%
Chinese Langs. 1% 2% 13% 19%
Lao 1% 2% 10% 14%
Filipino Dialect NA NA 3% 10%
Other 37% 8% 25% 38%
2 Note: Data from contracting providers is based on less than a 100%survey response,so particular groups may be
over-or.under-represented.
37
MHSA Community Supports and Services Final Plan, December 2005
While there is much work to be done in the area of building language capacity, the
range and depth of contractor's language capacities is impressive.
All Contracting Staff - Non-English Languages
Spoken (n=326)
Korean Italian
2%(n=6) Urdu French ,
2%(n=6) Bosnian 1%{n=3) 1/o(n=3)
Punjabi 1%(n=4)
2%(n=8) Tongan
1%(n=2)
Japanese 0%ASL 3 )
2%(n=8)
W
3%Mn n10) 4 f Spanish
Hindi ° 50%(n=159)
3%(n=11) to �
k �
Cantonese
5%(n=15) Russian
Vietnamese
5%(n=16) 22%(73)
QContracting
Clinial Staff- Non-English Languages Spoken (n=190)
French Mian
Farsi 2%(nom)
Punja ° n=4) Urdu 1%(n=2) Tongan
Korean 3%(n= ) (n=4) 1%(n=2)
3%(n=5) Telegu
Vietnamese 1%(n=2)
Fendi 3%(n=6) of
Japanese Spanish
4%(n=8)
58%(n=111)
Russian ''
5%(n=10)
Men
5%(n=10) Cantonese Bosnian
5%(n=10) 1%(n=2)
38
MHSA Community Supports and Services Final Plan, December 2005 '
V.3. System Barriers to Implementing Plan
Hiring
The most notable and ongoing systemic barrier to implementing the MHSA Plan will be
in finding and hiring culturally appropriate staff with the right training and experience to
v
fill the jobs available. This includes consumers and family members. Ideally, we would
improve our diversity at all levels — including among psychiatrists, counselors, nurses
and other professional staff as well as among paraprofessional positions. This is an
ongoing challenge that requires not only strong recruitment efforts, but a long term
workforce development plan.
CCMH will address these issues by setting multilingual hiring as a priority and
conducting wide recruitment efforts. CCMH will reach out to local community agencies
in ethnic communities for assistance in recruitment, and by participating in MHSA-led
and other efforts at workforce development at the State and regional level. CCMH will
also contract with community based agencies serving non-English speaking
communities to provide some services directly.
Additionally, CCMH is working with the Bay Area Mental Health Education Workforce
Collaborative, a project of the Bay Area Mental Health Directors, that is focusing on
promoting wellness, rehabilitation, and recovery-oriented principles and strategies that
increase the diversity, cultural competence, and skills and knowledge of the public
mental health workforce. Membership includes leaders from Bay Area secondary and
post-secondary educational institutions, public mental health departments, community-
based organizations, consumer and family groups, and California state agencies. This
group will be developing region-wide initiatives to achieve its goals.
Retaining Linguistically Diverse Staff
CCMH has made great strides in recent years to increase the language capacities of its
staff, however, when reductions in workforce occur— as they have in the past two years
—these new multi-lingual staff have the lowest seniority and are the first to be laid off.
Much ground is lost when this occurs. CCMH can deal with this, in part, by assuring
continuity of MHSA funds to its new projects.
Housing
Our next challenge is to develop the amount and types of housing needed to fully serve
our population. Our Plan recognizes that it is difficult to engage individuals in a
meaningful recovery process if they are homeless. Provision of housing -- crisis,
transitional and long term — is a core element of our programs for transitional age youth
and adults with the recognition that children, families and older adults will have housing
needs as well. Development of enough housing to meet the needs of all FSP clients will
take time — even with the availability of MHSA funds.
CCMH has recognized this barrier and has taken several steps to address it. First,
CCMH is already actively working with the county's homeless programs (following the
10 Year Plan to End Homelessness) and others to find opportunities to create
39
MHSA Community Supports and Services Final Plan, December 2005
partnerships and to leverage new funds for housing with MHSA dollars. Secondly, in
the short term, CCMH is allocating substantial MHSA funds for rent vouchers for market
rate apartments for clients needing transitional and long-term housing.
One future component of MHSA includes Capital Support that will include dollars for
housing development. DMH has contracted with the Corporation for Supportive
Housing to provide technical assistance to counties in the next few years for
development of this component of MRSA. No funds have been allocated in this
category yet.
Transportation Infrastructure
Transportation is a critical barrier to care in Contra Costa County. The County is very
large and still partially rural. Even within the three service areas of the county (East,
West, Central County), travel time to established mental health services can be up to
one hour. Many low-income residents of the county, including many mental health
consumers, do not have cars. Some cannot afford bus fare. And many do not have the
understanding of the public transit system required to get to services. For those who
have the capacity to take mass transit, some critical buses run only once an hour—
making the trip for even the briefest medical appointment a half-day activity.
CCMH will address this critical barrier by expanding its own internal transportation
support systems and those of its subcontractors. We have budgeted for bus and taxi
vouchers to help get clients to care and community services, and will expand the
system of cars, vans and drivers to transport consumers in Full Service Partnerships.
Drivers of cars and vans, who may be peers, will also serve as client advocates and
translators — assisting consumers at their travel destination with support and assistance
in accessing the desired services.
As part of its MHSA planning process, CCMH is also establishing a planning process to
assess other ways to improve the transportation infrastructure for consumers.
Service Capacity in Fast-Growing Areas if the County
Some areas of the county— such as Far East County— are not only remote, but growing
more rapidly than new services can be developed. Travel time to existing services can
be long and this provided a barrier to accessing care. As mentioned above, the
transportation infrastructure to this area is also not fully developed.
CCMH will address this critical barrier by introducing new services to remote areas.
Most notably, the Children's Full Service Partnership will be located in the remote Far
East Area of the County. It is envisioned that other FSPs will be expanded to this
region in the next 4-7 years.
40
MHSA Community Supports and Services Final Plan, December, 2005
Section VI. Workplans and Timeframes
VI.I. Summary of Programs to be Developed or Expanded
VI.1.1: Exhibits 1,2, & 3
{
Exhibit 1 is provided as the first page to this Plan.
Exhibits 2 & 3, which summarize key information on all programs proposed for funding,
are included within this section.
i
VI.1.2. System Development or Outreach & Engagement Funding Applied Toward
Requirement for Majority Of Funds to FSP
Funds for Full Service Partnerships make 77% of all dollars to be spent as part of this }
plan. .This was calculated from figures in Exhibit 2. The formula for calculation is: 100%
of FSP + 40% of Outreach. No Systems Development funds have been applied toward
the FSP figure — as they have already been allocated to FSP if any portion of the
positions or resources are to serve FSPs.
V.1.3. Estimated Number of Individual Expected to Receive Services Through
System Development Funds in the First Three Years and Number Who Will
Be FSP Each Year
Estimates for services with Systems Development funds are difficult to make. Capacity
to serve non-FSP consumers is achieve by either: 1) The excess capacity of staff
dedicated to FSPs — such as psychiatrists, family and peer advocates or transportation .
aides, or 2) Systems Development funds dedicated toward non-FSPs such as Older
Adults, Consumers in the SPIRIT Training Program and individuals served by Family
Partners and Benefits Counselors.
However, the following estimates have been made:
Yrl Yr2 Yr3 Total
Consumers Served w/ SD Funds 45 490 540 1250
It is important to remember that other than case managed Older Adults, individuals
served with System Development funds will be receiving limited support.
Any Systems Development funds that would be used to serve FSPs have already been
allocated as FSP funds. None of the dollars used to serve FSPs are considered here.
41
MRSA Community Supports and Services Final Plan, December, 2005
VI.1.4. Estimated Unduplicated Count of Individuals Expected to Be Reached
Through Outreach and Engagement Strategies and Number Who Will Be
FSP Each Year
We have estimated that about 40% of individuals reached through outreach and
engagement efforts proposed in this Plan will become Full Service Partners. The
remaining 60% will either not be eligible, will not choose to be an FSP, or the FSP
enrollment may be at capacity. Our estimates include:
Yr1 Yr2 Yr3 Total
Outreach & Engagement— FSP (40%) 65 230 385 680
Outreach & Engagement— Non-FSP (60%) 98 345 577 1.020
163 575 962 1,700
Of those who are reached through Outreach and Engagement who do not become
FSPs, at least 50 in the third year will be case managed Older Adults. Additionally,
some of those reached may already be in the system (but underserved) or may decline
to enter the system of care. Every effort will be made, however, to assist all non-FSPs
to get the supports and services that they want or need.
VI.1.5. Wraparound
Contra Costa County Mental Health currently has a wrap around program for children
and families that meet the requirements of W&I Code Sections 18250-18252. This
program has technically been available to residents of Far East County but few referrals
to the wrap around program have come from Far East County. A large factor in this is
the area's geographic isolation. While some wraparound services are available in-
home, many are not and travel is required. Far East County is an isolated area east of
Highway 160, and drives to clinics and services — even within the East County region —
can be up to one hour. Public transportation is also weak. Participation on facility-
based services is often not practical.
Program ASSIST, to be newly developed and fully supported with MHSA funds, will be
geographically located in Far East County with multiple referral sources and multiple
access points within the Far East region. While providing crisis stabilization, 24-hour
availability, blended and bilingual staff, peer support, advocacy and transportation
assistance, the program will also link with the existing wrap around services.
42
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MHSA Community Supports and Services Final Plan, December 2005
Fv XF�IB�IT 3. =aFUMSEA .[GF, MR,TJNERSHIP &GPULATION—OUERYIEW .
A
i' Number of individuals to be fully served:
FY 2005-06:. Children and Youth: 15 Transition Age Youth: 20 Adult: 30 Older Adult: 0 TOTAL: 65
FY 2006-07: Children and Youth: 65 Transition Age Youth: 65 Adult:_100 Older Adult: 0 TOTAL: 230
'4 FY 2007-08: Children and Youth: 100 Transition Age Youth 135 Adult: 150 Older Adult: 0 TOTAL:385
PE CEN7'•OF'INDIVDU�LLfS„"O'" E:t=tJ�L,YSERYED� '”
% Unserved served
`« ° Nlal ' mlei
°/ONon-fl %NOn- % %NOn- %Non-
Race/Ethnicity %Total English %Total English Total English. Total English %TOTAL
Speaking Speaking Speaking Speaking
2005/061
y.
%African 22% 3% 19% 5% 28% 5% 28% 5% a
American
%Asian Pacific 23% 40% 22% 40% 25% 40% 25% 40% _
,.0 Islander
% Latino 20% 40% 22% 40% 15% 40% 15% 40%
% Native 1% 0% 1% 0% 1% 0% 1% 0%
American
S,
%White 27% 15% 29% 15% 22% 15% 22% 15%
%Other 7% ' 30% 7% 30% 10% 30% 10% 30%
Total Population 100% ---- 100% ---- 100% ---- 100% ----
2006107
`^ %African 22% 5% 19% 5% 28% 5% 28% 5% _
j American
%Asian Pacific 23% 40% 22% 40% 25% 40% 25% 40% '
Islander
% Latino 20% 40% 22% 40% 15% 40% 15% 40%
% Native 1% 0% 1% 0% 1% 0% 1% 0% y
American
%White 27% 15% 29% 15% 22% 15% 22% 15%
%Other 7% 30% ' 7% 30% 10% 30% 10% 30%
' Total Population 100% — 100% ---- 100% ---- 100% ----
2007/08
---
00 0•
%African 22% 5% 19% 5% 28% 5% 28% 5% q
American
%Asian Pacific 24% 40% 23% 40% 26% 40% 26% 40%
Islander
% Latino 25% 40% 27% 40% 20% 40% 20% 40%
' % Native 1% 0% 1% 0% 1% 0% 1% 0% �
American
%White 22% 15% 24% 15% 16% 15% 16% 15%
% Other 6% 30% 6% 30% 9% 30% 9% 30%
,y
Total Population 100% ---- 100% ---- 100% ---- 100% ----
.t
46
v .
MHSA Community Supports and Services Final Plan, December 2005
VI.II. Programs to be Developed or Expanded
This Section includes:
• Exhibits 4, 5a, and 5b and budget narratives included with a narrative description for
each new program sequentially through the body of this Section
• Exhibit 5c—Administrative Budget—with a budget narrative is included on pages
179 - 187 of this Section.
• A note on justification for unspent funds is included on page 188.
• Exhibit 6 is found on pages 189 - 191.
• Exhibit 7 is found on page 193.
Co
0
47
MHSA Community Supports and Services Final Plan, December 2005
wo :,.n ab .wga.wF..„aww,cra�. 'Yn�ww.ssra rc-•ag..««w^ �. = ray... n wamx.ww.3aum=-31'.c a*a+rgn.^� .,g"E` 5;.e v
�E°C " IBI 4 CQM U'NIT1f SE VICE D S#JP O Tµ
WN-0,9X�1N
Ca E nty: Contra.Costa� �isc�l =rog" m Werk Plan dame. P��ojeci A��°S`ST
Pta ra , W orkPlar► #, 1 Esti atedSta Qat f1 til 260.6
Description of The Active Community Supports & Service Team (ACSST-
Program: pronounced "ASSIST") Project advances the goals of MHSA
through creation of new supports and services to improve
resilience for children with emphasis on access,
consumer/family involvement, a personalized/age specific
support plan for each child/family, strong cultural and linguistic
competence, strong community partnerships, and peer-led
services. This will be accomplished through creation of two 24-
hour/7 day a week service teams in Far East County. These
interagency, interdisciplinary, ethnically diverse community
response teams will provide crisis stabilization, short-term case
planning and problem resolution, family resource development,
community linkages and advocacy, educational linkages and
advocacy, and long term case management. Innovative
elements include blended teams comprised of CBO and
County staff, utilization of transportation aides for family
support, an increase in the availability of peer family support,
the incorporation of teen peer mentors as support staff, and the
requirement that staff form a multicultural, multilingual team.
Priority Population: Unserved children 0-18 years of age with a history of repeated
failure in learning environments including home, childcare,
preschool and school and who are from families at or below
300% of the poverty level and not eligible for other funding
sources. Priority within this population will go to those with one
or more of the risk factors of: Multiple foster care or family
caregiver placements, limited English proficiency, high risk
parents or community, populations whose cultural differences
have traditionally excluded them from MH services, out-of-
norm trauma, substance abuse, experience with the juvenile
justice system, and or PES visits. The target population is
culturally diverse and a large number are Spanish-speaking.
Fund Type Age Group
Sys
•- Groups . .be Served FSP Dev OE CY TAY A OA
Cultural and ender-sensitive outreach ❑ ❑ ® ® ❑ ❑ ❑
Services located in racial/ethnic communities ® ❑ ❑ ® ❑ ❑ ❑
with linkages to full range of supports
Integrated services and supports for those with ® ® ❑ ® ❑ ❑ ❑
co-occurringmental health/SA disorders
Services and supports provided at school, in ® ❑ ❑ ® ❑ ❑ ❑
the communityand at home
Youth peer mentoring ® ❑ ❑ ® ❑ ❑ ❑
Transportation ® ❑ ❑ ® ❑ ❑ ❑
48
MHSA Community Supports and Services Final Plan, December 2005
Program 1: Children
VI.11.2. Program Description
The Active Community Supports and Service Team (ACSST--pronounced ASSIST)
Project advances the goals of MHSA through creation of new supports and services
aimed at improving resilience for children with emphasis on access, consumer/family
involvement, a personalized and age specific support plan for each child and family,
strong cultural and linguistic competence, strong community partnerships, and peer-led
services.
This will be accomplished through creation of two regionally-based, 24 hour/7 day a
week Active Community Supports and Services Teams in Far East County which
includes the towns of Brentwood, Discovery Bay, Knightsen, Bethel Island, Oakley and
Byron. The area is best defined as being east of Highway 160.
These interagency, interdisciplinary, ethnically diverse community response teams will
provide crisis stabilization, short-term case planning and problem resolution, family
resource development, community linkages and advocacy, coordination of services,
educational linkages and advocacy, and long term case management. Innovative
elements layered onto this enhanced "wraparound" approach include blended teams
comprised of CBO and County staff, utilization of transportation aides for family support,
an increase in the availability of peer family support, the incorporation of teen peer
mentors as support staff, and the requirement that staff form a multicultural, multilingual
team. Additionally, an array of providers serving as resources will be formally linked to
the ACCST Team including a co-occurring disorders specialist, and a family law
specialist.
Outreach for this Program will be conducted by the Program Supervisor, community-
based contractors, Parent Partners and youth peer mentors. It will be bilingual and bi-
cultural in nature. Training will be provided.
Establishment of an infrastructure for service delivery and expanded referral and
collaborative relationships is especially important in Far East County because of its
rapid growth. With population growth greater than 200% between 1990 and 2004 in
some communities, and continued growth between 2004 and 2009 projected to be as
high as 15% in some areas, more capacity to serve families is clearly needed. Data on
school districts, provided by the California Dept. of Education, verify this growth with
actual increased enrollment between the 2000/2001 school year and the 2004/2005
school year rising to as high as 53% in Brentwood and 143% in Knightsen.
Extensive leadership and outreach is needed to help develop the system of community-
based supports and services. In some instances, outreach will also be conducted to
culturally-based and/or child-serving community-based agencies in other areas of the
county who may be.able to establish themselves in Far East County. The Program will
49
4
t.
MHSA Community Supports and Services Final Plan, December 2005
also develop a "community roundtable" of child-serving agencies in order to enhance
communication, coordination and referrals among them.
1
VI.11.3. Housing and Employment Services in this Program
At present, no new employment services are envisioned for this program. Rather, the
Community Supports and Service Teams will identify and refer families to existing
services as needed. Existing services include the Regional Occupational Program and
the Department of EDD on the other side of East County as well as community-based
services in Central and West County. The transportation and advocacy elements of this
program will help to make those referrals successful.
Funds have been included in the Housing Program budget to allow for some housing
vouchers for Project ACSST Families. Additionally, it is anticipated that housing that is
coordinated and/or developed under other MRSA-funded programs (see: Housing
Program) will result in increased availability of short term and transitional housing and/or
voucher programs for families—including families involved in Project ACSST. Existing
referral sources will also be used.
VI.11.4 Cost Per FSP Participant
The MHSA cost per FSP participant during the first three years of this program is
approximately $22,500. This includes an allocated portion of outreach and engagement
costs. Since the Children's Stakeholder Planning Group specifically targeted children
who are from families who are at or below 300% of the poverty level and not eligible for
other funding, we expect little reimbursement from other sources.
VI.11.5. ,How Values of Resiliency Will Be Promoted and Reinforced.
Project ACSST for children and families is based on a resiliency model and is designed
to foster resiliency in both individuals and families. The elements of the program that
will promote and support resiliency include: a strength-based approach, client-centered '
care planning, education and support to develop skills for navigating both county and
community "systems," support for parents in their parenting and living skills, and peer-
led activities, and.individualized services that can change in intensity as clients' needs
change. Strong exit planning will also be an important element of the program. At
present, approximately 15% - 20% of Children's Mental Health clients go on to enter the
adult system of care. It is anticipated that this figure will be lower with Project ACSST.
r'
VI.11.6. Program Expansion
The program proposed here is an entirely new program— it does not expand an existing
program. Project ACSST will have a strong linkage with the existing wraparound
program in the county— utilizing the existing program's resources where possible with '
an interdisciplinary approach. Additional elements of this new program that are
50 {
MHSA Community Supports and Services Final Plan, December 2005
modeled after the traditional wraparound approach includes team decision-making and
family participation in plan development.
Project ACSST has new elements that take the wraparound concept to a new, fully
enhanced level. New elements include: Crisis stabilization, 24-hour availability, a
blending of staff, strong Spanish speaking capabilities, strong peer services, partnering
with HMOs in the area, expansion of community partners, and transportation
assistance.
An additional new element of this program is culturally competent and embedded
outreach. The children we are seeking to serve in this program are not currently being
served. Outreach will conducted by the Program Supervisor, Parent Partners.
Outreach will build on existing relationships and will focus on building new relationships
in the community. Strong outreach materials will be developed in Spanish and English.
Ideally, as this new program demonstrates greater effectiveness in achieving resiliency
among children and families, this enhanced model can be expanded to support the
existing wrap around program in other parts of the county.
V1.11.7. Supports and Services to be Provided by Clients and/or Family Members
At present, peer family support services are severely limited in capacity in the county.
This program will have a strong peer family support component with four Family
Partners when full staffing is achieved. At least two of those Family Partners will be
bilingual Spanish speakers. If at all possible, at least one will be proficient in American
Sign Language. With the rapid population growth rate in this part of the county, an
emerging Southeast Asian population will also be factored into the language capability
of staff.
Family Partners will not only provide one-one support to families, but will assist with
resource development, and conduct parent education and training.
Additionally, the Program will employ an equivalent of four FTE Youth Peer Mentors for
children. These will be older teens that have graduated from Children's Services. In
addition to one-one support for children, they will develop and carry out group
developmental and social activities and outings. Depending on hiring opportunities, a
peer mentor may be able to provide direct peer support for LGBT and questioning
youth.
VI.11.8. Collaboration Strategies
CCMH currently has a number of strong collaborative relationships in East County and
is envisioning developing many more through this program. Collaborations are too
numerous to cover in detail in this Plan. The key to how these collaborations will
improve the service system and outcomes for individuals is to achieve smooth linkages
to meet clients' needs.
51
MHSA Community Supports and Services Final Plan, December 2005
Current Collaborative Relationships include:
Contra Costa Department of Employment and Human Services;
Contra Costa Health Department Division of Public Health
• Contra Costa Probation Department, Juvenile Probation Division
• Contra Costa County Office of Education m`
Pediatric Ambulatory Care
East County Child and Adolescent Services (Mental Health Clinic)
Five regional school districts
Reach Project (AOD Agency)
Head Start
Tobin World (Private school for children with severe behavioral problems)
Children's System of Care Policy Council
First Five
Potential New Collaborative Partners may include:
Note: This list is just a beginning; we know there are many potential partners in
the community.)
Faith-based Communities including Golden Hills, St. Anthony's, St. Anne's,
LDS
Police Departments in Brentwood and Oakley
Sheriffs Department
John/Muir/Mt. Diablo Health System
• Sutter Delta Medical Center
Kaiser Permanente
Brentwood Police Activities League x`
Village Drive Project (gang diversion) t
• Tri-Delta Transit R'=
• Contra Costa Housing Authority
Private medical and mental health practitioners R'
Recreation Departments of Brentwood and Oakley
Youth Sports including Pop Warner and Little League
• HIPPY (Home Intervention Pre-School Program — Brentwood School District)
Birthright (Perinatal supports)
• Aspira Foster Care Services
EMQ Foster Care Services
• Area cultural organizations and community leaders
• Familias Unidas (Latino social and mental health services)
• Los Medanos College
• Orin Allen Youth Rehabilitation Facility
• Community Services
ti<
F;
52
Ye:
MHSA Community Supports and Services Final Plan, December 2005
VI.11.9. Cultural Competency
One innovative element of this program is that the newly formed teams will be required
to include culturally and linguistically diverse staff. With Spanish as a threshold
language in this county, and a recognized high number of Latinos in the Far East region
of the county, our goal is for the majority of all staff hired for this program to be bilingual
and bicultural. This will be especially important for personal service coordinators and
transportation aides who can also assist monolingual clients with access to community
supports and services.
Additionally, this program is designed to be embedded in the communities being served.
With blended teams that include community-based contractors who are already located
in and serving the diverse communities in the area, cultural competence and outreach
will emerge from the community itself.
There are relatively few Asians or Pacific Islanders in Far East County at present and
funds for translators have been included in the budget. Currently, CCMH's East County
Clinic in Antioch has staff who speak several Asian languages. With enhanced
transportation supports, it will be possible to access support from those staff for this
emerging population, as well. Recent data show that the percentage of students in
public schools who are English Language Learners in Brentwood is 14.5%; in Byron it is
9.1%.
0 Additionally, there is a fairly large deaf population in East County as evidenced by
translator demand data. In one recent period, 40% of all county health translator
requests were for American Sign Language — second in volume to Spanish. The
County has had some success in hiring staff who are proficient in American Sign
Language and will actively recruit from such key programs as the California School for
the Deaf Counseling Program, Ohlone College, and Cal State Northridge.
VI.11.10. Sensitivity to Sexual Orientation, Gender and Differing Psychologies
and Needs of Women and Men, Boys and Girls.
Men and women have differing needs — related not only to sexual identify, but to their
socialization and the roles and expectations of family and society. Their differing
relationships to and experiences with violence in our society are also important. Boys
and girls face these same issues and often more as they are forming or grappling with
newly emerging issues about their sexuality, self-image, and relationships.
Both county and community-based hiring will be focused on establishing a diversity that
is reflective of the populations being served. This includes diversity in gender and
sexual orientation. Cultural sensitivity training that will be developed as part of MHSA
will address issues of gender and sexual orientation as well as race and culture.
Highly qualified staff, contractors and consumers working with children as part of Project
ACSST will be especially sensitivity to these issues. Assessments and care planning
53
{
S
f MHSA Community Supports and Services Final Plan, December 2005
will raise and examine these issues, and supports and referrals will be identified to meet
individual client needs.
Youth especially may have urgent and ongoing needs related to sexual orientation and
identify. Effort will be made to hire at least one gay or lesbian teen peer mentor.
Referrals will also be made to the Pacific Center—which has groups for emerging LGBT
and questioning youth. A hotline run by the National Center for Gay and Lesbian Rights
in nearby'Alameda County will also be offered.
V1.11.11. Meeting Service Needs of Individuals Residing Outside of the County '
CCMH is proposing a target population of children and families residing in Far East ='
Countywho are not currently served in the mental health system. Therefore, children
or families who are in residential treatment facilities outside of the county would not be
eligible for this program. On occasion there is a child in a foster care or juvenile justice
placement outside of the county who is being discharged back to Contra Costa County.
Several mechanisms are already in place for such referrals. These youth will be
considered for program eligibility. ;
VI.11.12. Selection of Strategies
µ:
All strategies employed as part of ACSST are included on the State list of accepted `
strategies. Strategies include:
• A family partnership program
Youth peer mentoring
• Cultural and gender-sensitive outreach '
Services and supports provided at school, in the community and in the home
• Crisis services
• Services in collaboration with faith-based communities; linkage for these '
families to the full range of community services and supports
• Services located in racial ethnic communities to reach children, youth and
families who may be more responsive to services in these settings; linkage for
these families to the full range of community services and supports within the
context of a single child/family services and supports plan. .
• Integrated services and supports for children/youth and their families with co-
occurring mental health and substance use disorders within the context of a
single child/family services and supports plan
Values-driven, evidence-based and promising clinical services that are
integrated with overall service planning and which support youth/family
v
selected goals
• Childcare
Transportation `
• Supportive family partnership educational opportunities
• Ethnic-specific social or community groups or other culture-based activities
for children/youth and their families
54
a
s
MHSA Community Supports and Services Final Plan, December 2005
�J VI.11.13. Timeline
Key program start-up and enrollment milestones include:
• 5/06 Staff for first team hired and operational
• 5/06 Outreach begins
5/06 First families enrolled
10/06 Second team hired and operational
1/07 Full enrollment achieved
55
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2005-06
Program Workplan# #1 Date: 12/8/05
Program Workplan Name Children's FSP: Project ACSST Page_of
Type of Funding 1.Full Service Partnership Months of Operation 3
Proposed Total Client Capacity of Program/Service: 15 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 15 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental Mental Health Total
Department ..,Agencies Contract
Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(8 Flex Funds) $3,000 $3,000
b.Travel and Transportation $1,100 $1,100
c.Housing $0 $0
i.Master Leases $0
ii.Subsidies $0
iii.Voucners $0
iv.Other Housing $_0
d.Employment and Education Supports $0 $0
e.Other Support Expenditures(provide description in budget narrative) $0
f.Total Support Expenditures $4,100 $0 $0 $4,100
,
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $49,999 $49,999
c.Employee Benefits $22,555 $22,555
d.Total Personnel Expenditures $72,554 $0 $0 $72,554
3. Operating Expenditures
a.Professional Services $8,000 $8,000
b.Translation and Interpreter Services $2,000 $2,000
c.Travel and Transportation $31,000 $31,000
d.General Once Expenditures $4,000 $4,000
e.Rent,Utilities and Equipment $25,500 $25,500
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $45,297 $45,297
h.Total Operating Expenditures $115,797 $0 $0 $115,797
4. Program Management
a.Existing Program Management $0
b.New Program Management _
c.Total Program Management $0 $0 $0
_ 5. Estimated Total Expenditures when service provider is not known $131,825 $131,825
6.Total Proposed Program Budget $324,276 $0 $0 $324,276
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
} c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue Lo
h.Total Existing Revenues $0 $0 $0 $0 -
2.New Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
d.Other Revenue L0
e.Total New Revenue $0 $0 $0 $0
3.Total Revenues $0 $0 $0 $0
C.One-Time CSS Funding Expenditures $42,000 $42,000 x
D.Total Funding Requirements $366,276 $0 $o $366,276
E.Percent of Total Funding Requirements for Full Service Partner-h-- 90.0%
Sf,
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2005.06
Program Workplan# #1 Date: 12/8/05
Q Program Workplan Name Children's FSP: Project ACSST Page_of
Type of Funding 1.Full Service Partnership Months of Operation 3
Proposed Total Client Capacity of Program/Service: 15 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 15 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs' of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions
$0
Total Current Existing Positions 0.00 0.00 p'= '* - ^-?1^ ^`. $0
B.New Additional Positions
Program Coordinator Program Supervisor 1.00 $76,774 $19,194
Clerk Clerical Support 1.00 $34,662 $8,666
Family Partner Advocacy and Support(Contract) 1.00 1.00 $27,000 $6,750
Clinical Specialist Personal Service Coordination 1.00 $51,480 $12,870
Psychiatrist Clinical Care 0.25 $168,000 $2,520
$0
$0
Total New Additional Positions 1.00 4.25 " ,x..�M & .,- -.,.i. $49,999
C.Total Program Positions 1.001 425 $49,999
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
0
57
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Program Workplan# #1 Date: 12/8/05
Program Workplan Name Children's FSP:Project ACSST Page_of_
Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: 65 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 65 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental Mental Health Total
Department Agencies Contract
Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(&Flex Funds) $15,000 $15,000
b.Travel and Transportation $8,000 $8,000
c.Housing $0 $0
I.Master Leases $0
ii.Subsidies $0
,5 iii.Vouchers $0
iv.Other Housing
d.Employment and Education Supports $0 $0
e.Other Support Expenditures(provide description in budget narrative) 10
f.Total Support Expenditures $23,000 $0 $0 $23,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $229,744 $229,744
c.Employee Benefits $125,696 $125,696
d.Total Personnel Expenditures $355,440 $0 $0 $355,440
3. Operating Expenditures
a.Professional Services $110,000 $110,000
b.Translation and Interpreter Services $10,000 $10,000
c.Travel and Transportation $8,000 $8,000
d.General Office Expenditures $12,000 $12,000
e.Rent,Utilities and Equipment $70,000 $70,000
f
f.Medication and Medical Supports $0
Other Operating Expenses(provide description in budget narrative 233 665 233 665
9� P 9 P (P P� 9 ) �� ��
h.Total Operating Expenditures $443,665 $0 $0 $443,665
n,
4. Program Management $1,050,771
a.Existing Program Management $0
b.New Program Management
c.Total Program Management $0 $0 $0
5. Estimated Total Expenditures when service provider is not known $931,000 $931,000
6.Total Proposed Program Budget $1,753,105 $0 $1,753,105
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue LO
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $25,000 $25,000
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
d.Other Revenue
e.Total New Revenue $25,000 $0 $0 $25,000
r 3.Total Revenues $25,000 $0 $0 $25,000
C.One-Time CSS Funding Expenditures $0
D.Total Funding Requirements $1,728,105 $0 $0 $1,728,105
E.Percent of Total Funding Requirements for Full Service Partnerships 87.0%
`•-, S R
Pr ,r
i
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Program Workplan# #1 Date:. 12/8/05
Program Workplan Name Children's FSP: Project ACSST Page_of_
Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: - 65 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: -65 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEsv of FTEs Overtime per FTE" Wages and Overtime
A.Current Existing Positions
$o
Total Current Existing Positions 0.00 0.00 ` , `.° ` $0
B.New Additional Positions
MHSA Coordinator Program Leadership 1.00 $74,602 $74,602
Clerk Clerical Support 1.00 $34,662 $34,662
Family Partner Advocacy and Support(Contract) 1.00 1.00 $27,000 $27,000
MH Clinical Specialist Personal Service Coordination 1.00 $51,480 $51,480
Psychiatrist Clinical Support 0.25 $169,000 $42,000
$0
$0
Total New Additional Positions 1.00 4.25'. $229,744
C.Total Program Positions 1.00 4.25 .' '-• °'.. ,.; $229,744
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
0
59
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2007-08
Program Workplan# #1 .Date:. 12/8/05
Program Workplan Name Children's FSP:Project ACSST Page_of_
Type of Funding 1. Full Service Partnership .Months of Operation 12
Proposed Total Client Capacity of Program/Service: 100 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through.MHSA: 100 Telephone Number: 925)957-5132
County Mental Other Community -
Health Governmental Mental Health Total
Department Agencies Contract
Providersv
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(&Flex Funds) $15,000 $15,000
b.Travel and Transportation $8,000 $8,000
c.Housing $0 $0
I.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing
d.Employment and Education Supports $0 - $0
e.Other Support Expenditures(provide description in budget narrative) LO
f.Total Support Expenditures $23,000 $0 $0 $23,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
_b.New Additional Personnel Expenditures(from Staffing Detail) $229,744 $229,744
c.Employee Benefits $125,696 $125,696
d.Total Personnel Expenditures $355,440 $0 $0 $355,440
3. Operating Expenditures
a.Professional Services $110,000 $110,000
b.Translation and Interpreter Services $10,000 $10,000 c
c.Travel and Transportation $8,000 $8,000
d.General Office Expenditures $12,000 $12,000
e.Rent,Utilities and Equipment $70,000 $70,000
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $219,056 $219,056
h.Total Operating Expenditures $429,056 $0 $0 $429,056
4. Program Management
i
a.Existing Program Management $0
b.New Program Management $-0
c.Total Program Management $0 $0 $0
5. Estimated Total Expenditures when service provider Is not known $833,600 $833,600
6.Total Proposed Program Budget $1,641,096 $01 $0 $1,641,096
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $95,000 $95,000
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
-; d.Other Revenue 0
t e.Total New Revenue $95,000 $0 $0 $95,000
3.Total Revenues $95,000 $0 $0 $95,000
C.One-Time CSS Funding Expenditures $o
D.Total Funding Requirements $1,546,066 $0 $0 $1,546,096
E.Percent of Total Funding Requirements for Full Service Partnerships 90.0%
�n
I
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2007-08
Program Workplan# #1 Date: 12/8/05
Program Workplan Name Children's FSP: Project ACSST Page_of_
Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: 100 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 100 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs° of FTEs Overtime per FTEs Wages and Overtime
A Current Existing Positions
$0
Total Current Existing Positions 0.00 0.00 $0
B.New Additional Positions
MHSA Coordinator Program Leadership 1.00 $74,602 $74,602
Clerk Clerical Support 1.00 $34,662 $34,662
Family Partner Advocacy and Support(Contract) 1.00 1.00 $27,000 $27,000
MH Clinical Specialist Personal Service Coordination 1.00 $51,480 $51,460
Psychiatrist Clinical Support 0.25 $166,000 $42,000
$0
$0
Total New Additional Positions 1.00 4.25-`#af;'r '�' $229,744
S 5 ryt�� i.Yx�k'x
C.Total Program Positions 1.00 4.25 aq ;, _E�, $229,744
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
0
0
61
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #1: Children's FSP: Project ACSST
FY 05-06
Introduction: This budget assumes funds approved for an April 1 Start-up, 2006. First
quarter activities presumes hiring efforts carried out before start date. Activities for
these three months include establishment of teams and development of outreach plans,
with outreach and enrollment beginning on May 1, 2006.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$3,000 based on prior experience, and partial year of operations
b. Travel and Transportation
$1,100 based on prior experience and partial year of operations
c. Housing See Program #5 for Housing
d. Employment and Education Supports
Included in Flex Funds above
e. Other Support Expenditures
Included in Flex Funds above
f. Total Support Expenditures
$4,100 for partial year operations
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
b. New Additional Personnel Expenditures
All salaries based on 25% of full-year operations. Salaries set at mid-step of
county scale for position. A minimum of 50% of new staff will be bilingual in
Spanish orASL.
1.0 FTE Program Coordinator— Full time administrative position with 20%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances.
1.0 FTE Clerk— Full time, Spanish speaking position responsible for
providing administrative and clerical support to the program.
1.0 FTE Family Partner— Peer position providing individual and family
support, advocacy and assists with linkages with public and
community-based systems and supports. Leads 16wk Psycho-
educational Parent Project Workshops, assists with independent
living skills, responds to family crises. Participates in 24/7 call
system. 40% of time allocated for outreach. At least one FP
(county and/or contract below) will be Spanish speaking.
Contracted positions.
62
MHSA Community Supports and Services Final Plan, December 2005
Q 1.0 FTE Personal Service Coordinator— Clinically trained case manager
oversees service plan development, long-term care coordination,
exit planning. Sits on Wrap Around Team with family. Participates
in crisis intervention. Also conducts some individual family therapy.
At least one PSC (county or contract— below)will be Spanish
Speaking.
.25 Psychiatrist— Provides direct client care for medication prescription
and monitoring. Up to 20% of time may serve non FSP clients who
live in remote E. County.
c. Employee Benefits
$22,555 in benefits based on county rates. Contracted position (Family
Partner) at reduced rate.
d. Total Personnel Expenditures
Total personnel expenditures total$72,554
3. Operating Expenditures
a. Professional Services
$8,000 Contracted Therapy Services— Licensed mental health clinicians
for individual family therapy located in Far East County because of
remoteness.
b. Translation and Interpreter Services
$2,000 -- Interpreters will be needed on an on-call basis forAsian/PI
languages and may be needed forAmerican Sign Language. They
will be acquired through existing county contracts. Prorated based
on experience with full-year programming.
c. Travel and Transportation
$31,000 includes $30,000 for purchase of consumer transportation van.
Includes $1,000 for vehicle maintenance. Prorated based on full-
year experience.
d. General Office Expenditures
$4,000 Based on start-up needs and full-year experience.
e. Rent, Utilities and Equipment
$25,500 based on 25% of full year and includes $8,000 toward start-up
expenditures for equipment.
f. Medication and Medical Supports None
g. Other Operating Expenses
$3,000 for outreach expense plus $42,297 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$115,797.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
63
MHSA Community Supports and Services Final Plan, December 2005
5. Estimated Total Expenditures when service provider is not known
Total estimated contractor's budget of$131,825 includes $105,608 for staffing
and benefits. A minimum of 50% of new staff will be bilingual in Spanish or ASL.
Includes the pro-rated positions of.•
✓ 1.0 Family Support Counselors (lic or lic waived)
✓ 1.0 Transportation Aide (start-up level for eventual staffing of 1.5 FTE)
✓ 1.0 MRT Liaison (Sits on existing emergency response team. Shares
MRT call and serves as liaison between MRT and ASSIST. Facilitates
communications and referrals.
✓ .5 FTE Co-Occurring Disorders Specialist—Assesses children and
families for alcohol and other drug use. Participates in care service
planning, facilitates linkages with AOD-related supports and services,
leads recovery-related education and treatment groups, educates and
supports staff on AOD issues.
✓ 1.0 Personal Service Coordinator(Start-up level for eventual full
staffing of 3.0) At least one PSC will be Spanish speaking.
$44,000 for operating expenses includes $20,000 for start-up purchase of
office and technical equipment.
6. Total Proposed Program Budget
$324,276 Total Program Budget
B. Revenues
1. Existing Revenues None this year
2. New Revenues None this year
3. Total Revenues None this year
C. One-Time CSS Funding Expenditures
$42,000 includes $30,000 for CCMH for a van for client transportation and
$12,000 toward start-up purchase of equipment for staff for the contract
provider. See Note on page 188 for discussion need for one-time funds.
D. Total Funding Requirements
$366,276 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 90%
64
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #1: Children's FSP: Project ACSST
FY 06-07
wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww
Introduction: This budget is based on a full service year with enrollment reaching 65
FSPs by end of year. At full staffing, with county and contractors combined. CCMH
envisions that this program will be introducing 19.25 FTE new positions for supports and
services, with a minimum of 9 of those FTEs to be filled by consumers.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$15,000 "Flex Funds"including clothing, food and other basic needs.
b. Travel and Transportation
$8,000 for bus/BART and taxi vouchers. Based on prior experience.
c. Housing See Program #5 for Housing.
d. Employment and Education Supports
Included in Flex Funds above.
e. Other Support Expenditures
Included in Flex Funds above.
f. Total Support Expenditures
Total Support Expenditures of$23,000.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
b. New Additional Personnel Expenditures
Salaries set at mid-step of county scale for position. A minimum of 50% of
new staff will be bilingual in Spanish orASL. Includes:
1.0 FTE Program Coordinator— Full time administrative position with 20%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances.
1.0 FTE Clerk— Full time, Spanish speaking position responsible for
providing administrative and clerical support to the program.
1.0 FTE Family Partner— Peer positions providing individual and family
support, advocacy and assists with linkages with public and
community-based systems and supports. Leads 16wk Psycho-
educational Parent Project Workshops, assists with independent
living skills, responds to family crises. Participates in 24/7 call
system. 40% of time allocated for outreach. At least one FP
(county and/or contract below) will be Spanish speaking.
Contracted positions.
1.0 FTE Personal Service Coordinator— Clinically trained case manager
65
MHSA Community Supports and Services Final Plan, December 2005
oversees service plan development, long-term care coordination,
exit planning. Sits on Wrap Around Team with family. Participates
in crisis intervention. Also conducts some individual family therapy.
At least one PSC (county or contract— below) will be Spanish
Speaking.
.25 Psychiatrist— Provides direct client care.for medication prescription
and monitoring. Up to 20% of time may serve non-FSP clients who
live in remote E. County.
c. Employee Benefits
$125,696 for full employee benefits based on county rates. Contracted
position (Family Partner) at reduced rate.
d. Total Personnel Expenditures
Total personnel expenditures total$355,440
3. Operating Expenditures
a. Professional Services
$110,000 Contracted Therapy Services— Licensed mental health clinicians for
individual family therapy located in Far East County because of remoteness
from County services
b. Translation and Interpreter Services
$10,000 -- Interpreters will be needed on an on-call basis forAsian/PI
languages and maybe needed for American Sign Language. They will be
acquired through existing county contracts. Prorated based on experience •
with full-year programming.
c. Travel and Transportation
$8,000 Maintenance and operation of 1 county-owned van. Based on prior
experience.
d: General Office Expenditures
$12,000 Based prior experience. .
e. Rent, Utilities and Equipment
$70,000 based on estimate for operations in Far East County.
f. Medication and Medical Supports
None
g. Other Operating Expenses f
$5,000 for outreach expense plus $228,665 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$433,665.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
66
MHSA Community Supports and Services Final Plan, December 2005
5. Estimated total Expenditures when service provider is not known
Total estimated contractor's budget of$931,000 includes $673,543 for staffing and
benefits. A minimum of 50% of new staff will be bilingual in Spanish orASL. Includes
the estimated positions of.•
✓ 3.0 FTE Family Partners (defined in county staffing section)
✓ 2.0 FTE Family Support Counselors (lic/lic waived) One a peer.
✓ 4.0 FTE Teen Peer Mentors— One will serve as lead with
$5,000 increase in pay. Will provide support and advocacy for
older children, design and run social activities.
✓ 1.5 FTE Transportation Aides—Will assist with transportation to
appointments and services. Will use new Van and existing
county cars as needed.
✓ 1.0 FTE MRT Liaison (Sits on existing emergency response
team. Shares MRT call and serves as liaison between MRT
and ASSIST. Facilitates communications and referrals.
✓ .5 FTE Co-Occurring Disorders Specialist—Assesses children
and families for alcohol and other drug use. Participates in care
service planning, facilitates linkages with AOD-related supports
and services, leads recovery-related education and treatment
groups, educates and supports staff on AOD issues.
✓ 3.0 FTE Personal Service Coordinators— Role described as
part of county staffing. At least one PSC will be Spanish
speaking.
$257,547 in operating expenses includes $80,000 for purchase of 2 vans
& 1 car for outreach and family transportation, vehicle maintenance, rent,
utilities, equipment, translation, travel, transportation, outreach expense.
6. Total Proposed Program Budget
$1,753,105 Total Program Budget
B. Revenues
1. Existing Revenues None this year
2. New Revenues $25,000 estimated. This FSP targets children and
families who are unserved and not eligible for services under other funding
streams. However, it is realized that some families may become eligible for
MediCal or other supports during the course of their relationships with us. A
modest amount of revenue for clinical services has been estimated for this.
3. Total Revenues $25,000
C. One-Time CSS Funding Expenditures None
D. Total Funding Requirements
$1,728,105 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 93%
67
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health A'
Budget Narrative
Plan #1: Children's FSP: Project ACSST
FY 07-08
Introduction: This budget is based on a full service year with total enrollment reaching
100 FSPs by the end of the year. At full staffing, with county and contractors combined.
CCMH envisions that this program will be introducing 19.25 FTE new positions for
supports and services, with a minimum of 9 of those FTEs expected to be filled by
consumers.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$15,000 "Flex Funds"including clothing, food and other basic needs.
b. Travel and Transportation
$8,000 for bus/BART and taxi vouchers. Based on prior experience.
c. Housing. See Program #5 for Housing
d. Employment and Education Supports
Included in Flex Funds above
e. Other Support Expenditures
Included in Flex Funds above
f. Total Support Expenditures
$23,000 t
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
b. New Additional Personnel Expenditures
Salaries set at mid-step of county scale for position. A minimum of 50% of new
staff will be bilingual in Spanish or ASL. Includes:
1.0 FTE Program Coordinator— Full time administrative position with 20%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff °
and services, reporting and finances.
1.0 FTE Clerk— Full time, Spanish speaking position responsible for
providing administrative and clerical support to the program.
1.0 FTE Family Partner— Peer positions providing individual and family
support, advocacy and assists with linkages with public and
community-based systems and supports. Leads 16wk Psycho-
educational Parent Project Workshops, assists with independent
living skills, responds to family crises. Participates in 24/7 call
system. 40% of time allocated for outreach. At least one FP
R
68 t
a
MHSA Community Supports and Services Final Plan, December 2005
(county and/or contract below) will be Spanish speaking.
Contracted positions.
1.0 FTE Personal Service Coordinator— Clinically trained case manager
oversees service plan development, long-term care coordination,
exit planning. Sits on Wrap Around Team with family. Participates
in crisis intervention. Also conducts some individual family therapy.
At least one PSC (county or contract—below) will be Spanish
Speaking.
.25 FTE Psychiatrist— Provides direct client care for medication
prescription and monitoring. Up to 20% of time may serve non FSP
clients who live in remote E. County.
c. Employee Benefits
$125,696 in full employee benefits figured at county rates. Contracted
position (Family Partner) at reduced rate.
d. Total Personnel Expenditures
Total personnel expenditures total$355,440
3. Operating Expenditures
a. Professional Services
$110,000 Contracted Therapy Services— Licensed mental health clinicians for
individual family therapy located in Far East County because of
remoteness from County services
b. Translation and Interpreter Services
$10,000 -- Interpreters will be needed on an on-call basis forAsian/PI
languages and may be needed for American Sign Language. They will be
acquired through existing county contracts. Prorated based on experience
with full-year programming.
c. Travel and Transportation
$8,000 Maintenance and operation of 1 county-owned van. Based on prior
experience.
d. General Office Expenditures
$12,000 Based prior experience.
e. Rent, Utilities and Equipment
$70,000 based on estimate for operations in Far East County.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$5,000 for outreach expense plus $214,056 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$429,056.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
69
Y^
MHSA Community Supports and Services Final Plan, December 2005
5. Estimated total Expenditures when service provider is not known
Total estimated contractor's budget of$833,600 is based on $716,599 for staffing
and benefits. A minimum of 50% of new staff will be bilingual in Spanish or ASL.
Based on the estimated positions of:
r
✓ 3.0 FTE Family Partners (defined in county staffing section)
✓ 2.0 FTE Family Support Counselors (lic or lic waived) One is a
peer.
✓ 4.0 FTE Teen Peer Mentors— One will serve as lead with $5,000 §`
increase in pay. Will provide support and advocacy for older children,
design and run social activities.
✓ 1.5 FTE Transportation Aides—Will assist with transportation to
appointments and services. Will use new Van and existing county cars
as needed. s
✓ 1.0 FTE MRT Liaison (Sits on existing emergency response team. u;
Shares MRT call and serves as liaison between MRT and ASSIST.
Facilitates communications and referrals.
✓ .5 FTE Co-Occurring Disorders Specialist—Assesses children and
families for alcohol and other drug use. Participates in care service
planning, facilitates linkages with AOD-related supports and services,
leads recovery-related education and treatment groups, educates andj
supports staff on AOD issues.
✓ 3.0 FTE Personal Service Coordinators— Role described as part of
county staffing. At least one PSC will be Spanish speaking.
$117,000 for operating expenses includes maintenance of vehicles, rent, r
utilities and equipment, translation, travel and transportation, and outreach
expense.
6. Total Proposed Program Budget
$1,641,096 Total Program Budget
B. Revenues '
y
1. Existing Revenues None this year
2. New Revenues $95,000 estimated. This FSP targets children and
families who are unserved and not eligible for services under other funding
streams. However, it is realized that some families may become eligible
for MediCal or other supports during the course of their relationships with
us. A modest amount of revenue for clinical services has been estimated
for this.
3. Total Revenues $95,000
C. One-Time CSS Funding Expenditures None
ti
70
MHSA Community Supports and Services Final Plan, December 2005
D. Total Funding Requirements
$1,546,096 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 95%
71
. kn
MHSA Community Supports and Services Final Plan, December 2005
XHIBt'[ 4C'�IVIIUI;IINIa SERICES ANI) SUP'P°ORT;$'WORaC PL`�►N
SIJ MARY
GJOTHA Contra Costa Fi cal Progra�WKA.Srelwla mea
s
PrQ ramWork pla, # EstrnatedStart ®ate n1120.0-6�
Description of The TAY Program will advance the goals of MHSA by creating
Program: a positive youth development environment in which homeless
or imminently homeless TAYs with psychiatric disabilities (SMI
or SED) can take personal responsibility and make good
choices about their lives when provided with housing, services
and supports that they need. Consumers' Person-Centered
Service Plans will define the services and supports that are
provided, allowing for development of participants' self-
direction and personal responsibility. By supporting consumers
to address mental and physical health issues, substance
abuse, housing instability, and critical social, education and
vocational needs, the Program will prevent admissions to jail,
acute care hospitals, institutionalization, and unnecessary lives
of poverty. This housing-first approach will be instituted through
a partnership-based framework building upon successful, pre-
established networks with homeless, housing, social service,
health and behavioral health care providers in the region.
Priority Population: This program, will serve TAYs (16 to 25) with psychiatric
disabilities, who are homeless or at imminent risk of
homelessness, living within the West County district of Contra
Costa County. This includes all areas of the county west of
Martinez, including Richmond, San Pablo, Pinole, EI Cerrito,
and Hercules. These TAYs are likely to have involvement with
gangs, the child welfare and criminal justice systems. They
may have co-occurring disorders. They may lack skills for
independent living.
MM Fund Type Age Group
-. - • . •- '-• - -. . .- Sys
• • • •- - -• FSP Dev OE CY TAY A OA
Crisis services ❑ ❑ ® ❑ ❑
Inte rated service teams ❑ ❑ ❑ ® ❑ ❑
Partnerships with ethnic-specific community ❑ ® ❑ ® ❑ ❑
providers and programs
Youth and family-run services ❑ ❑ ❑ ® ❑ ❑
Classes regarding what youth need to know for Z ❑ ❑ ❑ ® ❑ ❑
successful living in the community
Supported employment M ❑ ❑ ❑ I ❑ I ❑
Supportive education (Z ❑ IT ❑ ® I ❑ ❑ •
Client self-directed care plans RAP ® I ❑ I ❑ I ❑ ® ❑ 11 ❑
72
Y' 2"rcFa
���S$L b �
MRSA Community Supports and Services Final Plan, December 2005
QProgram 2: Transition Age Youth
VI.11.2. Program Description
The goal of the TAY Program for transition aged youth (between 16 and 25) is to create
a positive youth development environment in which transition aged youth with
psychiatric disabilities (SED or SMI) can take personal responsibility and make good
choices about their lives when provided with housing, services and supports that they
need.
One philosophy behind this goal is the Transition to Independence Process (TIP)'. This
model was developed to engage youth and young adults in their own future planning
process, providing them with developmentally appropriate services and supports, and
involving them and their families and other informal support persons in a process that
prepares and facilitates them in their movement toward greater self sufficiency and
successful achievement of their goals related to each of the transition domains —
employment, career-building education, living situation, personal effectiveness, quality
of life and community-life functioning.
This model includes engaging youth through relationship development, person-centered
planning, and a focus on their futures. It involves tailoring services and supports to be
accessible, coordinated, developmentally appropriate and building on strengths. It
includes acknowledging and developing personal choice and social responsibility. It
ensures a safety net of support and enhances young persons' competencies to assist
them in achieving greater self-sufficiency and confidence. It has an outcome focus.
In the TAY Program here in Contra Costa, consumers' stated needs and goals,
articulated in a Person-Centered Service Plan, will define the services and supports that
are provided, allowing for the development of participants' self-direction and personal
responsibility. By supporting consumers to address mental and physical health issues,
substance abuse, housing instability, and the critical social, education and vocational
needs of this age group, the program will prevent admissions to jail, acute care
hospitals, institutionalization, as well as unnecessary lives of poverty.
The primary focus of the TAY Program will be a Full Service Partnership that will assist
youth with psychiatric disabilities who are homeless or at imminent risk of
homelessness to move into long term housing with full access to both clinical and
consumer-driven supports that allow for the development of participants' self-direction
and personal responsibility. This housing-first approach will be instituted through a
partnership-based framework that builds upon successful, pre-established networks
with homeless, housing, social service, health and behavioral health care providers in
the region.
1 TIP Definition and Guidelines,Hewitt B. "Rusty"Clark,PhD.,Dept.of Child and Family Studies, de al Parte
Florida Mental Health Institute,University of South Florida, Tampa,Florida. Http://tipJhmi.usf.edu.
73
MHSA Community Supports and Services Final Plan, December 2005
Unlike the PowerHouse Project for adults (described in Program #3), youth need not •
already be homeless to be eligible for this program. The goal is to identify and engage
youth who are also at imminent risk of homelessness -- before they hit rock bottom '
homelessness, which is traumatic and debilitating itself. '
This TAY Program will also provide opportunities for peer-led services and role
modeling. In addition to consumer led outreach, recovery planning, advocacy and
support activities, youth will have the opportunity to engage in consumer-led training to
become peer advocates. Contract work providing support to other consumers will be
available in an expanding pilot (see SPIRIT training, Program #6). Additionally,
paraprofessional positions within the entire MHSA expansion will be available to
consumers.
Full Service Partnership
In addition to a continuum of housing options leading to long-term supported housing, h'
the Program will offer an integrated service team to its Full Service Partners to assist
with outreach and provide individualized assessment, services, and supports based on
client choice as expressed in the person-centered recovery plan, and 24/7 service :-
coordination for program participants.
FSP -Target Population
The TAY FSP will serve transition age youth (16 to 25) with psychiatric disabilities, who
are homeless or at imminent risk of homelessness, living within the West County district
of Contra Costa County. This includes all areas of the county west of Martinez,
including the cities of Richmond, San Pablo, EI Sobrante, El Cerrito, Pinole, Hercules
and Rodeo. West County was chosen because 47% of the County's homeless
population are estimated to be clustered in this area.
t:
Outreach and Engagement
Outreach for the TAY Program will take place in a number of ways:
f
New, Culturally Specific Outreach —Through an RFP process, the county will
contract with community-based organizations that already work with the Latino
and Asian/Pacific Islander populations in West County. These agencies will
provide combination Peer Outreach Workers/Personal Service Coordinators who
are reflective of these different communities and, hopefully, consumers as well.
These outreach workers will be located in their own parent agencies but will work
with the existing Hy-Hope Outreach Team of the Contra Costa Youth Continuum
of Services (CCYCS) of the County Health Services' Homeless Program, and
with the Full Service Partnership's Integrated Services Team to identify, contact,
engage and assist homeless youth in West.County in a linguistically and
culturally appropriate manner. Competence with youth will be an additional
factor in selecting these providers. `
y;
Once engagement is achieved, and eligibility for the FSP is determined, these
outreach workers will either stay with the consumer as their personal service
74
k-
MHSA Community Supports and Services Final Plan, December 2005
coordinator or, if caseloads are full, will support the consumer's transition to an
additional full-time personal services coordinator. If the person is found to be not
eligible for FSP, then System Development funding will support the outreach
team to provide appropriate support and referral to non-FSP homeless and
mental health services.
Expanded Capacity for Existing Homeless Outreach Efforts —While ethnic-
specific outreach workers described above may team with the existing Hy-Hope
Outreach Teams for occasionally ethnic-specific outreach efforts, the key
enhancement to existing outreach efforts will be to add an MHSA-funded mental
health clinician to the Hy-Hope Outreach Team to increase its capacity to assess
and engage homeless persons with psychiatric disabilities directly in the street
setting. This person will serve as a full member of the Hy-Hope Outreach Team.
He or she will be well-versed in co-occurring disorders and will begin a
relationship with eligible individuals out on the street and until they are ready to
move into housing. The primary objectives of this clinician will be crisis .
intervention and to identify, engage and enroll those who are eligible for the FSP.
Emancipating Foster Youth — CCMH is aware that many foster youth become
homeless within 2 years of emancipation. Linkages will be made with foster
youth-serving agencies to identify and support foster youth with psychiatric
disabilities as they are becoming homeless, or before their homelessness
becomes chronic. This population is in special need of life skills, educational and
vocational supports as well.
Supports and Services
Meeting the needs of young adults with psychiatric disabilities who are homeless or at
imminent risk of homelessness requires a complex range of flexible interventions.
Assistance must be designed to offer youth the ability to tailor their own support and
care in a manner that will lead to the greatest chance of success for their transitioning
out of homelessness, and for future stability. Person-centered personal care plans will
be a central element of this consumer-driven program.
FSP
Ongoing supports for Full Service Partners will be available from a newly formed
Integrated Service Teams (ISTs). Each team will have its own Team Leader,
combination Outreach Workers/Personal Service Coordinators and dedicated
Personal Service Coordinators. The teams will share an Outreach Clinician, a
Family Coordinator, Community Support Workers with specialties in supported
education and vocational services, a consumer financial service specialist, an co-
occurring disorders specialist (alcohol and other drugs), and weekend
Community Support Workers with co-occurring disorder specialties to increase
weekend supports and, hopefully, reduce weekend "on call" demand. Most of
these positions will be contracted out through an RFP process. The licensed
clinician and family coordinator will be county staff and contract positions.
75
MHSA Community Supports and Services Final Plan, December 2005
These Integrated Service Teams and related positions will conduct outreach,
offer counseling and linkages to services in the field. Emergency shelter will be
secured where appropriate with assisted moves toward transitional and longer- z
term housing. Benefits eligibility and counseling will be offered. Person-centered '
care plans will be developed, and supports offered for implementation of those
plans. Medical care and psychiatric care will be offered. AOD assessments will
be offered. Limited drug and alcohol treatment will be offered where appropriate,
and referrals to community treatment services will be made when needed. The
teams will be available on a 24/7 basis to Full Service Partners.
Where possible and desirable, families will become involved and reunification
explored. Natural support systems other than families will also become involved.
Transportation will be offered to needed supports and services either directly, by
car, by outreach workers or with bus passes and taxi.vouchers.
f,
Peer services will be available in a number of ways. In recruiting outreach
workers, we will prioritize the hiring of younger mental health consumers who
have experienced homelessness. The county's WRAP (Wellness Recovery
Action Plan) and TLC (in-home support and respite) will be made available to all
FSPs. Consumers may also participate in peer-led groups and activities.
Graduates of the CCMH's current youth program will be recruited for SPIRIT '
training — as preparation for future employment in peer services. Youth from this
MHSA-funded program may also be recruited into SPIRIT training for possible
future employment in peer services.
t
As a youth program, heavy emphasis will be placed on vocational and
educational supports. Two Community Support Workers —one for education and
one for vocation -- will be assigned exclusively to this program. These consumer ;
CSWs will help youth to define their need for life skills training, academic and
vocational education, and job placement and support. They will also provide t'
resume and school application assistance as well as on-site support at
community colleges and job sites.
Additionally, the Educational Support Worker will help to develop linkages both in
the community and on community college campuses with such key resources as
mental health-specific counselors in disabled student programs and GED
programs. The Vocational Support Worker will develop linkages with job
programs and support.
Court and jail liaisons and a Financial Services Specialist funded primarily under
systems development funds for adults (described as Program #3) will also be
available to support the TAY FSP program. `
An estimated 135 youth will be served by the Full Partnership Program in the first
27 months of operation (3 Year Plan).
t;
76
MHSA Community Supports and Services Final Plan, December 2005
0 VI.11.3. Housing and Employment Services in this Program
Housing is the backbone of the "housing first" approach of the TAY Program. It is the
Program's goal to move all Full Service Partners into long term housing at each
consumer's own pace, with supports provided in that housing at the level desired by the
consumer at any point in time.
As transitional housing is available, it is the goal of this program to move Full Service
Partners through a 3-18 month stay in transitional housing before placement in a
supported long term living environment in order to gain a sense of stability and life skills
training that may be needed for independent living. This will also encourage a break
from gang activity or substance abuse.
a. Emergency Shelter— Contra Costa's Health Services' Homeless Programs'
Youth Continuum of Services (CCYCS) currently runs an 6-bed emergency
shelter and day center for youth under 17 years of age and a 12-bed shelter
for youth ages 18-21 at Calli Annex, located within the West County
(Brookside) Adult Shelter. The location of youth aged 18-21 with the adult
shelter is problematic not only because of difficulties that arise with youth
mixing with adults in this setting, but because of the difficulty in offering
dedicated supports for youth in this setting.
Using MHSA funds, CCMH will purchase a 5-bedroom modular home for up
to 10 homeless youth at a time aged 18 to 25 with priority for Full Service
Partners. This manufactured home will be installed next door to the existing
Calli House, facilitating service delivery and a sense of community. CCYCS
will operate the new facility with the same services and supports offered when
the older youth shelter was within the adult shelter. Additionally, added
services such as groups and classes can be offered in the expansive group
areas of the modular home. An FSP Integrated Services Team will also be
able to work with youth in this setting.
The manufactured home, which is 3420 square feet with 5 bedrooms and
several social and common rooms is described in more detail in Attachment
16.
Additionally, 4-6 beds located upstairs from the offices/community services
building of the new Antioch transitional facility (described below) can be used
as emergency shelter beds as available and needed for FSPs.
b. Transitional Living — Currently, CCYCS operates a 6-bed transitional living
program for youth 18-21 who are homeless or exiting the foster care system.
Residents are provided guidance and support to maintain employment and
education while living at Appian House for up to 18 months.
77
MHSA Community Supports and Services Final Plan, December 2005
k'
MHSA funds will be used to expand the system's transitional care capacity by
adding a new Pittsburg Youth Campus located in East County. Full Service
Partners aged 16-24 will be given first priority for the new Pittsburg Campus
Transitional Living. The location of this campus outside of West County
where these youth will be from is seen as a benefit—as many may need to ;
separate from their involvement with gangs and substance abuse in their old
environments.
The Pittsburg Youth Campus, located at West 6th Street and Black Diamond
Boulevard in Pittsburg, will house up to 14 youth. This includes a building s
with one 2-bedroom and four 1-bedroom housing units for youth, two 2-
bedroom freestanding cottages for pregnant and parenting youth and their
children, and an additional 3-bedroom unit upstairs from a community center
and offices. Length of stay will be for up to 18 months, with an additional six
months for pregnant and parenting teens. 4-6 of the beds located upstairs
from the community center and offices can also be used for TAY emergency
shelter as needed and available.
The Campus is a gated property located in a tract home development that is
within walking distance to public transportation, restaurants, and banking
within the redevelopment area of Old Town Pittsburg. Each unit has a `
kitchen, bath, bedroom and living room. The community space has a tutoring
area/computer room, 3 offices, a living room, kitchen and conference room.
The site also includes a picnic area and jungle gym for children.
y,
The Pittsburg Youth Campus will be operated by CCYCS. CCYCS and the
MHSA-funded Integrated Care Teams will offer services and centers on r.
campus. The community center will be used4or groups, classes and social
events offered by both groups.
c. Residential Drug and Alcohol Treatment— Spaces in residential drug
treatment facilities will be acquired on a per bed basis. It is anticipated that
average length of stay in this setting will be 90 days.
d. Long Term Supported Living — Using the model developed by the county's
homeless services, CCMH will be using MHSA funds to provide vouchers for
master-leased, scattered site, supported housing for most Full Service
Partners in the TAY Program for transitional age youth. Each consumer's
Personal Services Coordinator, with support from the full Integrated Services 4
Team, will maintain supports to the consumer in this setting that will assist in
continued progress toward well-being and independence, and will develop
and maintain relationships with landlords as well.
Full Service Partners will have full access to CCMH's currently existing vocational
service programs and linkages. This includes but is not limited to, linkage to the
78 .
MHSA Community Supports and Services Final Plan, December 2005
Department of Rehabilitation cooperative, and community-based employment
J programs.
Partners will also access individual assistance from the Integrated Services Team's
Vocational and Education Specialists to ensure that they are fully supported to pursue
the training and/or employment of their choice. Vocational and Educational supports
will be available for goal clarification, applications to schools and jobs, and on-site
support in schools and jobs.
V1.11.4 Cost Per FSP Participant
The MHSA cost per FSP participant during the first three years of this program is
approximately $8,500 after other expected revenue is considered. This includes an
allocated portion of outreach and engagement costs. MediCal revenue is anticipated for
this population:
VI.11.5. How the Program Will Advance the Goal of Resiliency. How Values of
Recovery/Resiliency Will Be Promoted and Reinforced.
The TAY Program will take a collaborative and comprehensive approach to addressing
the individual needs of the youth served based on client choice. Consumers' stated
needs and goals will define the services and supports that are made available, allowing
for the development of participants' self-direction and personal responsibility. The
involvement of consumer-providers on the IST will ensure the understanding and
modeling of recovery practices and principles. These principles are discussed fully in
the introduction to this section.
Existing consumer-run supports will be available to Full Service Partners in the TAY
Program. Not only will FSPs choose services and supports in their Person-Centered
Care Plan, but they may also choose to create a Wellness Recovery Action Plan
(WRAP) with support from their peers. This Plan focuses on identifying changes an
individual wants for themselves and how they might achieve those changes.
Consumers will also have the opportunity to both receive or provide peer supports to
others through the innovative, existing Tender Loving Care (TLC) Program which
supports consumers to work -- offering a variety of part-time peer support services such
as transportation, training, grocery shopping, housekeeping, gardening and yard
maintenance, or support for community involvement such a attending meetings,
recreational, or social activities.
VI.11.6. Program Expansion
As described earlier, supports for the Full Service Partnership are all new with MHSA
funds. The Full Partnership Program will, however, be highly coordinated and
integrated with existing homeless services. Additional systems development pieces —
justice systems liaisons and mental health clinicians -- will add new mental health
capacity to existing homeless services.
79
MHSA Community Supports and Services Final Plan, December 2005 ,
4_.
VI.11.7. Supports and Services to be Provided by Clients and/or Family Members
As discussed in detail in numerous areas of this section, many aspects of the TAY
Program will be peer-led. These include:
t.
• Integrated Service Teams and CCYCS, with CCMH's Office for Consumer
Empowerment (OCE)will facilitate the development of peer-run support
meetings and house meetings
The Family Coordinator who will be under contract to CCMH for this project
will be the family member of a child mental health consumer
The Community Support Workers for both educational and vocational
services will be mental health consumers
• Existing peer-led resources within CCMH and through CCMH's contractor
Mental Health Consumer Concerns will become available to Full Service
Partners. The WRAP (Wellness Recovery Action Plan) and TLC (in-home
support and respite) will be made available to all FSPs. Additional groups
and trainings may also be provided through the OCE. Examples of groups t
might include co-occurring disorders, trauma recovery, and support for
community involvement.
• Peers also represent this population with seats on the Homeless Continuum
of Care Advisory Board.
A Note on Family Support
The program recognizes that families can play an integral part of a person's recovery.
While homeless youth often have no family they can turn to, or are not in touch with the
family that they do have, the Family Coordinator will be available to help individuals
regain contact and relationships with their families. They will be available to meet with
consumers and their available families for solving problems and improving Xt
communication. In addition, at the consumer's request, families can be invited to assist
in developing Full Service Partnership plans which detail the full range of services that
the consumer chooses to promote his or her wellness and recovery.
(
VI.11.8. Collaboration Strategies {
p'
The TAY Program described here represents a significant collaboration between CCMH
and Contra Costa Health Services' Homeless Program's Youth Continuum of Services s`
(CCYCS) for outreach, housing and supports to Full Service Partners. Not only will this
collaboration allow CCMH to provide the best possible supports for its Full Service
Partners, but it will increase the capacity of CCYCS to meet the needs of its homeless
client population with serious psychiatric disabilities.
The new court/jail liaison created primarily for the adult FSP (described below), will also
be available to youth in this program. Increased collaboration with courts and jails will
80 '
MHSA Community Supports and Services Final Plan, December 2005
help consumers to address judicial issues in a supported manner that takes their mental
health into consideration and will help them to move on with their lives.
Additional collaborations will be developed or expanded for this program. This will
include relationships with providers of services to pregnant and parenting teens and
young adults, vocational programs, educational programs, consumer-operated
programs, and substance abuse providers.
VI.11.9. Cultural Competency
Keys to the cultural competency of the TAY Program are the embedding of its
outreach/personal service coordinators in community-based agencies serving ethnic
populations that are often not reached by county systems. Because Latinos and
Asians/Pacific Islanders are the most significantly underserved populations, CCMH will
focus its efforts in these areas and with these language capacities.
By building upon the existing homeless services system in the county, the cultural
appropriateness of services to the homeless will be higher. This includes gaining the
benefit of the county homeless program's existing relationships with shelters,
community-based providers, and the homeless themselves.
Our program will employ an ethnically diverse staff within its Integrated Service Teams
who reflect the ethnic and cultural backgrounds of our clients. This will include
individuals who are fluent in English and Spanish —the county's threshold language.
Cultural competence with youth is also an important factor for the success of this
program. Involvement of youth and track record in supports and services to youth will
be important considerations in hiring and selecting community partners for this program.
V1.11.90. Sensitivity to Sexual Orientation, Gender Identify and Differing
Psychologies and Needs of Women and Men, Boys and Girls.
Men and women have differing needs— related not only to sexual identify, but to their
socialization and the roles and expectations of family and society. Their differing
relationships to and experiences with violence in our society are also important. Boys
and girls face these same issues and often more as they are forming or grappling with
newly emerging issues about their sexuality, self-image, and relationships.
Both county and community-based hiring will be focused on establishing a diversity that
is reflective of the populations being served. This includes diversity in gender and
sexual orientation. Cultural sensitivity training that will be developed as part of MHSA
will address issues of gender and sexual orientation as well as race and culture.
Highly qualified staff, contractors and consumers working with TAYs as part of TAY
Program will be especially sensitivity to these issues. Assessments and care planning
81
MHSA Community Supports and Services Final Plan, December 2005
will raise and examine these issues;and supports and referrals will be identified to meet
individual client needs.
Youth especially may have urgent and ongoing needs related to sexual orientation and. .
identify. In addition to achieving representation and competencies among staff and .
contractors hired for this program, referrals can also be made to the Pacific Center—
which has groups for emerging LGBT and questioning youth. A hotline run by the
National Center for Gay and Lesbian Rights in nearby Alameda County will also be
offered.
VI.11.11. Meeting the Service Needs of Individuals Residing Outside of the.
County
This Program will be available to any consumer who lives in West Contra Costa County.
VI.11.12. Selection of Strategies Not on State List ;
t
All of the key strategies employed in the TAY Program are on the State list of selected
strategies. These include:
• Development of housing options `
• Supportive Housing .
Integrated Service Teams `
• Youth and family-run services
Partnerships with ethnic-specific community providers and programs a
• Transportation
• Classes regarding what youth need to know for successful living in the :
community
• Supportive employment
• Supportive educational services
• Crisis Services
VI.11.13. Timeline f
• 5/06 Staff for first team hired, trained and operational
• 5/06 Outreach Plan developed and outreach begins
5/06 First Full Service Partners enrolled
• 10/06 Second team operational
• 1/07 Full enrollment achieved
y
3,
82
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2005-06
Program Workplan# #2 Date: 12/8/05
Program Workplan Name TAY FSP: TAY Program Page_of
Type of Funding 1.Full Service Partnership Months of Operation 3
Proposed Total Client Capacity of Program/Service: 20 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 20 Telephone Number: 925)957-5132
County Mental Other Community
Mental Health
Health Governmental Contract Total
Department Agencies
Emiders
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(Flex Fund) $3,000 $3,000
b.Travel and Transportation $5,000 $5,000
c.Housing
I.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing $0
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative)
f.Total Support Expenditures $8,000 $0 $0 $8,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $76,424 $76,424
c.Employee Benefits $45,011 $45,011
d.Total Personnel Expenditures $121,435 $0 $0 $121,435
3. Operating Expenditures
a.Professional Services $0
b.Translation and Interpreter Services $0
c.Travel and Transportation $1,000 $1,000
d.General Office Expenditures $4,000 $4,000
e.Rent,Utilities and Equipment $5,750
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $41,698 $41,698
h.Total Operating Expentlitures $52,448 $0 $0 $52,448
4. Program Management
a.Existing Program Management 1s ,a- $0
_,
b.New Program Management � a �r f9�.' LO
c.Total Program Management ' ^' $0 $0 $0
5. Estimated Total Expenditures when service provider Is not known $114,800 F: $114,800
6.Total Proposed Program Budget $296,682 $0 $0 $296,682
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue NO
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
d.Other Revenue
e.Total New Revenue $0 $0 $0 $0
3.Total Revenues $OI $0 $0 $0
C.One-Time CSS Funding Expenditures $80,000 $80,000
D.Total Funding Requirements $376,682 $0 $0 $376,682
E.Percent of Total Funding Requirements for Full Service Partnerships 87.0%
83
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2005-06
Program Workplan# #2 Date: 12/8/05
Program Workplan Name TAY FSP: TAY PROGRAM Page_of_�
"E. Type of Funding 1.Full Service Partnership Months of Operation 3 '
Proposed Total Client Capacity of Program/Service: 20 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 20 Telephone Number:• 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs° of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions
$0
Total Current Existing Positions 0.00 0.00 $0
B.New Additional Positions
Program Supervisor Program Leadership 0.50 $76,774 $9,597
Psychiatrist Clinical Care 0.30 $168,000 $12,600
Nurse Clinical Care 0.50 $74,640 $9,330
MH Clinical Spec(Lic) Outreach,Clinical Care 3.50 $57,504 $28,752
Clerk Clerical Support 0.50 $69,324 $8,666
Cons.Financial Services Sped Benefits Elgib.And Analysis 0.50 $44,838 $5,605
,i t.
Family Coordinator(Contr) Consumer Advocacy and Support 0.25 $30,000 $1,875
$0
$0
$0
$0
$0
$0
$0
$0
Lo
Total New Additional Positions 0.25 5.801 $76,424
C.Total Program Positions 1 0.25 5.8011111111M $76,424
3!� a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar. -
z
y :
s
84
I
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Program Workplan# #2 Date: 12/6/05
1 Program Workplan Name TAY FSP: TAY Program Page_of
(�/) Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: 65 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 65 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental Mental HealthContract Total
Department Agencies
Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(Flex Fund) $15,000 $15,000
b.Travel and Transportation $12,000 $12,000
c.Housing
i.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing Lo
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) $00
f.Total Support Expenditures $27,000 $0 $0 $27,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $399,452 $399,452
c.Employee Benefits $232,921 $232,921
d.Total Personnel Expenditures $632,373 $0 $0 $632,373
3. Operating Expenditures
a.Professional Services $25,000 $25,000
b.Translation and Interpreter Services $0
c.Travel and Transportation $16,000 $16,000
d.General Office Expenditures $12,000 $12,000
e.Rent,Utilities and Equipment $22,000
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $203,867 $203,867
h.Total Operating Expenditures $278,867 $0 $0 $278,867
4. Program Management
a.Existing Program Management .7�'".�" °"r ` $0
b.New Program Management 1' ` ' Lo
c.Total Program Management $0 $0 $0
5. Estimated Total Expenditures when service provider is not known $601,740 ?r 'I. 'a5'-. '' ""G' $601,740
6.Total Proposed Program Budget $1,539,980 $0 $0 $1,539,980
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue Lo
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $280,000 $280,000
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
d.Other Revenue $280,000 $280,000
e.Total New Revenue $560,000 $0 $0 $560,000
3.Total Revenues $560,000 $0 $0 $560,000
C.One-Time CSS Funding Expenditures I 1 1 $0
D.Total Funding Requirements $979,980 $o $0 $979,980
E.Percent of Total Funding Requirements for Full Service PartnershipsWOMM L x 66.0%
85
F
N,
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Program Workplan# #2 Dale: 12/8/05
Program Workplan Name TAY FSP: TAY PROGRAM Page_of_
Type of Funding 1.Full Service Partnership Months of Operation, 12
Proposed Total Client Capacity of Program/Service: 65 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 65 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs° of FTEs Overtime per FTEs Wages and Overtime
A-Current Existing Positions
$0
Lo
:- Total Current Existing Positions 0.00 0.00 $o
B.New Additional Positions
Program Supervisor Program Leadership 0.50 $76,774 $39,387
Psychiatrist Clinical Care 0.30 $168,000 $50,400
Nurse Clinical Care 0.50 $74,640 $37,320 k
MH Clinical Spec(Lic) Outreach,Clinical Care 3.50 $57,504 $201,264
Clerk Clerical Support 1.00 $34,662 $34,662
sz, Cons.Financial Services Sped Benefits Elgib.And Analysis 0.50 $44,838 $22,419
Family Coordinator(Contr) Consumer Advocacy and Support 0.25 0.25 $60,000 $15,000
$0
$0
$0
$0
$0
$0
$0
Lo
Total New Additional Positions 0.25 6.55 $399,452
j.� C.Total Program Positions 0.25 6.55 $399,452
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
4
F:
Y:
86
i
E
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2007-08
Program Workplan# #2 Date: 12/8/05
Program Workplan Name TAY FSP: TAY Program Page_of
Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: 135 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 135 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental Mental HealthContract Total
Department Agencies
Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(Flex Fund) $15,000 $15,000
b.Travel and Transportation $12,000 $12,000
c.Housing
I.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing L0
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) 500
f.Total Support Expenditures $27,000 $0 $0 $27,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $382,121 $382,121
c.Employee Benefits $222,523 $222,523
d.Total Personnel Expenditures $604,644 $0 $0 $604,644
3. Operating Expenditures
a.Professional Services $25,000 $25,000
b.Translation and Interpreter Services $0
c.Travel and Transportation $16,000 $16,000
d.General Office Expenditures $12,000 $12,000
e.Rent,Utilities and Equipment $22,000
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $190,708 $190,708
h.Total Operating Expenditures $265,708 $0 $0 $265,708
4. Program Management
a.Existing Program Management # }' $0
b.New Program Management E "r*" 0' :�* v
9 9 3 r, 2„ F:ak
c.Total Program Management + `, e: ,�: =` $0 $0 $0
5. Estimated Total Expenditures when service provider is not known $541,740 - , 'i,., $541,740
6.Total Proposed Program Budget $1,439,091 $0 $0 $1,439,091
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue LO
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $325,000 $325,000
/''� b.Medicare/Patient Fees/Patient Insurance $0
/ c.State General Funds $0
1L.../J d.Other Revenue $325,000 $325,000
e.Total New Revenue $650,000 $0 $0 $650,000
3.Total Revenues $650,000 $0 $0 $650,000
C.One-Time CSS Funding Expenditures 1 $0
D.Total Funding Requirements $789,0911 $0 $o $789,091
E.Percent of Total Funding Requirements for Full Service Partnerships «. 57.0%
87
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2007-08
Program Workplan# #2 .. Date: 12/8/05
Program Workplan Name TAY FSP: TAY PROGRAM Page_of_
Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: 135 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 135 Telephone Number: 925)957-5132
Classification Function
Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs' of FTEs Overtime per FTE' Wages and Overtime
A Current Existing Positions
$0
Total Current Existing Positions 0.00 0.00 IfANINFAM $0
B.New Additional Positions
' Program Supervisor Program Leadership 0.50 $76,774 $38,387
Psychiatrist Clinical Care 0.30 $168,000 $50,400
Nurse Clinical Care 0.50 $74,640 $37,320
MH Clinical Spec(Lie) Outreach,Clinical Care 3.50 $57,504 $201,264
Clerk Clerical Support 0.50 $34,662 $17,331
Cons.Financial Services Sped Benefits Elgib.And Analysis 0.50 $44,838 $22,419
Family Coordinator(Contr) Consumer Advocacy and Support 0.25 0.25 $60,000 $15,000
$0
$0
$0
$0
$0
$0
$00
$0
Total New Additional Positions 0.251 6.05 $382,121
C.Total Program Positions 0.25 6.05 $382,121
t a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
r�
s
i
88
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #2: TAY Program
FY 05-06
Introduction: This budget assumes funds approved for an April 1 Start-up, 2006. First
quarter activities presumes hiring efforts carried out before start date. Activities for
these three months include establishment of teams and development of outreach plans,
with outreach and enrollment beginning on May 1, 2006.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$3,000 based on prior experience, and partial year of operations
b. Travel and Transportation
$5,000 based on prior experience and partial year of operations
c. Housing See Program #5 for Housing
d. Employment and Education.Supports
Included in Flex Funds above
e. Other Support Expenditures
Included in Flex Funds above
f. Total Support Expenditures
$8,00 for partial year operations
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
b. New Additional Personnel Expenditures
All salaries based on 25% of full-year operations. Salaries set at mid-step of
county scale for position. Assumes a minimum of 50% of new hires will be
bilingual in Spanish, ASL or an Asian language. Includes:
.5 FTE Program Supervisor— Full time administrative position with 50%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances.
1.0 FTE Clerk— Full time position responsible for providing administrative
and clerical support to the program.
.3 FTE Psychiatrist -- Provides direct client care for medication
prescription and monitoring. Contract position.
.5 FTE Nurse— Provides direct client medical care
2.0 FTE Licensed Mental Health Clinicians— Start-up level for eventual
3.5 FTE full staffing. 1.0 FTE is for a combination of street outreach,
mobile crisis outreach, beginning clinical treatment in the field, and
eligibility determination. The other FTE will provide eligibility
89
MHSA Community Supports and Services Final Plan, December 2005
determination and support to the county contractor's outreach/PSC
teams, as well as serving as a Personal Service Coordinator.
.50 FTE Consumer Financial Services Specialist— Will support FSP
clients with eligibility determinations, education and support for
applying for benefits.
.25 FTE Family Partner— Contract peer position providing individual and
family support, advocacy and assists with linkages with public and
community-based systems and supports.
c. Employee Benefits
$45,011 in full employee benefits based on county rates. Contracted
positions at reduced rate.
d. Total Personnel Expenditures
Total personnel expenditures total$121,435.
3. Operating Expenditures
a. Professional Services None
b. Translation and Interpreter Services None
c. Travel and Transportation
$1,000 start-up level based on experience.
d. General Office Expenditures
$4,000 Based on start-up needs and full-year experience.
e. Rent, Utilities and Equipment
$5,750 based on full-year experience.
f. Medication and Medical Supports
None
= g. Other Operating Expenses
$3,000 for outreach expense plus $38,698 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$52,448.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
5. Estimated total Expenditures when service provider is not known
Total estimated contractor's budget of$114,800. Assumes that a minimum of
50% of positions will be bilingual in Spanish, ASL or an Asian language.
Includes $91,347 for staffing and benefits includes the pro-rated positions of.•
✓ 1.0 FTE Team Leader= 50% coordination and leadership of
outreach/PSC teams and 50% for outreach. Includes facilitating
communication with CCMH administrative and field staff.
✓ 1.0 FTE Community Support Worker— Start-up level for
eventual 2.0 FTEs providing advocacy and support for FSPs on
educational and vocational issues and placements. Includes x
90
MHSA Community Supports and Services Final Plan, December 2005
field support. A minimum of one CSW will be a consumer. A
minimum of one CSW will be Spanish speaking.
✓ .50 FTE Co-Occurring Disorders Specialist--Assesses TAYs
for alcohol and other drug use. Participates in care service
planning, facilitates linkages with AOD-related supports and
services, leads recovery-related education and treatment
groups, educates and supports staff on AOD issues.
✓ 3.0 FTE Personal Service Coordinators. One PSC will be a
specialist in co-occurring disorders and will be available to all
FSPs on weekend days to help reduce weekend call demand.
✓ .75 FTE Combination Peer Outreach Worker/Personal
Service Coordinators. This is three .25 FTE paraprofessional
peer positions for three bilingual, bicultural individuals based in
community organizations who will work with teams to provide
outreach and personal service coordination.
$23,453 for operating expenses includes travel and transportation,
translation, general office, renUutilities/equipment, vehicle maintenance
and a flex fund for clients.
6. Total Proposed Program Budget
$296,682 Total Program Budget.
OB. Revenues
1. Existing Revenues None
2. New Revenues None this year
3. Total Revenues None this year
C. One-Time CSS Funding Expenditures
$80,000 includes $60,000 for CCMH for purchase the critical need of 2 vans for
transportation of clients and $20,000 toward start-up purchase of
equipment for staff. See page 188 for a discussion of the need for one-
time funds.
D. Total Funding Requirements
$376,682 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 87%.
91
t
MHSA Community Supports and Services Final Plan, December 2005
r_
Contra Costa County Mental Health
Budget Narrative
Plan #2: TAY Program
FY 06-07
S
Introduction: This budget reflects a full year of operation, rising to an enrollment of 65
by the end of the year. The budget reflects the creation of 13.8 FTE new positions for
supports and services, with a minimum of 3 of those positions to be filled by consumers
and family members.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$15,000 based on prior experience, and partial year of operations
b. Travel and Transportation
$12,000 based on prior experience and partial year of operations
c. Housing See Program #5 for Housing
d. Employment and Education Supports
Included in Flex Funds above
e. Other Support Expenditures
Included in Flex Funds above
f. Total Support Expenditures
$27,000 in total Support Expenditures.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
b. New Additional Personnel Expenditures
Salaries set at mid-step of county scale for position. A minimum of 50% of
new hires will be bilingual in Spanish, ASL or an Asian language. Includes:
.5 FTE Program Supervisor— Full time administrative position with 50%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances. :
.3 Psychiatrist— Provides direct client care for medication prescription
and monitoring. Contract positron.
.5 Nurse— Provides direct client medical care
3.5 Licensed Mental Health Clinicians— Licensed clinical positions. .5
t
FTE is for a combination of street outreach, mobile crisis
intervention, beginning clinical treatment in the field, and eligibility
determination. 1.0 FTE will provide eligibility determination and "
support to the county contractor's outreach/PSC teams, as well as
z
92
f!
MHSA Community Supports and Services Final Plan, December 2005
serving as a Personal Service Coordinator. 2.0 FTEs will be a full-
time Personal Service Coordinators.
1.0 Clerk— Full time position responsible for providing administrative and
clerical support to the program.
.50 Consumer Financial Services Specialist— Will support FSP clients
with eligibility determinations, education and support for applying
for benefits.
.25 Family Partner— Peer position providing individual and family
support, advocacy and assists with linkages with public and
community-based systems and supports.
C. Employee Benefits
$232,921 in full employee benefits based on county rate. Contracted
positions at reduced rate.
d. Total Personnel Expenditures
Total personnel expenditures total$632,373.
3. Operating Expenditures
a. Professional Services
$25,000 for contracted services from consumers working through CCMH's
subcontractor Mental Health Consumer Concerns, to provide education
and support for WRAP (Wellness Action Recovery Planning) and TLC (in-
home peer-provided supports to clients).
b. Translation and Interpreter Services
Will rely upon new multilingual staff and existing resources.
c. Travel and Transportation
$16,000 vehicle maintenance based on experience.
d. General Office Expenditures
$12,000 Estimated based on prior experience.
e. Rent, Utilities and Equipment
$22,000 Estimated based on prior experience.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$3,000 for outreach expense plus $200,867 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$278,867.
4. - Program Management
a. Existing Program Management None
b. New Program Management None
C. Total Program Management None
93
MHSA Community Supports and Services Final Plan, December 2005
5. Estimated Total Expenditures when service provider is not known
Total estimated contractor's budget of$601,740 includes $481,740 for staffing
and benefits. A minimum of 50% of new hires will be bilingual in Spanish, ASL or
an Asian language. Includes the estimated positions of.,
✓ 1.0 FTE Team Leader— 50% coordination and leadership of
outreach/PSC teams and 50% for.outreach. Includes facilitating
communication with CCMH administrative and field staff.
✓ 2.0 FTE Community Support Workers — Peer positions
providing advocacy and support for FSPs. One specializes on
education and the other specializes invocational issues and
placements. Includes field support.
✓ .50 FTE Co-Occurring Disorders Specialist—Assesses TAYs
for alcohol and other drug use. Participates in care service
planning, facilitates linkages with AOD-related supports and
services, leads recovery=related education and treatment
groups, educates and supports staff on AOD issues.
✓ 3.0 FTE Personal Service Coordinators . One of these
positions is a specialist in co-occurring disorders and is
available to all FSPs on weekend days to reduce weekend call
demand.
✓ .75 FTE This is three .25 FTE paraprofessional peer positions
for three bilingual, bicultural individuals based in community
organizations who will work with teams to provide outreach and
personal service coordination.
$120,000 for operating expenses includes $60,000 for purchase of 2 vans
for client transportation, vehicle maintenance, general office, rent, utilities
and equipment, and a flex fund for clients.
6. Total Proposed Program Budget '
$1,539,980 Total Program Budget
B. Revenues
1. Existing Revenues None
2. New Revenues $600,000— Estimate income of$280,000 from
MediCal and $280,000 from EPSDT for care and services to this
population —based on prior experience. s.
3. Total Revenues $560,000
E>,
C. One-Time CSS Funding Expenditures None `
D. Total Funding Requirements
$979,980 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships '`
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 66%.
s>
F,
R'
94
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #2: TAY Program
FY 07-08
Introduction: This budget reflects a full year of operation, rising to an enrollment of
135 by the end of the year. The budget reflects the creation of 13.8 FTE new positions
for supports and services, with a minimum of 3 of those positions to be filled by
consumers.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$15,000 based on prior experience, and partial year of operations
b. Travel and Transportation
$12,000 based on prior experience and partial year of operations
c. Housing See Program #5 for Housing
d. Employment and Education Supports
Included in Flex Funds above.
e. Other Support Expenditures
Included in Flex Funds above.
O f. Total Support Expenditures
$27,000 in total Support Expenditures.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
a. New Additional Personnel Expenditures
Salaries set at mid-step of county scale for position. A minimum of 50% of
new hires will be bilingual in Spanish, ASL or an Asian language.
Includes:
.5 FTE Program Supervisor—Administrative position with 50%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances.
.3 Psychiatrist-- Provides direct client care for medication prescription
and monitoring. Contract position.
.5 Nurse — Provides direct client medical care
3.5 Licensed Mental Health Clinicians— Licensed clinical positions. .5
FTE is for a combination of street outreach, mobile crisis
intervention, beginning clinical treatment in the field, and eligibility
determination. 1.0 FTE will provide eligibility determination and
support to the county contractor's outreach/PSC teams, as well as
95
k
R.
MHSA Community Supports and Services Final Plan, December 2005
serving as a Personal Service Coordinator. 2.0 FTEs will be a full-
time Personal Service Coordinators.
1.0 Clerk— Full time position responsible for providing administrative and
clerical support to the program.
.50 Consumer Financial Services Specialist Will support FSP clients
with eligibility determinations, education and support for applying ti
for benefits.
.25 Family Partner-- Peer position providing individual and family f
support, advocacy and assists with linkages with public and
community-based systems and supports.
b. Employee Benefits
$222,523 in full employee benefits figured at county rate. Contracted
positions at reduced rate.
c. Total Personnel Expenditures
Total personnel expenditures total $604,644.
3. Operating Expenditures
a. Professional Services
$25,000 for contracted services from consumers working through CCMH's K`
subcontractor Mental Health Consumer Concerns to provide education
and support for WRAP (Wellness Action Recovery Planning) and TLC (in-
home peer-provided supports to clients).
b. Translation and Interpreter Services
Will rely upon new multilingual staff and existing resources
C. Travel and Transportation
$16,000 vehicle maintenance based on experience. `
d. General Office Expenditures
$12,000 Estimated based on prior experience. r
e. Rent, Utilities and Equipment e
$22,000 Estimated based on prior experience.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$3,000 for outreach expense plus $187,708 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$265,708.
r
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None '
5. ' Estimated total Expenditures when service provider is not known
Total estimated contractor's budget of$541,740. A minimum of 50% of new staff
will be bilingual in Spanish, ASL or an Asian language. $481,740 for staffing and
benefits including the estimated positions of: 4
t
96
t
MHSA Community Supports and Services Final Plan, December 2005
✓ 1.0 FTE Team Leader— 50% coordination and leadership of
outreach/PSC teams and 50% for outreach. Includes facilitating
communication with CCMH administrative and field staff.
✓ 2.0 FTE Community Support Workers— Peer positions
providing advocacy and support for FSPs. One specializes on
education and the other specializes in vocational issues and
placements. Includes field support.
✓ .50 FTE Co-Occurring Disorders Specialist—Assesses TA Ys
for alcohol and other drug use. Participates in care service
planning, facilitates linkages with AOD-related supports and
services, leads recovery-related education and treatment
groups, educates and supports staff on AOD issues.
✓ 3.0 FTE Personal Service Coordinators . One of these
positions is a specialist in co-occurring disorders and is
available to all FSPs on weekends days to reduce weekend call
demand.
✓ .75 FTE This is three .25 FTE paraprofessional peer positions
for three bilingual, bicultural individuals based in community
organizations who will work with teams to provide outreach and
personal service coordination.
$60,000 for operating expenses includes vehicle maintenance, general
Qoffice, rent, utilities and equipment, and a flex fund for clients.
6. Total Proposed Program Budget
$1,439,091 Total Program Budget
B. Revenues
1. Existing Revenues None
2. New Revenues $650,000— Estimate income of$325,000 from
MediCal and $325,000 from EPSDT for care and services to this
population — based on prior experience. Increased slightly from 06-07 to
reflect increased numbers of FSPs gaining benefits.
3. Total Revenues $650,000
C. One-Time CSS Funding Expenditures
D. Total Funding Requirements
$789,091 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 57%.
97
MHSA Community Supports and Services Final Plan, December 2005
N
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"CirityConf�a:Costa Fisca' i'rogram Work 'IanNae: adult FSP. ¢.
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Description of PowerHouse will advance the goals of MHSA by supporting
Program: individuals to address, reduce or resolve psychological issues
and sociological conditions often linked to homelessness; and
to attain hope, self-sufficiency, wellness, and a life of quality in
the community. Consumers' stated needs and goals will define
the services and supports provided, allowing for the
development of participants' self-direction and personal
responsibility. This FSP will assist persons with psychiatric
disabilities to move from the street, homeless encampments,
and situations that put them at serious risk of homelessness
into permanent housing with full access to both clinical and
consumer-driven supports. Culturally specific outreach efforts
will engage the target population. A mental health clinician will
serve as liaison to courts and jails. These efforts will be
instituted through a partnership-based framework that builds on
successful, pre-established networks with homeless, housing,
social service, health and behavioral health care providers.
Priority Population: PowerHouse Project will serve, adults aged 26-59 living within
the West County district of Contra Costa County including all
areas west of Martinez, including the cities of Richmond, San
Pablo, EI Cerrito, Pinole and Hercules. The Program will
target those who are homeless on the street or in
encampments, or at serious risk of homelessness. Eligible
participants will have serious mental illness, and be currently
unserved by Contra Costa Mental Health. They may have co-
occurring disorders, histories of hospitalization, justice system
involvement.
Fund Type Age Group
Sys
• • • •- • FSP
� .- Dev OE CY TAY A OA
Outreach to homeless persons; persistent, ® ❑ ® ❑ ❑ ® ❑
non-threatening; provide for immediate needs
Integrated services with ethnic-specific CBOs ® ❑ ❑ ❑ • ® ❑
Integrated services with substance abuse and ® E] El El El ® ❑
mental health services
Client self-directed care plans WRAP ® ❑ ❑ ❑ ❑ ® ❑
Intensive community services/supports teams ® ❑ ❑ ❑ ❑ ® ❑
where clients live 24/7
Transportation services ® ❑ ❑ ❑ ❑ ® ❑
Self-help and client-run programs ® ❑ ❑ ❑ ❑ ® ❑
Integrated services with law enforcement ® El ❑ ❑ ® ❑
98
y
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MHSA Community Supports and Services Final Plan, December 2005
Program 3: PowerHouse Project for Adults
VI.11.2. Program Description
The goal of the PowerHouse Project is to support individuals to address, reduce and/or
resolve the psychological issues and sociological conditions that are often linked to
homelessness; and to attain hope, self-sufficiency, wellness, and a life of quality in the
community. Consumers' stated needs and goals will define the services and supports
that are provided, allowing for the development of participants' self-direction and
personal responsibility.
The philosophy that supports this approach is best outlined in a paper produced by the
Contra Costa County Mental Health Recovery Task Force in January 2003.2 At the
core of this philosophy is the belief that a successful recovery approach must be
strength-based, focused on self-management and personal responsibility, and provide
social supports and community integration. Consumers must establish their own
personal recovery goals, and then have access to quality supports to achieve those
goals and to achieve their highest level of personal development.
By supporting consumers to address mental and physical health issues, substance
abuse, and housing instability, the Program will also reduce admissions to jail, acute
care hospitals, and institutionalization in long-term mental health facilities.
The primary focus of the PowerHouse Project will be a Full Service Partnership that will
assist persons with psychiatric disabilities to move from the street, homeless
encampments and situations where they are at serious risk of homelessness, into
permanent housing with full access to both clinical and consumer-driven supports that
allow for the development of participants' self-direction and personal responsibility.
Secondarily, there are some System Development components that will expand
culturally specific outreach efforts to the homeless people with psychiatric disabilities
and a provide a set of liaisons to assist those with psychiatric disabilities being
discharged from jails, hospitals and long term care facilities. Both efforts — FSP and
Systems Development—will be described here as part of this single program. Both
efforts will be instituted through a partnership-based framework that builds upon
successful, pre-established networks with homeless, housing, social service, self-help,
health and behavioral health care providers in the region.
As cited in the 2001-2006 Contra Costa County Homeless Continuum of Care Plan, at
least 14,757 people were homeless at some point during 2000. 2,000 of these
individuals were chronically homeless. While as many as 5,000 of these individuals
were estimated to need mental health services, only about half of them actually
accessed those services. Additionally, approximately 41% of the homeless were
estimated to have drug or alcohol problems.
2 Unpublished: The Recovery Vision:A Conceptual Framework and Implementation Plan, Contra Costa County
Mental Health Recovery Task Force,January,2003.
99
MHSA Community Supports and Services Final Plan, December 2005
2005 Data from Homeless Encampment Outreach efforts conducted by Contra Costa
County Homeless Services shows that, of 4,578 contacts with homeless individuals,
71% had been homeless for more than a year, with 23% homeless for more than 5 f
years. 55% of those contacted were White, 31% were African American, and 11% were
Latino. When compared to countywide census data (2000) data, we see that African
Americans are significantly over represented in the chronically homeless population.
Full Service Partnership
In addition to a continuum of housing options leading to long-term supported housing,
PowerHouse will offer an Integrated Service Team to its Full Service Partners to assist
with outreach and provide individualized assessment, services, and supports based on
client choice as expressed in the person-centered recovery plan, and 24/7 service
coordination for program participants.
FSP -Target Population
The PowerHouse FSP will serve adults aged 26-59 living within the West County district
of Contra Costa County. This includes all areas of the county west of Martinez,
including the cities of Richmond, San Pablo, EI Sobrante, EI Cerrito, Pinole and
Hercules. West County was chosen because 47% of the County's homeless population
are estimated to be clustered in this area. Occasionally, homeless older adults aged 60
and older may be served as well. Once outreach and housing is established, however,
their services will be provided by the Older Adults Program Team (See Older Adults --
Program #4).
Within West County, the Program will target those who are homeless on the street or in
encampments, or at serious risk of homelessness. Eligible participants will have r
serious mental illness, but will be unserved by Contra Costa Mental Health.
{
Outreach and Engagement
Outreach for the PowerHouse Project will take place in a number of ways: '
New, Culturally Specific Outreach —Through an RFP process, the county will
contract with community-based organizations that already work with the Latino
and Asian/Pacific Islander populations in West County. These agencies will
rprovide combination Peer Outreach Workers/Personal Service Coordinators who 1
are reflective of these different communities. These outreach workers will be `
located in their own parent agencies but will work with the existing Hope
Outreach Team of the Homeless Services Project of the County and with the Full F
Service Partnership's Integrated Services Team.to identify, contact, engage and
assist homeless individuals in West County in a linguistically and culturally k'
appropriate manner. In addition to racial/ethnic competence, a track record and
competency in working with the homeless and those with psychiatric disabilities x
will be factors in selecting contract partners. `
Once engagement is achieved, and eligibility for the FSP is determined
(homeless, not currently receiving services), these outreach workers will either
100
r
moll 11
MHSA Community Supports and Services Final Plan, December 2005
stay with the consumer as their personal service coordinator or, if caseloads are
full, will support the consumer in a transition to a additional full-time personal
services coordinator. If the person is found to be not eligible for FSP, then
System Development funding will support the outreach team to provide
appropriate support and referral to non-FSP homeless and mental health
services.
Expanded Capacity for Existing Homeless Outreach Efforts —While ethnic-
specific outreach workers described above may team with the existing Hope
Outreach Team of the County Homeless Services for occasionally ethnic-specific
outreach efforts, the key enhancement to existing outreach efforts will be to add
an MHSA-funded mental health clinician to the Hope Outreach Team to increase
its capacity to assess and engage homeless persons with psychiatric disabilities
directly in the street setting. This person will serve as a full member of the Hope
Outreach Team. He or she will be well versed in co-occurring disorders and will
begin a relationship with eligible individuals out on the street and until they are
ready to move into housing.
The primary objective of this clinician will be to identify, engage and enroll those
who are eligible for the FSP. However, this will involve general mobile crisis
outreach and engaging and beginning services with homeless individuals who
may not turn out to be eligible for the FSP. When a person is determined to be
not eligible for FSP, System Development funds will allow the clinician to provide
follow-through support and referral to non-FSP homeless and mental health
services. The Outreach Clinician will also be responsible for developing and
maintaining relationships with first responders — such as the police emergency
service providers.
With System Development Funds, the PowerHouse Project will also conduct
outreach to jails, acute care hospitals and long-term care facilities for referrals.
The goal will be to develop relationships with these facilities so,that they will
make contact when they are discharging a person with a psychiatric disability to
the streets. In this instance, a clinic-based case manager/service coordinator will
facilitate transition to community living. However, these individuals will not be
eligible for the FSP.
Supports and Services
Meeting the needs of persons with serious psychiatric disabilities who are homeless
without shelter requires a complex range of interventions which offer individuals the
ability to tailor their own support and care in a manner that will lead to the greatest
chance of success for their transitioning out of homelessness and for a strong recovery
process. Person-centered personal care plans and consumer-led supports will be
central elements of this consumer-driven program.
Q
101
MHSA Community Supports and Services Final Plan, December 2005
ik.
FSP
Ongoing supports for Full Service Partners will be available from two newly
formed Integrated Service Teams (ISTs). Each team will have its own Team
Leader, combination Outreach Workers/Personal Service Coordinators and
dedicated Personal Service Coordinators. The teams will share an Outreach
Clinician, a Family Coordinator, two Community Support Workers with specialties
in supported education and vocational services, an alcohol and drug specialist,
and weekend Community Support Workers with co-occurring disorder specialties
to increase weekend supports and, hopefully, reduce weekend "on call" demand.
Most of these positions will be contracted out through an RFP process. The
licensed clinician, family coordinator will be county positions.
These teams and related positions will conduct outreach, offer counseling and
linkages to services in the field, including linkages to the county's multi-service 3
centers for the homeless where showers, meals, personal hygiene supplies and
medical care are available. Emergency shelter will be secured where
appropriate with assisted moves toward transitional and longer-term shelter.
Benefits eligibility and counseling will be offered. Person-centered care plans will
be developed and supports offered for implementation of those plans. Medical 1 ,
care and psychiatric care will be offered. AOD assessments will be '
offered/available. Limited drug and alcohol treatment will be offered where t
appropriate, and referrals to community treatment services will be made when
needed. The teams will be available on a 24/7 basis to Full Service Partners.
Where possible and desirable, families will become involved. Transportation will
be offered to needed supports and services either directly, by car, by outreach
workers or with bus passes and taxi vouchers.
Peer services will be available in a number of ways. The hiring of mental health
consumers and the formerly homeless into new positions such as outreach and
community support workers will be a priority. New Service Coordinator positions
have been created at a range of experience levels to allow consumers to enter
and grow in those positions as well. Supports and services of CCMH's Office for
Consumer Empowerment will be available to FSPs. This includes peer-led .
Y-
programs offered through Mental Health Consumer Concerns, including the
WRAP Support Program (Wellness Recovery Action Planning) and TLC (in-home
support and respite) programs, groups and activities, advocacy opportunities,
and the possibility of involvement of the expanding SPIRIT training program for
peer advocates. Consumers may be paid for their work with TLC or other mental '
health related jobs after completion of the SPIRIT Training program.
Court and jail liaisons and a financial services specialist funded primarily under
systems development funds (described below) will also be available to support
the FSP.
102
MHSA Community Supports and Services Final Plan, December 2005
An estimated 150 individuals will be served by the Full Partnership Program in
the first 27 months of operation (3 Year Plan).
Systems Development
Parallel to this Full Service Partnership will be the expansion of overall systems
capacity to support individuals who are not eligible for the FSP because there are
either already enrolled in mental health services with the county, or because they
are being discharged to the streets from jails, acute care hospitals or long term
care facilities. This will be accomplished through enhancement of the county's
homeless programs to better serve homeless persons with serious mental
illness.
A key program that will be enhanced by Systems Development Funds is Contra
Costa County's Homeless Services' Health, Housing, and Integrated Services
Network (HHISN). HHISN is a comprehensive service program designed to offer
chronically homeless people the opportunity to improve their health, well being,
and quality of life, while addressing and resolving issues that have contributed to
their housing instability. HHISN is funded with a combination of federal, state,
and local funds. By coordinating efforts closely with HHISN, CCMH gains the
benefit of homeless services' extensive experience and relationships in the
shelter and service community and within the homeless population.
Using primarily system development funds, CCMH will make available a licensed
mental health clinician to conduct crisis intervention, mental health assessments
and eligibility determinations, jail and court liaisons to facilitate mental health
solutions to criminal justice problems, and a patient financial services specialist
to facilitate receipt of Social Security funds. These positions will serve FSPs as
needed as well.
CCMH anticipates that these system development funds will allow assessment,
enrollment and financial services support to as many as 50 non-FSP consumers
during the 3-year period covered in this Plan.
V1.11.3. Housing and Employment Services in this Program
Housing is the backbone of the "housing first" approach of the PowerHouse Project. It
is the Program's goal to move all Full Service Partners into long term housing at each
consumer's own pace, with supports provided in that housing at the level desired by the
consumer at any point in time. The process of moving into long-term supported housing
(and recovery) may include movement through an emergency shelter, residential drug
treatment and/or transitional housing along the way.
The PowerHouse Project will join with the existing Health, Housing, and Integrated
Services Network (HHISN) to expand this existing comprehensive homeless services
program's mental health capacities —while adding some entirely new resources directed
specifically at Full Service Partners.
103
MHSA Community Supports and Services Final Plan, December 2005
Housing FSP 3
a. Emergency Shelter— CCMH will purchase emergency shelter beds for
FSPs in existing facilities for periods of up to 30 days as needed. This will be,
primarily, the Brookside Shelter in Richmond and others as available. By `
purchasing the beds, CCMH is assuring their availability for FSPs on demand.
Removal of transition age youth from the Brookside Shelter (described in
Program #2 above) will free up space that will allow Homeless Services to
add the dedicated CCMH beds.
b. Transitional Living — Beds will be purchased as needed in existing
transitional facilities in the county for periods of up to 6 months. These will be
Medi-Cal certified (CCL) faculties. These services will be RFPd, and may
include Ujima Family Recovery Services for pregnant and parenting women
with children, Bonita House, Pinetree and The Farm. p
c. Residential Drug and Alcohol Treatment— Spaces in existing residential
drug treatment facilities will be acquired on a per-bed basis from existing
County contractors. It anticipated that average length of stay in this setting
will be 90 days.
Additionally, a new, 16-bed facility in Pleasant Hill for adults with co-occurring '
disorders and a primary diagnosis of SMI will become available through the
Crestwood Corporation for the PowerHouse Project. Adult and TAY FSPs will
receive first priority for this program. Average length of stay will be
approximately 90 days.
1:
d. Long Term Supported Living — Using the model developed by the county's
homeless services, CCMH will be using MHSA funds to provide vouchers for
scattered site, supported housing for most Full Service Partners in the
PowerHouse Project. Each consumer's Personal Services Coordinator, with
support from the full Integrated Services Team, will maintain supports to the
consumer in this setting that will assist in continued progress toward well-
being and independence, and will develop and maintain relationships with t`
landlords as well.
Adult Full Service Partners will have full access to CCMH's currently existing Vocational
Service Programs and linkages. This includes but is not limited to, linkage to the
Department of Rehabilitation and community-based employment programs. '
Partners may also access individual assistance from the Integrated Services Team's
Vocational and Education Specialists to ensure that they are fully supported to pursue
the training and/or employment of their choice. Vocational and Educational supports f
will be available for goal clarification, applications to schools and jobs, and on-site
support in schools and jobs.
104
MHSA Community Supports and Services Final Plan, December 2005
QVI.11.4 Cost Per FSP Participant
The MRSA cost per FSP participant during the first three years of this program is
approximately $9,500. This includes an allocated portion of outreach and engagement
costs. Some MediCal reimbursement in anticipated but not as much as for the TAY
population.
VI.11.5. How the Program Will Advance the Goal of Resiliency. How Values of
Recovery/Resiliency Will Be Promoted and Reinforced.
The PowerHouse Project will take a collaborative and comprehensive approach to
addressing the individual needs of the members served based on client choice.
Consumers' stated needs and goals will define the services and supports that are
offered, allowing for the development of participants' self-direction, goal setting and
personal responsibility. The involvement of consumer-providers on the IST will ensure
the understanding and modeling of recovery practices and principles. This philosophy
is discussed more fully in the introduction section of this program (above).
Existing consumer-run supports will be available to Full Service Partners in the
PowerHouse Project. Not only will FSPs choose services and supports in their Person-
Centered Care Plan, but they may also choose to create a Wellness Recovery Action
Plan (WRAP) with support from their peers. This Plan focuses on increasing self
awareness and improving self care, self responsibility and natural support. Consumers
will also have the opportunity to both receive or provide peer supports to others through
the innovative, existing Tender Loving Care (TLC) Program which supports consumers
to work -- offering a variety of part-time peer support services such as transportation,
training, grocery shopping, housekeeping, gardening and yard maintenance, or support
for community involvement such a attending meetings, recreational, or social activities.
They may be eligible to participate in OCE's expanding SPIRIT training program to train
consumer advocates (See Program #6). There will be an overall focus on harm
reduction, or "whatever it takes."
VI.11.6. Program Expansion
As described earlier, supports for the Full Service Partnership are all new with MHSA
funds. The Full Partnership Program will, however, be highly coordinated and
integrated with existing homeless services. Additional systems development pieces—
justice systems liaisons and mental health clinicians --will add new mental health
capacity to existing homeless services.
VI.11.7. Supports and Services to be Provided by Clients and/or Family Members
Numerous aspects of the PowerHouse Project will be peer-led. These include:
105
k
4'
MHSA Community Supports and Services Final Plan, December 2005
• Two of the Peer Outreach Workers/Personal Service Coordinators hired for
this program will be mental health consumers and/or formerly homeless
individuals who have been trained for the positions.
• The Family Coordinator who will be under contract to CCMH for this program
will be a consumer's family member `-
The Community Support Workers for both educational and vocational
services will be mental health consumers `'
k"
Existing peer-led resources within CCMH and its consumer-run contractor
Mental Health Consumer Concerns, will become available to Full Service
Partners. These include the WRAP Support Program (Wellness Recovery `
Action Planning) and TLC — a consumer operated peer support program
offering in-home support and respite to consumers and their families.
Additional groups and trainings may also be offered. Examples of groups
might include co-occurring disorder, trauma recovery, support for community
involvement, and money management. OCE's expanding SPIRIT program to
train consumer advocates will also be available. There will be consumer j
involvement in the planning, development, implementation and evaluation of
this new program.
A Note on Family Support
The program recognizes that families can play an integral part of a person's recovery. '`
While adults with psychiatric disabilities often have no family they can turn to, or are not
in touch with the family that they do have,,the Family Coordinator will be available to U
support individuals to regain contact and relationships with their families. They will be
available to meet with consumers and their available families for solving problems and ;
improving communication. In addition, at the consumer's request, families can be invited
to assist in developing Full Service Partnership plans which detail the full range of
services that the consumer chooses to promote his or her wellness and recovery. '
The Family Coordinator hired to support the PowerHouse Project will also be working
with the TAY Program 's Full Service Partners and their families.
t
V1.11.8. Collaboration Strategies
At its core, the PowerHouse Project is designed to enhance existing homeless services '
in the county to better serve individuals with psychiatric disabilities within the homeless '.
population, to help them move into long-term supported housing, improved mental
f
health status, and improved quality of life. Ideally, the Full Service Partnership,
developed as part of the PowerHouse Project will eventually expand to support all
homeless adults with psychiatric disabilities.
At present, there are very few specialized services for this population. To achieve the
expansion in an embedded manner, MOUs and contracts will be developed with the
County Homeless Programs to a) provide increased mental health capacity to existing
homeless services for outreach and systems development, and b) provide specific w
{
106
so 111t
MHSA Community Supports and Services Final Plan, December 2005
support services from county homeless services to adults with psychiatric disabilities
who enter the PowerHouse Project's Full Service Partnership.
Homeless services to Full Service Partners will include the experience and resources of
the Hope Outreach Team, the system of homeless multi-service centers, and systems
for placement of homeless individuals in emergency shelter. Mental health services to
existing homeless programs will include a field-based mental health clinician, jail and
Superior Court liaisons, and a Financial Services Specialist.
Additionally, CCMH will benefit from the existing relationships of the county homeless
programs with community-based organizations serving the Latino and Asian/Pacific
Islander communities in West Contra Costa for outreach and service supports.
PowerHouse will additionally, through an RFP process, contract with community-based
agencies directly for Peer Outreach Workers/Personal Service Coordinators,
Community Service Workers, a co-occurring disorder specialist, and PowerHouse Team
Leaders. The program will benefit from existing relationships with other consumer-
operated programs.
VI.11.9. Cultural Competency
Keys to the cultural competency of the PowerHouse Project are the embedding of its
outreach/personal service coordinators in community-based agencies serving ethnic
populations that are often not reached by county systems. Because Latinos and
Asians/Pacific Islanders are the most significantly underserved populations, CCMH will
focus its efforts in these areas and with these language capacities. Experience and
competency with the homeless and those with psychiatric disabilities will be criteria for
selecting community partners as well. Trauma-informed services are necessary.
By building upon the existing homeless services system in the county, the cultural
appropriateness of services to the homeless will be higher. This includes gaining the
benefit of the county homeless program's existing relationships with shelters,
community-based providers, and the homeless themselves.
Our program will employ an ethnically diverse staff within its Integrated Service Teams
who reflect the ethnic and cultural backgrounds of our clients. This will include
individuals who are fluent in English and Spanish —the county's threshold language.
VI.11.10. Sensitivity to Sexual Orientation, Gender Identity and Differing
Psychologies and Needs of Women and Men, Boys and Girls.
Men and women have differing needs — related not only to sexual identify, but to their
socialization and the roles and expectations of family and society. Their differing
relationships to and experiences with violence in our society are also important. Boys
and girls face these same issues and often more as they are forming or grappling with
newly emerging issues about their sexuality, self-image, and relationships.
107
MHSA Community Supports and Services Final Plan, December 2005
Both county and community-based hiring will be focused on establishing a diversity that
is reflective of the populations being served. This includes diversity in gender and
sexual orientation. Cultural sensitivity training that will be developed as part of MHSA
will address issues of gender and sexual orientation as well as race and culture. '
Highly qualified staff, contractors and consumers working with adults as part of the t
PowerHouse Project will be especially sensitivity to these issues. Assessments and
care planning will raise and examine these issues, and supports and referrals will be
identified to meet individual client needs.
V1.11.11. Meeting the Service Needs of Individuals Residing Outside of the r'
County
r
D7:
The PowerHouse Project will be available to any consumer who resides in Contra Costa
County.
VI.11.12. Selection of Strategies Not on State List
All of the key strategies employed in the PowerHouse Project are on the State list of
selected strategies. These include:
Development of housing options r
• Supportive Housing
Outreach services to homeless persons that involve persistent, non-
threatening, outreach and engagement strategies that include the ability to
provide for the immediate needs of an individual including physical health
care, food, clothing and shelter
• Integrated services with ethnic-specific community-based organizations
• Integrated substance abuse and mental health services
• Client self-directed care plans (WRAP)
Intensive community services and supports teams capable of providing
services to clients where they live, 24/7
• Self-help and client-run programs
• Values driven culturally competent evidence-based or promising clinical
services that are integrated with overall service planning and support housing,
employment and education goals
• Transportation services
V1.11.13. Timeline
b
Key start-up milestones include:
• 5/06 Staff for first team hired and operational ' ?'
• 5/06 Outreach Plan developed and outreach begins
5/06 First FSPs enrolled
• 10/06 Second team operational
• 1/07 Full enrollment achieved
k
108 . t
6s:
EXHIBIT 6a—Mental Health Services Act Community Services and Supports Budget Worksheet
County(les): Contra Costa Fiscal Year. 2005-06
Program Workplan# #3 Date: 1217/05
Program Workplan Name Adult FSP: PowerHouse Project Page_of
Type of Funding 1.Full Service Partnership Months of Operation 3
Proposed Total Client Capacity of Program/Service: 30 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 30 Telephone Number. 925)9575132
County Mental Other Community
Me
Health Governmental ntal HealthContract Total
Department Agencies
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(Flex Fund) $3.000 $3,000
b.Travel and Transportation $5.000 $5,000
c.Housing
I.Master Leases $0
it.Subsidies $0
iii.Vouchers $0
iv.Other Housing EQ
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) 10
f.Total Support Expenditures $8,000 s0 s0 $8,000
2. Personnel Expenditures
a.Current Existing Personnel ExpendRures(from Staffing Detail) $0
b.New Add@ional Personnel Expenditures(from Staffing Detail) $76,424 $76,424
c.Employee Benefits $4,9.011 $45,011
d.Total Personnel Expenditures $121,435 s0 s0 $121,435
3. Operating Expenditures
a.Professional Services $0
b.Translation and Interpreter Services $0
c.Travel and Transportation $31,000 $31,000
d.General Office Expenditures $4.000 $4.000
e.Rent,Utilities and Equipment $20,750 $20,750
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $53 558 $53,558
h.Total Operating nditures $109,308 $0 $0 $109,308
4. Program Management
a.Existing Program Management $0
b.New Program Management
c.Total Program Management f sc $0 $0 $0
5. Estimated Total Expenditures when service provider is not known $148,869 «,ss v `.il"c` 't 7f±- a 4 $148,869
6.Total Proposed Program Budget $387,612 so so $387,612
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient FeeslPatient Insurance $0
c.Realignment $0
d.State General Funds s0
e.County Funds so
f.Grants
g.Other Revenue 19
h.Total Existing Revenues $0 s0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient FeeslPatient Insurance $0
c.State General Funds so
d.Other Revenue K0
e.Total New Revenue $0 $0 s0 s0
3.Total Revenues $0 $D so $0
C.One-Time CSS Funding Expenditures $90,000 1 1 $90,000
D.Total Funding Requirements $477,612 50 So $477,612
E.Percent of Total FundingRequirements for Full Service Partnerships r.a 1M.'i 3 a r„'moi ._ 4 na 86.0%
109
EXHIBIT 5 ti—Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2005-06
Program Workplan S Ira Date: 12/7/05
Program Workplan Name Adult FSP: PowerHouse Project Page_of
Type of Funding 1.Full Service Partnership Months of Operation 3
Proposed Total Client Capacity of Program/Service: 30 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 30 Telephone Number: 925)957-5132
Classification Function Client,FM 8 CO Total Number Salary,Wages and Total Salaries.
FTEs"' of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions
$0
Total Current Existing Positions 0.00 0.00131VARTAMM,SM $0
B.New Additional Positions
Program Supervisor Program Leadership 0.50 $76,774 $9,597
Psychiatrist Clinical Cam 0.30 $168,000 $12,600
Nurse Clinical Cam 0.50 $74,640 $9,330
MH Clinical Spec(Lic) Outreach,Clinical Care 2.00 $57,504 $28,752
Clerk Clerical Support 0.50 $69,324 $8,666
Cons.Financial Services Specla Benefits Elgib.And Analysis 0.50 $44,838 $5,605
Family Coordinator(Contr) Consumer Advocacy and Support 0.25 0.25 $30,000 $1,875
$0
$0
$0
$0
$0
$0
16
$0
$0
Ko
Total New Additional Positions 0.251 4.55 $76,424
;,. �.,. ..
C.Total Program Positions 0.25 4.55 $76,424
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
110
EXHIBIT lia—Mental Health Services Act Community Services and Supports Budget Worksheet
County(es): Contra Costa Fiscal Year. 2006-07
Program Workplan# _ #3 Date: 12/7/05
Program Workplan Name Adult FSP: PowerHouse Program Page_of
Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: 100 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 100 Telephone Number: 925)9575132
County Mental Other Community
Me
Hearth GovernmentalContract ntal Health Total
Department Agenciess
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(Flex Fund) $15,000 $15,000
b.Travel and Transportation $12,000 $12,000
c.Housing
i.Master Leases s0
ii.Subsidies s0
iii.Vouchers s0
iv.Other Housing 19
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) 29
f.Total Support Expenditures S27,000 s0 s0 $27,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) s0
b.New Additional Personnel Expenditures(from Staffing Detail) $399,452 $399,452
c.Employee Benefits $232,921 $232.921
d.Total Personnel Expenditures $632,373 s0 so $632,373
3. Operating Expenditures
/--� a.Professional Services $25,000 $25,000
/ b.Translation and Interpreter Services s0
\\J� c.Travel and Transportation $16,000 $16,000
d.General Office Expenditures $12,000 $12,000
e.Rent,Utilities and Equipment $22,000
t Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $232,371 $232,371
h.Total Operating Expenditures $307,371 s0 $D $307,371
4. Program Management
a.Existing Program Management p '` ;yiX
�. . $0
b.New Program Management
a Program Prom Man ement `�',.�` � _ �., $0 $0 $0
5. Estimated Total Expenditures when service provider is not known $791,750 �;='� ,. 3 '^-''`r . T' ?}r 7'yy0rr $791,750
S.Total Proposed Program Bud et $1,758,495 $o so $1,758A95
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Meftarw?atient Fees/Pat(ent insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue 1'0
h.Total Existing Revenues s0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $160,000 $180,000
b.MedicerelPatient FeesfPatient Insurance $0
c.State General Funds $0
d.Other Revenue EO
e.Total New Revenue $180,000 so SD $180,000
3.Total Revenues $180,000 s0 $0 $180,000
C.One-Time CSS Funding Expenditures so
D.Total Funding Requirements $1,578,495 f0 $0 $1,578,495
1 d
E.Percent of Total FundingRequirements for Full Service Partnerships ' X � " �" ' x 76.0%
111
EXHIBIT 5 b-Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2006.07
Program Workplan# 93 Date: 12/7/05
Program Workplan Name Adult FSP: PowerHouse Project Page_of
Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: 100 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 100 Telephone Number: 925)9573132
Classification Function Client,FM&CO Total Number Salary,Wages and Total Salaries.
FTEs' of FTEs Overtime per FTE' Wages and Overtime
A.Current Existing Positions
$0
Total Current Existing Positions 0.00 0.00 $0
B.New Additional Positions _
Program Supervisor Program leadership 0.50 $76,774 $38,387
Psychiatrist Clinical Care 0.30 $168,000 $50,400
Nurse Clinical Care 0.50 $74,640 $37,320
MH Clinical Spec(Lic) Outreach,Clinical Care 3.50 $57,504 $201,264
Clerk - Clerical Support 1.00 $34,662 $34,662
Cons.Financial Services Specia Benefits Elgib.And Analysis 0.50 $44,838 $22,419
Family Coordinator(Contr) Consumer Advocacy and Support 0.25 0.25 $60,000 $15,000
$0
$0
$0
s0
$0
$0
$0
$0
Lo
Total New Additional Positions 0.25 6.55 $399,452
C.Total Program Positions 0.25 6.55 {_ $399,452
al Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
112
EXHIBIT Sa—Mental Health Services Act Community Services and Supports Budget Worksheet
County(jes): Contra Costa Fiscal Year. 2007-08
Program Workplan# #3 Date: 12/7/05
^ Program Workplan Name Adult FSP: Power-louse Project Page_of
Type of Funding 1.Full Service Partnership Months of Operation 12
Proposed Total Client Capacity of Program/Service: 150 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 150 Telephone Number: 925)9575132
County Mental Other Community
Menta
Health OGovernmentall Wealth
Coad Total
Department Agencies
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene(Flex Fund) $15,000 $15,000
b.Travel and Transportation $12,000 $12,000
c.Housing
i.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) 19
f Total Support Expenditures $27,000 $0 Sol $27,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Stalling Detail) $0
It.New Additional Personnel Expenditures(from Staffing Detail) $399,452 $399,452
c.Employee Benefits3$2 2.921 $232,921
d.Total Personnel Expenditures $632,373 $0 $0 $632,373
3. Operating Expenditures
a.Professional Services $25,000 $25,000
b.Translation and Interpreter Services $0
c.Travel and Transportation $16,000 $16,000
d.General Office Expenditures $12,000 $12,000
e.Rent,Utilities and Equipment $22,000
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) 2$2 9.367 $229,367
h.Total Operating Expenditures $304,367 $0 $0 $304,367
4. Program Management
a.Existing Program Management $0
.—
b.New Program Management
e Total Program Management =° ,;e.a= $0 $0 $0
5. Estimated Total Expenditures when service provider Is not known $771,738 *?a'�^� "r;s'�: 1''4 _. :'"'^ $771,738
S.Total Proposed Program Budget $1,735.478 $o $0 $1 735,478
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue $0-
h.Total Existing Revenues $o $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $285.000 $285,000
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
d.Other Revenue $4
e.Total New Revenue $285.000 $0 $0 $285,000
3.Total Revenues $285 000 $0 $0 $285,000
C.One-Time CSS Funding Expenditures so
D.Total Funding Requirements $1,450.478 $o $0 $1,450,478
E.Percent of Total FundingRequirements for Full Service Partnerships
? x t �x� 73.0%
113
v y
L
EXHIBIT 5 b–Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
CountyCws): Contra Costa Fiscal Year. 2007-08
Program Workplan 0 93 Date: 12/7105
Program Workplan Name Adult FSP: PowerHouse Project Page_of—
Type of Funding 1.Full Service Partnership Months of Operation 12
qrc Proposed Total Client Capacity of ProgramlService: 150 New Program/Servwe or Expansion New
` Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 150 . Telephone Number. 925)9575132
Classification Function Client,FM&CO Total Number Salary,Wages and Total Salaries.
FTEs"' of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions
$0
NO
Total Current Existing Positions 0.001 o.00 $0
B.New Additional Positions
Program Supervisor Program Leadership 0.50 $76,774 $38,387
Psychiatrist Clinical Care 0.30 $168,000 $50,400
Nurse Clinical Care 0.50 $74,640 $37,320
MH Clinical Spec(Lic) Outreach,Clinical Care + 3.50 $57,504 . $201,264
Clerk Clerical Support 1.00 $34,662 $34,662
Cons.Financial Services Specie Benefits Elglb.And Analysis 0.50 $44,838 $22,419
Family Coordinator(Contr) Consumer Advocacy and Support 0.25 0.25 $60,000 $15,000
$0
$0
$0
$0
$o
$0
$0
$0
Total New Additional Positions 0.25 6.55 $399,452
C.Total Program Positions 1 0.25 6.55031=1 $399,452
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
a
I
s^v '
4
114
+
At
K
`�
E 3w
�Z.3:,
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan#3: Adult FSP: PowerHouse Project
FY 05-06
rr. rnr r.r.cr..r.r�.nwnnrwr.r.�.r.r�r. r�.r. ..rr.crrrr..nrrw..r.r r.n.rwr�rw.r.c..r..�r�r.r.....r
Introduction: This budget assumes funds approved for an April 1 Start-up, 2006. First
quarter activities presumes hiring efforts carried out before start date. Activities for
these three months include establishment of teams and development of outreach plans,
with outreach and enrollment beginning on May 1, 2006.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$3,000 based on prior experience, and partial year of operations
b. Travel and Transportation
$5,000 based on prior experience and partial year of operations
c. Housing See Program #5 for Housing
d. Employment and Education Supports
Included in Flex Funds.
e. Other Support Expenditures
Included in Flex Funds.
f. Total Support Expenditures
$8,00 for partial year operations.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
b. New Additional Personnel Expenditures
All salaries based on 25% of full-year operations. Salaries set at mid-step
of county scale for position. A minimum of 50% of staff hired will be
bilingual in Spanish, ASL, or an Asian language.
.5 FTE Program Supervisor— Full time administrative position with 50%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances.
.3 FTE Psychiatrist-- Provides direct client care for medication
prescription and monitoring. Contract position.
.5 FTE Nurse— Provides direct client medical care
2.0 FTE Licensed Mental Health Clinicians— Start-up level for eventual
3.5 FTE full staffing. 1.0 FTE is for a combination of street outreach,
mobile crisis intervention, beginning clinical treatment in the field,
and eligibility determination. The other 1.0 FTE will provide
eligibility determination and support to the county contractor's
115
,
MHSA Community Supports and Services Final Plan, December 2005
outreach/PSC teams, as well as serving as a Personal Service
Coordinator.
.50 FTE Clerk— Start-up of eventual full time position responsible for
providing administrative and clerical support to the program.
.50 FTE Consumer Financial Services Specialist— Will support FSP
clients with eligibility determinations, education and support for
applying for benefits.
.25 FTE Family Partner— Contract peer position providing individual and
family support, advocacy and assists with linkages with public and
community-based systems and supports.
c. Employee Benefits
$45,011 in full employee benefits figured at county rate. Contracted
positions at reduced rate.
d. Total Personnel Expenditures
Total personnel expenditures total $121,435.
3. Operating Expenditures
a. Professional Services None
b. Translation and Interpreter Services
Will rely on multilingual capabilities of new staff and existing resources.
c. Travel and Transportation
$31,000. $30,000 for purchase of van for client transportation plus $1,000
for operation and maintenance of van.
d. General Office Expenditures
$4,000 Based on start-up needs and full-year experience.
e. Rent, Utilities and Equipment
$5,750 based on full-year experience plus $15,000 for start-up purchase of
equipment for new staff.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$3,000 for outreach expense plus $50,558 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$109,308.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
5. Estimated total Expenditures when service provider is not known
Total estimated contractor's budget of$148,869 includes $109,669 in staffing
and benefits. Pro-rated for 25% of the year. A minimum of 50% of staff hired will
be bilingual in Spanish, ASL or an Asian Language. Includes the positions of.
116
x :
d
,M
MHSA Community Supports and Services Final Plan, December 2005
✓ 2.0 FTE Team Leaders— 50% coordination and leadership of
outreach/PSC teams and 50% for outreach. Includes facilitating
communication with CCMH administrative and field staff.
✓ 1.0 FTE Community Support Worker— Peer position providing
advocacy and support for FSPs on educational and vocational
issues and placements. Includes field support.
✓ .50 FTE Co-Occurring Disorders Specialist --Assesses TA Ys
for alcohol and other drug use. Participates in care service
planning, facilitates linkages with AOD-related supports and
services, leads recovery-related education and treatment
groups, educates and supports staff on AOD issues.
✓ 1.0 FTE Personal Service Coordinator. Start-up for eventual
4.0 FTEs.
✓ 1.5 FTE (Start-up for eventual 3 position at .75 FTE each)
Combination Peer Outreach Workers/Personal Service
Coordinators"—paraprofessional peer position for outreach and
personal service coordination.
$40,200 for operating expenses includes purchase of 1 van for
transporting clients, maintenance of that van, travel and transportation,
translation, general office, rent/utilities/equipment, and a flex fund for
clients.
Q7. Total Proposed Program Budget
$387,612 Total Program Budget.
B. Revenues
1. Existing Revenues None
2. New Revenues None this year
3. Total Revenues None this year
C. One-Time CSS Funding Expenditures
$90,000 includes $60,000 for CCMH for purchase of 2 vans for transportation
of clients and $30,000 for contractor for purchase of 1 van for transporting
clients. See page 188 for a discussion of the need for one-time funds.
D. Total Funding Requirements
$477,612 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 86%.
117
MHSA Community Supports and Services Final Plan, December 2005
1'
'Contra Costa County Mental Health
Budget Narrative f
Plan #3: Adult FSP: PowerHouse Project €
FY 06-07
/.1141./.I../.V/V.V.V IV.V.V.V.V N.V N.VAI..I.V.V.V.WN.V..I..YWIV IV AI.V.V IV,V IV I.VIV AI/V..YIYR/.V.V fr..
Introduction: This budget reflects a full year of operation, rising to an enrollment of 65 `
by the end of the year. The budget reflects the creation of 16.3 FTE new positions for
supports and services, with a minimum of 3.5 of those positions to be filled by -
consumers.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$15,000 based on prior experience, and partial year of operations
b. Travel and Transportation
$12,000 based on prior experience and partial year of operations
c. Housing See Program #5 for Housing `
t.
d. Employment and Education Supports
Included in Flex Funds above
e. Other Support Expenditures
Included in Flex Funds above
f. Total Support Expenditures
$27,000 total Support Expenditures.
1
2. Personnel Expenditures
a. Current Existing Personnel Expenditures m
None
b. New Additional Personnel Expenditures ;
Salaries set at mid-step of county scale for position. A minimum of 50% of
staff hired will be bilingual in Spanish, ASL, or an Asian language.
Includes:
.5 FTE Program Supervisor— Full time administrative position with 50%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances.
.3 FTE Psychiatrist -- Provides direct client care for medication
prescription and monitoring. Contract position.
.5 FTE Nurse— Provides direct client medical care
3.5 FTE Licensed Mental Health Clinicians—Licensed clinical positions.
.5 FTE is for a combination of street outreach, mobile crisis intervention,
beginning clinical treatment in the field, and eligibility determination.
1.0 FTE will provide eligibility determination and support to the county ;
contractor's outreach/PSC teams, as well as serving as a Personal
Service Coordinator. 1.0 FTEs will be a full-time Personal Service
's
118 {
4'
WNW
MHSA Community Supports and Services Final Plan, December 2005
Coordinators and 1 FTE will be dedicated as a Mental Health
Jail/Court liaison, initiating a mental health court.
1.0 FTE Clerk— Full time position responsible for providing administrative
and clerical support to the program.
.50 FTE Consumer Financial Services Specialist— Will support FSP
clients with eligibility determinations, education and support for
applying for benefits.
.25 FTE Family Partner-- Peer position providing individual and family
support, advocacy and assists with linkages with public and
community-based systems and supports.
c. Employee Benefits
$232,921 in full employee benefits figured at county rate. Contracted
position at reduced rate.
d. Total Personnel Expenditures
Total personnel expenditures total$632,373.
3. Operating Expenditures
a. Professional Services
$25,000 for contracted services from consumers working through CCMH's
Office of Consumer Empowerment to provide education and support for
WRAP (Wellness Action Recovery Planning) and TLC (in-home peer-
provided supports to clients).
b. Translation and Interpreter Services
Will rely on new multilingual staff/contractor capabilities and existing
resources
c. Travel and Transportation
$16,000 vehicle maintenance based on experience.
d. General Office Expenditures
$12,000 Estimated based on prior experience.
e. Rent, Utilities and Equipment
$22,000 Estimated based on prior experience.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$3,000 for outreach expense plus $229,371 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$307,371.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
119
�te
MHSA Community Supports and Services Final Plan, December 2005
5. Estimated total Expenditures when service provider is not known
Total estimated contractor's budget of$791,750. A minimum of 50% of staff
hired will be bilingual in Spanish, ASL, or an Asian language. Includes $711,738
in staffing and benefits including the estimated positions of.•
✓ 1.0 FTE Team Leader— 50% coordination and leadership of
outreach/PSC teams and 50% for outreach. Includes facilitating
communication with CCMH administrative and field staff.
✓ 2.0 FTE Community Support Workers — Providing advocacy
and support for FSPs. One specializes in education and the
other specializes in vocational issues and placements. Includes
field support. At least one will be a peer, and at least one will be
:fr bilingual in Spanish. z.
✓ .50 FTE Co-Occurring Disorders Specialist--Assesses FSPs
for alcohol and other drug use. Participates in care service
planning, facilitates linkages with AOD-related supports and
services, leads recovery-related education and treatment
groups, educates and supports staff on AOD issues.
✓ 4.0 FTE Personal Service Coordinators . One of these
positions is a specialist in co-occurring disorders and is
available to all FSPs on weekend days to reduce weekend call
demand.
✓ 2.25 FTE Combination Peer Outreach Worker/Personal
Service Coordinators—bilingual, bicultural paraprofessional
peer positions for outreach and personal service coordination.
$120,000 for operating expenses includes $30,000 for purchase of a van
for client transportation, vehicle maintenance, general office, rent, utilities
and equipment, and a flex fund for clients.
6. Total Proposed Program Budget
$1,758,495 Total Program Budget.
B. Revenues
1. Existing Revenues None
2. New Revenues $180,000— Estimated income from MediCal—'based
on relatively low insurance rates within this population and great length of
time that it takes to secure new benefits.
3. Total Revenues $180,000
C. One-Time CSS Funding Expenditures None
D. Total Funding Requirements
$1,578,492 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only= 75%
120 .
ao
MRSA Community Supports and Services Final Plan, December 2005
O Contra Costa County Mental Health
Budget Narrative
Plan #3: Adult FSP: PowerHouse Project
FY 07-08
Introduction: This budget reflects a full year of operation, rising to enrollment of 135
by the end of the year. The budget reflects the creation of 16.3 FTE new positions for
supports and services, with a minimum of 3.5 of those positions filled by consumers.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$15,000 based on prior experience, and partial year of operations
b. Travel and Transportation
$12,000 based on prior experience and partial year of operations
c. Housing See Program #5 for Housing
d. Employment and Education Supports
Included in Flex Funds above.
e. Other Support Expenditures
Included in Flex Funds above.
f. Total Support Expenditures
$27,00 in total Support Expenditures.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
b. New Additional Personnel Expenditures
Salaries set at mid-step of county scale for position. A minimum of 50% of
staff hired will be bilingual in Spanish, ASL, or an Asian language. Includes:
.5 FTE Program Supervisor— Full time administrative position with 50%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances.
.3 FTE Psychiatrist-- Provides direct client care for medication
prescription and monitoring. Contract position.
.5 FTE Nurse —Provides direct client medical care
3.5 FTE Licensed Mental Health Clinicians— Licensed clinical positions.
.5 FTE is for a combination of street outreach, mobile crisis intervention,
beginning clinical treatment in the field, and eligibility determination.
1.0 FTE will provide eligibility determination and support to the county
contractor's outreach/PSC teams, as well as serving as a Personal
Service Coordinator. 1.0 FTEs will be a full-time Personal Service
Q Coordinators and 1 FTE will be dedicated as a Mental Health
Jail/Court liaison, initiating a mental health court.
121
MHSA Community Supports and Services Final Plan, December 2005
1.0 FTE Clerk— Full time position responsible for providing
administrative and clerical support to the program. .
.50 FTE Consumer Financial Services Specialist— Will support FSP
clients with eligibility determinations, education and support for
applying for benefits.
.25 FTE Family Partner-- Peer position providing individual and family
support, advocacy and assists with linkages with public and
community-based systems and supports.
c. Employee Benefits
$232,921 in full employee benefits figured at county rate. Contracted
positions at reduced rate. 4,
d. Total Personnel Expenditures
Total personnel expenditures total$632,373. E
3. Operating Expenditures k
a. Professional Services
$25,000 for contracted services from consumers working through CCMH's
Office of Consumer Empowerment to provide education and support for
WRAP (Wellness Action Recovery Planning) and TLC (in-home peer-
provided supports to clients).
b. Translation and Interpreter Services
Will rely on new multilingual staff/contractor.capabilities and existing t'
resources.
t
C. Travel and Transportation
$16,000 vehicle maintenance based on experience.
d. General Office Expenditures
$12,000 Estimated based on prior experience.
e. Rent, Utilities and Equipment ,
$22,000 Estimated based on prior experience.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$3,000 for outreach expense plus $226,367 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$304,367.
4. Program Management
a. Existing Program Management None
b. New Program Management None
C. Total Program Management None
5. Estimated total Expenditures when service provider is not known i
Total estimated contractor's budget of$771,738. A minimum of 50% of staff
hired will be bilingual in Spanish, ASL, or an Asian language. $711,738 in staffing `
and benefits including the estimated positions of:
x
122
a,'
MHSA Community Supports and Services Final Plan, December 2005
✓ 1.0 FTE Team Leader— 50% coordination and leadership of
outreach/PSC teams and 50% for outreach. Includes facilitating
communication with CCMH administrative and field staff.
✓ 2.0 FTE Community Support Workers— Providing advocacy
and support for FSPs. One specializes in education and the
other specializes in vocational issues and placements. Includes
field support. At least one will be a peer, and at least one will be
bilingual in Spanish.
✓ .50 FTE Co-Occurring Disorders Specialist--Assesses FSPs
for alcohol and other drug use. Participates in care service
planning, facilitates linkages with AOD-related supports and
services, leads recovery-related education and treatment
groups, educates and supports staff on AOD issues.
✓ 4.0 FTE Personal Service Coordinators . One of these
positions is a specialist in co-occurring disorders and is
available to all FSPs on weekend days to reduce weekend call
demand.
✓ 2.25 FTE Combination Peer Outreach Worker/Personal
Service Coordinator—bilingual, bicultural paraprofessional peer
positions for outreach and personal service coordination.
$60,000 for operating expenses includes vehicle maintenance, general
Ooffice, rent, utilities and equipment, and a flex fund for clients.
6. Total Proposed Program Budget
$1,735,478 Total Program Budget.
B. Revenues
I. Existing Revenues None
2. New Revenues $285,000—Estimated income from MediCal— based
on relatively low insurance rates within this population and great length of
time that it takes to secure new benefits. Show slight increase from prior
year.
3. Total Revenues $285,000
C. One-Time CSS Funding Expenditures
D. Total Funding Requirements
$1,450,478 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 73%.
123
MHSA Community Supports and Services Final Plan, December 2005
EXFIIBI' ' 4• COIIIIMUN SEl2�\%ICES ANDSUPP'Q 7'SIiNO P PF
a,
Cou ty Contra Costa 1=fiscal Progra""" VII rbc PI*ani` ame; .Older Ati�ttSystemr "'
4
fear; ED eVeloprment _
_
ProswaAWL ork P 4135#0 OOMa#edjSti rt ®ate.;' .Nouernber; 007
Description of Currently there are no specialized geriatric mental health
Program: services in Contra Costa County. The Older Adult Program will
advance the goals of MHSA by establishing an integrated
service delivery structure that does not currently exist for
seniors. Services will be consumer friendly, culturally
competent and client-driven. Culturally competent outreach
will help to identify and engage consumers. Co-located and
integrated medical/mental health services will reduce barriers
to care. This core structure will allow expansion for more
comprehensive services and increased service volume in the
future.
Priority Population: The target population is seniors, aged 60 years and older, who
are isolated and living in the community, and who are severely
` disabled. They will have complex presentations, often
involving psychiatric and medical problems (a serious mental
illness complicated by a serious medical problem) or a
diagnostic confusion of the two, without adequate support and
resources, including adequate insurance. First priority will be
those at risk for an unnecessary loss of ability to function, e.g.:
a Those seniors who may lose the ability to care for themselves
and their health, and/or who may lose their ability to remain at
home as a result of a downward spiral. Services will be
targeted to seniors who are MediCal recipients or with incomes
at 300% of the federal poverty level or below.
Fund Type A e Group
-• - • •- -• • •- Sys
-• - -• •- • • • •- -• FSP Dev OE CY TAY A OA
Inte rated Assessment Teams ❑ ® ® ❑ ❑ ❑
Inte rated Service Teams ❑ ® ❑ ❑ ❑ ❑
On-site or collaborative services with primary ❑ ® ❑ ❑ ❑ ❑
care clinics
Culturally appropriate services to reach E] ® ® El ❑
persons of racial/ethnic cultures ...
Peer-supportive services I ❑ ® I ❑ ❑ 11 ❑ I ❑
�z
t,
4
124.
n34
MHSA Community Supports and Services Final Plan, December 2005
0
Program #4: Older Adults System Development
V1.11.2. Program Description
Currently there are no specialized geriatric mental health services in Contra Costa
County. The Older Adult Program will establish an integrated service delivery structure
that does not currently exist for seniors. Services will be consumer friendly, culturally
competent and client-driven. This core structure will allow expansion for more
comprehensive services and increased service volume in the future.
Target Population
The target population for services will be seniors, aged 60 years and older, who are
isolated and living in the community, and who are severely disabled. They will have
complex presentations, often involving psychiatric and medical problems (a serious
mental illness complicated by a serious medical problem) or a diagnostic confusion of
the two, without adequate support and resources, including adequate insurance. First
priority will be those at risk for an unnecessary loss of ability to function, e.g.: Those
seniors who may lose the ability to care for themselves and their health, and/or who
may lose their ability to remain at home as a result of a downward spiral. Services will
be targeted to seniors who are MediCal recipients or with incomes at 300% of the
federal poverty level or below.
It is anticipated that approximately 425 clients will enter the Older Adult Program
countywide in the first full year of operation, with 225 becoming active for ongoing care
and care management services. The remaining 200 will not qualify— based on severity
of need -- for intensive services but will receive evaluation, referrals and tracking by the
team.
Outreach and Engagement
The centerpiece of the program is a system of three outreach teams that will serve the
three geographic regions of Contra Costa — East, West and Central County. These
teams will provide outreach, engagement, community education, assessment and
treatment intervention to older adults. They will provide ongoing service to those
identified as most in need. They will link consumers to community resources and
existing services and clinics. Each team will include a geropsychiatrist who will see
patients in both primary care settings and in their home environments —for those unable
or unwilling to be seen in a clinic setting.
A key element of the outreach effort will be linkages with community-based or faith-
based agencies that provide social services and supports to older adults. Contracts will
be established with community-based agencies that serve ethnically diverse
communities to assist in multiple forms of outreach to their service communities.
Contracted agencies will also provide a culturally appropriate mental health worker to
the Outreach Team.
125
MHSA Community Supports and Services Final Plan, December 2005
a=
Despite the outreach emphasis, there will be multiple points of entry into the Older Adult
system of care with referrals from first responders (police, meter readers, mail carriers,
etc.), community and faith-based agencies, community members, hospitals, clinics,
crisis lines, psychiatric emergency services and by self referral. The Program leader
and mental health workers will be responsible for development and implementation of a '
community education plan.
Linkages
Three important partnerships will exist. The first will be with community-based s
organizations (CBOs) with an emphasis on providing culturally competent services to '
ethnic communities. This is described in the previous section on Outreach. x
The second partnership will be with the Contra Costa Health Services' Regional Medical
Center and Health Centers, which will share funding for the program and will house the
outreach teams in their regional clinics. This will allow the program to serve both the
medical and mental health needs of high-risk individuals without requiring them to
access services in different places. The team psychiatrists will spend half of their time
addressing primary psychiatric issues and providing home visits with the team. The
remaining time will be spent in consultation to primary care physicians in the clinic
system and providing evaluation and treatment of primary dementia and other medical
disorders that present with behavioral symptoms. With this split, the geropsychiatrist
will be able to address any individual with high degrees of impairment from mental `
illness, dementia, medical illness, or complex interactions of any of these, within the t
context of broader medical care. Reimbursement will be obtained, where possible, for
medical and mental health diagnoses.
The third partnership will be with existing services — both public and private — serving
older adults in Contra Costa County. Services that do exist are currently separate and
uncoordinated. The plan calls for a dedicated program leader who will not only oversee
the clinical services, but also develop linkages with those services and supports, both
large and small, currently serving seniors: Aging and Adult Services, In Home Support
Services, senior housing, transportation services, Senior Peer Counselors, Meals on
Wheels, to name a few.
t
Team Composition
Each Outreach Team will be composed of a Team Leader/Social Worker, a nurse, a
peer counselor, a contracted mental health worker from a community-based agency,
and a geropsychiatrist. As mentioned earlier, while they will spend much time in the
field, each team will be housed in that region's county primary care clinic. The mental
health worker will also co-locate some of the time with his/her contracting community-
based agency.
Services
Clients will receive an initial assessment, and a geropsychiatric and/or medical '
evaluation as needed. A care plan for each client will be developed in collaboration with
126
d'
MHSA Community Supports and Services Final Plan, December 2005
the client. Care plans will address health, housing, financial, legal, and social needs.
Treatment modalities will include broad-based psychotherapy including family therapy,
case management, psychotropic medication, socialization and peer counseling. The
plan will be recovery-focused and client-directed. It will include family when possible.
Peer counseling, grounded in recovery principles, will be an essential element. The
program will draw upon an existing Senior Peer Counseling Program for qualified staff
as well as for additional services for clients.
Transportation will be provided as necessary to assist the consumer in getting to
necessary appointments and accomplishing desired linkages. When the consumer is
not able or not willing to travel, services will be provided in the home as possible. A
"flex fund" will be available to help the consumer to remain in their home and remain as
functional as possible. This could include building a wheelchair ramp or assistance with
home maintenance.
Some clients assessed by the team will not be deemed sufficiently impaired to require
the services of the team, but might benefit from treatment in primary care with a
combined primary care/geropsychiatry approach. The team will facilitate an
appointment at one of the regional health care centers. "One stop shopping" with
combined primary care and geropsychiatry will help these seniors maintain so they do
not lose ground and require a higher level of service.
VI.11.3. Housing and Employment Services in this Program
An important goal of the Older Adult Program is to keep older adults in (or return them
to) their own homes. To accomplish this, some funds will be available to be able to
make adaptations and repairs to homes so that older adults can be in them.
Additionally, referrals to community-based housing supports and services will be made.
Employment will not be a key focus for this older adult population. Rather, once
consumers are stabilized, teams will help them to achieve meaningful use of their time.
In a few instances, employment supports may be relevant and referrals to community-
based resources will be made.
VI.11.4 Cost Per FSP Participant
This is not a full service partnership program.
VI.11.5. How Values of Recovery/Resiliency Will Be Promoted and Reinforced.
The Older Adult Program, by design, takes a holistic approach to the physical, mental
and spiritual health of older adults with an emphasis on optimum functioning. It is
designed to reduce isolation and maximize well-being through an integrated approach
that is driven by consumer needs and preferences. It will put the consumer first and
emphasizes outreach, peer support and service linkages.
127
A
MHSA Community Supports and Services Final Plan, December 2005
VI.11.6. Program Expansion
As stated earlier, this program is establishing a new infrastructure of care for older
adults in the county with the establishment of new outreach/service teams and
integration of medical and mental health care through shared funding and co-location of
services.
The Program leader will provide leadership and direction in the future development of
the MHSA Older Adults Plan for services in the county. It is anticipated that this will
result in establishment of an Older Adult Full Service Partnership in the future. The
start-up program described here cannot be classified as a Full Service Partnership
because it will not have the capacity to provide "whatever it takes" or support availability
24 hours a day, 7 days a week. Rather, by establishing a basic outreach and service
delivery structure in the first few years, we will be able to add additional enhancements
in future years.
VI.11.7. Supports and Services to be Provided by Clients and/or Family Members
Each of the Older Adult Outreach Teams will include a full time peer counselor and a
community-based mental health worker. The three peer counselors will be mental
health consumers themselves. Community-based mental health workers will also
represent a range of ethnicities reflecting the populations to be served. Where possible,
new staff will be consumers as well.
VI.11.8. Collaboration Strategies
The key collaborator for the Older Adult Program is the Contra Costa Health Services'
Regional Medical Center and Health Centers. As stated earlier, they will share in the
funding of this effort— including providing housing for outreach teams in each of their
three regional health clinics. This joint funding will allow the geropsychiatrists to
address physical and mental health problems with behavioral manifestations regardless
of whether the diagnosis is primarily medical or mental health. This will help to reduce
the gaps between the two systems of care, allow an integrated approach to complex
physical/mental health problems, and eliminate a major barrier to entry into mental
health care through increased access and diagnostic capability. The program will
emphasize connecting people.
Community or faith-based agencies serving primarily ethnic communities will also be ;
important collaborators. They will have the opportunity to bid to join the Older Adult
Outreach Teams through provision of a shared mental health worker. Contracting
agencies and others will lend expertise to the development of outreach plans and will R
utilize their services and natural networks to reach older adults in need of program f'
services. Community-based partners will be selected through a bidding process and
cannot be named here.
128
t
MHSA Community Supports and Services Final Plan, December 2005
Examples of collaborating agencies for referrals and linkages include but are not limited
to: Contra Costa County departments and divisions within Health Services,
Employment and Human Services, the Health Plan, Aging and Adult Services, Alcohol
and Other Drugs, and Senior Peer Counselors. Community agencies include but are
not limited to: Familias Unidas, Asian Community Mental Health, Culture-to-Culture, La
Clinica de La Raza, Senior Housing, Visiting Angels, Meals on Wheels, Alzheimer
Association, Senior Centers, Adult Day Health Centers.
Another key collaborator is the Contra Costa Health Plan (CCHP). CCHP is another
division of Contra Costa Health Services. It is the oldest federally qualified, state
licensed, county sponsored HMO in the United States. In 1973, they became the first
county-sponsored health plan in California to offer Medi-Cal Managed Care coverage
and in 1976, it became the first county-run HMO to serve Medicare beneficiaries. In the
1980s, it expanded the program to reach county employees, businesses, individuals
and families. Contra Costa Health Plan currently has approximately 66,000 enrollees.
Contra Costa Mental Health supports the Health Plan with mental health services to
these clients.
The Health Plan is currently pursuing a plan to include the aged, blind and disabled into
its membership through the state's Acute and Long Term Care Integration Program
(ALCI). It is also applying to Medicare to become a Medicare Risk Plan. With these
changes, the Health Plan predicts that the number of older adults that will be receiving
care under the Health Plan could increase by 20,000 to 30,000 beginning in 2007. If
this were to occur, the existence of an infrastructure for coordinated outreach and
integrated mental and physical care would become critical. Implementation of the Older
Adult Full Service Partnership could be timed to match the expansion of the Health
Plan's coverage. Planning for a coordinated approach to integrated health and mental
health care management and services is in process.
VI.11.9. Cultural Competency
As stated earlier, establishment of strong linkages with culturally competent, community
and faith-based agencies for outreach and team participation is a key element of the
Older Adult Program. Additionally, each region will establish its own relationships with
non-contracted community agencies and services that bring language and cultural
diversity to the Program. With Spanish as a threshold language, hiring of team
members will include preference for bi-lingual and bi-cultural candidates. Candidates
who speak American Sign Language will be sought. In rare instances, county
translators may be used as well. Since this will be a primarily county-operated program,
it will also build on the strengths of the department's Reducing Health Disparities
Initiative, of which one of its foci is linguistic capacity.
129
y
i
MHSA Community Supports and Services Final Plan,December 2005
V1.11.10. Sensitivity to Sexual Orientation, Gender and Differing Psychologies
and Needs of Women and Men, Boys and Girls.
Men and women have differing needs— related not only to sexual identify, but to their
socialization and the roles and expectations of family and society. Their differing
relationships to and experiences with violence in our society are also important.
Both county and community-based hiring will be focused on establishing a diversity that
is reflective of the populations being served. This includes diversity in gender and
sexual orientation. Cultural sensitivity training that will be developed as part of MHSA
will address issues of gender and sexual orientation as well as race and culture.
Highly qualified staff, contractors and consumers working with older adults will be
especially sensitivity to these issues. Assessments and care planning will raise and
examine these issues, and supports and referrals will be identified to meet individual
client needs.
VI.11.11. Meeting the Service Needs of Individuals Residing Outside of the
County
The Older Adult Program will be serving a primarily unserved population that resides
within Contra Costa County. Outreach will be focused on low-income, isolated
individuals who do not ordinarily present for services. There may be rare instances
where an older adult, who has a history of residency in the county, is currently living in
an institution or with family outside of the county. In these cases, eligibility and service
needs will be addressed on a case-by-case basis.
VI.11.12. Selection of Strategies Not on State List
All the key strategies employed in this program are included in the State list of
strategies. These include:
• Integrated assessment teams
• Integrated service teams
• .On-site or collaborative services with primary care health clinics
• Culturally appropriate services to reach persons of racial/ethnic cultures who
may be better served and/or more responsive to services in specific culture-
based settings
• Peer-supportive services including peer counseling programs
• Joint service planning with special services for seniors
V1.11.13. Timeline
Implementation of the Older Adult Program is a Systems Development program that will
start in the third MHSA Program Year. The program will focus on the establishment of
t an infrastructure and delivery system for services to isolated older adults with complex
is
G
130
t
MHSA Community Supports and Services Final Plan, December 2005
Q presentations. This later start-up will allow for advance planning of new working and
billing relationships. Key milestones for start-up include:
10/07 Key staff are hired and begin work
11/07 First clients served
7/08 50 clients served in the first 8 months of operation
7/09 225 Clients served in the second year of operation
131
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa County Fiscal Year: 2005-06
Program Workplan# #4 Date: 12/8/05
Program Workplan Name Older Adult Program Page_of
Type of Funding 2.System Development Months of Operation 0
Proposed Total Client Capacity of Program/Service: 0 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 0 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental - Mental Health Total
Department Agencies Contract
Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene $0
b.Travel and Transportation $0
c.Housing
i.Master Leases $0
it.Subsidies $0
iii.Vouchers $0
iv.Other Housing0
d.Employment and Education Supports $0
- e.Other Support Expenditures(provide description in budget narrative) Lo
f.Total Support Expenditures $0 $0 $0 $0
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $0
c.Employee Benefits
d.Total Personnel Expenditures $0 $0 $0 $0
3. Operating Expenditures
a.Professional Services $0
b.Translation and Interpreter Services $0
c.Travel and Transportation $0
d.General Office Expenditures $0
e.Rent,Utilities and Equipment
s. f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative)
h.Total Operating Expenditures $0 $0 $0 $0
4. Program Management
a.Existing Program Management $0
b.New Program Management P_p
c.Total Program Management $0 $0 $0
5. Estimated Total Expenditures when service provider is not knownSMIMM $0
6.Total Proposed Program Budget "$0 $0 $0 $0
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds
$0
e.County Funds $0
f.Grants
g.Other Revenue Lo
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds
$0
d.Other Revenue L
e.Total New Revenue $0 $0 $0 $0
3.Total Revenues $0 $0 $0 $0
C.One-Time CSS Funding Expenditures $145,000
D.Total Funding Requirements $o $0 $0 $0
E.Percent of Total Funding Requirements for Full Service Partnerships 0.0%
132
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2005-06
Program Workplan# #4 Date: 12/8/05
Program Workplan Name Older Adults Program Page_of
Type of Funding 2.Systems Development Months of Operation 0
Proposed Total Client Capacity of Program/Service: 0 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 0 Telephone Number: 925)957.5132
Classification Function Client,FM 8.CG Total Number Salary,Wages and Total Salaries.
FTEs" of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions
$0
$0
Lo
Total Current Existing Positions 0.00 0.0077 — "+ria ,: $0
S.New Additional Positions
$0
$0
Total New Additional Positions 0.001 0.00 vs � a. ''...,�,�•'�.;.. $o
C.Total Program Positions 0.00 0.00s $0
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
0
Q
133
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet,
County(ies): Contra Costa County Fiscal Year: 2006-07
Program Workplan# #4 Date: 12/8/05
Program Workplan Name Older Adults Program Page_of
Type of Funding 2.System Development Months of Operation 0 <
Proposed Total Client Capacity of Program/Service: 0 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 0 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental Mental Health Total
Department AgenciesProviders
Contract
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures '
a.Clothing,Food and Hygiene $0
b.Travel and Transportation $0
c.Housing
I.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing - $0
d.Employment and Education Supports $0
- e.Other Support Expenditures(provide description in budget narrative) - $0
f.Total Support Expenditures $0 $0 $0 $0
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $0
c.Employee Benefits $0
d.Total Personnel Expenditures $0 $0 $0 $0
3. Operating Expenditures
a.Professional Services $o
b.Translation and Interpreter Services $0
c.Travel and Transportation $0
d.General Office Expenditures $0
e.Rent,Utilities and Equipment
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) L0
h.Total Operating Expenditures $0 $0 $0 $0
4. Program Management
a.Existing Program Management $0
b.New Program Management
c.Total Program Management $0 $0 $0
5. Estimated Total Expenditures when service provider is not known $0
6.Total Proposed Program Budget $0 $0 $0 $0
TT
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds - $0
f.Grants
g.Other Revenue Lo
h.Total Existing Revenues $0 $0 $0 - $0
s 2.New Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
d.Other Revenue Lo
e.Total New Revenue $0 $0 $0 $0
3.Total Revenues $0 $0 $0 $0
C.One-Time CSS Funding Expenditures $g
D.Total Funding Requirements $0 $0 $0 $0
is
E.Percent of Total Funding Requirements for Full Service Partnerships 0.0%
1.34
i
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Program Workplan# #4 Date: 12/8/05
Program Workplan Name Older Adult Program Page_of
Type of Funding 2.Systems Development Months of Operation 0
Proposed Total Client Capacity of Program/Service: 0 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 0 Telephone Number: 925)957-5132
Classification Function Client,FM 8 CG Total Number Salary,Wages and Total Salaries.
FTEs" of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions
$0
$o
Lo
Total Current Existing Positions 0.00 0.007717:9-7777777-. ?" $0
B.New Additional Positions
$0
$0
Lo
Total New Additional Positions 0.001 0.00 ,, $0
C.Total Program Positions 0.00 0 00�swy ro ' wt $0
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
0
0
135
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(jes): Contra Costa County Fiscal Year: 2007-08
Program Workplan# #4 Date: 12/8105
Program Workplan Name Older Adult Program I Page_of
Type of Funding 2.System Development Months of Operation 9
Proposed Total Client Capacity of Program/Service: 50 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 50 Telephone Number: 925)957-5132
County Mental Other Community
Mental Health
Health Governmental Total
Contract
Department Agencies
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a,Clothing,Food and Hygiene(Flex Funds) $30,000 $30,000
b,Travel and Transportation $4,000 $4,000
c.Housing
i.Master Leases $0
ii.Subsidies $0
III.Vouchers $0
iv.Other Housing to
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) Lo
f.Total Support Expenditures $34,000 -$o $0 $34,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $838,666 $838,666
c.Employee Benefits $467,157 $467,157
d.Total Personnel Expenditures $1,305,823 $0 $0 $1,305,823
3. Operating Expenditures
a.Professional Services $o
b.Translation and Interpreter Services $8,000 $8,000
c.Travel and Transportation $12,000 $12,000
d.General Office Expenditures $9,000 $9,000
e.Rent,Utilities and Equipment $33,750 $33,750
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $234,492 $234,492
h.Total Operating Expenditures $297,242� $0 $0 $297,242
4. Program Management
a.Existing Program Management $0
b.New Program Management $-o
c.Total Program Management $0 $0 $0
5. Estimated Total Expenditures when service provider Is not known $122,375 $122,375
6.Total Proposed Program Budget $1,759,440 $0 $0 $1,759,440
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
C.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue Mo
h.Total Existing Revenues $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $180,000 $180,000
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
d.Other Revenue $700,000 $700,000
e.Total New Revenue $8130,000 $0 $0 $880,000
3.Total Revenues $880,000 $01 $0 $880.0001
C.One-Time CSS Funding Expenditures $0
I D.Total Funding Requirements $879,440 $0 $0 $879,440
E.Percent of Total Funding Requirements for Full Service Partnerships 0.0%
136
10",
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2007-08
Program Workplan# #4 Date: 12/8/05
Program Workplan Name Older Adult Program Page_of_
Type of Funding 2.Systems Development Months of Operation 9
Proposed Total Client Capacity of Program/Service: 225 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 225 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs' of FTEs Overtime per FTEs Wages and Overtime
A Current Existing Positions
$0
$0
Lo
Total Current Existing Positions 0.00 00071,71 $0
B.New Additional Positions
Program Manager Program Oversight&Leadership 1.00 $84,346 $63,260
Senior Clerk Administrative Assistance 1.00 $38,922 $29,192
Clerk I I Clerical Support 0.20 $34,622 $5,193
Social Workers/Team Leaders Program Leadership,Clinical Services 3.00 $57,504 $129,384
Nurses i I Clinical Services 3.00 $74,640 $167,940
Geropsychiatrists Clinical Services 3.00 $161,601 $363,602
Peer Counselors Client Advocacy&Support(Contract) 3.00 3.00 $35,598 $80,096
I I I
Lo
Total New Additional Positions 3.00 14.20,js+} _;aur sx o„.,�;k $838,666
C.Total Program Positions 3.00 14.20[`'- r r` �
�`�'',r' ''�`' $838,866
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
137
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #4: Older Adult Program -- Systems Development
FY 05-06
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Introduction: The Older Adult Program, a Systems Development effort, does not
begin until FY 07-08. One-time.expenditures to support start-up are included here.
A. Expenditures
1. Client, Family Member, Caregiver Support
f. Total Expenditures None i
2. Personnel Expenditures
a. Current Existing Personnel Expenditures None
b. New Additional Personnel Expenditures None
c. Employee Benefits None
d. Total Personnel Expenditures None
3. Operating Expenditures
h. Total Operating Expenses None.
4. Program Management
a. Existing Program Management None
b. New Program Management None
C. Total Program Management None
5. Estimated total Expenditures when service provider is not known
None
6. Total Proposed Program Budget None
B. Revenues
1. Existing Revenues None
2. New Revenues None
3. Total Revenues None
C. One-Time CSS Funding Expenditures
$145,000 in start-up funds for 3 vans, 1 car, and start-up office equipment
for 3 sites is included here. Critical for outreach and transportation to
services. To be held for Year 3 implementation of Older Adult Program.
See page 188 for a discussion of the need for one-time funds.
D. Total Funding Requirements None
ki
E. Percent of Total Funding Requirements for Full Service Partnerships
0%
138
i
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #4: Older Adult Program -- Systems Development
FY 06-07
Introduction: The Older Adult Program, a Systems Development effort, does not
begin until FY 07-08.
A. Expenditures
1. Client, Family Member, Caregiver Support
f. Total Expenditures None
2. Personnel Expenditures
a. Current Existing Personnel Expenditures None
b. New Additional Personnel Expenditures None
c. Employee Benefits None
d. Total Personnel Expenditures None
3. Operating Expenditures
h. Total Operating Expenses None.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
5. Estimated total Expenditures when service provider is not known
None
6. Total Proposed Program Budget None
B. Revenues
1. Existing Revenues None
2. New Revenues None
3. Total Revenues None
C. One-Time CSS Funding Expenditures None
D. Total Funding Requirements None
E. Percent of Total Funding Requirements for Full Service Partnerships
0%
0
139
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative ;
Plan #4: Older Adult Program -- Systems Development
FY 07-08
MMM.V.VM.V.V.V.V.V.VIV.V..I.V.V.VM1..I/V.V.V N.VM.V.VNNNN.V.V M.V.V.V N.V...I.V..YN.V
Introduction: This budget reflects a 9 months of operation, rising to an enrollment of
50 by the end of the year. The budget reflects the creation of 17.2 new positions for
supports and services, with a minimum 6 of those positions to be filled by consumers.
A. Expenditures
1. Client, Family Member, Caregiver Support
a. Clothing, Food, Hygiene (& Flex Funds)
$30,000 based on prior experience and partial year of operations
b. Travel and Transportation
$4,000 for bus and BART vouchers based on prior experience and partial
year of operations
C. Housing None
d. Employment and Education Supports None
e. Other Support Expenditures None.
f. Total Support Expenditures
$34,000 for partial year operations.
k
2. Personnel Expenditures
a. Current Existing Personnel Expenditures
None
b. New Additional Personnel Expenditures
Salaries set at mid-step of county scale for position. Salaries calculated at.75%
to reflect 9 month of operations during the year. A minimum of 50% of new staff
will be bilingual in Spanish, ASL or an Asian language. Includes:
1.0 FTE Program Manager— Full time administrative position with 25%
allocated for outreach. Other duties include overall program
oversight, staff and contractor supervision, organization of team
functioning and team meetings, liaison to other MH Division staff
and services, reporting and finances.
1.0 FTE Senior Clerk— Full time position responsible for providing
administrative support to the program.
.2 Clerk— Responsible for providing clerical support to the program.
3.0 Social Workers/Team Leaders -- 75% coordination/leadership of
outreach/service teams and direct social work services. 25% for
home assessment.
3.0 Nurses— Members of outreach/service teams. 75% of time for direct c
care, 25% for home assessment. K
3.0 Geropsychiatrists— 75% direct client care and consultation with `
clinical staff. 25% home assessment.
3.0 Peer Counselors— 75% direct client support, 25% outreach.
140
y
MHSA Community Supports and Services Final Plan, December 2005
c. Employee Benefits
$467,157 in benefits with full benefits calculated at county rate. Contract
positions calculated at reduced rate.
d. Total Personnel Expenditures
Personnel expenditures total$1,305,823.
3. Operating Expenditures
a. Professional Services None
b. Translation and Interpreter Services
$8,000 for translation primarily in Asian languages and ASL. Includes
translation of outreach materials.
c. Travel and Transportation
$12,000 vehicle maintenance.
d. General Office Expenditures
$9,000 Estimated based on prior experience.
e. Rent, Utilities and Equipment
$33,750 Estimated based on prior experience.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$5,000 for outreach expense plus $229,492 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$297,242.
4. . Program Management
a. Existing Program Management None
b. New Program Management None
C. Total Program Management None
5. Estimated total Expenditures when service provider is not known
Total estimated contractor's budget of$122,375 includes $102,375 in salaries
and benefits based on the 9 month estimated positions of:
✓ 3.0 Mental Health Workers —Based in community agencies and
with multi-lingual capabilities, serve as members of Older Adult
outreach/care teams and assist with outreach to their own
communities. 50% care and 50% for outreach.
$20,000 in operating expenses includes vehicle maintenance, and
outreach and office expenses.
6. Total Proposed Program Budget
$1,759,440 Total Program Budget.
a
141
MHSA Community Supports and Services Final Plan, December 2005
B. Revenues
1. Existing Revenues None
2. New Revenues
$180,000— Estimated income from MediCal. $700,000— Provided by CC
Reg. Med. Ctr. & Health Ctrs.
3. Total Revenues 1$880,000
C. One-Time CSS Funding Expenditures None
D. Total Funding Requirements
$879,440 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships _
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 0%.
142
MHSA Community Supports and Services Final Plan, December 2005
Q a IEXHIE31T 4 Q 1111811NI>T1lxSERVICES�'AND�SUPPQR7yS�woizK"PLAN
B'°j
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,.7. ,wi <.n.8.. "^^,.�r- ..,a,x w ..,..,'r `SFr.q ra.
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Description of Housing is a key area of development for all current and
Program: future FSPs — currently Children, TAY and Adults. The CCMH
housing program will consist of several housing specific
elements. The services and supports that will wrap around
these housing elements are described in other appropriate
sections of this Plan. Specific housing elements include:
1. New Facilities
2. Housing Vouchers
3. Development of new housing options for all groups in
the future
Priority Population: Housing available in this program in the first 3 MHSA years
will support FSPs in programs #1,2 & 3 (Children/Families,
TAYs, Adults). They will be homeless (adults) or imminently
homeless (children, TAYs) and otherwise eligible for FSP
Programs 1-3.
Fund T e Age Group
-. - . .- -• . .- Sys
• - -• •as • • . •- -• FSP Dev OE CY TAY A OA
Crisis and transitional housing ® ❑ ❑ ® ® ® ❑
Supportive housing ® ❑ ❑ ® ® ® ❑
Development of housing options (for ® ❑ ❑
future FSPs
Program 5: Housing
V1.11.2. Program Description
Housing is a key area of development for all Full Service Partnerships —especially TAY
and Adults. Housing activities are extensive, similar and coordinated across programs,
and slated for focused development in the future. Based on this, housing activities
across age groups and across Full Service Partnerships are being presented as a
single 'Program" here.
0
143
a
MHSA Community Supports and Services Final Plan, December 2005
t The CCMH Housing Program will consist of several housing specific elements. The
services and supports that will wrap around these housing elements are described in
other appropriate sections of this Plan. Specific housing elements include:
4. New Facilities
5. Housing Vouchers
6. Development of new housing options for all groups in the future
a
1. New Facilities
TAY— Modular Emergency Shelter
Contra Costa's Health Services' Homeless Program Youth Continuum of
Services (CCYCS) currently runs an 6-bed emergency shelter and day center for
youth under 17 years of age and a.12-bed shelter for youth ages 18-21 at Calli
Annex, located within the West County (Brookside) Adult Shelter. The location of
youth aged 18-21 with the adult shelter is problematic not only because of
difficulties that arise with youth mixing with adults in this setting, but because of
the difficulty in offering dedicated services for youth in this setting.
Using MHSA funds, CCMH will purchase a 5 bedroom manufactured home for up
to 10 homeless youth at a time aged 18 to 25 with emphasis on Full Service
Partners. This manufactured home will be installed next door to the existing Calli
House, facilitating service delivery and a sense of community. CCYCS will
operate the new facility with the same services and supports offered when the
older youth shelter was within the adult shelter. Additionally, added services
such as groups and classes can be offered in the expansive group areas of the
manufactured home. An FSP Integrated Services Team will also be able to work
with youth in this setting.
The manufactured home, which is 3420 square feet with 5 bedrooms and several
social and common rooms is described in more detail in Attachment 16.
TAY — Pittsburg Campus
MHSA funds will be used to expand the system's transitional care capacity by
adding a new Pittsburg Youth Campus located in East County. Full Service
Partners aged 16-24 will be given first priority for the new Pittsburg Campus
Transitional Living. The location of this campus outside of West County where
these youth will be from is seen as a benefit— as many need to separate from
their involvement with gangs and substance abuse in their old environments.
The Pittsburg Youth Campus, located at West 6th Street and Black Diamond
Boulevard in Pittsburg, will house up to 14 youth. This includes a building with
one 2-bedroom and four 1-bedroom housing units for youth, two 2-bedroom
freestanding cottages for pregnant and parenting youth and their children, and an
additional 3-bedroom unit upstairs from a community center and offices. Length
144
MHSA Community Supports and Services Final Plan, December 2005
of stay will be for up to 18 months, with an additional six months for pregnant and
parenting teens.
The Campus is a gated property located in a tract home development that is
within walking distance to public transportation, restaurants, and banking within
the redevelopment area of Old Town Pittsburg. Each unit has a kitchen, bath,
bedroom and living room. The community space has a tutoring area/computer
room, 3 offices, a living room, kitchen and conference room. The site also
includes a picnic area an jungle gym for children.
The Pittsburg Youth Campus will be operated by Contra Costa Youth Continuum
of Services, a program of Contra Costs Health Services (CCYCS). CCYCS and
the MHSA-funded Integrated Care Teams will offer services and centers on
campus. The community center will be used for groups, classes and social
events offered by both groups.
Adult— Crestwood Transitional Facility for Co-Occurring Disorders
CCMH has negotiated an agreement at Crestwood Corporation's Pleasant Hill
facility for a dedicated, 16-bed residential unit for individuals with co-occurring
disorders including a primary diagnosis of serious and persistent mental illness.
Length of stay will average 90 days. Crestwood will run the program. Adult and
TAY FSPs will be given priority for admittance into the program.
2. Housing Vouchers
The Adult and TAY Full Service Partnerships are both based on a "housing first"
model. As described in the appropriate program sections earlier in this plan, one
goal of these programs is to facilitate the move of Full Service Partners into
long-term supported housing. This will be accomplished through a large-scale
master-leased voucher program based on the existing program run by Contra
Costa Health Services' Homeless Program. It is anticipated that 40 TAYS and
40 adults will enter long-term housing through this program in the second year of
MHSA. Numbers will grow in the third year.
Shelter, Inc. is currently the master tenant for the Homeless Service Program
and will continue in this role for CCMH. Services provided to consumers while in
the supported housing are described in earlier sections of this Plan. Vouchers
will also be available to Full Service Partners in the Children's Program.
3. Development of New Housing Options
CCMH will conduct an RFP process and will hire a housing development consultant
who is familiar with the county and familiar with supported housing requirements and
funding opportunities to help CCMH assess and stay on top of potential options for
housing development in the future.
145
MHSA Community Supports and Services Final Plan, December 2005
Additionally, approximately $1,700,000 has been*"set aside" for potential investment in
developing supported housing opportunities.
VI.11.3: Housing and Employment Services in this Program
This is primarily a housing service and is described fully in the Program Description
above. No employment services or services of any type will be provided as part of this
program.
VI.11.4 Cost Per FSP Participant
The MHSA cost per FSP for scattered site housing is estimated at about $9,000 per
person or family. Some revenue from SSI and other sources is expected from .
consumers as they pay a portion of their income toward housing. It is difficult to
determine the overall housing program cost per person because the cost of the
manufactured home and Antioch Campus for TAYs represent an initial investment that
will carry the program well beyond this first three-year period. The cost per person of
funds set aside for future use is also unknown.
VI.11.5. How the Program Will Advance the Goal of Resiliency. How Values of
Recovery/Resiliency Will Be Promoted and Reinforced
F_
Housing is a key element in the stabilization of a person's life, allowing them to move on
to addressing the issues that contributed to their homelessness and other problems.
CCMH's growing "housing first" emphasis under MHSA will support consumers by
offering a first step toward recovery and making sure that continued housing reduces
the likelihood of relapse.
VI.11.6. Program Expansion
All housing funds are for new services targeting MHSA Full Service Partners. The
administration of these new housing components will build upon existing infrastructures
in the County Health Services' Homeless Programs for adults and youth.
F
V1.11.7. Supports and Services to be Provided by Clients and/or Family Members
Supports and services to be provided by clients and/or family members are described in
the Full Service Partnership program descriptions above.
VI.11.8. Collaboration Strategies
As stated earlier, housing programs offered as a part of MHSA Full Service
Partnerships are highly coordinated with Contra Costa Health Service's Homeless
Programs. Homeless Services' protocols and relationships for master leasing of
scattered site housing, maintenance of that housing, and oversight of new transitional,
and emergency shelters will support these new MHSA programs. In return, CCMH will
146
F
MHSA Community Supports and Services Final Plan, December 2005
be helping Homeless Programs to expand its capacity to meet the needs of the most
seriously mentally ill adults that it conducts outreach to and shelters.
VI.11.9. Cultural Competency
As stated earlier, cultural competency is a priority for CCMH. How we will achieve this
is described in detail for each of the service programs. As the Housing "Program" does
not have a service component, little more will be added here. However, CCMH realizes
that housing must be in or near to one's community and cultural groupings to be
appreciated or accepted. Efforts will be made to develop a geographic range of
available units that will allow for continuous relationships with consumers' home
communities. The exception to this is where consumers agree that some distance from
their home community is desired to separate from gangs or substance abuse.
V1.11.10. Sensitivity to Sexual Orientation, Gender Identity and Differing
Psychologies and Needs of Women and Men, Boys and Girls.
Men and women have differing needs — related not only to sexual identify, but to their
socialization and the roles and expectations of family and society. Their differing
relationships to and experiences with violence in our society are also important. Boys
and girls face these same issues and often more as they are forming or grappling with
newly emerging issues about their sexuality, self-image, and relationships.
Both county and community-based hiring will be focused on establishing a diversity that
is reflective of the populations being served. This includes diversity in gender and
sexual orientation. Cultural sensitivity training that will be developed as part of MHSA
will address issues of gender and sexual orientation as well as race and culture.
VI.11.11. Meeting the Service Needs of Individuals Residing Outside of the
County
The housing programs described in this plan are for residents of Contra Costa County.
VI.11.12. Selection of Strategies Not on State List
The strategies selected for this program are included on the State List of acceptable
strategies. They include:
• Crisis and transitional housing
• Supportive housing
Development of Housing Options
147
MHSA Community Supports and Services Final Plan, December 2005
V1.11.13. Timeline
Key milestones in the housing timeline include:
6/06 Shelter first clients
• 7/06 Begin voucher program
7/06 Hire housing consultant
• 9/06 Shift TAY emergency shelter to modular with services
i
148
AV Wg,ill
U, OVII
y, ql H l Y
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2005-06
Program Workplan# #5 Date: 12/8/05
Program Workplan Name Housing Program Page_of
Type of Funding Full Service Partnership Funding Months of Operation 3
Proposed Total Client Capacity of Program/Service: 25 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 25 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental Mental Health Total
Department Agencies Contract
Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene $0
b.Travel and Transportation $0
c.Housing
I.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing $200,000 $200,000
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) $25.000 25 000
f.Total Support Expenditures $25,000 $0 $200,000 $225,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $0
c.Employee Benefits 5-0
d.Total Personnel Expenditures $0 $0 $0 $0
3. Operating Expenditures
a.Professional Services $0
b.Translation and Interpreter Services $0
c.Travel and Transportation $0
d.General Office Expenditures $0
e.Rent,Utilities and Equipment
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $33,750 $33,750
h.Total Operating Expenditures $33,750 $0 $0 $33,750
4. Program Management
a.Existing Program Management
$0
b.New Program Management
y4 >>t'
a Total Program Management �'....�, x, $0 $0 $0
S. Estimated Total Expenditures when service provider Is not known .;e-= §`""' ='*i ;*fi "' $0
6.Total Proposed Program Budget $58,750 $0 $200,000 $258,750
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue L0
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.State General Funds $0
d.Other Revenue $—o
e.Total New Revenue $0 $0 $0 $0
3.Total Revenues $0 $0 $0 $0
C.One•Time CSS Funding Expenditures $4,630,750
D.Total Funding Requirements $4,689,500 $0 $200,000 $4,889,500
E.Percent of Total Funding Requirements for Full Service Partnerships 100.0%
149
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2005-06
Program Workplan# #5 Date: 12/8/05
Program Workplan Name Housing Program Page_of_
Type of Funding Full Service Partnership Funding Months of Operation 3
Proposed Total Client Capacity of Program/Service: 25 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 25 Telephone Number: 925)957-5132
Classification Function Client,FM&CIS Total Number Salary,Wages and Total Salaries.
FTEs' of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions
$0
$0
Total Current Existing Positions 0.00 0.00 $0
B.New Additional Positions
$0
$0
$0
$0
LO
Total New Additional Positions 0.001 0.00 $0
C.Total Program Positions 0.00 0.00 $0
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
150
�+"q
,t6 yk`'y2• �z ' J `
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Program Workplan# #5 Date: 12/8/05
Program Workplan Name Housing Program Page_of_
Type of Funding Full Service Partnership Funding Months of Operation 12
Proposed Total Client Capacity of Program/Service: 120 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 120 Telephone Number: 925)957.5132
County Mental Other Community
Mental Health
Health Governmental Contract Total
Department Agencies Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene $0
b.Travel and Transportation $0
c.Housing
I.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing $1,331,600 $1,331600
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) $100,000 $100,0001
f.Total Support Expenditures $0 $1,431,600 $1,431,600
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $0
c.Employee Benefits No
d.Total Personnel Expenditures $0 $0 $0 $0
3. Operating Expenditures
a.Professional Services $70,000 $70,000
b.Translation and Interpreter Services $0
c.Travel and Transportation $0
d.General Office Expenditures $0
e.Rent,Utilities and Equipment
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) 225,240 $225,240
h.Total Operating Expenditures $0 $0 $0
4. Program Management
a.Existing Program Management $0
b.New Program Management '� Ko
a Total Program Management ; 4 $0 $0 $0
5. Estimated Total Expenditures when service provider is not known $0
6.Total Proposed Program Budget $295240 $0 $1,431,600 $1,726,840
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Padent Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue LO
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $409,000 $409,000
b.Medicare/Patient Fees/Patient Insurance $0
C.State General Funds $0
d.Other Revenue $60,000 $60,000
e.Total New Revenue $0 $0 $469,000 $469,000
3.Total Revenues $0 $0 $469,000 $469,000
C.One-Time CSS Funding Expenditures 1 1 $o
D.Total Funding Requirements $295,240 $0 $962,600 $1,257,840
E.Percent of Total Funding Requirements for Full Service Partnerships 4 100.0%
151
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Program Workplan# #5 Date: 12/8/05
Program Workplan Name Housing Program Page_of—
Type of Funding Full Service Partnership Funding Months of Operation 12
Proposed Total Client Capacity of Program/Service: 120 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 120 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs' of FTEs Overtime per FTEw Wages and Overtime
A.Current Existing Positions
$0
$0
Total Current Existing Positions 0.00 0.00 $0
B.New Additional Positions
$0
$0
$0
$0
Lo
Total New Additional Positions 0.00 0.00 $0
C.Total Program Positions 0.00 0.001MIM $0
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
152
��' ,d' a r� . {
�' h
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2007-08
Program Workplan# #5 Date: 12/8/05
Program Workplan Name Housing Page_of
Type of Funding FSP'System Dev, Months of Operation 12
Proposed Total Client Capacity of Program/Service: 125 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 125 Telephone Number: 925)957-5132
County Mental Other Community
Mental Health
Health Governmental Contract Total
Department Agencies
_ Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene $0
b.Travel and Transportation $0
c.Housing
i.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing $1,268,200 $1,268,200
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) $100,000 $100,000
f.Total Support Expenditures $0 $1,368,200 $1,368,200
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $0
c.Employee Benefits Lo
d.Total Personnel Expenditures $0 $0 $0 $0
/—� 3. Operating Expenditures
/ \ a.Professional Services $70,000 $70,000
b.Translation and Interpreter Services $0
c.Travel and Transportation $0
d.General Office Expenditures $0
e.Rent,Utilities and Equipment
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $248,090 $248,090
h.Total Operating Expenditures $318,090 $0 $0 $318,090
4. Program Management
a.Existing Program Management r $0
b.New Program Management Rv ': 10
I a
c.Total Program Management $0 $0 $0
5. Estimated Total Expenditures when service provider is not known "' '-` '4' `u'.' $0
6.Total Proposed Program Budget $318,090 $0 $1,368,200 $1,686,290
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue $0
In.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $409,000 $409,000
c.State General Funds $0
d.Other Revenue $135.000 135 000
e.Total New Revenue $0 $544,000 $544,000
3.Total Revenues $0 $0 $544,000 $544,000
C.One-Time CSS Funding Expenditures $0
D.Total Funding Requirements $318,0901 $0 $824,2001 $1,142,290
E.Percent of Total Funding Requirements for Full Service Partnerships 100.0%
153
r
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
I
County(ies): Contra Costa Fiscal Year: 2007-08
Program Workplan# #5 Date: 1218105
Program Workplan Name Housing Page_of .
Type of Funding FSPSystem Dev. Months of Operation 12
Proposed Total Client Capacity of Program/Service: 125 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 125 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs' of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions
$0
$0
10
Total Current Existing Positions 0.00 0.00 $0
B.New Additional Positions
$0
$0
$0
$0
10
Total New Additional Positions 0.00 0.00: $0
C.Total Program Positions 0.00 0.00FARISM $0
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
i G
Y.
L
t
4 .
154
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #5: Housing Program
FY 05-06
wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww
Introduction: This budget assumes funds approved for an April 1 Start-up, in 2006
with client enrollment beginning in other programs on May 1, 2006. There is no staff to
be hired for this program — all staffing & program support to be provided by FSPs
described as Programs #1-3.
A. Expenditures
1. Client, Family Member, Caregiver Support
c. Housing
iv. Other Housing
$200,000 -- Purchase of emergency shelter, transitional and AOD beds
from community providers currently contracted with county. Pro-
rated amount based on prior experience.
e. Other Support Expenditures
$25,000— Pro-rated for partial year for general supports to Adult and TAY
FSPs at weekend multi-service center, run by county Homeless
Services as well as placement and repair/management services for
long-term housing.
f. Total Support Expenditures
$225,000 for partial year operations.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures None
b. New Additional Personnel Expenditures None
c. Employee Benefits None
d. Total Personnel Expenditures None
3. Operating Expenditures
g. Other Operating Expenditures
$33,750 in overhead on housing expenses (excluding one-time
purchases)
h. Total Operating Expenses
Total operating expenses of$33,750.
4. Program Management
a. Existing Program Management None
b. New Program Management None
C. Total Program Management None
5. Estimated total Expenditures when service provider is not known None
155
4
MHSA Community Supports and Services Final Plan, December 2005
6. Total Proposed Program Budget $258,750
B. Revenues
1. Existing Revenues None
2. New Revenues None this year
3. Total Revenues None this year
C. One-Time CSS Funding Expenditures
$4,630,750 includes:
L $2,546,310 in vouchers for scattered site, master-leased, independent
long term housing based on $850/month. These funds will house
250 families/individuals for a year, or.125 families/individuals for
years 2 & 3 of programming. Additional SSI revenue anticipated in
years 2 & 3 would add 19 individuals/families for 2 years.
ii. $265,000 for one-time purchase of 3-br manufactured home for TAY
FSP. Described in proposal narrative. Includes $150,000 for
purchase, $100,000 for installation and overhead on installation
only.
iii.' �$90,000 for rehabilitation of Antioch TAY transitional living campus (See
Program #2). Includes furnishings.
iv. $1,729,440 in one-time funds set aside for housing development
opportunities for FSPs.
See page 188 for a discussion of the need for one-time funds.
.D. Total Funding Requirements
$4,889,500 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 100%.
156 t'
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #5: Housing Program
FY 06-07
Introduction: This budget reflects a full operational year. All staffing and program
supports provided by Full Service Partnerships described as Programs #1-3.
A. Expenditures
1. Client, Family Member, Caregiver Support
c. Housing
iv. Other Housing $1,331,600
$322,800 — Purchase of emergency shelter and transitional beds from
community providers currently contracted with county. Estimates
based on prior experience. Includes $131,400 for 12 dedicated
adult beds at county shelter at$30/day.
$817,600— Purchase of 16 dedicated beds at existing Crestwood facility
for adult and TAY FSPs with co-occurring disorders with SMI as
primary diagnosis. All treatment and services included.
$191,200— Purchase of additional beds based on actual use in shelters
and transitional care programs for TA Ys and adults including
existing county Homeless Programs'CASA facility and board and
care homes.
e. Other Support Expenditures
$50,000 -- Flat rate to existing contractor for supports to Adult and TAY
FSPs at weekend multi-service center. Includes meals, showers,
activities and supports for those in shelters and drop-ins.
$50,000— Flat rate to existing contractor for management and placement
services for master-leased scattered site, long-term supported
housing. Includes all repairs. Contracted through county Homeless
Services.
f. Total Support Expenditures
$1,431,600 in total Support Expenditures.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures None
b. New Additional Personnel Expenditures None
c. Employee Benefits None
d. Total Personnel Expenditures None
3. Operating Expenditures
a. Professional Services
$70,000 for housing consultation to support CCMH (and other housing
stakeholders) to make best leveraged use of one-time housing
funds.
157
MHSA Community Supports and Services Final Plan, December 2005
k
µ
g. Other Operating Expenditures
$225,240 -- Overhead on housing expenses (excluding one-time funds)
h. Total Operating Expenses
Total operating expenses of$295,240.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
5. Estimated total Expenditures when service provider is not known None
6. Total Proposed Program Budget $1,726,840_
B. Revenues
1. Existing Revenues None
2. New Revenues
$409,000— MediCal for partial reimbursement on Crestwood facility for co-
occurring disorders.
$ 60,000— Modest estimate for SSI reimbursement from clients for portion
of long-term supported housing for Adult, TAY and Children.
Assumes long lead time to obtain benefits. Estimate based on
average of 25 families or individuals across all programs paying
$2001month for 12 months.
3. Total Revenues $469,000
C. One-Time CSS Funding Expenditures
None
D. Total Funding Requirements
$1,257,840 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 100%.
158
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #5: Housing Program
FY 07-08
.V.V/V/V.VMN/V.V/V.V/V.V.V.V.V....V.V.V/VA/.V.V.V.V.VIV.V.VMIV/V iV.V.V.V/ViV/V iV.V.Y/VAI
Introduction: This budget reflects a full operational year. With all staffing and program
supports provided by Full Service Partnerships described as Programs #1-3. No FTEs
created.
A. Expenditures
1. Client, Family Member, Caregiver Support
c. Housing
iv. Other Housing $1,268,200
$290,000 -- Purchase of emergency shelter and transitional beds from
community providers currently contracted with county. Estimates
based on prior experience. Includes $131,400 for 12 dedicated
adult beds at county shelter at $30/day. Assumes some reduction
in use of short term housing as programs reach full enrollment and
fewer clients enter through shelters.
$817,600—Purchase of 16 dedicated beds at existing Crestwood facility
for adult and TAY FSPs with co-occurring disorders with SMI as
primary diagnosis. All treatment and services included.
$160,600— Purchase of additional beds based on actual use in shelters
and transitional care programs for TAYs and adults including
existing county Homeless Programs' CASA facility and board and
care homes. Assume some decline in usage,as programs reach
full enrollment and fewer clients enter through-shelters.
e. Other Support Expenditures
$50,000 -- Flat rate for supports to Adult and TAY FSPs at weekend multi-
service center. Includes meals, showers, activities and supports
for those in shelters and drop-ins.
$50,000— Flat rate for management and placement services for master-
leased scattered site, long-term supported housing. Includes all
repairs. Contracted through county Homeless Services.
f. Total Support Expenditures
$1,368,200
2. Personnel Expenditures
a. Current Existing Personnel Expenditures None
b. New Additional Personnel Expenditures None
c. Employee Benefits None
d. Total Personnel Expenditures None
0
159
MHSA Community Supports and Services Final Plan, December 2005
3. Operating Expenditures
a. Professional Services
$70,000 for housing consultation to support CCMH (and other housing
stakeholders) for best leveraged use of one-time housing funds.
g. Other Operating Expenditures
$248,090 -- Overhead on housing expenses (excluding one-time funds).
h. Total Operating Expenses
Total operating expenses of$318,090.
4. Program Management
a. Existing Program Management None
b. New Program Management None
c. Total Program Management None
5. Estimated total Expenditures when service provider is not known None
6. Total Proposed Program Budget
$1,686,290 Total Program Budget.
B. Revenues
1. Existing Revenues None
2. New Revenues
$409,000— MediCal for partial reimbursement on Crestwood facility for co-
occurring disorders.
$135,000— Rising estimate for SSI reimbursement from clients for portion
of long-term supported housing for Adult, TAY and Children.
Assumes long lead time to obtain benefits. Estimate based on
average of 56 families or individuals across all programs paying
$200/month for 12 months.
3. Total Revenues $544,000
C. One-Time CSS Funding Expenditures
None
D. Total Funding Requirements
$1,142,290 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
Proportion of funds for FSP THIS PROGRAM, THIS YEAR only = 100%.
x.
d
160
MHSA Community Supports and Services Final Plan, December 2005
XHIBIT4`;` 4MMUNITYS�ERVICESASUPPORTS�W4RRC'PLAN
FW�♦ lc '� � �e e.,,�t� iaa "3 P 3. +h m 1 � �+ 6_ 3 ,
County, ConaCtstaFlscalProgrrn'W
V "a`FY
r
aQeveio mbnf; ,
amu 6 Ext t r +}+ # f..'m' xt�d
:Pio rarriWork;Ptan� 's6 'Estima ,� taitDate: A r11;,2006°; ,
Description of A series of ongoing ngoing activities were identified as priorities for
Program: development of systems outside of Full Service Partnerships.
The most significant of these is the Older Adult Program which
is described as Program #4. The additional systems
development pieces do not constitute stand-alone programs
but rather, are a series of strategies for overall systems
improvement. They include:
Strategy 1: Enhancements to the Office for Consumer
Empowerment
Strategy 2: Planning for Future Systems Development
Strategy 3: Peer Benefits Advocates
Strategy 4: Expansion of Family Partner Program
Strategy 5: Wellness Services
Strategy 6: Transformation Training
Priority Population: Populations by Strategy:
O 1, 3, 5. Consumers who are TAYs, Adults, Older Adults
2,6. All consumers
4. Consumers who are Children and Families
Fund Type Age Group
. .- -. W
Sys
• •- P Dev I OE CY TAY A I OA
Consumer run programs and services ❑ ® I ❑
(Planning for) Integrated SA and mental health ❑ ® ❑ ❑
services
(Planning for Transportation services ❑ ® ❑
(Planning) & implementation of ❑ ® ❑
transformational infrastructure and attitudinal
change
On-site services in primary care clinics and ® ❑ ❑
other sites to provide services coordinated with
other health care providers
Classes and other instruction for clients re: El ® ❑
what clients need to know for successful living
wellness
161
MHSA Community Supports and Services Final Plan, December 2005
Program 6: Systems Development Strategies
VI.I1.2. Program Description
1
Systems development activities are being enhanced with MHSA funds in a variety of
ways:
1. Ancillary to FSP
5 In a number of instances, Full Service Partners will have needs that must be met and
the most effective way to meet those needs will produce excess system capacity that
can be shared with non-FSPs. For example, a clinical support psychiatrist budgeted at
25% time for the Children's FSP (Program #1) will have some time available to see non-
FSP clients. A court/jail liaison is being added to the Adult Program that will serve FSPs
about part of the time but will be available to other consumers the rest of the time.
These types of systems development enhancements are included in the FSP Program
Description that they are most integral to. In all, approximately $1.2 million of systems
development needs are being addressed this way.
4
2. Dedicated Systems Development Activities
There are a series of ongoing activities that were identified as priorities for development
of systems outside of Full Service Partnerships. The most significant of these is the
Older Adult Program which is described as Program #4. The additional Systems
Development pieces do not constitute stand-alone programs but rather, are a series of
strategies for overall systems improvement. They are described here as "Program #6:
Systems Development Strategies."
Strategy 1: Enhancements to the Office for Consumer Empowerment
The existing Office for Consumer Empowerment, led by Sharon Kuehn, offers a range
of trainings and supports by and for consumers that have been mentioned throughout
this Plan. They include: The SPIRIT training program for consumer providers, the TLC.
to provide in-home supports by and for consumers, WRAP (Wellness/Recovery Action.
Planning) led by and for consumers and consumer advocacy. Additionally, there is a 4`
Consumer Involvement Steering Committee makes sure that the consumer perspective
is meaningfully included in the planning, implementation, and evaluation of all
components of the Mental Health Services Act.
MHSA funds will allow the OCE to increase its capacity and effectiveness in several
ways:
A lead instructor for the SPIRIT program will be hired (contract) to expand
and lead that program.
A Consumer Employment Coordinator will be hired (contract) to develop and
expand placement for consumer providers trained in the SPIRIT Program and
to support consumers once they are hired in county or contract positions.
• Trainees who participate in the SPIRIT Program will receive stipends for their
work placements for the first time, and payment for their travel
162 -
MHSA Community Supports and Services Final Plan, December 2005
• Participants on the Consumer Involvement Steering Committee will be paid
for their travel to meetings for the first time and translation will be made
available at all key meetings — allowing for recruitment of a much more
diverse Committee.
• Training funds will allow core OCE staff to receive training available in the
community on such issues as management skills, budgeting, and leadership
skills
Strategy 2: Planning for Future Systems Development
CCMH has identified areas where new services or system improvements are needed —
but exactly what is needed is not yet clear. Using MHSA funds, CCMH will initiate 3
new planning processes to allow it to improve services in the complicated key areas of:
• Transportation for consumers to supports and services
Integrated services for Co-Occurring Disorders
Transforming the mental health delivery system to a truly culturally
competent, recovery-oriented, consumer-driven, community-involved,
integrated environment through training, ongoing supports, and possible
changes to organizational structures.
In each of these areas, CCMH will initiate an RFP process and will hire a consultant to
lead a planning process that builds on MHSA planning to-date, community input to-date,
and best practices and examples from the field. This will result in an action plan in each
area.
Some funds (full amount needed is unknown as of yet) have been included for
implementation of the transformation plan upon completion of that planning process.
Funds for implementation of the other plans have not yet been identified.
Strategy 3: Peer Benefits Advocates
Community input as part of the MHSA planning process clearly indicates a need for
assistance to consumers in figuring out and then obtaining the benefits they are entitled
to, and how to maximize use of those benefits.
Three new Peer Benefits Advocates will be hired with MHSA funds. They will be
located in CCMH, and will work out of CCMH clinics, but will be trained by and work
closely with the county's established Patient Financial Specialists. They will work with
individual consumers on benefits issues, and assist consumers to navigate the service
system as well.
Strategy 4: Expansion of Family Partner Program
Two new Family Partners will be added to Children's Services. These family partners
will be peer positions — adult members of families with child mental health consumers.
They will be bicultural and bilingual in Spanish. They will assist Latino families of child
mental health consumers with advocacy and support in the home, in the community,
163
MHSA Community Supports and Services Final Plan, December 2005
and at county service sites. The will assist with transportation to services and will help
client families to navigate the service system to get their recovery needs met.
Strategy 5: Wellness Services f
Community input about the need of mental health consumers for assistance in
improving and maintaining physical health and well-being was very strong. CCMH
envisions a larger, coordinated program across the county but will begin with a single
Wellness Nurse. This nurse will start out housed in Central County. She will design a
Wellness Services Plan, offer wellness trainings and courses, develop linkages for
consumers with medical services and supports, and assist CCMH in developing a
broader wellness services program.
Strategy 6: Transformation Training
As stated in Strategy 2 above, CCMH is committed to developing an effective effort to
establish a strong mental health recovery environment throughout its service system
and all of its staff. With the help of a consultant, a plan will be developed, initial training
will be provided, any necessary structural changes will be made, and ongoing efforts
and reinforcement will follow throughout the three MHSA years.
y
V1.11.3. Housing and Employment Services in this Program
This cluster of strategies does not include housing services.
This cluster of strategies includes a strong emphasis on the training and employment of
consumers. The Office for Consumer Empowerment will not only be strengthened and
expanded through the hiring of new consumer staff, but will solidify its innovative
SPIRIT training program to enable consumers to become employable consumer
advocates. Finally, expansion of WRAP and TLC programs, as described earlier, will s.
allow for additional hiring of consumers as advocates.
V1.11.4 Cost Per FSP Participant
These strategies are not related to the Full Service Partnerships directly.
VI.11.5. How the Program Will Advance the Goal of Resiliency. How Values of
Recovery/Resiliency Will Be Promoted and Reinforced.
All of the strategies outlined here advance the goal of resiliency/recovery through
strengthening peer leadership and supports, and by offering benefits and wellness
supports to support consumers to achieve maximum well-being.
VI.11.6. Program Expansion
The Family Partner program providing advocacy and support to families of mental
health consumers will be expanded with the addition of two new Spanish-speaking
t
164
MHSA Community Supports and Services Final Plan, December 2005
Family Partners. All of the other Systems Development strategies outlined here are
new and will enhance the effectiveness of the overall recovery system.
VI.11.7. Supports and Services to be Provided by Clients and/or Family Members
Three of the strategies outlined above are services and supports provided by
consumers. These are: The expansion of the Office for Consumer Empowerment,
addition of Peer Benefits Counselors, and the addition of Family Partners. All three
planning processes and transformation training will include consumers participation and
leadership as well.
VI.11.8. Collaboration Strategies
As mentioned earlier, Peer Benefits Counselors with collaborate closely with the
county's Patient Financial Specialists. Planning for Co-Occurring Disorders will require
close collaboration with providers of drug and alcohol services both within the county
system and in the community.
VI.11.9. Cultural Competency
As stated throughout this Plan, CCMH is seeking to increase the cultural competency of
all of its staff and services. The Systems Development Strategies described in this
Q section will be implemented in a culturally competent manner and will increase the
overall cultural competence of CCMH. Key examples include:
• The addition of translators for members of the Consumer Involvement
Steering Committee will allow much greater diversity within that group —which
in turn has significant input into CCMH planning and activities.
• Strategic planning for transportation, co-occurring disorders and
transformation training will include a diverse group in the planning process,
and address diversity issues in each individual plan. Transportation planning
must address isolated geographic communities if it is to be effective. These
isolated communities are often communities of color.
• Transformation training, by definition, must address cultural competency as a
requirement for a recovery environment if it is to be effective as well.
• The addition of Benefits Advocates who are peers will increase their ability to
work with mental health consumers in a culturally sensitive manner and to
help reduce the stigma related to mental health issues.
VI.11.10. Sensitivity to Sexual Orientation, Gender Identity and Differing
Psychologies and Needs of Women and Men, Boys and Girls.
Men and women have differing needs— related not only to sexual identify, but to their
socialization and the roles and expectations of family and society. Their differing
relationships to and experiences with violence in our society are also important. Boys
165
MHSA Community Supports and Services Final Plan, December 2005
and girls face these same issues and often more as they are forming or grappling with
newly emerging issues about their sexuality, self-image, and relationships.
r
Both county and community-based hiring will be focused on establishing a diversity that
is reflective of the populations being served. This includes diversity in gender and
sexual orientation. Cultural sensitivity training that will be developed as part of MHSA
will address issues of gender and sexual orientation as well as race and culture.
S
V1.11.11. Meeting the Service Needs of Individuals Residing Outside of the
County
The Strategies outlined in this section will serve mental health consumers who live in
Contra Costa County.
V1.11.12. Selection of Strategies Not on State List
The Strategies listed in this Systems Development section are mostly cross-age
strategies. Key strategies from State lists for all ages that are addressed in this section
include:
• Consumer-run programs and services
(Planning for) Integrated substance abuse and mental health services
(Planning for)Transportation services
(Planning for) and implementation of transformational infrastructure and
attitudinal change
• On-site services in primary care clinics or other health care sites to provide
individualized, inter-disciplinary services coordinated with other health care
providers
• Classes and other instruction for clients regarding what clients need to know
for successful living in the community (wellness activities)
VI.11.13. Timeline
Key milestones in the implementation of these strategies include:
• 4/06 Consultant for transformation planning begins work. RFPs for other
strategic planning consultants already issued and hiring
process underway '
4/06 New OCE staff hired and programs begin
• 5/06 Initial transformation training activities begin
11/07 Wellness nurse begins program planning and services
11/07 Bilingual Family Partners begin work
b-
166
EXHIBIT Sa--Mental Health Services Act Community Services and Supports Budget Worksheet
Countyfies): Contra Costa Fiscal Year: 2005-06
Program Workplan# #6 Date: 12/8/05
r^ti Program Workplan Name Systems Development Strategies Page_of`
Type of Funding 2.System Development Months of Operation 3
Proposed Total Client Capacity of Program/Service: 30 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 30 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental Mental Health Total
Department Agencies Contract
Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene $0
b.Travel and Transportation $0
c.Housing
I.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing 54
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative)
f.Total Support Expenditures $0 $0 $0 $0
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $81,885 $81,885
c.Employee Benefits $33,944 $33,944
d.Total Personnel Expenditures $115,829 $0 $0 $115,829
3. Operating Expenditures
a.Professional Services $50,000 $50,000
b.Translation and Interpreter Services $10,000 $10,000
c.Travel and Transportation $5,000 $5,000
d.General Office Expenditures $10,000 $10,000
e.Rent,Utilities and Equipment $0
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $86,124 $86,124
h.Total Operating Expenditures $161,124 $0 $0 $161,124
4. Program Management
a.Existing Program Management ,, ,md `w;,,. $0
b.New Program Management � ,� ; $�; 1-01
c.Total Program Mana ement $0 $0 $0
S. Estimated Total Expen when service rovider is not known ¢: '"` _..y: ` c°' - ` ' 5sag $0
6.Total Proposed Program Budget $276,953 $0 $0 $276,953
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue Lo
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $0
�-^� b.Medicare/Patient Fees/Patient Insurance $0
/ c.State General Funds $0
t',�// d.Other Revenue L0
e.Total New Revenue $0 $0 $0 $0
3.Total Revenues $0 $0 $0 $0
C.One-Time CSS Funding Expenditures $20,000 $20,000
D.Total Funding Requirements $296,953 $0 $0 $296,953
E.Percent of Total Funding Requirements for Full Service Partnerships0.0%
167
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies):_ Contra Costa Fiscal Year: 2005-06
Program Workplan# 6 Date: 12/8/05
Program Workplan Name_ Systems Development Strategies - Page_of
Type of Funding 2.System Development Months of Operation 3
Proposed Total Client Capacity of Program/Service: 30 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 30 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
F fEe of FTEs Overtime per FTE" Wages and Overtime
A Current Existing Positions
$0
$0
$0
LO
Total Current Existing Positions 0.00 0.00 $0
B.New Additional Positions
Lead Spirit Instructor Leadership of Spirit Training Program(contract 1.00 1.00 $27,000 $6,750
OCE-Extended Placement Cot Peer Superv.of SPIRIT Placements(contract) 1.00 1.00 $27,000 $6,750
Peer Benefits Advocates Peer Adv. 3.00 3.00 $39,300 $29,475
Wellness Nurse Wellness Programming 1.00 $74,640 $18,660
3 Bilingual Parent Partners Family Advocacy&Support 3.00 3.00 $27,000 $20,250
$0
L
Total New Additional Positions 8.00 9.00 $81,885
y;
C.Total Program Positions Boo9.00 $81,885
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
k .!
SF •
SS i
3,
1-
168
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Program Workplan# #6 Date: 12/8/05
Program Workplan Name Systems Development Strategies Page_of_
Type of Funding 2.System Development Months of Operation 12
Proposed Total Client Capacity of Program/Service: 370 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MRSA: 370 Telephone Number: 925)957-5132
County Mental Other Community
Mental Health
Health Governmental Total
Department Agencies Providers
Contract
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene $0
b.Travel and Transportation $6,000 $8,000
c.Housing
i.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing ja
d.Employment and Education Supports $50,000 $50,000
e.Other Support Expenditures(provide description in budget narrative) 0
f.Total Support Expenditures $58,000 $0 $0 $58,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $327,540 $327,540
c.Employee Benefits $135,774 $135,774
d.Total Personnel Expenditures $463,314 $0 $0 $463,314
3. Operating Expenditures
a.Professional Services $40,000 $40,000
b.Translation and Interpreter Services $12,000 $12,000
c.Travel and Transportation $6,000 $6,000
d.General Office Expenditures $60,000 $60,000
e.Rent,Utilities and Equipment $20,000 $20,000
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $126,497 $126,497
h.Total O eratin Ex enditures $264,497 $0 $0 $264,497
4. Program Management
a.Existing Program Management }'"-s<� ,f;� .:; $0
b.New Program Management $0_
c.Total Program Management ' ry $0 $0 $0
S. Estimated Total Expenditures when service provider is not known 240- . s "� ' $0
6.Total Proposed Program Budget $785,811 $0 $0 $785,811
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue U0
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $0
0 b.Medicare/Patient FeesIPalienl Insurance $0
c.State General Funds $0
d.Other Revenue $D
a.Total New Revenue $0 $0 $0 $0
3.Total Revenues $0 $0 $0 $0
C.One-Time CSS Funding Expenditures 50
D.Total Funding Requirements $785,811 $0 $0 5785,811
v
E.Percent of Total Funding Requirements for Full Service Partnerships 0.0%
169
Y
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
County(ies):_ Contra Costa Fiscal Year: 2006-07
k
Program Workplan# 6 Date: 12/8/05
Program Workplan Name_ Systems Development Strategies Page,of
Type of Funding 2.System Development Months of Operation 12
F Proposed Total Client Capacity of Program/Service: 370 New Program/Service or Expansion New
'- Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 370 Telephone Number: 925)957-5132
Client,FM&CG Total Number Salary,Wages and Total Salaries.
Classification Function
FTEs° of FTEs Overtime per FTEs Wages and Overtime
A.Current Existing Positions -
$0
$0
$0
Lo
Total Current Existing Positions 0.00 0.00 . $0
B.New Additional Positions t
OCE-Lead Spirit Instructor Peer Leadership of Spirit Program(contract) 1.00 1.00 $27,000 $27,000
OCE-Extended Placement Coon:Peer Superv.of SPIRIT Placements(contract) 1.00 1.00 $27,000 $27,000
Peer Benefits Advocates Peer Adv. 3.00 3.00 $39,300 $117,900
Wellness RN I Wellness Programming 1.00 $74,640 $74,640
Family Partners(Bilingual) Family Support&Advoc. 3.00 3.00 $27,000 $81,000 '
Lo
Total New Additional Positions 8.001 9.00 $327,540
C.Total Program Positions 1 8.00 9.00 $327,540
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers.
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar. - f
y
x
3
170
EXHIBIT 5a--Mental Health Services Act Community Services and Supports Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2007-08
Program Workplan# #6 Date: 12/8/05
Program Workplan Name Systems Development Strategies Page_Of
Type of Funding 2.System Development Months of Operation 12
Proposed Total Client Capacity of Program/Service: 370 New Program/Service or Expansion New
Existing Client Capacity of Program/Service: Prepared by: Kimberly Mayer
Client Capacity of ProgramlService Expanded through MHSA: 370 Telephone Number: 925)957-5132
County Mental Other Community
Health Governmental Mental HealthContract Total
Department Agencies
Providers
A.Expenditures
1. Client,Family Member and Caregiver Support Expenditures
a.Clothing,Food and Hygiene $0
b.Travel and Transportation $4,000 $4,000
c.Housing
I.Master Leases $0
ii.Subsidies $0
iii.Vouchers $0
iv.Other Housing Lo
d.Employment and Education Supports $0
e.Other Support Expenditures(provide description in budget narrative) U0
f.Total Support Expenditures $4,000 $0 $0 $4,000
2. Personnel Expenditures
a.Current Existing Personnel Expenditures(from Staffing Detail) $0
b.New Additional Personnel Expenditures(from Staffing Detail) $300,540 $300,540
c.Employee Benefits $131,724 $131,724
d.Total Personnel Expenditures $432,264 $0 $0 $432,264
3. Operating Expenditures
a.Professional Services $0
b.Translation and Interpreter Services $5,000 $5,000
c.Travel and Transportation $4,000 $4,000
d.General Office Expenditures $13,000 $13,000
e.Rent,Utilities and Equipment
f.Medication and Medical Supports $0
g.Other Operating Expenses(provide description in budget narrative) $91,945 $91,945
h.Total Operating Expenditures $113,945 $0 $0 $113,945
4. Program Management
a.Existing Program Management `� £,' ,' '* $0
b.New Program Management " " f `, Lo
c.Total Program Management1" _ $0 $0 $0
5. Estimated Total Expenditures when service provider is not known $0
6.Total Proposed Program Budget $550209 $0 $0 $550,209
B.Revenues
1.Existing Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
c.Realignment $0
d.State General Funds $0
e.County Funds $0
f.Grants
g.Other Revenue
h.Total Existing Revenues $0 $0 $0 $0
2.New Revenues
a.Medi-Cal(FFP only) $0
b.Medicare/Patient Fees/Patient Insurance $0
C.State General Funds $0
d.Other Revenue Lo
e.Total New Revenue $0 $0 $0 $0
3.Total Revenues $0 $0 $0 $0
C.One-Time CSS Funding Expenditures $0
D.Total Funding Requirements $550,209 $0 $01 550,209
E.Percent of Total Funding Requirements for Full Service Partnerships 0.0%
171
EXHIBIT 5 b--Mental Health Services Act Community Services and Supports Staffing Detail Worksheet
.. County(ies):_ Contra Costa Fiscal Year: 2007-08
Program Workplan#_ 6 Date: 12/8/05
Program Workplan Name Systems Development Strategies Page_of
Type of Funding 2.System Development - Months of Operation 12
Proposed Total Client Capacity of Program/Service: 370 New Program/Service or Expansion New G
Existing Client Capacity of Program/Service: 0 Prepared by: Kimberly Mayer
Client Capacity of Program/Service Expanded through MHSA: 370 Telephone Number: 925)957-5132
Classification Function Client,FM&CG Total Number Salary,Wages and Total Salaries.
FTEs"' of FTEs Overtime per FTE' Wages and Overtime
A.Current Existing Positions
$0
$0
$0
r
Total Current Existing Positions 0.00 0.00 $0
B.New Additional Positions
OCE-Lead Spirit Instructor Peer Leadership of Spirit Program(contract) 1.00 1.00 $27,000 $27,000
Peer Benefits Advocates Peer Advocacy and Support 3.00 3.00 $39,300 $117,900
Wellness RN Wellness Programming 1.00 $74,640 $74,640 z,
Family Partners(Bilingual) Family Support&Advoc. 3.00 3.00 $27,000 $81,000
Lo
Total New Additional Positions 6.00 7.00 $300,540
C.Total Program Positions 1 6.00 7.00 $300,540
a/ Enter the number of FTE positions that will be staffed with clients,family members or caregivers. "
b/ Include any bi-lingual pay supplements(if applicable). Round each amount to the nearest whole dollar.
s
r
172
MHSA Community Supports and Services Final Plan,December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #6: Systems Development Strategies
FY 05-06
Introduction: This budget assumes funds approved for an April 1 Start-up, 2006. First
quarter activities presumes hiring efforts carried out before start date. This budget
includes a range of systems development activities.
A. Expenditures
1. Client, Family Member, Caregiver Support
f. Total Support Expenditures None
2. Personnel Expenditures
a. Current Existing Personnel Expenditures None
b. New Additional Personnel Expenditures
All salaries based on 25% of full-year operations. Salaries set at mid-step
of county scale for position. Includes:
1.0 FTE Lead SPIRIT Instructor— Contract Peer position oversees
SPIRIT training program for consumers.
1.OFTE Extended Placement Coordinator— Contract Peer position
develops opportunities, supervises and provides support for
consumer placements as part of the SPIRIT training program.
3.0 FTE Peer Benefits Advocates— Peer staff positions providing benefits
advocacy to consumers
1.0 FTE Wellness Nurse — To develop and implement wellness program
for consumers
3.0 FTE Bilingual Parent Partners— Family Peer positions to work with
Children's Program providing support and advocacy for families.
c. Employee Benefits
Benefits of$33,944 covers 5 contract and three staff positions.
d. Total Personnel Expenditures
Total personnel expenditures are $115,829
3. Operating Expenditures
a. Professional Services
$50,000 for planning consultants/support in the areas of transportation,
co-occurring disorders, and transformation efforts. Balance of
consulting fees paid in Year 2.
b. Translation and Interpreter Services
$10,000 for translation services for Consumer Involvement Steering
Committee, $2,000 for development of multi-lingual materials for
wellness program, Peer Benefits Advocates and Parent Partners.
173
MHSA Community Supports and Services Final Plan, December 2005
c. Travel and Transportation
$5,000 this quarter.
d. General Office Expenditures
$10,000 to be shared among different SD programs. Based on start--up
needs and full-year experience. Combines with $20,000 in one-
time funds for equipment.
e. Rent, Utilities and Equipment
None this quarter.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$50,000 for direct program expenses to be determined for Wellness
Program and OCE expansion plus $36,124 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$161,124.
4. Program Management
a. Existing Program Management None
b. New Program Management None
C. Total Program Management None
5. Estimated total Expenditures when service provider is not known . None
6. Total Proposed Program Budget
$276,953 Total Program Budget.
B. Revenues
i
1. Existing Revenues None
. 2. New Revenues None this year
3. Total Revenues None this year
C. One-Time CSS Funding Expenditures
$20,000 includes $10,000 for staff development for OCE and$10,000 for
one-time start-up equipment for all programs. See page 188 for a
discussion
of the need for one-time funds.
D. Total Funding Requirements
$296,953 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
0%
t;
174
t '
f--
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Plan #6: Systems Development Strategies
FY 06-07
/V.-.N/V.VN..m.VNM..I.V.V.V/V/V.V.V.-Y/VA./V.Y/VI.IV1VA.IVIVNIVIV.VI.1/V/VrYIV.V/VNIV/VN
Introduction: This budget is for a full year of operation for 4 key systems development
activities: OCE expansion, peer benefits advocates, a wellness program, and parent
partners. Operating funds are shared among them.
A. Expenditures
1. Client, Family Member, Caregiver Support
b. Travel and Transportation
$8,000 -- $4,000 for Community Involvement Steering Committee (OCE)
and $4,000 to be shared by all programs.
d. Employment and Education Supports
$50,000 for stipends to consumers in SPIRIT Training and work
placements.
f. Total Support Expenditures
$58,000 for total Support Expenditures.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures None
b. New Additional Personnel Expenditures
Salaries set at mid-step of county scale for positions. Includes:
1.0 FTE Lead SPIRIT Instructor— Contract Peer position oversees
SPIRIT training program for consumers.
1.0 FTE Extended Placement Coordinator— Contract Peer position
develops opportunities, supervises and provides support for
consumer placements as part of the SPIRIT training program.
3.0 FTE Peer Benefits Advocates— Peer staff positions providing benefits
advocacy to consumers
1.0 FTE Wellness Nurse — To develop and implement wellness program
for consumers
3.0 FTE Bilingual Parent Partners — Contract Family Peer positions to
work with Children's Program providing support.and advocacy for
families.
c. Employee Benefits
Benefits of$135,774 covers 5 contract and 4 staff positions.
d. Total Personnel Expenditures
Total personnel expenditures are $463,314.
3. Operating Expenditures
a. Professional Services
$40,000 for planning consultants/support in the areas of transportation,
175
1.
MHSA Community Supports and Services Final Plan, December 2005
t
co-occurring disorders, and transformation efforts. Represents
R balance of consulting fees for consultations/efforts initiated in Yr 1. r
b. Translation and Interpreter Services is
$12,000 -- $10,000 for translation services for Consumer Involvement
Steering Committee, plus $2,000 to be shared among other
programs.
c. Travel and Transportation
1 $6,000 -- $4,000 for Consumer Involvement Steering Committee and t
$2,000 to be shared among other programs.
d. General Office Expenditures
$60,000 to be shared among different SD programs. Based on prior
experience.
e. Rent, Utilities and Equipment '
$20,000 to be allocated as needed among programs. Some staff will be
absorbed into existing space.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$24,000 for direct program expenses to be determined for Wellness
Program and OCE expansion plus $102,497 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$264,497.
4. Program Management
a. Existing Program Management None
b. New Program Management None
C. Total Program Management None
5. Estimated total Expenditures when service provider is not known None
6. Total Proposed Program Budget
$785,811 Total Program Budget
B. Revenues
1. Existing Revenues None
2. New Revenues None this year
3. Total Revenues None this year
C. One-Time CSS Funding Expenditures None
D. Total Funding Requirements
$785,811 as outlined above and in budget worksheets.
E. Percent of Total Funding Requirements for Full Service Partnerships
0%
40
176
MHSA Community Supports and Services Final Plan, December 2005
Q Contra Costa County Mental Health
Budget Narrative
Plan #6: Systems Development Strategies
FY 07-08
.V/V.V IV.V.V..I.V.V..Ii►`.V.V.V.V.Y.V.V.V i...y.V....V.V.V. .N.V.V.V.V.V..Y.V.V.V.V.V...P.V P...V.V/.e
Introduction: This budget is for a full year of operation for 4 key systems development
activities: OCE expansion, peer benefits advocates, a wellness program, and parent
partners. Operating funds are shared among them.
Note: Year Three System Development efforts are under funded in comparison to Year
2. This is because of budgetary limits. It is expected that additional funds due to
increased allocation by Year 3 will allow completion of this budget.
A. Expenditures .
1. Client, Family Member, Caregiver Support
b. Travel and Transportation
$4,000 -- $3,000 for Community Involvement Steering Committee (OCE)
and$1,000 to be shared by all programs.
d. Employment and Education Supports
None this year.
f. Total Support Expenditures
$4,000 for total Support Expenditures.
2. Personnel Expenditures
a. Current Existing Personnel Expenditures None
b. New Additional Personnel Expenditures
Salaries set at mid-step of county scale for positions. Includes:
1.0 FTE Lead SPIRIT Instructor— Contract Peer position oversees
SPIRIT training program for consumers.
3.0 FTE Peer Benefits Advocates— Peer staff positions providing benefits
advocacy to consumers
1.0 FTE Wellness Nurse — To develop and implement wellness program
for consumers
3.0 FTE Bilingual Parent Partners— Contract Family Peer positions to
work with Children's Program providing support and advocacy for
families.
c. Employee Benefits
Benefits of$131,724 covers 4 contract and 4 staff positions.
d. Total Personnel Expenditures
Total personnel expenditures are $432,264.
3. Operating Expenditures
a. Professional Services
None this year.
177
MHSA Community Supports and Services Final Plan, December 2005
b. Translation and Interpreter Services
$5,000 -- $4,000 for translation services for Consumer Involvement
Steering Committee, plus $1,000 to be shared among other
programs.
a
C. Travel and Transportation
$4,000 for Consumer Involvement Steering
d. General Office Expenditures
$13,000 this year.
e. Rent, Utilities and Equipment
None this year.
f. Medication and Medical Supports
None
g. Other Operating Expenses
$20,175 for direct program expenses to be determined for Wellness
Program and OCE expansion plus $71,770 for County Overhead.
h. Total Operating Expenses
Total operating expenses of$113,945.
4. ' Program Management
a. Existing Program Management None
b. New Program Management None-
c. Total Program Management None
5. Estimated total Expenditures when service provider is not known None
6. Total Proposed Program Budget
$550,209 Total Program Budget.
B. Revenues '
1. Existing Revenues None t
2. New Revenues None this year
1 Total Revenues None this year
C. One-Time CSS Funding Expenditures None '
D. :Total Funding Requirements
$550,209 as outlined above and in budget worksheets. '
E. Percent of Total Funding Requirements for Full Service Partnerships
0%
178
EXHIBIT 5c--Mental Health Services Act Community Services and Supports Administration Budget Worksheet
County(ies): Contra Costa Fiscal Year. 2005-06
3 months Date: 12/8/05
Client,Family
Member and Total FTEs Budgeted Expenditures
Caregiver FTEs
A.Expenditures
1.Personnel Expenditures
a.MHSA Coordinator(s) 1.00 $23,248
b.MHSA Support Staff(Clerk) 1.00 $9,731
c.Other Personnel(list below)
i. Health Services Planner/Evaluator B 1.00 $15,519
ii. Utilization Review Coordinator 1.00 $21,357
iii. Patient Financial Services Specialist 1.00 $11,210
iv, Analyst 1.00 $16,250
V.
A
vii.
d.Total FTEs/Salaries 0.00 6.00 $97,314
e. B
Employee Benefits £M , 7 , 7 $58,388
(.'rise r �wz E:�e«�k, a w "'.
f.Total Personnel Ex enditures ) ^ ". $155,702
2.Operating Expendituresi
a.Professional Services ` , , r"p " °'' , ;` g; $40,000
b.Travel and Transportation ° ' ° $5,000
c.General Office Expenditures $3,655
d.Rent,Utilities and Equipment �V
e.Other Operating Expenses(provide description in budget narrative) ' �'"'• Ili,N,
Y }j ryN y}
f.Total O eratin Expenditures ) 4 $48,655
3.County Allocated Administration
a.Countywide Administration(A-87) �
b.Other Administration(provide description in budget narrative) 4 o- " i; # v t $32,620+
c.Total County Allocated Administration $32,620
4.Total Proposed County Administration Budget 1 rya i.� � �� :, �, r�'+°e.'' $236,977
y- {
B.Revenues
1.New Revenues +
u , i "
a.Medi-Cal(FFP only)
b.Other Revenue
2.Total Revenues
$0
C.Start-up and One-Time Implementation Expenditures f � � r R,"�.tr xr 1s" x.'. x $20,000
D.Total CountyAdministration Funding Requirements w �'"x4�'s' 5256,977
COUNTY CERTIFICATION
I HEREBY CERTIFY under penalty of perjury that I am the official responsible for the administration of Community Mental Health
Services in and for said County;that I have not violated any of the provisions of Section 5891 of the Welfare and Institution Code in
that all identified funding requirements(in all related program budgets and this administration budget)represent costs related to the
expansion of mental health services since passage of the MHSA and do not represent supplanting of expenditures;that fiscal year
2004-05 funds required to be incurred on mental health services will be used in providing such services;and that to the best of my
knowledge and belief this administration budget and all related program budgets in all respects are true,correct,and in accordance
with the law.
Date: / 0 5, Signature
Local Mental Hr
irector
0
Executed at ,California August 1,2005
179
EXHIBIT 5c--Mental Health Services Act Community Services and Supports Administration Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2006-07
Date: 12/8/05
Client,Family
Member and Total FTEs Budgeted Expenditures
Caregiver FTEs
A.Expenditures
1.Personnel Expenditures
a.MHSA Coordinator(s) 1.00 $92,991
b. MHSA Support Staff(Clerk) 1.00 $38,922
c.Other Personnel(list below)
i. Health Services Planner/Evaluator B 1.00 $62,076
ii. Utilization Review Coordinator 1.00 $85,428
iii. Patient Financial Services Specialist 1.00 $44,838
iv. Analyst 1.00 $65,000
V.
A.
vii.
d.Total FTEs/Salaries 0.00 6.00 $389,255
e.Employee Benefits ; t r` $233,553
f.Total Personnel Ex dituresME, $622,808en
2.Operating Expenditures
a. Professional Services $33,300
b.Travel and Transportation "�. ',' , . $17,000
c.General Office Expenditures 5, $15,000
d.Rent,Utilities and Equipment
e.Other Operating Expenses(provide description in budget narrative) 'k
f.Total Operating Expenditure
s ; "* $65,300
3.County Allocated Administration ( '
a.Countywide Administration(A-87)
b.Other Administration(provide description in budget narrative) $103,161
c.Total County Allocated Administration c $103,161
4.Total Proposed County Administration Budget 3 RA ,.,,.E VR ' 03 $791,269
B.Revenues
t
1.New Revenues
a.Medi-Cal(FFP only)
b.Other Revenue `
2.Total Revenues ;. �.�,. r=. . .,.. $0
C.Start-up and One-Time Implementation Expenditures
D.Total County Administration Funding RequirementsMMAMIM� $791,269
COUNTY CERTIFICATION
I HEREBY CERTIFY under penalty of perjury that I am the official responsible for the administration of Community Mental Health
Services in and for said County;that I have not violated any of the provisions of Section 5891 of the Welfare and Institution Code in
that all identified funding requirements(in all related program budgets and this administration budget)represent costs related to the
expansion of mental health services since passage of the MHSA and do not represent supplanting of expenditures;that fiscal year
2004-05 funds required to be incurred on mental health services will be used in providing such services;and that to the best of my
knowledge and belief this administration budget and all related program budgets in all respects are true,correct,and in accordance
with the law.
Date: Signatu A
Loco Mental He Director
Executed at ,California August 1,2005
180
EXHIBIT 5c--Mental Health Services Act Community Services and Supports Administration Budget Worksheet
County(ies): Contra Costa Fiscal Year: 2007-08
Date: 12/8/05
Client,Family
Member and Total FTEs Budgeted Expenditures
Caregiver FTEs
A.Expenditures
1.Personnel Expenditures
a.MHSA Coordinator(s) 1.00 $92,991
b.MHSA Support Staff(Clerk) 1.00 $38,922
c.Other Personnel(list below)
I. Health Services Planner/Evaluator B 1.00 $62,076
ii. Utilization Review Coordinator 1.00 $85,428
iii. Patient Financial Services Specialist 1.00 $44,838
iv. Analyst 1.00 $65,000
V.
A
vii.
d.Total FTEs/Salaries 0.00 6.00 $389,255
e.Employee Benefits $233,553
f.Total Personnel Ex enditures 6 $622,808
2.Operating Expenditures
a.Professional Services $33,450
b.Travel and Transportation $17,000
c.General Office Expenditures $15,000
d.Rent,Utilities and Equipment 11
e.Other Operating Expenses(provide description in budget narrative) u 4
f.Total Operating Expenditures ppb w $65,450
3.County Allocated Administration
a.Countywide Administration(A-87) �»
b.Other Administration(provide description in budget narrative) $103,246
c.Total County Allocated Administration $103,248
4.Total Proposed County Administration Budget . . $791,506
13.Revenues '
1.New Revenues
a.Medi-Cal(FFP only)
b.Other Revenue b
i.
2.Total Revenues $0
C.Start-up and One-Time Implementation Expenditures I
D.Total County Administration Funding Requirements $791,506
COUNTY CERTIFICATION
I HEREBY CERTIFY under penalty of perjurythat I am the official responsible for the administration of Community Mental Health
Services in and for said County;that I have not violated any of the provisions of Section 5891 of the Welfare and Institution Code in
that all identified funding requirements(in all related program budgets and this administration budget)represent costs related to the
expansion of mental health services since passage of the MHSA and do not represent supplanting of expenditures;that fiscal year
2004-05 funds required to be incurred on mental health services will be used in providing such services;and that to the best of my
knowledge and belief this administration budget and all related program budgets in all respects are true,correct,and in accordance
with the law.
Date:1#n54
� Signature
° Le-19d
` Local Me al Health irector
Executed at California August 1,2005
i8�
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Administration
FY 05-06
M1MMM1M1M1.V.VM1M1.V IVM1M1M1.VNM1M1.V/VM1M1M1M1.V.V../M1M1M1.VM1M1N.VNM1M1M1NM1M1M1M1
S
3
Introduction: This budget assumes funds approved for an April 1 Start-up, 2006. First
quarter activities presumes hiring efforts carried out before start date.
A. Expenditures I.
1. Personnel Expenditures
All salaries based on 25% of full-year operations. Salaries set at mid-step of
county scale for position.
a. 1.0 FTE MHSA Coordinator— Manages and leads all aspect of MHSA
planning, implementation, monitoring and reporting.
b. 1.0 FTE MHSA Clerk — Provides administrative and clerical support to
project.
C. Other
i. 1.0 FTE Health Planner/Evaluator B —Assists in the development and
implementation of evaluation mechanisms for MHSA-funded activities
and reporting.
ii. 1.0 FTE Utilization Review Coordinator— Overseas and assures UR
activities to support MHSA funded projects.
iii. 1.0 FTE Patient Financial Services Specialist— Interviews and
counsels consumerslfamily members to determine eligibility for
County, State and Federal benefits.
iv. 1.0 Analyst— Provides administrative and analytic support to MHSA
Coordinator
d. Total FTES and Salaries
6.0 FTEs for a total of$97,314 in salaries.
e. Employee Benefits
Benefits of$58,388 covers all new positions.
f. Total Personnel Expenditures
Total personnel expenditures are $155,702.
2. Operating Expenditures
a. Professional Services
$40,000 for consultant support for MHSA planning, facilitation of planning
processes, development of RFPs, bids, and proposals.
b. Travel and Transportation
$5,000 for transportation to regional and statewide meetings re: MHSA
c. General Office Expenditures
$3,665 for general office expenditures based on prior experience and
partial year of operations.
d. Rent, Utilities and Equipment
None.
182
MHSA Community Supports and Services Final Plan, December 2005
e. Other Operating Expenses
None.
f. Total Operating Expenses
Total operating expenses of$48,655.
3. County Allocated Administration
b. Other Administration
$32,620 in county overhead.
c. Total county allocated administration
$32,620 Total.
4. Total Proposed County Administration Budget
$236,977 Total Proposed Admin. Budget.
B. Revenues
None.
C. Start-Up and One-Time CSS Funding Expenditures
$20,000 includes one-time start-up office equipment for new staff. See page 188
for a discussion of the need for one-time funds.
D. Total County Administration Funding Requirements
Q $256,977 as outlined above and in budget worksheets.
�J
183
fi
4
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Administration
FY 06-07
a
A. - Expenditures
1. Personnel Expenditures
Salaries set at mid-step of county scale for position.
a. 1.0 FTE MHSA Coordinator— Manages and leads all aspect of MHSA
planning, implementation, monitoring and reporting.
b. 1.0 FTE MHSA Clerk— Provides administrative and clerical support to
project
c. Other
i. 1.0 FTE Health PlannedEvaluator B—Assists in the development and
implementation of evaluation mechanisms for MHSA-funded activities
and reporting.
ii. 1.0 FTE Utilization Review Coordinator— Overseas and assures UR
activities to support MHSA funded projects.
iii. 1.0 FTE Patient Financial Services Specialist— Interviews and
counsels consumers/family members to determine eligibility for
County, State and Federal benefits.
iv. 1.0 Analyst— Provides administrative and analytic support to MHSA
Coordinator
d. Total FTES and Salaries
6.0 FTEs for a total of$389,255 in salaries
e. Employee Benefits
Benefits of$233,553 covers all new positions.
f. Total Personnel Expenditures
Total personnel expenditures are $622,808.
2. Operating Expenditures _
a. Professional Services
$33,300 for consultant support for MHSA planning, facilitation of planning
processes, development of RFPs, bids, and proposals. .;
b. Travel and Transportation
$17,000 for transportation to regional and statewide meetings re: MHSA
and it implementation.
c. General Office Expenditures
$15,000 for general office expenditures based on prior experience.
d. Rent, Utilities and Equipment
None.
e. Other Operating Expenses
None.
f. Total Operating Expenses
184
MRSA Community Supports and Services Final Plan, December 2005
Total operating expenses of$65,300.
3. County Allocated Administration
b. Other Administration
$103,161 in county overhead.
c. Total county allocated administration
$103,161 Total.
4. Total Proposed County Administration Budget
$791,269 Total Proposed Admin. Budget.
B. Revenue
None.
C. Start-Up and One-Time CSS Funding Expenditures
None
D. Total County Administration Funding Requirements
$791,269 as outlined above and in budget worksheets.
0
00
185
MHSA Community Supports and Services Final Plan, December 2005
Contra Costa County Mental Health
Budget Narrative
Administration
FY 07-08
�� .Y.V O.Y`MhIN.V IV/V V.V N/V.V/V N.-/V�M.V.Y V.V/V.V.V IV.V.V IV.V AIM.V.V.V 1V/V V.V/V.VAI
T
A. Expenditures
1. Personnel Expenditures
Salaries set at mid-step of county scale for position.
a. 1.0 FTE MHSA Coordinator— Manages and leads all aspect of MHSA
planning, implementation, monitoring and reporting.
b. 1.0 FTE MHSA Clerk— Provides administrative and clerical support to
project.
C. Other
i. 1.0 FTE Health Planner/Evaluator B-Assists in the development and
implementation of evaluation mechanisms for MHSA-funded activities f'
and reporting.
ii. 1.0 FTE Utilization Review Coordinator— Overseas and assures UR
activities to support MHSA funded projects.
iii. 1.0 FTE Patient Financial Services Specialist— Interviews and ='
counsels consumers/family members to determine eligibility for
County, State and Federal benefits.
iv. 1.0 Analyst— Provides administrative and analytic support to MHSA
Coordinator. is
4.
d. Total FTES and Salaries
6.0 FTEs for a total of$389,255 in salaries.
e. Employee Benefits
Benefits of$233,553 covers all new positions.
f. Total Personnel Expenditures
Total personnel expenditures are $622,808.
2. Operating Expenditures
a. Professional Services
$33,450 for consultant support for MHSA planning, facilitation of planning
processes, development of RFPs, bids, and proposals. '
b. Travel and Transportation
$17,000 for transportation to regional and statewide meetings re: MHSA
and it implementation.
c. General Office Expenditures
$15,000 for general office expenditures based on prior experience.
d. Rent, Utilities and Equipment
None.
e. Other Operating Expenses
None.
f. Total Operating Expenses
Total operating expenses of$65,450.
186
MHSA Community Supports and Services Final Plan, December 2005
3. County Allocated Administration
b. Other Administration
$103,248 in county overhead.
c. Total county allocated administration
$103,248 Total.
4. Total Proposed County Administration Budget
$791,506 Total Proposed Administrative Budget.
B. Revenue
None.
C. Start-Up and One-Time CSS Funding Expenditures
None
D. Total County Administration Funding Requirements
$791,506 as outlined above and in budget worksheets.
�.J
I
187
MHSA Community Supports and Services Final Plan, December 2005
NOTE ON JUSTIFICATION FOR UNSPENT FUNDS
Contra Costa's ambitious MHSA Plan is dependent upon receipt of all unspent funds
(75% of allocation) from Year One. These funds and their purposes are identified
throughout the budgets and budget narratives provided earlier in this Section. These
a
needs are discussed in more detail below.
One time request for the first 50%
z; As per the requirements in DMH Letter 05-06, Contra Costa Mental Health is requesting
$3,560,750 in funds for one-time costs as part of our Community Services and Supports
Plan (up to 50% of the first year's allocation).
$397,000 of these funds are for start-up expenses of equipment and cars for new
programs. Given the difficult transportation situation in Contra Costa County, the cars
are especially important to provide "whatever it takes"to full service partners.
4:
$2,901,310 of these funds are for housing. This includes funds for vouchers to support
long term, scattered site, supported housing for Full Service Partners in the children's,
TAY and Adult programs, to purchase a 3 bedroom manufactured home to serve as a
emergency and transitional residents for TAYs, and $90,000 to renovate and furnish the
newly available Antioch transitional living site for TAYs. These funds are capitalized
over the first three-year period. These funds for are crucial to the implementation and
ongoing services of our program and overall Housing First focus. From all of our
surveys, focus groups and community forums, housing was the number one requested
service for mental health consumers.
Last 25%
As per the requirements of DMH Letter 05-06, Contra Costa Mental Health requests the
final 25% of our first year's allocation, or$1,780,375. The majority of these funds are to
be reserved for future housing opportunities in the County ($1,729,440 — see Housing
Budget Narrative). As discussed, the number one concern and need that came from all
of our focus groups, surveys and community forums was the need for a full range of
housing including emergency shelter, temporary housing and permanent supportive
housing. Contra Costa has one of the highest housing costs in the State of California.
We currently must send over 200 of our existing mental health consumers to out-of-
county placements, because we do not have the facilities in Contra Costa to support
a:
them. Working with our community partners, we are working on identifying an
appropriate opportunity for new permanent supportive housing. This funding will provide
the critical foundation for the supportive housing this community so desperately needs.
188 -
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3
EXHIBIT 7--Mental Health Services Act Cash Balance Quarterly Report
County Contra Costa Date 12/08/05 (;
MHSA Component Comm. Services and Supports Fiscal Year 2005-06 t
r,
Quarter 1st (July-Sept) '
w
A. Cash Flow Activity
1. Cash,on hand at beginning of quarter(line 6 from prior Quarterly Report)
2. Quarterly advance from State DMH (insert as positive number)
3. Total cash available (sum of lines 1 and 2) $0
R'
4. Actual expenditures (insert as a negative number)
5. Adjustments of prior quarters(insert as negative or positive number, as appropriate)
6. Cash on hand at end of quarter(report on line 1 for next Quarterly Report) $0 '
B. Reserved Cash on Hand at End of Quarter(enter as negative numbers)
1. Anticipated one-time expenditures to be incurred during quarter
C. Cash on Hand for On-Going Operations 1 $0
COUNTY CERTIFICATION
I HEREBY CERTIFY, to the best of my knowledge and belief, under penalty of perjury,that this report is correct and
complete and that all expenditures have been made in accordance with the Mental Health Services Act
requirements.
Signature (To be completed and submitted following DMH approval of CSS Plan)
Name and Title Donna M. Wigand, LCSW, Mental Health Director
E-Mail Address dwigand@,hsd.co.contra-costa.ca.us
Telephone Number 925-957-5111 r
�r
1
7S
r
L;
s
Exhibit 7—Cash Balance August 1, 2005
192
x'
NOW
MHSA Community Supports and Services Final Plan, December 2005
Part III. REQUIRED EXHIBITS
Exhibit 1 is included as the first page of this Plan.
Exhibits 2 & 3 are includes on pages 43 - 46 of Part III.
Exhibits 4, 5a and 5b are included within each Program Description Part III.
Exhibit 5c is included on pages 179 - 187 with the Administrative Program budget
narrative within Part III.
Exhibit 6 is included as page 191 of Part III.
Exhibit 7 is included on page 192 of this Section. It will be filled out for future
progress reports.
Q
193
i
Wednesday, December 21, 2005 1;16 AM Liz Callahan 925-932-4917 p.01
Z �05
^ n
12
Attention: Supervisor Gayle Uilkema Date: 12/21/2005
Company: Number of Pages: 3
Fax Number: 335-1076
DC CCot� �
Voice Number:
DEC 2 1 4200. 5
From: Liz Callahan SUPERVISOR GAYLE B.UILKEMA
CONTRA COSTA COUNTY
Company:
Fax Number: 925-932-4917
Voice Number: 925-932-4755
Subject: comments for the record
Comments:
Dear Supervisor Uilkema --
Here are the comments of the Contractors' Alliance on D3 from
today's agenda -- the draft plan for Implementation of the Mental
Health Services Act. Thank you for inviting me to submit them.
Happy Holidays,
Liz Callahan
Wednesday, December 21,20051;16 AM Liz Callahan 925-932.4917 p.02
Contractors' Alliance of Contra Costa County
A Consortium of Non-Profit
Community-Based Agencies
Comments on D3: 1llental Health Services Act Community Services& Support Plan
December 20,2005
Presented by Liz Callahan,director
First of all,I want to acluiow-ledge all the work that the county,the eecutive directors and program staff of
conuruunity-based organizations,anti asserted other stakeholders luuve done. Thus was an enormous task:with
nnpossible deadlines. It is very hard to stand here and say that this plan is not enough and that we're not theta
yet laiowing how- hard everyone has worked.
The Mental Health Services Act(NIHSA)is about systems transformation, It's about moAinng away from the
current system which focuses primarily on alinucal services to a system that is driven by partnerdiips and by
an overarclinig ideal of prot•id ng"Avhatever it takes"to enable people to attain than•individual goals.
Whatever it takes. That's quite a vision. $7,INI is not enough to realize that-vision. But we're not really
talking about g7.lIvI because those dollars leverage other dolkurs. `Ve need not feel defeated, In fact,now
iuore than aver,we must be creative,eurnrageouu+and inispirad.
Implicit in that vision is a promise. It is the promise of building the aipacity of eonuumuities to understand
trental illness, to stop being afiaid, to bring mental illness out of the shadm s, to fiilly accept tlue ideas of
recovery and resilience,and to become intolerant of all the systemic failures Ave have tolerated for far too
long: homelessness,frequent and avoidable medical care and hospitalization, incarceration,out-of-home
placement,and longi tenn dependence on public welfare.
The NIHSA has 5 fiuidameital concepts inherent in it that must be woven into the fabric of the plans being
developed by this comity:
• Community collaboration
• Cultural competence
• C hent/fannily driven mental health
• Nvelhtess
• Integrated acrvicc cspericlWca
I am going to focus on three of those.
• Comnwnih•eollobolntion,as defined by the State in its guidelines,is the process by which various
stakeholders work together to share nnfomiation and resources to accomplish a sheered vision. Collaboration
allovm for slurred leadership,decisions,ownership,vision and responsibility. The goal of commiunity
collaboration is to bring members of the collmrunity together in an atmosphere of support to systematically
solve existing and emerging problems that could not easily be solved by one group alone.
This is not just about building teams colnhrised gfcounl)t and CBO pe,sonnel and clients. This is the
plrmise of conversation. This is uchel e Arc bllifd h ust and rmdcrstancling and oro success in
integl•atang this concept ui�illhe dependent entirely vn the processes tine use. it•7lere is the shored
visioll inthisplall? Ill fact ivlleic isatrl•visiollstotelnerltatoll?
2977 Ygnacio Valley Road, #445 Walnut Creek, CA 94598
phone:925-932-4755 fax, 925-932-4917 e-mail,thealliance@astound.net
Wednesday, December 21,20051;18 AM Liz Callahan 925-932-4917 p.03
• C'irlhu'al cornpetence--Cidtivally conipetet►t prograuus and services are N•iewed as away to eidnauee the
ability of the whole system to incorporate the lana cages an ciilhues of its clients into the services that
provide the most effective ortcotnes and create cost effective programs.
This plan creates silos of cultural competency and misses the opportunio,to build the capacity of the
communiht to become culhu'ally competent.
• Integrated s07110e means that services are"seamless"to clients and that clients do not have to
negotiate mtdtiple agencies and fitndnig sources to get critical needs stet.
li•7wre in the prrirosed jrlort is the vision q{seanrlrssness7 Cneatirtg a seamless sr•stear ol'carX- is an
enor mous task that requires bringing together oll the major stakeholders. It grill not evolve natin•oll)
it will not happen within the current plan.It will only haplren il'uv dedicate the resources—both
hrnnarr enrd fnanctol—too process whose goal is to creore a seamless system ofcare fen•clients and
families.
Systems development dollars equaling more than$1.21 will he spent in the ncit three ycois on
countrpersvnnel, Vile? Il ijf are bre cornrmtting those dollar's to creahngpermanentpositivns at
this early stage? The only positions Ire can create at this point are within the cm•r•ent s�-stent—the
veq system this Act Inas designed to overhaul;the veq systern Ire all ocknmvledge we need to
change. Systems development dollars ore to be used "to change...service delilrr),systems and build
h crnsforntativnirllrrcrgrarns and services. " We should not be adding petsomnel to the county Alental
Health DiNiiion. We should be identif}nng and implementing a process that brings stakeholders
together to have the rich conversations that systems transformation requires..
We urge the Board of Supervisors to be thoughtfiil yourselves and to provide the creative,courageous and
inspirational leadership we need, The current plan does not fillfill the promise of systems transformation, It
does not speak to a vision of what we want for this cotutty. It is entirely appropriate,therefore,that the Board
of Super%isors hold the t'ision for the Alental Health Seru•ices,act fit this county. The current plan is the
words Mthout the music, We look to you to provide the nnnsic.
2977 Ygnacio Valley Road, #445 Walnut Creek, CA 94598
phone:925-932-4755 fax: 925-932-4917 e-mail:thealliance@astound.net