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HomeMy WebLinkAboutMINUTES - 01112005 - SD.5 (3) TO: BOARD OF SUPERVISORS Contra { .. FROM: William Walker, M.D., Director Health Services Department Costa v DATE: December 14, 2004 rCounty-c-���+Y SUBJECT: Proposition 63 Implementation Overview SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUST€FICATION RECOMMENDATION: ACCEPT report from the Health Services Director on the process for Proposition 63, the methods in which the county will seek public input, the time lines for development of the County Plan, and public outreach strategies. DIRECT the Health Services Department to return in early 2005 to update the Board of Supervisors on the planning and implementation process. FISCAL IMPACT: The Legislative Analyst estimates the Proposition 63 will generate additional "state„ revenue of approximately $275 million in 2004-05, $750 million in 2005-2006, $800 million in 2006-07, with increasing amount is future years. Counties must go through a lengthy application process to receive funding, therefore it is unclear at this time how much money Contra Costa County will receive. BACKGROUND: The following is intended to provide only an outline of the key provisions of the statute that will impact Contra Costa County, not an in-depth analysis of requirements: Proposition 63, the Mental Health Initiative was passed by voters on November 2, 2004. This proposition imposes an additional 1% tax on taxable personal income above $1 million to provide dedicated funding for expansion of mental health services and programs. Proposition 63 is anticipated to have a major impact on County mental health services by generating new revenues and establishing new administrative mandates with which the County will have to comply. CONTINUED ON ATTACHMENT: X YES SIGNATURE: --------------------------------------....----—---------------------------------------------------w - - - -f ----- ,.-RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMME DATION OF BOARD C M€TTEE -! - APPROVE OTHER SIGNATURE(S): '� ACTION OF BOA D, N Gc f ti u APPROVE AS RECOMMENDED OTHER f, R r � r VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN h UNANIMOUS{ABSENT �'> k'._ ) AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE AYES: NOES: SHOWN. ABSENT: ABSTAIN: ATTESTED „ CONTACT: Donna Wigand,957-5911 JOHN SWEETEN,Cl^OF THE Dorothy Sansoe,335-9009 BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR CC: County Administrator Health Services-Administration Health Service-Mental HealthBY- s f �. 4. .... �, . Page 2 Since counties are the provider of last resort for mental health care services and often absorb significant casts through their general fund, Proposition 63 could benefit counties by providing a new revenue source. However the revenue stream is somewhat unstable as it is tied to the personal income of a relatively small population of Californians. The State Department of Mental Health is required to establish a program to expand access to mental health services, focusing on programs that emphasize preventing negative outcomes. The State will contract with county mental health programs for the provision of the services. County mental health programs are required to offer services to severely mentally ill children, adults and senior citizens who are not eligible to receive treatment under any other public or private insurance program. Proposition 63 attempts to address the shortage of individuals qualified to provide services and requires each county to submit a needs assessment to the State that identifies provider shortages and other staff that will be needed to provide the increased services. The State will develop a five year education and training plan to expand the pool of qualified individuals, with subsequent plans adopted every five years. Commission Established The statute also establishes the Mental Health Services Oversight and Accountability Commission to oversee the implementation of Proposition 63. While the Commission has a number of duties and responsibilities, the most significant function is the requirement that it annually review and approve each county mental health program for innovative programs, and for prevention and early intervention. County Plan Each county mental health program must prepare and submit a three-year service plan, which must be updated annually and approved by the State Department of Mental Health after review and comment by the Commission. Development of the plan must include local stakeholders and be circulated for review and comment for at least 30 days. The plan must detail the following: • Prevention and early intervention • Services to children, transitional youth, adults and seniors • Innovative services • Technological needs and capital facilities needs • Personnel shortages and assistance needed from education and training programs • Establishment and maintenance of a prudent reserve to ensure the county will be able to provide adequate services with funds provided by Proposition 63 • Expenditure plan including the cost per person for services provided. Funding The Mental Health Services Initiative (Proposition 63) will be enacted January 1, 2005. The roposition creates a revenue stream through a I% tax on income above the first one million dollars earned. The additional taxes raised will begin to be collected on January 1, 2005 on a quarterly basis. Proposition 63 establishes the Mental Health Services Fund, to be administered by the State Department of Mental Health. Funding may not be used to supplant existing State or County funds currently utilized to provide mental health services. The State cannot make any changes to the structure of financing mental health services that increases a county's share of the costs or the financial risk unless the State also provides additional funding. Each year the State must inform counties of the amount of funds available. The statute appears to provide a great deal of discretion to the State Department of Mental Health in terms of deciding how much funding will be made available to each County. The State must give greater weight to a county or a population that has historically been significantly underserved. Page 3 Each county must place all funds received from the State Mental Health Services Fund in a local Mental Health Services Fund. All expenditure for County mental health programs must be consistent with either the County plan or update which has already been approved by the State. Contracting The State Department of Mental Health must provide services through contracts with a county mental health programs including cities receiving mental health funds. The statute allows for two or more counties may join together to deliver or subcontract services. Timeline The effective date of the statute is January 1, 2005 but it does not address any timeline for counties to submit their service plans to the State or any timeline for the State to release the funding to counties. We anticipate that the first six month plan and the first funds to be released to the counties will occur in the Spring of 2005. Next Steps During the month of December a number of planning meetings and training sessions have taken place with State and local mental health experts, including County Mental Health Directors, and more are scheduled. Donna Wigand, Contra Costa County Mental Health Director, and her staff have been attending these meetings and will continue to do so. A County needs assessment must be completed before any plan can be submitted. The State just completed a draft of this self-assessment tool, so we anticipate finalizing this step in January. Community meetings to gather input will begin by February. In early 2005 the Health Services Department will return to update the Board on the planning and implementation process. SD.S ADDENDUM TO SD.5 January 11, 2005 On this day the Board considered accepting a report from the Health Services Director on the planning process for Proposition 63, outlining the methods by which the County will seek public input, the timeline for development of the County plan, and public outreach strategies. Donna M. Wigand, Director of the Mental Health Division for Contra Costa Health Services,presented the report. Supervisor Mark DeSaulnier expressed concern regarding outreach to constituents, and suggested that the outreach by the Mental Health Commission be the primary source of directing the planning process and that the Steering Committee provide policy oversight. Supervisor DeSaulnier requested Donna Wigand's involvement on the Steering Committee, and asked the County Administrator's office to have the County lobbyist get involved in the legislative effort. The Mental Health Committee expressed an intention to hold meetings in each District. Supervisor Piepho requested that because of the diversity within her District, two meetings be set up in District III. She also requested Donna Wigand concentrate on supporting the services for youth. The Chair invited the public to comment and the following persons spoke: Dr. Michael Cornwall, (Mental Health Coalition of Contra Costa County)Benicia Roland M. Katz, (P.E.U. Local 1) 5034 Blum Road,Martinez Herb Putnam, 1747 Bishop Drive, Concord Liz Callahan, (Contractors Alliance)2977 Ygnacio Valley Road, Walnut Creek After further discussions, the Board made the following recommendations: • ACCEPTED report from the Health Services Director on the process for Proposition 63, the methods in which the County will seek public input, the time lines for development of the County Plan, and public outreach strategies • DIRECTED the Health Services Department to return end of February 2005 to update the Board of Supervisors on the planning and implementation process The motion passed by unanimous vote with all Supervisors present.