ABOUT THE MHSA In 2004, California voters approved Proposition 63 and the MHSA was enacted in 2005 by placing a one percent tax on personal income above $1 million. It provided the first opportunity in many years to expand county mental health programs for all populations: children, transition age youth, adults, older adults, families, and, most especially, the unserved and under-served. It was also designed to provide a wide range of prevention, early intervention, and treatment services, including the necessary infrastructure, technology, and enhancement of the mental health workforce to support it . However, the economy took a severe downturn soon after Proposition 63 passed, and instead of experiencing a growth in the continuum of services, in many cases service levels could only be sustained since Proposition 63 money was often the only stable source of funds. Proposition 63 began as approximately 10% of the entire public mental health budget; it now comprises approximately 24%.
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CORE STANDARDS OF MHSA
"The County shall adopt the following standards in planning, implementing, and evaluating the programs and/or services provided with Mental Health Services Act (MHSA) funds. The planning, implementation and evaluation process includes, but is not limited to, the Community Program Planning Process...and the manner in which the County delivers services and evaluates services delivery."
-California Code of Regulations; Title 9. Rehabilitative and Development Services; Division 1. Department of Mental Health; Chapter 14. Mental Health Services Act; Section 3320. General Standards
-Community Collaboration
Community collaboration refers to the process by which various stakeholders including groups of individuals or families, citizens, agencies, organizations and businesses, work together to share information and resources in order to accomplish a shared vision.
-Cultural Competence
Culturally competent programs and services are viewed as a way to enhance the ability of the whole system to incorporate the languages and cultures of its clients.
-Client/Family Driven Services
Adult clients and families of children and youth identify their needs and preferences which lead to the services and supports that will be most effective for them.
Adult services are client-centered and child and youth services are family driven; with providers working in full partnership with the clients and families they serve to develop individualized, comprehensive service plans.
-Wellness focused
Recovery refers to the process in which people who are diagnosed with a mental illness are able to live, work, learn and participate fully in their communities.
Resilience refers to the personal qualities of optimism and hope, and the personal traits of good problem solving skills that lead individuals to live, work and learn with a sense of mastery and competence.
-Integrated Service Experience
Services are "seamless" to clients and that clients do not have to negotiate multiple agencies and funding sources to get critical needs met and to move toward recovery and develop resiliency. Services are delivered, or at a minimum, coordinated through a single agency or a system of care.
FIVE MHSA Components
Community Services & Support
Community Services & Support (CSS) is the largest component of the MHSA and receives 76% of the Mental Health Services Fund. It supports comprehensive mental health treatment for people of all ages living with serious emotional disturbance (SED) or serious mental illness (SMI). The CSS component is focused on community collaboration, cultural competence, client and family driven services and systems, wellness focus, which includes concepts of recovery and resilience, integrated service experiences for clients and families, as well as serving the unserved and underserved. Housing is also a large part of the CSS component.
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Prevention & Early Intervention
MHSA dedicates 19% of its allocation to Prevention and Early Intervention (PEI), which is intended to prevent mental illness from becoming severe and disabling and to improve timely access for people who are underserved by the mental health system. The goal of the Prevention & Early Intervention (PEI) component of the MHSA is to help counties implement services that promote wellness, foster health, and prevent the suffering that can result from untreated mental illness. The PEI component requires collaboration with consumers and family members in the development of PEI projects and programs.
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Innovation
MHSA designates 5% of a County's allocation to the Innovation component, which specifically and exclusively dedicates funds to trying new approaches that contribute to learning rather than expanding service delivery. The goal of Innovation is to increase access to underserved groups, increase the quality of services, promote interagency collaboration and increase access to services. Countries select one or more goals as the primary priority or priorities for their proposed Innovation plan. Projects are time-limited to a maximum of five years and evaluated for effectiveness and consideration for continued funding through CSS, PEI or other funds.
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Capital Facilities & Technological Needs
The Capital Facilities & Technological Needs (CFTN) component works towards the creation of a facility that is used for the delivery of MHSA services to mental health clients and their families or for administrative offices. Funds may also be used to support an increase in peer-support and consumer-run facilities, development of community-based settings, and the development of a technological infrastructure for the mental health system to facilitate the highest quality and cost-effective services and supports for clients and their families.
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Workforce Education &Training
The goal of the Workforce Education & Training (WET) component is to develop a diverse workforce. Clients and families/caregivers are given training to help others by providing skills to promote wellness and other positive mental health outcomes, they are able to work collaboratively to deliver client- and family-driven services, provide outreach to unserved and underserved populations, as well as services that are linguistically and culturally competent and relevant, and include the viewpoints and expertise of clients and their families/caregivers.
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LINKS TO PROP 63 RESOURCES
Mental Health Services Oversight and Accountability Commision (MHSOAC)
The MHSOAC was created by the MHSA to oversee the implementation of the Act.
California Department of Health Care Services (DHCS)
The mission of DHCS is to provide Californians with access to affordable, integrated, high-quality health care, including medical, dental, mental health, substance use treatment services and long-term care. Our vision is to preserve and improve the overall health and wellbeing of all Californians.
Office of Statewide Health Planning and Development (OSHPD)
OSHPD improves access to quality healthcare for Californians. We ensure hospital buildings are safe, offer financial assistance to individuals and healthcare institutions, and collect and publish healthcare data.
County Behavioral Health Directors Association (CBHDA)
The County Behavioral Health Directors Association of California (CBHDA) is a nonprofit advocacy association representing the behavioral health directors from each of California's 58 counties, as well as two cities (Berkeley and Tri-City).
California Institute for Behavioral Health Solutions (CIBHS)
The California Institute for Behavioral Health Solutions (CIBHS) is a non-profit agency that helps health professionals, agencies and funders improve the lives of people with mental health and substance use challenges through policy, training, evaluation, technical assistance, and research.
