The Mental Health Services Act (MHSA):
What Aging Services Providers
Need to Know
Aging Services of California Annual Conference
May 5, 2010
Lin Benjamin, MSW, MHA
Geriatric Mental Health Specialist
California Department of Aging
(916) 928-7890; lbenjamin@aging.ca.gov
Presentation Agenda
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Description of Proposition 63/MHSA
MHSA Core Principles
MHSA Stakeholder Process
MHSA Funding Components
Collaboration Among Older Adult
Service Providers
Resource Information
Description of Prop 63/MHSA
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California voters’ ballot initiative (November 2,
2004)
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1% tax on personal income in excess of $1M
Became effective as statute on Jan 1, 2005, as the Mental
Health Services Act (MHSA)
http://www.dmh.ca.gov/Prop_63/MHSA/docs/Ment
al_Health_Services_Act_Full_Text.pdf
Six MHSA Funding Components
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Community Services & Supports (CSS)
Prevention and Early Intervention (PEI)
Workforce Education and Training (WET)
Innovation
Capital Facilities & Technology
Housing
Description of Prop 63/MHSA
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Policy Guidelines developed for each funding component
defines how MHSA funds can be used
Funding is allocated to County Mental Health
Departments for each component on a 3-year basis
(Moving towards an Integrated Plan)
Requires a Community Planning Process involving
stakeholders to identify community needs and develop
County Plans for state approval
http://www.dmh.ca.gov/Prop_63/MHSA/Community_Planning/defa
ult.asp
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Non-Supplantation Policy
No MHSA funds can be used to fund mental health services that
were in existence prior to Prop 63
Description of Prop 63/MHSA
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Requires counties to fund a Prudent Reserve to be used
when revenue declines to maintain stability of MHSA
programs/services
State Administrative Funds
 5% of MHSA funds are used for state MHSA administrative
activities of the Department of Mental Health (DMH), the
Mental Health Services Oversight and Accountability
Commission (MHSOAC) and the California Mental Health
Planning Council (CMHPC)
 State-level Interagency Partners receive MHSA funding
from DMH through Memorandum of Understanding
(includes California Department of Aging)
http://www.dmh.ca.gov/Prop_63/MHSA/State_Intera
gency_Partners.asp
MHSA Core Principles
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Transform the public mental health system
Reach Un-served and Under-served populations
across the lifespan (Children & Youth, Transition-Age
Youth, Adults, Older Adults), including Racially,
Ethnically and Culturally Diverse Populations
Develop services that
 Promote Wellness and Recovery
 Reduce Disparities in Access and Outcomes
 Are Consumer & Family Driven; Culturally &
Linguistically Competent,
 Result from Community Collaboration,
 Provide an Integrated Service experience
MHSA Stakeholder Process
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MHSA County Plan Development and Approval
Process:
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Community Planning Process
County MHSA Steering/Advisory Committee (prioritize
proposals)
County DMH Writes County MHSA Plan
30 Day Public Comment Period and Public Hearing
County Mental Health Board Approval
County Board of Supervisors Approval
Submit County MHSA Plan to CA DMH or MHSOAC for State
Review/Approval for Funding
County DMH Implements MHSA Plan (RFPs)
County DMH Submits Annual Update to CA DMH for
Approval/Funding
MHSA Funding Components
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Community Services and Supports (CSS)
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Mental health services to address Serious Mental Illness
(SMI) in adults/older adults and Serious Emotional
Disturbance (SED) in children.
Full Service Partnerships – Services for specific age
groups that provide “whatever it takes” to prevent negative
outcomes (hospitalization, institutionalization, homelessness,
suicide, school failure, out of home placement, etc)
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Older Adult Full Service Partnerships (February, 2009)
http://cmhda.org/go/LinkClick.aspx?fileticket=IcWmQ9fKR4
Q%3d&tabid=169
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http://www.dmh.ca.gov/Prop_63/MHSA/Community_Services_and_
Supports/default.asp
MHSA Funding Components
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Prevention and Early Intervention (PEI)
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Prevent onset of SMI/SED
Prevent mental illness from becoming
severe and disabling
MHSA PEI Policy Guidelines for County PEI Plans
require allocation of 51% (minimum) of PEI funds
for ages 0-25 and must serve all age groups
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Small counties are excluded from these PEI
requirements (<200,000 population)
MHSA Funding Components
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Prevention and Early Intervention (PEI)
(cont.)
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County PEI Plans Must Address Key
Community Needs:
 Disparities in Access
 Psycho-social impact of trauma
 At-Risk Children, Youth and Young Adult
Populations
 Stigma and Discrimination
 Suicide Risk
MHSA Funding Components
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Prevention and Early Intervention (PEI)
(cont.)
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County PEI Plans Must Target Priority
Populations:
 Trauma Exposed Individuals
 Individuals Experiencing Onset of Serious
Psychiatric Illness
 Children & Youth in Stressed Families
 Children & Youth at Risk for School Failure
 Children & Youth at Risk of or Experiencing
Juvenile Justice Involvement
MHSA Funding Components
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Workforce Education & Training (WET)
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Statewide Five-Year WET Plan
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County Three-Year Expenditure WET Plan
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Promote post-secondary education strategies to prepare
future public mental health workforce and address workforce
shortages
http://www.dmh.ca.gov/Prop_63/MHSA/Workforce_Educatio
n_and_Training/docs/MHSA_FiveYearPlan_5-06-08.pdf
Complete a county mental health workforce needs assessment
to identify workforce shortages (by discipline, diversity issues)
Provide training to build skills and capacity of existing public
mental health workforce (professionals, consumers, families)
and system partners
http://www.dmh.ca.gov/DMHDocs/docs/notices07/0714_Enclosure1A.pdf
Regional WET Plans
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http://www.cimh.org/Services/MHSA/Workforce-EducationTraining.aspx
MHSA Funding Components
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Innovation
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Establish creative approaches to mental health
services that promote recovery, resilience and
reduce disparities in access and outcomes
Introduce a new mental health practice
Implement a promising community practice that
advances mental health service delivery, increases
quality of services, improves outcomes, promotes
interagency collaboration and new learning
http://www.dmh.ca.gov/Prop_63/MHSA/Innovatio
n/default.asp
MHSA Funding Components
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Capital Facilities and Technology
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To ensure the infrastructure necessary for the
expansion and transformation of the public mental
health system
Capital Facilities: Treatment, service and
administrative facilities
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http://www.dmh.ca.gov/Prop_63/MHSA/Capital_Facilities/defau
lt.asp
Technology: Electronic health records,
information/data systems, local priorities
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http://www.dmh.ca.gov/Prop_63/MHSA/Technology/default.as
p
MHSA Funding Components
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MHSA Housing
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Develops permanent supportive housing for
persons with SMI/SED
http://www.dmh.ca.gov/Prop_63/MHSA/Housing/defau
lt.asp
MHSA Statewide PEI Projects
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California Strategic Plan on Suicide Prevention
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California Strategic Plan on Stigma & Discrimination
Reduction
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http://www.dmh.ca.gov/PEIStatewideProjects/StrategicPlan.asp
Student Mental Health Initiative
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http://www.dmh.ca.gov/Prop_63/MHSA/Prevention_and_Early_Interventi
on/docs/CDMH_ExSummary_Web.pdf
http://www.dmh.ca.gov/Prop_63/MHSA/Prevention_and_Early_Interventi
on/docs/SuicidePreventionCommittee/FINAL_CalSPSP_V9.pdf
http://www.dmh.ca.gov/PEIStatewideProjects/SuicidePrevention.asp
http://www.dmh.ca.gov/PEIStatewideProjects/StudentMentalHe
althInitiative.asp
California Strategic Plan on Reducing Ethnic and
Cultural Disparities
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http://www.dmh.ca.gov/PEIStatewideProjects/ReducingDisparities.asp
http://www.dmh.ca.gov/Multicultural_Services/default.asp
Collaboration Among
Older Adult Service Providers
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MHSA provides opportunity to develop older
adult mental health services
 Older adult service providers/advocates must
participate in the MHSA stakeholder process to
ensure that MHSA funds the development of older
adult mental health services
 Promote development of collaborative and
integrated service models (health, mental
health, substance use, care management,
support services)
Collaboration Among
Older Adult Service Providers
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Mental Health
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Senior Peer Counseling/Peer Counseling Programs
Home & Community-Based Aging Services Network- Area Agencies on
Aging (Older Americans Act programs), Multipurpose Senior Services
Programs, Adult Day Health Care, Independent Living Centers, Aging
and Disability Resource Centers, Public Guardian
Alcohol/Substance Abuse
Primary Care, Hospitals, Home Health
Social Services-Adult Protective Services, In Home Supportive Services
Senior Housing Providers
Family Caregiver Programs
Ethnic & Cultural Brokers
Faith-Based Organizations
Educational Institutions
Legal
Mental Health & Aging Coalitions
Collaboration Among
Older Adult Service Providers
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Opportunities to Promote Older Adult Mental
Health Service Development
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California Department of Aging MHSA PEI Plan
Review Summary Report (Handout)
California Mental Health Directors Association
(CMHDA) Older Adult System of Care Committee
WET Issue Paper (Handout)
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Promote geriatric mental health training of public mental
health workforce and system partners working with older
adults with mental health needs
http://cmhda.org/go/Committees/OlderAdultSystemofCare
CommitteeOASOC/OASOCDocuments.aspx
Resource Information
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California Department of Mental Health (DMH)
MHSA Home Page/List-Serve:
http://www.dmh.ca.gov/Prop_63/MHSA/default.asp
http://www.dmh.ca.gov/Prop_63/MHSA/Apps/subscription/default.asp
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Link to County Mental Health Departments to determine
MHSA stakeholder activities:
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County MHSA Plans and Annual Updates:
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http://www.dmh.ca.gov/Prop_63/MHSA/County_Plans_and_Updates.
asp
http://www.dmh.ca.gov/DMHDocs/docs/notices08/08-28.pdf
MHSA Resource Information:
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http://www.dmh.ca.gov/docs/CMHDA.pdf
http://www.dmh.ca.gov/Prop_63/MHSA/Related_Resources.asp
Statewide PEI Projects - Policy Guidelines
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http://www.dmh.ca.gov/DMHDocs/docs/notices10/10-06_PEIGuidelines.pdf
Resource Information
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Mental Health Services Oversight and
Accountability Commission (MHSOAC)
http://www.dmh.ca.gov/MHSOAC/default.asp
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Monthly Commission meetings; Commission Committee
meetings
County PEI Plans Approved by MHSOAC
http://www.dmh.ca.gov/MHSOAC/Prevention_and_Early_Interventi
on.asp
MHSA Fast Facts
http://www.dmh.ca.gov/MHSOAC/docs/FastFacts_General_MHSAwFinalCh
gs-3-8-10.pdf
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PEI Fast Facts
http://www.dmh.ca.gov/MHSOAC/docs/FastFacts_PEI_Final-3-8-10.pdf
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Prop 63 Funding Fast Facts
http://www.dmh.ca.gov/MHSOAC/docs/Fast_Facts_Prop_63_fun
ding--Revised_03-8-10.pdf
Resource Information
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California Mental Health Directors Association
(CMHDA) http://www.cmhda.org/go/Home.aspxr
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MHSA Information
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California Counties Transforming Local Mental Health
Systems Publication (Description of County CSS-Funded
Programs)
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http://cmhda.org/go/MentalHealthServicesAct.aspx
http://cmhda.org/go/MentalHealthServicesAct/CommunitySe
rvicesSupports/CSSCompendium.aspx
Older Adult System of Care Committee Documents
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Workforce Education and Training (WET) Issue Paper
http://cmhda.org/go/Committees/OlderAdultSystemofCareCo
mmitteeOASOC/OASOCDocuments.aspx
Older Adult Full Service Partnerships (February, 2009)
http://cmhda.org/go/LinkClick.aspx?fileticket=IcWmQ9fKR4
Q%3d&tabid=169
Resource Information
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California Institute of Mental Health (CiMH)
www.cimh.org
 California Mental Health Directors Association
(CMHDA) Older Adult System of Care Conference
(2009)
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http://www.cimh.org/Learning/ConferencesTraining/Handouts/2009/Older-Adults.aspx
MHSA training activities
Mental health training resources
Resource Information
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California Mental Health Planning Council
(CMHPC)
http://www.dmh.ca.gov/Mental_Health_Planning_Cou
ncil/default.asp
 Committees
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http://www.dmh.ca.gov/Mental_Health_Planning_Cou
ncil/Meetings.asp
California Mental Health Planning Council Master
Plan
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http://www.dmh.ca.gov/Mental_Health_Planning_Cou
ncil/Master_Plan.asp
Resource Information
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California Department of Aging (CDA)
http://www.aging.ca.gov/
 California State Plan on Aging (2009-2013)
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Statistics and Demographics
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http://www.aging.ca.gov/stats/default.asp
Resource Links
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http://www.aging.ca.gov/legislation/California_State_
Plan_on_Aging_AoA_2009-2013_06-30-2009.pdf
http://www.aging.ca.gov/links/related_links.asp
California Commission on Aging
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http://www.ccoa.ca.gov/