# 58.
Board of Supervisors
- Meeting Date:
- 12/03/2024
- Brief Title
- MHSA Annual Update Fiscal Year 2024-25
From:
Nolan Sullivan, Director, Health and Human Services Agency
Staff Contact:
Karleen Jakowski, Assistant Director, Health and Human Services Agency, x2978
Supervisorial District Impact:
Countywide
Subject
Receive annual update on the Three-Year Mental Health Services Act Plan process. (No general fund impact) (Sullivan) (Est. Time: 10 min)
Recommended Action
Receive annual update on the Mental Health Services Act (MHSA) for Fiscal Year 2024-25.
Strategic Plan Goal(s)
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Thriving Residents |
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Collaborative Community |
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Sustainable Environment |
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Flourishing Agriculture |
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Robust Economy |
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Operational Excellence |
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In Support of All Goals (Internal Departments Only) |
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County Mandated Service |
Reason for Recommended Action/Background
The Fiscal Year (FY) 2024-25 Annual Update for the Mental Health Services Act (MHSA) provides the Yolo County Health and Human Services Agency (HHSA) an opportunity to inform stakeholders, partners, consumers, and community members about MHSA-funded programs and funding priorities and highlight outcomes from FY 2022-23.
On November 12, 2024, the Board received an initial presentation on the draft MHSA Annual Update for fiscal year 2024-25 and provided related feedback to staff. Since then, HHSA has presented the draft MHSA Annual Update to the Community Engagement Workgroup and has collected input from the public during the 30-day public comment period. This presentation will provide an overview of the public comment received on the draft plan and HHSA's responses to that feedback, including any relevant changes or updates. The plan will come back for Board approval on December 10, 2024, following the mandated public hearing held by the Local Mental Health Board on December 4, 2024.
California's public behavioral health system is set for significant transformation following the passage of Proposition 1, the Behavioral Health Services Act (BHSA). This act reprioritizes the MHSA on those with serious mental illnesses and substance use disorders, emphasizing housing support for the unhoused, while also emphasizing full-service partnerships and early intervention services. Key changes under the BHSA will take effect in July 2026, restructuring funding allocations to prioritize housing (30%), full-service partnerships (35%), and behavioral health services and supports (35%). Additionally, the BHSA eliminates funding for prevention and workforce training at the local level, removes the innovation component, and increases the state's funding share from 5% to 10%, redirecting approximately $140 million annually from counties to the state. Efforts are underway to assess the local impact of these changes and identify new opportunities.
As of January 2024, state projections indicated a 23.6% decline in MHSA revenue compared to March 2023, leading to reduced revenue projections for Yolo County during the current three-year plan. The volatility of MHSA revenue is evident, with actual revenue over the past three fiscal years being 20% lower than projected, resulting in a $12.4 million shortfall. This fluctuation, combined with rising costs and prior growth plans, has depleted Yolo County’s unspent fund balances.
In collaboration with county leadership and local stakeholders, this Annual Update sustains much of the core programming within Yolo County’s MHSA three-year plan and includes reductions in the Community Services and Supports (CSS) budget and adjustments in the Prevention and Early Intervention (PEI) budget. These changes reflect updated state projections, actual local revenue and expenditures and related impacts to fund balances, and anticipated impacts related to Proposition 1. Yolo County will continue to monitor state projections and make any necessary additional adjustments in the FY 2025-26 Annual Update.
The FY 2024-25 updates are informed by the community planning process, prioritize fiscal responsibility, and are guided by key principles, which include: Ensuring compliance with MHSA categorical spending requirements; Minimizing impacts on service delivery while prioritizing direct client services; Maximizing Medi-Cal revenue by leveraging MHSA funding for federal entitlements related to Medi-Cal Specialty Mental Health Services; Evaluating the eligibility of current MHSA programs for continued funding post-Proposition 1 implementation; and Utilizing data-driven decision-making to right-size Yolo County’s plan and budget based on changing MHSA revenue projections. These adjustments will result in minimal and targeted reductions to existing services, with a focus on maximizing Medi-Cal revenue and leveraging alternative funding sources wherever possible. The only new MHSA initiative for FY 2024-25 is one-time capital funding for the acquisition and rehabilitation of an MHSA-funded Adult Residential Facility serving seriously mentally ill adults.
Changes for the FY 2024-25 Annual Update include:
Reductions in Community Services and Supports (CSS) Budget
Next steps in the FY 2024-25 MHSA Annual Update Process include:
On November 12, 2024, the Board received an initial presentation on the draft MHSA Annual Update for fiscal year 2024-25 and provided related feedback to staff. Since then, HHSA has presented the draft MHSA Annual Update to the Community Engagement Workgroup and has collected input from the public during the 30-day public comment period. This presentation will provide an overview of the public comment received on the draft plan and HHSA's responses to that feedback, including any relevant changes or updates. The plan will come back for Board approval on December 10, 2024, following the mandated public hearing held by the Local Mental Health Board on December 4, 2024.
California's public behavioral health system is set for significant transformation following the passage of Proposition 1, the Behavioral Health Services Act (BHSA). This act reprioritizes the MHSA on those with serious mental illnesses and substance use disorders, emphasizing housing support for the unhoused, while also emphasizing full-service partnerships and early intervention services. Key changes under the BHSA will take effect in July 2026, restructuring funding allocations to prioritize housing (30%), full-service partnerships (35%), and behavioral health services and supports (35%). Additionally, the BHSA eliminates funding for prevention and workforce training at the local level, removes the innovation component, and increases the state's funding share from 5% to 10%, redirecting approximately $140 million annually from counties to the state. Efforts are underway to assess the local impact of these changes and identify new opportunities.
As of January 2024, state projections indicated a 23.6% decline in MHSA revenue compared to March 2023, leading to reduced revenue projections for Yolo County during the current three-year plan. The volatility of MHSA revenue is evident, with actual revenue over the past three fiscal years being 20% lower than projected, resulting in a $12.4 million shortfall. This fluctuation, combined with rising costs and prior growth plans, has depleted Yolo County’s unspent fund balances.
In collaboration with county leadership and local stakeholders, this Annual Update sustains much of the core programming within Yolo County’s MHSA three-year plan and includes reductions in the Community Services and Supports (CSS) budget and adjustments in the Prevention and Early Intervention (PEI) budget. These changes reflect updated state projections, actual local revenue and expenditures and related impacts to fund balances, and anticipated impacts related to Proposition 1. Yolo County will continue to monitor state projections and make any necessary additional adjustments in the FY 2025-26 Annual Update.
The FY 2024-25 updates are informed by the community planning process, prioritize fiscal responsibility, and are guided by key principles, which include: Ensuring compliance with MHSA categorical spending requirements; Minimizing impacts on service delivery while prioritizing direct client services; Maximizing Medi-Cal revenue by leveraging MHSA funding for federal entitlements related to Medi-Cal Specialty Mental Health Services; Evaluating the eligibility of current MHSA programs for continued funding post-Proposition 1 implementation; and Utilizing data-driven decision-making to right-size Yolo County’s plan and budget based on changing MHSA revenue projections. These adjustments will result in minimal and targeted reductions to existing services, with a focus on maximizing Medi-Cal revenue and leveraging alternative funding sources wherever possible. The only new MHSA initiative for FY 2024-25 is one-time capital funding for the acquisition and rehabilitation of an MHSA-funded Adult Residential Facility serving seriously mentally ill adults.
Changes for the FY 2024-25 Annual Update include:
Reductions in Community Services and Supports (CSS) Budget
- Return of contracted Adult, Transitional Aged Youth, and Older Adult Full-Service Partnership (FSP) to a core baseline of 200 slots, down from 240 slots.
- Discontinuation of the Case Management program at Pine Tree Gardens Adult Residential Facility.
- Discontinuation of the Behavioral Health Case Management (BHCM) program for the Public Guardian's Office and elimination of two (2) BHCM positions with HHSA.
- Elimination of several administrative support positions, including an MHSA Program Coordinator and Administrative Services Analyst, within HHSA.
- Elimination of the Supportive Housing and Social Services Coordination program.
- Discontinuation of the contract with CommuniCare+OLE to operate the Davis Navigation Center, with a concurrent proposal to add three (3) positions within HHSA to operate the center for cost savings.
- Transition of the NAMI Peer- and Family-Led Support Services program from the CSS to the PEI category.
- Reduction in Capital Facilities and Technology Needs (CFTN) transfers.
- Discontinuation of the Latinx Outreach/Mental Health Promotores program, with some services continued through other funding sources.
- Elimination of two (2) Administrative Services Analyst positions within HHSA.
- Discontinuation of the Mobile Hair Professionals to Support Mental Wellness and Connections program, with some services continued through other funding sources.
- Utilization of one-time incentive funds to offset annual subscription costs for the Avatar Electronic Health Record.
Next steps in the FY 2024-25 MHSA Annual Update Process include:
- December 3rd: Finalize Annual Update
- December 4th: Local Mental Health Board to hold public hearing to approve final update
- December 10th: Final MHSA Annual Update to BOS for approval of final update
Collaborations (including Board advisory groups and external partner agencies)
Local Mental Health Board
Fiscal Impact
No Fiscal Impact
Fiscal Impact (Expenditure)
- Total cost of recommended action:
- $
- Amount budgeted for expenditure:
- $
- Additional expenditure authority needed:
- $
- On-going commitment (annual cost):
- $
Source of Funds for this Expenditure
- General Fund
- $0
Attachments
Form Review
| Inbox | Reviewed By | Date |
|---|---|---|
| Yen Nguyen | Yen Nguyen | 11/25/2024 02:00 PM |
- Form Started By:
- Jonathan Bartlett
- Started On:
- 11/22/2024 04:56 PM
- Final Approval Date:
- 11/25/2024