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Consent-Health & Human Services   # 18.
Board of Supervisors
Meeting Date:
12/10/2024
Brief Title
Approval of MHSA Fiscal Year 24/25 Annual Update
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

Approve the Mental Health Services Act (MHSA) 3 year plan. (No general fund impact) (Sullivan)

Recommended Action

Approve the Mental Health Services Act (MHSA) 3 year plan. 

Strategic Plan Goal(s)

Thriving Residents

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 December 3, 2024, the Board received a presentation on the public comment received on the draft plan during the 30-day public comment period and HHSA's responses to that feedback, including any relevant changes or updates. A mandated public hearing was also held by the Local Mental Health Board on December 4, 2024. The plan is now coming back to the Board for approval.

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 fullservice 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.

Community planning priorities have highlighted the need to adapt to changes stemming from Proposition 1, enhance FSP program needs, and expand supportive housing options. Feedback from the community planning process has consistently underscored the importance of strengthening existing services. As we navigate these transitions and the evolving landscape of behavioral health in California, Yolo County HHSA remains committed to supporting our clients, partners, and the community. We will embrace new opportunities and uphold the core values of the MHSA: community collaboration, cultural competence, consumer and family-driven services, service integration, prioritization of the unserved and underserved, and a focus on mental wellness, recovery, and resilience.

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 Julie Dachtler 12/03/2024 04:26 PM
Yen Nguyen Yen Nguyen 12/05/2024 02:01 PM
Form Started By:
Jonathan Bartlett
Started On:
10/23/2024 09:49 AM
Final Approval Date:
12/05/2024