LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH   Policy 100.08 Mental Health Services Act Three Year Plan Development and Review     PROCEDURES

Overview  Develop a Three-Year Program and Expenditure Plan which includes:  A detailed description of new programs, programs that have changed from what was described in and/or discontinued from the last Three Year Program and Expenditure Plan   The rationale for all added, changed, or discontinued programs.   Supporting data  Updated finance and budget documentation  Descriptions should include, but not be limited to, all stakeholder input and/or evaluation data that contributed to the decision to add, change, or discontinue a program, and all impact on individuals served in changed or discontinued programs.   The following outline should be followed to ensure all the proper update elements are captured per Mental Health Services Oversight & Accountability Commission (MHSOAC) instruction:  Stakeholder Process  Describe the local stakeholder process including:  Date(s) of the meeting(s) and any other planning activities conducted.  Who participated in the planning process in enough detail to establish that the required stakeholders were included and reflect the County’s diverse population.  How were stakeholders meaningfully involved on mental health policy, program planning, and implementation, monitoring, quality improvement, evaluation, and budget allocations.  Training provided to participants in community planning.  If the Three-Year Program and Expenditure Plan includes a new INN project, a description of how training informed planning participants about the specific purposes and MHSA requirements for the INN component is required.  Program Updates and Changes  The Three-Year Program and Expenditure Plan should include updates and changes to all five MHSA components (CSS, PEI, INN, CFTN, and WET) and include the number of clients and the cost per client for all age groups (Children, TAY, Adults and Older Adults).   Community Services and Supports Update / change narratives and supporting data must address all the following CSS component service categories:  Full Service Partnership (FSP) Services  Outpatient Care Services (OCS)  Outreach and Engagement (O&E) Services  Alternative Crisis Services (ACS)  Housing   Linkage  Planning, Outreach and Engagement (POE)  Prevention and Early Intervention (PEI)  PEI update / change narratives and supporting data must be clearly delineated between:  Prevention - direct service programs that serve individuals who are at risk for mental illness/emotional disturbance  Early Intervention - direct service programs that provide service to individuals showing early onset of mental illness/emotional disturbance  Other - PEI programs that are neither “Prevention” nor “Early Intervention” (i.e., that do not have a direct service component). “Other” programs could include stand-alone programs focused on Outreach for Increasing Recognition of Early Signs of Mental Illness, Access to Treatment, Improving Timely Access to Services for Underserved Populations, Stigma and Discrimination   Reduction, and Suicide Prevention.  Innovation (INN)   The Three-Year Program and Expenditure Plan should include sufficient information about proposed new and changed INN projects so that the MHSOAC may determine if the project meets statutory requirements and can be approved.  Describe minor changes within the Three-Year Program and Expenditure Plan for changed INN projects that do not require MHSOAC approval (i.e., changes not made to the total funding for the project, the primary purpose, or the basic practice or approach that the county is piloting and evaluating).  If an INN project has proven successful and the county chooses to continue it, the INN project shall transition to another category of funding as appropriate.  Capital Facilities and Technological Needs (CFTN)  Include any changes or updates regarding projects designed to enhance the infrastructure needed to support the behavioral health system, which includes improving or replacing existing technology systems and/or developing capital facilities to meet increased needs of the local mental health system.   Workforce Education and Training  Identify shortages in personnel and any additional training and education needs that may have arisen that will enhance the public mental health workforce.  In addition to the required program updates listed above, counties should include the following information as part of the Three-Year Program and Expenditure Plan:  A description of county demographics, including but not limited to size of the county, threshold languages, unique characteristics, age, gender, and race/ethnicity.  A narrative analysis of the mental health needs of unserved, underserved/inappropriately served and fully served County residents who qualify for MHSA services.  Examples of notable community impact for any program, if applicable.  Any challenges or barriers with each of the programs and strategies to mitigate those challenges or barriers.  Outcomes  The Three-Year Program and Expenditure Plan shall include reports on the achievement of performance outcomes for MHSA services, e.g., results of any evaluations or performance outcomes for all programs and include specific time frames for performance outcomes. When including results of any evaluations or performance outcomes for PEI programs and program components/activities they must be separated by Prevention, Early Intervention, Other, Stigma and Discrimination Reduction, and Suicide Prevention categories.   County Compliance Certification  The Three-Year Program and Expenditure Plan must be certified by the county mental health director, which ensures that the county has complied with all pertinent regulations, laws, and statutes of the Mental Health Services Act, including stakeholder participation and non-supplantation requirements, must be included in the Annual Update.   County Fiscal Accountability Certification  The Three-Year Program and Expenditure Plan must be certified by the county mental health director and the county auditor-controller that the county has complied with any fiscal accountability requirements as directed by the State Department of Health Care Services, and that all expenditures are consistent with the requirements of the MHSA, shall be included in the Annual Update.  Expenditure Plan  MHSA funds may only be used to pay for MHSA programs. An expenditure plan must be included in the Annual Update based on available unspent funds, estimated revenue, and reserve amounts. Include Expenditure Plan Funding form in Update.  In addition, include the budgeted amount to be spent for the Fiscal Year on:  Full Service Partnerships, which should be at least 50% of CSS funds  General System Development,   Outreach Engagement,   PEI programs broken down by Prevention, Early Intervention, Other, Stigma and Discrimination Reduction, and Suicide Prevention (20% of MHSA funds)  INN by project (5% of CSS funds and 5% of PEI funds)  Workforce Education and Training   Capital Facilities and Technological Needs  Prudent Reserve  Thirty (30) Day Posting and Review   The following information must be included in the Three-Year Program and Expenditure Plan:  The dates the 30-day review process was conducted.  Methods used by the Department to circulate for the purpose of eliciting public comment the draft of the Three-Year Program and Expenditure Plan to representatives of the stakeholders’ interests and any other interested party who requested a copy.  The date of the public hearing held by the Los Angeles County Mental Health Commission.  Summary and analysis of any substantive recommendations received during the 30-day public comment period and the county’s resulting actions, including any substantive changes made to the Three-Year Program and Expenditure Plan in response to public comments.  Board of Supervisors Adoption  ​​​​​​​Include documentation that the Board of Supervisors adopted the Three-Year Program and Expenditure Plan and the date of that adoption.  MHSOAC Submission  ​​​​​​​The Three-Year Program and Expenditure Plan is emailed to the Mental Health Services Oversight and Accountability Commission by June 30th following the approval of the Los Angeles County Board of Supervisors.