Title
Approve the “Psychiatric Advance Directives Multi-County Collaborative - Phase II” Mental Health Services Act (MHSA) Innovation Plan.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
Approve the “Psychiatric Advance Directives Multi-County Collaborative - Phase II” Mental Health Services Act (MHSA) Innovation Plan
SUMMARY:
The Mental Health Services Act (“MHSA”), formerly known as Proposition 63, was approved by California voters in 2004 and is funded by a 1% sales tax on personal incomes greater than $1 million per year. In accordance with Welfare and Institution Code (“WIC”) Section 5892, 5% of MHSA funds received by counties must be allocated to Innovation projects. The MHSA Innovation component aims to pilot novel projects capable of transforming the mental health system, per the requirements set forth in WIC Section 5830. Funding under the Innovation component may only be utilized for Innovation Plans approved by the county Board of Supervisors and the State Mental Health Services Oversight and Accountability Commission. Local stakeholder input and other data are used in the development of each Innovation Plan. After a public review and comment process, which culminates with a Public Hearing conducted by the Behavioral Health Commission, the finalized Innovation Plan must be approved by the Board of Supervisors for Innovation funds to be spent. Unspent Innovation funds are subject to reversion, per WIC Section 5892(h), if the county has not encumbered Innovation funds within three-years of distribution.
DISCUSSION:
The “Psychiatric Advance Directives Multi-County Collaborative - Phase II” MHSA Innovation Plan has been informed by local stakeholder input gathered during the community program planning process. It reflects the identified priority needs and system improvements to serve residents with mental health challenges, particularly during times of crisis, with an intentional focus on increased in the quality of services in Monterey County, and promotion of interagency communication and collaboration to result in improved outcomes. The County of Monterey Behavioral Health Bureau participated in Phase I of this same project, achieving promising outcomes, and participation in Phase II will allow for expanded opportunities to serve the broader community, positively impact first responder and other professional communities, and reduce costs associated with recidivism to jail and hospital environments. Psychiatric Advance Directives Multi-County Collaborative - Phase II will encumber any unused portions of FY 2022-23 through FY 2024-25 MHSA Innovation funds that may be subject to reversion if not approved by June 30, 2025.
As required by MHSA regulations, the draft Innovation Plan was circulated and posted for a thirty-day public comment period beginning February 25 and concluding on March 26, 2025. On March 27, the Monterey County Behavioral Health Commission (“Commission”) conducted a Public Hearing on the draft Innovation Plan, which included a presentation, a summary of comments received, and the staff response to those comments. The Commission received additional comments from those attending the Public Hearing before voting to approve the “Psychiatric Advance Directives Multi-County Collaborative - Phase II” MHSA Innovation Plan to include the public comments, staff responses, and the Commission Meeting Minutes, and to forward the final document to the Board of Supervisors for approval.
This work supports the following County of Monterey Health Department 2025-2028 strategic plan initiatives: 2. enhance community health and safety by emphasizing prevention; and 3. ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports one or more of the ten essential public health services, specifically: 3. inform, educate, and empower people about health issues.
OTHER AGENCY INVOLVEMENT:
The “Psychiatric Advance Directives Multi-County Collaborative - Phase II” Mental Health Services Act (MHSA) Innovation Plan document has been reviewed and approved by the Monterey County Behavioral Health Commission and is recommended for approval by the Board of Supervisors.
FINANCING:
The “Psychiatric Advance Directives Multi-County Collaborative - Phase II” plan was included in the Health Department’s Behavioral Health Bureau FY 2025-26 (Fund 023, Unit 8410, Appr. HEA012) Requested Budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐ Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐ Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒ Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐ Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐ Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Wesley Schweikhard, Management Analyst II, 755-4856
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachment:
Board Report
Monterey County “Psychiatric Advance Directives Multi-County Collaborative - Phase II” Mental Health Services Act (MHSA) Innovation Plan