Mental Health Services Act Steering Committee

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Mental Health Services Act Steering Committee

August 3, 2009

Health Care Agency/Behavioral Health Services

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Welcome

Sharon Browning, Facilitator

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Art Perspective

Ron Gassaway, Art Instructor

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Local/State Updates

Mark Refowitz, BHS Director

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Prudent Reserve Originally, counties were required to

establish a prudent reserve for Community Services and Supports (CSS).

Purpose of Prudent Reserve is to ensure that services can continue in years where revenues decline.

Counties are required to fund the Prudent Reserve at 50% of the most recent annual approved CSS funding level.

The Prudent Reserve has been expanded to include PEI funding.

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Prudent Reserve (Cont’d) DMH has issued a draft policy on Prudent

Reserve.

Draft policy requires counties to fund Prudent Reserve at 50% of most recently approved CSS and 50% of most recently approved PEI.

Funds for Statewide PEI Projects are not

included in calculation of Prudent Reserve.

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Prudent Reserve (Cont’d) Originally, counties were required to

fully fund Prudent Reserve by 7/1/2010. Time frame has been extended to

6/30/2011. A county has only one Prudent Reserve

for CSS and PEI combined (blended fund).

A county may use both CSS and PEI funds made available prior to FY 2008/09 to fund the Prudent Reserve.

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Prudent Reserve (Cont’d) Starting in FY 2008/09, there is a cap on

the amount of PEI funding a county may use to fund the Prudent Reserve.

20% of the average amount allocated to a county over the previous 5 years may be redirected from CSS to fund: Capital & Technology Workforce Education & Training Prudent Reserve

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Prudent Reserve (Cont’d) Funds for PEI Statewide Projects may not

be used to fund the Prudent Reserve. Prudent Reserve Funds may be used in

years in which revenues for the MHS Fund are below recent averages adjusted by CPI and CA population.

Expected that counties will be able to access Prudent Reserve Funds in FY 2010/11, or sooner.

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Prudent Reserve (Cont’d) DMH will suspend the 50% requirement

in years when Prudent Reserve may be accessed.

Once access to the Prudent Reserve funds is no longer available, counties are expected to replenish their Prudent Reserves.

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Statewide PEI Projects DMH requested that counties assign

funding for three of the five statewide projects back to DMH.

The three projects involved are: Suicide Prevention Student Mental Health Stigma Elimination

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Statewide PEI Projects Counties were told they could not use

the money locally.

17 counties, including Orange County, assigned funds back to DMH to pay for these projects.

Recently decided that counties can use money locally as long as used in projects aligned with goal of statewide projects.

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Statewide PEI Projects Counties that assigned the funding to

DMH will be able to request return of those funds.

State has not spent the funding assigned for these three projects.

Process for requesting return of funding is being developed.

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PEI Update

Jenny Qian, PEI Coordinator

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PEI Update PEI Plan Roll-out Process Considerations in selecting first

programs to be implemented: Priorities set by the community

workgroups during the planning process Implement at least one program for

each age group Fill major gaps in the service system

(e.g., Hotline/Warm line) Reach out to underserved groups

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PEI Update

o Some programs will be contracted

o Others implemented by HCA

o Others implemented through a combination of contract and HCA staff

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PEI Update Who will implement a specific program

is determined by a variety of factors:

Level of community involvement needed: (For example, a program with high need for community involvement might be one targeting a specific ethnic underserved population)

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PEI Update Timing: Some programs can be

implemented earlier by using county staff. Requests for Proposals (RFPs) for a contract program take 9 months or longer.

Feasibility of combining types of providers: (Some programs can be started earlier with county staff. An RFP can be conducted to select a CBO that can serve part of the population later).

Type of contract to be used (RFP, Sole Source, other)

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PEI Update Timeline for roll-out

Selected county programs: early Fall

Selected contract programs: RFPs out in mid or late Fall

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PEI Update Contract Programs to be available for bid

in mid or late Fall, include: Socialization Program for Older Adults Positive Behavioral Interventions Violence Prevention Education Promotora Modeling Parent Education Survivor Support Services Crisis Prevention Hotline/Warm Line Triple P

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PEI Update HCA Programs include:

Children of Substance Abusing/Mentally Ill Parents (CSPP) – currently operational

First Onset-Post Partum – pilot in fall School Readiness – pilot in fall Outreach & Engagement – pilot in fall First Onset-First Break Services – TBD Juvenile Justice Youth’s Family Services

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PEI Update Sustainability

The amount of PEI funding in the next few years will be reduced;

FY 2009/10 funds =$27.7 million (22.8 allocated and 4.9 supplemental). Estimate that $16-$18 million can be

sustained, depending on continued monitoring of tax receipts and actions by OAC on Prudent Reserve for PEI

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PEI Update How will we plan for sustainable level of

programs? Education/Training Programs can be

offered on a rotating schedule.

Operate some programs for a limited timeframe.

Flexible programming is needed.

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WET/Innovation Component

Casey Dorman, WET Coordinator

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Veteran’s Services

Maureen Robles, Veteran’s Services

Coordinator

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Technological Needs Project Proposal

Kathleen Murray, Technological Needs

Coordinator

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Technology Goals of MHSA

To support the goal of transforming the Mental Health system, California State Department of Mental Health (DMH) allocated MHSA funds to meet their objective for all counties to develop an Integrated Information Systems Infrastructure through which they can securely access and exchange information

This is accomplished through an Electronic Health Record (EHR)

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Benefits of an EHR Improved real time access to critical clinical information

including medications, allowing for:

A reduction in errors and delays in care

Greater consistency in service planning and interventions

Improvement in care from on-line clinical decision-support and links to educational and reference sources

Improved care coordination among consumer, family, and multiple providers through information sharing (with consumer consent)

Improved compliance with HIPAA and State/Federal billing requirements

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Next Steps

We are ready to move forward with our first Project Proposal

It is the first of two phases that will result in a fully integrated Electronic Health Record (EHR) for Orange County Behavioral Health Services

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Our Project Proposal The first step towards building our EHR is to

build out or upgrade our infrastructure to provide us the necessary platform on which to build the functionality we need

The MHSA Technology project currently proposed is to perform this infrastructure enhancement

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Why is this Needed? Our current EHR application is built upon an old

hardware and software platform that cannot support any new functional development to add the tools that we need for: Clinical Documentation Management Medication Management

Interfacing/interoperability with other non-County clinics

Compliance with State and Federal regulations for billing, security, and privacy

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What is Needed?

Upgrade to current release of Cerner Millennium application

Acquire new Hewlett Packard servers with enhanced operating system and newest version of Oracle database

Acquire supporting storage and other related hardware and network equipment

Acquire current support applications to better utilize and manage the system

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DMH EHR Roadmap

Phase 1Practice Management

Electronic registration, scheduling and billing.

2008

Phase 2EHR “Lite”

Document Imaging, Clinical Notes and History

2009

Phase 3Ordering

Ordering Lab & Prescriptions, Viewing, Ordering, Reporting

2010-2011

Phase 4Fully Integrated EHR

Interface from external providers EHR and PHR

2012-2014

OCHCA Roadmap

Phase 1Practice Management

Electronic registration, scheduling, billing, and lab (PH)

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Phase 2Full EHR

Infrastructure BuildoutClinical documentation management- Assessments and Treatment Plan. Clinical notes moduleMedication management- Computer Provider Order Entry (CPOE) for prescriptionsDocument Imaging Able to interface with other non-county providers

2009-2012

Phase 3Fully Integrated EHR

Integrate and Interface with external provider EHR and PHR systems including Lab

2012-2014

Roadmap

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Timeline The expected timeline for the project to enhance our

infrastructure is 2009-2010 and the cost is estimated to be $3.8 million but we are budgeting for $4.5 million to allow for contingencies

We are asking for $3.3 million in MHSA Technology funds which covers the proportional share of the project costs that will benefit Mental Health Services

The proposed timeline for the build and implementation of the clinical documentation, medication management, and other components of a fully integrated EHR is 2011-2014

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Project Summary This project has been approved by the MHSA

Technology Advisory Committee

Information about it has been presented to the Community Action Advisory Committee (CAAC) and the Mental Health Board

The project proposal has been posted on the County’s MHSA website and the public comment period started 7/24/09

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Project Summary We are asking for your consensus today to

move forward on this project

Once approved by these stakeholder groups, we will submit the project to the County Board of Supervisors on 8/25/09 for approval

The final project proposal will be submitted to the Department of Mental Health on 8/25/09 for review and approval

DMH review will take 30 to 60 days

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Questions?

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Consensus on Project Proposal

Sharon Browning, Facilitator

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MHSA Program

Kate Pavich, MHSA Coordinator

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MHSA Updates FY 08/09 Progress Report Spirituality Initiative MHSA Newsletter 2nd Annual Vietnamese Family Fun Day Celebration Recovery Picnic MHSA Health Expo 9/24/09 at Delhi Center Orange County Peer-To-Peer Employment

Conference 2009

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Recovery Arts Call for Art Health Expo 9/24/09 Call for Art/Writing for MHSA On-Line

Gallery http://ochealthinfo.com/mhsa/arts-program.htm

Erase Stigma Art Festival “Storms of the Mind” by Kymberli

Kercher-Smith MHSA 2010 Calendar

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Orange County

Health Care Agency

Behavioral Health Services

Mental Health Services Act

Calendar 2010“Gardened Again Tended” by Mark

Doyle

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“Hummingbird” by Micaela Falcon

Xuân đã đến, Muôn hoa đua nở, cây đâm chồi nẩy lộc. Bướm lượn trên muôn hoa thắm tươi. Bao ước mơ thành hiện-thực, Nắng vàng tươi lóng lánh trên tóc ai. Gió nhẹ lay hoa đào hồng thắm. Tôi mong mọi người đạt được mọi điều mơ ước. Đất nước luôn thanh-bình, thịnh-vượng, vinh quang.

Dreaming in Spring

Spring is coming

Flowers open up; buds are growing

Butterflies fly on bright flowers

Many dreams will come true

Sun shines on the lover’s hair

The light wind stirs bright peach-blossoms

by K.N.

MƠ XUÂN by K.N.

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“Tongues of Fire” by Kevin Burroughs

Reflections by Judy Ann Adams

Mirror image shatters pieces falling randomlyAt their feet one sees a reflecting puzzle of what was collectivelyTo survive the gartering of pieces becomes necessityPiecing together that of choice slowly, selectivelyOld reflection reshaped into new realityNow reflecting a courageous person perceptively

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401 S. Tustin St.Allen Hibbs, AIA

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Steering Committee CommentsPublic Comments

Sharon Browning, Facilitator

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Next Steering Committee

September 14, 2009Delhi Community Center

1:00 pm – 4:00 pm