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6.
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| INTERNAL OPERATIONS COMMITTEE |
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| Information |
| Referral History: |
Welfare and Institutions Code Section 5898 states that each Mental Health Services Act (MHSA) Three Year Program and Expenditure Plan and annual Plan Update is to be developed in partnership with stakeholders to:
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Identify community issues related to mental illness resulting from lack of community services and supports, including any issues identified during the implementation of the Mental Health Services Act.
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Analyze the mental health needs in the community.
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Identify and re-evaluate priorities and strategies to meet those mental health needs.
In order to comply with the above statute and regulation, Contra Costa County Behavioral Health Services commissioned in 2009 an ongoing advisory body, entitled the Consolidated Planning Advisory Workgroup (CPAW), to assist and advise the Behavioral Health Services Director in implementing the required community program planning process that is part of development of the MHSA Three Year Program Plan and annual Plan Update. The Membership Committee of CPAW accepts and reviews applications from the public, and makes recommendations to the Behavioral Health Services Director for appointment to CPAW. The Membership Committee also analyzes stakeholder characteristics and affiliations, and assists in recruitment of individuals from stakeholder groups who are underrepresented.
Given the above, the Board of Supervisors’ Internal Operations Committee (IOC) has asked for a review of the County’s process for recommendation, review, and monitoring of the MHSA budget, the role of the CPAW and the Mental Health Commission in this process, and the protocol for identification and mitigation of any potential financial conflicts of interests by individuals who serve on either body. |
| Referral Update: |
In 2011, Contra Costa Mental Health (now part of Behavioral Health Services) reported to the IOC on: 1) the status of its compliance with statute and regulations pertaining to MHSA stakeholder participation, 2) a plan to ensure broad representation, 3) the necessity of service providers to be involved, and 4) the requirements for CPAW members to declare any potential conflict of interest, and to refrain from being involved in any decision-making or recommendations that might present a conflict of interest to them and/or their agency.
In 2012, the Office of the County Counsel provided a legal opinion for all County Boards, Commissions and their Administrative Officers and Secretaries pertaining to compliance with selected Brown Act and Better Government Ordinance provisions. The Mental Health Commission is subject to the provisions of the Brown Act, while CPAW is not. However, County Counsel stated that County bodies that are not subject to the Brown Act nevertheless must comply with comparable provisions under the Better Government Ordinance. CPAW has been operating under the intent of the Brown Act by holding all meetings open for public attendance and participation, and by publicly advertising and providing advance notice for meetings at fixed times and places.
In 2013, CPAW revisited its governance and membership provisions in order to more closely align its role as an advisory body for ensuring representative stakeholder input regarding priority mental health needs, strategies to meet those needs, and active ongoing participation in the MHSA-prescribed community program planning process. It was clarified that CPAW’s role does not include providing funding recommendations to the Behavioral Health Services Director or approval authority for MHSA programs, plan elements, categories, components or the MHSA budget in total. CPAW does not make recommendations on contract awards. A revised working agreement stipulates that any individual, whether a CPAW member or not, must identify to the group any perspective, affiliation or potential conflict of interest in discussions that lead to group positions or recommendations. All current members completed a revised membership application that updated their characteristics and affiliations. Analysis of these applications indicate that over 50% of CPAW members identify as consumers and/or family members, with five of the 22 members employed by a County contract provider, three employed by Contra Costa County, two serving on the NAMI board, and four serving on the Mental Health Commission (including the current chairperson).
In 2014, the MHSA Three Year Program and Expenditure Plan included a new chapter, entitled Evaluating the Plan. In partnership with the Mental Health Commission’s MHSA/Finance Committee, staff developed and implemented a comprehensive program and fiscal review process of each MHSA funded program and plan element in order to evaluate the effective use of funds provided by the MHSA. In addition, a monthly Finance Report was developed and generated to depict funds budgeted versus spent for each program and plan element. This enables fiscal transparency and accountability, as well as provides information with which to engage in sound planning. The results of both program reviews and monthly Finance Reports are shared with both CPAW in its planning and evaluation advisory role to the Behavioral Health Services Director, and the Mental Health Commission in its monitoring role to the Board of Supervisors. Neither entity recommends or approves MHSA budgets, as this is the purview of the County and the Board of Supervisors. |
| Recommendation(s)/Next Step(s): |
The IOC review the above information and analysis and request the County to clarify the following respective roles pertaining to the MHSA budget process:
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The Board of Supervisors approves the MHSA Three Year Program and Expenditure Plan and yearly Plan Updates.
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The County Administrator’s Office provides recommendations to the Board of Supervisors regarding the MHSA Three Year Plan and Updates prepared by the Health Services Department.
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The Mental Health Commission reviews the adopted MHSA Three Year Plan or Update, and makes recommendations to the Behavioral Health Services Director for any revisions. The Mental Health Commission also monitors the implementation of the MHSA Three Year Plan or Update through Program Review reports and monthly Finance Reports as part of its review and evaluation of the community’s mental health needs, services facilities, and special problems, and reports to the Board of Supervisors.
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The Consolidated Planning Advisory Workgroup advises the Behavioral Health Services Director regarding prioritized service needs and strategies to meet these needs, and assists the County to implement a comprehensive community program planning process in order to ensure active participation by the community in public mental health planning and evaluation efforts.
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All bodies commissioned by the County to support the above efforts are to abide by the letter and/or intent of the Brown Act to identify and mitigate any potential conflict of interest pertaining to recommendations regarding use of public resources, to include MHSA funds.
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| Fiscal Impact (if any): |
| None. |
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