EL DORADO COUNTY MENTAL HEALTH SERVICES ACT (MHSA

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Jenkinson Lake, Pollock Pines, CA

EL DORADO COUNTY

MENTAL HEALTH SERVICES ACT (MHSA)

ANNUAL UPDATE

FISCAL YEARS 2024/25

 
2 
Contents 
MHSA County Fiscal Accountability Certification .................................................................................. 4 
MHSA County Compliance Certification ............................................................................................... 5 
Message from the Behavioral Health Director ...................................................................................... 6 
Executive Summary ............................................................................................................................. 8 
History of MHSA ..................................................................................................................................... 8 
Substantial Changes in this FY 2024/25 Annual Update ........................................................................ 8 
Legislative, Regulatory, and Other MHSA Changes ............................................................................. 11 
El Dorado County Snapshot and Demographics .................................................................................. 14 
Snapshot ........................................................................................................................................ 14 
Demographics ....................................................................................................................................... 15 
Community Program Planning Process (CPPP) .................................................................................... 18 
MHSA Stakeholder and Community Meetings ..................................................................................... 18 
Stakeholder and Community Meeting Input ........................................................................................ 19 
Summary of Survey Responses ............................................................................................................ 20 
Publication of the MHSA FY 2024/25 MHSA Annual Update ............................................................... 31 
Substantive Comments  ........................................................................................................................ 32 
30-day Public Comment – January 12 to February 12, 2024 ......................................................... 32 
Public Hearing – February 21, 2024 ............................................................................................... 34 
Behavioral Health Commission – February 21, 2024 ..................................................................... 34 
MHSA Projects ................................................................................................................................... 35 
Limitations and Challenges ................................................................................................................... 35 
Staffing Shortage ............................................................................................................................ 35 
Contracted Providers ............................................................................................................................ 35 
MHSA Expenditures .............................................................................................................................. 36 
Community Services and Supports (CSS) .............................................................................................. 37 
Full Service Partnership (FSP) Programs ........................................................................................ 39 
General System Development Program ........................................................................................ 48 
Outreach and Engagement Programs ............................................................................................ 54 
CSS Administration ......................................................................................................................... 58 
Prevention and Early Intervention (PEI) ............................................................................................... 59 
Prevention Programs ..................................................................................................................... 63 
Early Intervention Programs .......................................................................................................... 69 

 
3 
Stigma and Discrimination Reduction Programs ........................................................................... 80 
Outreach for Increasing Recognition of Early Signs of Mental Illness Program ............................ 84 
Access and Linkage to Treatment Programs .................................................................................. 89 
Suicide Prevention and Stigma Reduction Programs ..................................................................... 94 
PEI Administration ......................................................................................................................... 96 
Innovation (INN) ................................................................................................................................... 97 
Existing Innovation Projects ........................................................................................................... 97 
Proposed INN Projects ................................................................................................................... 98 
INN Concepts ............................................................................................................................... 101 
Existing MHSOAC Collaborative Projects ..................................................................................... 101 
Proposed MHSOAC Collaborative Projects .................................................................................. 101 
Workforce Education and Training (WET) .......................................................................................... 104 
WET Coordinator ......................................................................................................................... 104 
WET Administration ..................................................................................................................... 107 
Capital Facilities and Technology Needs (CFTN) ................................................................................ 108 
CFTN Administration .................................................................................................................... 111 
FY 2024/25 Budget, Expenditure Plan, and Reversion Reallocation Expenditure Plan ....................... 112 
MHSA Funding .................................................................................................................................... 112 
Annual Revenues ................................................................................................................................ 112 
Fund Balances ..................................................................................................................................... 112 
Prudent Reserve ................................................................................................................................. 112 
Reversion ............................................................................................................................................ 114 
Transfer of Funds Between Components ........................................................................................... 114 
Community Program Planning Process Budget .................................................................................. 114 
El Dorado County Budget Philosophy ................................................................................................. 115 
MHSA Component Budgets ................................................................................................................ 118 
MHSA Component Budget – CSS ................................................................................................. 119 
MHSA Component Budget – PEI .................................................................................................. 122 
MHSA Component Budget – INN ................................................................................................. 124 
MHSA Component Budget – WET ................................................................................................ 125 
MHSA Component Budget – CFTN ............................................................................................... 126 
 
 
   

MHSA County Fiscal Accountability Certification

To be signed after BOS approval and included in final copy submitted to the Department of Health Care Services.

MHSA County Compliance Certification

To be signed after BOS approval and included in final copy submitted to the Department of Health Care Services.

EL DORADO COUNTY

HEALTH AND HUMAN SERVICES AGENCY

Behavioral Health Division

Message from the Behavioral Health Director

Reflecting on the past year, we recognize that it has been a time of transition. California Advancing and

Innovating Medi-Cal (CalAIM) initiative was launched through documentation reform; we saw the end of

the Public Health Emergency designation; and we experienced multiple changes in executive leadership

both within the Health and Human Services Agency (HHSA) and with the Chief Administrative Office (CAO).

Moving through these and many other transitions has allowed us to view our systems with an emphasis

on improvement and expansion, develop more comprehensive plans for situations that we have yet to

experience and gain fresh perspective for how to move forward, carrying with us the lessons learned along

the way.

The Fiscal Year 2024/25 MHSA Annual Update has been developed utilizing stakeholder input, capitalizing

on the diverse experiences of our community members. Through the projects described in this MHSA

Annual Update, we strive to establish a strong foundation for all Behavioral Health services. This

foundation will allow us to emerge from this period of transition with a wide variety of supportive services,

stronger partnerships and collaborative efforts, and a comprehensive system of care to support the full

spectrum of mental health needs in our community.

Thank you for your participation in community meetings; sharing your input via emails, surveys, and

conversations with the MHSA staff; and for taking the time to read this MHSA Annual Update.

Sincerely,

Nicole Ebrahimi-Nuyken, LMFT

Behavioral Health Director

El Dorado County Health and Human Services Agency

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Executive Summary

History of MHSA

California voters passed Proposition 63, the Mental Health Services Act (MHSA), in November 2004 and

the MHSA was enacted into law January 1, 2005. The MHSA places a one percent (1%) tax on personal

incomes in excess of $1,000,000. These funds are distributed to counties through the State and are

intended to transform the mental health system.

This Three-Year Program and Expenditure Plan provides El Dorado County stakeholders with an overview

of the direction of Behavioral Health services in El Dorado County for the next three (3) years, and to

report on existing MHSA projects and services.

The most recent instructions issued by the Mental Health Services Oversight and Accountability

Commission (MHSOAC) were issued for Fiscal Year (FY) 2014/15 through FY 2016/17. MHSA Plans are

written for three-year (3-year) durations, and Plans are to be updated annually to allow for significant

changes from the prior year’s Plan. This Plan complies with the instructions issued by the MHSOAC.

Substantial Changes in this FY 2024/25 Annual Update compared to the FY

2023/24 – 2025/26 Three-Year Program and Expenditure Plan

The MHSA Act establishes five (5) MHSA components that address specific priority populations and key

community mental health needs. The 2022 revision of the Mental Health Services Act describes the

components as follows:

1. Community Services and Supports (CSS): CSS Projects are for children, youth, transition age

youth, adults, and older adults with severe emotional disturbance (children and younger

transition age youth) or serious mental illness (older transition age youth, adults and older adults).

Individuals served through the CSS programs must meet medical necessity for Specialty Mental

Health Services (SMHS).

Eighty percent (80%) of MHSA funding must be used for community services and support projects

and of that, the majority (i.e., fifty-one percent [51%]) of the funding shall be used on Full Service

Partnerships

New or modified CSS Projects: As a reflection of a comprehensive CPPP, an examination of

available CSS revenue, and an analysis of previously

• FSP Unhoused Individuals Project – This is an FSP project with a specific focus on how best

to serve individuals experiencing homelessness. Behavioral Health Staff will work closely

with HHSA Housing and Homeless staff to provide outreach, linkage, and ongoing service

delivery as appropriate in a holistic model focused on ending individual cycles of trauma

and homelessness in the community.

Due to the MHSA requirement that counties contribute five percent (5%) of their allocation to the Innovation

component, four percent (4%) from the CSS component is transferred to Innovation, leaving 76% of the County’s

MHSA allocation to fund CSS programs.

• Crisis Residential Treatment Project – Expanded description and addition of subprogram

to provide stepdown services to clients prior to entering the CRT. No Fiscal Year 23/24

Cost Increase.

2. Prevention and Early Intervention (PEI): PEI projects are designed to prevent mental illness from

becoming severe and disabling, and emphasize improving timely access to services for

underserved populations. PEI projects shall include at least one of the each of the following

strategies: Prevention, Early Intervention, Outreach for Increasing Recognition of Early Signs of

Mental Illness, Access and Linkage to Treatment, and Stigma and Discrimination Reduction.

Suicide Prevention is an optional strategy.

Twenty percent (20%)

of MHSA funding must be used for prevention and early intervention

projects and of that, at least fifty-one percent (51%) of the funding shall be used on projects for

youth age 25 and younger.

New or Modified PEI Projects: As a reflection of a comprehensive Community Program Planning

Process (CPPP), an examination of available PEI revenue, and an analysis of previously funded PEI

program outcomes, significant changes to the PEI projects include the following:

• Community Stigma Reduction Project: This project, previously called Lesbian, Gay,

Bisexual, Transgender, Queer or Questioning, Intersex, and Asexual or Allied (LGBTQIA)

Community Education Project has been expanded in order to better serve a wider array

of disenfranchised community members. No Fiscal Year 23/24 Cost Increase.

• Community-Based Outreach and Linkage Project: This Project has been modified to

address mandated State requirements set forth in Behavioral Health Information Notice

(BHIN) 23-025 requiring all counties to implement 24/7 Medi-Cal Community-Based

Mobile Crisis Intervention Services. No Fiscal Year 23/24 Cost Increase. FY 24/25 and

25/26 increase of an additional $400,000 per year.

• Project Access Community Outreach Initiative: This project addresses the limitations of

office-based intake systems and documented challenges of engaging clients experiencing

greater barriers to access through the current system. Project Access will create dedicated

community health engagement positions to link individuals with identified Behavioral

Health and supportive service needs to the integrated service models provided by El

Dorado Health and Human Services Agency. Fiscal Year 23/24 Allocation of $250,000.

Fiscal Year 24/25 and 25/26 Allocation of $500,000 per year.

3. Innovation (INN): Innovation projects are defined as projects that contribute to learning, which

does not necessarily focus on providing a direct service. Innovation projects inform current and/or

future practices/approaches related to mental health and must be approved by the MHSOAC in

addition to local approvals.

Five percent (5%) of the funding must be used for innovation.

Due to the MHSA requirement that counties contribute five percent (5%) of their allocation to the Innovation

component, one percent (1%) from the PEI component is transferred to Innovation, leaving a net 19% of the County’s

MHSA allocation to fund PEI programs.

New or modified INN Projects: As a reflection of a comprehensive CPPP, an examination of

available INN revenue, and an analysis of previously funded INN program outcomes, significant

changes to the INN projects include the following:

• n/a

Removed INN Projects:

• Partnership Between Senior Nutrition and Behavioral Health to Reach Home-bound Older

Adults in Need of Mental Health Services Project – Project was not able to be

implemented prior to MHSOAC approved deadline.

4. Workforce Education and Training (WET): One of the primary purposes of WET is to remedy the

shortage of qualified individuals to provide services to address severe mental illness, as well as to

provide trainings for current and prospective mental health system employees, contractors, and

volunteers.

This component is no longer funded by the State, but counties can transfer funds from their CSS

component to the WET component

New or modified WET Projects: As a reflection of a comprehensive CPPP, an examination of

available WET revenue via transfer from CSS, and an analysis of previously funded WET program

outcomes, significant changes to the WET projects include the following:

• n/a

5. Capital Facilities and Technological Needs (CFTN): A program for capital facilities and

technological needs.

This component is no longer funded by the State, but counties can transfer funds from their

Community Services and Supports component to the Capital Facilities and Technological Needs

component

New or modified CFTN Projects:

• Integrated Community-based Wellness Center Project: With a favorable location

identified, this project has been adjusted to confirm zero expenditures in FY 23/24 and an

increase funding allotment in FY 24/25 to accommodate renovation and maintenance

costs.

Counties may transfer funds from the Community Services and Supports component to the Workforce Education

and Training component. The total allocation shall not exceed twenty percent (20%) of the average amount of funds

allocated to the Community Services and Supports component for the previous five (5) fiscal years.

Counties may transfer funds from the Community Services and Supports component to the Capital Facilities and

Technological Needs component. The total allocation shall not exceed twenty percent (20%) of the average amount

of funds allocated to the Community Services and Supports component for the previous five (5) fiscal years.

Legislative, Regulatory, and Other MHSA Changes

SB 326

(1) Existing law, the Mental Health Services Act (MHSA), an initiative measure enacted by the

voters as Proposition 63 at the November 2, 2004, statewide general election, funds a system of

county mental health plans for the provision of mental health services. Existing law authorizes the

MHSA to be amended by a 2/3 vote of the Legislature if the amendments are consistent with and

further the intent of the MHSA. Existing law authorizes the Legislature to add provisions to clarify

procedures and terms of the MHSA by majority vote.

This bill was approved by the voters at the March 5, 2024, statewide primary election and will

recast the MHSA by, among other things, renaming it the Behavioral Health Services Act (BHSA),

expanding it to include treatment of substance use disorders, changing the county planning

process, and expanding services for which counties and the state can use funds. The bill will revise

the distribution of MHSA moneys, including allocating up to $36,000,000 to the department for

behavioral health workforce funding. The bill will authorize the department to require a county

to implement specific evidence-based practices.

This bill will require a county, for behavioral health services eligible for reimbursement pursuant

to the federal Social Security Act, to submit the claims for reimbursement to the State Department

of Health Care Services (the department) under specific circumstances. The bill will require

counties to pursue reimbursement through various channels and will authorize the counties to

report issues with managed care plans and insurers to the Department of Managed Health Care

or the Department of Insurance.

The MHSA establishes the Mental Health Services Oversight and Accountability Commission and

requires it to adopt regulations for programs and expenditures for innovative programs and

prevention and early intervention programs established by the act. Existing law requires counties

to develop plans for innovative programs funded under the MHSA.

This bill will rename the commission the Behavioral Health Services Oversight and Accountability

Commission and will change the composition and duties of the commission, as specified. The bill

will delete the provisions relating to innovative programs and instead will require the counties to

establish and administer a program to provide housing interventions. The bill will provide that

“low rent housing project,” as defined, does not apply to a project that meets specified criteria.

This bill will make extensive technical and conforming changes.

(2) Existing law, the Bronzan-McCorquodale Act, contains provisions governing the operation and

financing of community mental health services for persons with mental disorders in every county

through locally administered and locally controlled community mental health programs. Existing

law further provides that, to the extent resources are available, community mental health services

should be organized to provide an array of treatment options in specified areas, including, among

others, case management and individual service plans. Under existing law, mental health services

are provided through contracts with county mental health programs.

The bill will authorize the State Department of Health Care Services to develop and revise

documentation standards for individual service plans, as specified. The bill will revise the

contracting process, including authorizing the department to temporarily withhold funds or

impose monetary sanctions on a county behavioral health department that is not in compliance

with the contract.

(3) This bill will take effect July 1, 2026

AB 531

Existing law establishes the Multifamily Housing Program administered by the Department of

Housing and Community Development. Existing law requires assistance for projects under the

program to be provided in the form of deferred payment loans to pay for eligible costs of specified

types of development, as provided. Existing law requires that specified funds appropriated to

provide housing for individuals and families who are experiencing homelessness or who are at risk

of homelessness and who are inherently impacted by or at increased risk for medical diseases or

conditions due to the COVID-19 pandemic or other communicable diseases be disbursed in

accordance with the Multifamily Housing Program for specified uses.

The California Environmental Quality Act (CEQA) requires a lead agency, as defined, to prepare,

or cause to be prepared, and certify the completion of, an environmental impact report on a

project that it proposes to carry out or approve that may have a significant effect on the

environment or to adopt a negative declaration if it finds that the project will not have that effect.

CEQA does not apply to the approval of ministerial projects. Existing law, until July 1, 2024,

exempts from CEQA a project funded to provide housing for individuals and families who are

experiencing homelessness, as described above, if certain requirements are satisfied, including if

the project proponent obtains an enforceable commitment to use a skilled and trained workforce

for any proposed rehabilitation, construction, or major alterations, as specified.

This bill will provide that projects funded by the Behavioral Health Infrastructure Bond Act of 2024

that provide housing for individuals and families who are experiencing homelessness or who are

at risk of homelessness and who are inherently impacted by or at increased risk for medical

diseases or conditions due to the COVID-19 pandemic or other communicable diseases and are

disbursed in accordance with the Multifamily Housing Program, or projects that are disbursed in

accordance with the Behavioral Health Continuum Infrastructure Program, are a use by right and

subject to the streamlined, ministerial review process. The bill would define use by right for these

purposes to mean that the local government’s review of the project does not require a conditional

use permit, planned unit development permit, or other discretionary local government review or

approval that would constitute a project subject to the approval process in CEQA.

Existing law authorizes the State Department of Health Care Services to, subject to an

appropriation, establish a Behavioral Health Continuum Infrastructure Program to award grants

as specified for the construction, acquisition, and rehabilitation of behavioral health treatment

resources, as described. Existing law repeals this program on January 1, 2027. This bill will

continue that program indefinitely.

Existing law, the Bronzan-McCorquodale Act, contains provisions governing the operation and

financing of community mental health services in every county through locally administered and

locally controlled community mental health programs. Existing law, the Mental Health Services

Act (MHSA), an initiative measure enacted by the voters as Proposition 63 in the November 2,

2004, statewide general election, establishes the Mental Health Services Fund to fund various

county mental health programs.

This bill will enact the Behavioral Health Infrastructure Bond Act of 2024 which, if approved by

the voters, would authorize the issuance of bonds in the amount of $6,380,000,000 to finance

loans or grants for the acquisition of capital assets for the conversion, rehabilitation, or new

construction of permanent supportive housing for veterans and others who are homeless and

meet specified criteria, and for grants for the Behavioral Health Continuum Infrastructure

Program, as specified.

SB 43

Existing law, the Lanterman-Petris-Short Act, provides for the involuntary commitment and

treatment of a person who is a danger to themselves or others or who is gravely disabled. Existing

law, for purposes of involuntary commitment, defines “gravely disabled” as either a condition in

which a person, as a result of a mental health disorder, is unable to provide for their basic personal

needs for food, clothing, or shelter or has been found mentally incompetent, as specified.

This bill expands the definition of “gravely disabled” to also include a condition in which a person,

as a result of a severe substance use disorder, or a co-occurring mental health disorder and a

severe substance use disorder, is, in addition to the basic personal needs described above, unable

to provide for their personal safety or necessary medical care, as defined. The bill would also

expand the definition of “gravely disabled,” as it applies to specified sections, to include, in

addition to the basic needs described above, the inability for a person to provide for their personal

safety or necessary medical care as a result of chronic alcoholism.

On October 23, 2023, at their regular meeting, the Board of Supervisors approved Resolution 176-

2023 to defer the implementation of SB 43 until January 1, 2026. This allows adequate time to

identify the treatment expansion, funding impacts, and staffing needs required to implement this

bill.

El Dorado County Snapshot and Demographics

Snapshot

El Dorado County, located in east-central California, encompasses 1,805 square miles of rolling hills and

mountainous terrain. The County’s western boundary contains part of Folsom Lake and the eastern

boundary extends to the California-Nevada State line. The County is topographically divided into two

zones. The northeast corner of the County is in the Lake Tahoe basin, while the remainder of the County

is in the “western slope,” the area west of Echo Summit.

The Tahoe Basin is separated from the remainder of the County by the Sierra Nevada Mountains, with

Highway 50 providing a mountainous, 60-mile connector route between the two regions. There is no

locally operated public transportation between the Tahoe basin and the West Slope of the County.

The population of El Dorado County as of March 2023 is 194,425

. Approximately eighty percent of the

county’s population resides in unincorporated areas of the county. The

rural nature of many unincorporated areas of the county results in

challenges to obtaining health service (e.g., transportation, outreach to

residents, and public awareness relative to available services).

As of March 2023, per welldorado.org

As used within the MHSA Plan Update, the following regional definitions apply:

West County

Cameron Park, El Dorado Hills, Rescue, Shingle Springs

Placerville Area

Diamond Springs, El Dorado, Placerville, Pleasant Valley

North County

Coloma, Cool, Garden Valley, Georgetown, Greenwood, Kelsey, Lotus, Pilot Hill

Mid County

Camino, Cedar Grove, Echo Lake, Kyburz, Pacific House, Pollock Pines, Twin

Bridges

South County

Fair Play, Grizzly Flats, Mt. Aukum, Somerset

Tahoe Basin

Meyers, South Lake Tahoe, Tahoma

Demographics

The following charts provide a summary of El Dorado County’s population information in these categories,

as obtained from WellDorado.org:

Healthy Communities Institute, Community Dashboard, March 2023. Retrieved from www.welldorado.org.

Community Program Planning Process (CPPP)

MHSA Stakeholder and Community Meetings

Stakeholders and the general public were invited to participate in MHSA planning opportunities and

provide initial comment to contribute to the development of the County’s Fiscal Year 2023-26 MHSA

Three Year Plan. Stakeholder meetings were first held with current and prospective providers to identify

opportunities for adaptation and expansion of existing MHSA Projects and possible additions to the El

Dorado County system of care. Public meetings were then held to train and solicit feedback from

community members. Topics included:

❖ MHSA history and planning cycle overview

❖ The five (5) MHSA components

❖ General expenditures and revenue information

❖ Intended Updates to existing projects

❖ Proposed new projects (including Innovation concepts)

❖ Overview of remaining steps in the MHSA process

❖ Questions & Answers

A survey was created through Microsoft Forms. The survey links were sent out to the MHSA email

distribution list, included in the Facebooks posts, and provided at all community and stakeholder

meetings. The survey was available in both English and Spanish.

The MHSA Project Team advertised the meetings through a Press Release, emailing notices, and posting

the meetings on the County’s HHSA Facebook and community partner Facebook pages. The Team also

reached out to the community by distributing a feedback survey. The survey was offered in both English

and Spanish. For individuals who did not have online access, the MHSA Project Team offered paper

surveys. The MHSA Project Team also accepted community feedback via email.

The MHSA email distribution list for communicating with stakeholders and other interested parties

includes over 1,400 individuals, including:

❖ Adults and older adults with severe mental illness

❖ Families of children, adults and older adults with severe mental illness

❖ Providers of services

❖ Law enforcement agencies

❖ Education providers

❖ Social Services agencies

❖ Veterans and representatives of veteran organizations

❖ Providers of substance use disorder services

❖ Health care organizations

❖ Native Americans

❖ Latinos

❖ Other interested individuals

A PowerPoint presentation guided the training and discussion. The meeting flyer, agenda, presentation,

and surveys are included Appendix A.

Stakeholder and Community Meetings

Date/ Time

Meeting

Number of

Attendees

7/24/23 at 8:30 am

MHSA Provider Conference

8/14/23 at 1:00 pm

MHSA Stakeholder Meeting – Stanford Sierra Youth and

Family Services

8/14/23 at 2:00 pm

MHSA Community Meeting – Hosted virtually by Lake Tahoe

Community College

8/17/23 at 3:00 pm

MHSA Community Meeting – Hosted virtually by Behavioral

Health Division Staff

8/29/23 at 2:30 pm

MHSA Stakeholder Meeting – El Dorado Office of Education -

Mental Health and Wellness staff

8/30/23 at 3:00 pm

MHSA Community Meeting – Hosted in person by Library

Services - Placerville

9/29/23 at 11:30 am

MHSA Community Meeting – Hosted virtually by Behavioral

Health Division Staff

10/2/23 at 2:00 pm

MHSA Community Meeting – Hosted virtually by Summitview

Child and Family Services

10/11/23 at 11:00 am

MHSA Community Meeting – Hosted in person by Infant

Parent Center

10/16/23 at 9:00 am

MHSA Community Meeting – Hosted virtually by Behavioral

Health Division Staff

10/19/23 at 3:00 pm

MHSA Community Meeting – Hosted in person by Only

Kindness

Stakeholder and Community Meeting Input

Through the CPPP, the MHSA project team heard recurring themes. Issues of primary concern included:

❖ Housing and Homelessness, including the cost of housing

❖ Availability of mental health services and access to services

❖ Youth mental health

❖ Suicide prevention, especially for youth

Summary of Survey Responses

101 English version surveys were received

0 Spanish version surveys were received

What area(s) do you represent relative to mental health issues? (Check all that apply.)

Answer Options

Response

Percent

Response

Count

Consumer

13.59%

Family of consumer

12.14%

Veteran

2.91%

Veteran organization

2.43%

Law enforcement

1.94%

Student

3.40%

Parent of student

11.65%

Education provider

5.83%

Mental Health provider

9.22%

Healthcare provider

2.91%

Substance Use Disorder provider

3.40%

Social Services Agency

8.74%

General interest in mental health issues

16.50%

Declined to State

0.97%

Other

4.37%

Answered Question

100

Skipped Question

“Other” Responses: Work for the County, Prospective County Commissioner, Navigator at

Georgetown Library Hub & Member of Mental Health on the Hill, Advocate for the Aging, Senior Peer

Counselor, Housing Provider, HHSA, Indian Education/Cultural Support, Healthcare Administrator

Where do you live?

Answer Options

Percent

Response

Count

West County (Cameron Park, El

Dorado Hills, Rescue, Shingle

Springs)

30.00%

Placerville Area (Diamond Springs,

El Dorado, Placerville, Pleasant

Valley)

30.00%

North County (Coloma, Cool, Lotus,

Garden Valley, Georgetown,

Greenwood, Kelsey, Lotus, Pilot Hill)

10.00%

South County (Fair Play, Grizzly

Flats, Mt. Aukum, Somerset)

5.00%

Mid County (Camino, Cedar Grove,

Echo Lake, Pollock Pines, Kyburz,

Pacific House, Riverton)

9.00%

Tahoe Basin (Meyers, South Lake

Tahoe, Tahoma)

9.00%

Out of the county, but I work in El

Dorado County

6.00%

Decline to state

1.00%

Answered Question

100

Skipped Question

What is your ethnicity? (choose only one)

Answer Options

Response

Percent

Response

Count

Hispanic or Latino

9.18%

Non-Hispanic or Non-Latino

77.55%

Declined to State

9.18%

Other

4.08%

Answered Question

Skipped Question

“Other” Responses: Anglo, Indigenous American, Jewish, Native American

What is your race? (choose only one)

Answer Options

Response

Percent

Response

Count

American Indian or Alaskan

Native

4.04%

Asian

1.01%

Black or African American

0.00%

Native Hawaiian of Pacific Islander

1.01%

White

82.83%

Multiracial

4.04%

Decline to state

6.06%

Other

1.01%

Answered Question

Skipped Question

Responses to “Other” question: Jewish

What is your age?

Answer Options

Percent

Response

Percent

Count

0-15 years

0.00%

16-24 years

2.00%

25-59 years

68.00%

60+ years

30.00%

Declined to state

0.00%

Answered Question

100

Skipped Question

What is your military affiliation? (choose all that apply)

Answer options

Percent

Response

Percent

Count

Service Member

0.00%

Parent of Service Member

3.00%

Child of Service Member

9.00%

Spouse of Service Member

2.00%

Active Duty

0.00%

Reservist

0.00%

Veteran

5.00%

Does not apply

81.00%

Decline to State

0.00%

Answered Question

100

Skipped

What is your gender identity?

Answer Options

Percent

Response

Percent

Count

Female

77.22%

Male

20.79%

Trans male/trans man

0.99%

Trans female/trans woman

0.00%

Genderqueer/gender non-conforming

0.00%

Declined to State

0.99%

Different Identity (please state):

0.00%

Answered Question

101

Skipped Question

Response to “Other”:

The Department of Health Care Services (DHCS) defines seven (7) negative outcomes of untreated

mental illness.

In your opinion, what are the most negative outcomes in El Dorado County?

Rank

Outcome

First

Choice

Last

Choice

Homelessness

19.2%

10.3%

Prolonged suffering

23.1%

3.8%

Suicide

34.6%

12.8%

Removal of children from their homes

5.1%

17.9%

Incarceration

3.8%

12.8%

School failure or dropout

7.7%

17.9%

Unemployment

6.4%

24.4%

Answered Question

Skipped Question

In your opinion, what groups of people are in the greatest need of additional support by the current

MHSA projects in El Dorado County? (Select 3)

Answer Options

Percent

Response

Perce

Count

Children 0-5

6.73%

School Age Children

10.47%

TAY (ages 16- 25)

12.21%

Adults

8.98%

Older Adults (ages 60+)

5.74%

LGBTQIA

7.73%

Parents / Family Members

5.74%

Justice- Involved on Probation or Parole

8.23%

Homeless/At Risk of Homelessness

14.21%

BICOP (black, Indigenous and people of color)

4.74%

Persons with Mental Health Needs (Consumers)

13.97%

Other

1.25%

Answered Question

101

Skipped Question

Responses to “Other” question: All of the above, Veterans, Incarcerated, Each population is as

important as another. This is a hard list to prioritize.,

What concerns do you continue to have, or have started to experience since the declaration of the

Public Health Emergency due to the Coronavirus? (Note: All concerns cannot necessarily be addressed

with MHSA programs.)

Answer Options

Percent

Response

Percent

Count

Financial Stress

19.05%

Mental Health Stress

23.08%

Childcare Challenges

8.79%

Isolation

13.92%

Distance Learning Issues

8.06%

Physical Health Issues

8.79%

Substance Use

9.89%

Education Challenges

6.23%

Other

2.20%

Answered Question

Skipped Question

Responses to “Other” question: My concern is for others, Caregiving, Domestic Violence, I am OK,

Familial Deterioration,

What areas do you continue to be impacted by the Caldor Fire OR Mosquito Fire as El Dorado County

continues its recovery efforts?

Answer Options

Percent

Response

Percent

Count

Finding Housing

25.99%

Mental Health issues

25.42%

Job assistance

6.21%

Financial Impact

23.16%

Navigating State and Federal Support

12.43%

Other

6.78%

Answered Question

Skipped Question

Responses to “Other” question: None (several responses), Watching others dealing with loss,

Preparation assistance for the next fire, Rebuilding barriers, such as no insurance, Fear of more

wildfires,

To what extent do the following barriers create challenges for individuals and family member(s) with

mental health issues to access mental health services?

Highlighted items are those where

“Very Challenging” received the most

responses

Very

Challenging

Somewhat

Challenging

No Added

Challenge

Total

Respondents

Appointment availability

Services not in my community

Safety concerns

Transportation

124

Slow Response Time

129

Resources (e.g. financial)

Stigma around mental health illness in

their community

Communication between providers

Embarrassed to ask for help

Did not want help

Legal concerns

Level of services did not match needs

No Insurance

Services not culturally appropriate

(e.g. not in my language)

Provider changes

Answered Question

Skipped Question

Do you support the following potential additions to the El Dorado County system of care?

This question was included as a placeholder but was not utilized because no new projects were suggested

during the CPPP.

MHSA requires 5% of revenue be spent on Innovation Projects which aims to explore and develop

new mental health models that improve the quality of services, promote collaboration, and increase

access to services. Projects are required to go through a thorough review process with the Mental

Health Services Oversight and Accountability Commission (MHSOAC). The following are several ideas

that we are exploring.

Do you support moving forward with the MHSOAC review and approval process on the following

Project ideas?

This question was included as a placeholder but was not utilized because no new projects were suggested

during the CPPP.

Publication of the MHSA FY 2024/25 MHSA Annual Update

El Dorado County, Health and Human Services Agency (HHSA) Behavioral Health Division provided

notification of the draft Update publication as follows:

Draft MHSA Annual Update Comment Period: The Draft MHSA Annual Update was posted on the MHSA

web page (www.edcgov.us/mhsa) on January 12, 2024, for a 30-day Public Comment Period. Emails were

sent on January 12, 2024, to the MHSA email distribution list, the Behavioral Health Commission

members, the Chief Administrative Office (CAO), the Board of Supervisors’ offices, and HHSA staff,

advising recipients that the Draft Update was posted and available for public comment for 30 days. On

January 12, 2024, a press release was distributed to the Tahoe Daily Tribune, Mountain Democrat,

Georgetown Gazette, South Tahoe Now, The Windfall, Life Newspapers, El Dorado Hills Telegraph, and

The Clipper. The press release also posted on the El Dorado County’s webpage (Press Release section),

Health and Human Services Agency webpage and Facebook page. The Draft MHSA Annual Update Public

Comment Period ended at 5:00 p.m. on February 12, 2024.

Draft MHSA Annual Update Public Hearing: The Behavioral Health Commission held a Public Hearing on

the Draft MHSA Annual Update on February 21, 2024, and the hearing was noticed on the Behavioral

Health Commission’s calendar and the MHSA web page. Notice of the Public Hearing was sent

electronically to individuals on the MHSA email distribution list and to individuals who subscribe to

Behavioral Health information through a government internet subscription service (GovDelivery.com).

The Public Hearing was held in a hybrid format with Behavioral Health Commissioners and public

participation both remotely via Zoom and in person at the Board of Supervisors meeting room at 330

Fair Lane, Placerville, CA 95667 and Mental Health Office, 1900 Lake Tahoe Blvd., Suite 103, South Lake

Tahoe, CA.

Substantive Comments: Substantive comments received during the Public Comment Period and at the

Public Hearing have been included in the final Update, along with an analysis and response to those

comments.

Behavioral Health Commission Recommendation: Recommendations from the Behavioral Health

Commission have been addressed in the final Update.

El Dorado County Board of Supervisors: After the Public Hearing, the draft Update was presented to the

El Dorado County Board of Supervisors for review on April 23, 2024. Based on Board of Supervisors review,

no additional adaptations were required before presenting the final MHSA Annual Update to the Board

of Supervisors for adoption on June 18, 2024. Notification of the date was posted on the MHSA web page

and included on the Board of Supervisors Agenda.

California Mental Health Services Oversight and Accountability Commission (MHSOAC) and California

Department of Health Care Services (DHCS): Within 30 days of Board of Supervisors’ adoption of the

Update, a copy of the Update will be provided to the MHSOAC and the DHCS, as required by the MHSA.

Innovation Projects: Once approved by the Board of Supervisors, the MHSOAC must review and approve

all Innovation programs. New Innovation programs and changes to existing Innovation programs will be

forwarded to the MHSOAC for consideration. Notification of the MHSOAC-assigned meeting date will be

posted on the MHSA web page.

Substantive Comments

Substantive comments received during the Public Comment Period and the Public Hearing, and the

analysis and responses to those comments, will be summarized below, and comments received from

individual Behavioral Health Commissioners will be added below the Public Comment / Public Hearing

comments. Comments on other non-MHSA Behavioral Health Division projects or general topics of

discussion that are outside the scope of this MHSA Plan will not be addressed.

The MHSA project team encourages greater discussion regarding these items and other topics impacting

mental health services in El Dorado County during the next MHSA CPPP.

30-day Public Comment – January 12 to February 12, 2024

General Comment

Comment

MHSA Analysis/ Response

As a resident, parent, and employee in the education

field, I want to bring attention to Mental Health on

school campuses. MHSA and Sierra Child and Family

have been able to support our High School campus

with their Wellness Centers. This has been an

extremely valuable resource to support our students

and our on-site school counselors. They support our

student's mental health, substance use programs, and

suicidal risk assessments.

I would like to bring attention to the needs of our

middle schools and elementary schools. The concept of

prevention starts at the younger ages and we need to

increase MHSA funding with that focus. Each school

campus needs and deserves to have access on school

sites to a Wellness Center for the higher-level needs of

our students. School counselors are often split

between campuses in our rural district. The student's

needs after COVID have dramatically increased and the

social-emotional intelligence of students and staff has

waivered. El Dorado County needs to increase funding

and support to Mental Health at the younger grade

levels with increased access to Wellness Centers using

Community Based Organizations like Sierra Family and

Family.

The Behavioral Health Division recognizes the

importance of prevention, early identification

and early intervention to support youth mental

health and substance use disorders. After a

63% increase in funding from FY 22/23 to FY

23/24, the Student Wellness Center Project

became the highest funded discretionary PEI

Project in the FY 23-26 MHSA Plan. This project

is anticipated to expend 40-50% of MHSA PEI

revenues in FY 24/25.

From FY 22/23 to the FY 23-26 MHSA Plan, the

project description and associated contracts

were updated to allow for more flexibility in

service provision to all grade school levels,

allowing for the discretion of the El Dorado

Office of Education (EDCOE) and contracted

services providers.

Funding from MHSA to El Dorado County’s school-

based Wellness Centers has had a tremendous impact

on the lives of students. The recognition by Behavioral

Health that there is a mental health need on our

school campuses, and the commitment to provide

funding through MHSA PEI funding to meet that need

has provided the opportunity for thousands of

After dedicated efforts to utilize previously

inflated PEI fund balances, current projections

anticipate a FY 23/24 ending fund balance of

approximately $2 million with the opportunity

of over $5 million in FY 24/25 expenditures. In

order to ensure adequate funding for all

projects into FY 25/26 with unknown

students to receive mental health services. Many of

these students would not have access to care if not for

the Wellness Center on their campus.

I request that, to meet the needs of our students as

identified by all stakeholders, El Dorado County

Behavioral Health use the anticipated MHSA reserve to

increase Wellness Center funding from $890,000 to

$1,500,000 this year and the remaining years of the

MHSA three-year plan.

revenues, funding for the Student Wellness

Centers will not be increased in order to

appropriately fund the various populations

served by MHSA PEI projects.

The Behavioral Health Division is dedicated to

continuing work with the El Dorado Office of

Education (EDCOE) and the contracted

providers delivering these essential services.

Collaboratively, other funding sources must be

maximized such as Mental Health Student

Services Act (MHSSA), Student Behavioral

Health Incentive Program (SBHIP), Medi-Cal

Managed Care Plans and other private

insurances as well as additional grant funding.

Rescue Union School District is an amazing place for

our students, but we have a population of students

with mental health needs that require additional

support(s). Over the past three years we have

attempted to address our students' needs internally by

adding full time counselors at all seven of our sites,

adding two behaviorists, adding a psychologist,

sponsoring several parent nights with students' needs

as the focus and partnering with Summitview for a

Wellness Center at Pleasant Grove Middle School.

However, even with this added supports/hours, the

student mental health needs are exceeding our current

resources. While our efforts and investments have

been significant, they do not meet the vast mental

health needs of our students. To provide our students

with more access to resources, the Rescue USD has an

interest in partnering with local agencies to create

additional support for our students. At the top of our

list is a Wellness Center at Marina Village Middle

School, similar to what we have done at Pleasant

Grove Middle School. We have seen great success at

Pleasant Grove in providing mental health support

through the Wellness Center, and believe that this

partnership can do the same for our students at

Marina Village - a school that has recently experienced

some heightened student trauma (i.e.: significant

student risk assessments, Residential Treatment

Center (RTC) placements, County Learning Emotional

and Academic Determination (LEAD) referrals, and

increased Educationally Related Mental Health

Services (ERMHS). We have a successful track record

with using MHSA funding, we have a supportive site

Please refer to above comments regarding the

Student Wellness Center Project.

administration and faculty, tremendous student need

and are ready to expand our partnership with county

organizations to best support our students. In closing,

the Rescue USD applauds the efforts of the El Dorado

County Behavior Commission and is looking forward to

continuing to enrich the support we offer our students

in partnership with the Commission.

Very happy that the PIP - Primary Project - continues

to be a part of the MHSA plan. In Black Oak Mine

Unified, it is such a valued program for our children,

families and teachers.

Thank you for your comment of support.

Public Hearing – February 21, 2024

General Comment

Comment

MHSA Analysis/ Response

No comments provided during February 21, 2024 Public Hearing

Behavioral Health Commission – February 21, 2024

General Comment

Comment

MHSA Analysis/ Response

MHSA component budget should list not only the

percentage of total funds but the dollar amounts equal

to the percentages.

Recommended dollar amounts added to

Component Budgets on pages 119 and 120.

Provide the completed Outcomes Report and Revenue

and Expense Report in tandem with the Draft Plan or

Update for 30-day public comment.

When planning for the FY 25/26 Annual

Update, deadlines will be evaluated to assess

the feasibility of this request. Deadlines

include Annual Revenue and Expense Report

submission deadline to the Department of

Health Care Services (DHCS), required

submission deadline to request presentation

of the Draft Annual Update before the Board

of supervisors, and required submission

deadline to request final approval of the

Annual Update before the Board of

Supervisors.

Include total cost per project immediately after each

project.

Reference links added following each project

for seamless access to Component Budgets.

Include glossary of abbreviations and definitions.

Glossary of Abbreviations added to Appendix.

MHSA Projects

This MHSA Three Year Plan includes previously approved and newly developed projects. Previously

approved projects were included in prior MHSA Plans/Updates. There may be a need to alter the direction

of services based on funding or community demand, and this MHSA Plan allows for such flexibility.

The projects for each of the five (5) MHSA components are identified on the following pages.

Limitations and Challenges

Staffing Shortage

Over the course of the pandemic, the need for behavioral health services has increased steadily while at

the same time clinical staff have left the profession at a higher rate than ever before. This is being

experienced by public, non-profit and private sector entities nationwide and has led to a critical staffing

shortage of which El Dorado County is not immune. With numerous vacancies some of which going on

over a year unable to be filled.

Currently efforts are being made at the County, State and Federal level to address this behavioral health

staffing crisis. Long term options to address this are being enacted at the State and Federal levels including

expanding opportunities for tuition assistance for college bound individuals intending to enter the

Behavioral Health field of study, while short term options like adapting recruitment and retention efforts

have already taken place at the County level.

With staffing shortages continuing throughout FY 23/24, EDC Behavioral Health has prioritized mandated

services and other state and federal requirements and has assessed prioritization of other projects in this

plan based on the benefit to the greater community, capacity of staff and providers, and processing

timelines for pending solicitations and contracts. With heavy emphasis on improving efficiency, this plan

includes several projects approved in the FY 23/24 MHSA Plan that are likely to not be implemented until

FY 24/25.

Contracted Providers

The MHSA projects list the provider(s) with current contracts, those awaiting final execution or those

exempt from competitive process under Policy C-17. In the event a new provider is selected, which may

occur at any time during the implementation period of this MHSA Update, providers will be selected in

compliance with the Board of Supervisors Policy C-17, or the County may elect to implement the program

directly. The current provider listed for each program/project is subject to change during the

implementation period of this MHSA Update.

In September 2022 the El Dorado County Board of Supervisors adopted an updated Procurement Policy

(C-17) effective October 20, 2022. Under the previous Policy C-17 contracts that had already gone through

a competitive process, or were otherwise exempt, were able to be renewed with the same vendor for the

same or similar scope of work. One action derived from this new policy is that all new and renewing service

contracts in excess of one hundred thousand dollars ($100,000) must go through a competitive

procurement process with few exemptions. As of the writing of this Draft MHSA Plan, a Request for

Qualifications (RFQ) process is being conducted to solicit submissions from new and existing vendors. The

RFQ process is scheduled to run concurrently with this 30-day public comment period.

MHSA Expenditures

Although the MHSA projects may indicate a budgeted amount, there may still be a change in the budget

for a program due to increased or decreased cost of services or increased or decreased revenues. In other

instances, expenditures may change due to any number of reasons, including but not limited to a change

to the services identified for the project, project demand, or lack of provider(s).

Since MHSA funding is dependent upon personal income (a 1% tax on personal income above $1,000,000),

MHSA revenues may be lower than budgeted in the event of an economic downturn or other significant

change in the infrastructure of California that impacts personal income. Should that occur, MHSA will first

focus funding toward mandated services, and then discretionary services.

Mandated services are those that are required to be provided, or required to be provided at a certain

funding level (e.g., 51% of the CSS funding must go to FSP projects) per federal or State law or regulation,

the Mental Health Plan agreement between DHCS and the County, the MHSA, any other requirement

issued by an oversight agency (e.g., DHCS, MHSOAC, Centers for Medicare & Medicaid Services), and the

necessary administrative staff to implement and monitor MHSA projects. Please see the MHSA

Component Budgets to determine which projects would be considered mandated services and

discretionary services.

Recognizing that new projects may take time to become fully established and may have higher costs within

the first year of operation, which may be further compounded by the adoption date of the Plan and/or

the contracting process, funds allocated but unspent in first year of operations for any new projects may

roll from the first full year or partial year of operations into second year of operations. Starting the third

year of operations, projects will maintain an annual budget amount without any rollover.

For example, if a new project has the following annual budget:

Year 1 $75,000

Year 2 $80,000

Year 3 $85,000

As a new project, this funding will be allowed as follows:

Year 1 and Year 2 $155,000 (with Year 1 not-to-exceed $75,000)

Year 3 $85,000

Any project subject to these rolling project budgets will be eligible to utilize Year 1 funds that were not

expended in Year 1 during Year 2 of operations.

Additionally, Department of Mental Health Information Notice 10-01 (2010) indicates that counties can

expand or reduce projects within 15% of the amount that was previously approved for the program (i.e.,

it can be 15% more or 15% less than the previously approved funding amount) without requiring the

change to be approved through a CPPP.

Further, consistent with California Code of Regulations, Title 9, section 3300, subdivision (d), counties may

use up to five percent (5%) of the MHSA Community Services and Supports allocation on the CPPP.

Community Services and Supports (CSS)

The CSS component consists of projects that provide direct service to children and adults who have a

serious emotional disturbance or serious mental illness for receiving Specialty Mental Health Services

(SMHS) as set forth in WIC § 5600.3.

Additionally, as outlined in SB 389 (2019) and effective January 1, 2020, the MHSA is amended to authorize

counties to use MHSA funds to provide services to persons who are participating in pre-sentencing or

post-sentencing diversion programs, or who are on parole, probation, post-release community

supervision, or mandatory supervision.

Services provided under CSS fall into at least one of the following categories:

• Full Service Partnership (FSP) – This service embraces the “whatever it takes” model for eligible

populations. The services shall be culturally informed and shall include individualized

client/family-driven mental health services and supports plans which emphasize recovery and

resilience, and which offer integrated service experiences for clients and families. Funding for the

services and supports for FSP may include non-mental health supportive services and goods

(“flexible funding”) to meet the goals of the individual services and supports plans. All FSP funds

are considered on a case-by-case basis and utilization of non-mental health supportive goods and

services shall follow Behavioral Health’s policy and procedures as well as California Code of

Regulations, Title 9, Section 3620, Full Service Partnership category.

• General System Development (GSD) – Funding for GSD helps counties change their service

delivery systems and build transformational programs and services. El Dorado County offers

Wellness and Recovery Services Programs under GSD. Pursuant to revisions to the MHSA, housing

assistance can be offered to individuals enrolled in a GSD program. Housing assistance may

include rental assistance; security deposits, utility deposits or other move-in cost assistance;

utility payments; and moving costs assistance.

• Outreach and Engagement (OE) – Funding for OE serves those populations who are currently

receiving little or no SMHS, including locating those individuals who have dropped out of SMHS.

In an effort to reach underserved populations, outreach and engagement efforts may involve

collaboration with community-based organizations, faith-based agencies, tribal organizations,

health clinics, schools, law enforcement agencies, Veteran groups, organizations that help

individuals who are homeless or incarcerated, and other groups or individuals who work with

underserved populations. Funds may be used for food, clothing, and shelter when used to engage

unserved individuals.

Additionally, HHSA receives time-limited grants in which the purpose of the grant pairs with MHSA

programs and for which MHSA funds may be used to provide a required match. Current grants have been

identified in this Plan, however, HHSA may receive additional grant funds throughout the duration of this

Update and those grants may be incorporated into existing MHSA programs to enhance (not supplant)

services.

CSS projects may provide a blend of FSP, GSD, and OE services and funding. If necessary to meet client

treatment goals, Behavioral Health may utilize multiple services and funding to expand and augment

mental health services to enhance service access, delivery, and recovery, including offering services to

individuals who may have justice involvement.

Further, Assembly Bill (AB) 2265 (2020), “The Mental Health Services Act: Use of Funds for Substance Use

Disorder Treatment” clarifies that MHSA funds are permitted to be used to fund treatment of individuals

COMMUNITY SERVICES AND

SUPPORTS

with co-occurring mental health and substance use disorders. In order to use MHSA funding for substance

use disorder treatments, the county must comply with all applicable MHSA requirements when providing

co-occurring substance use disorder treatment, including identifying the treatment of co-occurring

disorders in their Three-Year MHSA Program and Expenditure Plans and Updates.

Any CSS funds that are identified during the fiscal year as being at risk of reversion may be transferred

from CSS if those funds will not be fully utilized by existing CSS programs during this fiscal year. Funds may

be transferred to the County’s MHSA Prudent Reserve (if not at maximum funding level), Capital Facilities

and Technology (CFTN), or Workforce Education and Training (WET) to the extent allowed.

CSS project structure, as categorized by CSS program:

•Children's FSP

•Transitional Age Youth (TAY) FSP

•Adult and Older Adult FSP

•FSP Unhoused Individuals Project

•FSP Forensic Services

Full Service Partnership (FSP)

•Wellness and Recovery Services/Adult Wellness Center

•Wellness and Recovery Services/TAY Engagement

•Crisis Residential Treatment (CRT)

•Recreation Therapy Project

General System Development

•Access Services

•Assisted Outpatient Treatment (AOT)

•Lanterman-Petris-Short (LPS) Project

•Genetic Testing

Outreach and Engagement

Strategies to assist in the implementation of the CSS project include, but are not limited to:

• Telehealth – Telehealth allows clients to access SMHS from remote locations using a secure video

conferencing network. For clients who are unable to travel to their provider’s office or for clients

who live in remote, rural areas, telehealth offers an alternative method to obtain needed services.

Additionally, for clients who would benefit from services, but decline to engage in services due to

the stigma associated with going to a County Behavioral Health building, telehealth may serve as

a means of engagement. The actual purchase and maintenance of the equipment will occur under

the Capital Facilities and Technological Needs (CFTN) component, but ongoing services to

individuals via telehealth will be provided through CSS.

• Supportive Housing – The Permanent Supportive Housing Project provides eligible individuals

with affordable housing assistance, coupled with supportive services to help ensure successful

client integration and engagement in their community. Residents are expected to pay a portion

of their income toward rent and utilities, and for those in the County’s Transitions Treatment

Program, participate in house meetings to assign chores, discuss housing issues, create goals, and

maintain their housing. Eligible individuals are also offered supportive services provided though

Behavioral Health or a contracted provider. The supportive services may include, but are not

limited to mental health assessments, linkage to mental health/physical health/substance use

disorder providers, outreach, crisis intervention, forensic support, training and teaching on life

skills, transportation, and supports for landlords or contractors who are collaborating with El

Dorado County to provide housing. This also may include funds to purchase housing units to

provide permanent supportive housing to seriously mentally ill homeless individuals.

Full Service Partnership (FSP) Programs

Full Service Partnership (FSP) Programs improve the quality and intensity of SMHS for clients requiring a

high level of treatment interventions and supportive services to reach their treatment goals.

The FSP Programs serve children, transitional age youth (TAY), adults, and older adults. All FSP projects

will utilize the following basic guidelines as appropriate to each age group. Individuals whose age would

make them eligible to participate in more than one program (for example, a TAY and adult program) will

be assigned to the program that best aligns with the individual’s treatment needs. Additionally, when

individuals are engaged in SMHS through Assisted Outpatient Treatment (AOT), either voluntarily or as a

result of a court petition, AOT-engaged clients will be served initially through the FSP programs. FSP

services are provided in the language of the clients’ choice.

According to the California Code of Regulations, Title 9, Section 3200.130, a FSP is “the collaborative

relationship between the County and the client, and when appropriate, the client’s family and/or other

natural supports, through which the County plans for and provides the full spectrum of community

services so that the client can achieve the identified goals.”

FSPs require a “whatever it takes” approach to the provision of services, meaning finding the methods

and means to engage a client, determine his or her needs for recovery, and create collaborative services

and support to meet those needs. FSP teams may utilize non-traditional interventions, treatments, and

supportive services tailored to each client’s specific needs and strengths to aid in their recovery.

Additionally, it is critical to provide both mental health and non-mental health services and supports. In

addition to mental health services and supports, MHSA funds will be used to access non-mental health

resources identified within the treatment plan/problem list that are needed by the client to successfully

fulfill their individualized treatment plan/problem list, including but not limited to: medication and

medication support; housing-related costs (such as security deposits, rent/mortgage payments,

household establishment furniture and/or supplies, toiletries); moving expenses; child-care costs;

educational expenses (such as tutoring, parenting courses, school-based services and supports, after-

school services and supports); transportation assistance; emergency expenses; food; clothing; cost of

health care treatments (including medical and dental expenses); cost of treatment of co-occurring

conditions such as substance use disorders; gift cards; social activity costs (including recreational costs);

client incentives (such as outreach and engagement fees or stipends and meals or snacks for clients); and

other expenses that the FSP team considers necessary to support a client’s treatment plan goals,

objectives and/or interventions. Further, pursuant to the “Investment in Mental Health Wellness Act of

2013,” as outlined in the MHSA (revised January 2019) and pursuant to California Code of Regulations,

Title 9, Section 3620, FSP also may include family respite care to “help families to sustain caregiver health

and well-being.”

Within FSP (and also within General System Development), housing is of the utmost importance in

maintaining stability during and after SMHS. Therefore, included within these projects is a housing

specialist, who will be responsible for helping clients with their housing needs, regardless of which

treatment program a client may be enrolled. This staff member will be shared between all FSP and General

Service Delivery projects.

Children’s FSP Project

The Children’s FSP Project serves all eligible children ages six (6) to seventeen (17). All children, including

children in foster care who are eligible for services as a result of the Katie A v. Bonta State Settlement

(now referred to as “Pathways to Wellbeing”), will continue to be served under this project. Additionally,

children who are involved with multiple providers of services, in need of intensive mental health services,

are at a risk for out-of-home placement and/or at risk for a higher level of care are eligible for this program.

This includes children in any residential living situation (including but not limited to home, foster care,

kingap, etc.), and children placed in Short-Term Residential Treatment Programs (STRTP). Services

available under this program also include, but are not limited to, Intensive Care Coordination (ICC),

Intensive Home-Based Services (IHBS), and Crisis Residential Services.

The County has identified wraparound principles/Core Practice Model and services as the foundation for

the Children’s FSP project. Wraparound principles include family and individual voice, interdisciplinary

team-based approach and use of natural supports, collaboration, community-based services, culturally

informed practices, individualized plans, strength-based interventions, persistence, and outcome-based

strategies.

Additionally, funding through this project is included for Court-Appointed Advocate (CASA) Service as a

sole source contract to help ensure that all children receiving services through this project have an

assigned CASA, providing the provision of such funding is not determined in conflict with the roles of an

agency providing the children with services and CASA.

Presumptive Transfer

As a result of AB 1299 (2016), when a child is placed out of county, their Medi-Cal benefits will become

the responsibility of the host county (where the child is living) rather than the county of origin (where the

Child Welfare Case is active) through “presumptive transfer”. Under presumptive transfer, the cost of

SMHS for children placed in El Dorado County will become the responsibility of El Dorado County, unless

presumptive transfer is waived by the county of origin. Therefore, funding for this component reflects

potential impacts as a result of Presumptive Transfer.

Families First Prevention Services Act (FFPSA)

As a result of AB 153 (2021) El Dorado County Behavioral Health, as the county Mental Health Plan (MHP),

is required to provide a Qualified Individual (QI) as defined by WIC Section 4096(h), who determines the

setting which will provide the child with the most effective and appropriate level of care in the least

restrictive environment. Additionally, the MHP must arrange for or ensure the provision of six months of

aftercare services for youth and nonminor dependents transitioning from a Short-Term Residential

Therapeutic Program (STRTP) to a family-based setting.

Children’s FSP Project Goals:

• Reduce out-of-home placement, hospitalizations, and incarcerations for children/youth.

• Improve school attendance and academic performance.

• Safe and stable living environment.

• Strengthen family unification or reunification.

• Improve coping skills.

• Reduce at-risk behaviors.

• Reduce behaviors that interfere with quality of life.

Children’s FSP Outcome Measures:

• Measurement 1 – Days of psychiatric hospitalizations.

• Measurement 2 – School attendance.

• Measurement 3 – Results of c-50, and PSC-35.

Children's FSP Project Budget

Providers: Services will continue to be contracted out to New Morning Youth and Family Services (West

Slope), Sierra Child and Family Services (West Slope and South Lake Tahoe), Stanford Youth Solutions

(West Slope and South Lake Tahoe), Summitview Child and Family Services, Inc. (West Slope), and CASA

El Dorado.

Transitional Age Youth (TAY) FSP Project

The TAY FSP provides services to meet the unique needs of TAY (16 through age 25) and encourage

continued participation in mental health services. Individuals participating in this project would be eligible

for the type and extent of activities and supportive services identified in the Children and Youth FSP

project, or the Adult and Older Adult FSP, dependent upon the individual’s age.

Estimated Number of Individuals to be Served: 500

Estimated Cost Per Person: $10,500

This project is designed to meet the full range of services required by this population including, but not

limited to, assistance with developing independent living skills, which also help to stabilize their mental

health needs and build resiliency including, but not limited to: financial literacy, nutrition and healthy food

choices, grocery shopping, meal preparation, child care and children needs, education and career

development, obtaining medical, dental, vision, and mental health care, access to community resources,

self-care, home care (e.g., laundry, cleaning), drug and alcohol abuse awareness and prevention, and safe

sex and reproductive health information.

Additionally, TAY up to 21 years of age may be eligible for Short-term Residential Treatment Programs

(STRTP), Intensive Care Coordination (ICC), Intensive Home-Based Services (IHBS), and Crisis Residential

Services.

First Episode Psychosis (FEP)

Through Mental Health Block Grant (MHBG) funding specifically for First Episode Psychosis (FEP) services,

this MHSA project includes services to address the needs of TAY experiencing their first episode of

psychosis. Additionally, CRRSAA/ARPA funding has expanded to allow for services to be provided to

eligible individuals up to 40 years of age. MHBG funding may be utilized in collaboration with this project

to provide further services to TAY in community-based locations, such as schools, in compliance within

the requirements of the MHBG and MHSA. The age of individuals who qualify for the FEP and MHBG

programs will align with the target population identified in the FEP and MHBG program statements.

Evaluation of the FEP and MHBG programs will be performed in a manner consistent with the program

statements.

TAY FSP Project Goals:

• Reduce out-of-home placement, hospitalizations, and incarcerations.

• Improve school attendance and academic performance (if applicable).

• Safe and stable living environment.

• Services are individualized.

• Improve coping skills.

• Reduce at-risk behaviors.

• Work with clients in the homes, neighborhoods, and other places where their problems and

stresses arise and where they need support and skills.

• Team approach to treatment.

TAY FSP Outcome Measures:

• Measurement 1 – Key Event Tracking (KET) – As changes occur in a client’s status related to

housing, employment, education, entry or exit from a psychiatric hospital, emergency

department, or jail/juvenile hall.

• Measurement 2 – Number of clients graduating from Specialty Mental Health Services.

• Measurement 3 – Education attendance.

• Measurement 4 – Number of days of homelessness/housing stability.

• Measurement 5 – Continued engagement in mental health.

• Measurement 6 – Results of CANS-50/ANSA, and PSC-35, as age appropriate.

TAY FSP Project Budget

Providers: El Dorado County staff, Sierra Child and Family Services (West Slope), and/or other provider(s)

will be selected in compliance with the County’s Procurement Policy.

Adult and Older Adult FSP Projects

The Adult and Older Adult FSP Projects assists clients in becoming more engaged in their recovery through

intensive client-centered mental health and non-mental health services and supports focusing on

recovery, wellness, and resilience. Treatments are designed to reduce the symptoms associated with a

client’s mental illness and improve a client’s “quality of life” by helping a client gain insight into behaviors

and symptoms and adopting behaviors that contribute to recovery goals.

⁞ Intensive Case Management (ICM)

Adults and Older Adults who are enrolled in the FSP project are provided with a highly individualized and

community-based level of intensive case management utilizing the ICM team approach. The ICM team

consists of staff with specialties in areas such as psychiatry, psychology, nursing, social work, substance

use disorder treatment, crisis response, community resourcing, housing, and vocational rehabilitation.

Each FSP client has a single primary point of responsibility, known as a Personal Service Coordinator (PSC).

Caseloads are ideally kept low at approximately ten clients for each PSC on the ICM team. The services

provided are centered around and planned in coordination with the client, and if appropriate, his/her

family, taking into consideration the needs, interests, and strengths of each client.

Crisis intervention services (psychiatric emergency services) are a key component of an ICM team. Crisis

intervention is available through Mental Health 24 hours per day, 7 days per week.

Included within in the Adult and Older Adult FSP projects are the contracted operation of an Adult

Residential Facility, which allows individuals who have been placed in a locked facility out of county to

return to El Dorado County for continued treatment, or to assist clients who may need a higher level of

care in an effort to prevent them from being placed out of county in a locked facility. These clients require

a high level of staff support and the client-to-clinician ratio is low.

⁞ Transitions Treatment Program (TTP)

The Transition Treatment Program further expands on the FSP and ICM model to include designated

transition housing, to provide eligible clients in FSP with the opportunity to gain independent living skills

as part of the overall continuum of care.

Adult and Older Adult FSP Project Goals:

• Reduction in institutionalization.

• People are maintained in the community.

• Services are individualized.

Estimated Number of Individuals to be Served: 60

Estimated Cost Per Person: $8,750

• Work with clients in the homes, neighborhoods, and other places where their problems and

stresses arise and where they need support and skills.

• Team approach to treatment.

Adult and Older Adult FSP Outcome Measures:

• Measurement 1 – Key Event Tracking (KET) – As changes occur in a client’s status related to

housing, employment, education, entry or exit from a psychiatric hospital, emergency

department, or jail.

• Measurement 2 – Number of clients graduating from Specialty Mental Health Services.

• Measurement 3 – Continued engagement in services.

• Measurement 4 – Results of ANSA.

Adult and Older Adult FSP Project Budget

Providers: El Dorado County staff, Compassion Pathways (for operation of an Adult Residential

Facility), and/or other provider(s) who will be selected in compliance with the County’s Procurement

Policy.

FSP Unhoused Individuals Project

The Mental Health Services Act specifically authorizes Counties to support unhoused individuals as

reiterated in the March 23, 2020 “MHSA Fact Sheet for Homelessness”

. Many experiencing homelessness

have high rates of chronic and co-occurring health conditions, mental health needs and substance use

disorders. Individuals who are unhoused may also be dealing with trauma, and children experiencing

homelessness are at higher risk for emotional and behavioral problems. In order to more effectively meet

the growing community needs of unhoused individuals struggling with Serious Mental Illness, expanded

and specialized Full Service Partnership programming will be incorporated into El Dorado County’s

integrated HHSA Housing and Homelessness Service structures. These integrated clinical staff will afford

clients a greater level of access through their synchronistic work alongside the multi-disciplinary housing

and homelessness team, more effectively meeting the complex needs of this vulnerable population.

Members of the FSP Unhoused Individuals Project team will work alongside the HHSA Housing and

Homeless Services staff as members of a single unit, providing responsive and mobile client centered

service delivery and linkage to resources to meet the needs of these community members. In addition to

standard FSP services detailed above, this project will fund outreach, linkage, and ongoing service delivery

as appropriate in a holistic model focused on ending individual cycles of trauma and homelessness in the

community.

https://www.dhcs.ca.gov/Documents/CSD_KS/MHSA%20Main%20Page/FACTSHEET-MHSA-HOMELESSNESS.pdf

Estimated Number of Individuals to be Served: 250

Estimated Cost Per Person: $25,600

Unhoused Individuals FSP Project Goals:

• Increased engagement and service delivery to unhoused individuals experiencing mental health

or substance use disorders.

• Services are provided to vulnerable populations throughout the community.

• Reduction of at risk behaviors.

• Increase coordination and linkage to housing and other supportive resources.

Unhoused Individuals FSP Outcome Measures:

• Measurement 1 – Key Event Tracking (KET) – As changes occur in a client’s status related to

housing, employment, education, entry or exit from a psychiatric hospital, emergency

department, or jail.

• Measurement 2 – Number of clients graduating from Specialty Mental Health Services.

• Measurement 3 – Continued engagement in services.

Providers: El Dorado County staff, and/or other provider(s) who will be selected in compliance with

the County’s Procurement Policy.

Unhoused Individuals FSP Project Budget

FSP Forensic Services Project

Individuals age 18 year of age and older who have involvement in the criminal justice system and meet

the criteria for SMHS may be provided with treatment through the FSP Forensic Services program. This

also includes, but is not limited to, individuals who meet medical necessity for SMHS, are receiving services

from correctional health, and are within 30 days of release into the community. Additionally, individuals

who meet medical necessity for SMHS and have a co-occurring substance use disorder, who are

participating in El Dorado County problem-solving collaborative courts or other formal diversion programs

may receive services.

The FSP Forensic Services program provides additional services and supports from a collaborative team

approach including, but not limited to, Behavioral Health, Courts, Probation, Law Enforcement, and Jails.

Services may include, but are not limited to, outreach, support, linkage, assessment, treatment, crisis

intervention, medication support, and interagency collaboration in the courtroom and to supervising

Probation Officers to help ensure a successful re-entry and transition into the community for justice-

involved individuals. The program activities may align with the County’s Stepping-Up Initiative.

The term “involvement with the criminal justice system” may include, but is not limited to:

• Recent arrest and booking;

Estimated Number of Individuals to be Served: 20

Estimated Cost Per Person: $32,500

• Recent release from jail;

• Risk of arrest for nuisance of disturbing behaviors;

• Risk of incarceration;

• Risk of recidivism;

• Collaborative court system or probation supervision, including Community Corrections Center

participants; and/or

• Involvement in the criminal justice system.

A key component of this FSP program is addressing the criminogenic risk factors, needs, and/or behaviors.

If individuals with involvement with the criminal justice system do not meet medical necessity criteria for

SMHS, behavioral health linkages and/or case management services may be provided to eligible

participants with mild-to-moderate or emerging mental health concerns through the PEI project Forensic

Access and Engagement Project.

The FSP Forensic Services Project is rapidly expanding with additional programs developed throughout

the state and increased attention by the court system on connecting individuals with mental health needs

to appropriate treatment. As such, the funding allotment for this project is planned to increase over the

course of this Three-Year Plan. Funding will be reassessed with each annual update to true-up costs based

on actual expenditures seen over time.

⁞ CARE Court

Senate Bill 1338, signed by Gov. Newsom on Sept. 14, 2022, creates CARE Court (Community Assistance,

Recovery and Empowerment Court), which provides a new pathway to compel homeless individuals with

schizophrenia spectrum or other psychotic disorders to receive treatment and housing. The bill authorizes

specified adults to petition a civil court to create a voluntary CARE agreement or a court-ordered CARE

plan to implement services provided by county behavioral health agencies. Services will include

stabilization medication, housing and other services.

The bill requires Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne and San Francisco Counties to

implement the plan by Oct. 1, 2023. The remaining counties, including El Dorado, must begin the plan no

later than Dec. 1, 2024. Counties failing to comply with the CARE process may be fined up to $1,000 per

day.

FSP Forensic Services Project Goals:

• Reduction in incarceration.

• Reduction in hospitalizations.

• People are maintained in the community.

• Services are individualized.

• Work with clients in the homes, neighborhoods, and other places where their problems and

stresses arise and where they need support and skills.

• Team approach to treatment.

FSP Forensic Services Outcome Measures:

• Measurement 1 – Key Event Tracking (KET) – As changes occur in a client’s status related to

housing, employment, education, entry or exit from a psychiatric hospital, emergency

department, or jail.

• Measurement 2 – Number of clients graduating from Specialty Mental Health Services.

• Measurement 3 – Continued engagement in services.

FSP Forensic Services Project Budget

Providers: El Dorado County staff and/or other provider(s) who will be selected in compliance with the

County’s Procurement Policy.

Estimated Number of Individuals to be Served: 50

Estimated Cost Per Person: $28,600

General System Development Program

The General System Development Programs are projects that include the Wellness and Recovery Projects,

the Community Transition and Support Team and the Crisis Residential Treatment (CRT) Facility.

The General System Development Projects are designed to provide Behavioral Health services that may

be needed on a shorter-term basis, which will support individuals to access family, community-based

and/or coping skill supports for managing their mental illness upon graduation. The Vision of the El Dorado

County HHSA is “Transforming Lives and Improving Futures,” and consistent with that vision, the

Behavioral Health Division provides individuals who meet criteria for Specialty Mental Health Services

with client and family-driven services and supports to allow them to achieve their own vision of Wellness,

Recovery, and Resilience.

Effective January 1, 2018, MHSA funds may be utilized in General System Delivery programs for housing

assistance (defined as rental assistance, security deposits, utility deposits, move-in cost assistance, utility

payments, and/or moving cost assistance). MHSA CSS funds may also be used for capitalized operating

subsidies and capital funding to build or rehabilitate housing for people who are mentally ill and homeless,

and/or people who are mentally ill and at risk of being homeless.

Within General System Development (and also within FSP), housing is of the utmost importance in

maintaining stability during and after SMHS. Therefore, included within these projects is a housing

specialist, who will be responsible for helping clients with their housing needs, regardless of which

treatment program a client may be enrolled. This staff member will be shared between all FSP and General

Service Delivery projects.

Wellness and Recovery Services / Adult Wellness Center Project (includes the Outpatient

Specialty Mental Health Services)

The Adult Wellness Centers Project provides a welcoming location for individuals with severe mental

illness, to receive mental health services. The Wellness Centers provide a friendly setting, away from the

stigma and discrimination so often associated with mental illness. Wellness Centers are a place where

participants can receive mental health services; obtain information about health care; build life skills; gain

community integration experience; partake in support groups or classes that focus on self-healing,

resiliency, and recovery; and participate in social interaction and relationship building. Additional

activities may include direct SMHS treatment, individual meetings between Behavioral Health Division

staff and participants regarding the participant’s mental health and support needs, referrals to

community-based resources, and independent living skill building. The Wellness Centers strive to provide

both inside and outside spaces for clients that are healthy, engaging, and tranquil.

The Wellness Centers provide the setting from which to build local capacity to meet the diverse needs of

the seriously mentally ill and their families. The Wellness Centers also engage in collaboration with other

disciplines, community-based organizations, Public Health, NAMI, consumers, and volunteers. This

permits enhanced services to be provided to participants, including their family members and peer

support.

The Wellness Centers are located on the Western Slope and in South Lake Tahoe. Costs included under

the Adult Wellness Centers project include, but are not limited to, staff and staff overhead, the purchase

of training materials, books, project evaluation, activity supplies, gift cards for clients and/or Peer Leaders,

field trip costs (e.g., entrance fees, admission ticket fees, rental fees, food, beverages, transportation),

office and household supplies, cleaning supplies, computers and peripheral equipment and supplies,

equipment, furniture. Staff time includes activity preparation. Additionally, food items are purchased to

provide Wellness Center participants with healthy food choices and education regarding food

preparation. Other support may be provided to the participants in the form of, but not limited to,

transportation or transportation costs (e.g., bus passes/script, County vehicles), toiletries, and laundry.

Replacement of Wellness Center items (e.g., equipment or furniture) is also included.

Additional components of this project include:

⁞ Peer Leadership Academy and Peer Support Specialists

In 2020, California passed SB 803, that makes it possible for certified Peer Support Specialists to be eligible

for Medi-Cal reimbursement. The previously titled Consumer Leadership Academy in this MHSA Plans has

been updated to better align with this new opportunity for peer empowerment and employment. Since

the passage of SB 803, Peer Support Specialist jobs have been steadily increasing in county behavioral

health and community settings. El Dorado County Behavioral Health has begun developing job

opportunities for peers and is working closely with community providers to increase the number of Peer

Support Specialist job opportunities throughout the county.

The Wellness Centers’ Peer Leadership Academy provides educational opportunities to inform and

empower consumers to become more involved in meaningful participation in the Wellness Centers and

the community. The Academy includes peer-training, peer supportive skills training, job skills training, and

training related to consumer leadership in the community. A meaningful role in the community can serve

to be one of the most effective preventative measures against relapse to illness. Graduates of the

Academy provide mentoring to other consumers and assist Behavioral Health staff with providing services

and information throughout the community. The Peer Leadership Academy is used as a method to identify

and encourage clients to pursue Medi-Cal Peer Support Specialist Certification.

Consumers interested in obtaining the Peer Support Specialist Certification through CalMHSA, the

certifying entity, will be provided personal and financial support throughout the process which includes

an application, eighty (80) hour core competency training, and certification exam. Optional specialization

trainings may also be achieved as a part of the certification. Behavioral Health also seeks to support in-

county providers who wish to become an approved training entity with CalMHSA. Contracted providers

may be selected in accordance with Board of Supervisors Policy C-17 to provide Peer Support Specialist

services throughout different parts of the system of care described in this MHSA Plan.

⁞ Community Wellness Center / Integrated Service Center

Behavioral Health Division continues to explore the option of a Community Wellness Center, or an

integrated Behavioral Health and Community Wellness Center identified in previous MHSA Plans. If/when

an appropriate site and/or provider is identified, funds from this program will be utilized to support the

ongoing operations costs of the Community Wellness Center or integrated Center, including, but not

limited to, the same activities and expenditures identified for the Wellness Centers located on the West

Slope and in South Lake Tahoe. Community Wellness Center operations may be contracted to a provider

identified in compliance with the County’s Procurement Policy. Costs for the facilities will also be allocated

from the Integrated Community-based Wellness Center Project under Capital Facilities and Technology

Needs (CFTN).

Wellness and Recovery Services/Adult Wellness Center Project Goals:

• Decreased days of homelessness, institutionalization, hospitalization, and incarceration.

• Safe and adequate housing.

• Increased access to and engagement with mental health services.

• Increased use of peer support resources.

• Increased connection to their community.

• Increased independent living skills.

Wellness and Recovery Services/ Adult Wellness Center Outcome Measures:

• Measurement 1 – Number of participants.

• Measurement 2 – Number of clients graduating from Specialty Mental Health Services.

Wellness and Recovery Services/Adult Wellness Center Project Budget

Provider(s): El Dorado County staff and/or other provider(s) will be selected in compliance with the

County’s Procurement Policy.

Wellness and Recovery Services/TAY Engagement Project

The TAY Engagement Project provides services to meet the unique needs of transitional age youth and

encourage continued participation in Behavioral Health services. Youth will be empowered to take

responsibility for themselves and for their future, including continued participation in Behavioral Health

services, but they will be supported in their development journey through this project.

This project will collaborate with other agencies that may be involved with the youth, such as Child

Welfare Services or Probation, to develop an appropriate treatment plan for the youth. Wellness and

recovery strategies may include: Case management, peer support, substance use disorders and

psychiatric treatment, supportive housing, crisis response services, transportation assistance, recreation

and social activities, and linkage to vocational services.

This age group frequently needs assistance with developing independent living skills, which also help to

stabilize their mental health needs and build resiliency including, but not limited to: financial literacy,

nutrition and healthy food choices, grocery shopping, meal preparation, child care and children needs,

education and career development, obtaining medical, dental, vision, and mental health care, access to

community resources, self-care, home care (e.g., laundry, cleaning), drug and alcohol abuse awareness

and prevention, and safe sex and reproductive health information.

Through Mental Health Block Grant (MHBG) funding specifically for the provision of Dialectical Behavioral

Therapy (DBT), this MHSA project includes services to provide school-age youth with DBT services, both

in the schools and in the community and/or a clinic-based setting. The age of individuals who qualify for

the DBT and MHBG programs will align with the target population identified in the DBT MHBG program

Estimated Number of Individuals to be Served: 500

Estimated Cost Per Person: $8,000

statements. Evaluation of the DBT MHBG programs will be performed in a manner consistent with the

program statements.

Wellness and Recovery Services/TAY Engagement Project Goals:

• Decreased days of homelessness, institutionalization, hospitalization, and incarceration.

• Safe and adequate housing.

• Increased access to and engagement with mental health services.

• Increased use of peer support resources.

• Increased connection to their community.

• Increased independent living skills.

• Increased socialization skills.

Wellness and Recovery Services/TAY Engagement Outcome Measures:

• Measurement 1 – Number of participants.

• Measurement 2 – Number of clients graduating from Specialty Mental Health Services.

Wellness and Recovery Services/TAY Engagement Project Budget

Provider(s): El Dorado County staff, Sierra Child and Family Services (West Slope), and/or other provider(s)

will be selected in compliance with the County’s Procurement Policy.

Crisis Residential Treatment (CRT) Project

Behavioral Health will be using a combination of funding including American Rescue Plan Act (ARPA) and

non-MHSA funds to build, buy or lease a building for a Crisis Residential Treatment (CRT) Facility in El

Dorado County. CRTs are designed to serve individuals who are experiencing acute psychiatric crisis and

whose functioning is moderately impaired for a short duration

CRTs are short-term residential treatment programs that operate in a structured home-like setting

twenty-four hours a day, seven days a week. Eligible consumers may be served through the CRT for up to

30 days. These programs embrace client centered activities that are culturally responsive. CRTs are

designed for individuals, age 18 and up, who meet psychiatric inpatient admission criteria or are at risk of

admission due to an acute psychiatric crisis but can instead be served appropriately and voluntarily in a

community setting.

Beginning with an in-depth clinical assessment and development of an individual service plan, CRT staff

work with consumers to identify achievable goals, including a crisis plan and a treatment plan. Once

admitted, structured day and evening services are available seven days a week that include individual and

group counseling, crisis intervention, planned activities that encourage socialization, pre-vocational and

vocational counseling, consumer advocacy, medication evaluation and support, and linkages to resources

that are available after leaving the program.

Estimated Number of Individuals to be Served: 50

Estimated Cost Per Person: $8,000

Family members are included in counseling and plan development. Services are voluntary, community-

based, and alternative to acute psychiatric care. While the services are designed to resolve the immediate

crisis, they also focus on improving functioning and coping skills and encouraging wellness, resiliency and

recovery to enable consumers to return to the least restrictive, most independent setting possible in as

short a time as possible. Services are designed to be culturally responsive to the needs of the diverse

community members seeking treatment.

MHSA funds will be used in the delivery of services after the facility is established.

Update: In FY 23/24, a location for the CRT was identified. As of the writing of this project, adaptations to

the facility were being made in preparation for these services. Implementation of this project is anticipated

to begin in late FY 23/24 or early FY 24/25. This project was included in the FY 23/24 Plan Amendment

approved by the Board of Supervisor February 27, 2024. The Amendment expanded the opportunity for

funding through this project to include step down services to individuals in locked facilities preparing for

discharge to the CRT.

⁞ Inpatient Stepdown Program

Acute psychiatric hospitals and acute inpatient psychiatric units in medical hospitals should only be used

for individuals in the most acute phase of their psychiatric crisis and should be considered more of a last

treatment resort rather than a first option. Inpatient Hospital Care and Psychiatric Heath Facility (PHF)

services are often twice the cost of those in a CRT facility. As such, this project may fund opportunities for

assessment and services to clients in inpatient settings for the specific purpose of transitioning to a lower

level of care.

Crisis Residential Treatment Goals:

• Provide an opportunity to fill a gap in the El Dorado County system of care.

• Increase placement options for individuals stepping down from the Psychiatric Health Facility

(PHF) or stepping up from a lower level of care.

• Allow for individuals to stay within this community.

• Provide crisis stabilization, promote recovery, and optimize community functioning through short

term, effective mental health services and supports.

• Decrease utilization of hospital emergency departments, the Psychiatric Health Facility (PHF),

and private psychiatric facilities, as well as decreasing incarceration

Crisis Residential Treatment Outcome Measures:

• Measurement 1 – Length of stay in the Emergency Department when awaiting placement.

• Measurement 2 – In out-of-county inpatient hospitalization numbers.

• Measurement 3 – Length of stay in a Mental Health Rehabilitation Center (MHRC) or Institution

for Mental Disease (IMD).

Crisis Residential Treatment Project Budget

Estimated Number of Individuals to be Served: 70

Estimated Cost Per Person: $15,000

Providers: Provider(s) will be selected in compliance with the County’s Procurement Policy.

Recreation Therapy Project

Recreation Therapy utilizes activity-based interventions to address the treatment needs of individuals

with illnesses and/or disabling conditions, as a means to psychological and physical health, recovery and

well-being.

The Recreation Therapy Project provides alternative therapeutic interventions to current EDC Behavioral

Health clients as an additional service to improve or maintain physical, cognitive, social, and emotional

functioning. EDC Behavioral Health as well as Children’s FSP providers may refer clients to contracted

recreation therapy providers who must, at a minimum, employ at least one Certified Therapeutic

Recreation Specialist (CTRS) within the scope of their contracted work.

Interventions may include, but are not limited to arts and crafts, animals, sports, games, dance and

movement, drama, music, and community outings.

Update: This project is pending a Request for Qualifications (RFQ) prior to implementation.

Implementation for the Recreation Therapy Project is not anticipated until FY 24/25. See Limitations and

Challenges on page 34.

Recreation Therapy Project Goals:

• Improve or maintain physical, mental and emotional well-being.

• Improve confidence and socialization skills.

• Minimize the need for more costly services.

• Promote independence.

Recreation Therapy Project Outcome Measures:

• Measurement 1 – Number of referrals to Recreation Therapy services.

• Measurement 2 - Use established assessment tool, appropriate for the activity, to assess pre and

post client well-being.

Recreation Therapy Project Budget

Providers: Provider(s) will be selected in compliance with the County’s Procurement Policy.

Estimated Number of Individuals to be Served: 100

Estimated Cost Per Person: $500

Outreach and Engagement Programs

The Outreach and Engagement Programs are part of Behavioral Health’s Community System of Care

programming. The Community System of Care Programming is designed to provide outreach to and

engagement services to individuals who meet medical necessity for SMHS and to support the Behavioral

Health system of care.

Access Services Project

The Access Services Project engages individuals with a serious mental illness in Specialty Mental Health

Services and assists in continued engagement in services by addressing barriers to service. Mental health

professionals, in concert with Peer Support Specialist, when possible, will provide outreach and

engagement services for individuals with serious mental illness who are homeless, in the jails, receiving

primary care services, and who require outreach to their homes in order to reach the at-risk population.

Outreach and engagement services for current Behavioral Health clients will also be included to help them

continue engagement in services. Individuals who contact Behavioral Health for services may not meet

the criteria for “Specialty Mental Health Services”. However, when an individual contacts the HHSA for

mental health services, they are initially presumed to have a severe mental illness, and as such, triage calls

may be funded under this project.

Access Team activities may also include efforts to locate and re-engage individuals who are no longer

participating in Specialty Mental Health Services.

Staff costs for outreach and engagement activities under this project will be funded by MHSA, along with

associated costs (e.g., vehicle costs, overhead cost). These funds may also be utilized for the costs of

developing and printing materials utilized for outreach and engagement to include publication via local

media.

⁞ Projects for Transition from Homelessness (PATH)

HHSA receives approximately $35,000 federal funding annually for Projects for Assistance in Transition

from Homelessness (PATH). The PATH program may be facilitated by county staff for eligible housing

related needs or contracted to a community-based organization for outreach, case management, benefit

applications, training, linkage to services and housing assistance county-wide. These funds are designed

to help individuals and families who are homeless or soon to be homeless and who have a mental health

issue, receive necessary services, apply for public assistance/benefits, and assistance in obtaining housing

or remaining in housing.

Transportation assistance may be provided to individuals and families under this project, including but

not limited to bus scripts/passes and gas cards.

El Dorado County Navigation Center

In February 2022, El Dorado County opened its sixty (60) bed Navigation Center to support unhoused

community members through a coordinated entry system. The Navigation Center is a low-barrier, referral-

only center providing continental breakfasts, a sack lunch and hot dinner daily. The facility offers showers,

onsite laundry, internet, a common room with a television and outdoor recreation. Services provided

include case management and linkage to community resources.

EDC Behavioral Health is an active partner with co-located staff on site at least once a week. PATH funding

may be used at the Navigation Center to assist eligible individuals with PATH allowable services.

Individuals engaged at the Navigation Center who are assessed to meet criteria for Specialty Mental

Health Services may be engaged in other MHSA funded services described in this plan. Behavioral Health

continues to look for additional needs at the Navigation Center that may be address with future MHSA

funding.

Access Services Project Goals:

• To engage individuals with a serious mental illness in mental health services.

• Locate and re-engage individuals who are no longer participating in Specialty Mental Health

Services.

• Continue to engage clients in services by addressing barriers to service.

Access Services Outcome Measures:

• Measurement 1 – Number of requests for services.

• Measurement 2 – Timeliness of access to services.

• Measurement 3 – Results of each request for service (e.g., opened to outpatient SMHS, referred

to Substance Use Disorder Services, unable to contact beneficiary, beneficiary declined

assessment)

• Measurement 4 – Number of individuals re-engaged in SMHS.

Access Services Project Budget

Provider: El Dorado County staff and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Assisted Outpatient Treatment (AOT) Project

AOT provides for limited term, court-ordered outpatient mental health treatment for those individuals

meeting the criteria set forth by the law. On October 30, 2018, the El Dorado County Board of Supervisors

adopted Resolution 227-2018, which authorized continuation of the AOT program until terminated.

Although AOT requires individuals to be provided with the opportunity to voluntarily engage in SMHS,

AOT provides El Dorado County two new tools to assist people with mental illness who meet the specified

criteria.

The first tool is the ability to mandate someone to AOT through the use of court-ordered treatment if they

have refused to voluntarily participate in treatment. The second tool is the use of a court order to

authorize the transport of a person in the AOT project for them to be psychiatrically assessed. This can

occur if the individual is deteriorating and unsafe in the community.

Estimated Number of Individuals to be Served: 2,000

Estimated Cost Per Person: $550

Funds for this program are utilized only for evaluation of AOT referrals and the initial engagement of

activities in response to an AOT referral. Once an individual is engaged in Specialty Mental Health Services,

either voluntarily or through a petition to the court, they are provided with FSP-level services and will

receive those services through the FSP program.

AOT Project Goals:

• Reduction in institutionalization.

• People are maintained in the community.

• Services are individualized.

• Team approach to treatment.

AOT Project Outcome Measures:

• Measurement 1 – Number of referrals received and the sources of those referrals.

• Measurement 2 – Number of referrals resulting in engagement in services.

• Measurement 3 – Number of days between receipt of an AOT referral and clients’ engagement

in outpatient Specialty Mental Health Services, in the individual becomes engaged in services.

• Measurement 4 – Number of AOT petitions filed.

• Measurement 5 – Number of AOT referrals who remained engaged in services for at least six

months.

Outcome measures relating to how well a client does while engaged in services are reported through the

FSP projects.

AOT Project Budget

Provider(s): El Dorado County staff and/or other provider(s) will be selected in compliance with the

County’s Procurement Policy.

Lanterman-Petris-Short (LPS) Project

The Lanterman-Petris-Short Act of 1967 defines actions and services when an individual, as a result of a

mental health disorder, is considered a danger to others, or to themselves, or gravely disabled is taken

into custody on a temporary hold or a series of progressive holds leading to a determination of

conservatorship. The initial hold may be placed by a peace officer, professional person in charge of a

facility designated by the county for evaluation and treatment, member of the attending staff, as defined

by regulation, of a facility designated by the county for evaluation and treatment, designated members

of a mobile crisis team, or professional person designated by the county. As a result, the individual will

receive an assessment and crisis intervention as necessary and may be place in a locked psychiatric health

facility (PHF).

Estimated Number of Individuals to be Served: 15

Estimated Cost Per Person: $4,000

A referral by the PHF or courts may be made for an LPS evaluation, at which time the County Behavioral

Health Medical Director and a LPS Mental Health Clinician. Behavioral Health staff conduct a thorough

review of records, interview family members and the individual and conclude with a recommendation to

pursue a LPS Conservatorship for one year. A hearing is held by a Public Hearing Officer whereby a

Patients’ Rights Advocate serves to protect the client's best interest and ensure they are provided the

opportunity for the lowest level of care necessary for the success of their health. After the hearing, the

final determination of conservatorship is made.

On September 30, 2022, AB 2242 was passed, permitting MHSA funds to be used for specified services

under the LPS Act. Those services may include the initial assessment administered by the Behavioral

Health Medical Director through the final determination if an individual should be conserved or not

including any treatment services administered throughout that time. This project may also fund care

coordination, also defined by AB 2242, which supports planning for the individual’s needs after the hold(s)

is complete.

Update: At their regular meeting on July 25, 2023, the Board of Supervisors adopted Resolution 114-2023

designating dual responsibility to HHSA Behavioral Health and HHSA Public Guardian to perform LPS

conservatorship investigations. On September 12, 2023 they adopted Resolution 138-2023 authorizing an

additional Deputy Public Guardian staffing allocation to administer these services.

Lanterman-Petris-Short (LPS) Project Goals:

• Increase the services provided to individuals placed on a hold or series of holds.

• Develop comprehensive care coordination plans to support all clients after determination of

conservatorship is made.

Lanterman-Petris-Short (LPS) Project Outcome Measures:

• Measurement 1 – Number of clients referred for LPS evaluation.

• Measurement 2 – Number of clients on temporary conservatorships.

• Measurement 3 – Number of clients on conservatorships.

LPS Project Budget

Provider(s): El Dorado County staff and/or other provider(s) will be selected in compliance with the

County’s Procurement Policy.

Genetic Testing Project

Certain genetic tests can assist Medication Support Staff to determine which medications are most likely

to benefit a client, without the need for an extended trial and error process. Through a non-invasive test

(usually a cheek swab), a client can learn which medications they are more likely to benefit from and which

medications may not result in positive outcomes. While the genetic testing does not dictate the single,

Estimated Number of Individuals to be Served: 50

Estimated Cost Per Person: 10,000

specific medication that would most benefit a client, it does provide extensive information that can assist

a client and their medication provider to identify appropriate medications.

Genetic Testing Project Goals:

• Clients receive psychiatric medications that are most appropriate for their genetic profile in a

timely manner vs an extended trial and error period of medications.

Genetic Testing Outcome Measures:

• Measurement 1 – The number of clients who receive genetic testing.

• Measurement 2 – To the extent possible to measure, the number of clients who had

medications adjusted after receiving the outcome of the genetic testing.

Genetic Testing Project Budget

Provider: Provider(s) will be selected in compliance with the County’s Procurement Policy.

MHSA Permanent Supportive Housing Projects

All MHSA permanent supportive housing funds were allocated to the California Housing Finance Agency

(CalHFA) in 2010 for support of the MHSA Housing projects. These funds were allocated to Trailside

Terrace in Shingle Springs (five [5] units) and The Aspens at South Lake in South Lake Tahoe (six [6] units).

Services provided to individuals residing at one of the MHSA housing sites are funded through other

Mental Health programs, including but not limited to MHSA programs.

Behavioral Health Bridge Housing Program

Early in 2023 the State announced the development of the Behavioral Health Bridge Housing (BHBH)

Program which included nearly one billion dollars in non-competitive grants for counties to build

supporting housing infrastructure and provide housing assistance for individuals experiencing

homelessness or at risk of homelessness who have a serious behavioral health conditions, including

mental illness or substance use disorders. On December 12, 2023 the Board of Supervisors accepted the

grant award of $3,339,411 and approved the funding-in agreement to receive these funds through June,

30, 2027.These BHBH funds will complement the housing assistance opportunities already integrated into

other MHSA projects.

CSS Administration

County staff and/or contracted provider(s) will be utilized as consultation or performance of

administrative activities (e.g., contracting and accounting), program analysis, and quality

assurance/improvement activities related to this component.

Estimated Number of Individuals to be Served: 20

Estimated Cost Per Person: $2,500

Prevention and Early Intervention (PEI)

The PEI component consists of projects intended to prevent a mental illness/emotional disturbance from

becoming severe or disabling to the extent possible, promote positive mental health by reducing risk

factors by intervening to address mental health problems in the early stages of the illness, and to reduce

stigma and discrimination associated with mental illness.

PEI projects emphasize strategies to reduce the following negative outcomes that may result from

untreated mental illness: 1) Suicide; 2) Incarceration; 3) Homelessness; 4) Prolonged suffering; 5)

Unemployment; 6) Removal of children from their homes; and 7) School failure or dropout. As a result of

the 2018 PEI Regulations (adopted May 2018 by the MHSOAC and effective July 2018), small counties such

as El Dorado County, must include projects that include the following programs: Prevention; Early

Intervention; Outreach for Increasing Recognition of Early Signs of Mental Illness; Access and Linkage to

Treatment Program; and Stigma and Discrimination Reduction. Suicide Prevention is an optional program.

Additionally, SB 1004 was enacted in 2018, which required the MHSOAC, on or before January 1, 2020, to

establish priorities for the use of PEI funds and to develop a statewide strategy for monitoring

implementation of PEI services.

In a MHSOAC letter dated January 30, 2020, the MHSOAC states that pursuant to Welfare and Institutions

Code (WIC) Section 5840.7(d)(1), “counties shall focus use of their PEI funds on the Commission-

established priorities as determined through their respective, local stakeholder processes. If a county

chooses to focus on priorities other than or in addition to those established by the Commission, the plan

shall include a description of why those programs are included and the metrics by which the effectiveness

of those programs is to be measured. The Commission has not at this time established priorities additional

to those specifically enumerated in WIC § 5840.7(a).”

The priorities outlined in WIC § 5840.7(a) include:

Note: Projects may meet more than one priority, so the total allocation of funding appears to be more

than 100%.

1. Childhood trauma prevention and early intervention as defined in WIC § 5840.6(d) to deal with

the early origins of mental health needs. El Dorado County meets this priority by including the

Children 0-5 Project, the Primary Project, the Parenting Classes projects and the Bridge the Gap

Project. It is estimated that 18% of El Dorado’s PEI funding is allocated to this priority. These

projects were supported throughout the CPPP. (This priority also is met through the County’s

Community-based Engagement and Support Services/Community Hubs Innovation project.)

2. Early psychosis and mood disorder detection and intervention as defined in WIC § 5840.6(e), and

mood disorder and suicide prevention programming that occurs across the lifespan. El Dorado

County meets this priority by including the Suicide Prevention and Stigma Reduction Project,

Wennem Wadati, Children 0-5 and Their Families, Statewide PEI Projects, Whole Family Wellness

Project, Student Wellness Center Projects and the Community-based Outreach and Linkage Project

(includes Psychiatric Emergency Response Team (PERT)). Additionally, through the County’s

Community Services and Supports component, there is funding from the Mental Health Block

Grant for First Episode Psychosis treatment. It is estimated that 35% of El Dorado’s PEI funding is

allocated to this priority. These projects were supported throughout the CPPP.

3. Youth outreach and engagement strategies as defined in Section 5840.6(f) that target secondary

school and transition age youth, with a priority on partnership with college mental health

programs. El Dorado County meets this priority through the Student Wellness Center Projects,

PREVENTION AND

EARLY INTERVENTION

Timely Care Project, Prevention Wraparound Services: Juvenile Services and the Peer Partner

projects. It is estimated that 19% of El Dorado’s PEI funding is allocated to this priority.

4. Culturally competent and linguistically appropriate prevention and early intervention as defined

in Section 5840.6(g). El Dorado County meets this priority by including the Latino Outreach

Program, the Wennem Wadati project, Whole Family Wellness Project and the LGBTQIA project.

Additionally, the Primary Intervention Project in South Lake Tahoe is heavily accessed and utilized

by Latino students. It is estimated that 16% of El Dorado’s PEI funding is allocated to this priority.

These projects were supported throughout the CPPP.

5. Strategies targeting the mental health needs of older adults as defined in Section 5840.6(h). El

Dorado County meets this priority by including the Older Adult Enrichment. It is estimated that 5%

of El Dorado’s PEI funding is allocated to this priority. These projects were supported throughout

the CPPP. (This priority also will be met through the County’s Partnership between Senior Nutrition

and Behavioral Health Innovation project.)

6. Early identification programming of mental health symptoms and disorders, including but not

limited to, anxiety, depression, and psychosis. El Dorado County meets this priority by including

the Children 0-5 Project, Student Wellness Center Projects and the Community-based Outreach

and Linkage Project (includes Psychiatric Emergency Response Team (PERT)). Further, the Older

Adult Enrichment Projects may identify mental health symptoms and disorders. It is estimated that

29% of El Dorado’s PEI funding is allocated to this priority. These projects were supported

throughout the CPPP. (This priority also is met through the County’s Community-based

Engagement and Support Services/Community Hubs Innovation project and will be met through

the County’s Partnership between Senior Nutrition and Behavioral Health Innovation project.)

Other local priority populations and services include individuals involved with the justice system, resource

families, community education, Veterans, suicide prevention, and general mental health goods and

support for other local programs. These programs account for approximately 25% of the PEI funding.

Additional PEI projects identified and supported during the CPPP include National Suicide Prevention

Lifeline, Prevention Wraparound Services/Juvenile Services, Mental Health First Aid and Community

Education, Statewide PEI projects, Peer Partner services, Forensic Access and Engagement, and the

Veterans Outreach projects. The outcome metrics related to the assessment of the effectiveness of these

projects is discussed in further detail under the “Prevention and Early Intervention Component” section

of this Plan. These projects also meet the PEI strategies as outlined in Title 9, California Code of

Regulations.

Purchase of goods and services to promote positive mental health and reduce mental health risk factors

also is included in this component. Goods and services may include, but are not limited to, transportation

assistance, motel/hotel/rent payments, emergency food purchases, gift card purchases, vehicle

maintenance and upgrades as related to a mobile office (van retrofitted to resemble an office), and

resource materials.

PEI project structure, as categorized by PEI program

The PEI Program Structure includes the newly established PEI priorities as outlined in WIC § 5840.7(a).

•Latino Outreach Project

•Primary Project

•Wennem Wadati: A Native Path to Healing Project

•Clubhouse El Dorado Project

•Goods and Services to Promote Positive Mental Health and Reduce Mental

Health Risk Factors Project

Prevention Programs

•Older Adult Enrichment Project

•0-5 and Their Families Project

•Prevention Wraparound Services: Juvenile Services Project

•Forensic Access and Engagement Project

•National Suicide Prevention Lifeline Project

•TimleyCare Project

•Student Wellness Center Project

•Bridge the Gap Project

Early Intervention Programs

•Mental Health First Aid and SafeTALK Project

•Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, and

Asexual or Allied (LGBTQIA) Community Education Project

•Statewide PEI Projects

Stigma and Discrimination Reduction

Programs

•Community Education Project

•Peer Partner Project

•Mentoring for Youth Project

Outreach for Increasing Recognition of

Early Signs of Mental Illness Program

•Community-based Outreach and Linkage Project

•Veterans Outreach Project

Access and Linkage to Treatment

Programs

•Suicide Prevention and Stigma Reduction Project

Suicide Prevention and Stigma Reduction

Programs

Prevention Programs

Prevention Programs are projects that are intended to prevent serious mental illness/severe emotional

disturbance by promoting positive mental health, reducing mental health risk factors, and by intervening

to address mental health problems in the early stages of the illness. The goals of this program include

reducing the negative outcomes that result from untreated mental illness for individuals and members of

groups or populations whose risk of developing a serious mental illness is greater than average, and, as

applicable, their parents, caregivers, and other family members. Services may include relapse prevention

for individuals in recovery from a serious mental illness and universal prevention.

“Risk factors for mental illness” means conditions or experiences that are associated with a greater than

average risk of developing a potentially serious mental illness. Risk factors include, but are not limited to,

biological (including family history) and neurological, behavioral, social/economic, and environmental.

Reporting Requirements:

The following information, outcomes, and/or indicators are required for each Prevention project:

1. Unduplicated numbers of individuals served, including demographic data.

a. If a program served families, the County shall report the number of individual family

members served.

2. The reduction of prolonged suffering that may result from untreated mental illness by measuring

a reduction in risk factors, indicators, and/or increased protective factors that may lead to

improved mental, emotional, and relational functioning.

3. If known, the number of individuals with serious mental illness referred to treatment and the kind

of treatment to which the individual was referred.

4. If known, the number of individuals who followed through on the referral and engaged in

treatment.

a. If known, the average duration of untreated mental illness.

b. If known, the interval between the referral and participation in treatment.

5. Completion of Quarterly and Annual Reports.

6. Implementation challenges, successes, lessons learned, and relevant examples.

7. Any other outcomes or indicators identified for the specific project.

Latino Outreach Project

The Latino Outreach Project is a prevention program that addresses isolation in the Spanish-speaking or

limited English-speaking Latino adult population, peer and family problems in the youth population, and

community issues resulting from unmet mental health needs, by contributing to a system of care designed

to engage Latino families and provide greater access to culturally competent mental health services.

This project utilizes a Promotora services program that provides bilingual/bicultural Spanish-speaking

outreach, engagement, screening, integrated service linkage, interpretation services, and peer/family

support for Latino individuals and families. This strategy is intended to promote mental health and reduce

the stigma regarding and barriers to mental health services thereby decreasing the mental health/health

disparities experienced by the Latino population. Services are offered on each slope of the County and

may vary from each other depending on the needs identified by the local communities.

Latino Outreach Project Goals:

• Increased mental health service utilization by the Latino community.

• Decreased isolation that results from unmet mental health needs.

• Decreased peer and family problems that result from unmet health needs.

• Reduce stigma and discrimination.

• Reduction in suicide, incarcerations, and school failure or dropouts.

Latino Outreach Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Customer satisfaction surveys.

• Measurement 2 – Client outcome improvement measures.

• Measurement 3 – Increased engagement in traditional mental health services.

Latino Outreach Project Budget

Providers: New Morning Youth and Family Services and/or other provider(s) will be selected in compliance

with the County’s Procurement Policy.

Primary Project

The Primary Project is an evidence-based practice that offers short-term individual, non-directive play

services with a trained school aide to students in transitional kindergarten through third (3rd) grade who

are at risk of developing emotional problems. (NOTE: This project formerly was called “Primary

Intervention Project” but was for students in kindergarten through third grade and referred to as “PIP”.)

The school-based screening team determines those children who are at risk of developing emotional

problems based on indications of difficulties experienced with adjustments in school. The Primary Project

is currently offered in the Pioneer Unified School District, Black Oak Mine Unified School District and the

Lake Tahoe Unified School District.

In the Primary Project, supervised and trained child aides provide weekly non-directive play sessions with

the selected students. Students are selected for program participation through a selection process that

includes completion of standardized assessments and input from the school-based mental health

professionals and teachers. Parents/guardians and teaching staff are encouraged to build alliances to

promote student’s mental health and social and emotional development. Parental consent is required for

student participation.

Primary Project Goals:

• Provide services in a school-based setting to enhance access.

• Build protective factors by facilitating successful school adjustment.

Estimated Number of Individuals to be Served: 400

Estimated Cost Per Person: $1,000

• Target violence prevention as a function of skills training.

• To decrease school adjustment difficulties at an early age and build protective factors to foster

youth resilience and mental health.

Primary Project Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the

following measurements will be evaluated:

• Measurement 1 - Administer standardized rating scale in accordance with Primary Project

Standards to students at the time student is selected to enter the program and again when the

student exits the program (contracted vendor will be responsible for procuring use of the WAS

tool).

Primary Project Budget

Providers: Black Oak Mine Union School District (West Slope), Pioneer Unified School District (West Slope),

Tahoe Youth & Family Services and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Wennem Wadati: A Native Path to Healing Project

The Wennem Wadati Project applies a combination of mental health services and traditional cultural

teachings unique to the local Native American community. The project was designed to provide culturally

specific Native American services through use of Cultural Specialists, who are Native American community

members, working in a professional capacity that access unique cultural contexts and characteristics

through the use of traditional Native American healing approaches. The project uses various prevention

strategies to address all age groups in the target population with the intent to maintain mental health

well-being, improve wellness, and decrease health disparities experienced by the Native American

community. Services are provided at Foothill Indian Education Alliance in Placerville, schools, and other

community-based sites accessible to the Native American population.

Talking Circles will be conducted at schools and other community-based sites that are accessible to Native

American individuals, each facilitated by Cultural Specialists. The project also facilitates monthly

traditional gatherings, cultural activities, and youth activities designed to spread cultural knowledge and

support family preservation. One multi-day field trip will be scheduled for the Student Leadership group

annually. A dedicated crisis line is available to provide students access to a Native American mental health

Cultural Specialist who will be available via answering service to respond, by telephone or in person, to

situations where Native American students are experiencing a mental health crisis.

Update: Services were not available in the first half of FY 23/24. Contract for continued services was

executed 1/9/24.

Estimated Number of Individuals to be Served: 200

Estimated Cost Per Person: $1,225

Wennem Wadati Project Goals:

• Increase awareness in the Native American community about the crisis line and available services.

• Improve the overall mental health care of Native American individuals, families and communities.

• Reduce the prevalence of alcoholism and other drug dependencies.

• Maximize positive behavioral health and resiliency in Native American individuals and families

reducing suicide risk, prolonged suffering, and incarceration.

• Reduce school drop-out rates.

• Support culturally relevant mental health providers and their prevention efforts.

Wennem Wadati Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 - Casey Life Skills Native American Assessment, or other assessment tool to be

determined by Contractor, to be given when a student joins the Talking Circles, and when they

end their participation.

Wennem Wadati Project Budget

Provider: Foothill Indian Education Alliance.

Clubhouse El Dorado Project - Pilot

Clubhouse El Dorado provides a restorative environment for individuals (called members) whose lives

have been severely disrupted because of their mental illness and co-occurring disorders, and who would

benefit from the support of others who are in recovery. Clubhouse El Dorado provides a safe, structured,

welcoming place for members to build on one’s strengths, maintain recovery and prevent relapse.

Members work as colleagues with peers and a small staff through work and work-mediated relationships.

Members learn and/or regain vocational, social skills, and independence while doing everything involved

in running the Clubhouse as part of the “work-ordered day”. Services include self-help/peer support

groups, social/recreational activities, educational supports, and linkages to community resources and

employment opportunities, building partnerships with local businesses. Members seeking employment

and/or school enrollment will receive vocational supports.

Clubhouse El Dorado follows the Clubhouse International model and standards. Members have equal

access to all Clubhouse programs and may choose their level of participation with no differentiation based

on diagnosis or level of function. Clubhouses are built upon the belief that every member has the potential

to sufficiently recover from the effects of mental illness to lead a personally satisfying life as an integrated

member of society. Clubhouses are communities of people who are dedicated to one another’s success,

no matter how long it takes or how difficult it is.

Estimated Number of Individuals to be Served: 300

Estimated Cost Per Person: $350

This pilot project will include a development phase of no more than three (3) months to include site

preparations, member outreach and solicitation of employment partners partners prior to full project

implementation. Early members may be engaged in these preliminary activities.

Update: Services were not available in the first half of FY 23/24. Contract for services was executed 1/9/24.

Clubhouse El Dorado Project Goals:

• Engage community members with a history of mental illness.

• Increase the number of members employed outside of the clubhouse.

• Decrease the number of members who experience relapse.

• Decreasing hospitalizations, incarcerations, homelessness, recidivism.

• Increasing pursuit of education.

• Improving overall well-being .

• Provide respite and support for primary caregivers of members.

• Increase/maintain independent living .

• Reducing isolation.

Clubhouse El Dorado Outcome Measures:

• Measurement 1 – Number of members engaged in The Clubhouse.

• Measurement 2 – Number of members who maintain recovery.

• Measurement 3 – Number of members who gain employment outside of the clubhouse.

• Measurement 4 – Number of members who maintain stable housing.

• Measurement 5 – Number of members who report improved overall well-being.

• Measurement 6 – Number of family members who report improved well-being.

Clubhouse El Dorado Project Budget

Provider: NAMI El Dorado and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Goods and Services to Promote Positive Mental Health and Reduce Mental Health Risk

Factors Project

The Goods and Services to Promote Positive Mental Health and Reduce Mental Health Risk Factors Project

is focused on providing goods and services that will aid in preventing serious mental illness/emotional

disturbance by promoting mental health, reducing mental health risk factors, and by intervening to

address mental health problems in the early stages of the illness. The Goods and Services to Promote

Positive Mental Health and Reduce Mental Health Risk Factors Project also may serve to reduce the

negative outcomes that may result from untreated mental illness, including suicide, incarceration, school

Estimated Number of Individuals to be Served: 150

Estimated Cost Per Person: $2,000

failure or drop-out, unemployment, prolonged suffering, homelessness, and removal of children from

their homes.

The Goods and Services to Promote Positive Mental Health and Reduce Mental Health Risk Factors Project

may include, but are not limited to, transportation assistance, motel/hotel/rent payments, emergency

food purchases, gift cards, and resource materials. Additional goods and services may be purchased on

behalf of contracted vendors who demonstrate a need for a particular item or service for a PEI client.

⁞ County Emergency Support

In the event of a federal, state or local emergency declaration, funds within the Goods and Services to

Promote Positive Mental Health and Reduce Mental Health Risk Factors Project may be used to support

community needs related to mental Health that are not otherwise defined in this MHSA Plan. This may

include but is not limited to, mental health services at evacuation centers, transportation and shelter

assistance to vulnerable individuals. In the event goods and services beyond the county’s current capacity

are needed to support emergency efforts, contractors may be selected in compliance with the Board of

Supervisors C-17 Procurement Policy regarding Emergency Purchases of goods or services.

Project Budget

Provider: Provider(s) will be selected in compliance with the County’s Procurement Policy.

Estimated Number of Individuals to be Served: varies

Estimated Cost Per Person: varies

Early Intervention Programs

Early Intervention Programs are projects that provide treatment, services, and other interventions,

including relapse prevention, to address and promote recovery and related functional outcomes for a

mental illness early in its emergence, including the applicable negative outcomes that may result from

untreated mental illness. Early Intervention Program services are time limited, but no more than 18

months unless the individual is identified as experiencing first onset on psychotic features, in which PEI

services shall not exceed four (4) years (these individuals would be transferred to other Specialty Mental

Health Services upon diagnosis of a serious mental illness or severe emotional disturbance). Early

Intervention Program services may include services to parents, caregivers, and other family members of

the person with early onset of mental illness, as applicable.

Reporting Requirements:

The following information, outcomes, and/or indicators are required for each Early Intervention project:

1. Unduplicated numbers of individuals served, including demographic data.

a. If a program served families, the County shall report the number of individual family

members served.

2. The reduction of prolonged suffering that may result from untreated mental illness by measuring

reduced symptoms and/or improved recovery, including mental, emotional, and relational

functioning.

3. If known, the number of individuals with serious mental illness referred to treatment and the kind

of treatment the individual was referred to.

4. If known, the number of individuals who followed through on the referral and engaged in

treatment.

a. If known, the average duration of untreated mental illness.

b. If known, the interval between the referral and participation in treatment.

5. Completion of Quarterly and Annual Reports.

6. Implementation challenges, successes, lessons learned, and relevant examples.

7. Any other outcomes or indicators identified.

Older Adults Enrichment Project

The Older Adults Enrichment Project is an integrated continuum of care designed to provide

comprehensive services to meet the changing needs of older adults. In previous MHSA Plans/Updates this

project was divided into three independent programs (Senior Peer Counseling, Friendly Visitors and Senior

Link). These programs are being consolidated due to the overlapping nature of services provided and the

need for more fluid transition between the levels of care presented within the project.

Through this project staff or volunteers evaluate the needs of potential clients, referring them or assisting

them in making contact with other community services, including Mental Health evaluation and

treatment. Eligible clients may also choose to engage in Senior Peer Counseling or Senior Engagement

programs.

Staff or volunteers provide access, support, and linkage for older adults to a variety of community-based

services with the goal of improving their mental health. Services may include but are not limited to

collaboration with health care providers, advocacy, activities and outings, cultural and spiritual groups,

and transportation and referral services. These services may be provided directly to community members

through this project’s outreach efforts or as a part of assessments administered through other older adult

programs (senior peer counseling, senior engagement and other senior services).

Senior Peer Counseling provides free, confidential individual counseling to eligible adults age 55 and older.

Staff or volunteer counselors assist clients in regular self-assessment of their feelings of well-being using

a standardized measurement tool. The supervisory services of a licensed mental health clinician are

essential to the operation of Senior Peer Counseling. The supervisor meets weekly with the staff and/or

volunteers, reviewing the progress of each client, which ensures that standards of practice are met

protecting clients, counselors, and the community. Services may be available in clients’ homes and other

community meeting places. Individuals interested in becoming a Senior Peer Counselor must be an older

adult (aged 55 or older), complete a vigorous training, and pass a LiveScan background check prior to

becoming a Senior Peer Counselor.

Senior Engagement provides social opportunities and companionship in person and over the phone,

intended to help older adults prevent or overcome physical and mental health risks associated with

isolation and loneliness. Additionally, staff or volunteers may help identify the client’s unmet needs and

assist with referrals to other community services for access and linkage to mental health services or other

needed health care or social services resources. This helps lower the risks associated with social isolation,

including but not limited to depression, self-medication, anxiety, and loss of interest in life’s daily

activities.

Older Adult Enrichment Project Goals:

• Provide referrals and linkage to mental health providers, physical health providers, community

resources.

• Clients know of, and successfully access, other needed mental health services.

• Clients will achieve positive outcomes including increased socialization, improved resilience,

improved feelings of well-being and protective factors, and linkage to community resources as

shown on a client satisfaction surveys.

• Provide clients with meaningful, one-on-one interactions.

• Provide volunteer training to accommodate the different levels of care within the project.

• In addition to those listed above Senior Peer Counseling clients will also:

o Demonstrate improved lifestyle factors over the course of their counseling, as measured

by an evidence based measurement tool such as the Therapeutic Lifestyle Changes (TLC)

tool.

o Increased resiliency, clients improve their mental health and self-sufficiency.

o Identify the primary issue of focus (problem list) for counseling.

o Achieve improvements in their feelings of well-being as shown on the Outcomes Rating

Scale (ORS) or comparable measurement tool.

o Ameliorate their distress as described in their presenting problem.

Experience mental health and satisfaction with life as evidenced by scores on the ORS measurement

tool, or other measurement tool. Older Adult Enrichment Project Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the

following measurements will be evaluated:

• Measurement 1 –Pre-services and post-service customer satisfaction surveys.

• Measurement 2 – Number of referrals to mental health providers, physical health providers, and

community resources.

• Measurement 3 – Counseling clients will complete a pre-and post-rating form which measures

TLC, primary pro-health and pro-mental health activities and habits which have been shown to

lead to positive physical, emotional, and cognitive improvements in people of all ages. The

categories to be measured are: Exercise, Nutrition/Diet, Nature, Relationships, Recreating/

Enjoyable Activities, Relaxation/Stress Management, Religious/Spiritual Involvement, and

Contribution/Service.

• Measurement 4 – Counseling clients ORS, which measures the following four psychological

categories: 1) individually (personal well-being); 2) interpersonally (family, close relationships); 3)

Socially (work, school, friendships); and 4) Overall (general sense of well-being).

• Measurement 5 – Counseling Volunteers will record clients’ self-reported improvements in the

presenting problem.

Older Adult Enrichment Project Budget

Provider: EDCA Lifeskills and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Children 0-5 and Their Families Project

The Children 0-5 and Their Families Project is an early intervention project provided to children ages zero

to five (0-5) and their families. Services are provided in the service provider’s office or within the

community on both the West Slope and in South Lake Tahoe. This project assists in early intervention by

addressing needs of young children who may be experiencing symptoms related to adjustment disorder,

oppositional defiance disorder, and other childhood emotional disorders.

A plan of care will be developed by the service provider in concert with family and other community

collaborators, as appropriate, to address the family’s specific needs and goals. Activities performed may

include, but are not limited to:

• Infant-parent psychotherapy

• Individual, couple, and/or family sessions.

• Home visitation.

• Parenting support and guidance for fathers, mothers, and couples through programs such as

Circle of Security, Theraplay, Touch Points, and/or Wisdom Pathway Parenting.

• Infant massage.

• Pregnancy and post-partum support.

• Psychological parenting information and support for foster, grandparents, and adoptive

caregivers.

• Educational support to address colic, feeding, and sleep issues.

• Trauma-Focused Cognitive Behavioral Therapy (CBT).

Estimated Number of Individuals to be Served: 200

Estimated Cost Per Person: $

• Eye Movement Desensitization Reprocessing (EMDR).

• Identifying and removing barriers to treatment.

• Case Management.

• Assisting other providers to recognize early signs of poor coping, stress, and mental illness in the

target population.

• Community Outreach.

Children 0 – 5 and Their Families Project Goals:

• Increased number of families within the target population who are accessing

prevention/wellness/intervention services.

• Strengthened pipeline among area agencies to facilitate appropriate and seamless referrals

between agencies in El Dorado County.

• Increased awareness of services available among families, health care providers, educators and

others who may have access to target population.

• Emotional and physical stabilization of at-risk families (increasing trust).

• Improved infant/child wellness (physical and mental health).

• Improved coping/parenting abilities for young parents.

• Increased awareness and education of Domestic Violence and how it impacts families and young

children.

• Enhancement of programs serving children ages zero to five (0-5).

• Decreased number of children removed from the home.

• Decreased incidence of prolonged suffering of children/families.

• Child abuse prevention.

• Suicide prevention.

• Increased cooperation and referrals between agencies.

• Reduced stigma of mental health/counseling interventions among target population.

• Improved trust of services as evidenced by an increase in self-referral by target group families.

• Decreased cost of 5150 and hospitalizations by providing services in outpatient setting.

Children 0 – 5 and Their Families Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Success will be measured on a pre/post testing based on assessment tools,

Parent Stress Index, Beck’s Depression and Anxiety Scale, Post-partum Depression Scale, Ages and

Stages, and Marshak Interaction Method.

• Measurement 2 – Client satisfaction questionnaires, other provider questionnaires.

• Measurement 3 – Tracking of self-referred clients.

• Measurement 4 – Decreased incidents of Abusive Head Trauma (formerly known as “Shaken Baby

Syndrome”).

• Measurement 5 – Reduction of hospital emergency department visits.

Children 0-5 and their Families Project Budget

Provider: Infant Parent Center and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Prevention Wraparound Services: Juvenile Services Project

The Prevention Wraparound Services: Juvenile Services Project is an early intervention program that

utilizes a strength-based, needs-driven, family-centered and community-based planning process with an

emphasis on permanency, safety, and well-being for youth and families who are at risk of involvement

with or involved in the child welfare system and/or juvenile justice programs, but whose needs do not rise

to the level of Specialty Mental Health Services. The model to be utilized for this project is the High Fidelity

Wraparound, using the standardized Wraparound process developed by the National Wraparound

Initiative. The project is designed to help the youth avoid restrictive and expensive placements, including

group home placement, psychiatric hospitalization, and youth detention. The target population for this

project includes youth with complex needs who are living with their families and at risk of further

involvement in the child welfare, foster care, behavioral health, and/or juvenile justice systems.

Services will be individualized and typically not exceed six (6) months, however, the needs of each

participant will be considered on a case-by-case basis, to determine the service duration and array. The

service array may include, but is not limited to screening candidates, developing Wraparound plans for

each participant/family, family engagement, team decision making, mental health services, safety

planning, training, referrals and linkage to community resources, and flexible funding (“flex funds”) used

for access to specific non-mental health resources identified within the treatment plan that are needed

by the youth and their family to successful fulfill the treatment plan. In the case of a family emergency,

flex funds may be used to temporarily provide housing stability or support to a family in crisis. Examples

of flex funds include, but are not limited to, funding for transportation, child-care, medication, education,

and food/dining rewards for participating in services.

Participants appearing to meet the medical necessity criteria for SMHS at any time during their

participation in this project will be referred to El Dorado County Mental Health as appropriate.

Prevention Wraparound Services: Juvenile Services Project Goals:

• Improve the array of services and supports available to children and families involved in the child

welfare and juvenile probation systems.

• Engage families through a more individualized casework approach that emphasizes family

involvement.

• Increase child/youth safety without an over-reliance on out-of-home care.

• Improve permanency outcomes and timeliness.

• Improve child and family well-being.

• Prevent involvement in the juvenile justice system.

Estimated Number of Individuals to be Served: 230

Estimated Cost Per Person: $1,700

Prevention Wraparound Services: Juvenile Services Project Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Number of youth who have reduced the number, duration, and repetition of

in-patient psychiatric hospital care admissions.

• Measurement 2 – Number of youth who have had reduced contacts with law enforcement, the

Juvenile Justice system, and/or Child Welfare.

• Measurement 3 – Number of youth who maintain integration or have been reintegrated into a

permanent family-based setting and in the community.

• Measurement 4 – Customer satisfaction surveys.

Prevention Wraparound Project Budget

Provider: Stanford Sierra Youth & Family and/or other provider(s) will be selected in compliance with the

County’s Procurement Policy.

Forensic Access and Engagement Project

Repeat offenders with behavioral health concerns may be charged and remanded to one of El Dorado

County’s Superior Court’s Collaborative Court Programs designed for individuals with behavioral health or

other special concerns.

The Forensic Access and Engagement Project is designed for eligible individuals with mild-to-moderate

mental health concerns, which, if left untreated, may result in repeat incarcerations, prolonged suffering,

and risk of homelessness. This project is a collaborative effort between Behavioral Health, El Dorado

County Probation, the District Attorney, Public Defender, and the Superior Court. Activities may include,

but are not limited to, screening and assessment, individualized case management, outreach, assistance

with reviewing housing and placement options, and navigation support to engage and maintain

individuals in treatment services (including substance use disorder treatment services).

Community Corrections Partnership (CCP)

In April 2011, the California Legislature passed public safety legislation (AB 109) establishing the California

Public Safety Realignment Act of 2011. AB 109 is intended to reduce recidivism, in part by supervising non-

violent, non-serious, and non-sex offenders in-county with Evidence-Based Practices (EBP) including

behavioral health interventions.

In El Dorado County, the Community Correction Center (CCC) was established as a partnership between

Probation, Mental Health, Substance Use Disorders Services (SUDs), Public Health, Community Services

and EDC Office of Education to serve individuals qualified to receive these services. The population served

by the CCC funded by AB 109 and those served by the Forensic Access and Engagement Project are closely

Estimated Number of Individuals to be Served: 50

Estimated Cost Per Person: $6,900

linked. As such CCC activities may impact how MHSA funding is best used to support justice involved

individuals eligible for services within this project.

Forensic Access and Engagement Project Goals:

• Improve the connection to services and supports for transitional age youth (TAY), adults, and

older adults involved in the criminal justice system and collaborative court system.

• Engage individuals through a more individualized casework and navigation of services approach

that emphasizes successful reintegration into the community.

• Reduce jail recidivism for individuals incarcerated due to their mental illness being a component

of the commission of a crime.

Forensic Access and Engagement Outcome Measures

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Number of bookings, duration of stay, and repetition of incarceration due to

mental illness being a component of the commission of the crime.

• Measurement 2 – Number of contacts with law enforcement.

• Measurement 3 – Number of individuals who maintain integration or have been reintegrated in

the community.

• Measurement 4 – Customer satisfaction surveys.

Forensic Access and Engagement Project Budget

Provider: El Dorado County staff and/or other provider(s) who will be selected in compliance with the

County’s Procurement Policy.

National Suicide Prevention Lifeline Project

The National Suicide Prevention Lifeline is a 24/7, toll-free, confidential hotline available to anyone in

distress (988 or 1-800-273-8255). Calls from the national number are routed to regional call centers. The

hotline is accredited by the American Association of Suicidology.

National Suicide Prevention Lifeline Project Goals:

• Hotline shall be available 24 hours per day, seven days per week, to respond to crisis calls.

National Suicide Prevention Lifeline Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Call volume by day of the week and time of day.

Estimated Number of Individuals to be Served: 150

Estimated Cost Per Person: $1,000

• Measurement 2 – Caller concerns, such as mental health, social issues, suicidal content, general

needs, basic needs, physical health needs, abuse/violence.

• Measurement 3 – Caller age group.

• Measurement 4 – Caller gender.

• Measurement 5 – Number of calls the hotline employee was able to talk down from crisis

compared to the number of calls required an active rescue.

National Suicide Prevention Lifeline Project Budget

Provider: CalMHSA serves as the fiscal intermediary for the program to coordinate county payments. The

services are provided through a local call center. The previous call center is no longer operational. A new

provider is being solicited for by CalMHSA. In the meantime, all local calls will be routed to the nearest

available call center.

TimelyCare Project

The TimelyCare Project is an Early Intervention program that provides treatment to address and promote

recovery and related functional outcomes for a mental illness early in its emergence. Students enrolled at

Lake Tahoe Community College, through their TimelyCare application, will have upgraded access to the

TimelyCare telehealth application to schedule and attend one-time or ongoing mental health

appointments. This service is intended for students with mild-to-moderate mental health needs.

The service is available 24/7 and is differentiated from crisis services. Lake Tahoe Community College

contributed funding to this program to enable students to utilize the application for basic mental and

physical health needs. MHSA contributed funds to allow student access to up to 12 scheduled mental

health sessions per year. All medical services are provided by a licensed and board-certified physician,

nurse practitioner, or physician assistant. Mental health services are provided by a licensed mental health

provider. Psychiatry services also are available.

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Number of scheduled counseling visits and the average visit length.

• Measurement 2 – Number of psychiatry visits and the average visit length.

• Measurement 3 – Breakdown by gender for the scheduled counseling visits and the psychiatry

visits.

TimelyCare Project Budget

Estimated Number of Individuals to be Served: 350

Estimated Cost Per Person: $115

Estimated Number of Individuals to be Served: 150

Estimated Cost Per Person: $250

Provider: Behavioral Health will enter into a contract with Lake Tahoe Community College, who will then

use the funding to contract with TimelyCare. TimelyCare does not contract with entities outside of the

community colleges.

Student Wellness Centers Project

In previous MHSA Plans, High School Wellness Centers and Middle School Wellness Center Projects were

independent of each other and designated into two different MHSA Components. This MHSA Plan

integrates all Student Wellness Center services under PEI as the most appropriate component for the

services provided.

In collaboration with the El Dorado County Office of Education (EDCOE), local school district psychological

and nursing staff and other community-based organizations, Student Wellness Centers at El Dorado

County public schools are staffed minimally one day per week by a licensed, waivered or registered mental

health professional (for example, an Associate Social Worker or Licensed Clinical Social Worker) and a

mental health assistant when school is in session.

Services may include crisis support, brief mental health assessments, outreach and engagement, linkage

to community services, classroom activities emphasizing self-care and mental health awareness,

collaboration with parents, and training for parents and district staff. Training may include, but is not

limited to, trauma-informed care, crisis intervention, and Mental Health First Aid. Training will be essential

to the success of this program, as school faculty will be better equipped to recognize potential referrals

to the Student Wellness Center.

The school sites for the project will be selected in collaboration with the EDCOE. Multiple funding streams

will be utilized throughout the school system to establish Student Wellness Centers at all EDCOE school

sites with the MHSA portion of the funding not to exceed the budgeted amount.

Mental Health Student Services Act

The Mental Health Student Services Act (MHSSA) established a collaborative, competitive grant program

for the purposes of establishing mental health partnerships between a county’s Behavioral Health

Departments and school districts, charter schools, and the county office of education. In 2022, EDCOE in

partnership with El Dorado County Behavioral Health was awarded five million dollars ($5,000,000) for

the development and implementation of a system wide plan to more effectively administer mental health

services throughout the EDCOE schools. El Dorado County Behavioral Health serves as a fiscal

intermediary for the awarded funds. The plan developed by EDCOE in partnership with El Dorado County

Behavioral Health and other community partners receives no MHSA funds through the administration of

this MHSA Plan.

Student Behavioral Health Incentive Program (SBHIP)

In an effort to provide additional avenues to address behavioral health in schools, Assembly Bill 133:

Section 5961.3 outlines the Student Behavioral Health Incentive Program (SBHIP). Through this law $389

million is designated over a three-year period (January 1, 2022-December 31, 2024) for incentive

payments to Medi-Cal managed care plans (MCPs) that meet predefined goals and metrics. SBHIP goals

and metrics are associated with targeted interventions that increase access to preventive, early

intervention and behavioral health services by school-affiliated behavioral health providers for TK-12

children in public schools. This funding is currently being used to build stronger partnerships between

MCPs and education partners to expand Medi-Cal services,

Several El Dorado County school districts have begun participation in this initiative including Black Oak

Mine Unified School District, El Dorado Union High School District, Lake Tahoe Unified School District, and

Camino Union School District.

Student Wellness Centers Project Goals:

• Provide a dedicated Student Outreach and Engagement Center at El Dorado County schools. The

Center shall be accessible, inviting, and supportive to students seeking mental health education,

mental health services, and linkage to community services and outreach.

• Provide individual assessments and counseling services.

• Provide outreach and linkage to community resources.

• Provide customized trainings with input from school staff, faculty, students, and parents.

Student Wellness Centers Outcome Measures:

• Measurement 1 – Number of duplicated and unduplicated student contacts.

• Measurement 2 – The number of student mental health assessments performed.

• Measurement 3 – The number of training/education opportunities provided in person, writing

or other means, along with the target population, number of attendees, and training/education

topic.

• Measurement 4 – The number of students linked to community services, the names of the

community organizations to which students were referred, and the general reason for the

referral.

Student Wellness Centers Project Budget

Provider: Summitivew Child & Family Services, Sierra Child and Family Services and/or other provider(s)

will be selected in compliance with the County’s Procurement Policy.

Bridge the Gap Project

The Bridge the Gap Project addresses a current gap in service for youth experiencing mild to moderate

mental health needs. While the nation continues to experience a dramatic increase in the need for mental

health service and an equally dramatic shortage of qualified staff, youth are experiencing extended delays

in service through their private insurance provider or other means of accessing mental health treatment.

As delays in services grow, so too may the level of care if mental health needs go untreated.

Through referrals made by organizations serving youth such as, but not limited to, El Dorado County

Behavioral Health, El Dorado County Office of Education, Student Wellness Center providers and El Dorado

County Child Welfare, youth are linked to a contracted treatment provider for short term clinical care,

Estimated Number of Individuals to be Served: 1,500

Estimated Cost Per Person: $500

lasting no longer than eighteen (18) months

, until appropriate services become available through their

private insurance provider or other means of mental health treatment. The provider will also assist the

youth in accessing long term care by providing support in navigating the healthcare system and, when

necessary, supporting communication with the youth’s private insurance provider.

Update: After a successful solicitation for a qualified provider this project has taken time to develop due

to the complexity of serving youth, evaluating needs, identifying referral sources and execution of care

that may otherwise be addressed through other sources. There is no projected implementation date at this

time. See Limitations and Challenges on page 34.

Bridge the Gap Project Goals:

• Provide short term counseling services.

• Reduce the length of time between initial contact and assessment and long-term care.

• Decrease the number of youth referred to higher levels of care.

• Increase the number of youth served by long term counseling services.

• Decrease need for Psychiatric Emergency Services (PES) for youth.

Bridge the Gap Project Outcome Measures:

• Measurement 1 – Number of youth referred to services.

• Measurement 2 – Length of time youth participate in services within this project.

• Measurement 3 – Number of students who are connected to long term services.

• Measurement 4 – Occurrences of PES presentation in El Dorado County emergency

departments.

Bridge the Gap Project Budget

Provider: Sierra Child and Family Services and/or other provider(s) will be selected in compliance with the

County’s Procurement Policy.

As regulated by Title 9 California Code of Regulations, Division 1, Chapter 14 MHSA, Article 7. Prevention and

Early Intervention, Section 3710, item (c).

Estimated Number of Individuals to be Served: 80

Estimated Cost Per Person: $2,500

Stigma and Discrimination Reduction Programs

Stigma and Discrimination Reduction Programs are projects with the objective of reducing negative

feelings, attitudes, beliefs, perceptions, stereotypes, and/or discrimination related to being diagnosed

with a mental illness, having a mental illness, or to seeking mental health services. These projects also

strive to increase acceptance, dignity, inclusion, and equity for individuals with mental illness, and

members of their families. Stigma and Discrimination Reduction Programs shall include approaches that

are culturally congruent with the values of the populations for whom changes in attitudes, knowledge,

and behavior are intended.

Reporting Requirements:

The following information, outcomes, and/or indicators are required for each Stigma and Discrimination

Reduction Program:

1. Number of individuals reached, including demographic data.

2. Using a validated method, measure one or more of the following:

a. Changes in attitudes, knowledge, and/or behavior related to seeking mental health

services that are applicable to the specific program.

b. Changes in attitudes, knowledge, and/or behavior related to seeking mental health

services that are applicable to the specific program.

3. If known, the number of individuals with serious mental illness referred to treatment and the kind

of treatment the individual was referred to.

4. If known, the number of individuals who followed through on the referral and engaged in

treatment.

a. If known, the average duration of untreated mental illness.

b. If known, the interval between the referral and participation in treatment.

5. Completion of Quarterly and Annual Reports.

6. Implementation challenges, successes, lessons learned, and relevant examples.

7. Any other outcomes or indicates identified.

Mental Health First Aid and SafeTALK Projects

The Mental Health First Aid (MHFA) Project is an evidence-based project that introduces participants to

risk factors and warning signs of mental health problems. It also introduces the warning signs of mental

health problems, builds understanding of their impact, and provides an overview of common treatments.

MHFA uses the curriculum developed by Mental Health First Aid USA, and includes several programs,

including: MHFA, which focuses on risk-factors and mental illness in adults (available in English and

Spanish); Youth MHFA, which focuses on risk-factors and mental illness in youth ages 12 to 25; and a

military-focused module which focuses on the needs of active duty military personnel, veterans, and their

families. There also are modules for those who work with older adults and one for universities. A module

for those who work with high school students also is being developed. Classes are offered county-wide. A

team of two MHFA instructors provide the 8-hour training session. Topics covered in the session include:

• Identifying the potential risk factors and warning signs for a range of mental health problems,

including depression, suicide, anxiety/trauma, psychosis, eating disorders, substance use

disorders, and self-injury.

• An understanding of the frequency of various mental health disorders in the U.S. and the need

for reduced stigma/shame in their communities.

• An action plan including the skills, resources and knowledge to evaluate the situation, select and

implement appropriate interventions, and to help an individual in crisis connect with appropriate

professional care.

• Information on various resources available to help someone with a mental health problem.

• Upon completion of the training, attendees receive a Mental Health First Aid certification that is

valid for three years.

⁞ Instructor Development

In order to expand the service delivery of the MHFA and SafeTALK Project, EDC Behavioral Health may

host large group instructor training through the National Council for Mental Wellbeing or other

comparable certifying agency. In partnership with El Dorado County Office of Education (EDCOE), Marshall

Medical Center, Barton Heath and other partner agencies, EDC Behavioral Health seeks to expand the

network of course instructors within El Dorado County in order to meet increasing requests for non-clinical

mental health and suicide prevention training.

⁞ Community Funding Assistance

This project will support Community Funding Assistance opportunities which will provide funding to

individuals seeking to become Mental Health First Aid or SafeTALK providers in El Dorado County or

current providers seeking to expand service delivery throughout the county. A formal application and

award process will be developed in FY 23/24. Award recipients may receive up to $5,000. The number of

award recipients may vary.

Update: Development of an application and funding process for the Community Funding Assistance

program within the Mental Health First Aid and SafeTALK Projects is in process. Application announcement

is anticipated early in 2024 with funding available to awarded applicants prior to the end for FY 23/24.

Mental Health First Aid Project Goals:

• Raise personal awareness about mental health, including increasing personal recognition of

mental health risk factors.

• Community members use the knowledge gained in the trainings to assist those who may be

having a mental health crisis until appropriate professional assistance is available.

• Opens dialogue regarding mental health, risk factors, resource referrals, and suicide prevention.

• Work towards stigma and discrimination reduction in our communities and networks.

Mental Health First Aid Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Class evaluation provided to attendees at the end of each session.

Provider: El Dorado County staff and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

SafeTALK Project Goals:

• Raise awareness about suicide in communities.

• Provide community members the training to link those who may be having thoughts of suicide to

appropriate supports.

• Reduce stigma and discrimination about suicide in the community.

SafeTALK Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Raise awareness about suicide in communities.

• Recognize when individuals may be having thoughts of suicide.

• Apply the SafeTALK steps (Tell, Ask, Listen, and KeepSafe) to connect a person with thoughts of

suicide to a suicide first-aid intervention caregiver.

• Reduce stigma and discrimination about suicide in the community.

Mental Health First Aid and SafeTALK Project Budget

Provider: El Dorado County staff and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Community Stigma Reduction Project

The Community Stigma Reduction Project is a stigma and discrimination reduction project that supports

differences, and builds an understanding through community involvement, to reduce shame and support

ending discrimination. This project provides an opportunity for dialogue about sexual orientation and

gender identity and acts to promote a community that is healthy and respectful of human differences.

This project promotes resources and supportive services in the community and with community mental

health providers through the use of culturally responsive outreach events and materials.

Update: Services were not available in the first half of FY 23/24. Contract for services was executed 1/9/24.

This project was included in the FY 23/24 Plan Amendment approved by the Board of Supervisor on

February 27, 2024. The Amendment changed the name of this project to Community Stigma Reduction

Project in order to more broadly address the needs of all disenfranchised groups and individuals in El

Dorado County.

Community Stigma and Reduction Project Goals:

• Reduction of stigma and discrimination associated with being culturally diverse.

• Education, in the form of presentations/discussions to the general public regarding cultural

responsiveness.

Estimated Number of Individuals to be Served: 300

Estimated Cost Per Person: $300

Community Stigma and Reduction Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Number of informing materials distributed.

• Measurement 2 – Number of people reached through presentations.

Community Stigma Reduction Project Budget

Provider: New Morning Youth and Family Services, Inc. and/or other provider(s) will be selected in

compliance with the County’s Procurement Policy.

Statewide PEI Projects

The Statewide PEI Projects provide a mechanism at the statewide level for counties to collectively address

issues of suicide prevention, student mental health, and stigma and discrimination reduction. Counties

are required to contribute a percentage of their PEI allocation to support this project.

CalMHSA is currently the provider of Statewide PEI Projects. They provide projects including, but not

limited to:

• Educational materials

• Statewide Suicide Prevention campaigns

• Each Mind Matters activities (https://www.eachmindmatters.org/)

• Walk In Our Shoes (www.walkinourshoes.org)

• LivingWorks Education

• Institute on Aging Friendship Line for Older Adults (1-800-971-0016)

• WellSpace Health (crisis phone line for the general population – 1-800-273-8255 or 1-800-

SUICIDE)

• Student Mental Health Activities

Statewide PEI Project Goals:

• Reduce the stigma and discrimination associated with mental illness, prevent suicide, and

improve student mental health.

Statewide Outcome Measures:

The Outcome Measures for this project are established and managed by the State. For more information,

please see http://www.calmhsa.org/programs/evaluation/.

Statewide PEI Projects Budget

Provider: CalMHSA

Estimated Number of Individuals to be Served: 200

Estimated Cost Per Person: $500

Outreach for Increasing Recognition of Early Signs of Mental Illness

Program

Outreach for Increasing Recognition of Early Signs of Mental Illness Programs are projects that provide

outreach to families, employers, primary care health care providers, and others to recognize the early

signs of potentially severe and disabling mental illnesses.

“Outreach” may include a process of engaging, encouraging, educating, and/or training, and learning from

potential responders about ways to recognize and respond effectively to early signs of potentially severe

and disabling mental illness. “Potential responders” include, but are not limited to, families, employers,

primary health care providers, visiting nurses, school personnel, community service providers, peer

providers, cultural brokers, law enforcement personnel, emergency medical service providers, people

who provide services to individuals who are homeless, family law practitioners such as mediators, child

protective services, leaders of faith-based organizations, and others in a position to identify early signs of

potentially severe and disabling mental illness, provide support, and/or refer individuals who need

treatment or other mental health services.

Services may include reaching out to individuals with signs and symptoms of a mental illness, so they can

recognize and respond to their own symptoms.

Reporting Requirements:

The following information, outcomes and/or indicators are required for each Outreach for Increasing

Recognition of Early Signs of Mental Illness Program:

1. Unduplicated numbers of individuals served, including demographic data.

2. The number of potential responders engaged.

3. The setting(s) in which the potential responders were engaged.

a. Settings providing opportunities to identify early signs of mental illness include, but are not

limited to, family resource centers, senior centers, schools, cultural organizations, churches,

faith-based organizations, primary health care, recreation centers, libraries, public transit

facilities, support groups, law enforcement departments, residences, shelters, and clinics.

4. The type(s) of potential responders engaged in each setting (e.g. nurses, principles, parents).

5. If known, the number of individuals with serious mental illness referred to treatment and the kind

of treatment the individual was referred to.

6. If known, the number of individuals who followed through on the referral and engaged in

treatment.

a. If known, the average duration of untreated mental illness.

b. If known, the interval between the referral and participation in treatment.

7. Completion of Quarterly and Annual Reports.

8. Implementation challenges, successes, lessons learned, and relevant examples.

9. Any other outcomes and indicators identified.

Community Education Project

In previous plans and updates this Project was called the Community Education and Parenting Classes

Project. This project has been restructured to allow for a wider breadth of education to be implemented

in the El Dorado County.

The Community Education Project utilizes established models, curriculum and practices developed to

prompt positive mental health and wellbeing. The project is to support unserved and underserved

populations, individuals at higher risk of mental illness and their families.

Community Education Project Goals:

• Increase community wide understanding of mental illness, its causes and treatments.

• Reduction of stigma and discrimination associated with mental illness.

Community Education Project Outcome Measures:

• Measurement 1 – Number of individuals enrolled in classes.

• Measurement 2 – Participant Survey

⁞ Parenting Classes Program

The Parenting Classes Program is an outreach opportunity that incorporates a set of comprehensive,

multi-faceted, and developmentally-based curricula targeting parents whose children (ages two [2] to 12)

would benefit from the parent involvement in these classes. These programs address the role of multiple

interacting risk and protective factors and provide training to parents and caregivers of children and youth

with behavioral difficulties at school and/or home.

Update: Contract with Summitview Child and Family Services pending. Anticipated implementation in late

2024.

Parenting Classes Project Goals:

• Improvement in the caregiver-child relationship.

• Reduction in problematic behaviors at home, in school, and in the community.

• Reduction in dollars spent on mental health services, special education, and criminal justice

involvement.

Parenting Classes Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – Pre and post Conners Comprehensive Behavior Rating Scales (CBRS)

assessment.

• Measurement 2 – Post course participant surveys.

Providers: El Dorado County staff, Social Services Division/Child Welfare Services program, Summitview

Child and Family Services and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

⁞ Whole Family Wellness Program – Pilot Program

The Whole Family Wellness Program is a pilot program with Shingle Springs Health and Wellness,

providing educational opportunities for family members of clients receiving Mental Health or Substance

Use services. These client services are not funded through MHSA. Education opportunities utilize the

Medicine Wheel practices and principals with the goal of addressing inner generational trauma and

improve collaboration with western mental health practices. This provides increased focus on addressing

disparities for underserved populations.

Update: Services were not available in the first half of FY 23/24. Contract for services is still in process with

anticipated execution in early 2024.

Whole Family Wellness Project Goals:

• Reduce stigma of care for clients struggling with mental health and substance abuse issues, by

offering services to the entire family.

• Provide a multi-services approach to decrease the need for a higher level of care for clients.

• Reduce generational drug use and misuse by including the family in the process of recovery.

Whole Family Wellness Project Outcome Measures:

• Measurement 1 – Pre, post and mid-term progress surveys.

• Measurement 2 – Number of parent coaching meeting attendees.

Community Education Project Budget

Provider: Shingle Springs Health and Wellness.

Peer Partner Project

The Peer Partner Project is an outreach project that uses a model of parent partners and youth advocates

(collectively “peer partners”) who have prior personal participation in Child Welfare Services. Peer

partners offer their own personal experiences and advocacy skills to support youth and families and

services are designed to not only enhance service delivery, but to provide a continuum of care and to

share organizational knowledge and resources with the common goal of engaging families and promoting

the safety and well-being of at-risk children and families.

The Youth Advocate services are funded through the PEI component and the Parent Partner services are

funded through the CSS component.

Peer Partner Project Goals:

• Engage youth and parents more fully in the child welfare case planning and services process.

• Provide informal supports to families by providing linkage to community resources that will

support the efficacy of the family system.

Estimated Number of Individuals to be Served: 300

Estimated Cost Per Person: $730

• Empower families to make changes to address trauma and hardship, to keep families healthy,

safe, and together.

Peer Partner Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI Program type, the following

measurements will be evaluated:

Parent Partner Outcomes

• Measurement 1 – Increased family reunification rates.

• Measurement 2 – Increased family maintenance and stability rates.

• Measurement 3 – Improved child’s safety as it relates to addressing child abuse and maltreatment

risk factors. Children/youth will be safe and will not experience violence, abuse, and/or neglect.

• Measurement 4 – Increased overall well-being in the child and family functioning.

Youth Advocate Outcomes Measures:

• Measurement 1 – A reduction in seven-day notices.

• Measurement 2 – An improvement in foster care placement stability.

• Measurement 3 – Behavior tracking shows a decrease in maladaptive behavior.

• Measurement 4 – Behavior tracking shows an increase in strengths.

• Measurement 5 – Increase in discharges to permanency.

Parent Partner Budget

Youth Advocate Budget

Provider: Stanford Sierra Youth & Family and/or other provider(s) will be selected in compliance with the

County’s Procurement Policy.

Mentoring for Youth Project

The Mentoring for Youth Project pairs mentors with at-risk children and youth, countywide. The provider

recruits, screens, and trains adults and older adults to mentor at-risk, unserved, and underserved children

and youth. Each individual match is case managed by the provider’s staff. A case plan is developed with

the parent, teacher, and mentor to target activities that meet the child’s individual needs. This project

reduces parental stress and increases parent-child interaction as well as parent-teacher interaction. The

mentor teaches coping mechanisms to deal with day-to-day stressors and any mental health symptoms.

Mentoring for Youth Project Goals:

Estimated Number of Individuals to be Served: 100

Estimated Cost Per Person (Parent Partner): $5,000

Estimated Cost Per Person (Youth Advocate): $3,200

• Determine if child or family has organically or environmentally induced mental illness concerns

and develop a case plan for the child.

• Conduct parent workshops.

• Through skill building activities, mentors will develop coping mechanisms with the child.

• Through education and training, mentors will normalize mental health conditions, helping to

reduce stigma.

• Mentors will reduce the effects of parental mental health issues affecting the ch8ild.

• Children will utilize the skills learned to increase social and emotional development, increase

academic performance, and increase socialization skills in school and in public.

Mentoring for Youth Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Child Intake and case management – Contractor will assess child and family whenever possible,

for program effectiveness.

• Volunteer Enrollment – Contractor will assess potential volunteers for acceptance into the

program.

• Child Assessment – Contractor will use completed pre-match and annual behavior evaluations

and monthly volunteer match support of all enrolled children.

• Contractor will administer the Big Brothers, Big Sisters pre and end of school year surveys, such

as the “Start Early” interactive survey to enrolled children.

• Contractor will administer the Big Brothers Big Sisters “Strength of Relationship” survey to

volunteer mentors.

• Contractor shall provide testimonials, as appropriate from parents, mentors and children.

Mentoring for Youth Project Budget

Provider: Big Brothers Big Sisters and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Estimated Number of Individuals to be Served: 96

Estimated Cost Per Person: $1,000

Access and Linkage to Treatment Programs

Access and Linkage to Treatment Programs are projects that include activities to connect children, adults,

and older adults with mental illness, as early in the onset of these conditions as practical, to medically

necessary care and treatment.

Reporting Requirements:

The following information, outcomes, and/or indicators are required for each Access and Linkage to

Treatment Program:

1. Unduplicated numbers of individuals served, including demographic data.

2. If known, the number of individuals with serious mental illness referred to treatment referrals

and the kind of treatment to which the individual was referred to.

3. If known, the number of individuals who followed through on the referral and engaged in

treatment.

a. If known, the average duration of untreated mental illness.

b. If known, the interval between the referral and participation in treatment.

4. Completion of Quarterly and Annual Reports.

5. Implementation challenges, successes, lessons learned, and relevant examples.

6. Any other outcomes or indicators identified.

Project Access Community Outreach Initiative

The Project Access Community Outreach initiative addresses existing documented challenges with service

engagement and linkage for Behavioral Health, where El Dorado County experiences high levels of

contacts where clients have only one service and are not successfully engaged into ongoing supportive

treatment. The limitations of office based intake are broadly experienced as challenging for community

partners and potential Behavioral Health clients alike, and repeated requests have come in to take

advantage of the opportunities presented by CalAIM related to lowering barriers to accessing treatment

services. El Dorado County Behavioral Health is committed to improving this aspect of care and are seeking

to expand engagement and linkage through additional responsive, mobile, community-wide points of

contact.

Project Access will create dedicated community health engagement positions to link individuals with

identified Behavioral Health and supportive service needs to the integrated service models provided by El

Dorado Health and Human Services Agency. These community health engagement staff will actively

engage throughout the community . Initial outreach, follow up, and warm handoff to the appropriate

services to stabilize, support, and connect individuals to appropriate care will be delivered in a

comprehensive, culturally responsive, holistic manner to ensure that critical needs are met.

Update: This project was included in the FY 23/24 Plan Amendment approved by the Board of Supervisor

on February 27, 2024. The Amendment addressed the limitations of office-based intake systems and

documented challenges of engaging clients experiencing greater barriers to access through the current

system. Project Access will create dedicated community health engagement positions to link individuals

with identified Behavioral Health and supportive service needs to the integrated service models provided

by El Dorado Health and Human Services Agency.

Project Access Goals:

• Expand community outreach capacity for Behavioral Health system of care.

• Lower barriers to engagement and increase successful linkage for hard to engage clients.

• Serve as points of contact for identified areas of need, providing responsive service to the

community.

• Provide initial contact and follow up care to encourage and support client engagement.

• Link individuals to resources available through the integrated Health and Human Services Agency,

including public assistance, housing services, and other related resources

Project Access Outcome Measures:

• Measurement 1 – Number of remote access services provided utilizing a mobile office or

alternative access site.

• Measurement 2 – Number of persons who are linked to County Behavioral Health services.

Project Access Budget

Providers: El Dorado County staff, and/or other provider(s) who will be selected in compliance with the

County’s Procurement Policy.

Community-based Outreach and Linkage Project

The Community-based Outreach and Linkage Project is an access and linkage to treatment program in

which County staff and/or contracted providers will work closely with primary care providers, hospitals,

Public Health Nurses, community-based organizations, law enforcement, caring friends and family, and

individuals in need of services to determine the appropriate referrals for individuals and families, and to

work closely with those individuals and families in establishing services. Resource identification may

include, but not be limited to, identifying service providers, support groups, housing options, and

providing transportation. The program will utilize mobile services to the extent possible.

Update: This project was included in the FY 23/24 Plan Amendment approved by the Board of Supervisor

on February 27, 2024. The Amendment addressed mandated State requirements set forth in Behavioral

Health Information Notice (BHIN) 23-025 requiring all counties to implement 24/7 Medi-Cal Community-

Based Mobile Crisis Intervention Services.

Community-based Outreach and Linkage Project Goals:

• Raise awareness about mental health issues and community services available.

• Improve community health and wellness through local services.

• Improve access to medically necessary care and treatment.

Estimated Number of Individuals to be Served: 1,000

Estimated Cost Per Person: $500

Community-based Outreach and Linkage Outcome Measures:

This project will utilize the required outcomes and indicators for Access and Linkage to Treatment

Programs.

Provider: El Dorado County staff and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

⁞ Psychiatric Emergency Response Team (PERT) Project

The PERT Project is a collaboration between the El Dorado County Sheriff’s Office and Behavioral Health.

Clinicians are partnered with a Crisis Intervention Trained Deputy to provide direct mobile crisis response

services. PERT shifts and shift locations are determined by thorough analysis of the peak days and hours

of crisis calls. Shifts may change as dictated by data.

The PERT Team carefully evaluates each situation, assesses the mental health status of each individual,

and provides individualized interventions in the field, which may include, but are not limited to, safety

planning, referral to community-based resources, and crisis intervention. The PERT team also provides

follow-up services to individuals in need of PERT crisis intervention to provide stabilization and linkage to

services. This will help reduce any barriers to accessing Behavioral Health Services.

MHSA funds Behavioral Health Clinician(s) and one Sheriff Deputy position. In order to meet emerging

mandates related to El Dorado County providing 24 hour per day, 7 day per week mobile crisis services

these resources will be expanded and serve as the cornerstone for the integrated mobile crisis team.

PERT Project Goals:

• Raise awareness about mental health issues and community services available.

• Improve community mental health and wellness as a result of community-based PERT services.

• Community members will have increased community-based access to and linkage with medically

necessary care and treatment.

• Provide mobile crisis as a resource to individuals requiring Behavioral Health emergency response.

PERT Outcome Measures:

In addition to the required outcomes and indicators identified for each PEI program type, the following

measurements will be evaluated:

• Measurement 1 – PERT shall report on the number of Welfare and Institutions Code section 5150

holds written at the time of contact by PERT members.

⁞ Mobile Crisis Unit:

El Dorado County is responsible to provide 24 hour per day, 7 day per week mobile response to community

Behavioral Health crises, and has been developing strategies and resources for this capacity through a

state Crisis Care Mobile Unit (CCMU) infrastructure grant. Starting in 2024, mobile crisis teams developed

around the existing successes of the PERT Project, will begin deploying. These Mobile Crisis Teams

collaborate with law enforcement to provide crisis-related outreach and engagement, as well as respond

to 911 requests regarding possible psychiatric or emotional crisis in the community. The Mobile Crisis

Teams operate with the goal of reducing the use of involuntary psychiatric hospitalization by providing

consultation, crisis assessment, and engagement of the individual in need. They seek alternative

treatment resources, when appropriate, including referrals to voluntary psychiatric services as available.

The Mobile Crisis Teams are composed of formally trained counselors and peer specialists that partner

together on calls and connect with individuals in crisis on both a therapeutic and personal level. Peer

specialists may also provide follow up calls to consumers after a crisis to assist in providing resources and

support with follow through and engagement with services. This program will seamlessly integrate with

the existing PERT Project partnership that has been established with law enforcement both in South Lake

Tahoe and on the western slope of El Dorado County.

Mobile Crisis Unit Goals:

• Respond in a timely manner to crisis calls that include persons with mental health and/or

substance use crisis needs.

• Coordinate with law enforcement partner agencies to meet community needs, and when

appropriate reduce the amount of time law enforcement spends at the crisis.

• Respond in partnership with law enforcement, or when appropriate without law enforcement, to

meet community crisis needs.

• Provide follow up services after a crisis to ensure that individuals are receiving necessary services.

• Provide supportive services to family members during the crisis, and as possible following the

crisis response.

Mobile Crisis Unit Outcome Measures:

• Number of persons who receive a response from the mobile crisis unit.

• Number of individuals who receive a follow up service.

• Number of persons who are linked to ongoing services that receive a response from the mobile

crisis unit.

• Number of family members who receive support from mobile crisis as a follow up service.

• Number of persons with a crisis who do not have another crisis within six months.

• Number of PERT/Mobile Crisis responses with law enforcement and number where a non-tandem

response was made.

Community-based Outreach and Linkage Project Budget

Provider: El Dorado County staff and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Veterans Outreach Project

The Veterans Outreach Project is aimed at helping Veterans and their immediate family members who

may be in need of behavioral health services. This population was again identified as an underserved

group in the CPPP.

Estimated Number of Individuals to be Served: 500

Estimated Cost Per Person: $1,750

Services provided may include but are not limited to, outreach and case management services to Veterans

and their families, particularly those who are homeless or involved in the criminal justice system. Services

also include linkage to resources such as behavioral health, physical health services, housing assistance,

and other supportive services.

Veterans Outreach Project Goals:

• Provide outreach and linkage services to approximately 100 Veterans and their immediately

family members.

• Provide a point of entry for homeless Veterans to connect to and receive services.

• Assist Veterans with housing and reduce the number of homeless Veterans in El Dorado County.

Veterans Outreach Outcome Measures:

This project will utilize the required outcomes and indicators identified for Access and Linkage to

Treatment Programs.

Veterans Outreach Project Budget

Provider: Only Kindness and/or other provider(s) will be selected in compliance with the County’s

Procurement Policy.

Estimated Number of Individuals to be Served: 125

Estimated Cost Per Person: $1,380

Suicide Prevention and Stigma Reduction Programs

The Suicide Prevention and Stigma Reduction Program provides education and supportive services

regarding suicide prevention, intervention and postvention.

Reporting Requirements:

The following information, outcomes, and/or indicators are required for the Suicide Prevention and

Stigma Reduction project:

1. Use a validated method to measure changes in attitudes, knowledge, and/or behavior related to

mental illness.

2. Use a validated method to measure changes in attitudes, knowledge, and/or behavior related to

seeking mental health services.

3. Completion of Quarterly and Annual Reports.

4. Implementation challenges, successes, lessons learned, and relevant examples.

5. Any other outcomes identified.

Suicide Prevention and Stigma Reduction Project

The Suicide Prevention and Stigma Reduction Project endeavors to increase awareness of mental illness,

as well as awareness of mental health programs and resources, while employing strategies to increase

linkage to mental health resources. Services may include, but are not limited to, providing suicide

prevention awareness campaigns, workshops, trainings to the public, youth events, development of

suicide prevention plans, and wellness fairs. Additionally, services may include distribution of suicide

prevention resources and materials, and referrals to resources.

Youth Suicide Reporting and Crisis Response Pilot Program Grant Funding

The California Department of Public Health (CDPH) launched the Youth Suicide Reporting and Crisis

Response Pilot Program to develop and test models for making youth suicide and attempted suicide

reportable events. The pilot will also support models for rapidly and comprehensively responding to these

events by providing crisis services and follow-up support in school and community settings. El Dorado is

one of 10 counties to receive funding for this Public Health/Behavioral Health collaborative initiative.

⁞ Suicide Prevention Strategic Plan

On July 19, 2022 the Board of Supervisors approved the Fiscal Year 2022-2023 Suicide Prevention Strategic

Plan. The plan includes suicide prevention research and reporting as well as four (4) comprehensive

strategies to implement within El Dorado County. The strategies are:

1. Establish a framework to provide leadership, oversight, and accountability for the Suicide

Prevention Strategic Plan

2. Prevention: Develop a collaborative, coordinated system to promote suicide prevention,

education, and wellness

3. Intervention: Develop a collaborative, coordinated system to provide treatment and support for

those struggling with suicidal behavior or after a suicide attempt

4. Postvention: Develop a collaborative, coordinated system to promote healing and hope for a

better tomorrow after a suicide loss

Update: Prior to FY 23/24 a Request for Qualifications identified a single qualified vendor for this project.

After initial conversations with the selected provider it was agreed that they would not be able to

implement the full scope of this project. Alternative opportunities continue to be considered including how

to address goals in this project with the onset of Youth Suicide Reporting and Crisis Response Pilot Program

Grant Funding.

Suicide Prevention Strategic Plan Goals:

• Reduce the five-year average number of deaths due to Suicide in El dorado county by twenty

percent (20%) by 2027.

• Establish a suicide prevention infrastructure to advance and sustain suicide prevention efforts.

• Increase community awareness of suicide prevention and where to go for help or to learn more.

• Enhance early identification of suicide risk and connections to and between effective services and

supports.

• Share positive messages of hope and recovery so that more people in need of support will reach

out for help.

• Promote hope and healing for those who are impacted by a suicide loss or recovering after a

suicide attempt.

Suicide Prevention Strategic Plan Outcome Measures:

• Measurement 1 - This project shall use a validated method to measure changes in attitudes,

knowledge, and/or behavior regarding suicide related to mental health disorders

• Measurement 2 - Suicide-related data including deaths and attempts

⁞ Community Funding Assistance

This project will support Community Funding Assistance opportunities which will provide funding to

individuals or entities seeking to advertise, market or otherwise promote Suicide Prevention in El Dorado

County. A formal application and award process will be developed in FY 23/24. Award recipients may

receive up to $10,000. Technical Assistance may also be available through CalMHSA Striving for Zero

campaign. The number of award recipients may vary.

Update: Development of an application and funding process for the Community Funding Assistance

program within the Suicide Prevention and Stigma Reduction Project is in process. Application

announcement is anticipated early in FY 24/25 with funding available to awarded applicants available

soon after.

Suicide Prevention and Stigma Reduction Project Goals:

• Increase awareness of mental illness, programs, resources, and strategies.

• Increase linkage to mental health resources.

• Implement activities that are designed to attempt to reduce the number of attempted and

completed suicides in El Dorado County.

• Change negative attitudes and perceptions about seeking mental health services.

• Increase access to mental health resources to support individuals and families.

Suicide Prevention and Stigma Reduction Outcome Measures:

This project will utilize the required outcomes and indicators for the Suicide Prevention and Stigma

Reduction Programs.

Suicde Prevention and Stigma Reduction Project Budget

Provider: Provider(s) will be selected in compliance with the County’s Procurement Policy.

PEI Administration

County staff will be utilized to perform administrative activities (e.g., contracting and accounting),

program analysis, and quality assurance/improvement activities related to this Component.

Estimated Number of Individuals to be Served: Indirect Services

Estimated Cost Per Person: N/A

Innovation (INN)

The Innovation component consists of projects that are designed to contribute to learning, rather than a

primary focus on providing a service. By providing the opportunity to “try out” new approaches that can

inform current and future practices/approaches in communities, an Innovation project contributes to

learning. Innovation plans must be approved by the MHSOAC prior to the expenditure of funds in this

component.

Innovation projects must address one of the following as its primary purpose:

1. Increase access to mental health services to underserved groups.

2. Increase the quality of mental health services, including measurable outcomes.

3. Promote interagency and community collaboration related to mental health services or supports

or outcomes.

4. Increase access to mental health services, including, but not limited to, services provided through

permanent supportive housing.

Innovation projects also must support innovative approaches by doing one of the following:

1. Introduce a new mental health practice or approach.

2. Make a change to an existing mental health practice or approach.

3. Introduce a new application to the mental health system that has been successful in non-mental

health contexts or settings.

4. Participate in a housing program designed to stabilize a person’s living situation while also

providing supportive services on-site.

Existing Innovation Projects

Projects under this section have complete the MHSOAC approval process and may be at varying stages of

implementation.

Partnership Between Senior Nutrition and Behavioral Health to Reach Home-bound Older

Adults in Need of Mental Health Services Project:

Efforts to implement this project prior to the September 30, 2023 MHSOAC approved end date were

unsuccessful due to continued staff vacancies. See Limitations and Challenges on page 34.

INNOVATION

Proposed INN Projects

Projects under this section have been proposed through the CPPP and are at various stages of

development including projects pending MHSOAC approval.

Update: As of the writing of this Annual Update the projects in this section have not been brought before

the MHSOAC for and remain proposed projects into FY 24/25 until their approval.

Nature Therapy for Youth Project:

The Nature Therapy for Youth Project will utilize nature therapy techniques as a means to lower stress

and increase connectedness for El Dorado County youth. This concept was presented in the FY 23/24 CPPP

and supported by 82.6% of survey respondents with 14.5% wanting more information. Nature Therapy is

not in itself innovative with numerous programs, providers and services models in use around the world.

This project concept was presented with the understanding that it would focus on a specific subset of the

youth population that was yet to be determined at the start of the CPPP.

On September 6, 2022 the Mosquito Fire ignited near the northern edge of the county and began moving

rapidly west through the Middle Fork of the American River Canyon towards the towns of Volcanoville

and Foresthill. This immediately set residents across the county on edge because one year earlier the

Caldor Fire burned 221,835 acres, destroyed over 1,000 homes and saw over 40,000 residents evacuated

from their homes for weeks at a time. Behavioral Health staff were present at Mosquito Fire evacuation

centers to support evacuees all while staff continued to assist in the Caldor Fire recovery efforts for

residents continuing to build back their life after such a trauma. In the end the Mosquito Fire burned

76,788 acres and took a month and a half to be fully contained. In total approximately 26% of El Dorado

County burned in these two substantial fires in just barely over one year’s time.

Through the CPPP community meetings it was proposed that the youth of El Dorado County impacted by

wildfire could be a worthy subset of the population to explore the impacts of Nature Therapy. Staff agreed,

recognizing the opportunity to explore if reconnecting with nature minimized behavioral health needs in

these youth.

With origins dating back to the 16

century there are numerous evidence-based practices and service

models, so for this project we recognize it is imperative to have a thorough planning phase prior to

implementation.

Phase I: Planning

Modern Nature Therapy professionals most commonly have completed degrees in Recreation Therapy.

As such, we have connected with Recreation Therapy Faculty at the California State University,

Sacramento Recreation, Parks and Tourism Administration Department. We intend to partner with the

students and faculty of this department in a comprehensive planning phase for this project.

Early in FY 24/25 Behavioral Health staff will submit an Innovative Project Plan to the MHSOAC to gain

approval for the Nature Therapy for Youth Planning Phase. After approval is gained, innovation funds will

be utilized to research relevant literature and identify which Nature Therapy models would be best suited

for youth impacted by wildfire. County staff, university faculty and student scholars will together develop

the Innovative Project Plan for phase two of this project. The planning phase of this project will be no

more than one year duration.

Provider: El Dorado County staff and/or other provider(s) who will be selected in compliance with the

County’s Procurement Policy.

Phase II: Implementation

Towards the end of FY 24/25 Behavioral Health staff in collaboration with university faculty and student

scholars will submit the implementation plan to the MHSOAC to gain approval with the intention to fully

implement programming and data collection in early FY 25/26. The duration of time for the

implementation phase of this project will be dependent on the models chosen.

Provider: Provider(s) will be selected in compliance with the County’s Procurement Policy.

Nature Therapy for Youth Project Budget

In-Clinic Certified Therapeutic Recreation Specialist Project

As described in the Limitations and Challenges section of this MHSA Plan, El Dorado County Behavioral

Health has felt the full effect of the nationwide behavioral health staffing shortage. Staff have remained

dedicated to required and essential services leaving little time for expanding opportunities.

The Outdoor Recreation Therapy Project was presented during the CPPP. This concept was supported by

73.7% of survey respondents with 18.2% wanting more information. Through stakeholder input it was

recognized that this concept could be expanded to include other Recreation Therapy options. Through

CPPP community meeting discussions and stakeholder meeting input, the concept evolved into the In-

Clinic Certified Therapeutic Recreation Specialist Project as an opportunity to explore the impacts of

alternatively trained therapists in a behavioral health setting. This project seeks to explore if employing a

Certified Therapeutic Recreation Specialist (CTRS) in the County Behavioral Health Clinic will alleviate any

of the challenges experienced due to the staffing shortage.

CTRS are certified by the National Council for Therapeutic Recreation Certification which was established

in 1981. The certification establishes eligibility requirements including completion of a 90 credit hour

bachelor’s degree with specified course requirements, minimum of 560-hours, 14-week internship using

therapeutic recreation processes while being supervised by a CTRS and finally receiving a passing score

on the certification exam. The certification must be renewed every five years with an annual

“Maintenance Application” requirement to remain certified.

Phase I: Planning

As with the Nature Therapy for Youth Project described above, El Dorado County Behavioral Health seeks

to partner with the California State University, Sacramento Recreation, Parks and Tourism Administration

Department, Recreation Therapy Faculty as the local experts in CTRS.

In FY 24/25 Behavioral Health staff will submit an Innovative Project Plan to the MHSOAC to gain approval

for the In-Clinic Certified Therapeutic Recreation Specialist Planning Phase. After approval is gained,

innovation funds will be utilized to develop a job description, job requirements and hiring questions

specific to a CTRS as well as the scope of services for the employee including required data reporting for

this INN Project.

Through the Planning Phase, if Behavioral Health does not receive approval for a new position/job

allocation this project may be contracted to an external provider. The planning phase of this project will

be no more than one year duration.

100

Provider: El Dorado County staff and/or other provider(s) who will be selected in compliance with the

County’s Procurement Policy.

Phase II: Implementation

Towards the end of FY 24/25 Behavioral Health staff in collaboration with university faculty and student

scholars will submit the implementation plan to the MHSOAC to gain approval with the intention to fully

implement programming and data collection in early FY 25/26. The duration of time for the

implementation phase of this project will be dependent information identified in the Planning Phase.

Provider: Provider(s) will be selected in compliance with the County’s Procurement Policy.

In-Clinic Certified Therapeutic Recreation Specialist Project Budget

101

INN Concepts

This section seeks to inform community members of projects being considered and gain additional

feedback on concepts proposed during the CPP Process. We welcome ideas to expand these concepts,

clarifying questions, general feedback or concerns related to any of the concepts listed below.

Concept title

Description

THE MIND, THE BODY

AND THE GUT PROJECT

Explore the connection between mental health, physical health and the

foods we eat as a path towards a healthier community (a subset of the

population has yet to be identified for this project) This project was

supported by 72.4% of survey respondents with 15.7% wanting more

information.

Housing and homelessness issues continue to be a prominent need based on

FY 23/24 and previous MHSA CPPP surveys. We continue to seek a housing

related Innovation Projects to support the recognized need in the

community.

To propose additional INN Concepts please provide a working title and a brief description by emailing

[email protected]. Proposed projects that meet the MHSOAC criteria for funding under this component

may be included in future versions of the MHSA Plan and subsequent Annual Updates for future

consideration.

Existing MHSOAC Collaborative Projects

Data Driven Recovery Project – Cohort 2 (MHSOAC Multi- County Collaborative)

Funds of $50,000 were received by El Dorado County in May 2023 to conclude this project.

Proposed MHSOAC Collaborative Projects

Crisis Now Multi-County Collaborative

Crisis response systems are critical infrastructure for local agencies serving individuals with serious mental

health needs. Effective systems can improve outcomes for individuals while reducing avoidable law

enforcement involvement and preventing incarceration. Many counties, however, particularly smaller,

and more rural counties, are challenged to develop and sustain comprehensive crisis response systems.

The National Action Alliance for Suicide Prevention in 2016 produced Crisis Now: Transforming Services is

Within our Reach, which documented a proven strategy to crisis response with four core elements:

1. High-tech crisis Call Centers that coordinate all aspects of an immediate crisis response.

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2. Mobile Crisis Outreach Teams that work in the community with those at risk and reduce the need

for uniformed officers to provide mental health triage in the streets.

3. Facility-based Crisis Centers that divert away from hospital emergency departments and provide

crisis-specific interventions in safe and secure environments; and

4. Commitment to evidenced-based safe care practices, such as Trauma-Informed Care, Zero Suicide

in Healthcare principles, and a multidisciplinary approach to crisis resolution.

The Crisis Now model enables counties to assess community needs, enhance access to care and realize

overall cost savings. The Crisis Now model is endorsed by the National Association of State Mental Health

Program Directors and Crisis Intervention Team International.

Early Psychosis Learning Healthcare Network

California currently has 30 active programs providing Early Psychosis (EP) services across 26 counties.

However, there is no uniformity across the state in EP service implementation: treatment models and

outcomes measurement differ county by county. To address this challenge, this project aims to make an

innovative change to an existing practice in the field of mental health that will increase the quality of

services, including measurable outcomes. The project will create a unified network of CA early psychosis

programs to standardize practice and support knowledge-sharing, harmonize EP evaluation across core

outcomes to enable large scale evaluation and program development, and achieve measurement-based

care via EP-focused technology platform, enabling participation for consumers and families. Los Angeles,

San Diego, Orange, Solano, and Napa Counties, in collaboration with the UC Davis Behavioral Health

Center of Excellence, UCSF and UCSD, have signed on to develop the infrastructure for a sustainable

learning health care network for EP programs. This infrastructure will enable us to bring consumer-level

data across a variety of recovery-oriented measures to clinician’s fingertips and empower consumers to

use their own data in care decisions. This project will also allow programs to learn from each other through

a training and technical assistance collaborative and position the state to participate in the development

of a national network to inform and improve care for individuals with early psychosis across the US.

Collaboration from counties across the state will allow for development of a sustainable learning health

care network for California’s EP programs, allowing consumers, families, and the state to benefit from

data and improve the quality of services across diverse communities.

Psychiatric Advance Directives

People with mental health needs, at times, may not be able to have a collaborative interaction with service

providers or emergency personnel, such as law enforcement, especially if the person is in crisis. Behavior

exhibited by a person in crisis may draw the attention of law enforcement, thereby initiating a path into

the criminal justice system.

Practices that establish care directed by the person with mental health needs before a crisis show promise

in preventing disruption of community-based services. The use of psychiatric advance directives is one

method to explore using innovative funding to expand the tools available to local behavioral health

departments.

The overarching goal of this project is for participating Counties to work in partnership with various

contractors, stakeholders, peers with lived experience, consumers, and advocacy groups to provide

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resources relative to PADs training and a toolkit, as well as create a standardized PAD template and a PADs

technology-based platform to be utilized voluntarily by participating Counties.

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Workforce Education and Training (WET)

The Workforce Education and Training (WET) component includes education and training projects and

activities for prospective and current public behavioral health system employees, contractors, and

volunteers. WET provides funding to remedy the shortage of staff available to address mental illness and

substance use, improve the competency of staff, and to promote the employability of consumers.

As part of all WET projects, prepared food (including, but not limited to snacks, lunch, and beverages) may

be purchased through MHSA funds and provided at WET trainings. WET funds are also utilized for

registration fees, travel costs, trainer costs/fees, and all other costs related to the provision of or

attendance at training.

New MHSA funds are not allocated to WET component, however there is continued support for well-

trained mental health staff. Therefore, to ensure continued availability of trainings for the public

behavioral health system, funds shall be transferred from CSS to WET annually on an “as-needed” basis

to cover the costs of trainings scheduled for each fiscal year. Please see the “Expenditure Plan” and the

“FY 2020/21 Budget” section for more details.

WET Project Goals:

• Improve the quality of services.

• Reduce negative encounters and events.

• Create a community of hope, wellness, and recovery.

• Promote organizational wellness.

WET Outcome Measures:

• Measurement 1 – Number of training opportunities for the public behavioral health system

workforce, including staff, contractors, volunteers, and consumers.

• Measurement 2 – Number of bilingual/bicultural public behavioral health workforce system staff

in the County.

WET Coordinator

The WET Coordinator, as required by the MHSA, coordinates WET projects and activities, serves as the

liaison to the State, provides leadership for the implementation of the locally identified WET funding

priorities, develops goals of the workforce development project, and identifies career enhancement

opportunities.

Workforce Development Project

The Workforce Development project provides for various trainings to be brought to the County or for

members of the public behavioral health system to attend trainings in or out of the County. The trainings

are designed to improve direct behavioral health services (e.g., DBT, Motivational Interviewing, trauma-

informed approaches, other evidence-based, community-accepted, or promising practices models), and

non-direct treatment (e.g., raising awareness of early signs of mental illness, compliance, governance,

legal updates) available in the County.

WORKFORCE EDUCATION AND

TRAINING (WET)

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The following topics were identified during the CPPP as important to addressing the needs of our

community and will be a primary focus of this project. However, other topics that benefit the public

behavioral health system will also be funded through this project.

⁞ High Fidelity Wraparound Training

Wraparound principles include individualized plans, strength-based interventions, outcome-based

strategies, family voice and choice, team-based decision making, use of natural supports, collaboration,

community-based services, and cultural competence. Essentially, clients are “wrapped” around services

that shall build upon the strengths of each eligible client and shall be tailored to address their unique and

changing needs. Bringing this training to El Dorado County will help ensure children and youth receive the

highest level of care.

⁞ Early Identification of Behavioral Health Concerns Training

The Early Identification of Behavioral Health Concerns Training is primarily focused on assisting School

Resource Officers and others who work directly with youth to better identify and respond to students

who may have a mental health need emerging in the early stages. The training is intended to develop

critical skills and build the capacity for appropriately responding to behavioral health issues.

⁞ Annual Provider Conference

Beginning in summer of 2023 El Dorado County MHSA will host a provider conference as the kickoff to the

next CPPP.

In years that an Annual Update is being developed the Conference will be available to providers who

currently hold contracts (or have pending contracts) with the County. Training and networking

opportunities will be facilitated by subject matter experts to increase the collective knowledge throughout

the El Dorado County system of care as well as to support contracted providers with maintaining

compliance with the administration of their contract terms.

In years that a new Three Year Plan is being developed the Conference will be available to all behavioral

health service providers, advocacy groups and other collaborative partners. This Conference will also

provide training and networking opportunities and in addition will also serve as a Pre-Submittal

Conference for prospective providers wishing to submit to future MHSA Request for Qualifications (RFQ)

or Request for Proposals (RFP).

Conference registration costs may be considered as needed.

WET Coordinator Project Budget

Recruitment and Retention Project

Over the course of the pandemic, the need for behavioral health services has increased steadily while at

the same time clinical staff have left the profession at a higher rate than ever before. This is being

experienced by public, non-profit and private sector entities nationwide and has led to a critical staffing

shortage of which El Dorado County is not immune. Currently long-term options to address this are being

enacted at the State and Federal levels including expanding opportunities for tuition assistance

for

California Department of Health Care Access and Information (HCAI) Loan Repayments, Scholarships & Grants

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college bound individuals intending to enter the Behavioral Health field of study, while short term options

like adapting recruitment and retention efforts have already taken place at the County level.

With numerous vacancies some of which going on over a year unable to be filled, the County has explored

strategies to maintain and expand its current workforce. This project may include funding for additional

marketing and advertising initiatives to promote county Behavioral Health employment opportunities.

⁞ Behavioral Health Staff License and Certification Reimbursement

In the FY 2022/23 Annual Update additional funding was approved under the Workforce Development

Project to cover the cost for current County Behavioral Health staff licenses, certifications, examinations,

and associated costs required for their positions. This was identified as an early implementation retention

strategy. With the addition of the Recruitment and Retention Project, this funding allocation is being

shifted to this new project.

⁞ Hiring Incentives

In order to remain a competitive employer in the Behavioral Health field, in accordance with County

Human Resources Department, MHSA may fund hiring incentives at the time of employment for positions

identified as hard to fill.

⁞ Educational Funding

County staff continue to explore opportunities for MHSA to provide educational funding allowable by WET

Regulations

. As of the writing of this MHSA Plan, no such opportunity is available through El Dorado

County MHSA, however, if funding allows within the Recruitment and Retention Project, MHSA funding

may be used for loan assumption

or stipends

Non-MHSA Funded Educational Assistance

An informational resource list is available for County Behavioral Health staff that includes opportunities

for education assistance at the county, state and federal levels not funded by MHSA. The MHSA Team is

developing a similar resource for contracted providers.

Recruitment and Retention Project Budget

Statewide WET Planning and Community Needs Assessment

⁞ Statewide WET Planning

El Dorado County participated in a focus group and completed a survey for the Department of Health Care

Access and Information (HCAI) formerly the Office of Statewide Health Planning and Development

9 CCR § 3844 Financial Incentive Programs Funding Category

Title 9 CCR § 3850. Mental Health Loan Assumption Program

Title 9 CCR § 3851. Terms of Mental Health Loan Assumption

9 CCR § 3844.1 Stipends

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(OSHPD)’s FY 2020/2025 MHSA Workforce Education and Training Five-Year Plan. The Five-Year Plan

informs the Legislature and policymakers about current and future public mental health system workforce

needs. Participating in these activities fulfills the County’s obligation pursuant to WIC § 5820(b).

In Fall 2019, HCAI began holding workgroups to further define the program descriptions for covered

activities as provided for in the FY 2020-2025 WET Plan, which includes collecting baseline workforce data,

evaluation and monitoring measures. Counties, defined by region, will be required to commit a one-third

match to HCAI’s $65 million funding in the California State Budget. It is estimated that El Dorado’s match

will be approximately $55,000, payable either in one year or over the course of the five (5) years, however

the actual amount required to be contributed by El Dorado County may change as additional

communication from HCAI is received, and any change in the actual amount required will not require a

MHSA Plan amendment or Annual Update provided the change amount is no more than 15% of the

amount identified in this Plan. This Plan allows for flexibility, including shifting funds from CSS to WET, as

the details are determined.

⁞ Community Needs Assessments

In Fall 2018, Behavioral Health/MHSA completed a survey and participated in a focus group for HCAI. The

purpose of the survey and the focus group were to provide HCAI with a WET Evaluation/Workforce Needs

Assessment Survey for development of HCAI’s five-year (5) plan. Completion of the survey fulfilled the

County’s statutory requirement that the county submit a workforce needs assessment report. However,

further evaluation of the local Workforce Needs may benefit the community should the Statewide Needs

Assessment not provide a sufficient level of detail of the County’s needs. This Community Needs

Assessment may be completed independently through MHSA, or in partnership with other community-

based or healthcare related entities. County staff or a contracted provider selected incompliance with the

County’s Procurement Policy, may be utilized to complete the project.

Statewide WET Project Budget

WET Administration

County staff and/or contracted provider(s) will be utilized to perform administrative activities (e.g.,

contracting and accounting), program analysis, and quality assurance/improvement activities related to

this Component.

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Capital Facilities and Technology Needs (CFTN)

Capital Facilities and Technology Needs (CFTN) are items necessary to support the development of an

integrated infrastructure and improve the quality and coordination of care. CFTN funds should produce

long-term impacts with lasting benefits that move the mental health system toward the goals of wellness,

recovery, resiliency, cultural competence, prevention/early intervention, and expansion of opportunities

for accessible community-based services for clients and their families. The funds shall be used in ways to

promote a reduction in disparities to underserved groups. These efforts include development of a

technological infrastructure for the mental health system to facilitate the highest quality, cost-effective

services and supports for clients and their families.

Electronic Health Record Project

The Electronic Health Record (EHR) Project enables Behavioral Health to safely and securely access a

client’s medical record and obtain valuable information to assist in evaluating services. The use of

electronic mental health records enhances communication between treating health care professionals,

thus promoting coordination of mental had physical health care needs.

Funding from this project also may be utilized to provide integration with other mental health service

providers and primary health care providers, either through license expansion for Behavioral Health’s

current electronic health record system, or through the use of add-on software. Add-on software allows

for increased communication between entities to facilitate referrals, authorizations, invoicing, and client

progress notes, amongst other benefits such as providing a better continuum of care for shared clients.

Add-on software may include, but is not limited to CareConnect, CareManager, and OrderConnect.

Funding from this project also supports equipment purchases, renewal and product support, licenses, and

maintenance necessary for County staff to perform their work from out-stationed work locations such as

hospitals and medical clinics.

This project may also include funds to install devices to aid powering EHR devices when there is a power

outage and increase access to telehealth services, for both providers and consumers, such as, but not

limited to purchase of handheld devises or kiosks. Additionally, this funding may be utilized for outcome

measure/performance management software and/or other software and hardware in support of

Behavioral Health.

This project supports funding for 2.1 Full Time Equivalent (FTE) dedicated EHR staff.

Electronic Health Record Project Budget

Provider: Netsmart (Avatar Clinical Workstation); other providers will be selected in compliance with the

County’s Procurement Policy.

Telehealth Project (includes Video Conferencing and Technology to Reduce Barriers to

Service)

The Telehealth Project provides for the expansion of mental health and psychiatric services to clients and

providers in remote areas of the county, or are unable to travel, and utilize video conferencing to further

the public mental health system within El Dorado County. The county’s large, rural geographic area makes

it difficult to provide face-to-face services in some remote areas of our county. Telehealth allows

psychiatrists and other Behavioral Health professionals to provide Specialty Mental Health Services using

CAPITAL FACILITIES AND TECHNOLOGY NEEDS (CFTN)

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video conferencing technology, allowing clients and providers to see and hear one another through a

secure network.

Video conferencing similarly allows providers to communicate effectively via video for meetings, trainings,

presentations or other topics important to the public mental health system. Behavioral Health regularly

uses a video conference system to allow staff, the public, community partners, and Behavioral Health

Commissioners to participate in interactive video conferencing meetings and trainings. The equipment

periodically needs maintenance, updates, and/or repairs and those needs are funded through the CFTN

component.

Additionally, when a client may be experiencing barriers to service (e.g., communicating with the County

Mental Health Clinic due to language barriers, including visual or hearing impairments), these funds will

be utilized to purchase technology tools to better assist with access to services and/or the provision of

services.

Equipment, installation, maintenance, repairs, updates, upgrades, and ongoing costs (e.g., monthly access

fees) is funded through this project. The actual services provided via equipment funded through this

project is provided and funded through the CSS components.

Telehealth Project Budget

Integrated Community-based Wellness Center Project

The purpose of this project is to locate and purchase a practical and suitable location for operation of an

Integrated Community-based Wellness Center facility. Project costs include associate building renovation

costs. This project will continue beyond the purchase of the location in order to maintain adequate

funding for unforeseen facility needs such as renovations or repairs. Services operated in this facility will

be funded through the Wellness and Recovery Services / Adult Wellness Center Project and/or other CSS

projects.

Integrated Community-based Wellness Center Project Budget

Update: In March 2024 a possible location has been identified. Preliminary steps towards site acquisition

are in process including analysis of renovation cost to be included in this project. This project’s funding has

been increased to accommodate the option to purchase this facility at the start of FY 24/25.

County-Wide Clinic Project

El Dorado County is geographically diverse with mountainous landscape and propensity for inclement

weather presenting a major challenge to providing services beyond the primary city centers of Placerville

and South Lake Tahoe. Through CPPP surveys and meetings, including direct stakeholder input, the need

has been identified for creative solutions to provide services to the broader expanse of the county. The

Community-Wide Clinic Project seeks to partner with El Dorado County Library Services and El Dorado

County Public Health in order to more completely provide services to all regions of the county.

In collaboration with the Community HUBs, Behavioral Health will develop a system for county staff and

contracted providers to reserve space at any of the five (5) Community HUBs locations in order to provide

mental health services described in this MHSA Plan or otherwise required of the county as the Medi-Cal

Mental Health Plan. The five (5) Community HUBs locations are:

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• Community HUB 1 - El Dorado Hills

• Community HUB 2 - Cameron Park and South County

• Community HUB 3 – Placerville

• Community HUB 4 - Georgetown Divide

• Community HUB 5 - Pollock Pines to South Lake Tahoe

Services may include but are not limited to individual counseling, support groups, and classes. Services

will be funded through the associated project and not the Community-Wide Clinic Project.

Update: Behavioral Health staff toured all EDC Library facilities to identify site improvements that would

be required as part of this project implementation. As of the writing of this Annual Update a MOU is in

development.

⁞ Mobile Office

The Behavioral Health Division purchased a van that is designed and equipped to resemble a mobile office.

The van may be used for MHSA projects and HHSA programs, including, but not limited to, Senior Legal

and Adult Protective Services. Use of the van will be to assist programs in preventing the negative

consequences of untreated mental illness or provide other MHSA-based services. Vehicle maintenance,

repairs and upgrades also may be paid through this project. Additional vehicles to support MHSA projects

and community-based services may be purchased through this project, reflective of stakeholders’ strong

support for community-based services.

To maximize utilization of the mobile office Behavioral Health seeks to develop a collaborative effort with

El Dorado County Public Health, providing regular access and engagement opportunities by both Health

and Human Services divisions at each of the five (5) Community HUBs locations. A schedule will be

developed and advertised to make known the dates and times when these services will be available at

each location around the county.

County-Wide Clinic Goals:

• Increase access to underserved parts of the community.

• Increase service delivery to various parts of the county.

• Expand options for appropriate spaces to provide services.

County-Wide Clinic Outcome Measures:

Demographics and other data for individual users will be reported within the project summary of the

services being provided and are not captured by the Community-Wide C

• Measurement 1 – Number of times HUBs spaces were utilized under this project.

• Measurement 2 – Number of remote access services provided utilizing the Mobile Office.

County-Wide Clinic Project Budget

Provider: El Dorado County staff and other contracted mental health services providers.

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CFTN Administration

County staff and/or contracted provider(s) will be utilized to perform administrative activities (e.g.,

contracting and accounting), program analysis, and quality assurance/improvement activities related to

this Component.

⁞ Housing Consultant

In the FY 22/23 Annual Update the Board of Supervisors approved the addition of a Housing Consultant

to support MHSA and Behavioral Health Division real estate needs and opportunities. As of the writing a

consultant has yet to be identified. A Request For Proposal is scheduled for release in FY 2023/24.

The Housing Consultant will support County staff to expand Permanent Supportive Housing options within

El Dorado County, develop projects to support the unhoused population as it relates to MHSA as well as

assist with other Behavioral Health Division real-estate related needs. This may also include seeking out

and applying for additional funding opportunities related to housing. Provider(s) will be selected in

compliance with the County’s Procurement Policy.

Update: After a failed solicitation for a Housing Consultant in 2023 and with consideration of SB 326 (see

page 11) this project is on hold pending the results of the March 2024 election. If SB 326 passes, a new

RFQ may be released with considerations of updated MHSA housing regulations.

The Behavioral Health Continuum Infrastructure Program (BHCIP)

County staff received a Behavioral Health Continuum Infrastructure planning grant in 2022. The planning

period ended December 2022. Staff have applied for the BHCIP implementation grant. If awarded, staff

will pursue the identified plan. This grant does not require any MHSA match and no MHSA funds will be

encumbered in FY 24/25.

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FY 2024/25 Budget, Expenditure Plan, and Reversion Reallocation

Expenditure Plan

MHSA Funding

The revenue and expenditure data contained in this MHSA Plan is based upon the FY 2023/24 HHSA

budget. Any adjustments that may be needed as a result of the FY 2022/23 Annual Revenue and

Expenditure Report (ARER) or other reconciliations or audits are anticipated to be minimal and will not

require an Update to accomplish.

In the event that actual revenues are higher than anticipated, the additional funding may be utilized to

support the projects identified in this Update up to 15% above the identified expenditures or rolled into

the fund balance to be utilized on projects identified in the Update. In the event that actual revenues are

lower than anticipated the County will access fund balances remaining from previous years at a higher

than anticipated rate and/or reduce funding levels.

Additionally, it is important to note that all budgeted funds are not expected to be utilized each fiscal year.

MHSA requires that, absent a specific State “flexibility” such as those issued under the public health

emergency, projects and potential expenditures must be identified in the MHSA Plan / Annual Update.

The County budgets all potential expenditures, therefore sufficient funds to implement each identified

project are included in the MHSA Plan. However, not all identified funds will be spent each year, and the

budget actually anticipates that some funds budgeted in FY 2023/24 will not be spent and will be available

as the starting Fund Balance for budgeting in FY 2024/25.

Annual Revenues

MHSA revenues are based on a one percent (1%) tax on personal income in excess of $1,000,000 and the

amount received by the County varies each month and year based upon actual tax revenues received by

the State. In FY 2023/24, El Dorado County’s share of the statewide MHSA revenues is 0.394814%,

however, this percentage is recalculated annually as described in Department of Health Care Services

(DHCS) Mental Health and Substance Use Disorder Services (MHSUDS) Information Notice 23-061

[1]

. For

budgeting purposes, revenues are calculated based on the FY 2023/24 allocation percentage and total

annual MHSA revenues have been estimated at $11,703,721.

Fund Balances

In addition to the FY 2023/24 revenues, the El Dorado County MHSA projects maintain fund balances

accrued from previous fiscal years that may be accessed during the term of the Three-Year Program and

Expenditure Plan and Update. There also are planned usages of fund balances. Fund balances may be

adjusted due to changes in methodologies, such as at the direction of the State. Additionally, in the event

of audit findings, recoupment of Medi-Cal funds, overpayments, or other actions that result in the County

owing funds back to the State or federal government, CSS (or any other component to which the funds

were initially paid) may experience a revenue offset.

Prudent Reserve

The County is required to maintain a Prudent Reserve of MHSA funding to provide MHSA services during

years in which MHSA revenues fall below recent averages and in which the MHSA allocations are

insufficient to continue to serve the same number of individuals as the County had been serving the

previous fiscal year. The required amount of Prudent Reserve has varied since the inception of MHSA,

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however, the current requirement pursuant to SB 192 (2018) is that the Prudent Reserve may not exceed

33% of the average monthly amount allocated to the CSS component in the last five (5) years.

If the Prudent Reserve exceeds 33% of the average monthly amount allocated to the CSS component

during the previous five (5) fiscal years, the County may transfer excess funds to the CSS component and

the PEI component. The amount transferred into CSS and PEI shall be in proportion to the amount the

County transferred from the CSS component to the Prudent Reserve through FY 2020/21 and the PEI

component to the Prudent Reserve in FY 2007/08. Funds transferred from Prudent Reserve to CSS and PEI

are subject to reversion. The applicable reversion period for these funds begins in the fiscal year when the

county transfers the funds from the Prudent Reserve to the CSS component or PEI component. Since El

Dorado County is a small county, the funds are subject to a five-year (5) reversion period and any funds

transferred in FY 2023/24 must be spent by FY 2027/28.

Additionally, as discussed in the “Legislative, Regulatory, and other MHSA Changes” section of this

Update, DHCS Information Notice 20-040 provided new guidance to counties who need to transfer funds

from Prudent Reserve to PEI or CSS.

Pursuant to DHCS MHSUDS Notice 19-037, El Dorado County’s Maximum Prudent Reserve for Fiscal Year

2018/19 that were transferred into CSS in FY 2019/20 are reflected below. The County is required to

update and certify the Prudent Reserve amount once every five (5) years. As certified by the State on June

27, 2019, the County’s CSS Five-Year Average is $5,016,372 with a maximum allowable Prudent Reserve

of $1,655,402.

Prudent Reserve Calculation

(76% of all distributions from the Mental Health Services Fund/MHSF)

MHSA CSS Revenue Received by Fiscal Year:

Amount

FY 2017-18

$ 6,025,767

FY 2018-19

$ 5,928,911

FY 2019-20

$ 5,482,745

FY 2020-21

$ 8,332,223

FY 2021-22

$ 9,548,377

Total

$ 35,318,023

Average of Prior 5 Years

$7,063,605

Maximum Allowable Prudent Reserve Percent (33%)

$2,330,990

Minimum Allowable Prudent Reserve Percent (25%)

$1,765,901

Current balance of Prudent Reserve:

$1,655,402

Adjustment - Funds to transfer from CSS in FY 2023/24:

$110,499

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Reversion

Until the passage of AB 114 (2017), MHSA funds were subject to reversion (return of unspent MHSA funds

to the State) based on time frames established in the original Mental Health Services Act. AB 114 clarified

those time frames and extended some time frames for counties with a population of less than 200,000

(which includes El Dorado County).

Unspent MHSA funding may be carried forward as a fund balance to the next fiscal year for a limited

duration of time. Funds that are not used within the reversion period must be returned to the State.

This Update includes a Reversion Expenditure Plan.

MHSA Component

Original Reversion Time

Frames

New Timeframes

Effective 7/1/17 for

El Dorado County

Community Services and Supports (CSS)

Prevention and Early Intervention (PEI)

3 years after allocation

5 years after allocation

Innovation (INN)

3 years after allocation

5 years after date of

Innovation Plan approval

from the MHSOAC

Workforce Education and Training (WET)

Capital Facilities and Technology (CFTN)

10 years after allocation

Funds in Prudent Reserve

No reversion

Transfer of Funds Between Components

WIC § 5892(b) allows counties to use a portion of their CSS funds for WET, CFTN, and/or the Prudent

Reserve. The total amount of CSS funding used for this purpose may not exceed 20% of the total average

amount of funds allocated to that County for the previous five (5) years and may not exceed the maximum

allowable Prudent Reserve.

Community Program Planning Process Budget

Pursuant to WIC §§ 5892(a) and 5892(c), in order to promote efficient implementation of the MHSA,

counties shall use funds distributed from the Mental Health Services Fund for annual planning costs

pursuant to WIC § 5848. The total of these costs shall not exceed five percent (5%) of the total of annual

revenues received for the fund. The planning costs shall include funds for county mental health programs

to pay for the costs of consumers, family members, and other stakeholders to participate in the planning

process. These expenditures will be budgeted under the general MHSA Administration costs but will be

tracked separately for reporting purposes. Additionally, while WIC § 5848 permits five percent (5%) of the

total annual revenues received for the fund to be used for annual planning costs, El Dorado only accesses

CSS funding due to the conflicting statute that mandates all funding for INN must be pre-approved by the

MHSOAC. If the State issues updated guidelines, El Dorado will update its process to conform to the

guidelines. If adjustments are required, a Plan or Update amendment will not be necessary and the

adjustment will be explained in the successive Plan or Update.

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El Dorado County Budget Philosophy

El Dorado County is a fiscally conservative county and 100% of the potential expenditures are budgeted,

even though the Behavioral Health Division historically comes in under budget in expenditures.

Based on current projections, there are sufficient revenues and fund balance for all planned expenditures

in FY 2024/25. However, in year three of the Fiscal Year 2023/24-2025/26 MHSA Program and Expenditure

Plan, there may appear to be a shortage of funding to implement the approved projects due to the

budgeting methodology utilized. However, in the event that revenues and fund balances fall short of

expectations, expenditures will be adjusted as needed.

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FY 2024-25

CSS

PEI

INN

WET

CFTN

TOTAL

Available Funds:

Prop 63 (MHSA) - New Funding

$8,894,828

$2,223,707

$585,186

$11,703,721

AB 114 Reversion Reallocation 

Federal: PATH and MHBG

$679,868

Medi-Cal

$9,301,728

Private Insurance / Payors

$37,381

Misc. Revenue

$75,080

AB 109 / AOT (Community Corrections Partnership)

$207,633

Mental Health Student Services Act (MHSSA) (pass-through entity)

$1,194,025

Interest

$202,000

$45,000

$46,000

$2,000

$5,000

$300,000

Transfer from CSS 

($1,500,000)

$1,500,000

Transfer to CSS from Prudent Reserve

Estimated Starting Fund Balance[1]

($1,337,545)

$2,017,959

$3,713,231

$192,346

$508,137

$5,094,128

Total Available Funds Budgeted

$17,754,998

$4,286,666

$4,344,417

$194,346

$2,013,137

$28,593,564

117

FY 2024-25

CSS

PEI

INN

WET

CFTN

TOTAL

Expenditures:

Budgeted Expenditures from Fund Balance and New

Revenues

($26,125,000)

($6,644,900)

($820,000)

($410,000)

($2,810,000)

($36,309,900)

Total Budgeted FY 2023-24 MHSA Plan Expenditures

($26,125,000)

($6,644,900)

($820,000)

($410,000)

($2,810,000)

($36,809,900)

Budgeted Fund Balance at Fiscal Year End

($8,370,002)

($2,358,234)

$3,524,417

($215,654)

($796,863)

($8,216,336)

Average Actual Expenditures

46%

63%

33%

32%

24%

Anticipated Fund Balance at Fiscal Year End

$5,737,498

$100,379

$4,073,817

$63,146

$1,338,737

$11,313,577

Community Program Planning Costs [pursuant to WIC § 5892(c)]

Included in above expenditures, but not to exceed

$444,741

five percent (5%) of the CSS revenues ($ * 5%):

*Average Actual Expenditure Percentage

With all potential expenditures included in this MHSA Plan Budget, the Average Actual Expenditure Percentage provides a four (4) year historical average of actual

spending per component derived from the Annual Revenue and Expense Report (ARER). This percentage has no correlation to fund reversion but is included to

provide a more accurate representation of Budgeted Fund Balance at Fiscal Year End, presented as the Anticipated Fund Balance at Fiscal Year End.

In this FY 24/25 Annual Update, MHSA Projects and Programs have been able to successfully minimize fund balances carried over from FY 22/23 and anticipated

to carry over from FY 23/24 (Refer to MHSA FY 2022/23 Outcomes Report Appendix A – Revenue and Expense Report). This was done through multiple strategies

including increasing annual allotments when supported by data, supporting vendors to fully utilize their increased annual allotments, restructuring projects that

have been challenging to obtain a vendor, and the addition of new projects. CSS and PEI revenues are now both partially being expended in the same year they

are received. Further increase in expenditures without comparable increase to revenues may result in the inability to fund non-mandated projects.

118

MHSA Component Budgets

Each MHSA component and associated projects are identified below. As discussed under MHSA Projects

have been identified as Mandatory (M) or Discretionary (D) by designating a letter after the project name.

Mandatory services are those that are required to be provided, or required to be provided at a certain

funding level (e.g., 51% of the CSS funding must go to FSP projects) per federal or State law or regulation,

the Mental Health Plan agreement between DHCS and the County, the MHSA, any other requirement

issued by an oversight agency (e.g., DHCS, MHSOAC, Centers for Medicare & Medicaid Services), and the

necessary administrative staff to implement and monitor MHSA projects.

Generally speaking, the following categories of projects are mandatory:

• CSS FSP projects (funding level requirement);

• Certain CSS Outreach and Engagement projects (access to services is mandatory);

• PEI projects serving the needs of children (funding level requirement);

• At least one project under each required program type (PEI regulations);

• The WET Coordinator position (MHSA requirements);

• Statewide WET Planning and Community Needs Assessment (contractual requirement); and

• CFTN projects supporting the infrastructure of mental health services (federal requirement).

119

MHSA Component Budget – CSS

As previously discussed, of the total MHSA funding received by the County, a net 76% must be allocated

to CSS per the MHSA. CSS funds received during and after FY 2017/18 must be expended within five (5)

years or the funds are subject to reversion to the State.

Changes in the FY 2023/24 budget reflect a true-up to anticipated expenditures based upon budgeted

staffing levels and other client supports (e.g., housing-related costs, food for the Wellness Center, and

non-mental health services and supports). No direct service CSS programs were intentionally reduced to

allocate funding to other CSS programs.

Program

FY 2023/24 MHSA

Plan Budget

FY 2024/25 MHSA

Update Budget

FY 2025/26 MHSA

Update Budget

Full Service Partnership Projects

Total FSP Projects

$16,497,000

$17,673,000

$18,273,000

Approximate Percent Budgeted per Project

(total expenditures may float between these projects in any percentage):

Children’s FSP Project

(M)

41.28%

$6,810,000 / 38.53%

$6,810,000 / 37.27%

Peer Partner Project -

Parent Partner (M)

1.42%

$290,000 / 1.64%

$290,000 / 1.59%

CASA

0.14%

$23,000 / 0.13%

TAY FSP Project (M)

3.03%

$500,000 / 2.83%

$500,000 / 2.74%

Adult and Older Adult

FSP Project (M)

45.46%

$7,500,000 / 42.44%

$7,500,000 / 41.04%

FSP Unhoused

Individuals Project

n/a

$650,000 / 3.68%

$750,000 / 4.10%

FSP Forensic Services

(M)

8.67%

$1,900,000 / 10.75%

$2,400,000 / 13.13%

120

Program

FY 2023/24

MHSA Plan

Budget

FY 2024/25 MHSA

Update Budget

FY 2025/26 MHSA

Update Budget

General System Development

Total General System Development

Projects

$6,013,000

$6,413,000

Approximate Percent Budgeted per Project

(total expenditures may float between these projects in any percentage):

Wellness and Recovery

Services/Adult Wellness Centers (D)

68.40%

$4,113,000 / 64.14%

Wellness and Recovery

Services/TAY Engagement (D)

6.65%

$400,000 / 6.24%

Community Transition and Support

Team (D)

7.48%

$450,000 / 7.02%

Crisis Residential Treatment (CRT)

(D)

16.63%

$1,400,000 / 21.83%

Recreation Therapy Project (D)

0.83%

$50,000 / 0.73%

Outreach and Engagement

Access Services (M)

$1,275,000

Approximate Percent Budgeted per Project

(total expenditures may float between these projects in any percentage):

Access Services (M)

96.08%

$1,225,000 / 96.08%

PATH (D)

3.92%

$50,000 / 3.92%

Mental Health Student Services Act (D)

n/a

Assisted Outpatient Treatment (M)

$64,000

Lanterman-Petris-Short (LPS) Project (D)

$500,000

Genetic Testing (D)

$50,000

Administrative Costs

CSS Administrative Costs (M)

$150,000

Total Budget CSS Projects

$24,549,000

$26,125,000

$26,725,000

Percent of CSS Budget in FSP

67%

68%

69%

(per California Code of Regulations,

Title 9, Section 3620(c), “The County

shall direct the majority of its CSS to the

FSP Service Category”)

121

The following transfer of CSS funds are identified as a reduction in revenues in the “Anticipated Revenues

and Expenditures by Component” table above and are not included in the total budgeted expenditures:

Program

FY 2023/24 MHSA

Plan Budget

FY 2024/25 MHSA

Update Budget

FY 2025/26 MHSA

Update Budget

Transfer to WET

$375,000

n/a

TBD

Transfer to CFTN

$350,000

$1,500,000

TBD

Total

$725,000

Up to

$1,500,000

TBD

122

MHSA Component Budget – PEI

As previously discussed, of the total MHSA funding received by the County, a net 19% must be allocated

to PEI per the MHSA. PEI funds received during and after FY 2017/18 must be expended within five (5)

years or the funds are subject to reversion.

Program

FY 2023/24 MHSA

Plan Budget

FY 2024/25 MHSA

Update Budget

FY 2025/26 MHSA

Update Budget

Prevention Program

Latino Outreach Project (M)

$400,000

Primary Project (M)

$253,000

Wennem Wadati: A Native Path to

Healing Project (M)

$115,000

Clubhouse El Dorado Project (D)

$300,000

Goods and Services to Promote Positive

Mental Health and Reduce Mental

Health Risk Factors Project (D)

$125,000

Early Intervention Program

Older Adults Enrichment Projects (D)

$400,000

Children 0-5 and Their Families Project

(M)

$390,000

Prevention Wraparound Services:

Juvenile Services Project (M)

$500,000

Forensic Access and Engagement

Project (D)

$150,000

National Suicide Prevention Line

Project (M)

$40,000

TimelyCare Project

$40,000

Student Wellness Center Project(D)

$890,400

Bridge the Gap Project

$200,000

Stigma and Discrimination Reduction Program

Mental Health First Aid, safeTALK and

Other Community Education Projects

(D)

$160,000

Community Stigma Reduction Project

(D)

$100,000

Statewide PEI Projects (M)

$60,000

123

Program

FY 2023/24

MHSA Plan

Budget

FY 2024/25

MHSA Update

Budget

FY 2025/26 MHSA Update

Budget

Outreach for Increasing Recognition of Early Signs of Mental Illness Program

Community Education Project (D)

$218,000

Peer Partner Project - Youth Advocate (M)

$110,000

Mentoring for Youth Project (D)

$96,000

Access and Linkage to Treatment Program

Project Access

$250,000

$500,000

Community-Based Outreach and Linkage

Project/PERT (M)

$1,000,000

$1,400,000

Veterans Outreach Project (D)

$172,500

Suicide Prevention Program

Suicide Prevention and Stigma Reduction Project

(D)

$300,000

Administrative Costs

PEI Administrative Costs (M)

$125,000

Total Budget PEI Projects

$6,394,900

$6,644,900

124

MHSA Component Budget – INN

Of the total MHSA funding received by the County for CSS and PEI, five percent (5%) of the funding is

allocated to Innovation.

Program

FY 2023/24 MHSA

Plan Budget

FY 2024/25 MHSA

Update Budget

FY 2025/26 MHSA

Update Budget

Partnership Between Senior Nutrition

and Behavioral Health (D)[1]

$450,000

N/A

Nature Therapy for Youth Project

Phase I: Planning (D)

$150,000

N/A

Nature Therapy for Youth Project

Phase II: Implementation (D)

N/A

$500,000

In-Clinic Certified Therapeutic

Recreation Specialist

Phase I: Planning (D)

$150,000

N/A

In-Clinic Certified Therapeutic

Recreation Specialist

Phase II: Implementation (D)

N/A

$300,000

Data Driven Recovery Project – Cohort

2 (MHSOAC Multi-county

Collaborative) (D)

TBD

INN Administrative Costs (M)

$20,000

Total Budget INN Projects

$770,000

$820,000

125

MHSA Component Budget – WET

MHSA no longer provides funding for WET activities. WET projects will continue to be funded by

transferring CSS funds to this component as may be needed annually.

CSS funds transferred to WET during and after FY 2017/18 are subject to a 10-year reversion period. Any

unspent fund balances remaining at the end of FY 2023/24 will roll over as fund balance into FY 2024/25.

Program

FY 2023/24 MHSA

Plan Budget

FY 2024/25 MHSA

Update Budget

FY 2025/26 MHSA

Update Budget

WET Coordinator Project (M)

$35,000

Workforce Development (D)

$160,000

Recruitment and Retention Project (D)

$100,000

Statewide WET Planning and

Community Needs Assessment (M)

$110,000

WET Administrative Costs (M)

$5,000

Total Budget WET Projects

$410,000

126

MHSA Component Budget – CFTN

MHSA no longer provides funding for CFTN activities. The County has been operating this project through

funds previously received and remaining as fund balance, as well as transfers from CSS.

CSS funds transferred during and after FY 2017/18 are subject to a 10-year reversion period. Any unspent

fund balances remaining at the end of FY 2023/24 will roll over as fund balance into FY 2024/25.

Program

FY 2023/24 MHSA

Plan Budget

FY 2024/25 MHSA

Update Budget

FY 2025/26 MHSA

Update Budget

Electronic Health Record Project (M)

$950,000

Telehealth Project (D)

$75,000

Integrated Community-based

Wellness Center Project (D)

n/a

$1,500,000

$25,000

Community-wide Clinic Project (D)

$160,000

CFTN Administrative Costs (M)

$125,000

Total Budget CFTN Projects

$1,310,000

$2,810,000

$1,335,000

127

Appendix:

Glossary of Abbreviations

CPPP Meeting Agenda

CPPP Press Release

CPPP Training PowerPoint

CPPP Survey

Public Comment Press Release

 
128 
Glossary of Abbreviations 
Initials  Definition 
AB  Assembly Bill 
AOT  Assisted Outpatient Treatment 
ARF  Adult Residential Facility 
ARPA  American Rescue Plan Act of 2021 
B&C  Board and Care 
BHBH  Behavioral Health Bridge Housing 
BHD  Behavioral Health Division (formerly the Mental Health Division) 
CalAIM  California Advancing and Innovating Medi-Cal 
CalMHSA  California Mental Health Services Authority 
CANS  Child and Adolescent Needs and Strengths 
CBT  Cognitive Behavior Therapy 
CCC  Community Corrections Center 
CCP  Community Corrections Partnership 
CCR  California Code of Regulations 
CFTN  Capital Facilities and Technology Needs 
CIT  Crisis Intervention Team 
CIT  Crisis Intervention Training 
CPPP  Community Program Planning Process 
CRRSAA  Coronavirus Response and Relief Supplemental Appropriations Act, 2021 
CSS  Community Services and Supports 
CWS  Child Welfare Services 
DBT  Dialectical Behavior Therapy 
DHCS  Department of Health Care Services (California) 
ED  Emergency Department 
EDC  El Dorado County 
EDCOE  El Dorado County Office of Education  
EDSO  El Dorado Sheriff’s Office 
EHR  Electronic Health Record  
FEP  First Episode Psychosis 
FFPSA  Families First Prevention Services Act 
FSP  Full Service Partnership 
FTE  Full-Time Equivalent 
FY  Fiscal Year 
HHSA  Health and Human Services Agency 
Hubs  El Dorado County Community HUBs 
ICM  Intensive Case Management 
IHBS  Intensive Home-Based Services 
IMD  Institution for Mental Disease (facility) 
Katie A.  Katie A. vs. Bonta Lawsuit and/or resulting programs/services 
LPS  Lanterman-Petris Short 
MCP  Managed Care Plan 
MH  Mental Health 
MHBG  Mental Health Block Grant  
MHRC  Mental Health Rehabilitation Center (facility) 
MHSA  Mental Health Services Act 

129

MHSOAC Mental Health Oversight and Accountability Commission

MOU Memorandum of Understanding

NTE Not-to-Exceed

PATH Projects for Assistance in Transition from Homelessness

PEI Prevention and Early Intervention

PERT Psychiatric Emergency Response Team

PES Psychiatric Emergency Services

PHF Psychiatric Health Facility

PSC-35 Pediatric Symptom Checklist

QI Qualified Individual

RFP Request for Proposal

RFQ Request for Qualifications

SAMHSA Substance Abuse and Mental Health Services Administration

SB Senate Bill

SLT South Lake Tahoe

SMHS Specialty Mental Health Services

STACS South Tahoe Alternative Collaborative Services

STRTP Short-Term Residential Therapeutic Program

SUD Substance Use Disorders

SUDS Substance Use Disorder Services

TAY Transitional Age Youth

TBD To Be Determined

WET Workforce Education and Training

WS West Slope

130

CPPP Meeting Agenda

Mental Health Services Act (MHSA)

Fiscal Year 2024-25 Annual Update

Community Meeting

Agenda:

1. Welcome and Introductions

2. Overview of MHSA Guiding Principles and Practices

a. MHSA History

b. MHSA Plans/Annual Updates

c. MHSA Values

3. MHSA Component Overview

a. Components

i. Prevention and Early Intervention/PEI

ii. Community Services and Supports/CSS

iii. Innovation/INN

iv. Workforce Education and Training/WET

v. Capital Facilities and Technology/CFTN)

4. MHSA Budget

5. MHSA Project Overview

a. MHSA Recommended Updates

b. New Project/Program ideas

c. Innovation concepts

6. Community Input for current and proposed projects

7. Survey

a. English and Spanish

COMMUNITY INVITED TO PROVIDE INPUT ON COUNTY’S

EXPENDITURES OF STATE MENTAL HEALTH FUNDS

(Placerville, CA) - The El Dorado County Health and Human Services Agency, Behavioral Health

Division invites the public to provide input on the annual update to its Mental Health Services Act

(MHSA) Three-Year Program and Expenditure Plan. The Update covers fiscal years 2023/24 to

25/26.

California voters passed MHSA (Proposition 63) in November 2004, which places a 1% tax on

personal incomes over $1,000,000. Counties receive funds through the State, and are to be used

to ensure the County’s mental health system is consumer-friendly, recovery-oriented, and

accessible to all who need it.

"Community members can provide input by attending an upcoming community meeting or

submitting an online survey or an email,” said Nicole Ebrahimi-Nuyken, El Dorado County

Behavioral Health Director. “The meetings will be held by Zoom through one of the links below or

by calling (669) 900-6833 and entering the webinar ID and passcode."

Community meetings are scheduled as follows:

• Thursday, August 17, 2023, from 3:00 p.m. to 5:00 p.m.

https://tinyurl.com/yusburhk

Webinar ID: 861 3922 8674

Passcode: 987743

• Thursday, September 14, 2023, from 6:00 p.m. to 8:00 p.m.

https://tinyurl.com/phus8vsk

Webinar ID: 871 8774 9540

Passcode: 180810

N E W S R E L E A S E

El Dorado County

HEALTH & HUMAN SERVICES AGENCY

For Immediate Release: August 4, 2023

CONTACT:

Margaret Williams

(530) 642-7164

• Friday, September 29, 2023, from 11:30 a.m. to 1:30 p.m.

https://tinyurl.com/yhfvx8yt

Webinar ID: 861 1922 5513

Passcode: 503197

• Monday, October 16, 2023, from 9:00 a.m. to 11:00 a.m.

https://tinyurl.com/5624shxy

Webinar ID: 836 3172 1490

Passcode: 674217

For copies of the current and prior year MHSA Plans, please visit:

https://www.edcgov.us/government/mentalhealth/mhsa/pages/mhsa_plans.aspx.

To provide input on the FY 24/25 MHSA Annual Update via an online survey, go to:

https://forms.office.com/g/wUAw2k70R3.

Additional input can be submitted via email to [email protected] or via U.S. Mail to 768 Pleasant

Valley Road, Suite 201, Diamond Springs, CA 95619. For more information regarding the MHSA

or Community Program Planning Process, please contact Meredith Zanardi at (530) 621-6340.

# # #

El Dorado County

Mental Health

Services Act (MHSA)

and

Community Program

Planning Process (CPPP)

Training

for the

Fiscal Year 2024/2025

Annual Update

Health and Human Services Agency

Behavioral Health Division

What is MHSA?

(Mental Health Services Act)

 Proposition 63 passed by California voters in 2004

 Imposes a 1% tax on personal income above $1,000,000

 MHSA is designed to develop a public mental health system

of care that provides:

 A focus on wellness, recovery, and resiliency;

 Cultural and linguistic appropriate services;

 Consumer and family-driven services, participation, and

involvement;

 Community collaboration and partnerships; and

 An integrated service experience.

 Participation in services funded by MHSA must be voluntary

MHSA Three-Year Plan Cycle

Three years in

duration:

• Year 1 – Three-Year Plan

• Year 2 – Annual Update

• Year 3 – Annual Update

Months Activity

July - August 2023

Review FY 23/26 Three-Year MHSA Plan; continue

implementing projects in the Three- Year Plan;

develop Community Program Planning Process for

the FY 24/25 Annual Update

August - October 2023

Community Program Planning Process - meet with

stakeholders county-wide

October - November 2023

Draft FY 24/25 Annual Update and FY 22/23

Outcomes Report

MHSA Three-Year Plan Cycle

Three years in

duration:

• Year 1 – Three-Year Plan

• Year 2 – Annual Update

• Year 3 – Annual Update

Months

Activity

January - February 2024

Draft Update published for public

comments

February 2024

Public Hearing before the Behavioral

Health Commission

May 2024

Proposed Annual Update presented to the

Board of Supervisors

June 2024

Final Annual Update approved by the

Board of Supervisors

July 2024

Implement Projects and begin planning for

FY 25-26 Annual Update

MHSA Revenues

 MHSA Revenue is received monthly

 Revenues are extremely volatile and have

historically varied by up to 30% +/- from one year

to the next

 Projections allow us to consider what programs

can be funded, but actual amounts received are

often considerably more or less than expected.

MHSA Expenditures

 MHSA Plans and Updates provide the opportunity

to spend MHSA dollars. If an expense is not

included in the Plan, MHSA can not fund it

 MHSA Plans and Updates are projections and

often have greater expenditures considered than

actual amounts spent

Proposed MHSA Reform

AB 531 – Behavioral Health Infrastructure Bond Act of 2023

 $4.7 Billion Bond

 Build thousands of new community behavioral health beds in

residential settings to house Californians with mental illness and

substance use disorders.

SB 326 – The Behavioral Health Services Act (BHSA)

 Branded as MHSA Reform, this bill also restructures and adds

additional requirements that currently do not fall within the MHSA

scope and makes changes to more than just MHSA funding.

 Under the bill 30% of funding would be required for the chronically

homeless population

MARCH 2024 – California Primary Elections

July 1, 2024 – Preliminary changes anticipated

January 1, 2025 – Substantial changes expected.

FY 2024/2025

Annual Update

Programming Ideas for the

MHSA Plan & Updates

 Prior to the Community Program Planning Process (CPPP) - Information

about proposed new programs or changes to existing programs (e.g.,

funding, function or reporting) that was received by the MHSA Team prior to

July 2023 is included in this presentation.

 During CPPP - Other ideas for new or changed programs may be proposed

by stakeholders during the CPPP. Program ideas proposed during CPPP may

be incorporated into the FY 24/25 Annual Update even though not listed in

this presentation. The MHSA team may also consider ideas proposed during

CPPP for the FY 25/26 Annual Update due to varying factors (ex. funding

availability, implementation timelines, etc.).

 After CPPP – New ideas proposed after the 30-day public comment Period

will be considered for the FY 25/26 Annual Update.

Innovation Concepts

MHSA requires 5% of revenue be spent on Innovation Projects which aims to

explore and develop new mental health models that improve the quality of

services, promote collaboration, and increase access to services. Projects are

required to go through a thorough review process with the Mental Health

Services Oversight and Accountability Commission (MHSOAC). The following

are several ideas that we are exploring.

 Inpatient Socialization to Stepdown Project

 The Mind, The Body and The Gut Project

 Housing related project that is yet to be identified

Next Steps

 Receive input from stakeholders

 Analyze input received

 Begin writing Draft Annual Update

 The Draft Annual Update will be posted for 30-day public

comment period

 Public Hearing by the Behavioral Health Commission

 Final Annual Update, including substantive comments, will

be sent to the Board of Supervisors for consideration, resulting

in:

 Adoption of the Update as written;

 Adoption of the Update with revisions; or

 Decline to adopt the Update

Next Steps (continued)

 After the MHSA Annual Update is adopted by the Board of Supervisors:

 The County Auditor and Behavioral Health Director sign the Update

Certification forms

 A copy of the Update is forwarded to the Mental Health Services

Oversight and Accountability Commission (MHSOAC) and to the

California Department of Health Care Services (DHCS)

 The Behavioral Health Division will begin implementation of the Annual

Update

 Behavioral Health will begin the Community Program Planning

Process for the Fiscal Year 2025/26 Annual Update.

And now…

We want to hear from you!

 Please tell us what you think about:

 What are the unmet or underserved mental health needs in El

Dorado County

 Mental health policy in El Dorado County

 MHSA program planning

 MHSA program implementation

 Program monitoring, evaluation and reporting

 Quality improvement

 Funds budgeted to MHSA programs

Our contact information is on the next slide.

 Email:

 US Mail:

MHSA@edcgov.us

MHSA Team

El Dorado County Behavioral Health

768 Pleasant Valley Road, Suite 201

Diamond Springs, CA 95619

 Online Survey:

 English & Spanish:

https://forms.office.com/g/wUAw2k70R3

 For MHSA updates and links to our Press Release, visit

https://edcgov.us/MentalHealth

El Dorado County

HEALTH & HUMAN SERVICES AGENCY

For Immediate Release: January 12, 2024

CONTACT:

Margaret Williams

(530) 642-7164

COMMUNITY INVITED TO PROVIDE INPUT ON ANNUAL UPDATE TO

MENTAL HEALTH SERVICES ACT (MHSA) PLAN

(Placerville, CA) - The El Dorado County’s Behavioral Health Division is seeking public input on the

annual update to the County’s Mental Health Services Act (MHSA) Plan. This plan determines how

the County spends State funds to support County mental health programs for children, transition-age

youth, adults, older adults, and families. The annual update is developed to include new or updated

projects and budgets for Fiscal Year 2024-25.

A copy of the draft Update may be accessed on Behavioral Health’s MHSA website at:

http://tinyurl.com/84dhzpmu. Public comments or questions about the draft update can be submitted in

writing by email to [email protected] or postal mail to: Health and Human Services Agency,

Behavioral Health Division, MHSA Project Team, 768 Pleasant Valley Road, Suite 201, Diamond

Springs, CA, 95619. Comments must be received by Monday, February 12, 2024 at 5:00pm.

The MHSA requires Counties to complete an annual community planning process to either develop a

three-year plan or update a three-year plan. Updates like this one are posted for a 30-day comment

period, after which a public hearing will be hosted by the El Dorado County Behavioral Health

Commission. This meeting will be noticed on the Behavioral Health Commission calendar and on the

MHSA website. Substantive comments on the draft plan update received during the public comment

period will be included in the final Update, along with analysis and response to those comments.

California voters passed MHSA (Proposition 63) in November 2004, which places a 1% tax on

personal incomes over $1,000,000. Counties receive funds through the State, and these are to be

used to ensure the County’s mental health system is consumer-friendly, recovery-oriented, and

accessible to all who need it.

# # #

N E W S R E L E A S E