#1Mental Health Advisory Board Budget presentation Thursday, June 16th, 2022#2Content: New Santa Cruz County Budget website • • • Strategic Plan Department Budgets • Budget and Operational Plan Budget Dashboards Budget Details Personnel Details Transparency Portal • OPENGOV Resource Links#3New Santa Cruz County Budget website Google Santa Cruz County strategic plan proposed 2022-23 budget Google Search I'm Feeling Lucky ↓ Google Santa Cruz County strategic plan proposed 2022-23 budget Q All News Images Maps Shopping More X About 1,280,000 results (0.60 seconds) https://www.co.santa-cruz.ca.us> Vision Santa Cruz > Bu... PROPOSED 2022-23 BUDGET - Santa Cruz County Proposed 2022-23 Budget Budget Message What the County Does Economic Outlook & Financial Summary Department Budgets Budget Policies & Resources. Ő - Tools#4co.santa-cruz.ca.us/VisionSantaCruz/Budget.aspx STRATEGIC PLAN Santa Cruz County Facu Proposed 2022-23 Budget ☐ 2021-23 Operational Plan Performance Measurement Community Profile Library PROPOSED 2022-23 BUDGET How do I use this website? Guest G Select Language Contact Budget Message What the County Does Economic Outlook / Financial Summe Department Budgets Budget Policies & Resources Multiple ways presenting budget data#5STRATEGIC PLAN Santa Cruz County Proposed 2022-23 Budget Select Language 2021-23 Operational Plan Performance Measurement Community Profile Library Contact PROPOSED 2022-23 BUDGET Budget Message What the County Does Economic Outlook & Financial Department Budgets Budget Policies Transparency & Resources Portal Health & Human Services 1989 Summary Department Budgets Child Support Services CORE Investments Health Services xx Human Conviene Department Budgets Includes narrative and descriptive detail, goals and emerging issues, as well as charts and figures#6Budget and Operational Plan • Can be mined by: • Divisions, • Services (BH has 10 service areas) • And displays: • • Service Overview Operational Objectives • Detail information STRATEGIC PLAN Santa Cruz County Proposed 2022-23 Budget Budget Message Select a Department ▾ Mission Statement Select Language ▼ 2021-23 Operational Plan Performance Measurement Community Profile Library Contact PROPOSED 2022-23 BUDGET What the County Does Budget Policies & Resources 血 Economic Outlook & Financial 500 Department Budgets Summary Budget and Operational Plan Budget Dashboards Budget Details Personnel Details Health Services Transparency Portal To promote and ensure a healthy community and environment by providing education, outreach, and comprehensive health services in an inclusive and accessible manner. Department Budget Overview The Health Services Agency's budget makes important investments in improving community health, including working to save Watsonville Hospital, increasing the number of local beds available to serve children and adults in crisis, creating a Health Equity Office to improve results for the most burdened in our County, elevating readiness to respond to future health pandemics, and collaborating on health and housing issues for our communities most vulnerable residents. Total Expenses Total Revenues General Fund Contribution Funded Staffing $236,500,446 (+13%) 1 $222,909,339 (+12%)' Website $12,771,716 (+31%) 2 757.9 (+3%) 3 Health Services#7DIVISIONS SERVICES Adult Mental Health -> Behavioral Health → Clinic Services Environmental Health Substance Use Disorder Mental Health Managed Care Children's Mental Health Residential Mental Health Health Benefits Division Specialty Mental Health. Public Health Administration Access and Crisis Behavioral Health Support Quality Improvement Public Guardian Behavioral Health Administration SERVICE OVERVIEW Adult Mental Health Expenses $27,722,299 AMENDED Funded Staffing 58.8 OPERATIONAL PLAN OBJECTIVES Supported Housing Increase Beds 25% Last Updated 12/2021 0 Budget and Operational Plan: Filters • Once a Division is selected, the corresponding Service Areas will display in the middle column and the selected Service Overview will display on the right.#8Budget Operational Plan: Service Area Detail Sample DIVISIONS SERVICE Clos Behavioral Health Clinic Services Environmental Health Health Benefits Division Public Health Administration SERVICES Adult Mental Health Provides Specialty Mental Health outpatient services inclusive of psychotherapy, case management, occupational therapy and medication support to individuals with serious mental illness. Contract service providers also offer intensive residential treatment, long term residential care, permanent supported housing and peer-run support services. Revenues for Behavioral Health are budgeted within the Administration service. • • EMERGING ISSUES Implementation of Adult Mental Health's "An Innovativ Project, Healing the Streets", a collaborative effort between Behavioral Health, Clinics, and Housing for Health to integrate services to support the needs of th unhoused in the community. Evaluating Assisted Outpatient Treatment Program (AOT, Laura's Law), which could provido community- based, assisted AOT to a small population of individuals who meet strict legal criteria and who - as a result of their mental illness are unable to voluntarily access community mental health services. Expenses Revenues Funded Staffing Main Funding Source Primary Clients Strategic Plc Focus Arec $27,722,299 (+41%) $132,784 (+221%) 58.8 State/Federal Public Clients (+4%) Comprehens Health & Safe Description of the Service area • A list of Emerging Issues Expenses, Revenues and Staffing for this service area, including % change form previous year • Main funding source, and focus area#9SERVICE Access and Crisis Close (x Highlight: Access and Crisis SERVICES Operates a mandated walk-in crisis evaluation clinic and in-person community based crisis response for those seeking urgent behavioral healthcare. Clinicians provide behavioral health psychosocial assessments and level of care assessments for community members seeking specialty mental health treatment and substance use disorder treatment. Access and Crisis is required to provide timely access to services, and manages the Access hotline. Revenues for Behavioral Health are budgeted within the Administration service. EMERGING ISSUES Expanding mobile crisis services through a Department of Healthcare Services (DHCS) Crisis Care Mobile Units (CCMU) grant, a grant from the California Health Facilities Finance Authority (CHFFA) and a Substance Abuse and Mental Health Services Administration (SAMHSA) grant Ensuring individuals can access services at other locations and providers in the community as part of the Access for All initiative and new requirements from the State. Using the Mobile Emergency Response Team (MERT) and telehealth evaluations to reduce hospital strain in the Emergency Departments from people in Behavioral Health crisis. Expenses Revenues Funded Staffing Main Funding Source Primary Clients Strategic Plan Focus Area $5,870,052 (+63%) 41 State/Federal Public Clients (0%) (+5%) Comprehensive Health & Safety#10SERVICE Close (x Highlight: Mental Health Managed Care SERVICES Mental Health Managed Care Evaluates and manages Specialty Mental Health services for Medi-Cal beneficiaries inclusive of Psychiatric hospitalizations and emergency transportation. Revenues for Behavioral Health are budgeted within the Administration service. EMERGING ISSUES ⚫ Evaluating opportunities to mitigate continued state mandated rate increases in hospitalization costs and locked care costs and to mitigate use of out of area services. Expenses Revenues Funded Staffing Main Funding Source Primary Clients Strategic Plan Focus Area $18,228,059 (+5%) $5,873,707 State/Federal Public Clients (0%) (0%) Comprehensive Health & Safety#11SERVICE Close (x Highlight: Residential Mental Health SERVICES Residential Mental Health Provides residential mental health treatment programs inclusive of Locked Care, Skill Nursing Facilities and Rehabilitation programs under the responsibility of County MH continuum. The majority of these services are located out of county. Revenues for Behavioral Health are budgeted within the Administration service. " EMERGING ISSUES Evaluating opportunities to mitigate continued state mandated rate increases in hospitalization costs and locked care costs and to mitigate use of out of area services. Providing resources and additional expertise for aging populations with complex medical conditions. Expenses Revenues Funded Staffing Main Funding Source Primary Clients Strategic Plan Focus Area $11,171,148 $- 0 (+5%) State/Federal Public Clients (0%) (0%) Operational Excellence#12CAL MATTERS: California's Mental Health Timeline infographic C calmatters.org/explainers/breakdown-californias-mental-health-system-explained/ = CAL MATTERS ☐ Support nonprofit news $10 $15 $25 OTHER DONATE Timeline: How we got here A history of California's mental health policies FDA approves first antipsychotic drug to treat delusions/hallucinations. Thorazine opens possibility that some people with serious. mental illnesses can live in the community 1954 $ 1957 Number of patients in CA mental hospitals peaks at 37,500 1959 1965 Legislature expands state funds for local community mental health programs Congress creates Medicare and Medicaid, allowing people with mental illnesses. to live in their communities and collect federal benefits https://infogram.com/mental- health-timeline-a-history-of- californias-mental-health- policies-1h984wwloj8v4p3 Outstanding visual summary describing major events that shape Mental Health in California today#13Budget Message Select a Department ▾ What the County Does Economic Outlook & Financial Department Budgets Budget Policies & Resources Summary Budget and Operational Plan Budget Dashboards Budget Details Personnel Details Transparency Portal Budget Dashboards Health Services - Budget Dashboards - The charts below show department expenditures and revenues by division and service. Click on the pie charts to drill down for more detail. Complete detail can be found on the County's Transparency Portal. Expenses by Service • . • • Expenses by Service Pie chart - multi year slide at bottom Can be filtered by area Expenses and Revenues over time Updated On 7 Jun, 2022 Back History ▾ Reset Broken down by Health Services Agency T Expenses Visualization • In multiple formats Clinics Services $54,787,358 (23.0%) Help - Share ▼ Sort Large to Small Behavioral Health Clinics Services D Public Health Public Health $30,114,260 (12.6%) • Administration • Environmental Health Behavioral Health $123,125,792 (51.6%) Administration $11,650,397 (4.9%) Environmental Health $14,326,583 (6.0%) Health Benefits $4,703,421 (2.0%) 2022-23 Proposed Budget < Health Benefits 山 + TOP#14• • Budget Message Budget Details Select a Department Expenditure grid by Category, filtered by division, service area or funds. Top level categories: • Services and Supplies: service contracts . Salaries and Employee Benefits: county staff • Other Charges: mostly locked and residential care • • Other Financing Uses: Offset Intrafund Transfers: Partnerships with other departments and FQHC revenue What the County Does Economic Outlook & 口 Financial 660 Department Budgets Summary Budget and Operational Plan Budget Dashboards Health Services - Budget Details Budget Policies & Resources Budget Details Personnel Details Transparency Portal The charts below provide the department line-item detail, including explanation of major changes. Use the Division and Service filters to see more detail. Line-Item Detail Division All Service All Funds All Expenditure Category Actuals FY 2020-21 Expenditures Current Budget FY 2021-22 Estimated Actuals FY 2021-22 Proposed Budget FY 2022-23 Proposed Change from FY 2021-22 Salaries and Employee Benefits $83,467,607 $93,234,775 $90,772,927 + Services and Supplies $89,321,055 $93,551,113 $99,705,113 $114,202,069 $103,771,274 Other Charges $26,475,901 $32,772,628 $33,434,644 $38,581,267 Other Financing Uses = Fixed Assets +Intrafund Transfers Total $15,045,284 $46,909 ($18,518,568) $195,838,188 $11,428,159 $11,428,159 $196,211 ($22,126,637) $209,056,249 $652,675 ($21,996,957) $213,996,561 $2,988,019 $918,873 ($23,961,056) $236,500,446 $20,967,294 $10,220,161 $5,808,639 ($8,440,140) $722,662 ($1,834,419) $27,444,197#15Personnel Details • • Staffing totals in Full Time Equivalents (FTE) by division and year over year comparison Job Classification detail by division, with staffing change totals Budget 25 Message Select a Department Economic What the Outlook & County Does to Financial 品 Department Budgets Summary Budget and Operational Plan Budget Dashboards Health Services -Personnel Details The chart below provides the department personnel detail by division, service, and classification. Funded Staffing by Division Environmental Health Administration Public Health Clinics Services Behavioral Health Budget Policies & Resources Budget Details Personnel Details Transparen Portal Funded Staffing by Drill an Rows : Y 2021-22 2022-23 Division Funded Staffing (Adjusted) Funded Funded Staffing Staffing Change Behavioral Health 283.05 293.05 10.00 Clinics Services 202.86 210.85 7.99 Public Health 140.79 143.60 2.81 Administration 51.20 54.40 3.20 Environmental Health 40.00 42.00 2.00 + Health Benefits Total 15.00 14.00 -1.00 732.90 757.90 25.00 Funded Staffing by Job Classification 2021-22 2022-23 Classification Funded Staffing Funded Funded Staffing (Adjusted) Staffing Change SR MH CLIENT SPECI 89.40 92.80 3.40 MEDICAL ASSISTANT MH CLIENT SPECI 64.00 64.00 0.00 56.50 57.00 0.50 OFFICE ASSISTANT III 26.00 27.00 1.00 ADMIN AIDE 24.00 25.00 1.00 MH SUPVG CLIENT SPEC 23.00 25.00 2.00 PUB HLTH NURSE II 18.60 17.60 -1.00 MEDICAL BILLING TECH 17.00 17.00 0.00 SR DEPTI ADMIN ANALYST Total 16.00 16.00 non 732.90 757.90 25.00#16STRATEGIC PLAN Santa Cruz County Proposed 2022-23 Budget Select Language 2021-23 Operational Plan Performance Measurement Community Profile Library Contact PROPOSED 2022-23 BUDGET Budget Message What the County Does Economic Outlook & Financial Department Budgets Budget Policies Transparency & Resources Portal Health & Human Services 1989 Summary Department Budgets Child Support Services CORE Investments Health Services xx Human Conviene Transparency Portal Financial Summary powered by OPENGOV. Includes different filters and views to drill down Division Budgets#17OPENGOV: Ability to display data in different types of graphs, with source data tables OPENGOV FY 2022-23 Financial Summary ... FY 2022-23 Financial Summary Updated On 7 Jun, 2022 FY 2022-23 Budget Back History ▾ Roset Filters Views Broken down by Departments Expenses General Fund Revenues and Expenses Total Expenses by Type Visualization Total Revenues by Type Total Revenues by Fund Total Expenses by Fund State and Federal Revenues Total Expenses by Department Total Revenues by Department Expenses by Fund Type (Non- General Fund) Presentation Login Help▾ Share → OPENGOV Sort Large to Small Health and Human Services FY 2022-23 Financial Summary FY 2022-23 Budget Health and Human Services $423,490,077 (40.8%) Login Help ▾ Share $43,004,712 (4.1%) Filters Views Changing filters will update visualization automatically. | I I 2022-23 Proposed Budget > Land Use and Community S... Public Safety and Justice • General Government SHOW Expenses • .and Use and Community Se... 258,505,734 (24.9%) Public Safety and Ju... $183,602,364 (17.7%) Health and Human Services $423,490,077 (40.8%) General Govern... $115,187,633 (11.1... Capital Projects $43,004,712 (4.1%) County Financing Capital Projects 2022-23 Proposed Budget BROKEN DOWN BY Departments Data FILTERED BY All> Expand All 2018-19 Actual 2019-20 Actual 2020-21 Actual 2021-22 Estim Funds > Health and Human Services $296,374,538 $335,942,717 $394,197,518 $4 Departments > Expense Type > ▸ Land Use and Community Service 162,012,966 162,894,037 205,743,854 19 FISCAL YEAR ▸ Public Safety and Justice 143,754,585 155,874,431 156,356,449 1 ▸ General Government 2019 71,886,750 78,125,191 72,719,978 2023 OPTIONS ▸ County Financing 7,273,067 8,085,082 7,221,984 14 ▸ Capital Projects 22,520,274 19,236,882 13,317,092 Total $703,822,180 $760,158,341 $849,556,875 $1,0#18Strategic Plan - Santa Cruz County Department Budgets Links to websites mentioned in this presentation: Health Services - budget, operational plan details and dashboards CAL Matters infogram - timeline of MH policies OPENGOV - Financial Summary