Annual PEI Evaluation Report Contra Costa Behavioral Health Services Mental Health Services Act As submitted for MHOAC FY 2018-2019 Table of Contents Executive Summary ...................................................................................... 1 PEI Aggregate Data ...................................................................................... 6 PEI Programs by Component .................................................................... 11 Appendix A – Program Profiles…………………………………………………A-1 Appendix B – Annual Reports…………………………………………………..B-1 Executive Summary Prevention and Early Intervention (PEI) is the component of the Three-Year Plan that refers to services designed to prevent mental illnesses from becoming severe and disabling. This means providing outreach and engagement to increase recognition of early signs of mental illness and intervening early in the onset of a mental illness. First approved in 2009, with an initial State appropriation of $5.5 million, Contra Costa’s Prevention and Early Intervention budget has grown incrementally to $8.6 million for FY 2017-18 in commitments to programs and services. The construction and direction of how and where to provide funding for this component began with an extensive and comprehensive community program planning process that was similar to that conducted in 2005-06 for the Community Services and Support component. Underserved and at- risk populations were researched, stakeholders actively participated in identifying and prioritizing mental health needs, and strategies were developed to meet these needs. The programs and services described below are directly derived from this initial planning process, and expanded by subsequent yearly community program planning processes, to include current year. New regulations and demographic reporting requirements for the PEI component went into effect on October 6, 2015. Programs in this component now focus their programming on one of the following seven PEI categories: 1) Outreach for increasing recognition of early signs of mental illness 2) Prevention 3) Early intervention 4) Access and linkage to treatment 5) Improving timely access to mental health services for underserved populations 6) Stigma and discrimination reduction 7) Suicide prevention All programs contained in the PEI component help create access and linkage to mental health treatment, with an emphasis on utilizing non-stigmatizing and non- discriminatory strategies, as well as outreach and engagement to those populations who have been identified as traditionally underserved. 3 Outcome Indicators. PEI regulations (established October 2015) have data reporting requirements that programs started tracking in FY 2016-2017. In FY 18-19, over 32,000 consumers of all ages were served by PEI programs in Contra Costa County. This report includes updates from each program and is organized by PEI program category. The information gathered enables CCBHS to report on the following outcome indicators: • Outreach to Underserved Populations. Demographic data, such as age group, race/ethnicity, primary language and sexual orientation, enable an assessment of the impact of outreach and engagement efforts over time. • Linkage to Mental Health Care. Number of people connected to care, and average duration of reported untreated mental illness enable an assessment over time of impact of programs on connecting people to mental health care. Evaluation Component Contra Costa Behavioral Health Services is committed to evaluating the effective use of funds provided by the Mental Health Services Act. Toward this end, a comprehensive program and fiscal review process has been implemented to: a) improve the services and supports provided; b) more efficiently support the County’s MHSA Three Year Program and Expenditure Plan; c) ensure compliance with stature, regulations and policies. Each of the MHSA funded contract and county operated programs undergoes a triennial program and fiscal review. This entails interviews and surveys of individuals both delivering and receiving the services, review of data, case files, program and financial records, and performance history. Key areas of inquiry include: • Delivering services according to the values of MHSA • Serving those who need the service • Providing services for which funding was allocated • Meeting the needs of the community and/or population • Serving the number of individuals that have been agreed upon • Achieving outcomes that have been agreed upon • Assuring quality of care • Protecting confidential information • Providing sufficient and appropriate staff for the program • Having sufficient resources to deliver the services 4 • Following generally accepted accounting principles • Maintaining documentation that supports agreed upon expenditures • Charging reasonable administrative costs • Maintaining required insurance policies • Communicating effectively with community partners Each program receives a written report that addresses the above areas. Promising practices, opportunities for improvement, and/or areas of concern are noted for sharing or follow-up activity, as appropriate. The emphasis is to establish a culture of continuous improvement of service delivery, and quality feedback for future planning efforts. Completed reports are made available to members of the Consolidated Planning Advisory Workgroup (CPAW) and distributed at the monthly stakeholder meeting, or to the public upon request. Links to PEI program and fiscal reviews can be found here: https://cchealth.org/mentalhealth/mhsa/cpaw/agendas-minutes.php. During FY2018-19, completed PEI Program and Fiscal Review reports were distributed at the following monthly CPAW meetings: September 2018, February 2019, March 2019, April 2019. 5 PEI Aggregate Data FY 18-19 Contra Costa is a geographically and culturally diverse county with approximately 1.1 million residents. One of nine counties in the Greater San Francisco Bay Area, we are located in the East Bay region. According to the United States Census Bureau (https://www.census.gov/quickfacts/fact/table/contracostacountycalifornia), it’s estimated that about 9% of people in Contra Costa County are living in poverty and that children, adolescents & young adults (ages 0-25) make up approximately 30% of the population. Roughly 25% of residents are foreign born. The most common languages spoken after English include: Spanish, Chinese languages and Tagolog. Contra Costa County Racial/Ethnic Populations 2019 Caucasian / White 45% 25% African American / Black 9% American Indian / Alaskan Native 0.29% 45% Asian 15% 4% 0% Native Hawaiian / Pacific Islander 0.45% Multi-Ethnic 4% 15% Latino/Hispanic 25% 0% 9% MHSA funded Prevention and Early Intervention (PEI) programs in Contra Costa County served over 32,000 individuals during FY 18-19. For a complete listing of PEI programs, 6 please see Appendix A. PEI Providers gather quarterly for a Roundtable Meeting facilitated by MHSA staff, and are actively involved in MHSA stakeholder groups including Consolidated Planning and Advisory Workgroup(CPAW) and various sub-committees. In addition, PEI programs engage in the Community Program Planning Process (CPPP) by participating in three annual community forums located in various regions of the county. The below tables outline PEI Aggregate Data collected for FY 18-19. Total Served: 32,949 Total Number of Individual Family Members Served: 588 Table 1. Age Group # Served Child (0-15) 2,530 Transition Age Youth (16-25) 5,207 Adult (26-59) 10,831 Older Adult (60+) 2,684 Decline to State 11,700 Table 2. Primary Language # Served English 20,471 Spanish 6,181 Other 642 Decline to State 5,655 Table 3. Race # Served More than one Race 1,014 American Indian/Alaska Native 94 Asian 1,866 Black or African American 3,697 White or Caucasian 11,393 Hispanic or Latino/a 8,377 Native Hawaiian or Other Pacific Islander 103 Other 409 Decline to State 5,996 7 Table 4. Ethnicity (If Non- Hispanic or Latino/a) # Served African 190 Asian Indian/South Asian 150 Cambodian 7 Chinese 50 Eastern European 29 European 273 Filipino 143 Japanese 8 Korean 13 Middle Eastern 238 Vietnamese 23 More than one Ethnicity 173 Decline to State 3,002 Other 940 Table 5. Ethnicity (If Hispanic or Latino/a) # Served Caribbean 11 Central American 590 Mexican/Mexican American /Chicano 3,784 Puerto Rican 15 South American 162 Other 23 Table 6. Sexual Orientation # Served Heterosexual or Straight 14,997 Gay or Lesbian 220 Bisexual 133 Queer 24 Questioning or Unsure of Sexual Orientation 40 Another Sexual Orientation 168 Decline to State 17,367 Table 7. Gender Assigned at Birth # Served Male 10,289 Female 11,925 Decline to State 18,339 8 Table 8. Current Gender Identity # Served Man 8,699 Woman 8,801 Transgender 149 Genderqueer 13 Questioning or Unsure of Gender Identity 14 Another Gender Identity 68 Decline to State 15,205 Table 9. Active Military Status Table 10. Veteran Status # Served # Served Yes 52 Yes 75 No 3,049 No 8,045 Decline to State 29,848 Decline to State 24,829 Table 11. Disability Status # Served Yes 360 No 2,660 Decline to State 29,929 Table 12. Description of Disability Status # Served Difficulty Seeing 33 Difficulty Hearing or Having Speech Understood 38 Physical/Mobility 91 Chronic Health Condition 126 Other 406 Table 13. Cognitive Disability # Served Yes 116 No 987 Table 14. Referrals to Services # Served Clients Referred to Mental Health Services 1,850 Clients who Participated/ Engaged at Least Once in Referred Service 1,681 Table 15. External Mental Health Referral