Transformational Change Report: January – June 2024

TRANSFORMATIONAL CHANGE REPORT January – June 2024 Photo: Joshua Tree National Park mhsoac.ca.gov MHSOAC — Transformational Change Report STATE OF CALIFORNIA LETTER FROM THE COMMISSION | JANUARY - JUNE 2024 Gavin Newsom, Governor What’s in a Name? Opportunity California voters recently approved the Behavioral Health Services Act (BHSA), updating Mara Madrigal-Weiss and modifying the Mental Health Services Act (MHSA) along the way. Commission Chair Mayra E. Alvarez In 2004 the MHSA, through its prevention and early intervention component, established Vice Chair an expansive definition of what California wants to achieve with its mental health investments: supporting housing, reducing criminal justice involvement, helping adults Mark Bontrager Commissioner get jobs and young people thrive in school, reducing suicide, preventing prolonged suffering, and more. The MHSA expanded expectations of what we were able to Bill Brown accomplish through mental health strategies and supports. Sheriff, Commissioner Keyondria Bunch, Ph.D. A core goal of the BHSA is to ensure that substance use disorder needs are elevated Commissioner in California’s conversations and policies around behavioral health. There is a long history in the mental health field, including the Diagnostic and Statistical Manual, Steve Carnevale that recognizes addiction disorders as part of mental health. The BHSA explicitly calls Commissioner for improved integration of traditional substance use disorder (SUD) services with Wendy Carrillo traditional mental health services. It honors the broad and expansive goals of prevention Assemblymember, and early intervention, recognizing the negative outcomes that were articulated so Commissioner clearly and powerfully in the MHSA. Rayshell Chambers The name change for California from “mental health” to “behavioral health” includes Commissioner renaming this Commission. Although we’ve worked over the last five years to strengthen Shuo (Shuonan) Chen our attention on addiction and SUD services, and we recognize that the original makeup Commissioner of the Commission includes a Commissioner with expertise in SUD, the BHSA reinforces Dave Cortese the necessity of ensuring that we’re responsive to the needs of the people we serve Senator, Commissioner through improved integration of addiction services and behavioral health services. Itai Danovitch, M.D. Commissioner ... the BHSA reinforces the necessity of ensuring that David Gordon Commissioner we’re responsive to the needs of the people we serve Gladys Mitchell through improved integration of addiction services Commissioner and behavioral health services. Jay Robinson, Psy.D. Commissioner Alfred Rowlett There is much that remains unclear, including the extent to which a name change from Commissioner mental health to behavioral health will impact the structure of our statutes, how funding Toby Ewing, Ph.D. can be allocated, the attention that is paid to SUD services that don’t involve classic Executive Director mental health services, and most importantly, where they overlap. We hear concerns that the name change may dilute the focus on serious mental illnesses, or the intention may be misinterpreted as emphasizing behavior modification rather than addressing underlying mental health concerns. There are also legal implications, such as the potential expansion of involuntary commitment or conservatorship laws. ii Letter from the Commission | January - June 2024 As we navigate the opportunities in implementing the BHSA, we’re engaging in thoughtful discussions about the meaning and impact of this name change. We’re connecting our new Strategic Plan (see section 2), constructed in partnership with communities, with the goals and priorities set forth by the Governor, the Legislature, and the people of California. And we’re ensuring that the language we use accurately reflects these goals and priorities while being mindful of potential misinterpretations or unintended consequences. In the following report, you’ll see how we’ve laid the foundation for this next phase in our work. In section 1, “Community Engagement,” we showcase the community engagement activities we’ve supported over the past six months. We encourage you to visit our interactive events and impact map to see where and how community voices are facilitating policy and practice changes that improve the lives of Californians. In section 2, “Our Strategic Plan in Action,” we feature projects demonstrating how the Commission is implementing our new 2024-2027 Strategic Plan, and how this Strategic Plan is already reflecting the goals of the BHSA. In section 3, “Commission Progress Report,” we share updates and activities associated with our 12 priority initiatives and our foundational work around plan implementation, advocacy grants, communications, data, legislation, and transparency. In section 4, “Budget,” we outline where and how we are using essential public funds. In section 5, “What’s Next,” we explore how our priorities align with Proposition 1, and the steps we’re taking to support our partners who are charged with implementing this groundbreaking legislation. As you read about our activities and initiatives, we invite you to join us in considering the question: “What’s in a name?” This is a pivotal moment in our ongoing effort to transform behavioral health services in California. Together, we can work towards a shared understanding of the BHSA and our collective role in shaping the future of mental health care in California. iiii Transformational Change Report | January-June 2024 CONTENTS Photo: Joshua Tree National Park 01 Community Engagement 1 About Our Site Visits 5 Committees 8 02 Our Strategic Plan in Action 9 03 Commission Activity Updates 19 Strategic Initiatives Updates 20 Foundational Work Updates 34 04 Budget Update 40 05 What’s Next? 42 06 Stay in Touch 46 iii Transformational Change Report | January-June 2024 01 COMMUNITY ENGAGEMENT Photo: San Francisco Ferry Building Transformational Change Report | January-June 2024 Photo: California Orange Grove Community Engagement The mental health landscape in California is as diverse On the next page, you’ll find a map of the Commission’s as its natural landscape, with religion, language, cultural, community engagement events from January and racial backgrounds all in need of unique supports, through June 2024, including Commission-sponsored services, and a system that works to their benefit. The independent events and events hosted by others but Mental Health Services Act (MHSA) recognizes that attended by Commissioners or staff. government bodies must work in serious and consistent partnership with consumers, family members, and Also available on the Commission’s website is a complete community members; therefore, the Act requires the map, updated weekly, and showing Commission events, Commission to seek community input and guidance. independent events attended by Commissioners or staff, More than that, the Commission has enshrined and events by organizations funded by the Commission community engagement as a top priority in its that reduce stigma and strengthen advocacy for 2024-2027 Strategic Plan. behavioral health transformation. 2 Transformational Change Report | January-June 2024 Events In-person Events in California Napa County San Diego County • Commission Meeting [Napa] • “Best Practices in Student Information Sharing” Cross-System Convening • Napa State Hospital Site Visit [Napa] [San Diego] • San Diego County MHSSA Site Visits Riverside County [Descanso and San Diego] • Hemet Unified School District Site Visit: • Striving for Zero Learning Collaborative Whole Person Health Score [Hemet] Convening [Carlsbad] Sacramento County San Francisco County • 10th Annual Mental Health America of • CalMatters Live Panel [San Francisco] California (MHAC) Mental Health Matters Day [Sacramento] • Center for Aging and Brain Health Innovation Site Visit [San Francisco] • 988 Crisis Policy Advisory Group Meeting [Sacramento] • Roadmap to 90-90-90 with the Kennedy Forum [San Francisco] • California Senate District Directors Institute April Convening [Sacramento] • Voices with Impact Film Festival [San Francisco] Alameda County • Commission Meeting [Sacramento] • UC Berkeley Behavioral Health • EmPATH Unit Site Visit [Sacramento] San Mateo County Innovation Site Visit [Berkeley] • MHSA/Prop 1 Webinar [Sacramento] • allcove® Site Visit [San Mateo] • Mental Health First Aid Training Butte County • One Mind Accelerator Programming [Sacramento] Event [Menlo Park] • Youth Intensive Program (YIP) Site Visit • “No Deliveries: When Maternity Wards [Chico] Close, Where Do Patients Go?” Event Santa Barbara County [Sacramento] Fresno County • Commission Meeting [Santa Barbara] • Sacramento Youth Advocacy Initiative • Fresno Youth Advocacy Initiative Mental Mental Health Event [Sacramento] Health Event [Fresno] Shasta County • “The 50” Movie Premiere [Sacramento] • MHSA Multi-County PADs Innovation Humboldt County • “The Beautiful Game” Movie Premiere Project April Convening [Redding] [Sacramento] • Humboldt Youth Advocacy Initiative • University of San Francisco Public Mental Health Event [Arcata] Sonoma County Psychiatry Fellowship Class [Sacramento] • Sonoma Valley High School Site Visit: Los Angeles County Post-Disaster Mental Health Screening and Triage [Sonoma] • allcove® Site Visit [Redondo Beach] San Bernardino County • Directing Change Film Screening and • San Bernardino Youth Advocacy Yolo County Award Ceremony [Los Angeles] Initiative Mental Health Event [San Bernardino] • Multitudes Site Visit [West Sacramento] 3 Transformational Change Report | January-June 2024 Virtual Events → ACES Award for Small State Employer → ACSED/APSEA Career Development Program Webinar → “Let’s Talk Mental Health” Webinar → Mental Health Awareness Month Virtual CDP Workshop Photo: Carrizo Plain, San Luis Obispo County Transformational Change Report | January-June 2024 About Our Site Visits The Commission engages clients, consumers, families, providers, public officials, and others to understand what is working, what is not, and to explore pathways to improvement. Two recent visits showcased two very different points along the continuum of care and the experiences of people with behavioral health needs: a high school and a state hospital. SONOMA, CA County education leaders worked with national experts to develop a screening and data collection strategy to Universal Mental Health Screening in Schools improve the services and support the district could The Governor and Legislature have made historic provide to its students. The district partnered with commitments to school mental health. Much of that work University of California, Los Angeles faculty to deploy is guided by the Commission’s effort to elevate schools a mobile app to screen for acute trauma exposure or as key partners in meeting the behavioral health needs loss, focusing on the experiences of youth during and of children, youth, and their families. The Commission following the fires that destroyed homes and forced many laid out these strategies in Every Young Heart and Mind: families to move or live in temporary shelters. Schools As Centers of Wellness report. Among a range of opportunities and challenges, the state is working to understand whether and how it should invest in universal behavioral health screening as part of a broader prevention and early intervention strategy. The Commission received Mental health is at the kids’ table in funding and direction in the 2023-24 Budget Act to outline emergency response. We need to get at potential strategies to support universal screening. Among the big table and we need metrics and the issues being explored are what to screen for, which data to get there.” screening tools should be supported, who should take the ظ Dr. Merritt Schriber lead on screening, how the information from a screening UCLA Medical Center should be used, and more. To support that work, the Commission partnered with the Sonoma County Office of Education to facilitate a site visit The screening tool focused on a range of factors that may to Sonoma Valley High School to learn about their effort influence the potency of the recent traumatic event, such to implement Universal Mental Health Screening with as economic challenges and having a history of trauma. their students. Following the 2017 Tubbs Fire, Sonoma The app accumulates data that might point to the different crisis responses needed for different people depending on their level of risk, driving a more precise, strategic, and coordinated emergency mental health response. The app allowed education leaders to better understand how the fires impacted student mental health across the population, as well as individual needs. Local education leaders shared that implementing a rapid strategy for behavioral health screening helped them understand student needs and the scale of (left to right) Kendra Zoller, Deputy Director of Legislative Affairs, State Mental Health behavioral health impacts. The county was able to Commission; Debbie Look, California State Assembly Education Committee; Misty Feusahrens, California State Assembly Speaker’s Office; and Jeff Weiner, Dir. of Public provide support for more than 500 students in 16 Policy, Jewish Family and Children’s Services, during a tour of the Sonoma Valley Sonoma County school districts. High School Wellness Center in February 2024. 5 Transformational Change Report | January-June 2024 the effective use of Full Service Partnership programs to reduce homelessness, justice involvement, and hospitalizations; the first report was published in 2023. From 2006 to 2022, the state saw a 20 percent increase in the number of people committed to a state hospital program as a result of felony criminal charges and a court’s determination that an individual is incompetent to stand trial. Funding for California’s Department of State Hospitals has increased from $2.6 to $3.4 billion in the past two years. The state has struggled with a waiting list Sonoma Valley High School’s Camille Garcia, far left, leads a tour of the Wellness of 1,700 individuals referred to a state hospital program. Center in February 2024. To better understand how California responded to unmet mental health needs, and the impact of justice The behavioral health impacts of the Tubbs Fire, and the involvement of behavioral health clients on publicly subsequent lessons learned, have the potential to guide funded behavioral health programs, the Commission statewide strategies for mental health screening. sponsored a day-long visit to Napa State Hospital, which “I’m telling our story because I want everybody and serves some 1,100 behavioral health clients. Napa State everyone to be on the ready,” said Diann Kitamura, Hospital opened in 1875 and is the oldest state-run, Deputy Superintendent of Equitable Education Services, inpatient psychiatric facility still in operation. Sonoma County Office of Education. “I don’t want another Eighty-nine percent of the individuals served by Napa school district to go through what we went through.” State Hospital are criminal justice involved, in a pre-trial, post-trial, or post-sentencing stage. The remaining 11% of NAPA, CA clients are there under a non-criminal designation, such Napa State Hospital as a behavioral health conservatorship. California’s MHSA, recently re-cast as the BHSA, calls for prevention, early intervention, and innovation as The Commission, along with state and legislative leaders, foundational strategies to improve behavioral health Deputy Secretary for Behavioral Health Stephanie Welch, outcomes. In 2017, the Commission called for improved Department of State Hospital leadership, and other approaches to reduce the justice involvement of behavioral health clients in its report “Together We Can: Reducing Criminal Justice Involvement for People with Mental Illness.” More recently, the Commission has highlighted opportunities to improve the role of Full Service Partnership programs to better serve Californians with complex and persistent mental health needs. As part of that effort, the Governor and Legislature have directed the Commission to monitor the effectiveness of Full Service Partnerships and recommend strategies to improve the impact of these essential programs. The Commission is required by Senate Bill 465 to periodically Commission Chair Mara Madrigal-Weiss and Executive Director Toby Ewing at the Napa report to the Legislature on the state’s progress in State Hospital’s patient memorial site during a tour of the facility in February 2024. On the site, eight monuments list the full names of over 8,000 patients who died between 1876 and 1964 and were buried in unmarked graves. 6 Transformational Change Report | January-June 2024 partners, engaged with hospital leaders and staff. Most importantly, site visit attendees were able to sit down to talk with the hospital’s client-led Cooperative Advisory Council. Many clients freely shared their struggles to access behavioral health services, most sharing that their needs began very early in their lives – typically in their early teens. Nearly all shared that they did not have pathways to behavioral health support and often did not understand their behavioral health needs or how to ask for support. One client shared her experiences in the military and her struggle to access services as she transitioned back into civilian life, which led to her criminal justice involvement. Another shared her story of maternal depression, suicidal behavior, and assault on a peace officer trying to help Napa State Hospital’s patient memorial site features eight monuments listing the full names of over 8,000 patients who died between 1876 and 1964 and were buried in her as she stood on the edge of a highway overpass in a unmarked graves. heightened state of fear and depression. “It was a privilege to visit the Napa State Hospital program children, youth, families, and educators to recognize and connect with the staff and leaders who were working behavioral health needs, and to develop behavioral hard to meet the needs of their patients. It was also clear health literacy and peer strategies to support young that California must do more, as early as kindergarten people when their needs first develop,” said Commission but throughout our K-12 school systems, to better equip Chair Mara Madrigal-Weiss. “What struck me most,” said Tom Orrock, the Commission’s Deputy Director and a licensed behavioral health clinician, “was a deep feeling of frustration that we missed so many opportunities to provide behavioral health care early in the lives of everyone we spoke to, but we didn’t and the consequences of those missed opportunities are devastating.” The Commission’s visit to Napa was followed by a public hearing on the role of Full Service Partnerships and will guide the Commission’s discussions and guidance to the Governor and Legislature on opportunities to Camille Gentry, Chief of Rehabilitation Therapy Services at Department of State Hospitals – Napa, pauses before leading a tour of UNBOUND during a site visit in February 2024. UNBOUND is an 80-ft. sculpture featuring close to 800 papier- improve prevention and early mâché hearts, all hand-made by patients, staff, and community volunteers at the hospital over the course of a year. intervention programs. 7 Transformational Change Report | January-June 2024 Committees The Commission was formed, among other goals, to elevate the voices of behavioral health leaders, including clients and family members, and people who are currently not well-served by California’s behavioral health system. As outlined above, the Commission is committed to community engagement to ensure it is responsive to community needs and able to share community concerns with state and local leaders. In addition to engaging the public across the state, the Commission also hosts two standing committees made up of subject matter experts One of the hundreds of handmade papier-mâché hearts featured in the UNBOUND to bring a critical eye to the Commission’s work. The Client sculpture at Napa State Hospital. Over 1,500 patients, staff, and community volunteers and Family Leadership Committee (CFLC) represents took part in the project. behavioral health clients and family members who draw upon their lived experiences to inform the Commission’s portfolio of projects. The Cultural and Linguistic Competency Committee (CLCC) includes representatives of underserved communities to ensure attention to reducing disparities in access to care and outcomes. In my experience as both a consumer and micro and On May 8, 2024, the CFLC and CLCC met jointly to discuss macro behavioral health practitioner for the last 20 the Commission’s recently adopted Strategic Plan and years, the Napa State Hospital visit was a first look opportunities to improve the Commission’s approach for me at a world-class coordinated ecosystem of to strengthening California’s behavioral health system. high-level forensic-behavioral health care, grounded Beginning in the summer, the committees will meet every in treatment practices aimed at supporting the other month to inform and monitor the Commission’s person served with intentionally integrating back progress in meeting its strategic goals. into the community. The concept, framework, and treatment practice at Napa is client-centered and focused on competency and reintegration. Moreover, the most impressive discovery at Napa is the use of arts, advocacy, and enterprise in treatment practices. From supported employment opportunities and savings accounts, to a structured Client Advocacy group and a massive interactive arts exhibition, clients have all the tools needed to get them ready for community treatment. ” ظ Commissioner Rayshell Chambers 8 Transformational Change Report | January-June 2024 02 OUR STRATEGIC PLAN IN ACTION Photo: Mariposa Grove, Yosemite National Park Transformational Change Report | January-June 2024 Our Strategic Plan in Action The Commission’s newly adopted Strategic Plan is a roadmap to accelerate transformational change and is aligned with the public’s passage of Proposition 1 and the behavioral health reforms it requires. To pursue its mission, the Commission has highlighted four key goals, which are listed below. Please visit https://mhsoac.ca.gov/ to read the full Strategic Plan. CHAMPION CATALYZE INSPIRE VISION INTO BEST PRACTICE INNOVATION ACTION NETWORKS AND LEARNING RELENTLESSLY DRIVE EXPECTATIONS 10 Transformational Change Report | January-June 2024 GOAL 1 GOAL 2 GOAL 3 GOAL 4 Champion vision into action The Commission will analyze data and engage all partners to advance the evolution of policies necessary to provide an early, effective, and universally available system of behavioral health supports and services. OBJECTIVE 1 Elevate the perspective of diverse communities. The Commission will partner with local agencies and community organizations to engage all people with lived experience, their families, and their neighbors, to understand the impacts of the current systems; identify opportunities for improving services and reducing disparities; and, elevate concerns and suggestions to public and private system leaders. OBJECTIVE 2 Assess and advocate for system improvements. The Commission will assess and publish key opportunities for investments and changes in policies and practices that will move California toward a universally accessible, integrated, and effective system of care that prevents and reduces the incidence and consequence of mental health issues at the earliest possible moment. OBJECTIVE 3 Connect federally and globally to learn and apply. The Commission will identify and engage in federal and international initiatives seeking to promote the North Star goal, assess how California could contribute or benefit from those initiatives, and convene and share that information with system and community partners in California. Lancaster, CA Fresno, CA Santa Cruz, CA 11 Transformational Change Report | January-June 2024 Strategic Alignment To champion a vision of ending the impacts of firearm violence, the Commission visited a Sacramento gun The Commission is honored and excited to expand its range and spoke to firearm owners involved in suicide community engagement opportunities. Partnering prevention efforts. The Commission visited with Los with people with lived experience, advocates, local Angeles’ REACH Team, who are making a difference by officials, family members, and other community connecting with children in South Los Angeles who are members deepens the Commission’s ability to champion exposed to firearm violence. vision to action. Elevating the perspectives of diverse communities (Objective 1) requires the Commission For more on this project, see updates on page 24. to engage people who often feel left out of the conversation in public sector decision-making. Assessing UNIVERSAL MENTAL HEALTH SCREENING opportunities for investments and changes in policy (Objective 2) requires community input at all levels. Two Though research consistently demonstrates that examples highlight efforts to fulfill this goal. intervening early when mental health challenges arise leads to the best outcomes, children’s mental health often goes unsupported. The universal screening project is exploring how routine screenings in schools could help detect the risks and strengths of children’s mental health to prevent severe needs, leading to earlier intervention and referral to services. This is similar to routine screenings, such as for hearing or vision, that are already conducted. The project will deliver an analysis of existing practices and recommendations for further implementation in summer 2024. To elevate the perspective of a community with lived experience, the Commission visited a Chula Vista Darrell Frye, left, field representative to Dr. Corey Jackson, Assembly District 60; elementary school deeply impacted by gang violence. and Adelaida Moreno, Behavioral Health Services Supervisor at Riverside University To better understand investment opportunities to create Health System, next to the sound-proof, indoor office Moreno uses for private conversations with students at the Hemet Unified School District’s Wellness and change, the Commission visited Sonoma County, where Community Outreach Center. education officials are screening youth for risks and strength following a devastating wildfire. Example Projects For more on this project, see updates on page 29. IMPACTS OF FIREARM VIOLENCE PROJECT In 2022, the Commission sought ways to support those impacted by firearm violence while lifting their experiences – and the experiences of those creating solutions. The IFV project, with a report due out by the end of 2024, pioneers a transformative approach, reframing firearm violence as a multi-dimensional public health issue rather than a concern of law enforcement or criminal justice alone. 12 Transformational Change Report | January-June 2024 GOAL 1 GOAL 2 GOAL 3 GOAL 4 Catalyze best practice networks The Commission will engage public and private partners, including universities and institutes, to catalyze the creation of best practice networks of excellence. These dynamic networks will strive to accelerate the effective implementation of service models that work together to provide universal access to a system of high-quality supports and services. The networks will curate best practices, provide technical assistance, assess and address barriers to implementation, and identify policies and practices for continuous improvement. OBJECTIVE 1 Support organizational capacity building. The networks should support the development of organizational partnerships, the collaborative use of data to assess services, the ability to design and implement change projects, and manage toward continuous improvement. OBJECTIVE 2 Fortify professional development programs and resilient workforce strategies. The networks should help to align and augment professional development programs to build the needed skills and abilities, develop educational pipelines for future staff that begin in the communities that are being served, and build career ladders that provide for individual growth and robust service systems. OBJECTIVE 3 Develop adequate and reliable funding models. The networks should develop and implement models for integrating funding that provides universal access, high-quality services, and sustainable operations. The network should explore models that make use of existing resources under existing policies, as well as identifying changes in policies and practices that would result in integrated, adequate, and reliable funds. OBJECTIVE 4 Support system-level analysis to ensure the tailored care and universal access required to reduce disparities. The networks should ensure efficient and informative research and evaluations inform public storytelling and understanding, improve practices and outcomes, and drive changes in state and federal policies, regulations, and program administration. 13 Transformational Change Report | January-June 2024 Strategic Alignment The Commission’s work in creating a capacity-building strategy for FSPs is part of four-year funding from The Commission is actively engaged in overcoming the Mental Health Wellness Act. The Commission is persistent challenges in behavioral health care, including examining strategies to improve outcomes for FSP clients reducing disparities, fortifying the workforce, and securing and develop adequate and reliable funding methods adequate and reliable funding. Solutions are available, through outcomes-based billing. and the Commission is focused on its role to catalyze best practice networks, connecting partners of all kinds to For more on this project, see page 23. advance transformational change. Counties are working to create change, but are overloaded and need help building TRANSFORMATIONAL CHANGE PARTNERSHIP capacity (Objective 1) and supporting, retaining, and The Commission launched a comprehensive and novel growing their workforces (Objective 2). approach for building capacity within local behavioral health agencies with pilot counties in late 2023. This initiative aims to implement new programs in ways that transform operations, with the potential to improve results meaningfully over time. The program tailors comprehensive content, referred to as the “change building blocks,” along with expert technical assistance to build durable capacity through a learn-by-doing model. The Commission is supporting organizational capacity building through this partnership. The program is focused on connecting counties with experts and colleagues in other counties to create innovative solutions. Aaron Lyons (far left), Program Manager at Chico Community Counseling Center, and Sam Casale (second from left), Butte County MHSA Coordinator, talk with Commissioner Bill Brown (second from right) and Commission staff during a tour of For more on this project, see page 25. Butte County’s Youth Intensive Program FSP facilities. SUBSTANCE USE DISORDER PILOT PROGRAM Example Projects In February 2024, the Commission approved the Substance Use Disorder (SUD) Pilot Program to enhance FULL SERVICE PARTNERSHIPS access to medication-assisted treatment (MAT) by training Designed to serve high-need individuals with “whatever more prescribers, removing regulatory barriers, and it takes” support, Full Service Partnerships (FSPs) work to adopting a community-centric approach. The pilot targets reduce incarceration and homelessness and to improve diverse counties (in population structure, size, and the overall quality of life. FSPs will remain a cornerstone of range of services and supports available and accessible) – community support as Proposition 1 is implemented, Los Angeles, Marin, and Nevada – to tailor strategies that and the Commission is working in multiple areas to assist can effectively address specific local needs. FSPs, including facilitating a multi-county collaboration around improving FSPs, examining outcomes-based The SUD Pilot Program integrates SUD treatment into contracting for FSP service providers, creating a capacity- existing mental health services, supporting capacity- building strategy, and more. building efforts while connecting clients to best practices. For more on this project, see page 26. 14 Transformational Change Report | January-June 2024 GOAL 1 GOAL 2 GOAL 3 GOAL 4 Inspire innovation and learning The Commission will develop strategies and partnerships to catalyze innovation and accelerate the development and dissemination of new models and practices that further improve behavioral health and wellbeing. OBJECTIVE 1 Curate an analytical-based narrative on the potential for innovation to improve behavioral health outcomes. The narrative will be supported and promoted through convenings and communications that bring together community voices, researchers, practitioners, and system leaders to explore opportunities, learnings, and future applications. These collaborative efforts will analyze opportunities, experimental projects, results, and impacts on individual lives, families, and neighborhoods. OBJECTIVE 2 Establish an innovation fund to link and leverage public and private investments. The fund will seek investors and partners who can help resource and shape projects to identify high-value learning opportunities with the potential to reduce disparities, improve quality of life and public outcomes, and drive transformational change in behavioral health services and supports. OBJECTIVE 3 Accelerate learning and adaptation in public policies and programs. The Commission will initiate and participate in partnerships that elevate community voice and the public interest in innovation projects, as well as the learnings that should inform changes in statutes, budgets, and regulations. Pebble Beach, Monterey, CA Death Valley National Park Ventucopa, CA 15 Transformational Change Report | January-June 2024 Strategic Alignment In passing Proposition 63 and establishing the Mental The Commission has begun to engage private Health Services Act (MHSA), California voters created sector partners to support its ability to identify new an explicit priority for innovation in mental health. opportunities to address high-priority community The MHSA asks community behavioral health leaders mental health needs, including reducing disparities. to tap the creativity and ingenuity that California is The Commission has also begun to engage research known for and apply it to mental health with the intent institutions, centers of excellence, business schools, of driving persistent improvement in the ability of the and others across California – and elsewhere – to help mental health system to achieve the positive outcomes the Commission leverage the expansive capacity of the MHSA seeks. For years, the Commission has worked our academic, research, technology, and data partners in partnership with county behavioral health leaders to guide the best available use of these dollars. The and state agencies to elevate the voices of community Commission is also working to establish infrastructure – members to direct this innovation tool to reduce funding, legal authority, organizational design, staffing disparities and support opportunities to increase the – around the innovation investment fund in order to impact of available funding and expand the partners who develop a strategic approach to delivering on the mandate are part of the behavioral health conversation. to invest in new ideas that the voters of California gave to the Commission with the passage of Proposition 1. Now, with the passage of Proposition 1 and the implementation of the Behavioral Health Services Act (BHSA), the role the Commission plays in innovation is changing. The work of the Commission is moving from reviewing and approving county innovation spending to direct investments in innovation, including developing opportunities for public-private partnerships. The Commission’s strategic plan describes these investments not just as financial (Objective 2), but also as opportunities to catalyze learnings (Objective 1) and to elevate community voice (Objective 3). 16 Transformational Change Report | January-June 2024 GOAL 1 GOAL 2 GOAL 3 GOAL 4 Relentlessly drive expectations The Commission will work with all Californians to increase understanding, empathy, trust, and empowerment as a way to bolster public ownership, expectations, and accountability for improvement of the public behavioral health system. OBJECTIVE 1 Launch a public awareness strategy to reduce stigma, promote access to care, and communicate the potential for recovery. The strategy will be developed and managed with public partners, incorporate the Commission’s major initiatives, and be tailored to racial and geographic communities to inform and empower Californians to improve access to care and make better decisions regarding behavioral health. OBJECTIVE 2 Develop a behavioral health index. The index will track and promote key indicators for behavioral health, including the seven negative outcomes, by county with benchmarks for peer counties, as well as peer states and nations to California. OBJECTIVE 3 Promote understanding of the progress that is being made and the advocacy that will result in further improvements. The Commission will work with community voices, especially youth, to build understanding of the potential for additional healing and to inform and empower their advocacy for improvements with service providers and public decision-makers. Palos Verdes, CA Oakland, CA Malibu, CA 17 Transformational Change Report | January-June 2024 Strategic Alignment The objectives of CPEHN are to: Working in partnerships with community members and → Elevate Community Engagement organizations doesn’t just improve the Commission’s Facilitate in-person and digital forums where work. Sharing the vision and the possibility of recovery community members can connect, understand and wellness (Objectives 1 and 3) allows both the relevant policies, and collaborate on advocacy efforts. Commission and Californians to relentlessly drive expectations; expectations that galvanize the reshaping of → Influence Policy and Legislation mental health services through community-driven policies Use insights gathered from community engagement and practices that are inclusive, effective, sustainable, and activities to inform and guide state policymakers, accountable. aiming to align state and local policies with the actual needs of diverse racial and ethnic communities. → Foster Sustainable Advocacy Networks Build and strengthen networks of advocacy partners across the state to ensure a cohesive approach to mental health advocacy, enhancing the impact of outreach and policy influence efforts. → Document and Share Impact Continuously evaluate the effectiveness of advocacy initiatives, sharing successes and lessons learned with a broader audience to encourage replication and broader systemic change. The Commission’s advocacy grants support strategies such as developing and disseminating resources to Example Project elevate the lived experiences and advocacy efforts of ADVOCACY GRANTS BIPOC communities. One example is CPHEN’s new The Commission allocates targeted advocacy grants to podcast “A Right to Heal,” a platform for both community strengthen the voices of Californians who have historically organizations and community members to share their been left out of behavioral health policy-making. These lived experiences and insights into what effective grants are aimed at supporting nine populations: clients advocacy for their specific community looks like. and consumers, diverse racial and ethnic communities, For more on advocacy grants, see page 32. families, K-12 students, LGBTQ+, parents and caregivers, transition age youth, veterans, and immigrants and refugees. Through the funding, organizations such as the California Pan-Ethnic Health Network (CPEHN) strengthen community engagement and ensure policies include the unique needs of Black, Indigenous, and people of color (BIPOC) communities. Grantees, including CPEHN, help build public awareness and an understanding of the power of advocacy to drive improvements. 18 Transformational Change Report | January-June 2024 03 COMMISSION ACTIVITY UPDATES Photo: Palm Springs, CA Transformational Change Report | January-June 2024 Strategic Initiatives Updates The Commission currently supports 12 strategic initiatives. These multifaceted, interrelated efforts together aim to improve mental wellbeing in California. ALLCOVE® YOUTH DROP-IN CENTERS Half of all mental health conditions begin by age 14, and 75 percent develop by the age of 24, making early detection and treatment urgent and critical. The allcove® youth drop-in centers provide a one-stop shop for mental health, physical health, substance use counseling, and educational, vocational, and peer support services, guided by the wisdom that we all just need a moment to reset before we can move forward. OUR PROGRESS WHAT’S NEXT → The California Youth Behavioral Health Initiative → The Commission will support the planning of allcove® (CYBHI) awarded $11 million in grant funds that centers in Sacramento and UC Irvine. will be used to develop new allcove® youth drop-in centers statewide and to expand existing programs. • New allcove® programs will open in partnership with Chinatown Service Center in Los Angeles County, CoastPride in San Mateo County, Pajaro Valley Community Trust in Santa Cruz County, Ruby’s Place in Alameda County, the Yurok Youth Center in Humboldt County, and the Yuba County Office of Education. • $4 million was awarded to the existing four allcove® centers (Beach Cities, San Mateo, Sacramento, and UC Irvine) to expand their services. → Stanford hosted its virtual Second Annual Statewide allcove® Conference in April 2024. 20 Transformational Change Report | January-June 2024 CRIMINAL JUSTICE PREVENTION Following the 2017 adoption of its “Together We Can” report, the Commission is using an array of tools – research, policy development, financial incentives, and technical assistance – to implement its recommendations to help counties and their community partners build proactive and effective service systems that reduce criminal justice system involvement for those with mental health needs. OUR PROGRESS → The Commission conducted a site visit to Napa State Hospital, where 89 percent of individuals served are → Full Service Partnership (FSP) programs are a criminal justice involved, in a pre-trial, post-trial, or post- “whatever it takes” approach to partner with sentencing stage. For more on this site visit, see page 6. individuals on their path to wellness and recovery. FSP programs are a powerful tool to help keep people → California was invited to meet with leaders from from becoming involved in criminal justice – or to Britain’s mental health system to share California’s support those who have been involved in criminal progress in reducing justice involvement and to share justice. The Commission is working to improve, opportunities, including details of how outcomes-based support, and expand these programs throughout contracting tied to supporting housing and employment California. For more on the Commission’s FSP work, are used as an intervention against homelessness, see page 23. substance use, and criminal justice involvement. → Research and lived experience show that the earlier → The Commission is working on data linking, a person receives care after their first episode of connecting criminal justice data with behavioral psychosis, the better their life outcome will be, from health services data to identify opportunities to avoiding criminal justice involvement to living a improve service. fulfilling life. But the gold standard of care is not widely available – if care is available at all – and many who WHAT’S NEXT are deemed incompetent to stand trial in California’s criminal justice system have experienced psychosis. → The Words to Deeds convening on criminal justice The Commission’s Early Psychosis Intervention (EPI) and behavioral health metrics will be held in program is working to increase access and quality of September 2024. The convening will focus this year care through a statewide strategy. For more on the on accountability and developing criminal justice and Commission’s EPI work, see page 22. behavioral health metrics. → At its February 2024 meeting, the Commission heard → The Commission will explore how outcomes-based from a panel on strengthening early intervention contracting can be used to improve FSP outcomes, to reduce criminal justice involvement; the panel which will in turn reduce criminal justice involvement. included a parent, state hospital staff, and a child forensic psychiatrist. → The Behavioral Health Services Act (BHSA) changes how state and county governments spend on → Following its support of “Hiding In Plain Sight: population-based prevention and early intervention Youth Mental Illness,” a landmark documentary that services. The Commission looks forward to engaging premiered on PBS primetime, the Commission is with our state, county, and local partners to leverage supporting the production of “Hiding In Plain Sight: new opportunities in prevention and early intervention. Adult Mental Illness,” which will include topics like criminal justice involvement. The documentary is slated to premiere on PBS in the next three years. 21 Transformational Change Report | January-June 2024 → The Commission looks forward to working with state, → The Commission looks forward to working with state county, and local partners to make use of opportunities and community leaders to address behavioral health for investment created by the BHSA in innovation workforce shortages with new tools established under projects that reduce criminal justice involvement. the BHSA. → The Commission is engaging state and local leaders on opportunities to uplift accountability strategies created by the BHSA. EARLY PSYCHOSIS INTERVENTION PLUS Nearly 100,000 adolescents and young adults experience their first psychotic episode each year in the U.S. With half of all mental health challenges manifesting by the age of 14 and 75 percent by the age of 24, California is expanding the provision of high-quality Coordinated Specialty Care (CSC), focusing on early detection and intervention to improve the lives of adolescents and young adults, significantly reducing the impact of mental health challenges. → In addition, four programs received funds to expand their existing CSC clinics: Aldea SOAR, the County of Riverside, the Felton Institute, and Stanford Health Care. → The Commission partnered with Kaiser Permanente to compare costs and outcomes of best practice care versus typical care for clients early in their psychosis diagnosis. Findings indicate that best-practice care improves outcomes and reduces costs. → In partnership with state and national leaders, the Commission coauthored in Psychiatry Online a brief on the importance of improving access to CSC. → The Commission supported Assembly Bill 2161 (Arambula) which would require the Commission to Overview of the strategic plan for early psychosis intervention in California work with the Department of Health Care Services from the draft Strategic Plan for Early Psychosis Care in California. (DHCS) to develop a strategic plan to improve California’s response to early psychosis, and for DHCS OUR PROGRESS to partner with the University of California to plan for a Center for Practice Innovations to promote the → The Commission administered Round 5 of the widespread availability of evidence-based practices, California Youth Behavioral Health Initiative (CYBHI) including early psychosis intervention, to improve in support of programs that operate early intervention behavioral health services. services. It awarded funds to four new Coordinated Specialty Care clinics to launch programs that will → At its July 2024 meeting, the Commission discussed address the needs of individuals experiencing their a draft of a strategic plan on early psychosis first episode of psychosis: the Hanna Center, Integral intervention. The plan explores the impacts of scaling Community Solutions, Lucidity Behavioral Health, EPI, key solutions, strategic objectives, foundational and South Coast Children’s Society. levers, and next steps. 22 Transformational Change Report | January-June 2024 WHAT’S NEXT → The Commission will continue to explore partnerships with the private sector to enhance access to care. → The Commission is developing a community engagement strategy to receive feedback on the early → In approving Proposition 1, California voters set aside psychosis intervention strategic plan. a percentage of funding explicitly to address the state’s well-documented behavioral health workforce → The Commission will partner with national behavioral shortage. The Commission recognizes and is eager health boards to expand access to CSC. to pursue opportunities to partner with California’s Department of Health Care Access and Information → The Commission will speak at EPI-CAL Conference, a to target specific challenges like early psychosis national early psychosis intervention conference, in intervention by growing and supporting a workforce September 2024. that is reflective of the communities it serves, with an emphasis on correcting disparities. → The Commission will also support expanded training and technical assistance for providers. FULL SERVICE PARTNERSHIPS FSP programs serve people with severe and persistent mental health needs in the community – rather than in locked facilities or hospitals. These programs, required under California’s Mental Health Services Act (MHSA), apply a “whatever it takes” approach to partnering with individuals on their path to wellness and recovery. FSPs can reduce costs, improve the quality and consistency of care, enhance outcomes, and, most importantly, save lives when implemented with fidelity to the model and as part of a robust continuum of care. OUR PROGRESS → The Commission hosted a panel on FSPs, including recent efforts to drive improvements in service delivery → In 2021, Senate Bill 465 required the Commission and partner outcomes, at its May 2024 meeting. to report to the Legislature on the state of FSPs biennially. The first report was delivered in 2023. WHAT’S NEXT → The FSP project wrapped up community engagement → By the end of 2024, the Commission will deliver its and evaluation activities to inform the Commission’s second report to the Legislature on the state of FSPs FSP strategy and its ongoing efforts to evaluate and as required by SB 465. report on FSPs. → The Commission will consider investing $20 million in → Commission partner Third Sector Capital delivered Mental Health Wellness Act funding. The funding will a report on its technical assistance and listening focus on four areas to drive transformational change sessions with counties and FSP providers. in FSP service delivery and outcomes: sustainable → Commission partner Healthy Brains Global Initiative funding, workforce and capabilities, accountability, delivered a report on the prospect of using outcomes- and infrastructure. based contracting to improve results for FSP programs. → The Commission will conduct several site visits to FSP → The Commission conducted several site visits to programs: a child FSP site, an adult FSP site in Nevada illuminate the state of FSPs, including a youth FSP site County, and an adult FSP site in Los Angeles County. in Butte County and Napa State Hospital. 23 Transformational Change Report | January-June 2024 → The Commission, with its partner Third Sector Capital, → The Commission will analyze the impact of is developing a service provider toolkit to share best Proposition 1 on FSP spending. practices and identify areas of support for FSP providers. → As implementation of the Behavioral Health Services → The Commission, with its partner Healthy Brains Act begins, the Commission looks forward to working Global Initiative, is supporting training around with community, state, county, and local partners performance management in Sacramento and on supporting FSPs, and monitoring how early Nevada counties. intervention and accountability impact FSPs. → The Commission will develop a plan and timeline and secure partners to invest the $20 million in Mental Health Wellness Act funding set aside in four focus areas to drive transformational change in FSP service delivery and outcomes: sustainable funding, workforce and capabilities, accountability, and infrastructure. IMPACTS OF FIREARM VIOLENCE More than 3,400 people die from firearm violence in California each year; about half of these are homicides, and just under half are suicides. In addition to the detrimental physical health problems that follow firearm violence – including emergency department visits, hospitalizations, and death – firearm violence also can cause trauma and lead to immediate and ongoing mental health challenges for individuals, families, and communities. This initiative aims to identify opportunities to save lives, reduce trauma, and address the mental health challenges that result from firearm violence. OUR PROGRESS WHAT’S NEXT → The IFV project wrapped up its initial community → The IFV final report is scheduled to go to the full engagement phase and began working on Commission for consideration before the end of the year. synthesizing the project’s overall findings and recommendations for a final report. Yosemite National Park Lompoc, CA San Diego, CA 24 Transformational Change Report | January-June 2024 INNOVATION The Mental Health Services Act (MHSA) includes a rare and explicit commitment to fostering innovation in providing services and support. The Incubator model the Commission followed made it easier to engage in innovation through flexible State-sponsored support, external expertise, and relationship-building across multiple counties, agencies, and departments. With $5 million in one-time funding (completed as of 2023), the Commission brought together county behavioral health agencies, subject matter experts, and other partners to drive innovations that improve mental health outcomes for individuals and communities. OUR PROGRESS WHAT’S NEXT → In partnership with the University of the Pacific’s → Commission staff will continue to provide technical McGeorge School of Law and other partners, the assistance and support to counties as they plan for Commission launched its Transformational Change the reforms associated with the BHSA. Partnership, supporting county behavioral health agencies in multi-county collaborative learning cohorts → The Commission will continue to develop plans to as they explore ways to transform their operations and invest BHSA innovation funds, including establishing build durable capacity. Nevada and Placer counties a legal structure and hosting convenings with public, piloted the program in late 2023 and early 2024, private, and community partners, preparing as the pursuing projects to implement payment reform. A Commission will expand in 2025. second cohort began in May 2024; Placer and Yolo → A third cohort of counties will join the counties focused on improving coordination among Transformational Change Partnership program in late behavioral health and criminal justice agencies. 2024, focused on school-based mental health. → The Commission attended a site visit at the University → The Commission will participate in the United Nations of California, Berkeley. This site visit included a tour General Assembly Science Summit in September of the CRISPR lab as well as a visit to UC Berkeley’s 2024. Events will convene professionals, experts, SkyDeck and Venture Lab incubator programs to and community partners across various industries support innovation. The Commission has been invited and disciplines to explore science-inspired policy back to UC Berkeley this fall for a roundtable to strategies related to brain health, brain economy, and continue the conversation with incoming chancellor innovation. Rich Lyons and other UC representatives. → The Commission will attend the Organization for Economic Cooperation and Development’s World Forum on Wellbeing in November 2024. The forum will bring together experts, practitioners, and thought leaders to strengthen approaches for centering multidimensional wellbeing in policy, measurement, and societal action. 25 Transformational Change Report | January-June 2024 MENTAL HEALTH WELLNESS ACT California’s Mental Health Wellness Act (MHWA) grant program provides $20 million each year to improve community response to people facing mental health crises. Grants have supported the ability of crisis responders to connect those having a mental health episode with wellness, resiliency, and recovery-oriented programs that offer the least restrictive settings appropriate for their needs. OUR PROGRESS WHAT’S NEXT → Following an analysis of the Commission’s programs → The Commission will receive a proposal for investing along a lifespan of potential care opportunities, the $20 million in MHWA funding to strengthen strategies to Commission identified opportunities being missed in support the needs of children ages zero to five and their early childhood (ages zero to five) and older adulthood. caregivers. The Commission identified priorities and expanded potential use of MHWA funding, leading to funding for → The BHSA allows for MHWA funds to support innovation EmPATH programs, PEARLS and Age Wise for older and to incentivize the adoption of best practices in adults, children ages zero to five, Substance Use response to crises. The Commission looks forward to Disorder (SUD) pilot program, and FSPs. engaging state, county, local, and community partners to explore how to best use MHWA funding as the BHSA → The Commission authorized grants to expand the is implemented. number of EmPATH crisis stabilization units near hospital emergency rooms, expand mobile support services for older adults experiencing depression and other serious mental illnesses, and conduct a SUD pilot to increase access to medication-assisted treatment. The Commission has identified children ages zero to five as a focus of MHWA program funding. Yosemite National Park Big Sur, CA Moorpark, CA 26 Transformational Change Report | January-June 2024 PREVENTION & EARLY INTERVENTION Everyone should have the opportunity to be well and thrive, yet one in four people worldwide will experience a significant disruption to their mental wellbeing at some point in their lifetime. Guided by the Governor and Senate Bill 1004, the Commission launched a policy research project to explore opportunities for prevention and early intervention (PEI) in mental health. The Commission’s findings and recommendations were published in the 2023 report “Well and Thriving.” OUR PROGRESS WHAT’S NEXT → The Commission heard a presentation on the evaluation → The Commission will consider the report to the findings for Phase II of the California Reducing Legislature on universal mental health screening in Disparities Project at its January 2024 meeting. the fall of 2024. → The Legislature requested the Commission, in → The Commission is supporting the Breaking Barriers consultation with DHCS, submit a report to the Integrated Care Symposium in November 2024. The Legislature on universal mental health screenings Symposium focuses on highlighting best practices to of children in public schools. The Commission has integrate child-serving systems and programs for the completed community engagement for this report, benefit of children, youth, and families. visiting schools engaged in mental health screenings and conducting listening sessions. For more information → The Commission looks forward to engaging state, on this project, see page 29. county, local, and community partners as California prepares to implement the BHSA, which shifts → As part of its community engagement efforts for responsibility for prevention and early intervention the universal screening report, the Commission from the counties alone to a shared responsibility conducted three site visits to schools across the between the state and counties. state to learn how universal screening has been implemented to support the unmet needs of children and youth. These site visits highlighted the opportunities for early intervention for young people. → The Commission administered Round 5 of the CYBHI grants in support of programs that operate early intervention services. For more on this project, see page 22. → Through its support for Mental Health Student Services Act (MHSSA) programs, including through grants and technical assistance, the Commission invests in behavioral health programs in schools, working to reach youth where they are, as early as possible. For more information on this project, see page 28. 27 Transformational Change Report | January-June 2024 SCHOOL MENTAL HEALTH The Commission is engaged in a multi-year effort to guide funding and policy decisions supporting the provision of mental health services to promote the academic and social success of young people. The Commission’s 2020 report “Every Young Heart and Mind: Schools as Centers of Wellness” lays out a plan, providing insight into the mental health needs of children and youth and explaining the essential role of schools as both the venue and means for responding to these needs. Through Mental Health Student Services Act (MHSSA) funding, the Commission is supporting school-county partnerships through grants to expand and better integrate mental health services in schools. Looking forward to new strategies, the Universal Mental Health Screening (UMHS) project explores how routine screenings in schools could help detect the risks and strengths of children’s mental health, helping lead to earlier interventions and better outcomes. MHSSA MHSSA Evaluation OUR PROGRESS OUR PROGRESS → On behalf of the Commission, staff attended a “Best → The Commission established a 16-member youth Practices in Student Information Sharing” Cross- advisory group to guide the evaluation in February System Convening in San Diego in May 2024. 2024. → The Commission held MHSSA Quarterly Collaboration → The Commission held an MHSSA Evaluation Meetings in March and June 2024. The March meeting Workgroup meeting in February 2024 to receive public focused on peer-to-peer mental wellness support in comment on the MHSSA Evaluation Framework. schools and included presentations by student peers. → The Commission collected information from 50 The June meeting focused on implementing the MHSSA grantees who work closely with data reporting CYBHI multi-payer school-linked fee schedule. during a listening session on February 28, 2024, to → The Commission released RFA_004 for $25 million inform the metrics plan development. in funding in four areas: marginalized and vulnerable student populations, universal screening, sustainability, WHAT’S NEXT and other priorities. → In the summer of 2024, the Commission will convene → The Commission finalized contracts with the with state agencies to build consensus around key four Technical Assistance (TA) Technical Coaching statewide school mental health metrics. Teams (TCTs). → The Commission will hold an MHSSA Evaluation → The Commission approved funding for a TA Workgroup meeting in September 2024 to enable the Statewide Coordinator to structure the TCT teams and public to contribute to evaluation planning. develop technical assistance and coaching strategies, → Throughout the MHSSA evaluation planning and to create and support a learning collaborative of process, diverse community partners will continue MHSSA grantees. listening sessions. WHAT’S NEXT → Evaluation partner WestEd will develop recommendations for school mental health metrics. It → The Commission will select a TA Statewide will produce a Final Evaluation Plan for MHSSA in Fall Coordinator to work with TCTs. 2024 in consultation with community partners. → TCTs will begin the implementation of TA to MHSSA grantees. → The Commission will hold MHSSA Quarterly Collaboration Meetings in September and December 2024. 28 Transformational Change Report | January-June 2024 Universal Mental Health Screening OUR PROGRESS • Elkhorn Village Elementary Site Visit - Lessons from Universal Literacy Screening: On March 22, → The Commission approved the Phase 1 Universal the Commission visited West Sacramento’s Mental Health Screening Literature Review Report in Elkhorn Village Elementary School to learn about February and submitted it to the Legislature in March. Multitudes, a neuroscience-based universal screener used to identify the risk of dyslexia among → In April, the Commission launched a statewide school early readers. survey in partnership with the University of California, San Francisco (UCSF), to learn from schools directly • Riverside County Site Visit - Whole Person Health about their mental health screening practices and, Score: On May 30, the Commission visited Hemet from schools not screening, about their barriers, Unified School District in Riverside County to learn challenges, and concerns. As of early May, it has about the Whole Person Health Score, a universal received more than 250 survey responses, and the screening tool administered to high school students UCSF contractor will provide a report summarizing to identify and respond to areas of risk and the survey and engagement findings. strengths across six domains of physical, emotional, behavioral, and socioeconomic health. → The policy research team conducted a series of listening sessions to gather input from students and parents about UMHS in schools. It held three youth listening WHAT’S NEXT sessions and two parent/guardian listening sessions. → The Commission will develop a Phase 2 UMHS Report, including a landscape analysis and recommendations → The Commission conducted three site visits to for school-based UMHS. learn about examples of universal screening practices in California schools. During each site visit, → The Commission will consider the report to the Commissioners, legislative staff, and other partners Legislature in the fall of 2024. learned about screening practices and procedures and gained insights from those involved, including teachers, administrators, providers, students, and family members. • Sonoma County Site Visit - Post-Disaster Universal Mental Health Screening: On February 6, the Commission visited Sonoma Valley High School to learn about the County’s “stepped triage to care”’ model — a post-disaster universal screening tool used to identify the risks of post-traumatic stress and other mental health needs so schools can help students get the care they need. Dr. Geoffrey Leung, Public Health Officer for Riverside University Health System, discusses universal screening of high school students in the Hemet Unified School District during a Commission site visit in May 2024. 29 Transformational Change Report | January-June 2024 SUICIDE PREVENTION Suicide in California is a significant public health challenge. Guided by data and community input, the Commission developed a statewide strategic plan for suicide prevention that incorporates the latest information and evidence to guide state and local actions for saving lives. Following the Commission’s 2019 adoption of the plan, the Commission is working with governments and community partners to implement recommendations from the report with the goal of reducing the rate and incidence of suicide in California. Commission Projects OUR PROGRESS WHAT’S NEXT → The Commission joined hundreds of middle and high → The Commission will work with Assemblymember school-age filmmakers at the annual Directing Change Ramos to develop a strategic initiative to reduce film festival in May 2024. The film festival’s mission is suicide risk in the Native American community. to educate young people about critical health topics through film and promote social justice by changing → The Commission will continue to partner with conversations; one film category this year was suicide the California Department of Public Health on prevention. implementing California’s strategic suicide prevention plan, recognizing that the Commission-drafted → The Commission attended a commemoration plan expires at the end of 2025. The Commission ceremony on June 15 to honor the completion of the anticipates opportunities to update and strengthen Golden Gate Bridge Suicide Deterrent System. The “net” efforts under the leadership of the Office of Suicide is intended to deter individuals and reduce suicides. Prevention. → In July 2024, the Commission participated in a → The Commission looks forward to engaging state, roundtable discussion at the Morongo Band of county, local, and community partners as California Mission Indians Tribal Council Chambers, hosted prepares to implement the BHSA, which holds by Assemblymember James Ramos as Chair of the numerous opportunities to transform prevention and California Native American Legislative Caucus. Discussion early intervention programs to prevent suicide. centered around California’s “Striving for Zero” suicide prevention plan implementation and opportunities to → In approving Proposition 1, California voters set aside improve focus on Native American youth. a percentage of funding explicitly to address the state’s well-documented behavioral health workforce → The Commission met with veterans’ organizations on shortage. The Commission recognizes and is eager opportunities to strengthen behavioral health strategies to pursue opportunities to partner with California’s under behavioral health reforms with the BHSA. Department of Health Care Access and Information to target specific challenges like suicide prevention by increasing the workforce and supporting a workforce that is reflective of the communities it serves, with an emphasis on correcting disparities. 30 Transformational Change Report | January-June 2024 Suicide Prevention Learning Collaborative OUR PROGRESS WHAT’S NEXT → The Striving for Zero Learning Collaborative was → The Commission’s Learning Collaborative Contractor formed in 2021 to support counties in developing will provide a final report that includes: and implementing local suicide prevention strategic plans that support the state’s broader strategic goals 1) Common lessons distilled from the defined in the Commission’s report “Striving for Zero.” participating counties → On February 28, the Commission sponsored a 2) Learning Collaborative outcomes convening in Carlsbad to bring counties together and 3) How the project has advanced local planning mark the end of a three-year local strategic planning and implementation aligned with the strategic process. Commission Chair Mara Madrigal-Weiss aims, goals, and objectives outlined in California’s presented opening remarks and Commission staff Strategic Plan for Suicide Prevention presented updates about the Commission’s portfolio of suicide prevention initiatives. Other guest speakers included national experts and representatives from California’s Office of Suicide Prevention. WORKPLACE MENTAL HEALTH (WPMH) Nearly one in five Americans live with a mental health condition, yet there are no well-established and agreed-upon standards in the U.S. to guide public and private employers about how to increase mental health awareness in the workplace, support prevention, and respond to needs with recovery strategies. The Commission developed a framework of five voluntary standards to support mental health in the workplace for all Californians. OUR PROGRESS WHAT’S NEXT → The Commission is working on a contract with the → In the next six months, the Commission will be University of California, Berkeley Haas School of working to establish a Center of Excellence for Business to host a convening around WPMH. Workplace Mental Health with the aim of partnering with UC Berkeley and UCLA as co-leads. → The Commission connected with the University of California, Los Angeles, and the Healthy Campus Initiative to explore opportunities for alignment around the WPMH strategy. 31 Transformational Change Report | January-June 2024 YOUTH & PEER EMPOWERMENT The Commission works through advocacy funding, sponsored legislation, sponsored youth participation, and committees like the Youth Innovation Committee to amplify the voices of youth and peer leaders seeking to create innovative solutions in the pursuit of emotional wellbeing and prevention. Youth Innovation Committee The Youth Innovation Committee formed in February 2019 to identify unmet mental health needs of California youth and identify opportunities for innovation. OUR PROGRESS WHAT’S NEXT → The Commission’s Youth Innovation Committee → The Commission will continue to share the toolkit as a developed and published the Youth-Led Innovation resource for other organizations. Toolkit in February 2024. This toolkit is a resource for organizations looking to include youth leaders in their work. Advocacy Grants Through MHSA funding, the Commission awards grants to local and state-level organizations to provide advocacy, training, education, and outreach on behalf of nine specific populations, including K-12 students. For more on advocacy grants, see page 35. OUR PROGRESS WHAT’S NEXT → The Commission and PRO Youth Families will publish → In partnership with PRO Youth and Families and 26 a report on the findings of working with more than K-12 student advocacy grantees, the Commission held 200 K-12 students. four in-person youth convenings. Anti-Bullying Peer Social Network In July 2021, the Asian Pacific Islander (API) Equity Budget authorized the Commission to allocate $5 million to create and support a peer social media network project for children and youth, with an emphasis on students in kindergarten and grades 1 to 12 who have experienced bullying, or who are at risk of bullying based on race, ethnicity, language, country of origin, perceived race, or ethnicity. The Commission contracted with Media Cause, a marketing firm with demonstrated experience with similar social media campaigns and strategies, skills, and professional services, and their mission to “help those doing good do more.” Over the last 12 months, Media Cause worked with subcontractors and cultural organizations that asked to participate in the campaign. OUR PROGRESS → The “Right Our Story” campaign launched in February 2023, supported by its youth advisory committee. To date, the campaign has generated 338 million impressions across California, both online and offline (46% increase since December 2023), 207,000 social engagements, including discussions and reactions, and 4,016 submissions of heartbreaking bullying experiences (114% increase since December 2023). 32 Transformational Change Report | January-June 2024 → As current funding draws to a close, Right Our Story WHAT’S NEXT has shifted focus from advertising to deepening → With no further funding available from the state, engagement with community members through Media Cause concluded the campaign while allowing monthly digital activations to help youth build the Right Our Story website and evergreen resources leadership and resilience skills to fight race-based to be available for youth in California. However, bullying in their schools and communities. Monthly the Right Our Story community and social media themes included how to be a peer advocate, channels were sunsetted in late June 2024. embracing heritage and community to build resilience, and planning an anti-race-based bullying campaign in your community. → The Right Our Story campaign continued to be recognized by the marketing and communications industry, winning a prestigious Bronze Anthem Award and Silver Muse Award. Design company Canva showcased the campaign for its innovation. PPhhoottoo:: PPiissmmoo BBeeaacchh,, CCAA Transformational Change Report | January-June 2024 Foundational Work Updates In its effort to create transformational change for wellbeing in California, the Commission uses research, grants, innovation, communications, and more to explore bold new ideas. These tools underpin Commission initiatives to create more robust evidence and exploration. ADMINISTRATION The Commission’s administrative work encompasses strategic planning, contracts and budgeting, and human resources. Additionally, the Commission’s administrative team leads racial equity and internal workplace mental health initiatives. These efforts are highlighted in particular by the newly adopted 2024-2027 Strategic Plan. OUR PROGRESS WHAT’S NEXT → The Commission adopted the 2024-2027 Strategic → Administration staff will work with a developer to Plan at the January 25 Commission meeting. create an intranet to serve as a central hub for staff policies, calendars, trainings, and other resources. → The Commission reviewed a strategic implementation plan — with metrics for tracking and reporting → Budget staff will continue to monitor the Governor’s progress against the Strategic Plan’s goals and budget and prepare to advise counties on changes. objectives — at the May 23 Commission meeting. → The administration staff is working with the research → In May 2024, members of the Commission’s Human and evaluation team to develop a survey supporting Resources team led a workshop at St. John’s Program staff returning to the office for a hybrid work schedule. for Real Change, the largest residential program in the Sacramento region for women and children experiencing homelessness. During this workshop, attendees were guided through the process of creating a CalCareers account and given helpful insights on how to maximize their potential of gaining employment with the State of California. In May, Kelsey Wood, left, and Brittany Scangarello, right, of the Commission’s Human Resources Department led a two-day seminar on how to apply for a state job at Saint John’s Program for Real Change. Saint John’s started as an emergency shelter in 1985 and is now the largest residential program dedicated to unhoused women and children in the Sacramento region. 34 Transformational Change Report | January-June 2024 ADVOCACY GRANTS Through MHSA funding, the Commission awards grants to local and state-level organizations to provide advocacy, training, education, and outreach on behalf of nine specific populations: clients and consumers, diverse racial and ethnic communities, families, K-12 students, LGBTQ+, parents and caregivers, transition-age youth, veterans, and immigrants and refugees. OUR PROGRESS WHAT’S NEXT → In partnership with PRO Youth and Families and the → The Commission and PRO Youth and Families are 26 K-12 student advocacy grantees, the Commission preparing a report that shares the findings from successfully held four in-person youth convenings in working with more than 200 K-12 students over the six early 2024. More than 180 students from 14 counties months of the K-12 advocacy grant. A professionally had the opportunity to connect, build their mental produced video will accompany the report and health literacy, and learn about local and state showcase the in-person convenings and individual advocacy. Individual students also participated in interviews, providing an inside look into how today’s one-on-one interviews to share their experiences youth think about school-related mental health. and insights. → The advocacy grantees are preparing to hold their → In April, the Commission began advocacy work activities and events across the state. There will with six statewide partners. The six organizations be a focus on rural communities among the six will conduct local and statewide activities and populations, which is new for the advocacy grants. events to advocate for the needs of the underserved communities identified by the Commission. Commission staff completed kick-off meetings with these partners in early April. 35 Transformational Change Report | January-June 2024 COMMUNICATIONS The Commission leverages communication opportunities to improve public understanding of mental health needs, the potential for recovery, the value of services, and the opportunity for transformational change to significantly improve results. The Commission publishes its own communications in addition to leveraging strategic partnerships. OUR PROGRESS → In June 2024, Commissioners and staff attended → Communications staff has worked to create a library Voices With Impact’s short film festival premiere, of high-quality photos taken at Commission events. the first in-person celebration since the COVID-19 These original images help the Commission share pandemic. This year’s short films focused on two its story through vivid visuals – like the photos of the themes: “cliques and echo chambers” and “serious Napa State Hospital visit on pages 6-8. These photos mental illness.” take readers behind closed doors into the long and storied history of California’s state hospital system, as revealed through a moving art display, symbolic of both the past and future transformational changes needed in California’s mental health care system. → The Communications team set benchmarks for its social media engagement. These benchmarks will provide a baseline as the Communications staff implements efforts to grow Commission reach and engagement on social media. Since the beginning of the year, the Commission has seen exponential growth in multiple metrics. This includes a 267% increase in LinkedIn followers, as well as a 744% increase in engagement on Instagram. Attendees watch a scene from the film “ALL MEAT DIET” during the 2024 Voices With Impact Film Festival at the San Francisco LGBT Center in June. → The Communications staff monitors news outlets and creates a weekly “Media Monitor” email to help keep → In January 2024, the Communications team launched Commissioners and staff up-to-date on how public the Commission’s community engagement map, a narratives about issues impacting the Commission’s brand-new tool to show areas of the state where the work are portrayed in the media. During the first half Commission has actively engaged and areas that of 2024, the reach of the Media Monitor tool expanded require broader outreach efforts. The map shows to include some strategic partners. activities back to 2019 and is updated weekly with → The Communications team supported work around community engagement, grantee, and advocacy events. the Commission’s 2024-2027 strategic plan, including → As part of its anti-stigma work, the Commission publishing it to the website and producing a supported “Hiding In Plain Sight: Youth Mental designed version for print release. Additionally, the Illness,” a documentary that premiered on PBS in Communications team created plans to implement 2022. The Commission is now supporting “Hiding In the new strategic plan in its work areas and supported Plain Sight: Adult Mental Illness,” set to premiere on implementation planning with other divisions. PBS within three years. Production is underway; the production team has begun to edit interviews and create preview reels. 36 Transformational Change Report | January-June 2024 WHAT’S NEXT → As the Commission’s research and policy teams prepare → To prepare for Proposition 1 implementation in 2025, to publish reports on MHSSA implementation, Universal the Communications team will create plans to update Mental Health Screening, Full Service Partnerships, and the Commission’s website to reflect changes in the the Impacts of Firearm Violence in the second half of Commission’s statutory requirements, including 2024, the Communications team will provide design implementing a rebrand. This plan will also reflect the and strategic communication support around each increased workload in support of the Commission’s new report’s publication. reporting requirements and additional Commissioners. DATA ANALYSIS, MANAGEMENT, AND WAREHOUSE The Commission’s data team coordinates and maintains a broad data warehouse to help inform research, policy, and evaluations. Our data warehouse includes state and federal data, allowing the Commission to cross-reference and clean data to draw accurate conclusions to help improve wellbeing for all Californians. OUR PROGRESS WHAT’S NEXT → The Commission drafted a business use case proposal → The data team will continue to make progress with for MediCal data, submitted it to the Department of the California Department of Social Services to Health Care Services, and received feedback to address. receive social welfare data. → A California Department of Education data → The Commission and the Council on Criminal memorandum of understanding (MOU) amendment Justice and Behavioral Health (CCJBH), along with is in progress to add special education and post- other departments, will draft a joint letter to the secondary data. Department of Justice. → Staff is working on a data dashboard showcasing CDE → The Commission will discuss the use case for mental health client-linked data. obtaining Department of State Hospital Data for Criminal Justice relevant data. → Data refreshes (i.e., seed list submissions, and in term, data receipts) have occurred or are in progress for several state department data with which the Commission has established MOUs. 37 Transformational Change Report | January-June 2024 LEGISLATION As the Commission itself was created and is guided by legislation, the Commission constantly monitors California legislation that impacts its work. Periodically, consistent with the Commission’s policy projects and publicly adopted priorities, the Commission will sponsor or support selective legislation. OUR PROGRESS → The Commission sponsored one bill this spring: • SB 1318 (Wahab) would require local educational agencies (LEA) to adopt a youth suicide crisis • AB 2411 (Carrillo and Cortese) would require intervention protocol that prioritizes mental health each community mental health service to have a professionals first and limits involvement and local youth advisory board to provide youth with a notification to law enforcement. Awaiting action by platform to better advocate for effective and quality Governor Newsom. mental health programs. Held in the Assembly Appropriations Committee. • AB 1472 (Limon) would require the California Department of Justice to develop and launch a → The Commission supported five bills this spring: system to allow a California resident to voluntarily add their name to the California Do Not Sell • AB 2161 (Arambula) would require the List, preventing a person on that list from being Commission to work with the Department of Health sold or transferred a firearm. Held in the Senate Care Services (DCHS) to develop a strategic plan to Appropriations Committee. improve California’s response to early psychosis. The bill would also require the DHCS to seek to • AB 1282 (Lowenthal) would require the partner with the University of California to develop Commission to consult with the California a plan to establish a Center for Practice Innovations Department of Public Health on a statewide to promote the widespread availability of evidence- strategy to address mental health risks associated based practices, including early psychosis with the use of social media by children and youth. intervention, to improve behavioral health services. Awaiting action by Governor Newsom. Held in the Senate Appropriations Committee. • AB 2352 (Irwin) seeks to build out a legal framework WHAT’S NEXT for Psychiatric Advance Directives (PADs) in → The Commission will continue the 2024 California, which will work in tandem with a pilot legislative session. project already underway in seven counties across the state to expand the use of PADs and ensure access to first responders and health care professionals. Held in the Senate Judiciary Committee. • AB 2711 (Ramos) would revise school suspension and expulsion policies for drug-related infractions by requiring local education agencies to create policies using a public health approach. Awaiting action by Governor Newsom. 38 Transformational Change Report | January-June 2024 TRANSPARENCY SUITE The MHSA Transparency Suite of dashboards provides high-level statistics showing county and statewide demand for mental health service programs, where money gets spent, programs offered, and associated outcomes. OUR PROGRESS WHAT’S NEXT → The Commission updated the Fiscal Transparency Tool → The Commission will continue to update the FTT (FTT) with the most recent county data via DHCS. It also and work on new dashboards around SUD and has been building new dashboards linking California homelessness that align with the modernization of Department of Education data with FSP data to explore the MSHA. educational outcomes for youth receiving FSP services. 39 Photo: Bakersfield, CA Transformational Change Report | January-June 2024 04 BUDGET UPDATE Photo: San Joaquin Valley, CA Transformational Change Report | January-June 2024 Budget Update The table below illustrates the budget for Fiscal Year 2024-2025, year-to-date expenses, committed funds, and funds that are potentially available for the Commission to use in the future. APPROVED ADJUSTED EXPENSE YTD POTENTIALLY ITEM FY 23-24 ADJUSTMENT FY 23-24 ENCUMBERED EARMARKED TYPE EXPENSES AVAILABLE BUDGET BUDGET Operations Personnel $8,968,000 -$1,500,000 $7,468,000 $6,405,256 $0 $596,104 $466,640 Core Operations $1,869,913 $550,000 $2,419,913 $1,802,093 $435,740 $605,940 -$423,860 Commission Communications $599,418 $104,726 $704,144 $286,114 $384,700 $104,726 -$71,396 Priorities Innovation $500,000 $500,000 $0 $0 $500,000 $0 Research $1,075,669 $650,000 $1,725,669 $651,907 $604,544 $491,300 -$22,082 Budget Universal mental health $200,000 -$40,000 $160,000 $0 $160,000 $0 $0 Directed screening study Evaluation of FSP Outcomes $400,000 $400,000 $0 $250,000 $150,000 $0 (SB 465) EPI+ reappropriation $1,674,726 -$64,726 $1,610,000 $0 $1,610,000 $0 $0 Children and Youth $15,000,000 $15,000,000 $107,775 $5,042,225 $5,000,000 $4,850,000 Behavioral Health Initiative Local Mental Health Wellness Act $20,000,000 $20,000,000 $0 $1,500,000 $18,500,000 $0 Assistance Mental Health Student $7,606,000 $7,606,000 $0 $0 $7,606,000 $0 Services Act (MHSSA) Community Advocacy $6,700,000 $300,000 $7,000,000 $562,500 $5,467,500 $970,000 $0 Money Held For Reserve $250,000 $250,000 Total $64,843,726 $0 $64,843,726 $9,815,645 $15,454,709 $34,524,070 $4,799,302 41 Transformational Change Report | January-June 2024 05 WHAT’S NEXT? Photo: Visalia, CA Transformational Change Report | January-June 2024 California’s Behavioral Health Services Act: A Transformative Approach to Mental Health Care Proposition 1 reflects a historic moment – California is transforming its behavioral health system, establishing the Behavioral Health Services Act (BHSA) on the foundation of the state’s landmark Mental Health Services Act (MHSA) with key components intended to drive transformational change and improve outcomes for all Californians. Prevention early intervention efforts of local behavioral health The MHSA was pioneering in its emphasis on prevention. agencies. New state responsibilities include the The BHSA continues that focus and transitions the development of scalable standards of practice and responsibility from being primarily county-led to a enhanced technical assistance. The Commission is shared responsibility between the state and counties. collaborating with state partners to leverage research and This shift includes a dedicated funding stream managed analysis to identify the best opportunities and programs by the California Department of Public Health (CDPH), for early intervention. These collaborative efforts are positioning California’s lead with the most expansive intended to support the ability of local partners to tailor and aggressive statewide behavioral health prevention care to meet community needs, reduce disparities, strategy in the nation. California has the opportunity and ensure a more consistent set of behavioral health to elevate and escalate behavioral health prevention to programs and practices across the state. become on par with much more established prevention strategies that have reframed how we think about health Community engagement care and the impacts of prevention. The Commission Engagement remains a cornerstone of the BHSA. The looks forward to working with CDPH, local partners, Commission recognizes the need for robust and consistent and community members across the state to realize the community-driven decision-making as the state and prevention goals of the BHSA. counties manage the transitions called for under the newly enacted reforms. While the Commission has made progress in elevating the voices of diverse communities, Early intervention we have more work to do. We are working to further Early intervention remains a critical component under enhance our ability to understand and share how we are the BHSA, with new mandates for the state to provide elevating community voices and to receive guidance on more consistent guidance and framing to support the opportunities to be more effective in this key aspect of behavioral health planning, oversight, and accountability with an emphasis on reducing disparities. Innovation Innovation continues as a key focus under the BHSA. When it passed, the MHSA’s mandate for innovation was groundbreaking – providing an explicit recognition that California’s behavioral health system must improve, and all aspects of that system should be challenged through an innovation lens to better support communities, improve effectiveness, extend the reach of limited Photo: Mojave Desert, CA funding, and enhance outcomes. Under the BHSA, 43 Transformational Change Report | January-June 2024 responsibility for fostering behavioral health innovation has shifted from the counties to the Commission, with $100 million in seed funding to explore models from around the world. The BHSA challenges the Commission to leverage the expertise and experiences of behavioral health partners and to develop new opportunities through public-private partnerships. These efforts aim to create effective, innovative solutions that can address the many challenges impeding our ability to ensure all Californians have access to prevention, early intervention, and effective services and supports. Accountability Photo: Chino Hills, CA Accountability is built into the Commission’s name and remains a core component of the BHSA. The Act California and the California Institute for Regenerative calls for a more robust approach to transparency and Medicine, the state has the opportunity to deepen the accountability, including a focus on resource allocation, understanding of the drivers of mental health needs. service delivery, and outcome measurement. The BHSA These opportunities include their environmental, reinforces the need for robust data systems and elevates biological, and other drivers of mental health needs, the role of the California Health and Human Services and identifying new avenues for prevention, early Agency to fortify existing accountability and transparency intervention, services, and supports. Collaborative efforts. The Commission also recognizes the need to opportunities can support more tailored approaches to strengthen financial tools to ensure sustainability in meeting community needs, reducing disparities, and today’s systems, and we look forward to working with ensuring a consistent approach across the state. state and local leaders to make that happen. Full Service Partnerships Research Full Service Partnerships (FSPs) are a California The BHSA recognizes the growing need for a robust innovation that grew out of the recognition that recovery behavioral health research agenda. By leveraging the is possible, people with mental health needs must be fields of neuroscience, health care research, technology, in charge of their care, and strategies for services and evaluation, community engagement, and social science, supports must be tailored to the unique needs of the in partnership with institutions like the University of individuals. The MHSA elevated the role of FSPs across California and the BHSA reinforces their significance. Despite strong conceptual foundations, many FSP programs are struggling to address homelessness, hospitalizations, and criminal justice involvement for the clients they serve. The Commission is partnering with state, local, and community leaders to enhance the impacts of these essential programs. [For more on FSPs, read our report to the Legislature here.] Workforce Ensuring that California has an adequate workforce reflects that the demographics and geographic distributions of people with behavioral health needs Photo: Bonny Doon, Santa Cruz County, CA is essential to improving behavioral health outcomes. 44 Transformational Change Report | January-June 2024 It is also crucial for meeting the wellbeing goals of We look forward to working with our new colleagues when Proposition 1 and the host of related reforms supported they join us at the beginning of next year, and as always, by the Governor and Legislature. We are excited to work we are eager to leverage our experience in innovation, with the California Department of Health Care Access partnerships, and community engagement to support and Information to ensure the newly established funding the Governor’s Office, state services, organizations, opportunities result in the workforce and behavioral and individual counties to create a more effective and health outcomes expected by voters. equitable behavioral health system for all Californians. Housing Since the passage of the MHSA, behavioral health advocates have highlighted the importance of stable, Apply to Become a Commissioner affordable, and supportive housing as a core element of a recovery-focused behavioral health system. The MHSA With modernization comes 11 new Governor- calls out reducing homelessness as a prevention and appointed Commissioners; those interested should early intervention goal. Building upon that recognition, learn more and apply through the Governor’s the BHSA further elevates housing as a mandatory area Appointments Unit. New members of the of spending, to reshape incentives to do more to ensure Commission will represent the following: that unmet mental behavioral needs do not continue 1 A peer youth to be a driver of California’s unhoused population. The Commission has partnered with the California 2 Two people with substance use disorders (SUD) Department of Housing and Community Development to support the implementation of the No Place Like Home 3 A family member of an adult or older adult grant program. We look forward to supporting the state’s with SUD strategy to sever the links between unmet behavioral health needs and housing instability. 4 A family member of a child or youth with SUD Substance Use Disorder 5 A professional with expertise in housing Prop 1 emphasizes the need to integrate traditional and homelessness mental health services and substance use disorder (SUD) services to ensure clients are treated with a unified 6 A representative of an aging or approach as a whole person. The Commission looks disability organization forward to working with community members, the Governor’s Office, the Legislature, and our colleagues at 7 A person with knowledge and experience in state and local agencies to support this effort. community-defined evidence practices and reducing behavioral health disparities POISED FOR GROWTH 8 A representative of a children and When California voters created the Commission, they youth organization envisioned people from diverse backgrounds – clients, family members, care providers, business leaders, law 9 A veteran or a representative of a enforcement, legislators, and more – working together veterans’ organization with their community to improve wellbeing for all Californians. Now, our Commission is set to grow from 10 A current or former county behavioral 16 to 27, expanding our membership to include youth, health director people with lived experience in SUD, a veteran, and more. Link to more info and how to apply: Appointments | Governor of California 45 Transformational Change Report | January-June 2024 Photo: Joshua Tree National Park 06 STAY IN TOUCH  https://mhsoac.ca.gov/  https://www.facebook.com/mhsoac LINKEDIN-IN https://www.linkedin.com/company/california-mental-health- services-oversight-and-accountabilty-commission/  https://www.youtube.com/mhsoac  https://www.instagram.com/mhsoac 46