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⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 5 findings
F1
Underspending of MHSA funds is still a State-wide issue, although the changes made by the State to extend the time given to expend funds have eased the immediate concern of losing funding earmarked for mental health programs.
Related Recommendations (1)
R1
The County should continue to contact counties who have been successful in spending MHSA funds in a timely manner to determine if there are best practices that might be used here to better utilize MHSA funds.
F2
The County's MHSA Project Team is continuing their efforts to minimize the risk of reversion of MHSA funds, recently assisted by Statewide changes to the reversion rules.
Related Recommendations (1)
R2
The Chief Administrative Officer, the Director of Health and Human Services, and the County Auditor-Controller should review County budgeting and personnel philosophies, strategies, and procedures to ensure that these administrative functions fully support a) the best available opportunities to hire and retain MHSA program staff and b) the timely expenditure of MHSA funds.
F3
There are still systemic and persistent issues in hiring and retaining County mental health employees that impact the timely expenditure of MHSA funds.
Related Recommendations (1)
R3
The Director of Health and Human Services and the County Auditor-Controller should use all available options to implement an over-budgeting strategy or the use of recruitment allowance positions to maximize staffing of the MHSA program.
F4
The El Dorado County budgeting philosophy puts County MHSA funds at risk of reversion.
No recommendations for this finding
F5
The County's contracting procedures, listed as one of the problems in the Grand Jury's previous MHSA report, have been significantly improved.
No recommendations for this finding
Conclusions 1
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CL1While there have been steps taken by the State's Department of Health Care Services to relax the codes and timeframes that control the reversion of funds, unexpended MHSA funds are still subject to be returned back to the State, unlike most other County programs, where funds not spent during a budget year are returned to the County's General Fund. The State then redistributes unspent funds to all 58 counties. The County 2018-2019 annual plan update has a Reversion Reallocation Expenditure Plan, which calls for funds subject to reversion to be given priority for expenditure. The County's new three year Program Plan (Fiscal Years 2020-21 to 2022-23) also includes a Reversion Reallocation Expenditure Plan. Additionally, the annual update (Fiscal Year 2019-20) calls for Community Services and Support funds identified during the fiscal year that are at risk of reversion be transferred to the Reserve account. As was the case with the previous Grand Jury, we interviewed individuals with the most knowledge of MHSA funds. This time around, however, these key County administrators indicated that there have been some recent changes that reduce the risk of the County having funds returned to the State. While the underlying budget philosophy in the County has not changed, we can see that progress has been made, including: Taking steps to start the contract process sooner, including earlier approval by the Board of Supervisors, so that the contracted services are available when they are needed. Assuring that funds are used in a "First In, First Out" sequence, so as to minimize the possibility of losing funds. While we've noted these successes since our last MHSA report a few years ago, both County and Behavioral Health Division administrators need to strongly consider possible strategies to assist with the hiring and retention of MHSA staff, especially clinicians. One thing that has not changed since our last report is the extremely high vacancy rate in the program, and we don't see that improving without a significant change to how our County administrators deal with both the high turnover and the difficulty in recruiting. Finally, it should be noted that the Grand Jury believes that the risk to the County by "over- hiring" staff for the MHSA program is minimal, as historically, the program has never been fully staffed, nor have they expended anywhere close to the amount budgeted for program personnel. This could be accomplished by the use of Recruitment Allowance Positions. In addition, according to high-level MHSA staff the Grand Jury interviewed, the Prudent Reserve from MHSA funding may be used to cover potential personnel cost overages, although such use would probably require the prior approval of the State's MHSOAC. It has also been reported to us that counties in our area-including Sacramento County, are already using this budgeting strategy. 6/30/2021 Mental Health Services Act Fund Spending
No Responses Found 1
Government entities assigned to respond to this report. No response documents have been linked in our database.
El Dorado County Board of Supervisors
Elected County Office
* This report's PDF did not contain easily extractable text and required Optical Character Recognition (OCR) for analysis. There may be minor errors in the extracted findings and recommendations due to OCR limitations with scanned documents.