Report 2012-122 Recommendation 1 Responses

Report 2012-122: Mental Health Services Act: The State's Oversight Has Provided Little Assurance of the Act's Effectiveness, and Some Counties Can Improve Measurement of Their Program Performance (Release Date: August 2013)

Recommendation #1 To: Health Care Services, Department of

To ensure that it monitors counties to the fullest extent as the MHSA specifies and that it implements best practices, Health Care Services should draft and enter into a performance contract with each county that contains assurances for effective oversight and furthers the intent of the MHSA, including demonstration that each of the county's MHSA programs are meeting the MHSA's intent.

Annual Follow-Up Agency Response From October 2015

DHCS has incorporated provisions in the County Performance Contract that specify best practices for monitoring and oversight and provide guidance to counties to effectively demonstrate the implementation of their MHSA funded programs. DHCS outlines Department Compliance Investigations and County Breach, Plan of Correction and Withholding of State Mental Health Funds processes in each Performance Contract. Of the contracts submitted, 47 have been fully executed and six are in final processing.

  • Completion Date: July 2015

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

1-Year Agency Response

As of June 30, 2014, 36 counties submitted their Board of Supervisor's approved FY 2013-14 Performance Contracts to DHCS. Of the contracts submitted, 22 are fully executed and 14 are in final processing.

DHCS has continued to work with the County Behavioral Health Director's Association and the California State Association of Counties to address concerns regarding the applicability of certain requirements contained within the contract. Having completed these contract discussions, the FY 2014-15 Performance Contracts were released to the counties on July 28, 2014 with a due date for submission to DHCS within 45 days (by September 12, 2014).

  • Estimated Completion Date: 09/12/14
  • Response Date: August 2014

California State Auditor's Assessment of 1-Year Status: Partially Implemented

6-Month Agency Response

Performance Contracts were forwarded to counties on September 27, 2013, and as of January 21, 2014, 24 counties have submitted their Board of Supervisors approved Performance Contracts to DHCS. Of the 24 contracts submitted, 18 are fully executed and 6 are in final processing. Three contracts were calendared at local Boards of Supervisor meetings during January 2014.

The California Mental Health Directors Association (CMHDA) has informed DHCS that many counties are stalled on processing the Performance Contracts because the California State Association of Counties (CSAC) counsel has concerns about the applicability of certain requirements contained within a contract exhibit. DHCS is researching this issue and is scheduled to meet on February 10, 2014 with CMHDA and their CSAC Counsel to address their concern.

  • Estimated Completion Date: Fall 2014
  • Response Date: February 2014

California State Auditor's Assessment of 6-Month Status: Partially Implemented

60-Day Agency Response

The Performance Contract contains language that allows the Department of Health Care Services (DHCS) to monitor a county's performance according to the provisions of the Mental Health Services Act (MHSA) and related regulations. The Performance Contract provides that a county may be required to develop a plan of correction with specific timelines regarding any findings. DHCS may, after a hearing held with no less than 20 days notice to the county mental health director, withhold payments from the MHS Fund until the County is in compliance. The Performance Contract requires MHSA data reporting of full service partnerships, the achievement of performance outcomes, and of revenues and expenditures.

The Performance Contract will be sent to the counties for signature approval in September 2013. The time required to fully execute this contract will depend on how quickly each county is able to gain Board of Supervisor approval. In the next report, this recommendation's implementation status will be updated with the number of counties that have fully executed their Performance Contract.

  • Estimated Completion Date: Fall 2013
  • Response Date: October 2013

California State Auditor's Assessment of 60-Day Status: Partially Implemented

All Recommendations in 2012-122

Agency responses received are posted verbatim.