Advocating for an Inclusive Community Program Planning (CPP) process

A presentation to the Mental Health America of San Francisco (MHAoSF) 2025: Redefining Crazy: Rewriting the Rules Conference, May 2025.

The Behavioral Health Services Act (BHSA) Integrated Plan requires meaningful stakeholder engagement in county behavioral health services planning process.

The presentation describes the many ways the community engagement process intends, and many times misses, opportunities to stay connected with their consumers and stakeholders.

1. ADVOCATING FOR AN INCLUSIVE
COMMUNITY PROGRAM PLANNING (CPP)
PLANNING PROCESS
Planning Procedures: Collaborate, Educate, Evaluate, Plan, & Budget
2025 Redefining Crazy: Rewriting the Rules Conference
Mental Health America of San Franscisco (MHAOSF)
Jerry Hall, May 2025

2. INTRODUCTION

3. LANGUAGE
❑BHS –MHS, DMH county Behavioral Health Services
❑Advisory Board –BHAB, BHC, MHB, MHC
❑Community Program Planning (CPP) Plan –procedures of engagement
❑BHSA Integrated Plan –3-Year Plan –aka. MHSA Plan, Annual Plan

4. CPP PROCEDURES
VS. INTEGRATED PLAN
The BHSA Integrated Plan (IP)
A plan to deliver behavioral
health services to meet the
behavioral health needs of
county residents.
Community Program
Planning (CPP)
Procedures used to
inform and
meaningfully engage
stakeholders by a
county Behavioral
Health System (BHS).
Community
Program Planning
(CPP)
Procedures
BHSA
Integrated Plan
(IP)

5. CRUX OF ISSUE
❑The status quo is broken.
❑Plan vs. Report
❑Meaningful Involvement in all stages of the planning process.
❑The need for a well-informedand capable Advisory Board performing its duties.
❑The new BHSA Integrated Plan –stakeholder engagement process –every 3 years
❑FY 2021-22 of $121 m, $8m spent, leaving $113m on the table

6. BARRIERS: PLANNING COUNCIL
DATA NOTEBOOK
59% General difficulty with reaching stakeholders
45% Difficulty conducting community outreach to racial/ethnic, & specific communities
45% Difficulty reaching stakeholders with disabilities.
27% Shortage of properly trained staff to support/facilitate engagement.
25% Lack of funding or resources for stakeholder engagement efforts.
18% Difficulty incorporating stakeholder input in the early stages of programming.
14% Difficulty adapting to virtual meetings/communications.
2023 Data Notebook Report: Project on California Behavioral Health: Stakeholder Engagement in the Public Mental Health System
Why the CPP matters? In the 2023 CBHPC, counties reported about their CPP:

7. THE LAW
‘…review and approve the procedures used to ensure citizen and professional involvement at
all stages of the planning process.’
Counties are required to demonstrate a partnership with constituents and stakeholders
throughout the processthat includes meaningful stakeholder involvement on mental health
and substance use disorder policy, program planning and implementation, monitoring,
workforce, quality improvement, evaluation, health equity, evaluation, and budget
allocations.19
Meaningful stakeholder engagement requires that counties conduct a community planning
process that is open to all interested stakeholders and that stakeholders have opportunities to
provide feedback on key planning decisions. Stakeholder engagement should not be limited to
individuals who belong to organizations or advocacy groups.
Page 21 BHSA County Policy Manual 4/2025
The intent was to ensure that consumer and community stakeholders co-developed their mental
health services delivery system, with a clear communication path to their Board of Supervisors
through their local BHAB.
WIC Section
§5604.2, subdivision (a)(4)(A)

8. THE NEW BHSA
❑BHSA formed after Prop 1, approved by voters, effective 1/1/2025
❑Includes additional stakeholders (~29 stakeholder target groups) –Government,
Corporate, Individuals & Groups, & Community Organizations
❑Includes BHSA Integrated Plan (IP) and annual BOHATR report.
❑Includes Stakeholder Engagement requirements and certification.
❑Includes shifting funding and state and local focus (Prevention, Homeless)
❑Includes integration with Public Health Services and Managed Care Plans

9. BHSA IP PLANNING TIMELINE
BY QUARTER & FISCALYEAR
JANAPRJULOCT JANAPRJULOCT JANAPRJULOCT JANAPRJULOCT
BHSA IP PLANNING PERIOD
3 YEARS FY2026- 28
BHSA IP PLANNING PERIOD
1 YEAR UPDATE FY2027-28
BHSA IP PLANNING PERIOD
1 YEAR FY2025- 26
We Are Here
BHSA IP Plan Reports
CPP Activities Done last FY
BHSA IP Plan & Budget Details
CPP Activities Planned for next FY
FY 2024- 25 FY 2025- 26 FY 2026- 27 FY 2027- 28FY 2023- 24

10. INTEGRATING PLANS
Behavioral
Health
System
Local
Health
Jurisdiction
Managed
Care Plans
Community
Health
Improvement
Plan
(CHIP)
Community
Health
Assessment
(PNA/CHA)
BHSA
Integrated
Plan
(IP)

11. COMMUNITY
HEALTH
IMPROVEMENT
PLANS
(CHIP)
https://www.sandiegocounty.gov/content/dam/sdc/hhsa/programs/phs/documents/NEW%20FINAL%2023-25%20CHIP%20(and%20Regional%20Plans).pdf

12. CHA is equivalent
to a Public Needs
Assessment (PNA)
https://about.kaiserpermanente.org/content/dam/kp/mykp/documents/reports/community-health/san-diego-chna-
2022.pdf
COMMUNITY
HEALTH
ASSESSMENT

13. LOCALQUESTIONS-San Diego County
Homeless –headless
ecosystems
Jail Behavioral Health
and deaths ($60m to
contracted provider
with zero insight)
Crisis Response (Cost
per Contact: PERT
($1k/per) vs. MCRT
($1.8k/per)
Unspent Funds
9-8-8, Access and
Crisis Line (ACL)
Program, Service, &
Resource Priorities
Resources & Support
website (24 links to
click on one page)

14. COVERED CPP PLANNING EXPENSES
Planning costs may be used to help pay for infrastructure and technologies that will support
robust stakeholder engagement. Examples may include but are not limited to:
❑Laptops and other technologies to help stakeholders participate in the planning process
❑Web-based meeting platforms
❑Virtual engagement tools
❑Accessibility services
❑Stipends, wages, and contracts to be paid to consumers and family members
❑Translation/interpretation services
❑Travel and transportation for stakeholders
❑Childcare
❑Eldercare
❑Training and technical assistance (TTA) for stakeholders to be meaningfully involved,
including TTA on fiscal policies

15. LA CPT PROCESS
& TIMELINE

16. LA’S BHSA CPP PROCESS

17. LA’S INTEGRATED PLAN APPROVAL

18. LOS ANGELES
Co-developed CPP plan.
Unknown MHC review and approval.
Community Planning Team (CPT) 100
-160.
Meeting bi-monthly. 19 meetings this FY
Compensation and stipends.
Training and education.
Transparent and timely reporting.
Mailing list.
No dedicated Planning Team.
No Planning team meetings.
No CPP Plan.
Some Forums and Survey in late fall.
Plan & CPP Report dropped March 1.
Public Hearing April.
Few public comments.
No substantive feedback.
SAN DIEGO
CPP ACTIVITIES: TALE OF TWO COUNTIES

19. WHAT WE
CAN ASK
FROM DHCS
Inform and engage advisory boards and BHS
systems with guidance.
Include recommended CPP procedures.
Provide Templates for CPP Plan Development Timeline, CPP Plan, and CPP Budget.
Define BHAB CPP Plan review and approval process.
Require CPP Plan for Next Fiscal Year be Included in each BHSA Integrated Plan.
Integrated Plan Should Include CPP Activities Performed to Create the Current Plan.

20. WHAT YOU
CAN DO
LOCALLY
Understand your CPP opportunities.
Research your county’s practices.
Share your findings.
How are representatives selected?
Who is serving on your Advisory Board?
Advocate to your Advisory Board & BHS.
Notify staff of Advisory Board Supervisor.
Notify staff of your Supervisor.
Share challenges and results.

21. LET’S CONNECT!
BHABrehab.com
[email protected]
858-344-1104