PEI RegulationsOverview: What’s Different and What’s

the Same?

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How Did We Get Here?PEI Regulations

• August 2013: First work group meeting of interested stakeholders

• September 2013: Second work group meeting of interested stakeholders

• October 2013: Discussion with MHSOAC Services Committee

• August 2015: Final version of PEI Regulations approved by MHSOAC

• October 6, 2015: PEI Regulations effective: Office of Administrative Law

• In between: thousands of pages of public comment

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Mental Health Services Act: PEI

• Prevent mental illnesses from becoming severe and disabling

• Improve timely access to services for underserved populations

• Outreach to families, employers, primary care health care providers, and others to recognize the early signs of potentially severe and disabling mental illnesses

• Access and linkage to medically necessary care provided by county mental health programs for children with severe mental illness, as defined in Section 5600.3, and for adults and seniors with severe mental illness, as defined in Section 5600.3, as early in the onset of these conditions as practicable

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Mental Health Services Act: PEI

• Reduction in stigma associated with either being diagnosed with a mental illness or seeking mental health services

• Reduction in discrimination against people with mental illness

• The program shall include mental health services similar to those provided under other programs effective in preventing mental illnesses from becoming severe

• The program shall include mental health services similar to those provided under other programs successful in reducing the duration of untreated severe mental illnesses and assisting people in quickly regaining productive lives

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Mental Health Services Act: PEI

• The program shall emphasize strategies to reduce the following negative outcomes that may result from untreated mental illness:• Suicide

• Incarcerations

• School failure or drop out

• Unemployment

• Prolonged suffering

• Homelessness

• Removal of children from their homes.

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What Is Unchanged?

• Program definition and logic model based on outcomes

• PEI programs promote access for underserved populations

• PEI programs link people with a severe mental illness to assessment and treatment, which contributes to reducing duration of untreated mental illness

• Programs selected based on evidence of effectiveness to bring about outcomes

• Collaboration that facilitates an integrated experience for clients

• Differentiation of PEI from CSS

• At least 51 percent of the PEI funds shall be used to serve individuals who are 25 years old or younger

• Support for diverse community/county priorities while aspiring to statewide vista

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What is Different?

• A specific focus to “prevent mental illness from becoming severe and disabling” for all PEI programs

• Two kinds of programs: • Direct: outcomes intended for individuals with risk or early onset of a

mental illness

• Indirect: encourage access to services that bring about outcomes for individuals with risk or early onset of a mental illness

• Derived from MHSA, not research• No menu of “key community needs” or “priority populations”

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What is Different?

• New program requirements: prevention, early intervention, access to treatment for people with a severe mental illness, outreach to people who can recognize early signs and symptoms of a mental illness, stigma and discrimination reduction

• All programs must include strategies to reduce stigma and discrimination related to mental illness or seeking mental health services

• Program reports: how are PEI funds being spent?

• Evaluation reports: what are the outcomes of PEI programs?

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Direct Programs: Outcomes for Individuals with Risk or Onset of a Mental Illness

• Early Intervention

• Prevention

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Indirect: Encouraging Access

• Timely Access to Services for Underserved Populations

• Access and Linkage to Treatment for People with a Severe Mental Illness

• Outreach for Increasing Recognition of Early Signs of Mental Illness

• Stigma and Discrimination Reduction

• Suicide Prevention

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Strategies Included in all PEI Programs

• Timely Access to Services for Underserved Populations

• Access and Linkage to Treatment for People with a Severe Mental Illness

• Stigma and Discrimination Reduction

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Prevent Mental Illness from Becoming Severe and Disabling• Prevention includes relapse prevention for people with a serious

mental illness

• Early intervention always includes relapse prevention

• Access strategies are to programs and services that bring about outcomes for people with risk or onset of a mental illness

• Everyone in an underserved population is not at risk of or experiencing a mental illness

• Seven negative outcomes are as a result of untreated mental illness

• Universal prevention strategies intend outcomes for people with risk of a mental illness

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How are PEI Funds being Used?

• Kinds of programs

• People served

• Money spent

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What are Outcomes of PEI Programs?

• Timely Access to Services for Underserved Populations

• Access and Linkage to Treatment for People with a Severe Mental Illness

• Stigma and Discrimination Reduction

• Suicide Prevention

• Early Intervention

• Prevention

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Collaborating to Make PEI Regulations Feasible and Useful

• Consistency with Community Services and Supports (CSS) and other county reporting requirements

• Systems/data support and consistency

• Addressing reporting challenges: access to treatment, duration of untreated mental illness, and demographic categories, for example

• Learning, technical assistance, peer support, access to resources

• Stronger and more consistent evaluations, including population as well as program measures

• Quality improvement: for all of us

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PEI Regulations Questions and Going Forward

• Email: mhsoac@mhsoac.ca.gov

• Phone: Kim Johnson, 916-445-8723