Report 2012-122 Recommendations

When an audit is completed and a report is issued, auditees must provide the State Auditor with information regarding their progress in implementing recommendations from our reports at three intervals from the release of the report: 60 days, six months, and one year. Additionally, Senate Bill 1452 (Chapter 452, Statutes of 2006), requires auditees who have not implemented recommendations after one year, to report to us and to the Legislature why they have not implemented them or to state when they intend to implement them. Below, is a listing of each recommendation the State Auditor made in the report referenced and a link to the most recent response from the auditee addressing their progress in implementing the recommendation and the State Auditor's assessment of auditee's response based on our review of the supporting documentation.

Recommendations in 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)

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Recommendations to Health Care Services, Department of
Number Recommendation Status
1

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.

Fully Implemented
2

To ensure that it monitors counties to the fullest extent as the MHSA specifies and that it implements best practices, Health Care Services should conduct comprehensive on-site reviews of county MHSA programs, including verifying county compliance with MHSA requirements.

Partially Implemented
3

To ensure that counties have the needed guidance to implement and evaluate their MHSA programs, Health Care Services should coordinate with the Accountability Commission and issue guidance or regulations, as appropriate, for Facilities programs and for other MHSA requirements, such as a prudent reserve.

Partially Implemented
4

To ensure that counties have the needed guidance to implement and evaluate their MHSA programs, Health Care Services should commence this regulatory process no later than January 2014.

Fully Implemented
5

To ensure that counties have the needed guidance to implement and evaluate their MHSA programs, Health Care Services should collaborate with the Accountability Commission to develop and issue guidance or regulations, as appropriate, to counties on how to effectively evaluate and report on the performance of their MHSA programs.

Partially Implemented
6

To ensure that Health Care Services and other state entities can evaluate MHSA programs and assist the Accountability Commission in its efforts, Health Care Services should collect complete and relevant MHSA data from the counties.

Partially Implemented
7

To ensure that Health Care Services and other state entities can evaluate MHSA programs and assist the Accountability Commission in its efforts, Health Care Services should resolve all known technical issues with the partnership and client services systems and provide adequate and expert resources to manage the systems going forward.

Not Fully Implemented
8

Health Care Services should, as soon as is feasible, revise or create a reasonable and justifiable allocation methodology to ensure that counties are appropriately funded based on their identified needs for mental health services. Health Care Services should ensure that it reviews the methodology regularly and updates it as necessary so that the factors and their weighting are appropriate.

Fully Implemented
16

To improve the quality of county processes related to measuring program performance, Health Care Services should use its performance contracts with counties to ensure that they specify MHSA program goals in their plans and annual updates and include those same goals in their contracts with program providers.

Fully Implemented
17

To improve the quality of county processes related to measuring program performance, Health Care Services should use its performance contracts with counties to ensure that they identify meaningful data to measure the achievement of all their goals, set specific objectives, and require their program providers to capture those data so they can use the data to verify and report the effectiveness of their MHSA programs.

Fully Implemented
18

Health Care Services should develop standardized data collection guidelines or regulations, as appropriate, that will address inconsistencies in the data that counties report to the State. In developing these guidelines or regulations, Health Care Services should consult with the Accountability Commission to ensure that data collected reasonably fulfill statewide evaluation purposes.

Not Fully Implemented
19

To help ensure county compliance with stakeholder regulations, Health Care Services should provide technical assistance to counties on the MHSA local planning review process and ensure that its guidance to counties is clear and consistent with state regulations.

Not Fully Implemented
Recommendations to Legislature
Number Recommendation Status
24

To ensure that Health Care Services can withhold MHSA funds from counties that fail to comply with MHSA requirements, the Legislature should enact legislation that clarifies Health Care Services' statutory authority to direct the State Controller's Office to withhold such funds from a noncompliant county.

No Action Taken
Recommendations to Mental Health Planning Council, California
Number Recommendation Status
14

The Planning Council should take steps to ensure that it annually reviews the overall effectiveness of MHSA programs in accordance with state law.

Fully Implemented
15

The Planning Council should document and make public the reviews that it performs of MHSA programs to demonstrate that it is performing all required reviews.

Fully Implemented
Recommendations to Mental Health Services Oversight and Accountability Commission
Number Recommendation Status
9

To ensure that counties have needed guidance to implement and evaluate MHSA programs, the Accountability Commission should issue regulations, as appropriate, for Prevention and Innovation programs.

Fully Implemented
10

To ensure that counties have needed guidance to implement and evaluate MHSA programs, the Accountability Commission should commence the regulatory process no later than January 2014.

Fully Implemented
11

To fulfill its charge to evaluate MHSA programs, the Accountability Commission should undertake the evaluations specified in its implementation plan.

Fully Implemented
12

To ensure that it can fulfill its evaluation responsibilities, the Accountability Commission should examine its prioritization of resources as it pertains to performing all necessary evaluations.

Fully Implemented
13

To report on the progress of MHSA programs and support continuous improvement, the Accountability Commission should fully use the results of its evaluations to demonstrate to taxpayers and counties the successes and challenges of these programs.

Fully Implemented
Recommendations to Sacramento Department of Health and Human Services, County of
Number Recommendation Status
22

Sacramento County should review its existing MHSA contracts and by December 31, 2013, or as soon as is feasible, amend them as necessary to include plan goals.

Fully Implemented
Recommendations to San Bernardino Department of Behavioral Health Administration, County of
Number Recommendation Status
23

San Bernardino County should review its existing MHSA contracts and by December 31, 2013, or as soon as is feasible, amend them as necessary to include plan goals.

Fully Implemented
Recommendations to Santa Clara County Mental Health Department
Number Recommendation Status
20

Santa Clara County should review its existing MHSA contracts and by December 31, 2013, or as soon as is feasible, amend them as necessary to include plan goals.

Fully Implemented
21

Santa Clara County should ensure that all MHSA invoices are adequately supported with information that demonstrates that MHSA services were provided.

Fully Implemented


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