RESEARCH BRIEF: ADMINISTRATIVE CONTEXT

& SERVICES PROVIDED BY TAY PROGRAMS

July 1, 2015
Services for Transition Age Youth Implemented in California Under
the Mental Health Services Act
In 2004, the California Mental Health Services Act (MHSA) authorized a diverse array of
new mental health programs for priority populations. Transition age youth (TAY) ages
16 to 25 with mental health needs were identified as a priority population in need of
services that are tailored to their specific age and developmental needs. TAY were also
identified as a priority population since they often straddle the child and adult systems of
care, which can contribute to gaps in services. Since the implementation of the MHSA in
2005, many of Californias counties have supported the development of communitybased health care, employment, and social services to meet the needs of TAY with
mental health needs. This research brief is based on interviews with representatives
from 39 counties and survey data collected from 180 TAY programs provided at the
county level throughout California. We describe selected administrative elements of
Californias TAY programs and provide an overview of the range of services offered.

Counties Vision for a TAY Oriented Delivery System

County representatives described their goal of providing youth-specific services focused
on supporting independence, self-sufficiency, and transition to adulthood. They
described working towards a system of care that supported a network of youth-specific
providers and facilitated increased coordination of traditionally separate service sectors.
Representatives discussed the importance of early engagement and empowerment,
and inclusion of youths perspective in service planning and delivery. Recommendations
included embedded youth advocates and peer-led services.
County representatives also pointed to the central role of the MHSA in developing and
supporting youth-specific services. The MHSA was identified as a catalyst and
opportunity to engage stakeholders and create a youth-oriented system of care. Several
representatives credited the MHSA in the transformation of service delivery for youth,
and several cited it as the sole reason that these services were being provided.

TAY Program Context

Most TAY programs (75%) were operated by contracted providers; fewer TAY programs
were directly operated by counties (25%). About half (45%) of survey participants
described their programs as stand-alone TAY programs and about half (55%) described
providing TAY-specific services within a broader non-TAY specific mental health
program.

TAY Program Caseload

Individual TAY programs served about 250 clients per year on average. The typical age
range of TAY clients was 16 years to 25 years, although some programs reported
enrolling clients as young as 10 and as old as 34.
This report was funded by the Mental Health Services Oversight and Accountability Commission
(Contract #13MHSOAC014)

Exhibit 1. Sources of TAY Program Funding

PEI

49%

Medicaid

MHSA

CSS-FSP

37%

CSS-Other

24%

Housing

10%

Innovations

9%

Other MHSA

9%

EPSDT

33%
0%

20%

40%

60%

80%

100%

Sources of Funding for TAY Programs

TAY programs reported accessing diverse sources of funding (see Exhibit 1), most
commonly Prevention and Early Intervention (PEI, 49%), Community Services and
Supports-Full Services Partnership (CSS-FSP, 37%), and Community Services and
Supports-other type of funds (CSS-Other 24%). Other MHSA funding included Housing
(10%), Innovations (9%) and other MHSA funds (9%, specific funding source unknown).
In addition to MHSA funding, TAY programs also reported receiving funding from the
Medicaid Early Periodic Screening, Diagnosis, and Treatment program (EPSDT) (33%).
TAY programs reported accessing multiple sources of funding: 29% of programs
reported receiving two or more sources of MHSA funding.

Diagnosis

Exhibit 2. Mental Health Diagnosis and Residential Status of TAY

Served by TAY Programs

Serious Mental Illness

70%

Dual Mental Illness and Substance Abuse

70%

Residential
Status

Homeless or at risk

66%

Aging out of foster care

59%

Exiting the Juvenile or Criminal Justice System

56%

TAY residing in institutional or residential care

34%
0%

20%

40%

60%

80%

100%

TAY Programs Serve a Diverse Client Population

Californias TAY programs have targeted clients with diverse diagnoses, residential
status, racial/ethnic backgrounds, and other defined TAY populations, such as parenting
TAY or Lesbian, Gay, Bisexual, Transgender, or Queer (LGBTQ) TAY.
Diagnosis and Residential Status: Programs primarily reported targeting TAY with either
serious mental illness or dual mental illness and substance use disorders (80%, see
Exhibit 2); this percentage was higher for programs receiving funding from CSS-FSP
(100%) than programs receiving PEI funding (67%). Programs targeted TAY who are
homeless or at risk of becoming homeless (66%), TAY who are aging out of the foster
care system (59%), TAY exiting the juvenile or adult criminal justice system (56%), or
TAY residing in institutional or residential care (34%, see Exhibit 2).
Exhibit 3. Race/Ethnicity of TAY Clients
Latino

51%

African American/Black

44%

Asian American

34%

Native American/Alaskan Native

32%

Pacific Islander

28%

Native Hawaiian

23%
0%

20%

40%

60%

80%

100%

Race/Ethnicity and other priority populations: TAY programs targeted diverse groups
including TAY who are Latino (51%), African American/Black (44%), Asian American
(34%), Native American/Alaska Native (32%), Pacific Islander (28%), and Native
Hawaiian (23%) (see Exhibit 3). Other priority populations served by TAY programs
included LGBTQ TAY (49%), parenting or pregnant TAY (43%), undocumented TAY
immigrants (38%), and TAY who are veterans (17%) (see Exhibit 4).

Exhibit 4. Other TAY Priority Populations Served by TAY

Programs
LGBTQ

49%

Parent or Pregnant

43%

Undocumented

38%

Veterans

17%

Others

8%
0%

20%

40%

60%

80%

100%

A Wide Range of Services are Offered by TAY Programs

TAY programs offer a wide array of services to support TAY with mental health needs in
their health and daily living (see Exhibit 5). All programs reported providing multiple
service types. Programs receiving funding from CSS_FSP reported providing more
service types on average (9.0) than programs receiving PEI funding (6.5).
With respect to health care, most TAY programs (91%) reported offering behavioral
health services, and the majority (63%) reported offering physical health care services.
TAY can benefit from services that help them build their human capital and strengthen
their financial skills. Many TAY programs reported offering educational (62%) and
employment (54%) support services as well as financial (56%) and benefits
management (57%) services.
Many TAY lack good options for housing. Nearly half (48%) of TAY programs reported
offering housing supports, and the majority (63%) reported offering basic services, such
as laundry, meals, and showers.
Often, TAY are in need of social services. The majority of TAY programs reported
offering social support (84%), family-oriented services (80%), and mentoring and peer
support (60% and 54%, respectively).

Housing

Human Capital

Health

Exhibit 5. TAY Programs Offering Support Services

Behavioral Health Care

91%

Physical Health Care

63%

Educational Support

62%

Benefits Management

57%

Financial Management

56%

Employment Support

54%

Basic Services

63%

Housing Support

48%

Social

Social Support Services

84%

Family Oriented Services

80%

Mentoring Support

60%

Peer Support

54%
0%

20%

40%

60%

80%

100%

A Wide Range of Outreach Activities Among TAY Programs

TAY programs conduct outreach to TAY in diverse settings. The majority of programs
conduct outreach to TAY in the community (72%) and nearly half conduct outreach to
families of TAY (44%). Also, about half of TAY programs conduct outreach to
educational (53%) and outpatient (45%) settings, TAY in Foster Care (51%) and TAY in
the justice system (43%). TAY programs target multiple settings for outreach, identifying
an average of four settings where they conducted outreach to TAY.
Exhibit 6: TAY Program Outreach
TAY in the Community

72%

TAY in Educational Settings

53%

TAY in Foster Care

51%

TAY in Outpatient Settings

45%

Families of TAY

44%

TAY in the Justice System

43%

TAY in Residential Settings

38%

TAY in Inpatient Settings

31%

TAY with Initial Onset

27%
0%

20%

40%

60%

80%

Gaps in TAY Services

Program respondents were asked to describe any important remaining gaps in services
for TAY in their county. The most commonly reported gaps were housing (48%) and
behavioral health services (31%) followed by employment support (14%, see Exhibit 7).
Housing: Respondents described needs for more independent, transitional and
emergency housing (including crisis houses and youth-specific shelters) as well as
laundry services and shower facilities. Barriers to having or maintaining adequate
housing included limited resources, rigid housing rules, and renters unwilling to rent to
TAY with criminal records or without an employment history or verifiable income.
Behavioral Health: Respondents described unmet needs for case management,
medication management, and dual diagnosis services, and crisis residential services for
TAY experiencing acute and sub-acute mental health episodes. Barriers to behavioral
health services included less access for TAY with less severe mental health issues,
having few psychiatrists and therapists who work with TAY or accept Medicaid, and
lengthy processes involved in completing psychiatric assessments.

Employment: Respondents discussed gaps in employment services including job

placement, supported employment, and job development. Barriers to employment
included lack of jobs in rural areas, criminal records, lack of transportation to work, and
the need for more funding to support employment staff.

Housing

Human
Capital

Health

Exhibit 7. Gaps in TAY Services Provided

Behavioral Health Services

31%

Physical Health Care

4%

Employment Support

14%

Educational Support

9%

Financial/Legal/Benefits Services

4%

Housing and Homeless Services

48%

Transportation

7%

Social

Drop-in/Wellness Centers

9%

Parenting/Childcare

6%

Social skills/ Life skills

3%

Stigma Reduction

2%
0%

20%

40%

60%

80%

100%

Conclusions
California has made great strides to meet the California Mental Health Services Acts
(MHSA) goal of providing services to youths with mental health challenges in a
critical period of emotional, mental, physical and institutional transitions. The data
presented in this research brief reflect the efforts made by TAY programs statewide
to meet the needs of a very diverse youth clientele. TAY programs are supported by
MHSA funding as well as other sources of funding including Medicaid, which
enables the programs to leverage the resources available to provide a wide array of
services to meet TAYs evolving needs.
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Data show that although a wide array of services are being newly provided, gaps in
services for TAY persist. Recommendations include a continuing focus on the
development of a TAY oriented delivery system, expanding the networks of TAY
specific behavioral health providers and services, and increasing the options for TAY
specific housing. These efforts should be accompanied by ongoing evaluation and
quality improvement efforts to identify what is working for TAY as well as areas that
need strengthening.

Ojeda, V. Hiller, S. Gilmer, T. (2015). Research Brief: Administrative Context & Services
Provided by TAY Programs. Sacramento, CA: MHSOAC.