GOP Health Care Proposal, No Place Like Home, and Vancouver Youth Center

Congressional Budget Office slams Republican healthcare proposal. More people lose health insurance than gained it under Affordable Care Act.

The analysis that came out Monday from the CBO confirms the views of healthcare experts and state officials. Moreover, it only covers impacts through 2026. My analysis suggests that over 20 years most states will find it impossible to continue the Medicaid program as the block grant spending cap gets tighter the gap between Medicaid costs and federal funding grows. If that happens, the number who lose insurance could eventually be double the numbers in this estimate. Continue reading GOP Health Care Proposal, No Place Like Home, and Vancouver Youth Center

Signs of Hope

Signs of Hope – from leading national behavioral health policy advocate Chuck Ingoglia

At CCCBHA’s February membership meeting we were fortunate to have Chuck Ingoglia of the National Council for Behavioral Health as a presenter.  There is probably no one in behavioral health closer to the action in Washington DC and better positioned to make our case.  He had good news to report in that there is growing support for maintaining federal support for behavioral health.  He noted that everyone’s advocacy is making a difference and that the more extreme potential funding cuts are less likely to be enacted. Continue reading Signs of Hope

A Long Strange Trip – and About to Get Stranger

I have been lobbying since 1977, and with CCCBHA since 1986, and in all of those years there has never been one like 2017. One where Sacramento is totally consumed by what will, or will not, happen in Washington DC and what it might mean.

Our agencies are impacted by what it means for Medicaid, and the state and counties will act with that looming shadow.  Immigration policies create threats for many families we serve. For many of us and our staff, we have personal concerns that go beyond any of these specific issues.

These fears and uncertainties are so big that they are now part of every meeting and conversation. What we can do about it must take precedence over everything else. So, all of my blogs this year will start with this subject and my latest thinking. Continue reading A Long Strange Trip – and About to Get Stranger

Proposition 64 Funds Can Close Gaps in Realignment and MHSA Funding and Structure

Proposition 64 (Marijuana Legalization) directs 60% of its funds to “Education, Prevention, Early Intervention and Treatment” for substance use disorders including related services such as mental health for youth and their families.

The measure includes a page or more of detail on how the funds “could” be spent, but from my reading this is the only specific limitation on how it must be spent. Youth is not defined, which leaves that up to the legislature which should define it as primarily ages 12-25 with prevention and early intervention for younger children and the “and their families” including parents.

The estimates on the amount of tax on marijuana sales revenues from this portion of the measure range from $300 million to $800 million – with $500 million as a best guess for the first year (2018-19). We then expect revenues to rise in future years.

This is a very significant level of new funding – nearly as much as the original funding from Proposition 63 of 2004 (The Mental Health Services Act) and more than half as much as the original mental health sub-account of 1991 realignment or behavioral health subaccount of 2011 realignment. Continue reading Proposition 64 Funds Can Close Gaps in Realignment and MHSA Funding and Structure

Election Over . . . Now What?

Wow is this country divided!!! California voters approved four statewide tax extensions or increases and many local property taxes and strengthened the already total Democratic Party control of the legislature while at the same time the majority of states gave Republicans the White House and re-affirmed their control of both houses of Congress.

So what will this mean for community behavioral health care in California?

Continue reading Election Over . . . Now What?

MHSA Now and Then: Need for Comprehensive Needs Analysis and Planning

For the past year I have been participating in a work group regarding Older Adults focusing on the extent to which the Mental Health Services Act (Prop 63/MHSA) has resulted in developing a system of care for that population. Recently I was interviewed, mainly in my capacity as a co-author and principal drafter of that law with questions about our expectations, how it is going, and what needs to happen.

Continue reading MHSA Now and Then: Need for Comprehensive Needs Analysis and Planning

Counties’ Housing Ballot Measures Important to Mental Health

As we look toward the November election, all eyes seem to be on the presidential race, but some are focused on the high profile state initiatives – such as Proposition 64, which legalizes marijuana and provides funding for substance abuse treatment.

Four Bay Area Counties’ Housing Ballot Measures Very Important to Mental Health

However, four bay area housing bond measures may turn out to be the most important issues impacting mental health service funding and housing. They would free up mental health funds that might otherwise have been needed for housing and, even more importantly, act as a catalyst for more similar measures. Any new funding to support people who are homeless will help the Mental Health Services Act (MHSA or Prop 63) in achieving its primary goal of serving everyone with a severe and disabling mental illness – by reducing the pressure to use MHSA funds for housing.

Continue reading Counties’ Housing Ballot Measures Important to Mental Health

Shedding Light on County Behavioral Health Finances

I was fortunate to have two outstanding summer interns from the University of California: Monica Venegas and Deepika Dilip. They produced this report which is now as complete as it is going to get, so it is time to share what they found and provide some explanation.

Since this is not a formal report, but intended only to provide a meaningful snapshot of what information was available, I asked them only to develop information on the 20 largest counties (by population). While this excludes 38 counties it does cover about 95% of the state’s population and behavioral health funding.

Continue reading Shedding Light on County Behavioral Health Finances

Behavioral Health Revenues Rise – November Ballot Measures of Interest

County behavioral health revenues continue to rise. Many counties are budgeting for significant spending increases for 2016-17

My summer interns were asked to contact the state’s twenty largest counties (by population) to ascertain behavioral health revenue and spending information for 2014-15, 2015-16 and 2016-17.  They started by looking online and then contacted county officials to obtain more information.  They reported more success in obtaining this information than had previously been experienced by most mental health stakeholder organizations, which had expressed frustration in the lack of readily available information online.  The key to their success seems to have been contacting county budget offices instead of behavioral health departments. Continue reading Behavioral Health Revenues Rise – November Ballot Measures of Interest

Budget and MHSA Housing Bond Pass – 17 Ballot Initiatives Qualify for November

  • Legislature Passes MHSA Housing Bond and Adjourns for Summer Recess
  • Governor signs budget
  • 17 measures qualify for November ballot

July 1st came on a Friday which meant the legislature started its summer recess on the earliest possible day (returning on August 1st also the earliest possible day).

One of their last actions before adjourning was to pass the Mental Health Services Act (MHSA) housing bond.  It required a 2/3 vote, and to secure passage Republicans insisted on a few amendments to require more publishing of county spending reports, someone with an auditing background on the MHSOAC (Mental Health Services Oversight and Accountability Commission) and $10 million for transitional housing (which likely was in direct response to letters from CCCBHA members). Continue reading Budget and MHSA Housing Bond Pass – 17 Ballot Initiatives Qualify for November

Rusty Selix – California Leader in Mental Health Policy Issues and Co-author of Proposition 63