In discussing this year’s state budget most of our attention has gone to the re-realignment of in-home support services back to counties in a form that will divert $36 million of realignment funds that otherwise would have gone to mental health – and increasing amounts in future years the could total as much as $200 million annually after six years – unless there are changes made to this legislation. Viewed in total dollars at risk over the long term this action alone makes it a bad budget year for mental health and substance use disorders. But in terms of advocacy and support we got just about everything else we were seeking, so we have to view the budget overall in a positive way similar to the press release that the County Behavioral Health Directors Association recently sent out.
At the start of 2017, CCCBHA’s highest priority was to secure funding for the children’s crisis care system. This had been approved in the 2016-17 state budget. But in presenting his 2017-18 budget Governor Brown eliminated $17 million in funding for that program, as well as $67.5 million for mental health and substance use disorder services and facilities for people discharged from state prisons. Continue reading The State budget has more good news than bad, but federal uncertainty is still the elephant in the room
AB 1250 (Jones- Sawyer): Extreme limits on County contracting. This is the biggest threat ever to member agencies. Strong opposition seems to be making an impact, but the outcome is uncertain.
By now all members should be familiar with this SEIU and ASFCME sponsored bill which would make it virtually impossible for counties to continue to contract out for the types of services our members provide. Continue reading AB 1250; Prop 63 and 64; School Mental Health
For a variety of reasons, I am being asked much more than ever about the thinking behind various provisions of the mental health services act when we are writing it in 2003 and how that relates to some of the challenges we now have.
Not surprisingly, most of the challenges we now are seeing involved issues we anticipated when we wrote the Act. We have posted all of the preliminary drafts of the MHSA on our website in case anyone is curious about how the language evolved from the first draft in May 2003 to the final language in September.
The Act still looks like it correctly identified what was needed to fulfill our goals. But many parts of it have not been implemented the way it was envisioned and a lot has changed from what we knew in 2003 when it was written. In 2006 I had a different way of viewing how would be implemented and significantly underestimated how challenging it would be for state agencies to regularly update regulations which I thought could be an ongoing process with updates every three years. I also significantly underestimated the delays and challenges in developing outcome data.
In this blog I will speak to some of the issues and some of the solutions. Mostly what is required is a recognition that we have not revisited the guidelines (which led to regulations), all of which were developed before the applicable parts of the act had been implemented.
Now that we have had many years of implementing each part of the act is time to revisit the guidance (leading eventually to updated regulations) through a series of separate workgroups, that can move us more firmly in the direction that I think we all know is where we need to go.
Continue reading The Mental Health Services Act – Then and Now
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?
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
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
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
- 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
State Budget Reflects Healthy Economy and Increased Attention to Behavioral Health Issues
Last week the legislature sent the 2016-17 budget to the Governor with a record general fund spending level of $122 billion. Revenues were a bit below what had been projected in January but still enough above the previous year to allow for some program increases as well as an increase in the state “rainy day fund.”
Housing to address homelessness and related increases in SSI/SSP payments were important parts of the budget for the first time in recent memory. Continue reading State Budget Reflects Healthy Economy and Increased Attention to Behavioral Health Issues
After about ten years of implementation some fine tuning is needed for the Mental Health Services Act to better achieve its goals
This Thursday May 26th the Little Hoover Commission will hold its second hearing on the Mental Health Services Act (MHSA). At issue is its conclusion that state officials have not implemented the recommendations they made in January 2015.
At the same time legislators are taking unprecedented steps to earmark funds (Senate No Place Like Home budget proposal; AB 2017 McCarty – College Students; AB 2279 – Fiscal Reporting). CCCBHA and I support these efforts and join other stakeholders in recognizing the need for some fine tuning of this act.
Continue reading After 10 Years, Fine Tuning is Needed for the Mental Health Services Act