I am writing this before the governor’s budget is released on Wednesday, January 10 but by the time you read it the budget will be out. We already know that there is a projected $19 billion surplus between the current year and 2018-19 budget year.
The governor is certain to say that it has to be viewed as one time money; with the next economic downturn due to hit soon and a portion of it will go to increasing the so-called rainy day reserve. Continue reading $19 billion surplus. What opportunities might it present for behavioral 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.
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 they were envisioned and a lot has changed from what we knew in 2003 when it was written.
Continue reading Mental Health Services Act: Then and Now
Last week the US Senate began hearings on a bipartisan effort to provide greater short-term or moderate term stability to the health benefit exchanges which depend upon federal subsidies to provide affordable health insurance to individuals who do not qualify for Medicaid or employer insurance.
These exchanges also depend upon the mandate that everyone must pay at least part of their health insurance if they have above Medicaid incomes, which is the single part of the Affordable Care Act that Republicans have most strongly campaigned to eliminate. Continue reading Growing Washington bipartisanship on many issues gives hope for healthcare future, but everything is still at risk.
Right now it is hard to think about anything beyond the president’s unbelievably offensive statements made on Tuesday in response to the Charlottesville protests and Neo-Nazi terrorist attack that killed one woman and injured many. The statements were broadly condemned by both Republican and Democrat congressional leaders. But what impact will this have on policy? Continue reading What Happens Next in Washington DC?
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
Last week the House of Representatives passed the American Health Care Act by the narrowest of margins, with all Democrats and 20 Republicans voting no. It succeeded because of amendments to satisfy the so-called “Freedom Caucus” of very conservative Republicans who objected to the bill in March because it left too much of the Affordable Care Act intact.
The key amendment was to allow states to eliminate pre-existing condition protections replacing that with high risk pools that could be subsidized with federal funds.
The focus on pre-existing conditions got all the news media attention and certainly will adversely affect people with mental illnesses and substance use disorders both of which would be considered pre-existing conditions – even if the only treatment was one or two visits to a therapist, or a single prescription for an antidepressant. Continue reading AHCA approved by House. What does its passage mean in California?
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