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.
We are still finalizing the data but hope to have it out soon. In the meantime, not only were we pleased to see more information than was generally available before – but we also saw information that counties are now increasing spending reflecting the rising revenues, while at the same time having significant reserves in Mental Health Services Act (MHSA) funds.
The substantial reserves in MHSA funds means that counties are able to avoid cutting current services. The amounts look adequate to address the next recession (depending on how severe and long) and also to commit funds to housing and services related to the MHSA housing bond (AB 1618) that has now been signed into law.
Housing bond implementation guidelines will impact MHSA spending and services
The State Department of Housing and Community Development is tasked with developing guidelines for implementation of the housing bond measure. One of the key elements of the guidelines will be the requirement for planning for reducing homelessness. Any county that wants to compete for this money will have to submit such a plan. The bond measure primarily funds one type of housing – permanent, supportive housing that is integrated with housing for the general public. This is the level and type of housing that will serve many people who are homeless or at risk of homelessness. However, it won’t be the right model for everyone. Some will need more intensive services – in specialized housing. Counties will be expected to identify a continuum of care that estimates the total population of homeless individuals and families and segments this population into categories.
It is estimated that one third meet the MHSA and MHSA bond measure target population of having a serious emotional disturbance or severe mental illness (in addition to being homeless or at risk of homelessness). For this population, counties will also have to identify the resources necessary to provide supportive services.
If this works the way we hope, it could result in county plans that truly estimate the amount of additional resources needed to serve everyone currently homeless or at risk of homelessness – with information on how many people need each level of service.
This should lead to more discussion about workforce challenges and other barriers to expanding services besides funding and housing..
The guideline development process should start soon, with guideline adoption and county planning and competitive proposals to follow in 2017.
This November there will be a new Proposition 63 – it deals with gun control
Each year in July the Secretary of State certifies the ballot measures that have qualified for the November election and assigns each one a ballot number from 1-200. The numbers are the next in sequence after the previous election, and it has taken from 2004 to 2016 for there to be another Proposition 63. This one is a gun control measure, sponsored by Lt. Governor Gavin Newsom; it would prohibit the possession of large-capacity ammunition magazines and would require most individuals to pass a background check and obtain authorization from the California Department of Justice to purchase ammunition.
Probably not something to get people confused but, just in case you are ever asked, now you know the facts. Proposition 63 is one of seventeen ballot measures; that number could grow through legislative action in early August. The greatest publicity is around the legalization of marijuana – Proposition 64.
The greatest spending (and probably advertising you will start to see) will be regarding Proposition 61– a proposed limit on the prices of medications (not impacting MediCal or commercial managed care plans), and a tobacco tax increase – Proposition 56.