- 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
April 11 – Governor signs AB 847 (Mullin) – Funding for Certified Community Behavioral Health Centers
- 30% increase in federal matching funds for outpatient behavioral health
- Improved and streamlined way to receive federal funds
- Counties must elect to participate and be certified by state
- State must be selected as a participating state; odds are good that this will happen
- Lots of work between now and October 31 Deadline for submittal of the state plan
AB 847 appropriates $1 million to enable DHCS to develop a California proposal to participate in the federal Certified Community Behavioral Health Centers (CCBHC) program.
California is one of 24 states receiving a planning grant in October 2015 to develop a proposal to submit in October of 2016. Under current federal law, eight states will be selected to begin a two year demonstration program. These programs will show that increased federal investment in outpatient behavioral health will pay for itself in reduced physical health and behavioral health inpatient and other costs.
Continue reading Governor Signs Funding for Certified Community Behavioral Health Centers
MHSA revenues are growing much faster than other state and county revenue sources. Why is this true and what are its implications?
Mike Geiss, the fiscal consultant to the Mental Health Services and Accountability Commission (OAC), and County Behavioral Health Directors (CBHDA) recently provided a report to the OAC documenting MHSA (Mental Health Services Act/Proposition 63) revenues since its enactment in November 2004.
The key finding in this report is that revenues for 2016-17 will be $450 million higher for 2016-17 than for 2015-16 and that revenues for 2015-16 will be about $200 million higher than had been forecast when those state and county budgets were adopted last summer.
We have the percentages for each county and the methodology showing how the distributions were generated, so now everyone can see how much of a revenue increase their county or counties will be receiving – and how their relative shares may change over time under the current formula (which the state can change each year).
His report also documents the growth in MHSA revenues – from $900 million in the first full year of 2005-06 to $2 billion the current year of 2015-16. That reflects an 8% annual growth rate and is significantly higher than any other state revenue source as shown on this chart of historic tax yields.
Continue reading MHSA Revenues Grow Much Faster Than Other State and County Revenue Sources
Highlights from Governor’s 2016-17 Budget Proposal
On January 7th Governor Brown introduced his proposed 2016-17 budget.
State revenues are projected to be up about $6 Billion. This is the Department of Finance forecast which is more conservative than that of the legislative analyst. The actual budget to be enacted in June will be based on revised estimates due in May. Continue reading Highlights from Governor’s 2016-17 Budget Proposal
December 20, 2015
On Monday, December 7th, I participated in the National Council for Behavioral Health’s second all day training for state associations to support state planning to develop proposal under the Excellence in Mental Health Act Certified Community Behavioral Health Centers program which will significantly increase funding and significantly reduce documentation requirements for outpatient behavioral healthcare. See my paper documenting that the value of this is about $1 Billion statewide in the first year and growing.
A centerpiece of that training was the review of a new and expanded “Integrated CCBHC Certification Criteria Feasibility and Readiness Tool (I-CCFRT)”.
In studying that tool and discussions with other state association representatives I learned that the structure of county mental health in California (not yet the case for substance use disorders- but should eventually be with the implementation of the Organized Delivery System) is well aligned with the requirements for CCBHC certification, management and establishment of a prospective payment system.
Continue reading California Well Positioned for Excellence Act (CCBHC) Certification, Management and PPS
Economic Outlook Remains Positive, But Homeless Numbers Increase.
Time to Update the Mental Health Services Act
November 23, 2015
Last week two very important sets of numbers were released showing the disconnect between a healthy economy and the status of people who need behavioral health services.
The state’s Legislative Analyst presented an updated state budget forecast showing that state revenues will exceed the budget estimates by $3.5 billion for this year, a growing surplus for next year and for the next several years.
This is consistent with trends in reports we have provided showing significantly increased revenues for county behavioral health authorities. However, as we have reported in the past these revenue increases have not translated into expansion of services in very many counties. We noted that most counties had discontinued homeless outreach services during the recession and very few had restarted them in spite of two very good years of revenue growth with more forecast for next year.
That pattern is now reinforced by new homeless data showing that homeless numbers in California had risen over the past few years and we know that most of the homeless have significant behavioral health challenges and that chronic homelessness is almost always due to an untreated behavioral health condition (usually co-occurring mental health and chemical dependency).
Continue reading Time to Update the Mental Health Services Act
November 16, 2015
- Opportunities and challenges for counties and providers
- New Alcohol and Drug Organized Delivery System
- CCBHC/Excellence in Mental Health Act Certification and PPS
- Whole Person Healthcare Integration Pilots under Section 1115 Waiver
All of these issues have to be addressed in the coming year by counties and providers.
When I speak with community behavioral health agencies, the biggest issue for most seems to be the lack of contract expansion and the frustration that counties don’t seem to make that a very high priority and claim that they don’t have the significant growth in revenues that all of the state revenue charts indicate they have received or soon will receive.
Continue reading 12 Months of Planning for Biggest Changes in Decades