I have good news and really good news. The good news is that the California Department of Health Care Services (DHCS) issued a ruling that clarifies that County Health Care Agencies can utilize Proposition 63 Mental Health Services Act (MHSA) funding for mental health crisis stabilization services. This is what I’ve been trying to accomplish with SB 1273 (see MOORLACH UPDATE — Mentally Ill Inmates — June 11, 2016 june 11, 2016 john moorlach and related links).
Riverside’s Press-Enterprise and San Bernardino’s The Sun provide the news in the piece below. My office also issued a press release on the news, which is provided directly below.
This is good news. In fact, I just received a nice note in the mail from the Chief Government Relations Officer of CHOC, Jena Jensen:
"I wanted to take a moment to express the gratitude of our entire organization for your continuing commitment and focus on improving mental health services and access in our community.
"This morning’s news on DHCS’s clarification on use of MHSA funding was undoubtedly thanks to your incredibly effective championship of the issue through SB 1273.
"Orange County is fortunate to have you representing our community in the Senate, and I’m honored to have the opportunity to work with you."
I want to thank David Mansdoerfer, my Deputy Chief of Staff, and the rest of my staff for the amazing effort that they put into working with all of the impacted stakeholders and Committee Consultants in moving SB 1273 through the Legislature. It is now on the Assembly Floor.
Now for the really good news. Speaking of the Governor’s Desk. We were able to get SB 1255 through the Senate and Assembly and it is my first bill to reach the Governor. He signed the bill this morning!
SB 1255 allows a family going through the difficult process of separation the flexibility to do so in a manner best suited for their situation.
I want to thank Robert Nash of my Sacramento office for shepherding this bill through the process. He worked with Bruce and Lisa Hughes of Coto de Caza, who brought the matter to our attention, with the State Bar, and numerous other stakeholders. It was not an easy task, but it was a righteous bill and garnered nearly unanimous support along the way. Attorneys familiar with civil litigation were extremely understanding and supportive of this bill. And I am so excited about this first accomplishment.
This bill did not garner any media attention. For a compendium on the bill, see the following at my website:http://district37.cssrc.us/search/node/1255.
The Governor’s press release is provided at the bottom below.
Bill to Make Mental Health Funds More Flexible Sparks Movement at
Dept of Health Care Services
Pivotal Victory Clarifies Use of Mental Health Services Act Funds
(Sacramento) – Yesterday, the State of California Department of Health Care Services (DHCS) issued Information Notice: 16-034, which clarifies that counties can use Mental Health Services Act (MHSA) funding to provide crisis stabilization services to clients on a voluntary or involuntary basis.
The spark for the clarification came from the bi-partisan legislative effort lead by Senator John Moorlach and Senate Bill 1273, which passed with a 38-0 vote off the Senate Floor, and passed with an 18-0 out of the Assembly Health Committee. This is a momentous victory for the mental health community in Orange County, as well as counties up and down the state. The bill was co-authored by Senator Robert Hertzberg (D-Van Nuys), Senator Jean Fuller (R-Bakersfield) and other legislators.
"I am thrilled that the Department of Health Care Services has acted on the intended goal of SB 1273. Allowing counties greater flexibility in the use of MHSA funds not only directly benefits the mental health community, but it also relieves our police officers, first responders and our emergency rooms that have been so over-burdened caring for people for which they were unequipped to adequately handle," said Senator Moorlach. "There is no doubt that we are facing a critical mental health crisis. This simple clarification is a victory, as it gives the flexibility to better fund outpatient care and serves as a valuable tool to ensure that patients in psychiatric crisis receive prompt and effective therapeutic evaluations and treatment."
Senate Bill 1273 gained early and widespread support by the Steinberg Institute, County Behavioral Health Directors Association of California, California Psychiatric Association, American College of Emergency Physicians-California Chapter, California Emergency Nurses Association, St. Joseph Hoag Health System, St. Joseph Hospital, Hoag Memorial Presbyterian, St. Jude Medical Center, Tenet Health, Orange County Medical Association, California State Association of Counties, Urban Counties of California, County of Orange, City of Newport Beach, League of California Cities-Orange County, California State Sheriff’s Association, Orange County Sheriff’s Department, Orange County Police Chiefs and Sheriffs Association and others.
"The County is currently exploring options to expand our crisis stabilization services and this notice couldn’t have come at a better time," said Orange County Board of Supervisors Chairwoman Lisa Bartlett.
"Crisis stabilization services are a critical component of Orange County’s comprehensive response to mental health and homelessness," said Orange County Supervisor Andrew Do, who has worked to streamline the delivery of county social services. "For too long, bureaucratic restrictions have blocked millions of dollars in mental health funds from being used for our greatest need. I’m grateful to Senator Moorlach for his work with the Department of Health Care Services to remove the bureaucratic restrictions that have blocked access to care."
“The Mental Health Services Act was intended to help people get the services they need, and the legal circumstances under which they’re accessing that vital care shouldn’t serve as an unnecessary barrier to treatment. This policy clarification is good for clients, families and providers,” said Mark Refowitz, Director of the OC Health Care Agency.
“Orange County’s 624 ER beds must be reserved for medical emergencies. This landmark opinion resulting from the Senator’s forward-thinking legislation will allow Orange County to develop a network of mental health urgent care centers designed for responsive therapeutic treatment, thereby preserving critical ER access for patients with true medical emergencies," said Steven C. Moreau, President and Chief Executive Officer of St. Joseph Hospital.
To read DHCS’ official notice on Mental Health Services Act (MHSA) Use of Funds for Crisis Services, CLICK HERE.
For more information on SB 1273, CLICK HERE.
Inland Empire being shortchanged on mental health funding: Cassie MacDuff
By Cassie MacDuff, The Press-Enterprise
The attempted suicide of a 15-year-old girl in Riverside County’s psychiatric emergency room this spring shown a spotlight on the overstretched county behavioral health system.
In that, Riverside County is not alone. Counties throughout the state of California need more funding to care for the mentally ill.
But in a meeting with top county mental health officials Monday, I learned that the crisis is worse in Riverside and San Bernardino counties, because they receive less funding per capita than other regions of California.
Sound familiar? Once again, inland Southern California is being shortchanged.
I’ve written repeatedly about the shortage of judges in the two counties, where court caseloads are far higher than in other parts of the state.
But this was the first I’d heard the mental health system gets short shrift, too.
The reason for the shortfall is the same:
State funding formulas were set decades ago, before the Inland counties experienced explosive population growth. The formulas haven’t been adjusted sufficiently for the greater number of residents.
The inequity frustrates area leaders.
Inland taxpayers are contributing the same share of their income and sales taxes as other Californians, said John Benoit, Riverside County supervisor and former state legislator. But they’re getting less in return.
“We just get second shift on a whole lot of things,” Benoit said, wondering aloud if it’s a coastal vs. inland battle, Democrat vs. Republican or something else.
“It’s becoming so misaligned,” he said, “I’ve got to believe logic and common sense will override… politics.”
How did things get in this sad shape?
In 1991, the state shifted the responsibility for mental health care to the counties. It was called “realignment.” (That word resurfaced recently when the state pushed many prisoners out of the state system into county jails.)
As usual with such shifts, its cause was a recession that pinched the state’s budget, said Sen. Richard Roth, D-Riverside.
It was meant to stabilize mental health funding, “and it sort of worked,” Roth said. But the funding formula was based on 1991 caseloads, when Riverside County had 1.1 million residents. It now has over 2.2 million.
There was an effort to help “under-equity counties,” Roth said, by giving them a portion of increased state revenue. But the amount never made up for what they were missing.
Riverside County finds itself in crisis mode, with fewer than nine beds per 100,000 population. The state average is 17.4 beds. The recommended number is 50, said Kim Trone, spokeswoman for Riverside County’s medical center, which includes the psychiatric unit.
San Bernardino County has fared a little better, with 18.2 beds per 100,000 population. How did it do that? Private, nonprofit Loma Linda University Health fills the gap, Riverside County officials told us.
Benoit said county supervisors are trying to address the funding disparity, including it in their legislative platform year after year.
On a May trip to Sacramento, Benoit and Supervisor Marion Ashley spoke to the Inland Empire legislative caucus.
“Frankly both Democrats and Republicans are 100 percent understanding and empathetic,” Benoit said. “Getting that translated into something in the budget to fix it is another thing.”
He pointed out that Sen. Richard Roth, D-Riverside, has tried to address the shortage of judges, only to have Governor Jerry Brown veto it.
“We’ll continue to carry it in our legislative program, and continue to lobby for it at every opportunity, even though it feels like you’re banging your head against the wall,” Benoit said.
The San Bernardino County Board of Supervisors also has funding equity in its legislative platform, said Scott Vanhorne, spokesman for Supervisor Janice Rutherford.
The 1991 mental health realignment actually had benefits for counties, Vanhorne said, enabling them to control where mental-health dollars are spent. For example, Rutherford on Thursday announced a new, early intervention program to keep people out of the crises that land them in emergency rooms.
“We’ve definitely done a lot with the limited funding we have,” Vanhorne said.
State Sen. John Moorlach, R-Costa Mesa, carried a bill to give counties more flexibility in how they spend mental-health funds. It won bipartisan support, inspiring the Department of Health Care Services to clarify rules giving counties flexibility, even without the legislation.
Moorlach was an Orange County supervisor when a mentally ill homeless man, Kelly Thomas, died after an encounter with Fullerton police five years ago. It inspired him to work on making treatment alternatives available for the mental health ill.
He said no one has ever brought the disparity in funding for the Inland counties to his attention, adding that he would gladly work with Roth or state Sen. Connie Leyva, D-Chino, to get the inequity address.
At the beginning of the next Legislature session, Roth said he plans to work with county officials to figure out what the appropriate fix is.
“I am committed to work on this issue, because there is a mental health crisis in this state,” he said.
With bipartisan support like this for fixing the issue, perhaps there’s hope. Otherwise, Inland advocates will keep feeling like they’re beating their heads against a wall.
Columnist Cassie MacDuff, a longtime local journalist, writes about people, politics and public affairs in Inland Southern California. Cassie has been writing her column in The Press-Enterprise and PE.com since 1999. Previously, she was a columnist with The Sun in San Bernardino. She studied journalism at San Jose State. Reach the author atcmacduff or follow Cassie on Twitter: @CassieMacDuff. Reach the author at cmacduffor follow Cassie on Twitter: @CassieMacDuff.
|Governor Edmund G. Brown Jr.
State Capitol Building
Sacramento, CA 95814
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