PROP. 63, MENTAL HEALTH SERVICES ACT, NOT AS ADVERTISED
SFGate.com July 8, 2012 San Francisco Chronicle
By Rose King
Updated 12:10 a.m., Saturday, July 7, 2012
In 2004, voters approved Proposition 63, which levied a 1 percent tax on millionaires to expand mental health services, and created a state plan to ensure progress toward providing them. Before we passed the law, the official ballot pamphlet told us “how the money would be spent.” New tax revenue would:
— Expand existing county mental health Systems of Care for children, adults and older adults, based upon a proven model of service; and
— Create prevention and early intervention programs within the model systems to help prevent mental illnesses from becoming more severe and disabling.
As one of several co-authors of the Mental Health Services Act, the official name of Prop. 63, I thought the purpose and intent provisions spelled out a clear path to implementation. The Systems of Care model that would receive 75 percent of the Prop. 63 revenue was fully explained in legal codes; government couldn’t screw this up.
I was wrong. Incompetence and politics led the state Department of Mental Health to change the law for private reasons and required counties to follow a different path altogether.
In 2007, the director of the department explained to me that we now were prioritizing services to “those most in need.” To do so, the department tossed the proven model to begin anew, with startups, and a new costly and endless stakeholder, planning and training process. This generated a bonanza for the consulting and contracting industry.
Mental health care in California is provided through a partnership of the state with each county. The new state regulations directed counties to spend the majority of Prop. 63 revenues on new programs for new clients. Counties were told to ignore the existing mental health programs, which, while underfunded and understaffed, are the primary source of treatment for mental illness.
Twenty percent of Prop. 63 funds are to be spent for prevention and early intervention so as to keep mental illnesses from becoming “severe and disabling.” But few such programs exist because state regulations prohibit counties from spending this prevention money to serve those “diagnosed with a serious mental illness or serious emotional disturbance.” Continue reading →