State’s Mental Health Care Realignment Plan Draws Support, Concern

Health care providers and patient advocates are expressing cautious optimism with Gov. Jerry Brown's (D) plan to significantly change California's mental health care services, Capitol Weekly reports.

Background

In 2004, voters approved Proposition 63, which levied a tax on individuals with annual incomes above $1 million to raise money for mental health services (Bathen, Capitol Weekly, 8/18). Since it took effect in January 2005, the tax has generated $7.4 billion (California Healthline, 6/27).

Reorganization Details

The reorganization plan is funded in part through an appropriation in the fiscal year 2011-2012 state budget of $861 million in funds from Prop. 63.

The plan seeks to provide a more coordinated approach to mental health care. The plan also shifts funding and management from the state to counties but maintains state oversight.

Some services are being transferred to California's Department of Health Care Services, but two new agencies also could be created to manage behavioral health issues and state institutions.

Officials say that state oversight and evaluating outcomes will be top priorities under the mental health care realignment strategy.

According to Capitol Weekly, the details of long-term funding and the specifics of state oversight of local services remain unknown.

Concerns About the Plan

Some advocates have expressed concern about the possible changes, specifically the idea of eliminating the Department of Mental Health.

Rose King, a legislative and state policy expert on mental health issues, said she is concerned that the vague outlines of a new system do not address historic discrimination against individuals with mental illness, even though state and federal laws mandate equal treatment for mental and physical health care.

In addition, critics say the implementation of Prop. 63 has been affected by bureaucratic problems that have led to sluggish payment rates and few funds for actual mental health programs.

Supporters' Response

Senate President Pro Tempore Darrell Steinberg (D-Sacramento) said Prop. 63 cannot be blamed for problems in mental health care that have been "decades in the making."

He said that he is hopeful the reorganization of mental health care services will address flaws in the system, adding that the reorganization will help improve coordination of care and keep those with mental illness out of prisons and jails.

Local officials also have expressed support for plans that would minimize some administrative tasks required to procure Prop. 63 funding (Capitol Weekly, 8/18).