California Mental Health Services Act

In November 2004, voters in the U.S. state of California passed Proposition 63, the Mental Health Services Act (MHSA), which has been designed to expand and transform California’s county mental health service systems by increasing the taxes of high income individuals. The MHSA will be funded by imposing an additional one percent tax on individual, but not corporate, taxable income in excess of one million dollars.

Contents

Overview

The voter-approved MHSA initiative provides for developing, through an extensive stakeholder process, a comprehensive approach to providing community based mental health services and supports for California residents. Approximately 51,000 taxpayers are directly affected by the tax, which will generate an estimated $750 million in revenue during fiscal year 2005-06.

The MHSA addresses six components of building a better mental health system to guide policies and programs:

The MHSA stipulates that the California State Department of Mental Health (DMH) will contract with county mental health departments to develop and manage the implementation of its provisions. Oversight responsibility for MHSA implementation was handed over to the sixteen member Mental Health Services Oversight and Accountability Commission (MHSOAC) on July 7, 2005, when the commission first met.

The MHSA specifies requirements for service delivery and supports for children, youths, adults and older adults with serious emotional disturbances and/or severe mental illnesses. MHSA funding will be made annually to counties to:

Proposition 63 mandate

The requirements of the MHSA, mandated by approval of California Proposition 63 in 2004 with 53.4% of the vote, are intended to initiate significant changes, including:

Counties are required to develop their own three-year plan, consistent with the requirements outlined in the act, in order to receive funding under the MHSA. Counties are obliged to collaborate with citizens and stakeholders to develop plans that will accomplish desired results through the meaningful use of time and capabilities, including things such as employment, vocational training, education, and social and community activities. Also required will be annual updates by the counties, along with a public review process. County proposals will be evaluated for their contribution to achieving the following goals:

MHSA specifies three stages of local funding, to fulfill initial plans, three year plans, and long term strategies. No services will be funded in the first year of implementation; it is anticipated county plans, and subsequent funding of new services, will be approved by DMH perhaps as early as January, 2006. Allocations for each category of funding will be granted annually, based upon detailed plans with prior approval. For the first year of implementation, the initiative allocates:

  • The California Department of Mental Health, for carrying out its collaborative role in implementing proposition 63
  • The California Mental Health Planning Council, for its role in overseeing education and training initiatives
  • The Mental Health Services Oversight and Accountability Commission

Department of Mental Health collaboration

In the first few months immediately following its passage, the DMH will:

The DMH has directed all counties to develop plans incorporating five essential concepts:

The DMH, in assuming and asserting its primacy over MHSA implementation, has dictated requirements for service delivery and supports as follows:

Pharmaceutical industry influence

Few, if any, representatives of the pharmaceutical industry have openly participated in the town hall and stakeholder meetings during 2005. Many mental health clients and family members have requested easier access to less expensive medications during the initial stakeholder outreach process, while a similar number have expressed interest in alternative medicine options.

Mental Health Services Oversight and Accountability Commission

Sixteen members have been appointed to the Mental Health Services Oversight and Accountability Commission (MHSOAC), whose role is to develop strategies to help mental health service clients overcome the stigma of being labeled 'mentally ill', and to accomplish the objectives of the MHSA. Twelve members have been appointed by Governor Arnold Schwarzenegger, joining four State government appointed officials.

The Commission advises the governor and legislature regarding actions the State may take to improve care and services for people with mental illness, and is required to annually review and approve each county mental health program for expenditures. Whenever the commission identifies a critical issue related to the performance of a county mental health program, it may refer the issue to the DMH.

The first meeting of the MHSOAC was held July 7, 2005, at which time Proposition 63 author Darrell Steinberg was selected unanimously by fellow commissioners as chairman, without comment or discussion. After accepting the gavel, Steinberg was roundly praised for devising Proposition 63's 'creative financing' scheme. Steinberg then said, "We must focus on the big picture," and stated his priorities with regard to the implementation of the MHSA:

MHSOAC commissioners

In accordance with MHSA requirements, the Commission shall consist of 16 voting members as follows:

  1. The Attorney General or his or her designee
  2. The Superintendent of Public Instruction or his or her designee
  3. The Chairperson of the Senate Health and Human Services Committee or another member of the Senate selected by the President pro Tempore of the Senate
  4. The Chairperson of the Assembly Health Committee or another member of the Assembly selected by the Speaker of the Assembly
  5. Twelve appointees of the Governor, who shall seek individuals who have had personal or family experience with mental illness, to include:
  • two persons with a severe mental illness
  • a family member of an adult or senior with a severe mental illness
  • a family member of a child who has or has had a severe mental illness
  • a physician specializing in alcohol and drug treatment
  • a mental health professional
  • a county Sheriff,
  • a Superintendent of a school district
  • a representative of a labor organization
  • a representative of an employer with less than 500 employees
  • a representative of an employer with more than 500 employees
  • a representative of a health care services plan or insurer

State government appointees

The initial government officials and designee appointed:

Governor's appointees

On June 21, 2005, Governor Schwarzenegger announced his appointment of twelve appointees to the MHSOAC:

See also

External links

Government agencies

Private Organizations

Media coverage