Governor, Lawmakers Offer Solutions For California Counties That Don’t Spend Mental-Health Funds

Counties are leaving billions of dollars in state mental health funds unspent. Now Gov. Jerry Brown and lawmakers are looking for solutions to make sure that the money gets used.

The Mental Health Services Act provides funding to counties so they can offer mental health prevention and treatment services to Medi-Cal patients. Brown wants to spend $6.7 million on new staff at the Department of Health Care Services to oversee how counties use the state money. It comes after a February audit indicated counties had amassed $2.5 billion in unspent funds.

The auditor says the state Department of Health Care Services didn’t provide proper oversight and guidance. It also failed to recover leftover funds that under state law must go back to the state. The state then reallocates it to other mental health agencies.

Adrienne Shilton, government affairs director for a mental health nonprofit called the Steinberg Institute, said some counties weren’t spending the money because they thought it was going to be returned.

“So, there was confusion about whether they could legally spend these dollars,” she said.

Farrah McDaid-Ting, director of the California State Association of Counties, said that after the recession the state provided less direction to counties on how to administer special mental health services to Medi-Cal patients.

“[The Department of Health Care Services] has really struggled in the past few years to do what they had to to with the staff they had, so we strongly support the proposal to increase the staffing level,” she said.

Meanwhile, a newly introduced Assembly bill seeks to allocate unspent MHSA dollars — which currently go to the state — to cities, school districts or other public entities providing mental health services.

The act currently divides available funding into two categories: 80 percent to be used to treat people with serious mental illness, and 20 percent to be used for prevention. Most of the unspent dollars were in the prevention category.

The Steinberg Institute is supporting a Senate bill that would require counties to spend the prevention funds specifically onearly psychosis and mood disorder detection, mental health outreach for young adults, with an emphasis on colleges; and childhood trauma prevention and intervention services. The bill would allow counties to make an argument for other uses.

“Until the Mental Health Services Act, there wasn’t a funding stream, in the public system at least, to get to people before they had a diagnosed mental illness,” Shilton said.

She said confusion around what services fell under the bounds of the act and a “lack of clarity and enforcement around the reversion policy” contributed to the dollars not getting spent.