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Mental Health Services Act (MHSA) and Prop 63 Home Page

(Laura's Law Home Page Moved Here)

Issue: In 2004,California voters alturistically passed Proposition 63 (Mental Health Services Act (MHSA), a 1% tax on millionaires to help people with "severe mental illness" and to "prevent mental illness from becoming severe and disabling". MHSA is an important program that does a lot of good. But mission-creep, insider dealing, and lack of oversight, have enabled both worthy and unworthy social services programs to masquerade as mental illness programs and claim they are eligible for MHSA funds. This bait and switch led to programs that fail to serve the seriously ill being showered with funds while those that do serve the seriously ill go unfunded. A new report found:

Fact Sheets on Problems with Mental Health Services Act

Op-ed explains mission creep and other problems plaguing MHSA
Summary of Problems with Mental Health Services Act
Insider dealing in MHSA
Voters wanted Proposition 63/Mental Health Services Act(MHSA) to help the most seriously mentally ill

Overview: How MHSA Prevention and Early Intervention Funds were diverted from people with mental illness
Examples of statewide misspending on ineffective programs that do not to help people with serious mental illness
County by county misuse of MHSA Prevention and Early Intervention (PEI) Funds
Full Service Partnerships (FSP) $2.5 billion unaccounted for
$10 million in MHSA funds go to prevent treatment for the most seriously ill
Who is Responsible for Diverting MHSA (Darrell Steinberg, County MH Directors, Mental Health Industry, Oversight Commissioners)
County Behavioral Healthcare Directors use Stakeholder Input to Divert Funds from Serious Mental Illness
Oversight Commission uses regulatory process to divert MHSA Funds from people with serious mental illness
How to fix problems with Mental Health Services Act (Replace Commissioners with new ones that don't have conflicts of interest)

Additional Findings

  • The state auditor found that because the Oversight Commissioners failed to provide oversight, taxpayers do not know if MHSA funds were spent effectively or efficiently.
  • County Behavioral Health Directors chaired meetings that allowed “stakeholder input” to trump the legislative language and voter intent to spend the funds on those with serious mental illness.
  • No attempt is made to ensure programs receiving MHSA funds serve people with serious mental illness.(FN1)
  • MHSA funds are being lavished on studies, reports, and consultants that generate jobs for those who get the contracts, but not services for people with serious mental illness. (FN 2)
  • Millions were diverted to programs intended to ‘improve the wellness’ of all Californians, rather than provide treatment to Californians with serious mental illnesses. (FN3)
  •  Funds failed to expand the capacity of proven existing programs as the legislation required.
  • The most important programs to help the most seriously ill (like Laura’s Law) are going unfunded.
  • The Oversight Commission evaluated counties based on what they said they were going to do rather than on what they did.
  • A series of amendments and related legislation introduced by legislators made it less likely MHSA funds will ever reach people with serious mental illness. (FN4)

Our response to new MHSOAC regs designed to divert PEI MHSA funds from people with mental illness
2015: Little Hoover Commission says there's no oversight of $13 billion MHSA funds

2012: California State Auditor Report Finds Lack of Oversight
2011: Mental Health Services Act (Prop 63) became "Bait & Switch"
2015: New Regs proposed (8/14) to drive MHSA funds away from people with serious mental illness
Dec 2013: Sen. Darrell Steinberg asks taxpayers to pay twice for same program
Dec 2013: Op-ed urges Jerry Brown to replace MHSA Oversight Commissioners to restore integrity
Letter to Jerry Brown: State auditors found oversight commisioners failed. Replace them.
October 2013: Our proposed Changes to Prevention/Early Intervention Regs

Why doesn't the public know about this?

$11 million in MHSA funds went to hire a P.R. firm that works to convince the media that all is well. They continually issue press releases and call editorial boards to extol the virtues of the program. County mental health directors and recipients of the diverted funds benefit from the status quo and therefore defend it. Governor Brown and Senator Steinberg appointed recipients of MHSA funds who represent the mental health and social service industries to sit on the Oversight Commission. As a result of this conflict, MHSA is being overseen by cheerleaders for mission creep, rather than stewards of the public purse. This is not what voters wanted to happen or were told would happen. Money is not the issue. Leadership is.

Counties should use Mental Health Services Act (MHSA/Proposition 63) to fund Laura's Law:

MHSA Funds Can be Used for Laura's Law: Legal Analysis by Mental Illness Policy Org
MHSA funds can be used to fund Laura's Law: Legal Analysis by Treatment Advocacy Center:
MHSA Funds can be used to fund Laura's Law: Legal Analysis by Mental Illness Policy Org. (California Office)
Much More on Laura's Law

Selected Media Coverage of problems in MHSA caused by failure to replace oversight commissioner

Dec 2013: San Diego Trib on failure of MHSA to serve seriously mentally ill
San Francisco Chronicle: Proposition 63 raised money and expectations, but not services for mental illness (8/15/13)
San Francisco Chronicle: Audit finds funds for mental health services misspent (8/15/2013)
San Francisco Bay Guardian: Slipping Away
Los Angeles Times: Audit finds lack of oversight for Mental Health Services Act spending (8/15/2013)
Sacramento Bee: Auditor says California not watching mental health funds (8/16/2013)
Associated Press Reveals Waste of MHSA Proposition 63 funds
San Diego Union Tribune: Best op-ed on the problem
Chico-Enterprise Editorial: Taxpayer money isn't free money
Contra Costa Times Editorial: Should ensure Proposition 63 money is used wisely (8/18/13)
Press-Enterprise Editorial State mental-health spending needs tracking, accountability (8/19/13)
SF Chronicle: Mental "health" industry diverts MHSA money meant to help people with mental "illness"
Prop 63 Missing Goals (SacBee)
Mental Health Services Act Funds Being Wasted (3 articles by Mental Illness Policy Org)
New Report: $16 million of MHSA funds goes to organizations directly associated with Oversight Commission (MHSAOC)
Mental Health Services Act (MHSA) creating a two-tier mental health system (News Review)
NAMI says MHSA fails. (Note: NAMI subsequently got $3 million grant and is now satisfied)
Rose King's Whistleblower complaint: Prop 63 not reaching intended target
MHSA co-author on how Prop/63 MHSA money is wasted and diverted
Whistleblower says Prop63/MHSA not working for mentally ill Californians
Legislators call for Auditing Prop 63

MHSA Source documents

Text of Mental Health Services Act (as ammended 9/2013)
List of MHSA funded programs by county(PDF)
Contacts: County PEI Coordinators
Contacts: County Mental Health Directors
Welfare and Instutions Code (Includes MHSA, Laura's Law, Guardianship, etc.)
Mental Illness Policy Org Study
California State Auditor Report
Assemblymen Dan Logue & Brian Nestande letter asking for audit of Prop 63/MHSA.

Regulatory and other organizations that play a role in distrubuting fund

California Mental Health Services Oversight and Accountability Commission (MHSOAC is supposed to oversee MHSA spending. The state auditor said they failed
California Department of Heatlh Care Services (now has some MHSA Oversight responsibilities formerly held by MHSOAC)
California Institute of Mental Health (Founded by local mental heatlh directors to provide policy direction. See Insider Dealing)
California Mental Health Services Authority (CalMHSA is a "Joint Authority" made up of CA counties that pool MHSA resources to run certain programs so each county does not reinvent the wheel. See "Insider Dealing')
Learn How much MHSA (Prop 63) money your county recieved
MHSOAC 3 Year Plan Requirements for Counties (8/1/05)
MHSOAC 2/09 Minutes on 2 Tier System
Department of Finance review critical of MHSA Rollout

Problems MHSA Oversight Commissioners should be addressing, but ignore

Preventable Trragedies in Sacramento
Preventable Tragedies in Orange County (PDF Version)
Preventable Tragedies in San Mateo (PDF Version here)

Severe Psychiatric Hospital Bed Shortage in California (Data)
Untreated persons with mental illness drain California law enforcement resources (survey) (PDF version)
Recommendations to Improve LPS Act (2012 Lanterman Petris Short Task Force Report)
Future of Psychiatric Services in California (Powerpoint presentation by Dr. E. Fuller Torrey)
Two Tier Mental Health System (F.A.C.T.S)
"Problems with MHSA" by Rose King (12.2.12)

County by county info on Mental Health Services Act / Prop 63 funds

Note: MHSA Plans change annually, so many of the links below are not likely to the most recent county MHSA plan. Google "name of county" "MHSA" to find the latest.

Alameda County Behavioral Health Home Page
Alpine County
Amador County

Butte County
Calveras County

ContraCosta County MHSA Plan
Contra Costa MHSA Home Page

Del Norte County
El Dorado County
Fresno County
Glenn County
Humboldt County
Imperial County

Kern County MHSA Home Page
Kern County MHSA Plan

Kings County
Lake County
Lassen County

Los Angeles County Proposition 63 Plan

Problems with LA County Stakeholder Process
Laura's Law works says Los Angeles Dept. of Mental Health report

Madera County
Marin County
Mariposa County

Mendocino County Proposition 63/MHSA Home Page
Mendocio MHSA Plan Update
Mental Health Dept convinces Supervisors to not use Laura's Law (7/12)
Ft. Bragg Advocate on Laura's Law
Op-ed by James Bassler on why his mentally ill son killed two and how Laura's Law would have helped(Fort Bragg News)
Explanatory Letter to Editor Ukiah Daily Journal on why Mendocino needs Laura's Law (by DJ Jaffe)
Letter to Editor by James Bassler (father of Aaron) (Ukiah News) on logic of Laura's Law
Laura's Law might save county money, force better services (Ft. Bragg Advocate)

Merced County
Mono County
Monterey County
Napa County

Nevada County

Orange County
Misspending Plagues Orange County MHSA programs
Analysis of Report by Orange County Health Care Agency to Supervisors (Important)
Preventable Tragedies in Orange County (PDF Version)
Response to OC Health Care Agency Report to Supervisors (by NAMI Orange County & California Treatment Advocacy Coalition)
Ending Homelessness 2020 Testimony on Laura's Law by Carla Jacobs
Preventable Tragedies in Orange County (PDF Version)
Health Care Agency misleads County Supervisors
(OC Register)

Placer County
Plumas County
Riverside County

Preventable Trragedies in Sacramento
Laura's Law Languishes (Sacramento News and Review)

San Diego
Dec 2013: San Diego Trib on failure of MHSA to serve seriously mentally ill

San Francisco County
New: Op-ed, editorial, article SF Chronicle

San Francisco Ignores Mentally ill
Ignore mentally ill and court disaster (SF Chronicle)
San Francisco Prevention and Early Intervention Plan

San Luis Obispo Prop 63 Home Page
San Luis Obispo MHSA Plan
San Luis Obispo Tribune Special Report on Mental Illness

San Mateo County MHSA Home Page
Analysis of San Mateo Officials Claims About Laura's Law(Important)
Preventable Tragedies in San Mateo (PDF Version here)

Shasta County
MHSA Funded Suicide Prevention Activities Fail

Siskiyou County
Tragedies are preventable

Sonoma County
Sonoma Behavioral Health Care Director defends status quo (and read our response)

Stanislaus County

Other Media
California Emergency Rooms Very Expensive Way to treat mental illness (LA Times)

FN 1Many of the outcome reports are at http://www.mhsoac.ca.gov/Evaluations/CSS-Outcomes.aspx . They do not include any info on the diagnosis of people served.

FN 2 Ex. The Oversight Commission put out an RFP for an evaluation to evaluate the evaluations. Neither the original evaluations or the evaluation of the evaluations require evaluation of whether the people being served were seriously mentally ill individuals eligible for services. http://mhsoac.ca.gov/Evaluations/docs/Contracts/RFP_MHSOAC012-015.pdf

FN3The Oversight Commission itself created an eight page glossy insert for papers throughout the state headlined, “Mental Illness: It Affects Everyone, even though the legislation is not intended to affect everyone. See http://issuu.com/news_review/docs/2013-01-03_mentalillness (accessed 6/23/12).

FN4 Most notably, AB-100 took $863 million out of the MHSA fund and directed it to fund programs courts had mandated the state to fund. AB 1467 (July 2012) essentially disconnected Innovative Funds (5% of total MHSA funds) from a connection with serious mental illness.  

The information on Mental Illness Policy Org. is not legal advice or medical advice. Do not rely on it. Discuss with your lawyer or medical doctor. Mental Illness Policy Org was founded in February 2011 and recently received 501(c)(3) status. In order to maintain independence MIPO does not accept any donations from companies in the health care industry or government. That makes us dependent on the generosity of people who care about these issues. If you can support our work, please send a donation to Mental Illness Policy Org., 50 East 129 St., Suite PH7, New York, NY 10035. Thank you. For more information, http://mentalillnesspolicy.org.