August 22, 2019

This week, the Assembly’s Accountability and Administrative Review and Health Committees, chaired by Assembly Member Cottie Petrie-Norris and Assembly Member Jim Wood, convened a joint informational hearing on the oversight and accountability of Mental Health Services Act Funds (MHSA).

The MHSA was enacted by voters with the passage of Proposition 63 in November 2004 with the goal of providing flexible funding to improve California’s public mental health system. Since the enactment California’s county administered mental health plans have used the funding to implement and expand a range of community-based programs and services.

In February 2018, the California State Auditor released a report on the role of key state agencies in the implementation of MHSA. The report examined how counties accounted for and spent the funding, as well as the effectiveness of the Department of Health Care Services (DHCS) and the Mental Health Services Oversight and Accountability Commission (MHSOAC) in overseeing the MHSA.

The audit found that DHCS has not provided effective direction to local mental health agencies on how to spend MHSA funds, the audit reported that DHCS did not adequately oversees the MHSA funds received by local mental health agencies, such as not enforcing reporting deadline or establishing a guideline for reserves. The audit also reported that while the MHSOAC is implementing processes to evaluate the effectiveness of MHSA-funded programs, there is still work needed on issues such as developing guidance on the Innovation program approval process.

The joint committee heard from panelist from the Legislative Analysts’ Office who read their MHSA report, DHCS, and MHSOAC on the key changes that have been implemented following the 2018 audit. Some challenges discussed by DHCS and MHSOAC were the complexity of data sharing and data analysis across county jurisdictions.

Representatives from DHCS and MHSOAC assured the committee that the audit recommendations were taken seriously and implemented. Michelle Cabrera, Executive Director of the County Behavioral Director’s Association of California, provided the committee with a comprehensive overview of the historical background of MHSA funding, the challenges counties have overcome, the challenges counties continue to face, and the improvements to the mental health infrastructure provided by the MHSA funding source.

Dr. Veronica Kelly, Director of San Bernardino County Department of Behavioral Health accompanied Ms. Cabrera to offer the experience of the local administration of MHSA funded programs to committee members. Dr. Kelly expressed the continued need for investments into the mental health infrastructure, and the work that many counties are doing with the funding. Ultimately, the panelist emphasized the uniqueness of the MHSA as well as the intended goal to implement programs and services that improve lives.