|
Protection & Advocacy Inc. Advancing the Rights of Californians with Disabilities |
LEGISLATION & PUBLIC 1029 J Street, Suite 150 |
|
|
|
||
PAI Policy on use of Mental Health Services Act Funds (Proposition 63)
Adopted |
||
BACKGROUNDOn Proposition 63 provides funding for the following
services: § Children’s System of Care Program. § Adult and Older Adult System of Care Program. § Prevention and early intervention. § Education and training programs to address the shortage of qualified mental health service providers. § Capital facilities and technology needed to provide mental health services. Proposition 63 also requires that 5% of the funds for Children’s
System of Care, Adult and Older Adult Systems of Care, and prevention and
early intervention be used for innovative programs. Welfare and Institutions
Code section 5892(a)(6). Innovative programs include services that increase
access for underserved groups, increase access to services, increase the
quality of services, and promote interagency collaboration. Welfare and
Institutions Code section 5830. The following principles outline PAI’s position on how
to fully realize the promise of Proposition 63. PRINCIPLES
1.
Mental Health Services Act (MHSA) funds should be
used to provide client-centered and client directed services that will
transform the public mental health system. § Consumers/clients of mental health services must stand at the center of the system of care. Consumers’/clients’ choices must drive the care and services that are provided.[1] § MSHA funded services must be consistent with the philosophy, principles and practices of the Recovery Vision for mental health consumers/clients.[2] § MSHA funded services must support self-determination and provide people with disabilities with opportunities to choose community-based options.
§
MHSA funded services must provide full state
law rights and due process protections to persons served by the programs. 2.
Consumers/clients should be involved in all aspects
of both the local and statewide planning, implementation, service delivery and
evaluation process. § Each county must include consumers/clients in development and implementation and evaluation of their MSHA plans. § Each county must demonstrate how they will provide peer-run services. Counties should develop plans containing the best methods for providing peer services. Counties should not seek, nor be granted, waivers from the requirement to develop peer services. Peer services should include services to residents in institutions to assist in identifying services and supports that are needed in order to assist in the transition from the institution into the community. § An inclusive process should be developed by the State Department of Mental Health for determining how Proposition 63 funds should be allocated to the counties. On a statewide basis, consumers/clients and family members should be involved in all aspects of the process for determining how funds will be allocated to the counties. There are wide differences in mental health service needs of various counties. Only a broad, inclusive process for identifying the unique needs of various counties can lead to an equitable allocation formula. 3.
MSHA funds should be used to expand and strengthen
community mental health services and eliminate unnecessary institutionalization. § MHSA funds, including capital improvement funds, must only be used to expand outpatient crisis services, housing, and similar outpatient and living arrangements that reduce the need for incarceration, inpatient or institutional care. § Neither MHSA funds nor MHSA capital improvement funds should be used for remodeling or expansion of county jails or inpatient or institutional facilities. § Proposition 63 funds should be used to expand the availability of crisis services so that the need for acute care hospitalization will be reduced. MHSA funds must not be used to pay for acute care hospitalization uncompensated care. Provision of non-institutional crisis services should be the focus of addressing uncompensated care in acute care hospitals.[3] 4.
The state and counties should comply with the
maintenance of effort and non-supplantation requirements of the MHSA by
providing full funding from non-MHSA funds for each category of mental health
services previously funded as of the 2003/2004 fiscal year, including $20
million in General Funds previously provided for the Children’s System of
Care. § Use of Proposition 63 funds to pay for the costs of services currently provided under an existing program (other than a voluntary Adult and Older Adult System of Care Program under AB 34/2034) violates the maintenance of efforts requirements of Proposition 63. § MHSA funds should not be used to meet existing state or local obligations for Children’s System of Care Services and special education services provided pursuant to AB 3632, which should be paid for by other funding sources. § In addition, MHSA funds should be used for new and innovate services as determined by the county planning team. 5. Programs funded under Proposition 63 must provide services in the most integrated setting appropriate.
§
Services must be provided consistent with the
Americans with Disabilities Act’s (
§
Programs funded under Proposition 63 must
focus on reducing existing institutionalization and out-of-home care, as well
as preventing future institutionalization and out-of-home care.
§
Community-based services must be made
available to people in institutions or out-of-home placements in order to
implement the Olmstead requirements
of the Americans with Disabilities Act.
§
Each county should identify all residents of
institutions who could transition to the community with community-based
services, and should provide the community-based services needed in order to
begin the transition. Input into the planning and delivery process should be
obtained from residents of institutions by both the state and the counties. Planning
for discharge to the community should be done in accordance with the
principles in the 6.
Cultural competence components in each county plan
should address access and quality of care for each underserved community or
group and each individual with special health care needs in the county, and
should involve members in all levels of the planning or decision making
process. § Each county must identify all underserved communities or groups and individuals with special health care needs in the county for the purpose of determining how to provide culturally competent services. This includes individuals who are underserved or have special needs based on language, immigration status, culture, ethnicity, gender, physical, sensory, or developmental disability, sexual orientation, religious and spiritual beliefs, and urban and rural living arrangements that present barriers to access to services. § Each county must identify other consumer/client and community groups within the health, mental health, and social service populations that have not previously or traditionally been identified and/or included, such as residents of Board and Care Homes, juvenile group homes, foster care settings, skilled nursing facilities, independent living facilities, institutions for mental diseases (IMDs), state hospitals, homeless shelters, single room occupancy hotels (SROs), Supported Housing communities, and adult and juvenile detention and correctional facilities.
§
Each county must provide culturally competent
outreach, public information and focus groups to each of the identified
groups and communities as part of the planning and service delivery process. 7.
MHSA funds must be used to expand voluntary community
based services, and must not be used to fund involuntary programs such as AB 1421. § MHSA Adult System of Care funds should be used for the expansion of the voluntary Adult and Older Adult System of Care Program (AB 34/2034 program), which provides a broad array of services, supports, and housing to assist people to live in the community. § MSHA funds should not be used for the expansion of other existing programs, including existing involuntary programs such as the involuntary assisted outpatient treatment (AB 1421) program.[7] |
||
|
Policy #1025.01 |
Adopted |
|
[1] See
President’s New Freedom Commission report.
[2] See Welfare
and Institutions Code section 5813.5(d).
[3] In addition, acute care hospitalization is an
existing program that cannot legally be funded under Proposition 63.
[4] See PAI
Policy On Community Integration, Adopted
[5]
[6] The
[7] Moreover, under the terms of AB 1421 itself, AB 1421
cannot be implemented if implementation would reduce the availability of
voluntary services under other programs, including AB 34/2034 services funded
with State general funds or Proposition 63 funds.