May 4th, 2016
California SMI Coalition-CaSMI-Co
Honorable Edmund G. Brown, Jr.
Office of the Governor
California State Capitol, Suite 1173
Sacramento, CA 95814
RE: Oppose “No Place Like Home” Bond Debt
Dear Governor Brown:
We ask that you consider our thoughtful opposition to a budget plan that would divert vital funds from treatment of serious mental illnesses. A Senate bond plan would indebt the state for 30 years, while depriving more Californians of any hope for independence. The human logjam for California’s most severely psychiatrically disabled population is at critical mass. This is the target population that voters were promised would receive treatment and supportive housing back in 2004, with passage of Prop 63, the Mental Health Services Act/MHSA. However in 2016, this population is still housed in prisons, jails, state hospitals, their families’ back bedrooms, roach motels and graveyards in addition to a percentage that are homeless.
There is no doubt that there must be a radical redesign of the current systems in order to stop wasting money and lives. However, the California Senate’s “housing first” plan is not the bold action needed and it is not legal or affordable. A Steinberg/DeLeon proposal, “No Place Like Home,” would authorize $2 Billion in state bonds and indebt the Prop 63 fund. The purpose of the Prop 63 debt is to construct housing for all homeless Californians. However, Steinberg and Senate supporters ignore a former Attorney General Opinion* that explains why Prop 63 funds may not be used to fund housing construction.
This AG opinion clearly cites the provisions that dedicate funding for CA WIC 5600.3 Systems of Care treatment for children, adults, and older adults. Advisors tell us that housing bonds would risk legal challenges based on this opinion. The 2016 proposal by Senate President Pro-Tem Kevin DeLeon goes beyond the earlier violations identified by the AG opinion by proposing to take money from the mental health system to fund housing development with no guarantee that it will target the Prop 63 population entitled to treatment services. And, the proposal creates debt that is not clearly defined or publicly vetted.
Based on the information released, the MHSA fund could end up paying back $3.9 Billion for a ‘housing first’ plan, an idea to reduce homelessness already tried and failed. California mental health systems have no money to spare for this unlawful plan. The state must first develop and fund a system of care that provides “medically necessary treatment” for serious mental illnesses under the same terms as that for physical illnesses and other disabilities.
This housing plan to combat homelessness is set to come before the Senate in a June Budget Bill and must be opposed. ‘No Place like Home’ is a slogan, not a plan, seemingly predicated on the belief that “if you build it they will come.” But housing first, and treatment later, is bound to fail. Those suffering the delusions, paranoia, and cognitive disorganization of severe mental illness may not be able to utilize housing until and unless they receive treatment. Intensive support services and treatment for chronic and severe mental illness must go hand-in-hand with housing.
The only bold action required by the governor and the legislature is to keep the original promise to the Prop 63 voters and follow the law to fully fund a system of care for the WIC 5600.3 population. The legislature, governor and Mr. Steinberg are in a position to help rein in Prop 63 spending and instead invest in developing an accountability system. This is the only Prop 63 repurposing identified by the Governor’s Department of Finance, the CA State Auditor, and Little Hoover Commission reports.
The undersigned have combined our regional efforts across numerous counties to unify our voices and establish a California SMI Coalition (CASMI-Co). This coalition is dedicated to ending the delivery system gaps for California’s population with serious mental illnesses. After 11 years and over 16 Billion dollars in MHSA Revenue we find that the CA mental health system is more impacted, more fragmented and more divided.
We call for clear reforms of Prop 63 expenditures to keep the promise to voters to guarantee an entitlement to treatment first.
CaSMI Coalition (CaSMI-CO)
Signature page attached
Lt. Governor Gavin Newsom
Senate President Pro Tem De Leon
Assembly Speaker Anthony Rendon
Senate Minority Leader Jean Fuller
Assembly Minority Leader Chad Mayes
Senator Emeritus Darrell Steinberg
Senator Loni Hancock (D-Oakland)
Senator Holly Mitchell (D- Los Angeles)
Senator Mark Leno (D-San Francisco)
Senator Jim Beall (D-San Jose)
Senator Bob Hertzberg (D-Van Nuys)
Congresswoman Doris Matsui (D-Sacramento)
Department of Finance Director Michael Cohen
Department of Finance Chief Counsel K. Krogseng
Office of State Audits and Evaluations, Assistant Chief, Cheryl McCormick
Health and Human Services Program Budget Manager, M. Paulin
Health and Human Services Agency Secretary Diana S. Dooley
*Read the AG Opinion here:
June 2, 2017
The Honorable Senator Holly Mitchell, Chair
Budget Conference Committee
State Capitol, Room 5080
The Honorable Assemblyman Phil Ting, Co- Chair
Budget Conference Committee
State Capitol, Room 6026
Sacramento, CA 95814
Re: Proposed 2017 – 2018 California Budget Concerns
Dear Budget Conference Committee Members,
We write to strongly oppose the redirection of the 1991 Realignment Vehicle License Fee (VLF) from the Mental Health, Health and County Medical Services subaccounts to pay for the In-Home Supportive Services (IHSS) costs. The loss of $110 million from these accounts over 5 years would destroy lives and families who need higher levels of medically necessary psychiatric care.
Counties use 1991 Mental Health Realignment funds to pay for a number of community mental health services which have either no other funding source, are non-Medi-Cal reimbursable, or have substantially limited funding under Medi-Cal, including psychiatric inpatient hospitalization services. The funds are also used for Institutions for Mental Disease (IMD) services for adults with serious mental illness in need of 24-hour skilled nursing care, Lanterman-Petris-Short (LPS) Act responsibilities for involuntary mental health evaluation and treatment, and indigent mental health services for persons without Medi-Cal or other health coverage.
We formed Mental Illness FACTS, Family and Consumer True Stories, an action partnership, in 2010 committed to bringing equal rights to treatment of serious mental illnesses in the public mental health systems of California. Mental Illness FACTS is a strategy to properly fund treatment of serious mental illnesses while respecting both family and consumer priorities. True stories expose the tragedy of the discriminatory, unaccountable system, which lacks standards of care and invites undue political influence.
It is clear that power politics has led to this shameful and short-sighted attempt to balance the budget on the backs of California’s most psychiatrically vulnerable who are rarely offered IHSS to live in their own homes. Instead, they are relegated to the streets, jails prisons and morgues. This budget scheme will ensure that the fiscal and human toll of being failed and jailed and the explosion of Incompetent to Stand Trial cases will continue in California.
While CSAC and CBHDA make “back channel” deals with the Governor, the members of Mental Illness FACTS and Right to Treatment used transparent and progressive politics by encouraging the Democratic State Party to adopt the attached DRAFT resolution at their recent convention. This resolution was amended and passed by consent and will be formally adopted by the Executive Committee of the State Democratic Party in July. *See Resolution No. 17-05.65, “Resolution on the Need to Guarantee Mental Health Parity of Services.” We will be submitting this resolution to the Republican State Party for their consideration since serious mental illness is a bipartisan disease.
The current May Revise defies the spirit of the 2017/2018 Democratic State Party Platform and the Federal 21st Century Cures Act and Federal Mental Health Parity and Addiction Equity Act/MHPAEA acts. It does nothing to promote parity or a right to treatment before tragedy. Rather, it encourages the crisis of care and public safety to continue in our communities for our most psychiatrically disabled populations who depend on public inpatient and outpatient services. It also continues to send a message that serious mental illnesses are not worthy of an adequate continuum of medically necessary treatment in hospitals, IMDs or the community. We do not treat any other illness so inhumanely.
It is a moral and fiscal imperative that the legislature rejects this ongoing discrimination against people with serious mental illnesses. The 2017/2018 budget should reflect the entitlement of parity not further inequity and health disparities for people and families living with serious mental illnesses.
Teresa Pasquini and Rose King
Co-Founders, Mental Illness FACTS for Right 2 Treatment
*Resolution Title * Resolution on the Need to Guarantee Mental Health Parity of Services
Whereas 1 * WHEREAS California laws do not guarantee treatment of serious mental illnesses or addiction disorders on the same terms
as that guaranteed for physical illnesses or disabilities and this longstanding discrepancy in care results in the neglect of people with treatable illnesses.
Whereas 2 WHEREAS this widespread neglect of treatable mental illnesses and addictions has resulted in escalating the number of suicides, increasing the incarcerations of people with mental illnesses and treatable addictions, widening the divide of
broken families with painful, lifelong losses, and these exponential costs of neglect negatively impact families and the State
of California endlessly without resolution.
Whereas 3 WHEREAS the California Democratic Party Platform makes clear its intention when it states: "Promote parity of services for mental health and substance-related disorder benefits . . . under all private and public health care and delivery plans."
Resolve 1 * THEREFORE BE IT RESOLVED that the California Democratic Party recognizes that the cost of neglect and discrimination is a needless, wasteful, ever-increasing expense for state and local budgets.
Resolve 2 BE IT FURTHER RESOLVED that the California Democratic Party affirms the critical need to guarantee treatment of serious mental illnesses or addiction disorders on the same terms as that guaranteed for physical illnesses or disabilities.
June 14, 2016
Statement by Rose King and Teresa Pasquini, Co-Founders of Mental Illness FACTS and
Right 2 Treatment:
FACTS-Family and Consumer
We believe HR 2646 will support our California mission and campaign for Right 2 Treatment for serious mental illnesses for people who are disabled. And, it will honor and help the family members who have been shackled by the system in trying to support their loved one's health and care.
In 2010, we formed an action partnership committed to bringing about equal rights to treatment of serious mental illnesses in the public mental health systems of California. Mental Illness FACTS © is a strategy to properly fund treatment of serious mental illness while respecting both family and consumer priorities. True stories expose the tragedy of the discriminatory, unaccountable system, which lacks standards of care and invites undue political influence. As family members, we know the punishing effects of inequity in health and care for our loved ones.
HR 2646 has helped to show that our national, misguided state/federal policies and political interests are diverting treatment funds to subsidize other social programs, legitimate and frivolous alike. Mental Illness F.A.C.T.S. support policies that ensure the integrity of public mental health spending, and an equal entitlement to treatment of mental and physical illnesses. We support funding direct services in demand by consumers and families, paying for quality medical staffing to provide appropriate treatment, and the integration of mental health with all medical services. We believe HR 2646 will support our mission and bring funding into focus.
HR 2646 must help direct funding intended to improve standards of care for people with serious mental illnesses. HR 2646 must help prevent funding from being misused for political and special interest agendas by Protection and Advocacy for Individuals with Mental Illness(PAIMI.) It must strongly reform SAMHSA, which promotes a meeting/consulting industry, massive new bureaucracies, and wastes money on new programs with no evidence based criteria. We must have a science and evidence-based foundation for supporting spending that leads to whole health for a population that is dying by suicide, co-morbidities and shame.
HR 2646 has focused the nation on the need to remove discriminatory barriers to accessing SMI treatment. It has helped highlight that the system itself is the central source of stigma because it denies access to medically necessary treatment. It has highlighted the tragedies, the torture and the tremendous tax waste. It has highlighted the need to enforce mental health parity for all who have a serious mental illness.
Like Congressman Tim Murphy, Mental Illness FACTS is independent, informed and dedicated to equal, quality treatment for all people with serious mental illnesses. We believe it is time for HR2646. It is time to meet the essential health standards for people living with serious mental illnesses identified by the national Institute of Medicine (IOM): Safe, Equitable, Timely, Efficient, Patient/Family Centered, Effective. It is time for national change that matters.
A strong HR 2646 will help to stop the shunning of our loved ones and our families. A strong HR 2646 will force our nation to stop assigning medically necessary treatment for serious mental illnesses to relatives, police and prison guards! A strong HR 2646 will move the nation to whole health by providing a continuum of care including preventative assisted outpatient treatment, hospital beds, HIPAA relief for parents and evidence based treatment before tragedy, jail, homelessness and suicide.
Our plea is honest and heartfelt. We urge the E & C members to support the bold, courageous leadership of Congressman Tim Murphy when considering amendments to HR2646.
Teresa Pasquini and Rose King
Co-Founders of Mental Illness FACTS and Right 2 Treatment
For Immediate Release: Monday, May 23, 2016
Contact: Rose King 916-768-8012