Don't backslide on mental health funding

By: North County Times Opinion Staff | Thursday, May 31, 2007 9:39 PM PDT ∞

Our view: State and county must maintain commitment to core services

Since Californians voted in 2004 to tax the rich to fund mental health programs, county health agencies can count on billions of dollars in new tax revenues. This infusion of cash has its downside, however. Mental health programs that existed before 2004 can't share in the bounty, and have seen funding levels stagnate and in some cases cut. Both the state and San Diego County must maintain their commitment to funding the core programs that have extended a helping hand to the mentally ill for decades.

After all, most of the 40,000-plus clients of the county's mental health services depend on programs that predate the 2004 passage of Proposition 63. We can't afford to neglect these people; any supposed savings are quickly eradicated by the cost incurred in emergency treatment and incarceration. More importantly, they are our neighbors, and they need our continued support.

In 2004, voters approved Prop. 63, or the Mental Health Services Act, an initiative that levied a 1 percent tax on incomes over $1 million to fund mental health services and programs. That same year, the state made severe cuts to existing mental health programs that left many counties, including San Diego, scrambling to fill a multimillion-dollar gap.

The county's solution was managed competition, at least for its mental health clinics. In 2005, public employees at the county's seven adult mental health centers, including the two located in North County, were required to submit a plan for maintaining services while reducing costs. The regional centers in Oceanside and Escondido were the only two that were underbid by a nonprofit health services provider, Mental Health Systems.

The change appears to have worked out in favor of the county, which saved money and has avoided slashing programs, and Mental Health Systems, which won the North County contracts and now manages the facilities in Oceanside and Escondido. But there's some question whether the switch benefited the most important parts of this equation: North County residents who need help with mental health issues.

In April, we reported that the average waiting time for an assessment by a psychiatrist at the centers in Oceanside and Escondido was 43 days. County officials had initially hoped that waits wouldn't be longer than 21 days. Sadly, this wait has only gotten worse since then ---- an average of 45 days in Oceanside and 48 days in Escondido.

Why not use some of that new Prop. 63 money to support the North County centers? Because Prop. 63's cash was caught up in one major string: The funds could only be used for new mental health programs. The money was meant to supplement, not supplant, funding for existing services. As a result, San Diego County now has a two-tiered mental health system that rewards new programs while neglecting the pre-Prop. 63 mental health programs, which include some 90 percent of San Diego County's services.

And things could be getting worse. Arguing that higher-than-expected Prop. 63 revenues will make up the difference, Gov. Schwarzenegger has proposed cutting $55 million in his proposed budget for the coming fiscal year from a program that provides housing for the homeless mentally ill. The author of the initiative says that would be illegal. Legal or not, it's a bad idea that would further erode the state's commitment to pre-Prop. 63 mental health programs.

That's not to say the Prop. 63 money isn't benefiting North County. Several new programs targeting the region have been created. One, Mental Health Systems' North Star program, helps mentally ill North County folks who are or could become homeless; another, the Rady Children's Behavioral Crisis Center in Oceanside, started helping children in crisis in late April.

The county is also trying to find a vendor willing to run a walk-in mental health urgent care center for North County. After four unsuccessful attempts, the county has increased the project's annual budget by $300,000 ---- to $1 million per year ---- in the hopes of finally attracting an interested bidder. We hope that the fifth time is the charm here.

Voters approved Prop. 63 to increase the state's spending on mental health care, not to cut funding for established mental health programs in favor of new ones. The state, working through the county, must not allow short-term funding considerations to undermine mental health care in North County.

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