SAN DIEGO —— The county has asked people with business connections to the mental health community to resign from county panels that dole out public money for mental health programs, a move that has angered some mental health advocates who say the move will keep valuable experts off the panels.

The county has received about $40 million as a result of a new law, Proposition 63, which passed last year. The law imposes a 1 percent tax on California residents who make $1 million or more to help pay for mental health programs.

Counties have been instructed to submit plans for the money —— with advice from patients, family members and mental health service providers —— to the state for approval.

The office of Alfredo Aguirre, director of the county's adult and children's mental health departments, sent letters earlier this month telling agencies that anyone with any connection to a company that could bid to provide services paid for by Prop. 63 funding would have to resign from the work groups.

Aguirre said the county was being cautious about whom to allow on the panels in order to avoid conflicts of interest.

The county does not want to jeopardize the $40 million by giving anyone a chance to say later that it allowed service providers —— companies that could profit from Prop. 63's funding —— to influence how the money should be spent, Aguirre said.

"It's all about whether you're involved as a contractor," he said. "At the end of the day if there are services approved … that organization could be subject to potential disqualification from seeking those funds because they were involved in the voting."

But Karen Luton, executive director of the Mental Health Association in San Diego County, and Paul Cumming, a longtime member of the county's Mental Health Advisory board, said last week that barring some mental health experts from the work groups was a bad idea. The panels will decide how to spend money on help for mental health patients through educational programs, therapy, medication and other services that require the knowledge of experts, the two said.

"You want your experts to be involved," Luton said. "If you eliminate those folks you're left with a much smaller pool … of people who don't have the same depth and breadth of knowledge and experience."

The county initially planned to include most of the agencies in its working groups, but asked them to resign after the plan triggered alarm bells in the county counsel's office.

Too cautious?

Cumming and Luton said it was perfectly reasonable for the county to be concerned about potential conflicts of interest.

But they said the county has taken that concern to unreasonable lengths. Luton and Cumming said the county had stretched the definition of a potential "contractor" to include people who volunteer their time to be on boards of agencies that provide mental health services.

"For instance," Luton said, "Mental Health Services has had a contract to run a rehabilitation center in Chula Vista for the last six years. But we've been in the advocacy business for 65 years —— talking about legislation, approaching county supervisors, to make our (mental health) system better. I have a volunteer on the board of directors. She's not allowed to participate."

The 49-year-old Cumming, who was diagnosed with bipolar disorder in his 20s, said it's common for patients and family members of people who have suffered mental illness to volunteer their services to the agencies that have helped them.

Cumming said he's been kept off the work groups because he is a volunteer director on the board of the San Diego chapter of the National Alliance for the Mentally Ill. The group's main purpose is to inform the public about mental illness and erase the public stigma attached to it in the hope of encouraging treatment. But Cumming said the group does contract to provide some mental health services, including a bookkeeping service the county outsourced years ago.

Cumming said the county's conflict-of-interest ruling is eliminating a lot of important advice. Mental health "experts" —— providers, patients and others —— that make up its Mental Health Advisory Board have been barred from the voting working groups.

"To give you a quick example, housing (in mental health) is a very complicated issue," Cumming said. "The Mental Health (Advisory) Board has a housing subcommittee of highly qualified professionals and consumer and family advocates. Not one person from this committee passes the conflict interpretations. Therefore, there are no housing representatives on the work groups."

Cumming said the work groups from which agencies have been barred were not making recommendations about funding specific programs, but were creating priorities for potential services they think should receive funding.

"They really reached out far and wide to exclude people," he said, "completely ignoring the fact that all we're talking about is preferences, not specific programs."

Shot in the arm

One thing all sides agreed upon is that the Prop. 63 money is ultra-important to the county's mental health system. Patients, counselors, agencies and others have said for years that San Diego County's system is a poorly funded patchwork of disconnected services that are hard to find and use.

Two years ago, the county slashed the budget of its children's mental health department by a third, or about $10 million. This year, over the objections of their own Mental Health Advisory Board, supervisors agreed to turn management of North County's mental health clinics to private companies in order to cut costs.

Aguirre, meanwhile, said the $40 million a year Prop. 63 would provide —— $25 million for new services and $15 million for capital improvements and early prevention programs —— would represent a roughly 20 percent increase for the county's mental health budget.

Aguirre said his department still plans to incorporate assistance from all experts in the mental health field.

He said the county plans to hold a special forum after the work groups vote for their preferences. And, he said, the ousted advocates can still attend work group meetings. They just can't vote.

But Cumming, Luton and others have said that is not enough.

"Being a member of the public with a comment at the beginning or at the end of a meeting just isn't the same," Cumming said. "This is terrible."

Contact staff writer Gig Conaughton at (760) 739-6696 or gconaughton@nctimes.com.