1. The Mental Health Services Act SB677 to Proposition 63

2. Mental Health Care in California The Lanterman–Petris–Short Act of 1968 The Lanterman–Petris–Short Act of 1968 Protected individuals from being committed to an institution unless they were a danger to self, others or gravely disabled. Protected individuals from being committed to an institution unless they were a danger to self, others or gravely disabled. Called for individuals to receive outpatient care in the least restrictive environment Called for individuals to receive outpatient care in the least restrictive environment

3. De-institutionalization Necessary monies did not flow into the Counties for care of individuals Necessary monies did not flow into the Counties for care of individuals Thousands of people homeless and ill Thousands of people homeless and ill Thousands untreated Thousands untreated Non-profit agencies developed to provide community care Non-profit agencies developed to provide community care Out-patient clinics developed Out-patient clinics developed Public distressed by homeless but feel that this is a personal choice Public distressed by homeless but feel that this is a personal choice Stigma and discrimination Stigma and discrimination

4. Money and Mental Health 1973 State Spending Cap limits the amount spent on mental health1998 California had a budget surplus 1973 State Spending Cap limits the amount spent on mental health1998 California had a budget surplus 1998 California had a budget surplus 1998 California had a budget surplus 1998 AB 34 written and sponsored by Freshman Steinberg – Pilot to provide for “whatever it takes” care for 3 counties 1998 AB 34 written and sponsored by Freshman Steinberg – Pilot to provide for “whatever it takes” care for 3 counties AB 2034 Expanded to most counties in 1999 AB 2034 Expanded to most counties in 1999 2004 AB2034 defunded due to budget deficit 2004 AB2034 defunded due to budget deficit

5. Proposition 63 Ballot Initiative Proposition 63 passes with 53% of the vote. Ballot Initiative Proposition 63 passes with 53% of the vote. Authored by Steinberg Authored by Steinberg Meant to “keep the promise of Lanterman-Petris- Short” Meant to “keep the promise of Lanterman-Petris- Short” Imposes a 1% income tax after the first million dollars of income Imposes a 1% income tax after the first million dollars of income

6. Adoption Stage Public adopted the policy when it was felt the Legislature would not Public adopted the policy when it was felt the Legislature would not Proponents led a campaign to point out that every family is affected by mental illness. Power was in the group. Proponents led a campaign to point out that every family is affected by mental illness. Power was in the group. No organized constituency to oppose. No organized constituency to oppose. First time in history that mental health services are mandated and have dedicated funds. First time in history that mental health services are mandated and have dedicated funds.

7. Implementation Stage The Department of Mental Health establishes funding guidelines in 2005 The Department of Mental Health establishes funding guidelines in 2005 Onerous grant requirements creates the need for hiring of positions or consultants to write the plans. Onerous grant requirements creates the need for hiring of positions or consultants to write the plans. Five different plans required Five different plans required Community Services and Supports Community Services and Supports Half dedicated to FSP Half dedicated to FSP Workforce Education and Training Workforce Education and Training Housing Housing Prevention and Intervention Prevention and Intervention Innovation Innovation

8. Implementation Stage Each plan required extensive community input Each plan required extensive community input Monies could not be used for existing on-going programs Monies could not be used for existing on-going programs Monies were to be used for under-served populations Monies were to be used for under-served populations

9. Bureaucrats Making Law Interpretation leads to a cadillac system for previously un-served populations Interpretation leads to a cadillac system for previously un-served populations Leaves majority of individuals with level of care dictated by the whims of the budget process Leaves majority of individuals with level of care dictated by the whims of the budget process