California’s Millionaire’s Tax for Mental Health Proposition 63 of 2004 The Mental Health Services Act Rusty Selix Executive Director Mental Health Association/America of California (MHAC) and California Council of Community Mental Health Agencies (CCCMHA) and Primary Drafter and Co Author Proposition 63 – the mental health services act of 2004

A proven successful model Integrated Service Agency –whatever it takes 3 Pilot projects as alternative to state hospitals in 1987 (AB 3777) Outreach to homeless AB 34 (1999) Reduced hopspitalizations 70% and incarcerations 80% Expand from 3 to 38 counties – Dotcom bubble ends – no more leg $$ Initiative was only way to expand

Prop 63 Concepts Fully fund AB 34 model Estimated cost $500 million – 60,000 people Go from fail first to help first Prevention and Early Intervention Workforce, Capital Facilities, IT, Innovation Planning evaluation and oversight by state Tax millionaires to pay for it

Prop 63/MHSA Funding Categories Community Services and Supports – 70% Prevention and Early Intervention – 20%+ Innovation – 5% Education and Training - $400 m then CSS Total about $1.3 Billion Was $1.6 Billion before recession Dropped to $800 million –back to $1.6B Need $2 B+ due to $700m losses in 91 Realignment MHSA $$ just covered loss

Community Services and Supports “Whatever it takes” flexible funding Must be disabled due to SED or SMI Full Service Partnerships Wellness Centers Peer Support Case management and care coordination Outreach and engagement teams

Prevention and Early Intervention Identify and treat mental illnesses before they become disabling Primary Care and Schools as best sites Avoids stigma of mental health facility Completely new for county mental health 2009 plans focused on where people might go for help and care for uninsured New plans in – ACA covers care Create school and primary care systems?

Innovations Next generation of new ideas hard to get state $$ because of Prop 63 $$ Only limitation is that it must be an innovation Something not already being widely done Evaluation to determine to continue New projects in next plans- not continuation Other funds to continue

Education and Training Attract and Retain Workforce Educate and Train for new approaches 10 year plans with about two years left Money divided between state and counties New plans and $$ will be up to each county

Can still get there Progress diminished by recession and losses from realignment Affordable Care Act and continued recovery will eventually offset losses Programs working as expected Prevention through Early Identification requires school and health plan partnerships

Questions and Comments Contact information – Rusty Selix – – California Council of Community Mental Health Agencies (CCCMHA) – Mental Health Association of California (MHAC)