California's Millionaire's Tax for Mental Health Proposition 63 of 2004

1. California’s Millionaire’s Tax for Mental HealthProposition 63 of 2004The 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

2. 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 – 2000-01 • 2001Dotcom bubble ends – no more leg $$ • Initiative was only way to expand

3. 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

4. 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

5. 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

6. 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 2014-15 – ACA covers care • Create school and primary care systems?

7. 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

8. 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

9. 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

10. Questions and Comments • Contact information • Rusty Selix • rselix@mhac.org 916-205-7777 • California Council of Community Mental Health Agencies (CCCMHA) www.cccmha.org • Mental Health Association of California (MHAC) www.mhac.org