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HomeMy WebLinkAboutMINUTES - 01262010 - C.18RECOMMENDATION(S): APPROVE the Mental Health Commission's 2010 Legislative Platform, as recommended by the Commission and the Health Services Director. FISCAL IMPACT: No fiscal impact. BACKGROUND: Each year the Board of Supervisors adopts a State and a federal legislative platform that establishes prioritites and policy positins with regard to potential legislation and regulation. The platforms include policy issues the provide direction and guidance for indentification of bills which would affect the services, programs or finance of Contra Costa county; County-Sponsored bill proposals; and issues regarding the intergovernmental relationships. The Mental Health Commission, at their January 8, 2009 meeting, consider the need to be able to react expeditiously when the need to advocate on the part of Contra Costa County mental health consumers arose. At that meeting, they unanimously approved the attached 2010 Legislative Platform and requested that APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 01/26/2010 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYES 5 NOES ____ ABSENT ____ ABSTAIN ____ RECUSE ____ Contact: Dorothy Sansoe, 335-1009 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: January 26, 2010 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: C.18 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:January 26, 2010 Contra Costa County Subject:Approval of Mental Health Commission 2010 Legislative Platform BACKGROUND: (CONT'D) it be submitted to the Board of Supervisors for approval. This platform reflects the same priorities as those adopted by the Board of Supervisors on January 19, 2009 for Contra Costa County. The platform includes policy issues that provide direction and guidance for identification of bills which would affect the mental health services, program or finances of Contra Costa County; County-sponsored bill proposals; and issues regarding the State and local budget and state-local relationships. To provide a streamlined approach to the appointed members of the Mental Health to advocate on behalf of mental health consumers in Contra Costa County, the Department of Health Services recommends that the Board of Supervisors approve the attached platform and authorize the Mental Health Commission to take positions on issues that fall under this platform. 2010 Mental Health Commission State Legislative Platform 1 2010 LEGISLATIVE PLATFORM CONTRA COSTA COUNTY MENTAL HEALTH COMMISSION Each year, the Board of Supervisors adopts a State legislative platform that establishes priorities and policy positions with regard to potential state legislation and regulation. The Mental Health Commission also adopts a related platform with regard to mental health issue. The Mental Health Commission State Legislative Platform includes policy issues that provide direction and guidance for identification of bills which would affect the services, programs or finances of mental health services in Contra Costa County. 2010 Legislative/Regulatory Advocacy Priorities Each year, issues emerge through the legislative process that are of importance to the Contra Costa County Mental Health Commission (Commission) and require advocacy. For 2010, it is anticipated that critical issues requiring the attention of the Commission will include the following: State and Local Budget – Both the state and County are facing continuing structural deficits through 2009-10 and into the future. The long-standing practice of state government has been to look to counties as a means of balancing its budget. While opportunities to do so are more limited with the passage of Proposition 1A, the magnitude of the deficit makes it certain the state will be creative in their effort to include counties as part of its budget balancing solution. Of particular concern to the Commission is the inadequate funding for mental health services. The annual shortfall between actual county expenses and state reimbursement has grown steadily since 2001, creating a de facto cost shift to counties. The funding gap forces counties to reduce services to vulnerable populations and/or divert scarce county resources from other critical local services. Mental Health Care – Counties have a high stake in California’s health reform efforts. Counties serve as employers, payers, and providers of mental health care to vulnerable populations. Consequently, counties stand ready to actively participate in discussions surrounding improving the mental health care system in California. As proposals for Health Care reform by either the Administration or the Legislature are presented, they will be reviewed for their inclusion of and impact on the mental health system of care. 2010 State Legislative Platform Policy Positions As requested by the Board, a brief background statement accompanies policy positions that are not self-evident. Explanatory notes are included either as the preface to an issue area or following a specific policy position. 2010 Mental Health Commission State Legislative Platform 2 Mental Health Revenues/Finance Issues As a political subdivision of the state, many of Contra Costa County’s mental health services and programs are the result of state statute and regulation. The state also provides a substantial portion of the County’s revenues. However, the state has often used its authority to shift costs to counties and to generally put counties in the difficult position of trying to meet local mental health service needs with inadequate resources. While Proposition 1A provided some protections for counties, vigilance is necessary to protect the fiscal integrity of the mental health system in Contra Costa County. 1. SUPPORT the State's effort to balance its budget through actions that do not adversely affect County revenues, services or ability to provide mental health services. 2. OPPOSE any state-imposed redistribution, reduction or use restriction on general purpose revenue, sales taxes or property taxes unless financially beneficial to the County. 3. OPPOSE any efforts to increase the County's share-of-cost, maintenance-of- effort requirements or other financing responsibility for state mandated mental health programs absent new revenues sufficient to meet current and future program needs. 4. SUPPORT efforts to ensure that Contra Costa County receives its fair share of state allocations, including mental health funding under Proposition 63. The state utilizes a variety of methods to allocate funds among counties, at times detrimental to Contra Costa County. For example, with Proposition 63 mental health funding, the Department had anticipated $12-16 million per year. The state allocation is only $7.1 million for the first 3 years, in part because the homeless population was not considered in the allocation methodology. 5. SUPPORT continued efforts to reform the state/local relationship in a way that makes both fiscal and programmatic sense for local government. 6. OPPOSE reductions in county-run State mental health programs that shift responsibility or costs to the County. 7. SUPPORT state actions that maximize federal and state revenues for county-run mental health services and programs. 8. OPPOSE efforts of the State to avoid state mandate claims related to AB3632 mental health services for children by delaying payment schedules. 9. SUPPORT timely, full payments to counties by the State for programs operated on their behalf or by mandate. The State currently owes counties approximately 2010 Mental Health Commission State Legislative Platform 3 $1 billion in State General Funds for social services program costs dating back to FY 2002-03. Mental Health Care Issues Currently, California has a complex array of existing mental health coverage and delivery systems that serve many, but not all, Californians. Moving this array of systems into a universal coverage framework is a complex undertaking that requires sound analysis, thoughtful and deliberative planning, and a multi-year implementation process. As California moves forward with health care reform, counties urge the state to prevent reform efforts from exacerbating problems with existing service and funding. The State must also consider the differences across California counties and the impacts of reform efforts on the network of safety-net providers, including county mental health providers. The end result of health reform must provide a strengthened mental health care delivery system for all Californians, including those served by the safety net. 10. SUPPORT State action to increase mental health access and affordability. Access to care and affordability of care are critical components of any health reform plan. Expanding eligibility for existing programs will not provide access to care in significant areas of the state. Important improvements to our current programs, including Medi-Cal, must be made either prior to, or in concert with, a coverage expansion in order to ensure access. Coverage must be affordable for all Californians to access care. 11. SUPPORT Medi-Cal mental health reimbursement rate increases to incentivize providers to participate in the program. 12. SUPPORT efforts that implement comprehensive systems of mental health care, including case management, for frequent users of emergency care and those with dual diagnoses. Approaches could be modeled after current programs in place in safety net systems. 13. SUPPORT efforts that provide sufficient time for detailed data gathering of current safety funding in the system and the impact of any redirection of funds on remaining county responsibilities. The interconnectedness of county indigent health funding to public health, correctional health, mental health, alcohol and drug services and social services must be fully understood and accounted for in order to protect, and enhance as appropriate, funding for these related services. 14. SUPPORT efforts to clearly define and adequately fund remaining county responsibilities. 15. SUPPORT State action to provide an analysis of current mental health care infrastructure (facilities and providers), including current safety net facilities across the state, to ensure that there are adequate providers and health care facilities, and that they can remain viable after health reform. 2010 Mental Health Commission State Legislative Platform 4 16. SUPPORT efforts to provide adequate financing for the reforms to succeed. 17. SUPPORT legislation that improves the quality of mental health care, whether through the use of technology, innovative delivery models or combining and better accessing various streams of revenue.