Governor’s Proposed 2015-16 Budget: Mental Health Highlights

Last Friday, January 9th, Governor Brown released his 2015-16 state budget proposal. NAMI California has identified the following areas, among others, as having potential impacts on consumers and families. NAMI California will continue to follow the budget through the legislative process and provide updates and advocacy opportunities to members.

  • Mental Health Services Act Revenues. The budget estimates annual revenues of $1.8 billion for 2014-15 and $1.775 billion for 2015-16. The 2013-14 estimates and 2014-15 estimates are $100 million and $200 million above the estimates for those years stated in the Governor’s January 2014 budget.
  • Medi-Cal Growth. The budget proposes total expenditures of $95.4 billion ($18.6 billion General Fund) for 2015-16. With enrollment projected at 12.2 million eligibles, about 32 percent of Californians will be in Medi-Cal. The Medi-Cal expansion, as provided by the Affordable Care Act, will result in an additional 3.3 million people enrolled in Medi-Cal.
  • AB 3632 Payments. The budget proposes $533 million of the $800 million currently owed to counties for pre-2004 mandates be paid in the 2015-16 year presuming that the May 2015 revenue estimates continue to show funds exceeding the May 2014 estimates. AB 3632 mental health services for students are a significant share of these payments.
  • Coordinated Care Initiative. Under this pilot project, dual eligibles (Medi-Cal and Medicare) receive medical, behavioral health and long-term supports. This pilot was intended to operate in eight counties; however, Alameda will now not be participating. Due to various implementation issues, including a large opt-out of participation rate of 69 percent, less federal shared savings, and delays in implementation, the program may not continue in the future due to poor cost-benefit. If factors don’t improve by January 2016, the CCI may cease operating effective January, 2017.
  • Drug Medi-Cal Program. California has submitted a federal Waiver for the Drug Medi-Cal Program, which focuses on the delivery of substance use disorder services, which will be finalized in 2015. A key component of this Waiver is to expand Residential Treatment Services. In addition to the federal Waiver submitted for restructuring this program, the Department of Health Care Services is in the process of trying to complete recertification of hundreds of facilities that provide drug treatment. DHCS contends they will complete this recertification process by November 2015.
  • 2011 County Realignment. The Behavioral Health Account within realignment is to receive growth funds of $146 million in 2014-15 and $141 million in 2015-16. A priority for these growth funds will be for children’s specialty mental health and Drug Medi-Cal Program services.
  • Department of Social Services-Continuum of Care Reform. The budget proposes $9.6 million for DSS to begin implementing the Continuum of Care Reform, which includes preventative, wraparound and mental health services for foster youth.
  • Supplemental Security Income/State Supplementary Payment (SSI/SSP). Total expenditures of $2.8 billion are budgeted which reflects a revised maximum grant level for January 2015 set at $881/month for individuals and $1483/month for couples, and a caseload of 1.3 million recipients.
  • Department of State Hospitals and Department of Social Services: Department of State Hospitals and Department of Social Services will increase the number of beds available to admit clients who need to be restored to competency in order to stand trial. The San Bernardino County Restoration of Competency Program and Porterville Secure Treatment Program are likely to be expanded.
  • Proposition 47 Funds. Proposition 47 funds will be placed in a new fund to be used for mental health and substance use disorder treatment services, among other programs. These funds will be available beginning in the 2016-17 fiscal year.

Thank you for your dedication to
mental health advocacy!

Mental Health Investment By States Slowed in 2014

By Jessica Hart, NAMI State Advocacy Manager

NAMI just released a report highlighting what went on in state legislatures in 2014 across the country when it comes to mental health issues. The report, State Mental Health Legislation 2014 shows that investment in mental health services slowed from last year and that when progress was made around specific policy issues much of the legislation felt like it only skimmed the surface.

This year, only 29 states and the District of Columbia increased funding for mental health services. Overall, the mental health care system still simply needs to recover lost ground from the state budget cuts of 2009-2012. But reinvestment is unsteady. See where your state fell in investment this year below.

There were some victories this year. Minnesota, Virginia and Wisconsin were leaders in the country by passing measures that can serve as models for other states in areas such as workforce shortage, children and youth, school-based mental health, employment and criminal justice.

Our policy recommendations for states in 2015 are:

  • Strengthen public mental health funding.
  • Hold public and private insurers and providers accountable for appropriate, high-quality services with measurement of outcomes.
  • Expand Medicaid with adequate coverage for mental health.
  • Implement effective practices such as first episode psychosis (FEP), assertive community treatment (ACT) and crisis intervention team (CIT) programs.

What can you do?

Write to your Governor and State Legislators to let them know that they need to make mental health care a priority.

Connect with your local NAMI to see how you can help advocate for mental health services and supports in your community.

Important NAMI Survey: How is Your Health Insurance Treating You?

From NAMI Blog. By Everly Groves, NAMI Policy Intern and Sita Diehl, NAMI Director of State Policy and Advocacy. Dramatic changes now taking place in our nation’s health care system should mean that people living with mental illnesses will have better access to mental health services. But will they? NAMI created a brief online Coverage for Care Survey to answer this very question. We need your help to find out how recent changes in federal law affect you and your family.

Over 11 million people with mental illness were uninsured as of 2010. Most are now eligible for mental health and substance use care because of changes to health coverage under the Affordable Care Act (ACA). The ACA requires Medicaid expansion and individual and small group private health plans to cover mental health and substance use services as one of the 10 Essential Health Benefits. This change will mean that millions of people will be getting access to private health coverage or Medicaid for the first time.

Even more changes to mental health and substance use coverage came July 1. Provisions to the Mental Health Parity and Addiction Equity Act of 2008 were put in place to ensure parity for mental health and substance use care. But what exactly is parity? Parity ensures that all plans cover mental health and substance use treatment on par with other types of care. That means fair and equal terms for what types of services are covered, the procedures necessary to get care and how much you pay out of pocket.

Coverage for Care Survey
Because these changes are so important, NAMI wants to understand how the ACA and the new parity rules affect you and your ability to get the care you need. We created the Coverage for Care Survey to learn from you.

We want to hear from everyone in need of mental health or substance use care. So if you or your family member uses these services, complete this survey! It doesn’t matter if you have private health insurance, Medicare, Medicaid, TRICARE, VA health benefits, student health, any other type of coverage or don’t have coverage at all.

Take this survey on behalf of you or your loved ones in need of mental health and/or substance use care. Spread the word to your friends, family, co-workers, and colleagues. It should only take 15-20 minutes. Post the link on your Facebook or Twitter! The more responses we get, the stronger our findings will be.

The deadline to complete the survey is 12 p.m. EST on Sept. 30, 2014.

Biden Announces $100 Million to Increase Mental Health Services Access

December 10, Vice President Biden announced that $100 million will soon be available to increase access to mental health services and improve mental health facilities.

“The fact that less than half of children and adults with diagnosable mental health problems receive the treatment they need is unacceptable.  The President and I have made it a priority to do everything we can to make it easier to access mental health services, and today’s announcements by the U.S. Departments of Health and Human Services and Agriculture build on that commitment.”

  • $50 Million for Mental Health Services at Community Health Centers:  The Department of Health and Human Services will issue a $50 million funding opportunity to help Community Health Centers establish or expand behavioral health services for people living with mental illness or addiction.
  • $50 Million to Improve Mental Health Facilities:  Because proximity to mental health services can be a unique challenge in rural America, the Department of Agriculture has a new goal:  finance $50 million for the construction, expansion, or improvement of mental health facilities in rural areas over the next three years.

The Affordable Care Act expands mental health and substance abuse disorder benefits and federal parity protections for approximately 60 million Americans. The law also requires most health plans to cover recommended preventive services like depression screenings for adults and behavioral assessments for children at no cost to consumers. And starting in 2014, insurers will no longer be able to deny coverage or charge individuals more due to pre-existing health conditions, including mental illnesses.

In addition, the President’s FY 2014 Budget proposes a new $130 million initiative to address several barriers that may prevent people from accessing help. The initiative proposes to train teachers to recognize signs of mental illness and refer students to mental health services when needed. It supports the training of an additional 5,000 mental health professionals.  And it would give grants to states to implement innovative strategies to help young people ages 16 to 25 with mental health or substance abuse issues. The Administration calls on Congress to appropriate funds for these important purposes.

How the Affordable Care Act Changes Mental Health Coverage

from The Fiscal Times: The passage of Affordable Care Act has brought sweeping changes that will make coverage of mental health and drug treatment one of the “10 essential health benefits” that all insurers must offer. Insurers, patient advocates and state regulators are still hammering out specifics, but critics contend it will lead to an even greater shortage of services and that it doesn’t do enough to address issues specific to treating the mentally ill. Many industry experts also aren’t sure what changes in the field of mental health will even be needed as new challenges arise.

According to Ron Honberg, the national director for policy and legal affairs at the National Alliance on Mental Illness:

“The reality is that the ACA is not going to solve all of our health care problems, either for physical or mental health. People are still going to struggle to get everything covered that they need to, but the inclusion of mental health care in this law is a huge step forward.”

Read the whole story.

Project ABC

“It’s not only children who grow. Parents do too. As much as we watch to see what our children do with their lives, they are watching us to see what we do with ours. I can’t tell my children to reach for the sun. All I can do is reach for it, myself.” —Joyce Maynard

Project ABC is a collaborative partnership between professionals in Mental Health-LA County Department of Mental Health; Child Welfare-LA County Department of Children and Family Services; and Community Service Providers-Children’s Institute, Inc, For the Child, Pacific Asian Counseling Center and TIES for Families; designed to create a system of care for young children in the Los Angeles County area who would benefit from mental health services. With funding support from the SAMHSA, LADMH has taken the lead and has brought together the key partners from these varied disciplines to ensure that children birth through five have access to services that are family-centered, strength-based, and culturally competent.

“Family voice and choice is essential to everything we do and we are guided by the strengths of each family to plan and deliver services that will result in the best possible care for the children in our community.”

Community-based, infant/early childhood mental-health-treatment programs provide families with needed services and support when families identify challenges working through atypical behaviors in very young children or managing the after-effects of difficult family experiences or traumatic exposure.

What is Infant/Early Childhood Mental Health?

Infant/Early Childhood Mental Health is a comprehensive approach that refers to the social and emotional well being of very young children under the age of six. Positive relationships between young children and adults lay the foundation for healthy social and emotional development. This foundation allows children the freedom to:

  • Experience and manage a full range of emotions, cope with frustrations and regulate their behaviors
  • Develop supportive relationships with caregivers as well as other children
  • Safely and actively explore and learn from their environments, feel protected in the context of their families, neighborhoods, and cultures.

Project ABC’s History

In 2005 the Federal Substance Abuse and Mental Health Services Administration funded the Los Angeles County Department of Mental Health to develop Project ABC. In partnership with The Department of Children and Family Services,

Children’s Hospital Los Angeles and Children’s Institute, Inc., a system of care was developed in the Los Angeles County Metro region. This network of organizations provided professional training and consultation, leadership in relevant advocacy and policy changes and a wide array of educational and support materials for use by professionals as well as families with children birth to 5. The families also gained the benefit of a range of specialized and evidence-based services proven to strengthen infant-adult relationships and reduce the impact of traumatic exposure for children and their families. With the success of that partnership as our foundation, Project ABC has now redirected its efforts to focus on the South Bay, Long Beach and Inglewood communities and its partnership now includes For the Child, Pacific Asian Counseling Services and Ties for Families in addition to its on-going collaboration with DMH, DCFS, CII, and USC.

10 Simple Things to Help a Child’s Mental Health

1. Interaction – Spend time watching me and responding to my cues. It tells me I’m important and special to you.

2. Loving Touch – Cradle me, hold me. Give me lots of hugs. It keeps me calm and comforts me, and gives me courage to move on.

3. Stable Relationship – I need someone special to be there when I call. When I look around and see you, I know I can go far.

4. Safe, Healthy Environment – Plug the outlets, block the stairs. Keep lead away for sure! Make a safe, special place so I’m free to explore.

5. Self-Esteem – I can do it, yes I can, if you tell me. So pay attention, give me praise and watch me go, go, go!

6. Quality Child Care – When you’re gone I need to be with people you can trust to help me grow and teach me new, exciting stuff.

7. Communication – I may not talk, but don’t be fooled, I understand a lot. Our little conversations mean so very much!

8. Play – Play is fun, play is work, it’s how I learn the ropes. When we play together you help me more than you know.

9. Music – 1,2,3 sing to me and make up silly tunes. Music is special time that’s fun to share with you.

10. Reading – Read to me, show me books with lots of pretty pictures. Write my stories out in words. I’ll love to read forever.

Courtesy of Safe From The Start, California Attorney General’s