Important legislation is emerging that would significantly improve care for the most severely mentally ill people in California.
Proposed by Senate President Pro Tem Darrell Steinberg, the package of bills warrants serious consideration by Gov. Jerry Brown, even though the measures would add to state costs, at least in the short run.
Among his proposals, Steinberg is calling for construction or leasing of facilities that would provide 2,000 beds controlled by counties for individuals who are in the midst of crisis. He also proposes to add 200 mental health workers who would focus on people with serious issues, and 25 mobile crisis teams deployed across the state, plus 3,500 more treatment slots for felons with serious mental illness upon their release from prison.
At least part of the costs would be borne by the federal government through Medicaid and the Affordable Care Act. But there would be costs to the state general fund, which will give Brown pause -- though Steinberg makes a compelling argument that spending money before individuals land in jail, prison or locked in state and county hospital wards ultimately saves taxpayers' money. Steinberg also is working on legislation to overhaul aspects of the 45-year-old Lanterman-Petris-Short Act, a law that governs the care, or lack thereof, of the most severely mentally ill individuals, though details have not yet emerged.
Additionally, he is crafting a bill that would make clear that counties are authorized to use some Mental Health Services Act money to implement assisted outpatient treatment programs for their sickest residents. In such programs, judges can direct that individuals take medication and regularly meet with therapists.
As it is, the $1 billion a year generated by the tax created by Proposition 63, the 2004 initiative he promoted cannot be used for these such programs. However, he proposes that counties should not be permitted to divert Prop. 63 money to assisted outpatient treatment from existing programs that provide voluntary programs. That top-down approach unnecessarily substitutes Sacramento's judgment for county supervisors who generally know better how to make best use of their money. Legislators other than Steinberg have ideas that warrant consideration, too.
Assembly GOP Leader Connie Conway of Visalia proposed legislation to permit judges to impose assisted outpatient treatment plans on individuals for up to a year, rather than the current six months. However, Assembly Judiciary Committee Chairman Bob Wieckowski, D-Fremont, and Assemblyman Roger Dickinson, D-Sacramento, led the effort to kill it. The issue of how to help people with severe mental illness is not one that attracts campaign donations or votes. Politicians would prefer the issue go away, as top Nevada state officials demonstrated with their once-surreptitious policy of busing people from the Rawson-Neal Psychiatric Hospital in Las Vegas to all corners of the country. Steinberg's proposal is a thoughtful step toward dealing with one of the major health challenges of our time.