California Let $2.5B of Mental Health Funds Go Unspent, Reveals Audit
In November 2004, voters in California approved Proposition 63, known as the Mental Health Services Act (MHSA) that provided the state’s Department of Mental Health (DMH) an opportunity to allocate funding, personnel and other resources to support mental health programs and services across the state, and closely monitor the progress. In addition to providing services to individuals with serious mental illnesses, the MHSA also aimed to reduce the impact of untreated serious mental illness on individuals, families, local and state budgets. In order to get the required funding, the Act imposed a 1 percent tax on personal income exceeding $1 million that got deposited annually into the Mental Health Services Fund (MHSF).
Now, a recent audit report by the California State Auditor has made a shocking revelation. As per the report, the state counties have failed to utilize the $2.5 billion taxpayer money allocated for helping Californians suffering from mental health issues. It further indicts the Department of Health Care Services for allowing the local mental health care agencies accumulate hundreds of millions in unspent MHSA funds. The report pulls up the Health Care Services for not categorizing the $225 million fund balance existing in the MHSF since 2012 as a long-standing accounting error or resources available to local mental health agencies to expand their services.
The report also highlighted how the absence of adequate guidelines from Health Care Services led to accumulation of $81 million in unspent interest in 2015–16 by the local mental health agencies and leaving millions in excess reserves that could have been put to use for additional mental health services. It says, the Health Care Services neither enforces annual revenue and expenditure reporting nor conducts audit to ensure that the local mental health agencies adhere to the fiscal and program requirements as per state laws and regulations.
Recommendations for improvement
The auditors evaluated the effectiveness of two state entities — Health Care Services and the Mental Health Services Oversight and Accountability Commission or the Oversight Commission — in overseeing the MHSA funding. They also visited some local mental health agencies to examine their monitoring of the projects supported with MHSA funding.
The report cited the following reasons for the unspent funds and unmet needs:
· Complete lack of guidelines to utilize the resources as well as absence of a process to recover unspent MHSA funds and reallocate to other mental health agencies.
· Ineffective oversight of the local mental health agencies and the MHSF by the Health Care Services.
· Minimal oversight of the MHSA funds received by local mental health agencies by the Health Care Services.
In addition to pointing out the existing flaws in the system, the report made the following recommendations:
· Health Care Services should execute a fiscal reversion process to reallocate unspent funds to other local mental health agencies.
· Health Care Services should oversee spending of the MHSA funds by the local mental health agencies.
· Health Care Services should analyze the $225 million fund balance by May 2018 to determine the reason behind the accumulation and its impact on funding to the local mental health agencies.
· Oversight Commission should ensure that local mental health agencies spend funds in a timely and efficient manner.
As per the audit report, given the state of mental health affairs in the state, lack of oversight and leadership at the state level is troublesome and needs to be addressed immediately. According to Kiran Savage-Sangwan, health integration policy director for the California Pan-Ethnic Health Network, there is a need “to make sure those resources are utilized to close gaps and reduce disparities.”
Integrated treatment for mental disorders
Mental health needs to be treated at par with physical health. It’s important to know that mental illnesses cannot go away with time and there is no shame in asking for help. The earlier one gets the support, the better are the treatment outcomes.
The California Mental Health Help provides information on various mental health issues and most suitable options for mental health treatment in California. We can help you or your loved one connect to the best treatment providers and obtain the finest treatment basis your needs. To know more, call us at 24/7 helpline (855) 559–3923.
