New legislation will bring much-needed accountability to the 2004 Mental Health Services Act

California Counties will utilize a proven model to meet ambitious goals and ensure more Californians with severe mental illness receive care

(Sacramento) Legislation introduced today by Senator Susan Talamantes Eggman (D – Stockton) will focus the Mental Health Service Act on addressing some of the state’s greatest challenges, bringing California closer to achieving the bold vision voters supported in 2004. Sponsored by the Steinberg Institute, the Mental Health Services Act Outcomes and Accountability Act sets ambitious goals, including reducing homelessness and hospitalizations, and holds counties accountable for meeting them.

SB 970 is modeled after a “continuous quality improvement” approach refined through other state programs. The state and counties will set measurable “stretch” goals, track progress, and course-correct to steadily improve the lives of Californians living with severe mental illness and substance use disorders. The legislation also transitions from a “one size fits all” approach in the funding of county-based programs to help them meet their ambitious goals.

“The MHSA has been instrumental in changing the approach to treating those with serious mental illness in California and its fundamental focus on community-based treatment provides a strong foundation for improving outcomes amidst a troubling landscape,” Senator Eggman said. “This legislation strengthens the state/counties partnership, supports innovation, and adds accountability through the identification of specific goals and a transparent tracking of

“While many counties have adopted innovative approaches to expand and improve behavioral health services, there is little accountability for measuring progress or achieving specific outcomes,” said Steinberg Institute Executive Director Maggie Merritt. “We continue to see people living with severe mental illness suffering on our streets or cycling through hospitalizations with no long-term recovery in sight.”

Steinberg Institute founder and Sacramento Mayor Darrell Steinberg spearheaded Proposition 63, the Mental Health Services Act, approved by California voters in 2004. Since its passage, MHSA has provided more than $18 billion to address a broad continuum of prevention, early intervention, and service needs of individuals with, and at risk of, serious mental health and substance use conditions. The act is funded by a 1% income tax on personal income in excess of $1 million per year.

“MHSA has generated billions in the effort to help Californians with severe mental illness,” said Steinberg. “As the state faces unprecedented mental health challenges due to the pandemic, it’s the perfect opportunity to look for areas of improvement. Ambitious goals, combined with accountability and collaboration, will spark the innovation we desperately need.”

SB 970 requires the Health and Human Services Agency to convene a technical working group with expertise in developing metrics. Based on their recommendations and the goals specified in the bill, HHS will establish a suite of measurable outcomes from which each county will identify its priority goals every five years, in consultation with local stakeholders.

Counties will engage in self-assessment to track their performance on the outcomes, followed by a self-improvement plan and regular progress updates to the state. An online dashboard will make the information easily accessible and allow policymakers and the public to compare counties’ progress.

The state will also provide technical assistance to support counties in reaching their goals. This will leverage state expertise and create collaborative space for counties to learn from each other.

The bill also adjusts administrative requirements in order to achieve the new goals, moving from a three-year planning cycle to a five-year cycle to allow counties to focus more energy on serving clients.

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