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State providing little oversight for billions in mental health funds

August 15, 2013|By Patrick McGreevy

SACRAMENTO -- Nearly a decade after California voters approved a multibillion-dollar tax increase to improve mental health programs, the state has failed to provide proper oversight of county programs funded by Proposition 63, a state audit concluded Thursday.

State Auditor Elaine Howle looked at the last six years during which time almost $7.4 billion from the Mental Health Services Act (MHSA) was directed to counties for mental health programs.

“This report concludes that Mental Health [Department] and the Accountability Commission have provided little oversight of counties’ implementation of MHSA programs, particularly as it relates to evaluating whether these programs are effective,” Howle wrote to Gov. Jerry Brown and the Legislature.

“We expected that Mental Health and the Accountability Commission would have used a process to monitor, guide and evaluate county implementation that built on their broad and specific MHSA oversight  responsibilities and also incorporated best practices in doing so, but that is not what we found,” Howle added.

The audit was requested by lawmakers after reports by The Times that some counties were using the funds to provide yoga and martial arts classes. Proposition 63 levies a 1% income tax on individuals earning more than $1 million, with money going to counties to target individuals severely affected by mental illness.

“We found no evidence that Mental Health performed on-site reviews to ensure that county assertions about their compliance with MHSA requirements and use of funds were accurate and proper,” the audit said, adding that none of the agencies responsible for evaluating the effectiveness of the program has “undertaken serious efforts to do so.”

An Accountability Commission didn’t adopt a framework for evaluation until recently — more than eight years after the passage of the MHSA, the audit concluded. Auditors looked at operations in Los Angeles, San Bernardino, Sacramento and Santa Clara counties and “we found that the four counties rarely developed specific objectives to assess the effectiveness of program services.”

However, the audit said Los Angeles County was “generally effective” in collecting and analyzing data to determine whether goals were met.

Rusty Selix, a co-author of Proposition 63, said he agreed with the call for more state oversight.

"Most important is that it did not find that any of these counties were expending funds in violation of the Act,’’ said Selix, executive director of the California Council of Community Mental Health Agencies.

Toby Douglas, director of the Department of Health Care Services, which has taken over mental health programs, agreed with recommendations for improving oversight.


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