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EDITORIAL: Mental health initiative still lacks accountability

San Jose Mercury News (CA) - 2/7/2015

Feb. 06--Voters were promised in 2004 that a tax on millionaires would fund programs to keep the mentally ill "off the streets, out of the hospital and out of jail," and help people "move from tax user to taxpayer."

While Proposition 63, approved by 54 percent of the voters, has increased funding for mental health programs, there is no evidence that the more than $13 billion collected during the past decade has produced the promised results. The program has been hampered by bureaucracy and confusing lines of authority, while basic spending and performance data is not required or maintained, as the state's watchdog Little Hoover Commission concluded in a report issued last week.

Fortunately, the initiative allows the state Legislature to amend the law with a two-thirds vote if the changes are consistent with the ballot measure's purpose and intent. They should do so this year. There is anecdotal evidence that programs have improved or expanded mental health care, but a $13 billion project needs actual data to document its value.

Proposition 63 was flawed from the start, imposing a 1 percent tax on income over $1 million and earmarking the money for one cause with no direct relationship with the source. It's the sort of ballot-box budgeting for which California is infamous, tying the hands of lawmakers who must make policy choices with limited funds.

The state has had a severe problem stemming from the closure of mental hospitals that began in the 1970s. Patients were sent back to their communities, but sufficient funding to help care for them was never provided.

When Gov. Gray Davis in 2002 vetoed corrective legislation, mental health advocates including then-state Sen. Darrell Steinberg floated the initiative to take their case to voters.

Proposition 63 now provides about one-quarter of the state's mental health funds, with the state general fund and federal allocations providing almost all the rest. Voters and mental health advocates who championed the initiative deserve to know whether the money has been spent efficiently and most effectively.

As the watchdog Little Hoover Commission concluded, "Authorities still can't clearly show, much less measure, what more than $13.2 billion has accomplished in terms of improving services for the estimated one in six California adults with a mental health need or the one in 20 who suffer from a serious mental illness."

The commission proposes strengthening authority of the Mental Health Services Oversight and Accountability Commission created by Proposition 63 to ensure the state and counties responsibly spend the money. The report also recommends establishing a comprehensive statewide mental health data collection system so analysts can determine whether the money produces the promised results.

It's amazing that after a decade this information still isn't available. Who will step up with a plan?

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