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Sacramento County left $126M in state mental health funds unspent. Now it has a new plan

Sacramento Bee - 8/12/2019

Aug. 12--Sacramento County has yet to spend $126.1 million in allocated state money meant to invest in mental health services, even as the region wrestles with a growing crisis in hospital emergency rooms, in police calls and on city streets.

In light of the significant cache amassed through the state's Mental Health Services Act, Sacramento County Board of Supervisors approved a proposal last week to spend more money, more quickly. Under the plan, the county will expand existing programs helping children and adults with mental health issues, and fund community organizations focused on prevention and early intervention services.

Local officials and advocates say the situation has become untenable: Sacramento Police Department has receive more mental health-related calls for service each year, now up to nearly 11,000. Thousands overwhelm emergency rooms across the county because of a lack psychiatric care. At least 1 in 5 of the more than 5,000 homeless people living in Sacramento County reported having a severe mental health condition such as severe depression or schizophrenia.

"We did find past staff was a little too conservative about programming multiple years out (saying) you can save it for a rainy day," said board chair Patrick Kennedy. "But you look outside and it's a monsoon."

Among the services and programs getting a boost in funding:

* $5 million for crisis residential programs that offer a people transitioning out of acute mental health crises in hospitals a place to recover.

* $2.2 million for mobile crisis support teams responding to mental health calls.

* $14 million set aside as potential matching funds for future housing projects for homeless people with mental health issues.

The county will also expedite its planning process on an "innovative" project tackling regional mental health issues. It must get state approval on the project by next year or it will lose the $9 million innovation fund grant from the state.

And under the new plan, $10 million in state funds for prevention and early intervention programs is up for grabs for community-based groups offering care for trauma and adverse childhood experiences, or ACEs.

"Smaller grass-roots organizations that are doing great work in the community that can really use this money," said Leslie Napper, who serves on the county's MHSA steering committee.

A potential project that could win state money might be a local group that wanted to train staff members at nearby middle and high schools on how to identify ACEs among students, mental health services director Peter Beilenson told the board Tuesday.

Sacramento County's conservative spending approach over the past few years doesn't mean it hasn't used some of the MHSA money to fund major projects: The county has opened new behavioral health crisis clinics in Carmichael and Sacramento, for example, and dedicated $44 million over three years toward mental health and drug services for homeless people.

In addition, Kennedy said that the unspent money "always looks worse than it is" because some has already been earmarked to pay for ongoing or planned projects in future years.

The county's large pot of unspent money echoes findings from a state audit last year, which found that counties and local mental health agencies had amassed $2.5 billion in unspent Mental Health Services Act funds by the end of 2016. The act, passed as a state ballot measure in 2004, places a 1 percent tax on people making more than $1 million a year to fund local mental health programs.

By the end of 2021, under the plan approved Tuesday, Sacramento County will have a balance of $49 million in unspent state funding for mental health services.

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