Marc Berman Chair, Assembly Committee on Business and Professions 1020 N Street, Room 379 Sacramento, CA 95814
Angelique Ashby Chair, Senate Committee on Business, Professions, and Economic Development 1021 O Street, Room 3320 Sacramento, CA 95814
RE: Joint Sunset Review – Board of Psychology – Exception to Psychotherapist-Patient Privilege for Board Investigations—OPPOSE
Dear Chair Berman and Chair Ashby,
Mental Health America of California (MHAC) would like to express opposition to the California Board of Psychology’s proposed exception to the psychotherapist-patient privilege in Board investigations (Proposal #1 of Section 10 of the Sunset Review Report, page 97) and request that proposal not move forward. The proposal would establish a psychotherapist-patient privilege exception for Board investigations.
MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues. The people and communities we aim to serve include those of all ages; sexual orientation, gender identity or expression; language, racial and ethnic backgrounds, national origin, and immigration status; spirituality and religious affiliations; or socioeconomic status. Our communities rely on the expectation of privacy when accessing mental health care.
Currently, if a patient refuses to disclose records in a Board investigation, the Board has recourse to obtain the records through a subpoena and obtain a civil court order to enforce the subpoena. This ensures that the Board demonstrates compelling interest that the disclosure of such records is relevant and material to the issue. This court process offers the Board an avenue to obtain records while upholding the psychotherapist’s duty to patient privilege and protecting the patient’s constitutional right to privacy.
Confidentiality is essential to successful psychotherapy because it allows for open dialogue between the Psychologist and the patient on extremely personal and sensitive issues. Patients rely on the expectation of privacy every time they attend a therapy session, and without the guarantee of privacy, patients will be less likely to be forthcoming with their therapist and possibly be less likely to seek care.
In addition, this proposal has the potential to severely undermine the quality and effectiveness of psychotherapy. If Psychotherapists fear that their client records could be seized without proper protections, this could result in less than accurate and potentially reductive work products.
The Board has reported that over the last four years it has had to close only three cases due to an inability to access records. The low number of cases being closed does not provide any significant or compelling arguments for a psychotherapist-patient privilege exception. It is for these reasons that MHAC asks you not to move forward with the Board’s proposal. If you have any questions, or if MHAC can provide any assistance on this issue or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.
In Community,
Heidi L. Strunk President & CEO
Cc: Honorable Members, Assembly Business and Professions Committee Honorable Members, Senate Business and Professions and Economic Development Committee Kaitlin Curry, Consultant, Assembly Business and Professions Committee Anna Billy, Consultant, Senate Business and Professions and Economic Development Committee
The Honorable Jesse Gabriel Assembly Budget Committee 1021 O Street, Suite 8230 Sacramento, CA 95814
The Honorable Dawn Addis Assembly Budget Subcommittee 1 on Health 1021 O Street, Suite 4120 Sacramento, CA 95814
The Honorable Scott Wiener Senate Budget and Fiscal Review Committee 1021 O Street, Suite 502 Sacramento, CA 95814
The Honorable Akilah Weber Pierson Senate Budget Subcommittee 3 on Health and Human Services 1021 O Street, Suite 7310 Sacramento, CA 95814
RE: Opposition to Cuts in Governor Newsom’s May Revise Budget Proposal
Dear Chairs Wiener, Gabriel, Addis and Weber Pierson,
Mental Health America of California (MHAC) is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues. The people and communities we aim to serve include those of all ages; sexual orientation, gender identity or expression; language, racial and ethnic backgrounds, national origin, and immigration status; spirituality and religious affiliations; or socioeconomic status.
As California faces a staggering $12 billion budget deficit, the state must prioritize and preserve the vital mental health and substance use supports and services that Californians depend on. These supports and services have proven to be effective in reducing long term state costs related to criminal justice involvement, emergency hospitalization, and institutionalization. MHAC opposes the following proposals in Governor Newsom’s May Revise and urges action from the Assembly and Senate to preserve funding for the following supports and services:
Peer Support Personnel Training and Placement Program This program provides grants to community-based organizations to train and place individuals with lived experience, or peers, to work as Medi-Cal Certified Peer Support Specialists. Peer Support Specialists provide a wide range of services including crisis support, individualized wellness planning, and trauma informed care. In addition to being an evidence-based practice, it is essential to address the state’s behavioral workforce shortage and meet the growing demand for mental health and substance use services. MHAC requests an annual apportionment of $14 million a year, $4 million from the Behavioral Health Services Fund, and $10 million from the General Fund to continue producing trained behavioral health professionals.
California Peer-Run Warm Line The California Peer Run Warm Line is a 24/7 telephone and text line that provides peer-led, non-coercive, and stigma-reducing support that addresses a wide range of challenges, including anxiety, depression, and substance use. 77% of users surveyed indicated a reduced likelihood of needing emergency services such as 911, suicide prevention, and emergency room visits. These services provide an alternative to costly crisis intervention services and can ensure individuals of all demographics can be served. The CA Peer Run Warm Line continues to see a rise in calls and to meet the rising demand the state must fully fund it. MHAC requests $25 million annually for FY25-26 and FY26-27 in order to continue this vital 24/7 support.
Mental Health Wellness Act (MHWA) The current proposal eliminates $20 million in annual grant funding that would improve access to and expand capacity for vital behavioral health services. These grants would provide needed funding for the following vital behavioral health supports and services:
Peer Respites
Peer Respite is a voluntary service that provides community-based support to people experiencing or at risk of experiencing a mental health crisis. Services include but are not limited to peer support, linkages to mental health support or resources, short-term overnight stays, and individualized care support planning. Peer Respites are effective in reducing hospitalization and incarceration, resulting in improved long-term health outcomes and reduced costs to the state’s behavioral health system. Sustaining and growing Peer Respites also supports the development of the California behavioral health workforce, aligning with the state’s investments in Peer Support Personnel.
Full-Service Partnerships (FSP)
FSPs offer person centered wrap around support with a “whatever it takes” approach for people with severe mental health challenges, prioritizing those who are unhoused, have a history of being justice involvement, or have experienced multiple hospitalizations. In 2023, the Behavioral Health Services Oversight and Accountability Commission reported that FSP participants experienced a 54% reduction in emergency room visits, a rapid reduction in emergency mental health services, and a 47% reduction in justice involvement. As the Behavioral Health Services Act funding has been reduced for FSPs, MHWA funding is now essential to support technical assistance and capacity building that strengthens and improves service delivery.
Gender Health Equity Section (GHES) at the Department of Public Health GHES develops programs and policies intended to eliminate gender-based health disparities in California through the following grant programs:
The Lesbian, Bisexual, Transgender & Queer (LBTQ) Unit, which centers community solutions and leadership to eliminate health disparities and research gaps impacting diverse LBTQ Californians.
The Wellness & Equity Unit, Transgender, Gender Diverse and Intersex (TGI) Unit which exists to elevate health equity issues experienced by TGI people caused by systemic discrimination in healthcare settings, housing, employment, and public accommodations.
Wellness and Equity Unit, and the Reproductive Freedom and Abortion Access (RFAA) Unit which addresses issues related to reproductive freedom and justice, abortion access and focus attention on California communities who historically and/or systemically experience inequities related to access to related services.
The proposed budget seeks to reduce $14 million in local assistance that supports these LGBTQ+ and reproductive health programs. LGBTQ+ individuals are experiencing heightened anxiety, depression, and risk of suicide due to the current political climate, most notably the attacks on the transgender community. The transgender community faces discriminatory barriers to housing, healthcare, and public facilities creating hostile and unwelcoming environments. Preserving funding for these programs is essential to addressing the institutional gaps in care for the LGBTQ+ community and improving long term health outcomes.
Phase II of the California Reducing Disparities Project (CRDP) CRDP is a statewide mental health initiative targeting five populations in California that have been historically unserved, underserved, and inappropriately served: African Americans, Asians and Pacific Islanders (API), Latinos, Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQ), and Native Americans. Grants are awarded to local community-based organizations (CBO) to help serve these populations and provide an analysis of solutions for reducing mental health disparities. The May Revise proposes reverting $15.8 million previously allocated to this initiative, threatening to stop funding to CBOs currently in progress of executing their awarded grant. In addition to disrupting care being provided, this budget reversion would threaten the existence of these CBOs and their programs.
Individuals 19 and Older with Unsatisfactory Immigration Status (IUIS) The proposed budget freezes new enrollment into Full-Scope Medi-Cal, enacts a $100 monthly premium on current enrollees, and lowers reimbursement rates to federally qualified health centers (FQHC) for services to IUIS. This proposal would prevent one of our most underserved populations from accessing vital behavioral health services. Additionally, lower reimbursement rates to federally qualified health centers would not just impact services to IUIS, but would also impact FQHC’s fiscal operation, thus impacting the services it provides to their entire community.
Medi-Cal Asset Limits This policy would reinstate Medi-Cal asset limits (which were removed by the Legislature in 2024) for seniors and people with disabilities, resulting in individuals from this population with more than $2,000 in assets or a couple with more than $3,000 in assets to be ineligible for Medi-Cal. This is a significant reduction that would prevent many of those in the most need of assistance from accessing vital behavioral health supports and services.
MHAC is committed to the mental health and wellness of all Californians regardless of immigration status, race, ethnicity, sexual orientation, or gender. Governor Newsom’s May Revise proposes significant cuts to investments in mental healthcare that will negatively impact diversity, equity, and inclusion. These proposed cuts will strip essential services from historically underserved communities, pushing more individuals to experience impacts to their behavioral health and deepening health disparities.
Without continued investments in voluntary, culturally responsive, community based mental health and substance use supports and services, California will overburden our emergency systems, increasing hospitalization, institutionalization, and the criminalization of individuals with unmet behavioral health needs.
Mental Health America of California urges you to reject the proposed cuts and preserve funding for mental health support and services that meet Californians where they are. If you have any questions, or if MHAC can provide any assistance on this budget please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.
In Community,
Heidi L. Strunk President & CEO
CC: Paula Villescaz, Deputy Legislative Affairs Secretary, Office of Governor Gavin Newsom Richard Figueroa, Deputy Cabinet Secretary, Office of Governor Gavin Newsom Michelle Baass, Director, California Department of Health Care Services Dr. Erica Pan, Director, California Department of Public Health Kendra Zoller, Deputy Director of Legislative & External Affairs, Commission for Behavioral Health
Marc Berman Chair, Assembly Committee on Business and Professions 1020 N Street, Room 379 Sacramento, CA 95814
Angelique Ashby Chair, Senate Committee on Business, Professions, and Economic Development 1021 O Street, Room 3320 Sacramento, CA 95814
RE: Joint Sunset Review – Board of Psychology – Exception to Psychotherapist-Patient Privilege for Board Investigations—OPPOSE
Dear Chair Berman and Chair Ashby,
Mental Health America of California (MHAC) would like to express opposition to the California Board of Psychology’s proposed exception to the psychotherapist-patient privilege in Board investigations (Proposal #1 of Section 10 of the Sunset Review Report, page 97) and request that proposal not move forward. The proposal would establish a psychotherapist-patient privilege exception for Board investigations.
MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues. The people and communities we aim to serve include those of all ages; sexual orientation, gender identity or expression; language, racial and ethnic backgrounds, national origin, and immigration status; spirituality and religious affiliations; or socioeconomic status. Our communities rely on the expectation of privacy when accessing mental health care.
Currently, if a patient refuses to disclose records in a Board investigation, the Board has recourse to obtain the records through a subpoena and obtain a civil court order to enforce the subpoena. This ensures that the Board demonstrates compelling interest that the disclosure of such records is relevant and material to the issue. This court process offers the Board an avenue to obtain records while upholding the psychotherapist’s duty to patient privilege and protecting the patient’s constitutional right to privacy.
Confidentiality is essential to successful psychotherapy because it allows for open dialogue between the Psychologist and the patient on extremely personal and sensitive issues. Patients rely on the expectation of privacy every time they attend a therapy session, and without the guarantee of privacy, patients will be less likely to be forthcoming with their therapist and possibly be less likely to seek care.
In addition, this proposal has the potential to severely undermine the quality and effectiveness of psychotherapy. If Psychotherapists fear that their client records could be seized without proper protections, this could result in less than accurate and potentially reductive work products.
The Board has reported that over the last four years it has had to close only three cases due to an inability to access records. The low number of cases being closed does not provide any significant or compelling arguments for a psychotherapist-patient privilege exception. It is for these reasons that MHAC asks you not to move forward with the Board’s proposal. If you have any questions, or if MHAC can provide any assistance on this issue or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.
In Community,
Heidi L. Strunk
President & CEO
Cc: Honorable Members, Assembly Business and Professions Committee Honorable Members, Senate Business and Professions and Economic Development Committee Kaitlin Curry, Consultant, Assembly Business and Professions Committee Anna Billy, Consultant, Senate Business and Professions and Economic Development Committee
The Honorable Scott Wiener, Chair Senate Budget Committee 1020 N Street, Room 502 Sacramento, CA 95814
The Honorable Jesse Gabriel, Chair Assembly Budget Committee 1021 O Street, Suite 8230 Sacramento, CA 95814
The Honorable Laura Richardson, Chair Senate Budget Subcommittee No. 5 1020 N Street, Room 502 Sacramento, CA 95814
The Honorable James Ramos, Chair Assembly Budget Subcommittee No. 6 1021 O Street, Suite 8230 Sacramento, CA 95814
Re: Proposition 36 Behavioral Health Treatment Implementation Recommendations
Dear Chairs Wiener, Gabriel, Richardson and Ramos:
The below signed coalition of advocates representing behavioral health treatment providers and advocates for safe and healthy communities, respectfully request the Legislature provide funding to expand the capacity to deliver more behavioral health treatment, including for individuals charged with treatment-mandated felony offenses created by Proposition 36. As organizations dedicated to improving behavioral health outcomes across the state, we recognize the urgent need to provide individuals charged with treatment-mandated felonies and those voluntarily seeking treatment and supportive services that often serve as pathways to treatment the comprehensive and accessible treatment and support they need and deserve.
In November, voters sent a clear message that treatment must be part of a successful public safety strategy. Ensuring the availability of appropriate, on-demand behavioral health services for anyone seeking them is essential to meeting needs created by Proposition 36 and reducing entry into the criminal legal system. To do so, we recommend the Legislature take the following actions:
Invest $105 Million in Behavioral Health Treatment for Proposition 36: California’s behavioral health treatment system, particularly for substance use disorders, remains under-resourced and oversubscribed. Without additional funding, many individuals eligible for treatment under Proposition 36 will be unable to access the care they need. There is a significant need for substance use disorder treatment capacity across the continuum, particularly acute need for residential treatment capacity given the current wait times can be weeks or even months long.
While it is difficult to estimate the treatment needs under Proposition 36 only a few months into implementation, based on the Judicial Council’s Proposition 36 survey, we anticipate an additional $105 million in treatment investments is needed.1 This investment is critical to ensuring that treatment programs statewide can meet demand, improve outcomes, and provide a path of recovery and opportunity that ultimately create safer communities.
Build Out the Forensic Behavioral Health Continuum of Care with Focused Workforce and Infrastructure Investments: California faces a devastating behavioral health workforce crisis. Estimates from the Steinberg Institute suggest that we need to add 375,000 workers over the next decade to meet the demand for care. This estimate does not include the increased need for services being driven by Proposition 36. While the state is poised to invest billions into the build-out of new capacity through the Bond BHCIP and Proposition 1 workforce investments, it is important that a portion of these dollars are prioritized for the buildout of a forensic behavioral health continuum of care with a focus on individuals in the criminal legal system who have behavioral health needs.
Ensure Behavioral Health Clinicians Perform Evaluations and Make Level of Care Recommendations: Clinical evaluations and decisions regarding the appropriate level of treatment for individuals should be made by qualified behavioral health clinicians working within the county behavioral health safety net and using the criteria and guidelines set forth in the most recent versions of treatment criteria developed by the nonprofit professional association for the relevant clinical specialty, such as the ASAM criteria for substance use disorders. This will ensure that those mandated to treatment under Proposition 36 receive care that is evidence-based, appropriately tailored to their individual needs, and in compliance with insurance-based medical necessity requirements.
Direct Treatment Funds to State and Local Behavioral Health Agencies: To maximize the effectiveness and accountability of Proposition 36 funding, all treatment dollars should be allocated to appropriate state and local behavioral health entities, specifically the Department of Health Care Services and county behavioral health departments. These entities have the expertise necessary to deliver high-quality treatment services and oversee program implementation.
Require Reimbursement by Commercial Insurance: Proposition 36 is payer agnostic and not all those who meet criteria for the treatment-mandated felony will qualify for Medi-Cal County behavioral health services. County behavioral health agencies do not have the infrastructure nor funding to serve additional populations within the county behavioral health delivery system. The Legislature should leverage existing commercial insurance requirements for behavioral health care (SB 855, Wiener, 2020) and further clarify that commercial insurance is required to cover treatment provided under Proposition 36, similar to the language included in the CARE Act (SB 1338, Umberg, 2022), will ensure that county behavioral health agencies and providers are reimbursed for the services provided to individuals who may not meet Medi-Cal eligibility criteria.
Implement Robust Spending and Outcomes Reporting: To ensure that Proposition 36 achieves its intended goals, all new funds should be accompanied by clear spending and outcomes reporting requirements. Transparency and accountability measures should not duplicate existing reporting, outcomes, and accountability requirements and leverage existing reporting mechanisms to the extent possible in order to reduce the documentation burden on providers and plans. Requiring reporting will help track the success of the various investments made by the state, identify areas for improvement, and demonstrate the positive impact of investing in behavioral health services.
These recommendations can help ensure that individuals charged with treatment-mandated felonies receive the care they need. However, there is also a need to build out our substance use treatment system beyond these recommendations to ensure Californians get care before they are involved in the justice system. We would urge the Legislature to continue to invest in substance use treatment and support services. Our coalition stands ready to collaborate with the Legislature and the Administration to advance these vital improvements. Should you have any questions, please feel free to contact Tara Gamboa-Eastman with the Steinberg Institute at tara@steinberginstitute.org.
Sincerely,
Karen Larsen Chief Executive Officer Steinberg Institute
Le Ondra Clark Harvey Chief Executive Officer California Behavioral Health Association
Robb Layne Executive Director California Association of Alcohol and Drug Program Executives
Pete Nielsen President and Chief Executive Officer California Consortium of Addiction Programs and Professionals
Michelle Doty Cabrera Executive Director County Behavioral Health Directors Association
Heid Strunk President and CEO Mental Health America of California
Anne Irwin Founder and Director Smart Justice
Anthony Di Martino Government Affairs Director Californians for Safety and Justice
Grey Gardiner State Director, California Drug Policy Alliance
Claire Simonich Associate Director Vera Institute for Justice
Paul Yoder Legislative Advocate California State Association of Psychiatrists
Selena Liu Raphael Senior Policy Advocate California Alliance of Child and Family Services
Chad Costello Executive Director California Association of Social Rehabilitation Agencies
Tyler Rinde Director of Government Affairs California Psychological Association
Meron Agonafer Policy Director CalVoices
CC: Senator Akilah Weber, Senate Subcommittee No. 1 Chair Assemblymember Dawn Addis, Assembly Subcommittee No. 1 Chair Scott Ogus, Senate Budget Deputy Staff Director Nora Brackbill, Senate Budget Subcommittee No. 5 Consultant Jennifer Kim, Assembly Budget Subcommittee No. 6 Consultant Patrick Le, Assembly Budget Subcommittee No. 1 Consultant Eric Dang, Principal Consultant, Office of President Pro Tempore Mike McGuire Marjorie Swartz, Principal Consultant, Office of President Pro Tempore Mike McGuire Shaun Naidu, Policy Consultant, Office of Speaker Robert Rivas Rosielyn Pulmano, Policy Consultant, Office of Speaker Robert Rivas
1 This estimate was determined by estimating the annual number of treatment-mandated felonies to be 13,164 people per year based on the data from the Judicial Council Proposition 36 Survey. This estimate assumes that treatment costs will be $20,000 per person on average and that 80% percent of those charged with treatment mandated felonies will be Medi-Cal eligible and, therefore, 50% of the costs will be covered by the federal government. The formula used was (13,164)*(0.8)*(0.5)*($20,000) = $105,312,000.3
The Honorable Caroline Menjivar Senate Health Committee 1021 O Street, Room 3310 Sacramento, CA 95814
RE: Support for AB 539 (Schiavo)
Dear Chair Menjivar,
Mental Health America of California (MHAC) is pleased to support Assembly Bill 539 (Schiavo), legislation that would allow prior authorizations for health care services to remain valid for one year from the date of approval or throughout the course of treatment if less than a year.
MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. Prior authorization procedures can create significant barriers to accessing voluntary mental health and substance use services.
The prior authorization process requires providers to obtain approval from health plans before delivering certain supports or services, including mental healthcare. However, it can take anywhere from one to five days before receiving approval. Additionally, prior authorizations are not permanent. How long an authorization remains active is determined by and varies across health plans and may need to be renewed multiple times for the same care within a given year. These delays create unnecessary barriers to addressing known health challenges and widen the gap in access to vital support and services intended to help individuals before they reach a point of crisis.
This bill helps ensure continuity of care by reducing disruptions caused by repeated prior authorization requests by standardizing the length of approval for at least one year. It is for these reasons MHAC supports AB 539 (Schiavo) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.
The Honorable Caroline Menjivar Chair, Senate Health Committee 1021 O Street, Room 3310 Sacramento, CA 95814
RE: MHAC Support for SB 306 (Becker)
Dear Chair Menjivar,
Mental Health America of California (MHAC) is pleased to support Senate Bill 306 (Becker), legislation that would exempt commonly approved healthcare services from requiring prior authorization.
MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy.
Commonly covered mental health and substance use services include various forms of therapy or counseling and medication management. This bill ensures that health plans that approve 90% or more of prior authorization requests for a given service in the previous year must exempt that service from prior authorization for the following year. This will help streamline access to commonly utilized mental health and substance use services and ensure more timely care.
It is for these reasons MHAC supports SB 306 (Becker) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.
The Honorable Caroline Menjivar Chair, Senate Health Committee 1021 O Street, Room 3310 Sacramento, CA 95814
RE: Support for Senate Bill 338 (Becker)
Dear Chair Menjivar,
Mental Health America of California (MHAC), the California Youth Empowerment Network (CAYEN) and LGBTQ+ Inclusivity, Visibility, and Empowerment (LIVE) are pleased to support Senate Bill 338 (Becker), legislation that would establish the Mobile Health for Rural Communities Pilot Program with the goal of increasing access to health services, including mental health, for rural communities.
MHAC, CAYEN, and LIVE are dedicated to advancing mental health, wellness, and equity through community-led advocacy, education, and empowerment. By centering the voices of those with lived experience, including youth, LGBTQ+ individuals, and people living with mental health and substance use challenges, we aim to reduce stigma, influence public policy, and create inclusive environments where everyone has access to vital community-based culturally responsive mental health and substance use supports and services.
Access to these services is extremely challenging for individuals in the rural communities, especially youth and the LGBTQ+ community. People often travel for hours for in-person services. Additionally, rural communities lack the appropriate internet infrastructure to support telehealth or virtual services. Senate Bill 338 (Becker) invests in mobile health, bringing services directly to communities in need, reducing barriers to access in-person and virtual health services.
It is for these reasons MHAC, CAYEN, and LIVE support SB 338 (Becker) and respectfully ask for your “Aye” vote. If you have any questions or need further assistance, please do not hesitate to contact MHAC’s Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org, CAYEN’s Public Policy Coordinator Danny Thirakul at dthirakul@mhac.org, or LIVE’s Project Manager Anthony Garibay-Mena at agaribaymena@mhac.org.
In Community,
Heidi L. Strunk President & CEO
Danny Thirakul California Youth Empowerment Network Public Policy Coordinator
Anthony Garibay-Mena LGBTQ+ Inclusivity, Visibility, and Empowerment Project Manager
The Honorable Jesse Arreguín Senate Public Safety Committee 1020 N Street, Room 545 Sacramento, CA 95814
RE: Support for Senate Bill 691 (Wahab)
Dear Chair Arreguín,
Mental Health America of California (MHAC) is pleased to support Senate Bill 691 (Wahab), legislation that would require guidance to law enforcement personnel who wear body-worn cameras to limit the recording of medical or psychological evaluations, procedures, or treatment that may cause embarrassment or humiliation to the patient. The bill would also require a procedure for emergency service personnel to request the redaction of evidentiary recordings of a patient undergoing medical or psychological evaluation, procedure, or treatment.
MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. The types of services and supports individuals receive during a mental health crisis require trust, rapport with providers, and an assurance of confidentiality.
People experiencing a mental health crisis are often in an immensely vulnerable, isolating, and sometimes life-threatening situation. In the event an individual must be forced into treatment, their right to privacy must be prioritized and upheld. Furthermore, recordings and sharable videos of individuals without their consent during moments of crisis may be used to further inflame and stigmatize individuals during assessments or conservatorship investigations. These potentially singular moments of crisis should not be used to define the entirety of an individual’s journey towards wellness.
MHAC is committed to reducing stigma and empowering individuals to seek and accept support and services for mental health challenges. A moment of crisis should not define them or prohibit their ability to establish a path towards recovery that works for them. It is for these reasons MHAC supports SB 691 (Wahab) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.
The Honorable Caroline Menjivar Senate Health Committee 1021 O Street, Room 3310 Sacramento, CA 95814
RE: MHAC Support for Assembly 1032 (Harabedian)
Dear Chair Menjivar,
Mental Health America of California (MHAC) is pleased to support AB 1032 (Harabedian), legislation that will allow health plan enrollees to be reimbursed for up to 12 visits with a behavioral health provider if they reside in a county where a state of emergency has been declared due to wildfires. This bill would also require health plans to notify enrollees of their eligibility and ensure these benefits would not be subject to utilization review.
MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy.
During moments of crisis, especially ones brought about from natural disasters such as wildfires, access to proper support and services can be extremely difficult. The recent Los Angeles fires have displaced hundreds of thousands of people without proper access to critical mental health and substance use supports. The American Addiction Centers notes that natural disasters often lead to increased substance use.[1] As displaced individuals attempt to access mental health and substance use supports and services, cost and insurance coverage should not prevent them from accessing care.
This bill ensures that individuals who experience a crisis due to a natural disaster can receive critical care without cost becoming a barrier to continuity of care. It is for these reasons MHAC supports AB 1032 (Harabedian) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any other behavioral health legislation, please do not hesitate to contact me at kvicari@mhac.org or our Public Policy Coordinator, Danny Thirakul, at dthirakul@mhac.org.
In Community,
Karen Vicari Director of Public Policy Mental Health America of California
Department of Health Care Services Behavioral Health Transformation 1501 Capitol Ave Sacramento, CA 95814
RE: Behavioral Health Services Act County Policy Manual Module 3
To Whom It May Concern,
Mental Health America of California (MHAC) is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. Below are MHAC’s recommendations regarding the proposed Behavioral Health Services Act County Policy Manual Module 3.
Section E.2.1 IP Requirements
Recommendation #1: Add language encouraging meaningful stakeholder engagement in annual updates.
Reasoning: Although the Behavioral Health Services Act (BHSA) does not require a full stakeholder process for annual updates, language in the Act implies ongoing involvement of stakeholders. For instance, Welfare & Institutions Code Section 5892 (e) (1) (A-C) requires counties to include funding for annual planning costs to fund stakeholder participation:
(e) (1) (A) Notwithstanding subdivision (a) of Section 5891, the allocations pursuant to subdivision (a) shall include funding for annual planning costs pursuant to Sections 5963.02 and 5963.03.
(B) The total of these costs shall not exceed 5 percent of the total of annual revenues received for the Local Behavioral Health Services Fund.
(C) The planning costs shall include funds for county mental health and substance use disorder programs to pay for the costs of consumers, family members, and other stakeholders to participate in the planning process.
Additionally, Welfare & Institutions Code Section 5963.03 (a)(2)(A)(i) retains original MHSA language which states:
(2) (A) (i) A county shall demonstrate a partnership with constituents and stakeholders throughout the process that includes meaningful stakeholder involvement on mental health and substance use disorder policy, program planning, and implementation, monitoring, workforce, quality improvement, health equity, evaluation, and budget allocations.
Meaningful stakeholder involvement in processes such as program planning, implementation, quality improvement and evaluation are not one-time processes that can occur once every three years, these are ongoing processes that must be implemented throughout a 3-year period as programs are rolled out and eventually evaluated.
Recommendation #2: Strengthen the language in this section to clearly state that the local agency must “provide an annual report of written explanations to the local governing body and the department for substantive recommendations made by the local behavioral health board that are not included in the final integrated plan or update.”[1]
Reasoning: This is a key section of the BHSA which ensures that Behavioral Health Board (BHB) recommendations are carefully considered. Behavioral Health Board meetings are an open and transparent forum for stakeholder involvement and their impact in the planning process should be maintained.
Section E3.4 Exemption Approval
Recommendation # 3: The manual should state that DHCS will provide counties with specific feedback on why exemption requests are denied.
Reasoning: Exemptions will allow counties to more effectively plan for services that meet local needs. Clarity in how to obtain these exemptions is vital.
Section E4.2 DHCS Review Standards
Recommendation #4: Require BHB review of revised IPs that are found to inadequately address local needs.
Reasoning: The Draft Module 3 states that DHCS may require counties to revise their IP if it fails to address local needs, including prevalence of mental health and substance use disorder and unmet need for mental health and substance use disorder treatment in the county, among others. Revisions to an IP for reasons as substantive as failing to address local needs should be subject to some form of stakeholder review. The input of stakeholders who are intricately involved in the system is vital to ensuring the appropriate use of funds to address local needs and BHB review would provide the opportunity for stakeholder input into revised IPs without unduly burdening the local agency.
E.5.3 Approval Process for Joint Integrated Plans
See recommendation #2
We ask these recommendations be included in the final version of the Behavioral Health Services Act County Policy Manual Module 3. If you have any questions, or if MHAC can provide any assistance regarding the implementation of the Behavioral Health Services Act please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.
