Position Category: MHAC

SB 367 (ALLEN) Expand the Lanterman Petris Short (LPS) Act – Oppose

April 4th, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento , CA 95814

RE: OPPOSE Senate Bill 367 (Allen)

Dear Chair Menjivar,   

Mental Health America of California (MHAC) respectfully opposes Senate Bill 367 (Allen), which would expand Lanterman Petris Short (LPS) Act involuntary commitment and conservatorship statutes by: 1) Requiring information about the historical course of a person’s medical, psychological, educational, social, financial, and legal conditions to be included in the assessment for an involuntary hold; 2) Authorizing conservatorships for people who have accepted voluntary care; and 3) Expanding the list of individuals or entities that can recommend conservatorship. These expansions of current law will risk infringing on peoples’ civil rights by inappropriately increasing conservatorships.  

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. In accordance with our mission, MHAC supports increasing the availability of voluntary, accessible, culturally responsive, community-based services.

MHAC is opposed to SB 367 for the following reasons:

Requiring information about the historical course of a person’s medical, psychological, educational, social, financial, and legal conditions to be included in the assessment for an involuntary hold is an egregious and inappropriate expansion of involuntary commitment statute. Current law requires information on the historical course of a person’s mental disorder be considered only if it is determined that the information has a “reasonable bearing” on whether the individual meets criteria for involuntary treatment. Furthermore, current statute specifies limited sources of the historical information.[1] In contrast, SB 367 requires information on the historical course of a broad range of factors that are not relevant to an immediate mental health crisis, including educational, social, financial, and legal. We struggle to understand how the historical course of an individual’s education, for example, bears on their potential status as currently gravely disabled. Requiring this information in assessments risks wrongful involuntary commitments based on bias and prejudice rather than immediate mental health needs, and threatens the privacy of the individual. Furthermore, by not limiting or specifying the sources of this information, the bill would create excessive burdens on evaluation staff who are now required to collect this historical information.

Allowing conservatorships for individuals who have “demonstrated an inability to follow through with stated plans of self-care” is untenably broad and will likely result in wrongful conservatorships. Self-care is a term that can encompass a wide range of activities, including simple things like getting outside, getting enough sleep, meditating, etc.. Moreover, “stated plans” is a vague term that implies an unwritten expression of self-care goals.

Conservatorships remove individuals’ rights, autonomy and self-determination and should only be used when absolutely necessary and only after significant evaluation of the individual’s mental health. SB 326 expands authority to recommend conservatorships to a judicial officer, a treating physician or an emergency physician. These individuals are not likely to have sufficient knowledge of an individual’s mental health history to make an accurate conservatorship recommendation, which runs the risk of inappropriately increasing unnecessary conservatorships.

It is for these reasons MHAC is opposed to SB 326 (Allen). 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. 

In Community,   

Heidi L. Strunk   
President & CEO 

[1] California Welfare & Institutions Code Section 5150.05

SB 418 (MENJIVAR) Prohibit Health Discrimination – Support

June 24th, 2025

The Honorable Mia Bonta
Assembly Health Committee
1020 N Street, Room 390
Sacramento, CA 95814 

RE: Support for Senate Bill 418 (Menjivar) 

Dear Chair, 

Mental Health America of California (MHAC) is pleased to support Senate Bill 418 (Menjivar), a bill that would prohibit discrimination or a denial of benefits from a health plan or insurer based on race, color, national origin, age, disability, or sex with specific protections for the LGBTQ+ community.  

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. 

As healthcare institutions face increasing scrutiny from the federal administration for providing gender-affirming care, denials of such care are expected to rise unless specific protections are established. These denials include limiting access to essential services and adopting policies that restrict or exclude the LGBTQ+ community from receiving gender-affirming care. 

This bill strengthens protections for the LGBTQ+ population by explicitly defining discrimination based on sex to include sex characteristics, pregnancy and related conditions, sexual orientation, gender identity, and sex stereotypes. Ensuring access to gender-affirming care is critical for the well-being of transgender individuals, as it provides access to necessary medical, mental health, and substance use services and supports. According to The Trevor Project, there has been a 72% increase in suicide attempts among transgender youth due to the rise in anti-transgender laws.[1] These laws attempt to erase the existence of the transgender community by denying access to direct services and critical care.

Everyone deserves access to essential services and support. It is for these reasons MHAC supports Senate Bill 418 (Menjivar) 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 kvicari@mhaofca.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

[1] News, T. (2025a, February 11). Anti-transgender laws cause up to 72% increase in suicide attempts among transgender and nonbinary youth, study shows. The Trevor Project.

SB 823 (STERN) Adding Bipolar 1 to CARE Court Criteria – Oppose

March 18th, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

Re: MHAC Opposition to Senate Bill 823 (Stern)

Dear Chair,

Mental Health America of California is writing to oppose SB 823 (Stern), legislation that would add Bipolar I Disorder to the criteria for a person to be petitioned into CARE Court and forced into involuntary treatment. CARE Court represents an ineffective approach to mental healthcare in California. It fails to address the systemic barriers individuals face and, in some cases, comes at the cost of their civil liberties.

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 primary barriers to accessing mental health services include a shortage of providers, stigma, and lack of voluntary services and supports. Investing in the behavioral health workforce, reducing stigma through community engagement, and voluntary community-based services has proven to prevent mental health crisis, reduce hospitalizations, institutionalization, and incarceration.[1] In contrast, CARE Court fails to address the provider shortage, inadvertently increases stigma due to its court-based setting, and provides no additional funding to increase mental health services and supports beyond what’s currently available.

The ineffectiveness of CARE Court is demonstrated in the enrollment numbers. When San Francisco rolled out CARE Court in 2023, city officials projected approximately 2,000 eligible individuals, but only 11 referrals were made.[2] The Department of Health Care Services also released its Early Implementation Report in November of 2024 which recorded a total of 100 Care Court participants, yet state officials estimated 7,000 to 12,000 people would be eligible.[3][4] One of the primary reasons for the low enrollment is due to the many respondents who are receiving care voluntarily or receiving supports and services in a different way other than CARE Court. This further supports the idea that when voluntary supports and services are available, people will accept them.

The state’s failure to meet expectations shows an inherent flaw in the system that won’t be solved by expanding the criteria of who can be forced into treatment via a court order. For these reasons MHAC opposes SB 823 (Stern) and asks for your “No” 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 or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.  

In Community, 

Heidi L. Strunk 
President & CEO

[1] Yehya, N. A. (2024, November 27). Report finds State’s mental health programs need consistent funding, community engagement. UC Davis Health News.

[2] SF Chronicle “S.F. Helped Only a Handful of People So Far through California’s Ambitious New Health Program” (2024)

[3] Depart of Health Care Services . (2024, November). CARE Act Early Implementation Report. Community Assistance, Recovery, and Empowerment Act.

[4] Mai-Duc, C. (2024, November 27). California falling short of enrollment goal as Mental Health Courts Roll Out Statewide. California Healthline.

AB 1429 (BAINS) Kaiser Behavioral Health Reimbursement – Support

April 4th, 2025

The Honorable Mia Bonta
Chair, Assembly Health Committee
1020 N Street, Room 390
Sacramento, CA 95814

RE: Support for AB 1429 (Bains)

Dear Chair Bonta,   

Mental Health America of California (MHAC) is pleased to support Assembly Bill 1429 (Bains), legislation that would require Kaiser to reimburse enrollees for out of network behavioral health services, including prescription medication.

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.   

Since 2011, Kaiser Permanente has consistently failed to provide its enrollees access to timely and adequate behavioral health care services. The Department of Managed Health Care (DMHC) just released a Final Report of Nonroutine Survey of Kaiser Foundation Health Plan, Inc. and found that Kaiser failed to provide timely access to behavioral health services, failed to take effective corrective action to improve care in response to grievance and appeal deficiencies, and lacked quality assurance and oversight.[1]

Due to Kaiser’s consistent failure to meet the standards set by state law, patients must accept inadequate care or seek out-of-network care when Kaiser’s care falls short. AB 1429 would rectify this by requiring Kaiser to fully reimburse an enrollee for out-of-pocket costs for necessary behavioral health care obtained from non-Kaiser providers or facilities and mental health prescriptions obtained from a non-Kaiser pharmacy or provider. This reimbursement would be required until DMHC certifies that Kaiser has successfully completed implementation of their corrective action work plan.

In short, AB 1429 ensures that Kaiser patients do not have to choose between the inability to access critical mental health services or be forced to pay out of pocket for care they already pay Kaiser for. It places the financial responsibility where it belongs – with the health plan that has repeatedly failed to meet its legal obligations to provide adequate care.

It is for these reasons MHAC supports AB 1429 (Bains) 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. 

In Community,   

Heidi L. Strunk   
President & CEO 

[1] OFFICE OF PLAN MONITORING DIVISION OF PLAN SURVEYS. (2025, February 25). FINAL REPORT NONROUTINE SURVEY OF KAISER FOUNDATION HEALTH PLAN, INC. California Department of Managed Health Care.

SB 331 (MENJIVAR) Substance Abuse – Opposed Unless Amended

April 3rd, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento , CA 95814

RE: OPPOSE UNLESS AMENDED Senate Bill 331 (Menjivar)

Dear Chair Menjivar,   

Mental Health America of California (MHAC) respectfully opposes unless amended Senate Bill 331 (Menjivar), which would define a “mental health disorder” as a condition outlined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders.

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. In accordance with our mission, MHAC supports increasing the availability of voluntary, accessible, culturally responsive, community-based services.

The definition of “mental health disorder” as outlined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is not only overly broad, but also misaligned with the intent of the statute regarding involuntary commitment.

The current version of the DSM lists 265 conditions, a large number of which are inappropriate grounds for involuntary commitment. Some of these include sexual dysfunction, sleep wake disorders, communication disorders, stuttering, caffeine use disorder, and tobacco use disorder. [1]

The Lanterman-Petris-Short (LPS) Act was intended to “end the inappropriate, indefinite, and involuntary commitment of persons with mental health disorders” by authorizing involuntary treatment in very limited circumstances. By defining “mental health disorder” as broadly as the DSM criteria, California risks expansion of involuntary commitment far beyond the intent of the LPS Act. Furthermore, the LPS Act requires the provision of evaluation and treatment services for individuals placed on involuntary holds. Yet, many of the conditions listed in the DSM are not appropriate for treatment within locked facilities.

While we are opposed to the current bill language defining a “mental health disorder” as outlined in the current edition of the DSM, we are not necessarily opposed to defining “mental health disorder” in statute. Ideally, we would like this provision removed from the bill but if that is not possible, we would welcome the opportunity to work with the author and sponsors to develop a more suitable definition.

It is for these reasons MHAC must oppose SB 331 (Menjivar). 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. 

In Community,   

Heidi L. Strunk   
President & CEO 

[1] American Psychiatric Association. (2013). DSM-5 Table of Contents.

AB 0416 (KRELL) Expanding 5150 Involuntary Hold Eligibility – Oppose

August 1st, 2025

The Honorable Anna Caballero
Senate Appropriations Committee
State Capitol, 412
Sacramento, CA 95814

Re: Opposition to Assembly Bill 416 (Krell)

Dear Chair Caballero,

The undersigned organizations write in opposition to Assembly Bill 416 (Krell), legislation that expands eligibility for people who can place individuals on a 5150 psychiatric hold to include Emergency Room (ER) physicians.

We are a coalition of youth, peer, and community-based organizations that envisions a society in which all communities, families and individuals can enjoy full, productive, and healthy lives free from discrimination of all kinds regardless of current and past mental health or substance use challenges. Every person deserves access to appropriate, voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. When an individual is experiencing a crisis, their civil liberties should not be substituted for convenience.

Expanding 5150 designation to ER physicians would increase the number of patients placed on psychiatric holds, driving up state costs. The bill’s author has stated that the intent is to allow ER physicians to write holds and reduce overcrowding in emergency rooms. However, emergency room delays for psychiatric patients are caused primarily by delays in finding an appropriate placement. The bill would only exacerbate an already overburdened crisis system with an excessive number of individuals on a psychiatric hold requiring inpatient hospitalization.

For the fiscal years 2021-2022, just over 100,000 individuals were placed on a 5150 psychiatric hold.[1] The Department of Health Care Serivces (DHCS) reimburses Mental Health Plans for Specialty Mental Health Services (SMHS), which includes psychiatric inpatient hospital services.  According to the SMHS Fee Schedules, this costs the state up to $15,000 per person for a 72-Hour psychiatric hold.[2] This amounts to an average of $306 million for psychiatric inpatient services for individuals placed on a single 5150 hold and does not include the cost of additional intensive treatments that may last weeks or months. Nearly 30,000 individuals required 14-Day Intensive Treatment after the 72-hour hold. These additional holds cost the state an average of $1.3 billion.

For comparison, Full-Service Partnerships (FSP) are designed to provide ongoing support and services to adults with serious mental illness. These programs cost taxpayers approximately $16,666 per person a year and served more than 60,000 people statewide in 2021, totaling approximately $960 million. Considering that FSP’s reduce hospitalization, homelessness, incarceration, and overall costs within California’s health and justice system, FSPs are far more   cost effective.

Our behavioral health system should focus on reducing, rather than increasing, the number of costly 5150 holds, and prioritizing voluntary, community-based supports and services that can prevent individuals from experiencing a mental health crisis, reduce emergency department utilization, and are person-centered. These strategies help reduce systemic burdens and are more cost effective. For these reasons, the undersigned organizations oppose AB 416 (Krell) and respectfully request your “No” vote.

[1] DHCS – California Involuntary Detentions Data Report (IDR). (2024)

[2] DHCS – Medi-Cal Behavioral Health Fee Schedules Fiscal Year 2025-26

In Community, 

Karen Vicari
Director of Public policy
Mental Health America of California

Danny Thirakul
Public Policy Coordinator
California Youth Empowerment Network

Anthony Garibay-Mena 
Program Manager 
LGBTQ+ Inclusivity, Visibility, and Empowerment (LIVE)

Lynn Rivas
Executive Director
California Association of Peer Run Mental Health Organization

AB 309 (ZBUR) Hypodermic Needles and Syringes – Support

June 11th, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

RE: MHAC Support for Assembly Bill 309 (Zbur)

Dear Chair Menjivar,   

Mental Health America of California (MHAC) is pleased to support AB 309 (Zbur), legislation that would allow a physician or pharmacist to continue providing clean and safe hypodermic needles and syringes to individuals 18 years or older without a prescription or permit.

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. MHAC recognizes the importance of harm reduction strategies that support individuals on their path to recovery while safeguarding public health.

Recovering from a substance use disorder is a journey, often nonlinear, with progress and setbacks. Individuals who use substances requiring hypodermic needles face numerous challenges and should not be further harmed while working towards recovery. Access to clean syringes is a proven harm reduction strategy that prevents the transmission of HIV, viral hepatitis, and other bloodborne diseases, ultimately improving public health and safety.[1] The distribution of safe and clean needles and syringes ensures that if individuals experience a setback in their recovery, the harm done to them is minimized.

This bill is a critical step toward reducing preventable harm and protecting community health. It is for these reasons MHAC supports AB 309 (Zbur) 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. 

In Community,   

Heidi L. Strunk   
President & CEO 

[1] Centers for Disease Control and Prevention. (n.d.-b). Syringe Services Programs. Centers for Disease Control and Prevention.

AB 0843 (GARCIA) Language Access to Health Care Coverage – Support

June 27th, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

Re: MHAC Support for Assembly Bill 843 (Garcia)

Dear Chair Menjivar,

Mental Health America of California (MHAC) is writing in support of Assembly Bill 843 (Garcia), legislation aimed at reducing barriers to healthcare access for individuals with limited English proficiency. The bill would require health plans and insurers to provide language-accessible documents and translation services, ensuring that all individuals can effectively navigate the healthcare systems and receive the services they need.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. MHAC envisions a society in which all communities, families and individuals can ENJOY full, productive and healthy lives free from discrimination of all kinds regardless of previous or current issues with their mental health or substance use issues. MHAC believes that every person deserves access to appropriate, voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. Due to language barriers, English language learners have significant barriers accessing voluntary community-based services.

Limited English proficiency contributes to the growing mental health disparities among Asian and Latino populations.[1] The inability to communicate effectively prohibits understanding of cultural behaviors and values, leading to unmet needs and discourages them from seeking help. Without proper accommodations to address language barriers, these disparities will continue to widen, preventing underserved populations from accessing voluntary mental health and substance use services.

This bill directly addresses the language barrier by requiring health plans and insurers to take responsibility for properly informing their enrollees. They must provide translation services and translated documents to ensure that language is not an obstacle to receiving care. For these reason MHAC supports Assembly Bill 843 (Garcia) 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 kvicari@mhac.org or our Public Policy Coordinator, Danny Thirakul at dthirakul@mhac.org.  

In Community,   

Karen Vicari
Director of Public Policy

[1] Sentell, T., Shumway, M., & Snowden, L. (2007). Access to mental health treatment by English language proficiency and race/ethnicity. Journal of general internal medicine, 22 Suppl 2(Suppl 2), 289–293.

AB 0529 (AHRENS) Pharmacy Declared State of Emergency – Support

March 14, 2025

The Honorable Marc Berman
Chair, Assembly Committee on Business and Professions
1020 N Street, Room 379
Sacramento, CA 95814

Re: MHAC Support for AB 529 (Ahrens)

Dear Chair,

Mental Health America of California is writing in support of AB 529 (Ahrens), legislation that would allow the California State Board of Pharmacy to waive provisions of the Pharmacy Law for up to 120 days instead of 90 days after the end of a declared federal, state, or local state of emergency. This would allow mobile pharmacies or clinics to continue severing impacted areas and ensure continuity of services.

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.

A state of emergency can arise in various forms, including epidemics, power outages, extreme weather, and natural disasters such as floods, earthquakes, and wildfires. During such emergencies the availability of resources and public services become scarce, such as access to healthcare services and medication. During times of great stress, Individuals may develop, or experience heightened, mental health challenges increasing the need for these vital services.

While the Board of Pharmacy may currently waive provisions of the pharmacy law for up to 90 days after the end of a state of emergency to allow mobile clinics and pharmacies to operate, it can take more than 90 days to rebuild a community and for any sense of normalcy to return. This bill would allow for an additional 30 days for a total of 120 days expanding access to care and medications as communities transition from crisis intervention to rehabilitation.

For these reason MHAC supports AB 529 (Ahrens) 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.  

In Community, 

Heidi L. Strunk 
President & CEO

Statement of Support to Commute the Sentences of Every Individual on Death Row in California

Mental Health America of California (MHAC) proudly joins over 112 organizations (see Attachment 1) in urging California Governor Gavin Newsom to commute the sentences of the more than 600 individuals on death row. In 2019, Governor Newsom signed Executive Order N-09-19, establishing a moratorium on the death penalty during his term in office. With his term nearing its end, the moratorium will also expire.

A third of those on California’s death row have been diagnosed with a serious mental illness, underscoring the urgent need to address a deeply flawed system that fails to guarantee justice and fairness for all.[1] The death penalty neither rehabilitates individuals nor offers opportunities for reparations. Its inequitable application disproportionately impacts people with serious mental illness, as well as Hispanic and Black or African American individuals, who are sentenced to death at higher rates.

The 2021 Death Penalty Report from the CA Committee on Revision of the Penal Code recommends not only commuting existing death sentences but also abolishing the death penalty altogether. MHAC remains steadfast in its commitment to justice, especially for those who are incarcerated and living with a serious mental illness. Call on Gov. Newsom to act now! If you would like to add your name or organization to the list of supporters, please visit https://clemencyca.org/join/ to sign on.

[1] The Office of the State Public Defender