(The Center Square) – California’s mental health funding skips the highest-need areas and most of its small counties, according to a new report from the state Legislative Analyst’s Office.
The report also suggested the legislature has only a small window to take action to ensure a recently approved $12.7 billion bond for homeless housing and mental health is properly allocated before the first $3.3 billion round of funding goes out in May.
“We found that a majority of new capacity is being added in four (out of ten) regions of the state estimated to have the least need,” wrote Gabriel Petek, an analyst for the non-partisan office. “Moreover, BHCIP has not made any progress in building these facilities in the region that was identified as having the greatest need (southern San Joaquin Valley).”
California created the Behavioral Health Continuum Infrastructure Program, or BHCIP, in 2001 to expand mental health services in the state, which have historically been funded by the Mental Health Services Act — a tax on high incomes that provides billions of dollars per year in support.
The program has thus far awarded $1.8 billion towards mental health and substance abuse treatment expansions, and will be the means by which funding for Prop 1. — the aforementioned $12.7 billion bond — is allocated.
The report on the program and its grant-approval mechanism found that 19 of 30 of the state’s small counties — which often have high demand for mental and behavioral health services in excess of their existing funding and treatment capacity — did not receive any grants.
“On a per-person basis, small counties overall received disproportionately more BHCIP dollars than larger counties in these grant rounds. This funding, however, has been concentrated within 11 out of 30 small counties,” wrote Petek. “The remaining 19 small counties did not receive any awards in these rounds.”
Petek also noted that there has only been “mixed success in siting behavioral health infrastructure in counties where it did not exist prior to BHCIP,” suggesting in some instances that even when funding has been secured, counties face difficulty in finding somewhere appropriate to place these new facilities.
The program also scores “launch-ready” projects the highest. This means that the best-funded areas with the greatest amount of resources to execute lengthy bids for projects make it harder for “small and disadvantaged applicants” to secure funding and “may be limiting the program’s success in siting the hardest-to-build facilities.”
Petek shared that the RAND Corporation, a public sector consulting firm contracted by the state for a mental health system assessment in 2021, estimates the state is short 7,800 adult inpatient treatment beds, or short about one-third of the existing demand. Southern San Joaquin faces the biggest shortage, but has received zero funding.
Petek’s report directs the legislature to consider allocating Prop. 1 funding relative to RAND-identified regional shortfalls. It also suggests the state should use more of the Prop. 1 funding for mental health treatment — implicitly highlighting Prop. 1’s inclusion of housing funding as a component of mental health funding.
In December, the Biden administration approved a waiver allowing California to use a portion of its $98.5 billion in federal funding for the taxpayer-financed Medi-Cal system towards housing. The waiver allows the state to use some of this funding for covering six months of rent in many cases, and “permanent rental subsidies and housing” for individuals with “significant behavioral health needs.”
This could free up Prop. 1 funding set aside for housing to be used on mental health treatment.