State Budget Passes – Even More $$$ for Mental Health 

Pretty astounding what is in the 2022-23 State Budget just approved by the Legislature and now awaiting action by Governor Newsom

The Legislature has sent Governor Newsom new budget bills as well as over a dozen budget trailer bills. Below are some of the highlights in the State Budget from a behavioral health perspective:

$1.5 billion over two years for immediate, clinically enhanced bridge housing solutions for individuals experiencing homelessness with serious mental illness and state operations resources for DHCS to implement the project and provide technical assistance to counties.

$200 million for Psychiatric Resident Program to increase the number of behavioral health providers, such as psychiatrists, psychiatric nurse practitioners, and psychologists.

$100 million one-time to Los Angeles County to provide community-based mental health services to justice-involved individuals.

$7.5 million in 2022-23 and $6 million ongoing to implement a new federal mandated 9-8-8 call system for behavioral and mental health crisis (this would be in addition to federal monies that can be drawn down (next sentence) and revenues potentially raised as a result of AB 988). $108 million total funds ($16 million General Fund), and trailer bill language, to add qualifying 24 hours a day, 7 days a week community-based mobile crisis intervention services, as soon as January 1, 2023, as a mandatory Medi-Cal benefit available to eligible Medi-Cal beneficiaries, statewide.

$250,000,000 one-time funding, available over three years, to address urgent needs and emergent issues in behavioral health for children and youth age 25 and younger in the following areas: $50,000,000 – Youth Suicide Reporting and Crisis Response Pilot Program at CDPH; $85,000,000 – Wellness and Resilience Building Supports for Children, Youth, and Parents at DHCS; $15,000,000 – Video Series to Provide Parents with Resources and Skills to Support their Children’s Mental Health; $75,000,000 – Leveraging of Emerging Technologies to Develop Next Generation Digital Supports for Remote Mental Health Assessment and Intervention; $25,000,000 – Support for Culturally Diverse Future Behavioral Health Workers.

$10 million one-time to develop and promote high quality peer-to-peer mental health support programs for youth through DHCS via a contract with The Children’s Partnership.

$40 million one-time to establish and administer a Youth Suicide Prevention Project through CDPH, requiring CDPH to begin executing grants for this purpose by December 1, 2022.

$489,336,000 and 76.0 positions in 2022-23, $436,108,000 and 93.5 positions in 2023-24, $471,739,000 and 98.5 positions in 2024-25, $591,933,000 and 95.0 positions in 2025-26 ongoing, and trailer bill to implement solutions proposed by the Incompetent to Stand Trail (IST) Workgroup to address early stabilization, care coordination, waitlist management, and increasing IST beds in community-based programs by 5,000 over four years. 

$39,113,000 one-time Opioid Settlements Fund (OSF) in 2022-23, of which $10,000,000 is to augment (from $4,750,000 to $14,750,000) the DHCS Medication Assisted Treatment (MAT) Expansion Project’s Naloxone Distribution Project to distribute naloxone to homeless service providers. The remaining funds will support substance abuse disorder provider workforce training. Adopts trailer bill to establish the Opioid Settlements Fund.

$101,000,000 ($96,000,000 General Fund and $5,000,000 Opioid Settlement Fund) in 2022-23, and $61,000,000 General Fund in 2023-24 and ongoing and adopts trailer bill to expand the Medication Assisted Treatment Program.

$10.9 million General Fund in FY 2021-22, $80 million General Fund in FY 2022- 23, and $40 million General Fund in FY 2023-24 to continue support for CalHOPE after May 2022, through December 2023.

$30 million total funds ($16.5 million General Fund, $13.5 million Mental Health Services Fund) one-time, in 23-24, 24-25, and 25-26 for support of the California Peer-Run Warm Line. 

$5 million one-time Mental Health Services Fund for the Mental Health Services Oversight and Accountability Commission to establish a California Behavioral Health Outcomes Fellowship for Transformational Change, to provide intensive training to local government behavioral health staff.

$40.8 million Opioid Settlement Fund for an opioid public awareness campaign including these components: 1) promote behavior change, reduce opioid misuse, and decrease stigma associated with seeking treatment among youth and young adults; 2) messaging and educational information specific to the risks of fentanyl use and prevalence of fentanyl in other drugs targeting adults 21 – 40 years of age; and 3) raise awareness of the Shatterproof Atlas service, a web-based, consumer-oriented resource for those in need of SUD treatment services to help locate service providers, with information on services provided, locations, quality information, and user feedback.

Resources to establish BioSense in California specifically for non-fatal overdose and drug misuse surveillance and for overdose spike identification at the local level, to improve overall overdose surveillance, respond more rapidly to overdose spikes, and to inform prevention and treatment.

$50 million one-time for the Officer Wellness and Mental Health Grant Program for grants to improve general officer health and well-being, build resiliency, and decrease stress and trauma.

$7 million one-time 2022-23 to support the Governor’s Advisory Council on Physical Fitness and Mental Well-Being, established by the Governor in June 2021. Approves of $8.6 million for a comprehensive social marketing campaign on physical fitness

$10.4 million one-time to support a portion of Short-Term Residential Therapeutic Program (STRTP) providers to transition to a reduced capacity of 16 beds or fewer, or other programs models, through December 2022. This funding will help prevent a loss of federal Medicaid funding resulting from STRTPs being classified as Institutions for Mental Disease, as clarified in federal guidance.

$172.34 million ongoing general fund, and $314 million ongoing Proposition 98, for the California State Preschool program to provide a 1.8 adjustment factor for three year olds, a 2.49 factor for students with exceptional needs, and 1.1 factor for mental health services.

$50 million one-time, to be spent over three years, for grant programs that will provide outreach and support activities aiming to end veteran suicide through the California Veteran Health Initiative (CVHI). The CVHI will focus on prevention, early intervention, and direct services associated with suicidal ideation. Three programs will be funded: Outreach and Education Campaign ($5 million); Veteran Mental Health Support Network ($40 million); and Veteran Suicide Surveillance and Review Program ($5 million).

Pre and Post Release Transitional Housing and Support – expands pre- and post-release programs to decrease recidivism, including $120 million over three years for the Community Reentry Program at CDCR, $60 million over three years for the Adult Reentry Grant Program, and $3 million for a creative workforce program for the formerly incarcerated.

If you noticed a lot of “one-time” funding, you are right. Sustaining funding for vital programs is always a tougher test.

As much as this is, you can expect at least a little more next week as we dive deeper into a couple issue areas (such as Cal-AIM, CARE Court, Medi-Cal) and also undoubtedly discover at least a couple items that were buried deeper in the various bills.

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