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May 10, 2013
Editorial: Steinberg plan for mental health has real merit

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(May 10 -- By the Editorial Board)

Important legislation is emerging that would significantly improve care for the most severely mentally ill people in California.

Proposed by Senate President Pro Tem Darrell Steinberg, the package of bills warrants serious consideration by Gov. Jerry Brown, even though the measures would add to state costs, at least in the short run.

Among his proposals, Steinberg is calling for construction or leasing of facilities that would provide 2,000 beds controlled by counties for individuals who are in the midst of crisis.

Steinberg also proposes to add 200 mental health workers who would focus on people with serious issues, and 25 mobile crisis teams deployed across the state, plus 3,500 more treatment slots for felons with serious mental illness upon their release from prison.

At least part of the costs would be borne by the federal government through Medi-Cal and the Affordable Care Act. But there would be costs to the state general fund, which will give Brown pause - though Steinberg makes a compelling argument that spending money before individuals land in jail, prison or locked state and county hospital wards ultimately saves taxpayers' money.

Steinberg also is working on legislation to overhaul aspects of the 45-year-old Lanterman-Petris-Short Act, a law that governs the care, or lack thereof, of the most severely mentally ill individuals, though details have not yet emerged.

Additionally, he is crafting a bill that would make clear that counties are authorized to use some Mental Health Services Act money to implement assisted outpatient treatment programs for their sickest residents. In such programs, judges can direct that individuals take medication and regularly meet with therapists.

As it is, the $1 billion a year generated by the tax created by Proposition 63, the 2004 initiative Steinberg promoted, cannot be used for such programs.

Steinberg's proposal doesn't go far enough. He doesn't want counties to be able to divert Proposition 63 money to assisted outpatient treatment from existing programs that provide voluntary care. That top-down approach unnecessarily substitutes Sacramento's judgment for county supervisors who generally know better how to make best use their money.

Legislators other than Steinberg have ideas that warrant consideration, too.

Assembly Republican leader Connie Conway of Visalia proposed legislation to permit judges to impose assisted outpatient treatment plans on individuals for up to a year, rather the current six months. However, Assembly Judiciary Committee Chairman Bob Wieckowski, D-Fremont, and Assemblyman Roger Dickinson, D-Sacramento, led the effort to kill the measure.

The issue of how to help people with severe mental illness is not one that attracts campaign donations or votes. Politicians would prefer that the issue go away, as top Nevada state officials demonstrated with their once-surreptitious policy of busing people from the Rawson-Neal Psychiatric Hospital in Las Vegas to all corners of the country.

Although we have disagreed at times with Steinberg's approach, he is one of the few legislators in the state and nation who has fought to elevate mental health care as n issue. Policymakers ought to address the care of mentally ill people in a compassionate manner.

Steinberg's legislation will need to be squared with other spending priorities, many of which will emerge when Brown reveals his revised budget on Tuesday. That said, the Senate leader's proposal is a thoughtful step toward dealing with one the major health challenges of our time.

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