State agencies have not properly overseen how California counties are spending billions of dollars on mental health care programs generated by Proposition 63, according to a state audit released today.
The 2004 ballot initiative, written by Senate President Pro Tem Darrell Steinberg, levies a 1 percent tax on people who make more than $1 million, to be spent by counties on mental health services. The state Department of Mental Health and the Mental Health Services Oversight and Accountability Commission are supposed to oversee how counties use the funds.
But today's review by state auditor Elaine Howle says the state agencies are not adequately monitoring the effectiveness of county programs.
"Because of the minimal oversight Mental Health and the Accountability Commission
provided in the past, the State has little current assurance that the funds directed to counties--almost $7.4 billion from fiscal years 2006-07 through 2011-12--have been used effectively and appropriately," Howle wrote in a letter to Gov. Jerry Brown.
Her audit of the Mental Health Services Act found that:
- the state Department of Mental Health did not conduct on-site reviews of county programs to ensure they were properly administered.
- none of the responsible state agencies undertook serious efforts to evaluate the effectiveness of county mental health programs.
- the Department of Mental Health "either did not always obtain certain data or did not ensure counties reported the required data."
- the Accountability Commission intended to monitor Proposition 63 funds only recently established a framework for evaluating programs, several years after voters approved the initiative.
"We expected that Mental Health and the Accountability Commission would have used a process to monitor, guide, and evaluate county implementation that built on their broad and specific MHSA oversight responsibilities and also incorporated best practices in doing so, but that is not what we found," the audit says.
Lawmakers requested the audit last year after media reports questioned whether county programs that offered yoga and gardening were appropriately spending Proposition 63 funds. The audit focused on four counties: Sacramento, Los Angeles, San Bernardino and Santa Clara. It made no recommendations for changes to how Los Angeles runs it programs but suggested that the other three counties amend their contracts with the state by the end of the year to include specific goals.
Sacramento, San Bernardino, and Santa Clara counties, as well as three state agencies targeted in the audit, agreed with the auditor's recommendations to step up reporting and oversight.
PHOTO: The exterior of the Sacramento County Mental Health Treatment Center photographed in 2009. The Sacramento Bee/Carl Costas