Breach of public trust in Ventura County’s mental healthcare system
4 min read
In December, the Ventura County Board of Supervisors voted to delay implementation of a new law that was scheduled to go into effect on Jan. 1. SB 43, a bill that amends the definition of “grave disability” to allow counties to intervene to help people who are struggling to provide for their own necessary medical care because of mental illness and substance use disorders, will save lives.
According to VCMC Dr. Vlaskovits’ recent letter to the editor in support of this delay, the state legislature has not provided for the “necessary infrastructure (primarily acute care, sub-acute and long-term psychiatric beds to meet the drastically increased demand …)” in order to be able to treat these individuals who need services.
The truth is that the state has provided opportunities for counties to bolster their continuums of care. In 2021, the legislature passed the Behavioral Health Continuum Infrastructure Program, granting over $2.2 billion to counties to meet the needs of vulnerable populations with the greatest barriers to access, including people experiencing homelessness and jail. Over five rounds of funds have been awarded and almost all counties, including those bordering ours, received millions for hundreds of beds, infrastructure, and intensive treatment. In one round, 45 counties were awarded $518.5 million for crisis stabilization units (CSUs), intensive outpatient treatment facilities, psychiatric health facilities (PHFs), acute psychiatric hospitals and mental health rehabilitation centers (MHRCs) for a total of 208 beds and 18,206 annual treatment slots — none of this money went to Ventura County.
In another round, 33 counties were awarded a total of $430 million for similar projects, totaling 916 beds and 73,848 annual treatment slots; again, none of this money went to Ventura County. Instead of working to make itself eligible for these grant funds and instead of using the funds it does have to bolster a continuum of care, Ventura County uses the over $100 million of mental healthcare funds it receives annually to funnel people with mental illness into our jails and to pay for out-of-county facilities to treat and house Ventura County residents with mental illness.
Ventura County is an outlier in the state for its lack of infrastructure and planning for this population; the money is available, but the needs of its most ill and vulnerable citizens have never been prioritized. The failure to plan and invest wisely to care for people who live with serious and disabling illnesses is fiscally irresponsible as it increases long-term costs exponentially across numerous county departments and communities.
Stewardship of the funds we have for mental health services is crucial. Every year, the state monitors counties for their use of these funds. Counties that do not spend the money within a specific timeframe must revert unspent funds back to the state. In fiscal year 2018-19, Ventura County had, by far, the largest reversion amount in the state — $2.68 million. Ventura County was the only large California county and one of only 19 counties required to revert mental healthcare funds because of its failure to spend it within the requisite timeframe, even after maxing out the prudent reserve. In fact, for funds reverted that year, excluding counties where data was incomplete, Ventura County’s reversion accounted for approximately 47% of all funds reverted to the state.
Too many people remained untreated, and we have too many tragedies in this county to justify mismanagement of funds and indifference to the need. The county has been sued numerous times relating to the failure to provide treatment to county residents, including the Tomoko Hoetzlein tragedy in which our CEO is a named defendant in a federal lawsuit.
In 2021, Ventura County received $164 million from the American Rescue Plan Act. Supervisors allocated $15 million for the MHRC and $7 million for an East County CSU. Where is that money now? We have not broken ground on an MHRC, and we have no $7 million CSU in the East County.
In 2023, the county received a $30 million windfall of Mental Health Services Act (MHSA) funds to provide housing assistance to target populations to build housing for homeless mentally persons or mentally ill persons who are at risk of being homeless. The county represented that it would use $20 million of this money to build the MHRC promised over three years ago. Historically, MHSA money is not available to fund these facilities and it is unlikely that the state will allow Ventura County to use this money for the MHRC.
This is the pattern and practice of those in charge of spending mental health dollars in Ventura County — delay, make representations of more services with no follow-through, spend the money outside the county, mismanage the funds that we do have, and give money back to the state.
The Board of Supervisors is tasked with overseeing county departments. If the board does not require accountability from its departments, constituents can hold supervisors accountable. This is an election year. Fiscal responsibility, accountability, and the public trust are on the ballot.
Mary Haffner, a partner in the law firm of Haffner Law Group, served on the Ventura County Behavioral Health Advisory Board from 2015-2021.
link
