[Marin County] Marin officials like grand jury’s mental health plan

Marin County officials, taking a grand jury review to heart, agree that the panel’s proposals for mental health program improvements make sense.

The county administration, expressing support for the jury’s recommendations, said one has already been put to work, and another two will be in short order. County supervisors will chime in Tuesday morning.

An administration report said the budget process will be revised to track individual program costs and benefits using quantifiable data. It added the county intends to find a replacement locale for the Helen Vine Detox Center “within a time frame that avoids a disruption of services” before the program’s lease expires next year.

And a jury recommendation that the county provide more housing for the mentally ill already has been implemented, with this year’s budget providing $10 million more for mental health programs, including $2 million for a residential placement program. About 400 mental health patients are enrolled in county residential programs, according to the administration.

“Yes, we agree with the grand jury on several points,” County Administrator Matthew Hymel said Friday. “Improving our mental health services is a high priority of the Board of Supervisors.”

The administration did disagree with several jury “findings” in its review of the county’s mental health program, including the panel’s assertion that it was “unfathomable” the county failed to provide additional housing for mental health patients during the recession despite available grant money.

“With the onset of the recession and a commensurate decline in new building, additional housing development projects could not be identified,” according to the county.

Officials also lodged “partial” disagreement with jury findings of “major gaps and bottlenecks” in county mental health services, as well as a jury assertion there is no way to determine program effectiveness because “outcome metrics lack clear meaning and their program costs are not defined.”

The county said mental health programs “meet all state and federal requirements for outcome and performance measures,” although more “readily usable reports” would be beneficial for all.

There were 3,700 mental health patients in Marin in fiscal 2012-13, according to Mental Health and Substance Use Services, a division of Marin County’s Department of Health and Human Services that oversees mental health programs. Patients suffered from conditions such as severe schizophrenia, bipolar disorder and major depression.

The county’s budget last fiscal year included $47 million to provide mental health and substance use services. Revenues from state and federal sources provided about $36 million.

The grand jury found that Marin’s mental health “budget process is flawed.”

The grand jury repeatedly requested budget information from the mental health division about its programs, but a budget for each program could not be provided. Instead the panel said it was told, “Marin County department budgets are developed based on cost centers and organized based on state required templates, which are not program specific.”

 “The county can and should use the same state data to develop its own budgeting system that tracks individual program costs,” the jury concluded.

July 31, 2015

Marin Independent Journal

By Nels Johnson