To combat workforce shortages with scholarships, California bill aims to strengthen mental health courts

A seemingly innocuous proposal to provide scholarships for mental health workers in a new California court-ordered treatment program has sparked debate over whether the state should prioritize the program or deal with it. and severe staffing shortages in mental health services.

Nine states have already begun offering the Relief, Recovery, and Community Empowerment Act, which Gov. Gavin Newsom (D) signed it into law in 2022 to get treatment for people with untreated schizophrenia or other mental illnesses, many of whom are incarcerated or homeless. But those skilled nurses have often been pulled by counties from other underperforming health programs.

“There’s a lot of turnover that comes with less staff, less treatment resources, and higher expectations for counties to address things like homelessness,” said Scott Kennelly, director of the Department of Behavioral Health. of Butte County. “It’s like I turn on the fire hose and say, ‘Start drinking.’

Sen. Bill Tom Umberg will establish an annual scholarship fund for students pursuing a career in mental health provided they serve three years with the CARE Council. Umberg had requested $10 million for the program, but it is unclear how many students will receive the scholarship, said Jackie Koenig, a spokeswoman for the senator. The bill moved through the legislature without a single senator voting against it.

Umberg, a Democrat from Orange County, said the CARE Council deserves targeted funding because it is a new program, and noted that some state scholarships are available for students pursuing a degree in behavioral health. For example, the government announced in March 2023 that it will provide $118 million in grants to support health providers in 134 non-profit organizations.

“The CARE Council is new, and it’s in a unique area that requires unique skills in behavioral health, dealing with schizophrenics,” Umberg said. “So, we want to encourage people to get into that area, because it’s a challenge.”

But local health officials say that translating professionals to the CARE Council could cause shortages in other programs or force mental health professionals into more burdensome programs.

The CARE Act allows patients or others, such as their relatives, behavioral health care providers, or people they live with, to petition a county court for assistance. People who agree to participate can receive up to 24 months of treatment, which may include substance abuse treatment, stabilization medication, social service connections and housing. It’s one of Newsom’s pilot initiatives aimed at getting some of the 181,000 homeless people off the streets and into housing without using mandatory services.

Only 7,000 to 12,000 Californians are estimated to be eligible for treatment, according to the Justice Department, which helps oversee the program.

The state has allocated $251 million to staff and start the CARE program throughout the current budget year, including $122 million in grants to counties, according to the Office of the National Auditor. At the same time, counties are directed to implement other behavioral health programs, such as telephone crisis groups, and to strengthen mental health services for Medi-Cal patients. . Last year, Newsom also signed legislation that expanded the number of Californians who can voluntarily surrender.

“As a high-level mandate, counties are deploying existing, experienced, and experienced staff to launch and operate Council CARE teams,” said Michelle Cabrera, executive director of County Behavioral Health Directors. Association of California, which supports the bill.

That’s why critics, including ACLU California Action, Mental Health America of California, and other counties, say the CARE Council study should support other county programs that treat people with serious illnesses. psychological and housing instability.

Alexandra Pierce, assistant director of the Merced County Department of Behavioral Health and Recovery Services, said: “Blocking workforce development efforts to one of the new behavioral health systems will not solve workforce problems in across behavioral health services.

County health departments are in the midst of a major shortage of behavioral health workers — operating 25% to 30% below full staff, on average, according to a 2023 internal survey created by an association of county health directors and the University of California-San Francisco Healthforce Center, Cabrera said.

More than a dozen rural and urban county behavioral health directors told KFF Health News that staffing problems are widespread and not unique to CARE Council, pointing to fatigue from when the covid-19 crisis started, there was intense competition from schools, correctional and behavioral institutions. private sector, which can offer skilled doctors high salaries, telecommuting jobs and good vacations.

Michelle Funez, director of Marin County Behavioral Health and Recovery Services, said the CARE Council scholarship can encourage students to pursue careers in the county that support vulnerable people in the community.

Finding the right doctor for the CARE Council can be tricky because the job requires skilled people to work in homeless camps and other unusual locations, Funez said.

“It would seem like we’re looking for a needle in a haystack,” Funez said, from “a small group of workers who have the skills necessary for this type of work, who are also up for the challenge.” .”

The nine divisions that started the special councils have received more than 600 applications in the first 10 months of the program, said Leah Myers, a spokeswoman for the state Department of Health Services, which helps oversee the program. The remaining 49 counties are scheduled to launch their programs on December 1.

There has been initial success with the program. A year later, San Diego County is starting to “graduate” patients, meaning they have received treatment and made enough progress to leave the court system.

As more counties offer CARE Councils, they will need more doctors. A scholarship program, some districts said, could help. But the price of the bill could be its downfall. In June, Newsom signed a federal budget closing an estimated deficit of $46.8 billion, and last year he rejected hundreds of bills, many of them on spending. Newsom’s spokeswoman Elana Ross declined to comment on the move.

Newsom has until the end of the month to sign or reject the bill.

This article was published by KFF Health News, which publishes California Healthline, an independent service of the California Health Care Foundation.

This article is reprinted from khn.org, a national newsroom that produces journalism on health issues and is one of the main programs operating at KFF – an independent source of health policy research. beauty, elections and journalism.