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HomeMy WebLinkAbout18 - Proposed Temporary Emergency Shelter for Homeless Individuals Located at the City Corporation Yard at 592 Superior Avenue - CorrespondenceCITY OF COSTA MESA 77 Fair Drive I P.O. Box 1200, Costa Mesa I California 92628-1200 Phone 714.754.5285 1 Fax 714.754.5330 1 www.costaniesaca.gov From the Office of the City Council September 23, 2019 Newport Beach City Council 100 Civic Center Drive Newport Beach, CA 92660 Received After Agenda Printed September 24, 2019 Item No. 18 SUBJECT: COMMENTS ON PUBLIC HEARING ITEM NO. 18 - PROPOSED TEMPORARY EMERGENCY SHELTER FOR HOMELESS INDIVIDUALS LOCATED AT THE CITY CORPORATION YARD AT 592 SUPERIOR AVENUE Dear Mayor Dixon and Members of the City Council: I understand that on Tuesday, September 24, you are considering options to create a temporary 14 -day, 40 bed homeless shelter on City -owned property at 592 Superior Avenue, While I am encouraged about your desire to take action to address rising homelessness in our region, as the District 5 Representative, I oppose the proposed project plan and location which cause immediate concerns. The project you are considering will concentrate impacts and may compromise both public safety and economic growth in an area long -impacted by homelessness and currently under revitalization. As you are likely aware, Costa Mesa has taken significant action to address homelessness. We hired a professional shelter operator and established a temporary homeless shelter earlier this year, are developing a more robust facility to be opened next year, and developed a comprehensive management, operations, and security plan that is working to end homelessness in our city. We developed our model after substantial research, analysis of many potential locations across the city, and in-depth discussions with professional shelter operators and our community members. Six months into operation, our model has proven successful in both helping people out of homelessness and improving public health and safety in the surrounding neighborhood. Our shelter model is successful and cost effective, resulting in transitioning 18 clients into permanent housing with more in process every day. I am proud of the model we implemented because we are solving the problem rather than shifting the problem. MAYOR I MAYOR PRO TEM I COUNCIL MEMBER I COUNCIL MEMBER I COUNCIL MEMBER I COUNCIL MEMBER I COUNCIL MEMBER Katrina Faley John B. Stephens Andrea Marr Manuel Chavez Arlis Reynolds Sandra L. Crenis Allan R. Mansoor At Lai e At Lar e Digtrict 3 District 4 District 5 At Lenge At Lenge September 23, 2019 Page Two Mayor Dixon and Members of the City Council Costa Mesa's shelter model works because it is comprehensive and reflects a "Housing First" approach. Anything less, such as the model I understand you may be considering, may only shift the issues you are trying to solve and has the potential to undermine the shelter model that we have worked diligently to create. Ending homelessness in our cities requires a comprehensive plan, appropriate investment, community buy -in, and coordination with your neighbors. I urge you to oppose staff's recommendation with this project and instead request that you continue to engage in productive and forward -thinking conversations with the City of Costa Mesa to explore opportunities for a more collaborative and cooperative approach to sheltering homeless individuals, which can have a far better benefit than Newport Beach moving forward with any homeless shelter project unilaterally. Thank you, Arlis Reynolds, Councilmember, District 5 r`Dyt+w AIiFs9 =IL's 'clfl of lflE�ATS: �C CITY OF COSTA MESA Received After Agenda Printed September 24, 2019 Item No. 18 77 Fair Drive I P.O. Box 1.200, Costa Mesa I California 92628-1200 Phone 714.754.5285 1 Fax 714.754.5330 1 www.costamesaca.gov I Katrina.Foley@costamesaca.gov From the Office of the Mayor Katrina Foley September 23, 2019 Newport Beach City Council 100 Civic Center Dr. Newport Beach, CA 92660 Dear Mayor Dixon and Members of the City Council, As Mayor of Costa Mesa, it is my duty to look out for the best interests and well-being of the residents of my city. While I recognize Newport Beach is seeking to take action to address homelessness, the proposal under consideration, to move forward with a concept to create a temporary homeless shelter located at 592 Superior Avenue, concerns me. The City of Costa Mesa's highly successful temporary bridge shelter is situated in close proximity to your proposed site, and one of the program's shuttle pickup/dropoff locations is directly adjacent, locating an additional shelter in this area under separate jurisdiction, and with a different operational model, may compromise the Costa Mesa shelter model that the City has worked diligently to create. Your consideration of this site causes serious concern for the Costa Mesa City Council, specifically regarding the potential negative impacts on residents of Costa Mesa's 5th Council District. The City of Costa Mesa previously considered possible shelter sites within this neighborhood, and rejected them due to the previously mentioned potential negative impacts on the surrounding community. Furthermore, the City of Costa Mesa located its shelter entirely within the City, and extensively engaged the surrounding and citywide communities to assist staff in vetting the proposal before moving forward. While we respect your efforts to explore various solutions to address homelessness in your community, we strongly urge you to continue to engage with the City of Costa Mesa in a productive, cooperative dialogue focused on a collaborative approach to addressing the homeless situation. The potential greater benefit of our collaboration stands in stark contrast to the potential negative impacts to Costa Mesa, and the neighborhoods of our 51h Council District, that could result from your taking unilateral, uncopperative action. Katr of y Mayr City if Costa Mesa MAYOR MAYOR PRO TEM COUNCIL MEMBER COUNCIL MEMBER COUNCIL MEMBER COUNCIL MEMBER I COUNCIL MEMBER nu Katrina Foley John B. Stephens Andrea Marr Manuel Chavez Arlis Reynolds Sandra L. Gents Allan R. Mansoor At Large At Large DistrW 3 District 4 District 5 At Large A La ,ge Recieved After Agenda Printed September 24, 2019 Item No. 18 From: Jeanine Miller <nene_sd@yahoo.com> Sent: Tuesday, September 24, 2019 2:22 PM To: Dept - City Council Subject: Fw: Please Share - Newport Beach Homeless Plan Newport Beach City Council, This email is to voice opposition to the proposed location for the Newport Beach Homeless shelter on Superior Avenue This proposed location is just 1 mile from our new homeless shelter in Costa Mesa. It's technically on the same street. This location would have a very negative impact on Costa Mesa and everything we, as a City and community, have been working so hard to turn around. This area is already too impacted by homelessness and everything that goes along with it! Costa Mesa City Council, Mayor, and residents took steps within our own City and community to assist with this growing problem by engaging experts and working together as a Community. Newport Beach needs to do the same within their own City. It has taken us so long to finally see a slight improvement with the homelessness in this area (and the problems that go along with it), going backwards now, by adding to the problem with the location of yet ANOTHER homeless shelter in the same location as many of our current problem area's, is inexcusable. Though I understand Newport Beach residents would like this problem as far from sight as possible and away from their homes, so do Costa Mesa residents! We are of no less value due to our different zip code. We want to raise our children in a clean and safe environment the same as Newport Beach residents do. Costa Mesa residents have bore the brunt of this issue for long enough, it's time for our city neighbors such as Newport Beach, to do their part! Select a location WITHIN your City Limits, and not at the border with Costa Mesa where the impact of homelessness is already great. Selecting a site within one City block of Costa Mesa city limits, in an area well known for existing homeless issues, is a shameful move by the City of Newport Beach. We encourage the City of Newpert Beach to engage with experts as our City has done, as well as work with community members to earn community buy -in, and learn from the successes of Costa Mesa's shelter program. Do your part and we will continue to do ours. Sincerely, Jeanine Miller Concerned Costa Mesa Resident Recieved After Agenda Printed September 24, 2019 Item No. 18 From: Michael Caruso<michael.caruso@theagencyre.com> Sent: Tuesday, September 24, 2019 2:32 PM To: Dept - City Council; Duffield, Duffy; kmuldoon@newportbeachca.gove; Herdman, Jeff; Brenner, Joy; Dixon, Diane; Avery, Brad Cc: Michael Caruso; Cristina Caruso Subject: Newport Beach Homeowners - Opposing Homeless Shelter Dear Newport Beach City Council Members: My name is Michael Caruso. My wife Cristina Caruso and I own a new home in Newport Beach. We can be reached at our office: 949-220-0750 or mobile lines: 949-584-2300 and 949-584-2200. This email is to register our formal opposition to a homeless shelter proposal at 592 Superior for reasons associated with legal and social implications, as listed below: 1. Close proximity to 3 schools and child safety concerns, young adult safety concerns, drug use exposure. 2. Close proximity to 2 parks (Heller and Bolsa) which would likely become drug traffic / drug exchange havens. 3. Close proximity to renowned Hospital and Medical Centers. 4. Close proximity to senior living facilities and the safety of guests who visit the elderly in these centers. 5. It will impede the continuance of long awaited redevelopment in West Newport and halt its economic resurrection. 6. It will endanger the young families, their infants and newborn children investing in homes within that area. Will everyone become a prisoner in their own home for safety reasons? 7. Pollution and Hepatitis A, toxic contamination and vermin on public property. 8. The need for additional police reinforcement in the area. 9. The concept of this homeless station drawing additional homeless from other areas to a glamorous beach location. 10. The concept of having Superior Avenue become the next homeless corridor in Orange County. 11. Environmental impact of public property. 12. Substantial erosion of residential property value in areas that are just recently evolving into pride of ownership areas in West Newport after decades of being a blighted area. 13. Local businesses having their business traffic slow down, hurting their ability to remain open, forcing unemployment and bankruptcy. 14. The precedent of non-success has been set with similar shelters backfiring in San Clemente and San Juan Capistrano. 15. Proper Disclosure - There are 33 open escrows at Ebb Tide Development that do not know about this temporary shelter idea. The non -disclosure would likely create a class action. Researchers and psychologists classify the homeless situation in many instances as a lifestyle choice with high drug use or the result of mental illness. While we understand and empathize with these studies, we oppose the 592 Superior location as a resting place for homeless and it does not solve any problems we face locally or nationally. Rather, it adds complications, undesirability and resulting asset devaluation to Newport and in particular to the West Newport areas as well as egregious safety concerns for the citizens of Newport Beach, and contamination / health concerns for residents. THEAGENCY A Global Marketing and Sales Organization MICHAEL CARUSO Broker of Record CA Managing Partner, Orange County t: 949 220 0750 1 m: 949 584 2300 TheAgencyRE.com Lic# 01073919 Recieved After Agenda Printed September 24, 2019 Item No. 18 Recieved After Agenda Printed September 24, 2019 Item No. 18 From: Carole Santos <csantos6243@gmail.com> Sent: Tuesday, September 24, 2019 2:46 PM To: Dept - City Council Cc: arlis.reynolds@costamesaca.gov Subject: Proposed Newport Beach homeless shelter near Costa Mesa's westside Attn: All Newport Beach City Council Members Ladies and Gentlemen: We are property owners in Westside Costa Mesa. We oppose the proposed Newport Beach shelter location in Westside Newport, adjacent to Westside Costa Mesa. Your proposed approach and location at 592 Superior, less than one mile from Costa Mesa's established shelter, risks compromising public safety and economic growth in this area which is very close to our property. A successful shelter program requires a comprehensive plan, appropriate investment, community buy -in, and coordination with neighbors. The location consolidates and impacts an already heavily -impacted area. Newport Beach must engage with experts and community members to earn community buy -in, and invest in a robust shelter model that works rather than just shift impacts onto specific neighborhoods. Once again, we oppose this proposed location site for a homeless shelter. September 24, 2019 Item No. 18 From: Jacobs, Carol Sent: Thursday, September 19, 2019 10:21 AM 4aE �PoRT _ Brown, Leilani ,ct: FW: A NB West Side Resident Outreach Should Be Called By the Task Force �ClFpRNr' For the City Council. Carol Jacobs I assistant Cite .l[ana cr I CitN o('Newport Beach 100 Civic Cantel- Drive J Newport Beach, CA j 92060 ciacobsQne Tortbeachca.gov Phone: (949) 644-3313 1ax: (949) 644-3020 From: Jimmy Thomas Sent: Wednesday, September 18, 2019 7:02 PM To: Avery, Brad ; Brenner, Joy; O'Neill, William ; Cameron, Helen ; Heffernan, John ; Moore, Terry; Peterson, Thomas; Snow, David ; Voorhees, Cindy; Wegener, Jean ; Jacobs, Carol ; Wegener, Jean Subject: A NB West Side Resident Outreach Should Be Called By the Task Force 9/18/19 RE: A NB West Side Resident Outreach Should Be Called By the Task Force Dear Sir, Yesterday, I wrote a letter regarding the problem with locating a single temporary homeless shelter on the west side of the bay. A copy of that letter follows this one. I conveyed unease since a single temporary homeless shelter on the west side is unfair. Fact is the single Superior Ave approach negatively impacts the west side of the bay. West side NB residents need more information and a forum to be heard. I ask the City Council to instruct the Task Force to do more work. I ask them to update their findings to consider west side resident input collected in a west side NB resident outreach session. Specifically: Currently, the homeless population is spread on both sides of the bay. The Superior solution would shift the entire city's homeless population to the west side of the bay. This is unfair, and it is the city council's responsibility to not let that happen. Our homes would be less desirable because our homeless population would swell while theirs plummets. Because of this inequity, the committee needs to take another look at the downside of establishing a single temporary homeless shelter on Superior. Relocating the problem to one side of the bay in the name of enforcing anti -camping ordinances does not work for us. The Task Force should be able to find a way that anti -camping ordinances can be enforced without shifting the entire homeless burden to the west side of town. NB residents west of the bay would experience significant negative impact. Legally, I would like to think an impact of this magnitude requires an EIR that reveals the downside and mitigation of these impacts. If not, we need some kind of honest disclosure. I ask the Task Force to call a community outreach session for NB residents west of the bay. It would be best if residents are notified by US mail. I would hope one or more city council members would be present. Most people I talk to know nothing of this major item. I researched the address of everyone on the Homeless Task Force, and I found a sizable overrepresentation of east bay NB residents. I am trying to grapple with a Task Force stacked with east of the bay residents finds the "only possible" solution is temporary shelter on the other side of the bay. I recommend west bay residents are added to the Task Force such that our interests are fairly represented in the findings before any outreach occurs. Frankly, in my opinion, the west side of the bay resident is considerably better off now than they would be if a single temporary Superior shelter is established. The ability to enforce anti -camping laws does not offset the negativity of relocating 100% of the city's homeless population on our doorstep. The Task Force should be able to do better than this Thank You Jim Kociuba, 407 Fullerton Ave. From: Jimmy Thomas <itx12@hotmail.com> Sent: Tuesday, September 17, 2019 8:43 PM To: bavery@newportbeachca.gov <bavery@newportbeachca.gov>; joy@newportbeachca.gov <loy@newportbeachca.gov>; woneill@newportbeachca.gov <woneill@newportbeachca.gov>; hcameron@newportbeachca.gov <hcameron@newportbeachca.gov>; iheffernan@newportbeachca.gov <iheffernan@newportbeachca.gov>; tmoore@newportbeachca.gov <tmoore@newportbeachca.gov>; tpeterson@newportbeachca.gov <tpeterson@newportbeachca.gov>; dsnow@newportbeachca.gov <dsnow@newportbeachca.gov>; cvoorhees@newportbeachca.gov <cvoorhees@newportbeachca.gov>; iwegener@newportbeachca.gov <jwegener@newportbeachca.gov>; ciacobs@newportbeachca.gov <ciacobs@newportbeachca.gov>; iwegener@newportbeachca.gov <iwegener@newportbeachca.gov> Subject: Re: Temporary and Permanent Homeless Shelter In the following letter, I refer to West Newport and East Newport. When I say West Newport, I mean all areas of Newport Beach that is west of the bay. Likewise, when I say East Newport, I mean all areas of Newport Beach that is on the east side of the bay, including CdM and Newport Coast. Sorry if there is any confusion. Jim Kociuba From: Jimmy Thomas Sent: Tuesday, September 17, 2019 7:36 PM To: bavery@newportbeachca.gov <bavery@newportbeachca.gov>; joy@ newportbeachca.gov <ioy@newportbeachca.gov>; woneill@newportbeachca.gov <woneill@newportbeachca.gov>; hcameron@newportbeachca.gov <hcameron@newportbeachca.gov>; iheffernan@newportbeachca.gov <iheffernan@newportbeachca.gov>; tmoore@newportbeachca.gov <tmoore@newportbeachca.gov>; tpeterson@newportbeachca.gov <tpeterson@newportbeachca.gov>; dsnow@newportbeachca.gov <dsnow@newportbeachca.gov>; cvoorhees@newportbeachca.gov <cvoorhees@newportbeachca.gov>; iwegener@newportbeachca.gov <iwegener@newportbeachca.gov>; ciacobs@newportbeachca.gov <ciacobs@newportbeachca.gov>; iwegener@newportbeachca.gov <iwegener@newportbeachca.gov> Subject: Temporary and Permanent Homeless Shelter 9/17/19 RE: Temporary and Permanent Homeless Shelter Dear Sir, My name is Jim Kociuba and I am a NB resident living on the west side of the bay. I am concerned about the fairness of establishing of a single temporary homeless shelter in West Newport Beach. Currently, the homeless burden is distributed across East and West Newport. A temporary shelter in the airport area would reduce the homeless problem on both sides of the bay. That is an impartial solution for all residents. I urge the city to adopt a temporary homeless shelter in the airport area. However, if the airport location can't be selected, then we have a political problem. Let's just call a spade a spade. East Newport residents would love to see a single temporary shelter in West Newport since it shifts their homeless problem miles away. Likewise, West Newport residents want to see it in East Newport. When the smoke clears, that is what we are looking at here and it is the responsibility of the city leaders to help the homeless while avoiding an unequitable solution for either side of Newport. Some East Newport residents suggest that West Newport need not worry because it is just a "temporary" shelter. However, that argument does not account for the substantial risk that future politics, regulations, or rulings may eliminate a permanent shelter from the equation. In that case, the West Newport temporary shelter morphs into a permanent shelter which is completely one-sided. Residents from the east other side of the bay postulate that homeless services are better in West Newport than anywhere else so the temporary shelter needs to be on the west side. Fact is there are premier homeless services all over Southern California. We are talking about county wide homeless services being a bus ride away and the bus station is right next to Fashion Island. Frankly, most homeless are quite capable, they frequently use public transportation, and a bus ride will not stop anyone from seeking help. Another argument centers around land use restrictions. Some claim the homeless situation is so dire that there is no time to revise zoning for a temporary homeless shelter. Without the airport option, that narrative forces a single temp shelter in West Newport Beach. The homeless situation has been around for many years, so a knee jerk solution is not defensible. We have the time to get the zoning fair such that we can have a smaller temporary shelter on each side of the bay. A final option is a temporary shelter is never set up. Instead, we continue to live without a temporary shelter while the permanent shelter is established. While this would delay the enforcement of anti -camping laws, in the name of fairness, the homeless problem remains shared and I would favor this over a west side only solution . I would like to think most NB residents support helping the homeless. I would also like to think most NB residents believe in fairness. I fully support establishing a temporary, and eventually a permanent homeless solution, as long as I see both East and West Newport hosting shelters. However, I don't want to see the homeless solution gamed such that West Newport takes the entire hit. I strongly support helping the homeless, but I am not a martyr. Thank You Jim Kociuba, 407 Fullerton Ave. Received After Agenda Printed September 24, 2019 Item No. 18 From: Rieff, Kim Sent: Thursday, September 19, 2019 4:33 PM To: Mulvey, Jennifer Subject: FW: Voluntary Temporary Homeless Shelter Program Attachments: Voluntary Temporary Homeless Shelter Program.pdf From: dave@earsi.com <dave@earsi.com> Sent: Thursday, September 19, 2019 3:58 PM To: Dept - City Council <CityCouncil@newportbeachca.gov> Cc: Harp, Aaron <aharp@newportbeachca.gov> Subject: Voluntary Temporary Homeless Shelter Program Hello Mayor Dixon and Members of the City Council, I am aware of the City's efforts to solve the issue of homelessness for the benefit of these individuals in need, as well as the residents and the businesses of Newport Beach. After studying the issue I have developed a Voluntary Temporary Homeless Shelter Program that may help the City solve this problem for City linked homeless individuals willing and able to work. Given the urgency of this problem, I though it best to forward my draft proposal now rather than wait until the next Council Meeting. I would appreciate your consideration of this draft proposal. Thank you, David Tanner 223 62nd Street Newport Beach, CA 92663 949 233-0895 cell September 19, 2019 Voluntary Temporary Homeless Shelter Program This proposal calls for Newport Beach businesses to address Newport Beach's homeless problem through a voluntary program. One where the private sector can approach local governments, indicate its desire to voluntarily assist in this humanitarian cause. Where local governments thank them, publicly acknowledge their efforts, and provide their full support. If this Program is successful it can be a template for other communities within the state and throughout the Country. Program Overview: A City program which permits Newport Beach businesses to establish temporary homeless shelters on their properties if the businesses agrees to the following 2 conditions: 1. House no more than 2 City of Newport Beach linked homeless individuals or one family unit on the business's property; and 2. Provides paid employment to the homeless individual(s). City's Role: 1. Expedite the adoption process for this Program. 2. Provide initial screening of business to make a finding the business is "Qualified" 3. If needed, provide expedited permitting to businesses (Example: Staff approval of a temporary parking variance if the business (example: church) wants to locate a trailer to house the homeless in its parking lot resulting in a parking deficiency). 4. Make available the full resources of the City to assist the businesses accomplish this humanitarian task. S. Provide incentives to local businesses that request incentives (Examples: reduced business liability and provide financial assistance if needed). Renefits- 1. This decentralized approach avoids problems associated with clustering homeless individuals in larger shelters. 2. Provides temporary housing, food and clothing for homeless individuals or families willing and able to work. 3. Provides humanitarian services to the homeless upon request of the business. 4. Addresses drug addiction, discarded drug paraphernalia, defecation in public, loitering and reduces the number of homeless individuals linked to the City of Newport Beach. 5. Provides the homeless paid employment and a path to reintroduction into the community. 6. Reduces the potential for the homeless to be criminalized for "quality of life" violations. 7. Demonstrates action on behalf of the City Council to provide temporary shelters to many of the homeless linked to Newport Beach. 8. Potential cost savings compared to other alternatives being considered. The City Can Lead By Example: Who would argue or threaten to sue if the City's Police Department volunteered to temporarily house and employ one or two homeless individuals or a family? Other possibilities include the City's fire stations, corporate maintenance yard, Harbor Department, etc. Use of City facilities can easily provide temporary homeless shelters to 10-15% of the City of Newport Beach's linked homeless population. Dave Tanner 223 62nd Street, Newport Beach, CA 92663, Phone: 949 233-0895 cell Received After Agenda Printed September 24, 2019 Item No. 18 From: Leung, Grace Sent: Friday, September 20, 2019 4:22 PM To: Harp, Aaron Cc: Brown, Leilani; Jurjis, Seimone Subject: FW: 592 Superior Temporary Emergency Shelter Attachments: 592 Superior Homeless Shelter Letter - Signed 20190918.pdf From: Janssen W [mailto:janswee@gmail.com] Sent: Thursday, September 19, 2019 2:36 PM To: Leung, Grace <gleung@newportbeachca.gov>; Basmaciyan, Natalie <nbasmaciyan@newportbeachca.gov>; Jacobs, Carol <cjacobs@newportbeachca.gov>; katrina.foley@costamesaca.gov; Avery, Brad <bavery@newportbeachca.gov>; Brenner, Joy <JBrenner@newportbeachca.gov>; O'Neill, William <woneill@newportbeachca.gov>; Cameron, Helen <hcameron@newportbeachca.gov>; Heffernan, John<JHeffernan@newportbeachca.gov>; Moore, Terry <TMoore@newportbeachca.gov>; Peterson, Thomas <TPeterson@newportbeachca.gov>; Snow, David <DSnow@newportbeachca.gov>; Voorhees, Cindy <CVoorhees@newportbeachca.gov>; Wegener, Jean <JWegener@newportbeachca.gov> Cc: karena gibbs <karenagibbs@yahoo.com>; Valerie Shedd <vshedd@icloud.com>; Kevin O'Connell <kevin@oclm.com>; MJP0716 <Mjp0716@yahoo.com> Subject: RE: 592 Superior Temporary Emergency Shelter Dear Newport Beach City Council Members and Homeless Taskforce Committee Members, I hope this email finds you well. I am writing to you on behalf of several residents in the Level 1 Community and business owners nearby the proposed shelter at 592 Superior Avenue. Please also refer to the signed copy of this letter attached to this email. The residents of the Level 1 Community (located on Industrial Way and Newport Beach Frontage Road) and nearby business owners and operators objects to the proposal of a temporary shelter located on 592 Superior Avenue. Our residents are only a mere couple hundred yards from the proposed site. We fear that this proposed shelter will only worsen our quality of life, increase crime, and reduce our property values. We believe there are better alternative locations for this shelter that won't adversely impact residents. Please review the list of issues we would like to bring to the Committee's attention: 1. We fear that the homeless shelter will substantially decrease property values of surrounding homeowner community including Level 1's and make this neighborhood a less desirable place to live. Homeowners may have to bear additional costs including security and higher insurance premiums 2. The residents of Level 1 already bear a substantial portion of the homeless problem for Costa Mesa and Newport Beach with the presence of Share Our Selves nearby. There is no way to contain the flow of people between Costa Mesa and Newport Beach 3. We are concerned that crime will increase in our neighborhood. We already do not feel safe walking our dogs or having our children play outside unattended with Share Our Selves and the shelter will exacerbate this. Our community already experiences high incidents of trespassing, squatting, vandalism, automobile break-ins, unauthorized water use, and package theft due to Share Our Selves. Loitering and temporary encampments are already very high in this area. This emergency shelter will only make it worse 4. Pomona Avenue to Industrial Way is a route used by school -aged children to go to the Newport Mesa school district. Their commute and safety will be negatively affected 5. We ask for a higher police presence from Newport Beach and Costa Mesa PD right now to mitigate repeated crime in our area 6. We ask the City Council to look for alternative locations that are more industrial and commercial and not within direct proximity to homes and communities, such as the warehouse district west of Placentia 7. We would like a copy of the Environment Impact Study done for this proposed site 8. We ask the members of this committee to give us more details on the proposal, remediation plans, and timeline of events so that we can work together on a more robust solution to curb the impact of homelessness in the area Some of the residents and business owners in this area will be attending the public hearing next Tuesday, September 24th to voice their concerns. Respectfully, Residents of Level 1 Community and Business Owners, Costa Mesa Septernber 20, 2019 City Council Charmers 100 Qivic realer Drive Newport reach_ CA 926$0 Dear Newport Beach City Council Members and Homeless Taskforce Committee Members, The Level 1 Commvnity located on Industrial Ways and Newport Beach Frontage Road objects to thff proposal of a temporary shelter located on 522 Superior Avenue. Our residents are only a mere couple hundred yards from the proposed site. We fear that this proposed shelter will oniy worsen our quality of life, increarse crime, and reduce our property values. Plewe review ft list of isaries we would lime to bring to the Cornmittee's attention_ 1. We fear that the hanri less. shelter will substarbally decrease prop" values of surrounding homeowner communi y including Level 1's and make this neighborhood a less desirable place t,o lure. Homeowners may have to Isar odditionial Cfists itwdUdIFIg SSCuritk 8nd higher insurance prer ri luras 2. The r-sidents of Level 1 already bear a subvtantial portion of the homeless probWm for Com Me&a and Newport Beach with the presence of Share Our Selves nearby_ There is no way to cantafn tha flow Df people between Co to Mesaand Newport leach 3. W* are concerned that crime will increase in our neighborhood. We already do not feel safe walking our dogs or hawing our children play outside unatte+'rded With Share Our SC#ras a+kd the shelter will exacerbate this. Our communify already experimances high incidents of trespassing, squatting, vandalism_ automobdle break-4ns. vneuthwized water use, and package theft due to Share Our SeWes. Loitering and temporary encampments are already very high in this area. This emergency i halter wit only make it worse 4, Pomona Avenue 10 fnbu&trial Icy is a route used by school -aged children to go to the Newport Mesa sahooi district. Thei r comm ute and 6$fety wall be negativeily affected S. We ask for a higher police presence from Newport Beach and Costa Mesa PC) right now to mitigate repeated gime in our area $. We ask the City Council to look for eNemative locatlon5 that are more ind us rial and commercial and not wrthin dired proxirrrily to homes and communities, such as the warehouse d iStriC I WG!Yt 4f P IaCer%tia 7 would lila a copy of the Environment I mpact Study done for this proposed site 8. We ask the members of this committee to give us more details on the proposal, remediation plans, and timeline of events so that we can work together on a more robust solution to curb the impact of homelessness in the area Respectfully, Residents of Level 1 Community, Costa Mesa Name: Sar 5S" vi -e- e Address: 15 31 MfXwe I I Way , C'osrA Mesa, CA 12-01 Email: A� @ hO�M�I� Signature Name: W�l'�te� �" ` Address: (�J�-`'i Su. (i ✓omav{ , nq � u21 Email: ���2 `� 1 to z5ry ju e Name: '`-`'` l���,R "� Address: l At %JAV Email: Signatures � `- Name: e < r " ►� Address: Email: �Oj `''Ylrrt_VJ Signature ` � I C OL44 - � (A- -2 ,2, 7 - Name: � ':l o^✓�>'.+%s/���Address: A Email: ci.�s-,co�/. [yvsr7'��,y���nature Cv,tT.r yyssp 1�2,��i Name: by -oval Email: i Name: Email: `�-n�v �✓1ci ulQb S -t- Name`"�c•r,r� Email:nhna.w,ence� _ rI -may lA>' Address: Signature Address: Signatur C C awL-7) 2 Name: Uw�� 670 Address: 1 S I O`O Vfr,�--, fiVi Email:OwiN ?ffj6C6P'A L-.0 Signature Name: �A�ef `` �Gt,I AAII Address: � C.&- Email: AmAaw>° . GAm Signature Name: At AvJOJA L Address: Email: Ma )It. Signature Name: P D V ,4� Address: VII rj &Lf)t LMVI Email: i Signature _ �l ova vvoq Q w^ Q . c-,"^ Name: I'aw Lq VT W WKAddress: (49 Email: pa lu rt PI3� � gnature Lf Name: V L) Address: Email: �U ��`�C %dNl.�KI?�4:0 mature Name: Address: D I Gy( Email: Signature Name: 6421+41� 5r-141N5kl Address- 1521 ��cEnJiv)e wx1� Email 13CMtOMCA INSic: I c, Signature Name: C alzl_%� Address: ISZ`i GIG-6zNwkc* t�n� Email: i .i., -i itSROpnkSeCz r'1 A11-CcrSignature Name: Address: IS3� Ci dee (1 cit �a� Email:;�� I �O(�yo c �+M Signatures Name: f-FA141< l tl.-�M0 Address: � M^U-e!( I/,Ay Email: ' fO,"kO j'{Awe uL-j-;wo Signature I Cn V, Noma: Address- Email: signature - Name= _ � L L Add ress: & 11\4 4ry Email, r aLk, Signatufa . .. �., Name: Address' JL Email: i ignature N:arre; 1 SfTi Address; . Email- 1 �6,;;gnatr� re Carr: Add resp' Email: 1 .n r C:.0 a Loter o� gnahure �:. Nrrr$-IL 14 Addras: Email: S ignatijte J s Niorrre: Addrass: Email' 1 Signature Name= Lfti Adds_ Email; Sig Name= �f�cll�' 1# Add resp. Email; a. ignature Name- , i �i Addr ; Efnigil:aignature 11 �'F-� ftv-c�- V-7-� !1 Ii Vow VC/V) LCP-- Name: ��'.'Add re, 1� Email: � 4� � �� � �� id,� [0 5 6ature 5L M VLL•M �;.VVIr4J + f �r September 20, 2-019 Addewid um to Letter: Buaiinms Owners and Operators near 592 Superior Avenuo The folk wMg business owners and operators of C09ke Mese alae objets wr h the proposal for a temporary bridge sliebte€ w 592 Superior Avenue fDr scimitar reasons as stated in the original fatter SQMd by the rec idents of the Level, 1 Community. Business Owners and Operators, Costa Mesa Business Email: Buskness Name: 1�-� •�I e4U- Name: - -- Address_ Vh )Ifl?Z • -Em WE Signature } ...&--i4 Business Business dame: VM Mame_ ai4 f �' 4 _ Address= HWneas Name: // Narrw; Add resa: + }, Email: Signature BusirleaaNanioe- ]ams: r'� Address:' Email: Sig n0ure Business Name: +�� ; z Address_ Email-. ftnature 5 Business Name' A�:�� Name- Ernsil" iyly -- 1 s Addy: l NaTne: A Erriail- Busirles� ���-AMPI y• irk[ Iter i _rte._• .��. _. .. - • _ g�i�rtufe all: d 'B"ness !deme' irchf Email, 'I Bu:sinGsr>Narno' ` N21 �: Add rasz- Err wil f Email - 4e, Sid naxure - •71 Busi rwss Name; Name, Address: Email: Signature 6 I Received After Agenda Printed September 24, 2019 Item no. 18 Subject: FW: Homeless on SUperior From: constance z <ConstanceBroker@outlook.com> Date: September 20, 2019 at 5:31:53 PM PDT To: "ciacobs@newportbeachca.gov" <ciacobs@newportbeachca.gov> Subject: Homeless on SUperior Why was this location chosen and not Campus Drive. That is very close to private school children and its an outrage that we are forced to deal with drug addicts that choose the life of drugs and the street. What about our children's rights? Despicable — NG City Council needs to fight not cowtow to a weak disgusting governor. Sent from Mail for Windows 10 Received After Agenda Printed September 24, 2019 Item no. 18 Subject: FW: 9/24/19 Agenda Item XVII. (18) Temp Homeless Shelter From: Siobhan Robinson <robiland@gmail.com> Sent: Sunday, September 22, 2019 2:49 PM To: Dixon, Diane <ddixon@newportbeachca.gov>; Avery, Brad <bavery@newportbeachca.gov>; Brenner, Joy <JBrenner@newportbeachca.gov>; O'Neill, William <woneill@newportbeachca.gov>; Cameron, Helen <hcameron@newportbeachca.gov>; Heffernan, John<JHeffernan@newportbeachca.gov>; Moore, Terry <TMoore@newportbeachca.gov>; Peterson, Thomas <TPeterson@newportbeachca.gov>; Snow, David <DSnow@newportbeachca.gov>; Voorhees, Cindy <CVoorhees@newportbeachca.gov>; Wegener, Jean <JWegener@newportbeachca.gov>; Jacobs, Carol <ciacobs@newportbeachca.gov> Subject: 9/24/19 Agenda Item XVII. (18) Temp Homeless Shelter Dear Mayor Dixon, Newport Beach City Council Members, and Homeless Task Force Members, My name is Siobhan Robinson and I am a 36 -year resident of Newport Heights. I am deeply concerned about the fairness of establishing of a single temporary homeless shelter at the proposed 592 Superior Avenue site in West Newport Beach. The homeless burden is currently distributed across the city of Newport Beach, and therefore should not be encumbered by just one particular area of the city. A fairer and less impartial solution for all Newport Beach residents would be to construct a temporary shelter in the airport area where there would be a much less significant impact to residential property owners and renters, as well as the thousands of students that attend the three largest schools in the Newport - Mesa Unified School District. I urge the city to adopt a temporary homeless shelter in the airport area rather than the City's Corporate Yard located at 592 Superior Avenue. I understand that you are tasked with an extremely difficult situation, but a commercial area with less residential and school impact seems to make much more sense when dealing with the issues and complexities that come with homeless populations. Thank you for your time and service. Regards, Siobhan Robinson 153o El Modena Avenue] Received After Agenda Printed September 24, 2019 Item no. 18 From: Jack <yankeeljack@sbcglobal.net> Sent: Sunday, September 22, 2019 10:11 PM To: Dept - City Council; Dixon, Diane; Avery, Brad; Duffield, Duffy; Muldoon, Kevin; Herdman, Jeff; Brenner, Joy; O'Neill, William Subject: 592 superior 40 Bed Emergency Shelter -Against Dear Mayor, Council Members and City Manager, I am a homeowner at Ebb Tide at Production Place and Placentia which is 2,000 feet driving distance or as the crow flies, 400 feet away from the proposed homeless shelter. While I understand the need to enforce trespassing laws while balancing the disability, mental health and substance abuse needs of our 60 or so homeless in Newport Beach. I am sensing that haste is being done without thinking of longer term and permanent solutions beside knee jerk reaction to the whims of corporate interest land developers and shoppers at our Fashion Island and our more affluent neighborhoods. Also, it saddens me to share that maybe 20 students at Newport Harbor High are under reported and in need of services but hide this need due to stigmatization at school and this debate in the community probably makes it worse for those residents as us parents probably discuss this over dinner time and probably we aren't saying such nice things about homeless as we think about the bums and not the students. The official school stats count chose living in spare rooms and hotels as homeless too. Not sure as to why the 201 mention in cars and RV as privacy reasons but sounds like next wave of homeless to me for Newport Beach. Check with the school and see what can be done! I hope I have incorrect information. I am against the shelter proposal at 592 Superior for the following reasons: -are we adding a new risk since our school buses fill up there so unauthorized access by a resident of this homeless shelter is a concerning possibility. Why add risk for picking this location. -no nearby public transportation on superior. Will they just wander about for 1/2 mile to the bus stop. Also, if student need to be added, check with NMUSD to ensure they have but coverage as some of your residents may be kids. -sharing this property with city staff may subject them to harm and related employee lawsuits from employer negligence that us taxpayers will pickup the tab on -the yard has lots of pubic works, Lifeguard, FD, linen service, admin workers going in and out of the ingress and egress on Superior so a pedestrian accident increases by adding foot traffic in this city yard. Who will pay those lawsuits? -we already have Costa Mesa Share our shelve SOS pantry that just expanded to the car lot there that allows homeless to congregation Superior such as I saw I Wednesday 1030 am. See attached pic. This is in addition to .9 miles away we have Lighthouse Church Costa Mesa 50 bed shelter so we in effect have skid row forming that wasn't here just a few months ago. All new and expanded. -concerned about property values as a real example I am a landlord at the Newport Crest where my rent may be $150 to $300 less month as our properties will be more like Costa Mesa values versus premium Newport. This impact for the rental and my home I am thinking will be $100-$200k personally if we allow this in a residential neighborhood. So much burden due to a poor location selection by the city. Received After Agenda Printed September 24, 2019 -concerned about lawsuit by atheist claiming separation of Church vs State as this is citylt0id ltd. Agny of the homeless shelter operators are Christ based and they may want to display Jesus and his Word and they may offend someone or even a city worker and then we pay to defend against those type of lawsuits. Maybe a separate property is better. -this yard at 592 Superior will only hold 40 beds not the intended 50 sought so why invest in location that doesn't serve the need nor is expandable in the future. Seems like a waste of taxpayers money. I would encourage our City Council member Brad Avery to support a motion to remove 592 Superior as he did for the hotel property. The Avis property or other industrial properties areas (not within 1/2 mile of schools or residential) should be higher on the list then subjecting the city to lawsuits by activist and angry homeowners. Thank you for reading, Jack Rose 29 Ebb Tide Newport Beach Sent from my Phone Received After Agenda Printed September 24, 2019 Item No. 18 From: andrea peterson <apetersonl0@yahoo.com> Sent: Monday, September 23, 2019 11:00 AM To: Avery, Brad; Dept - City Council Subject: Proposed Homeless Shelter at 592 Superior Maintenance Yard Hello, I'm emailing today to voice my concerns regarding the proposed homeless shelter at 592 Superior Maintenance Yard. I recently purchased a home at 70 Ebb Tide Circle in Westside Newport Beach, only a few blocks from here. Our home is currently undergoing renovations for water damage, along with the rest of the community, but are excited to be able to move in next spring hopefully! The redevelopment & resurrection of the Westside Newport Beach community is what sparked our interest to move to this area, with many young & old restaurants, coffee shops, small businesses, artists in the area, new communities being built, a community college, etc. I've fallen in love with the area and am worried that a nearby homeless shelter will have a negative impact on the community. I'm asking that our elected officials help to protect the redevelopment and resurrection of Westside Newport Beach and help us keep our neighborhood safe from a transient homeless population. I am in support of the shelter being built closer to the airport by the Avis, or a similar property that is further away from residential, schools, and parks. Thank you for listening! Andrea Peterson 70 Ebb Tide Circle Newport Beach 310.508.4871 apetersonlO@yahoo.com Received After Agenda Printed September 24, 2019 Item No. 18 Subject: FW: 592 Superior Avenue From: Steve Byers <csbyers@mac.com> Sent: Monday, September 23, 2019 11:40 AM To: Jacobs, Carol <ciacobs@newportbeachca.gov> Subject: 592 Superior Avenue Assistant City Manager Jacobs I am opposed to the city's proposed construction and operation of a temporary emergency shelter for homeless individuals at the city yard located at 592 Superior Avenue. First, it is a three-minute walk, 0.6 miles, from Newport Heights Elementary School. And second, it is too close to our Neighbors here in Newport Heights. I believe we all recognize the need for shelters for the homeless individuals, but this location is not safe for the neighborhood and a potential risk to the children who attend Newport Heights Elementary. I urge you to find an alternate site that will better serve all the members of our city. Regards Steve Byers 535 Tustin Avenue Newport Beach, CA 92663 Received After Agenda Printed September 24, 2019 Item No. 18 Subject: FW: Homeless From: Heather Fitchner <heather.fitchnerggmail.com> Date: September 21, 2019 at 5:18:23 PM CDT To: "Brenner, Joy"<JBrenner(a,newportbeachca.gov>, "O'Neill, William" <woneill(a)newportbeachca.gov>, "baver newportbeachca. ov" <baveryga,newportbeachca.gov>, "ddixongnevportbeachca.gov" <ddixonga,newportbeachca.gov>, "dduffieldgnewportbeachca.gov" <dduffieldgnewportbeachca.gov>, "jherdmanAnewportbeachca.gov" <jherdman(a�newportbeachca.gov>, "kmuldoon(a)newportbeachca.gov" <kmuldoon(anewnortbeachca. i2ov> Subject: Homeless Good afternoon members of the city council, I am writing to you because I am unable to attend the city council meeting this coming Tuesday but wanted to bring up some concerns I have. First I wanted to thank you for working so diligently to get the OCTA facility cleared out, I know we're all worried about where they'll go next but I think this was a necessary first step. Now here are the things I would like some type of answer in a response from you guys. 1. I wanted to support either facility you choose, either 4200 campus rd or 592 superior ave. I think both of these spots are good spots for a shelter. That being said I have heard that some residents near Costa Mesa are pushing for multiple sites for shelters due to spreading these people out to not inundate one area with a shelter. I think this is a fair request but I think it will be much more expensive to have two buildings, staff two buildings etc. I think financially this is unwise. 2. I was reading in the daily pilot (so correct me if the article was wrong) but it was saying that even if the council declares a homeless crisis, it would still take 5-6 months to get this shelter open. That timing I'm a little confused by. San Clemente has a tent shelter which if we did that could probably get opened a lot sooner than 5-6 months and Anaheim got their shelter open within 60 days, why are we not able to do this faster than 5-6 months? Our point in time count could be way higher than that by the time you get this done and this shelter does not need to be beautiful and the most comfortable place, it doesn't need trailers, it needs to be functional with a roof over their heads, cots, blankets, clean clothes, hygiene supplies, and social services to get them the help they need. 3. I'd like to address something else the article said. It said "admission would be prioritized for people who can prove some kind of connection to Newport Beach, such as prior residency." Is this meaning our shelter will still take in people who have no ties to NB? It said in prior meetings that our shelter, when opened, would ONLY take homeless individuals who had prior ties, not just prioritized. 12:40 .� � ■ & latimes.com Daily Pilot q City officials want the shelter to operate on a reservation -only basis, with no walk-ups. It would have around-the-clock security, and admission would be prioritized for people who can prove some kind of connection to Newport Beach, such as prior i*esidencyr. Occupants would be given a change of clothes and a storage locker. No alcohol, smoking or drugs would he allowed. According to � _ f .; 11 1 � , shelters are limited to 4o beds and a maximum stay of 14 dans, among other restrictions, and are allowed oI lv In certain areas without a special 1_1 ii i But loocal re ulc tions like The idea behind opening this shelter was to get these people who had ties to NB into our shelter and off the streets, and those who didn't have ties to our city, tell them to go back to their city of origination or face arrest if they camp somewhere in our city. I think we need to take a firm stance on this issue. We cannot wax and wane as to what we want to do, our city is following the laws and the residents want our citizens protected instead of just having the homeless people being protected. 4. I wanted to know what the city's plan was for loitering at night, not necessarily trespassing per say. Once we have a shelter in place (again I'm hoping for way sooner than 5-6 months) are we going to have laws that the homeless at a certain time at night either have to go to a shelter or leave the city? Just because they're not "camping" or pitching a tent somewhere shouldn't also mean that they're able to loiter places at night. Like right now I know they're all hanging out at the OCTA facility still until 11:15 which we can't do anything about. I understand why we can't do anything about it right now but does that mean if they're not sleeping we can't make them leave even if we have a shelter available? If you could let me know a response to these points I would appreciate it. Thank you so much! Sincerely, Heather C. Fitchner, MSN, FNP -C 619-339-3262 Received After Agenda Printed September 24, 2019 Item No. 18 From: BRUCE DICKSON <bruce2003mn@yahoo.com> Sent: Monday, September 23, 2019 11:37 AM To: Dept - City Council Subject: RE: Proposed Homeless Shelter at 592 Superior Avenue, Newport Beach bear Mayor Dixo,nn and I'lie Meni[ ers Beach t'ounCH', The City's plan doesn't appear to be factually based and fails to solve the current mental health and drug abuse issues with the homeless. The plan doesn't provide any long term rehabilitation solutions to resolve the growing homeless population in Newport Beach. I believe that most of the mental health and outreach programs are located in Costa Mesa and justifying this location is simply an easy way out for the city to cite an "Emergency Declaration" as a tactic to push the city's decision onto our neighborhood. I have the following questions for the city: Where is the feasibility and sustainability study that supports the 592 Superior Ave. location? Why is this location the best location for a shelter? Why does the city want to place this shelter next to residential neighborhoods, schools, hospitals and senior living facilities? What checks and balances will be in place to make sure this temporary shelter will remain temporary? What measures can be put in place to limit the migration of homeless to this shelter? If this temporary shelter is put in place when will it be restored back to its prior purpose as a public facilities property? Have you completed a environmental impact studies for this location? What part of the revitalization project does the homeless shelter fall under? There are also numerous new residential developments just a block away in Costa Mesa. Would the city of Newport Beach be responsible for the decrease of all of their Property values as well as ours in Newport Beach due to the homeless shelter being placed at 592 Superior? Can the city afford to pay for lawsuits from the owners of several new developments banding together and suing the city? How long will this shelter be used considering it is currently labeled "Temporary"? 1 Is this an acceptable location considering 3 schools are nearby? Is the city willing to overlook the safety of our children? Has the Newport Police department been involved in any of the discussions in regard to the 592 Superior Ave. location? Would this be a good location from a law enforcement standpoint and from a fire department standpoint? Is the city proposing to place full-time police officers in this location considering it can take 15-20 minutes in traffic from NB Police station to 592 Superior Ave? What form of security checks will be performed on each person placed in the facility? How will Heller Park and Bolsa Park be patrolled considering they are less than a 1/2 mile from the proposed shelter location? Is the city proposing to monitor crime rates in the area? Before and after placement of the shelter? Will the city place and maintain security cameras along superior and the 592 Location? Are you aware of the SOS Community Pantry (Costa Mesa)across the street from the 592 location? Has the city contacted the Mayor of Costa Mesa to discuss the potential impact of having the SOS and a homeless shelter right next to each other? Would this catapult Superior Ave into the next homeless corridor of the OC? Will the homeless use the SOS shelter as an excuse to be able to be in the area milling around 24/7. Newport Beach will not be able to enforce anything because Costa Mesa and the SOS is just right across the street. How will the city resolve this "Enforcement Pickle"? How will the homeless living in the shelter come and go during the day? Will this location draw other homeless from all around the area to hang out around 592 Superior Ave. in hopes of being placed in there? As elected officials you should be protecting the redevelopment and resurrection of the West side of Newport Beach thus help;_ng keep our neighborhoods safe. It appears that the city is attempting to look for an easy way out in order to be able to enforce no camping laws in other parts of Newport Beach thus not serving our best interests or offering real solutions to solve the actual problems. I look forward in hearing back from you. K Sincerely, Bruce 949-345-5635 Received After Agenda Printed September 24, 2019 Item No. 18 From: Natalie J Machado <junqueiro@yahoo.com> Sent: Monday, September 23, 2019 12:44 PM To: Dept - City Council; Dixon, Diane; Avery, Brad; Duffield, Duffy; Muldoon, Kevin; Herdman, Jeff; Brenner, Joy; O'Neill, William Subject: Concerned Resident: Oppose Homeless Shelter Locations Good Afternoon, I am writing to you as an extremely concerned Newport Beach city resident regarding the two proposed homeless shelters that are located less then 1 mile of my home in the NEW Ebb Ride Community. I highly encourage you to please reconsider the locations of the two proposed homeless shelters (592 Superior Ave and 825 West 16th Street) since this will negatively impact our neighborhood, surrounding businesses and community of the cities of Newport Beach and Costa Mesa. The two proposed homeless shelter locations are not suitable locations due to the fact they are adjacent and near to residential homes, nursing homes, communities, business and hospital buildings, and especially young school and daycare facilities. Also, the close proximity of the two proposed homeless shelters (less then 1 mile apart) does not make any sense. This is not a fair option for the residents and businesses for this area and should be reconsidered and evaluated. I truly appreciate the city doing something to help the homeless situation, however the city really needs to understand the impact this has on tax -paying citizens who want their children to grow up in a safe environment that is near the beach. By having two proposed Homeless Shelters right next to a new home we just purchased, is beyond upsetting. Please let me know what I and my community of Ebb Tide can do to stop these proposed homeless shelters near our forever home! Thank you for your attention. Sincerely, Natalie Junqueiro Received After Agenda Printed September 24, 2019 Item No. 18 From: johnpurchase@comcast.net Sent: Monday, September 23, 2019 9:32 AM To: Dept - City Council; Avery, Brad Subject: Homeless Shelter comments from out of state resident moving to NB Dear Council Members, (please read this at tomorrow night's Public hearing) I currently reside in Colorado and am planning on purchasing a home in Newport Beach in the Summer of 2021. 1 am in escrow at the Ebb Tide Development on Placentia Ave. While I have empathy in many cases for the homeless and the predicament in which many of them find themselves, I cannot imagine that there is not a better location for a homeless shelter than the one proposed at the City Maintenance facility. What attracted me to this location was the fact that it had started to see redevelopment with several new housing communities and businesses springing up recently. This seemed set to continue, however adding a homeless shelter of such size will surely hurt this economic expansion and detrimentally affect housing prices and growth potential of existing small businesses and new businesses relocating to benefit from the current growth. I understand the urgency in which the City needs to act in order to add beds, however a short-term rash decision to benefit the relative few, will surely stifle the medium and long term growth potential in this part of the City for the majority. Adding a homeless shelter at the City facility could trigger huge economic setback for this neighborhood's multitude of homeowners and business owners alike. I do not believe that the risk of economic stagnation or even decline is a fair balance, so I ask that you consider all other possibilities to their fullest extent and carefully consider the longer term consequences of this action. Sincerely, John Purchase Received After Agenda Printed September 24, 2019 Item No. 18 From: Ryan Janis <ryanjanisoc@yahoo.com> Sent: Monday, September 23, 2019 9:28 AM To: Avery, Brad; Dept - City Council Subject: Proposed Homeless Shelter at 592 Superior Hello - My name is Ryan Janis and I am a homeowner at Ebb Tide by 15th/Placentia in Newport Beach. I was extremely disturbed when I recently learned that the city of NB was proposing to open an Emergency Homeless Shelter in my neighborhood. I bought my house in December 2017 and enjoy living in Newport Beach. HOWEVER, putting a homeless shelter so close to my home makes me nervous and scared for not only myself but family and friends who come to visit me. It's like telling me I have to put my head on a swivel if I want to walk outside in my own neighborhood (especially in the evening). I don't want to have to look 360 degrees every time I go for a walk or take my dog for a stroll in my own neighborhood. If this is added on Superior, it will increase the flow of transient "monsters" in my neighborhood, which is not a place anyone will ever want to raise a family or buy property. I urge you to reconsider other locations away from Residential neighborhoods in Newport Beach. The airport option seems to be the best site for a shelter of this nature given there are no immediate residential homes nearby that site. The West Newport redevelopment planswill be destroyed if you throw a shelter in the middle of Superior. I will be in attendance at the City Council meeting tomorrow and plan to make a statement regarding this proposal. Thank you- -Ryan Sent from my iPhone Received After Agenda Printed September 24, 2019 Item No. 18 From: Jacobs, Carol Sent: Monday, September 23, 2019 4:05 PM �aE I oRT Brown, Leilani FW: Proposed Homeless Shelter at 592 Superior Avenue For City Council Carol Jacob. j 1� ktant Cite AIana(Tcr CiLN ofNcNvhort 13cach 100 Civic Center Drize Nc wport Beach, CA ( )22o l) cjacobs@new1jortbeachca.Qov Phone: (949) o44-3313 I ax: 1949) 644-30'0 From: Chris Budnik <clbudnik2003@yahoo.com> Sent: Monday, September 23, 2019 3:03 PM To: chris budnik <clbudnik2003@yahoo.com>; Dixon, Diane <ddixon@newportbeachca.gov>; Avery, Brad <bavery@newportbeachca.gov>; Brenner, Joy <JBrenner@newportbeachca.gov>; O'Neill, William <woneill@newportbeachca.gov>; Cameron, Helen <hcameron@newportbeachca.gov>; Heffernan, John <JHeffernan@newportbeachca.gov>; Moore, Terry <TMoore@newportbeachca.gov>; Peterson, Thomas <TPeterson@newportbeachca.gov>; Snow, David <DSnow@newportbeachca.gov>; Voorhees, Cindy <CVoorhees@newportbeachca.gov>; Wegener, Jean <JWegener@newportbeachca.gov>; Jacobs, Carol <cjacobs@newportbeachca.gov> Subject: Proposed Homeless Shelter at 592 Superior Avenue Dear City Council and members of the Homeless Task Force, I live in Newport Beach near Ensign Middle School. I would like to offer my thanks for all your efforts to help address the needs of the homeless in our community. Volunteering to help the less fortunate is a special gift you're giving to everyone in the city. I would like to volunteer to help by joining the Task Force as I don't feel the Task Force has enough citizen representation from the Newport Heights area. I'd like to encourage us all to work together on this and consider a few points that may have been overlooked. The homeless have been in Newport for quite a while. Recent events including court rulings are being publicized in a manner that can give the impression there is a homeless emergency everywhere. While there may be emergencies in downtown Los Angeles or Seattle, I don't see an emergency homeless situation in Newport Beach. This doesn't mean we should in any way decrease our efforts to help them. However, I believe declaring a shelter crisis in Newport Beach in order to bypass procedures could be a slippery legal slope we should avoid. I do not agree the existing homeless conditions in Newport Beach meet the criteria necessary to declare a shelter crisis per Government Code Section 8698.2. 1 do not agree this project is categorically exempt from CEQA guidelines under sections 15301, 15303, 15304 and 15332. 1 also believe recent court rulings allowing for emergency declarations to bypass CEQA/EIR requirements only applied to certain parts of Los Angeles county. If this is true, using those rulings to bypass process could be challenged. Additionally, we have the issue of neighborhood impact to consider. The temporary shelter would displace the homeless from all areas of Newport Beach and temporarily concentrate them in just one neighborhood. Doing so impacts one neighborhood disproportionately and is inconsistent with the goal of allowing all Newport residents to play a role in helping the homeless. Creating this temporary shelter is not like placing a new fire station or police station in a neighborhood. Part of the city storage yard bounded by Superior Ave and Newport Blvd is less than 400 feet from Nobis Preschool and about a quarter mile from the elementary school. The impacts of a homeless shelter are very different than other public facilities and I think it would make sense to proactively solicit resident feedback so we can fully understand and mitigate concerns. Most importantly, we must approach this from the point of view of the homeless, not our own. Any solution we implement should be something the homeless both need and want. The homeless have chosen to locate themselves in certain areas of our city for reasons important to them. For us to now force them to leave all the areas they've chosen and relocate to a site we've chosen could expose us to the very type of litigation we are trying to avoid. Any temporary solution that displaces the homeless could be viewed as causing greater harm than good. Perhaps it makes more sense to let the homeless remain in the locations they chosen for themselves until a permanent facility and higher court rulings become available. In summary, I believe assessing the full impacts of any solution is a process we should not rush and the affected residents need a lot more information. We should take the time to fully understand the implications of our intended actions and do so from the point of view of the homeless, not our own. As President Reagan once said, "The most terrifying words in the English language are: I'm from the government and I'm here to help". I look forward to finding a solution that provides help the homeless both need and want. Sincerely, Chris Budnik Received After Agenda Printed September 24, 2019 Item No. 18 From: Bonnie <bonmail@pacbell.net> Sent: Tuesday, September 24, 2019 7:49 AM To: Dept - City Council Subject: Temporary Homeless Shelter I am a resident of Costa Mesa's Westside, and I urge you NOT to place your temporary homeless shelter at the 592 Superior Avenue location. While I support your city's intention to have a homeless shelter within its' borders, I believe you can find a better location that will: • Allow Newport to have a shelter that works for the homeless along with the neighborhood it is located in. Not increase the homeless impact on a neighborhood that already is struggling with the issue. The Westside of Costa Mesa has been bearing the burden of the homeless problem for years. It is time for other neighborhoods to do their share! Engage with your neighbors, local governments, experts and community members to earn wisdom, community buy -in, and build the best shelter for our coastal region as well as the homeless population, and • Use successful models from other neighborhoods, cities and programs to build a shelter that will provide the best hope for the homeless and win the support of neighboring communities, residents, and businesses! xQf t& `'"e&nd 904 West 19th Street Costa Mesa, CA 92627 Received After Agenda Printed September 24, 2019 Item No. 18 From: Bret Rosol <bret.rosol@icloud.com> Sent: Tuesday, September 24, 2019 7:34 AM To: Dept - City Council Subject: No Homeless Shelter on Superior Ave My name is Bret Rosol and my family lives at 69 Ebb Tide Circle. I am traveling this week and will not be able to make tonight's meeting but I wanted to write you to express my strong objection to a shelter on Superior ave. We have a 7 month old baby and moved from Eastside Costa Mesa to get away from the nearby sober living homes. We never would have purchased our home had we known the city was going to make us live next to a shelter! We already had problems with transients before this shelter and after it will be a nightmare. If approved this is going to totally destroy the surrounding neighborhood and concentrate all of Newport's homeless less than 400 feet from where my baby sleeps. On top of that you are going to severely negatively affect our home values and I'm worried about being able to sell to get away from this nightmare. But if approved we will have no choice but to uproot from our dream home that we purchased only a year ago. Please consider moving the location near the airport and away from people. I know my neighbors all feel the same way and I'm sure you've gotten hundreds of emails letting you know. This has a huge impact on our lives and it is critical this location is removed from consideration. Regards, Bret Rosol 949-910-2229 Sent from my iPhone Received After Agenda Printed September 24, 2019 Item No. 18 From: Julia Chu <julia.chu426@gmail.com> Sent: Monday, September 23, 2019 10:54 PM To: Dept - City Council Cc: Albert Pei -Chen Lin Subject: 592 Superior Shelter - AGAINST To all whom are involved in Newport Beach's homeless shelter task force: My husband and I are writing in regards to the proposed site (592 Superior) for the temporary homeless shelter. As residents of the Newport Beach community, we are deeply concerned with the idea of a homeless shelter being right around the corner from our home. I am also a Hoag Hospital employee that requires working some late night shifts, and knowing that a homeless shelter will be right next door, frightens me tremendously for my safety and my fellow colleagues. With so many homes, schools, businesses, and parks in the area, it would greatly impact the way our future kids would be raised in the neighborhood with the shelter bringing in so many transient people that would roam the area. Why does the city want to place this shelter next to residential neighborhoods, schools, hospitals and senior living facilities? Is this an acceptable location considering 3 schools are nearby? Is the city willing to overlook the safety of our children? Our elected officials need to protect the redevelopment and resurrection of Westside Newport Beach and help us keep our neighborhood safe from transients that are mentally ill and drug abusers that pollutes our community. Please consider locations that are not near homes and schools. Just as you wouldn't want it in your neighborhood, don't try to put it on someone else's. Thank you for your time and service. Sincerely, Julia and Albert Lin 949-400-2044 Received After Agenda Printed September 24, 2019 Item No. 18 From: Todd Stuve <tstuve@gmail.com> Sent: Monday, September 23, 2019 10:35 PM To: Dept - City Council; Dixon, Diane; Avery, Brad; Duffield, Duffy; Muldoon, Kevin; Herdman, Jeff, Brenner, Joy; O'Neill, William Subject: Oppose - 592 Superior Homeless Shelter Hi Brad, and the City Council Members, Homelessness is a severe problem, but we need a permanent strategy that invests money wisely. Cities who successfully lowered the rate of homelessness invested in apartments and services. Building a temporary shelter in Newport Beach with one of the highest costs in the Nation might not serve us well. You could be adding additional costs as seen below: Osceola County, Florida, tracked 37 homeless people arrested i,25o times over to yearn for 61,896 total days of incarceration. Here's what they cost: $130,000 11"1 ,�.�:�1.t �€1 -;S1.33(),22 Booking costs fail cysts mental-health care in jell 7'0 141' IV SOWO `i'he �014 Anntial t cjmeless Assessment ReIpOrt (AWAR) to Conerrs We're quite frustrated and upset to learn about this proposal. Could you please share the Feasibility and sustainability study that supports this location? We plan to attend the hearing on 9/24. Received After Agenda Printed September 24, 2019 Item No. 18 From: BRUCE DICKSON <bruce2003mn@yahoo.com> Sent: Monday, September 23, 2019 10:25 PM To: Dept - City Council Subject: Against Proposed Homeless Shelter 592 Superior Avenue Newport Beach Dear City Council Members, I am very disappointed in hearing that an additional homeless site has been proposed at 592 Superior street which is right behind my house. I bought a brand new house in the Ebbtide community last year and with the help of all my neighbors we have been trying to clean up the block around our house. I've been calling in about graffiti, homeless, unattended junk and everything else you can imagine. Everything was finally looking up and now this absolutely poor location choice for a homeless shelter. There are a lot of new residential areas located close to these sites. I know that property values will plummet and an increase of crime, theft, drugs will take over the Superior Avenue corridor. My wife and 2 year old take walks around the block and walk down the streets everyday. Many of my neighbors have small children also. They would all be in danger if this shelter is placed in our neighborhood. What about the 3 schools within a mile of this location? One of the schools is 1/2 mile away. I guess the genius who chose this spot didn't think of this or even care. This location should of been shot down immediately. I see that the city appears to be hell bent on moving forward with this location. I guess the city may not care about our children, neighbors and area residents on the west side but I do and I'm willing to take this fight as far as needed. I don't take chances when the safety of my family and neighborhood at stake. I'm not sure who made this absolutely terrible choice of proposing 592 Superior but they obviously don't live in the area or have thought about all the horrible negative effects it will have on the area and it's resident's. I would like to see the city work with Costa Mesa and possibly build a shelter together over by the airport. It's not reasonable or wise to place one of these in a residential area where it is such a liability and a danger to the public. Sincerely, Bruce Dickson 949-345-5635 Received After Agenda Printed September 24, 2019 Item No. 18 From: Elizabeth Hoang <anhethelm@yahoo.com> Sent: Monday, September 23, 2019 9:58 PM To: Dept - City Council; Dixon, Diane; Avery, Brad; Duffield, Duffy; Muldoon, Kevin; Herdman, Jeff; Brenner, Joy; O'Neill, William Subject: 592 Superior Homeless Shelter - Against Good evening, As a resident at Ebb Tide in Newport Beach, I am writing to you to express my concern regarding the recent proposal for a homeless shelter at 592 Superior. Although I recognize the problems we face with homelessness in the area, I do not believe setting up a temporary shelter here will resolve the issue at hand. I have some questions I would like to leave with you to ponder before decisions are made. This proposal seems very rushed without adequate thought into the ramifications on the surrounding area. Thank you for your consideration. Thank you, Elizabeth Hoang - Where is the feasibility and sustainability study that supports the 592 Superior Ave. location? Why is this location the best location for a shelter? - Why does the city want to place this shelter next to residential neighborhoods, schools, hospitals, and senior living facilities? - What measures can be put in place to limit the migration of homeless to this shelter'? - If this temporary shelter is put in place, when will it be restored back to its prior purpose as a public facilities property? - I lave you completed an environmental impact studies for this Location`? - What part of the revitalization project in this area does the homeless shelter fall under? - In addition to Ebb Tide in Newport Beach, there are also numerous new residential developments just a block away in Costa Mesa. Would the city of Newport Beach be responsible for the decrease of all of their Property values due to the homeless shelter being placed at 592 Superior? Can the city afford to pay for lawsuits from the owners of several new developments banding together and potentially suing the city? - Is this an acceptable location considering ) schools are nearby? Is the city willing to overlook the safety of our children? - What form of security checks will be performed on each person placed in the facility? - Is the city proposing to monitor crime rates in the area, before and after placement of the shelter`? Received After Agenda Printed September 24, 2019 Item No. 18 From: Connie Truong <connie.nk.truong@gmail.com> Sent: Monday, September 23, 2019 8:08 PM To: Dept - City Council; Dixon, Diane; Avery, Brad; Duffield, Duffy; Muldoon, Kevin; Herdman, Jeff; Brenner, Joy; O'Neill, William Cc: Connie Truong; Todd Leslie Stuve Subject: Oppose - 592 Superior Homeless Shelter Hi Brad, and the City Council Members, My family currently owns our residence that is near by, very close to the 592 Superior location in Newport Beach, where the proposed Emergency Shelter Plan is targeting at the moment. We're quite frustrated and upset to learn about this proposal. Could you please share the Feasibility and sustainability study that supports this location? Our elected officials need to protect the redevelopment and resurrection of Westside Newport Beach and help us keep our neighborhood safe from transient criminals who infiltrate and pollute our community. I would be afraid knowing that our community will be imposed with more potential crimes, so close to home. During the water intrusion issue this year, we have had many break-in attempts while the campus was partially vacant. If a homeless shelter is built nearby, we would no longer feel safe for our children, grand -children, and our property values would also be significantly impacted to the down side. We elected the City officials to keep us safe. I find that it is your duties to be accountable and push back to defeat this problematic decision. rhe: city must build the c:merrcncl shelter �%iihin the city to enforce the and camping: trespassing lames sty redirecting the shelter to the ;avis (airport option) or similar property away from rc-,idential and schools/ arks./kid areas. Ladies would be afraid to work for businesses in this area. Parents would be filled with fears for the safety of their children. I would be afraid to walk outside.... Can you imagine? If this proposal is passed, many many homeless people will pour into Newport Beach because of its brand name... Where will Newport Beach become? Why can the homeless be sent to an area where they will not affect the health, economic growth, safety of a community? We plan to attend the Hearing on 9/24. Connie Truong @ 714-675-2457 & Todd Stuve @ 760-685-1018 - Has the city contacted the Mayor of Costa Mesa to discuss the potential impact of having the SOS Community Pantry (Costa Mesa) and a homeless shelter right next to each other? Would this catapult Superior Ave into the next homeless corridor of the OC? Received After Agenda Printed September 24, 2019 Item No. 18 From: Cristiane Dickson <ckimizuka@yahoo.com> Sent: Monday, September 23, 2019 9:57 PM To: Dept - City Council Subject: Against - Proposed Homeless Shelter at 592 Superior Avenue Dear Newport Beach City Council Members, I recently learned of a proposal by the city of Newport Beach to place a homeless shelter at 592 Superior Avenue in Newport Beach. I am strongly opposed to this considering the fact that I currently live with my family less than a block away from this location. I have a two year old son and we take walks daily around our block and even walk to the grocery store and restaurants that are located nearby. I fear for me and my son's safety if a homeless shelter is placed in this area. I don't believe that we could continue to safely walk around the area and our house without being in fear of random drug addicted and drunk homeless people with possible mental illness aimlessly wandering all around. -he crime rate in the area will definitely increase and the area will suffer greatly due to break-ins, littering and various forms of assaults etc. I don't want our neighborhood to be littered with garbage, needles and human waste. We don't want this area to become another LA or San Fran with it's out of control homeless problem. We don't want to walk down our streets and see needles everywhere and have to smell feces and urine. How many of these people are sex offenders and pedophiles? This really freaks me out! What about the three schools nearby and all of the businesses and the HOAG Women's Center that is right door. Placing a homeless shelter next to so many residential units sounds like an extreme liability for -the city and not very well thought out plan to me. If anything happens to my child or family or anyone's family in the neighborhood the liability will lie directly on the city for locating the shelter to the 592 Superior Ave. location. Another thing I do not understand about this proposed location is that the West Side of Newport Beach has so much potential and the revitalization has already began with the new construction of numerous condos, townhomes, and new businesses. Why would the city approve these projects then slap a homeless shelter right next to or nearby them? I'm confident that would not be good for business or property values or the area and people that live around the area. We paid a premium for our new house and I don't recall seeing anything in the paperwork about the city constructing a homeless shelter right next door. I propose either locating the homeless shelter at the campus location by the airport or possibly joining forces with Tustin or Costa Mesa with their current plans. Sincerely, 1 Cristiane Kimizuka 949-439-7292 Received After Agenda Printed September 24, 2019 Item No. 18 From: Charlotte <imcharsweb@yahoo.com> Sent: Monday, September 23, 2019 8:54 PM To: Dept - City Council Cc: arlis.reynolds@costamesaca.gov Subject: Homeless shelter To Whom It May Concern, We have been made aware of the possibility of providing the homeless of Newport a shelter near our city, and bordering our Westside neighborhoods. We already have our share of homeless, and the concerns many of them bring in our area. We truly appreciate your consideration of our lives, and the impact your decision would have on them. Please consider moving your shelter to a less invasive location for our city. There are too many activities where drugs and crime come along with the homeless. We need lives changed, not just housed! Perhaps open dialogue between cities could provide better solutions! Get faith -based church involved so these people are given hope, if they will accept it, and have good, godly counsel. God can change a life! The word is from our council... The proposed approach consolidates and pushes those impacts onto the West Newport and Westside Costa Mesa business and residential communities. Their proposed approach and location at 592 Superior, less than one mile from Costa Mesa's established shelter, risks compromising public safety and economic growth in this area and could undermine the progress achieved by Costa Mesa's shelter." A successful shelter program requires a comprehensive plan, appropriate investment, community buy -in, and coordination with neighbors. Please contact the Newport Beach City Council members, and ask them to: • oppose the proposed shelter location in westside Newport so as to not consolidate impacts on an already - impacted area, • invest in a robust shelter model that works (rather than just shift impacts onto specific neighborhoods), • engage with experts and community members to earn community buy -in, and • learn from the successes of Costa Mesa's shelter program. Thank you, Sincerely, Jim and Charlotte Jurekovic Received After Agenda Printed September 24, 2019 Dear Ms. Brenner, Mr. Avery, and Mr. O'Neill, Item No. 18 Thank you for your work on the Homeless Task Force, your leadership on the City Council and to the NBPD for their excellence. As I watch the progress of this important work, I'm hoping that the following questions can be addressed: 1. May the public get weekly reports on citations & arrests (quantity and type) that are transient - related? 2. When can we expect to see enforcement of the posted no loitering signs at the bus terminal? 3. Can the City of Newport Beach request the OCTA and/or the Irvine Co provide security at the bus terminal to address loitering and have them call the police when needed? 4. What is the City and/or NBPD plan to address the relocation of transients from the bus terminal into the community during the day and overnight? 5. Please approve and install "no panhandling" signs in targeted locations asap and also consider a similar "no panhandling" information to residents and business owners. A few ideas that may enhance the long term success of the task force: Creation of a Homeless Response Strategic Plan to include: o Mission • Background • Goals & Objectives • Key Stakeholders • Data Reporting • Best Practices • Performance Measures • Action Plan • Evaluation Fine Tuning of Task Force Sub -committee Groups: • Health & Public Safety ( Law Enforcement/Health Department) • Substance Abuse ( Medical/CBOs) • Mental Health & PERT ( Mental Health partners with Outreach Officers) • Housing ( Short Term-Emergency/Long Term) • Finance & Legal Final thoughts: -The primary issues raised by the community regarding the city homeless crisis to the city council are public safety and health concerns. -Law Enforcement is a critical component in any multi -disciplinary approach to keeping Newport Beach safe. -Law Enforcement needs to be a part of the Homeless Task Force Sub -committee as a component of a strategic plan with regular progress updates and data reporting to ensure established performance measures and goals are met. -Local example of interdisciplinary approach: Pomona Police Department & "Operation Healthy/Safe Streets". Our residents need to feel safe in their community; be able to walk outside their homes in the flower streets, go to our parks, beaches, and shops/businesses without being threatened or approached by aggressive panhandlers. Our children should not witness criminal behaviors such as assaults, public use of illegal drugs, indecent exposure, public defecation, individuals living in tents, or passed out on the sidewalks and no one should live this way. Having this continue anywhere in our community is inhumane for those involved. Allowing it delays their treatment, recovery, and future success in life and takes away a sense of health and safety in the community. Attached below are pictures taken in the past few days, since the OCTA encampment was cleared from overnight camping. These pictures explain why I asked the 5 questions at the beginning of this email. Again, your commitment to this challenging situation is greatly appreciated. Sincerely, Trisha L. Sanchez Corona del Mar Received After Agenda Printed September 24, 2019 Item No. 18 September 24, 2019 To: Honorable City Council Members of City of Newport Beach and the City Manager Subject: City Council Agenda Item No.18 Public Hearing Proposed Temporary Emergency Shelter for Homeless at 592 Superior Avenue Honorable Council Members of the City of Newport Beach and the City Manager, I live at the City of Costa Mesa a block away from the proposed subject site at a new development 17 West. I strongly object the City's actions outlined to create a temporary emergency shelter at the City Corporation Yard at 592 Superior Avenue by bypassing all requirements of the land use and minimizing compliance with State environmental law by declaring "Emergency" for a know issue with absolutely no study of impacts to the businesses and residents living in the adjacent area, specifically the City of Costa Mesa. There are 3 new residential communities built within the last 5 years within 50 feet (across from the proposed site on 16th street) to 200 feet of the proposed site with many families with children. These children take 16th Street and Superior to go to school and for recreational walks. Superior Avenue is heavily used by families, general public as a bike route to reach to the beaches from Costa Mesa. Newport Avenue has very heavy traffic for bike use and the Superior Avenue is the main bike route going by the proposed site. City of Newport Beach's action tonight is declaring "Emergency" for an issue known to the City for months. City is utilizing this "Declaration" to minimize requirements of State Environmental Law (CEQA) by declaring the project as "Categorical Exemption" eliminating the need for the City to provide studies and public input to determine real impact of the proposed Project. Other then City's own Committees reviewing the couple proposed locations (2 on 16th street and 1 at PCH) no other public meetings were held by the City of Newport Beach involving the residents of bordering City of Costa Mesa which is within 50 feet of the proposed site for this proposed use. I reviewed the Findings of CEQA "Categorical Exemption" provided in the Staff's report. City is converting a "Utility" use site to a "Residential Site", exempting the City from CEQA required studies and from its own "Zoning" and "Development" requirements. What a stretch! Only discussion in the CEQA Categorical Exemption as to project impacts is "Traffic Impact" as if people with the proposed occupancy have many vehicles. This "Utility" use site cannot even be used for the proposed occupancy for months and provides a "one side open" shelter with potable trailers and open space to hang out for homeless. Not a very humane way of providing shelter for the most needy people within the community. City of Newport Beach has no permanent shelter solution proposed/committed. It appears that this so called "Temporary" shelter is paving the way for a "Permanent" one as the land use and environmental requirements are cleared by the City by a quick action today without review of impacts to the Community as required by the law. Even though it is called "Temporary" City is proposing to potentially commit millions in capital improvements and operations. Source of funding for this "Temporary" Shelter project is identified as " City's "Affordable Housing Reserve". These are restricted use funds collected from the developers by the City with the intent to create permanent affordable housing opportunities for people with limited income to be able to live in the City. Now City is proposing to exhaust these funds for "Temporary Emergency Shelter". Is this really the intent of the funds collected? In summary, I urge the City Council to reject use of the City property at 592 Superior Avenue as a "Temporary Emergency Shelter" and follow the laws of this State and be a good neighbor to the City of Costa Mesa. Continue search for a permanent shelter with full disclosure and provide a humane environment for the most needy in this City. Thank you, Sincerely, Handan Cirit 1665 Grand View Costa Mesa 92627 Cc: Mr. Justin Martin, City of Costa Mesa (Via e-mail) Received After Agenda Printed September 24, 2019 Item No. 18 From: Mary Howard <mghoward08@gmail.com> Sent: Tuesday, September 24, 2019 8:21 AM To: Dept - City Council Subject: Proposed Temporary Emergency Shelter for Homeless Individuals Located at the City Corporation Yard at 592 Superior Avenue Many citizens are concerned and oppose your plans and location for the Temporary Emergency Shelter and ask that you take the. following action: • oppose the proposed shelter location in westside Newport so as to not consolidate impacts on an already -impacted area, • invest in a robust shelter model that works (rather than just shift impacts onto specific neighborhoods), • engage with experts and community members to earn community buy -in, and • learn from the successes of Costa Mesa's shelter program. We are trusting you will make the right decision for all citizens. Thank you, Mary Howard Newport Terrance/Costa Mesa Citizens From: John or David Hawley <railmakersinc@hotmail.com> Sent: Tuesday, September 24, 2019 9:10 AM To: Dept - City Council; REYNOLDS, ARLIS Subject: Homeless Shelter Location Dear Council Members, Costa Mesa has for years invested in improving the Westside. As you well know your residents are very concerned about the location of a shelter that would effect their quality of life and property values. Please respect Costa Mesa and reject the proposed Superior corprate yard location. Thank You, John Hawley Received After Agenda Printed September 24, 2019 Item No. 18 From: Jacobs, Carol Sent: Tuesday, September 24, 2019 7:23 AM ��EwPOR, Brown, Leilani ct: FW: Interesting article .Ct(IFORH* For Council Carol jmobl A,,i:tant Citi \l.u�.�`�rr i C its ofNc\\pm-t Be,,( h 100 PICU: (enter Drake . Nr\Chorr 6vm h, O 2o(,U c,jacobs�new})ortbeactica.gov Plionc: (14111 (344 )31 3 1 ax: 19+)) From: Heather Fitchner <heather.fitchner@gmail.com> Sent: Tuesday, September 24, 2019 6:50 AM To: Brenner, Joy <1Brenner@newportbeachca.gov>; Jacobs, Carol <cjacobs@newportbeachca.gov>; O'Neill, William <woneill@newportbeachca.gov>; Avery, Brad <bavery@newportbeachca.gov>; Dixon, Diane <ddixon@newportbeachca.gov>; Duffield, Duffy <dduffield@newportbeachca.gov>; Leung, Grace <gleung@newportbeachca.gov>; Herdman, Jeff <jherdman@newportbeachca.gov>; Muldoon, Kevin <kmuldoon@newportbeachca.gov> Subject: Interesting article Just thought the council would like to see what Laguna is now getting to do, they have a ruling that states they can start cleaning up their streets. https://patch.comlcalifomialsanj uancapistranolsouth-county-cities-slammed-dumping-homeless-laguna-beach Also, how do we know that the dumping isn't happening here???? We need to start being able to clean up our 'streets and if those who have ties to Newport refuse shelter, it's jail time, those that have no ties to Newport, they need to go somewhere else, not just loiter here in Newport. Sincerely, Heather C. Fitchner, MSN, FNP -C 619-339-3262 Received After Agenda Printed September 24, 2019 Item No. 18 From: PHD <pdobbsl0@gmail.com> Sent: Tuesday, September 24, 2019 9:54 AM To: Dept - City Council Subject: Temporary homeless shelter at 592 Superior Avenue, one block from the city's border with Costa Mesa's westside community I am writing to oppose the proposed temporary homeless shelter at 592 Superior Avenue, one block from the city's border with Costa Mesa's westside community. While I understand and agree with the need for these facilities/services, this location is far from appropriate and poses considerable risk to the community. The mere fact that it would be located close schools/homes is reason enough to reject this proposed location. Not a risk we should introduce to the children at our community schools. The residents of our community bought into a $80+ million dollar (significant tax revenues for the city) ocean view development investing our life savings with the expectation that the area will continue to develop with parks, schools, community centers and local shops that will enhance the value of the area. Many other new developments/communities are also being developed and contributing significant tax revenues for Newport Beach and West Costa Mesa. The proposed facility will drop home valuations and quality of life as proven by other developments of this nature in residential areas. A more appropriate location would be inland, near more commercial, non residential areas. A highly valued ocean proximity location adjacent to a schools/homes is wrong, disappointing and short cited. Keeping these facilities in non residential areas fully aligns with the City of Costa Mesa plan to "positively restore the character and safety of Costa Mesa". A recent article saying this is already an existing homeless hub is completely inaccurate! Let's not make it one! In closing, • invest in a robust shelter model that works (rather than just shift impacts onto specific neighborhoods), • engage with experts and community members to earn community buy -in, and • learn from the successes of Costa Mesa's shelter program Please reject this location tonight and seek one that is more appropriate. Concerned West Costa Mesa/NPB Resident Received After Agenda Printed September 24, 2019 Item No. 18 From: Jacobs, Carol Sent: Tuesday, September 24, 2019 9:59 AM �a IPo., Brown, Leilani ----,ct: FW: Interesting article For Council Carol Jacob, I assistant UtN'Jlanauer I Cite Of'N(•«1)ort Beach 100 Civic Center Drive Newport Belch, CA 92()60 cjacobs C[,nemgjortbeachca.gov Phone: (949) 644- 3313 Fax: (949) 644-3020 From: Heather Fitchner <heather.fitchner@gmail.com> Sent: Tuesday, September 24, 2019 8:49 AM To: Brenner, Joy <J Brenner@ newportbeachca.gov>; Jacobs, Carol <cjacobs@newportbeachca.gov>; O'Neill, William <woneill@newportbeachca.gov>; Avery, Brad <bavery@newportbeachca.gov>; Dixon, Diane <ddixon@newportbeachca.gov>; Duffield, Duffy <dduffield@newportbeachca.gov>; Leung, Grace <gleung@newportbeachca.gov>; Herdman, Jeff <jherdman@newportbeachca.gov>; Muldoon, Kevin <kmuldoon@newportbeachca.gov> Subject: Re: Interesting article Another interesting article https:Hpatch.comlcalifomialsanjuancapistrano/s/ urg 3211aguna-settles-homeless-liti ation-pioneer-homeless- work-lauded On Tue, Sep 24, 2019 at 6:49 AM Heather Fitchner <heather.fitchnerkgmail.com> wrote: Just thought the council would like to see what Laguna is now getting to do, they have a ruling that states they can start cleaning up their streets. https://patch. comlealifornialsanj uancgpi§tranolsouth-county-cities-slammed-dumping-homeless-laguna-beach Also, how do we know that the dumping isn't happening here???? We need to start being able to clean up our streets and if those who have ties to Newport refuse shelter, it's jail time, those that have no ties to Newport, they need to go somewhere else, not just loiter here in Newport. Sincerely, Heather C. Fitchner, MSN, FNP -C 619-339-3262 Sincerely, Heather C. Fitchner, MSN, FNP -C 619-339-3262 Received After Agenda Printed September 24, 2019 Item No. 18 From: Dawn Bowe <dbowe9@att.net> Sent: Tuesday, September 24, 2019 12:48 PM To: Dept - City Council Cc: ARLIS REYNOLDS Subject: NO - DON'T PUSH YOUR HOMELESS IN US Dear Newport Beach City Council, As a West Side Costa Mesa resident, homeowner and business owner, we already have to deal with too many homeless people as it is. As our own city leaders have been working hard to drastically reduce and eliminate the issues from homelessness, we have finally just begun to see fewer camping on our sidewalks. Prior to this we were dealing with homeless people tampering with our mail and yelling at us as we would get home or walk down our streets. I should be comfortable walking my dog or walking to the market, but as a female have been terrified to do so based on what we've encountered in the past. I was just beginning to see hope. We do not need more homeless people pushed our direction, which then again compromises our families safety and our property values. Just because we live on the west side doesn't mean we can be treated as a dumping ground. We are all working hard to make our neighborhoods safe and an enjoyable place to live. Please look for another solution and location that doesn't inundate our neighborhood. Thank you! Mark and Dawn Bowe Westside Costa Mesa Homeowners Sent from Yahoo Mail on Android Received After Agenda Printed September 24, 2019 Item No. 18 Subject: FW: Project file no. BPA2019-170 housing for homeless Importance: High From: GCfinS2 <gcfins2@gmail.com> Sent: Tuesday, September 24, 2019 12:06 PM To: Basmaciyan, Natalie<nbasmaciyan@newportbeachca.gov> Subject: Project file no. BPA2019-170 housing for homeless Importance: High Dear Newport Beach city council and planning commission, We fully understand that we face an evolving and growing challenge before us in addressing the very sad homeless issue. Furthermore, we fully understand the sensitive position you all find yourselves in on behalf of our community. There doesn't seem to be an apparent, nor may there ever be any right or wrong solution or any one size fits all solution. At this point an implementation is likely eminent no matter what. As we understand it, currently there are still a couple of location options being considered. The property currently being used by Avis car rental on Campus near the airport as well as now the latest one for establishing a homeless shelter of sorts at the city of Newport Beach Public works utility yard which is on both Newport Beach and Costa Mesa property on superior. We can't be sure which is the right way to ultimately go, but certainly for now it would seem that the airport area would be the better option. As the Newport City yard area is extremely busy with heavy industrial equipment traffic it's a dangerous and noisy equipment space even for those who know there way in that area. The noise level alone of all of the machinery "backing up beeper alarms" are deafeningly annoying for several blocks around starting in the wee hours of the mornings and weekend with employees encouraged to wear ear protection when in the yard. The city yard area and its proximity to a residential area is already very high density for substance abuse treatment centers, sober living and addiction homes, which appear to finally show some signs of control and improvement in the community. So not a very suitable environment for either population. The Avis property on the other hand, is already in a commercial space relatively devoid of immediate residential issues. For those that should or should not be there are more readily identifiable making it easier for authorities to more safely monitor and enforce any relative policies. The benefit would be, a segregated area in a commercial environment with less impact on 24/7 residents. Thanks in advance for taking our perspective into consideration. For concerned citizens, Mark Received After Agenda Printed September 24, 2019 Item No. 18 Subject: FW: Temporary Hm-Less Shelter—PLEASEadd to packet for tonight's meeting. Thanks From: robby cannedy <thelia.cannedy@gmail.com> Sent: Tuesday, September 24, 2019 1:06 PM To: Jacobs, Carol <ciacobs@newportbeachca.gov> Subject: Fwd: Temporary Hm-Less Shelter—PLEASEadd to packet for tonight's meeting. Thanks Sent from my iPhone Begin forwarded message: From: robby cannedy <thelia.cannedyn@gmail.com> Date: September 23, 2019 at 5:00:26 PM PDT To: ddixon@newportbeachca.gov Subject: Temporary Hm-Less Shelter To whom it may concern, I am a long-term resident of Newport heights. I was just recently informed by my neighbor ,whom stays abreast of city matters ,that there is to be a vote on temporary emergency shelter in N.B. Tomarrow. I realize this is a not in my back yard topic. While I may not personally be opposed to using city property for this purpose I am disappointed that there was not a mailing to the neighborhood alerting them of this proposal temporary or not. While frustrating to come up with a space within any city for this purpose, especially with bad weather approaching, I still feel residents have not been properly informed. You do mailings on group hms in the area as I recall especially if they are mental health- drug/alcohol recovery or sex offenders. Don't you think a large percentage of the people you are providing housing for fall into those categories?? This is why I am opposed to a decisive vote at tomarrows city counsel meeting on this subject. I believe an emergency meeting notice in a mailing form be delivered to the residents and businesses adjacent to the proposed site. This notification will allow residents to attend an informative meeting in which you can explain how this site would work. Hours of operation- police security- drug dealing and use - sanitation— occupancy -health measures- segregation of sexes, women, children, seniors to protect them from abuse. I personally may not be against this site, but I certainly want and need time to be informed of how this will be handled and the possible impact to the neighborhood. I am curious if the city has any opportunity to pursue a combined use of the Fairview State Hospital property under discussion for homeless housing. The property is state owned and is almost completely empty of clients. Location is currently secured and has sq. Footage for fema trailers etc. Please take these thoughts in consideration. I feel you should postpone any decision until proper notification, input and information can be gleaned by the neighborhoods directly -&adjacent to the proposed site. Sincerely, Roberta Cannedy Clay St., Newport Heights Received After Agenda Printed September 24, 2019 Item No. 18 From: Rieff, Kim Sent: Wednesday, September 25, 2019 7:29 AM To: Mulvey, Jennifer Subject: FW: Marine avenue preservation association From: Jane Davis <janedavis110@road run ner.com> Sent: Tuesday, September 24, 2019 5:46 PM To: Dept - City Council <CityCouncil@newportbeachca.gov> Subject: Marine avenue preservation association Just read something posted on NextDoor. Just FYI the MAPA does not represent me. I live on Balboa island and am a member of the Balboa Island Improvement Association � they speak for me. I think the merchants should also have a say about Marine Avenue. Don't think we need another group. why did they form? Can't they get along with the existing groups? Thanks Have fun tonight Jane Davis 110 Garnet From: Rieff, Kim Sent: Wednesday, September 25, 2019 7:29 AM To: Mulvey, Jennifer Subject: FW: No homeless shelter by our schools ! From: Sandra Dawson <sandradawson33@icloud.com> Sent: Tuesday, September 24, 2019 6:10 PM To: Dept - City Council <CityCouncil@newportbeachca.gov> Subject: No homeless shelter by our schools I Sent from my Whone Si ce message ne s'affiche pas correctement, cliquez ici Received After Agenda Printed September 24, 2019 Item No. 18 From: Rieff, Kim Sent: Wednesday, September 25, 2019 7:31 AM To: Mulvey, Jennifer Subject: FW: Homeless shelter location -----Original Message ----- From: Nancy Anderson <nancyandersonfit@gmail.com> Sent: Tuesday, September 24, 2019 8:30 PM To: Dept - City Council <CityCouncil@newportbeachca.gov>; ddixon@newportbeachca.gov; bavery@newportbeachca.gov; dduffield@newpo rtbeachca.gov; kmuldoon@newportbeachca.gov; jherdman@newportbeachca.gov; joy@newportbeachca.gov; woneil I@newportbeachca.gov Subject: Homeless shelter location Hi there First, thanks so much for working hard to find a solution for this issue to help the homeless while keeping our neighborhood clear and safe. I have children that attend schools near the suggested spot 826 w 16th and am considered about this location for a shelter. I am please asking to encourage placement of -this facility to be located near the airport and not near the schools in Newport. Thanks in advance Nancy Anderson Sent from my Phone 1 Received After Agenda Printed September 24, 2019 Item No. 18 Subject: FW: Public Comment on Homeless Shelter From: "Bryan, Eric" <EBryan@newportbeachca.Rov> Date: September 24, 2019 at 3:30:11 PM PDT To: "Rieff, Kim" <KRieff@newportbeachca.gov> Subject: Public Comment on Homeless Shelter Hi Kim, A resident called and left a message for Council Member Avery. She lives within 400 feet of the proposed homeless shelter on Superior (corporate yard) and wanted to express her concern and objection. She has a young family and they recently moved from Costa Mesa due to homeless neighbors causing problems. They would likely sell their home and move again if a homeless shelter were built in their vicinity. She didn't give a phone number but will be at Council tonight and speak during public comments. Eric Bryan, CRM Records, City of Newport Beach 100 Civic Center Drive I Newport Beach I CA 1 92660 T 949-644-30831 F 949-644-3039 1 ebryan@newportbeachca.gov Please note that email correspondence with the City of Newport Beach, along with attachments, may be subject to the California Public Records Act, and therefore may be subject to disclosure unless otherwise exempt. 1 Received After Agenda Printed September 24, 2019 Item No. 18 From: Rieff, Kim Sent: Tuesday, September 24, 2019 4:02 PM To: Mulvey, Jennifer Subject: Fwd: Shelter Sent from my iPhone Begin forwarded message: From: Olga Reynolds <ozreynoldsna,sbcglobal.net> Date: September 24, 2019 at 3:20:41 PM PDT To:<citycouncil(a�newportbeachca.gov> Subject: Shelter Dear NB City Council Members, Please do not locate a shelter right next to Costa Mesa. It is not the right thing to do for the following reasons: • the proposed shelter location in westside Newport impacts on an already -impacted area, • invest in a comprehensive shelter model that works (rather than just shift impacts onto specific neighborhoods), • get buy in from the immediate community... engage with experts and community members and • use the example set by and learn from the successes of Costa Mesa's shelter program. STOP moving your problems around! RESPECT the community you are invading! GET a soul! Show your humanness..be examples for your children! Thank you, Olga Zapata Reynolds Westside Costa Mesa Sent from my Wad Received After Agenda Printed September 24, 2019 Item No. 18 From: Rieff, Kim Sent: Wednesday, September 25, 2019 7:31 AM To: Mulvey, Jennifer Subject: FW: Re proposed Homeless Shelter! From: Kong Shyng <kongshyng@me.com> Sent: Tuesday, September 24, 2019 10:13 PM To: Dept - City Council <CityCouncil@newportbeachca.gov> Subject: Re proposed Homeless Shelter! Dear Newport Beach council members, While I support Homeless shelters and am proud of the successful shelter program we have established in Costa Mesa, I am concerned about the approach and location under discussion currently. The proposed approach and location at 592 Superior, less than one mile from Costa Mesa's established shelter, risks compromising public safety and economic growth in this area and could undermine the progress achieved by Costa Mesa's shelter. • oppose the proposed shelter location in westside Newport so as to not consolidate impacts on an already - impacted area, • invest in a robust shelter model that works (rather than just shift impacts onto specific neighborhoods), • engage with experts and community members to earn community buy -in, and • learn from the successes of Costa Mesa's shelter program. Sincerely, Kong Shyng 1810 Coastal Way Costa Mesa, CA. 92627 Received After Agenda Printed September 24, 2019 Item No. 18 From: Rieff, Kim Sent: Wednesday, September 25, 2019 7:31 AM To: Mulvey, Jennifer Subject: FW: Mental Health Services Act (And More!) Attachments: 2019Aug26_AviationCommittee_Agend aComments_JimMosher. pdf; Little Hoover MHSA Report 1-2015.pdf From: Charles Klobe <cklobe@icloud.com> Sent: Wednesday, September 25, 2019 1:00 AM To: Dept - City Council <CityCouncil@newportbeachca.gov> Subject: Mental Health Services Act (And More!) Good day Madam Mayor and Members of the City Council, Recently I sent you a link to a Forbes article on Homeless in California. I know some of you saw it. Attached is a report from 2015 on the MHSA of 2004 and its progress. Perhaps you could ask those with expertise on the Homeless committee about it or direct staff to research if there is money there for NB to pursue. This is new to us and there may be money there that we do not know how to access. There are many members of the Newport Heights community that think the NHIA should have opposed the Superior decision. I believe given the strategic choices that you made the right call. It can be unwound if something better presents. I do not support the Costa Mesa lobby to push NB into their arms. That building that I sent you info on next to the Harbor courthouse is still available for sale! Borders Irvine on two sides! Gotta love Jim Mosher. Did you know he has a PhD in Physics? His written comments to the Airport Committee on the 8/26 meeting about noise measurements have merit. They are attached. They should be passed along to Bill O'Conner of Cooley for analysis. They were handed out at the Monday meeting, Thanks for listening, Charles Klobe Cell: 949-500-3969 Thanks for listening, 6 4F ! iURFK`F � I � L7 � L M � b .r F �grrFORest� . . REPORT #225, JANUARY 2015 LITTLE HOOVER COMMISSION DEDICATED TO PROMOTING ECONOMY AND EFFICIENCY IN CALIFORNIA STATE GOVERNMENT To Promote Economy and Efficiency Little Hoover Commission The Little Hoover Commission, formally known as the Milton Marks "Little Hoover" Commission on California State Government Pedro Nava Organization and Economy, is an independent state oversight agency. Chairman Loren Kaye By statute, the Commission is a bipartisan board composed of five Vice Chairman public members appointed by the governor, four public members Katcho Achadjian appointed by the Legislature, two senators and two assemblymembers. Assemblymember David Beier E In creating the Commission in 1962, the Legislature declared its purpose: Anthony Cannella Senator ... to secure assistance for the Governor and itself in promoting economy, efficiency and improved services in the transaction of the public business Jack Flanigan in the various departments, agencies and instrumentalities of the executive Don Perata branch of the state government, and in making the operation of all state departments, agencies and instrumentalities, and all expenditures of Anthony Rendon Assemblymember funds, more directresponsive to the wishes o people public l %'s f the p p ple as expressed by their elected representatives... Richard Roth Senator The Commission fulfills this charge by listening to the public, David A. Schwarz consulting with the experts and conferring with the wise. In the course of its investigations, the Commission typically empanels advisory Jonathan Shapiro committees, conducts public hearings and visits government operations Sumi Sousa in action. Commission Staff Its conclusions are submitted to the Governor and the Legislature for Carole D'Elia their consideration. Recommendations often take the form of legislation, Executive Director which the Commission supports through the legislative process. Jim Wasserman Deputy Executive Director Tamar Lazarus Project Manager Contacting the Commission Ciana Gallardo All correspondence should be addressed to the Commission Office: Research Analyst Little Hoover Commission 925 L Street, Suite 805, Sacramento, CA 95814 (916)445-2125 littlehooverolhc.ca.gov This report is available from the Commission's website at www.lhc.ca.goe State of California ytPF ..�F rhE. �T h: W LITTLE HOOVER COMMISSION CqL p OR P January 27, 2015 Pedro Nava Chaiman The Honorable Kevin de Le6n The Honorable Bob Huff Loren Kaye President pro Tempore of the Senate Senate Minority Leader Vice Chairman and members of the Senate Katcho Achadjian A—nblymember The Honorable Toni G. Atkins The Honorable Kristin Olsen David Beier Speaker of the Assembly Assembly Minority Leader Anthony Cannella and members of the Assembly Senator Jack Flanigan Dear Governor and Members of the Legislature: Loren Kaye Don Perata California recently marked the 10th anniversary of a landmark mental health ballot Anthony Rendon Assemhymember initiative that promised additional help for the severely mentally ill and bold new Richard Roth programs to emphasize prevention and early intervention. The Mental Health Services Senator Act - or Proposition 63 - won a majority vote in November 2004 with promises of fewer David Schwarz mentally ill Californians on the streets and in jail, better community-based care and Jonathan Shapiro strict oversight of spending. Sarni Sousa Carole D'Elia The act has since raised more than $13 billion for mental health programs through an Executive Diireetor income tax surcharge on California's wealthiest residents. By many accounts, the Mental Health Services Act is finding its stride after a decade and has demonstrated successes in improving lives throughout the state. For oversight, the record is not so notable. After 10 years, the state cannot provide basic answers to basic questions: Has homelessness declined? Are programs helping Californians stay at work or in school? Who is being served and who is falling through the cracks? The state cannot adequately quantify an anecdotal sense that the act has made California a better place for the estimated 2.2 million adults with a mental health need and their families. The Little Hoover Commission undertook its study of the Mental Health Services Act as part of a broader review of California's century -old initiative process, which has often proved an effective tool for special interests to steer tax revenue to their causes. The proposition represents a classic case of bypassing the Legislature's budget process to capture an assured funding source - but also of granting the Legislature limited power to amend the act upon its passage. The Legislature is typically powerless to amend ballot initiatives, but in this case, it was given and several times used its power to refashion the original provisions of the act as approved by voters. The Commission's review of the act provided a unique window to analyze - particularly through the experience of one measure - the arc of the ballot initiative process over an extended period of time. Ballot propositions, in general, can be useful when a societal or large-scale problem is too complicated or controversial to be addressed within the legislative process. Backers of the Mental Health Services Act claimed in 2004 they had no choice but to bypass a Legislature that proved unwilling for decades to adequately fund community mental health programs after the state began closing its hospitals in the 1970s. Milton Marks Commission on California State Government Organization and Economy • http://www.lhc.ca.gov/ 925 L Street, Suite 805 • Sacramento, CA 95814 + 916-445-2125 • fax 916-322-7709 • e-maillittlehoover@lhc.ca.gov Ballot propositions that delegate modest authority to the Legislature to improve the implementation of a ballot measure also can be effective, provided the rules for such alterations are clear. In the case of Proposition 63, the Legislature's intervention and involvement produced mixed results, but generally kept implementation on course through early bureaucratic stumbles and a severe economic downturn that annihilated mental health and social services budgets. In this review, the Commission learned that funding provided by Proposition 63 - now more than $1 billion annually and representing about 25 percent of California's overall mental health spending - continues to evade effective evaluation due to antiquated state technology and overlapping and sometimes unaccountable bureaucracies. The Legislature appropriately empowered the Mental Health Services Oversight and Accountability Commission by making it independent, but it still lacks teeth and shares oversight responsibilities for the act with the Department of Health Care Services. The Legislature should expand the authority of the oversight commission. Specifically, it should have the authority to conduct up -front reviews of the more controversial preventive programs funded by the act and be empowered to impose sanctions if counties misspend funds from the act or fail to file timely reports with the state. Nationally and globally, mental health professionals and policy analysts are trying to assess whether California's enhanced funding and new prevention -oriented mental health practices are paying dividends. For the sake of its innovative care programs at home and their potential replication elsewhere, it is imperative that California overcome its bureaucratic and technological obstacles to provide evidence of statewide outcomes instead of success stories from individual programs. Californians still see the mentally ill on their streets and see too often the impacts of mental illness in senseless crimes, suicides and inability to stay in school or on the job. Without conclusive data no one knows how far the state has come in addressing mental illness through the act and how far it still has to go. The state must make more existing data easily accessible and invest in a modern data collection system using a portion of the Mental Health Services Act state administrative funds. Clearly, the Mental Health Services Act has promises still to keep. Backers in 2004 promised voters their support would "keep people off the streets, out of the hospital and out of jail," as well as increase access to programs and services to help people "make the move from tax user to taxpayer." They also promised a skeptical voting public strict state oversight. The results on all fronts, even if actually being accomplished, cannot be convincingly demonstrated. The Commission heard no testimony that the act has not worked, but even initiative backers, along with the Commission, believe the state must streamline its bureaucracy and collect the necessary data to tell the story. The Commission respectfully submits these findings and recommendations regarding improved implementation of the Mental Health Services Act and is prepared to help you take on this challenge. Sincerely, Pedro Nava Chairman PROMISES STILL TO KEEP: A DECADE OF THE MENTAL HEALTH SERVICES ACT Table of Contents A Claim on State Spending: The Voters' 2004 Millionaire's Tax for the Mentally III...... 1 StrengtheningOversight........................................................................................... 15 Improving Transparency and Accountability.............................................................. 29 Conclusion.............................................................................................................. 47 Appendices& Notes................................................................................................ 51 Appendix A: Public Hearing Witnesses.................................................................... 53 Appendix B: Timeline: The Shaping of California's Mental Health System ................... 55 Notes..................................................................................................................... 59 Table of Sidebars & Charts Little Hoover Commission Attention Helped Inform Proposition 63 ........................... 2 Mental Health Services Act State Administration Expenditures .................................. 8 Apportionment of Mental Health Services Act Funds ................................................ 9 MHSA Revenue Fiscal Years 2004-05 through 2014-15 ............................................. 9 Public Mental Health Funding Sources in California ................................................. 10 Before and After: The Client Perspective.................................................................. 12 Implementing the Mental Health Services Act: A Small -County Perspective ............... 13 Major Players in MHSA's Implementation................................................................ 21 California Reducing Disparities Project.................................................................... 33 Community Services and Supports Priority Indicators ............................................... 37 Mental Health Services Act..................................................................................... 40 A CLAIM ON STATE SPENDING: THE VOTERS 2004 MILLIONAIRES TAX FOR THE MENTALLY ILL A Claim on State Spending: The Voters' 2004 Millionaire's Tax for the Mentally 111 alifornia voters wield extraordinary powers through the ballot initiative process. Voting at kitchen tables or in person at polling places, they handily bypass the traditional lawmaking and budgeting machinery that governs other states. Each June and November, Californians decide - yes or no - significant questions of crime and punishment, business regulation or environmental and social policy. They also steer billions of state tax dollars toward favored priorities by issuing bonds for stem cell research, children's hospitals, open space acquisition and big-ticket infrastructure. Discussion has long abounded about the positive and negative impacts of Californians' ability to directly set budget and policy priorities. Many in recent years have expressed concerns that a Progressive Era tool of direct democracy, created to overcome powerful early 20th Century interests in Sacramento, has become a favorite tool for powerful current interests. In all, a wide variety of advocacy groups and backers of causes have submitted over 1,800 initiatives under this century -old voting practice in California. Of all these proposals, 369 qualified for the ballot and voters passed 125.1 Rarely do voters directly increase income taxes, however. Since 1990, they have done it only twice.2 The Commission decided to examine one of those votes, in which a majority of California's voters targeted a minority of the population - wealthy millionaires - for an income tax hike. A permanent 1 percent surtax on the state's highest incomes has since steered approximately $13.2 billion primarily to caring for the severely mentally ill. As part of a potential periodic examination of what ballot -budgeting initiatives specifically promised voters - and what they delivered to the street - the Commission reviewed Proposition 63, the Mental Health Services Act (MHSA). Voting majorities in nearly 60 percent of California counties rejected the measure, but statewide it passed with support of 53.8 percent of voters in November 2004.3 1 LITTLE HOOVER COMMISSION Proposition 63 passed in the wake of failed legislative attempts to strengthen a public mental health system that often jailed or turned away the severely mentally ill and had little focus on prevention and early intervention — a problem that persists to some degree today. As now, the public saw the face of mental illness daily in the streets. Among failed attempts to improve the system was a 2001 bill by Assemblymember Helen Thomson that proposed to expand mental health services for adults and children. The bill also proposed creating a commission to engage California communities in reducing the stigma and discrimination often perceived when citizens sought mental health services. The legislation incorporated several Little Hoover Commission recommendations made in its November 2000 report, Being There: Making a Commitment to Mental Health. The bill also proposed new General Fund dollars for mental health training and human resource development programs.4 Legislators at the time discussed a general lack of baseline funding for the public mental health system. Some contended that the system had never been adequately funded since the state began closing its hospitals in the 1970s. At that critical juncture, California decided that people with mental illness should live in their communities rather than be locked or warehoused in institutions. People with mental illness, it was said, had a right to experience everyday life and would benefit from community-based treatment. For the next several decades, people with mental illness did, in fact, integrate into California communities. They were on street corners and sleeping in parks. They crowded local jails. Little Hoover Commission Attention Helped Inform Proposition 63 When the Little Hoover Commission last reviewed the state's mental health system between 1999 and 2000, it found a system that rationed care to those with the most extreme needs — and even then sometimes turned people away or criminalized those needing care. Following its year-long study, the Commission called for major reform, citing billions of dollars the state spent dealing with consequences of untreated mental illness, such as lost productivity, lower property values and quality of life, and increased costs for criminal justice. In its November 2000 report, Being There: Making a Commitment to Mental Health, the Commission emphasized the need for the state's mental health system to focus on successful treatment and recovery for those living with mental illness. It advocated policies to help people function in everyday life and investments in programs to "help first," rather than let people "fail first," overcome by fear, stigma and lost hope. The Commission also called for an oversight body to prod change, develop strategies to overcome stigma, detail the state's need and provide mental health policy advice to the Legislature and Governor. The Commission suggested the composition of this body should reflect the interests of key stakeholders from education, law enforcement, employment and health plans. The Commission's report found a receptive audience within the mental health community. Some of the Commission's recommendations were incorporated into AB 1422, the Thomson legislation that preceded Proposition 63, and ultimately the Mental Health Services Act. Specifically, the act included the Commission's recommendation to fund programs that promote early intervention and more comprehensive services. It also implemented the Commission's recommendation to establish an oversight commission which took the form of the Mental Health Services Oversight and Accountability Commission. 2 A CLAIM ON STATE SPENDING: THE VOTERS' 2004 MILLIONAIRES TAX FOR THE MENTALLY ILL Many were in the community, but went unseen while quietly struggling to hold jobs and care for children, burdened by the stigma as well as the disease. Unfortunately, mental health funding did not follow mental health clients out of the hospitals and into California communities. Further reductions implemented during the recession years of the 1990s exacerbated the system's shortcomings.5 Nevertheless, Governor Gray Davis vetoed the Thomson legislation in September 2002, citing insufficient budget resources and suggesting future opportunities "when the State's fiscal health improves."6 When it became clear that funding would not come through the legislative process, mental health advocates, including co-author Senator Darrell Steinberg, began to move on another front, crafting the first draft of Proposition 63 to model the failed Thomson bill.? "This initiative was needed because it was clear that there was no way that mental health could ever become a sufficient legislative priority to achieve its needed funding in any other way," Rusty Selix, the initiative's other co-author told the Commission in September 2014. "After 10 years, I still believe that Proposition 63 represents one of the best ever uses of the initiative process [in] accomplishing important public policy goals that could not have been enacted any other way.118 Importantly, for this Commission review of state initiatives, Proposition 63's authors included specific language allowing the Legislature to amend the act with a two-thirds vote, so long as the changes were consistent with the act's purpose and intent. The Legislature also can clarify terms of the act by majority vote.9 "Knowing that these provisions would govern the public mental health system permanently, we did not have enough confidence that we could be sure we got it right and so we wanted to allow amendments," Mr. Selix explained to the Commission. io The Commission's interest in Proposition 63 stems from discussions regarding the power of special or narrow interests to claim a portion of the state's funding stream for specific projects or causes and the Legislature's general inability to modify ballot or bond initiatives approved by voters. With enacted legislation the Governor and Legislature can revisit laws and amend them as needed. But most voter - approved initiatives lock in their statutory provisions, providing the Legislature and Governor limited or no ability to make changes for unintended consequences or other conditions that arise years later. Just as the governor lacks the right to veto laws passed by the initiative process, the Legislature cannot repeal or amend a statutory initiative, unless permitted by the initiative.11 3 LITTLE HOOVER COMMISSION Proposition 63, which now accounts for approximately 25 percent of California's public mental health spending, provides a vivid example of what happens after the majority of voters say yes - and when the Legislature also uses its power to modify what voters approved. The Commission's examination of the Mental Health Services Act offered a case study of best voter intentions that soon encountered bureaucratic entanglements, unforeseen financial circumstances and sometimes dramatic actions taken by the Legislature in response. In the years since its passage, the Legislature has exercised its authority to amend the act four times, in 2009, 2011, 2012 and 2013.12 A timeline describing these legislative changes, as well as other significant legislative reforms to the public mental health system, is included as Appendix B. In brief, the state bureaucracy's initial orientation toward process stalled the special tax revenues from getting to the street, which caused the Legislature to curb the state's power and send money directly to counties. For a time, severe state budget cuts during the Great Recession diminished county resources and turned a funding stream meant to supplement existing programs into one that, according to stakeholders, helped sustain the community mental health infrastructure. 13 Later, policymakers eliminated the Department of Mental Health, shifting responsibility for oversight of the act to various state entities and creating new confusion and oversight challenges. These amendments, however, have resulted in an oversight structure and funding process that is different from what voters initially approved. At its 2014 hearing, the Commission heard from stakeholders that a bumpy 10 -year ride of implementing Proposition 63 has changed the mental health system for the better. In addition to funds provided by the millionaire's tax, they say, the ballot initiative has stimulated a novel approach to mental health treatment that focuses on prevention and early detection. The system is more proactive. Less often is it forced to turn people away until they reach crisis. Nevertheless, 10 years after the act created its unique funding stream, concerns remain about its implementation. Stakeholders told the Commission that overlapping bureaucratic oversight continues to weaken accountability for the act's performance and outcomes. More importantly, authorities still can't clearly show, much less measure, what more than $13.2 billion has accomplished in terms of improving services for the estimated one in six California adults with a mental health need or the one in 20 who suffer from a serious mental illness. 14 The Commission's review offers several recommendations to counter these weaknesses and improve implementation of the act for this vulnerable population, while also enhancing public safety and the quality of life in California. 2 A CLAIM ON STATE SPENDING: THE VOTERs� 2004 MILLIONAIRE's TAX FOR THE MENTALLY ILL The Proposition 63 Campaign: High Expectations for Improvements Press coverage leading up to the November 2004 election described an emaciated mental health system, largely neglected by the state since it began closing its mental health hospitals in the 1950s, 1960s and 1970s, and shifting responsibility, but not adequate funds, for community-based mental health programs to the counties. Proposition 63 backers told voters that investing in the Mental Health Services Act could greatly reduce costs for incarceration, medical care, homeless shelters and social service programs.15 As described by its co-author, Rusty Selix, the act intended to achieve three goals: 1) fully fund integrated mental health services for the severely mentally ill, 2) protect existing mental health funding and 3) steer the culture of the state's mental health system toward prevention and early intervention. 16 Proposition 63 backers encountered powerful skepticism, however, about their so-called "ballot box" budgeting approach. The editorial pages of the state's most influential newspapers - the Los Angeles Times, San Diego Union -Tribune, Sacramento Bee, Orange County Register, San Jose Mercury News and Oakland Tribune - urged voters to reject the initiative. Editorials described it as well-intentioned, but "bad public policy" and a poor way to address state budget issues. Some opponents argued that the income tax would be a volatile revenue source and expressed concerns that an extra tax on millionaires might drive some to leave the state.17 Still, front-page media coverage across the state suggested Proposition 63 would provide a way for California to fulfill a past promise by creating a dedicated funding stream for mental health programs and a built-in accountability system to ensure effective use of the funds. The San Francisco Chronicle, which supported the measure in its editorial pages, told readers the funds would "be directed to programs that use a comprehensive approach to dealing with the mentally ill," and would earmark money for "expanding care and early intervention for children, training and supporting staff for clinics and improving facilities across the state."18 Los Angeles Times reports stated the measure would pay for mental health services that were in short supply, including: ■ "Hundreds more beds, added counseling, more vocational assistance and new prescription drug programs for overrun county clinics. ■ Building more clinics and training more mental healthcare workers to address continuing shortages. 5 LITTLE HOOVER COMMISSION ■ New prevention and early intervention outreach programs to help people showing signs of mental illness get aid before the problem becomes severe."19 The Ventura County Star, serving a county that had been plagued by money scandals in its mental health programs, reported that backers had "built tough oversight rules into Proposition 63." The newspaper stated that funding to counties would be based on how well they demonstrated the effectiveness of the programs included in their annual MHSA plans.20 The State's Implementation Apparatus Proposition 63's victory at the polls quickly ushered in a critical implementation phase by state and county governments that continues to evolve today. The Mental Health Services Act intended to change the way California treated mental illness by expanding the availability of innovative and preventative programs. It also intended to reduce stigma and long-term adverse impacts for those suffering from untreated mental illness and ultimately, make programs accountable for achieving those outcomes.21 The act directed the majority of revenues to county mental health programs and services, specifying that counties could spend their share in five separate funding categories, or components: 1. Community Services and Supports (CSS): 80 percent of county funding from the Mental Health Services Act treats severely mentally ill Californians through CSS. Within this component counties fund a variety of programs and services to help people recover and thrive, including full service partnerships and outreach and engagement activities aimed at reaching unserved populations. Full service partnerships provide "whatever it takes" services to support those with the most severe mental health challenges. A variety of agencies might participate by providing intensive, team -based services for clients who might have a history of incarceration or homelessness. Services might include therapy or behavioral therapy to help clients reduce their symptoms or case management to get clients housing, employment, education, substance abuse treatment or other social services. The Department of Health Care Services estimates that in fiscal year 2014-15, the act will generate $1.254 billion for CSS.22 2. Prevention and Early Intervention (PEI). Counties may use up to 20 percent of their MHSA funds for PEI programs, which are designed to identify early mental illness before it becomes severe and disabling. PEI programs are intended to improve timely access to services for underserved populations and reduce 101 A CLAIM ON STATE SPENDING: THE VOTERS 2004 MILLIONAIRES TAX FOR THE MENTALLY ILL negative outcomes from untreated mental illness, such as suicide, incarceration, school failure or dropping out, unemployment, homelessness and removal of children from homes.23 Within this category, the Mental Health Services Act encourages counties to take a proactive "help first" approach rather than wait for a condition to become severe and disabling. The Department of Health Care Services estimates that in fiscal year 2014-15, the act will generate $313.7 million for PEI.24 3. Innovation: Counties may use up to 5 percent of the funding they receive for CSS and PEI to pay for new and innovative programs that develop, test and implement promising practices that have not yet demonstrated their effectiveness. Innovation funds are designed to increase access to services, increase the quality of services, improve outcomes and promote interagency collaboration. 25 Expenditures in this component are intended to infuse new effective mental health approaches into the mental health system at the county level and throughout the state. The Department of Health Care Services estimates that in fiscal year 2014-15, the act will generate $82.5 million that can be used for Innovation programs.26 The Mental Health Services Act also required counties to spend a portion of their revenues on two additional components to build the infrastructure to support mental health programs. Since 2008-09, counties have the option of using a portion of their CSS funding in these areas or to build up a prudent reserve:27 4. Workforce Education and Training. This component aims to train more people to remedy the shortage of qualified individuals who provide services to address severe mental illness. Counties may use funds to promote employment of mental health clients and their family members in the mental health system and increase the cultural competency of staff and workforce development programs, among other uses.28 5. Capital Facilities and Technological Needs: This component finances necessary capital and infrastructure to support implementation of the other programs. It includes funding to improve or replace technology systems and other capital proj ects.29 Local assistance funds currently are allocated to the counties through a formula developed by the former Department of Mental Health in consultation with the California Mental Health Director's Association in 2005 and updated in 2008. The formula weighs each county's need for mental health services, the size of its population most likely to apply for services (based on its poverty rate and uninsured populations) and the 7 LITTLE HOOVER COMMISSION prevalence of mental illness in the county. Adjustments are made for the cost of living in each county and for other non-MHSA resources available to the county. Additionally, to ensure a minimum funding for rural counties, the formula established a minimum allocation for the CSS and PEI components.30 The Department of Health Care Services currently is responsible for updating the formula for county allocations of MHSA funds.31 State Administration Funds. The act also directs up to 5 percent of annual revenues toward state administration and specifies that these funds are to be used by state agencies to "implement all duties pursuant to the [MHSAI programs." This includes ensuring adequate research and evaluation regarding the effectiveness and outcomes of MHSA services and programs.32 In any given year, the Legislature and Governor may change the percent of funds appropriated for the state's administration of the act. The Legislature has reduced this cap, to as low as 3.5 percent and has raised it to as high as 5 percent where it stands in 2015. The Legislature exercises its discretion in determining how to allocate the state administration funds to various state entities each year through the annual Budget Act. Currently, 12 state departments, boards and commissions, as well as the adult and juvenile court systems, receive a portion of the state administration funds. The Department of Health Care Services estimates that in fiscal year 2014-15 the act will generate $86.9 million for state administration. 33 Mental Health Services Act State Administration Expenditures In fiscal year 2014-15, an estimated $81 million in revenue generated from the Mental Health Services Act will pay for an array of services across the following 12 state entities: ■ Board of Governors of the California Community Colleges ■ California Health Facilities Financing Authority ■ Department of Developmental Services ■ Department of Education ■ Department of Health Care Services ■ Department of Public Health, Office of Health Equity ■ Department of Veterans Affairs ■ Financial Information System for California ■ Judicial Branch ■ Mental Health Services Oversight & Accountability Commission ■ Military Department ■ Office of Statewide Health Planning and Development ■ State Controller's Office Source: Department of Health Care Services. May 2014. Mental Health Services Act Expenditure Report. Fiscal year 2014-15. A CLAIM ON STATE SPENDING: THE VOTERs' 2004 MILLIONAIRE's TAX FOR THE MENTALLY ILL State admininistration 5% Apportionment of Mental Health Services Act Funds Local funding 95% \ Innovation 5% PEI 4A 20% CSS/PEI Source: California State Auditor. Report 2012-122. Also, Mental Health Services Act. A Decade Later: What Proposition 63 Accomplished The Mental Health Services Act (MHSA) has generated a powerful funding stream — more than $13.2 billion, according to the Department of Finance — for the state's public mental health system since enacted a decade ago.34 In the past five years, this has amounted to more than $1 billion annually directed toward mental health programs and services, as shown in the table below. MHSA Revenue Fiscal Years 2004-05 through 2014-15 $2,000 (dollars in millions) $1,500 $1,319 S1 377 $1,564 $1,684 ' $1,000 $1,022 $1,062 $1,064 — $500 — $0 U'1 1.0n N O10 O O O O O 7�t n LP)I� 00 ON O N O O O O O O M 4 O O O O O O O O O N N N N N N N N N O O N N Total Revenue: $13.271 billion Note: Fiscal Years 2013-14 and 2014-15 reflect estimated revenue amounts.35 I LITTLE HOOVER COMMISSION Public Mental Health Funding Sources in California Local 3% Average Fiscal Years 2011-12 to 2015-16 Federal: Federal Medicaid Match: The majority of federal funding for mental health services in California comes through federal matching funds to counties for providing specialty mental health treatment to Medi -Cal beneficiaries. Beginning in 2014, a significant new federal match flowed to the state as a result of California's adoption of a new Medi -Cal benefit for non -specialty mental health services to all beneficiaries. Federal reimbursement is based on California's Federal Medical Assistance Percentage (FMAP), which is 50 percent for all Medi -Cal beneficiaries that qualify for Medi -Cal under pre -Affordable Care Act (ACA) eligibility criteria, such as a disability. However, for those Medi -Cal beneficiaries enrolled under the expanded eligibility criteria established under the ACA, California will receive an enhanced FMAP of 100 percent for 2014 — 2016, which then phases down to a permanent 90 percent match beginning 2020. Substance Abuse and Mental Health Services Administration: The mental health block grants are noncompetitive grants that provide funding to counties for substance abuse and mental health services. State: • Realignment: A portion of the state's revenues from sales tax and vehicle license fees is directed to the counties to pay for increased responsibilities for a number of mental health and other programs. Funding supports services provided to individuals who are dangers to themselves or others or who are unable to provide for their immediate needs, community-based mental health services, state hospital services for civil commitments and institutions for mental disease which provide long-term care services. Mental Health Services Act: A surtax on personal income over $1 million which flows to counties for community- based mental health services, prevention and early intervention services, innovative programs, mental health workforce development and others. General Fund: Support for the state hospitals and Medi -Cal program constitute the majority of state General Fund spending. Over $1.5 billion in state General Fund dollars supports inpatient psychiatric and mental health services to inmates and patients at California's five state hospitals. Additionally, more than $800 million is spent annually on psychiatric prescription drugs and non -specialty mental health benefits for Medi -Cal beneficiaries, behavioral health therapy for Medi -Cal enrollees with autism up to age 21 and educationally related mental health services for disabled students. Local: • Various sources: Counties collect local property taxes, patient fees, payments from private insurance companies to fund mental health services and other funding sources which they primarily use for their maintenance of effort — the level of spending required to receive their portion of state realignment revenue for mental health services. Funds may also go toward Medi -Cal services allowing the county to draw down additional federal dollars, or on services not reimbursable through Medi -Cal. Sources: Mental Health Services Oversight and Accountability Commission, Financial Oversight Committee. January 22, 2015. Financial Oversight Report. Also, Legislative Analyst's Office. November 4, 2013. "The 2013-14 Budget: California Spending Plan." Also, California HealthCare Foundation. July 2013. "A Complex Case: Public Mental Health Delivery and Financing in California." Also, Department of Finance, Governor's Proposed Budget, FY 2015-16, Department of Health Care Services. Also, SB 852 (Leno), Chapter 25, Statutes of 2014. 10 A CLAIM ON STATE SPENDING: THE VOTERS 2004 MILLIONAIRES TAX FOR THE MENTALLY ILL The act was designed to provide new funding to expand mental health services statewide, not to serve as the sole funding source for county mental health programs and services, Jessica Cruz, executive director of National Alliance on Mental Illness, California explained in testimony.36 And between 2010-11 and 2014-15, money from the act accounted for about a quarter of funding for all of the state's public mental health system, as shown in the chart below.37 At the county level, MHSA funds are woven into a complex funding stream that includes federal and state dollars, as well as various local resources. "MHSA funds act as both the primary funding source for programs, as well as the match for Medi -Cal services that fund recovery - oriented mental health services and supports," Debbie Innes -Gomberg, District Chief of Los Angeles County's MHSA implementation and outcomes division, explained to Commissioners in September 2014. "As a result, MHSA funding is embedded within the Los Angeles County Department of Mental Health outpatient system of care for children, transition age youth, adults and older adults and is integral to our recovery -oriented outpatient service delivery system."38 Throughout its study process, the Commission heard enthusiastic support for the Mental Health Services Act and the changes these funds have generated within the state's public mental health system. Some witnesses and stakeholders described in general terms how the act has achieved the outcomes promised to voters. "MHSA programs have served hundreds of thousands of Californians over the past 10 years," Ms. Cruz told the Commission. "These programs have reduced hospitalization, homelessness, suicide, and incarcerations... [and] help people achieve recovery and obtain meaningful places in society.1139 Others, like Larry Poaster, Mental Health Services Oversight and Accountability Commissioner and former Stanislaus County behavioral health director, credited the act with sustaining the state's mental health system through a period of severe economic recession, protecting mental health programs and services at a time when many others experienced deep cuts. In his testimony to the Commission, Mr. Poaster reflected that "had there not been an MHSA during the worst parts of the recession, the impact on the overall system would have been catastrophic. 1140 But beyond providing financial stability, stakeholders also credited the act's historic financial commitment, and its particular focus on prevention and early intervention, with vastly transforming the mental health system. Instead of just focusing on those with the most severe 11 LITTLE HOOVER COMMISSION Before and After: The Client Perspective Though California decided decades before the Mental Health Services Act that people with mental illnesses should live in their communities rather than locked institutions, the state failed to follow through with adequate funding, services and facilities. As a result, people with mental illnesses were visible on the streets, sleeping in city parks or housed in jails and prisons. They faced more stigma than support. Though these conditions still exist, the Mental Health Services Act has begun to shift the paradigm of programs and care with new emphasis on wellness, recovery, resilience and hope. Many programs supported by the act are designed to catch people who might otherwise fall through the cracks, particularly those unable or reluctant to seek care in traditional institutional or office settings. For example, a renter in Los Angeles County threatened with eviction due to hoarding, enrolled in weekly counseling sessions conducted by volunteer peer counselors and was able to remain in his apartment. Other programs aim to prevent mental illness from developing or worsening. New counseling programs helped one young woman identify her special education needs and transfer to a new school to thrive. Another MHSA program helped a mother teach her two-year-old daughter the words to express her feelings and better manage stressful situations. Other programs provide "whatever it takes" support to restore stability to people with mental illness compounded by drug abuse, homelessness or unemployment. Often, these programs mean fewer days being homeless, hospitalized or jailed. After receiving care funded by the act, one client reflected: "When I started experiencing hope, life seemed more livable. I began to look forward to the coming days. I became busier and more productive." While recovery will be a "long journey," she said she knows now where to get help and "looks forward to seeing how the rest of life unfolds." Sources: Little Hoover Commission. November 2000. Being There: Making a Commitment to Mental Health. Also, Los Angeles County Department of Mental Health. 2010. Transformations: How the Mental Health Services Act is Changing Lives in Los Angeles. Also, California Behavioral Health Director's Association. "Measures, Outcomes, and Quality Assessment at a Glance. 12 needs, the Commission heard that the act is providing Californians more comprehensive mental health treatment options.41 "I cannot fathom what the mental health system would look like without Proposition 63 because of the flexibility it has given the system to focus more on the community, parents and consumers," Mike Kennedy of Sonoma County told Commission staff. Before Proposition 63, he explained, California had a "fail first" system. "To get in the door, you had to be at a really severe level. Now, I have staff in high schools and colleges working to do early intervention with students.1142 Ms. Innes -Gomberg testified to the Commission how funding from the Mental Health Services Act allowed Los Angeles County to establish new and never -done -before prevention programs, early intervention programs that have been proven to work and innovative projects that are intended to help shape decisions about the county's system of care. "The MHSA has really, I think, achieved many of its goals," she said. "And what I mean by that is that it has really served to transform our system of care and to augment our system of care... It really has served to create a full continuum of care."43 Addressing the Remaining Weaknesses Despite the act's many perceived successes, the Commission also A CLAIM ON STATE SPENDING: THE VOTERs� 2004 MILLIONAIRE's TAX FOR THE MENTALLY ILL heard testimony about significant weaknesses that the state and counties must address to better channel its funding streams and honor promises made to voters in 2004. Critical among them is strengthening state and county oversight of spending and programs for mentally ill Californians. Equally critical: improving public transparency about where the money goes and the outcomes it produces. The Commission heard that legislative reforms changed the governance system for the better, clearing the path for money to get to the counties, and ultimately to the streets. However, some stakeholders said these changes have left the state without a strong oversight body empowered to monitor and oversee expenditures, and impose sanctions when necessary to ensure the act is implemented as intended. These issues are discussed further beginning on page 13. Additionally, the Commission heard that many basic facts about the act's outcomes remain unknown. Participants at the Commission's September hearing said state administrators cannot answer seemingly straightforward questions about the number of individuals served through MHSA programs, the amount of money raised and distributed through the act and the nature and quality of services clients received. Implementing the Mental Health Services Act: A Small County Perspective More than half of the state's counties have populations of 200,000 or less, presenting unique challenges in implementing the Mental Health Services Act. Smaller counties generally face staffing challenges — both within their own departments and in the broader mental health community, representatives from the County Behavioral Health Directors Association told Commission staff. A single staffer, for example, might implement the Mental Health Services Act in a rural county, whereas a highly -populated county would assign the responsibility to an entire unit of staff within its behavioral health department. As in other health care fields, it also is hard for small counties to maintain an adequate corps of well- trained mental health professionals. Some counties have dealt with these challenges by pooling their funds regionally. Facing local shortages of psychiatrists, for example, some counties have collectively used funds from the act to pay off school loans for psychiatrists attracted to their remote locations. Small counties also traditionally lack specialty skills in assembling tax credits and other layered funding sources to build supportive housing for their mentally ill residents. Consequently, they have been unable to apply for housing funds available from the Mental Health Services Act. Starting in 2015, however, they will be able to gain access to these funds by applying directly to the Department of Health Care Services through a partnership with the California Housing Finance Agency, representatives from the County Behavioral Health Directors Association told Commission staff. Sources: Adrienne Shilton, Senior Associate, California Institute for Mental Health. December 22, 2014. Personal communication. Also, California Office of Statewide Health Planning and Development. Mental Health Services Act, Central Region partnership implementation progress report. Accessed on December 22, 2014 at http://www.oshpd.ca.gov/HPEF/Text pdf files/WET/Central ImplementationReport. pdf 13 LITTLE HOOVER COMMISSION Most importantly, they said the state still cannot accurately say how effectively services and programs supported by the act have helped those with mental illness get better or prevented others from developing a severe or disabling mental illness. These issues are discussed further beginning on page 25. Until the state and counties better address these problems, the act's achievements will remain cloudy, potentially leaving successful programs vulnerable to further legislative action. Commission Study Process The Commission approached its review of Proposition 63 with the intention of studying what happens after voters approve a ballot initiative that steers significant tax dollars to specific programs and services. On September 23, 2014, the Commission held a hearing to review the Mental Health Services Act as one example of how initiatives are used to fund special programs. Hearing witnesses included Rusty Selix, co-author of the initiative, leaders from two organizations that represent mental health clients and their families, as well as officials at the Mental Health Services Oversight and Accountability Commission and the Department of Health Care Services. It also included officials from the Los Angeles County Department of Mental Health and Sonoma County Department of Health Services who administer MHSA programs in their respective counties. The Commission also received extensive public comments from leaders inside the state and county mental health systems, clients, advocates for the mentally ill, researchers and members of the California Reducing Disparities Project. A list of invited witnesses from this hearing is included in Appendix A. Video coverage of the September 2014 hearing is available through the Commission's website at www.lhc.ca.gov. The Commission's hearing provided an opportunity to assess the outcome of an individual ballot initiative 10 years after its passage and begin to identify lessons to improve the writing and implementation of future initiatives. In particular, the hearing helped Commissioners better understand the state's oversight mechanisms for Proposition 63's considerable revenue stream and learn about the range of outcomes resulting from California's ballot -box investment in mental health services. The following chapters in this report detail the Commission's findings and recommendations. 14 STRENGTHENING OVERSIGHT Strengthening Oversight hen voters raised the income taxes of California's millionaires in 2004, they simultaneously approved a statewide governance system to administer and oversee mental health programs funded by this new tax. Proposition 63 supporters expected state -level oversight and evaluation of program funding to be of utmost importance, said Jessica Cruz, executive director of the National Alliance on Mental Illness, California, to Commissioners in September 2014. However, from the start, responsibility was diffused among various entities at the state and local levels. Though 10 years has passed and the Legislature has at times intervened, the state has yet to develop a cohesive system for governing the Mental Health Services Act. This ongoing weakness has implications for effective oversight and evaluation of the use of the funds, and ultimately, confidence that an important public investment is being spent well and delivering desired results. Challenges from the Start: Multiple Bureaucracies, a Confusion of Oversight The Mental Health Service Act established a governance system where a patchwork of local and state entities shared overlapping responsibility to implement and oversee the local assistance programs funded by the act in five component areas: Community Services and Supports (CSS), Prevention and Early Intervention (PEI), Innovation, Workforce Education and Training and Capital Facilities and Technology Needs. Initially, the Department of Mental Health and the Mental Health Services Oversight and Accountability Commission (oversight commission), a 16 -member statewide board created by the act, shared responsibility to review and approve county spending plans. Each entity was to help assure that funds were spent in accordance with the intent and purpose of the act before funds were released to counties. As a division within the Department of Mental Health, the oversight commission held primary responsibility to review and approve county PEI and Innovation plans and to oversee implementation activities in those components as well as in CSS. The act instructed the oversight commission to refer critical issues related to county performance to the Department of Mental Health. The department held power to address local shortcomings by imposing administrative sanctions such as is LITTLE HOOVER COMMISSION withholding funds and requiring the county to enter into negotiations to comply with state laws and regulations. The department also could refer issues to the courts.44 Critics said early implementation was neither smooth nor swift. Some called the oversight structure complicated and redundant due to reviews and approvals by both the Department of Mental Health and the oversight commission. Key complaints zeroed in on unwieldy state government processes that seemed to be amassing a bureaucracy around the new MHSA funds rather than speedily moving them to counties for programs and services. Stakeholders' considerable frustrations with the state's initial implementation of Proposition 63 included: Undefined Roles and Responsibilities: The act identified numerous entities responsible for its implementation, including the Department of Mental Health, the oversight commission, the Mental Health Planning Council, counties and stakeholder community groups. However, a 2008 Department of Finance audit concluded the act did not clearly define their individual roles. The act stipulated that the Department of Mental Health would develop regulations for itself and designate local agencies to implement the act. The audit, however, found that the department never exercised its authority. Various roles and responsibilities evolved happenstance based on each entity's interpretation. 45 Staggered Implementation: Many complaints stemmed from the mental health department's staggered implementation of the act, issuing separate guidelines for county plans for each of the five components beginning with the primary Community Services and Supports component in 2005. (The oversight commission issued guidelines for PEI programs in 2007 and for Innovation programs in 2009.46) The act required counties to develop three-year plans with significant input from stakeholders, along with annual updates describing how they would use the act's money for the five component areas. The department's staggered implementation strategy made it impossible for counties, which were required by the act to conduct a stakeholder -involved planning process for allocating funds, to develop comprehensive plans for their use. Instead counties had to undergo labor-intensive and time- consuming processes to develop plans for each individual component.47 Onerous Plan Requirements: From the start, the Department of Mental Health received considerable complaints about onerous plan requirements in which counties had to account in detail how they would spend funds and implement programs.48 A 2008 performance audit conducted by the Department of Finance found that CSS guidelines did not reflect the diversity of the state's 58 counties and as a result, county plans ranged in size from 300 pages to 1,000 pages. The department's 16 STRENGTHENING OVERSIGHT initial review process also exceeded its 90 -day timeframe for the majority of counties. For seven counties, the department's review times ranged from 180 days to 336 days.49 With funding tied to approval of county plans, and approval of county plans being slow, distribution of funds to the counties became significantly delayed. Lack of Coordination: Initially, counties submitted three-year spending plans for Community Services and Supports, Workforce Education and Training and Capital Facilities and Technology Needs programs to the state mental health department for approval. The department worked with counties to develop their plans and monitor implementation. County spending plans for the Prevention and Early Intervention and Innovation programs went to a separate agency, the oversight commission, for review and approval. However, if the oversight commission or the department identified a problem with a county's plan, either could work directly with the county to seek additional information and ultimately stall the review process. so A Flawed Fund Distribution Process: The Department of Finance's 2008 audit found the Department of Mental Health's process to steer Proposition 63 funds to counties quickly proved cumbersome and inefficient, bogged down by lack of policies and procedures to process payments. The audit concluded this process, too, reduced cash flows to counties. 51 Overall, these issues contributed to a frustrating sense among stakeholders and Proposition 63 supporters of bureaucratic entanglement and stalled implementation. The state, devoting its energies in the initial years to launching and refining a process to implement the act, eventually added to this frustration by providing little oversight of whether the programs they funded helped the mentally ill. Empowered by Proposition 63 to Respond, the Legislature Intervenes Less than five years after voters enacted Proposition 63, and largely in response to concerns raised in the Department of Finance's audit, the Legislature first exercised its authority to amend the act. In the years since, it has made three additional - and in some cases, significant - amendments, which are summarized below and in a timeline in Appendix B. Stakeholders credited the Legislature with removing burdensome administrative requirements and generally streamlining the flow of money to the counties. But others say these changes produced a new funding process and a local oversight structure significantly different from what voters enacted in 2004. 17 LITTLE HOOVER COMMISSION Clarifying Role of Oversight Commission. Lawmakers first amended the act in 2009, moving the Mental Health Services Oversight and Accountability Commission out of the Department of Mental Health and authorizing the oversight commission to obtain data from the mental health department and local entities that receive MHSA funds. By 2010, the oversight commission had shifted its focus from reviewing and approving PEI plans to evaluating the act's outcomes and studying the appropriate and effective use of MHSA funds, its executive director told the Commission.52 Hampering the oversight commission, however, was its dependence on other entities to provide data necessary for its evaluations. This complication continues to impede the commission and is discussed further in the next chapter. The legislation also gave the oversight commission authority to issue guidelines for how counties would spend MHSA funds on some of the act's more controversial - but also cutting-edge - Prevention and Early Intervention and Innovation programs. 53 Shifting Oversight Responsibilities to Counties. In 2011, frustrated by the state's lengthy approval process and delays in getting money to the counties, the Legislature introduced more significant amendments, including one redirecting $861 million of MHSA funds away from expanding and adding new programs to propping up existing General Fund programs devastated by state budget cuts. Lawmakers also amended the act to require the State Controller's Office to provide counties their MHSA funds directly in monthly lump sum installments. This change eliminated state approval of county mental health plans. Now county boards of supervisors "self -certify" their plans in accordance with requirements of the act.54 While the Legislature made these changes to speed the flow of MHSA money to counties, it reduced the state's ability to oversee use of the funds. Previously, county allocations were distributed by component, making it easier to understand how each county invested its MHSA dollars. Oversight Responsibility Changes Hands at the State, Overlap Remains. In 2012, lawmakers again introduced major reform to the state's mental health system, producing significant consequences for who would oversee the Mental Health Services Act and how. To streamline the state's administration of its mental health programs, lawmakers eliminated the Department of Mental Health and transferred many of its MHSA-related functions to the Department of Health Care Services.55 Lawmakers also codified requirements for counties to provide the oversight commission annual revenue and expenditure reports to facilitate the commission's financial oversight of MHSA expenditures. The oversight commission regained authority to approve county plans for developing Innovation programs before funds were distributed to I STRENGTHENING OVERSIGHT counties. However, decisions about the vast majority of spending through Community Services and Supports and Prevention and Early Intervention programs remained with the counties, which continue to submit plans for these programs to the state for review, but not approval. 56 In 2013, lawmakers further empowered the oversight commission to issue regulations for Prevention and Early Intervention and Innovation programs, which will be adopted by early June 2015.57 Responsibility for regulating other components remained with the department. The department told the Commission it is currently updating regulations related to Community Services and Supports, Capital Facilities and Technology Needs and Workforce Education and Training. 58 "At this time, I believe that all of [the amendments] have improved the functioning of the act," Rusty Selix, Proposition 63 co-author, told the Commission.59 Yet, the Commission also heard from stakeholders suggesting that current state oversight remains a confusing patchwork of overlapping responsibilities. More, they said, the multiple government entities overseeing today's MHSA's funding streams and programs still cannot systematically or comprehensively evaluate outcomes to demonstrate what the act has accomplished. Governing the MHSA Today: Oversight Challenges Persist Despite well-intentioned state efforts to improve the MHSA's implementation, today's newer landscape of multiple -entity oversight can still baffle stakeholders. The Legislature's initial modifications empowered the Mental Health Services Oversight and Accountability Commission by making it independent of the Department of Mental Health. Yet both continued to share oversight responsibility for the act. The Legislature's more recent modifications largely preserved this original structure of diffused authority, with the Department of Health Care Services rather than the Department of Mental Health, sharing primary oversight for the act with the Mental Health Services Oversight and Accountability Commission. Both entities also collectively regulate how counties spend MHSA funds. The oversight commission, however, must rely on the department and counties to provide the data it needs to evaluate programs funded by the act. Getting that data can sometimes prove difficult. Indeed, some believe that despite the Legislature's attempts to improve initially -blurred governance of the act, state oversight continues to be muddled, confusing and inadequate. "Right now, with the dissolving of [the Department of Mental Health], we have five different state organizations that are overseeing the different funding sources," Jessica 19 LITTLE HOOVER COMMISSION Cruz, executive director of the National Alliance on Mental Illness, California, told Commissioners in September 2014.60 The roles of these entities and others involved in implementing the act are summarized in the box on the following page. 61 Stakeholders told the Commission that the partnership between the department and the oversight commission appears collaborative. Both recently conducted efforts to improve mental health data systems and held joint discussions regarding ways to improve data quality.62 Yet challenges also abound in this governing arrangement. In some respects the two state entities could hardly be more different. The department is massive and focused on an entire health care universe that includes Medi -Cal, the Affordable Care Act, dental health, substance use disorder services and long-term care. Mental health is a small piece of its portfolio and the MHSA even less so. Put simply, "DHCS is the statutory entity for the administration and implementation of the MHSA as well as the overall public mental health system," one member of the oversight commission explained. "They are the owners of the major data systems by which counties report information to the state. This includes accumulating financial information as well as outcomes [for the MHSA]." The oversight commission is independent, small and responsible only for the MHSA's 25 percent share of California's overall mental health care spending. Yet, the oversight commission is reliant on the department and counties for the data it needs to fulfill its evaluation function. Little State Oversight of County Expenditures, Implementation Among the consequences of the Legislature's modifications of the original 2004 Mental Health Services Act, few are bigger than the current overall lack of state control over how counties spend their funds. The Legislature's changes provided a significant win for local control of MHSA spending that the original act did not. Counties now enjoy great flexibility in determining where and how to deliver the vast majority of services funded by Proposition 63. Only small-scale plans for innovative and experimental programs require approval from the oversight commission before funds are released. Amplifying local control is not out of step with the initial design of Proposition 63, which created a client- and family -driven decision process that weighed heavily toward spending priorities set by local stakeholders. But unlike the checks and balances that often govern public spending, counties, in this sphere, have a one-stop accountability structure in which the boards of supervisors approve MHSA plans and then also allocate the MHSA funds for them. 20 STRENGTHENING OVERSIGHT Major Players in MHSA's Implementation California's Counties: County boards of supervisors approve counties' three-year program and expenditure plans and annual updates. Prior to adoption, a county's mental health director or auditor controller must certify that its mental health program and expenditure plans comply with the Mental Health Services Act. Counties must submit their plans to the oversight commission and Department of Health Care Services for review, but no longer require their approval. Mental Health Services Oversight and Accountability Commission (oversight commission): With 30 positions and an operating budget of approximately $9 million in 2014-15, the oversight commission monitors and evaluates use of funds in each of the five MHSA components and researches and evaluates the effectiveness of MHSA services and their outcomes. To date, it has launched dozens of new evaluation projects ranging from descriptive studies to complex services outcome studies for multiple components. It also: ■ Advises the Governor and Legislature on ways to improve care and services for people with mental illness. ■ Provides training and technical assistance to counties. ■ Develops regulations for the Prevention and Early Intervention and Innovation components and approves county innovation plans. In addition to its oversight role, the commission administers $32 million in annual grants to fund triage staff that will provide crisis support services, such as brief, therapeutic intervention and intensive case management in participating counties. Department of Health Care Services, Mental Health Services Division (DHCS): With 19 positions and an operating budget of more than $9.3 million in fiscal year 2014-15 devoted to the MHSA, the department's mental health services division provides fiscal and program oversight of counties' use of MHSA funds. The department collects MHSA data from the counties, develops and monitors counties' performance contracts and conducts annual fiscal data reviews and triennial on-site reviews and: ■ Reviews the MHSA allocation methodology and monitors distribution and reporting of MHSA funds. ■ Develops and reviews county revenue and expenditure reports. ■ Develops regulations for the Community Services and Supports, Workforce Education and Training and Capital Facilities and Technological Needs components. ■ Administers contracts with several entities related to statewide prevention and early intervention activities. The department is the only state entity with ability to require corrective action of the counties regarding the act. Office of Statewide Health Planning and Development (OSHPD): When the Department of Mental Health was dismantled in 2012, OSHPD assumed responsibility for preparing the MHSA five-year Workforce Education and Training plan. With 15 positions and an operating budget of approximately $3.87 million in fiscal year 2014-15, OSHPD conducts various planning activities including psychiatric residency programs, a statewide technical assistance center to support county health agencies, a residency program for physician assistance in mental health and a mental health loan assumption program to encourage professionals to practice in underserved locations in the state. California Mental Health Planning Council. Established in 1993 in response to the Legislature's realignment of mental health program responsibility and funding to the counties, the council advises the DHCS mental health policy, provides oversight of OSHPD's Education and Training plan development and also reviews and approves each five-year Education and Training plan. The council consists of 32 members appointed by DHCS and eight state department representatives. Half of the appointees are family members, direct consumers of mental health services or people who represent organizations that advocate on behalf of people with mental illness. Office of Health Equity, California Department of Public Health: Established in June 2012, the Office of Health Equity works to align state resources and programs to reduce health and mental health disparities, with special attention focused on disadvantaged, vulnerable, or isolated communities. The office consists of 17 employees and received $60 million of MHSA state administration funds to implement the statewide California Reducing Disparities Project over the course of four fiscal years 2012-13 through 2016-17. The project is designed to improve access, quality of care, and increase positive outcomes for racial, ethnic and Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) communities in the public mental health system. 21 LITTLE HOOVER COMMISSION Many stakeholders recognize the value of community involvement in prioritizing funding, and equally recognize that individual counties have their own priorities and needs. One stakeholder called the local emphasis "the best piece of the act." But some also see a variety of local decision-making processes and lack of a state oversight body to ensure statewide consistency in local programs as an implementation weakness. Others expressed concerns to the Commission that counties lack staff with sufficient knowledge of the act to ensure appropriate types of expenditures. For example, local mental health boards - required by the act to advise boards of supervisors on the content of county MHSA plans - often lack adequate funding and staff to carry out meaningful advisory roles, Rusty Selix told the Commission. He said the sometimes -limited makeup of mental health boards also can fail to include the views and needs of unrepresented client groups. 63 The annual budget process in California's 58 counties triggered additional concerns about lack of transparency or meaningful ways for participants to engage in decision-making. The Commission heard, for example, that stakeholders hesitate to speak out against county decisions for fear of losing funding for their priorities in the next budget cycle. They suggested that dominant local voices often hold sway over county spending priorities while groups that lack an organized presence or maintain a low profile due to the stigma of mental illness are excluded. Without a broader statewide oversight body, advocates said there is nowhere to voice concerns about county spending except to those making the actual decisions. 64 Stacie Hiramoto, another advocate, told the Commission that at the state "there is a culture of accommodating and supporting the counties, even when community stakeholders [consumers, family members, community providers and representatives of underserved racial, ethnic and cultural communities] are advocating for stronger oversight and accountability in terms of administration of the MHSA.1165 "If a county is not adhering to the vision of the MHSA, there is no statewide oversight body with authority over county MHSA funding distribution that would be able to oversee the process," Jessica Cruz, executive director of National Alliance on Mental Illness, California, told the Commission. "In fact, the counties providing services are the ones who are creating them, and if someone has a problem, they have to attempt to go to those in power which will more than likely result in status quo."66 Ms. Cruz recommended giving a statewide agency the authority to approve, oversee and fund county plans and programs. She argued that this extra layer of review would enable the state to provide better guidance to counties and ultimately create better outcomes for consumers. 67 22 STRENGTHENING OVERSIGHT Still, as demonstrated by the act's initial implementation, comprehensive state oversight of county MHSA spending plans has its own potential shortcomings. Early state oversight created an overly bureaucratic, paper -heavy process that ultimately slowed the flow of funding to the counties and delayed delivery of critical services for those with the most severe mental illnesses. The majority of money from the act - 80 percent - is sent to the counties to fund proven programs for the severely mentally ill. It is important that the department continue to monitor this spending and equally important that the oversight commission study program outcomes to better understand how they are helping people lead better lives. But building an additional bureaucratic layer of state review for proven programs might prove excessive and could once again slow the flow of funding to the counties. By design, however, not all programs funded by the act are built on proven models. Through its Prevention and Early Intervention and Innovation components, the act allows counties to spend approximately 25 percent of their MHSA dollars on new and innovative community - defined or promising practices designed to help people before they are formally diagnosed with a severe mental illness. The act directed a large part of this pot to brand new preventative programs meant to end the pattern whereby children have to fail in school or at home before their mental health problem is identified and treated and before adults drop out of college or lose their job, Mr. Selix told the Commission. 68 These programs have the most potential to increase culturally competent services to racial and ethnic communities and reduce disparities across the state, Stacie Hiramoto, director of the Racial and Ethnic Mental Health Disparities Coalition, told the Commission. Counties only started introducing these programs in 2009 - due to MHSA's initially -staggered implementation schedule - and are just beginning to develop the data to demonstrate the results. Without comprehensive outcome data, some programs have attracted criticism within the mental health community and from those who believe the act's funds should be directed solely towards those with severe mental illness. The media has amplified the concerns. Media reports in mid -2012 strongly criticized various programs being funded by the MHSA, citing state spending for "acupuncture, art and drama classes, sweat lodges for American Indians, parenting courses for Spanish -speakers and massage chairs for students in Southern California.1169 Reports also criticized expenditures for anti -bullying programs, horseback riding therapy, yoga classes and gardens for rural Asian refugees. "Every objective review [of Prevention and Early Intervention programs] has found those critics to be off -base, generally reflecting a lack of appreciation of the value of prevention and early intervention versus 23 LITTLE HOOVER COMMISSION focusing all funds on people who are already severely disabled," Mr. Selix told the Commission. 70 Until the state evaluates whether these programs have tangible benefits, critics could continue to single them out. In the meantime, to quell concerns about expenditures on these sometimes controversial programs, the state should bolster oversight of the Prevention and Early Intervention plans, as it already does for the Innovation plans, which require oversight commission review and approval before money goes out. Before the Legislature changed the plan approval process, the oversight commission had established a track record of approving both plans in a timely manner - just 28 days.71 Indeed, lawmakers already have granted the oversight commission responsibility to regulate the Prevention and Early Intervention programs. The regulations, expected to be adopted in June 2015, "will clarify what data reporting is necessary, and when, and how often this data reporting must happen." They also will establish a more standardized process for obtaining consistent county data.72 Like Innovation programs, Prevention and Early Intervention programs are unique, and because of their new and different approaches to treatment, counties and stakeholders could benefit from additional technical assistance from the state as well as approval.73 Many others too believe upfront review of the PEI programs by a state entity could enhance confidence in the way counties spend this portion of their funds. No One -Stop Authority to Sanction Counties that Mishandle Funds One especially confusing segment of Mental Health Services Act oversight revolves around the diffused authority of the oversight commission and the health care services department to require corrective action when counties mishandle funds. The two entities share authority to oversee county spending, but not to correct errors or abuses. This diffused authority undermines effective oversight of funds approved by voters in 2004. As described earlier, lawmakers created the dilemma when they sped the flow of money to counties by eliminating requirements for the state to approve most county MHSA program and expenditure plans. The State's Review Role. Counties are still required to send their three year program and expenditure plans to the oversight commission, describing how they will use the funds in accordance with the act.74 They also must provide annual updates describing changes to those plans. The oversight commission is required only to receive these plans. Nonetheless, as part of its oversight function, it reviews them to ensure compliance with the act. In their reviews, oversight commission staff said they occasionally have identified instances where counties inappropriately spent MHSA money. Violations include directing all funds to programs for the severely mentally ill without funding 24 STRENGTHENING OVERSIGHT prevention and early intervention programs as required by law. Others include failing to spend MHSA money in a timely manner or using it to supplant other program funds.75 Though the oversight commission can and does help counties correct some of these issues, it is not empowered to require counties to correct their actions. Instead the oversight commission is directed by law to refer any critical performance issues it identifies to the department for a response.76 The department then can withhold mental health funds from counties or require counties to enter into negotiations to comply with laws and regulations. The deputy director in charge of mental health and substance use programs told the Commission the department reviews issues identified by the oversight commission and determines if further action is required under current laws, regulations and performance contracts. Stakeholders told the Commission, however, the department does not always exercise this authority in a timely manner and that at least one case has been pending for two years. The deputy director told Commission staff the two year case is only one example and doesn't accurately reflect how long the process will take in the future. She said the department is currently "improving administrative capabilities to provide increased oversight and monitoring.1177 Indeed, the department has recently developed a draft protocol to ensure that it handles future critical performance issues in an effective and consistent manner.78 Counties' Role to Report Spending and Program Implementation. As described above, lawmakers in 2012 codified the requirement for counties to submit electronically annual revenue and expenditure reports to both the Department of Health Care Services and the oversight commission. 79 The department also is authorized to withhold MHSA funds if counties fail to meet reporting deadlines. 80 While the department reviews these reports to verify the accuracy and appropriateness of county's expenditures, these reports also are a critical evaluative tool for the oversight commission because they show how counties spend MHSA funds, quantify the total funds generated for the mental health system and provide information to evaluate of each of the MHSA components. However, not all counties submit these reports to the state in a timely or consistent manner. As of December 2014, both the oversight commission and department had received these reports from all counties for fiscal years 2009-10 and 2010-11 (but were missing reports from several counties for fiscal year 2011-12).81 More current financial information is not yet available (the department has plans to issue instructions for the counties to submit reports through fiscal years 2014-15 by early summer 2015).82 Taking these steps to fill the gaps in financial reporting is critical to the oversight commission's ability to hold counties accountable for their MHSA expenditures. Additionally, without 25 LITTLE HOOVER COMMISSION such information, the commission is limited in its ability to monitor and evaluate the statewide impact of MHSA funding. "We also need to know where all of the funding not spent on comprehensive services has gone and how big the gap is in achieving our goals in each county. This is still a missing set of data," Rusty Selix told the Commission. "It appears as though the oversight commission has the authority to require this information from counties. However, there might be a need to strengthen the authority of the commission to obtain the information it may need." The success of the act depends on the success of the counties. However, stakeholders told the Commission that until a state watchdog agency can ensure repercussions for counties that fail to provide required information about their implementation of the act, the state will not be able to collect data consistently and its evaluative efforts will continue to be hampered.83 It is therefore imperative that the state exercises its authority to ensure that each county spends the money as allowed by law - and is sanctioned accordingly if it does not comply. Equally imperative is that counties fulfill their reporting obligations in a complete and timely manner. To ensure consistency among counties statewide, stakeholders recommended that "there should be a statewide oversight that has teeth for enforcement." 84 Like the department, the oversight commission should be empowered to work directly with counties to address deficiencies and require corrective action, including the ability to withhold MHSA funds, to ensure compliance if necessary. Weak Oversight of State Administration Funds The MHSA allows the state to allocate a small percentage of funds to state entities involved in administrative duties related to the act. The Department of Health Care Services estimates that in fiscal year 2014-15 it will allocate $86.9 million in MHSA state administration funds to 12 state entities. Some of those entities include the mental health department, oversight commission, Department of Public Health, the state's Judicial Branch, Military Department, Department of Education and Department of Veterans Affairs. The former Department of Mental Health used to coordinate interagency partnerships among the various entities that received MHSA state administration funds. As part of its oversight function, the department would coordinate annual budget change proposals from entities seeking a portion of the MHSA state administrative funds. If approved through the budget process, the department would establish memorandums of understandings with receiving agencies based on their budget change proposals. The memorandums of understanding clarified expectations 26 STRENGTHENING OVERSIGHT and responsibilities around how the receiving entities would use the MHSA funds. The department also monitored expenditures through work plans and progress reports submitted by receiving entities. 85 The Department of Health Care Services assumed responsibility for administering the MHSA fund since the dissolution of the Department of Mental Health. But it has not instituted its predecessor's approach to overseeing allocation of the state administrative funds. Today, departments submit budget change proposals for state administrative funds directly to the Department of Finance and finance analysts may seek additional input from the department or the oversight commission. Funds are allocated through the state budget process.86 The Department of Health Care Services describes administrative expenditures for state entities receiving MHSA funds in its annual Mental Health Services Act Expenditure Report. Though the level of detail provided varies, the report generally describes the amount and number of positions funded by the MHSA and includes an overview of the program's activities. 87 Though the oversight commission is not formally involved in decisions about how these funds are used, its financial oversight committee recently began inviting entities that receive part of the MHSA state administrative funds to report their uses to the oversight commission.88 To date, five state entities have made presentations to the committee on their use of MHSA funds: the Judicial Council, Office of Statewide Health Planning and Development, Department of Developmental Services, Department of Education and Military Department. According to the subcommittee's chair, it is developing a format for sharing findings from these presentations to the full oversight commission.89 Rather than evaluate the merits of funding each individual program, the state should comprehensively evaluate its spending to ensure program purposes and efforts align with the context of the act and its various goals. Also, because the funds stem from a surtax - by nature, a variable revenue stream - the state also must be capable of prioritizing spending to best meet the goals and intent of the act, particularly in times when requests exceed available revenue. By strengthening its reporting of how these funds are used, as well as the outcomes they are achieving, the state could model the type of accountability that is needed for all of the act's expenditures and ultimately, help to build confidence that the act is achieving its goals. Summary Despite the Legislature's interventions to streamline the governance and financial outlays of the Mental Health Services Act, the state still lacks a strong oversight body that is empowered to monitor and oversee 27 LITTLE HOOVER COMMISSION expenditures. Nor can the state effectively impose sanctions, when necessary, to ensure the act is implemented and delivers the results voters were promised. Primary responsibility for overseeing the act continues to be shared by two entities at the state level. But stakeholders said these entities have yet to provide comprehensive oversight the state needs to demonstrate that $ 1 billion a year or more is funding appropriate and effective mental health programs and services. The Department of Health Care Services is still relatively new to its mental health responsibilities. And it is simultaneously focused on the much larger task of implementing federal health care reform and transforming Medi -Cal, the state's version of the federal Medicaid program that provides health insurance for low-income, senior and disabled Californians. The Mental Health Oversight and Accountability Commission is designed to provide the kind of monitoring and evaluative efforts the state lacks. But it is not currently empowered to do so. The time is opportune for policy leaders to re-evaluate this shared governance of the Mental Health Services Act so that oversight and enforcement responsibilities are clear and the state is more responsive to its county partners and mental health system stakeholders. Recommendations Recommendation 1: The Legislature should expand the authority of the Mental Health Services Oversight and Accountability Commission. Specifically, it should: ❑ Strengthen the ability of the state to conduct up -front reviews of the more controversial programs funded by the act before funds are expended by requiring the oversight commission to review and approve county Prevention and Early Intervention plans annually, as it currently does for Innovation plans. ❑ Refine the process by which the state responds to critical issues identified in county three-year plans or annual updates to ensure swift action. Empower the oversight commission to impose sanctions, including the ability to withhold part of the county's MHSA funds, if and when it identifies deficiencies in a county's spending plan. Decisions of the oversight commission should become mandatory unless they are overturned by the Department of Health Care Services within a reasonable period, such as 60 days. Recommendation 2: To provide greater oversight and evaluation of the state administrative funds, the oversight commission should annually develop recommendations for and consult with the Department of Finance before the funds are allocated. W IMPROVING TRANSPARENCYAND ACCOUNTABILITY Improving Transparency and Accountability Voters in 2004 were told their investment in the Mental Health Services Act would likely trim millions of dollars from costs of incarceration, medical care, homeless shelter and social service programs by helping Californians with serious mental illness get better care and support. The act would save more by getting in front of this health problem and preventing mental illness from becoming debilitating. Despite apparent successes in both realms after 10 years, the state entities in charge of overseeing the act have yet to produce data to fully demonstrate the act's statewide achievements and its overall progress toward these intended results. "The act transformed the mental health system and is helping tens of thousands of people," Senator Darrell Steinberg told the Commission chair and staff as he reflected on successes of the Community Services and Supports programs that provide wrap-around supportive care for the severely mentally ill. However, without collecting data and aggregating results to demonstrate similar successes of Prevention and Early Intervention and Innovation programs, Senator Steinberg said he feared critics would continue to argue that the state is spending money on "soft" programs. "It's a gift from the people," he said. "It ought to be pushed to be even better."90 Critical Questions Remain Unanswered Commission witnesses largely confirmed Senator Steinberg's assessment of an act that has successfully provided care and services to thousands while also focusing the system on prevention and early detection of mental illness. Yet witnesses also shared his concerns about a lack of hard data to demonstrate or confirm those successes statewide. Indeed, there remains today a lack of easily accessible information about how much revenue the act has generated, how and where the mental health system has invested the money, who those investments have benefitted and how they have improved mental health services in California. To provide voters with confidence that money is being spent as promised, 29 LITTLE HOOVER COMMISSION the state needs to be able to answer basic questions about how the act has been implemented and what it has achieved. How Much Money is Being Spent? And Where? To be confident that the state is appropriately spending MHSA dollars, Californians should be able to see exactly how much money has been raised through the Mental Health Services Act and have at least a broad understanding of how and where that money is being spent, by county and by component. However, in researching this topic, the Commission found that basic and up-to-date financial information about MHSA revenues and expenditures is widely scattered across the websites of key state oversight entities and is not easy to locate. 91 Information about the Mental Health Services Act is available on websites of the Department of Health Care Services and the Mental Health Services Oversight and Accountability Commission, as well as a separate website maintained by the oversight commission - prop63.org. Though all provide some description of the act, its source of revenue and purposes, none give a current or complete statewide financial picture. Additional information about the act is scattered across various county websites, as well as other organizations that are affiliated with implementing the act. California's 58 counties are required to report to the state how they intend to use MHSA funds in their three-year program and expenditure plans and annual updates. However, neither the department's nor the oversight commission's website contains a complete online repository of these plans. (The oversight commission maintains an archive of approved county Prevention and Early Intervention plans through fiscal year 2009-10, as well as approved Innovation plans.) Without a single repository for information about the act, those interested in understanding or comparing county plans must separately visit each county's website. Similarly, counties are required to send revenue and expenditure reports to the state that certify how they used their MHSA funds. However, these reports are not consistently available on state websites. The Department of Mental Health used to post these reports online, but the Department of Health Care Services has not continued the practice (though their website still hosts counties' reports from fiscal years 2008- 09 and 2009-10).92 As of December 2014, the department's website said these reports were "pending" and they were not readily available on the oversight commission's website.93 30 IMPROVING TRANSPARENCYAND ACCOUNTABILITY Though the Department of Health Care Services annually compiles financial information about the act into an annual revenue and expenditure report for the Legislature, it only provides summary information by component area for local expenditures and explains in greater detail how the state administrative funds are spent.94 This annual compilation is likely helpful for experts who work in the Capitol or those who monitor the act at a high level, but does not allow for county -by -county comparisons. Previous Department of Mental Health reports summarized approved allocations by county and by component for each fiscal year.95 The best, most detailed information about how counties use their MHSA funds in each of the component areas comes from outside organizations, not from the state's oversight bodies. Since 2012, National Alliance on Mental Illness, California, a grass roots organization representing families and individuals whose lives have been affected by serious mental illness, has compiled information from all 58 counties into an annual report that describes each county's MHSA program, population served and the name and contact information for each county's MHSA coordinator or link to its county website.96 Who is Being Served? Of California's 26.9 million adults, 2.2 million or 8.3 percent, have a mental health need, according to the Mental Health Services Oversight and Accountability Commission.97 Mental health needs tend to be greater for women, younger adults, the poor, the uninsured, and some ethnic groups, such as Native Americans.98 Though improving the lives of these individuals is core to the purpose and intent of Mental Health Services Act, witnesses at the September hearing told the Commission the state cannot account for the overall number of people served by the act or produce basic demographic data to understand who has benefited from Proposition 63's historic investment. Part of the problem is that the oversight commission's evaluations must rely on data gathered from counties by the Department of Health Care Services. But counties do not collect demographic data in a consistent manner across the state. Nor do all consistently or completely comply with reporting requirements. A lack of standard practices in gathering up -front client information and demographics, such as race and ethnicity, makes it difficult for the state to say with authority who has been helped by programs funded with MHSA dollars. "We need reliable data that measures client -level outcomes that can be scaled up to produce program, county and state results," Dr. David Pating, chair of the oversight commission's evaluation committee told the Commission. 99 Lack of this data limits the oversight commission in the types of conclusions it can draw about the act's impact. It has said, for example, 31 LITTLE HOOVER COMMISSION that Prevention and Early Intervention programs have reached an increasing number of people across all age groups, or that an increasing proportion of children, transition -age youth and older adults are participating in full-service partnership programs within the Community Services and Supports component.100 But it lacks data necessary to report with certainty how many people were helped overall, how many were helped within each component area, and how different groups of people (as measured by age, gender, race, ethnicity, socioeconomic status) fare compared to others. 101 This lack of data is particularly concerning for advocates for the state's varied ethnic communities who fear there are gaps between needs and services tailored to their communities. These stakeholders explained that the state lacks critical data to help evaluators track where mental health services are provided, understand their effectiveness and identify remaining needs. Without data on gender identity, for example, the state cannot know if care to the LGBTQ population is sufficient or effective. Similarly, better data on the settings where services are provided, including the correctional system, could help the state analyze the quality and appropriateness of those services. More information about the composition of the mental health workforce, including the number and availability of bicultural or bilingual staff, could target training and recruitment efforts to fill specific gaps. Many of these recommendations are included in the research and findings of the California Reducing Disparities Project, which is described further in the box below. "LGBTQ people face harm every day," Pasha Mikalson, project director with Mental Health America of Northern California told Commissioners in September 2014. "But not being counted, and therefore remaining invisible in this system, represents an absolutely preventable harm and also an enormous disparity."lot "We don't come to the traditional mental health system because it doesn't fix us. It makes us feel worse. It actually makes us sicker," Janet King, community relations coordinator with the Native American Health Center told the Commission. "We need our own indigenous system of care [and] our own best practices. And that's what the MHSA has allowed us to do and has great potential for us to do more of."103 "We want to get historically traumatized and at -risk audiences served early, in order to short-circuit some of the law enforcement treatment African Americans with mental illness typically received," Nicelma King, project director of the African American strategic plan workgroup told the Commission. "Our community needs access to jobs and job training, not just more antipsychotic medication." 104 32 Though advocates discussed the potential for the act to address the unique needs of the state's diverse communities, they said the evaluations have not yet produced the evidence to show that these new programs are working. "The Mental Health Services Act has undoubtedly increased the potential for more culturally competent services to be provided to racial and ethnic communities and for disparities to be reduced," Stacie Hiramoto, director of the Racial and Ethnic Mental Health Disparities Coalition, told the Commission. "However, there is very little evidence in the way of formal studies or evaluations regarding whether the MHSA has actually reduced disparities or increased culturally competent services." As a result, she explained, the state cannot determine the extent to which the act has reduced disparities in services for racial and ethnic minorities. los IMPROVING TRANSPARENCYAND ACCOUNTABILITY California Reducing Disparities Project In 2009, in order to reduce mental health disparities and improve the health of California's diverse population, the California Department of Mental Health — now the California Department of Public Health's Office of Health Equity — launched the California Reducing Disparities Project. It was a multi-year project that allocated over $3 million of Mental Health Services Act funding to identify and develop community -defined treatment practices to improve access, services, outcomes and quality of care for diverse racial, ethnic and cultural groups. The project focused on identifying unique mental health needs of five population groups: African Americans, Asian/Pacific Islanders, Latinos, Native Americans and Lesbian, Gay, Bisexual, Transgender and Questioning. As part of the project, five strategic planning workgroups comprised of community members and leaders developed population -specific reports highlighting new practices and recommendations for their respective communities. Source: California Health Equity. 2013. "California Reducing Disparities Project (CRDP) Population Reports." Reports available at http://cahealtheg uity.org/cal iforn ia-reduci ng -di sparities-project-crdp- population-reports/. Stakeholders recommended that people who are knowledgeable about disparities and committed to reducing them, and not simply those who belong to or represent racial or ethnic communities, should be at the table in local and state -level discussions about oversight and evaluation of the act. At its October 23, 2014 meeting, the oversight commission voted to incorporate reducing disparities in access to mental health services into its evaluation work plan and to continue to plan how to get the data necessary to evaluate projects based on how they will reduce racial and ethnic disparities. 106 The Commission commends this action as a step in the right direction, while recognizing that the oversight commission must ensure that it succeeds in obtaining necessary data and incorporating in its evaluations reviews of the effectiveness of MHSA-funded programs in reducing disparities. Has the Act Achieved Its Goals? The Commission recognizes that the success of the state's mental health programs cannot be measured through evaluation of the act alone. But after a decade and an investment of more than $13 billion, it is 33 LITTLE HOOVER COMMISSION reasonable for Californians to expect to better understand how the Mental Health Services Act has lived up to expectations promised in the Proposition 63 campaign. The Mental Health Services Oversight and Accountability Commission has a statutory mandate to evaluate how MHSA funds have been used, what outcomes have resulted from those investments and how to improve the services and programs to maximize positive outcomes for all populations. Since 2010, the oversight commission has developed and refined its strategy for evaluating the act's outcomes through its adoption of a MHSA evaluation master plan. 107 The oversight commission is working with key stakeholders to modify and improve existing performance indicators and identify new indicators that will provide a broader measure of the impact of the act and support quality improvement efforts at the state and local levels. Future performance monitoring will incorporate additional measures that include community level indicators that assess the potential impact of the MHSA on California as a whole, its executive director told the Commission. 108 In the meantime, the oversight commission has launched dozens of evaluation projects for programs in multiple components. 109 Though the oversight commission's evaluation studies are available online for the public and other interested parties to review, none speak directly to the state's progress toward broad goals identified in the act. Instead, efforts generally focus on individual program evaluation. As such, these studies cannot answer these types of questions: ■ Have statewide rates of incarceration and homelessness declined? ■ Are Californians getting the help they need to stay in school or continue working? ■ How have statewide rates of suicide changed since the Mental Health Services Act was enacted? ■ Are more programs available to meet California's diverse cultural and linguistic needs? ■ Which Californians are being served and who is falling through the cracks? The state now needs to begin to answer those, and similar, broad questions so it can better tell the story of how this special tax has improved California's mental health system and enacted the reforms intended by voters in 2004. Until the state can better demonstrate that the Mental Health Services Act has helped reduced negative outcomes associated with untreated mental illness and describe how the programs have contributed to Californians' improved mental health and emotional well-being, critics likely will continue to question the effectiveness of the 34 IMPROVING TRANSPARENCYAND ACCOUNTABILITY act. Ultimately, such questioning can erode public confidence in state government's ability to hold up its side of the bargain and deliver societal benefits promised in a ballot initiative. Worse, a growing erosion of public confidence in this measure in particular could encourage a policy atmosphere for diverting the money or even a movement to rescind the act. How Has the Act Helped Improve Lives? Basic fiscal and program information combined with treatment outcome data could be a powerful tool for helping legislators and others better understand the state's mental health needs and the act's successes in addressing those needs. But the state does not yet have the capability to conduct this type of analysis, Rusty Selix explained in testimony to the Commission. "At the state level, there is more data analysis and reporting needed to develop the foundation to do the real work, which is to shine a bright light on the counties and providers who are having the greatest success and educating the others on the changes they need to make."110 Representatives from the state entities in charge of overseeing the act told the Commission that the state still lacks data to answer the question: Are people getting better as a result of these MHSA services? "Do we know the efficacy of these programs?" Karen Baylor, deputy director of the Department of Health Care Services asked. "No, we don't."111 One significant hurdle stands out: The oversight commission, which is in charge of evaluating the act, does not have access to complete and timely data about counties' programs in the various component areas. To conduct its analyses, the oversight commission must rely on county data obtained from the Department of Health Care Services, which has owned the state's mental health data systems since the Department of Mental Health was dismantled in 2012. Problems stemming from these data systems dominated testimony at the Commission's September 2014 hearing. Witnesses attributed the lack of evaluation data to an "antiquated" state data infrastructure that, despite recent investment of approximately $3 million of MHSA funds to upgrade the department's data systems, has serious problems. In addition, the systems only provide limited data (specifically, client outcome data for those participating in one type of CSS program - full-service partnerships) that is useful for the type of regular assessment the oversight commission wants to conduct. 112 35 LITTLE HOOVER COMMISSION "We have a legacy [data] system," Richard Van Horn, chair of the Mental Health Services Oversight and Accountability Commission told Commissioners, "[but] we need to have a system, statewide, where counties can talk to each other, agencies can talk to each other and all can talk to the state." And, he said, the ideal system would be fully interactive and allow the state to "talk back" so we can communicate evaluation results back to the counties, not just get the data from them. 113 In addition, the state's mental health data system is limited by "input" challenges related to how data is collected, verified, validated, corrected and ultimately entered into the system. According to a report of the oversight commission, client information is not consistently entered during intake processes, making it difficult to measure individual change over time. Counties do not all submit their data to the state in a timely manner. Nor do they collect data in a consistent manner across counties. Additionally, at the state level, data submitted by the counties might get tied up in department processes for review and certification before it is available for analysis by the oversight commission. 114 Experts told the Commission that counties' ability to report and analyze MHSA outcomes varies based on the type of data system they have established. Only some counties, like Los Angeles, produce advanced reports for some of their MHSA programs that describe how many people are able to continue working, remain at home or out of jail as a consequence of accessing mental health services they needed. 115 Taken together, these inconsistencies ultimately hinder the state's ability to conduct statewide evaluations of the act. Witnesses told the Commission that without a stronger data system that produces accurate, complete, meaningful and timely data, the state will be unable to produce a comprehensive, outcome -based evaluation of the MHSA funds. "Ultimately, these data systems are unable to provide the detailed client, program or county results that we've deemed important in the MHSA evaluation master plan," explained Dr. Pating, chair of the oversight commission's evaluation committee. "In the long term, a new statewide mental health data system will be needed." 116 Evaluating Outcomes In the Meantime Despite these difficulties described above, the oversight commission has moved forward with evaluation efforts in several of the component areas: Community Services and Supports. This largest share of MHSA funds to counties, up to 80 percent, supports a variety of programs and services to help people recover from mental illness and thrive, including full - 36 IMPROVING TRANSPARENCYAND ACCOUNTABILITY service partnerships and outreach and engagement Community Services and Supports activities aimed at reaching unserved populations. Priority Indicators To monitor the success of programs and services Consumer Outcomes funded within this component, the oversight 1. School attendance commission, along with partners, identified a list of 12 priority indicators intended to measure consumer 2• Employment outcomes and system performance. 117 3. Homelessness and housing Noting its challenges with the overall data quality, 4. Arrests reliability and availability to adequately calculate System Performance progress on all 12 indicators, the oversight 5. Demographic profile of commission nevertheless decided to proceed with its consumers served analyses using the data it had available. A May 2014 report funded by the oversight commission analyzed 6. Demographic profile of new CSS data to identify trends among the priority consumers indicators and interpret and discuss implications of 7. Penetration of mental health consumer outcomes and the system's performance. services Though findings were limited due to issues with the data sources, the report begins to present a snapshot 8. Access to a primary care of who these program are serving and how well they physician fare. 118 9. Perceptions of access to services Analysis by the oversight commission suggests that 10. Involuntary status since the act's passage, more people have received expanded services provided by full-service partnership 11. Consumer well-being programs. The commission also suggested that more 12. Satisfaction with services previously underserved populations are accessing these services. A greater number of program Source: UCLA Center for Healthier Children, Families & Communities. May 20, 2014. participants also reported increased access to primary California's Mental Health Services Act — care physicians, while fewer had substance abuse Statewide Evaluation. Priority Indicators Trends Report — Executive Summary (Deliverable related emergencies or were homeless, incarcerated or 2.c.2). in an emergency shelter. 119 Yet, the oversight commission also noted that its ability to calculate the state's progress on priority indicators will continue to be stalled by flaws with the state's data collection system. As previously described, large amounts of data are missing. Without more complete data, the oversight commission notes it will be unable to "draw comprehensive conclusions regarding the impact of the MHSA or confidently make comparisons across years or between service areas." Especially troubling: These analyses cannot yet account for consumer's race and ethnicity. 120 Prevention and Early Intervention. In addition to funding services for people with severe mental illness, the Mental Health Services Act funded new county programs to steer underserved populations such as 37 LITTLE HOOVER COMMISSION traumatized youth, isolated seniors and culturally and linguistically diverse communities to services and reduce negative outcomes of untreated mental illness. The act also established clear goals for programs within this component: specifically, that programs should emphasize strategies to reduce suicide, incarcerations, school failure or dropout, unemployment, prolonged suffering, homelessness and removal of children from their homes. 121 Programs to accomplish these goals were brand new for counties, Rusty Selix told the Commission. Measurement of their success can take many years "because what we are looking for is not direct results, but a reduction in the number of people who `fail first'."122 Today, approximately 76 percent of counties offer preventative programs for people at risk of a serious mental illness. About 69 percent offer early intervention programs and 71 percent offer programs that focus on identifying people with a mental illness and linking them to treatment. 123 Counties, now, are beginning to evaluate the outcomes of these programs to better understand how they are bringing about change. A survey conducted by the oversight commission found that nearly 40 counties have completed an evaluation or are in the process of doing so for at least one of their PEI projects. Many have evaluated all of their PEI programs.124 Still, the relative newness of these programs has made statewide evaluation difficult and various challenges remain. The oversight commission has not yet adopted system -wide performance indicators for the prevention and early intervention component, its representatives said. Additionally, the oversight commission has identified various challenges to evaluating PEI programs. For example, commission officials said it receives minimal PEI outcome data from counties, and the data it receives varies from county to county. Often, data is provided in narrative form, making it difficult to analyze. Additionally, guidelines for counties to submit PEI program data have not been updated since 2008 when issued by the former Department of Mental Health. These guidelines do not require counties to evaluate all of their PEI programs, but do require them to identify target outcomes for each PEI program. "These barriers have created challenges when trying to understand the utility of the PEI component to achieve MHSA goals across the state," Sherri Gauger, the oversight commission's executive director, said in testimony to the Commission. 125 Despite these challenges, an evaluation report by the oversight commission highlighted positive preliminary findings of early intervention programs in a subset of counties: ■ Children and youth showed improved social competence and skills, 0J IMPROVING TRANSPARENCYAND ACCOUNTABILITY ■ Programs for transition aged youth may have positive impacts of higher employment, less homelessness and fewer encounters with the legal system, and ■ Parent -focused programs may result in improved parenting skills, family function and decreased depression, stress and anxiety. 126 Still, its analysis also found that some counties lacked internal capacity or guidance needed to develop and meet their evaluation goals. Data on individual services also was inconsistent or unavailable across counties. 127 Mission: Find Ways to Successfully Tell the Proposition 63 Story Though the oversight commission and health care services department are planning ways to improve evaluation efforts through better data collection - an important undertaking in its own right - steps can be taken today to better demonstrate to voters, taxpayers, lawmakers and, importantly, mental health clients, families and advocates how the state is using this voter -approved investment. Improving Transparency and Financial Accountability Online To begin to address critics' concerns about where and how the MHSA dollars are spent, while also improving accountability to the public, lawmakers and others, the entities responsible for overseeing the act could better organize and consolidate existing financial information online. A model exists in the state's bond accountability website. After voters passed a series of bond measures in November 2006, Governor Schwarzenegger directed the Department of Finance to create a website for the public to readily access information on how the bond money would be used. Though not without its flaws, 128 the website - www.bondaccountability.ca.gov - includes overviews of the various programs and projects funded by the bonds as well as detailed information about expenditures including a project's name, description, objectives, amount of funding allocated, location and contact information. In particular, the website for Proposition 1B, transportation bonds, provides a range of information to accommodate those with only a broad interest to those seeking detailed information about where the funds were spent. Building on this model, the state could use existing MHSA financial and program data to create a website that accounts for MHSA fund revenues and expenditures. At a minimum, the website should provide a fiscal 39 LITTLE HOOVER COMMISSION snapshot of both overall and current year revenues and allocations by program component areas, including information on the state's annual expenditures of the state administration funds. To help interested parties better understand where the money is spent, the site should allow users to see how much money counties receive by component area - and similarly, how much state agencies receive - and include a description of the funded programs with links to program websites. Among possible models is the example below: Mental Health Services Act How Much Revenue Has the MHSA Generated? (dollars in millions) Total Revenue Since 2004: $13.271 billion $2,000 $1,564 $1,684 $1,737 $1,319 $1.377 $1,454 $1,500 $1,022 $1,062 $1,064 $1,000 $734 $500 $254 ' $0 . 01 ti� �� �Oh �Oco XJ �Ocb Opp oyy yyL �y,� 00 00 00 00 00 00 O'y Oti Oti ti� ,yb * Estimated Revenue Fiscal Year 2014-15 Program Components Estimated Revenue (dollars in millions) Percent Community Services and Supports (CSS) Comprehensive mental health treatment for people of all ages with serious $1,254.6 72% mental illness. Prevention & Early Intervention (PEI) Programs to prevent mental illness from becoming severe and disabling $313.7 o 18/ and to improve timely access for people who are underserved by the mental health system. Innovation Funding for counties to design and test new and improved approaches to $82.5 5% mental health service delivery with time-limited pilot projects. Workforce Education and Training (WET) Programs to increase the number of qualified individuals to provide mental N/A N/A health services and improve the cultural and language competency of the mental health workforce. Capital Facilities and Technological Needs (CFTN) Supports a wide range of county projects to support service delivery, N/A N/A including acquiring, constructing and renovating county -owned buildings or modernizing, updating and transforming clinical and information systems. IMPROVING TRANSPARENCYAND ACCOUNTABILITY State Administration Current Fiscal Year Allocation Alameda Supports administrative functions at the state level, including evaluation of $86.9 5% the Mental Health Services Act. $ Butte Total All Components $1,737.7 100% Community Services and Supports County Current Fiscal Year Allocation Alameda $ Alpine $ Amador $ Butte $ Calaveras $ Alameda Countv Communitv Services and Supports Program Name/Description Component Support Housing for Transition Age Youth Provides permanent supportive housing for youth who are homeless, aged Full Service Partnership out of foster care, leaving the justice system or residential treatment. Greater HOPE Adds housing, personal service coordination and medication capacity to Full Service Partnership existing mobile homeless outreach provider in South and East County. CHOICES for Community Living/Recovery Education Centers Integrates supportive housing, supportive employment, peer counseling and Full Service Partnership case management to enable clients to graduate from Service Teams system. Forensic Assertive Community Treatment Creates a multi -disciplinary community treatment team and community Full Service Partnership support center for adults with extensive criminal justice histories and those experiencing their first or second incarceration. Mental Health Court Specialist Outreach &Engagement Team of mental health staff at Alameda courtrooms to provide assessment, System Development treatment and advocacy for defendants with serious mental illness. In addition to providing accessible financial and program information summaries, the state should maintain an easily -accessible online archive of MHSA plans and reports that it is required to receive from the counties, including three-year program and expenditure plans and annual updates and revenue and expenditure reports. Where possible, the archive should include other related documents, such as county cultural competence plans that describe how counties plan to address the cultural and linguistic needs of their diverse communities through their mental health system. 129 Improved accessibility to these types of reports would make it easier for consumers, families, advocates and stakeholders to compare programs across communities, research 41 LITTLE HOOVER COMMISSION successful practices, evaluate and measure how counties are addressing diverse cultural needs and reducing disparities, and effectively advocate for community needs. Monitoring Progress Toward Statewide Mental Health Goals Despite significant data limitations, the oversight commission has begun to evaluate Community Services and Supports and Prevention and Early Intervention programs - programs that together receive the lion's share of county MHSA funds. This work is both important and admirable. Yet, more can be done to help Californians better understand how this unique surtax has helped drive statewide progress toward the act's goals. The oversight commission's website currently hosts a wealth of evaluation information. It describes its evaluation plans and priorities, houses an extensive body of reports and includes other documents. But this information is not organized in a way that makes it easy for an interested, but uninformed, Californian, to understand how the state is monitoring and evaluating progress towards the act's goals. Instead, individuals must cull through multiple and often lengthy reports. The oversight commission could easily improve transparency by reorganizing information on its website, helping an interested individual better understand who has benefitted from MHSA-funded programs and how they have been helped. The oversight commission should begin by highlighting indicators already identified as important. For example: ■ To begin to address the question of whom the act serves, the oversight commission should include, to the extent possible, data on its website detailing the number of individuals served, their ages, gender, racial and ethnic backgrounds and languages spoken. ■ To address how the act had helped improve lives for those living with severe mental illness, the oversight commission could more visibly post information on key indicators - much of which is already available in the oversight commission's priority indicators trends reports. ■ To better understand how prevention programs are working throughout California, the oversight commission could share data on the rates of negative statewide outcomes that result from untreated mental illness. The data would highlight rates of suicide, incarceration, school failure and dropping out of school. It also would show rates of unemployment, prolonged suffering, substance abuse, homelessness, removal of children from homes and recidivism rates among juvenile offenders. 130 42 IMPROVING TRANSPARENCYAND ACCOUNTABILITY In sharing this information online, the oversight commission should replicate the approach it has taken in written reports that both analyze trends and clearly communicate any limitations with the data. Ideally, this level of transparency will allow interested Californians to better understand what the act has achieved, and also, help to identify where service gaps or challenges remain. Building Infrastructure Necessary for Evaluation The state must do a better job of answering critical questions about the act's achievements and evaluating programs to determine what really works. The state ultimately must also serve as the authoritative voice about what programs and services are effective in helping people get better and stay well. By disseminating proven practices in treatment and prevention, the state could be a resource to counties seeking to identify model programs and help ensure those types of programs are adopted statewide. But the state can't play this role until it addresses the inadequacy of its mental health data system. Stakeholders told the Commission the system has reached the end of its usefulness despite significant investment of MHSA funds to prop it up. To analyze and evaluate MHSA-supported programs statewide, the state needs a data system that can deliver information from the local clinical level directly to the state, they said. Such a system would then allow the state to monitor outcomes for all mental health programs - from those serving the severely mentally ill to those trying to prevent mental illness from escalating - and compare results across counties. As a first step to rectify this problem, the oversight commission voted in October 2014 to conduct a feasibility study assessing what mental health data is currently available within the Department of Health Care Services' behavioral health data systems. The study will likewise identify the oversight commission's current data and reporting needs and identify gaps between what it needs and resources available to get the data. A final report and blueprint estimating costs of improving state data systems is due to the commission in February 2015.131 While this is a step in the right direction and will likely provide important information about the state's data needs, it does not guarantee any next steps. The state then should take immediate action to ensure it is prepared to act on the findings of the study. The oversight commission and department should develop a formal plan and timeline to build and implement a comprehensive, statewide mental health data collection system capable of tracking data for all MHSA-funded programs, as well as the state's other behavioral and mental health programs. 43 LITTLE HOOVER COMMISSION Recognizing that building this type of data system may come at significant cost, the oversight commission and department should consider in their plan various funding options. One option in particular should be evaluated. The plan should consider using some of the act's state administration funds to build an appropriate data collection system. Use of those funds may easily be justified given the system's critical role in evaluating effectiveness of services provided through this act. To ensure that progress is made in a timely manner, the oversight commission and department should also regularly report to the Legislature on their progress in developing this data system, as well as identify challenges that may arise. Summary Though the act appears successful in improving the range of mental health services provided in California, the state must now take steps to ensure that it can demonstrate those outcomes to voters, taxpayers, mental health advocates, patients and their families. As a start, the Mental Health Services Oversight and Accountability Commission must improve transparency about how much money the act generates each year and where and how it is spent. Further, the oversight commission must be able to better tell who has benefitted from the act and how. The commission's ability to tell this story will provide a basis for continued state support of these programs. It also will allow counties to adapt successful models to their communities. The state must act to overcome its technology infrastructure problem and create a mental health data system with improved data collection capacity. This system would help the oversight commission better evaluate and communicate the act's effectiveness, identify areas for further improvement and inform future policy decisions. Recommendations Recommendation 3: To make MHSA finances more transparent and make it easier for voters, taxpayers and mental health advocates, consumers and their families to see how and where the money is spent and who benefits from its services, the Mental Health Services Oversight and Accountability Commission should add to and update material on its website to include: ❑ MHSA revenues, by component and annual allocations, and the cumulative total revenue since voters approved the act. 44 IMPROVING TRANSPARENCYAND ACCOUNTABILITY ❑ Data about who benefits from the act, including the number of individuals served, their ages, gender, racial and ethnic background and language spoken. ❑ Data to demonstrate statewide trends on key indicators such as rates of homelessness and suicide that show how well the act's programs help those living with mental illness to function independently and successfully. ❑ A rotating showcase of model programs in each of the component areas to clearly demonstrate examples of what works. ❑ All county MHSA plans and reports submitted to the state, including: ✓ MHSA annual revenue and expenditure reports. ✓ Three-year program and expenditure plans and annual updates. ✓ Other relevant mental health reports, such county cultural competence plans that describe how a county intends to reduce mental health service disparities identified in racial, ethnic, cultural, linguistic and other unserved and underserved populations. Recommendation 4: To promote meaningful accountability of the MHSA, the state needs access to reliable, timely information that allows it to monitor effective progress toward the act's goals. The Mental Health Services Oversight and Accountability Commission and Department of Health Care Services should. ❑ Immediately develop a formal plan and timeline to implement a comprehensive, statewide mental health data collection system capable of incorporating data for all MHSA components, as well as other state behavioral and mental health programs. ✓ This plan should address how the development of such a data collection system would be funded and should use a portion of the MHSA state administrative funds to support the effort. ❑ Regularly report to the Legislature on the progress made in developing this data system and identify challenges that arise. 45 LITTLE HOOVER COMMISSION Me Conclusion CONCLUSION ince voters passed Proposition 63 in November 2004, the Mental Health Services Act has survived serious challenges - from excessive bureaucracy that made distributing money to counties overly complicated to the Great Recession that brought deep cuts to the state's social service infrastructure. Through it all, state lawmakers played a key role in guiding implementation, an assignment typically not granted to the Legislature when voters pass ballot initiatives. Stakeholders expressed to the Commission a strong sense of pride that the act has helped redefine how mental health services are provided in California, reorienting the system toward wellness, recovery and hope. While steering up to 80 percent of funding toward Californians with the most serious mental illnesses, an accompanying emphasis on innovative and preventative programs opened doors to new and experimental ways to reach people who might otherwise not seek help. These aspects of the act have been invaluable in expanding the range of mental health services for Californians. Stakeholders also expressed optimism for the future. The act has endured through its growing pains. Implementation is hitting its stride and settling in for the long run. The state bureaucracy's current management arrangement, as ordered by the Legislature, is a step in the right direction, providing greater independence for the Mental Health Services Oversight and Accountability Commission and a new partnership in oversight with the Department in Healthcare Services. But in its review, the Commission found bureaucratic confusion remains and the oversight commission still lacks the authority envisioned to ensure that the annual $1 billion investment in the mental health system is achieving what voters intended. The Legislature must take the next step and grant the oversight commission the authority to review the more controversial prevention -oriented programs funded by the act before they are implemented, have a role in deciding how the state administrative portion of the funding is allocated and be empowered to impose sanctions if counties misspend funds from the act or fail to file timely reports with the state. During the course of the review, many also shared frustration over the state's inability to address a significant long-running barrier. As described many times in this report, that is the technology challenge that 47 LITTLE HOOVER COMMISSION makes it hard, if not impossible, to demonstrate success or back up perceived outcomes with facts and data. Once again, the state is hampered by antiquated data systems. Overwhelmingly the Commission heard that more must be done, and soon, to build the infrastructure necessary for the state to effectively oversee and evaluate the impact of this significant investment. The Commission recommends that the oversight commission improve public access to the data and county plans that already exist and to do a better job of showcasing model programs. The oversight commission, working with Department of Healthcare Services, must immediately develop a formal plan and timeline to implement a comprehensive, statewide mental health data collection system. The Legislature should consider using a portion of the Mental Health Services Act state administrative funds to pay for the data system. Moving forward, communities and mental health advocates need to better understand how local programs are helping people recover. They need to know who might be falling through the cracks, and what other communities are doing to serve hard -to -reach populations. State lawmakers and local government leaders need better information to assess the state's progress in delivering mental health services and to identify shortcomings. But the audience is even broader: As California continues to experiment with mental health treatment programs, particularly for prevention and early intervention, its successes likely will inform how care is provided throughout the United States. Having data that ensures the best possible implementation will make the transformative effect of this act even more significant. The Commission's review of Proposition 63 and its aftermath began with a simple question: Should the Legislature have more authority to tinker with successful ballot measures crafted often by special interests and sometimes carving out a revenue stream for their own purposes. This review offers unique insight into what happens long after voters say yes on election day. Proposition 63, in which a voting majority hiked income taxes for millionaires, can be described as extraordinary, establishing a powerful, continuing funding stream for mental health needs that usually fly well below the popular radar. We cannot know how implementation might have differed had the authors of this initiative not allowed for legislative involvement. But, in this case, the ability of lawmakers to amend the act, once implemented, appears to have allowed it to weather changes in the state's policy and fiscal environment while generally staying on course toward outcomes promised in 2004. One final important question must address how much these successes might be due to the tone set by the leadership of the Legislature. To date, all significant amendments have been made under the watchful eye M. CONCLUSION of Senator Darrell Steinberg, Senate President Pro Tem from 2008 through 2014, and co-author of the Mental Health Services Act. Going forward, it will be beneficial to watch how the Legislature, under new leadership, uses its authority to guide implementation of the act. Though Proposition 63 alone would not make the case that allowing legislative amendments after an initiative passes should be routine, it does provide a case study that illustrates the potential for its benefits. Additionally, the scope of this study purposely was limited to reviewing the oversight mechanisms for the Mental Health Services Act funds and the outcomes resulting from the state's historic investment in mental health services. However, revenue generated from the Mental Health Services Act only accounts for about 25 percent of the state's overall mental health funding. To better understand how the state manages and evaluates its broader mental health system, the state should consider reviewing governance among the various departments, councils and commissions involved in the system. Such a review might help the state consider whether opportunities exist to streamline oversight and reporting requirements for counties, improve coordination and leverage resources to best infuse the values of the Mental Health Services Act throughout the entire mental health system. 49 LITTLE HOOVER COMMISSION 50 APPENDICES & NOTES Appendices & Notes ✓ Public Hearing Witnesses ✓ Timeline: The Shaping of California's Mental Health System ✓ No tes 51 LITTLE HOOVER COMMISSION 52 Appendix A Public Hearing Witnesses Public Hearing on the Mental Health Services Act September 23, 2014 Sacramento, California Karen Baylor, Deputy Executive Director of Mental Health and Substance Use Disorder Services, California Department of Health Care Services APPENDICES & NOTES Michael Kennedy, Behavioral Health Division Director, Sonoma County Department of Health Services Renay Bradley, Director of Research and David Pating, Vice Chair, Mental Health Evaluation, Mental Health Services Oversight Services Oversight & Accountability & Accountability Commission Commission Jessica Cruz, Executive Director, National Alliance on Mental Illness California Stacie Hiramoto, Director, Racial and Ethnic Mental Health Disparities Coalition Debbie Innes -Gomberg, District Chief, Mental Health Services Act Implementation and Outcomes Division, Los Angeles County Department of Mental Health 53 Larry Poaster, Commissioner, Mental Health Services Oversight & Accountability Commission Rusty Selix, Executive Director, California Council of Community Mental Health Agencies LITTLE HOOVER COMMISSION 54 APPENDICES & NOTES Appendix B Timeline: The Shaping of California's Mental Health System 1950's — State operates eight hospitals serving 36,319 mental health clients (1956-57), but deinstitutionalization is becoming the predominant mental health public policy in the nation. 1957 Short -Doyle Act: creates framework and funding for local governments to develop community-based mental health programs. 1960's — Nurse Ratched, the sadistic nurse portrayed in the book and film "One Flew Over The Cuckoo's Nest," famously symbolizes institutional indifference to the mentally ill. California continues movement toward deinstitutionalization. 1966 California establishes Medi -Cal program, with the State and Federal government sharing the costs of providing some mental health services. 1967 Lanterman-Petris-Short Act establishes standards and legal procedures for civil commitments to a mental hospital, ending the inappropriate, indefinite and involuntary commitment of mentally ill people. Also, increases state funding for community mental health programs. 1969 California begins closing three state hospitals. 1970's — Deinstitutionalization is failing because financial support did not follow patients into the community. Governor Ronald Reagan vetoes legislation to move state funds to community programs, resulting in state's failure to distribute savings achieved through the closures of state hospitals to the community mental health system. 1980's — State allocations to counties to support community mental health are severely diminished due to inflation. Counties ability to fund mental health system is diminished further by passage of Proposition 13 in 1978. Homelessness and incarceration of mentally ill increases. Concerns rise about system's ability to meet needs of communities of color. 1984 AB 3622, Special Education Pupils Program, requires schools to educate, mental health departments to treat, and social services to oversee placement of children with severe mental illness. 1987 AB 377 expands pilot program to test the effectiveness of community- and home-based services for severely emotionally disturbed children. 1988 AB 3777, Wright, McCorquodale, Bronzan Act, moves California toward integrated and community-based "system of care" for adult mental health clients. Bill authorizes funding for three pilot projects in Ventura, Los Angeles and Stanislaus Counties as alternative to state hospitalization. 1989 The state begins reducing its General Fund commitment to mental health services. Because these services are not established as "entitlements," it is difficult for them to compete for state General Fund dollars through times of economic recession and diminishing state revenues. 1990's — The California Mental Health Planning Council reports that California's mental health system is inadequate financially and suffers from a lack of clear governance structure. While the state controls the funding and the counties are responsible for providing services and operating programs, neither is fully accountable. 1990 State projects a $14 billion General Fund shortfall and leaders look to cut various programs, including those pertaining to mental health. AB 904 mandates the California Planning Council to create a Mental Health Master Plan. 55 LITTLE HOOVER COMMISSION 1991 AB 1288, the Bronzan-McCorquodale Act, or Realignment I, uses funds raised by an increase in the state sales tax and vehicle license fee to shift fiscal and administrative responsibility for many mental health services from the state to counties, institutionalizes the "systems of care" service delivery model consisting of consumer- and family -focused services, personal service plans, coordinated care, intensive case management assistance and measureable and accountable delivery of services. 1995 California moves to implement Medi -Cal Mental Health Managed Care. Each county establishes a single Mental Health Plan for providing Medi -Cal services. 1999 AB 34 provides funding for three pilot programs to provide integrated services to the homeless. Proves successful in lowering hospitalization, incarceration and homelessness. 2000's — California voters approve landmark initiative to invest in mental health services, including preventive and new and innovative models of care. The Great Recession lessens impact of new funds. 2000 Little Hoover Commission issues Being There: Making a Commitment to Mental Health, and calls for a transformation of the state's mental health system. AB 2034 expands the 1999 AB 34 pilot program to more than 30 counties. 2001 Little Hoover Commission issues Young Hearts & Minds: Making a Commitment to Children's Mental Health, and calls for a redesign and integration of services provided to mentally ill children. 2002 AB 1421, Laura's Law, allows counties to provide court-ordered outpatient treatment or anti -psychotics for people with serious mental illness. 2004 53.8 percent of voters approve Proposition 63, the Mental Health Services Act. 2005 Proposition 63 implementation begins January 1; establishes the Mental Health Services Oversight and Accountability Commission (MHSOAC) within the Department of Mental Health to oversee MHSA programs. 2009 AB 5xxx separates the MHSOAC from the Department of Mental Health and requires it to issue guidelines for INN and PEI component programs and speeds state approval for county mental health program plans. 2010's — Amid federal health care reform, Legislature shifts more oversight responsibility for the Mental Health Services Act to the counties. 2010 The federal Patient Protection and Affordable Care Act requires health insurance plans offered through new health insurance exchanges to provide a minimum package of essential health benefits, including mental health and substance use disorder services. 2011 AB 100, aiming to speed funds to counties, significantly reduces the state's role in administering the MHSA. Eliminates state reviews of county mental health plans, requiring MHSOAC only to provide training and technical assistance for county mental health planning. Transfers administrative responsibilities of MHSA funds from the Department of Mental Health to the State Controller and reduces the cap of state administrative funds from 5 to 3.5 percent. The 2011-12 budget includes a one-time use of $861 million MHSA funds, most of which is used to support realignment of fiscal responsibility for two Medicaid programs: mental health managed care, including inpatient and psychiatric and outpatient services primarily for adults, and early and periodic screening, diagnosis and treatment (EPSDT), a federally mandated program requiring a broad range of screening, diagnosis and medically necessary treatment services to Medi -Cal beneficiaries under age 21. 2012 AB 1467, part of a package of bills to eliminate the Department of Mental Health, transfers responsibility for administering MHSA to Department of Health Care Services beginning July 1, 2012. Also expands the MHSOAC's role of providing evaluations, training and technical assistance. Requires counties to provide the commission with three-year program and expenditure plans and annual updates, but does not specify what the commission must do with these plans. 56 APPENDICES & NOTES SB 1009 completes reorganization of mental health services out of the Department of Mental Health effective July 1, 2012. 2013 SB 82, the Investment in Mental Health Wellness Act, aims to improve access to mental health crisis services. Uses a portion of MHSA state administration funds to expand crisis beds and mobile crisis capacity. AB 82 requires the MHSOAC to work with DHCS and others to design a comprehensive joint plan for a coordinated evaluation of client outcomes in the community-based mental health system. Sources: Eli Lilly and Company. 2008 Navigating the Currents: A Guide to California's Public Mental Health System. p.6 Report produced for the California Association of Local Mental Health Boards and Commissions. Also, Diane Van Maren, Consultant, Senate Committee on Budget and Fiscal Review. Overview of the 2000-01 Budget Bill: California's Mental Health System- Underfunded from the Start. Also, Secretary of State. Approval Percentages of Initiatives Voted Into Law. www.sos.ca.gov/elections/ballot- measures/pdf/approval-percentages-initiatives.pdf. Also, California State Auditor. August 2013. Mental Health Services Act. Report 2012-122. 57 LITTLE HOOVER COMMISSION W APPENDICES & NOTES Notes 1. California Secretary of State. 2014. "History of California Initiatives: Summary of Data." Accessed November 13, 2014. http://www.sos.ca.izov/elections/ballot- measures / pdf / summary -data. pdf. 2. Note: In recent years, California's voters have passed two initiatives to increase taxes: Proposition 63 (2004) and Proposition 30 (2012). 3. California Secretary of State. November 2, 2004, Presidential General Election. Statewide Ballot Measures. Pages 7-9. Accessed October 17, 2014. http: / /www.sos.ca.gov/ elections /prior -elections / statewide -election - results /presidential -general -election -november -2-2004 / statement -vote. 4. Note: The Little Hoover Commission supported AB 1422 based on its November 2000 report, "Being There: Making a Commitment to Mental Health." Source: AB 1422 (Thomson, 2001). April 16, 2001. Assembly Committee Bill Analysis. 5. Diane Van Maren, consultant, Senate Committee on Budget and Fiscal Review. Overview of the 2000-01 Budget Bill: California's Mental Health System - Underfunded from the Start. 6. AB 1422 (Thomson, 2001) was vetoed by Governor on 9/30/02. http: / /le in�gislature.ca.gov. 7. Howard Padwa, UCLA Health Services Research Center. Rusty Selix Interview. Pages 24-25. Accessed on October 17, 2014. http://www.mhac.org/pdf/rusty- selix-interview. pdf. 8. Rusty Selix, executive director and legislative advocate, California Council of Community Mental Health Agencies. September 23, 2014. Testimony to the Commission. 9. Mental Health Services Act, Section 18. Accessed December 12, 2014. http://www.mhsoac.ca.gov/docs/MHSA AsAmendedIn2012 AB1467And0thers 0 10813.pdf. 10. Rusty Selix. See endnote 8. 11. Initiative & Referendum Institute. "Comparison of Statewide Initiative Processes." University of Southern California. Page 26. Accessed on May 5, 2014. http: / /www.iandrinstitute.org/New%20IRI%20Website%20Info/Drop%20Down%2 OBoxes /Requirements /A%20Comparison%20of%20Statewide%20I&R%20Process es.pdf. Also, Jason Sisney, Deputy Legislative Analyst, State and Local Finance, California Legislative Analyst's Office. May 6, 2014. Phone Interview with Commission staff. 12. ABX3-5 (Evans), Chapter 20, Statutes of 2009-10 Third Extraordinary Session. Also, Assembly Bill 100 (Committee on Budget), Chapter 5, Statutes of 2011. Also, Assembly Bill 1467 (Committee on Budget), Chapter 23, Statutes of 2012. Also, Assembly Bill 82 (Committee on Budget), Chapter 23 of 2013. 13. Larry Poaster, commissioner, Mental Health Services Oversight and Accountability Commission. September 23, 2014. Written testimony to the Commission. Also, Rusty Selix, executive director and legislative advocate, California Council of Community Mental Health Agencies. August 1, 2014. Personal communication with Commission staff. Also, Michael Kennedy, behavioral health division 59 LITTLE HOOVER COMMISSION director, Sonoma County Department of Health Services. August 27, 2014. Personal communication with Commission staff. 14. California Healthcare Foundation. July 2013. Mental Health Care in California: Painting a Picture. 15. Legislative Analyst's Office. July 2004. Proposition 63: Mental Health Services Expansion and Funding. Tax on Incomes Over $1 Million. Initiative Statute. Accessed on October 22, 2014. http: / /www.lao.ca.gov/ballot/2004/63-11-2004.htm. 16. Rusty Selix. See endnote 8. 17. The California Budget Project. September 2004. Budget Brief: What Would Proposition 63, the Mental Health Services Act, Mean for California? Page 4. Accessed on October 22, 2014. http://www.cbp.org/pdfs/2004/0409prop63.pdf. 18. Lynda Gledhill. "Campaign 2004 - Prop. 63 calls on rich to fund mental health." October 22, 2004. San Francisco Chronicle. 19. Evan Halper. "State's Voters Agreeable to New Tax - on Millionaires." October 12, 2004. The Los Angeles Times. 20. Tamara Koehler. "Ballot measure would raise money for mental healthcare." October 22, 2004. Ventura Count. 21. Mental Health Services Act. Section 3. Purpose and Intent. 22. Mental Health Services Act. Welfare and Institutions Code, Section 5813.5. Also, California Department of Mental Health. 2009 MHSA expenditure report to legislature. Page 2. Accessed on October 24, 2014. http://www.dhcs.ca.gov/services/MH/Documents/08_09AddendumMHSA LegRe port.pdf. Also, California Department of Health Care Services. May 2014. Mental Health Services Act Expenditure Report. Fiscal year 2014-15. Pages 3, 7. Also, Debbie Innes -Gomberg, district chief, MHSA implementation and outcomes division, Los Angeles County Department of Mental Health. September 23, 2014. Testimony to the Commission. 23. Mental Health Services Act. Welfare and Institutions Code, Section 5840. Also, California Department of Health Care Services. Mental Health Services Act Expenditure Report. March 2014. Fiscal year 2014-15. Pages 12-13. Also, California Department of Mental Health. See endnote 22. Page 2. 24. California Department of Health Care Services. See endnote 22. Pages 3, 14. 25. Mental Health Services Act. Welfare and Institutions Code, Section 5830. Also, California Department of Mental Health. See endnote 22. Page 2. 26. California Department of Health Care Services. See endnote 22. Pages 3, 16. 27. Mental Health Services Act. Welfare and Institutions Code, Section 5892. Also, California State Auditor. August 2013. Report 2012-122. Pages 9-10. 28. Mental Health Services Act. Welfare and Institutions Code, Section 5822. Also, California State Auditor. See endnote 27. Pages 9-10. 29. California Department of Mental Health. See endnote 22. Page 2. 30. California Department of Health Care Services. August 7, 2013. MHSD Information Notice No.: 13-15. Page 2. 31. Karen Baylor, deputy director, mental health and substance use disorder services, California Department of Health Care Services. September 23, 2014. Written testimony to the Commission. Page 2. :1 APPENDICES & NOTES 32. Mental Health Services Act. Welfare and Institutions Code, Section 5892(d). 33. California Department of Health Care Services. See endnote 22. Page 3. 34. Personal Communication from Carla Castaneda, principal program budget analyst, Department of Finance. August 13, 2014. Mental Health Services Fund (MHSF-3085), Accrued Revenue, 2014-15 May Revision. 35. Personal Communication from Carla Castaneda. See endnote 34. 36. Jessica Cruz, executive director, National Alliance on Mental Illness California. September 2014. Written testimony to the Commission. 37. Note: During the five year period between fiscal years 2011-12 and 2015-16, the California public mental health system received 42% from state sources including the general fund, state sales taxes and the state vehicle license fee; 31% of funds from federal sources; 24% from the Mental Health Services Act and 3% from various other sources at the county level - such as local property taxes, patient fees and insurance and grants. LHC staff calculation. Source: Larry Poaster, commissioner, Mental Health Services Oversight and Accountability Commission. September 23, 2014. Testimony to the Commission. Also, Mental Health Services Oversight and Accountability Commission, Financial Oversight Committee Financial Oversight Report. May 22, 2014. Included with written testimony to the Commission. September 2014. 38. Debbie Inness -Gomberg, district chief, MHSA implementation and outcomes division, Los Angeles County Department of Mental Health. September 2, 2014. Written testimony to the Commission. 39. Jessica Cruz. See endnote 36. 40. Larry Poaster. See endnote 13. 41. Larry Poaster. See endnote 13. 42. Michael Kennedy. See endnote 13. 43. Debbie Inness -Gomberg. See endnote 38. 44. Welfare and Institutions Code, Section 5655. 45. Department of Finance. June 3, 2008. Final Report - California Department of Mental Health, Mental Health Services Act Performance Audit. 46. David Pating, vice chair, Mental Health Services Oversight and Accountability Commission. September 23, 2014. Written testimony to the Commission. 47. Department of Finance. See endnote 45. 48. David Pating. See endnote 46. Also, personal communication with Commission staff. August 29, 2014. 49. Department of Finance. See endnote 45. 50. Department of Finance. See endnote 45. 51. Department of Finance. See endnote 45. 52. Sherri Gauger, interim executive director, Mental Health Services Oversight and Accountability Commission. September 23, 2014. Written testimony to the Commission. 53. ABX3-5 (Evans). See endnote 12. Also, Senate Rules Committee, Office of Senate Floor Analyses. February 14, 2009. Also, Sherri Gauger. See endnote 52. nej LITTLE HOOVER COMMISSION 54. California Department of Health Care Services. MHSD Information Notice No: 13- 15. See endnote 22. Also, AB 100 (Committee on Budget). See endnote 12. Also, AB 100 (Committee on Budget) Senate Rules Committee, Office of Senate Floor Analyses. March 17, 2011. Senate Floor Analysis. 55. Karen Baylor. See endnote 31. 56. Assembly Bill 1467 (Committee on Budget). See endnote 12. 57. Assembly Bill 82 (Committee on Budget). See endnote 12. Welfare and Institutions Code Section 5846. Also, Sherri Gauger, interim executive director, Mental Health Services Oversight and Accountability Commission. December 9, 2014. Personal communication with Commission staff. 58. Karen Baylor. See endnote 31. 59. Rusty Selix, executive director and legislative advocate, California Council of Community Mental Health Agencies. September 23, 2014. Written testimony to the Commission. 60. Jessica Cruz, executive director, National Alliance on Mental Illness California. September 23, 2014. Testimony to the Commission. 61. California Department of Health Care Services. CMHPC Roles and Responsibilities. Accessed November 21, 2014. http: / /www.dhcs.ca.gov/services/MH/Pa eg_s/MHPCRolesResponsibilities.aspx. Also, California Department of Health Care Services. CMHPC Council Members. Accessed December 12, 2014. http://dhcs.ca.gov/services/MH/Pages/MHCouncilMembers.aspx. Also, California Department of Health Care Services. Mental Health Services Act Expenditure Report. May 2014. See endnote 22. Page 22. Also, AB 1467 (Committee on Budget). See endnote 12. Also, California Department of Public Health. 2015. http://www.cdph.ca.gov/pro rg ams/Pages/OHEAboutUs.aspx. Also, David Pating. See endnote 46. Also, Sherri Gauger. See endnote 52. Also, Karen Baylor. See endnote 31. Also, California Department of Health Care Services. See endnote 22. 62. Michael Kennedy. See endnote 13. Also, Karen Baylor. See endnote 31. 63. Rusty Selix. See endnote 59. 64. Michael Kennedy. See endnote 13. Also, Stacie Hiramoto, director, Racial and Ethnic Mental Health Disparities Coalition. August 15, 2014. Personal communication. Also, Jessica Cruz, executive director, NAMI California. August 25, 2014. Personal communication with Commission staff. Also, Jim Gilmer, public comment at September 23, 2014 Little Hoover Commission hearing. 65. Stacie Hiramoto, director, Racial and Ethnic Mental Health Disparities Coalition. September 23, 2014. Written testimony to the Commission. 66. Jessica Cruz. See endnote 36. 67. Jessica Cruz. See endnote 36. 68. Rusty Selix. See endnote 59. 69. Hannah Dreier. July 29, 2012. "Calif mental health dollars bypassing mentally ill." The Associated Press. 70. Rusty Selix. See endnote 59. 71. Sherri Gauger. See endnote 57. 72. Sherri Gauger. See endnote 52. M APPENDICES & NOTES 73. Sherri Gauger. See endnote 57. 74. Welfare and Institutions Code, Section 5847. 75. Mental Health Services Oversight and Accountability Commission executive staff. October 28, 2014. Personal communication with Commission staff. 76. Welfare and Institutions Code, Section 5845 (d)(10). 77. Karen Baylor. See endnote 31. Also, December 11, 2014. Personal communication. 78. Melissa Roland, Legislative Coordinator, Department of Health Care Services. December 30, 2014. Personal communication. 79. Assembly Bill 1467 (Committee on Budget). See endnote 12. Also, Welfare and Institutions Code, Section 5899. 80. California Code of Regulations, Title 9, § 3510. 81. Filomena Yeroshek, chief counsel, mental health services oversight and accountability commission. December 10, 2014. Personal communication. Also, Donna Ures, program outcomes, evaluation, and reporting section chief, mental health services division, California Department of Health Care Services. December 11, 2014. Personal communication. 82. Donna Ures. See endnote 81. 83. Jessica Cruz. See endnote 60. Also, Stacie Hiramoto, director, Racial and Ethnic Mental Health Disparities Coalition. September 23, 2014. Testimony to the Commission. 84. Jessica Cruz. See endnote 60. 85. The WayBack Machine Internet Archive. Captured January 21, 2012, http: / /www.dmh.ca.gov/ Prop_63 /MHSA/ State_Interagengy_Partners.asp. 86. Department of Finance Health and Human Services program staff. August 13, 2014 and November 7, 2014. Personal communication with Commission staff. 87. California Department of Health Care Services. See endnote 23. 88. California Department of Health Care Services. Mental Health Services Act Expenditure Report. See endnote 22. Also, Carla Castaneda and Teresa Calvert, Department of Finance. August 13, 2014. Personal communication. Sacramento, CA. 89. Larry Poaster. See endnote 13. 90. Darrell Steinberg, California Senate President pro Tempore. September 17, 2014. Personal communication with Commission staff. 91. Note: As of October 2014, the Proposition 63 website, prop63.org, maintained by the Mental Health Services Oversight and Accountability Commission, stated that "more than $8 billion dollars has been generated since Proposition 63 went into effect in 2005." Total revenues for each year are not available on the website. The California Department of Health Care Services website provides a similarly incomplete fiscal picture. Sources: Mental Health Services Oversight & Accountability Commission. 2015. Mental Health Services Act. "Proposition 63 Today." http://www.prop63.org/about/prop-63-today/. Also, California Department of Health Care Services. 2014. "MHSA Funding." http: / /www.dhcs.ca.gov/services/MH/Pages/MHSAFunding.aspx. Me LITTLE HOOVER COMMISSION 92. Donna Ures. See endnote 81. 93. The Department of Health Care Services. MHSA Fiscal References. Accessed December 22, 2014. http://www.dhcs.ca.gov/services/MH/Pages/MHSAFiscalRef.aspx. Also, The Mental Health Services Oversight and Accountability Commission website. Accessed on December 22, 2014. www.mhsoac.ca.gov. 94. Karen Baylor, deputy director, and Brenda Grealish, chief of the mental health services division, California Department of Health Care Services. September 23, 2014. Testimony to the Commission. 95. Department of Mental Health. "Component Allocations and Approved Amounts." Accessed December 22, 2014. http: / /www.dhcs.ca.gov/services/MH/Documents/ApprovedAllocations.xls. 96. National Alliance on Mental Illness, California. September 2013. "MHSA Programs 2013: Saving Lives, Saving Money." MHSA full report final. Pages i, vi. http: / /www.namica.org/announcements/eng/mhsa%20fu11%20report%20final.pd f. 97. Mental Health Services Oversight and Accountability Commission. Prop. 63 MHSOAC Evaluation Fact Sheet: Assessing California's Mental Health Needs. Accessed November 18, 2014. http: / / mhsoac.ca.gov/ Evaluations / docs / FactSheet_Eval l_ AssessingCAMHNeeds_ Dec20l2.pdf. 98. Mental Health Services Oversight and Accountability Commission. See endnote 97. 99. David Pating. See endnote 46. Also, Sherri Gauger. See endnote 52. 100. Mental Health Services Oversight and Accountability Commission. Prop. 63 MHSOAC Evaluation Fact Sheet: Summary and Synthesis of County MHSA Evaluations. Accessed November 18, 2014. http: / /www.mhsoac.ca.gov/ Meetings/ PriorMeetings_2013 / docs /Meetings /2013 OAC _032813_ Corr _ SummAndSynthOfMHSAEvalFactSheet. pdf. 101. Mental Health Services Oversight and Accountability Commission. UCLA Statewide Evaluation of MHSA - Priority Indicators Trends. July 24, 2014. Accessed November 18, 2014. http: / /www.mhsoac.ca.gov/ Meetings/ PriorMeetings_2014 / docs /Meetings /2014 / July/ OAC_072414_Handout_4A_UCLAStatewide_EvaluationOfMHSA_ PPT. pdf. 102. Pasha Mikalson, project director with Mental Health America of Northern California. September 23, 2014. Public comment to the Commission. 103. Janet King, community relations coordinator, Native American Health Center. September 23, 2014. Public comment to the Commission. 104. Nicelma J. King, Ph.D., cooperative extension specialist, UC Davis Department of Human and Community Development and project director, African American Strategic Plan Workgroup. September 24, 2014. Letter to the Commission. 105. Stacie Hiramoto. See endnote 83. 106. Mental Health Services Oversight and Accountability Commission. October 23, 2014. Commission Meeting. http: / /www.mhsoac.ca.gov/ Meetings/ PriorMeetings_2014 / docs /Meetings /2014 / October/ Commission/ Motions%20Summary%200ct%202014.pdf. APPENDICES & NOTES 107. Joan Meisel. March 25, 2013. "Mental Health Services Oversight and Accountability Commission Evaluation Master Plan - Final." http: / / mhsoac. ca. gov / Evaluations / docs / EvaluationMasterPlan_Final _040413. pdf Also, Mental Health Services Oversight and Accountability Commission. 2014. "Evaluations." http://mhsoac.ca.gov/Evaluations/. 108. Sherri Gauger. See endnote 52. 109. David Pating. See endnote 46. 110. Rusty Selix. See endnote 59. 111. Karen Baylor. See endnote 94. 112. Sherri Gauger. See endnote 52. 113. Richard Van Horn, chair, Mental Health Services Oversight and Accountability Commission. September 23, 2014. Testimony to the Commission. 114. Mental Health Services Oversight and Accountability Commission. See endnote 101. Also, Sherri Gauger. See endnote 52. 115. Debbie Innes -Gomberg. See endnote 38. 116. David Pating. See endnote 46. 117. Mental Health Services Oversight and Accountability Commission. See endnote 101. 118. UCLA Center for Healthier Children, Families & Communities. May 20, 2014. California's Mental Health Services Act - Statewide Evaluation. Priority Indicators Trends Report - Executive Summary (Deliverable 2.G.2). Accessed November 25, 2014. http: / /www.mhsoac.ca.gov/Meetings/docs/Meetings/2014/July/OAC 072414 4 A_ PriorityIndicatorsTrendsReport_UCLA. p df. 119. Mental Health Services Oversight and Accountability Commission. Evaluation Fact Sheet #6. Priority Indicators. Accessed on November 20, 2014. http://www.mhsoac.ca.gov/MHSOAC Publications /docs/FactSheet Eva16 Priorit yIndicators_2014_JAN. pd. Also, Mental Health Services Oversight and Accountability Commission. See endnote 101. Also, MHSA. Highlights from MHSOAC Evaluation Activities: July 2014. Accessed on November 20, 2014. http: / /www.mhsoac.ca.gov/ Evaluations/ docs/ FactSheet_HighlightsFromMHSOA CEvaluationActivities_Ju1y2014. pdf. 120. Mental Health Services Oversight and Accountability Commission. Evaluation Fact Sheet #6. See endnote 119. Also, MHSOAC. California's Mental Health Services Act - Statewide Evaluation. "Priority Indicators Trends Report." Interpretation Paper. July 2014. Accessed on November 24, 2014. http: / /www.mhsoac.ca.gov/Meetings/docs/Meetings/2014/July/OAC 072414 H andout_4A_TrendsReport_InterpretationPaper. pdf. 121. Mental Health Services Act. Welfare and Institutions Code, Section 5840(d) (PEI). 122. Rusty Selix. See endnote 59. 123. Mental Health Services Oversight and Accountability Commission. See endnote 100. Also, Sherri Gauger. See endnote 52. 124. Filomena Yeroshek. See endnote 81. 125. Sherri Gauger. See endnote 52. Ong LITTLE HOOVER COMMISSION 126. Mental Health Services Oversight and Accountability Commission. See endnote 100. Also, MHSA. Highlights from MHSOAC Evaluation Activities: July 2014. See endnote 119. 127. Mental Health Services Oversight and Accountability Commission. See endnote 100. 128. Little Hoover Commission. June 2009. Bond Spending: Expanding and Enhancing Oversight. Report # 197. http: / /www.lhc.ca.gov/studies/ 197/report197.html. 129. California Department of Mental Health. March 15, 2011. "California Department of Mental Health Cultural Competence Plan Requirements." http: / /www.dhcs.ca.gov/services/MH/Documents/CCPR10-17Enclosure1.pd . Also, California Department of Health Care Services. 2014. "Cultural Competence." http: / /www.dhcs.ca.gov/services/mh/pages/culturalcompetenceplanrequirement s. aspx. 130. Mental Health Services Act. Welfare and Institutions Code, Section 5851(c)(3) (CSS for children), Section 5801(b) (CSS for adults) and Section 5840(d) (PEI). 131. Mental Health Services Oversight and Accountability Commission. October 23, 2014. Commission Meeting. Agenda Item 3A: Consider Recommendation for a contract to develop a feasibility study report or advanced planning document to evaluate the Department of Health Care Services behavioral health data systems. Accessed December 12, 2014. http: / /www. mhsoac. ca. gov / Meetings / docs / Meetings / 2014 / November/ Commissi on/OAC_112014_1B_ MotionSummary.pdf. Also, http: / /www.mhsoac.ca.gov/ Meetings/ docs/ Meetings /2014/ October/ Commission / OAC_ 102314_FINAL3A_Summary.pdf. Me Little Hoover Commission Members CHAIRMAN PEDRO NAVA (D -Santa Barbara) Appointed to the Commission by Speaker of the Assembly John Perez in April 2013. Advisor to telecommunications industry on environmental and regulatory issues and to nonprofit organizations. Former state Assemblymember. Former civil litigator, deputy district attorney and member of the state Coastal Commission. Elected chair of the Commission in March 2014. VICE CHAIRMAN LOREN KAYE (R -Sacramento) Appointed to the Commission in March 2006 and reappointed in December 2010 by Governor Arnold Schwarzenegger. President of the California Foundation for Commerce and Education. Former partner at KP Public Affairs. Served in senior policy positions for Governors Pete Wilson and George Deukmejian, including cabinet secretary to the Governor and undersecretary for the California Trade and Commerce Agency. ASSEMBLYMEMBER KATCHo ACHADJIAN (R -San Luis Obispo) Appointed to the Commission by Speaker of the Assembly John Perez in July 2011. Elected in November 2010 to the 33rd Assembly District and re-elected to the 35th District in November 2012 and 2014. Represents Arroyo Grande, Atascadero, Grover Beach, Guadalupe, Lompoc, Morro Bay, Paso Robles, Pismo Beach, San Luis Obispo, Santa Maria and surrounding areas. DAVID BEIER (D -San Francisco) Appointed to the Commission by Governor Edmund G. Brown, Jr. in June 2014. Managing director of Bay City Capital. Former senior officer of Genetech and Amgen. Former counsel to the U.S. House of Representatives Committee on the Judiciary. Serves on the board of directors for the Constitution Project. SENATOR ANTHONY CANNELLA (R -Ceres) Appointed to the Commission by the Senate Rules Committee in January 2014. Elected in November 2010 an re-elected in 2014 to the 12th Senate District. Represents Merced and San Benito counties and a portion of Fresno, Madera, Monterey and Stanislaus counties. JACK FLANIGAN (R -Granite Bay) Appointed to the Commission by Governor Edmund G. Brown, Jr. in April 2012. A member of the Flanigan Law Firm. Co-founded California Strategies, a public affairs consulting firm, in 1997. DON PERATA (D-Orinda) Appointed to the Commission in February 2014 and reappointed in January 2015 by the Senate Rules Committee. Political consultant. Former president pro tempore of the state Senate, from 2004 to 2008. Former Assemblymember, Alameda County supervisor and high school teacher. ASSEMBLYMEMBER ANTHoNYRENDON (D -Lynwood) Appointed to the Commission by Speaker of the Assembly John Perez in February 2013. Elected in November 2012 and re-elected in 2014 to represent the 63rd Assembly District. Represents Bell, Cudahy, Hawaiian Gardens, Lakewood, Lynwood, Maywood, Paramount and South Gate and the North Long Beach community. SENATOR RICHARD ROTH (D -Riverside) Appointed to the Commission by the Senate Rules Committee in February 2013. Elected in November 2012 to the 31st Senate District, representing Corona, Coronita, Eastvale, El Cerrito, Highgrove, Home Gardens, Jurupa Valley, March Air Reserve Base, Mead Valley, Moreno Valley, Norco, Perris and Riverside. DAVID A. SCHWARZ (R -Beverly Hills) Appointed to the Commission in October 2007 and reappointed in December 2010 by Governor Arnold Schwarzenegger. Partner in the Los Angeles office of Irell & Manella LLP and a member of the firms litigation workgroup. Former U.S. delegate to the United Nations Human Rights Commission. JONATHAN SHAPIRO (D -Beverly Hills) Appointed to the Commission in April 2010 and reappointed in January 2014 by the Senate Rules Committee. Writer and producer for FX, HBO and Warner Brothers. Of counsel to Kirkland & Ellis. Former chief of staff to Lt. Governor Cruz Bustamante, counsel for the law firm of O'Melveny & Myers, federal prosecutor for the U.S. Department of Justice Criminal Division in Washington, D.C., and the Central District of California. SUMI SOUSA (D -San Francisco) Appointed to the Commission by Speaker of the Assembly John Perez in April 2013. Officer of policy development for San Francisco Health Plan. Former advisor to Speaker Perez. Former executive director of the California Health Facilities Financing Authority. Full biographies available on the Commission's website at wwwlhc.ca.gov. "Democracy itself is a process of change, and satisfaction and complacency are enemies of good government." Governor Edmund G. "Pat" Brown, addressing the inaugural meeting of the Little Hoover Commission, April 24, 1962, Sacramento, California August 26, 2019, Aviation Committee Comments The following comments for the Newport Beach Aviation Committee meeting are submitted by: Jim Mosher ( limmosher(o-)yahoo.com ), 2210 Private Road, Newport Beach 92660 (949-548-6229) Item 4(a) Presentation on the 1985 John Wayne Airport Settlement Agreement (As Amended) and General Aviation Noise Ordinance Curfew There has been considerable interest in how the Settlement Agreement relates to the curfew. The relevant provisions in the original 1985 Agreement are numbered paragraphs 37 and 38. In paragraph 37, the County promises to retain for the duration of the Agreement "The existing curfew regulations and hours for JWA, contained in County Ordinance 35051, and the provisions of paragraph 4 at page 62 of Board of Supervisor's Resolution 85-255 (February 26, 1985), reducing the curfew exemption threshold to 86.0 dB SENEU — with the exception that the County could, at its discretion, increase the duration of the curfew. In paragraph 38, the County promises to retain the basic policy principal of General Aviation Noise Ordinance 3505: namely, that general aviation aircraft not be allowed to generate noise levels higher than those allowed for commercial planes. During the many amendments and extensions to the Agreement, these two paragraphs have been renumbered — in the Ninth Supplemental Stipulation (the current version of them) they are paragraphs 43 and 44 -- but the only changes to their content have been that the promise of paragraph 37 (now 43) extends for 5 years beyond the end of the remainder of the Agreement and the language about expanding the curfew hours has been eliminated. The current paragraphs continue to refer to "Ordinance 3505" and "paragraph 4 at page 62 of Resolution 85-255." Resolution 85-255 (adopted February 26, 1985) is the resolution certifying Environmental Impact Report No. 5082 and the project associated with it, allowing a phased increase in the JWA's commercial capacity. Ordinance 3505 (adopted March 19, 1985, as a mitigation measure required by EIR 508) is the original, pre -Settlement Agreement GANG. Commercial noise and hours restrictions had formerly been in the Access Plan and lease agreements, while general aviation noise and hours had been unregulated. Ordinance 3505 set quarterly -average SENEL limits3 for commercial aircraft at the three noise monitoring stations closest to the runway (Section 2-1-30.4) and prohibited individual general Copies of Ordinance 3505 and Resolution 85-255 can be found on the SPON website (http://sponnb.org). Under "Recent Posts" or from the "Watch List" select John Wayne Airport and on that page go to Helpful Links. The documents can be viewed here, at the second bullet under "JWA's Settlement Agreement page." 2 EIR No. 508 can also be accessed from SPON's John Wayne Airport page. It is the second item under "Environmental Documentation.". August 26, 2019, Aviation Committee comments - Jim Mosher Page 2 of 5 aviation flights from exceeding those same levels (Section 2-1-30.5). In addition, Section 2-1-30.6 imposed on all flights (commercial or general aviation) a noise -based curfew whereby aircraft performing "takeoffs between the hours of 10:00 p.m. and 7:00 a.m. (8:00 a.m. on Sundays); and landings between the hours of 11:00 p.m. and 7:00 a.m. (8:00 a.m. on Sundays)" could not exceed 86.0 dB(A) SENEL at any noise monitor (of which there were then six to the south of the runway — the present NMS No. 6 not yet existing). "Paragraph 4 at page 62 of Resolution 85-255" lowered the curfew exemption limit from the previous 89.5 dB SENEL considered in the EIR to 86.0 dB SENEL. The stated purpose of this change was "to preclude regularly scheduled commercial departures during the curfew hours" (thus transforming the noise -based curfew on commercial flights into an absolute one). It seems important to note that the Settlement Agreement has been extended as recently as 2014 without ever changing the 86.0 dB SENEL curfew limit agreed upon in 1985. Yet the County's current GANO Section 2-1-30.5 allows curfew hour general aviation noise levels of up to 87.6 dB SENEL (at NMS 2S in East Santa Ana Heights). The reason for that questionable change is explained in the next section. Noise limits The term "SENEL" does not appear to have ever been defined in the Settlement Agreement, but since the noise monitoring in 1985 and now is a requirement of state law, it was presumably understood to be the quantity described in the California Noise Standards of the California Code of Regulations.4 Like pounds or feet or any other physical quantity, SENEL is a concept defined in absolute terms, independent of the (always somewhat imperfect) instrument used to measure it. Tellingly, the Settlement agreement has always referred to allowable SENEL levels measured at the noise monitoring stations (that is, at their geographic locations), not by them (the measurement always being understood to be somewhat different from the true SENEL). The SENEL limits in the Agreement have been changed three times (see my attachment from 2015). The first of these changes, in 1997, increased the allowable noise at what are now called Noise Monitoring Stations 1 S, 2S and 3S (those closest to the runway on the south), while imposing (for the first time) limits on Class A planes at Monitors 4S, 5S, 6S and 7S5. This change was apparently intended to encourage the steeper "NADP 1" takeoffs — generating a bit more noise close in, in return for staying quieter farther along the flight path. 3 See my handout (attached) to Items SS6 and 15 at the September 8, 2015, City Council meeting. The commercial limits seem to have been originally understood as the quarterly average for all operations by a particular carrier. They now appear to be applied separately to each of a carrier's aircraft models — as in JWA's Quarterly Noise Abatement Reports to the state. 4 The state's definition of SENEL (in 21 CCR 5001) was presumably also adopted then, as it is now, in the JWA Access Plan. See Section 2.22 of the current Access Plan for its definition of "dB SENEL" deferring to the CCR. 5 This addition of new limits, presumably approved by the FAA, was post -ANCA but imposed new restrictions — making one wonder about the claim at the last meeting that no airport has ever successfully gained approval of any new noise or access restrictions since ANCA. August 26, 2019, Aviation Committee comments - Jim Mosher Page 3 of 5 The two remaining changes, in 1999 and 2015, were upward adjustments to the decibel limits said to be necessary to "maintain parity" with prior equipment when new microphones for measuring the noise levels were installed. I believe the 1999 and 2015 adjustments were based on an erroneous understanding of the noise limits. As indicated above, the noise limits have always been defined in terms of an absolute physical quantity (decibels) traceable to the National Institute of Standards and Technology. New and more "sensitive" microphones provide a mechanism for enforcing the existing limit more accurately. They should not trigger a need to revise the limit. Doing the latter is like saying a regulation limiting the number of pounds of produce that can be transported across state lines needs to be revised to a new number of pounds each time the inspection station installs a new scale (or recalibrates its old one) — or that a sign setting the speed limit at 40 MPH needs to be revised to 40.683 MPH because the local police department has purchased a new radar guns that reads differently than the old. As indicated above, the JWA noise limits have always referred to absolute decibel levels as read at the monitoring locations, not as read by any particular set of instrumentation at those locations. That fact is reinforced by the observation that no adjustment to allowable SENEL limits is made when a microphone fails and is replaced — there being, in that case, no information available as to how the new readings compare to the old, but by the same token no assurance they would be precisely the same. The 1999 (or 2000?) and even more so the 2015 "adjustments" have led to the bizarre situation in which under the current GANO, general aviation aircraft flying during the curfew hours face arbitrarily different SENEL limits at different noise monitoring stations — ranging from 86.7 to 87.6 dB. Not only do these limits conflict with the uniform 86.0 dB limit promised in the Settlement Agreement (presumably intended to provide equal protection to all citizens regardless of location), but a majority of the new curfew noise limits were created without any side-by-side comparison of the old microphones at those locations with the new. The worst-case differences observed at one station were simply assumed to apply at other stations without any testing. Finally regarding noise monitoring, I believe the public deserves an explanation of the HMMH study conducted at public expense (contract C-7297-1) and posted on the City's JWA Documents and Resources page under Reports: "June 2, 2018 - HMMH's Short -Term Noise Monitoring in December 2017 and January 2018." The Technical Memorandum compares HMMH's independent noise measurements to those reported by the JWA Access and Noise Office and also reports on measurements collected at additional locations. No conclusions are provided, but disturbingly, the HMMH results for individual flights differ from those obtained by JWA by as much as 9 dB (sometimes higher, sometimes lower). Since the public paid for this, it deserves an explanation and conclusions. August 26, 2019, Aviation Committee comments - Jim Mosher Page 4 of 5 Item 5. PUBLIC COMMENTS ON NON -AGENDA ITEMS Transparency Failures As indicated in the draft minutes, at the July 22, 2019, the Committee heard a presentation about the Airport Noise and Capacity Act of 1990 by Bill O'Connor, of Cooley LLP, who was introduced as an outside attorney advising the City. It came as a surprise to me, and I think many, that the City had an ANCA attorney, and it was unclear if Mr. O'Connor and his firm had been hired just for the presentation or have a continuing role with the City. It is troubling that the City Clerk has no contract on file in her contracts database showing when Mr.O'Connor was hired, what he is being paid and what his scope of work is. This is doubling troubling. First, because the City Charter Section 603(c) requires the City Clerk to maintain books containing copies of all contracts and bonds. Second, because the end of Section 602 places the responsibility for controlling legal business and hiring outside counsel on the City Council (not the City Attorney), and the City Council has not publicly hired any aviation attorneys (Tom Edwards, contract C-7071-2, is an attorney by profession, but not hired for legal advice or research). Similarly, the minutes show another aviation consultant, David Wilson, was introduced at the meeting. Again, the City Clerk had no record of a contract, and a Public Records Act request turned up only a series of "purchase orders" dated months after services had supposedly been rendered to the City. In addition, from the Chair's remarks at previous Aviation Committee meetings, it has come to light that City staff has convened aviation "issues" and "messaging" groups to advise on and develop aviation policy. Again, there is no mention of this on the City website or in its aviation handouts. A Public Records Act request turned up agendas for 12 "Issues" conference calls from May 17, 2018, through April 25, 2019, and agendas or notes from 17 "Messaging" meetings between September 13, 2018, and May 15, 2019. Corrective Actions 1. Regarding the hiring of consultants and other City expenditures, as I indicated at the last meeting, it seems important for the Aviation Committee to understand the City's aviation budget: a. How many dollars has the City Council committed to JWA matters? b. What are they being spent on? I do not recall seeing any public presentation about JWA-related expenses, including during the City's annual budget presentations. Trying to track them is particularly difficult since there does not seem to be anything in the budget identifying aviation -related expenses. 2. Regarding the various City -convened groups that have worked behind the scenes, it seems important for the Aviation Committee to know what they have done and what conclusions they have reached, including whether they, or similar groups, will continue to meet in parallel with the public Committee. A written summary would be good. That seems important not just for transparency, but to avoid "re -inventing the wheel." August 26, 2019, Aviation Committee comments - Jim Mosher Page 5 of 5 September 8, 2015, Council Item SS6/15 Comment The following comment on items on the Newport Beach City Council agenda is submitted by: Jim Mosher (i immosher(d)-yahoo.com ), 2210 Private Road, Newport Beach 92660 (949-548-6229) Item SS6115. JWA Settlement Agreement Amendment. Noise Monitoring Station Technology I would like to offer as a supplement to my previous comment these tables showing the ever- increasing absolute Single Event Noise Exposure Level noise limits (SENEL in dB) for jet overflights of Newport Beach that the City has agreed to over the years by amending the numbers in the Settlement Agreement, largely at the urging of Landrum and Brown. Maximum Allowable Quarterly Noise Averages for all flights (Class A limits) Noise Monitoring Station Number Original Agreement (1985) Stipulation 2 (1997) Stipulation ? (1999) Stipulation 10 (proposed, 2015) is 100.0 101.5 101.8 102.5 2S 100.0 101.0 101.1 101.8 3S 98.5 100.5 100.7 101.1 4S 86.0 93.5 94.1 94.8 5S 86.0 93.5 94.6 95.3 6S -- 95.5 96.1 96.8 7S 86.0 92.0 93.0 93.7 Class E ("exempt") Quarterly Noise Limits Noise Monitoring Station Number Original Agreement (1985) Stipulation 2 (1997) Stipulation ? (1999) Stipulation 10 (proposed, 2015) is 86.0 92.5 93.5 94.1 2S 86.0 92.5 93.0 93.5 3S 86.0 89.0 89.7 90.3 4S 86.0 86.0 86.0 86.6 5S 86.0 86.0 86.6 87.2 6S -- 86.0 86.6 87.2 7S 86.0 86.0 86.0 86.6 The tables have been adjusted to match the changing numbering of the monitoring station locations, with the first three having been originally designated M6, M7 and M1, and later M-1, M- 2 and M-3, and the remaining four having been called M-2 (then M-22), M-3 (then M-21), M-24 and M-8 (then M-6). The 1997 adjustments are said to be the result of a "noise demonstration test" conducted in 1992. 1 have been unable to determine when the City Council agreed to that stipulation. The 1999(?) adjustments followed a previous change -over of monitoring equipment as detailed in Item 15 at the Council's March 22, 1999, meeting, although in that case I have been unable to locate the signed stipulation memorializing the changed limits which were reflected in the 2003 extension.