MOORLACH UPDATE — SB 688 — September 20, 2018

The Mountain View Voice provides another piece on legislation impacting those in the arena of mental health services below (also see MOORLACH UPDATE — Youth Mental Health Care — September 15, 2018).

I worked with the County Behavioral Health Directors Association on SB 688, who were the bill’s sponsor, to collaboratively obtain a uniform reporting format that works for them and makes sense to the public (see

It would seem that this would be a simple bill to move through the process, but it actually took my team two years to accomplish. And, it did not get over the finish line in the legislative process until the end of Session. We picked up great support along the way, as the link to my website displays the wonderful organizations that provided their assist.

Providing accountability and transparency is one of our key focuses, so this was a fun project. Thanks go to all that participated.

New state laws aim to boost mental health services

Gov. Jerry Brown signs mental health care bills into law

by Kevin Forestieri / Mountain View Voice

Gov. Jerry Brown has signed several pieces of legislation this month aimed at fixing or improving access to mental health services in California, while vetoing one bill that promised to reimburse student loans for mental health professionals working in “shortage areas.”

Brown has until Sept. 30 to sign bills passed by the legislature last month.

Two bills signed by the governor seek to increase transparency and use of county mental health dollars provided through the Mental Health Services Act (MHSA), which generates close to $2.2 billion each year. Senate Bill 688, authored by Sen. John Moorlach (R-Costa Mesa), requires counties to fill out what he called “apples-to-apples” budget reports that make it easier to figure out how counties are spending mental health funds.

“Each of the counties watch their counterparts closely, and when there’s innovation, it should be mimicked,” Moorlachsaid in a Sept. 15 statement. “And when there’s waste, it should be called out. Consistent accounting leads to better accountability.”

Senate Bill 192, authored by Sen. Jim Beall (D-San Jose) and signed by the governor last week, sets up a “reversion account” for MHSA dollars to be reallocated when counties fail to spend down the money provided by the state for mental health care services. An audit report earlier this year found many counties were sitting on tens or even hundreds of millions of dollars in unspent MHSA money, including $133 million here in Santa Clara County.

Assembly bills approved by the governor this week include AB 2022, proposed by Assemblyman Kansen Chu (D-San Jose), which requires public schools to notify parents and students of mental health services available on campus and in the community at least twice per year, using a mix of hard-copy and electronic messaging. A previous version of the bill required that all public schools have “at least one mental health professional for every 600 pupils generally accessible to pupils on campus during school hours,” but that language was struck from the bill in April.

“By providing our kids and families with information about available mental health services, we will destigmatize and connect more kids to critical resources,” Chu said in a statement Tuesday. “I am grateful to the governor for his support.”

Assembly Bill 2639, put forward by local Assemblyman Marc Berman (D-Palo Alto) requires schools serving middle- and high school-age students in the state to review and update suicide prevention policies every five years. The bill puts a particular emphasis on what he calls “high risk” groups including LGBT students, youth bereaved by suicide, students with disabilities and homeless and foster care students.

“This is critically important as youth suicide rates continue to rise,” Berman said in a statement. “The health and safety of our students is paramount and these policies better equip schools to recognize the warning signs and make the appropriate referrals for help.”

In the same vein, Brown also signed SB 972 by Sen. Anthony Portantino (D-La Canada Flintridge), which requires public, private and charter schools to print the National Suicide Prevention Hotline number on student ID cards. Portantino said that the number should foster an open dialogue about suicide, and that it would be worth it if “one life can be saved through this bill.”

Despite the widespread support for mental health legislation, Brown ultimately vetoed a bill proposed by Assemblywoman Anna Caballero (D-Salinas) that would have provided grants to offset the cost of student loans for psychiatric nurse practitioners and physicians working in a psychiatric setting in “publicly funded facility or a mental health professional shortage area.”

A recent report by researchers at the University of California at San Francisco found that behavioral health workers are in short supply across California, and that the state’s workforce of psychiatrists — 45 percent of whom are over the age of 60 — is expected to decrease by 34 percent between 2016 and 2018. Santa Clara County has fewer than 27 psychiatrists per 100,000 residents, lower than San Mateo and San Francisco counties, and even fewer psychiatrists licensed to treat kids and teens, which requires additional years of education.

In his veto message, Brown wrote that the state’s existing reimbursement fund for mental health professionals is already strained, and would be made worse by the bill because it doesn’t designate any additional funding.

“The loan repayment fund referenced in this bill lacks the necessary funding to pay for the hundreds of applications it currently receives,” Brown said in the message. “Adding more applicants as this bill requires just compounds the problem.”


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MOORLACH UPDATE — Youth Mental Health Care — September 15, 2018

Santa Clara County is very similar to Orange County. It has 1 million fewer people, but it has a dynamic business community, including Silicon Valley. It also has major universities and a robust county Health Care Agency. Its concerns about addressing those with mental health issues mirror those here in the OC.

There is one big exception, however. The Children’s Hospital of Orange County, which recently opened an incredible, state of the art, pediatric floor for young people addressing mental health issues. CHOC has stepped up to meet a major need. After you read the Mountain View Voice piece below, you will see how blessed our community is.

The Mountain View Voice provides a very thorough analysis of mental health services in Santa Clara County. While reading it, you can insert “Orange” for “Santa Clara” and you’ll receive a great tutorial on what is occurring here. The good news is that there is a collaboration of public and private sector leaders working to continue improving the OC’s status.

This would be a good time to tell you that Governor Brown signed SB 688 yesterday. It is my bill to improve the reporting of the Mental Health Services Act (MHSA) by counties so that there is apples-to-apples comparisons on expenditures between the 58 counties (see MOORLACH UPDATE — Quiet Bills, And Not So Quiet — May 3, 2018 ). Each of the counties watch their counterparts closely, and when there’s innovation, it should be mimicked. And, when there’s waste, it should be called out. Consistent accounting leads to better accountability.

Also, as a member of the California Senate Mental Health Caucus (see, I’ve had the privilege to meet and listen to Dr. Steven Adelsheim, the Director of the Center for Youth Mental Health and Wellbeing at Stanford University. He is mentioned in the Mountain View Voice piece below. And, his program and Headspace in Australia are models the OC needs to review.

Just yesterday, I met with the CEO of the mental health care assistance nonprofit Living Success Center, located in Costa Mesa, who confirmed the administrative nightmare that working with the Orange County Health Care Agency’s Mental Health Services has become (see This would be an area where legislative improvements can be pursued.

For more on SB 1004, see MOORLACH UPDATE — SB 1004 and CIRM — September 10, 2018.

As for providing psychiatric beds, my bill, SB 1273, was a moving force in adding more of them in the OC and the other 57 counties (see MOORLACH UPDATE — SB 1255 and SB 1273 — July 25, 2016). Unfortunately, it was for those at the age of majority or older. So, refocusing on minors is another area for legislative opportunity.

With regards to the languishing MHSA funds, this year I have met with Elaine Howell, the State Auditor, and Toby Ewing, the Executive Director of the Mental Health Services Oversight and Accountability Commission. I also asked tough questions of Jennifer Kent, Director of the California Department of Health Care Services during a hearing of the Senate’s Select Committee on Mental Health. Improvements at the state level must be pursued.

Now that the 2017-2018 Session has concluded, it is that time of they year to construct legislation for 2019. You may see me collaborating with Sen. Jim Beall of Santa Clara County to formulate streamlining efforts to move the MHSA funds to areas where they would be best utilized. Providing clarity and leadership is the crying need, and I hope we can provide it next year.

If you have recommendations in this area of healthcare, please do not hesitate to let me or my staff know.

County struggles to meet ‘overwhelming’ needs

State’s patchwork system makes youth mental health care hard to provide

by Kevin Forestieri

Back in 2006, Chris Tanti sought to reinvent the way Australia delivered youth mental health services.

With an early $50 million in government funding, Tanti and his organization, Headspace, would spend the next decade creating a network of 100 mental health centers serving 355,000 people throughout the country, each one with its own personality. Some were located in shopping districts like downtown Mountain View, Tanti said, while one was in a remodeled former train station.

Each Headspace center has a broad range of help at the ready — psychiatrists, psychologists, primary care doctors, occupational therapists, social workers, nurses and more — but the vibe is nothing like a sterile medical clinic.

The centers and the way they were marketed had such little resemblance to mental health clinics, while essentially playing the same role, that roughly half of the children and young adults who walked through the door were self-referrals. They showed up looking for help, even if they weren’t quite sure what was wrong with them, Tanti said.

Could something like Headspace take root in California, where the health care model and financing is so different from that of Australia’s? A number of organizations in the Bay Area, notably the Stanford Center for Youth Mental Health, are seeking to emulate Headspace, widely considered to be the gold standard for youth mental health care. Stanford Hospital recently received $15 million in Santa Clara County funds to open clinics in San Jose and the North County area.

Just north of the county border in Menlo Park, a program called SafeSpace launched last year aiming to fill the same niche as Headspace, with Tanti serving as the organization’s CEO for its first year. Its downtown center is open as a hub for middle and high school students, with a direct link to clinical services just a block away.

Getting a Headspace model that could serve anyone who walks through its doors will likely be a significant uphill battle — California doesn’t have the type of government-sponsored health care system that Australia has, Tanti said. Instead, Stanford would need to broker agreements with commercial insurance companies and public agencies. These contracts are often seen as a significant barrier to providing care, made more difficult by the fractious nature of Medi-Cal and how individual counties provide mental health services.

“The need is so overwhelming,” said Steve Adelsheim, director of Stanford’s Center for Youth Mental Health and Wellbeing. “Part of the concern is that when we open there will be many, many people coming. Will it be an overwhelming task? We won’t know.”

A fragmented system

The structure of mental health care services in California is unusual compared to most of the country. Among the biggest challenges is trying to circumvent bureaucratic roadblocks and tap into roughly $8 billion in mental health care funding provided by the state each year.

For the last six decades, California has taken steps to reduce the role of the state in providing mental health care, opting instead for a decentralized system that pushes most of the administrative and financial responsibility to the state’s 58 counties. This patchwork approach of counties trying to fill mental health care gaps ends up isolating mental health from the rest of the Medi-Cal model.

Few other states do this “carving out” that delegates Specialty Mental Health Services down to the county level, something that requires a waiver from the federal government every two years. Other states, including Iowa, Nebraska and New York have sought to shift behavioral health services back to statewide Medicaid managed care plans.

One of the downsides of California’s fragmented system is that every county has approached mental health care in a different way, without any continuity, according to Sheree Lowe, vice president of Behavioral Services at the California Hospital Association. She said it’s hard enough that behavioral health is so underfunded in California, but it only adds to the difficulty of getting care when every county is approaching the problem in a different way.

If private practices want to provide psychiatric care or therapy for Medi-Cal patients and have the government pay the bill, it’s an uphill battle. Lowe said they not only have to contend with relatively low reimbursement rates, but also have to work their way through the bureaucratic slog of contracting with individual counties. It’s unreasonable to think a small practice has the administrative bandwidth to ink contracts with so many different government agencies.

“Imagine a psychiatrist in private practice in Sacramento having to have contracts with 30 different counties. For a one-man psychiatrist office — that’s just too much to ask,” she said. “Most psychiatrists refuse to contract with commercial and Medi-Cal payers and put the burden on patients to pay and get reimbursed from the insurance companies.”

One study found that psychiatrists are among the least likely physicians to accept new patients on public insurance, with only 37 percent accepting Medi-Cal, according to a report by the California Healthcare Foundation. Payment amounts were the number one problem cited, followed by “administrative hassles” and delays in payments.

For families, those numbers translate into long delays in getting care and a lot more legwork for patients searching for a timely appointment, said Saul Wasserman, government affairs committee co-chair for the California Academy of Child and Adolescent Psychiatry.

“You can find a child psychiatrist now if you’re willing to pay out of pocket,” he said. “You may or may not be able to find someone if you are on a PPO-type insurance plan, and if you’re using public insurance like Medi-Cal, it’s impossible.”

More than half of Santa Clara County’s half-billion dollar annual budget for mental health and substance abuse services doesn’t actually finance county-operated programs, instead flowing out to roughly 40 different community-based organizations (CBOs). This includes a network of nonprofits and health care agencies peppered throughout the county and serving tens of thousands of patients each year.

Although Santa Clara County consistently passes state performance reviews and requirements with flying colors — and has received praise for its Crisis Stabilization Unit for youth as a means to avoid hospitalization — there are signs that the county has struggled to maintain good relationships with its partners.

Last year, a group called the Community Health Partnership brought together 35 people from health care clinics, mental health nonprofits and hospitals serving North County and West Valley cities and asked them, candidly, what kind of problems they have working with the county. The long list of grievances show that CBOs rarely have the administrative bandwidth to make it through the laborious application process with the county, particularly smaller nonprofits with shoestring budgets. The contracts, they said, usually comes with a fairly low reimbursement rate and burdensome reporting requirements.

Santa Clara County Supervisor Joe Simitian, who requested the report, told the Voice that the results didn’t come as a surprise to him, reaffirming that nonprofits and the larger community see the county as a bureaucracy that is slow to respond to crises and difficult to work with.

“County staff has to work harder to overcome some of that bureaucratic inertia that likely affects counties of our size,” Simitian said. “It’s a great big battleship, and it’s difficult to turn it in even a degree or two.”

Simitian said it’s worth remembering that the county has its own hands tied in many ways, with burdensome restrictions by state and federal agencies on how money is spent. The latest example was the county’s contract with an intensive outpatient program called ASPIRE, operated by El Camino Hospital, which took two years of planning and creativity in order to comply with the billing structure allowed by Medicaid.

Contracting for services isn’t so difficult when the county is looking to buy widgets, Simitian said, but the same can’t be said for mental health services. Spending is heavily constrained and monitored, and services often simply don’t fit within the framework of state law.

“The provisions that are in state law to try and make sure that the process doesn’t involve misuse of public funds, doesn’t have favoritism and gives people the best product at the lowest price — which is fine, if you want to buy widgets,” he said. “But if you want to solve complex social problems like the mental health needs of teens in our area, the process doesn’t function particularly well.”

Even without the bureaucratic slowdown, Lowe said the state’s strategy of isolating Specialty Mental Health Services from the state’s health care system is fundamentally part of the problem, and a vestigial approach to mental illness that’s based on stigma. Physicians have more difficulty coordinating care, and patients are expected to figure out where to go for services.

“What we need is some leadership from the governor’s office on down to take on the crisis that is present today and re-engineer it,” Lowe said. “Maybe if we had one health care delivery system and treated the whole person, and stopped cutting them off at the neck, that might improve the stigma discrimination. I think it’s actually fed into the problem.”

Not a bed in sight

One glaring hole in Santa Clara County’s mental health services is the dearth of hospital services for children and teens in crisis.

In emergency cases, where children are a danger to themselves and others, many local families often face the gut-wrenching decision to send their children as far away as Sacramento, often for an entire week of inpatient treatment, because Santa Clara County fails to offer a nearby alternative.

And while county officials have acknowledged the problem and considered how to fill this crucial gap in health care services since 2011, the region’s most vulnerable children are still being directed out of the area for inpatient psychiatric services.

Sarah Gentile, a Los Altos parent who has made a name for herself as a mental health advocate in Santa Clara County, said she has been assisting families as an advisory resource for years, helping navigate through a confusing and spotty network of mental health services. She said one of the “heartbreaking truths” that comes up time and again is that the younger and sicker a child is, the fewer the resources available in Santa Clara County.

Inpatient psychiatric facilities play an important role, providing treatment in a secure and heavily supervised environment for patients suffering acute psychiatric symptoms including psychosis or “active suicidality” — behaviors that put themselves and others at high risk of harm. Many of the patients who are admitted are compelled via a “5150” involuntary psychiatric hold.

Despite having a life-saving role, psychiatric beds are hard to come by — particularly for children and teens. Up until last year, Santa Clara County had zero psychiatric beds for children and adolescents, despite a population of more than 1.9 million residents. It was by far the largest county without any beds for kids, with Kern County in second place with 882,000 residents, according to data compiled by the California Hospital Association.

Since then, Santa Clara County has approved a contract with a new psychiatric hospital, San Jose Behavioral Health, to offer six of its beds for child and adolescent patients, though the deal was seen as a stopgap measure until a dedicated facility for children and teens is established. The facility still doesn’t take children 12 or younger, who make up a small portion of the total patients.

Parents with teenagers in Santa Clara County often find themselves having to send their children to the Mills-Peninsula Inpatient Adolescent Department in San Mateo, while younger children are often sent to Sacramento, Gentile said. Throw in any kind of co-occurring physical condition or a mental health disorder like schizophrenia, she said, and families very likely have to go out of state for care.

Gentile said her family grappled with the problem in 2015, when her son had a major depressive episode and landed in the hospital. She said it was bizarre to hear that a world-renowned organization like Lucile Packard Children’s Hospital, just a short drive from her home, couldn’t serve her child.

“I was in disbelief that a children’s hospital with Stanford’s resources and reputation would turn away critically ill children who need mental health treatment,” she said.

Frustration over the poor access to mental health care bubbled over at an El Camino Hospital board meeting in 2016, with several parents making an emotional appeal for youth inpatient psychiatric care. One mother said she was “filled with despair and fear” that she had nowhere to go if her child with special needs ever has a depressive episode, and called it “incomprehensible” that prestigious award-winning hospitals in the region would fall short of providing services to children in the same situation.

Deborah Scharfetter, a parent of two, recounted how her teenage daughter had gone through five months of severe depression — too sick to attend school and too ashamed and embarrassed to admit her situation — before deciding she needed to go to the hospital.

“When she was at tremendous risk of self-harm, of death, her community sent her away, the hospital — this hospital, where she was born — did not help her recover, they sent her away,” she said. “You sent her away.”

The problem is pervasive in California, with state laws and changing attitudes toward involuntary psychiatric care driving down the number of psychiatric beds going back decades, said Lowe of the California Hospital Association. The total number of beds sank from 9,353 in 1995 to 6,702 in 2016, a nearly 30 percent drop despite the state’s rising population. Although experts recommend one psychiatric bed for every 2,000 people, in California it’s closer to one for every 5,900 people.

Lowe said the anemic number of child and adolescent psychiatric beds — around 650 in a state with 39 million people — is likely linked to the high cost of staffing. Others suggest it has more to do with patient numbers that fluctuate throughout the year, with a big drop during summer.

It also stems from having 58 counties all administering separate Medi-Cal contracts with different terms, requirements and constraints, Lowe said. Sacramento isn’t just a destination for Santa Clara County kids in crisis; it pulls from more than half the counties in the state.

“In Sacramento County we have three free-standing acute hospitals, and they provide care and services to over 30 of our counties,” she said. “They have 30 different billing systems that they have to follow. The administrative burden is extreme.”

Gentile said she finds the whole situation unconscionable, given the economic prosperity in the region and huge sums of public and private money earmarked for mental health services.

“The fact that neither Santa Clara County nor Stanford provide care for these children while acquiring millions of dollars specifically to treat mental illness is especially shameful,” she said.

A swing and a miss

So what exactly is the holdup in Santa Clara County? Concrete efforts to establish an inpatient psychiatric facility for children in the county go at least as far back as 2011 — not long after a youth suicide cluster in Palo Alto — when the county sought bids for a facility to serve the more than 600 kids who show up in emergency rooms each year in need of psychiatric hospital care. The request for proposals (RFP) fell flat due to “budget constraints” at the time, according to county reports.

The idea was resurrected in June 2015, when Simitian announced he would spearhead an effort to meet the “significant needs for inpatient psychiatric care for kids.” Simitian’s proposal essentially called out the practice of sending hundreds of youth to Alameda, Contra Costa and Sacramento counties for treatment as problematic, and vowed to find ways to get the inpatient unit built.

“I’m worried that having this treatment option so far away deters kids and families from seeking the help they need,” Simitian said at the time. “We know that these beds are an integral and essential part of the continuum of care. The next step is to figure out how to get the best possible help for these kids closer to home.”

Several hospitals and nonprofits laid out their visions, with the most ambitious coming from a proposed joint venture between El Camino Hospital, Kaiser Permanente and Lucile Packard Children’s Hospital. The idea, floated in April 2016, described an 18-bed facility built on the El Camino campus serving youth ages 12 to 17, with an opening date slated for 2020. The vision included step-down services like partial hospitalization and intensive outpatient services so patients could ease back into a normal life after being discharged.

Despite the fanfare, the idea fell flat, and county officials at the time did little to explain why it fizzled. A press release from Simitian’s office late last year stated that the process had simply ended “without a successful bid” in January 2017.

Behavioral Health Services Director Toni Tullys told the Voice that one organization did submit a proposal, but subsequent discussions with county staff revealed that it needed almost twice as much money as the $1.8 million allotted — about $3.5 million — to get the psychiatric unit off the ground. The county denied the request for extra money and the RFP was closed with no contract.

The tepid response could have been due to the RFP itself, which made a pretty big ask without much compensation. The county stated it was seeking a 20-bed facility that could serve ages 4 to 17, a huge range of ages that don’t commingle very well.

The RFP also stated that the provider would need to have a child psychiatrist available 24 hours a day, along with a pediatrician, psychiatric nurse, social workers or marriage and family therapists, a nutritionist, a pharmacist, a behaviorist and therapists qualified to assess and treat substance abuse. The contract needed to be ready to go live starting Oct. 1 that year — five months after the RFP was submitted — and the county was willing to pay $1.8 million for the first year of operation.

One interested party referred to it as “a recipe for bankruptcy.”

A new proposal, due to appear in front of the Board of Supervisors this month, will instead propose having Santa Clara County take the lead, though it’s unclear when the facility would finally be built.

In the aftermath of the failed RFP, Simitian said he gathered representatives from all the major hospitals in the area, including Kaiser, El Camino and Stanford, and asked them frankly what it was going to take to get the inpatient unit built.

“Ultimately what became apparent was that everybody wanted to do their part, but nobody felt they could take the entire challenge on themselves or take the lead with a new facility,” he said.

Gentile said she was frustrated with the county’s slow response to the problem, but was likewise baffled that no one else had stepped up to the plate. Stanford just opened its new children’s hospital last year, doubling the square footage and number of beds, but the expansion plans didn’t include a single bed for inpatient psychiatric care, she said.

Tiffany Maciel, whose search for psychiatric help for her young son turned into a full-time job that took four years, said she questioned the idea that the start-up costs for an inpatient psychiatric unit exceeded what hospitals could pay, particularly when Stanford had just wrapped up a $1.2 billion expansion. It rings hollow, she said, when Stanford envisions itself as a partner with a county-led psychiatric unit rather than taking the lead.

“Most parents who are involved are pretty angry at Stanford and the new pediatric facility that doesn’t have a single pediatric mental health bed for kids in crises,” Maciel said. “When the county put out the RFP they said couldn’t raise the money to build it, but how much did Stanford spend on their new facility?”

A funding logjam

The consensus among public officials and the medical community is that mental health services are underfunded, and that taxpayer dollars could go a long way toward supporting early intervention and new, innovative approaches to fill — or at least reduce — big gaps in access to effective services.

It’s all the more surprising, in light of a major state audit report this year revealing that counties across California have failed for years to spend money earmarked for mental health services. The audit concluded that the counties had amassed $2.5 billion in unspent funding, some of which had been sitting in bank accounts for a decade. Santa Clara County is no exception, with a total of $133 million in unspent funds.

Individual counties receive funds through California’s Mental Health Services Act (MHSA), an income tax measure passed by voters in 2004, to spend on mental health programs as each county sees fit. The money is broken up into three categories to ensure counties invest in a range of services: community services and support, innovative programs and prevention and early intervention. The act now generates one-fourth of all state dollars devoted to mental health.

The MHSA follows the same mold that the state has been following for decades, which puts individual counties in the driver’s seat for spending public dollars on mental health services. But with so much money going unspent, some state lawmakers are questioning the wisdom of a hands-off approach, seeking instead to claw back funds and hold counties accountable for a backlog that shouldn’t exist.

State officials say the the problem could be blamed, at least in part, on lax oversight and an unwillingness to compel counties to spend close to $2.2 billion in funds each year. The MHSA includes language that allows California to “revert” unspent money back to the state after three years, but state health officials have declined to do so since at least 2008, according to a recent testimony to state lawmakers by Toby Ewing, executive director of the Mental Health Services Oversight and Accountability Commission.

The audit found that $230 million in MHSA funds should have reverted to the state but haven’t.

The majority of California counties have also failed to meet deadlines for submitting annual reports on how the money is spent, and are two or three years behind, according to the oversight committee. As of February 2017, for example, fewer than half of public agencies had filed 2014-15 spending reports, which were due by the end of December 2015. The state audit used numbers from Santa Clara County’s 2014-15 annual report because the county was one of 12 agencies in the state that had yet to submit a 2015-16 annual report.

Amid the ongoing debate over forcing counties to give back unspent money, counties were not being entirely candid about the extent of money available — oversight commission members reviewed fiscal reports and discovered large, unspent funding balances that were “not publicly revealed and discussed as part of the mandatory community planning process required of the counties,” Ewing said.

Gentile said the unspent funding, to her, represented a big disparity between the rhetoric of county leaders and politicians — that mental health care for children and youth is a top priority — and complacency.

“I lost all hope when the state released its 2017 audit, which showed that Santa Clara County has been holding over $133 million in unspent mental health funds,” she said. “I have little faith that these politicians will ever make good on their commitment to help our children.”

Behavioral Health Services Director Tullys said there are “many, many reasons” for the $133 million figure in the annual report. Difficulty starting up programs, lack of guidance from the state and fluctuations in funding from one year to the next all play into the problem. Some county officials claim that restrictions and oversight requirements are too burdensome, while others complain that counties didn’t get enough direction on how to spend the money.

The county also gets to hang on to some of that $133 million as “prudent” reserves of about $20 million, which arguably inflates the total amount of unspent cash.

Tullys, still relatively new to the position since joining in December 2014, said she has made it a top priority to find the “gaps” in the Mental Health Services Act. The county hired an outside firm, which Tullys described as a a “crackerjack” team of experts, to spend a year sifting through all of the billing, utilization and expense papers.

The result is a recently published three-year plan — making Santa Clara one of only two counties in the state to do a full system assessment, Tullys said — that acts as a road map for using much of the unspent funding. Stanford’s version of the Headspace program alone helps draw down $15 million from the innovation fund.

“The (firm) confirmed that there were gaps and put them into the plan. We’re spending down $90 million in the first three years,” she said. “Yes, there was unspent money, but we had done the assessment and now we’re putting out money to new services.”

California lawmakers have pushed in recent months for policy changes that would either streamline the use of MHSA funds or put the threat of reversion back on the table. Senate bill 1004, authored by state Sens. Scott Wiener and John Moorlach, proposes clear guidelines for money spent on prevention and early intervention, with a preference toward children and teens. Top priorities would include childhood trauma prevention, early detection of psychosis and mood disorders and “engagement strategies” for young adults, particularly those in college.

Senate bill 192, authored by state Sen. Jim Beall, was signed into law Sept. 10. It says all county funds subject to reversion will be sent back to the state as of July 1, 2020, and put into an account and eventually redistributed — essentially following through on a promise made in the original language of the MHSA.

Both bills have received a mixed response, with SB 1004 catching heat from counties seeking to retain autonomy as well as from mental health advocacy groups worried that adults and the elderly would be excluded from services provided under the bill. In an op-ed penned by Wiener and MHSA author and Sacramento Mayor Darrell Steinberg, the two did not concede ground.

“We make no apologies,” the opinion piece reads. “Fifty percent of serious mental illness takes root by age 14, and 75 percent by age 25. So, intervening at the earliest age possible to avoid the consequences of years of untreated illness? It’s not only common sense, it is just.”

The Voice compiled a list of youth mental health resources available in Santa Clara County.

This article is the second in a two-part series that was supported by a USC Annenberg Center for Health Journalism 2018 California Fellowship.


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MOORLACH UPDATE — Joint Author Details — July 7, 2018

Now that the California Legislature has started its summer break, it seems the media attention of late has been focused in the Opinion pages. This is true of my last UPDATE (see MOORLACH UPDATE — Watching Our Votes — July 4, 2018).

In the first editorial below, The Sacramento Bee has a piece about SB 1004 on its website by former Assemblywoman Cheryl Brown. I enjoyed working with Ms. Brown and built a good relationship with her while she was in Sacramento, during my first half-term. Because of my affection for Ms. Brown, allow me to provide more detail than normal and to share two themes that have been evolving recently in my life.

The first is building relationships with members across the aisle (see MOORLACH UPDATE — AB 521 — November 12, 2015). On occasion, I will coauthor a bill introduced by a Democratic Legislator. This year I upped the game and Joint Authored two bills with Democratic Senators.

Senate Bill 1206, the No Place Like Home Act of 2018 was introduced by Senator, and former President Pro Tem, Kevin De Leon and myself (see It was recently replaced by Assembly Bill 1827, a budget trailer bill, due to the urgency of needing to get this measure on the November ballot (see For more background on this proposal, see MOORLACH UPDATE — SB 1273 and MCO Tax — February 27, 2016.

You will see this effort as Proposition 2 on the November General Election ballot. You know that I usually oppose general obligation bonds, but this proposed bond has an existing revenue stream to pay the principal and interest. I would call this technique hypothecating or securitizing an income stream to get the principal up front in order to begin constructing or investing in a project immediately.

The revenue source is the Mental Health Services Act (MHSA), created by voter approval through Proposition 63 of 2004. It is also known as the millionaires tax, so the revenues should be reliable as long as wealthy residents are willing to pay for the great weather. I say this, as there are signs that high net worth individuals have been leaving the state since the passage of Gov. Brown’s income tax increase resulting from the successful passage of Proposition 30 in 2012. This was a proposition that I opposed (see MOORLACH UPDATE — Costa Mesa Voter’s Guide — October 6, 2012 ).

The MHSA revenues helped me to find funding to implement Laura’s Law in Orange County through the passage of SB 585 (Steinberg). It also helped me to change state law to provide more crisis stabilization unit beds to assist our public safety officials when they encounter an individual facing a mental health crisis (see MOORLACH UPDATE — Mentally Ill Inmates — June 11, 2016).

Appreciating this strategy, I was an early supporter of the No Place Like Home effort by Sen. De Leon, which uses a small percentage of MHSA revenues to repay the bondholders. The proceeds will be used to construct or refurbish immediate housing for the mentally ill homeless population.

This year I also joint authored Senate Bill 1004 with Sen. Scott Wiener of San Francisco (see This bill focuses on prevention and early intervention, as mental illness is showing up in impacted children as early as age 14. The sooner it is diagnosed, the better the opportunity to implement appropriate strategies. A great example would be CHOC’s pediatric psychology efforts, a new treasure in my District, which I mentioned in my May 1st UPDATE (see

Why do I provide so much detail? Because the MHSA is rather vague and has confused counties to such a degree that they have accumulated nearly $2.5 billion in unspent funds.

Consequently, providing some clarity in this area would be helpful. Which brings me to the second theme. I have found myself focusing on the topic of mental illness. It started while I was a County Supervisor in trying to understand and implement Laura’s Law (see MOORLACH UPDATE — Laura’s Law Journey — August 11, 2014).

This evolution has found me joining the Mental Health Caucus and being appointed this year to the Senate Select Committee on Mental Health. I remind everyone that I was a business major, not a pre-med major. So, this has been an education for me over the past dozen years or so, starting with the killing of Kelly Thomas in Fullerton (see MOORLACH UPDATE — Kelly Thomas Reverberations — January 15, 2014).

With that, I joined Sen. Wiener to provide clarity. SB 1004 seeks to clarify where some of the funding should be prioritized. Former Assemblywoman Brown fears this will impact the share of the pie for the elderly. I believe this fear is unfounded. Instead of opposing the bill, she should work with me and others in the Mental Health Caucus to draft a bill that focuses funding attention for the elderly and even pursues an effort to classify dementia and Alzheimer’s as mental illnesses eligible for MHSA funds.

The second column is in the Press-Enterprise and Daily Breeze and it follows the theme recently presented in MOORLACH UPDATE — Janus Decision — June 28, 2018.

It refers to an effort I pursued last year (see MOORLACH UPDATE — There Ought Not Be A Law — April 23, 2017 and MOORLACH UPDATE — Earning a Living — November 30, 2017). Ironically, the argument that Sen. Morrell received for stopping his efforts was the same one used to kill my bill.

What a tragedy that Assemblyman Low would bow to the pressures of an industry group’s representatives in attendance with their weak opposition argument, but could totally ignore the long line of opponents to his bill, AB 2943, when it recently came before the Senate Judiciary Committee, of which I am Vice Chair. All the more when the number of individuals wishing to testify against his bill was so large that they had to fill the balcony of the Senate’s largest hearing room and the hallways, requiring one and one-half hours to let them all come to the microphone. The ironies continue.


Legislature must not slight seniors in mental health money


Special to The Sacramento Bee

An important measure to expand access to mental health care services in California is going through the Legislature, but it would make it more difficult for counties to serve older adults.

Senate Bill 1004, which was approved by the Assembly Health Committee on June 19, would amend Proposition 63, passed by voters in 2004 to provide funding for county mental health services with a 1 percent tax on annual incomes of more than $1 million.

Sens. Scott Wiener, D-San Francisco, and John Moorlach, R-Costa Mesa, who introduced SB 1004, appear to be at odds with the needs of older adults because the bill shifts the focus of the Mental Health Services Act primarily to young people.

The bill says that 75 percent of mental illnesses begin by 14 years of age, citing a study showing the relationship between early trauma and life-long problems.

Most of them grew up when mental health problems were less understood, diagnosed or appropriately treated. As a result, many tend to shy away from mental health services. Yet adults between 45 and 64 old are at the highest risk for suicide nationally, and in recent years California’s suicide rate among adults 65 and older has been higher than the national average.

The senior community believes that SB 1004 should also address the mental health needs of seniors as much MHSA money remains unspent. The California Commission on Aging offered amendments stressing that older adults are also at risk of anxiety depression, anxiety, psychological traumas and suicide.

Sadly, the Assembly Health Committee did not consider the amendments. As a result, the Commission on Aging opposes SB 1004 because it would make it more difficult for seniors to secure the mental health services they need.

Cheryl Brown is a member of the California Commission on Aging and former chairwoman of the Assembly Committee on Aging and Long-Term Care. She can be contacted at cheryl1242.


Will ‘sunset review’ shut the

lights on onerous licensing


By STEVEN GREENHUT | Press-Enterprise

SACRAMENTO — One of my favorite Ronald Reagan quotations illustrates the problem of an ever-growing government: “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this Earth!” In my decades covering public agencies, I can think of only a handful of rollbacks — and they usually ended up perversely expanding government power.

In one recent case, the state Legislature gutted a state tax board, known as the Board of Equalization. But its powers merely were shifted from elected officials to bureaucrats in different agencies — and now California taxpayers are more frequently getting the shaft. That’s how government works.

Last week, a simple bill (sponsored by my employer, the R Street Institute) would have rolled back licensing requirements for only one of the hundreds of trades and professions that require a state license to work. Burdensome education requirements, fees and testing become obstacles for lower-income people to get gainful employment that doesn’t involve flipping burgers. The requirements often have no relevance to public safety, but usually are the result of powerful interest groups that use government to lock up some part of the market.

Last year, Sen. John Moorlach, R-Costa Mesa, introduced a bill that would have eliminated such requirements in a variety of fields, but it was a non-starter given its broad scope. It was referred to multiple committees and dead on arrival. So this year Sen. Mike Morrell, R-Rancho Cucamonga, introduced legislation that targeted one particular — and particularly ridiculous — set of licensing rules involving people who want to shampoo, arrange, dress and curl (but not cut) hair for a living.

If you shampoo hair for pay at, say, elderly people’s homes or at a salon — and haven’t spent as much as $19,000 at a barbering and cosmetology school — then you are an outlaw. It’s illegal to do so in California. The Board of Barbering and Cosmetology posts this Frequently Asked Question on its website: “I would like to hire a person for the sole purpose of shampooing or preparing consumers services; can I do this?” The answer: “No, only a licensed barber, cosmetologist or apprentice can wash a consumer’s hair or prepare a consumer for services.”

Did I mention that a shampooer needs 1,500 hours of training, whereas a first responder/emergency medical technician only needs 120 to 150 hours of training? The Morrell bill passed the full Senate with only two “no” votes, but was killed last week in the Assembly Business and Professions Committee on a 14-3 vote in spite of the fact that most of us have shampooed our own hair for years without calamity.

The hearing room was packed with students from local cosmetology schools. It should surprise no one that the main beneficiaries of the current rules are the schools that charge hefty tuitions for such training, nor should it be a surprise that the state bureaucracy (the Department of Consumer Affairs) estimated excessive fee-revenue losses if the bill became law. Those estimates are hard to fathom given how unimaginable it is that people currently go through the whole licensing rigmarole and then only use the degree mainly to shampoo and arrange hair.

But government agencies see any kind of minor regulatory rollbacks as a threat to their authority. There’s always that fear of the slippery slope. There’s also an economic term known as “regulatory capture.” It’s typical in all aspects of government for industries that are being regulated to dominate the agencies that do the regulating.

The main argument that the Assembly Business and Professions Committee Chairman Evan Low, D-San Jose, used to oppose the bill is that the issue can be handled in the forthcoming Sunset Review hearings. The Assembly and Senate business and professions committees hold these annual hearings in the fall to “discuss the performance of the boards and make recommendations for improvements,” according to the legislative website. The term “sunset” comes from the legislation, which would sunset the many boards out of existence unless they justify their existence.

This is one of those cool ideas that sounds much better in theory than in reality. Government agencies should indeed have to explain what they do to stay in business. But California’s Sunset Review process rarely leads to the sunset of anything. Senate Bill 999’s opponents note that the review led to legislation last year that eliminated the Board of Guide Dogs for the Blind. That was a welcome development, but the elimination of that pointless board was backed by regulators and the industry itself.

By contrast, SB999 is opposed by the beauty industry and the bureaucracy. Nevertheless, I’ll take legislators at their word and closely watch as they advocate for the end of onerous regulations that benefit business owners at the expense of aspiring low-income workers. Wouldn’t it be great if California’s Legislature turned out to be the exception that proved Reagan’s rule?

Steven Greenhut is Western region director for the R Street Institute. He was a Register editorial writer from 1998-2009. Write to him at sgreenhut.

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MOORLACH UPDATE — Funding OC’s Homelessness — March 18, 2018

Yesterday morning I decided to sit in on Judge David Carter’s homeless hearing for a brief period. I have been working with Judge Carter as a liaison with the state and its efforts to find funding for the homeless.

I have recently met with Elaine Howle, the State Auditor, to review her most recent audit report on the status of the Mental Health Services Act (MHSA) created by Proposition 63 in 2004 (see

This past week, as a follow up, I also met with Toby Ewing, the Executive Director, of the Mental Health Services Oversight and Accountability Commission to corroborate the audit findings (see

The audit report found some $2.5 billion in unspent funds to assist those with mental illness has accumulated since the passage of Proposition 63 in 2004. This is the case for all 58 counties and the state. There has been a paralysis and lack of leadership by the Department of Health Care Services as to what and where these funds can go, frustrating all parties.

Both of these meetings were disconcerting. I am no longer an executive who can provide guidance and direct staff to get something accomplished. I am now a legislator in a state so large that managing it is next to impossible. You thought Caltrans was messed up. Well, serious improvements can also be made to the Department of Health Care Services, which directs MHSA funding (see

I now must provide directives through legislation. Fine, but I am only allowed 20 bills per year. And, my executive brain is screaming in a legislator’s body. So, one of my bills this year is to establish an executive position to help run this state, SB 1297, but more on that at another time.

I dropped by the hearing after it had been proceeding for about an hour, but Judge Carter brought me up front and I listened to his reactions to various components of the State Auditor’s MHSA audit report. He also provided PowerPoint slides showing various pages. His lecture also included available locations, with Fairview Developmental Center being the most prominent one that he was aware of (see
MOORLACH UPDATE — Burning Year End Issues — December 15, 2017). The audience cheered in applause when it was recommended.

Judge Carter had invited Mayors and City Managers to be present and then, around 11 a.m., took them for a tour of the nearby bus depot, a location that I worked to provide as a roof for the homeless while still a County Supervisor. In the meantime, it has been made available and currently has some 400 residents! Due to other commitments, I left midway through the walk. The Voice of OC provides their take in the first piece below.

It was a Federal Judge that may have started this dilemma with the mandate for the State of California to reduce its inmate population. Instead of building more prisons, which is cost prohibitive thanks to the high cost to staff them with the providing of public safety defined benefit pensions and other employee benefits, the Governor backed and signed AB 109, Public Safety Realignment, in 2011, which released supposed nonviolent inmates prematurely to the 58 counties. The ironies continue. But, I digress.

As you know, after reviewing my recent ten volume series, cities are not flush with the cash needed to address this immediate housing requirement for the homeless.

The media is picking up my recent study on the fiscal well being of California’s 482 cities. The Orange County Breeze provides a reaction concerning its marketing sphere of influence in the second piece below. The Bakersfield California provides its local perspective in the third piece. Chino and Chino Hills are noted in the Chino Champion in the fourth piece below. And Fox and Hounds rounds out the topic in the fifth piece.

The MHSA provides a funding opportunity and I worked side-by-side with President Pro Tem Kevin de Leon in 2016 on the passage of AB 1618, “No Place Like Home,” to securitize this tax revenue source (see We announced the initiative at Skid Row in Los Angeles (see MOORLACH UPDATE — Governor’s 2016-17 Proposed Budget — January 8, 2016)

Senate President pro Tem Kevin de Leon even allowed me to provide input on constructing the bill. It passed and was signed into law, but has not been implemented because it is tied up in Sacramento County Superior Court on validation concerns. (One would wish that Attorney General Becerra would push the courts to help our homeless instead of constantly fighting the Trump Administration, but I digress.)

Senator de Leon is trying to request $2 billion from the Governor, which would be replaced once the bonds are issued. This would start the process of counties submitting grants for immediate housing construction now. I also informed the President pro Tem to tell the Governor that there are $2.5 billion in funds that can be used as collateral for the cash advance.

Federal Judge Expands OC Homeless Housing to Include Longtime Santa Ana Civic Center Camp



Homeless people congregate in the Plaza of the Flags at the Santa Ana Civic Center on March 17, 2018. About 150 people live in tents and make shift structures at the Plaza.

U.S. District Judge David O. Carter expanded the scope of his inquiry into homelessness at the Santa Ana riverbed Saturday pushing city and county officials during a day-long federal court hearing to also agree to relocate the roughly 150 homeless people living in the Santa Ana Civic Center.

County Supervisor Andrew Do, before a crowd of activists, homeless people, county officials and city managers from across the county, struck a decidedly different tone than he has in the past.

“We don’t have a defense. I’m going to be the first to own up that we have failed,” Do said at the start of the hearing, to loud applause. “To lead requires we are proactive and not reactive, and we have failed.”

Carter held the hearing at Santa Ana City Hall, where just outside, hundreds of homeless people have camped for more than a decade, although numbers have dwindled after the recent opening of an emergency shelter nearby. The Civic Center is part of Do’s supervisorial district.

Carter has taken an unusually active role in pushing collaboration and negotiations between government officials and attorneys for the homeless. The hearing was called Saturday to resolve complaints, part of a federal lawsuit against the county, that former riverbed homeless people being moved from motel rooms have not been given adequate services and housing options by the county.

Attorneys for homeless people cited examples of people with serious medical problems and disabilities who cannot sleep in a shelter, or who rely on a spouse or partner as a caretaker. The medical and detox beds offered by the county often do not allow people to be housed with their partners.

For example, Shane Allen, a man who is confined to a wheelchair after a stroke who also suffers from stage 4 cancer, has a weakened immune system and cannot live in a shelter, said attorney Brooke Weitzman. As Allen also depends on his wife as a caretaker, sending them to different shelters would be an unnecessary emotional burden, Weitzman said.

Allen waited to testify at the hearing through the late afternoon, when he was taken to a hospital by paramedics for heart issues.

After several hours of negotiation, attorneys for homeless clients and for the county came to an informal agreement.

Over the next week, the county will continue to relocate nearly 600 former riverbed homeless, most now in motel rooms, as their 30-day maximum stays begin to expire.

People who can prove the need for privacy and individualized housing may be, pending approval by the county, allowed to stay in motel rooms for additional time.

“This is not a blanket extension of all motel vouchers,” said Do, who called the extension of motel stays a “big concession.” “If we feel there are cases that warrant closer examination…we are willing to extend the motel vouchers for those individuals, on a case-by-case basis.”

No more than 100 people will be moved out of motels each day, so the attorneys for the homeless – Weitzman and Carol Sobel — won’t be overwhelmed as they monitor the process.

Carter has also required the county to turn over information to Weitzman and Sobel about each person relocated from the riverbed and where they will be placed after their motel stay. The attorneys, with permission from each individual, will have access to clinical evaluations conducted by the county.

People will be given 48-hours notice before they are relocated.

“We will see how this works,” said Sobel. “Frankly, I think they’re going to run out [of shelter space].”

Do said the county has identified $70 million in funding from the Mental Health Services Act (MHSA) that will be made available to address homelessness, although he declined to give further details about that funding when asked by a reporter.

A recent audit report released Feb. 27 by the State Auditor’s office found local health agencies statewide have “amassed hundreds of millions in unspent MHSA funds.”

More details about that funding will be announced at a special meeting of the Board of Supervisors at 9 a.m. Monday, where supervisors will discuss additional services and housing options for homeless people.

Although Saturday’s hearing was called to address the future of former riverbed homeless people, Carter expanded it to include the Santa Ana Civic Center, where at least 150 people still sleep each night. He pointed to a murder that occurred last week and a woman who was raped the night before.

“I haven’t told you until today that I am adamant of getting rid of this degradation in the Civic Center. I’m going to put more stress on the system, and if you’re not going to do it, I’m going to write an opinion,” Carter said Saturday morning. “Got it? It’s not ramping down, it’s ramping up.”

Carter announced Saturday night the city of Santa Ana and the county agreed to begin a “dignified and humane movement of people” from the Civic Center area. The Santa Ana Police will work with county social workers to clear the area with a similar strategy used at the riverbed.

Beginning Sunday, women living at the Civic Center will be offered immediate shelter at WISEPlace, a women’s shelter with a contract with the county.

County CEO Frank Kim said the county and city have not worked out details of when and how they will begin to move people out of the Civic Center.

Carter was largely complimentary of county officials, praising Do and county Supervisor Todd Spitzer for their leadership. He also thanked the Sheriff’s Department, Health Care Agency workers and Weitzman and Sobel for facilitating a peaceful clear-out of the riverbed encampment.

The county began clearing a massive homeless encampment from the Santa Ana Riverbed on Feb. 20. By the following week, officials said all people on the riverbed had been moved to motels and other shelters, and closed the riverbed to the public on Feb. 26. No one was arrested for refusing to leave the area.

On Saturday, Carter called on cities to step up and contribute to solutions.

“Each of your cities doesn’t want this problem to land in your city,” Carter told the audience, which included city managers and representatives from the most of the county’s 34 cities. “Maybe our constituency would understand that if…it’s one way to solve it is if everybody steps up.”

State Sen. John Moorlach, (R-Costa Mesa) who is sponsoring a bill in the state legislature to determine the use of the Fairview Developmental Center in Costa Mesa, also was invited to the hearing by Carter.

Homeless advocates are eyeing the large property as a potential site for permanent supportive housing for the homeless or a mental health facility. The 114-acre developmental center, owned by the state, is slated to close in 2021.

Moorlach also has worked with state Senate President Pro Tem Kevin de Leon (D-Los Angeles) to support legislation, signed by Gov. Jerry Brown in July 2016, that creates $2 billion in bond proceeds to fund housing for the homeless. The bonds would be repaid with funding from the Mental Health Services Act, although use of the money is still pending court approval.

De Leon also spoke by phone with Carter Saturday morning before the hearing, the judge said. Moorlach, in a phone call with a reporter Saturday night, said he is working with De Leon to find other funding sources to address homelessness.

Meanwhile, Carter rebuked cities that have moved homeless people out of their cities and into other cities, especially those “dumping” them off at the Civic Center.

“If hypothetically there is dumping, moving of human beings from one city or another, you’ve created a problem, not only in terms of loading up the riverbed, but you’ve created a problem for cities like Anaheim and Santa Ana,” Carter said.

He said if anyone wants to claim dumping isn’t happening, they would be called on to prove it under oath.

“Be very careful what your accusation is, in terms of not taking some of these folks back into your communities that are pristine and virtuous,” Carter said, pointing to a representative from the U.S. Attorney’s office who he had invited to the meeting. “But if anyone wants to play the [body camera] tapes, I’m asking for a Justice Department investigation.”

Carter paused, and the room was silent for a moment.

“That silence means we’ve forgiven and forgotten and it never happens again,” said the judge.

Contact Thy Vo at tvo and Spencer Custodio at scustodio.

Senator John Moorlach ranks California’s 482 cities for financial soundness

Which California cities are in financial distress and which are sound? Today State Sen. John Moorlach releases the first edition of his new report, “Senator John Moorlach Ranks California’s 482 Cities for Financial Soundness.”

The report examines the audited finances of the state’s 482 cities. Specifically, it looks at each city’s Comprehensive Annual Financial Report, and the per-capita share for a city’s Unrestricted Net Position, or UNP.

A negative UNP shows a city has fiscal concerns that city officials should be aware of. If they are not aware of the problem, this is a useful tool for the city residents to hold their elected officials accountable.

“Why the project?” Senator Moorlach asked. “Well, in the California Senate I carried some eight public employee pension reform measures in 2017 alone. And did the cities come to testify in support? No. And, are they now highly concerned about their predicament? Yes.”

Senator Moorlach plans to update the study every six months.

A copy of the study is available on Senator Moorlach’s website by clicking HERE.

If you would like to request an interview with Senator John Moorlach, please contact John Seiler at john.seileror 714-662-6050.

About Senator John Moorlach (R-Costa Mesa):

State Senator John Moorlach represents the 37th district of California, is a trained Certified Financial Planner and is the only trained CPA in the California Senate. He gained national attention 23 years ago when he was appointed Orange County Treasurer-Tax Collector and helped the County recover from its bankruptcy filing – at the time the largest municipal bankruptcy in U.S. history. Follow him on Facebook & Twitter.

This article was released by the Office of Senator John Moorlach.

Editor’s Note: Of the 482 cities in California, Cypress ranks in at 33, and highest among the cities in Orange County. It is the only Orange County city in the top 50. La Palma is ranked 104, Stanton at 150, Seal Beach at 201, Buena Park at 302, Los Alamitos at 328, followed closely by Garden Grove at 330.


Worth Noting: Historical Society holding St. Patrick’s Day Walking Tour

California Senator John Moorlach has ranked California’s cities based on financial soundness and Bakersfield ranks closer to the bottom of the list than the top. Bakersfield was ranked 289th out of 482 cities.

Here & There

In State Senator (37th district) John Moorlach’s ranking of 482 California cities for “financial soundness,” Chino Hills came in at 154 and Chino came in 104. Both cities fit into what he described as the “positive part of the curve.” Mr. Moorlach based his rankings by dividing the city’s unrestricted financial position by the city’s population.

Ranking California’s 482 Cities for Financial Soundness

Senator John Moorlach

By Senator John MoorlachCalifornia State Senate, 37th District

Which California cities are in financial distress and which are sound? I am releasing the first edition of my new report, “Senator John Moorlach Ranks California’s 482 Cities for Financial Soundness.”

The report examines the audited finances of the state’s 482 cities. Specifically, it looks at each city’s Comprehensive Annual Financial Report, and the per-capita share for a city’s Unrestricted Net Position, or UNP.

A negative UNP shows a city has fiscal concerns that city officials should be aware of. If they are not aware of the problem, this is a useful tool for the city residents to hold their elected officials accountable.

Why the project?

Well, in the California Senate I carried some eight public employee pension reform measures in 2017 alone. And did the cities come to testify in support? No.

And, are they now highly concerned about their predicament? Yes.

I plan to update the study every six months.

An op-ed specifically looking at Orange County’s cities also is online in the Orange County Register, “Most Orange County city finances bleed red ink.”

This e-mail has been sent by California State Senator John M. W. Moorlach, 37th District. If you no longer wish to subscribe, just let me know by responding with a request to do so.

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