Last updated on May 13, 2023

Behavioral Health Advisory Board (BHAB) Member Training

Regrettably, a significant number, if not most, of BHAB board members have not yet received advisory board training provided by the California Behavioral Health Boards and Commissions (CALBHBC) [i]. This training is provided annually in January of each year. CALBHBC could provide such training virtually or locally for under $1k.

Local Ethics Training

Also regrettably, many BHAB members have yet to take their bi-annual AB1234 Local Ethics Training, required by law [Appendix B: SEC. 4. Article 2.4 Ethics Training] and provided free to San Diego County officials, including BHAB members.

Behavioral Health Advisory Board (BHAB)

One major element of the previous Mental Health Board and now by inheritance, the BHAB, is that their work is mandated by state Welfare and Institutions Code (WIC) law, directing both the Behavioral Health Services (BHS) and the BHAB to certain mandatory duties and responsibilities.

BHAB in Context

The San Diego County Behavioral Health Advisory Board (BHAB), was formed when the Alcohol & Other Drug Advisory Board (ADAB) and Mental Health Board (MHB) merged back in 2015. There was a lot of duplicative efforts made by each board, and, although both sectors were closely intertwined in the outside world, that is, many people are experiencing the combination of mental illness and substance use disorders, internally we seemed to be missing opportunities to address them effectively. This integration strategy followed other California counties who projected improved efficiencies. The jury is still out on if this was a good strategy. Many of us from the ADAB, who migrated into BHAB, have seen a relatively significant loss of focus on SUD-related issues. In any case the integration is here to stay for the time being.

Some believe integrating the county’s Public Health Services would be the next natural step. This is likely a long way from fruition but, be on the lookout for arguments for and against.

BHAB Duties

The primary duties and responsibilities of the BHAB include in part [A: Behavioral Health Advisory Board (BHAB) Bylaws]:

6. Review and approve the procedures used to ensure citizen and professional involvement at all stages of the planning process. Involvement shall include individuals with lived experience of mental illness or substance use disorders and their families, community members, advocacy organizations, and mental health professionals. It shall also include other professionals that interact with individuals living with mental illnesses or substance use disorders on a daily basis, such as education, emergency services, employment, health care, housing, law enforcement, local business owners, social services, seniors, transportation, and veterans.

Even though this requirement has been in place since 2004, San Diego County has not taken action in any of the five years this author served on the BHAB through early 2021, nor since.

What is the Community Program Planning (CPP) processes?

The state Mental Health Fund is disbursed by the state under the provision that the CPP process, including obtaining the BHAB’s approval, has been agreed upon. Without such approval, BHS spending MHSA funds is frankly being done so unethically.

Why is the CPP so important?

The CPP ensures that mental health services-consumers, their families, and all other stakeholders, are meaningfully engaged throughout the year in the evaluation, strategic planning, and budgeting processes the county deploys each year. The state believed the process so important, they allocated up to 5% of annual MHSA funds could be allocated to CPP-related efforts. Although this is not a definitive list, some of these funds could include being allocated for:

Sending BHAB members and community stakeholders to convenings, conferences, and trainings so that they could provide more informed feedback to the BHAB.
Training local stakeholders about the capabilities and processes BHS has in place regarding how it handles behavioral health, procurement, and related data and how dashboards and reports are made available or otherwise communicated to members and the public, as well as how they might be improved.
Funding an adequate level of BHS staff who are dedicated to conduct tasks needed to ensure BHAB members are fully equipped to do their work effectively.
Training stakeholders about data, statistics, and analysis, all to enable them to make more informed contributions.
Collaborative efforts and events among stakeholders, BHS, and BHAB.

MHSA Oversight Body – Mental Health Services Accountability and Oversight Commission (MHSOAC)

The MHSOAC conducted an extensive look into the CPP and made a number of recommendations for the future. See the earlier post for a synopsis and source documents.

Appendices

Appendix A: Behavioral Health Advisory Board (BHAB) Bylaws

These duties and responsibilities are included in BHAB bylaws and are nearly verbatim of the text in the Welfare and Institutions Code:

ARTICLE III [ii]
Duties and Responsibilities of Advisory Board Members
Section A: Duties

The Advisory Board shall have the following duties:

1. Review the County’s Behavioral Health contracts and grants awarded to support services and initiatives administered through the Behavioral Health Services Division including those entered into pursuant to Section 5650 of the California Welfare and Institutions Code Section 5650.

2. Review and comment on reports to the Board of Supervisors and other entities as necessary and appropriate regarding the needs and performance of County funded behavioral health programs.

3. Review and evaluate the community’s public mental health needs, services, facilities, and special problems in any facility within the county where mental health evaluations or services are being provided, including, but not limited to, schools, emergency departments, and psychiatric facilities.

4. Review any County agreements entered into pursuant to California Welfare and Institutions Code Section 5650. The Advisory Board may make recommendations to the Board of Supervisors regarding concerns identified within these agreements.

5. Advise the Board of Supervisors and the Director of BHS as to any aspect of the local mental health program. The Advisory Board may request assistance from the local patients’ rights advocates when reviewing and advising on mental health evaluations or services provided in public facilities with limited access.

6. Review and approve the procedures used to ensure citizen and professional involvement at all stages of the planning process. Involvement shall include individuals with lived experience of mental illness or substance use disorders and their families, community members, advocacy organizations, and mental health professionals. It shall also include other professionals that interact with individuals living with mental illnesses or substance use disorders on a daily basis, such as education, emergency services, employment, health care, housing, law enforcement, local business owners, social services, seniors, transportation, and veterans.

7. Submit an annual report to the Board of Supervisors on the needs and performance of the County behavioral health system.

8. Review and make recommendations on applicants for the appointment of the Behavioral Health Services Director. The Advisory Board shall be included in the Director’s selection process prior to appointment.

9. Review and comment on County’s performance outcome data, as it relates to behavioral health matters, and communicate its findings to the California Behavioral Health Planning Council.

10. Assess the impact of the realignment of services from the State to the County on behavioral health services delivered to clients and on the local community.

11. Review the County’s plans and outcomes for developing the three-year program and expenditure plan and updates pursuant to Welfare and Institutions Code Section 5848.

12. Pursuant to Welfare and Institutions Code Section 5848 (b): (1) conduct a public hearing on the Mental Health Services Act draft three-year program and expenditure plan and annual updates at the close of the 30-day comment period required by Welfare and Institutions Code Section 5848(a); (2) review the County’s adopted plan or update; and (3) if approved by a majority vote of the Advisory Board, make substantive recommendations to BHS for revisions to the plan or update.

13. Any other duties assigned by the Board of Supervisors or required by State law.

Appendix B: SEC. 4. Article 2.4 Ethics Training [iii]

53234.

For the purposes of this article, the following terms have the following meanings:

(a) “Legislative body” has the same meaning as specified in Section 54952.

(b) “Local agency” means a city, county, city and county, charter city, charter county, charter city and county, or special district.

(1) Any member of a local agency legislative body or any elected local agency official who receives any type of compensation, salary, or stipend or reimbursement for actual and necessary expenses incurred in the performance of official duties.

(2) Any employee designated by a local agency legislative body to receive the training specified under this article.

(d) “Ethics laws” include, but are not limited to, the following:

(1) Laws relating to personal financial gain by public servants, including, but not limited to, laws prohibiting bribery and conflict‑of‑interest laws.

(2) Laws relating to claiming prerequisites of office, including, but not limited to, gift and travel restrictions, prohibitions against the use of public resources for personal or political purposes, prohibitions against gifts of public funds, mass mailing restrictions, and prohibitions against acceptance of free or discounted transportation by transportation companies.

(3) Government transparency laws, including, but not limited to, financial interest disclosure requirements and open government laws.

(4) Laws relating to fair processes, including, but not limited to, common law bias prohibitions, due process requirements, incompatible offices, competitive bidding requirements for public contracts, and disqualification from participating in decisions affecting family members.

See: AB1234 Local Ethics Training

[i] CALBHBC is funded by the Mental Health Services Accountability and Oversight Commission (MHSOAC), and acts as the association of all mandated California mental health advisory boards and commissions throughout the state.

[ii] Updated Bylaws. October 4, 2021. County of San Diego Behavioral Health Advisory Board.

[iii] 2005. Assembly Bill 1234. Article 2.4. Ethics Training. https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=200520060AB1234

BHAB members need training!