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Board of Supervisors 4/8: County Mental Health Money; ACID Water Transfer; Blood-borne Disease Prevention Project

On April 8, the Board of Supervisors transferred $1.8 million to meet increased costs for county mental health services. The Board conducted a public hearing to make budget adjustments in the Health and Human Services Agency. In 1991 the state transferred more responsibility for certain health, mental health and social services programs to counties, along with revenues from an increase in sales tax and vehicle license fees. Counties were authorized to transfer up to 10% of funds from one program (health or mental health or social services) to another. On this day, the Board authorized the transfer of 10% from public health ($600,000) and 10% from social services ($1.2 million) to mental health. This action was required to meet the costs for mental health services. The number of clients receiving mental health services has increased. The need for intensive care for some clients has also increased. In addition, the county mental health department has not received approximately $2 million in Medi-Cal payments from the state that were budgeted for this fiscal year. These funds are still anticipated to be received in the future. The Board expressed frustration at the slow rate of payment from Medi-Cal. The Health and Human Services Agency believes that multi- county collaborative efforts to redesign billing procedures will begin to address this issue in future, and that additional mental health resources in the community (a new psychiatric health facility and a planned geriatric psychiatric facility) will permit better management of the most acute patients in the future. In addition, realignment funding for mental health is expected to grow as the state recovers from the recession.

The Board heard an informational presentation from Stan Wangberg, Executive Director of the Anderson-Cottonwood Irrigation District (ACID) about a proposed water transfer for this year. ACID diverts water from the Sacramento River north of Redding and conveys that water to their customers for irrigation, primarily for pasture and hay. In 2012 the District installed two wells to tap into the groundwater basin that lies under this part of the valley. This groundwater basin contains in the neighborhood of 4 million acre feet of water, equal to another Shasta Lake. In 2013, ACID reduced its diversion of Sacramento River water by 3500 feet, pumped water from the wells into the ACID canals, and sold the river water to a willing buyer to the south of the Delta. Through monitoring of water related to this transfer, they found that the groundwater level recovered within a couple of months. ACID will determine this week whether to reduce its diversion of river water in 2014 by 2000 acre feet, pump a comparable amount, and sell the diverted water to the Tehama Colusa Canal Authority to the south. Funds from this sale will be used for deferred maintenance to the ACID infrastructure and to maintain the cost of ACID water at reasonable levels for their customers. ACID engineering information suggests that at that level the groundwater level will recover again, possibly taking a bit longer than last year. This sale will not address the fact that ACID at this time has been allowed only 40% of its allocation from the Sacramento River by the Bureau of Reclamation. ACID customers can address that reduction only if they have wells, and can afford the pumping costs. 2000 acre feet of water would only reduce the ACID allocation by a 4-day supply, and the funds from the sale with its maintenance and rate impact may be more beneficial. A final decision will be made by the ACID Board of Directors soon.

Dr. Andrew Deckert, Shasta County Health Officer, reported on the Blood-borne Disease Prevention Project. After a three-year pilot program from 2006 – 2009, the County has authorized a two-part program to reduce infections of Hepatitis B, Hepatitis C and HIV infection through control of needles and public education and referral. 5000 residents of the county use approximately 1 million needles for injections each year. 80% of these residents use needles legally to address medical conditions; their needles must, however, be disposed of safely. The County provides collection boxes at 16 locations throughout the County for the collection of ‘sharps’, or used needles. From the period October 2006 through 2013 nearly 18,000 pounds of sharps were collected and disposed of safely. In addition, 20% of needles are used by injection drug users. The County offers one-for-one needle exchange two days per week. Those using this program are also offered safe sharps disposal, health education, referral for HIV and Hepatitis testing and referral to substance abuse treatment. During the period 2007 – 2013 the program has seen nearly 900 unique clients. More dirty needles are received than clean needles distributed. New acute hepatitis cases have fallen somewhat over this period and HIV cases have remained stable. There have been no significant law enforcement problems at the needle exchange sites and some clients have used the referral to stop using drugs. The costs of treatment for a single case of any of these blood-borne diseased far exceeds the $25,000 annual cost of the program.

The Board of Supervisors meeting scheduled for April 15 is cancelled (Happy Easter!).

Catherine Camp is currently retired. During her career, she worked as a policy and budget analyst for the California Assembly and California Senate, in health and human services fields. She worked as a policy analyst and advocate for California’s public mental health system. Early in her career, she worked in the Community Action and Head Start programs in Shasta County.