Chair of health to prioritize mental health, homeless people
State Sen. Susan Talamantes Eggman (D-Stockton), who was instrumental in passing Gov. Gavin Newsom’s mental health care legislation last year, has been appointed to lead the influential Senate health committee, a shift that promises a more urgent focus on expanding mental health services and moving homeless people into housing and treatment.
Eggman, a licensed social worker, is a co-author of the new law that allows families, doctors, first responders and others to petition a judge to order government-funded treatment and services for people whose lives have been upended. derailed by untreated psychotic and substance use disorders.
It was a victory for Newsom, who proposed the Community Empowerment, Recovery and Assistance Acto CARE Court, as a powerful new tool to address the tens of thousands of people in California who are experiencing homelessness or at risk of incarceration due to untreated mental illness and addiction.
The measure faced staunch opposition from disability and civil liberties groups concerned with stripping people of the right to make decisions for themselves.
“We see real examples of people dying every day and dying with their rights,” Eggman said in an interview with Kaiser Health News before the appointment. “I think we need to step back a little bit and look at the broader public health problem. It is a danger for everyone to live near needles or have people hide under highways.”
Senate Pro-Temporary Toni Atkins (D-San Diego) announced Eggman’s appointment Thursday night. Eggman replaces Dr. Richard Pan (D-Sacramento), who was released last year after serving five years as president. Pan, a pediatrician, had prioritized the state’s response to the COVID-19 pandemic and defended legislation which tightened the state’s childhood immunization laws. Those moves made him a hero among public health advocateseven when he faced taunts and physical threats from his opponents.
The leadership change is expected to coincide with a Democratic health agenda focused on two of the state’s thorniest and most intractable problems: homelessness and mental illness. According to federal dataCalifornia accounts for 30% of the nation’s homeless population, while it makes up 12% of the US population. A recent Stanford study estimated that in 2020 about 25% of homeless adults in Los Angeles County had a serious mental illness such as schizophrenia and 27% had a long-term substance use disorder.
Eggman will work with Assemblyman Jim Wood (D-Santa Rosa), who returns as chairman of the Assembly Health Committee. Although presidents may set different priorities, they must cooperate to get bills to the governor’s desk.
Eggman takes the helm as California grapples with a project $24 billion budget deficit, which could force reductions in health spending. The tighter financial outlook is prompting politicians to shift from big “vaunted” ideas like universal health care coverage to showing voters progress on the state’s homelessness crisis, said David McCuan, the department’s chairman. in political science from Sonoma State University. Seven in 10 likely voters list homelessness as a big problem, according to a recent study. state survey by the California Public Policy Institute.
Eggman, 61, served eight years in the state Assembly before his election to the Senate in 2020. In 2015, he authored California’s End of Life Option Law, which allowed terminally ill patients who met specific conditions to obtain aid-in-dying drugs from their doctor. His previous work in mental health included changing eligibility rules for outpatient treatment or conservatorships, and trying to make it easier for community clinics to bill the government for mental health services.
He hasn’t announced his future plans, but he has about $70,000 in a campaign account for lieutenant governor, as well as $175,000 in a ballot measure committee for “Fix California’s mental health system.”
Eggman said the CARE Court initiative seeks to strike a balance between civil rights and public health. She said she believes people should be in the least restrictive environment necessary to receive care, but when someone is a danger to themselves or the community, there should be an option to hold them against their will. A Berkeley Institute for Government Studies survey released in October found 76% of registered voters He had a positive view of the law.
Sen. Tom Umberg (D-Orange), a co-author of the bill with Eggman, credited his behavioral health expertise and dedication to explaining the mechanics of the plan to other lawmakers. “I think she really helped put a face on it,” Umberg said.
But it will be difficult to show quick results. The measure will be developed in phases, with the first seven counties (Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus and Tuolumne) set to launch their efforts in October. The remaining 51 counties will launch in 2024.
County governments remain concerned about a steady and sufficient flow of funds to cover the treatment and housing costs inherent in the scheme.
California has assigned $57 million in seed money for counties to establish local CARE courts, but the state hasn’t specified how much money will flow to counties to keep them running, said Jacqueline Wong-Hernandez, deputy executive director for legislative affairs at the California State Assn. of Counties.
Robin Kennedy is an emeritus professor of social work at Sacramento State, where Eggman taught social work before being elected to the Assembly. Kennedy described Eggman as data-driven, a listener attuned to the needs of caregivers, and a leader willing to do the hard things. The two have known each other since Eggman began teaching in 2002.
“Most of us, when we become faculty, we just want to research and teach,” Kennedy said. “Susan had only been there for two or three years and she was taking leadership roles.”
She said Eggman’s view of mental health as a community issue, rather than just an individual concern, is controversial, but that she is willing to engage in tough conversations and listen to all sides. Plus, Kennedy added, “she’s not just she’s going to do whatever Newsom tells her to do.”
Eggman and Wood are expected to oversee CalAIM, the Newsom administration’s sweeping overhaul of Medi-Cal, California’s Medicaid program for low-income residents. The effort is a multimillion-dollar experiment that aims to improve the health of patients by funneling money into social programs and keeping patients out of expensive institutions like emergency departments, jails, nursing homes and mental health crisis centers.
Wood said he believes there are opportunities to improve the CalAIM initiative and monitor consolidation in the health care industry, which he says drives up costs.
Eggman said she is also concerned about labor shortages in the healthcare industry and would be open to resuming a conversation about a higher minimum wage for hospital workers after negotiations between industry and workers failed last year.
But with just two years to go before his term, Eggman said, his lens will be framed narrowly around his area of expertise: improving behavioral health care in California.
“In my later years,” he said, “I want to focus on where my background is.”
This article was produced by KHN (Kaiser Health News), one of the top three operating programs in KFF (Kaiser Family Foundation).