Advocates urge county to retain addiction board
The creation of a behavioral health advisory board has left members of the Marin County Alcohol and Other Drug Advisory Board apprehensive about the future of their panel.
Benita McLarin, director of the Marin County Department of Health and Human Services, told the alcohol and drug board in March that she planned to merge the group with the county’s Mental Health Board, despite the AOD board’s opposition. She said she would inform supervisors of her decision in early April.
Instead, on April 26, supervisors voted to approve a county staff recommendation to expand the Mental Health Board.
The concept is “to create a behavioral health board that really focuses our priorities on populations served by the behavioral health and recovery services divisions,” said Jei Africa, director of the county’s behavioral health division.
John Riley, a psychologist who is on the alcohol and drug board, called the timing of the newly created board an “interesting coincidence.”
“The current alcohol and drug advisory board is quite concerned that when the decisions are made about discretionary boards in August that this particular board will not be supported by a vote of the Board of Supervisors,” Riley said.
Tori Kropp, an AOD board member who lost her 18-year-old son, Alexander, to an accidental fentanyl overdose in 2020, said, “There is absolutely no question that the real plan is to get rid of the AOD board.”
Members of the AOD board, several of whom have lost children to overdose deaths, have pleaded with McLarin to reconsider her decision to merge the boards. The group has been at odds with McLarin over the county’s efforts to address substance use, which is almost entirely focused on residents who qualify for Medi-Cal, even though only about 17% of Marin’s residents rely on Medi-Cal for health care.
“I fear that the recent proposal to repurpose the Mental Health Board to the behavioral health board is a maneuver to convince you that the AOD board is no longer relevant,” the AOD board’s chair, Ruby Gibney, told supervisors during the April 26 meeting. “Whatever the new Mental Health Board repurposes itself to include, we believe it is not the complete solution. The county still needs a wider scope on what’s killing people, and the AOD provides that wider scope and mission.”
There were only two references during the meeting to the fact that the alcohol and drug board must be reauthorized by supervisors in August to continue to exist. It is not mandated, as opposed to the Mental Health Board.
Africa said the recommendation to form a new behavioral health board had “nothing to do with” the pending decision by the Board of Supervisors on whether to continue the AOD board.
Supervisor Katie Rice, who represents the Board of Supervisors on both boards, said, “We'll take up the AOD board as a separate item in August.”
When Supervisor Damon Connolly asked who would serve on the new board and how its members would be selected, Africa said that members of the Mental Health Board would be invited and that two other slots would be made available “to ensure there is substance-use representation.”
Rice, however, said that the bylaws for the new board were still being written.
“More detail to come,” said Rice, regarding how appointees to the board will be selected.
Regarding the creation of the new board, Africa said, “We feel this is really a great idea because it will expand the focus and work of the Mental Health Board to include people who have substance-use conditions.”
Africa said about 40% of the county's behavioral health clients are also dealing
with a substance problem, and 50% of the county's substance-use clients have a co-occurring mental health condition.
During the public comment portion of the meeting, a number of speakers cited the co-occurrence of mental health and substance use issues as their reason for supporting the creation of a behavioral health board.
“I think this is a great idea,” said Michael Maritzen, substance-use specialist for Sonoma County. “It is important to recognize that substance use is a mental health condition.”
In a letter, Elizabeth Horevitz, chief behavioral health officer for Marin Community Clinics, wrote, “The rate of concurrent mental health and addictive disorders is staggering. For far too long in the history of health care, services have been siloed.”
Several members of the AOD board voiced their support for the creation of a behavioral health board but stressed the need for maintaining the alcohol and drug board. They emphasized the fact that the new board would focus its attention on Marin's Medi-Cal-eligible population.
AOD members said this approach ignores the fact that many of the youths dying of drug overdoses in Marin come from families who earn too much to qualify for government assistance but sometimes too little to afford expensive, private rehabilitation programs.
They said they would also like to see more money spent on prevention efforts. Currently, 7% of the money the county spends on substance use goes towards prevention.
“This is not just happening in the 17% sector
that the newly proposed behavioral health board will be overseeing,” said AOD board member Suzanne Kanner. “Currently in this county for those suffering from substance use disorder, there is not enough services, access to service or trained professionals to help, regardless of insurance coverage, whether it is private or Medi-Cal.”
AOD board member Tracy Novick said, “Why wouldn't you want to keep the AOD? We're very dedicated. We represent 83% of the residents of Marin County who will not be addressed by a behavioral health board.”
Several of those who spoke in favor of forming the new board said that the alcohol and drug board should not be phased out.
“I think this board is a brilliant idea,” said Bobby Moske. “Absolutely by no means should the AOD board go away.”