The director of California’s mental health commission traveled to London this summer thanks to a state vendor while helping avert a $360 million budget cut that would have voided the agency’s contract.
Emails and diaries reviewed by KFF Health News show Toby Ewing, executive director of the Mental Health Services Oversight and Accountability Commission, worked to protect funding for Kooth, a London-based digital mental health company that hired the state to develop a virtual tool to help address the youth mental health crisis. Ewing pushed key lawmakers to keep his contract even as Democratic Gov. Gavin Newsom and lawmakers proposed cuts in the face of California’s $45 billion deficit.
When Ewing and three commissioners — Mara Madrigal-Weiss, the committee chair. Bill Brown? and Steve Carnevale — left for London in June, Ewing wasn’t sure if he had saved Kooth’s funding. On the second day of their trip, the staff informed him that the lawmakers had restored the money.
A few days later, she emailed Kooth Chief Operating Officer Kate Newhouse suggestions she had shared with Assembly and Senate staff to improve Kooth’s youth teletherapy app. “We expect you to be a part of what we dream of,” Ewing wrote to Newhouse in another email.
It’s unclear why Kooth picked up a $15,000 tab for government officials to travel to London. It’s also unclear why Ewing pushed to protect his app from spending cuts. The commission is a 16-member independent body appointed by various elected officials to ensure that funds from a millionaire’s tax are used appropriately and effectively by counties for mental health services. Kooth’s contract is with the Department of Health Services, which is separate from the commission.
Kooth signed a four-year, $271 million deal last year to create Soluna, a free mental health app for California users ages 13 to 25. The app, along with another by Brightline for younger users, launched in January to fill a need for young Californians and their families to have free access to professional telehealth. It is one component of Newsom’s $4.7 billion youth mental health plan.
Ewing, who reports to the committee, started in 2015 and earned $175,026 in 2023, according to The Sacramento Bee. He was placed on paid administrative leave in September pending the investigation. Commission general counsel Sandra Gallardo said the commission does not comment on personnel matters. Ewing did not respond to requests for comment.
Three commission employees filed whistleblower complaints against Ewing in September with the California state auditor. They spoke to KFF Health News on the condition that their names not be used due to fears of workplace retaliation. They say Ewing’s behavior in promoting a private company’s agenda as a public servant crossed the line.
The agenda for Thursday’s committee meeting listed a personnel matter to be discussed in closed session. Informants said Ewing is the subject of the conversation.
Madrigal-Weiss said she could not comment on Ewing’s actions. However, he said the committee supports virtual mental health resources for youth.
“These resources are less expensive and have proven valuable for youth, especially those who struggle to access services in typical brick-and-mortar settings,” said Madrigal-Weiss, who is also executive director of student wellness and school culture. for San Diego. Provincial Office of Education.
Brown and Carnevale did not respond to requests for comment.
Kooth is committed to promoting youth access to behavioral health services, said Caroline Curran of Metis Communications, a public relations firm representing Kooth.
“As a leader in youth behavioral health services with over 20 years’ experience in the UK and the United States, we regularly convene leading organizations to facilitate learning through the sharing of expertise and different perspectives on youth behavioral health,” he said. Curran.
As KFF Health News reported in April, the Kooth and Brightline apps have been slow to take off, with few kids using them. In May, Newsom proposed $140 million in budget cuts. DHCS Director Michelle Baass said at a hearing that’s because of low usage, but the state expects more users to come on board over time.
He told lawmakers on May 16 that about 20,000 of the state’s more than 12.6 million children and young adults had signed up for the apps and used them for only about 2,800 tutoring sessions.
State Sen. Caroline Menjivar (D-Van Nuys) asked Baass at the hearing if “there’s room to get out” of the convention altogether. Senators later voted unanimously to cut the platform’s entire budget to save the state $360 million.
Ewing texted a colleague on June 3: “Kooth is horrible. Is the cut coming from the admin or the leg? Do we know if it’s over?”
State lobbying records show Kooth has paid about $100,000 this year to Capital Advocacy. At the same time, Ewing’s emails and diaries show that he pushed to keep Kooth funded. For example, his diary for June 4 shows that he was scheduled to meet with Laura Tully, an executive from Kooth USA, at a coffee shop near the Capitol.
The next day, a source said, Ewing met with key Senate staff members: Scott Ogus, deputy staff director of the Senate Budget and Fiscal Review Committee, and Marjorie Swartz, adviser to Senate President Pro Tempore Mike McGuire. They said Ewing also discussed Kooth’s contract that week with Rosielyn Pulmano, a health policy adviser to Assembly Speaker Robert Rivas.
“Toby kept saying ‘California needs to have a digital strategy,'” recalled the insider, who attended both meetings. “He kept pushing Marjorie and Scott, saying he would give them ideas to make the platform better.”
Ewing emailed ideas to lawmakers on June 10 and 12.
About two weeks later, he and the commissioners left for the seven-day trip to the United Kingdom. , meals, train tickets and international flights.
Public disclosure forms show Kooth paid expenses for Ewing, Madrigal-Weiss and Brown. The forms do not show the company that paid for Carnevale’s trip.
Under California law, state officials generally must report travel payments to the FPPC, which Ewing and his fellow commissioners did.
Kooth postponed a mental health investment conference in London in June, emails and documents show, but then organized new events for California commissioners to attend.
On May 23, Newhouse informed Carnevale and Ewing in an email that Kooth had to postpone the planned June event. Carnevale, a venture capitalist, described the news as “disappointing for everyone”, especially “because we have already booked trips, including members of the Commissioners’ family who were planning to turn it into a holiday”.
Acknowledging the disorder, Newhouse told Carnevale that she “would like to think creatively about whether we could try to arrange a meeting where you can talk about CYBHI,” referring to Newsom’s Behavioral Health Initiative for Children and Youth.
“But I know from our conversation that we need to cover the ‘purpose’ of your trip and not be sure what is possible or not,” he wrote.
Curran, the Kooth spokesman, said the company “adapted by holding a knowledge exchange between representatives from international policy institutes, research institutions and non-profit organizations.”
Madrigal-Weiss defended the trip, which she said included meetings with “members of government, service providers, education and funding” who shared ideas on how to “strengthen funds for public mental health needs” through private and philanthropic collaborations.
One of the whistleblowers said many of the commissioners in California didn’t know about the trip until their colleagues were halfway around the world. Sami Gallegos, a spokesman for the California Department of Health and Human Services, said the Department of Health Services was not involved in the trip.
Ewing was placed on leave ahead of Kooth’s rescheduled conference this month in London.
While it’s not unusual for state officials to travel abroad — often on the money of private entities — it doesn’t look good, said Sean McMorris, a government ethics specialist with California Common Cause, a nonprofit government watchdog group.
“It looks like undue influence,” McMorris said. “I think a lot of people would see something like that as a way to gain favor. You can connect the dots.”
Kooth has also given trips to state officials in Pennsylvania, where he had a $3 million contract with 30 school districts. In any case, Kooth invited the officials to speak to highlight their work. Pennsylvania has informed Kooth that it intends to terminate the contract.
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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