BILL NUMBER: AB 1367 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Mansoor
(Coauthors: Assembly Members Achadjian, Allen, Conway, Beth
Gaines, Gorell, Hagman, Harkey, and Morrell)
FEBRUARY 22, 2013
An act to amend Sections 5813.5, 5840, 5890, and 5892 of the
Welfare and Institutions Code, relating to mental health, and making
an appropriation therefor.
LEGISLATIVE COUNSEL'S DIGEST
AB 1367, as introduced, Mansoor. Mental health: Mental Health
Services Fund.
Existing law, known as Laura's Law, until January 1, 2017,
regulates designated assisted outpatient treatment services, which a
county may choose to provide for its residents. In a county where
assisted outpatient treatment services are available, a person is
authorized to receive specified mental health services pursuant to an
order if requisite criteria are met, as specified. Under that law,
participating counties are required to provide prescribed assisted
outpatient services, including a service planning and delivery
process that provides for services that are client-directed and
employ psychosocial rehabilitation and recovery principles.
Existing law contains provisions governing the operation and
financing of community mental health services for the mentally
disordered in every county through locally administered and locally
controlled community mental health programs. Existing law, the Mental
Health Services Act, an initiative measure enacted by the voters as
Proposition 63 at the November 2, 2004, statewide general election,
funds a system of county mental health plans for the provision of
mental health services, as specified. The act provides that it may be
amended by the Legislature by a 2/3 vote of each house as long as
the amendment is consistent with and furthers the intent of the act,
and that the Legislature may also clarify procedures and terms of the
act by majority vote.
The act establishes the Mental Health Services Fund, continuously
appropriated to and administered by the State Department of Health
Care Services, to fund specified county mental health programs,
including prevention and early intervention programs, which include
outreach, and programs implemented under the Adult and Older Adult
Mental Health System of Care Act. The Adult and Older Adult Mental
Health System of Care Act establishes services standards that
require, among other things, that a service planning and delivery
process provides for services that are client-directed and employ
psychosocial rehabilitation and recovery principles.
This bill would declare that it is consistent with and furthers
the intent of the Mental Health Services Act. This bill would clarify
that services provided under Laura's Law may be provided pursuant to
the Mental Health Services Act. This bill would provide that
outreach under prevention and early intervention programs may include
the provision of funds to school districts, county offices of
education, and charter schools for the purposes of obtaining and
providing training to identify students with mental health issues
that may result in a threat to themselves or others. By allocating
moneys in the Mental Health Services Fund for new purposes, this bill
would make an appropriation.
This bill would delete obsolete provisions and make other
conforming changes.
Because the bill would amend Proposition 63, it would require a
2/3 vote of the Legislature.
Vote: 2/3. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature hereby finds and declares that the
provisions of this act are consistent with, and further the intent
of, the Mental Health Services Act.
SEC. 2. Section 5813.5 of the Welfare and Institutions Code is
amended to read:
5813.5. Subject to the availability of funds from the Mental
Health Services Fund, the state shall distribute funds for the
provision of services under Sections 5347, 5348, 5801,
5802, and 5806 to county mental health programs. Services shall be
available to adults and seniors with severe illnesses who meet the
eligibility criteria in subdivisions (b) and (c) of Section 5600.3.
For purposes of this act the Mental Health
Services Act , seniors means older adult persons identified in
Part 3 (commencing with Section 5800) of this
division part .
(a) Funding shall be provided at sufficient levels to ensure that
counties can provide each adult and senior served pursuant to this
part with the medically necessary mental health services,
medications, and supportive services set forth in the applicable
treatment plan.
(b) The funding shall only cover the portions of those costs of
services that cannot be paid for with other funds including other
mental health funds, public and private insurance, and other local,
state, and federal funds.
(c) Each county mental health programs plan shall provide for
services in accordance with the system of care for adults and seniors
who meet the eligibility criteria in subdivisions (b) and (c) of
Section 5600.3.
(d) Planning for services shall be consistent with the philosophy,
principles, and practices of the Recovery Vision for mental health
consumers:
(1) To promote concepts key to the recovery for individuals who
have mental illness: hope, personal empowerment, respect, social
connections, self-responsibility, and self-determination.
(2) To promote consumer-operated services as a way to support
recovery.
(3) To reflect the cultural, ethnic, and racial diversity of
mental health consumers.
(4) To plan for each consumer's individual needs.
(e) The plan for each county mental health program shall indicate,
subject to the availability of funds as determined by Part 4.5
(commencing with Section 5890) of this division, and other funds
available for mental health services, adults and seniors with a
severe mental illness being served by this program are either
receiving services from this program or have a mental illness that is
not sufficiently severe to require the level of services required of
this program.
(f) Each county plan and annual update pursuant to Section 5847
shall consider ways to provide services similar to those established
pursuant to the Mentally Ill Offender Crime Reduction Grant Program.
Funds shall not be used to pay for persons incarcerated in state
prison or parolees from state prisons.
(g) The department shall contract for services with county mental
health programs pursuant to Section 5897. After the
effective date of this section January 1, 2005,
the term grants referred to "grant" as used
in Sections 5814 and 5814.5 shall refer to such
contracts means a contract described in this
subdivision .
SEC. 3. Section 5840 of the Welfare and Institutions Code is
amended to read:
5840. (a) The State Department of Health Care Services, in
coordination with counties, shall establish a program designed to
prevent mental illnesses from becoming severe and disabling. The
program shall emphasize improving timely access to services for
underserved populations.
(b) The program shall include the following components:
(1) Outreach to families, employers, primary care health care
providers, school districts, county off ices of
education, charter schools, and others to recognize the early
signs of potentially severe and disabling mental illnesses. This
may include the provision of funds to school districts, county
offices of education, and charter schools for the purposes of
obtaining and providing training to identify students with mental
health issues that may result in a threat to themselves or others in
order to provide for timely intervention.
(2) Access and linkage to medically necessary care provided by
county mental health programs for children with severe mental
illness, as defined in Section 5600.3, and for adults and seniors
with severe mental illness, as defined in Section 5600.3, as early in
the onset of these conditions as practicable.
(3) Reduction in stigma associated with either being diagnosed
with a mental illness or seeking mental health services.
(4) Reduction in discrimination against people with mental
illness.
(c) The program shall include mental health services similar to
those provided under other programs effective in preventing mental
illnesses from becoming severe, and shall also include components
similar to programs that have been successful in reducing the
duration of untreated severe mental illnesses and assisting people in
quickly regaining productive lives.
(d) The program shall emphasize strategies to reduce the following
negative outcomes that may result from untreated mental illness:
(1) Suicide.
(2) Incarcerations.
(3) School failure or dropout.
(4) Unemployment.
(5) Prolonged suffering.
(6) Homelessness.
(7) Removal of children from their homes.
(e) Prevention and early intervention funds may be used to broaden
the provision of community-based mental health services by adding
prevention and early intervention services or activities to these
services.
(f) In consultation with mental health stakeholders, and
consistent with guidelines from the Mental Health Services Oversight
and Accountability Commission, pursuant to Section 5846, the
department shall revise the program elements in Section 5840
applicable to all county mental health programs in future years to
reflect what is learned about the most effective prevention and
intervention programs for children, adults, and seniors.
SEC. 4. Section 5890 of the Welfare and Institutions Code is
amended to read:
5890. (a) The Mental Health Services Fund is hereby created in
the State Treasury. The fund shall be administered by the state.
Notwithstanding Section 13340 of the Government Code, all moneys in
the fund are, except as provided in subdivision (d) of Section 5892,
continuously appropriated, without regard to fiscal years, for the
purpose of funding the following programs and other related
activities as designated by other provisions of this division:
(1) Part 3 (commencing with Section 5800), the Adult and Older
Adult Mental Health System of Care Act.
(2) Part 3.2 (commencing with Section 5830), Innovative Programs.
(3) Part 3.6 (commencing with Section 5840), Prevention and Early
Intervention Programs.
(4) Part 4 (commencing with Section 5850), the Children's Mental
Health Services Act.
(5) Article 9 (commencing with Section 5345) of Chapter 2 of Part
1, Laura's Law.
(b) Nothing in the establishment of this fund, nor any other
provisions of the act establishing it or the programs funded shall be
construed to modify the obligation of health care service plans and
disability insurance policies to provide coverage for mental health
services, including those services required under Section 1374.72 of
the Health and Safety Code and Section 10144.5 of the Insurance Code,
related to mental health parity. Nothing in this act shall be
construed to modify the oversight duties of the Department of Managed
Health Care or the duties of the Department of Insurance with
respect to enforcing these obligations of plans and insurance
policies.
(c) Nothing in this act shall be construed to modify or reduce the
existing authority or responsibility of the State Department of
Health Care Services.
(d) The State Department of Health Care Services shall seek
approval of all applicable federal Medicaid approvals to maximize the
availability of federal funds and eligibility of participating
children, adults, and seniors for medically necessary care.
(e) Share of costs for services pursuant to Part 3 (commencing
with Section 5800), and Part 4 (commencing with Section 5850) of this
division, shall be determined in accordance with the Uniform Method
for Determining Ability to Pay applicable to other publicly funded
mental health services, unless this Uniform Method is replaced by
another method of determining co-payments, in which case the new
method applicable to other mental health services shall be applicable
to services pursuant to Part 3 (commencing with Section 5800), and
Part 4 (commencing with Section 5850) of this division.
SEC. 5. Section 5892 of the Welfare and Institutions Code is
amended to read:
5892. (a) In order to promote efficient implementation of
this act the Mental Health Services Act
, the county shall use funds distributed from the Mental Health
Services Fund as follows:
(1) In 2005-06, 2006-07, and in 2007-08 10 percent shall be placed
in a trust fund to be expended for education and training programs
pursuant to Part 3.1 (commencing with Section 5820) .
(2) In 2005-06, 2006-07 and in 2007-08 10 percent for capital
facilities and technological needs distributed to counties in
accordance with a formula developed in consultation with the
California Mental Health Directors Association to implement plans
developed pursuant to Section 5847.
(3) Twenty percent of funds distributed to the counties pursuant
to subdivision (c) of Section 5891 shall be used for prevention and
early intervention programs in accordance with Part 3.6 (commencing
with Section 5840) of this division .
(4) The expenditure for prevention and early intervention may be
increased in any county in which the department determines that the
increase will decrease the need and cost for additional services to
severely mentally ill persons in that county by an amount at least
commensurate with the proposed increase.
(5) The balance of funds shall be distributed to county mental
health programs for services to persons with severe mental illnesses
pursuant to Part 4 (commencing with Section 5850), for the children's
system of care and care, Part 3
(commencing with Section 5800), for the adult and older adult system
of care care, and Article 9 (commencing with
Section 5345) of Chapter 2 of Part 1 .
(6) Five percent of the total funding for each county mental
health program for Part 3 (commencing with Section 5800), Part 3.6
(commencing with Section 5840), and Part 4 (commencing with Section
5850) of this division, shall be utilized for innovative programs in
accordance with Sections 5830, 5847, and 5848.
(b) In any year after 2007-08, programs for services pursuant to
Part 3 (commencing with Section 5800), and Part 4 (commencing with
Section 5850) of this division may include funds for technological
needs and capital facilities, human resource needs, and a prudent
reserve to ensure services do not have to be significantly reduced in
years in which revenues are below the average of previous years. The
total allocation for purposes authorized by this subdivision shall
not exceed 20 percent of the average amount of funds allocated to
that county for the previous five years pursuant to this section.
(c) The allocations pursuant to subdivisions (a) and (b) shall
include funding for annual planning costs pursuant to Section 5848.
The total of these costs shall not exceed 5 percent of the total of
annual revenues received for the fund. The planning costs shall
include funds for county mental health programs to pay for the costs
of consumers, family members, and other stakeholders to participate
in the planning process and for the planning and implementation
required for private provider contracts to be significantly expanded
to provide additional services pursuant to Part 3 (commencing with
Section 5800), and Part 4 (commencing with Section 5850) of this
division.
(d) Prior to making the allocations pursuant to subdivisions (a),
(b), and (c), funds shall be reserved for the costs for the State
Department of Health Care Services, the California Mental Health
Planning Council, the Office of Statewide Health Planning and
Development, the Mental Health Services Oversight and Accountability
Commission, the State Department of Public Health, and any other
state agency to implement all duties pursuant to the programs set
forth in this section. These costs shall not exceed 3.5 percent of
the total of annual revenues received for the fund. The
administrative costs shall include funds to assist consumers and
family members to ensure the appropriate state and county agencies
give full consideration to concerns about quality, structure of
service delivery, or access to services. The amounts allocated for
administration shall include amounts sufficient to ensure adequate
research and evaluation regarding the effectiveness of services being
provided and achievement of the outcome measures set forth in Part 3
(commencing with Section 5800), Part 3.6 (commencing with Section
5840), and Part 4 (commencing with Section 5850) of this division.
The amount of funds available for the purposes of this subdivision in
any fiscal year shall be subject to appropriation in the annual
Budget Act.
(e) In 2004-05 funds shall be allocated as follows:
(1) Forty-five percent for education and training pursuant to Part
3.1 (commencing with Section 5820) of this division.
(2) Forty-five percent for capital facilities and technology needs
in the manner specified by paragraph (2) of subdivision (a).
(3) Five percent for local planning in the manner specified in
subdivision (c).
(4) Five percent for state implementation in the manner specified
in subdivision (d).
(f) Each county shall place all funds received from the State
Mental Health Services Fund in a local Mental Health Services Fund.
The Local Mental Health Services Fund balance shall be invested
consistent with other county funds and the interest earned on the
investments shall be transferred into the fund. The earnings on
investment of these funds shall be available for distribution from
the fund in future years.
(g) All expenditures for county mental health programs shall be
consistent with a currently approved plan or update pursuant to
Section 5847.
(h) Other than funds placed in a reserve in accordance with an
approved plan, any funds allocated to a county which have not been
spent for their authorized purpose within three years shall revert to
the state to be deposited into the fund and available for other
counties in future years, provided however, that funds for capital
facilities, technological needs, or education and training may be
retained for up to 10 years before reverting to the fund.
(i) If there are still additional revenues available in the fund
after the Mental Health Services Oversight and Accountability
Commission has determined there are prudent reserves and no unmet
needs for any of the programs funded pursuant to this section,
including all purposes of the Prevention and Early Intervention
Program, the commission shall develop a plan for expenditures of
these revenues to further the purposes of this act and the
Legislature may appropriate these funds for any purpose consistent
with the commission's adopted plan which furthers the purposes of
this act.
(j) For the 2011-12 fiscal year, General Fund revenues will be
insufficient to fully fund many existing mental health programs,
including Early and Periodic Screening, Diagnosis, and Treatment
(EPSDT), Medi-Cal Specialty Mental Health Managed Care, and mental
health services provided for special education pupils. In order to
adequately fund those programs for the 2011-12 fiscal year and avoid
deeper reductions in programs that serve individuals with severe
mental illness and the most vulnerable, medically needy citizens of
the state, prior to distribution of funds under paragraphs (1) to
(6), inclusive, of subdivision (a), effective July 1, 2011, moneys
shall be allocated from the Mental Health Services Fund to the
counties as follows:
(1) Commencing July 1, 2011, one hundred eighty-three million six
hundred thousand dollars ($183,600,000) of the funds available as of
July 1, 2011, in the Mental Health Services Fund, shall be allocated
in a manner consistent with subdivision (c) of Section 5778 and based
on a formula determined by the state in consultation with the
California Mental Health Directors Association to meet the fiscal
year 2011-12 General Fund obligation for Medi-Cal Specialty Mental
Health Managed Care.
(2) Upon completion of the allocation in paragraph (1), the
Controller shall distribute to counties ninety-eight million five
hundred eighty-six thousand dollars ($98,586,000) from the Mental
Health Services Fund for mental health services for special education
pupils based on a formula determined by the state in consultation
with the California Mental Health Directors Association.
(3) Upon completion of the allocation in paragraph (2), the
Controller shall distribute to counties 50 percent of their 2011-12
Mental Health Services Act component allocations consistent with
Sections 5847 and 5891, not to exceed four hundred eighty-eight
million dollars ($488,000,000). This allocation shall commence
beginning August 1, 2011.
(4) Upon completion of the allocation in paragraph (3), and as
revenues are deposited into the Mental Health Services Fund, the
Controller shall distribute five hundred seventy-nine million dollars
($579,000,000) from the Mental Health Services Fund to counties to
meet the General Fund obligation for EPSDT for fiscal year 2011-12.
These revenues shall be distributed to counties on a quarterly basis
and based on a formula determined by the state in consultation with
the California Mental Health Directors Association. These funds shall
not be subject to reconciliation or cost settlement.
(5) The Controller shall distribute to counties the remaining
2011-12 Mental Health Services Act component allocations consistent
with Sections 5847 and 5891, beginning no later than April 30, 2012.
These remaining allocations shall be made on a monthly basis.
(6) The total one-time allocation from the Mental Health Services
Fund for EPSDT, Medi-Cal Specialty Mental Health Managed Care, and
mental health services provided to special education pupils as
referenced shall not exceed eight hundred sixty-two million dollars
($862,000,000). Any revenues deposited in the Mental Health Services
Fund in fiscal year 2011-12 that exceed this obligation shall be
distributed to counties for remaining fiscal year 2011-12 Mental
Health Services Act component allocations, consistent with Sections
5847 and 5891.
(k) Subdivision (j) shall not be subject to repayment.
(l) Subdivision (j) shall become inoperative on July 1, 2012.