BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1392|
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UNFINISHED BUSINESS
Bill No: SB 1392
Author: Steinberg (D)
Amended: 8/18/10
Vote: 21
PRIOR SENATE VOTES NOT REVELENT
ASSEMBLY FLOOR : 66-10, 8/23/10 - See last page for vote
SUBJECT : Mental health: community mental health
services
SOURCE : Author
DIGEST : This bill expedites the disbursement of various
sources of mental health funds from the Department of
Mental Health to counties.
Assembly Amendments delete the version of the bill that
passed the Senate, dealing with housing and community
development, and insert language regarding mental health
funding.
ANALYSIS :
Existing law:
1. Establishes the Department of Mental Health (DMH), which
directs and coordinates statewide efforts for the
treatment of mental disabilities.
CONTINUED
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2. Establishes the Medi-Cal Program, administered by the
Department of Health Care Services (DHCS), which
provides health benefits to low-income children, their
parents, or caretaker relatives, pregnant women,
elderly, blind or disabled persons, and other
individuals who meet specified eligibility criteria.
3. Establishes the Bronzan-McCorquodale Act, also known as
"Realignment," which shifted responsibility for the
provision of mental health services from the state to
counties. Funds Realignment programs using revenues
from vehicle licensing fees and sales taxes.
4. Requires public mental health services to be provided to
specified priority target populations in systems of care
that are client-centered, culturally competent, and
fully accountable and specifies the minimum array of
services that must be provided to target populations.
5. Provides for DMH to implement specialty mental health
services for Medi-Cal beneficiaries through
fee-for-service or capitated rate contracts with county
mental health plans (MHPs).
6. Authorizes DMH, contingent on passage of the annual
Budget Act, to distribute total state General Fund (GF)
allocations to counties in 12 monthly increments but
requires the total amount advanced to each county to not
exceed 95 percent of the county's total allocation for
that year.
7. Directs DMH and DHCS to consult with a statewide
organization representing counties to establish a
mechanism to facilitate timely availability of the state
GF allocations described in #4 above.
8. States legislative intent that DMH and DHCS consult and
collaborate closely regarding administrative functions
related to the delivery and provision of specialty
mental health services provided under Medi-Cal.
9. Establishes the Mental Health Services Act (MHSA),
enacted by voters in 2004 as Proposition 63, to provide
funds, through a one percent income tax on personal
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income above $1 million, to counties to expand services
and develop innovative programs and integrated service
plans for mentally ill children, adults, and seniors who
meet the existing priority target population eligibility
criteria.
10.Requires each county mental health department to prepare
and submit to DMH a three-year program and expenditure
plan for MHSA funding.
This bill:
1. Deletes a provision in existing law requiring DMH to
distribute a maximum of 95 percent of total state GF
realignment allocations to counties each fiscal year
upon passage of the annual Budget Act.
2. Makes conforming changes to existing law governing
Medi-Cal specialty mental health services to mirror the
requirement in this bill to delete DMH's five percent
withholding authority pursuant to #1 above.
3. Requires DMH to distribute in a single lump sum the
total approved funding to each county for the provision
of programs and other activities related to the MHSA,
subject to the availability of funding as determined by
the Department of Finance.
4. Clarifies that MHSA funding distributions must be based
on the amount specified in each county's three-year
funding plan or update, as required by existing law, and
specifies that the provisions of this bill in no way
change the authority to approve, deny, or request
further information regarding a county's three-year plan
or update.
5. Makes various legislative findings and declarations
including that this bill is needed to facilitate the
efficiency and cost effectiveness of community mental
health services and prevent avoidable future county
budget cuts to mental health.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
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According to the Assembly Appropriations Committee,
establishing a lump sum distribution of MHSA funding will
result in the earlier release of $275 million (100 percent
MHSA special funds) from a total annual allocation of $1.1
billion, and ending the five percent withhold of Mental
Health Managed Care Funds will result in the earlier
release of approximately $5 million each year.
SUPPORT : (Verified 8/24/10)
California Chapter of the American College of Emergency
Physicians
California Council of Community Mental Health Agencies
California Mental Health Directors Association
California State Association of Counties
Counties of Contra Costa, Los Angeles, and Sacramento
National Alliance on Mental Illness California
Regional Council of Rural Counties
Service Employees International Union, California State
Council
Urban Counties Caucus
ARGUMENTS IN SUPPORT : The author states that this bill
removes unnecessary mental health funding delays at the
state level to enable counties to appropriately access
funding in a timely manner and prevent avoidable budget
cuts. The author notes that the sharp budget reductions in
the last few years to county-administered mental health
services have had numerous negative impacts on California
communities. The author maintains that, too often, people
with serious mental illnesses are showing up in emergency
rooms with acute mental health needs instead of at mental
health programs that provide earlier and more appropriate
care. The author points to numerous audits, most recently
by the federal Centers for Medicaid and Medicare Services
in 2008 and 2010, that have unearthed state inefficiencies
in the administration of mental health dollars to the
counties. The author intends for this bill to hold state
departments accountable for these inefficiencies while
streamlining the processes by which the state reimburses
and distributes funds for community mental health services
to provide counties with cash flow relief.
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ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Arambula, Bass, Beall, Bill
Berryhill, Tom Berryhill, Block, Blumenfield, Bradford,
Brownley, Buchanan, Caballero, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,
DeVore, Eng, Evans, Feuer, Fletcher, Fong, Fuentes,
Galgiani, Gatto, Gilmore, Hagman, Hall, Harkey, Hayashi,
Hernandez, Hill, Huber, Huffman, Jeffries, Jones, Lieu,
Bonnie Lowenthal, Ma, Mendoza, Monning, Nava, V. Manuel
Perez, Portantino, Ruskin, Salas, Saldana, Silva,
Skinner, Smyth, Solorio, Audra Strickland, Swanson,
Torlakson, Torres, Torrico, Tran, Villines, Yamada, John
A. Perez
NOES: Anderson, Fuller, Gaines, Garrick, Knight, Logue,
Miller, Niello, Nielsen, Norby
NO VOTE RECORDED: Furutani, Nestande, Vacancy, Vacancy
CW:kc 8/24/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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