BILL NUMBER: AB 100 CHAPTERED
BILL TEXT
CHAPTER 5
FILED WITH SECRETARY OF STATE MARCH 24, 2011
APPROVED BY GOVERNOR MARCH 24, 2011
PASSED THE SENATE MARCH 16, 2011
PASSED THE ASSEMBLY MARCH 16, 2011
AMENDED IN SENATE MARCH 14, 2011
INTRODUCED BY Committee on Budget (Blumenfield (Chair), Alejo,
Allen, Brownley, Buchanan, Butler, Cedillo, Chesbro, Dickinson,
Feuer, Gordon, Huffman, Mitchell, Monning, and Swanson)
JANUARY 10, 2011
An act to amend Sections 5813.5, 5846, 5847, 5890, 5891, 5892, and
5898 of the Welfare and Institutions Code, relating to mental health
services, making an appropriation therefor, and declaring the
urgency thereof, to take effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 100, Committee on Budget. Mental Health Services Act.
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.
Existing law establishes the Mental Health Services Oversight and
Accountability Commission. Under existing law, the commission is
required to annually review and approve county mental health programs
for expenditures relating to innovative programs and prevention and
early intervention programs. Existing law authorizes the State
Department of Mental Health to provide technical assistance to county
mental health plans, as specified.
This bill would delete the requirement for these annual reviews
and would authorize the commission, instead of the department, to
provide technical assistance to the county mental health plans.
Existing law requires each county mental health program to prepare
and submit a 3-year plan to be updated at least annually and
approved by the department after review and comment by the
commission.
This bill would delete the annual update requirement for the
3-year plans and the requirement that the plans be approved by the
department after review and comment by the commission.
The act establishes the Mental Health Services Fund, continuously
appropriated to and administered by the department, to fund specified
county mental health programs. The act prohibits funds from the
Mental Health Services Fund from being used to supplant existing
state or county funds utilized to provide mental health services, and
requires state financial support for mental health programs with not
less than the same entitlements, amounts of allocations from the
General Fund, and formula distributions as the 2003-04 fiscal year.
Existing law also requires, subject to availability of funding, the
department to distribute a single lump sum of the total amount of
approved funding to each county.
This bill would require the state, instead of the department, to
administer the fund. The bill would authorize continued financial
support for mental health programs to come from the Local Revenue
Fund 2011 in the State Treasury, and would, commencing July 1, 2012,
require the Controller to distribute to the counties all unexpended
and unreserved funds on deposit in the Mental Health Services Fund
monthly.
Under existing law, moneys in the Mental Health Services Fund may
be used only for specified purposes, including 5% for innovative
programs, as specified, and 5% for administrative costs of the
department, the California Mental Health Planning Council, and the
commission.
The bill would reduce the amount available for administrative
costs to 3.5% and would make that distribution subject to
appropriation each fiscal year in the annual Budget Act. The bill,
for the 2011-12 fiscal year, would allocate specified funds in the
Mental Health Services Fund for Medi-Cal specialty mental health
services, mental health services for special education pupils, and
the Early and Periodic Screening, Diagnosis, and Treatment program.
By allocating moneys in the Mental Health Services Fund for new
purposes, this bill would make an appropriation.
Existing law requires the department to develop regulations, which
may be enacted as emergency regulations, for the department or
designated local agencies to implement the act.
This bill, instead, would require the state to develop regulations
for the department, the commission, or designated state and local
agencies to implement the act.
This bill would declare that it is consistent with and furthers
the purpose of the act.
The California Constitution authorizes the Governor to declare a
fiscal emergency and to call the Legislature into special session for
that purpose. Governor Schwarzenegger issued a proclamation
declaring a fiscal emergency, and calling a special session for this
purpose, on December 6, 2010. Governor Brown issued a proclamation on
January 20, 2011, declaring and reaffirming that a fiscal emergency
exists and stating that his proclamation supersedes the earlier
proclamation for purposes of that constitutional provision.
This bill would state that it addresses the fiscal emergency
declared and reaffirmed by the Governor by proclamation issued on
January 20, 2011, pursuant to the California Constitution.
This bill would declare that it is to take effect immediately as
an urgency statute.
Appropriation: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. (a) The Legislature hereby finds and declares that the
statutory changes in this act are consistent with, and further the
intent of, the Mental Health Services Act. These specified changes
are necessary to adequately fund essential mental health services
that would otherwise be significantly and substantially reduced or
eliminated absent this temporary funding support.
(b) Further, it is the intent of the Legislature to ensure
continued state oversight and accountability of the Mental Health
Services Act. In eliminating state approval of county mental health
programs, the Legislature expects the state, in consultation with the
Mental Health Services Oversight and Accountability Commission, to
establish a more effective means of ensuring that county performance
complies with 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 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,
seniors means older adult persons identified in Part 3 (commencing
with Section 5800) of this division.
(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 the term grants referred to in Sections 5814 and 5814.5
shall refer to such contracts.
SEC. 3. Section 5846 of the Welfare and Institutions Code is
amended to read:
5846. (a) The commission shall issue guidelines for expenditures
pursuant to Part 3.2 (commencing with Section 5830), for innovative
programs, and Part 3.6 (commencing with Section 5840), for prevention
and early intervention, no later than 180 days before the fiscal
year for which the funds will apply.
(b) The commission may provide technical assistance to any county
mental health plan as needed to address concerns or recommendations
of the commission or when local programs could benefit from technical
assistance for improvement of their plans.
(c) The commission shall ensure that the perspective and
participation of members and others suffering from severe mental
illness and their family members is a significant factor in all of
its decisions and recommendations.
SEC. 4. Section 5847 of the Welfare and Institutions Code is
amended to read:
5847. Integrated Plans for Prevention, Innovation, and System of
Care Services.
(a) It is the intent of the Legislature to streamline the approval
processes of the State Department of Mental Health and the Mental
Health Services Oversight and Accountability Commission of programs
developed pursuant to Sections 5891 and 5892.
(b) Each county mental health program shall prepare and submit a
three-year plan. The plan and update shall include all of the
following:
(1) A program for prevention and early intervention in accordance
with Part 3.6 (commencing with Section 5840).
(2) A program for services to children in accordance with Part 4
(commencing with Section 5850), to include a program pursuant to
Chapter 4 (commencing with Section 18250) of Part 6 of Division 9 or
provide substantial evidence that it is not feasible to establish a
wraparound program in that county.
(3) A program for services to adults and seniors in accordance
with Part 3 (commencing with Section 5800).
(4) A program for innovations in accordance with Part 3.2
(commencing with Section 5830).
(5) A program for technological needs and capital facilities
needed to provide services pursuant to Part 3 (commencing with
Section 5800), Part 3.6 (commencing with Section 5840), and Part 4
(commencing with Section 5850). All plans for proposed facilities
with restrictive settings shall demonstrate that the needs of the
people to be served cannot be met in a less restrictive or more
integrated setting.
(6) Identification of shortages in personnel to provide services
pursuant to the above programs and the additional assistance needed
from the education and training programs established pursuant to Part
3.1 (commencing with Section 5820).
(7) Establishment and maintenance of a prudent reserve to ensure
the county program will continue to be able to serve children,
adults, and seniors that it is currently serving pursuant to Part 3
(commencing with Section 5800), the Adult and Older Adult Mental
Health System of Care Act, Part 3.6 (commencing with Section 5840),
Prevention and Early Intervention Programs, and Part 4 (commencing
with Section 5850), the Children's Mental Health Services Act, during
years in which revenues for the Mental Health Services Fund are
below recent averages adjusted by changes in the state population and
the California Consumer Price Index.
(c) The State Department of Mental Health shall not issue
guidelines for the Integrated Plans for Prevention, Innovation, and
System of Care Services before January 1, 2012.
(d) The programs established pursuant to paragraphs (2) and (3) of
subdivision (b) shall include services to address the needs of
transition age youth ages 16 to 25.
(e) Each year the State Department of Mental Health, in
consultation with the California Mental Health Directors Association,
the Mental Health Services Oversight and Accountability Commission,
and the Mental Health Planning Council, shall inform counties of the
amounts of funds available for services to children pursuant to Part
4 (commencing with Section 5850), and to adults and seniors pursuant
to Part 3 (commencing with Section 5800). Each county mental health
program shall prepare expenditure plans pursuant to Part 3
(commencing with Section 5800), and Part 4 (commencing with Section
5850), and updates to the plans developed pursuant to this section.
Each expenditure update shall indicate the number of children,
adults, and seniors to be served pursuant to Part 3 (commencing with
Section 5800), and Part 4 (commencing with Section 5850), and the
cost per person. The expenditure update shall include utilization of
unspent funds allocated in the previous year and the proposed
expenditure for the same purpose.
(f) A county mental health program shall include an allocation of
funds from a reserve established pursuant to paragraph (6) of
subdivision (b) for services pursuant to paragraphs (2) and (3) of
subdivision (b) in years in which the allocation of funds for
services pursuant to subdivision (d) are not adequate to continue to
serve the same number of individuals as the county had been serving
in the previous fiscal year.
SEC. 5. 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 System of Care Act.
(2) Part 3.6 (commencing with Section 5840), Prevention and Early
Intervention Programs.
(3) Part 4 (commencing with Section 5850), the Children's Mental
Health Services Act.
(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
Mental Health.
(d) The State Department of Health Care Services, in consultation
with the State Department of Mental Health, 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. 6. Section 5891 of the Welfare and Institutions Code is
amended to read:
5891. (a) The funding established pursuant to this act shall be
utilized to expand mental health services. Except as provided in
subdivision (j) of Section 5892 due to the state's fiscal crisis,
these funds shall not be used to supplant existing state or county
funds utilized to provide mental health services. The state shall
continue to provide financial support for mental health programs with
not less than the same entitlements, amounts of allocations from the
General Fund or from the Local Revenue Fund 2011 in the State
Treasury, and formula distributions of dedicated funds as provided in
the last fiscal year which ended prior to the effective date of this
act. The state shall not make any change to the structure of
financing mental health services, which increases a county's share of
costs or financial risk for mental health services unless the state
includes adequate funding to fully compensate for such increased
costs or financial risk. These funds shall only be used to pay for
the programs authorized in Section 5892. These funds may not be used
to pay for any other program. These funds may not be loaned to the
state General Fund or any other fund of the state, or a county
general fund or any other county fund for any purpose other than
those authorized by Section 5892.
(b) Notwithstanding subdivision (a), the Controller may use the
funds created pursuant to this part for loans to the General Fund as
provided in Sections 16310 and 16381 of the Government Code. Any such
loan shall be repaid from the General Fund with interest computed at
110 percent of the Pooled Money Investment Account rate, with
interest commencing to accrue on the date the loan is made from the
fund. This subdivision does not authorize any transfer that would
interfere with the carrying out of the object for which these funds
were created.
(c) Commencing July 1, 2012, on or before the 15th day of each
month, the Controller shall distribute to each Local Mental Health
Service Fund established by counties pursuant to subdivision (f) of
Section 5892, all unexpended and unreserved funds on deposit as of
the last day of the prior month in the Mental Health Services Fund,
established pursuant to Section 5890, for the provision of programs
and other related activities set forth in Part 3 (commencing with
Section 5800), Part 3.2 (commencing with Section 5830), Part 3.6
(commencing with Section 5840), and Part 4 (commencing with Section
5850). Funding distributions shall be based on the amount specified
in the county mental health program's three-year plan or update, as
required by Section 5847. Nothing in this subdivision shall affect
subdivision (a) or (b).
SEC. 7. Section 5892 of the Welfare and Institutions Code is
amended to read:
5892. (a) In order to promote efficient implementation of this
act allocate the following portions of funds available in the Mental
Health Services Fund in 2005-06 and each year thereafter:
(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.
(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 for prevention and early intervention programs
distributed to counties in accordance with a formula developed in
consultation with the California Mental Health Directors Association
pursuant to Part 3.6 (commencing with Section 5840) of this division.
(4) The allocation for prevention and early intervention may be
increased in any county 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. The statewide allocation for
prevention and early intervention may be increased whenever the
Mental Health Services Oversight and Accountability Commission
determines that all counties are receiving all necessary funds for
services to severely mentally ill persons and have established
prudent reserves and there are additional revenues available in the
fund.
(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 Part 3 (commencing with Section 5800), for the
adult and older adult system of care.
(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 Mental Health, the California Mental Health Planning
Council, and the Mental Health Services Oversight and Accountability
Commission 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.
SEC. 8. Section 5898 of the Welfare and Institutions Code is
amended to read:
5898. The state shall develop regulations, as necessary, for the
State Department of Mental Health, the Mental Health Services
Oversight and Accountability Commission, or designated state and
local agencies to implement this act. Regulations adopted pursuant to
this section shall be developed with the maximum feasible
opportunity for public participation and comments.
SEC. 9. This act addresses the fiscal emergency declared and
reaffirmed by the Governor by proclamation on January 20, 2011,
pursuant to subdivision (f) of Section 10 of Article IV of the
California Constitution.
SEC. 10. This act is an urgency statute necessary for the
immediate preservation of the public peace, health, or safety within
the meaning of Article IV of the Constitution and shall go into
immediate effect. The facts constituting the necessity are:
In order to make changes necessary for implementation of the
Budget Act of 2011, it is necessary that this act take effect
immediately.