BILL NUMBER: SB 1009	ENROLLED
	BILL TEXT

	PASSED THE SENATE  JUNE 27, 2012
	PASSED THE ASSEMBLY  JUNE 27, 2012
	AMENDED IN ASSEMBLY  JUNE 25, 2012

INTRODUCED BY   Committee on Budget and Fiscal Review

                        FEBRUARY 6, 2012

   An act to amend Section 680 of the Business and Professions Code,
to amend Section 43.7 of the Civil Code, to amend Sections 1179.3,
1180.6, 1250.2, 1254, 1254.1, 1266.1, 1275.1, 1275.5, 1324.20, 1343,
1373, 1422.1, 1502, 1502.4, 1507, 1522.08, 1522.41, 1522.42, 1530.9,
1562.3, 11217, 11998.1, 50451, 50685.5, 50687.5, 50689, 120840,
124174.4, 128454, 128456, and 129230 of, and to repeal Section 1565
of, the Health and Safety Code, to amend Sections 10125, 10127, and
12693.61 of the Insurance Code, and to amend Sections 21, 359, 708,
4005.1, 4011, 4030, 4031, 4032, 4033, 4040, 4050, 4051, 4052, 4060,
4061, 4080, 4090, 4091, 4094, 4094.1, 4094.2, 4094.7, 4095, 4096.5,
4098.2, 4340, 4369.4, 4681, 4681.1, 4696.1, 4835, 4844, 5150, 5151,
5152, 5157, 5202, 5270.12, 5325, 5326, 5326.1, 5326.15, 5326.3,
5326.8, 5326.9, 5326.91, 5326.95, 5328, 5348, 5349, 5349.1, 5358,
5366.1, 5370.2, 5400, 5402, 5404, 5405, 5510, 5513, 5514, 5520, 5530,
5585.21, 5585.22, 5585.50, 5585.55, 5601, 5602, 5604, 5607, 5610,
5650, 5651, 5652.7, 5653, 5653.1, 5654, 5655, 5664, 5664.5, 5666,
5675, 5675.1, 5675.2, 5676, 5688.6, 5692, 5701, 5701.1, 5705, 5707,
5709, 5710, 5714, 5715, 5717, 5750, 5751, 5751.1, 5751.2, 5751.7,
5768, 5770, 5770.5, 5771, 5771.3, 5772, 5803, 5805, 5806, 5807, 5809,
5813.6, 5814, 5815, 5851.5, 5852, 5852.5, 5854, 5855, 5855.5, 5863,
5867.5, 5868, 5869, 5872, 5878, 5880, 5881, 5901, 5909, 6002.15,
6002.40, 6007, 6551, 7100, 9101, 11325.7, 11462.01, 11495.1, 14021.4,
14021.5, 14053.3, 14108.1, 14110.15, 14131.07, 14132.73, 14167.1,
14167.11, 14168.1, 14169.1, 14456.5, 14680, 14681, 14683, 14684,
14684.1, 14685, 18358.15, 18986.40, 18987.7, and 18994.9 of, to amend
the heading of Article 2 (commencing with Section 5510) of Chapter
6.2 of Part 1 of Division 5 of, to amend and renumber Sections 4070,
4071, 5711, 5716, 5718, 5719, 5720, 5721, 5722, 5723, 5724, 5775,
5776, 5777, 5777.5, 5777.6, 5777.7, 5778, 5778.3, 5780, 5781, and
5783 of, to amend and repeal Sections 5779, 5782, 14021.3, and 14682,
of, to amend, renumber, and repeal Section 5719.5 of, to add
Sections 4005.6, 4005.7, 14682.1, 14685.1, 14702, 14703, 14704, and
14707.5 to, to repeal Sections 5600.8, 5673, 5708, 5712, 5723.5,
5750.1, 5804, 14640, and 25002 of, to repeal the heading of Article 4
(commencing with Section 4070) of Chapter 2 of Part 1 of Division 4
of, to repeal Article 1 (commencing with Section 4074) and Article 2
(commencing with Section 4075) of Chapter 3 of Part 1 of Division 4
of, to repeal Article 2.5 (commencing with Section 5689) of Chapter
2.5 of Part 2 of Division 5 of, to repeal Article 3 (commencing with
Section 5810) of Part 3 of Division 5 of, and to repeal Chapter 5
(commencing with Section 4097) of Part 1 of Division 4 of, the
Welfare and Institutions Code, relating to health and human services,
and making an appropriation therefor, to take effect immediately,
bill related to the budget.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1009, Committee on Budget and Fiscal Review. Health and human
services.
   Under existing law, the State Department of Mental Health is
authorized and required to perform various functions relating to the
care and treatment of persons with mental disorders. Under existing
law, services for these individuals may be provided in psychiatric
hospitals or other types of facilities, as well as in community
settings.
   This bill would eliminate or modify certain duties of, and
programs administered by, the State Department of Mental Health, and
would transfer the functions of the State Department of Mental Health
to other state departments. The transferred responsibilities would
include, among others, transferring licensing authority for
psychiatric health facilities, as defined, to the State Department of
Social Services, transferring authority for oversight of group homes
for seriously emotionally disturbed children and community treatment
facilities, and certain duties relating to drug and alcohol abuse
programs, to the State Department of Health Care Services, and
transferring to the State Department of State Hospitals jurisdiction
over individuals under the treatment of state hospitals.
   This bill would abolish the existing Licensing and Certification
Fund, Mental Health, and would create in its place the Mental Health
Facility Licensing Fund, which, upon appropriation by the
Legislature, would fund administrative and other activities in
support of the mental health licensing and certification functions of
the State Department of Social Services.
   This bill would make various related, technical, and conforming
changes to reflect the transfer of state mental health
responsibilities.
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are provided to qualified low-income persons. The
Medi-Cal program is, in part, governed and funded by federal Medicaid
provisions. Under existing law, the State Department of Mental
Health is required to implement mental health care services, as
specified, for Medi-Cal recipients. Existing law, commencing July 1,
2012, requires state administrative functions for the operation of
Medi-Cal specialty mental health managed care, the Early and
Periodic, Screening, Diagnosis, and Treatment (EPSDT) Program, and
applicable functions related to federal Medicaid requirements that
are performed by the State Department of Mental Health to be
transferred to the State Department of Health Care Services.
   This bill would transfer the administration of mental health
services described above for Medi-Cal beneficiaries to the State
Department of Health Care Services, effective July 1, 2012, and would
make related changes.
   Existing law provides that clinics providing Medi-Cal specialty
mental health services are not required to be licensed as a condition
to reimbursement.
   This bill would require instead that clinics providing those
services be certified as a condition to reimbursement.
   Existing law, to the extent permitted under federal law,
authorizes funds deposited into a local health and welfare trust fund
from the Sales Tax Account of the Local Revenue Fund to be used to
match federal Medicaid funds in order to achieve the maximum federal
reimbursement possible.
   This bill would instead authorize, to the extent permitted under
specified provisions of law, that funds distributed to counties from
the Mental Health Subaccount, the Mental Health Equity Subaccount,
and the Vehicle License Collection Account of the Local Revenue Fund,
funds from the Mental Health Account and the Behavioral Health
Subaccount from the Local Revenue Fund 2011, funds from the Mental
Health Services Fund, and any other funds from which the Controller
makes distributions to the counties be used to pay for services
provided by these funds that the counties may certify as public
expenditures in order to achieve the maximum federal reimbursement
possible.
   This bill would make related and conforming changes relating to
federal audit exceptions.
   Existing law requires the State Department of Mental Health to
implement managed mental health care for Medi-Cal beneficiaries
through fee-for-service or capitated rate contracts with mental
health plans, as specified.
   This bill would instead require the State Department of Health
Care Services to implement managed mental health care for Medi-Cal
beneficiaries through contracts with mental health plans. The bill
would make various changes to associated contracting procedures and
would specify the sources from which fines and penalties for
noncompliance with specialty mental health service requirements may
be satisfied.
   Existing law provides that a contract with a mental health plan
may be renewed, for a period not to exceed 3 years, if the mental
health plan continues to meet specified requirements.
   This bill would delete the 3-year limitation on renewed contracts.

   Existing law specifies responsibilities and procedures for audit
exceptions, disallowances, and appeals for Medi-Cal specialty mental
health services provided by mental health plans and mental health
plan subcontractors. Existing law limits the maximum amount withheld
for purposes of audit exceptions or disallowances to 25% of each
payment, as specified.
   This bill would revise the responsibilities and procedures
relating to audit exceptions, disallowances, and appeals, would
eliminate obsolete language, and would make conforming and clarifying
changes. The bill would authorize the department to increase the
amount withheld to an amount greater than 25% of each payment in
order to comply with federal laws and regulations.
   Existing law requires the State Department of Mental Health to
allocate funds for the provision of mental health services to
Medi-Cal eligible persons over 20 years of age to counties of over
one million population that own and operate an acute psychiatric
health facility, as specified.
   This bill would delete that provision.
   Existing law provides that counties have the right of first
refusal to serve as a mental health plan.
   This bill would repeal these provisions on November 7, 2012, if a
specified provision of law takes effect.
   Existing law requires the Secretary for California Health and
Human Services to establish a process by which options for achieving
universal health care coverage are developed.
   This bill would delete these provisions.
   This bill would delete obsolete provisions of law, and would make
conforming, clarifying, and technical changes.
   This bill would appropriate the sum of $1,000 from the General
Fund to the State Department of Health Care Services for
administration.
   This bill would declare that it is to take effect immediately as a
bill providing for appropriations related to the Budget Bill.
   This bill would become operative contingent upon the enactment of
AB 1480 or SB 1020 of the 2011-12 Regular Session.
   Appropriation: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  This act is titled and may be cited as 2011 Realignment
Legislation.
  SEC. 2.  Section 680 of the Business and Professions Code is
amended to read:
   680.  (a) Except as otherwise provided in this section, a health
care practitioner shall disclose, while working, his or her name and
practitioner's license status, as granted by this state, on a name
tag in at least 18-point type. A health care practitioner in a
practice or an office, whose license is prominently displayed, may
opt to not wear a name tag. If a health care practitioner or a
licensed clinical social worker is working in a psychiatric setting
or in a setting that is not licensed by the state, the employing
entity or agency shall have the discretion to make an exception from
the name tag requirement for individual safety or therapeutic
concerns. In the interest of public safety and consumer awareness, it
shall be unlawful for any person to use the title "nurse" in
reference to himself or herself and in any capacity, except for an
individual who is a registered nurse or a licensed vocational nurse,
or as otherwise provided in Section 2800. Nothing in this section
shall prohibit a certified nurse assistant from using his or her
title.
   (b) Facilities licensed by the State Department of Social Services
or the State Department of Public Health shall develop and implement
policies to ensure that health care practitioners providing care in
those facilities are in compliance with subdivision (a). The State
Department of Social Services and the State Department of Public
Health shall verify through periodic inspections that the policies
required pursuant to subdivision (a) have been developed and
implemented by the respective licensed facilities.
   (c) For purposes of this article, "health care practitioner" means
any person who engages in acts that are the subject of licensure or
regulation under this division or under any initiative act referred
to in this division.
  SEC. 3.  Section 43.7 of the Civil Code is amended to read:
   43.7.  (a) There shall be no monetary liability on the part of,
and no cause of action for damages shall arise against, any member of
a duly appointed mental health professional quality assurance
committee that is established in compliance with Section 14725 of the
Welfare and Institutions Code, for any act or proceeding undertaken
or performed within the scope of the functions of the committee which
is formed to review and evaluate the adequacy, appropriateness, or
effectiveness of the care and treatment planned for, or provided to,
mental health patients in order to improve quality of care by mental
health professionals if the committee member acts without malice, has
made a reasonable effort to obtain the facts of the matter as to
which he or she acts, and acts in reasonable belief that the action
taken by him or her is warranted by the facts known to him or her
after the reasonable effort to obtain facts.
   (b) There shall be no monetary liability on the part of, and no
cause of action for damages shall arise against, any professional
society, any member of a duly appointed committee of a medical
specialty society, or any member of a duly appointed committee of a
state or local professional society, or duly appointed member of a
committee of a professional staff of a licensed hospital (provided
the professional staff operates pursuant to written bylaws that have
been approved by the governing board of the hospital), for any act or
proceeding undertaken or performed within the scope of the functions
of the committee which is formed to maintain the professional
standards of the society established by its bylaws, or any member of
any peer review committee whose purpose is to review the quality of
medical, dental, dietetic, chiropractic, optometric, acupuncture,
psychotherapy, or veterinary services rendered by physicians and
surgeons, dentists, dental hygienists, podiatrists, registered
dietitians, chiropractors, optometrists, acupuncturists,
veterinarians, marriage and family therapists, professional clinical
counselors, or psychologists, which committee is composed chiefly of
physicians and surgeons, dentists, dental hygienists, podiatrists,
registered dietitians, chiropractors, optometrists, acupuncturists,
veterinarians, marriage and family therapists, professional clinical
counselors, or psychologists for any act or proceeding undertaken or
performed in reviewing the quality of medical, dental, dietetic,
chiropractic, optometric, acupuncture, psychotherapy, or veterinary
services rendered by physicians and surgeons, dentists, dental
hygienists, podiatrists, registered dietitians, chiropractors,
optometrists, acupuncturists, veterinarians, marriage and family
therapists, professional clinical counselors, or psychologists or any
member of the governing board of a hospital in reviewing the quality
of medical services rendered by members of the staff if the
professional society, committee, or board member acts without malice,
has made a reasonable effort to obtain the facts of the matter as to
which he, she, or it acts, and acts in reasonable belief that the
action taken by him, her, or it is warranted by the facts known to
him, her, or it after the reasonable effort to obtain facts.
"Professional society" includes legal, medical, psychological,
dental, dental hygiene, dietetic, accounting, optometric,
acupuncture, podiatric, pharmaceutic, chiropractic, physical
therapist, veterinary, licensed marriage and family therapy, licensed
clinical social work, licensed professional clinical counselor, and
engineering organizations having as members at least 25 percent of
the eligible persons or licentiates in the geographic area served by
the particular society. However, if the society has fewer than 100
members, it shall have as members at least a majority of the eligible
persons or licentiates in the geographic area served by the
particular society.
   "Medical specialty society" means an organization having as
members at least 25 percent of the eligible physicians and surgeons
within a given professionally recognized medical specialty in the
geographic area served by the particular society.
   (c) This section does not affect the official immunity of an
officer or employee of a public corporation.
   (d) There shall be no monetary liability on the part of, and no
cause of action for damages shall arise against, any physician and
surgeon, podiatrist, or chiropractor who is a member of an
underwriting committee of an interindemnity or reciprocal or
interinsurance exchange or mutual company for any act or proceeding
undertaken or performed in evaluating physicians and surgeons,
podiatrists, or chiropractors for the writing of professional
liability insurance, or any act or proceeding undertaken or performed
in evaluating physicians and surgeons for the writing of an
interindemnity, reciprocal, or interinsurance contract as specified
in Section 1280.7 of the Insurance Code, if the evaluating physician
and surgeon, podiatrist, or chiropractor acts without malice, has
made a reasonable effort to obtain the facts of the matter as to
which he or she acts, and acts in reasonable belief that the action
taken by him or her is warranted by the facts known to him or her
after the reasonable effort to obtain the facts.
   (e) This section shall not be construed to confer immunity from
liability on any quality assurance committee established in
compliance with Section 14725 of the Welfare and Institutions Code or
hospital. In any case in which, but for the enactment of the
preceding provisions of this section, a cause of action would arise
against a quality assurance committee established in compliance with
Section 14725 of the Welfare and Institutions Code or hospital, the
cause of action shall exist as if the preceding provisions of this
section had not been enacted.
  SEC. 4.  Section 1179.3 of the Health and Safety Code is amended to
read:
   1179.3.  (a) (1) The Office of Statewide Health Planning and
Development shall develop and administer a competitive grants program
for projects located in rural areas of California.
   (2) The office shall define "rural area" for the purposes of this
section after receiving public input and upon recommendation of the
Interdepartmental Rural Health Coordinating Committee and the Rural
Health Programs Liaison.
   (3) The purpose of the grants program shall be to fund innovative,
collaborative, cost-effective, and efficient projects that pertain
to the delivery of health and medical services in rural areas of the
state.
   (4) The office shall develop and establish uses for the funds to
fund special projects that alleviate problems of access to quality
health care in rural areas and to compensate public and private
health care providers associated with direct delivery of patient
care. The funds shall be used for medical and hospital care and
treatment of patients who cannot afford to pay for services and for
whom payment will not be made through private or public programs.
   (5) The office shall administer the funds appropriated by the
Legislature for purposes of this section. Entities eligible for these
funds shall include rural health providers served by the programs
operated by the office, the State Department of Alcohol and Drug
Programs, the Emergency Medical Services Authority, the State
Department of Health Care Services, the State Department of Public
Health, and the Managed Risk Medical Insurance Board. The grant funds
shall be used to expand existing services or establish new services
and shall not be used to supplant existing levels of service. Funds
appropriated by the Legislature for this purpose may be expended in
the fiscal year of the appropriation or the subsequent fiscal year.
   (b) The Office of Statewide Health Planning and Development shall
establish the criteria and standards for eligibility to be used in
requests for proposals or requests for application, the application
review process, determining the maximum amount and number of grants
to be awarded, preference and priority of projects, compliance
monitoring, and the measurement of outcomes achieved after receiving
comment from the public at a meeting held pursuant to the
Bagley-Keene Open Meeting Act (Article 9 (commencing with Section
11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of the
Government Code).
   (c) The Office of Statewide Health Planning and Development shall
make information regarding the status of the funded projects
available at the public meetings described in subdivision (b).
  SEC. 5.  Section 1180.6 of the Health and Safety Code is amended to
read:
   1180.6.  The State Department of Public Health, the State
Department of State Hospitals, the State Department of Social
Services, and the State Department of Developmental Services shall
annually provide information to the Legislature, during Senate and
Assembly budget committee hearings, about the progress made in
implementing this division. This information shall include the
progress of implementation and barriers to achieving full
implementation.
  SEC. 6.  Section 1250.2 of the Health and Safety Code is amended to
read:
   1250.2.  (a) As defined in Section 1250, "health facility"
includes a "psychiatric health facility," defined to mean a health
facility, licensed by the State Department of Social Services, that
provides 24-hour inpatient care for mentally disordered, incompetent,
or other persons described in Division 5 (commencing with Section
5000) or Division 6 (commencing with Section 6000) of the Welfare and
Institutions Code. This care shall include, but not be limited to,
the following basic services: psychiatry, clinical psychology,
psychiatric nursing, social work, rehabilitation, drug
administration, and appropriate food services for those persons whose
physical health needs can be met in an affiliated hospital or in
outpatient settings.
   It is the intent of the Legislature that the psychiatric health
facility shall provide a distinct type of service to psychiatric
patients in a 24-hour acute inpatient setting. The State Department
of Social Services shall require regular utilization reviews of
admission and discharge criteria and lengths of stay in order to
assure that these patients are moved to less restrictive levels of
care as soon as appropriate.
   (b) The State Department of Social Services may issue a special
permit to a psychiatric health facility for it to provide structured
outpatient services (commonly referred to as SOPS) consisting of
morning, afternoon, or full daytime organized programs, not exceeding
10 hours, for acute daytime care for patients admitted to the
facility. This subdivision shall not be construed as requiring a
psychiatric health facility to apply for a special permit to provide
these alternative levels of care.
   The Legislature recognizes that, with access to structured
outpatient services, as an alternative to 24-hour inpatient care,
certain patients would be provided with effective intervention and
less restrictive levels of care. The Legislature further recognizes
that, for certain patients, the less restrictive levels of care
eliminate the need for inpatient care, enable earlier discharge from
inpatient care by providing a continuum of care with effective
aftercare services, or reduce or prevent the need for a subsequent
readmission to inpatient care.
   (c) Any reference in any statute to Section 1250 of the Health and
Safety Code shall be deemed and construed to also be a reference to
this section.
   (d) Notwithstanding any other provision of law, and to the extent
consistent with federal law, a psychiatric health facility shall be
eligible to participate in the medicare program under Title XVIII of
the federal Social Security Act (42 U.S.C. Sec. 1395 et seq.), and
the medicaid program under Title XIX of the federal Social Security
Act (42 U.S.C. Sec. 1396 et seq.), if all of the following conditions
are met:
   (1) The facility is a licensed facility.
   (2) The facility is in compliance with all related statutes and
regulations enforced by the State Department of Social Services,
including regulations contained in Chapter 9 (commencing with Section
77001) of Division 5 of Title 22 of the California Code of
Regulations.
   (3) The facility meets the definitions and requirements contained
in subdivisions (e) and (f) of Section 1861 of the federal Social
Security Act (42 U.S.C. Sec. 1395x(e) and (f)), including the
approval process specified in Section 1861(e)(7)(B) of the federal
Social Security Act (42 U.S.C. Sec. 1395x(e)(7)(B)), which requires
that the state agency responsible for licensing hospitals has assured
that the facility meets licensing requirements.
   (4) The facility meets the conditions of participation for
hospitals pursuant to Part 482 of Title 42 of the Code of Federal
Regulations.
  SEC. 7.  Section 1254 of the Health and Safety Code is amended to
read:
   1254.  (a) Except as provided in subdivision (e), the state
department shall inspect and license health facilities. The state
department shall license health facilities to provide their
respective basic services specified in Section 1250. Except as
provided in Section 1253, the state department shall inspect and
approve a general acute care hospital to provide special services as
specified in Section 1255. The state department shall develop and
adopt regulations to implement the provisions contained in this
section.
   (b) Upon approval, the state department shall issue a separate
license for the provision of the basic services enumerated in
subdivision (c) or (d) of Section 1250 whenever these basic services
are to be provided by an acute care hospital, as defined in
subdivision (a), (b), or (f) of that section, where the services
enumerated in subdivision (c) or (d) of Section 1250 are to be
provided in any separate freestanding facility, whether or not the
location of the separate freestanding facility is contiguous to the
acute care hospital. The same requirement shall apply to any new
freestanding facility constructed for the purpose of providing basic
services, as defined in subdivision (c) or (d) of Section 1250, by
any acute care hospital on or after January 1, 1984.
   (c) (1) Those beds licensed to an acute care hospital which, prior
to January 1, 1984, were separate freestanding beds and were not
part of the physical structure licensed to provide acute care, and
which beds were licensed to provide those services enumerated in
subdivision (c) or (d) of Section 1250, are exempt from the
requirements of subdivision (b).
   (2) All beds licensed to an acute care hospital and located within
the physical structure in which acute care is provided are exempt
from the requirements of subdivision (b) irrespective of the date of
original licensure of the beds, or the licensed category of the beds.

   (3) All beds licensed to an acute care hospital owned and operated
by the State of California or any other public agency are exempt
from the requirements of subdivision (b).
   (4) All beds licensed to an acute care hospital in a rural area as
defined by Chapter 1010, of the Statutes of 1982, are exempt from
the requirements of subdivision (b), except where there is a
freestanding skilled nursing facility or intermediate care facility
which has experienced an occupancy rate of 95 percent or less during
the past 12 months within a 25-mile radius or which may be reached
within 30 minutes using a motor vehicle.
   (5) All beds licensed to an acute care hospital which meet the
criteria for designation within peer group six or eight, as defined
in the report entitled Hospital Peer Grouping for Efficiency
Comparison, dated December 20, 1982, and published by the California
Health Facilities Commission, and all beds in hospitals which have
fewer than 76 licensed acute care beds and which are located in a
census designation place of 15,000 or less population, are exempt
from the requirements of subdivision (b), except where there is a
free-standing skilled nursing facility or intermediate care facility
which has experienced an occupancy rate of 95 percent or less during
the past 12 months within a 25-mile radius or which may be reached
within 30 minutes using a motor vehicle.
   (6) All beds licensed to an acute care hospital which has had a
certificate of need approved by a health systems agency on or before
July 1, 1983, are exempt from the requirements of subdivision (b).
   (7) All beds licensed to an acute care hospital are exempt from
the requirements of subdivision (b), if reimbursement from the
Medi-Cal program for beds licensed for the provision of services
enumerated in subdivision (c) or (d) of Section 1250 and not
otherwise exempt does not exceed the reimbursement which would be
received if the beds were in a separately licensed facility.
   (d) Except as provided in Section 1253, the state department shall
inspect and approve a general acute care hospital to provide special
services as specified in Section 1255. The state department shall
develop and adopt regulations to implement subdivisions (a) to (d),
inclusive, of this section.
   (e) The State Department of Social Services shall inspect and
license psychiatric health facilities. The State Department of Social
Services shall license psychiatric health facilities to provide
their basic services specified in Section 1250.2. The State
Department of Social Services shall develop and adopt regulations to
implement this subdivision.
  SEC. 8.  Section 1254.1 of the Health and Safety Code is amended to
read:
   1254.1.  (a) The State Department of Social Services shall license
psychiatric health facilities to provide their basic services
specified in Section 1250.
   (b) Any reference in any statute to Section 1254 shall be deemed
and construed to also be a reference to this section.
  SEC. 9.  Section 1266.1 of the Health and Safety Code is amended to
read:
   1266.1.  (a) Each new or renewal application for a license for a
psychiatric health facility shall be accompanied by a fee credited to
the State Department of Social Services for its costs incurred in
the review of psychiatric health facility programs, in connection
with the licensing of these facilities. The amount of the fees shall
be determined and collected by the State Department of Social
Services, but the total amount of the fees collected shall not exceed
the actual costs of licensure and review of psychiatric health
facility programs, including, but not limited to, the costs of
processing the application, inspection costs, and other related
costs.
   (b) New or renewal licensure application fees for psychiatric
health facilities shall be collected by the State Department of
Social Services.
   (c) The annual fees shall be waived for any psychiatric health
facility conducted, maintained, or operated by this state or any
state department, authority, bureau, commission, or officer, or by
the Regents of the University of California, or by a local hospital
district, city, county, or city and county.
   (d) If additional private psychiatric health facilities seek new
licensure on or after January 1, 1991, the State Department of Social
Services may increase the fees for all private psychiatric health
facilities with more than nine beds sufficient to accommodate the
increased level of workload and costs.
   (e) (1) Any licensee desiring to obtain a special permit to offer
and provide structured outpatient services shall file an application
with the State Department of Social Services.
   (2) The application for a special permit, if any, shall be
submitted with each new or renewal application for a license for a
psychiatric health facility, and shall be accompanied by a reasonable
fee, as determined by the State Department of Social Services, not
to exceed the actual costs of administration related to the special
permit. An application for a special permit submitted by a
psychiatric health facility operated by a public entity shall be
exempt from the fee required pursuant to this section for the
issuance of the special permit.
   (3) The State Department of Social Services shall not issue a
special permit unless the applicant furnishes all of the following:
   (A) Its annual licensing fee required pursuant to subdivision (a).

   (B) A completed application submitted on forms furnished by the
department.
   (C) A written agreement ensuring that the facility will have
additional staffing for the services to be provided under the special
permit, that the additional staffing will meet the same professional
standards as required by regulation for inpatient services, and that
a coordinator of these services will be appointed.
   (D) Any other information or documentation as may be required by
the department for its proper and efficient administration and
enforcement of special permit services.
   (4) The provision of structured outpatient services pursuant to a
special permit may be as an alternative to admission to inpatient
services, as aftercare services following discharge from inpatient
care, or as both.
  SEC. 10.  Section 1275.1 of the Health and Safety Code is amended
to read:
   1275.1.  (a) Notwithstanding any rules or regulations governing
other health facilities, the regulations developed by the State
Department of Social Services for psychiatric health facilities shall
prevail. The regulations applying to psychiatric health facilities
shall prescribe standards of adequacy, safety, and sanitation of the
physical plant, of staffing with duly qualified licensed personnel,
and of services based on the needs of the persons served thereby.
   (b) The regulations shall include standards appropriate for two
levels of disorder:
   (1) Involuntary ambulatory psychiatric patients.
   (2) Voluntary ambulatory psychiatric patients.
   For purposes of this subdivision, "ambulatory patients" shall
include, but not be limited to, deaf, blind, and physically
handicapped persons. Disoriented persons who are not bedridden or
confined to a wheelchair shall also be considered as ambulatory
patients.
   (c) The regulations shall not require, but may permit building and
services requirements for hospitals which are only applicable to
physical health care needs of patients that can be met in an
affiliated hospital or in outpatient settings including, but not
limited to, such requirements as surgical, dietary, laboratory,
laundry, central supply, radiologic, and pharmacy.
   (d) The regulations shall include provisions for an "open planning"
architectural concept.
   (e) The regulations shall exempt from seismic requirements all
structures of Type V and of one-story construction.
   (f) Standards for involuntary patients shall include provisions to
allow for restraint and seclusion of patients. These standards shall
provide for adequate safeguards for patient safety and protection of
patient rights.
   (g) The regulations shall provide for the retention by the
psychiatric health facility of a consultant pharmacist, who shall
supervise and review pharmaceutical services within the facility and
perform any other services, including prevention of the unlawful
diversion of controlled substances subject to abuse, as the state
department may by regulation require. Regulations adopted pursuant to
this subdivision shall take into consideration the varying bed sizes
of psychiatric health facilities.
  SEC. 11.  Section 1275.5 of the Health and Safety Code is amended
to read:
   1275.5.  (a) The regulations relating to the licensing of
hospitals, heretofore adopted by the State Department of Public
Health pursuant to Chapter 2 (commencing with Section 1400) of
Division 2, and in effect immediately prior to July 1, 1973, shall
remain in effect and shall be fully enforceable with respect to any
hospital required to be licensed by this chapter, unless and until
the regulations are readopted, amended, or repealed by the director.
   (b) The regulations relating to private institutions receiving or
caring for any mentally disordered persons, mentally retarded
persons, and other incompetent persons, heretofore adopted by the
Department of Mental Hygiene pursuant to Chapter 1 (commencing with
Section 7000) of Division 7 of the Welfare and Institutions Code, and
in effect immediately prior to July 1, 1973, shall remain in effect
and shall be fully enforceable with respect to any facility,
establishment, or institution for the reception and care of mentally
disordered persons, mentally retarded persons and other incompetent
persons, required to be licensed by the provisions of this chapter
unless and until said regulations are readopted, amended, or repealed
by the director.
   (c) (1) All regulations relating to the licensing of psychiatric
health facilities heretofore adopted by the State Department of
Health Services,                                          pursuant to
authority now vested in the State Department of Mental Health by
Section 5652.5 of the Welfare and Institutions Code, and in effect
immediately preceding September 20, 1988, shall remain in effect and
shall be fully enforceable by the State Department of Mental Health
with respect to any facility or program required to be licensed as a
psychiatric health facility, unless and until readopted, amended, or
repealed by the Director of Mental Health.
   (2) The State Department of Social Services shall succeed to and
be vested with all duties, powers, purposes, functions,
responsibilities, and jurisdiction of the State Department of Mental
Health, described in paragraph (1), as they relate to licensing
psychiatric health facilities.
  SEC. 12.  Section 1324.20 of the Health and Safety Code is amended
to read:
   1324.20.  For purposes of this article, the following definitions
shall apply:
   (a) (1) "Continuing care retirement community" means a provider of
a continuum of services, including independent living services,
assisted living services as defined in paragraph (5) of subdivision
(a) of Section 1771, and skilled nursing care, on a single campus,
that is subject to Section 1791, or a provider of such a continuum of
services on a single campus that has not received a Letter of
Exemption pursuant to subdivision (d) of Section 1771.3.
   (2) Notwithstanding paragraph (1), beginning with the 2010-11 rate
year and for every rate year thereafter, the term "continuing care
retirement community" shall have the definition contained in
paragraph (11) of subdivision (c) of Section 1771.
   (b) "Department," unless otherwise specified, means the State
Department of Health Care Services.
   (c) (1) "Exempt facility" means a skilled nursing facility that is
part of a continuing care retirement community, a skilled nursing
facility operated by the state or another public entity, a unit that
provides pediatric subacute services in a skilled nursing facility, a
skilled nursing facility that is certified by the department for a
special treatment program and is an institution for mental disease as
defined in Section 1396d(i) of Title 42 of the United States Code,
or a skilled nursing facility that is a distinct part of a facility
that is licensed as a general acute care hospital.
   (2) Notwithstanding paragraph (1), beginning with the 2010-11 rate
year and for every rate year thereafter, the term "exempt facility"
shall mean a skilled nursing facility that is part of a continuing
care retirement community, as defined in paragraph (2) of subdivision
(a), a skilled nursing facility operated by the state or another
public entity, a unit that provides pediatric subacute services in a
skilled nursing facility, a skilled nursing facility that is
certified by the department for a special treatment program and is an
institution for mental disease as defined in Section 1396d(i) of
Title 42 of the United States Code, or a skilled nursing facility
that is a distinct part of a facility that is licensed as a general
acute care hospital.
   (3) Notwithstanding paragraph (1), beginning with the 2010-11 rate
year and every rate year thereafter, a multilevel facility, as
described in paragraph (1) of subdivision (a), shall not be exempt
from the quality assurance fee requirements pursuant to this article,
unless it meets the definition of a continuing care retirement
community in paragraph (11) of subdivision (c) of Section 1771.
   (4) (A) Notwithstanding paragraph (1), beginning with the 2011-12
rate year, and every rate year thereafter, a unit that provides
freestanding pediatric subacute care services in a skilled nursing
facility, as described in paragraph (1) of subdivision (c), shall not
be exempt from the quality assurance fee requirements pursuant to
this article.
   (B) For the purposes of this article, "freestanding pediatric
subacute care unit" has the same meaning as defined in Section
51215.8 of Title 22 of the California Code of Regulations.
   (d) (1) "Net revenue" means gross resident revenue for routine
nursing services and ancillary services provided to all residents by
a skilled nursing facility, less Medicare revenue for routine and
ancillary services, including Medicare revenue for services provided
to residents covered under a Medicare managed care plan, less payer
discounts and applicable contractual allowances as permitted under
federal law and regulation.
   (2) Notwithstanding paragraph (1), for the 2009-10, 2010-11, and
2011-12 rate years, and each rate year thereafter, "net revenue"
means gross resident revenue for routine nursing services and
ancillary services provided to all residents by a skilled nursing
facility, including Medicare revenue for routine and ancillary
services and Medicare revenue for services provided to residents
covered under a Medicare managed care plan, less payer discounts and
applicable contractual allowances as permitted under federal law and
regulation. To implement this paragraph, the department shall request
federal approval pursuant to Section 1324.27.
   (3) "Net revenue" does not mean charitable contributions and bad
debt.
   (e) "Payer discounts and contractual allowances" means the
difference between the facility's resident charges for routine or
ancillary services and the actual amount paid.
   (f) "Skilled nursing facility" means a licensed facility as
defined in subdivision (c) of Section 1250.
  SEC. 13.  Section 1343 of the Health and Safety Code is amended to
read:
   1343.  (a) This chapter shall apply to health care service plans
and specialized health care service plan contracts as defined in
subdivisions (f) and (o) of Section 1345.
   (b) The director may by the adoption of rules or the issuance of
orders deemed necessary and appropriate, either unconditionally or
upon specified terms and conditions or for specified periods, exempt
from this chapter any class of persons or plan contracts if the
director finds the action to be in the public interest and not
detrimental to the protection of subscribers, enrollees, or persons
regulated under this chapter, and that the regulation of the persons
or plan contracts is not essential to the purposes of this chapter.
   (c) The director, upon request of the Director of Health Care
Services, shall exempt from this chapter any county-operated pilot
program contracting with the State Department of Health Care Services
pursuant to Article 7 (commencing with Section 14490) of Chapter 8
of Part 3 of Division 9 of the Welfare and Institutions Code. The
director may exempt noncounty-operated pilot programs upon request of
the Director of Health Care Services. Those exemptions may be
subject to conditions the Director of Health Care Services deems
appropriate.
   (d) Upon the request of the Director of Health Care Services, the
director may exempt from this chapter any mental health plan
contractor or any capitated rate contract under Chapter 8.9
(commencing with Section 14700) of Part 3 of Division 9 of the
Welfare and Institutions Code. Those exemptions may be subject to
conditions the Director of Health Care Services deems appropriate.
   (e) This chapter shall not apply to:
   (1) A person organized and operating pursuant to a certificate
issued by the Insurance Commissioner unless the entity is directly
providing the health care service through those entity-owned or
contracting health facilities and providers, in which case this
chapter shall apply to the insurer's plan and to the insurer.
   (2) A plan directly operated by a bona fide public or private
institution of higher learning which directly provides health care
services only to its students, faculty, staff, administration, and
their respective dependents.
   (3) A person who does all of the following:
   (A) Promises to provide care for life or for more than one year in
return for a transfer of consideration from, or on behalf of, a
person 60 years of age or older.
   (B) Has obtained a written license pursuant to Chapter 2
(commencing with Section 1250) or Chapter 3.2 (commencing with
Section 1569).
   (C) Has obtained a certificate of authority from the State
Department of Social Services.
   (4) The Major Risk Medical Insurance Board when engaging in
activities under Chapter 8 (commencing with Section 10700) of Part 2
of Division 2 of the Insurance Code, Part 6.3 (commencing with
Section 12695) of Division 2 of the Insurance Code, and Part 6.5
(commencing with Section 12700) of Division 2 of the Insurance Code.
   (5) The California Small Group Reinsurance Fund.
  SEC. 14.  Section 1373 of the Health and Safety Code is amended to
read:
   1373.  (a) A plan contract may not provide an exception for other
coverage if the other coverage is entitlement to Medi-Cal benefits
under Chapter 7 (commencing with Section 14000) or Chapter 8
(commencing with Section 14200) of Part 3 of Division 9 of the
Welfare and Institutions Code, or Medicaid benefits under Subchapter
19 (commencing with Section 1396) of Chapter 7 of Title 42 of the
United States Code.
   Each plan contract shall be interpreted not to provide an
exception for the Medi-Cal or Medicaid benefits.
   A plan contract shall not provide an exemption for enrollment
because of an applicant's entitlement to Medi-Cal benefits under
Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing
with Section 14200) of Part 3 of Division 9 of the Welfare and
Institutions Code, or Medicaid benefits under Subchapter 19
(commencing with Section 1396) of Chapter 7 of Title 42 of the United
States Code.
   A plan contract may not provide that the benefits payable
thereunder are subject to reduction if the individual insured has
entitlement to the Medi-Cal or Medicaid benefits.
   (b) A plan contract that provides coverage, whether by specific
benefit or by the effect of general wording, for sterilization
operations or procedures shall not impose any disclaimer, restriction
on, or limitation of, coverage relative to the covered individual's
reason for sterilization.
   As used in this section, "sterilization operations or procedures"
shall have the same meaning as that specified in Section 10120 of the
Insurance Code.
   (c) Every plan contract that provides coverage to the spouse or
dependents of the subscriber or spouse shall grant immediate accident
and sickness coverage, from and after the moment of birth, to each
newborn infant of any subscriber or spouse covered and to each minor
child placed for adoption from and after the date on which the
adoptive child's birth parent or other appropriate legal authority
signs a written document, including, but not limited to, a health
facility minor release report, a medical authorization form, or a
relinquishment form, granting the subscriber or spouse the right to
control health care for the adoptive child or, absent this written
document, on the date there exists evidence of the subscriber's or
spouse's right to control the health care of the child placed for
adoption. No plan may be entered into or amended if it contains any
disclaimer, waiver, or other limitation of coverage relative to the
coverage or insurability of newborn infants of, or children placed
for adoption with, a subscriber or spouse covered as required by this
subdivision.
   (d) (1) Every plan contract that provides that coverage of a
dependent child of a subscriber shall terminate upon attainment of
the limiting age for dependent children specified in the plan, shall
also provide that attainment of the limiting age shall not operate to
terminate the coverage of the child while the child is and continues
to meet both of the following criteria:
   (A) Incapable of self-sustaining employment by reason of a
physically or mentally disabling injury, illness, or condition.
   (B) Chiefly dependent upon the subscriber for support and
maintenance.
   (2) The plan shall notify the subscriber that the dependent child'
s coverage will terminate upon attainment of the limiting age unless
the subscriber submits proof of the criteria described in
subparagraphs (A) and (B) of paragraph (1) to the plan within 60 days
of the date of receipt of the notification. The plan shall send this
notification to the subscriber at least 90 days prior to the date
the child attains the limiting age. Upon receipt of a request by the
subscriber for continued coverage of the child and proof of the
criteria described in subparagraphs (A) and (B) of paragraph (1), the
plan shall determine whether the child meets that criteria before
the child attains the limiting age. If the plan fails to make the
determination by that date, it shall continue coverage of the child
pending its determination.
   (3) The plan may subsequently request information about a
dependent child whose coverage is continued beyond the limiting age
under this subdivision but not more frequently than annually after
the two-year period following the child's attainment of the limiting
age.
   (4) If the subscriber changes carriers to another plan or to a
health insurer, the new plan or insurer shall continue to provide
coverage for the dependent child. The new plan or insurer may request
information about the dependent child initially and not more
frequently than annually thereafter to determine if the child
continues to satisfy the criteria in subparagraphs (A) and (B) of
paragraph (1). The subscriber shall submit the information requested
by the new plan or insurer within 60 days of receiving the request.
   (5) (A) Except as set forth in subparagraph (B), under no
circumstances shall the limiting age be less than 26 years of age
with respect to plan years beginning on or after September 23, 2010.
   (B) For plan years beginning before January 1, 2014, a group
health care service plan contract that qualifies as a grandfathered
health plan under Section 1251 of the federal Patient Protection and
Affordable Care Act (Public Law 111-148) and that makes available
dependent coverage of children may exclude from coverage an adult
child who has not attained 26 years of age only if the adult child is
eligible to enroll in an eligible employer-sponsored health plan, as
defined in Section 5000A(f)(2) of the Internal Revenue Code, other
than a group health plan of a parent.
   (C) (i) With respect to a child (I) whose coverage under a group
or individual plan contract ended, or who was denied or not eligible
for coverage under a group or individual plan contract, because under
the terms of the contract the availability of dependent coverage of
children ended before the attainment of 26 years of age, and (II) who
becomes eligible for that coverage by reason of the application of
this paragraph, the health care service plan shall give the child an
opportunity to enroll that shall continue for at least 30 days. This
opportunity and the notice described in clause (ii) shall be provided
not later than the first day of the first plan year beginning on or
after September 23, 2010, consistent with the federal Patient
Protection and Affordable Care Act (Public Law 111-148), as amended
by the federal Health Care and Education Reconciliation Act of 2010
(Public Law 111-152), and any additional federal guidance or
regulations issued by the United States Secretary of Health and Human
Services.
   (ii)  The health care service plan shall provide written notice
stating that a dependent described in clause (i) who has not attained
26 years of age is eligible to enroll in the plan for coverage. This
notice may be provided to the dependent's parent on behalf of the
dependent. If the notice is included with other enrollment materials
for a group plan, the notice shall be prominent.
   (iii) In the case of an individual who enrolls under this
subparagraph, coverage shall take effect no later than the first day
of the first plan year beginning on or after September 23, 2010.
   (iv) A dependent enrolling in a group health plan for coverage
pursuant to this subparagraph shall be treated as a special enrollee
as provided under the rules of Section 146.117(d) of Title 45 of the
Code of Federal Regulations. The health care service plan shall offer
the recipient of the notice all of the benefit packages available to
similarly situated individuals who did not lose coverage by reason
of cessation of dependent status. Any difference in benefits or
cost-sharing requirements shall constitute a different benefit
package. A dependent enrolling in a group health plan for coverage
pursuant to this subparagraph shall not be required to pay more for
coverage than similarly situated individuals who did not lose
coverage by reason of cessation of dependent status.
   (D) Nothing in this section shall require a health care service
plan to make coverage available for a child of a child receiving
dependent coverage. Nothing in this section shall be construed to
modify the definition of "dependent" as used in the Revenue and
Taxation Code with respect to the tax treatment of the cost of
coverage.
   (e) A plan contract that provides coverage, whether by specific
benefit or by the effect of general wording, for both an employee and
one or more covered persons dependent upon the employee and provides
for an extension of the coverage for any period following a
termination of employment of the employee shall also provide that
this extension of coverage shall apply to dependents upon the same
terms and conditions precedent as applied to the covered employee,
for the same period of time, subject to payment of premiums, if any,
as required by the terms of the policy and subject to any applicable
collective bargaining agreement.
   (f) A group contract shall not discriminate against handicapped
persons or against groups containing handicapped persons. Nothing in
this subdivision shall preclude reasonable provisions in a plan
contract against liability for services or reimbursement of the
handicap condition or conditions relating thereto, as may be allowed
by rules of the director.
   (g) Every group contract shall set forth the terms and conditions
under which subscribers and enrollees may remain in the plan in the
event the group ceases to exist, the group contract is terminated, or
an individual subscriber leaves the group, or the enrollees'
eligibility status changes.
   (h) (1) A health care service plan or specialized health care
service plan may provide for coverage of, or for payment for,
professional mental health services, or vision care services, or for
the exclusion of these services. If the terms and conditions include
coverage for services provided in a general acute care hospital or an
acute psychiatric hospital as defined in Section 1250 and do not
restrict or modify the choice of providers, the coverage shall extend
to care provided by a psychiatric health facility as defined in
Section 1250.2 operating pursuant to licensure by the State
Department of Social Services. A health care service plan that offers
outpatient mental health services but does not cover these services
in all of its group contracts shall communicate to prospective group
contractholders as to the availability of outpatient coverage for the
treatment of mental or nervous disorders.
   (2) No plan shall prohibit the member from selecting any
psychologist who is licensed pursuant to the Psychology Licensing Law
(Chapter 6.6 (commencing with Section 2900) of Division 2 of the
Business and Professions Code), any optometrist who is the holder of
a certificate issued pursuant to Chapter 7 (commencing with Section
3000) of Division 2 of the Business and Professions Code or, upon
referral by a physician and surgeon licensed pursuant to the Medical
Practice Act (Chapter 5 (commencing with Section 2000) of Division 2
of the Business and Professions Code), (A) any marriage and family
therapist who is the holder of a license under Section 4980.50 of the
Business and Professions Code, (B) any licensed clinical social
worker who is the holder of a license under Section 4996 of the
Business and Professions Code, (C) any registered nurse licensed
pursuant to Chapter 6 (commencing with Section 2700) of Division 2 of
the Business and Professions Code, who possesses a master's degree
in psychiatric-mental health nursing and is listed as a
psychiatric-mental health nurse by the Board of Registered Nursing,
(D) any advanced practice registered nurse certified as a clinical
nurse specialist pursuant to Article 9 (commencing with Section 2838)
of Chapter 6 of Division 2 of the Business and Professions Code who
participates in expert clinical practice in the specialty of
psychiatric-mental health nursing, to perform the particular services
covered under the terms of the plan, and the certificate holder is
expressly authorized by law to perform these services, or (E) any
professional clinical counselor who is the holder of a license under
Chapter 16 (commencing with Section 4999.10) of Division 2 of the
Business and Professions Code.
   (3) Nothing in this section shall be construed to allow any
certificate holder or licensee enumerated in this section to perform
professional mental health services beyond his or her field or fields
of competence as established by his or her education, training, and
experience.
   (4) For the purposes of this section:
   (A) "Marriage and family therapist" means a licensed marriage and
family therapist who has received specific instruction in assessment,
diagnosis, prognosis, and counseling, and psychotherapeutic
treatment of premarital, marriage, family, and child relationship
dysfunctions, which is equivalent to the instruction required for
licensure on January 1, 1981.
   (B) "Professional clinical counselor" means a licensed
professional clinical counselor who has received specific instruction
in assessment, diagnosis, prognosis, counseling, and
psychotherapeutic treatment of mental and emotional disorders, which
is equivalent to the instruction required for licensure on January 1,
2012.
   (5) Nothing in this section shall be construed to allow a member
to select and obtain mental health or psychological or vision care
services from a certificate holder or licenseholder who is not
directly affiliated with or under contract to the health care service
plan or specialized health care service plan to which the member
belongs. All health care service plans and individual practice
associations that offer mental health benefits shall make reasonable
efforts to make available to their members the services of licensed
psychologists. However, a failure of a plan or association to comply
with the requirements of the preceding sentence shall not constitute
a misdemeanor.
   (6) As used in this subdivision, "individual practice association"
means an entity as defined in subsection (5) of Section 1307 of the
federal Public Health Service Act (42 U.S.C. Sec. 300e-1(5)).
   (7) Health care service plan coverage for professional mental
health services may include community residential treatment services
that are alternatives to inpatient care and that are directly
affiliated with the plan or to which enrollees are referred by
providers affiliated with the plan.
   (i) If the plan utilizes arbitration to settle disputes, the plan
contracts shall set forth the type of disputes subject to
arbitration, the process to be utilized, and how it is to be
initiated.
   (j) A plan contract that provides benefits that accrue after a
certain time of confinement in a health care facility shall specify
what constitutes a day of confinement or the number of consecutive
hours of confinement that are requisite to the commencement of
benefits.
   (k) If a plan provides coverage for a dependent child who is over
26 years of age and enrolled as a full-time student at a secondary or
postsecondary educational institution, the following shall apply:
   (1) Any break in the school calendar shall not disqualify the
dependent child from coverage.
   (2) If the dependent child takes a medical leave of absence, and
the nature of the dependent child's injury, illness, or condition
would render the dependent child incapable of self-sustaining
employment, the provisions of subdivision (d) shall apply if the
dependent child is chiefly dependent on the subscriber for support
and maintenance.
   (3) (A) If the dependent child takes a medical leave of absence
from school, but the nature of the dependent child's injury, illness,
or condition does not meet the requirements of paragraph (2), the
dependent child's coverage shall not terminate for a period not to
exceed 12 months or until the date on which the coverage is scheduled
to terminate pursuant to the terms and conditions of the plan,
whichever comes first. The period of coverage under this paragraph
shall commence on the first day of the medical leave of absence from
the school or on the date the physician and surgeon determines the
illness prevented the dependent child from attending school,
whichever comes first. Any break in the school calendar shall not
disqualify the dependent child from coverage under this paragraph.
   (B) Documentation or certification of the medical necessity for a
leave of absence from school shall be submitted to the plan at least
30 days prior to the medical leave of absence from the school, if the
medical reason for the absence and the absence are foreseeable, or
30 days after the start date of the medical leave of absence from
school and shall be considered prima facie evidence of entitlement to
coverage under this paragraph.
   (4) This subdivision shall not apply to a specialized health care
service plan or to a Medicare supplement plan.
  SEC. 15.  Section 1422.1 of the Health and Safety Code is amended
to read:
   1422.1.  (a) Notwithstanding Section 1422, the State Department of
Public Health shall conduct, when feasible, annual licensing
inspections of licensed long-term health care facilities providing
special treatment programs for the mentally disordered, concurrently
with inspections conducted by the State Department of Health Care
Services for the purposes of approving the special treatment program.

   (b) The State Department of Public Health survey teams conducting
inspections pursuant to this section shall include at least one
licensed mental health professional if the inspections are not done
concurrently pursuant to subdivision (a).
   (c) Survey team members shall receive training specific to the
mental health treatment needs of mentally disordered residents served
in these facilities.
  SEC. 16.  Section 1502 of the Health and Safety Code is amended to
read:
   1502.  As used in this chapter:
   (a) "Community care facility" means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, or foster family
agency services for children, adults, or children and adults,
including, but not limited
     to, the physically handicapped, mentally impaired, incompetent
persons, and abused or neglected children, and includes the
following:
   (1) "Residential facility" means any family home, group care
facility, or similar facility determined by the director, for 24-hour
nonmedical care of persons in need of personal services,
supervision, or assistance essential for sustaining the activities of
daily living or for the protection of the individual.
   (2) "Adult day program" means any community-based facility or
program that provides care to persons 18 years of age or older in
need of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of
these individuals on less than a 24-hour basis.
   (3) "Therapeutic day services facility" means any facility that
provides nonmedical care, counseling, educational or vocational
support, or social rehabilitation services on less than a 24-hour
basis to persons under 18 years of age who would otherwise be placed
in foster care or who are returning to families from foster care.
Program standards for these facilities shall be developed by the
department, pursuant to Section 1530, in consultation with
therapeutic day services and foster care providers.
   (4) "Foster family agency" means any organization engaged in the
recruiting, certifying, and training of, and providing professional
support to, foster parents, or in finding homes or other places for
placement of children for temporary or permanent care who require
that level of care as an alternative to a group home. Private foster
family agencies shall be organized and operated on a nonprofit basis.

   (5) "Foster family home" means any residential facility providing
24-hour care for six or fewer foster children that is owned, leased,
or rented and is the residence of the foster parent or parents,
including their family, in whose care the foster children have been
placed. The placement may be by a public or private child placement
agency or by a court order, or by voluntary placement by a parent,
parents, or guardian. It also means a foster family home described in
Section 1505.2.
   (6) "Small family home" means any residential facility, in the
licensee's family residence, that provides 24-hour care for six or
fewer foster children who have mental disorders or developmental or
physical disabilities and who require special care and supervision as
a result of their disabilities. A small family home may accept
children with special health care needs, pursuant to subdivision (a)
of Section 17710 of the Welfare and Institutions Code. In addition to
placing children with special health care needs, the department may
approve placement of children without special health care needs, up
to the licensed capacity.
   (7) "Social rehabilitation facility" means any residential
facility that provides social rehabilitation services for no longer
than 18 months in a group setting to adults recovering from mental
illness who temporarily need assistance, guidance, or counseling.
Program components shall be subject to program standards pursuant to
Article 1 (commencing with Section 5670) of Chapter 2.5 of Part 2 of
Division 5 of the Welfare and Institutions Code.
   (8) "Community treatment facility" means any residential facility
that provides mental health treatment services to children in a group
setting and that has the capacity to provide secure containment.
Program components shall be subject to program standards developed
and enforced by the State Department of Health Care Services pursuant
to Section 4094 of the Welfare and Institutions Code.
   Nothing in this section shall be construed to prohibit or
discourage placement of persons who have mental or physical
disabilities into any category of community care facility that meets
the needs of the individual placed, if the placement is consistent
with the licensing regulations of the department.
   (9) "Full-service adoption agency" means any licensed entity
engaged in the business of providing adoption services, that does all
of the following:
   (A) Assumes care, custody, and control of a child through
relinquishment of the child to the agency or involuntary termination
of parental rights to the child.
   (B) Assesses the birth parents, prospective adoptive parents, or
child.
   (C) Places children for adoption.
   (D) Supervises adoptive placements.
   Private full-service adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a full-service adoption agency shall
be accredited and in good standing according to Part 96 of Title 22
of the Code of Federal Regulations, or supervised by an accredited
primary provider, or acting as an exempted provider, in compliance
with Subpart F (commencing with Section 96.29) of Part 96 of Title 22
of the Code of Federal Regulations.
   (10) "Noncustodial adoption agency" means any licensed entity
engaged in the business of providing adoption services, that does all
of the following:
   (A) Assesses the prospective adoptive parents.
   (B) Cooperatively matches children freed for adoption, who are
under the care, custody, and control of a licensed adoption agency,
for adoption, with assessed and approved adoptive applicants.
   (C) Cooperatively supervises adoptive placements with a
full-service adoptive agency, but does not disrupt a placement or
remove a child from a placement.
   Private noncustodial adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a noncustodial adoption agency shall
be accredited and in good standing according to Part 96 of Title 22
of the Code of Federal Regulations, or supervised by an accredited
primary provider, or acting as an exempted provider, in compliance
with Subpart F (commencing with Section 96.29) of Part 96 of Title 22
of the Code of Federal Regulations.
   (11) "Transitional shelter care facility" means any group care
facility that provides for 24-hour nonmedical care of persons in need
of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of
the individual. Program components shall be subject to program
standards developed by the State Department of Social Services
pursuant to Section 1502.3.
   (12)  "Transitional housing placement facility" means a community
care facility licensed by the department pursuant to Section 1559.110
to provide transitional housing opportunities to persons at least 16
years of age, and not more than 18 years of age unless the
requirements of Section 11403 and paragraph (1) of subdivision (a) of
Section 11403.2 of the Welfare and Institutions Code are met, who
are in out-of-home placement under the supervision of the county
department of social services or the county probation department, and
who are participating in an independent living program.
   (b) "Department" or "state department" means the State Department
of Social Services.
   (c) "Director" means the Director of Social Services.
  SEC. 17.  Section 1502.4 of the Health and Safety Code is amended
to read:
   1502.4.  (a) (1) A community care facility licensed as a group
home for children pursuant to this chapter may accept for placement,
and provide care and supervision to, a child assessed as seriously
emotionally disturbed as long as the child does not need inpatient
care in a licensed health facility.
   (2) For the purpose of this chapter, the following definitions
shall apply:
   (A) "Inpatient care in a licensed health facility" means care and
supervision at a level greater than incidental medical services as
specified in Section 1507.
   (B) "Seriously emotionally disturbed" means the same as paragraph
(2) of subdivision (a) of Section 5600.3 of the Welfare and
Institutions Code.
   (b) If a child described in subdivision (a) is placed into a group
home program classified at rate classification level 13 or rate
classification level 14 pursuant to Section 11462.01 of the Welfare
and Institutions Code, the licensee shall meet both of the following
requirements:
   (1) The licensee shall agree to accept, for placement into its
group home program, only children who have been assessed as seriously
emotionally disturbed by either of the following:
   (A) An interagency placement committee, as described in Section
4096 of the Welfare and Institutions Code or by a licensed mental
health professional, as defined in Sections 629 to 633, inclusive, of
Title 9 of the California Code of Regulations.
   (B) A licensed mental health professional pursuant to paragraph
(3) of subdivision (i), or subdivision (j), of Section 11462.01 of
the Welfare and Institutions Code if the child is privately placed or
only county funded.
   (2) The program is certified by the State Department of Health
Care Services, pursuant to Section 4096.5 of the Welfare and
Institutions Code, as a program that provides mental health treatment
services for seriously emotionally disturbed children.
   (c) The department shall not evaluate, or have any responsibility
or liability with regard to the evaluation of, the mental health
treatment services provided pursuant to this section and paragraph
(3) of subdivision (f) of Section 11462.01 of the Welfare and
Institutions Code.
  SEC. 18.  Section 1507 of the Health and Safety Code is amended to
read:
   1507.  (a) Notwithstanding any other provision of law, incidental
medical services may be provided in a community care facility. If the
medical services constitute a substantial component of the services
provided by the community care facility as defined by the director in
regulations, the medical services component shall be approved as set
forth in Chapter 1 (commencing with Section 1200) or Chapter 2
(commencing with Section 1250).
   (b) Notwithstanding any other provision of law, if the
requirements of subdivision (c) are met, the department shall permit
incidental medical services to be provided in community care
facilities for adults by facility staff who are not licensed health
care professionals but who are trained by a licensed health care
professional and supervised according to the client's individualized
health care plan prepared pursuant to subdivision (c). Incidental
medical services provided by trained facility staff for the following
conditions shall be limited as follows:
   (1) Colostomy and ileostomy: changing bags and cleaning stoma.
   (2) Urinary catheter: emptying bags in day care facilities;
emptying and changing bags in residential facilities.
   (3) Gastrostomy: feeding, hydration, cleaning stoma, and adding
medication per physician's or nurse practitioner's orders for the
routine medication of patients with chronic, stable conditions.
   (c) Facility staff may provide incidental medical services if the
following conditions have been met:
   (1) For regional center clients the following shall apply:
   (A) An individualized health care plan, which may be part of a
client's individual program plan, shall be prepared for each client
by a health care team that shall include the client or his or her
designee if the client is not able to participate in planning his or
her health care, the client's primary care physician or nurse
practitioner or other health care professional designated by the
physician or nurse practitioner, the licensee or licensee's designee,
any involved social worker or regional center worker, and any health
care professional designated to monitor the client's individualized
health care plan.
   (B) The client's individualized health care plan shall be
reassessed at least every 12 months or more frequently as determined
by the client's physician or nurse practitioner during the time the
client receives incidental medical services in the facility.
   (C) The client's regional center, primary care physician or nurse
practitioner, or other health care professional designated by the
physician or nurse practitioner shall identify the health care
professional who shall be responsible for training facility staff in
the provision of incidental medical services.
   (D) Facility staff shall be trained by the identified health care
professional practicing within his or her scope of practice who shall
monitor, according to the individualized health care plan, the staff'
s ability to provide incidental medical services and who shall
review, correct, or update facility staff training as the health care
professional deems necessary.
   (E) The regional center or placing agency shall evaluate, monitor,
and have responsibility for oversight of the incidental medical
services provided in the facility by facility staff. However, nothing
in this section shall preclude the department from taking an
administrative action against a licensee or facility staff member for
failure or refusal to carry out, or negligence in carrying out, his
or her duties in providing these incidental medical services.
   (2) For persons who are not regional center clients, the following
shall apply:
   (A) An individualized health care plan shall be prepared that
includes the physician's or nurse practitioner's order for services
to be provided during the time the client is in the day care
facility. The plan shall be prepared by a team that includes the
client or his or her designee if the client is not able to
participate in planning his or her care, the client's social worker,
conservator, or legal guardian, as appropriate, a licensed health
care professional, and the licensee or the licensee's designee.
   (B) The client's individualized health care plan shall be
reassessed at least every 12 months or more frequently as determined
by the client's physician or nurse practitioner during the time the
client receives incidental medical services in the facility.
   (C) A licensed health care professional practicing within his or
her scope of practice shall train the staff of the facility on
procedures for caring for clients who require incidental medical
services and shall periodically review, correct, or update facility
staff training as the health care professional deems necessary.
   (d) Facilities providing incidental medical services shall remain
in substantial compliance with all other applicable regulations of
the department.
   (e) The department shall adopt emergency regulations for community
care facilities for adults by February 1, 1997, to do all of the
following:
   (1) Specify incidental medical services that may be provided.
These incidental medical services shall include, but need not be
limited to, any of the following: gastrostomy, colostomy, ileostomy,
and urinary catheters.
   (2) Specify the conditions under which incidental medical services
may be provided.
   (3) Specify the medical services that, due to the level of care
required, are prohibited services.
   (f) The department shall consult with the State Department of
Developmental Services, the State Department of Health Care Services,
the Association of Regional Center Agencies, and provider
associations in the development of the regulations required by
subdivision (e).
  SEC. 19.  Section 1522.08 of the Health and Safety Code, as amended
by Section 16 of Chapter 483 of the Statutes of 2007, is amended to
read:
   1522.08.  (a) In order to protect the health and safety of persons
receiving care or services from individuals or facilities licensed
or certified by the state, the California Department of Aging, State
Department of Public Health, State Department of Alcohol and Drug
Programs, State Department of Health Care Services, State Department
of Social Services, and the Emergency Medical Services Authority may
share information with respect to applicants, licensees,
certificates, or individuals who have been the subject of any
administrative action resulting in the denial, suspension, probation,
or revocation of a license, permit, or certificate, or in the
exclusion of any person from a facility who is subject to a
background check, as otherwise provided by law.
   (b) The State Department of Social Services shall maintain a
centralized system for the monitoring and tracking of final
administrative actions, to be used by the California Department of
Aging, State Department of Public Health, State Department of Alcohol
and Drug Programs, State Department of Health Care Services, State
Department of Social Services, and the Emergency Medical Services
Authority as a part of the background check process. The State
Department of Social Services may charge a fee to departments under
the jurisdiction of the California Health and Human Services Agency
sufficient to cover the cost of providing those departments with the
final administrative action specified in subdivision (a). To the
extent that additional funds are needed for this purpose,
implementation of this subdivision shall be contingent upon a
specific appropriation provided for this purpose in the annual Budget
Act.
   (c) The State Department of Social Services, in consultation with
the other departments under the jurisdiction of the California Health
and Human Services Agency, may adopt regulations to implement this
section.
   (d) For the purposes of this section and Section 1499,
"administrative action" means any proceeding initiated by the
California Department of Aging, State Department of Public Health,
State Department of Alcohol and Drug Programs, State Department of
Health Care Services, State Department of Social Services, and the
Emergency Medical Services Authority to determine the rights and
duties of an applicant, licensee, or other individual or entity over
which the department has jurisdiction. "Administrative action" may
include, but is not limited to, action involving the denial of an
application for, or the suspension or revocation of, any license,
special permit, administrator certificate, criminal record clearance,
or exemption.
  SEC. 20.  Section 1522.41 of the Health and Safety Code is amended
to read:
   1522.41.  (a) The director, in consultation and collaboration with
county placement officials, group home provider organizations, the
Director of Health Care Services, and the Director of Developmental
Services, shall develop and establish a certification program to
ensure that administrators of group home facilities have appropriate
training to provide the care and services for which a license or
certificate is issued.
   (b) (1) In addition to any other requirements or qualifications
required by the department, an administrator of a group home facility
shall successfully complete a department-approved certification
program, pursuant to subdivision (c), prior to employment. An
administrator employed in a group home on the effective date of this
section shall meet the requirements of paragraph (2) of subdivision
(c).
   (2) In those cases where the individual is both the licensee and
the administrator of a facility, the individual shall comply with all
of the licensee and administrator requirements of this section.
   (3) Failure to comply with this section shall constitute cause for
revocation of the license of the facility.
   (4) The licensee shall notify the department within 10 days of any
change in administrators.
   (c) (1) The administrator certification programs shall require a
minimum of 40 hours of classroom instruction that provides training
on a uniform core of knowledge in each of the following areas:
   (A) Laws, regulations, and policies and procedural standards that
impact the operations of the type of facility for which the applicant
will be an administrator.
   (B) Business operations.
   (C) Management and supervision of staff.
   (D) Psychosocial and educational needs of the facility residents.
   (E) Community and support services.
   (F) Physical needs for facility residents.
   (G) Administration, storage, misuse, and interaction of medication
used by facility residents.
   (H) Resident admission, retention, and assessment procedures,
including the right of a foster child to have fair and equal access
to all available services, placement, care, treatment, and benefits,
and to not be subjected to discrimination or harassment on the basis
of actual or perceived race, ethnic group identification, ancestry,
national origin, color, religion, sex, sexual orientation, gender
identity, mental or physical disability, or HIV status.
   (I) Nonviolent emergency intervention and reporting requirements.
   (J) Basic instruction on the existing laws and procedures
regarding the safety of foster youth at school and the ensuring of a
harassment- and violence-free school environment contained in the
School Safety and Violence Prevention Act (Article 3.6 (commencing
with Section 32228) of Chapter 2 of Part 19 of Division 1 of Title 1
of the Education Code).
   (2) The department shall adopt separate program requirements for
initial certification for persons who are employed as group home
administrators on the effective date of this section. A person
employed as an administrator of a group home facility on the
effective date of this section shall obtain a certificate by
completing the training and testing requirements imposed by the
department within 12 months of the effective date of the regulations
implementing this section. After the effective date of this section,
these administrators shall meet the requirements imposed by the
department on all other group home administrators for certificate
renewal.
   (3) Individuals applying for certification under this section
shall successfully complete an approved certification program, pass a
written test administered by the department within 60 days of
completing the program, and submit to the department the
documentation required by subdivision (d) within 30 days after being
notified of having passed the test. The department may extend these
time deadlines for good cause. The department shall notify the
applicant of his or her test results within 30 days of administering
the test.
   (d) The department shall not begin the process of issuing a
certificate until receipt of all of the following:
   (1) A certificate of completion of the administrator training
required pursuant to this chapter.
   (2) The fee required for issuance of the certificate. A fee of one
hundred dollars ($100) shall be charged by the department to cover
the costs of processing the application for certification.
   (3) Documentation from the applicant that he or she has passed the
written test.
   (4) Submission of fingerprints pursuant to Section 1522. The
department may waive the submission for those persons who have a
current clearance on file.
   (5) That person is at least 21 years of age.
   (e) It shall be unlawful for any person not certified under this
section to hold himself or herself out as a certified administrator
of a group home facility. Any person willfully making any false
representation as being a certified administrator or facility manager
is guilty of a misdemeanor.
   (f) (1) Certificates issued under this section shall be renewed
every two years and renewal shall be conditional upon the certificate
holder submitting documentation of completion of 40 hours of
continuing education related to the core of knowledge specified in
subdivision (c). No more than one-half of the required 40 hours of
continuing education necessary to renew the certificate may be
satisfied through online courses. All other continuing education
hours shall be completed in a classroom setting. For purposes of this
section, an individual who is a group home facility administrator
and who is required to complete the continuing education hours
required by the regulations of the State Department of Developmental
Services, and approved by the regional center, may have up to 24 of
the required continuing education course hours credited toward the
40-hour continuing education requirement of this section. Community
college course hours approved by the regional centers shall be
accepted by the department for certification.
   (2) Every administrator of a group home facility shall complete
the continuing education requirements of this subdivision.
   (3) Certificates issued under this section shall expire every two
years on the anniversary date of the initial issuance of the
certificate, except that any administrator receiving his or her
initial certification on or after July 1, 1999, shall make an
irrevocable election to have his or her recertification date for any
subsequent recertification either on the date two years from the date
of issuance of the certificate or on the individual's birthday
during the second calendar year following certification. The
department shall send a renewal notice to the certificate holder 90
days prior to the expiration date of the certificate. If the
certificate is not renewed prior to its expiration date,
reinstatement shall only be permitted after the certificate holder
has paid a delinquency fee equal to three times the renewal fee and
has provided evidence of completion of the continuing education
required.
   (4) To renew a certificate, the certificate holder shall, on or
before the certificate expiration date, request renewal by submitting
to the department documentation of completion of the required
continuing education courses and pay the renewal fee of one hundred
dollars ($100), irrespective of receipt of the department's
notification of the renewal. A renewal request postmarked on or
before the expiration of the certificate shall be proof of compliance
with this paragraph.
   (5) A suspended or revoked certificate shall be subject to
expiration as provided for in this section. If reinstatement of the
certificate is approved by the department, the certificate holder, as
a condition precedent to reinstatement, shall submit proof of
compliance with paragraphs (1) and (2) of subdivision (f), and shall
pay a fee in an amount equal to the renewal fee, plus the delinquency
fee, if any, accrued at the time of its revocation or suspension.
Delinquency fees, if any, accrued subsequent to the time of its
revocation or suspension and prior to an order for reinstatement,
shall be waived for a period of 12 months to allow the individual
sufficient time to complete the required continuing education units
and to submit the required documentation. Individuals whose
certificates will expire within 90 days after the order for
reinstatement may be granted a three-month extension to renew their
certificates during which time the delinquency fees shall not accrue.

   (6) A certificate that is not renewed within four years after its
expiration shall not be renewed, restored, reissued, or reinstated
except upon completion of a certification training program, passing
any test that may be required of
       an applicant for a new certificate at that time, and paying
the appropriate fees provided for in this section.
   (7) A fee of twenty-five dollars ($25) shall be charged for the
reissuance of a lost certificate.
   (8) A certificate holder shall inform the department of his or her
employment status and change of mailing address within 30 days of
any change.
   (g) Unless otherwise ordered by the department, the certificate
shall be considered forfeited under either of the following
conditions:
   (1) The department has revoked any license held by the
administrator after the department issued the certificate.
   (2) The department has issued an exclusion order against the
administrator pursuant to Section 1558, 1568.092, 1569.58, or
1596.8897, after the department issued the certificate, and the
administrator did not appeal the exclusion order or, after the
appeal, the department issued a decision and order that upheld the
exclusion order.
   (h) (1) The department, in consultation and collaboration with
county placement officials, provider organizations, the State
Department of Health Care Services, and the State Department of
Developmental Services, shall establish, by regulation, the program
content, the testing instrument, the process for approving
certification training programs, and criteria to be used in
authorizing individuals, organizations, or educational institutions
to conduct certification training programs and continuing education
courses. The department may also grant continuing education hours for
continuing courses offered by accredited educational institutions
that are consistent with the requirements in this section. The
department may deny vendor approval to any agency or person in any of
the following circumstances:
   (A) The applicant has not provided the department with evidence
satisfactory to the department of the ability of the applicant to
satisfy the requirements of vendorization set out in the regulations
adopted by the department pursuant to subdivision (j).
   (B) The applicant person or agency has a conflict of interest in
that the person or agency places its clients in group home
facilities.
   (C) The applicant public or private agency has a conflict of
interest in that the agency is mandated to place clients in group
homes and to pay directly for the services. The department may deny
vendorization to this type of agency only as long as there are other
vendor programs available to conduct the certification training
programs and conduct education courses.
   (2) The department may authorize vendors to conduct the
administrator's certification training program pursuant to this
section. The department shall conduct the written test pursuant to
regulations adopted by the department.
   (3) The department shall prepare and maintain an updated list of
approved training vendors.
   (4) The department may inspect certification training programs and
continuing education courses, including online courses, at no charge
to the department, to determine if content and teaching methods
comply with regulations. If the department determines that any vendor
is not complying with the requirements of this section, the
department shall take appropriate action to bring the program into
compliance, which may include removing the vendor from the approved
list.
   (5) The department shall establish reasonable procedures and
timeframes not to exceed 30 days for the approval of vendor training
programs.
   (6) The department may charge a reasonable fee, not to exceed one
hundred fifty dollars ($150) every two years, to certification
program vendors for review and approval of the initial 40-hour
training program pursuant to subdivision (c). The department may also
charge the vendor a fee, not to exceed one hundred dollars ($100)
every two years, for the review and approval of the continuing
education courses needed for recertification pursuant to this
subdivision.
   (7) (A) A vendor of online programs for continuing education shall
ensure that each online course contains all of the following:
   (i) An interactive portion in which the participant receives
feedback, through online communication, based on input from the
participant.
   (ii) Required use of a personal identification number or personal
identification information to confirm the identity of the
participant.
   (iii) A final screen displaying a printable statement, to be
signed by the participant, certifying that the identified participant
completed the course. The vendor shall obtain a copy of the final
screen statement with the original signature of the participant prior
to the issuance of a certificate of completion. The signed statement
of completion shall be maintained by the vendor for a period of
three years and be available to the department upon demand. Any
person who certifies as true any material matter pursuant to this
clause that he or she knows to be false is guilty of a misdemeanor.
   (B) Nothing in this subdivision shall prohibit the department from
approving online programs for continuing education that do not meet
the requirements of subparagraph (A) if the vendor demonstrates to
the department's satisfaction that, through advanced technology, the
course and the course delivery meet the requirements of this section.

   (i) The department shall establish a registry for holders of
certificates that shall include, at a minimum, information on
employment status and criminal record clearance.
   (j) Subdivisions (b) to (i), inclusive, shall be implemented upon
regulations being adopted by the department, by January 1, 2000.
   (k) Notwithstanding any provision of law to the contrary, vendors
approved by the department who exclusively provide either initial or
continuing education courses for certification of administrators of a
group home facility as defined by regulations of the department, an
adult residential facility as defined by regulations of the
department, or a residential care facility for the elderly as defined
in subdivision (k) of Section 1569.2, shall be regulated solely by
the department pursuant to this chapter. No other state or local
governmental entity shall be responsible for regulating the activity
of those vendors.
  SEC. 21.  Section 1522.42 of the Health and Safety Code is amended
to read:
   1522.42.  (a) The department, in consultation and collaboration
with county placement officials, provider organizations, the State
Department of Health Care Services, and the State Department of
Developmental Services, shall adopt regulations that establish
standardized training and continuing education curricula for facility
managers and direct child care workers in group homes.
   (b) The regulations required by subdivision (a) shall specify the
date by which new and current employees shall be required to meet the
standardized training and continuing education requirements. For
persons employed as child care staff and facility managers on the
effective date of the regulations, the department shall provide
adequate time for these persons to comply with the regulatory
requirements.
  SEC. 22.  Section 1530.9 of the Health and Safety Code is amended
to read:
   1530.9.  (a) The department shall, with the advice and assistance
of the State Department of Health Care Services, counties, parent and
children's advocacy groups, and group home providers, adopt
regulations for the licensing of licensed community treatment
facilities at the earliest possible date.
   (b) The regulations adopted pursuant to this section shall specify
requirements for facility operation and maintenance.
   (c) Program certification and standards enforcement shall be the
responsibility of the State Department of Health Care Services,
pursuant to Section 4094 of the Welfare and Institutions Code. The
State Department of Social Services shall not issue a community
treatment facility license unless the applicant has obtained
certification of compliance from the State Department of Health Care
Services.
  SEC. 23.  Section 1562.3 of the Health and Safety Code is amended
to read:
   1562.3.  (a) The Director of Social Services, in consultation with
the Director of Health Care Services and the Director of
Developmental Services, shall establish a training program to ensure
that licensees, operators, and staffs of adult residential
facilities, as defined in paragraph (1) of subdivision (a) of Section
1502, have appropriate training to provide the care and services for
which a license or certificate is issued. The training program shall
be developed in consultation with provider organizations.
   (b) (1) An administrator of an adult residential care facility, as
defined in paragraph (1) of subdivision (a) of Section 1502, shall
successfully complete a department-approved certification program
pursuant to subdivision (c) prior to employment.
   (2) In those cases where the individual is both the licensee and
the administrator of a facility, the individual shall comply with
both the licensee and administrator requirements of this section.
   (3) Failure to comply with this section shall constitute cause for
revocation of the license of the facility.
   (4) The licensee shall notify the department within 30 days of any
change in administrators.
   (c) (1) The administrator certification program shall require a
minimum of 35 hours of classroom instruction that provides training
on a uniform core of knowledge in each of the following areas:
   (A) Laws, regulations, and policies and procedural standards that
impact the operations of the type of facility for which the applicant
will be an administrator.
   (B) Business operations.
   (C) Management and supervision of staff.
   (D) Psychosocial needs of the facility residents.
   (E) Community and support services.
   (F) Physical needs for facility residents.
   (G) Use, misuse, and interaction of medication commonly used by
facility residents.
   (H) Resident admission, retention, and assessment procedures.
   (I) Nonviolent crisis intervention for administrators.
   (2) The requirement for 35 hours of classroom instruction pursuant
to this subdivision shall not apply to persons who were employed as
administrators prior to July 1, 1996. A person holding the position
of administrator of an adult residential facility on June 30, 1996,
shall file a completed application for certification with the
department on or before April 1, 1998. In order to be exempt from the
35-hour training program and the test component, the application
shall include documentation showing proof of continuous employment as
the administrator of an adult residential facility between, at a
minimum, June 30, 1994, and June 30, 1996. An administrator of an
adult residential facility who became certified as a result of
passing the department-administered challenge test, that was offered
between October 1, 1996, and December 23, 1996, shall be deemed to
have fulfilled the requirements of this paragraph.
   (3) Unless an extension is granted to the applicant by the
department, an applicant for an administrator's certificate shall,
within 60 days of the applicant's completion of classroom
instruction, pass the written test provided in this section.
   (d) The department shall not begin the process of issuing a
certificate until receipt of all of the following:
   (1) A certificate of completion of the administrator training
required pursuant to this chapter.
   (2) The fee required for issuance of the certificate. A fee of one
hundred dollars ($100) shall be charged by the department to cover
the costs of processing the application for certification.
   (3) Documentation from the applicant that he or she has passed the
written test.
   (4) Submission of fingerprints. The department and the Department
of Justice shall expedite the criminal record clearance for holders
of certificates of completion. The department may waive the
submission for those persons who have a current clearance on file.
   (e) It shall be unlawful for any person not certified under this
section to hold himself or herself out as a certified administrator
of an adult residential facility. Any person willfully making any
false representation as being a certified administrator is guilty of
a misdemeanor.
   (f) (1) Certificates issued under this section shall be renewed
every two years and renewal shall be conditional upon the certificate
holder submitting documentation of completion of 40 hours of
continuing education related to the core of knowledge specified in
subdivision (c). No more than one-half of the required 40 hours of
continuing education necessary to renew the certificate may be
satisfied through online courses. All other continuing education
hours shall be completed in a classroom setting. For purposes of this
section, an individual who is an adult residential facility
administrator and who is required to complete the continuing
education hours required by the regulations of the State Department
of Developmental Services, and approved by the regional center, shall
be permitted to have up to 24 of the required continuing education
course hours credited toward the 40-hour continuing education
requirement of this section. Community college course hours approved
by the regional centers shall be accepted by the department for
certification.
   (2) Every licensee and administrator of an adult residential
facility is required to complete the continuing education
requirements of this subdivision.
   (3) Certificates issued under this section shall expire every two
years, on the anniversary date of the initial issuance of the
certificate, except that any administrator receiving his or her
initial certification on or after January 1, 1999, shall make an
irrevocable election to have his or her recertification date for any
subsequent recertification either on the date two years from the date
of issuance of the certificate or on the individual's birthday
during the second calendar year following certification. The
department shall send a renewal notice to the certificate holder 90
days prior to the expiration date of the certificate. If the
certificate is not renewed prior to its expiration date,
reinstatement shall only be permitted after the certificate holder
has paid a delinquency fee equal to three times the renewal fee and
has provided evidence of completion of the continuing education
required.
   (4) To renew a certificate, the certificate holder shall, on or
before the certificate expiration date, request renewal by submitting
to the department documentation of completion of the required
continuing education courses and pay the renewal fee of one hundred
dollars ($100), irrespective of receipt of the department's
notification of the renewal. A renewal request postmarked on or
before the expiration of the certificate is proof of compliance with
this paragraph.
   (5) A suspended or revoked certificate is subject to expiration as
provided for in this section. If reinstatement of the certificate is
approved by the department, the certificate holder, as a condition
precedent to reinstatement, shall submit proof of compliance with
paragraphs (1) and (2) of subdivision (f) and shall pay a fee in an
amount equal to the renewal fee, plus the delinquency fee, if any,
accrued at the time of its revocation or suspension. Delinquency
fees, if any, accrued subsequent to the time of its revocation or
suspension and prior to an order for reinstatement, shall be waived
for one year to allow the individual sufficient time to complete the
required continuing education units and to submit the required
documentation. Individuals whose certificates will expire within 90
days after the order for reinstatement may be granted a three-month
extension to renew their certificates during which time the
delinquency fees shall not accrue.
   (6) A certificate that is not renewed within four years after its
expiration shall not be renewed, restored, reissued, or reinstated
except upon completion of a certification training program, passing
any test that may be required of an applicant for a new certificate
at that time, and paying the appropriate fees provided for in this
section.
   (7) A fee of twenty-five dollars ($25) shall be charged for the
reissuance of a lost certificate.
   (8) A certificate holder shall inform the department of his or her
employment status within 30 days of any change.
   (g) The certificate shall be considered forfeited under the
following conditions:
   (1) The administrator has had a license revoked, suspended, or
denied as authorized under Section 1550.
   (2) The administrator has been denied employment, residence, or
presence in a facility based on action resulting from an
administrative hearing pursuant to Section 1522 or Section 1558.
   (h) (1) The department, in consultation with the State Department
of Health Care Services and the State Department of Developmental
Services, shall establish, by regulation, the program content, the
testing instrument, the process for approving certification training
programs, and criteria to be used in authorizing individuals,
organizations, or educational institutions to conduct certification
training programs and continuing education courses. These regulations
shall be developed in consultation with provider organizations, and
shall be made available at least six months prior to the deadline
required for certification. The department may deny vendor approval
to any agency or person in any of the following circumstances:
   (A) The applicant has not provided the department with evidence
satisfactory to the department of the ability of the applicant to
satisfy the requirements of vendorization set out in the regulations
adopted by the department pursuant to subdivision (i).
   (B) The applicant person or agency has a conflict of interest in
that the person or agency places its clients in adult residential
facilities.
   (C) The applicant public or private agency has a conflict of
interest in that the agency is mandated to place clients in adult
residential facilities and to pay directly for the services. The
department may deny vendorization to this type of agency only as long
as there are other vendor programs available to conduct the
certification training programs and conduct education courses.
   (2) The department may authorize vendors to conduct the
administrator's certification training program pursuant to provisions
set forth in this section. The department shall conduct the written
test pursuant to regulations adopted by the department.
   (3) The department shall prepare and maintain an updated list of
approved training vendors.
   (4) The department may inspect certification training programs and
continuing education courses, including online courses, at no charge
to the department, to determine if content and teaching methods
comply with regulations. If the department determines that any vendor
is not complying with the intent of this section, the department
shall take appropriate action to bring the program into compliance,
which may include removing the vendor from the approved list.
   (5) The department shall establish reasonable procedures and
timeframes not to exceed 30 days for the approval of vendor training
programs.
   (6) The department may charge a reasonable fee, not to exceed one
hundred fifty dollars ($150) every two years to certification program
vendors for review and approval of the initial 35-hour training
program pursuant to subdivision (c). The department may also charge
the vendor a fee not to exceed one hundred dollars ($100) every two
years for the review and approval of the continuing education courses
needed for recertification pursuant to this subdivision.
   (7) (A) A vendor of online programs for continuing education shall
ensure that each online course contains all of the following:
   (i) An interactive portion in which the participant receives
feedback, through online communication, based on input from the
participant.
   (ii) Required use of a personal identification number or personal
identification information to confirm the identity of the
participant.
   (iii) A final screen displaying a printable statement, to be
signed by the participant, certifying that the identified participant
completed the course. The vendor shall obtain a copy of the final
screen statement with the original signature of the participant prior
to the issuance of a certificate of completion. The signed statement
of completion shall be maintained by the vendor for a period of
three years and be available to the department upon demand. Any
person who certifies as true any material matter pursuant to this
clause that he or she knows to be false is guilty of a misdemeanor.
   (B) Nothing in this subdivision shall prohibit the department from
approving online programs for continuing education that do not meet
the requirements of subparagraph (A) if the vendor demonstrates to
the department's satisfaction that, through advanced technology, the
course and the course delivery meet the requirements of this section.

   (i) The department shall establish a registry for holders of
certificates that shall include, at a minimum, information on
employment status and criminal record clearance.
  SEC. 24.  Section 1565 of the Health and Safety Code is repealed.
  SEC. 25.  Section 11217 of the Health and Safety Code is amended to
read:
   11217.  No person shall treat an addict for addiction to a
narcotic drug except in one of the following:
   (a) An institution approved by the State Department of Social
Services and the State Department of Health Care Services, and where
the patient is at all times kept under restraint and control.
   (b) A city or county jail.
   (c) A state prison.
   (d) A facility designated by a county and approved by the State
Department of Social Services pursuant to Division 5 (commencing with
Section 5000) of the Welfare and Institutions Code.
   (e) A state hospital.
   (f) A county hospital.
   (g) A facility licensed by the State Department of Alcohol and
Drug Programs pursuant to Division 10.5 (commencing with Section
11750).
   (h) A facility as defined in subdivision (a) or (b) of Section
1250 and Section 1250.3.
   A narcotic controlled substance in the continuing treatment of
addiction to a controlled substance shall be used only in those
programs licensed by the State Department of Alcohol and Drug
Programs pursuant to Article 3 (commencing with Section 11875) of
Chapter 1 of Part 3 of Division 10.5 on either an inpatient or
outpatient basis, or both.
   This section does not apply during emergency treatment, or where
the patient's addiction is complicated by the presence of incurable
disease, serious accident, or injury, or the infirmities of old age.
   Neither this section nor any other provision of this division
shall be construed to prohibit the maintenance of a place in which
persons seeking to recover from addiction to a controlled substance
reside and endeavor to aid one another and receive aid from others in
recovering from that addiction, nor does this section or this
division prohibit that aid, provided that no person is treated for
addiction in a place by means of administering, furnishing, or
prescribing of controlled substances. The preceding sentence is
declaratory of preexisting law.
   Neither this section or any other provision of this division shall
be construed to prohibit short-term narcotic detoxification
treatment in a controlled setting approved by the director and
pursuant to rules and regulations of the director. Facilities and
treatment approved by the director under this paragraph shall not be
subject to approval or inspection by the Medical Board of California,
nor shall persons in those facilities be required to register with,
or report the termination of residence with, the police department or
sheriff's office.
  SEC. 26.  Section 11998.1 of the Health and Safety Code is amended
to read:
   11998.1.  It is the intent of the Legislature that the following
long-term five-year goals be achieved:
   (a) With regard to education and prevention of drug and alcohol
abuse programs, the following goals:
   (1) Drug and alcohol abuse education has been included within the
mandatory curriculum in kindergarten and grades 1 to 12, inclusive,
in every public school in California.
   (2) Basic training on how to recognize, and understand what to do
about, drug and alcohol abuse has been provided to administrators and
all teachers of kindergarten and grades 1 to 12, inclusive.
   (3) All school counselors and school nurses have received
comprehensive drug and alcohol abuse training.
   (4) Each school district with kindergarten and grades 1 to 12,
inclusive, has appointed a drug and alcohol abuse advisory team of
school administrators, teachers, counselors, students, parents,
community representatives, and health care professionals, all of whom
have expertise in drug and alcohol abuse prevention. The team
coordinates with and receives consultation from the county alcohol
and drug program administrators.
   (5) Every school board member has received basic drug and alcohol
abuse information.
   (6) Each school district has a drug and alcohol abuse specialist
to assist the individual schools.
   (7) Each school in grades 7 to 12, inclusive, has student peer
group drug and alcohol abuse programs.
   (8) Every school district with kindergarten and grades 1 to 12,
inclusive, has updated written drug and alcohol abuse policies and
procedures including disciplinary procedures which will be given to
every school employee, every student, and every parent.
   (9) The California State University and the University of
California have evaluated and, if feasible, established educational
programs and degrees in the area of drug and alcohol abuse.
   (10) Every school district with kindergarten and grades 1 to 12,
inclusive, has an established parent teachers group with drug and
alcohol abuse prevention goals.
   (11) Every school district has instituted a drug and alcohol abuse
education program for parents.
   (12) Drug and alcohol abuse training has been imposed as a
condition for teacher credentialing and license renewal, and
knowledge on the issue is measured on the California Basic Education
Skills Test.
   (13) Drug and alcohol abuse knowledge has been established as a
component on standardized competency tests as a requirement for
graduation.
   (14) Every school district has established a parent support group.

   (15) Every school district has instituted policies that address
the special needs of children who have been rehabilitated for drug or
alcohol abuse problems and who are reentering school. These policies
shall consider the loss of schooltime, the loss of academic credits,
and the sociological problems associated with drug and
                                 alcohol abuse, its rehabilitation,
and the educational delay it causes.
   (16) The number of drug and alcohol abuse related incidents on
school grounds has decreased by 20 percent.
   (b) With regard to community programs, the following goals:
   (1) Every community-based social service organization that
receives state and local financial assistance has drug and alcohol
abuse information available for clients.
   (2) All neighborhood watch, business watch, and community conflict
resolution programs have included drug and alcohol abuse prevention
efforts.
   (3) All community-based programs that serve schoolaged children
have staff trained in drug and alcohol abuse and give a clear, drug-
and alcohol-free message.
   (c) With regard to drug and alcohol abuse programs of the media,
the following goals:
   (1) The state has established a comprehensive media campaign that
involves all facets of the drug and alcohol abuse problem, including
treatment, education, prevention, and intervention that will result
in increasing the public's knowledge and awareness of the detrimental
effects of alcohol and drug use, reducing the use of alcohol and
drugs, and increasing healthy lifestyle choices.
   (2) The department on a statewide basis, and the county board of
supervisors or its designees at the local level, have:
   (A) Assisted the entertainment industry in identifying ways to use
the entertainment industry effectively to encourage lifestyles free
of substance abuse.
   (B) Assisted the manufacturers of drug and alcohol products in
identifying ways to use product advertising effectively to discourage
substance abuse.
   (C) Assisted television stations in identifying ways to use
television programming effectively to encourage lifestyles free of
substance abuse.
   (3) A statewide cooperative fundraising program with recording
artists and the entertainment industry has been encouraged to fund
drug and alcohol abuse prevention efforts in the state.
   (d) With regard to drug and alcohol abuse health care programs,
the following goals:
   (1) The number of drug and alcohol abuse-related medical
emergencies has decreased by 4 percent per year.
   (2) All general acute care hospitals and AIDS medical service
providers have provided information to their patients on drug and
alcohol abuse.
   (3) The Medical Board of California, the Psychology Examining
Committee, the Board of Registered Nursing, and the Board of
Behavioral Science Examiners have developed and implemented the
guidelines or regulations requiring drug and alcohol abuse training
for their licensees, and have developed methods of providing training
for those professionals.
   (e) With regard to private sector drug and alcohol abuse programs,
the following goals:
   (1) A significant percentage of businesses in the private sector
have developed personnel policies that discourage drug and alcohol
abuse and encourage supervision, training, and employee education.
   (2) Noteworthy and publicly recognized figures and private
industry have been encouraged to sponsor fundraising events for drug
and alcohol abuse prevention.
   (3) Every public or private athletic team has been encouraged to
establish policies forbidding drug and alcohol abuse.
   (4) The private sector has established personnel policies that
discourage drug and alcohol abuse but encourage treatment for those
employees who require this assistance.
   (f) With regard to local government drug and alcohol abuse
programs, the following goals:
   (1) Every county has a five-year master plan to eliminate drug and
alcohol abuse developed jointly by the county-designated alcohol and
drug program administrators, reviewed jointly by the advisory boards
set forth in paragraph (2), and approved by the board of
supervisors. For those counties in which the alcohol and drug
programs are jointly administered, the administrator shall develop
the five-year master plan. To the degree possible, all existing local
plans relating to drug or alcohol abuse shall be incorporated into
the master plan.
   (2) Every county has an advisory board on alcohol problems and an
advisory board on drug programs. The membership of these advisory
boards is representative of the county's population and is
geographically balanced. To the maximum extent possible, the county
advisory board on alcohol problems and the county advisory board on
drug programs will have representatives of the following:
   (A) Law enforcement.
   (B) Education.
   (C) The treatment and recovery community, including a
representative with expertise in AIDS treatment services.
   (D) Judiciary.
   (E) Students.
   (F) Parents.
   (G) Private industry.
   (H) Other community organizations involved in drug and alcohol
services.
   (I) A representative of organized labor responsible for the
provision of Employee Assistance Program services.
   If any of these areas is not represented on the advisory bodies,
the administrator designated in paragraph (1) shall solicit input
from a representative of the nonrepresented area prior to the
development of a master plan pursuant to paragraph (1).
   (3) Every county public social service agency has established
policies that discourage drug and alcohol abuse and encourage
treatment and recovery services when necessary.
   (4) Every local unit of government has an employee assistance
program that addresses drug and alcohol abuse problems.
   (5) Every local unit of government has considered the potential
for drug and alcohol abuse problems when developing zoning ordinances
and issuing conditional use permits.
   (6) Every county master plan includes treatment and recovery
services.
   (6.5) Every county master plan includes specialized provisions to
ensure optimum alcohol and drug abuse service delivery for
handicapped and disabled persons.
   (7) Every local unit of government has been encouraged to
establish an employee assistance program that includes the treatment
of drug and alcohol abuse-related programs.
   (8) Every local governmental social service provider has
established a referral system under which clients with drug and
alcohol abuse problems can be referred for treatment.
   (9) Every county drug and alcohol abuse treatment or recovery
program that serves women gives priority for services to pregnant
women.
   (10) Every alcohol and drug abuse program provides AIDS
information to all program participants.
   (g) With regard to state and federal government drug and alcohol
abuse programs, the following goals:
   (1) The Department of Alcoholic Beverage Control has informed all
alcohol retailers of the laws governing liquor sales and has provided
training available to all personnel selling alcoholic beverages, on
identifying and handling minors attempting to purchase alcohol.
   (2) The California Emergency Management Agency has required all
applicants for crime prevention and juvenile justice and delinquency
prevention funds to include drug and alcohol abuse prevention efforts
in their programs.
   (3) All county applications for direct or indirect drug and
alcohol services funding from the department include a prevention
component.
   (4) The Superintendent of Public Instruction has employed drug and
alcohol abuse school prevention specialists and assisted school
districts with the implementation of prevention programs.
   (5) The State Department of Health Care Services has staff trained
in drug and alcohol abuse prevention who can assist local mental
health programs with prevention efforts.
   (6) The Department of the California Highway Patrol, as permitted
by the United States Constitution, has established routine statewide
sobriety checkpoints for driving while under the influence.
   (7) The Department of Corrections and the Department of the Youth
Authority have provided drug and alcohol abuse education and
prevention services for all inmates, wards, and parolees. Both
departments have provided drug and alcohol abuse treatment services
for any inmate, ward, or parolee determined to be in need of these
services, or who personally requests these services.
   (8) The Department of Motor Vehicles has distributed prevention
materials with each driver's license or certificate of renewal and
each vehicle registration renewal mailed by the Department of Motor
Vehicles.
   (9) Federal prevention programs have been encouraged to follow the
master plan.
   (10) State licensing and program regulations for drug and alcohol
abuse treatment programs have been consolidated and administered by
one state agency.
   (11) State treatment funding priorities have been included to
specially recognize the multiple diagnosed client who would be
eligible for services from more than one state agency.
   (12) Every state agency has formalized employee assistance
programs that include the treatment of drug and alcohol abuse-related
problems.
   (13) The state master plan includes specialized provisions to
ensure optimum drug and alcohol abuse service delivery for
handicapped and disabled persons.
   (h) With regard to private sector direct service providers, the
following goals:
   (1) Drinking drivers programs have provided clear measurements of
successful completion of the program to the courts for each
court-ordered client.
   (2) Sufficient drug and alcohol treatment and recovery services
exist throughout the state to meet all clients' immediate and
long-range needs.
   (3) Each county to the extent possible provides localized alcohol
and drug treatment and recovery services designed for individuals
seeking assistance for polydrug abuse.
   (4) Adequate nonresidential and residential services are available
statewide for juveniles in need of alcohol or drug abuse services.
   (5) Each provider of alcohol or drug services has been certified
by the state.
   (6) Drug and alcohol abuse treatment providers provide general
AIDS information during treatment.
   (i) With regard to supply regulation and reduction in conjunction
with drug and alcohol abuse, the following goals:
   (1) The California National Guard supports federal, state, and
local drug enforcement agencies in counternarcotic operations as
permitted by applicable laws and regulations.
   (2) Each county has a drug and alcohol abuse enforcement team,
designated by the board of supervisors. This team includes all
components of the criminal justice system. This team shall be
responsible to the board of supervisors, shall coordinate with the
drug and alcohol abuse advisory board and the county on all criminal
justice matters relating to drug and alcohol abuse, and shall
coordinate, and actively participate, with the county alcohol and
drug program administrators throughout the development and
implementation of the five-year master plan.
   (3) The California Emergency Management Agency, the Youth and
Adult Correctional Agency, the Department of the California Highway
Patrol, the Office of Traffic Safety, and the Department of Justice
have established a state level drug and alcohol abuse enforcement
team that includes representatives from all facets of criminal
justice. The lead agency for the enforcement team has been designated
by the Governor. This team advises the state and assists the local
teams.
   (4) The California Emergency Management Agency, the Youth and
Adult Correctional Agency, and the Department of Justice have, as a
priority when determining training subjects, prevention seminars on
drug and alcohol abuse. The Commission on Peace Officer Standards and
Training has, as a priority, when determining training subjects,
drug and alcohol enforcement.
   (5) The Department of the California Highway Patrol, as permitted
by the United States Constitution, will, in conjunction with
establishing sobriety checkpoints statewide, assist local law
enforcement agencies with the establishment of local programs.
   (6) Counties with more than 10 superior court judgeships have
established programs under which drug cases receive swift prosecution
by well-trained prosecutors before judges who are experienced in the
handling of drug cases.
   (7) The courts, when determining bail eligibility and the amount
of bail for persons suspected of a crime involving a controlled
substance, shall consider the quantity of the substance involved when
measuring the danger to society if the suspect is released.
   (8) Drunk driving jails have been established that provide
offender education and treatment during incarceration.
   (9) All probation and parole officers have received drug and
alcohol abuse training, including particular training on drug
recognition.
   (10) All parolees and persons on probation with a criminal history
that involves drug or alcohol abuse have conditions of parole or
probation that prohibit drug and alcohol abuse.
   (11) The Judicial Council has provided training on drug and
alcohol abuse for the judges.
   (12) The courts, when sentencing offenders convicted of selling
drugs, consider "street value" of the drugs involved in the
underlying crime.
   (13) Judges have been encouraged to include drug and alcohol abuse
treatment and prevention services in sentences for all offenders.
Judges are requiring, as a condition of sentencing, drug and alcohol
abuse education and treatment services for all persons convicted of
driving under the influence of alcohol or drugs.
   (14) Juvenile halls and jails provide clients with information on
drug and alcohol abuse.
   (15) The estimated number of clandestine labs operating in
California has decreased by 10 percent per year.
   (16) Each local law enforcement agency has developed, with the
schools, protocol on responding to school drug and alcohol abuse
problems.
   (17) Every county has instituted a mandatory
driving-under-the-influence presentence offender evaluation program.
  SEC. 27.  Section 50451 of the Health and Safety Code is amended to
read:
   50451.  The California Statewide Housing Plan shall incorporate a
statement of housing goals, policies, and objectives, as well as all
of the following segments:
   (a) An evaluation and summary of housing conditions throughout the
state, with particular emphasis upon the availability of housing for
all economic segments of the state. The evaluation shall include
summary statistics for all counties, all multicounty metropolitan
areas, and rural areas, as defined and designated by the Bureau of
the Census of the United States Department of Commerce, rather than
as defined in Section 50101. The evaluation shall include the
existing distribution of housing by type, size, gross rent, value,
and, to the extent data is available, condition, and the existing
distribution of households by gross income, size, and ethnic
character for each of those areas.
   (b) A determination of the statewide need for housing development
for the year the plan is revised and projected four additional years
ahead. The determination of statewide need shall be established as
the minimum number of units necessary to be built or rehabilitated in
order to provide sufficient housing to house all residents of the
state in standard, uncrowded units in suitable locations.
   (c) Goals for the provision of housing assistance for the year the
plan is revised and projected four additional years ahead. The goals
shall be established as the minimum number of households to be
assisted that will result in achieving, by the fourth subsequent
year, a substantial reduction in the number of very low income
households and other persons and families of low or moderate income
constrained to pay more than 30 percent of their gross income for
housing. Income groups to be considered in establishing the goals
shall be designated by the department and shall include households a
significant number of which are required to pay more than 30 percent
of their gross income for housing in the fiscal year the plan is
revised, as determined by the department.
   (d) An identification of governmental and nongovernmental
constraints and obstacles and specific recommendations for their
removal.
   (e) An analysis of state and local housing and building codes and
their enforcement. The analysis shall include consideration of
whether those codes contain sufficient flexibility to respond to new
methods of construction and new materials.
   (f) Recommendations for actions by federal, state, and local
governments and the private sector that will contribute to the
attainment of the housing goals established for California.
   (g) A housing strategy that coordinates the housing assistance and
activities of state and local agencies, including the provision of
housing assistance for various population groups including, but not
limited to, elderly persons, persons with disabilities, large
families, families where a female is the head of the household,
farmworker households, and other specific population groups as deemed
appropriate by the department. To inform the strategy, the
department shall, to the extent possible, do the following:
   (1) Consider information compiled by the University of California
pursuant to Section 9101.5 of the Welfare and Institutions Code, and
from provider and consumer organizations as available.
   (2) Consult with various state departments, including the
California Department of Aging, the State Department of Social
Services, the State Department of Health Care Services, the
Employment Development Department, the State Department of
Developmental Services, and other state departments or agencies to
obtain information deemed relevant to the housing needs of
populations addressed in the housing strategy. This paragraph shall
not be construed to require activity beyond the customary scope of
the department's planning process.
   (h) A review of housing assistance policies, goals, and objectives
affecting the homeless.
  SEC. 28.  Section 50685.5 of the Health and Safety Code is amended
to read:
   50685.5.  As used in this chapter, "persons requiring supportive
services" means persons who are eligible to receive housing
assistance pursuant to federal law because of financial inability to
provide adequate housing for themselves or persons dependent upon
them, who are or will be participating in programs of rehabilitation,
education, or social services, and who meet any of the following
criteria:
   (a) The person shall have been determined to be developmentally
disabled, but not requiring institutional care, by the State
Department of Developmental Services, a regional center established
pursuant to Section 4620 of the Welfare and Institutions Code, or by
the designated representative thereof.
   (b) The person shall have been determined to be mentally
disordered, but not requiring institutional care, by a local director
of mental health services, by the State Department of Health Care
Services, or by the designated representatives thereof.
   (c) The person shall have been determined to be physically
disabled by the Department of Rehabilitation or by the designated
representatives thereof.
  SEC. 29.  Section 50687.5 of the Health and Safety Code is amended
to read:
   50687.5.  The department, after consultation with the State
Department of Developmental Services, the Department of
Rehabilitation, or the State Department of Health Care Services, may
adopt, amend or repeal regulations for the administration of this
chapter.
   The department shall submit applications for federal housing
subsidies for persons requiring supportive services.
  SEC. 30.  Section 50689 of the Health and Safety Code is amended to
read:
   50689.  (a) It is the intent of the Legislature in enacting this
section to provide housing assistance for the developmentally or
physically disabled, and mentally disordered where such assistance is
for the purpose of providing a transition from an institutional to
an independent setting, and where that assistance is administered in
the context of ongoing local programs leading to rehabilitation and
independence.
   (b) The department shall establish a program for the purpose of
housing assistance for the physically or developmentally disabled, or
mentally disordered. The department shall contract with local
agencies or nonprofit corporations incorporated pursuant to Part 1
(commencing with Section 9000) of Division 2 of Title 1 of the
Corporations Code which provide supportive services for such
individuals, where those services are designed to provide a
transition to independent living. The local agencies or nonprofit
corporation shall ensure that recipients of housing assistance are
income qualified under guidelines for programs of the federal
Department of Housing and Urban Development under Section 8 of the
United States Housing Act of 1937, as amended (42 U.S.C. Sec. 1437
(f)), and shall not contract for housing which exceeds such
guidelines for fair market rents for the Section 8 program. Public
and private agencies participating in the program established
pursuant to this section shall be those whose program philosophies
and activities conform substantially to the principles of community
living under Chapter 12 (commencing with Section 4830) of Division
4.5, community residential treatment under Chapter 5 (commencing with
Section 5450) of Part 1 of Division 5, and independent living under
Chapter 8 (commencing with Section 19800) of Part 2 of Division 10,
of the Welfare and Institutions Code.
   (c) Any local agency making application for housing assistance
payments to the department shall, in its application, explain how the
housing assistance payments are part of its ongoing programs to
establish independent living for its disabled clientele. The
department, in reviewing these applications, may consult with the
Department of Developmental Disabilities, the State Department of
Health Care Services, and the Department of Rehabilitation.
   (d) In order to receive housing assistance payments for any
specific structure pursuant to the provisions of this section, the
local agency or nonprofit corporation shall not contract for rental
of more than 12 units, or for rental of space for more than 24
persons, in the structure. No individual shall remain in a payment
assisted unit for more than 18 months.
  SEC. 31.  Section 120840 of the Health and Safety Code is amended
to read:
   120840.  The State Department of Health Care Services shall
establish an AIDS mental health project, as described in this
section.
   (a) The program should include, but need not be limited to, the
following:
   (1) The conduct of a statewide needs assessment of AIDS-related
mental health issues.
   (2) The conduct of education and training for mental health
professionals throughout the state.
   (3) The conduct, through the Office of Promotion, of a media
campaign on such issues as the use of support groups, the
relationship between stress and the immune system, and dealing with
grief.
   (b) The State Department of Health Care Services shall coordinate
projects and resources directly with the department.
   (c) The Director of Health Care Services may appoint advisory
groups for this project as needed.
   (d) Notwithstanding any provision of Chapter 2 (commencing with
Section 10290) of Part 2 of Division 2 of the Public Contract Code,
if the Director of Health Care Services determines that it is in the
best interest of the state to enter into a contract for the purposes
specified in this section without competitive bids, then the director
may, during the 1985-86 fiscal year, enter into a sole source
contract for these purposes.
  SEC. 32.  Section 124174.4 of the Health and Safety Code is amended
to read:
   124174.4.  The State Department of Education, in collaboration
with the department, shall perform the following functions:
   (a) Coordination of programs within the State Department of
Education that support school health centers and programs within the
State Department of Health Care Services and the State Department of
Alcohol and Drug Programs, where appropriate.
   (b) The provision of technical assistance to facilitate and
encourage the establishment, retention, and expansion of school
health centers in public schools. For purposes of this subdivision,
"technical assistance" may include the provision of information to
local educational agencies and other entities regarding the
utilization of facilities, liability insurance, cooperative
agreements with community-based providers, and other issues pertinent
to school health centers.
  SEC. 33.  Section 128454 of the Health and Safety Code is amended
to read:
   128454.  (a) There is hereby created the Licensed Mental Health
Service Provider Education Program within the Health Professions
Education Foundation.
   (b) For purposes of this article, the following definitions shall
apply:
   (1) "Licensed mental health service provider" means a psychologist
licensed by the Board of Psychology, registered psychologist,
postdoctoral psychological assistant, postdoctoral psychology trainee
employed in an exempt setting pursuant to Section 2910 of the
Business and Professions Code, or employed pursuant to a State
Department of Health Care Services waiver pursuant to Section 5751.2
of the Welfare and Institutions Code, marriage and family therapist,
marriage and family therapist intern, licensed clinical social
worker, and associate clinical social worker.
   (2) "Mental health professional shortage area" means an area
designated as such by the Health Resources and Services
Administration (HRSA) of the United States Department of Health and
Human Services.
   (c) Commencing January 1, 2005, any licensed mental health service
provider, including a mental health service provider who is employed
at a publicly funded mental health facility or a public or nonprofit
private mental health facility that contracts with a county mental
health entity or facility to provide mental health services, who
provides direct patient care in a publicly funded facility or a
mental health professional shortage area may apply for grants under
the program to reimburse his or her educational loans related to a
career as a licensed mental health service provider.
   (d) The Health Professions Education Foundation shall make
recommendations to the director of the office concerning all of the
following:
   (1) A standard contractual agreement to be signed by the director
and any licensed mental health service provider who is serving in a
publicly funded facility or a mental health professional shortage
area that would require the licensed mental health service provider
who receives a grant under the program to work in the publicly funded
facility or a mental health professional shortage area for at least
one year.
   (2) The maximum allowable total grant amount per individual
licensed mental health service provider.
         (3) The maximum allowable annual grant amount per individual
licensed mental health service provider.
   (e) The Health Professions Education Foundation shall develop the
program, which shall comply with all of the following requirements:
   (1) The total amount of grants under the program per individual
licensed mental health service provider shall not exceed the amount
of educational loans related to a career as a licensed mental health
service provider incurred by that provider.
   (2) The program shall keep the fees from the different licensed
providers separate to ensure that all grants are funded by those fees
collected from the corresponding licensed provider groups.
   (3) A loan forgiveness grant may be provided in installments
proportionate to the amount of the service obligation that has been
completed.
   (4) The number of persons who may be considered for the program
shall be limited by the funds made available pursuant to Section
128458.
  SEC. 34.  Section 128456 of the Health and Safety Code is amended
to read:
   128456.  In developing the program established pursuant to this
article, the Health Professions Education Foundation shall solicit
the advice of representatives of the Board of Behavioral Sciences,
the Board of Psychology, the State Department of Health Care
Services, the California Mental Health Directors Association, the
California Mental Health Planning Council, professional mental health
care organizations, the California Healthcare Association, the
Chancellor of the California Community Colleges, and the Chancellor
of the California State University. The foundation shall solicit the
advice of representatives who reflect the demographic, cultural, and
linguistic diversity of the state.
  SEC. 35.  Section 129230 of the Health and Safety Code is amended
to read:
   129230.  It is the intent of the Legislature in enacting this
article to encourage the development of facilities for
community-based programs that assist mental health clients living in
any institutional setting, including state and local inpatient
hospitals, skilled nursing homes, intermediate care facilities, and
community care facilities to move to more independent living
arrangements. It is further the intent of the Legislature to
encourage local programs to seek funding for facility development
from private sources and with the assistance provided pursuant to
this chapter.
   To achieve this purpose in determining eligibility for loan
insurance pursuant to this chapter, the following special provisions
apply to facilities approved in the local mental health program and
meeting the intentions of this article:
   (a) Facilities shall not require approval pursuant to Section
129295 by the statewide system of health facility planning, the area
health planning agency, or the Health Advisory Council, for the
issuance of loan insurance, unless specifically required for the
facilities by the facility category of licensure.
   (b) Notwithstanding subdivision (i) of Section 129050, any loan of
under three hundred thousand dollars ($300,000) for a nonprofit
corporation as well as a political subdivision may be fully insured
equal to the total construction cost, except a loan to any
proprietary corporation that is insured pursuant to subdivision (d)
of this section.
   (c) The local mental health program may provide all application
fees, inspection fees, premiums and other administrative payments
required by this chapter, except with respect to any loan to a
proprietary corporation that is insured pursuant to subdivision (d)
of this section.
   (d) The borrower may be a proprietary corporation, provided that
the facility is leased to the local mental health program for the
duration of the insurance agreement. In these instances, all
provisions in this chapter and this article that apply to a nonprofit
corporation shall apply to the proprietary corporation, except as
provided in subdivisions (b) and (c) of this section.
   (e) For the purposes of this article, subdivision (c) of Section
129010 shall include the purchase of existing buildings.
   (f) Facilities shall not require approval pursuant to Section
129020 by the statewide system of health facility planning, the area
health planning agency, or the Health Advisory Council, for the
issuance of loan insurance, until the director of the office
determines that the state plan developed pursuant to Section 129020
adequately and comprehensively addresses the need for community
mental health facilities and that finding is reported to the
appropriate policy committees of the Legislature.
  SEC. 36.  Section 10125 of the Insurance Code is amended to read:
   10125.  (a) On and after January 1, 1974, every insurer issuing
group disability insurance which covers hospital, medical, or
surgical expenses shall offer coverage for expenses incurred as a
result of mental or nervous disorders, under the terms and conditions
which may be agreed upon between the group policyholder and the
insurer. If the terms and conditions include coverage for inpatient
care for nervous or mental disorders, the coverage shall extend to
treatment provided at all of the following facilities:
   (1) A general acute care hospital as defined in subdivision (a) of
Section 1250 of the Health and Safety Code.
   (2) An acute psychiatric hospital as defined in subdivision (b) of
Section 1250 of the Health and Safety Code.
   (3) A psychiatric health facility as defined by Section 1250.2 of
the Health and Safety Code operating pursuant to licensure by the
State Department of Social Services.
   Nothing in this subdivision prohibits an insurer which negotiates
and enters into a contract with a professional or institutional
provider for alternative rates of payment pursuant to Sections 10133
and 11512 of this code from restricting or modifying the choice of
providers.
   (b) Every insurer shall communicate to prospective group
policyholders as to the availability of outpatient coverage for the
treatment of mental or nervous disorders. Every insurer shall
communicate the availability of that coverage to all group
policyholders and to all prospective group policyholders with whom
they are negotiating. This coverage may include community residential
treatment services, as described in Section 5458 of the Welfare and
Institutions Code, which are alternatives to institutional care.
  SEC. 37.  Section 10127 of the Insurance Code is amended to read:
   10127.  On and after January 1, 1974, every self-insured employee
welfare benefit plan which provides coverage for hospital, medical,
or surgical expenses shall offer coverage for expenses incurred as a
result of mental or nervous disorders, under the terms and conditions
which may be agreed upon between the self-insured welfare benefit
plan and the member. If the terms and conditions include coverage for
services provided in a general acute care hospital, or an acute
psychiatric hospital as defined in Section 1250 of the Health and
Safety Code, and do not restrict or modify the choice of providers,
the coverage shall extend to care provided by a psychiatric health
facility, as defined by Section 1250.2 of the Health and Safety Code,
operating pursuant to licensure by the State Department of Social
Services. Every plan shall communicate to prospective members as to
the availability of outpatient coverage for the treatment of mental
or nervous disorders. Every self-insured welfare benefit plan shall
communicate the availability of this coverage to all members and
prospective members. This coverage may include community residential
treatment services, as described in Section 5458 of the Welfare and
Institutions Code, which are alternatives to institutional care.
  SEC. 38.  Section 12693.61 of the Insurance Code is amended to
read:
   12693.61.  The following provisions apply for subscribers who have
been identified by the participating health plans as potentially
seriously emotionally disturbed.
   (a) Participating plans, to the extent feasible, including plans
receiving purchasing credits shall develop memoranda of
understanding, consistent with criteria established by the board in
consultation with the State Department of Health Care Services, for
referral of subscribers who are seriously emotionally disturbed to a
county mental health department. This referral does not relieve a
participating plan from providing the mental health coverage
specified in its contract, including assessment of, and development
of, a treatment plan for serious emotional disturbance. Plans may
contract with county mental health departments to provide for all, or
a portion of, the services provided under the program's mental
health benefit.
   (b) The board shall establish an accounting process under which
counties providing services to subscribers who have been determined
to be seriously emotionally disturbed pursuant to Section 5600.3 of
the Welfare and Institutions Code can claim federal reimbursement for
the services. The board shall reimburse counties pursuant to the
rates set by the State Department of Health Care Services in
accordance with Sections 5705, 14705.7, 14705, 14708, 14711, and
14718 of the Welfare and Institutions Code. The actual amount
reimbursed by the board shall be the federal share of the cost of the
subscriber.
   (c) This section shall only become operative with federal approval
of the State Child Health Plan and the approval of federal financial
participation.
   (d) Counties choosing to enter into a memorandum of understanding
pursuant to subdivision (a) shall provide the nonfederal share of
cost for the subscriber.
  SEC. 39.  Section 21 of the Welfare and Institutions Code is
amended to read:
   21.  (a) Whenever any reference is made in any provision of this
code to the "State Department of Benefit Payments" or the "Department
of Benefit Payments" with respect to aid, it means the State
Department of Social Services.
   Whenever any reference is made to the "State Department of Benefit
Payments" or "Department of Benefit Payments" with respect to mental
disorders, it means the State Department of Health Care Services.
Whenever reference is made to the "State Department of Benefit
Payments" or "Department of Benefit Payments" with respect to
developmental disabilities, it means the State Department of
Developmental Services.
   (b) Whenever any reference is made in any provision of this code
to the "State Department of Health" or the "Department of Health"
with respect to health services, medical assistance, or benefits, it
means the State Department of Health Care Services or the State
Department of Public Health, as applicable.
   Whenever any reference is made to the "State Department of Health"
or the "Department of Health" with respect to mental disorders, it
means the State Department of Health Care Services. Whenever any
reference is made to the "State Department of Health" or "Department
of Health" in respect to developmental disabilities, it means the
State Department of Developmental Services.
   (c) Whenever any reference is made in any provision of this code
to the "Director of Benefit Payments" with respect to aid, it means
the Director of Social Services.
   Whenever any reference is made to the "Director of Benefit
Payments" with respect to mental disorders, it means the Director of
Health Care Services. Whenever any reference is made to the "Director
of Benefit Payments" with respect to developmental disabilities, it
means the Director of Developmental Services.
   (d) Whenever any reference is made in any provision of this code
to the "State Director of Health" or "Director of Health" with
respect to health services, medical assistance, or benefits, it means
the Director of Health Care Services.
   Whenever any reference is made to the "State Director of Health"
or "Director of Health" with respect to mental disorders, it means
the Director of Health Care Services. Whenever any reference is made
to the "State Director of Health" or "Director of Health" with
reference to developmental disabilities, it means the Director of
Developmental Services.
  SEC. 40.  Section 359 of the Welfare and Institutions Code is
amended to read:
   359.  Whenever a minor who appears to be a danger to himself or
others as a result of the use of narcotics (as defined in Section
11001 of the Health and Safety Code), or a restricted dangerous drug
(as defined in Section 11901 of the Health and Safety Code), is
brought before any judge of the juvenile court, the judge may
continue the hearing and proceed pursuant to this section. The court
may order the minor taken to a facility designated by the county and
approved by the State Department of Social Services as a facility for
72-hour treatment and evaluation. Thereupon the provisions of
Section 11922 of the Health and Safety Code shall apply, except that
the professional person in charge of the facility shall make a
written report to the court concerning the results of the evaluation
of the minor.
   If the professional person in charge of the facility for 72-hour
evaluation and treatment reports to the juvenile court that the minor
is not a danger to himself or others as a result of the use of
narcotics or restricted dangerous drugs or that the minor does not
require 14-day intensive treatment, or if the minor has been
certified for not more than 14 days of intensive treatment and the
certification is terminated, the minor shall be released if the
juvenile court proceedings have been dismissed; referred for further
care and treatment on a voluntary basis, subject to the disposition
of the juvenile court proceedings; or returned to the juvenile court,
in which event the court shall proceed with the case pursuant to
this chapter.
   Any expenditure for the evaluation or intensive treatment of a
minor under this section shall be considered an expenditure made
under Part 2 (commencing with Section 5600) of Division 5, and shall
be reimbursed by the state as are other local expenditures pursuant
to that part.
  SEC. 41.  Section 708 of the Welfare and Institutions Code is
amended to read:
   708.  Whenever a minor who appears to be a danger to himself or
herself or others as a result of the use of controlled substances (as
defined in Division 10 (commencing with Section 11000) of the Health
and Safety Code), is brought before any judge of the juvenile court,
the judge may continue the hearing and proceed pursuant to this
section. The court may order the minor taken to a facility designated
by the county and approved by the State Department of Social
Services as a facility for 72-hour treatment and evaluation.
Thereupon the provisions of Section 5343 of the Welfare and
Institutions Code shall apply, except that the professional person in
charge of the facility shall make a written report to the court
concerning the results of the evaluation of the minor.
   If the professional person in charge of the facility for 72-hour
evaluation and treatment reports to the juvenile court that the minor
is not a danger to himself or herself or others as a result of the
use of controlled substances or that the minor does not require
14-day intensive treatment, or if the minor has been certified for
not more than 14 days of intensive treatment and the certification is
terminated, the minor shall be released if the juvenile court
proceedings have been dismissed; referred for further care and
treatment on a voluntary basis, subject to the disposition of the
juvenile court proceedings; or returned to the juvenile court, in
which event the court shall proceed with the case pursuant to this
chapter.
   Any expenditure for the evaluation or intensive treatment of a
minor under this section shall be considered an expenditure made
under Part 2 (commencing with Section 5600) of Division 5, and shall
be reimbursed by the state as are other local expenditures pursuant
to that part.
  SEC. 42.  Section 4005.1 of the Welfare and Institutions Code is
amended to read:
   4005.1.  The State Department of State Hospitals, the State
Department of Health Care Services, and the State Department of
Social Services may adopt and enforce rules and regulations necessary
to carry out their respective duties under this division.
  SEC. 43.  Section 4005.6 is added to the Welfare and Institutions
Code, to read:
   4005.6.  All regulations heretofore adopted by the State
Department of Mental Health pursuant to authority vested in the State
Department of Health Care Services by Section 4005.1 and in effect
immediately preceding the operative date of the act that added this
section shall remain in effect and shall be fully enforceable unless
and until readopted, amended, or repealed by the Director of Health
Care Services.
  SEC. 44.  Section 4005.7 is added to the Welfare and Institutions
Code, to read:
   4005.7.  All regulations heretofore adopted by the State
Department of Mental Health pursuant to authority vested in the State
Department of Social Services by Section 4005.1 and in effect
immediately preceding the operative date of the act that added this
section shall remain in effect and shall be fully enforceable unless
and until readopted, amended, or repealed by the Director of Social
Services.
  SEC. 45.  Section 4011 of the Welfare and Institutions Code is
amended to read:
   4011.  The State Department of Health Care Services has
jurisdiction over the execution of the laws relating to the care,
custody, and treatment of mentally disordered persons only to the
extent and in the manner provided in this code. The State Department
of State Hospitals shall have jurisdiction over the execution of the
laws relating to care and treatment of the mentally ill individuals
under the custody of the State Department of State Hospitals.
   As used in this division, "establishment" and "institution"
include every hospital, sanitarium, boarding home, or other place
receiving or caring for mentally disordered persons.
  SEC. 46.  Section 4030 of the Welfare and Institutions Code is
amended to read:
   4030.  The Director of Health Care Services shall organize
appropriate staff of the department to ensure implementation of the
planning, research, evaluation, technical assistance, and quality
assurance responsibilities set forth in this chapter.
  SEC. 47.  Section 4031 of the Welfare and Institutions Code is
amended to read:
   4031.  The State Department of Health Care Services shall, to the
extent resources are available, do all of the following:
   (a) Conduct, sponsor, coordinate, and disseminate results of
research and evaluation directed to the public policy issues entailed
in the selection of resource utilization and service delivery in the
state.
   (b) Make available technical assistance to local mental health
programs incorporating the results of research, evaluation, and
quality assurance to local mental health programs.
   (c) Implement a system of required performance reporting by local
mental health programs.
   (d) Perform any other activities useful to improving and
maintaining the quality of community mental health programs.
  SEC. 48.  Section 4032 of the Welfare and Institutions Code is
amended to read:
   4032.  The State Department of Health Care Services shall, when
appropriate, give and receive grants and contracts for research,
evaluation, and quality assurance efforts.
  SEC. 49.  Section 4033 of the Welfare and Institutions Code is
amended to read:
   4033.  (a) The State Department of Health Care Services shall, to
the extent resources are available, comply with the Substance Abuse
and Mental Health Services Administration federal planning
requirements. The department shall update and issue a state plan,
which may also be any federally required state service plan, so that
citizens may be informed regarding the implementation of, and
long-range goals for, programs to serve mentally ill persons in the
state. The department shall gather information from counties
necessary to comply with this section.
   (b) (1) If the State Department of Health Care Services makes a
decision not to comply with any Substance Abuse and Mental Health
Services Administration federal planning requirement to which this
section applies, the State Department of Health Care Services shall
submit the decision, for consultation, to the California Mental
Health Directors Association, the California Mental Health Planning
Council, and affected mental health entities.
   (2) The State Department of Health Care Services shall not
implement any decision not to comply with the Substance Abuse and
Mental Health Services Administration federal planning requirements
sooner than 30 days after notification of that decision, in writing,
by the Department of Finance, to the chairperson of the committee in
each house of the Legislature which considers appropriations, and the
Chairperson of the Joint Legislative Budget Committee.
  SEC. 50.  Section 4040 of the Welfare and Institutions Code is
amended to read:
   4040.  The State Department of Health Care Services or State
Department of State Hospitals may conduct, or contract for, research
or evaluation studies that have application to mental health policy
and management issues. In selecting areas for study the department
shall be guided by the information needs of state and local
policymakers and managers, and suggestions from the California Mental
Health Directors Association.
  SEC. 51.  Section 4050 of the Welfare and Institutions Code is
amended to read:
   4050.  The State Department of Health Care Services shall provide,
to the extent resources are available, technical assistance, through
its own staff, or by contract, to county mental health programs and
other local mental health agencies in the areas of program
operations, research, evaluation, demonstration, or quality assurance
projects.
  SEC. 52.  Section 4051 of the Welfare and Institutions Code is
amended to read:
   4051.  The State Department of Health Care Services shall, to the
extent resources are available, provide program development
guidelines, evaluation models, and operational assistance on all
aspects of services to mentally ill persons of all ages. These
services include, but are not limited to, the following:
   (a) Self-help programs.
   (b) Housing development.
   (c) Disaster preparation.
   (d) Vocational services.
   (e) Regional programs.
   (f) Multiple diagnosis programs.
  SEC. 53.  Section 4052 of the Welfare and Institutions Code is
amended to read:
   4052.  The State Department of Health Care Services shall, to the
extent resources are available, provide training in performance
standards, model programs, cultural competency, and program
development.
  SEC. 54.  Section 4060 of the Welfare and Institutions Code is
amended to read:
   4060.  The State Department of Health Care Services shall, in
order to implement Section 4050, utilize a meaningful decisionmaking
process that includes local mental health directors and
representatives of local mental health boards as well as other
stakeholders as determined by the department. The purpose of this
collaboration shall be to promote effective and efficient quality
mental health services to the residents of the state under the
realigned mental health system.
  SEC. 55.  Section 4061 of the Welfare and Institutions Code is
amended to read:
   4061.  (a) The State Department of Health Care Services shall
utilize a joint state-county decisionmaking process to determine the
appropriate use of state and local training, technical assistance,
and regulatory resources to meet the mission and goals of the state's
mental health system. The department shall use the decisionmaking
collaborative process required by this section in all of the
following areas:
   (1) Providing technical assistance to personnel of the State
Department of Health Care Services and local mental health
departments through direction of existing state and local mental
health staff and other resources.
   (2) Analyzing mental health programs, policies, and procedures.
   (3) Providing forums on specific topics as they relate to the
following:
   (A) Identifying current level of services.
   (B) Evaluating existing needs and gaps in current services.
   (C) Developing strategies for achieving statewide goals and
objectives in the provision of services for the specific area.
   (D) Developing plans to accomplish the identified goals and
objectives.
   (4) Providing forums on policy development and direction with
respect to mental health program operations and clinical issues.
   (5) Identifying and funding a statewide training and technical
assistance entity jointly governed by local mental health directors
and mental health constituency representation, which can do all of
the following:
   (A) Coordinate state and local resources to support training and
technical assistance to promote quality mental health programs.
   (B) Coordinate training and technical assistance to ensure
efficient and effective program development.
   (C) Provide essential training and technical assistance, as
determined by the state-county decisionmaking process.
   (b) Local mental health board members shall be included in
discussions pursuant to Section 4060 when the following areas are
discussed:
   (1) Training and education program recommendations.
   (2) Establishment of statewide forums for all organizations and
individuals involved in mental health matters to meet and discuss
program and policy issues.
   (3) Distribution of information between the state, local programs,
local mental health boards, and other organizations as appropriate.
   (c) The State Department of Health Care Services and local mental
health departments may provide staff or other resources, including
travel reimbursement, for consultant and advisory services; for the
training of personnel, board members, or consumers and families in
state and local programs and in educational institutions and field
training centers approved by the department; and for the
establishment and maintenance of field training centers.
  SEC. 56.  The heading of Article 4 (commencing with Section 4070)
of Chapter 2 of Part 1 of Division 4 of the Welfare and Institutions
Code is repealed.
  SEC. 57.  Section 4070 of the Welfare and Institutions Code is
amended and renumbered to read:
   14725.  (a) The State Department of Health Care Services shall
develop a quality assurance program to govern the delivery of
Medi-Cal specialty mental health services, in order to assure quality
patient care based on community standards of practice.
   (b) The department shall issue standards and guidelines for local
quality assurance activities. These standards and guidelines shall be
reviewed and revised in consultation with the California Mental
Health Directors Association as well as other stakeholders
                               from the mental health community,
including, but not limited to, individuals who receive services,
family members, providers, mental health advocacy groups, and other
interested parties. The standards and guidelines shall be based on
federal Medicaid requirements.
   (c) The standards and guidelines developed by the department shall
reflect the special problems that small rural counties have in
undertaking comprehensive quality assurance systems.
  SEC. 58.  Section 4071 of the Welfare and Institutions Code is
amended and renumbered to read:
   14726.  The department shall approve each local program's initial
quality assurance plan, and shall thereafter review and approve each
program's Medi-Cal specialty mental health services quality assurance
plan whenever the plan is amended or changed.
  SEC. 59.  Article 1 (commencing with Section 4074) of Chapter 3 of
Part 1 of Division 4 of the Welfare and Institutions Code is
repealed.
  SEC. 60.  Article 2 (commencing with Section 4075) of Chapter 3 of
Part 1 of Division 4 of the Welfare and Institutions Code is
repealed.
  SEC. 61.  Section 4080 of the Welfare and Institutions Code is
amended to read:
   4080.  (a) Psychiatric health facilities, as defined in Section
1250.2 of the Health and Safety Code, shall only be licensed by the
State Department of Social Services subsequent to application by
counties, county contract providers, or other organizations pursuant
to this part.
   (b) (1) For counties or county contract providers that choose to
apply, the local mental health director shall first present to the
local mental health advisory board for its review an explanation of
the need for the facility and a description of the services to be
provided. The local mental health director shall then submit to the
governing body the explanation and description. The governing body,
upon its approval, may submit the application to the State Department
of Social Services.
   (2) Other organizations that will be applying for licensure and do
not intend to use any Bronzan-McCorquodale funds pursuant to Section
5707 shall submit to the local mental health director and the
governing body in the county in which the facility is to be located a
written and dated proposal of the services to be provided. The local
mental health director and governing body shall have 30 days during
which to provide any advice and recommendations regarding licensure,
as they deem appropriate. At any time after the 30-day period, the
organizations may then submit their applications, along with the
mental health director's and governing body's advice and
recommendations, if any, to the State Department of Social Services.
   (c) The State Fire Marshal and other appropriate state agencies,
to the extent required by law, shall cooperate fully with the State
Department of Social Services to ensure that the State Department of
Social Services approves or disapproves the licensure applications
not later than 90 days after the application submission by a county,
county contract provider, or other organization.
   (d) Every psychiatric health facility and program for which a
license has been issued shall be periodically inspected by a
multidisciplinary team appointed or designated by the State
Department of Social Services. The inspection shall be conducted no
less than once every two years and as often as necessary to ensure
the quality of care provided. During the inspections the review team
shall offer such advice and assistance to the psychiatric health
facility as it deems appropriate.
   (e) (1) The program aspects of a psychiatric health facility that
shall be reviewed and may be approved by the State Department of
Social Services shall include, but not be limited to:
   (A) Activities programs.
   (B) Administrative policies and procedures.
   (C) Admissions, including provisions for a mental evaluation.
   (D) Discharge planning.
   (E) Health records content.
   (F) Health records services.
   (G) Interdisciplinary treatment teams.
   (H) Nursing services.
   (I) Patient rights.
   (J) Pharmaceutical services.
   (K) Program space requirements.
   (L) Psychiatrist and clinical psychological services.
   (M) Rehabilitation services.
   (N) Restraint and seclusion.
   (O) Social work services.
   (P) Space, supplies, and equipment.
   (Q) Staffing standards.
   (R) Unusual occurrences.
   (S) Use of outside resources, including agreements with general
acute care hospitals.
   (T) Linguistic access and cultural competence.
   (U) Structured outpatient services to be provided under special
permit.
   (2) The State Department of Social Services has the sole authority
to grant program flexibility.
   (f) Commencing July 1, 2012, the State Department of Social
Services shall adopt regulations that shall include, but not be
limited to, all of the following:
   (1) Procedures by which the State Department of Social Services
shall review and may approve the program and facility requesting
licensure as a psychiatric health facility as being in compliance
with program standards established by the department.
   (2) Procedures by which the Director of Social Services shall
approve, or deny approval of, the program and facility licensed as a
psychiatric health facility pursuant to this section.
   (3) Provisions for site visits by the State Department of Social
Services for the purpose of reviewing a facility's compliance with
program and facility standards.
   (4) Provisions for the State Department of Social Services for any
administrative proceeding regarding denial, suspension, or
revocation of a psychiatric health facility license.
   (5) Procedures for the appeal of an administrative finding or
action pursuant to paragraph (4) of this subdivision and subdivision
(j).
   (g) Regulations shall be adopted by the State Department of Social
Services, which shall establish standards for pharmaceutical
services in psychiatric health facilities. Licensed psychiatric
health facilities shall be exempt from requirements to obtain a
separate pharmacy license or permit.
   (h) (1) It is the intent of the Legislature that the State
Department of Social Services shall license the facility in order to
establish innovative and more competitive and specialized acute care
services.
   (2) The State Department of Social Services shall review and may
approve the program aspects of public or private facilities, with the
exception of those facilities that are federally certified or
accredited by a nationally recognized commission that accredits
health care facilities, only if the average per diem charges or costs
of service provided in the facility is approximately 60 percent of
the average per diem charges or costs of similar psychiatric services
provided in a general hospital.
   (3) (A) When a private facility is accredited by a nationally
recognized commission that accredits health care facilities, the
State Department of Social Services shall review and may approve the
program aspects only if the average per diem charges or costs of
service provided in the facility do not exceed approximately 75
percent of the average per diem charges or costs of similar
psychiatric service provided in a psychiatric or general hospital.
   (B) When a private facility serves county patients, the State
Department of Social Services shall review and may approve the
program aspects only if the facility is federally certified by the
federal Centers for Medicare and Medicaid Services and serves a
population mix that includes a proportion of Medi-Cal patients
sufficient to project an overall cost savings to the county, and the
average per diem charges or costs of service provided in the facility
do not exceed approximately 75 percent of the average per diem
charges or costs of similar psychiatric service provided in a
psychiatric or general hospital.
   (4) When a public facility is federally certified by the federal
Centers for Medicare and Medicaid Services and serves a population
mix that includes a proportion of Medi-Cal patients sufficient to
project an overall program cost savings with certification, the State
Department of Social Services shall approve the program aspects only
if the average per diem charges or costs of service provided in the
facility do not exceed approximately 75 percent of the average per
diem charges or costs of similar psychiatric service provided in a
psychiatric or general hospital.
   (5) (A) The State Department of Health Care Services may set a
lower rate for private or public facilities than that required by
paragraph (3) or paragraph (4), respectively if so required by the
federal Centers for Medicare and Medicaid Services as a condition for
the receipt of federal matching funds.
   (B) This section does not impose any obligation on any private
facility to contract with a county for the provision of services to
Medi-Cal beneficiaries, and any contract for that purpose is subject
to the agreement of the participating facility.
   (6) (A) In using the guidelines specified in this subdivision, the
State Department of Social Services shall take into account local
conditions affecting the costs or charges.
   (B) In those psychiatric health facilities authorized by special
permit to offer structured outpatient services not exceeding 10
daytime hours, the following limits on per diem rates shall apply:
   (i) The per diem charge for patients in both a morning and an
afternoon program on the same day shall not exceed 60 percent of the
facility's authorized per diem charge for inpatient services.
   (ii) The per diem charge for patients in either a morning or
afternoon program shall not exceed 30 percent of the facility's
authorized per diem charge for inpatient services.
   (i) The licensing fees charged for these facilities shall be
credited to the State Department of Social Services for its costs
incurred in the review of psychiatric health facility programs, in
connection with the licensing of these facilities.
   (j) (1) The State Department of Social Services shall establish a
system for the imposition of prompt and effective civil sanctions
against psychiatric health facilities in violation of the laws and
regulations of this state pertaining to psychiatric health
facilities. If the State Department of Social Services determines
that there is or has been a failure, in a substantial manner, on the
part of a psychiatric health facility to comply with the laws and
regulations, the Director of Social Services may impose the following
sanctions:
   (A) Cease and desist orders.
   (B) Monetary sanctions, which may be imposed in addition to the
penalties of suspension, revocation, or cease and desist orders. The
amount of monetary sanctions permitted to be imposed pursuant to this
subparagraph shall not be less than fifty dollars ($50) nor more
than one hundred dollars ($100) multiplied by the licensed bed
capacity, per day, for each violation. However, the monetary sanction
shall not exceed three thousand dollars ($3,000) per day. A facility
that is assessed a monetary sanction under this subparagraph, and
that repeats the deficiency, may, in accordance with the regulations
adopted pursuant to this subdivision, be subject to immediate
suspension of its license until the deficiency is corrected.
   (2) The State Department of Social Services shall adopt
regulations necessary to implement this subdivision and paragraph (5)
of subdivision (f) in accordance with the Administrative Procedure
Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of
Division 3 of Title 2 of the Government Code).
   (k) Proposed changes in the standards or regulations affecting
health facilities that serve the mentally disordered shall be
effected only with the review and coordination of the California
Health and Human Services Agency.
   (l) In psychiatric health facilities where the clinical director
is not a physician, a psychiatrist, or if one is temporarily not
available, a physician shall be designated who shall direct those
medical treatments and services that can only be provided by, or
under the direction of, a physician.
  SEC. 62.  Section 4090 of the Welfare and Institutions Code is
amended to read:
   4090.  (a) The State Department of Health Care Services shall
establish, by regulation, standards for the programs listed in
Chapter 2.5 (commencing with Section 5670) of Part 2 of Division 5.
These standards shall also be applied by the department to any
facility licensed as a social rehabilitation facility pursuant to
paragraph (7) of subdivision (a) of Section 1502 of the Health and
Safety Code.
   (b) In establishing the standards required by this section, the
department shall not establish standards which in themselves impose
any new or increased costs on the programs or facilities affected by
the standards.
  SEC. 63.  Section 4091 of the Welfare and Institutions Code is
amended to read:
   4091.  Nothing in Section 4090 limits the authority of the State
Department of Health Care Services to delegate the evaluation and
enforcement of the program standards to a county mental health
program when a licensed social rehabilitation facility has a
contractual relationship with a county mental health program and the
county has requested the delegation.
  SEC. 64.  Section 4094 of the Welfare and Institutions Code is
amended to read:
   4094.  (a) The State Department of Mental Health shall establish,
by regulations adopted at the earliest possible date, but no later
than December 31, 1994, program standards for any facility licensed
as a community treatment facility. This section shall apply only to
community treatment facilities described in this subdivision.
   (b) Commencing July 1, 2012, the State Department of Health Care
Services may adopt or amend regulations pertaining to the program
standards for any facility licensed as a community treatment
facility.
   (c) A certification of compliance issued by the State Department
of Health Care Services shall be a condition of licensure for the
community treatment facility by the State Department of Social
Services. The department may, upon the request of a county, delegate
the certification and supervision of a community treatment facility
to the county department of mental health.
   (d) The State Department of Health Care Services shall adopt
regulations to include, but not be limited to, the following:
   (1) Procedures by which the Director of Health Care Services shall
certify that a facility requesting licensure as a community
treatment facility pursuant to Chapter 3 (commencing with Section
1500) of Division 2 of the Health and Safety Code is in compliance
with program standards established pursuant to this section.
   (2) Procedures by which the Director of Health Care Services shall
deny a certification to a facility or decertify a facility that is
licensed as a community treatment facility pursuant to Chapter 3
(commencing with Section 1500) of Division 2 of the Health and Safety
Code, but no longer complying with program standards established
pursuant to this section, in accordance with Chapter 5 (commencing
with Section 11500) of Part 1 of Division 3 of Title 2 of the
Government Code.
   (3) Provisions for site visits by the State Department of Health
Care Services for the purpose of reviewing a facility's compliance
with program standards established pursuant to this section.
   (4) Provisions for the community care licensing staff of the State
Department of Social Services to report to the State Department of
Health Care Services when there is reasonable cause to believe that a
community treatment facility is not in compliance with program
standards established pursuant to this section.
   (5) Provisions for the State Department of Health Care Services to
provide consultation and documentation to the State Department of
Social Services in any administrative proceeding regarding denial,
suspension, or revocation of a community treatment facility license.
   (e) The standards adopted by regulations pursuant to subdivisions
(a) and (b) shall include, but not be limited to, standards for
treatment, staffing, and for the use of psychotropic medication,
discipline, and restraints in the facilities. The standards shall
also meet the requirements of Section 4094.5.
   (f) (1) Until January 1, 2014, all of the following are
applicable:
   (A) A community treatment facility shall not be required by the
State Department of Health Care Services to have 24-hour onsite
licensed nursing staff, but shall retain at least one full-time, or
full-time-equivalent, registered nurse onsite if both of the
following are applicable:
   (i) The facility does not use mechanical restraint.
   (ii) The facility only admits children who have been assessed, at
the point of admission, by a licensed primary care provider and a
licensed psychiatrist, who have concluded, with respect to each
child, that the child does not require medical services that require
24-hour nursing coverage. For purposes of this section, a "primary
care provider" includes a person defined in Section 14254, or a nurse
practitioner who has the responsibility for providing initial and
primary care to patients, for maintaining the continuity of care, and
for initiating referral for specialist care.
   (B) Other medical or nursing staff shall be available on call to
provide appropriate services, when necessary, within one hour.
   (C) All direct care staff shall be trained in first aid and
cardiopulmonary resuscitation, and in emergency intervention
techniques and methods approved by the Community Care Licensing
Division of the State Department of Social Services.
   (2) The State Department of Health Care Services may adopt
emergency regulations as necessary to implement this subdivision. The
adoption of these regulations shall be deemed to be an emergency and
necessary for the immediate preservation of the public peace, health
and safety, and general welfare. The regulations shall be exempt
from review by the Office of Administrative Law and shall become
effective immediately upon filing with the Secretary of State. The
regulations shall not remain in effect more than 180 days unless the
adopting agency complies with all the provisions of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code, as required by subdivision (e) of Section
11346.1 of the Government Code.
   (g) During the initial public comment period for the adoption of
the regulations required by this section, the community care facility
licensing regulations proposed by the State Department of Social
Services and the program standards proposed by the State Department
of Health Care Services shall be presented simultaneously.
   (h) A minor shall be admitted to a community treatment facility
only if the requirements of Section 4094.5 and either of the
following conditions are met:
   (1) The minor is within the jurisdiction of the juvenile court,
and has made voluntary application for mental health services
pursuant to Section 6552.
   (2) Informed consent is given by a parent, guardian, conservator,
or other person having custody of the minor.
   (i) Any minor admitted to a community treatment facility shall
have the same due process rights afforded to a minor who may be
admitted to a state hospital, pursuant to the holding in In re Roger
S. (1977) 19 Cal.3d 921. Minors who are wards or dependents of the
court and to whom this subdivision applies shall be afforded due
process in accordance with Section 6552 and related case law,
including In re Michael E. (1975) 15 Cal.3d 183. Regulations adopted
pursuant to Section 4094 shall specify the procedures for ensuring
these rights, including provisions for notification of rights and the
time and place of hearings.
   (j) Notwithstanding Section 13340 of the Government Code, the sum
of forty-five thousand dollars ($45,000) is hereby appropriated
annually from the General Fund to the State Department of Health Care
Services for one personnel year to carry out the provisions of this
section.
  SEC. 65.  Section 4094.1 of the Welfare and Institutions Code is
amended to read:
   4094.1.  The State Department of Health Care Services and the
State Department of Social Services, in consultation with community
treatment providers, local mental health departments, and county
welfare departments, shall develop joint protocols for the oversight
of community treatment facilities.
  SEC. 66.  Section 4094.2 of the Welfare and Institutions Code is
amended to read:
   4094.2.  (a) For the purpose of establishing payment rates for
community treatment facility programs, the private nonprofit agencies
selected to operate these programs shall prepare a budget that
covers the total costs of providing residential care and supervision
and mental health services for their proposed programs. These costs
shall include categories that are allowable under California's Foster
Care program and existing programs for mental health services. They
shall not include educational, nonmental health medical, and dental
costs.
   (b) Each agency operating a community treatment facility program
shall negotiate a final budget with the local mental health
department in the county in which its facility is located (the host
county) and other local agencies, as appropriate. This budget
agreement shall specify the types and level of care and services to
be provided by the community treatment facility program and a payment
rate that fully covers the costs included in the negotiated budget.
All counties that place children in a community treatment facility
program shall make payments using the budget agreement negotiated by
the community treatment facility provider and the host county.
   (c) A foster care rate shall be established for each community
treatment facility program by the State Department of Social
Services. These rates shall be established using the existing foster
care ratesetting system for group homes, with modifications designed
as necessary. It is anticipated that all community treatment facility
programs will offer the level of care and services required to
receive the highest foster care rate provided for under the current
group home ratesetting system.
   (d) For the 2001-02 fiscal year, the 2002-03 fiscal year, the
2003-04 fiscal year, and the 2004-05 fiscal year, community treatment
facility programs shall also be paid a community treatment facility
supplemental rate of up to two thousand five hundred dollars ($2,500)
per child per month on behalf of children eligible under the foster
care program and children placed out of home pursuant to an
individualized education program developed under Section 7572.5 of
the Government Code. Subject to the availability of funds, the
supplemental rate shall be shared by the state and the counties.
Counties shall be responsible for paying a county share of cost equal
to 60 percent of the community treatment rate for children placed by
counties in community treatment facilities and the state shall be
responsible for 40 percent of the community treatment facility
supplemental rate. The community treatment facility supplemental rate
is intended to supplement, and not to supplant, the payments for
which children placed in community treatment facilities are eligible
to receive under the foster care program and the existing programs
for mental health services.
   (e) For initial ratesetting purposes for community treatment
facility funding, the cost of mental health services shall be
determined by deducting the foster care rate and the community
treatment facility supplemental rate from the total allowable cost of
the community treatment facility program. Payments to certified
providers for mental health services shall be based on eligible
services provided to children who are Medi-Cal beneficiaries, up to
the approved federal rate for these services.
   (f) The State Department of Health Care Services shall provide the
community treatment facility supplemental rates to the counties for
advanced payment to the community treatment facility providers in the
same manner as the regular foster care payment and within the same
required payment time limits.
   (g) In order to facilitate the study of the costs of community
treatment facilities, licensed community treatment facilities shall
provide all documents regarding facility operations, treatment, and
placements requested by the department.
   (h) It is the intent of the Legislature that the State Department
of Health Care Services and the State Department of Social Services
work to maximize federal financial participation in funding for
children placed in community treatment facilities through funds
available pursuant to Titles IV-E and XIX of the federal Social
Security Act (Title 42 U.S.C. Sec. 670 et seq. and Sec. 1396 et seq.)
and other appropriate federal programs.
   (i) The State Department of Health Care Services and the State
Department of Social Services may adopt emergency regulations
necessary to implement joint protocols for the oversight of community
treatment facilities, to modify existing licensing regulations
governing reporting requirements and other procedural and
administrative mandates to take into account the seriousness and
frequency of behaviors that are likely to be exhibited by the
seriously emotionally disturbed children placed in community
treatment facility programs, to modify the existing foster care
ratesetting regulations, and to pay the community treatment facility
supplemental rate. The adoption of these regulations shall be deemed
to be an emergency and necessary for the immediate preservation of
the public peace, health and safety, and general welfare. The
regulations shall become effective immediately upon filing with the
Secretary of State. The regulations shall not remain in effect more
than 180 days unless the adopting agency complies with all the
provisions of Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code, as required by
subdivision (e) of Section 11346.1 of the Government Code.
  SEC. 67.  Section 4094.7 of the Welfare and Institutions Code is
amended to read:
   4094.7.  (a) A community treatment facility may have both secure
and nonsecure beds. However, the State Department of Health Care
Services shall limit the total number of beds in community treatment
facilities to not more than 400 statewide. The State Department of
Health Care Services shall certify community treatment facilities in
such a manner as to ensure an adequate dispersal of these facilities
within the state. The State Department of Health Care Services shall
ensure that there is at least one facility in each of the State
Department of Social Services' four regional licensing divisions.

          (b) The State Department of Health Care Services shall
notify the State Department of Social Services when a facility has
been certified and has met the program standards pursuant to Section
4094. The State Department of Social Services shall license a
community treatment facility for a specified number of secure beds
and a specified number of nonsecure beds. The number of secure and
nonsecure beds in a facility shall be modified only with the approval
of both the State Department of Social Services and the State
Department of Health Care Services.
   (c) The State Department of Health Care Services shall develop,
with the advice of the State Department of Social Services, county
representatives, providers, and interested parties, the criteria to
be used to determine which programs among applicant providers shall
be licensed. The State Department of Health Care Services shall
determine which agencies best meet the criteria, certify them in
accordance with Section 4094, and refer them to the State Department
of Social Services for licensure.
   (d) Any community treatment facility proposing to serve seriously
emotionally disturbed foster children shall be incorporated as a
nonprofit organization.
  SEC. 68.  Section 4095 of the Welfare and Institutions Code is
amended to read:
   4095.  (a) It is the intent of the Legislature that essential and
culturally relevant mental health assessment, case management, and
treatment services be available to wards of the court and dependent
children of the court placed out of home or who are at risk of
requiring out-of-home care. This can be best achieved at the
community level through the active collaboration of county social
service, probation, education, mental health agencies, and foster
care providers.
   (b) Therefore, using the Children's Mental Health Services Act
(Part 4 (commencing with Section 5850) of Division 5) as a guideline,
the State Department of Health Care Services, in consultation with
the California Mental Health Directors Association, the State
Department of Social Services, the County Welfare Directors
Association, the Chief Probation Officers of California, county
alcohol and drug program administrators, and foster care providers,
shall do all of the following:
   (1) By July 1, 1994, develop an individualized mental health
treatment needs assessment protocol for wards of the court and
dependent children of the court.
   (2) Define supplemental services to be made available to the
target population, including, but not limited to, services defined in
Section 540 and following of Title 9 of the California Code of
Regulations as of January 1, 1994, family therapy, prevocational
services, and crisis support activities.
   (3) Establish statewide standardized rates for the various types
of services defined by the department in accordance with paragraph
(2), and provided pursuant to this section. The rates shall be
designed to reduce the impact of competition for scarce treatment
resources on the cost and availability of care. The rates shall be
implemented only when the state provides funding for the services
described in this section.
   (4) By January 1, 1994, to the extent state funds are available to
implement this section, establish, by regulation, all of the
following:
   (A) Definitions of priority ranking of subsets of the court wards
and dependents target population.
   (B) A procedure to certify the mental health programs.
   (c) (1) Only those individuals within the target population as
defined in regulation and determined to be eligible for services as a
result of a mental health treatment needs assessment may receive
services pursuant to this section.
   (2) Allocation of funds appropriated for the purposes of this
section shall be based on the number of wards and dependents and may
be adjusted in subsequent fiscal years to reflect costs.
   (3) The counties shall be held harmless for failure to provide any
assessment, case management, and treatment services to those
children identified in need of services for whom there is no funding.

   (d) (1) The State Department of Health Care Services shall make
information available to the Legislature, on request, on the service
populations provided mental health treatment services pursuant to
this section, the types and costs of services provided, and the
number of children identified in need of treatment services who did
not receive the services.
   (2) The information required by paragraph (1) may include
information on need, cost, and service impact experience from the
following:
   (A) Family preservation pilot programs.
   (B) Pilot programs implemented under the former Children's Mental
Health Services Act, as contained in Chapter 6.8 (commencing with
Section 5565.10) of Part 1 of Division 5.
   (C) Programs implemented under Chapter 26 (commencing with Section
7570) of Division 7 of Title 1 of the Government Code and Section
11401.
   (D) County experience in the implementation of Section 4096.
  SEC. 69.  Section 4096.5 of the Welfare and Institutions Code is
amended to read:
   4096.5.  (a) The State Department of Health Care Services shall
make a determination, within 45 days of receiving a request from a
group home to be classified at RCL 13 or RCL 14 pursuant to Section
11462.01, to certify or deny certification that the group home
program includes provisions for mental health treatment services that
meet the needs of seriously emotionally disturbed children. The
department shall issue each certification for a period of one year
and shall specify the effective date the program met the
certification requirements. A program may be recertified if the
program continues to meet the criteria for certification.
   (b) The State Department of Health Care Services shall, in
consultation with the California Mental Health Directors Association
and representatives of provider organizations, develop the criteria
for the certification required by subdivision (a) by July 1, 1992.
   (c) (1) The State Department of Health Care Services may, upon the
request of a county, delegate to that county the certification task.

   (2) Any county to which the certification task is delegated
pursuant to paragraph (1) shall use the criteria and format developed
by the department.
   (d) The State Department of Health Care Services or delegated
county shall notify the State Department of Social Services Community
Care Licensing Division immediately upon the termination of any
certification issued in accordance with subdivision (a).
  SEC. 70.  Chapter 5 (commencing with Section 4097) of Part 1 of
Division 4 of the Welfare and Institutions Code is repealed.
  SEC. 71.  Section 4098.2 of the Welfare and Institutions Code is
amended to read:
   4098.2.  (a) The State Department of Health Care Services,
contingent upon appropriation in the annual Budget Act, may establish
and implement a suicide prevention, education, and gatekeeper
training program to reduce the severity, duration, and incidence of
suicidal behaviors.
   (b) In developing and implementing the components of this program,
the department shall build upon the existing network of nonprofit
suicide prevention programs in the state, and shall utilize the
expertise of existing suicide prevention programs that meet any of
the following criteria:
   (1) Have been identified by a county as providing suicide
prevention services for that county.
   (2) Are certified by the American Association of Suicidology.
   (3) Meet criteria for suicide prevention programs that may be
established by the department.
   (c) The program established by this section shall be consistent
with the public health model proposed by the Surgeon General of the
United States, and the system of care approach pursuant to the
Bronzan-McCorquodale Act (Part 2 (commencing with Section 5600) of
Division 5).
  SEC. 72.  Section 4340 of the Welfare and Institutions Code is
amended to read:
   4340.  The State Department of Health Care Services may maintain a
statewide mental health prevention program directed toward a
reduction in the need for utilization of the treatment system and the
development and strengthening of community support and self-help
networks. The State Department of State Hospitals may support the
establishment of self-help groups, which may be facilitated by an
outside entity, subject to the approval of the hospital
administrator, at state hospitals.
  SEC. 73.  Section 4369.4 of the Welfare and Institutions Code is
amended to read:
   4369.4.  All state agencies, including, but not limited to, the
California Horse Racing Board, the California Gambling Control
Commission, the Department of Justice, and any other agency that
regulates casino gambling or cardrooms within the state, and the
Department of Corrections and Rehabilitation, the Department of
Corrections and Rehabilitation, Division of Juvenile Justice, the
State Department of Health Care Services, State Department of Alcohol
and Drug Programs, and the California State Lottery, shall
coordinate with the office to ensure that state programs take into
account, as much as practicable, problem and pathological gamblers.
The office shall also coordinate and work with other entities
involved in gambling and the treatment of problem and pathological
gamblers.
  SEC. 74.  Section 4681 of the Welfare and Institutions Code is
amended to read:
   4681.  By July 1, 1977, and each year thereafter, the State
Department of Developmental Services shall establish rates, which
shall be reviewed by the state council. Such rates shall annually be
proposed to the Legislature by March 1 and shall be operative on July
1 of each year, subject to the appropriation of sufficient funds for
such purpose in the Budget Act. In reviewing the sufficiency of
these rates that is required by March 1, 1985, the department shall
take into account the findings and recommendations of the study
conducted by the State Council on Developmental Disabilities pursuant
to Section 4541.
   In establishing rates to be paid for out-of-home care, the
department shall include each of the cost elements in this section as
follows:
   (a) Rates established for all facilities shall include an adequate
amount to care for "basic living needs" of a person with
developmental disabilities. "Basic living needs" are defined to
include housing (shelter, utilities, and furnishings), food, and
personal care. The amount required for basic living needs shall be
calculated each year as the average cost of an additional normal
child, of the ages of 12 to 17, inclusive, living at home. The amount
for basic living needs shall be adjusted depending on the size of
the out-of-home facility. These amounts shall be adjusted annually to
reflect cost-of-living changes. A redetermination of basic living
costs shall be undertaken every three years by the State Department
of Developmental Services, using the best available estimating
methods.
   (b) Rates established for all facilities that provide direct
supervision for persons with developmental disabilities shall include
an amount for "direct supervision." The cost of "direct supervision"
shall reflect the ability of the persons in the facility to function
with minimal, moderate, or intensive supervision. Minimal
supervision means that a developmentally disabled person needs the
assistance of other persons with certain daily activities. Moderate
supervision means that a developmentally disabled person needs the
assistance of other persons with daily activities most of the time.
Intensive supervision means that all the personal and physical needs
of a developmentally disabled person are provided by other persons.
The individual program plan developed pursuant to Section 4646 shall
determine the amount of "direct supervision" required for each
individual. The cost of "direct supervision" is calculated as the
wage costs of care-giving staff depending on the needs of the person
with developmental disabilities. These rates shall be adjusted
annually to reflect wage changes and shall comply with all federal
regulations for hospitals and residential-care establishments under
provisions of the federal Fair Labor Standards Act.
   (c) Rates established for all facilities that provide "special
services" for persons with developmental disabilities shall include
an amount to pay for these "special services" for each person
receiving special services. "Special services" include medical and
dental care and therapeutic, educational, training, or other services
required in the individual program plan of each person. Facilities
shall be paid for providing special services for each individual to
the extent that such services are specified in the person's
individual program plan and the facility is designated provider of
those special services. Rates of payment for special services shall
be the same as prevailing rates paid for similar services in the
area.
   (d) To the extent applicable, rates established for facilities
shall include a reasonable amount for "unallocated services." Such
costs shall be determined using generally accepted accounting
principles. "Unallocated services" means the indirect costs of
managing a facility and includes costs of managerial personnel,
facility operation, maintenance and repair, employee benefits, taxes,
interest, insurance, depreciation, and general and administrative
support. If a facility serves other persons in addition to
developmentally disabled persons, unallocated services expenses shall
be reimbursed under the provision of this section, only for the
proportion of the costs associated with the care of developmentally
disabled persons.
   (e) Rates established for facilities shall include an amount to
reimburse facilities for the depreciation of "mandated capital
improvements and equipment" as established in the state's uniform
accounting manual. For purposes of this section, "mandated capital
improvements and equipment" are only those remodeling and equipment
costs incurred by a facility because an agency of government has
required such remodeling or equipment as a condition for the use of
the facility as a provider of out-of-home care to persons with
developmental disabilities.
   (f) When applicable, rates established for proprietary facilities
shall include a reasonable "proprietary fee."
   (g) Rates established for all facilities shall include as a
"factor" an amount to reflect differences in the cost of living for
different geographic areas in the state.
   (h) Rates established for developmentally disabled persons who are
also mentally disordered may be fixed at a higher rate. The higher
rate for developmentally disabled persons who are also mentally
disordered may be paid when requested by the director of the regional
center and approved by the Director of Developmental Services.
   This section shall apply to rates for facilities not participating
in the alternative residential care rate model originally authorized
in Item 4300-101-001 of the Budget Act of 1985, and as identified in
the department's report of April 1987 entitled Alternative
Residential Model (ARM).
   (i) Except as provided in subdivision (j), this section shall
remain in effect only until January 1, 1991, and as of that date is
repealed, unless a later enacted statute, which is enacted before
January 1, 1991, deletes or extends that date.
   (j) This section shall not be repealed until the State Department
of Developmental Services achieves statewide implementation of the
Alternative Residential Model.
  SEC. 75.  Section 4681.1 of the Welfare and Institutions Code is
amended to read:
   4681.1.  (a) The department shall adopt regulations that specify
rates for community care facilities serving persons with
developmental disabilities. The implementation of the regulations
shall be contingent upon an appropriation in the annual Budget Act
for this purpose. These rates shall be calculated on the basis of a
cost model designed by the department which ensures that aggregate
facility payments support the provision of services to each person in
accordance with his or her individual program plan and applicable
program requirements. The cost model shall reflect cost elements that
shall include, but are not limited to, all of the following:
   (1) "Basic living needs" include utilities, furnishings, food,
supplies, incidental transportation, housekeeping, personal care
items, and other items necessary to ensure a quality environment for
persons with developmental disabilities. The amount identified for
the basic living needs element of the rate shall be calculated as the
average projected cost of these items in an economically and
efficiently operated community care facility.
   (2) "Direct care" includes salaries, wages, benefits, and other
expenses necessary to supervise or support the person's functioning
in the areas of self-care and daily living skills, physical
coordination mobility, and behavioral self-control, choice making,
and integration. The amount identified for direct care shall be
calculated as the average projected cost of providing the level of
service required to meet each person's functional needs in an
economically and efficiently operated community care facility. The
direct care portion of the rate shall reflect specific service levels
defined by the department on the basis of relative resident need and
the individual program plan.
   (3) "Special services" include specialized training, treatment,
supervision, or other services which a person's individual program
plan requires to be provided by the residential facility in addition
to the direct care provided under paragraph (2). The amount
identified for special services shall be calculated for each
individual based on the additional services specified in the person's
individual program plan and the prevailing rates paid for similar
services in the area. The special services portion of the rate shall
reflect a negotiated agreement between the facility and the regional
center in accordance with Section 4648.
   (4) "Indirect costs" include managerial personnel, facility
operation, maintenance and repair, other nondirect care, employee
benefits, contracts, training, travel, licenses, taxes, interest,
insurance, depreciation, and general administrative expenses. The
amount identified for indirect costs shall be calculated as the
average projected cost for these expenses in an economically and
efficiently operated community care facility.
   (5) "Property costs" include mortgages, leases, rent, taxes,
capital or leasehold improvements, depreciation, and other expenses
related to the physical structure. The amount identified for property
costs shall be based on the fair rental value of a model facility
which is adequately designed, constructed, and maintained to meet the
needs of persons with developmental disabilities. The amount
identified for property costs shall be calculated as the average
projected fair rental value of an economically and efficiently
operated community care facility.
   (b) The cost model shall take into account factors which include,
but are not limited to, all of the following:
   (1) Facility size, as defined by the department on the basis of
the number of facility beds licensed by the State Department of
Social Services and vendorized by the regional center.
   (2) Specific geographic areas, as defined by the department on the
basis of cost of living and other pertinent economic indicators.
   (3) Common levels of direct care, as defined by the department on
the basis of services specific to an identifiable group of persons as
determined through the individual program plan.
   (4) Positive outcomes, as defined by the department on the basis
of increased integration, independence, and productivity at the
aggregate facility and individual consumer level.
   (5) Owner-operated and staff-operated reimbursement which shall,
not differ for facilities that are required to comply with the same
program requirements.
   (c) The rates established for individual community care facilities
serving persons with developmental disabilities shall reflect all of
the model cost elements and rate development factors described in
this section. The cost model design shall include a process for
updating the cost model elements that address variables, including,
but not limited to, all of the following:
   (1) Economic trends in California.
   (2) New state or federal program requirements.
   (3) Changes in the state or federal minimum wage.
   (4) Increases in fees, taxes, or other business costs.
   (5) Increases in federal supplemental security income/state
supplementary program for the aged, blind, and disabled payments.
   (d) Rates established for developmentally disabled persons who are
also dually diagnosed with a mental disorder may be fixed at a
higher rate. The department shall work with the State Department of
Health Care Services to establish criteria upon which higher rates
may be fixed pursuant to this subdivision. The higher rate for
developmentally disabled persons who are also dually diagnosed with a
mental disorder may be paid when requested by the director of the
regional center and approved by the Director of Developmental
Services.
   (e) By January 1, 2001, the department shall prepare proposed
regulations to implement the changes outlined in this section. The
department may use a private firm to assist in the development of
these changes and shall confer with consumers, providers, and other
interested parties concerning the proposed regulations. By May 15,
2001, and each year thereafter, the department shall provide the
Legislature with annual community care facility rates, including any
draft amendments to the regulations as required. By July 1, 2001, and
each year thereafter, contingent upon an appropriation in the annual
Budget Act for this purpose, the department shall adopt emergency
regulations which establish the annual rates for community care
facilities serving persons with developmental disabilities for each
fiscal year.
   (f) During the first year of operation under the revised rate
model, individual facilities shall be held harmless for any reduction
in aggregate facility payments caused solely by the change in
reimbursement methodology.
  SEC. 76.  Section 4696.1 of the Welfare and Institutions Code is
amended to read:
   4696.1.  (a) The Legislature finds and declares that improved
cooperative efforts between regional centers and county mental health
agencies are necessary in order to achieve each of the following:
   (1) Increased leadership, communication, and organizational
effectiveness between regional centers and county mental health
agencies.
   (2) Decreased costs and minimized fiscal risk in serving persons
who are dually diagnosed with mental illness and developmental
disabilities.
   (3) Continuity of services.
   (4) Improved quality of mental health outcomes for persons who are
dually diagnosed.
   (5) Optimized utilization of agency resources by building on the
strengths of each organization.
   (6) Timely resolution of conflicts.
   (b) In order to achieve the outcomes specified in subdivision (a),
by July 1, 1999, each regional center and county mental health
agency shall develop a memorandum of understanding to do all of the
following:
   (1) Identify staff who will be responsible for all of the
following:
   (A) Coordinate service activity between the two agencies.
   (B) Identify dually diagnosed consumers of mutual concern.
   (C) Conduct problem resolution for those consumers serviced by
both systems.
   (2) Develop a general plan for crisis intervention for persons
served by both systems. The plan shall include after-hours emergency
response systems, interagency notification guidelines, and followup
protocols.
   (3) Develop a procedure by which each dually diagnosed consumer
shall be the subject of a case conference conducted jointly by both
regional center staff and county mental health as soon as possible
after admission into a county operated or contracted acute, inpatient
mental health facility. The case conference shall confirm the
diagnosis and the treatment plan.
   (4) Develop a procedure by which planning for dually diagnosed
consumers admitted to a mental health inpatient facility shall be
conducted collaboratively by both the regional center and the local
mental health agency and shall commence as soon as possible or as
deemed appropriate by the treatment staff. The discharge plan shall
include subsequent treatment needs and the agency responsible for
those services.
   (5) Develop a procedure by which regional center staff and county
mental health staff shall collaborate to plan and provide training to
community service providers, including day programs, residential
facilities, and intermediate care facilities, regarding effective
services to persons who are dually diagnosed. This training shall
include crisis prevention with a focus on proactively recognizing
crisis and intervening effectively with consumers who are dually
diagnosed.
   (6) Develop a procedure by which the regional center and the
county mental health agency shall work toward agreement on a
consumer-by-consumer basis on the presenting diagnosis and medical
necessity, as defined by regulations of the State Department of
Health Care Services.
   (c) The department and the State Department of Health Care
Services shall collaborate to provide a statewide perspective and
technical assistance to local service regions when local problem
resolution mechanisms have been exhausted and state level
participation has been requested by both local agencies.
   (d) The director of the local regional center and the director of
the county mental health agency or their designees shall meet as
needed but no less than annually to do all of the following:
   (1) Review the effectiveness of the interagency collaboration.
   (2) Address any outstanding policy issues between the two
agencies.
   (3) Establish the direction and priorities for ongoing
collaboration efforts between the two agencies.
   (e) Copies of each memorandum of understanding shall be forwarded
to the State Department of Developmental Services upon completion or
whenever amended. The department shall make copies of the memorandum
of understanding available to the public upon request.
   (f) By May 15 of each year, the department shall provide all of
the following information to the Legislature:
   (1) The status of the memorandums of understanding developed
jointly by each regional center and the county mental health agency
and identify any barriers to meeting the outcomes specified in this
section.
   (2) The availability of mobile crisis intervention services,
including generic services, by regional center catchment area,
including the names of vendors and rates
                  paid.
   (3) A description of each regional center's funded emergency
housing options, including the names and types of vendors, the number
of beds and rates, including, but not limited to, crisis emergency
group homes, crisis beds in a regular group home, crisis foster
homes, motel or hotel or psychiatric facility beds, and whether each
emergency housing option serves minors or adults and whether it is
physically accessible.
  SEC. 77.  Section 4835 of the Welfare and Institutions Code is
amended to read:
   4835.  The Director of Developmental Services may establish
uniform operational procedures, performance and evaluation standards
and utilization criteria for designated agencies pursuant to this
chapter.
   These standards and criteria shall be developed with participation
by consumer organizations, area boards on developmental
disabilities, the Association of Regional Center Agencies, the State
Department of Social Services, the State Department of Health Care
Services, the State Department of Education, and the Department of
Rehabilitation, and consultations with individuals with experience in
developmental services programming.
  SEC. 78.  Section 4844 of the Welfare and Institutions Code is
amended to read:
   4844.  The Director of Developmental Services shall initiate and
monitor interagency performance agreements between the Department of
Rehabilitation, the State Department of Health Care Services, the
State Department of Social Services, and the Department of Housing
and Community Development to ensure planning, coordination, and
resource sharing.
  SEC. 79.  Section 5150 of the Welfare and Institutions Code is
amended to read:
   5150.  When any person, as a result of mental disorder, is a
danger to others, or to himself or herself, or gravely disabled, a
peace officer, member of the attending staff, as defined by
regulation, of an evaluation facility designated by the county,
designated members of a mobile crisis team provided by Section
5651.7, or other professional person designated by the county may,
upon probable cause, take, or cause to be taken, the person into
custody and place him or her in a facility designated by the county
and approved by the State Department of Social Services as a facility
for 72-hour treatment and evaluation.
   The facility shall require an application in writing stating the
circumstances under which the person's condition was called to the
attention of the officer, member of the attending staff, or
professional person, and stating that the officer, member of the
attending staff, or professional person has probable cause to believe
that the person is, as a result of mental disorder, a danger to
others, or to himself or herself, or gravely disabled. If the
probable cause is based on the statement of a person other than the
officer, member of the attending staff, or professional person, the
person shall be liable in a civil action for intentionally giving a
statement which he or she knows to be false.
  SEC. 80.  Section 5151 of the Welfare and Institutions Code is
amended to read:
   5151.  If the facility for 72-hour treatment and evaluation admits
the person, it may detain him or her for evaluation and treatment
for a period not to exceed 72 hours. Saturdays, Sundays, and holidays
may be excluded from the 72-hour period if the State Department of
Social Services certifies for each facility that evaluation and
treatment services cannot reasonably be made available on those days.
The certification by the department is subject to renewal every two
years. The department shall adopt regulations defining criteria for
determining whether a facility can reasonably be expected to make
evaluation and treatment services available on Saturdays, Sundays,
and holidays.
   Prior to admitting a person to the facility for 72-hour treatment
and evaluation pursuant to Section 5150, the professional person in
charge of the facility or his or her designee shall assess the
individual in person to determine the appropriateness of the
involuntary detention.
   If in the judgment of the professional person in charge of the
facility providing evaluation and treatment, or his or her designee,
the person can be properly served without being detained, he or she
shall be provided evaluation, crisis intervention, or other inpatient
or outpatient services on a voluntary basis.
   Nothing in this section shall be interpreted to prevent a peace
officer from delivering individuals to a designated facility for
assessment under Section 5150. Furthermore, the preadmission
assessment requirement of this section shall not be interpreted to
require peace officers to perform any additional duties other than
those specified in Sections 5150.1 and 5150.2.
  SEC. 81.  Section 5152 of the Welfare and Institutions Code is
amended to read:
   5152.  (a) Each person admitted to a facility for 72-hour
treatment and evaluation under the provisions of this article shall
receive an evaluation as soon as possible after he or she is admitted
and shall receive whatever treatment and care his or her condition
requires for the full period that he or she is held. The person shall
be released before 72 hours have elapsed only if the psychiatrist
directly responsible for the person's treatment believes, as a result
of the psychiatrist's personal observations, that the person no
longer requires evaluation or treatment. However, in those situations
in which both a psychiatrist and psychologist have personally
evaluated or examined a person who is placed under a 72-hour hold and
there is a collaborative treatment relationship between the
psychiatrist and psychologist, either the psychiatrist or
psychologist may authorize the release of the person from the hold,
but only after they have consulted with one another. In the event of
a clinical or professional disagreement regarding the early release
of a person who has been placed under a 72-hour hold, the hold shall
be maintained unless the facility's medical director overrules the
decision of the psychiatrist or psychologist opposing the release.
Both the psychiatrist and psychologist shall enter their findings,
concerns, or objections into the person's medical record. If any
other professional person who is authorized to release the person
believes the person should be released before 72 hours have elapsed,
and the psychiatrist directly responsible for the person's treatment
objects, the matter shall be referred to the medical director of the
facility for the final decision. However, if the medical director is
not a psychiatrist, he or she shall appoint a designee who is a
psychiatrist. If the matter is referred, the person shall be released
before 72 hours have elapsed only if the psychiatrist making the
final decision believes, as a result of the psychiatrist's personal
observations, that the person no longer requires evaluation or
treatment.
   (b) Any person who has been detained for evaluation and treatment
shall be released, referred for further care and treatment on a
voluntary basis, or certified for intensive treatment, or a
conservator or temporary conservator shall be appointed pursuant to
this part as required.
   (c) A person designated by the mental health facility shall give
to any person who has been detained at that facility for evaluation
and treatment and who is receiving medication as a result of his or
her mental illness, as soon as possible after detention, written and
oral information about the probable effects and possible side effects
of the medication. The State Department of Health Care Services
shall develop and promulgate written materials on the effects of
medications, for use by county mental health programs as disseminated
or as modified by the county mental health program, addressing the
probable effects and the possible side effects of the medication. The
following information shall be given orally to the patient:
   (1) The nature of the mental illness, or behavior, that is the
reason the medication is being given or recommended.
   (2) The likelihood of improving or not improving without the
medication.
   (3) Reasonable alternative treatments available.
   (4) The name and type, frequency, amount, and method of dispensing
the medication, and the probable length of time the medication will
be taken.
   The fact that the information has or has not been given shall be
indicated in the patient's chart. If the information has not been
given, the designated person shall document in the patient's chart
the justification for not providing the information. A failure to
give information about the probable effects and possible side effects
of the medication shall not constitute new grounds for release.
   (d) The amendments to this section made by Assembly Bill 348 of
the 2003-04 Regular Session shall not be construed to revise or
expand the scope of practice of psychologists, as defined in Chapter
6.6 (commencing with Section 2900) of Division 2 of the Business and
Professions Code.
  SEC. 82.  Section 5157 of the Welfare and Institutions Code is
amended to read:
   5157.  (a) Each person, at the time he or she is first taken into
custody under provisions of Section 5150, shall be provided, by the
person who takes such other person into custody, the following
information orally. The information shall be in substantially the
following form:
My name is ___________________________________ .
I am a ______________________________
                    (peace officer, mental health
______________ .
professional)
with ________________________ .
                        (name of       agency)
You are not under criminal arrest, but I am
taking you for examination by mental health
professionals at _____________________________ .
____________________
                              (name of facility)
You will be told your rights by the mental
health staff.
  If taken into custody at his or her residence,
the person shall also be told the following
information in substantially the following form:
  You may bring a few personal items with you
which I will have to approve. You can make a
phone call and/or leave a note to tell your
friends and/or family where you have been taken.


   (b) The designated facility shall keep, for each patient
evaluated, a record of the advisement given pursuant to subdivision
(a) which shall include:
   (1) Name of person detained for evaluation.
   (2) Name and position of peace officer or mental health
professional taking person into custody.
   (3) Date.
   (4) Whether advisement was completed.
   (5) If not given or completed, the mental health professional at
the facility shall either provide the information specified in
subdivision (a), or include a statement of good cause, as defined by
regulations of the State Department of Social Services, which shall
be kept with the patient's medical record.
   (c) Each person admitted to a designated facility for 72-hour
evaluation and treatment shall be given the following information by
admission staff at the evaluation unit. The information shall be
given orally and in writing and in a language or modality accessible
to the person. The written information shall be available in the
person's native language or the language which is the person's
principal means of communication. The information shall be in
substantially the following form:
My name is ____________________________________.
My position here is____________________________.
  You are being placed into the psychiatric unit
because it is our professional opinion that as
a result of mental disorder, you are likely to:
  (check
applicable)
harm yourself
____
harm someone else
____
be unable to take care of your
own
food, clothing, and housing needs
____
We feel this is true because
________________________________________________
  (herewith a listing of the facts upon which the
              allegation of dangerous
   or gravely disabled due to mental disorder is
            based, including pertinent
   facts arising from the admission interview.)
  You will be held on the ward for a period up
to 72
hours.
This does not include weekends or holidays.
Your 72-hour period will begin ____________
                                        (day
__________________
and time.)
  During these 72 hours you will be evaluated by
the hospital staff, and you may be given
treatment, including medications. It is
possible for you to be released before the end
of the 72 hours. But if the staff decides that
you need continued treatment you       can be
held for a longer period of time. If you are
held longer than 72 hours you have the right to
a lawyer and a qualified interpreter and a
hearing before a judge. If you are unable to
pay for the lawyer, then one will be provided
free.


   (d) For each patient admitted for 72-hour evaluation and
treatment, the facility shall keep with the patient's medical record
a record of the advisement given pursuant to subdivision (c) which
shall include:
   (1) Name of person performing advisement.
   (2) Date.
   (3) Whether advisement was completed.
   (4) If not completed, a statement of good cause.
   If the advisement was not completed at admission, the advisement
process shall be continued on the ward until completed. A record of
the matters prescribed by subdivisions (a), (b), and (c) shall be
kept with the patient's medical record.
  SEC. 83.  Section 5202 of the Welfare and Institutions Code is
amended to read:
   5202.  The person or agency designated by the county shall prepare
the petition and all other forms required in the proceeding, and
shall be responsible for filing the petition. Before filing the
petition, the person or agency designated by the county shall request
the person or agency designated by the county and approved by the
State Department of Social Services to provide prepetition screening
to determine whether there is probable cause to believe the
allegations. The person or agency providing prepetition screening
shall conduct a reasonable investigation of the allegations and make
a reasonable effort to personally interview the subject of the
petition. The screening shall also determine whether the person will
agree voluntarily to receive crisis intervention services or an
evaluation in his own home or in a facility designated by the county
and approved by the State Department of Social Services. Following
prepetition screening, the person or agency designated by the county
shall file the petition if satisfied that there is probable cause to
believe that the person is, as a result of mental disorder, a danger
to others, or to himself or herself, or gravely disabled, and that
the person will not voluntarily receive evaluation or crisis
intervention.
   If the petition is filed, it shall be accompanied by a report
containing the findings of the person or agency designated by the
county to provide prepetition screening. The prepetition screening
report submitted to the superior court shall be confidential and
shall be subject to the provisions of Section 5328.
  SEC. 84.  Section 5270.12 of the Welfare and Institutions Code is
amended to read:
   5270.12.  This article shall be operative only in those counties
in which the county board of supervisors, by resolution, authorizes
its application and, by resolution, makes a finding that any
additional costs incurred by the county in the implementation of this
article are funded either by new funding sufficient to cover the
costs incurred by the county resulting from this article, or funds
redirected from cost savings resulting from this article, or a
combination thereof, so that no current service reductions will occur
as a result of the enactment of this article. Compliance with this
section shall be monitored by the State Department of Health Care
Services as part of its review and approval of mental health plans
and performance contracts.
  SEC. 85.  Section 5325 of the Welfare and Institutions Code is
amended to read:
   5325.  Each person involuntarily detained for evaluation or
treatment under provisions of this part, and each person admitted as
a voluntary patient for psychiatric evaluation or treatment to any
health facility, as defined in Section 1250 of the Health and Safety
Code, in which psychiatric evaluation or treatment is offered, shall
have the following rights, a list of which shall be prominently
posted in the predominant languages of the community and explained in
a language or modality accessible to the patient in all facilities
providing those services, and otherwise brought to his or her
attention by any additional means as the Director of Health Care
Services may designate by regulation. Each person committed to a
state hospital shall also have the following rights, a list of which
shall be prominently posted in the predominant languages of the
community and explained in a language or modality accessible to the
patient in all facilities providing those services and otherwise
brought to his or her attention by any additional means as the
Director of State Hospitals may designate by regulation:
   (a) To wear his or her own clothes; to keep and use his or her own
personal possessions including his or her toilet articles; and to
keep and be allowed to spend a reasonable sum of his or her own money
for canteen expenses and small purchases.
   (b) To have access to individual storage space for his or her
private use.
   (c) To see visitors each day.
   (d) To have reasonable access to telephones, both to make and
receive confidential calls or to have such calls made for them.
   (e) To have ready access to letterwriting materials, including
stamps, and to mail and receive unopened correspondence.
   (f) To refuse convulsive treatment including, but not limited to,
any electroconvulsive treatment, any treatment of the mental
condition which depends on the induction of a convulsion by any
means, and insulin coma treatment.
   (g) To refuse psychosurgery. Psychosurgery is defined as those
operations currently referred to as lobotomy, psychiatric surgery,
and behavioral surgery, and all other forms of brain surgery if the
surgery is performed for the purpose of any of the following:
   (1) Modification or control of thoughts, feelings, actions, or
behavior rather than the treatment of a known and diagnosed physical
disease of the brain.
   (2) Modification of normal brain function or normal brain tissue
in order to control thoughts, feelings, actions, or behavior.
   (3) Treatment of abnormal brain function or abnormal brain tissue
in order to modify thoughts, feelings, actions or behavior when the
abnormality is not an established cause for those thoughts, feelings,
actions, or behavior.
   Psychosurgery does not include prefrontal sonic treatment wherein
there is no destruction of brain tissue. The Director of Health Care
Services and the Director of State Hospitals shall promulgate
appropriate regulations to assure adequate protection of patients'
rights in such treatment.
   (h) To see and receive the services of a patient advocate who has
no direct or indirect clinical or administrative responsibility for
the person receiving mental health services.
   (i) Other rights, as specified by regulation.
   Each patient shall also be given notification in a language or
modality accessible to the patient of other constitutional and
statutory rights which are found by the State Department of Health
Care Services and the State Department of State Hospitals to be
frequently misunderstood, ignored, or denied.
   Upon admission to a facility each patient, involuntarily detained
for evaluation or treatment under provisions of this part, or as a
voluntary patient for psychiatric evaluation or treatment to a health
facility, as defined in Section 1250 of the Health and Safety Code,
in which psychiatric evaluation or treatment is offered, shall
immediately be given a copy of a State Department of Health Care
Services prepared patients' rights handbook. Each person committed to
a state hospital, upon admission, shall immediately be given a copy
of a State Department of State Hospitals prepared patients' rights
handbook.
   The State Department of Health Care Services and the State
Department of State Hospitals shall prepare and provide the forms
specified in this section. The State Department of Health Care
Services shall prepare and provide the forms specified in Section
5157.
   The rights specified in this section may not be waived by the
person's parent, guardian, or conservator.
  SEC. 86.  Section 5326 of the Welfare and Institutions Code is
amended to read:
   5326.  The professional person in charge of the facility or state
hospital or his or her designee may, for good cause, deny a person
any of the rights under Section 5325, except under subdivisions (g)
and (h) and the rights under subdivision (f) may be denied only under
the conditions specified in Section 5326.7. To ensure that these
rights are denied only for good cause, the Director of Health Care
Services and Director of State Hospitals shall adopt regulations
specifying the conditions under which they may be denied. Denial of a
person's rights shall in all cases be entered into the person's
treatment record.
  SEC. 87.  Section 5326.1 of the Welfare and Institutions Code is
amended to read:
   5326.1.  Quarterly, each local mental health director shall
furnish to the Director of Health Care Services, the facility reports
of the number of persons whose rights were denied and the right or
rights which were denied. The content of the reports from facilities
shall enable the local mental health director and Director of Health
Care Services to identify individual treatment records, if necessary,
for further analysis and investigation. These quarterly reports,
except for the identity of the person whose rights are denied, shall
be available, upon request, to Members of the State Legislature, or a
member of a county board of supervisors.
   Notwithstanding any other provision of law, information pertaining
to denial of rights contained in the person's treatment record shall
be made available, on request, to the person, his or her attorney,
his or her conservator or guardian, the local mental health director,
or his or her designee, or the Patients' Rights program of the State
Department of Health Care Services. The information may include
consent forms, required documentation for convulsive treatment,
documentation regarding the use of restraints and seclusion,
physician's orders, nursing notes, and involuntary detention and
conservatorship papers. The information, except for the identity of
the person whose rights are denied, shall be made available to the
Members of the State Legislature or a member of a county board of
supervisors.
  SEC. 88.  Section 5326.15 of the Welfare and Institutions Code is
amended to read:
   5326.15.  (a) Quarterly, any doctor or facility which administers
convulsive treatments or psychosurgery, shall report to the local
mental health director, who shall transmit a copy to the Director of
Health Care Services, the number of persons who received such
treatments wherever administered, in each of the following
categories:
   (1) Involuntary patients who gave informed consent.
   (2) Involuntary patients who were deemed incapable of giving
informed consent and received convulsive treatment against their
will.
   (3) Voluntary patients who gave informed consent.
   (4) Voluntary patients deemed incapable of giving consent.
   (b) Quarterly, the State Department of State Hospitals shall
report to the Director of Health Care Services the number of persons
who received such treatments wherever administered, in each of the
following categories:
   (1) Involuntary patients who gave informed consent.
   (2) Involuntary patients who were deemed incapable of giving
informed consent and received convulsive treatment against their
will.
   (3) Voluntary patients who gave informed consent.
   (4) Voluntary patients deemed incapable of giving consent.
   (c) Quarterly, the Director of Health Care Services shall forward
to the Medical Board of California any records or information
received from these reports indicating violation of the law, and the
regulations which have been adopted thereto.
  SEC. 89.  Section 5326.3 of the Welfare and Institutions Code is
amended to read:
   5326.3.  The State Department of Health Care Services and State
Department of State Hospitals shall promulgate a standard written
consent form, setting forth clearly and in detail the matters listed
in Section 5326.2, and any further information with respect to each
item as deemed generally appropriate to all patients.
   The treating physician shall utilize the standard written consent
form and in writing supplement it with those details which pertain to
the particular patient being treated.
  SEC. 90.  Section 5326.8 of the Welfare and Institutions Code is
amended to read:
   5326.8.  Under no circumstances shall convulsive treatment be
performed on a minor under 12 years of age. Persons 16 and 17 years
of age shall personally have and exercise the rights under this
article.
   Persons 12 years of age and over, and under 16, may be
administered convulsive treatment only if all the other provisions of
this law are complied with and in addition:
   (a) It is an emergency situation and convulsive treatment is
deemed a lifesaving treatment.
   (b) This fact and the need for and appropriateness of the
treatment are unanimously certified to by a review board of three
board-eligible or board-certified child psychiatrists appointed by
the local mental health director.
   (c) It is otherwise performed in full compliance with regulations
promulgated by the Director of State Hospitals under Section 5326.95.

   (d) It is thoroughly documented and reported immediately to the
Director of Health Care Services.
  SEC. 91.  Section 5326.9 of the Welfare and Institutions Code is
amended to read:
   5326.9.  (a) Any alleged or suspected violation of the rights
described in Chapter 2 (commencing with Section 5150) shall be
investigated by the local director of mental health, or his or her
designee. Violations of Sections 5326.2 to 5326.8, inclusive,
concerning patients involuntarily detained for evaluation or
treatment under this part, or as a voluntary patient for psychiatric
evaluation or treatment to a health facility, as defined in Section
1250 of the Health and Safety Code, in which psychiatric evaluation
or treatment is offered, shall also be investigated by the Director
of Health Care Services, or his or her designee. Violations of
Sections 5326.2 to 5326.8, inclusive, concerning persons committed to
a state hospital shall also be investigated by the Director of State
Hospitals, or his or her designee. If it is determined by the local
                                              director of mental
health, the Director of Health Care Services, or the Director of
State Hospitals that a right has been violated, a formal notice of
violation shall be issued.
   (b) Either the local director of mental health or the Director of
Health Care Services, upon issuing a notice of violation, may take
any or all of the following action:
   (1) Assign a specified time period during which the violation
shall be corrected.
   (2) Referral to the Medical Board of California or other
professional licensing agency. Such board shall investigate further,
if warranted, and shall subject the individual practitioner to any
penalty the board finds necessary and is authorized to impose.
   (3) Make a recommendation to the State Department of Social
Services to revoke the approval of the county facility designation.
The local director of mental health may revoke a facility's
designation and authorization under Section 5404 to evaluate and
treat persons detained involuntarily.
   (4) Refer any violation of law to a local district attorney or the
Attorney General for prosecution in any court with jurisdiction.
   (c) The Director of State Hospitals, upon issuing a notice of
violation, may take any or all of the following actions:
   (1) Assign a specified time period during which the violation
shall be corrected.
   (2) Make a referral to the Medical Board of California or other
professional licensing agency. The board or agency shall investigate
further, if warranted, and shall subject the individual practitioner
to any penalty the board finds necessary and is authorized to impose.

   (3) Refer any violation of law to a local district attorney or the
Attorney General for prosecution in any court with jurisdiction.
   (d) Any physician who intentionally violates Sections 5326.2 to
5326.8, inclusive, shall be subject to a civil penalty of not more
than five thousand dollars ($5,000) for each violation. The penalty
may be assessed and collected in a civil action brought by the
Attorney General in a superior court. Such intentional violation
shall be grounds for revocation of license.
   (e) Any person or facility found to have knowingly violated the
provisions of the first paragraph of Section 5325.1 or to have denied
without good cause any of the rights specified in Section 5325 shall
pay a civil penalty, as determined by the court, of fifty dollars
($50) per day during the time in which the violation is not
corrected, commencing on the day on which a notice of violation was
issued, not to exceed one thousand dollars ($1,000), for each and
every violation, except that any liability under this provision shall
be offset by an amount equal to a fine or penalty imposed for the
same violation under the provisions of Sections 1423 to 1425,
inclusive, or 1428 of the Health and Safety Code. These penalties
shall be deposited in the general fund of the county in which the
violation occurred. The local district attorney or the Attorney
General shall enforce this section in any court with jurisdiction.
Where the State Department of Public Health, under the provisions of
Sections 1423 to 1425, inclusive, of the Health and Safety Code,
determines that no violation has occurred, the provisions of
paragraph (4) of subdivision (b) shall not apply.
   (f) The remedies provided by this subdivision shall be in addition
to and not in substitution for any other remedies which an
individual may have under law.
  SEC. 92.  Section 5326.91 of the Welfare and Institutions Code is
amended to read:
   5326.91.  In any facility in which convulsive treatment is
performed on a person whether admitted to the facility as an
involuntary or voluntary patient, the facility will designate a
qualified committee to review all such treatments and to verify the
appropriateness and need for such treatment. The local mental health
director shall establish a postaudit review committee for convulsive
treatments administered anywhere other than in any facility as
defined in Section 1250 of the Health and Safety Code in which
psychiatric evaluation or treatment is offered. Records of these
committees will be subject to availability in the same manner as are
the records of other hospital utilization and audit committees and to
other regulations. Persons serving on these review committees will
enjoy the same immunities as other persons serving on utilization,
peer review, and audit committees of health care facilities.
  SEC. 93.  Section 5326.95 of the Welfare and Institutions Code is
amended to read:
   5326.95.  The Director of State Hospitals shall adopt regulations
to carry out the provisions of this chapter, including standards
defining excessive use of convulsive treatment which shall be
developed in consultation with the State Department of Health Care
Services and the California Mental Health Directors Association.
  SEC. 94.  Section 5328 of the Welfare and Institutions Code is
amended to read:
   5328.  All information and records obtained in the course of
providing services under Division 4 (commencing with Section 4000),
Division 4.1 (commencing with Section 4400), Division 4.5 (commencing
with Section 4500), Division 5 (commencing with Section 5000),
Division 6 (commencing with Section 6000), or Division 7 (commencing
with Section 7100), to either voluntary or involuntary recipients of
services shall be confidential. Information and records obtained in
the course of providing similar services to either voluntary or
involuntary recipients prior to 1969 shall also be confidential.
Information and records shall be disclosed only in any of the
following cases:
   (a) In communications between qualified professional persons in
the provision of services or appropriate referrals, or in the course
of conservatorship proceedings. The consent of the patient, or his or
her guardian or conservator, shall be obtained before information or
records may be disclosed by a professional person employed by a
facility to a professional person not employed by the facility who
does not have the medical or psychological responsibility for the
patient's care.
   (b) When the patient, with the approval of the physician and
surgeon, licensed psychologist, social worker with a master's degree
in social work, licensed marriage and family therapist, or licensed
professional clinical counselor, who is in charge of the patient,
designates persons to whom information or records may be released,
except that nothing in this article shall be construed to compel a
physician and surgeon, licensed psychologist, social worker with a
master's degree in social work, licensed marriage and family
therapist, licensed professional clinical counselor, nurse, attorney,
or other professional person to reveal information that has been
given to him or her in confidence by members of a patient's family.
Nothing in this subdivision shall be construed to authorize a
licensed marriage and family therapist or licensed professional
clinical counselor to provide services or to be in charge of a
patient's care beyond his or her lawful scope of practice.
   (c) To the extent necessary for a recipient to make a claim, or
for a claim to be made on behalf of a recipient for aid, insurance,
or medical assistance to which he or she may be entitled.
   (d) If the recipient of services is a minor, ward, dependent, or
conservatee, and his or her parent, guardian, guardian ad litem,
conservator, or authorized representative designates, in writing,
persons to whom records or information may be disclosed, except that
nothing in this article shall be construed to compel a physician and
surgeon, licensed psychologist, social worker with a master's degree
in social work, licensed marriage and family therapist, licensed
professional clinical counselor, nurse, attorney, or other
professional person to reveal information that has been given to him
or her in confidence by members of a patient's family.
   (e) For research, provided that the Director of Health Care
Services, the Director of State Hospitals, the Director of Social
Services, or the Director of Developmental Services designates by
regulation, rules for the conduct of research and requires the
research to be first reviewed by the appropriate institutional review
board or boards. The rules shall include, but need not be limited
to, the requirement that all researchers shall sign an oath of
confidentiality as follows:
                              Date


   As a condition of doing research concerning persons who have
received services from ____ (fill in the facility, agency or person),
I, ____, agree to obtain the prior informed consent of such persons
who have received services to the maximum degree possible as
determined by the appropriate institutional review board or boards
for protection of human subjects reviewing my research, and I further
agree not to divulge any information obtained in the course of such
research to unauthorized persons, and not to publish or otherwise
make public any information regarding persons who have received
services such that the person who received services is identifiable.
   I recognize that the unauthorized release of confidential
information may make me subject to a civil action under provisions of
the Welfare and Institutions Code.

   (f) To the courts, as necessary to the administration of justice.
   (g) To governmental law enforcement agencies as needed for the
protection of federal and state elective constitutional officers and
their families.
   (h) To the Senate Committee on Rules or the Assembly Committee on
Rules for the purposes of legislative investigation authorized by the
committee.
   (i) If the recipient of services who applies for life or
disability insurance designates in writing the insurer to which
records or information may be disclosed.
   (j) To the attorney for the patient in any and all proceedings
upon presentation of a release of information signed by the patient,
except that when the patient is unable to sign the release, the staff
of the facility, upon satisfying itself of the identity of the
attorney, and of the fact that the attorney does represent the
interests of the patient, may release all information and records
relating to the patient except that nothing in this article shall be
construed to compel a physician and surgeon, licensed psychologist,
social worker with a master's degree in social work, licensed
marriage and family therapist, licensed professional clinical
counselor, nurse, attorney, or other professional person to reveal
information that has been given to him or her in confidence by
members of a patient's family.
   (k) Upon written agreement by a person previously confined in or
otherwise treated by a facility, the professional person in charge of
the facility or his or her designee may release any information,
except information that has been given in confidence by members of
the person's family, requested by a probation officer charged with
the evaluation of the person after his or her conviction of a crime
if the professional person in charge of the facility determines that
the information is relevant to the evaluation. The agreement shall
only be operative until sentence is passed on the crime of which the
person was convicted. The confidential information released pursuant
to this subdivision shall be transmitted to the court separately from
the probation report and shall not be placed in the probation
report. The confidential information shall remain confidential except
for purposes of sentencing. After sentencing, the confidential
information shall be sealed.
   (l) (1) Between persons who are trained and qualified to serve on
multidisciplinary personnel teams pursuant to subdivision (d) of
Section 18951. The information and records sought to be disclosed
shall be relevant to the provision of child welfare services or the
investigation, prevention, identification, management, or treatment
of child abuse or neglect pursuant to Chapter 11 (commencing with
Section 18950) of Part 6 of Division 9. Information obtained pursuant
to this subdivision shall not be used in any criminal or delinquency
proceeding. Nothing in this subdivision shall prohibit evidence
identical to that contained within the records from being admissible
in a criminal or delinquency proceeding, if the evidence is derived
solely from means other than this subdivision, as permitted by law.
   (2) As used in this subdivision, "child welfare services" means
those services that are directed at preventing child abuse or
neglect.
   (m) To county patients' rights advocates who have been given
knowing voluntary authorization by a client or a guardian ad litem.
The client or guardian ad litem, whoever entered into the agreement,
may revoke the authorization at any time, either in writing or by
oral declaration to an approved advocate.
   (n) To a committee established in compliance with Section 14725.
   (o) In providing information as described in Section 7325.5.
Nothing in this subdivision shall permit the release of any
information other than that described in Section 7325.5.
   (p) To the county mental health director or the director's
designee, or to a law enforcement officer, or to the person
designated by a law enforcement agency, pursuant to Sections 5152.1
and 5250.1.
   (q) If the patient gives his or her consent, information
specifically pertaining to the existence of genetically handicapping
conditions, as defined in Section 125135 of the Health and Safety
Code, may be released to qualified professional persons for purposes
of genetic counseling for blood relatives upon request of the blood
relative. For purposes of this subdivision, "qualified professional
persons" means those persons with the qualifications necessary to
carry out the genetic counseling duties under this subdivision as
determined by the genetic disease unit established in the State
Department of Health Care Services under Section 125000 of the Health
and Safety Code. If the patient does not respond or cannot respond
to a request for permission to release information pursuant to this
subdivision after reasonable attempts have been made over a two-week
period to get a response, the information may be released upon
request of the blood relative.
   (r) When the patient, in the opinion of his or her
psychotherapist, presents a serious danger of violence to a
reasonably foreseeable victim or victims, then any of the information
or records specified in this section may be released to that person
or persons and to law enforcement agencies and county child welfare
agencies as the psychotherapist determines is needed for the
protection of that person or persons. For purposes of this
subdivision, "psychotherapist" means anyone so defined within Section
1010 of the Evidence Code.
   (s) (1) To the designated officer of an emergency response
employee, and from that designated officer to an emergency response
employee regarding possible exposure to HIV or AIDS, but only to the
extent necessary to comply with provisions of the federal Ryan White
Comprehensive AIDS Resources Emergency Act of 1990 (Public Law
101-381; 42 U.S.C. Sec. 201).
   (2) For purposes of this subdivision, "designated officer" and
"emergency response employee" have the same meaning as these terms
are used in the federal Ryan White Comprehensive AIDS Resources
Emergency Act of 1990 (Public Law 101-381; 42 U.S.C. Sec. 201).
   (3) The designated officer shall be subject to the confidentiality
requirements specified in Section 120980, and may be personally
liable for unauthorized release of any identifying information about
the HIV results. Further, the designated officer shall inform the
exposed emergency response employee that the employee is also subject
to the confidentiality requirements specified in Section 120980, and
may be personally liable for unauthorized release of any identifying
information about the HIV test results.
   (t) (1) To a law enforcement officer who personally lodges with a
facility, as defined in paragraph (2), a warrant of arrest or an
abstract of such a warrant showing that the person sought is wanted
for a serious felony, as defined in Section 1192.7 of the Penal Code,
or a violent felony, as defined in Section 667.5 of the Penal Code.
The information sought and released shall be limited to whether or
not the person named in the arrest warrant is presently confined in
the facility. This paragraph shall be implemented with minimum
disruption to health facility operations and patients, in accordance
with Section 5212. If the law enforcement officer is informed that
the person named in the warrant is confined in the facility, the
officer may not enter the facility to arrest the person without
obtaining a valid search warrant or the permission of staff of the
facility.
   (2) For purposes of paragraph (1), a facility means all of the
following:
   (A) A state hospital, as defined in Section 4001.
   (B) A general acute care hospital, as defined in subdivision (a)
of Section 1250 of the Health and Safety Code, solely with regard to
information pertaining to a person with mental illness subject to
this section.
   (C) An acute psychiatric hospital, as defined in subdivision (b)
of Section 1250 of the Health and Safety Code.
   (D) A psychiatric health facility, as described in Section 1250.2
of the Health and Safety Code.
   (E) A mental health rehabilitation center, as described in Section
5675.
   (F) A skilled nursing facility with a special treatment program
for individuals with mental illness, as described in Sections 51335
and 72445 to 72475, inclusive, of Title 22 of the California Code of
Regulations.
   (u) Between persons who are trained and qualified to serve on
multidisciplinary personnel teams pursuant to Section 15610.55,
15753.5, or 15761. The information and records sought to be disclosed
shall be relevant to the prevention, identification, management, or
treatment of an abused elder or dependent adult pursuant to Chapter
13 (commencing with Section 15750) of Part 3 of Division 9.
   (v) The amendment of subdivision (d) enacted at the 1970 Regular
Session of the Legislature does not constitute a change in, but is
declaratory of, the preexisting law.
   (w) This section shall not be limited by Section 5150.05 or 5332.
   (x) (1) When an employee is served with a notice of adverse
action, as defined in Section 19570 of the Government Code, the
following information and records may be released:
   (A) All information and records that the appointing authority
relied upon in issuing the notice of adverse action.
   (B) All other information and records that are relevant to the
adverse action, or that would constitute relevant evidence as defined
in Section 210 of the Evidence Code.
   (C) The information described in subparagraphs (A) and (B) may be
released only if both of the following conditions are met:
   (i) The appointing authority has provided written notice to the
consumer and the consumer's legal representative or, if the consumer
has no legal representative or if the legal representative is a state
agency, to the clients' rights advocate, and the consumer, the
consumer's legal representative, or the clients' rights advocate has
not objected in writing to the appointing authority within five
business days of receipt of the notice, or the appointing authority,
upon review of the objection has determined that the circumstances on
which the adverse action is based are egregious or threaten the
health, safety, or life of the consumer or other consumers and
without the information the adverse action could not be taken.
   (ii) The appointing authority, the person against whom the adverse
action has been taken, and the person's representative, if any, have
entered into a stipulation that does all of the following:
   (I) Prohibits the parties from disclosing or using the information
or records for any purpose other than the proceedings for which the
information or records were requested or provided.
   (II) Requires the employee and the employee's legal representative
to return to the appointing authority all records provided to them
under this subdivision, including, but not limited to, all records
and documents from any source containing confidential information
protected by this section, and all copies of those records and
documents, within 10 days of the date that the adverse action becomes
final except for the actual records and documents or copies thereof
that are no longer in the possession of the employee or the employee'
s legal representative because they were submitted to the
administrative tribunal as a component of an appeal from the adverse
action.
   (III) Requires the parties to submit the stipulation to the
administrative tribunal with jurisdiction over the adverse action at
the earliest possible opportunity.
   (2) For the purposes of this subdivision, the State Personnel
Board may, prior to any appeal from adverse action being filed with
it, issue a protective order, upon application by the appointing
authority, for the limited purpose of prohibiting the parties from
disclosing or using information or records for any purpose other than
the proceeding for which the information or records were requested
or provided, and to require the employee or the employee's legal
representative to return to the appointing authority all records
provided to them under this subdivision, including, but not limited
to, all records and documents from any source containing confidential
information protected by this section, and all copies of those
records and documents, within 10 days of the date that the adverse
action becomes final, except for the actual records and documents or
copies thereof that are no longer in the possession of the employee
or the employee's legal representatives because they were submitted
to the administrative tribunal as a component of an appeal from the
adverse action.
   (3) Individual identifiers, including, but not limited to, names,
social security numbers, and hospital numbers, that are not necessary
for the prosecution or defense of the adverse action, shall not be
disclosed.
   (4) All records, documents, or other materials containing
confidential information protected by this section that have been
submitted or otherwise disclosed to the administrative agency or
other person as a component of an appeal from an adverse action
shall, upon proper motion by the appointing authority to the
administrative tribunal, be placed under administrative seal and
shall not, thereafter, be subject to disclosure to any person or
entity except upon the issuance of an order of a court of competent
jurisdiction.
   (5) For purposes of this subdivision, an adverse action becomes
final when the employee fails to answer within the time specified in
Section 19575 of the Government Code, or, after filing an answer,
withdraws the appeal, or, upon exhaustion of the administrative
appeal or of the judicial review remedies as otherwise provided by
law.
   (y) To the person appointed as the developmental services
decisionmaker for a minor, dependent, or ward pursuant to Section
319, 361, or 726.
  SEC. 95.  Section 5348 of the Welfare and Institutions Code is
amended to read:
   5348.  (a) For purposes of subdivision (e) of Section 5346, a
county that chooses to provide assisted outpatient treatment services
pursuant to this article shall offer assisted outpatient treatment
services including, but not limited to, all of the following:
   (1) Community-based, mobile, multidisciplinary, highly trained
mental health teams that use high staff-to-client ratios of no more
than 10 clients per team member for those subject to court-ordered
services pursuant to Section 5346.
   (2) A service planning and delivery process that includes the
following:
   (A) Determination of the numbers of persons to be served and the
programs and services that will be provided to meet their needs. The
local director of mental health shall consult with the sheriff, the
police chief, the probation officer, the mental health board,
contract agencies, and family, client, ethnic, and citizen
constituency groups as determined by the director.
   (B) Plans for services, including outreach to families whose
severely mentally ill adult is living with them, design of mental
health services, coordination and access to medications, psychiatric
and psychological services, substance abuse services, supportive
housing or other housing assistance, vocational rehabilitation, and
veterans' services. Plans shall also contain evaluation strategies,
which shall consider cultural, linguistic, gender, age, and special
needs of minorities and those based on any characteristic listed or
defined in Section 11135 of the Government Code in the target
populations. Provision shall be made for staff with the cultural
background and linguistic skills necessary to remove barriers to
mental health services as a result of having limited-English-speaking
ability and cultural differences. Recipients of outreach services
may include families, the public, primary care physicians, and others
who are likely to come into contact with individuals who may be
suffering from an untreated severe mental illness who would be likely
to become homeless if the illness continued to be untreated for a
substantial period of time. Outreach to adults may include adults
voluntarily or involuntarily hospitalized as a result of a severe
mental illness.
   (C) Provision for services to meet the needs of persons who are
physically disabled.
   (D) Provision for services to meet the special needs of older
adults.
   (E) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, where appropriate.
   (F) Provision for services to be client-directed and that employ
psychosocial rehabilitation and recovery principles.
   (G) Provision for psychiatric and psychological services that are
integrated with other services and for psychiatric and psychological
collaboration in overall service planning.
   (H) Provision for services specifically directed to seriously
mentally ill young adults 25 years of age or younger who are homeless
or at significant risk of becoming homeless. These provisions may
include continuation of services that still would be received through
other funds had eligibility not been terminated as a result of age.
   (I) Services reflecting special needs of women from diverse
cultural backgrounds, including supportive housing that accepts
children, personal services coordinator therapeutic treatment, and
substance treatment programs that address gender-specific trauma and
abuse in the lives of persons with mental illness, and vocational
rehabilitation programs that offer job training programs free of
gender bias and                                             sensitive
to the needs of women.
   (J) Provision for housing for clients that is immediate,
transitional, permanent, or all of these.
   (K) Provision for clients who have been suffering from an
untreated severe mental illness for less than one year, and who do
not require the full range of services, but are at risk of becoming
homeless unless a comprehensive individual and family support
services plan is implemented. These clients shall be served in a
manner that is designed to meet their needs.
   (3) Each client shall have a clearly designated mental health
personal services coordinator who may be part of a multidisciplinary
treatment team who is responsible for providing or assuring needed
services. Responsibilities include complete assessment of the client'
s needs, development of the client's personal services plan, linkage
with all appropriate community services, monitoring of the quality
and followthrough of services, and necessary advocacy to ensure each
client receives those services that are agreed to in the personal
services plan. Each client shall participate in the development of
his or her personal services plan, and responsible staff shall
consult with the designated conservator, if one has been appointed,
and, with the consent of the client, shall consult with the family
and other significant persons as appropriate.
   (4) The individual personal services plan shall ensure that
persons subject to assisted outpatient treatment programs receive
age-appropriate, gender-appropriate, and culturally appropriate
services, to the extent feasible, that are designed to enable
recipients to:
   (A) Live in the most independent, least restrictive housing
feasible in the local community, and, for clients with children, to
live in a supportive housing environment that strives for
reunification with their children or assists clients in maintaining
custody of their children as is appropriate.
   (B) Engage in the highest level of work or productive activity
appropriate to their abilities and experience.
   (C) Create and maintain a support system consisting of friends,
family, and participation in community activities.
   (D) Access an appropriate level of academic education or
vocational training.
   (E) Obtain an adequate income.
   (F) Self-manage their illnesses and exert as much control as
possible over both the day-to-day and long-term decisions that affect
their lives.
   (G) Access necessary physical health care and maintain the best
possible physical health.
   (H) Reduce or eliminate serious antisocial or criminal behavior,
and thereby reduce or eliminate their contact with the criminal
justice system.
   (I) Reduce or eliminate the distress caused by the symptoms of
mental illness.
   (J) Have freedom from dangerous addictive substances.
   (5) The individual personal services plan shall describe the
service array that meets the requirements of paragraph (4), and to
the extent applicable to the individual, the requirements of
paragraph (2).
   (b) A county that provides assisted outpatient treatment services
pursuant to this article also shall offer the same services on a
voluntary basis.
   (c) Involuntary medication shall not be allowed absent a separate
order by the court pursuant to Sections 5332 to 5336, inclusive.
   (d) A county that operates an assisted outpatient treatment
program pursuant to this article shall provide data to the State
Department of Health Care Services and, based on the data, the
department shall report to the Legislature on or before May 1 of each
year in which the county provides services pursuant to this article.
The report shall include, at a minimum, an evaluation of the
effectiveness of the strategies employed by each program operated
pursuant to this article in reducing homelessness and hospitalization
of persons in the program and in reducing involvement with local law
enforcement by persons in the program. The evaluation and report
shall also include any other measures identified by the department
regarding persons in the program and all of the following, based on
information that is available:
   (1) The number of persons served by the program and, of those, the
number who are able to maintain housing and the number who maintain
contact with the treatment system.
   (2) The number of persons in the program with contacts with local
law enforcement, and the extent to which local and state
incarceration of persons in the program has been reduced or avoided.
   (3) The number of persons in the program participating in
employment services programs, including competitive employment.
   (4) The days of hospitalization of persons in the program that
have been reduced or avoided.
   (5) Adherence to prescribed treatment by persons in the program.
   (6) Other indicators of successful engagement, if any, by persons
in the program.
   (7) Victimization of persons in the program.
   (8) Violent behavior of persons in the program.
   (9) Substance abuse by persons in the program.
   (10) Type, intensity, and frequency of treatment of persons in the
program.
   (11) Extent to which enforcement mechanisms are used by the
program, when applicable.
   (12) Social functioning of persons in the program.
   (13) Skills in independent living of persons in the program.
   (14) Satisfaction with program services both by those receiving
them and by their families, when relevant.
  SEC. 96.  Section 5349 of the Welfare and Institutions Code is
amended to read:
   5349.  This article shall be operative in those counties in which
the county board of supervisors, by resolution, authorizes its
application and makes a finding that no voluntary mental health
program serving adults, and no children's mental health program, may
be reduced as a result of the implementation of this article.
Compliance with this section shall be monitored by the State
Department of Health Care Services as part of its review and approval
of county performance contracts.
  SEC. 97.  Section 5349.1 of the Welfare and Institutions Code is
amended to read:
   5349.1.  (a) Counties that elect to implement this article, shall,
in consultation with the State Department of Health Care Services,
client and family advocacy organizations, and other stakeholders,
develop a training and education program for purposes of improving
the delivery of services to mentally ill individuals who are, or who
are at risk of being, involuntarily committed under this part. This
training shall be provided to mental health treatment providers
contracting with participating counties and to other individuals,
including, but not limited to, mental health professionals, law
enforcement officials, and certification hearing officers involved in
making treatment and involuntary commitment decisions.
   (b) The training shall include both of the following:
   (1) Information relative to legal requirements for detaining a
person for involuntary inpatient and outpatient treatment, including
criteria to be considered with respect to determining if a person is
considered to be gravely disabled.
   (2) Methods for ensuring that decisions regarding involuntary
treatment as provided for in this part direct patients toward the
most effective treatment. Training shall include an emphasis on each
patient's right to provide informed consent to assistance.
  SEC. 98.  Section 5358 of the Welfare and Institutions Code is
amended to read:
   5358.  (a) (1) When ordered by the court after the hearing
required by this section, a conservator appointed pursuant to this
chapter shall place his or her conservatee as follows:
   (A) For a conservatee who is gravely disabled, as defined in
subparagraph (A) of paragraph (1) of subdivision (h) of Section 5008,
in the least restrictive alternative placement, as designated by the
court.
   (B) For a conservatee who is gravely disabled, as defined in
subparagraph (B) of paragraph (1) of subdivision (h) of Section 5008,
in a placement that achieves the purposes of treatment of the
conservatee and protection of the public.
   (2) The placement may include a medical, psychiatric, nursing, or
other state-licensed facility, or a state hospital, county hospital,
hospital operated by the Regents of the University of California, a
United States government hospital, or other nonmedical facility
approved by the State Department of Social Services or an agency
accredited by the State Department of Health Care Services, or in
addition to any of the foregoing, in cases of chronic alcoholism, to
a county alcoholic treatment center.
   (b) A conservator shall also have the right, if specified in the
court order, to require his or her conservatee to receive treatment
related specifically to remedying or preventing the recurrence of the
conservatee's being gravely disabled, or to require his or her
conservatee to receive routine medical treatment unrelated to
remedying or preventing the recurrence of the conservatee's being
gravely disabled. Except in emergency cases in which the conservatee
faces loss of life or serious bodily injury, no surgery shall be
performed upon the conservatee without the conservatee's prior
consent or a court order obtained pursuant to Section 5358.2
specifically authorizing that surgery.
   (c) (1) For a conservatee who is gravely disabled, as defined in
subparagraph (A) of paragraph (1) of subdivision (h) of Section 5008,
if the conservatee is not to be placed in his or her own home or the
home of a relative, first priority shall be to placement in a
suitable facility as close as possible to his or her home or the home
of a relative. For the purposes of this section, suitable facility
means the least restrictive residential placement available and
necessary to achieve the purpose of treatment. At the time that the
court considers the report of the officer providing conservatorship
investigation specified in Section 5356, the court shall consider
available placement alternatives. After considering all the evidence
the court shall determine the least restrictive and most appropriate
alternative placement for the conservatee. The court shall also
determine those persons to be notified of a change of placement. The
fact that a person for whom conservatorship is recommended is not an
inpatient shall not be construed by the court as an indication that
the person does not meet the criteria of grave disability.
   (2) For a conservatee who is gravely disabled, as defined in
subparagraph (B) of paragraph (1) of subdivision (h) of Section 5008,
first priority shall be placement in a facility that achieves the
purposes of treatment of the conservatee and protection of the
public. The court shall determine the most appropriate placement for
the conservatee. The court shall also determine those persons to be
notified of a change of placement, and additionally require the
conservator to notify the district attorney or attorney representing
the originating county prior to any change of placement.
   (3) For any conservatee, if requested, the local mental health
director shall assist the conservator or the court in selecting a
placement facility for the conservatee. When a conservatee who is
receiving services from the local mental health program is placed,
the conservator shall inform the local mental health director of the
facility's location and any movement of the conservatee to another
facility.
   (d) (1) Except for a conservatee who is gravely disabled, as
defined in subparagraph (B) of paragraph (1) of subdivision (h) of
Section 5008, the conservator may transfer his or her conservatee to
a less restrictive alternative placement without a further hearing
and court approval. In any case in which a conservator has reasonable
cause to believe that his or her conservatee is in need of immediate
more restrictive placement because the condition of the conservatee
has so changed that the conservatee poses an immediate and
substantial danger to himself or herself or others, the conservator
shall have the right to place his or her conservatee in a more
restrictive facility or hospital. Notwithstanding Section 5328, if
the change of placement is to a placement more restrictive than the
court-determined placement, the conservator shall provide written
notice of the change of placement and the reason therefor to the
court, the conservatee's attorney, the county patient's rights
advocate and any other persons designated by the court pursuant to
subdivision (c).
   (2) For a conservatee who is gravely disabled, as defined in
subparagraph (B) of paragraph (1) of subdivision (h) of Section 5008,
the conservator may not transfer his or her conservatee without
providing written notice of the proposed change of placement and the
reason therefor to the court, the conservatee's attorney, the county
patient's rights advocate, the district attorney of the county that
made the commitment, and any other persons designated by the court to
receive notice. If any person designated to receive notice objects
to the proposed transfer within 10 days after receiving notice, the
matter shall be set for a further hearing and court approval. The
notification and hearing is not required for the transfer of persons
between state hospitals.
   (3) At a hearing where the conservator is seeking placement to a
less restrictive alternative placement pursuant to paragraph (2), the
placement shall not be approved where it is determined by a
preponderance of the evidence that the placement poses a threat to
the safety of the public, the conservatee, or any other individual.
   (4) A hearing as to placement to a less restrictive alternative
placement, whether requested pursuant to paragraph (2) or pursuant to
Section 5358.3, shall be granted no more frequently than is provided
for in Section 5358.3.
  SEC. 99.  Section 5366.1 of the Welfare and Institutions Code is
amended to read:
   5366.1.  Any person detained as of June 30, 1969, under court
commitment, in a private institution, a county psychiatric hospital,
facility of the Veterans Administration, or other agency of the
United States government, community mental health service, or
detained in a state hospital or facility of the Veterans
Administration upon application of a local health officer, pursuant
to former Section 5567 or Sections 6000 to 6019, inclusive, as they
read immediately preceding July 1, 1969, may be detained, after
January 1, 1972, for a period no longer than 180 days, except as
provided in this section.
   Any person detained pursuant to this section on the effective date
of this section shall be evaluated by the facility designated by the
county and approved by the State Department of Social Services
pursuant to Section 5150 as a facility for 72-hour treatment and
evaluation. The evaluation shall be made at the request of the person
in charge of the institution in which the person is detained. If in
the opinion of the professional person in charge of the evaluation
and treatment facility or his or her designee, the evaluation of the
person can be made by the professional person or his or her designee
at the institution in which the person is detained, the person shall
not be required to be evaluated at the evaluation and treatment
facility, but shall be evaluated at the institution where he or she
is detained, or other place to determine if the person is a danger to
others, himself or herself, or gravely disabled as a result of
mental disorder.
   Any person evaluated under this section shall be released from the
institution in which he or she is detained immediately upon
completion of the evaluation if in the opinion of the professional
person in charge of the evaluation and treatment facility, or his or
her designee, the person evaluated is not a danger to others, or to
himself or herself, or gravely disabled as a result of mental
disorder, unless the person agrees voluntarily to remain in the
institution in which he or she has been detained.
   If in the opinion of the professional person in charge of the
facility or his or her designee, the person evaluated requires
intensive treatment or recommendation for conservatorship, the
professional person or his or her designee shall proceed under
Article 4 (commencing with Section 5250) of Chapter 2, or under
Chapter 3 (commencing with Section 5350), of Part 1 of Division 5.
   If it is determined from the evaluation that the person is gravely
disabled and a recommendation for conservatorship is made, and if
the petition for conservatorship for the person is not filed by June
30, 1972, the court commitment or detention under a local health
officer application for the person shall terminate and the patient
shall be released unless he or she agrees to accept treatment on a
voluntary basis.
  SEC. 100.  Section 5370.2 of the Welfare and Institutions Code is
amended to read:
   5370.2.  (a) The State Department of State Hospitals and the State
Department of Health Care Services shall contract with a single
nonprofit agency that meets the criteria specified in subdivision (b)
of Section 5510 to conduct the activities specified in paragraphs
(1) to (4), inclusive. These two state departments shall enter into a
memorandum of understanding to ensure the effective management of
the contract and the required activities affecting county patients'
rights programs:
   (1) Provide patients' rights advocacy services for, and conduct
investigations of alleged or suspected abuse and neglect of,
including deaths of, persons with mental disabilities residing in
state hospitals.
   (2) Investigate and take action as appropriate and necessary to
resolve complaints from or concerning recipients of mental health
services residing in licensed health or community care facilities
regarding abuse, and unreasonable denial, or punitive withholding of
rights guaranteed under this division that cannot be resolved by
county patients' rights advocates.
   (3) Provide consultation, technical assistance, and support to
county patients' rights advocates in accordance with their duties
under Section 5520.
   (4) Conduct program review of patients' rights programs.
   (b) The services shall be provided in coordination with the
appropriate mental health patients' rights advocates.
   (c) (1) The contractor shall develop a plan to provide patients'
rights advocacy services for, and conduct investigations of alleged
or suspected abuse and neglect of, including the deaths of, persons
with mental disabilities residing in state hospitals.
   (2) The contractor shall develop the plan in consultation with the
statewide organization of mental health patients' rights advocates,
the statewide organization of mental health clients, and the
statewide organization of family members of persons with mental
disabilities, and the statewide organization of county mental health
directors.
   (3) In order to ensure that persons with mental disabilities have
access to high quality advocacy services, the contractor shall
establish a grievance procedure and shall advise persons receiving
services under the contract of the availability of other advocacy
services, including services provided by the protection and advocacy
agency specified in Section 4901 and the county patients' rights
advocates specified in Section 5520.
   (d) Nothing contained in this section shall be construed to
restrict or limit the authority of the department to conduct the
reviews and investigations it deems necessary for personnel,
criminal, and litigation purposes.
   (e) The State Department of State Hospitals and the State
Department of Health Care Services shall jointly contract on a
multiyear basis for a contract term of up to five years.
  SEC. 101.  Section 5400 of the Welfare and Institutions Code is
amended to read:
   5400.  The Director of Health Care Services shall administer this
part and shall adopt rules, regulations, and standards as necessary.
In developing rules, regulations, and standards, the Director of
Health Care Services shall consult with the California Mental Health
Directors Association, the California Mental Health Planning Council,
and the office of the Attorney General. Adoption of these standards,
rules, and regulations shall require approval by the California
Mental Health Directors Association by majority vote of those present
at an official session.
   Wherever feasible and appropriate, rules, regulations, and
standards adopted under this part shall correspond to comparable
rules, regulations, and standards adopted under the
Bronzan-McCorquodale Act. These corresponding rules, regulations, and
standards shall include qualifications for professional personnel.
   Regulations adopted pursuant to this part may provide standards
for services for chronic alcoholics which differ from the standards
for services for the mentally disordered.
  SEC. 102.  Section 5402 of the Welfare and Institutions Code is
amended to read:
   5402.  (a) The State Department of Health Care Services shall
collect and publish annually quantitative information concerning the
operation of this division including the number of persons admitted
for 72-hour evaluation and treatment, 14-day and 30-day periods of
intensive treatment, and 180-day postcertification intensive
treatment, the number of persons transferred to mental health
facilities pursuant to Section 4011.6 of the Penal Code, the number
of persons for whom temporary conservatorships are established, and
the number of persons for whom conservatorships are established in
each county.
   (b) Each local mental health director, and each facility providing
services to persons pursuant to this division, shall provide the
department, upon its request, with any information, records, and
reports which the department deems necessary for the purposes of this
section. The department shall not have access to any patient name
identifiers.
   (c) Information published pursuant to this section shall not
contain patient name identifiers and shall contain statistical data
only.
   (d) The department shall make the reports available to medical,
legal, and other professional groups involved in the implementation
of this division.
  SEC. 103.  Section 5404 of the Welfare and Institutions Code is
amended to read:
   5404.  (a) Each county may designate facilities, which are not
hospitals or clinics, as 72-hour evaluation and treatment facilities
and as 14-day intensive treatment facilities if the facilities meet
those requirements as the Director of Social Services shall establish
by regulation. The Director of Social Services shall encourage the
use by counties of appropriate facilities, which are not hospitals or
clinics, for the evaluation and treatment of patients pursuant to
this part.
   (b) All regulations relating to the approval of facilities
designated by the county for 72-hour treatment and evaluation and
14-day intensive treatment facilities, heretofore adopted by the
State Department of Mental Health, shall remain in effect and shall
be fully enforceable by the State Department of Social Services with
respect to any facility or program required to be approved as a
facility for 72-hour treatment and evaluation and 14-day intensive
treatment facilities, unless and until readopted, amended, or
repealed by the Director of Social Services. The State Department of
Social Services shall succeed to and be vested with all duties,
powers, purposes, functions, responsibilities, and jurisdiction of
the State Department of Mental Health as they relate to approval of
facilities for 72-hour treatment and evaluation and 14-day intensive
treatment facilities.
  SEC. 104.  Section 5405 of the Welfare and Institutions Code is
amended to read:
   5405.  (a) This section shall apply to each facility licensed by
the State Department of Social Services, or its delegated agent, on
or after January 1, 2003. For purposes of this section, "facility"
means psychiatric health facilities, as defined in Section 1250.2 of
the Health and Safety Code, licensed pursuant to Chapter 9
(commencing with Section 77001) of Division 5 of Title 22 of the
California Code of Regulations and mental health rehabilitation
centers licensed pursuant to Chapter 3.5 (commencing with Section
781.00) of Division 1 of Title 9 of the California Code of
Regulations.
   (b) (1) (A) Prior to the initial licensure or first renewal of a
license on or after January 1, 2003, of any person to operate or
manage a facility specified in subdivision (a), the department shall
submit fingerprint images and related information pertaining to the
applicant or licensee to the Department of Justice for purposes of a
criminal record check, as specified in paragraph (2), at the expense
of the applicant or licensee. The Department of Justice shall provide
the results of the criminal record check to the department. The
department may take into consideration information obtained from or
provided by other government agencies. The department shall determine
whether the applicant or licensee has ever been convicted of a crime
specified in subdivision (c). The department shall submit
fingerprint images and related information each time the position of
administrator, manager, program director, or fiscal officer of a
facility is filled and prior to actual employment for initial
licensure or an individual who is initially hired on or after January
1, 2003. For purposes of this subdivision, "applicant" and "licensee"
include the administrator, manager, program director, or fiscal
officer of a facility.
   (B) Commencing July 1, 2012, upon the employment of, or contract
with or for, any direct care staff the State Department of Social
Services shall submit fingerprint images and related information
pertaining to the direct care staff person to the Department of
Justice for purposes of a criminal record check, as specified in
paragraph (2), at the expense of the direct care staff person or
licensee. The Department of Justice shall provide the results of the
criminal record check to the department. The department shall
determine whether the direct care staff person has ever been
convicted of a crime specified in subdivision (c). The department
shall notify the licensee of these results. No direct client contact
by the trainee or newly hired staff, or by any direct care contractor
shall occur prior to clearance by the department unless the trainee,
newly hired employee, contractor, or employee of the contractor is
constantly supervised.
   (C) Commencing July 1, 2012, any contract for services provided
directly to patients or residents shall contain provisions to ensure
that the direct services contractor submits to the State Department
of Social Services fingerprint images and related information
pertaining to the direct services contractor for submission to the
Department of Justice for purposes of a criminal record check, as
specified in paragraph                                          (2),
at the expense of the direct services contractor or licensee. The
Department of Justice shall provide the results of the criminal
record check to the department. The department shall determine
whether the direct services contractor has ever been convicted of a
crime specified in subdivision (c). The department shall notify the
licensee of these results.
   (2) If the applicant, licensee, direct care staff person, or
direct services contractor specified in paragraph (1) has resided in
California for at least the previous seven years, the State
Department of Social Services shall only require the submission of
one set of fingerprint images and related information. The Department
of Justice shall charge a fee sufficient to cover the reasonable
cost of processing the fingerprint submission. Fingerprints and
related information submitted pursuant to this subdivision include
fingerprint images captured and transmitted electronically. When
requested, the Department of Justice shall forward one set of
fingerprint images to the Federal Bureau of Investigation for the
purpose of obtaining any record of previous convictions or arrests
pending adjudication of the applicant, licensee, direct care staff
person, or direct services contractor. The results of a criminal
record check provided by the Department of Justice shall contain
every conviction rendered against an applicant, licensee, direct care
staff person, or direct services contractor, and every offense for
which the applicant, licensee, direct care staff person, or direct
services contractor is presently awaiting trial, whether the person
is incarcerated or has been released on bail or on his or her own
recognizance pending trial. The department shall request subsequent
arrest notification from the Department of Justice pursuant to
Section 11105.2 of the Penal Code.
   (3) An applicant and any other person specified in this
subdivision, as part of the background clearance process, shall
provide information as to whether or not the person has any prior
criminal convictions, has had any arrests within the past 12-month
period, or has any active arrests, and shall certify that, to the
best of his or her knowledge, the information provided is true. This
requirement is not intended to duplicate existing requirements for
individuals who are required to submit fingerprint images as part of
a criminal background clearance process. Every applicant shall
provide information on any prior administrative action taken against
him or her by any federal, state, or local government agency and
shall certify that, to the best of his or her knowledge, the
information provided is true. An applicant or other person required
to provide information pursuant to this section that knowingly or
willfully makes false statements, representations, or omissions may
be subject to administrative action, including, but not limited to,
denial of his or her application or exemption or revocation of any
exemption previously granted.
   (c) (1) The State Department of Social Services shall deny any
application for any license, suspend or revoke any existing license,
and disapprove or revoke any employment or contract for direct
services, if the applicant, licensee, employee, or direct services
contractor has been convicted of, or incarcerated for, a felony
defined in subdivision (c) of Section 667.5 of, or subdivision (c) of
Section 1192.7 of, the Penal Code, within the preceding 10 years.
   (2) The application for licensure or renewal of any license shall
be denied, and any employment or contract to provide direct services
shall be disapproved or revoked, if the criminal record of the person
includes a conviction in another jurisdiction for an offense that,
if committed or attempted in this state, would have been punishable
as one or more of the offenses referred to in paragraph (1).
   (d) (1) The State Department of Social Services may approve an
application for, or renewal of, a license, or continue any employment
or contract for direct services, if the person has been convicted of
a misdemeanor offense that is not a crime upon the person of
another, the nature of which has no bearing upon the duties for which
the person will perform as a licensee, direct care staff person, or
direct services contractor. In determining whether to approve the
application, employment, or contract for direct services, the
department shall take into consideration the factors enumerated in
paragraph (2).
   (2) Notwithstanding subdivision (c), if the criminal record of a
person indicates any conviction other than a minor traffic violation,
the State Department of Social Services may deny the application for
license or renewal, and may disapprove or revoke any employment or
contract for direct services. In determining whether or not to deny
the application for licensure or renewal, or to disapprove or revoke
any employment or contract for direct services, the department shall
take into consideration the following factors:
   (A) The nature and seriousness of the offense under consideration
and its relationship to the person's employment, duties, and
responsibilities.
   (B) Activities since conviction, including employment or
participation in therapy or education, that would indicate changed
behavior.
   (C) The time that has elapsed since the commission of the conduct
or offense and the number of offenses.
   (D) The extent to which the person has complied with any terms of
parole, probation, restitution, or any other sanction lawfully
imposed against the person.
   (E) Any rehabilitation evidence, including character references,
submitted by the person.
   (F) Employment history and current employer recommendations.
   (G) Circumstances surrounding the commission of the offense that
would demonstrate the unlikelihood of repetition.
   (H) The granting by the Governor of a full and unconditional
pardon.
   (I) A certificate of rehabilitation from a superior court.
   (e) Denial, suspension, or revocation of a license, or disapproval
or revocation of any employment or contract for direct services
specified in subdivision (c) and paragraph (2) of subdivision (d) are
not subject to appeal, except as provided in subdivision (f).
   (f) After a review of the record, the director may grant an
exemption from denial, suspension, or revocation of any license, or
disapproval of any employment or contract for direct services, if the
crime for which the person was convicted was a property crime that
did not involve injury to any person and the director has substantial
and convincing evidence to support a reasonable belief that the
person is of such good character as to justify issuance or renewal of
the license or approval of the employment or contract.
   (g) A plea or verdict of guilty, or a conviction following a plea
of nolo contendere shall be deemed a conviction within the meaning of
this section. The State Department of Social Services may deny any
application, or deny, suspend, or revoke a license, or disapprove or
revoke any employment or contract for direct services based on a
conviction specified in subdivision (c) when the judgment of
conviction is entered or when an order granting probation is made
suspending the imposition of sentence.
   (h) (1) For purposes of this section, "direct care staff" means
any person who is an employee, contractor, or volunteer who has
contact with other patients or residents in the provision of
services. Administrative and licensed personnel shall be considered
direct care staff when directly providing program services to
participants.
   (2) An additional background check shall not be required pursuant
to this section if the direct care staff or licensee has received a
prior criminal history background check while working in a mental
health rehabilitation center or psychiatric health facility licensed
by the State Department of Social Services, and provided the
department has maintained continuous subsequent arrest notification
on the individual from the Department of Justice since the prior
criminal background check was initiated.
   (3) When an application is denied on the basis of a conviction
pursuant to this section, the State Department of Social Services
shall provide the individual whose application was denied with
notice, in writing, of the specific grounds for the proposed denial.
  SEC. 105.  The heading of Article 2 (commencing with Section 5510)
of Chapter 6.2 of Part 1 of Division 5 of the Welfare and
Institutions Code is amended to read:

      Article 2.  Patients' Rights Program


  SEC. 106.  Section 5510 of the Welfare and Institutions Code is
amended to read:
   5510.  (a) The Legislature finds and declares as follows:
   (1) The State of California accepts its responsibility to ensure
and uphold the right of persons with mental disabilities and an
obligation, to be executed by the State Department of State Hospitals
and the State Department of Health Care Services, to ensure that
mental health laws, regulations and policies on the rights of
recipients of mental health services are observed and protected in
state hospitals and in licensed health and community care facilities.

   (2) Persons with mental illness are vulnerable to abuse, neglect,
and unreasonable and unlawful deprivations of their rights.
   (3) Patients' rights advocacy and investigative services
concerning patient abuse and neglect previously provided by the State
Department of Mental Health, including the Office of Human Rights
and investigator, and state hospitals' patients' rights advocates and
state hospital investigators and transferred to the State Department
of Health Care Services and the State Department of State Hospitals,
may have had or have conflicts of interest or the appearance of a
conflict of interest.
   (4) The services provided to patients and their families are of
such a special and unique nature that they must be contracted out
pursuant to paragraph (3) of subdivision (b) of Section 19130 of the
Government Code.
   (b) Therefore, to avoid the potential for a conflict of interest
or the appearance of a conflict of interest, it is the intent of the
Legislature that the patients' rights advocacy and investigative
services described in this article be provided by a single contractor
specified in Section 5370.2 that meets both of the following
criteria:
   (1) The contractor can demonstrate the capability to provide
statewide advocacy services for persons with mental disabilities.
   (2) The contractor has no direct or indirect responsibility for
providing services to persons with mental disabilities, except
advocacy services.
   (c) For the purposes of this article, the Legislature further
finds and declares, because of a potential conflict of interest or
the appearance of a conflict of interest, that the goals and purposes
of the state patients' rights advocacy and investigative services
cannot be accomplished through the utilization of persons selected
pursuant to the regular state civil service system. Accordingly, the
contracts into which the department enters pursuant to this section
are permitted and authorized by paragraphs (3) and (5) of subdivision
(b) of Section 19130 of the Government Code.
   (d) The State Department of State Hospitals and the State
Department of Health Care Services shall contract with a single
nonprofit entity to provide for the protection and advocacy services
to persons with mental disabilities, as specified in Section 5370.2.
The State Department of Health Care Services and the State Department
of State Hospitals shall enter into a memorandum of understanding to
ensure the effective management of the contract and the required
activities affecting county patients' rights programs. The entity
shall be responsible for ensuring that mental health laws,
regulations, and policies on the rights of recipients of mental
health services are observed in state hospitals and in licensed
health and community care facilities.
   (e) The findings and declarations of potential conflict of
interest provided in this section shall not apply to advocacy
services provided under Article 3 (commencing with Section 5520).
  SEC. 107.  Section 5513 of the Welfare and Institutions Code is
amended to read:
   5513.  The patients' rights program shall serve as a liaison
between county patients' rights advocates and the State Department of
Health Care Services.
  SEC. 108.  Section 5514 of the Welfare and Institutions Code is
amended to read:
   5514.  There shall be a five-person Patients' Rights Committee
formed through the California Mental Health Planning Council. This
committee, supplemented by two ad hoc members appointed by the
chairperson of the committee, shall advise the Director of Health
Care Services and the Director of State Hospitals regarding
department policies and practices that affect patients' rights. The
committee shall also review the advocacy and patients' rights
components of each county mental health plan or performance contract
and advise the Director of Health Care Services and the Director of
State Hospitals concerning the adequacy of each plan or performance
contract in protecting patients' rights. The ad hoc members of the
committee shall be persons with substantial experience in
establishing and providing independent advocacy services to
recipients of mental health services.
  SEC. 109.  Section 5520 of the Welfare and Institutions Code is
amended to read:
   5520.  Each local mental health director shall appoint, or
contract for the services of, one or more county patients' rights
advocates. The duties of these advocates shall include, but not be
limited to, the following:
   (a) To receive and investigate complaints from or concerning
recipients of mental health services residing in licensed health or
community care facilities regarding abuse, unreasonable denial or
punitive withholding of rights guaranteed under the provisions of
Division 5 (commencing with Section 5000).
   (b) To monitor mental health facilities, services and programs for
compliance with statutory and regulatory patients' rights
provisions.
   (c) To provide training and education about mental health law and
patients' rights to mental health providers.
   (d) To ensure that recipients of mental health services in all
licensed health and community care facilities are notified of their
rights.
   (e) To exchange information and cooperate with the patients'
rights program.
   This section does not constitute a change in, but is declarative
of the existing law.
  SEC. 110.  Section 5530 of the Welfare and Institutions Code is
amended to read:
   5530.  (a) County patients' rights advocates shall have access to
all clients and other recipients of mental health services in any
mental health facility, program, or service at all times as are
necessary to investigate or resolve specific complaints and in accord
with subdivision (b) of Section 5523. County patients' rights
advocates shall have access to mental health facilities, programs,
and services, and recipients of services therein during normal
working hours and visiting hours for other advocacy purposes.
Advocates may appeal any denial of access directly to the head of any
facility, the director of a county mental health program, or the
State Department of Health Care Services, or may seek appropriate
relief in the courts. If a petition to a court sets forth prima facie
evidence for relief, a hearing on the merits of the petition shall
be held within two judicial days of the filing of the petition. The
superior court for the county in which the facility is located shall
have jurisdiction to review petitions filed pursuant to this chapter.

   (b) County patients' rights advocates shall have the right to
interview all persons providing the client with diagnostic or
treatment services.
   (c) Upon request, all mental health facilities shall, when
available, provide reasonable space for county patients' rights
advocates to interview clients in privacy and shall make appropriate
staff persons available for interview with the advocates in
connection with pending matters.
   (d) Individual patients shall have a right to privacy which shall
include the right to terminate any visit by persons who have access
pursuant to this chapter and the right to refuse to see any patient
advocate.
   (e) Notice of the availability of advocacy services and
information about patients' rights may be provided by county patients'
rights advocates by means of distribution of educational materials
and discussions in groups and with individual patients.
  SEC. 111.  Section 5585.21 of the Welfare and Institutions Code is
amended to read:
   5585.21.  The Director of Social Services may promulgate
regulations as necessary to implement and clarify the provisions of
this part as they relate to minors.
  SEC. 112.  Section 5585.22 of the Welfare and Institutions Code is
amended to read:
   5585.22.  The Director of Health Care Services, in consultation
with the California Mental Health Directors Association, may develop
the appropriate educational materials and a training curriculum, and
may provide training as necessary to ensure that those persons
providing services pursuant to this part fully understand its
purpose.
  SEC. 113.  Section 5585.50 of the Welfare and Institutions Code is
amended to read:
   5585.50.  When any minor, as a result of mental disorder, is a
danger to others, or to himself or herself, or gravely disabled and
authorization for voluntary treatment is not available, a peace
officer, member of the attending staff, as defined by regulation, of
an evaluation facility designated by the county, designated members
of a mobile crisis team provided by Section 5651.7, or other
professional person designated by the county may, upon probable
cause, take, or cause to be taken, the minor into custody and place
him or her in a facility designated by the county and approved by the
State Department of Social Services as a facility for 72-hour
treatment and evaluation of minors. The facility shall make every
effort to notify the minor's parent or legal guardian as soon as
possible after the minor is detained.
   The facility shall require an application in writing stating the
circumstances under which the minor's condition was called to the
attention of the officer, member of the attending staff, or
professional person, and stating that the officer, member of the
attending staff, or professional person has probable cause to believe
that the minor is, as a result of mental disorder, a danger to
others, or to himself or herself, or gravely disabled and
authorization for voluntary treatment is not available. If the
probable cause is based on the statement of a person other than the
officer, member of the attending staff, or professional person, the
person shall be liable in a civil action for intentionally giving a
statement which he or she knows to be false.
  SEC. 114.  Section 5585.55 of the Welfare and Institutions Code is
amended to read:
   5585.55.  The minor committed for involuntary treatment under this
part shall be placed in a health facility designated by the county
and approved by the State Department of Social Services as a facility
for 72-hour evaluation and treatment. Except as provided for in
Section 5751.7, each county shall ensure that minors under 16 years
of age are not held with adults receiving psychiatric treatment under
the provisions of the Lanterman-Petris-Short Act (Part 1 (commencing
with Section 5000)).
  SEC. 115.  Section 5600.8 of the Welfare and Institutions Code is
repealed.
  SEC. 116.  Section 5601 of the Welfare and Institutions Code is
amended to read:
   5601.  As used in this part:
   (a) "Governing body" means the county board of supervisors or
boards of supervisors in the case of counties acting jointly; and in
the case of a city, the city council or city councils acting jointly.

   (b) "Conference" means the California Mental Health Directors
Association as established under former Section 5757.
   (c)  Unless the context requires otherwise, "to the extent
resources are available" means to the extent that funds deposited in
the mental health account of the local health and welfare fund are
available to an entity qualified to use those funds.
   (d) "Part 1" refers to the Lanterman-Petris-Short Act (Part 1
(commencing with Section 5000)).
   (e) "Director of Health Care Services" or "director" means the
Director of the State Department of Health Care Services.
   (f) "Institution" includes a general acute care hospital, a state
hospital, a psychiatric hospital, a psychiatric health facility, a
skilled nursing facility, including an institution for mental disease
as described in Chapter 1 (commencing with Section 5900) of Part 5,
an intermediate care facility, a community care facility or other
residential treatment facility, or a juvenile or criminal justice
institution.
   (g) "Mental health service" means any service directed toward
early intervention in, or alleviation or prevention of, mental
disorder, including, but not limited to, diagnosis, evaluation,
treatment, personal care, day care, respite care, special living
arrangements, community skill training, sheltered employment,
socialization, case management, transportation, information,
referral, consultation, and community services.
  SEC. 117.  Section 5602 of the Welfare and Institutions Code is
amended to read:
   5602.  The board of supervisors of every county, or the boards of
supervisors of counties acting under the joint powers provisions of
Article 1 (commencing with Section 6500) of Chapter 5 of Division 7
of Title 1 of the Government Code shall establish a community mental
health service to cover the entire area of the county or counties.
Services of the State Department of Health Care Services shall be
provided to the county, or counties acting jointly, or, if both
parties agree, the state facilities may, in whole or in part, be
leased, rented or sold to the county or counties for county
operation, subject to terms and conditions approved by the Director
of General Services.
  SEC. 118.  Section 5604 of the Welfare and Institutions Code is
amended to read:
   5604.  (a) (1) Each community mental health service shall have a
mental health board consisting of 10 to 15 members, depending on the
preference of the county, appointed by the governing body, except
that boards in counties with a population of less than 80,000 may
have a minimum of five members. One member of the board shall be a
member of the local governing body. Any county with more than five
supervisors shall have at least the same number of members as the
size of its board of supervisors. Nothing in this section shall be
construed to limit the ability of the governing body to increase the
number of members above 15. Local mental health boards may recommend
appointees to the county supervisors. Counties are encouraged to
appoint individuals who have experience and knowledge of the mental
health system. The board membership should reflect the ethnic
diversity of the client population in the county.
   (2) Fifty percent of the board membership shall be consumers or
the parents, spouses, siblings, or adult children of consumers, who
are receiving or have received mental health services. At least 20
percent of the total membership shall be consumers, and at least 20
percent shall be families of consumers.
   (3) (A) In counties under 80,000 population, at least one member
shall be a consumer, and at least one member shall be a parent,
spouse, sibling, or adult child of a consumer, who is receiving, or
has received, mental health services.
   (B) Notwithstanding subparagraph (A), a board in a county with a
population under 80,000 that elects to have the board exceed the
five-member minimum permitted under paragraph (1) shall be required
to comply with paragraph (2).
   (b) The term of each member of the board shall be for three years.
The governing body shall equitably stagger the appointments so that
approximately one-third of the appointments expire in each year.
   (c) If two or more local agencies jointly establish a community
mental health service under Article 1 (commencing with Section 6500)
of Chapter 5 of Division 7 of Title 1 of the Government Code, the
mental health board for the community mental health service shall
consist of an additional two members for each additional agency, one
of whom shall be a consumer or a parent, spouse, sibling, or adult
child of a consumer who has received mental health services.
   (d)  No member of the board or his or her spouse shall be a
full-time or part-time county employee of a county mental health
service, an employee of the State Department of Health Care Services,
or an employee of, or a paid member of the governing body of, a
mental health contract agency.
   (e) Members of the board shall abstain from voting on any issue in
which the member has a financial interest as defined in Section
87103 of the Government Code.
   (f) If it is not possible to secure membership as specified from
among persons who reside in the county, the governing body may
substitute representatives of the public interest in mental health
who are not full-time or part-time employees of the county mental
health service, the State Department of Health Care Services, or on
the staff of, or a paid member of the governing body of, a mental
health contract agency.
   (g) The mental health board may be established as an advisory
board or a commission, depending on the preference of the county.
  SEC. 119.  Section 5607 of the Welfare and Institutions Code is
amended to read:
   5607.  The local mental health services shall be administered by a
local director of mental health services to be appointed by the
governing body. He or she shall meet such standards of training and
experience as the State Department of Health Care Services, by
regulation, shall require. Applicants for these positions need not be
residents of the city, county, or state, and may be employed on a
full or part-time basis. If a county is unable to secure the services
of a person who meets the standards of the State Department of
Health Care Services, the county may select an alternate
administrator.
  SEC. 120.  Section 5610 of the Welfare and Institutions Code is
amended to read:
   5610.  (a) Each county mental health system shall comply with
reporting requirements developed by the State Department of Health
Care Services, in consultation with the California Mental Health
Planning Council and the Mental Health Services Oversight and
Accountability Commission, which shall be uniform and simplified. The
department shall review existing data requirements to eliminate
unnecessary requirements and consolidate requirements which are
necessary. These requirements shall provide
                        comparability between counties in reports.
   (b) The department shall develop, in consultation with the
Performance Outcome Committee, the California Mental Health Planning
Council, and the Mental Health Services Oversight and Accountability
Commission, pursuant to Section 5611, and with the California Health
and Human Services Agency, uniform definitions and formats for a
statewide, nonduplicative client-based information system that
includes all information necessary to meet federal mental health
grant requirements and state and federal Medicaid reporting
requirements, as well as any other state requirements established by
law. The data system, including performance outcome measures reported
pursuant to Section 5613, shall be developed by July 1, 1992.
   (c) Unless determined necessary by the department to comply with
federal law and regulations, the data system developed pursuant to
subdivision (b) shall not be more costly than that in place during
the 1990-91 fiscal year.
   (d) (1) The department shall develop unique client identifiers
that permit development of client-specific cost and outcome measures
and related research and analysis.
   (2) The department's collection and use of client information, and
the development and use of client identifiers, shall be consistent
with clients' constitutional and statutory rights to privacy and
confidentiality.
   (3) Data reported to the department may include name and other
personal identifiers. That information is confidential and subject to
Section 5328 and any other state and federal laws regarding
confidential client information.
   (4) Personal client identifiers reported to the department shall
be protected to ensure confidentiality during transmission and
storage through encryption and other appropriate means.
   (5) Information reported to the department may be shared with
local public mental health agencies submitting records for the same
person and that information is subject to Section 5328.
   (e) All client information reported to the department pursuant to
Chapter 2 (commencing with Section 4030) of Part 1 of Division 4 and
Sections 5328 to 5772.5, inclusive, Chapter 8.9 (commencing with
Section 14700), and any other state and federal laws regarding
reporting requirements, consistent with Section 5328, shall not be
used for purposes other than those purposes expressly stated in the
reporting requirements referred to in this subdivision.
   (f) The department may adopt emergency regulations to implement
this section in accordance with the Administrative Procedure Act,
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code. The adoption of emergency
regulations to implement this section that are filed with the Office
of Administrative Law within one year of the date on which the act
that added this subdivision took effect shall be deemed to be an
emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare and shall remain in
effect for no more than 180 days.
  SEC. 121.  Section 5650 of the Welfare and Institutions Code is
amended to read:
   5650.  (a) The board of supervisors of each county, or boards of
supervisors of counties acting jointly, shall adopt, and submit to
the Director of Health Care Services in the form and according to the
procedures specified by the director, a proposed annual county
mental health services performance contract for mental health
services in the county or counties.
   (b) The State Department of Health Care Services shall develop and
implement the requirements, format, procedure, and submission dates
for the preparation and submission of the proposed performance
contract.
  SEC. 122.  Section 5651 of the Welfare and Institutions Code is
amended to read:
   5651.  The proposed annual county mental health services
performance contract shall include all of the following:
   (a) The following assurances:
   (1) That the county is in compliance with the expenditure
requirements of Section 17608.05.
   (2) That the county shall provide services to persons receiving
involuntary treatment as required by Part 1 (commencing with Section
5000) and Part 1.5 (commencing with Section 5585).
   (3) That the county shall comply with all requirements necessary
for Medi-Cal reimbursement for mental health treatment services and
case management programs provided to Medi-Cal eligible individuals,
including, but not limited to, the provisions set forth in Chapter 3
(commencing with Section 5700), and that the county shall submit cost
reports and other data to the department in the form and manner
determined by the State Department of Health Care Services.
   (4) That the local mental health advisory board has reviewed and
approved procedures ensuring citizen and professional involvement at
all stages of the planning process pursuant to Section 5604.2.
   (5) That the county shall comply with all provisions and
requirements in law pertaining to patient rights.
   (6) That the county shall comply with all requirements in federal
law and regulation pertaining to federally funded mental health
programs.
   (7) That the county shall provide all data and information set
forth in Sections 5610 and 5664.
   (8) That the county, if it elects to provide the services
described in Chapter 2.5 (commencing with Section 5670), shall comply
with guidelines established for program initiatives outlined in that
chapter.
   (9) Assurances that the county shall comply with all applicable
laws and regulations for all services delivered, including all laws,
regulations, and guidelines of the Mental Health Services Act.
   (b) Any contractual requirements needed for any program
initiatives utilized by the county contained within this part. In
addition, any county may choose to include contract provisions for
other state directed mental health managed programs within this
performance contract.
   (c) The State Department of Health Care Services' ability to
monitor the county's three-year program and expenditure plan and
annual update pursuant to Section 5847.
   (d) Other information determined to be necessary by the director,
to the extent this requirement does not substantially increase county
costs.
  SEC. 123.  Section 5652.7 of the Welfare and Institutions Code is
amended to read:
   5652.7.  A county shall have only 60 days from the date of
submission of an application to review and certify or deny an
application to establish a new mental health care provider. If an
application requires review by the State Department of Health Care
Services, the department shall also have only 60 days from the date
of submission of the application to review and certify or deny an
application to establish a new mental health care provider.
  SEC. 124.  Section 5653 of the Welfare and Institutions Code is
amended to read:
   5653.  Optimum use shall be made of appropriate local public and
private organizations, community professional personnel, and state
agencies. Optimum use shall also be made of federal, state, county,
and private funds which may be available for mental health planning.
   In order that maximum utilization be made of federal and other
funds made available to the Department of Rehabilitation, the
Department of Rehabilitation may serve as a contractual provider
under the provisions of a county plan of vocational rehabilitation
services for the mentally disordered.
  SEC. 125.  Section 5653.1 of the Welfare and Institutions Code is
amended to read:
   5653.1.  In conducting evaluation, planning, and research
activities, counties may contract with public or private agencies.
  SEC. 126.  Section 5654 of the Welfare and Institutions Code is
amended to read:
   5654.  In order to serve the increasing needs of children and
adolescents with mental and emotional problems, county mental health
programs may use funds for the purposes of consultation and training.

  SEC. 127.  Section 5655 of the Welfare and Institutions Code is
amended to read:
   5655.  All departments of state government and all local public
agencies shall cooperate with county officials to assist them in
mental health planning. The State Department of Health Care Services
shall, upon request and with available staff, provide consultation
services to the local mental health directors, local governing
bodies, and local mental health advisory boards.
   If the Director of Health Care Services considers any county to be
failing, in a substantial manner, to comply with any provision of
this code or any regulation, the director shall order the county to
appear at a hearing, before the director or the director's designee,
to show cause why the department should not take action as set forth
in this section. The county shall be given at least 20 days' notice
of the hearing. The director shall consider the case on the record
established at the hearing and make final findings and decision.
   If the director determines that there is or has been a failure, in
a substantial manner, on the part of the county to comply with any
provision of this code or any regulations, and that administrative
sanctions are necessary, the department may invoke any, or any
combination of, the following sanctions:
   (a) Withhold part or all of state mental health funds from the
county.
   (b) Require the county to enter into negotiations for the purpose
of ensuring county compliance with those laws and regulations.
   (c) Bring an action in mandamus or any other action in court as
may be appropriate to compel compliance. Any action filed in
accordance with this section shall be entitled to a preference in
setting a date for a hearing.
  SEC. 128.  Section 5664 of the Welfare and Institutions Code is
amended to read:
   5664.  In consultation with the California Mental Health Directors
Association, the State Department of Health Care Services, the
Mental Health Services Oversight and Accountability Commission, the
California Mental Health Planning Council, and the California Health
and Human Services Agency, county mental health systems shall provide
reports and data to meet the information needs of the state, as
necessary.
  SEC. 129.  Section 5664.5 of the Welfare and Institutions Code is
amended to read:
   5664.5.  (a) County mental health systems shall continue to
provide data required by the State Department of Health Care Services
to establish uniform definitions and time increments for reporting
type and cost of services received by local mental health program
clients.
   (b) This section shall remain in effect only until January 1,
1994, and as of that date is repealed, unless a later enacted
statute, which becomes effective on or before January 1, 1994,
deletes or extends the dates on which it is repealed; or until the
date upon which the director informs the Legislature that the new
data system is established pursuant to Section 5610, whichever is
later, unless the provisions of the section are required by the
federal government.
  SEC. 130.  Section 5666 of the Welfare and Institutions Code is
amended to read:
   5666.  (a) The Director of Health Care Services, or his or her
designee, shall review each proposed county mental health services
performance contract to determine that it complies with the
requirements of this division.
   (b) The director or his or her designee shall require
modifications in the proposed county mental health services
performance contract which he or she deems necessary to bring the
proposed contract into conformance with the requirements of this
division.
   (c) Upon approval by both parties, the provisions of the
performance contract required by Section 5651 shall be deemed to be a
contractual arrangement between the state and county.
  SEC. 131.  Section 5673 of the Welfare and Institutions Code is
repealed.
  SEC. 132.  Section 5675 of the Welfare and Institutions Code is
amended to read:
   5675.  (a) Mental health rehabilitation centers shall only be
licensed by the State Department of Social Services subsequent to
application by counties, county contract providers, or other
organizations. In the application for a mental health rehabilitation
center, program evaluation measures shall include, but not be limited
to:
   (1) That the clients placed in the facilities show improved global
assessment scores, as measured by preadmission and postadmission
tests.
   (2) That the clients placed in the facilities demonstrate improved
functional behavior as measured by preadmission and postadmission
tests.
   (3) That the clients placed in the facilities have reduced
medication levels as determined by comparison of preadmission and
postadmission records.
   (b) The State Department of Social Services shall conduct annual
licensing inspections of mental health rehabilitation centers.
   (c) All regulations relating to the licensing of mental health
rehabilitation centers, heretofore adopted by the State Department of
Mental Health, shall remain in effect and shall be fully enforceable
by the State Department of Social Services with respect to any
facility or program required to be licensed as a mental health
rehabilitation center, unless and until readopted, amended, or
repealed by the Director of Social Services. The State Department of
Social Services shall succeed to and be vested with all duties,
powers, purposes, functions, responsibilities, and jurisdiction of
the State Department of Mental Health as they relate to licensing
mental health rehabilitation centers.
  SEC. 133.  Section 5675.1 of the Welfare and Institutions Code is
amended to read:
   5675.1.  (a) In accordance with subdivision (b), the State
Department of Social Services and the State Department of Health Care
Services may establish a system for the imposition of prompt and
effective civil sanctions for long-term care facilities licensed or
certified by those departments, including facilities licensed under
the provisions of Sections 5675 and 5768, and including facilities
certified as providing a special treatment program under Sections
72443 to 72474, inclusive, of Title 22 of the California Code of
Regulations.
   (b) If the departments determine that there is or has been a
failure, in a substantial manner, on the part of any such facility to
comply with the applicable laws and regulations, the directors may
impose the following sanctions:
   (1) A plan of corrective action that addresses all failure
identified by the departments and includes timelines for correction.
   (2) A facility that is issued a plan of corrective action, and
that fails to comply with the plan and repeats the deficiency, may be
subject to immediate suspension of its license or certification,
until the deficiency is corrected, when failure to comply with the
plan of correction may cause a health or safety risk to residents.
   (c) The departments may also establish procedures for the appeal
of an administrative action taken pursuant to this section, including
a plan of corrective action or a suspension of license or
certification.
  SEC. 134.  Section 5675.2 of the Welfare and Institutions Code is
amended to read:
   5675.2.  (a) There is hereby created in the State Treasury the
Mental Health Facility Licensing Fund, from which money, upon
appropriation by the Legislature in the Budget Act, shall be expended
by the State Department of Social Services to fund administrative
and other activities in support of the mental health licensing and
certification functions of the State Department of Social Services.
The Mental Health Facility Licensing Fund is the successor to the
Licensing and Certification Fund, Mental Health, which fund is hereby
abolished. All references in any law to the Licensing and
Certification Fund, Mental Health shall be deemed to refer to the
Mental Health Facility Licensing Fund.
   (b) Commencing January 1, 2005, each new and renewal application
for a license to operate a mental health rehabilitation center shall
be accompanied by an application or renewal fee.
   (c) The amount of the fees shall be determined and collected by
the State Department of Social Services, but the total amount of the
fees collected shall not exceed the actual costs of licensure and
regulation of the centers, including, but not limited to, the costs
of processing the application, inspection costs, and other related
costs.
   (d) Each license or renewal issued pursuant to this chapter shall
expire 12 months from the date of issuance. Application for renewal
of the license shall be accompanied by the necessary fee and shall be
filed with the department at least 30 days prior to the expiration
date. Failure to file a timely renewal may result in expiration of
the license.
   (e) License and renewal fees collected pursuant to this section
shall be deposited into the Mental Health Facility Licensing Fund.
   (f) Fees collected by the State Department of Social Services
pursuant to this section shall be expended by the State Department of
Social Services for the purpose of ensuring the health and safety of
all individuals providing care and supervision by licensees and to
support activities of the department, including, but not limited to,
monitoring facilities for compliance with applicable laws and
regulations.
   (g) The State Department of Social Services may make additional
charges to the facilities if additional visits are required to ensure
that corrective action is taken by the licensee.
  SEC. 135.  Section 5676 of the Welfare and Institutions Code is
amended to read:
   5676.  (a) The State Department of Health Care Services, in
conjunction with the State Department of Public Health, shall develop
a state-level plan for a streamlined and consolidated evaluation and
monitoring program for the review of skilled nursing facilities with
special treatment programs. The plan shall provide for consolidated
reviews, reports, and penalties for these facilities. The plan shall
include the cost of, and a timeline for implementing, the plan. The
plan shall be developed in consultation with stakeholders, including
county mental health programs, consumers, family members of persons
residing in long-term care facilities who have serious mental
illness, and long-term care providers. The plan shall review resident
safety and quality programming, ensure that long-term care
facilities engaged primarily in diagnosis, treatment, and care of
persons with mental diseases are available and appropriately
evaluated, and ensure that strong linkages are built to local
communities and other treatment resources for residents and their
families. The plan shall be submitted to the Legislature on or before
March 1, 2001.
   (b) The State Department of Public Health shall forward to the
State Department of Health Care Services copies of citations issued
to a skilled nursing facility that has a special treatment program
certified by the State Department of Health Care Services.
  SEC. 136.  Section 5688.6 of the Welfare and Institutions Code is
amended to read:
   5688.6.  Any and all funds appropriated for the homeless mentally
disabled which have been determined to be unexpended and unencumbered
two years after the date the funds were appropriated shall be
transferred to the Department of Housing and Community Development.
The amount of transfer shall be determined after the State Department
of Health Care Services settles county cost reports for the fiscal
year the funds were appropriated. The funds transferred to the
Department of Housing and Community Development shall be administered
in accordance with that department's Special Users Housing
Rehabilitation or Emergency Shelter programs to provide low-income
transitional and long-term housing for homeless mentally disabled
persons. Special priority shall be given to project proposals for
homeless mentally disabled persons in the same county from which the
funds for the support of the community support system were originally
allocated.
  SEC. 137.  Article 2.5 (commencing with Section 5689) of Chapter
2.5 of Part 2 of Division 5 of the Welfare and Institutions Code is
repealed.
  SEC. 138.  Section 5692 of the Welfare and Institutions Code is
amended to read:
   5692.  The State Department of Health Care Services shall, to the
extent resources are available, have responsibility for the provision
of technical assistance, maximizing federal revenue, and ensuring
coordination with other state agencies including implementing and
coordinating interagency agreements between the Department of
Rehabilitation and the State Department of Health Care Services.
  SEC. 139.  Section 5701 of the Welfare and Institutions Code is
amended to read:
   5701.  (a) To achieve equity of funding, available funding for
local mental health programs beyond the funding provided pursuant to
Section 17601 shall be distributed to cities, counties, and cities
and counties pursuant to the procedures described in subdivision (c)
of Section 17606.05.
   (b) Funding provided pursuant to Section 6 of Article XIII B of
the California Constitution, funding provided pursuant to subdivision
(c), and funding provided for future pilot projects shall be exempt
from the requirements of subdivision (a).
   (c) Effective in the 2012-13 fiscal year and each year thereafter:

   (1) The State Department of Health Care Services shall annually
identify from mental health block grant funds provided by the federal
government, the maximum amount that federal law and regulation
permit to be allocated to counties and cities and counties pursuant
to this subdivision. This section shall apply to any federal mental
health block grant funds in excess of the following:
   (A) Funds for departmental support.
   (B) Amounts awarded to counties and cities and counties for
children's systems of care programs pursuant to Part 4 (commencing
with Section 5850).
   (C) Amounts appropriated by the Legislature for the purposes of
this part.
   (2) Notwithstanding subdivision (a), annually the State Department
of Health Care Services shall allocate to counties and cities and
counties the funds identified in paragraph (1), not to exceed forty
million dollars ($40,000,000) in any year. The allocations shall be
proportional to each county's and each city and county's percentage
of the forty million dollars ($40,000,000) in Cigarette and Tobacco
Products Surtax funds that were allocated to local mental health
programs in the 1991-92 fiscal year.
   (3) Monthly, the Controller shall allocate funds from the Vehicle
License Collection Account of the Local Revenue Fund to counties and
cities and counties for mental health services. Allocations shall be
made to each county or city and county in the same percentages as
described in paragraph (2), until the total of the funds allocated to
all counties in each year pursuant to paragraph (2) and this
paragraph reaches forty million dollars ($40,000,000).
   (4) Funds allocated to counties and cities and counties pursuant
to paragraphs (2) and (3) shall not be subject to Section 17606.05.
   (5) Funds that are available for allocation in any year in excess
of the forty million dollar ($40,000,000) limits described in
paragraph (2) or (3) shall be deposited into the Mental Health
Subaccount of the Local Revenue Fund.
   (6) Nothing in this section is intended to, nor shall it, change
the base allocation of any city, county, or city and county as
provided in Section 17601.
  SEC. 140.  Section 5701.1 of the Welfare and Institutions Code is
amended to read:
   5701.1.  Notwithstanding Section 5701, the State Department of
Health Care Services, in consultation with the California Mental
Health Directors Association and the California Mental Health
Planning Council, may utilize funding from the Substance Abuse and
Mental Health Services Administration Block Grant, awarded to the
State Department of Health Care Services, above the funding level
provided in federal fiscal year 1998, for the development of
innovative programs for identified target populations, upon
appropriation by the Legislature.
  SEC. 141.  Section 5705 of the Welfare and Institutions Code is
amended to read:
   5705.  (a) Negotiated net amounts may be used as the cost of
services in contracts between the county and a subprovider of
services. A negotiated net amount shall be determined by calculating
the total budget for services for a program or a component of a
program, less the amount of projected revenue. All participating
government funding sources, except for the Medi-Cal program (Chapter
7 (commencing with Section 14000) of Part 3 of Division 9), shall be
bound to that amount as the cost of providing all or part of the
total county mental health program as described in the county
performance contract for each fiscal year, to the extent that the
governmental funding source participates in funding the county mental
health programs. Where the State Department of Health Care Services
promulgates regulations for determining reimbursement of mental
health services allowable under the Medi-Cal program, those
regulations shall be controlling as to the rates for reimbursement of
mental health services allowable under the Medi-Cal program and
rendered to Medi-Cal beneficiaries. Providers under this subdivision
shall report to the State Department of Health Care Services and
local mental health programs any information required by the State
Department of Health Care Services in accordance with procedures
established by the Director of Health Care Services.
   (b) Notwithstanding any other provision of this division or
Division 9 (commencing with Section 10000), absent a finding of
fraud, abuse, or failure to achieve contract objectives, no
restrictions, other than any contained in the contract, shall be
placed upon a provider's expenditure pursuant to this section.
  SEC. 142.  Section 5707 of the Welfare and Institutions Code is
amended to read:
   5707.  Funds appropriated to the State Department of Health Care
Services which are designated for local mental health services and
funds which the State Department of Health Care Services is
responsible for allocating or administering, including, but not
limited to, federal block grants funds, shall be expended in
accordance with this section and Sections 5710 to 5717, inclusive,
except when there are conflicting federal requirements, in which case
the federal requirements shall be controlling.
  SEC. 143.  Section 5708 of the Welfare and Institutions Code is
repealed.
  SEC. 144.  Section 5709 of the Welfare and Institutions Code is
amended to read:
   5709.  Regardless of the funding source involved, fees shall be
charged in accordance with the ability to pay for specialty mental
health services rendered but not in excess of actual costs in
accordance with Section 14708.
            SEC. 145.  Section 5710 of the Welfare and Institutions
Code is amended to read:
   5710.  (a) Charges for the care and treatment of each patient
receiving service from a county mental health program shall not
exceed the actual cost thereof as determined or approved by the
Director of Health Care Services in accordance with standard
accounting practices. The director may include the amount of
expenditures for capital outlay or the interest thereon, or both, in
his or her determination of actual cost. The responsibility of a
patient, his or her estate, or his or her responsible relatives to
pay the charges and the powers of the director with respect thereto
shall be determined in accordance with Article 4 (commencing with
Section 7275) of Chapter 3 of Division 7.
   (b) The Director of Health Care Services may delegate to each
county all or part of the responsibility for determining the
financial liability of patients to whom services are rendered by a
county mental health program and all or part of the responsibility
for determining the ability of the responsible parties to pay for
services to minor children who are referred by a county for treatment
in a state hospital. Liability shall extend to the estates of
patients and to responsible relatives, including the spouse of an
adult patient and the parents of minor children. The Director of
Health Care Services may also delegate all or part of the
responsibility for collecting the charges for patient fees. Counties
may decline this responsibility as it pertains to state hospitals, at
their discretion. If this responsibility is delegated by the
director, the director shall establish and maintain the policies and
procedures for making the determinations and collections. Each county
to which the responsibility is delegated shall comply with the
policy and procedures.
   (c) The director shall prepare and adopt a uniform sliding scale
patient fee schedule to be used in all mental health agencies for
services rendered to each patient. In preparing the uniform patient
fee schedule, the director shall take into account the existing
charges for state hospital services and those for community mental
health program services. If the director determines that it is not
practicable to devise a single uniform patient fee schedule
applicable to both state hospital services and services of other
mental health agencies, the director may adopt a separate fee
schedule for the state hospital services which differs from the
uniform patient fee schedule applicable to other mental health
agencies.
  SEC. 146.  Section 5711 of the Welfare and Institutions Code is
amended and renumbered to read:
   14707.  (a) In the case of federal audit exceptions, the
department shall follow federal audit appeal processes unless the
department, in consultation with the California Mental Health
Directors Association, determines that those appeals are not cost
beneficial.
   (b) Whenever there is a final federal audit exception against the
state resulting from expenditure of federal funds by individual
counties, the department may offset federal reimbursement and request
the Controller's office to offset the distribution of funds to the
counties from the Mental Health Subaccount, the Mental Health Equity
Subaccount, and the Vehicle License Collection Account of the Local
Revenue Fund, funds from the Mental Health Account and the Behavioral
Health Subaccount of the Local Revenue Fund 2011, and any other
mental health realignment funds from which the Controller makes
distributions to the counties by the amount of the exception. The
department shall provide evidence to the Controller that the county
has been notified of the amount of the audit exception no less than
30 days before the offset is to occur. The department shall involve
the appropriate counties in developing responses to any draft federal
audit reports that directly impact the county.
  SEC. 147.  Section 5712 of the Welfare and Institutions Code is
repealed.
  SEC. 148.  Section 5714 of the Welfare and Institutions Code is
amended to read:
   5714.  To continue county expenditures for legal proceedings
involving mentally disordered persons, the following costs incurred
in carrying out Part 1 (commencing with Section 5000) of this
division shall not be paid for from funds designated for mental
health services.
   (a) The costs involved in bringing a person in for 72-hour
treatment and evaluation.
   (b) The costs of court proceedings for court-ordered evaluation,
including the service of the court order and the apprehension of the
person ordered to evaluation when necessary.
   (c) The costs of court proceedings in cases of appeal from 14-day
intensive treatment.
   (d) The cost of legal proceedings in conservatorship other than
the costs of conservatorship investigation as defined by regulations
of the State Department of Health Care Services.
   (e) The court costs in postcertification proceedings.
   (f) The cost of providing a public defender or other
court-appointed attorneys in proceedings for those unable to pay.
  SEC. 149.  Section 5715 of the Welfare and Institutions Code is
amended to read:
   5715.  Subject to the approval of the State Department of Health
Care Services, at the end of the fiscal year, a county may retain
unexpended funds allocated to it by the department from funds
appropriated to the department, with the exception of block grant
funds, exclusive of the amount required to pay for the care of
patients in state hospitals, for 12 months for expenditure for mental
health services in accordance with this part.
  SEC. 150.  Section 5716 of the Welfare and Institutions Code is
amended and renumbered to read:
   14705.7.  Mental health plans may contract with providers on a
negotiated net amount basis in the same manner as set forth in
Section 5705. Negotiated net amounts or rates shall not be in
contracts between the state and mental health plans for specialty
mental health services. Reimbursement to mental health plans that
have certified public expenditures shall be consistent with federal
Medicaid requirements for calculating upper payment limits, as
specified in the approved Medicaid state plan and waivers.
  SEC. 151.  Section 5717 of the Welfare and Institutions Code is
amended to read:
   5717.  (a) Expenditures that may be funded from amounts allocated
to the county by the State Department of Health Care Services from
funds appropriated to the department shall include, salaries of
personnel, approved facilities and services provided through
contract, and operation, maintenance, and service costs, including
insurance costs or departmental charges for participation in a county
self-insurance program if the charges are not in excess of
comparable available commercial insurance premiums and on the
condition that any surplus reserves be used to reduce future year
contributions; depreciation of county facilities as established in
the state's uniform accounting manual, disregarding depreciation on
the facility to the extent it was financed by state funds under this
part; lease of facilities where there is no intention to, nor option
to, purchase; expenses incurred under this act by members of the
California Mental Health Directors Association for attendance at
regular meetings of these conferences; expenses incurred by either
the chairperson or elected representative of the local mental health
advisory boards for attendance at regular meetings of the
Organization of Mental Health Advisory Boards; expenditures included
in approved countywide cost allocation plans submitted in accordance
with the Controller's guidelines, including, but not limited to,
adjustments of prior year estimated general county overhead to actual
costs, but excluding allowable costs otherwise compensated by state
funding; net costs of conservatorship investigation, approved by the
Director of Health Care Services. Except for expenditures made
pursuant to Article 6 (commencing with Section 129225) of Chapter 1
of Part 6 of Division 107 of the Health and Safety Code, it shall not
include expenditures for initial capital improvements; the purchaser
or construction of buildings except for equipment items and
remodeling expense as may be provided for in regulations of the State
Department of Health Care Services; compensation to members of a
local mental health advisory board, except actual and necessary
expenses incurred in the performance of official duties that may
include travel, lodging, and meals while on official business; or
expenditures for a purpose for which state reimbursement is claimed
under any other provision of law.
   (b) The Director of Health Care Services may make investigations
and audits of expenditures the director may deem necessary.
   (c) With respect to funds allocated to a county by the State
Department of Health Care Services from funds appropriated to the
department, the county shall repay to the state amounts found not to
have been expended in accordance with the requirements set forth in
this part. Repayment shall be within 30 days after it is determined
that an expenditure has been made that is not in accordance with the
requirements. In the event that repayment is not made in a timely
manner, the department shall offset any amount improperly expended
against the amount of any current or future advance payment or cost
report settlement from the state for mental health services.
Repayment provisions shall not apply to Short-Doyle funds allocated
by the department for fiscal years up to and including the 1990-91
fiscal year.
  SEC. 152.  Section 5718 of the Welfare and Institutions Code, as
added by Section 2 of Chapter 651 of the Statutes of 2011, is amended
and renumbered to read:
   14705.  (a) (1) This section shall apply to specialty mental
health services provided by counties to Medi-Cal eligible
individuals. Counties shall provide services to Medi-Cal
beneficiaries and seek the maximum federal reimbursement possible for
services rendered to persons with mental illnesses.
   (2) To the extent permitted under federal law and Section 5892,
funds distributed to the counties from the Mental Health Subaccount,
the Mental Health Equity Subaccount, and the Vehicle License
Collection Account of the Local Revenue Fund, funds from the Mental
Health Account and the Behavioral Health Subaccount of the Local
Revenue Fund 2011, funds from the Mental Health Services Fund, and
any other funds from which the Controller makes distributions to the
counties may be used to pay for services provided by these funds that
the counties can then certify as public expenditures in order to
achieve the maximum federal reimbursement possible for services
pursuant to this chapter.
   (3) The standards and guidelines for the administration of
specialty mental health services to Medi-Cal eligible persons shall
be consistent with federal Medicaid requirements, as specified in the
approved Medicaid state plan and waivers to ensure full and timely
federal reimbursement to counties for services that are rendered and
claimed consistent with federal Medicaid requirements.
   (b) With regard to each person receiving specialty mental health
services from a mental health plan, the mental health plan shall
verify whether the person is Medi-Cal eligible and, if determined to
be Medi-Cal eligible, the person shall be referred when appropriate
to a facility, clinic, or program that is certified for Medi-Cal
reimbursement.
   (c) With regard to county operated facilities, clinics, or
programs for which claims are submitted to the department for
Medi-Cal reimbursement for specialty mental health services to
Medi-Cal eligible individuals, the county shall ensure that all
requirements necessary for Medi-Cal reimbursement for these services
are complied with, including, but not limited to, utilization review
and the submission of yearend cost reports by December 31 following
the close of the fiscal year.
   (d) Counties shall certify to the state that they have incurred
public expenditures prior to requesting the reimbursement of federal
funds.
   (e) This section shall become operative on July 1, 2012.
  SEC. 153.  Section 5719 of the Welfare and Institutions Code is
amended and renumbered to read:
   14705.5.  Each public or private facility or agency providing
local specialty mental health services pursuant to a county
performance contract plan shall make a written certification within
30 days after a patient is admitted to the facility as a patient or
first given services by such a facility or agency, to the local
mental health director of the county, stating whether or not each of
these patients is presumed to be eligible for specialty mental health
services under the Medi-Cal program.
  SEC. 154.  Section 5719.5 of the Welfare and Institutions Code is
amended and renumbered to read:
   14705.6.  (a) Notwithstanding any other provision of state law,
and to the extent permitted by federal law, the State Department of
Mental Health may, in consultation with the State Department of
Health Care Services, field test major components of a capitated,
integrated service system of Medi-Cal mental health managed care in
not less than two, and not more than five participating counties.
   (b) County participation in the field test shall be at the
counties' option.
   (c) Counties eligible to participate in the field test described
in subdivision (a) shall include either of the following:
   (1) Any county with an existing county organized health system.
   (2) Any county that has been designated for the development of a
new county organized health system.
   (d) The State Department of Mental Health, in consultation with
the State Department of Health Care Services, the counties selected
for field testing, and groups representing mental health clients,
their families and advocates, county mental health directors, and
public and private mental health professionals and providers, shall
develop, for the purpose of the field test, major components for an
integrated, capitated service system of Medi-Cal mental health
managed care, including, but not limited to, all of the following:
   (1) (A) A definition of medical necessity.
   (B) The preliminary definition developed pursuant to this
paragraph shall be submitted to the Legislature no later than
February 1, 1994.
   (2) Protocols for facilitating access and coordination of mental
health, physical health, educational, vocational, and other
supportive services for persons receiving services through the field
test.
   (3) Procedures for promoting quality assurance, performance
monitoring measures and outcome evaluation, including measures of
client satisfaction, and procedures for addressing beneficiary
grievances concerning service denials, changes, or terminations.
   (e) Counties participating in the field test shall report to the
State Department of Mental Health as the department deems necessary.
   (f) Counties participating in the field test shall do both of the
following:
   (1) (A) Explore, in consultation with the State Department of
Mental Health, the State Department of Health Care Services, and the
California Mental Health Directors Association, rates for capitated,
integrated Medi-Cal mental health managed care systems, using an
actuarially sound ratesetting methodology.
   (B) These rates shall be evaluated by the State Department of
Mental Health and the State Department of Health Care Services to
determine their fiscal impact, and shall result in no increase in
cost to the General Fund, compared with the cost that would occur
under the existing organization of Medi-Cal funded mental health
services, except for caseload growth and price increases as included
in the Medi-Cal estimates prepared by the State Department of Health
Care Services and approved by the Department of Finance. In
evaluating the fiscal impact of these rates, the departments shall
take into account any shift in clients between Medi-Cal programs in
which the nonfederal match is funded by state funds and those in
which the match is funded by local funds.
   (2) Demonstrate the appropriate fiscal relationship between county
organized health systems for the federal medicaid program and
integrated, capitated Medi-Cal mental health managed care programs.
   (3) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute that
is enacted before January 1, 2013, deletes or extends the dates on
which it becomes inoperative and is repealed.
  SEC. 155.  Section 5720 of the Welfare and Institutions Code, as
added by Section 4 of Chapter 651 of the Statutes of 2011, is amended
and renumbered to read:
   14708.  (a) For purposes of federal reimbursement to counties that
have certified to the state that they have incurred certified public
expenditures, the reimbursement amounts shall be consistent with
federal Medicaid requirements for calculating federal upper payment
limits, as specified in the approved Medicaid state plan and waivers.

   (b) If the reimbursement methodology utilizes federal upper
payment limits and the total cost of services exceeds the state
maximum rates in effect for the 2011-12 fiscal year, a county may use
certified public expenditures to claim the costs of services that
exceed the state maximum rates, up to the federal upper payment
limits. If a county chooses to claim costs that exceed the state
maximum rates with certified public expenditures, the county shall
use only local funds, and not state funds, to claim the portion of
the costs over the state maximum rates. As a condition of receiving
reimbursement up to the federal upper payment limits, a county shall
enter into and maintain an agreement with the department implementing
this subdivision.
   (c) Notwithstanding this section, in the event that a health
facility has entered into a negotiated rate agreement pursuant to
Article 2.6 (commencing with Section 14081) of Chapter 7 of Part 4 of
Division 9, the facility's rates shall be governed by that
agreement.
   (d) This section shall become operative on July 1, 2012.
  SEC. 156.  Section 5721 of the Welfare and Institutions Code is
amended and renumbered to read:
   14710.  Except as otherwise provided in this section, in
determining the amounts which may be paid, fees paid by persons
receiving services or fees paid on behalf of persons receiving
services by the federal government, by the Medi-Cal program set forth
in Chapter 7 (commencing with Section 14000), and by other public or
private sources, shall be deducted from the costs of providing
services. However, a mental health plan may negotiate a contract that
permits a specialty mental health care provider to retain
unanticipated funds above the budgeted contract amount, provided that
the unanticipated revenues are utilized for the specialty mental
health services specified in the contract. If a provider is permitted
by contract to retain unanticipated revenues above the budgeted
amount, the specialty mental health provider shall specify the
services funded by those revenues in the yearend cost report
submitted to the mental health plan. A mental health plan shall not
permit the retention of any fees paid by private resources on behalf
of Medi-Cal beneficiaries without having those fees deducted from the
costs of providing services. Whenever feasible, persons with mental
illness who are eligible for specialty mental health services under
the Medi-Cal program shall be treated in a facility approved for
reimbursement in that program. General unrestricted or undesignated
private charitable donations and contributions made to charitable or
nonprofit organizations shall not be considered as "fees paid by
persons" or "fees paid on behalf of persons receiving services" under
this section and the contributions shall not be applied in
determining the amounts to be paid. These unrestricted contributions
shall not be used in part or in whole to defray the costs or the
allocated costs of the Medi-Cal program.
  SEC. 157.  Section 5722 of the Welfare and Institutions Code is
amended and renumbered to read:
   14706.  (a) The department shall have responsibility for
conducting investigations and audits of claims and reimbursements for
expenditures for specialty mental health services provided by mental
health plans to Medi-Cal eligible individuals.
   (b) The amount of the payment or repayment of federal funds in
accordance with audit findings pertaining to Medi-Cal specialty
mental health services shall be determined by the department pursuant
to the existing administrative appeals process of the department.
  SEC. 158.  Section 5723 of the Welfare and Institutions Code is
amended and renumbered to read:
   14709.  The provisions of subdivision (a) of Section 14000 shall
not be construed to prevent providers of specialty mental health
services pursuant to this chapter from also being providers of
medical assistance mental health services for the purposes of Chapter
7 (commencing with Section 14000). Clinics providing Medi-Cal
specialty mental health services pursuant to this chapter shall be
required to be certified as a condition to reimbursement for
providing those medical assistance mental health services.
  SEC. 159.  Section 5723.5 of the Welfare and Institutions Code is
repealed.
  SEC. 160.  Section 5724 of the Welfare and Institutions Code, as
added by Section 6 of Chapter 651 of the Statutes of 2011, is amended
and renumbered to read:
   14711.  (a) The department shall develop, in consultation with the
California Mental Health Directors Association, a reimbursement
methodology for use in the Medi-Cal claims processing and interim
payment system that maximizes federal funding and utilizes, as much
as practicable, federal Medicaid and Medicare reimbursement
principles. The department shall work with the federal Centers for
Medicare and Medicaid Services in the development of the methodology
required by this section.
   (b) Reimbursement amounts developed through the methodology
required by this section shall be consistent with federal Medicaid
requirements and the approved Medicaid state plan and waivers.
   (c) Administrative costs shall be claimed separately in a manner
consistent with federal Medicaid requirements and the approved
Medicaid state plan and waivers and shall be limited to 15 percent of
the total actual cost of direct client services.
   (d) The cost of performing quality assurance and utilization
review activities shall be reimbursed separately and shall not be
included in administrative cost.
   (e) The reimbursement methodology established pursuant to this
section shall be based upon certified public expenditures, which
encourage economy and efficiency in service delivery.
   (f) The reimbursement amounts established for direct client
services pursuant to this section shall be based on increments of
time for all noninpatient services.
   (g) The reimbursement methodology shall not be implemented until
it has received any necessary federal approvals.
   (h) This section shall become operative on July 1, 2012.
  SEC. 161.  Section 5750 of the Welfare and Institutions Code is
amended to read:
   5750.  The State Department of Health Care Services shall
administer this part and shall adopt standards for the approval of
mental health services, and rules and regulations necessary thereto.
However, these standards, rules, and regulations shall be adopted
only after consultation with the California Mental Health Directors
Association and the California Mental Health Planning Council.
  SEC. 162.  Section 5750.1 of the Welfare and Institutions Code is
repealed.
  SEC. 163.  Section 5751 of the Welfare and Institutions Code is
amended to read:
   5751.  (a) Regulations pertaining to the qualifications of
directors of local mental health services shall be administered in
accordance with Section 5607. These standards may include the
maintenance of records of service which shall be reported to the
State Department of Health Care Services in a manner and at times as
it may specify.
   (b) Regulations pertaining to the position of director of local
mental health services, where the local director is other than the
local health officer or medical administrator of the county
hospitals, shall require that the director be a psychiatrist,
psychologist, clinical social worker, marriage and family therapist,
professional clinical counselor, registered nurse, or hospital
administrator, who meets standards of education and experience
established by the Director of Health Care Services. Where the
director is not a psychiatrist, the program shall have a psychiatrist
licensed to practice medicine in this state and who shall provide to
patients medical care and services as authorized by Section 2051 of
the Business and Professions Code.
   (c) The regulations shall be adopted in accordance with the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
  SEC. 164.  Section 5751.1 of the Welfare and Institutions Code is
amended to read:
   5751.1.  Regulations pertaining to the position of director of
local mental health services, where the local director is other than
the local health officer or medical administrator of the county
hospitals, shall require that the director meet the standards of
education and experience established by the Director of Health Care
Services and that the appointment be open on the basis of competence
to all eligible disciplines pursuant to Section 5751. Regulations
pertaining to the qualifications of directors of local mental health
services shall be administered in accordance with Section 5607.
   Where the director of local mental health services is not a
psychiatrist, the program shall have a psychiatrist licensed to
practice medicine in this state and who shall provide to patients
medical care and services as authorized by Section 2137 of the
Business and Professions Code.
  SEC. 165.  Section 5751.2 of the Welfare and Institutions Code is
amended to read:
   5751.2.  (a) Except as provided in this section, persons employed
or under contract to provide mental health services pursuant to this
part shall be subject to all applicable requirements of law regarding
professional licensure, and no person shall be employed in local
mental health programs pursuant to this part to provide services for
which a license is required, unless the person possesses a valid
license.
   (b) Persons employed as psychologists and clinical social workers,
while continuing in their employment in the same class as of January
1, 1979, in the same program or facility, including those persons on
authorized leave, but not including intermittent personnel, shall be
exempt from the requirements of subdivision (a).
                                                 (c) While registered
with the licensing board of jurisdiction for the purpose of
acquiring the experience required for licensure, persons employed or
under contract to provide mental health services pursuant to this
part as clinical social workers, marriage and family therapists, or
professional clinical counselors shall be exempt from subdivision
(a). Registration shall be subject to regulations adopted by the
appropriate licensing board.
   (d) The requirements of subdivision (a) shall be waived by the
State Department of Health Care Services for persons employed or
under contract to provide mental health services pursuant to this
part as psychologists who are gaining the experience required for
licensure. A waiver granted under this subdivision may not exceed
five years from the date of employment by, or contract with, a local
mental health program for persons in the profession of psychology.
   (e) The requirements of subdivision (a) shall be waived by the
State Department of Health Care Services for persons who have been
recruited for employment from outside this state as psychologists,
clinical social workers, marriage and family therapists, or
professional clinical counselors and whose experience is sufficient
to gain admission to a licensing examination. A waiver granted under
this subdivision may not exceed three years from the date of
employment by, or contract with, a local mental health program for
persons in these four professions who are recruited from outside this
state.
  SEC. 166.  Section 5751.7 of the Welfare and Institutions Code is
amended to read:
   5751.7.  For the purposes of this part and the
Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000)),
the State Department of Social Services and the State Department of
State Hospitals shall ensure that, whenever feasible, minors shall
not be admitted into psychiatric treatment with adults if the health
facility has no specific separate housing arrangements, treatment
staff, and treatment programs designed to serve children or
adolescents. The Director of Social Services shall provide waivers to
counties, upon their request, if this policy creates undue hardship
in any county due to inadequate or unavailable alternative resources.
In granting the waivers, the Director of Social Services shall
require the county to establish specific treatment protocols and
administrative procedures for identifying and providing appropriate
treatment to minors admitted with adults.
   However, notwithstanding any other provision of law, no minor may
be admitted for psychiatric treatment into the same treatment ward as
any adult receiving treatment who is in the custody of any jailor
for a violent crime, is a known registered sex offender, or has a
known history of, or exhibits inappropriate, sexual, or other violent
behavior which would present a threat to the physical safety of
minors.
  SEC. 167.  Section 5768 of the Welfare and Institutions Code is
amended to read:
   5768.  (a) Notwithstanding any other provision of law, except as
to requirements relating to fire and life safety of persons with
mental illness, the State Department of Social Services, in its
discretion, may permit new programs to be developed and implemented
without complying with licensure requirements established pursuant to
existing state law.
   (b) Any program developed and implemented pursuant to subdivision
(a) shall be reviewed at least once each six months, as determined by
the State Department of Social Services.
   (c) The State Department of Social Services may establish
appropriate licensing requirements for these new programs upon a
determination that the programs should be continued.
   (d) Within six years, any program shall require a licensure
category if it is to be continued. However, in the event that any
agency other than the State Department of Social Services is
responsible for developing a licensure category and fails to do so
within the six years, the program may continue to be developed and
implemented pursuant to subdivisions (a) and (b) until such time that
the licensure category is established.
   (e) (1) A nongovernmental entity proposing a program shall submit
a program application and plan to the local mental health director
that describes at least the following components: clinical treatment
programs, activity programs, administrative policies and procedures,
admissions, discharge planning, health records content, health
records service, interdisciplinary treatment teams, client
empowerment, patient rights, pharmaceutical services, program space
requirements, psychiatric and psychological services, rehabilitation
services, restraint and seclusion, space, supplies, equipment, and
staffing standards. If the local mental health director determines
that the application and plan are consistent with local needs and
satisfactorily address the above components, he or she may approve
the application and plan and forward them to the department.
   (2) Upon the State Department of Social Services' approval, the
local mental health director shall implement the program and shall be
responsible for regular program oversight and monitoring. The
department shall be notified in writing of the outcome of each review
of the program by the local mental health director, or his or her
designee, for compliance with program requirements. The department
shall retain ultimate responsibility for approving the method for
review of each program, and the authority for determining the
appropriateness of the local program's oversight and monitoring
activities.
   (f) Governmental entities proposing a program shall submit a
program application and plan to the State Department of Social
Services that describes at least the components described in
subdivision (e). Upon approval, the department shall be responsible
for program oversight and monitoring.
   (g) Implementation of a program shall be contingent upon the State
Department of Social Services' approval, and the department may
reject applications or require modifications as it deems necessary.
The department shall respond to each proposal within 90 days of
receipt.
   (h) The State Department of Social Services shall submit an
evaluation to the Legislature of all pilot projects authorized
pursuant to this section within five years of the commencement of
operation of the pilot project, determining the effectiveness of that
program or facility, or both, based on, but not limited to, changes
in clinical indicators with respect to client functions.
  SEC. 168.  Section 5770 of the Welfare and Institutions Code is
amended to read:
   5770.  Notwithstanding any other provision of law, the State
Department of Health Care Services may directly, or by contract, with
any public or private agency, provide any of the services under this
division when the state determines that the services are necessary
to protect the public health, safety, or welfare.
  SEC. 169.  Section 5770.5 of the Welfare and Institutions Code is
amended to read:
   5770.5.  The State Department of Health Care Services shall
encourage county mental health programs to develop and support local
programs designed to provide technical assistance to self-help groups
for the purposes of maintaining existing groups, as well as to
stimulate development of new self-help groups from locally defined
needs.
  SEC. 170.  Section 5771 of the Welfare and Institutions Code is
amended to read:
   5771.  (a) Pursuant to Public Law 102-321, there is the California
Mental Health Planning Council. The purpose of the planning council
shall be to fulfill those mental health planning requirements
mandated by federal law.
   (b) (1) The planning council shall have 40 members, to be
comprised of members appointed from both the local and state levels
in order to ensure a balance of state and local concerns relative to
planning.
   (2) As required by federal law, eight members of the planning
council shall represent various state departments.
   (3) Members of the planning council shall be appointed in a manner
that will ensure that at least one-half are persons with mental
disabilities, family members of persons with mental disabilities, and
representatives of organizations advocating on behalf of persons
with mental disabilities. Persons with mental disabilities and family
members shall be represented in equal numbers.
   (4) The Director of Health Care Services shall make appointments
from among nominees from various mental health constituency
organizations, which shall include representatives of
consumer-related advocacy organizations, representatives of mental
health professional and provider organizations, and representatives
who are direct service providers from both the public and private
sectors. The director shall also appoint one representative of the
California Coalition on Mental Health.
   (c) Members should be balanced according to demography, geography,
gender, and ethnicity. Members should include representatives with
interest in all target populations, including, but not limited to,
children and youth, adults, and older adults.
   (d) The planning council shall annually elect a chairperson and a
chair-elect.
   (e) The term of each member shall be three years, to be staggered
so that approximately one-third of the appointments expire in each
year.
   (f) In the event of changes in the federal requirements regarding
the structure and function of the planning council, or the
discontinuation of federal funding, the State Department of Health
Care Services shall, with input from state-level advocacy groups,
consumers, family members and providers, and other stakeholders,
propose to the Legislature modifications in the structure of the
planning council that the department deems appropriate.
  SEC. 171.  Section 5771.3 of the Welfare and Institutions Code is
amended to read:
   5771.3.  The California Mental Health Planning Council may utilize
staff of the State Department of Health Care Services, to the extent
they are available, and the staff of any other public or private
agencies that have an interest in the mental health of the public and
that are able and willing to provide those services.
  SEC. 172.  Section 5772 of the Welfare and Institutions Code is
amended to read:
   5772.  The California Mental Health Planning Council shall have
the powers and authority necessary to carry out the duties imposed
upon it by this chapter, including, but not limited to, the
following:
   (a) To advocate for effective, quality mental health programs.
   (b) To review, assess, and make recommendations regarding all
components of California's mental health system, and to report as
necessary to the Legislature, the State Department of Health Care
Services, local boards, and local programs.
   (c) To review program performance in delivering mental health
services by annually reviewing performance outcome data as follows:
   (1) To review and approve the performance outcome measures.
   (2) To review the performance of mental health programs based on
performance outcome data and other reports from the State Department
of Health Care Services and other sources.
   (3) To report findings and recommendations on programs'
performance annually to the Legislature, the State Department of
Health Care Services, and the local boards.
   (4) To identify successful programs for recommendation and for
consideration of replication in other areas. As data and technology
are available, identify programs experiencing difficulties.
   (d) When appropriate, make a finding pursuant to Section 5655 that
a county's performance is failing in a substantive manner. The State
Department of Health Care Services shall investigate and review the
finding, and report the action taken to the Legislature.
   (e) To advise the Legislature, the State Department of Health Care
Services, and county boards on mental health issues and the policies
and priorities that this state should be pursuing in developing its
mental health system.
   (f) To periodically review the state's data systems and paperwork
requirements to ensure that they are reasonable and in compliance
with state and federal law.
   (g) To make recommendations to the State Department of Health Care
Services on the award of grants to county programs to reward and
stimulate innovation in providing mental health services.
   (h) To conduct public hearings on the state mental health plan,
the Substance Abuse and Mental Health Services Administration block
grant, and other topics, as needed.
   (i) In conjunction with other statewide and local mental health
organizations, assist in the coordination of training and information
to local mental health boards as needed to ensure that they can
effectively carry out their duties.
   (j) To advise the Director of Health Care Services on the
development of the state mental health plan and the system of
priorities contained in that plan.
   (k) To assess periodically the effect of realignment of mental
health services and any other important changes in the state's mental
health system, and to report its findings to the Legislature, the
State Department of Health Care Services, local programs, and local
boards, as appropriate.
   (l) To suggest rules, regulations, and standards for the
administration of this division.
   (m) When requested, to mediate disputes between counties and the
state arising under this part.
   (n) To employ administrative, technical, and other personnel
necessary for the performance of its powers and duties, subject to
the approval of the Department of Finance.
   (o) To accept any federal fund granted, by act of Congress or by
executive order, for purposes within the purview of the California
Mental Health Planning Council, subject to the approval of the
Department of Finance.
   (p) To accept any gift, donation, bequest, or grants of funds from
private and public agencies for all or any of the purposes within
the purview of the California Mental Health Planning Council, subject
to the approval of the Department of Finance.
  SEC. 173.  Section 5775 of the Welfare and Institutions Code is
amended and renumbered to read:
   14712.  (a) Notwithstanding any other provision of state law, the
department shall implement managed mental health care for Medi-Cal
beneficiaries through contracts with mental health plans. Mental
health plans may include individual counties, counties acting
jointly, or an organization or nongovernmental entity determined by
the department to meet mental health plan standards. A contract may
be exclusive and may be awarded on a geographic basis.
   (b) Two or more counties acting jointly may agree to deliver or
subcontract for the delivery of specialty mental health services
subject to the approval by the department. The agreement may
encompass all or any portion of the specialty mental health services
provided pursuant to this chapter. This agreement shall not relieve
the individual counties of fiscal responsibility for providing these
services. Any agreement between counties shall delineate each county'
s responsibilities and fiscal liability for overpayments.
   (c) (1) The department shall contract with a county or counties
acting jointly for the delivery of specialty mental health services
to each county's eligible Medi-Cal beneficiary population. If a
county decides not to contract with the department, does not renew
its contract, or is unable to meet the standards set by the
department, the county shall inform the department of this decision
in writing.
   (2) If the county is unwilling to contract for the delivery of
specialty mental health services, the department shall ensure that
specialty mental health services are provided to Medi-Cal
beneficiaries.
   (3) If the department or county determines that the county is
unable to adequately provide specialty mental health services, or
that the county does not meet the standards of a mental health plan,
the department shall ensure that specialty mental health services are
provided to Medi-Cal beneficiaries.
   (4) The department may contract with qualifying individual
counties, counties acting jointly, or other qualified entities
approved by the department for the delivery of specialty mental
health services in any county that is unable or unwilling to contract
with the department. The county may not subsequently contract to
provide specialty mental health services under this chapter unless
the department elects to contract with the county.
   (d) If a county does not contract with the department or other
department-approved entity to provide specialty mental health
services, the department shall work with the Department of Finance
and the Controller to sequester funds from the county that is unable
or unwilling to contract in accordance with Section 30027.10 of the
Government Code.
   (e) Whenever the department determines that a mental health plan
has failed to comply with this chapter or any regulations,
contractual requirements, state plan, or waivers adopted pursuant to
this chapter, the department shall notify the mental health plan in
writing within 30 days of its determination and may impose sanctions,
including, but not limited to, fines, penalties, the withholding of
payments, special requirements, probationary or corrective actions,
or any other actions deemed necessary to promptly ensure contract and
performance compliance. If the department imposes fines or
penalties, to the extent permitted by federal law and state law or
contract, it may offset the fines from either of the following:
   (1) Funds from the Mental Health Subaccount, the Mental Health
Equity Subaccount, and the Vehicle License Collection Account of the
Local Revenue Fund and funds from the Mental Health Account and the
Behavioral Health Subaccount of the Local Revenue Fund 2011.
   (2) Any other mental health realignment funds from which the
Controller is authorized to make distributions to the counties, if
the funds described in paragraph (1) are insufficient for the
purposes described in this subdivision.
   (f) The due process and appeals process specified in paragraph (4)
of subdivision (b) of Section 14718 shall be made available to the
mental health plan under the circumstances described in subdivision
(e).
  SEC. 174.  Section 5776 of the Welfare and Institutions Code is
amended and renumbered to read:
   14713.  (a) The department and mental health plans shall comply
with all applicable federal laws, regulations, and the guidelines,
standards, and requirements specified in the state plan, waiver, and
mental health plan contract, and, except as provided in this chapter,
all applicable state statutes and regulations.
   (b) If federal requirements that affect the provisions of this
chapter are changed, it is the intent of the Legislature that state
requirements be revised to comply with those changes.
  SEC. 175.  Section 5777 of the Welfare and Institutions Code is
amended and renumbered to read:
   14714.  (a) (1) Except as otherwise specified in this chapter, a
contract entered into pursuant to this chapter shall include a
provision that the mental health plan contractor shall bear the
financial risk for the cost of providing medically necessary
specialty mental health services to Medi-Cal beneficiaries.
   (2) If the mental health plan is not administered by a county, the
mental health plan shall not transfer the obligation for any
specialty mental health services to Medi-Cal beneficiaries to the
county. The mental health plan may purchase services from the county.
The mental health plan shall establish mutually agreed-upon
protocols with the county that clearly establish conditions under
which beneficiaries may obtain non-Medi-Cal reimbursable services
from the county. Additionally, the plan shall establish mutually
agreed-upon protocols with the county for the conditions of transfer
of beneficiaries who have lost Medi-Cal eligibility to the county for
care under Part 2 (commencing with Section 5600), Part 3 (commencing
with Section 5800), and Part 4 (commencing with Section 5850) of
Division 5.
   (3) The mental health plan shall be financially responsible for
ensuring access and a minimum required scope of benefits and
services, consistent with state and federal requirements, to Medi-Cal
beneficiaries who are residents of that county regardless of where
the beneficiary resides. The department shall require that the same
definition of medical necessity be used, and the minimum scope of
benefits offered by each mental health plan be the same, except to
the extent that prior federal approval is received and is consistent
with state and federal laws.
   (b) (1) Any contract entered into pursuant to this chapter may be
renewed if the mental health plan continues to meet the requirements
of this chapter, regulations promulgated pursuant thereto, and the
terms and conditions of the contract. Failure to meet these
requirements shall be cause for nonrenewal of the contract. The
department may base the decision to renew on timely completion of a
mutually agreed-upon plan of correction of any deficiencies,
submissions of required information in a timely manner, or other
conditions of the contract.
   (2) In the event the contract is not renewed based on the reasons
specified in paragraph (1), the department shall notify the
Department of Finance, the fiscal and policy committees of the
Legislature, and the Controller of the amounts to be sequestered from
the Mental Health Subaccount, the Mental Health Equity Account, and
the Vehicle License Fee Collection Account of the Local Revenue Fund
and the Mental Health Account and the Behavioral Health Subaccount of
the Local Revenue Fund 2011, and the Controller shall sequester
those funds in the Behavioral Health Subaccount pursuant to Section
30027.10 of the Government Code. Upon this sequestration, the
department shall use the funds in accordance with the provisions of
Section 30027.10 of the Government Code.
   (c) (1) The obligations of the mental health plan shall be changed
only by contract or contract amendment.
   (2) Notwithstanding paragraph (1), the mental health plan shall
comply with federal and state requirements, including the applicable
sections of the state plan and waiver.
   (3) A change may be made during a contract term or at the time of
contract renewal, when there is a change in obligations required by
federal or state law or when required by a change in the
interpretation or implementation of any law or regulation.
   (4) To the extent permitted by federal law, either the department
or the mental health plan may request that contract negotiations be
reopened during the course of a contract due to substantial changes
in the cost of covered benefits that result from an unanticipated
event.
   (d) The department shall immediately terminate a contract when the
director finds that there is an immediate threat to the health and
safety of Medi-Cal beneficiaries. Termination of the contract for
other reasons shall be subject to reasonable notice of the department'
s intent to take that action and notification to affected
beneficiaries. The plan may request a hearing by the Office of
Administrative Hearings and Appeals.
   (e) A mental health plan may terminate its contract in accordance
with the provisions in the contract. The mental health plan shall
provide written notice to the department at least 180 days prior to
the termination or nonrenewal of the contract.
   (f) Upon the request of the director, the Director of the
Department of Managed Health Care may exempt a mental health plan
from the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and
Safety Code). These exemptions may be subject to conditions the
director deems appropriate. Nothing in this chapter shall be
construed to impair or diminish the authority of the Director of the
Department of Managed Health Care under the Knox-Keene Health Care
Service Plan Act of 1975, nor shall anything in this chapter be
construed to reduce or otherwise limit the obligation of a mental
health plan contractor licensed as a health care service plan to
comply with the requirements of the Knox-Keene Health Care Service
Plan Act of 1975, and the rules of the Director of the Department of
Managed Health Care promulgated thereunder. The director, in
consultation with the Director of the Department of Managed Health
Care, shall analyze the appropriateness of licensure or application
of applicable standards of the Knox-Keene Health Care Service Plan
Act of 1975.
   (g) The department shall provide oversight to the mental health
plans to ensure quality, access, cost efficiency, and compliance with
data and reporting requirements. At a minimum, the department shall,
through a method independent of any agency of the mental health plan
contractor, monitor the level and quality of services provided,
expenditures pursuant to the contract, and conformity with federal
and state law.
   (h) County employees implementing or administering a mental health
plan act in a discretionary capacity when they determine whether or
not to admit a person for care or to provide any level of care
pursuant to this chapter.
   (i) If a county discontinues operations as the mental health plan,
the department shall approve any new mental health plan. The new
mental health plan shall give reasonable consideration to affiliation
with nonprofit community mental health agencies that were under
contract with the county and that meet the mental health plan's
quality and cost efficiency standards.
   (j) Nothing in this chapter shall be construed to modify, alter,
or increase the obligations of counties as otherwise limited and
defined in Chapter 3 (commencing with Section 5700) of Part 2 of
Division 5. The county's maximum obligation for services to persons
not eligible for Medi-Cal shall be no more than the amount of funds
remaining in the mental health subaccount pursuant to Sections 17600,
17601, 17604, 17605, and 17609 after fulfilling the Medi-Cal
contract obligations.
  SEC. 176.  Section 5777.5 of the Welfare and Institutions Code is
amended and renumbered to read:
   14715.  (a) (1) The department shall require any mental health
plan that provides Medi-Cal specialty mental health services to enter
into a memorandum of understanding with any Medi-Cal managed care
plan that provides Medi-Cal health services to some of the same
Medi-Cal recipients served by the mental health plan. The memorandum
of understanding shall comply with applicable regulations.
   (2) For purposes of this section, a "Medi-Cal managed care plan"
means any prepaid health plan or Medi-Cal managed care plan
contracting with the department to provide services to enrolled
Medi-Cal beneficiaries under Chapter
                   7 (commencing with Section 14000) or Chapter 8
(commencing with Section 14200), or Part 4 (commencing with Section
101525) of Division 101 of the Health and Safety Code.
   (b) The department shall require the memorandum of understanding
to include all of the following:
   (1) A process or entity to be designated by the local mental
health plan to receive notice of actions, denials, or deferrals from
the Medi-Cal managed care plan, and to provide any additional
information requested in the deferral notice as necessary for a
medical necessity determination.
   (2) A requirement that the local mental health plan respond by the
close of the business day following the day the deferral notice is
received.
   (c) The department may sanction a mental health plan pursuant to
subdivision (e) of Section 14712 for failure to comply with this
section.
   (d) This section shall apply to any contracts entered into,
amended, modified, extended, or renewed on or after January 1, 2001.
  SEC. 177.  Section 5777.6 of the Welfare and Institutions Code is
amended and renumbered to read:
   14716.  (a) Each local mental health plan shall establish a
procedure to ensure access to outpatient specialty mental health
services, as required by the Early Periodic Screening and Diagnostic
Treatment program standards, for any child in foster care who has
been placed outside his or her county of adjudication.
   (b) The procedure required by subdivision (a) may be established
through one or more of the following:
   (1) The establishment of, and federal approval, if required, of, a
statewide system or procedure.
   (2) An arrangement between local mental health plans for
reimbursement for services provided by a mental health plan other
than the mental health plan in the county of adjudication and
designation of an entity to provide additional information needed for
approval or reimbursement. This arrangement shall not require
providers who are already credentialed or certified by the mental
health plan in the beneficiary's county of residence to be
credentialed or certified by, or to contract with, the mental health
plan in the county of adjudication.
   (3) Arrangements between the mental health plan in the county of
adjudication and mental health providers in the beneficiary's county
of residence for authorization of, and reimbursement for, services.
This arrangement shall not require providers credentialed or
certified by, and in good standing with, the mental health plan in
the beneficiary's county of residence to be credentialed or certified
by the mental health plan in the county of adjudication.
   (c) The department shall collect and keep statistics that will
enable the department to compare access to outpatient specialty
mental health services by foster children placed in their county of
adjudication with access to outpatient specialty mental health
services by foster children placed outside of their county of
adjudication.
  SEC. 178.  Section 5777.7 of the Welfare and Institutions Code is
amended and renumbered to read:
   14717.  (a) In order to facilitate the receipt of medically
necessary specialty mental health services by a foster child who is
placed outside his or her county of original jurisdiction, the
department shall take all of the following actions:
   (1) On or before July 1, 2008, create all of the following items,
in consultation with stakeholders, including, but not limited to, the
California Institute for Mental Health, the Child and Family Policy
Institute, the California Mental Health Directors Association, and
the California Alliance of Child and Family Services:
   (A) A standardized contract for the purchase of medically
necessary specialty mental health services from organizational
providers, when a contract is required.
   (B) A standardized specialty mental health service authorization
procedure.
   (C) A standardized set of documentation standards and forms,
including, but not limited to, forms for treatment plans, annual
treatment plan updates, day treatment intensive and day treatment
rehabilitative progress notes, and treatment authorization requests.
   (2) On or before January 1, 2009, use the standardized items as
described in paragraph (1) to provide medically necessary specialty
mental health services to a foster child who is placed outside his or
her county of original jurisdiction, so that organizational
providers who are already certified by a mental health plan are not
required to be additionally certified by the mental health plan in
the county of original jurisdiction.
   (3) (A) On or before January 1, 2009, use the standardized items
described in paragraph (1) to provide medically necessary specialty
mental health services to a foster child placed outside his or her
county of original jurisdiction to constitute a complete contract,
authorization procedure, and set of documentation standards and
forms, so that no additional documents are required.
   (B) Authorize a county mental health plan to be exempt from
subparagraph (A) and have an addendum to a contract, authorization
procedure, or set of documentation standards and forms, if the county
mental health plan has an externally placed requirement, such as a
requirement from a federal integrity agreement, that would affect one
of these documents.
   (4) Following consultation with stakeholders, including, but not
limited to, the California Institute for Mental Health, the Child and
Family Policy Institute, the California Mental Health Directors
Association, the California State Association of Counties, and the
California Alliance of Child and Family Services, require the use of
the standardized contracts, authorization procedures, and
documentation standards and forms as specified in paragraph (1) in
the 2008-09 state-county mental health plan contract and each
state-county mental health plan contract thereafter.
   (5) The mental health plan shall complete a standardized contract,
as provided in paragraph (1), if a contract is required, or another
mechanism of payment if a contract is not required, with a provider
or providers of the county's choice, to deliver approved specialty
mental health services for a specified foster child, within 30 days
of an approved treatment authorization request.
   (b) The California Health and Human Services Agency shall
coordinate the efforts of the department and the State Department of
Social Services to do all of the following:
   (1) Participate with the stakeholders in the activities described
in this section.
   (2) During budget hearings in 2008 and 2009, report to the
Legislature regarding the implementation of this section and
subdivision (c) of Section 14716.
   (3) On or before July 1, 2008, establish the following, in
consultation with stakeholders, including, but not limited to, the
California Mental Health Directors Association, the California
Alliance of Child and Family Services, and the County Welfare
Directors Association of California:
   (A) Informational materials that explain to foster care providers
how to arrange for specialty mental health services on behalf of the
beneficiary in their care.
   (B) Informational materials that county child welfare agencies can
access relevant to the provision of services to children in their
care from the out-of-county local mental health plan that is
responsible for providing those services, including, but not limited
to, receiving a copy of the child's treatment plan within 60 days
after requesting services.
   (C) It is the intent of the Legislature to ensure that foster
children who are adopted or placed permanently with relative
guardians, and who move to a county outside their original county of
residence, can access specialty mental health services in a timely
manner. It is the intent of the Legislature to enact this section as
a temporary means of ensuring access to these services, while the
appropriate stakeholders pursue a long-term solution in the form of a
change to the Medi-Cal Eligibility Data System that will allow these
children to receive specialty mental health services through their
new county of residence.
  SEC. 179.  Section 5778 of the Welfare and Institutions Code, as
added by Section 8 of Chapter 651 of the Statutes of 2011, is amended
and renumbered to read:
   14718.  (a) This section shall be limited to specialty mental
health services reimbursed to a mental health plan that certifies
public expenditures subject to cost settlement or specialty mental
health services reimbursed through the department's fiscal
intermediary.
   (b) The following provisions shall apply to matters related to
specialty mental health services provided under the approved Medi-Cal
state plan and the Specialty Mental Health Services Waiver,
including, but not limited to, reimbursement and claiming procedures,
reviews and oversight, and appeal processes for mental health plans
(MHPs) and MHP subcontractors.
   (1) As determined by the department, the MHP shall submit claims
for reimbursement to the Medi-Cal program for eligible services.
   (2) The department may offset the amount of any federal
disallowance, audit exception, or overpayment against subsequent
claims from the MHP. The department may offset the amount of any
state disallowance, or audit exception or overpayment against
subsequent claims from the mental health plan, through the 2010-11
fiscal year. This offset may be done at any time, after the
department has invoiced or otherwise notified the mental health plan
about the audit exception, disallowance, or overpayment. The
department shall determine the amount that may be withheld from each
payment to the mental health plan. The maximum withheld amount shall
be 25 percent of each payment as long as the department is able to
comply with the federal requirements for repayment of federal
financial participation pursuant to Section 1903(d)(2) of the federal
Social Security Act (42 U.S.C. Sec. 1396b(d)(2)). The department may
increase the maximum amount when necessary for compliance with
federal laws and regulations.
   (3) (A) Oversight by the department of the MHPs may include client
record reviews of Early Periodic Screening Diagnosis and Treatment
(EPSDT) specialty mental health services rendered by MHPs and MHP
subcontractors under the Medi-Cal specialty mental health services
waiver in addition to other audits or reviews that are conducted.
   (B) The department may contract with an independent,
nongovernmental entity to conduct client record reviews. The contract
awarded in connection with this section shall be on a competitive
bid basis, pursuant to the Department of General Services contracting
requirements, and shall meet both of the following additional
requirements:
   (i) Require the entity awarded the contract to comply with all
federal and state privacy laws, including, but not limited to, the
federal Health Insurance Portability and Accountability Act (HIPAA;
42 U.S.C. Sec. 1320d et seq.) and its implementing regulations, the
Confidentiality of Medical Information Act (Part 2.6 (commencing with
Section 56) of Division 1 of the Civil Code), and Section 1798.81.5
of the Civil Code. The entity shall be subject to existing penalties
for violation of these laws.
   (ii) Prohibit the entity awarded the contract from using or
disclosing client records or client information for a purpose other
than the one for which the record was given.
   (iii) Prohibit the entity awarded the contract from selling client
records or client information.
   (C) For purposes of this paragraph, the following terms shall have
the following meanings:
   (i) "Client record" means a medical record, chart, or similar
file, as well as other documents containing information regarding an
individual recipient of services, including, but not limited to,
clinical information, dates and times of services, and other
information relevant to the individual and services provided and that
evidences compliance with legal requirements for Medi-Cal
reimbursement.
   (ii) "Client record review" means examination of the client record
for a selected individual recipient for the purpose of confirming
the existence of documents that verify compliance with legal
requirements for claims submitted for Medi-Cal reimbursement.
   (D) The department shall recover overpayments of federal financial
participation from MHPs within the timeframes required by federal
law and regulation for repayment to the federal Centers for Medicare
and Medicaid Services.
   (4) (A) The department, in consultation with mental health
stakeholders, the California Mental Health Directors Association, and
MHP subcontractor representatives, shall provide an appeals process
that specifies a progressive process for resolution of disputes about
claims or recoupments relating to specialty mental health services
under the Medi-Cal specialty mental health services waiver.
   (B) The department shall provide MHPs and MHP subcontractors the
opportunity to directly appeal findings in accordance with procedures
that are similar to those described in Article 1.5 (commencing with
Section 51016) of Chapter 3 of Subdivision 1 of Division 3 of Title
22 of the California Code of Regulations, until new regulations for a
progressive appeals process are promulgated. When an MHP
subcontractor initiates an appeal, it shall give notice to the MHP.
The department shall propose a rulemaking package consistent with the
department's appeals process that is in effect on July 1, 2012 by no
later than the end of the 2013-14 fiscal year. The reference in this
subparagraph to the procedures described in Article 1.5 (commencing
with Section 51016) of Chapter 3 of Subdivision 1 of Division 3 of
Title 22 of the California Code of Regulations, shall only apply to
those appeals addressed in this subparagraph.
   (C) The department shall develop regulations as necessary to
implement this paragraph.
   (5) The department shall conduct oversight of utilization controls
as specified in Section 14133. The MHP shall include a requirement
in any subcontracts that all inpatient subcontractors maintain
necessary licensing and certification. MHPs shall require that
services delivered by licensed staff are within their scope of
practice. Nothing in this chapter shall prohibit the MHPs from
establishing standards that are in addition to the federal and state
requirements, provided that these standards do not violate federal
and state requirements and guidelines.
   (6) (A)  Subject to federal approval and consistent with state
requirements, the MHP may negotiate rates with providers of specialty
mental health services.
   (B) Any excess in the distribution of funds over the expenditures
for services by the mental health plan shall be spent for the
provision of specialty mental health services and related
administrative costs.
   (7) Nothing in this chapter shall limit the MHP from being
reimbursed appropriate federal financial participation for any
qualified services. To receive federal financial participation, the
mental health plan shall certify its public expenditures for
specialty mental health services to the department.
   (8) Notwithstanding Section 14115, claims for federal
reimbursement for service pursuant to this chapter shall be submitted
by MHPs within the timeframes required by federal Medicaid
requirements and the approved Medicaid state plan and waivers.
   (9) The MHP shall use the fiscal intermediary of the Medi-Cal
program of the State Department of Health Care Services for the
processing of claims for inpatient psychiatric hospital services
rendered in fee-for-service Medi-Cal hospitals. The department shall
request the Controller to offset the distribution of funds to the
counties from the Mental Health Subaccount, the Mental Health Equity
Subaccount, or the Vehicle License Collection Account of the Local
Revenue Fund, or funds from the Mental Health Account or the
Behavioral Health Subaccount of the Local Revenue Fund 2011 for the
nonfederal financial participation share for these claims.
   (c) Counties may set aside funds for self-insurance, audit
settlement, and statewide program risk pools. The counties shall
assume all responsibility and liability for appropriate
administration of the funds. Special consideration may be given to
small counties with a population of less than 200,000. Nothing in the
paragraph shall in any way make the state or department liable for
mismanagement or loss of funds by the entity designated by counties
under this subdivision.
   (d) The department shall consult with the California Mental Health
Directors Association in February and September of each year to
obtain data and methodology necessary to forecast future fiscal
trends in the provision of specialty mental health services provided
under the Medi-Cal specialty mental health services waiver, to
estimate yearly specialty mental health services related costs, and
to estimate the annual amount of federal funding participation to
reimburse costs of specialty mental health services provided under
the Medi-Cal specialty mental health services waiver. This shall
include a separate presentation of the data and methodology necessary
to forecast future fiscal trends in the provision of Early Periodic
Screening, Diagnosis, and Treatment specialty mental health services
provided under the Medi-Cal specialty mental health services waiver,
to estimate annual EPSDT specialty mental health services related
costs, and to estimate the annual amount of EPSDT specialty mental
health services provided under the state Medi-Cal specialty mental
health services waiver, including federal funding participation to
reimburse costs of EPSDT.
   (e) When seeking federal approval for any federal Medicaid state
plan amendment or waiver associated with Medi-Cal specialty mental
health services, the department shall consult with staff of the
Legislature, counties, providers, and other stakeholders in the
development of the state plan amendment or waiver.
   (f) This section shall become operative on July 1, 2012.
  SEC. 180.  Section 5778.3 of the Welfare and Institutions Code is
amended and renumbered to read:
   14718.5.  Notwithstanding any other law, including subdivision (b)
of Section 16310 of the Government Code, the Controller may use the
moneys in the Mental Health Managed Care Deposit Fund for loans to
the General Fund as provided in Sections 16310 and 16381 of the
Government Code. Interest shall be paid on all moneys loaned to the
General Fund from the Mental Health Managed Care Deposit Fund.
Interest payable shall be computed at a rate determined by the Pooled
Money Investment Board to be the current earning rate of the fund
from which loaned. This subdivision does not authorize any transfer
that will interfere with the carrying out of the object for which the
Mental Health Managed Care Deposit Fund was created.
  SEC. 181.  Section 5779 of the Welfare and Institutions Code is
amended to read:
   5779.  (a) This section shall be limited to mental health services
reimbursed through a capitated rate payment system.
   (b) Upon mutual agreement, the department and the State Department
of Health Care Services may combine the funds transferred under this
part, other funds available pursuant to Chapter 6 (commencing with
Section 17600) of Part 5 of Division 9, and federal financial
participation funds to establish a contract for the delivery of
mental health services to Medi-Cal beneficiaries under a capitated
rate payment system. The combining of funds shall be done in
consultation with a statewide organization representing counties. The
combined funding shall be the budget responsibility of the
department.
   (c) The department, in consultation with a statewide organization
representing counties, shall establish a methodology for a capitated
rate payment system that is consistent with federal requirements.
   (d) Capitated rate payments shall be made on a schedule specified
in the contract with the mental health plan.
   (e) The department may levy any necessary fines and audit
disallowances to mental health plans relative to operations under
this part. The mental health plans shall be liable for all federal
audit exceptions or disallowances based on the plan's conduct or
determinations. The mental health plan shall not be liable for
federal audit exceptions or disallowances based on the state's
conduct or determinations. The department shall work jointly with the
mental health plan in initiating any necessary appeals. The
department may offset the amount of any federal disallowance or audit
exception against subsequent payment to the mental health plan at
any time. The maximum amount that may be withheld shall be 25 percent
of each payment to the mental health plan.
   (f) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute that
is enacted before January 1, 2013, deletes or extends the dates on
which it becomes inoperative and is repealed.
  SEC. 182.  Section 5780 of the Welfare and Institutions Code is
amended and renumbered to read:
   14721.  (a) This chapter shall only be implemented to the extent
that the necessary federal waivers are obtained. The director shall
execute a declaration, to be retained by the director, that a waiver
necessary to implement any provision of this chapter has been
obtained.
   (b) This chapter shall become inoperative on the date that, and
only if, the director executes a declaration, to be retained by the
director, that more than 10 percent of all counties fail to become
mental health plan contractors, and acceptable alternative
contractors are not available, or if more than 10 percent of all
funds allocated for Medi-Cal mental health services must be
administered by the department because an acceptable plan is not
available.
  SEC. 183.  Section 5781 of the Welfare and Institutions Code is
amended and renumbered to read:
   14722.  (a) Notwithstanding any other law, a mental health plan
may enter into a contract for the provision of specialty mental
health services for Medi-Cal beneficiaries with a hospital that
provides for a per diem reimbursement rate for services that include
room and board, routine hospital services, and all hospital-based
ancillary services and that provides separately for the attending
mental health professional's daily visit fee. The payment of these
negotiated reimbursement rates to the hospital by the mental health
plan shall be considered payment in full for each day of inpatient
psychiatric and hospital care rendered to a Medi-Cal beneficiary,
subject to third-party liability and patient share of costs, if any.
   (b) This section shall not be construed to allow a hospital to
interfere with, control, or otherwise direct the professional
judgment of a physician and surgeon in a manner prohibited by Section
2400 of the Business and Professions Code or any other provision of
law.
   (c) For purposes of this section, "hospital" means a hospital that
submits reimbursement claims for Medi-Cal psychiatric inpatient
hospital services through the Medi-Cal fiscal intermediary.
  SEC. 184.  Section 5782 of the Welfare and Institutions Code is
amended to read:
   5782.  (a) The provisions of this part are subject to and shall be
read as incorporating the authority and oversight responsibilities
of the State Department of Health Care Services in its role as the
single state agency for the Medicaid program in California. The
provisions of this part shall be implemented only to the extent that
federal financial participation is available.
   (b) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute that
is enacted before January 1, 2013, deletes or extends the dates on
which it becomes inoperative and is repealed.
  SEC. 185.  Section 5783 of the Welfare and Institutions Code is
amended and renumbered to read:
   14723.  (a) Each eligible public agency, as described in
subdivision (b), may, in addition to reimbursement or other payments
that the agency would otherwise receive for Medi-Cal specialty mental
health services, receive supplemental Medi-Cal reimbursement to the
extent provided for in this section.
   (b) A public agency shall be eligible for supplemental
reimbursement only if it is a county, city, or city and county and
if, consistent with Section 14718 it provides as a mental health
plan, or subcontracts for, specialty mental health services to
Medi-Cal beneficiaries pursuant to the Medi-Cal Specialty Mental
Health Consolidation Waiver (Number CA.17), as approved by the
federal Centers for Medicare and Medicaid Services.
   (c) (1) Subject to paragraph (2), an eligible public agency's
supplemental reimbursement pursuant to this section shall be equal to
the amount of federal financial participation received as a result
of the claims submitted pursuant to paragraph (2) of subdivision (f).

   (2) Notwithstanding paragraph (1), in computing an eligible public
agency's reimbursement, in no instance shall the expenditures
certified pursuant to paragraph (1) of subdivision (e), when combined
with the amount received from other sources of payment and with
reimbursement from the Medi-Cal program, including expenditures
otherwise certified for purposes of claiming federal financial
participation, exceed 100 percent of actual, allowable costs, as
determined pursuant to California's Medicaid State Plan, for the
specialty mental health services to which the expenditure relates.
Supplemental payment may be made on an interim basis until the time
when actual, allowable costs are finally determined.
   (3) The supplemental Medi-Cal reimbursement provided by this
section shall be distributed under a payment methodology based on
specialty mental health services provided to Medi-Cal patients by
each eligible public agency, on a per-visit basis, a per-procedure
basis, a time basis, in one or more lump sums, or on any other
federally permissible basis. The department shall seek approval from
the federal Centers for Medicare and Medicaid Services for the
payment methodology to be utilized, and shall not make any payment
pursuant to this section prior to obtaining that federal approval.
   (d) (1) It is the intent of the Legislature in enacting this
section to provide the supplemental reimbursement described in this
section without any expenditure from the General Fund. The department
may require an eligible public agency, as a condition of receiving
supplemental reimbursement pursuant to this section, to enter into,
and maintain, an agreement with the department for the purposes of
implementing this section and reimbursing the department for the
costs of administering this section.
                                                (2) Expenditures
submitted to the department for purposes of claiming federal
financial participation under this section shall have been paid only
with funds from the public agencies described in subdivision (b) and
certified to the state as provided in subdivision (e).
   (e) An eligible public agency shall do all of the following:
   (1) Certify, in conformity with the requirements of Section 433.51
of Title 42 of the Code of Federal Regulations, that the claimed
expenditures for the specialty mental health services are eligible
for federal financial participation.
   (2) Provide evidence supporting the certification as specified by
the department.
   (3) Submit data as specified by the department to determine the
appropriate amounts to claim as expenditures qualifying for federal
financial participation.
   (4) Keep, maintain, and have readily retrievable, any records
specified by the department to fully disclose reimbursement amounts
to which the eligible public agency is entitled, and any other
records required by the federal Centers for Medicare and Medicaid
Services.
   (f) (1) The department shall promptly seek any necessary federal
approvals for the implementation of this section. If necessary to
obtain federal approval, the program shall be limited to those costs
that the federal Centers for Medicare and Medicaid Services
determines to be allowable expenditures under Title XIX of the
federal Social Security Act (Subchapter 19 (commencing with Section
1396) of Chapter 7 of Title 42 of the United States Code). If federal
approval is not obtained for implementation of this section, this
section shall not be implemented.
   (2) The department shall submit claims for federal financial
participation for the expenditures described in subdivision (e)
related to specialty mental health services that are allowable
expenditures under federal law.
   (3) The department shall, on an annual basis, submit any necessary
materials to the federal Centers for Medicare and Medicaid Services
to provide assurances that claims for federal financial participation
will include only those expenditures that are allowable under
federal law.
   (g) (1) The director may adopt regulations as are necessary to
implement this section. The adoption, amendment, repeal, or
readoption of a regulation authorized by this subdivision shall be
deemed to be necessary for the immediate preservation of the public
peace, health and safety, or general welfare, for purposes of
Sections 11346.1 and 11349.6 of the Government Code, and the
department is hereby exempted from the requirement that it describe
specific facts showing the need for immediate action.
   (2) As an alternative to the adoption of regulations pursuant to
paragraph (1), and notwithstanding Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code, the director may implement and administer this article, in
whole or in part, by means of provider bulletins or similar
instructions, without taking regulatory action, provided that no
bulletin or similar instruction shall remain in effect after June 30,
2011. It is the intent that regulations adopted pursuant to
paragraph (1) shall be in place on or before June 30, 2011.
  SEC. 186.  Section 5803 of the Welfare and Institutions Code is
amended to read:
   5803.  (a) The State Department of Health Care Services shall
issue a request for proposals to develop system of care programs no
later than October 1 in any year in which the state budget provides
new funds to expand the system of care provided for in this chapter.
The request for proposals shall include the following:
   (1) Proposals may be submitted as a regional system of care by
counties acting jointly, independent countywide proposals, and
proposals to serve discrete geographic areas within counties or for a
specific integrated services agency team. Nothing in the request for
proposal shall be construed to restrict a county from contracting
for part or all services included in the demonstration project
proposal.
   (2) The department shall establish reporting requirements for
direct and indirect costs, and these requirements may be included in
the request for proposals.
   (3) The department shall require that proposals identify resources
necessary to measure client and cost outcome and interagency
collaboration. Proposal guidelines shall clearly require
identification of procedures to document outcomes.
   (4) Proposals must be approved by the board of supervisors and the
local mental health board or commission.
   (b) The director shall prepare a method for rating proposals to
assure objectivity and selection of the best qualified applications.
New proposals shall be selected with consideration of regional
balance across the state.
   (c) The State Department of Health Care Services shall fund
counties with integrated service agencies or countywide systems of
care funded under Chapter 982 of the Statutes of 1988, operating at
the time of passage of this part. Those programs shall be funded
under the provisions paragraph (2) of subdivision (a) of Section 5700
and shall be subject to all of the requirements and sanctions of
this part.
  SEC. 187.  Section 5804 of the Welfare and Institutions Code is
repealed.
  SEC. 188.  Section 5805 of the Welfare and Institutions Code is
amended to read:
   5805.  The State Department of Health Care Services shall require
counties to use available state and matching funds for the client
target population as defined in Section 5600.3 to develop a
comprehensive array of services as defined in Sections 5600.6 and
5600.7.
  SEC. 189.  Section 5806 of the Welfare and Institutions Code is
amended to read:
   5806.  The State Department of Health Care Services shall
establish service standards that ensure that members of the target
population are identified, and services provided to assist them to
live independently, work, and reach their potential as productive
citizens. The department shall provide annual oversight of grants
issued pursuant to this part for compliance with these standards.
These standards shall include, but are not limited to, all of the
following:
   (a) A service planning and delivery process that is target
population based and includes the following:
   (1) Determination of the numbers of clients to be served and the
programs and services that will be provided to meet their needs. The
local director of mental health shall consult with the sheriff, the
police chief, the probation officer, the mental health board,
contract agencies, and family, client, ethnic, and citizen
constituency groups as determined by the director.
   (2) Plans for services, including outreach to families whose
severely mentally ill adult is living with them, design of mental
health services, coordination and access to medications, psychiatric
and psychological services, substance abuse services, supportive
housing or other housing assistance, vocational rehabilitation, and
veterans' services. Plans also shall contain evaluation strategies,
that shall consider cultural, linguistic, gender, age, and special
needs of minorities in the target populations. Provision shall be
made for staff with the cultural background and linguistic skills
necessary to remove barriers to mental health services due to
limited-English-speaking ability and cultural differences. Recipients
of outreach services may include families, the public, primary care
physicians, and others who are likely to come into contact with
individuals who may be suffering from an untreated severe mental
illness who would be likely to become homeless if the illness
continued to be untreated for a substantial period of time. Outreach
to adults may include adults voluntarily or involuntarily
hospitalized as a result of a severe mental illness.
   (3) Provision for services to meet the needs of target population
clients who are physically disabled.
   (4) Provision for services to meet the special needs of older
adults.
   (5) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, where appropriate for the individual.
   (6) Provision for services to be client-directed and that employ
psychosocial rehabilitation and recovery principles.
   (7) Provision for psychiatric and psychological services that are
integrated with other services and for psychiatric and psychological
collaboration in overall service planning.
   (8) Provision for services specifically directed to seriously
mentally ill young adults 25 years of age or younger who are homeless
or at significant risk of becoming homeless. These provisions may
include continuation of services that still would be received through
other funds had eligibility not been terminated due to age.
   (9) Services reflecting special needs of women from diverse
cultural backgrounds, including supportive housing that accepts
children, personal services coordinator therapeutic treatment, and
substance treatment programs that address gender-specific trauma and
abuse in the lives of persons with mental illness, and vocational
rehabilitation programs that offer job training programs free of
gender bias and sensitive to the needs of women.
   (10) Provision for housing for clients that is immediate,
transitional, permanent, or all of these.
   (11) Provision for clients who have been suffering from an
untreated severe mental illness for less than one year, and who do
not require the full range of services but are at risk of becoming
homeless unless a comprehensive individual and family support
services plan is implemented. These clients shall be served in a
manner that is designed to meet their needs.
   (12) Provision for services for veterans.
   (b) A client shall have a clearly designated mental health
personal services coordinator who may be part of a multidisciplinary
treatment team who is responsible for providing or assuring needed
services. Responsibilities include complete assessment of the client'
s needs, development of the client's personal services plan, linkage
with all appropriate community services, monitoring of the quality
and followthrough of services, and necessary advocacy to ensure that
the client receives those services that are agreed to in the personal
services plan. A client shall participate in the development of his
or her personal services plan, and responsible staff shall consult
with the designated conservator, if one has been appointed, and, with
the consent of the client, consult with the family and other
significant persons as appropriate.
   (c) The individual personal services plan shall ensure that
members of the target population involved in the system of care
receive age-appropriate, gender-appropriate, and culturally
appropriate services or appropriate services based on any
characteristic listed or defined in Section 11135 of the Government
Code, to the extent feasible, that are designed to enable recipients
to:
   (1) Live in the most independent, least restrictive housing
feasible in the local community, and for clients with children, to
live in a supportive housing environment that strives for
reunification with their children or assists clients in maintaining
custody of their children as is appropriate.
   (2) Engage in the highest level of work or productive activity
appropriate to their abilities and experience.
   (3) Create and maintain a support system consisting of friends,
family, and participation in community activities.
   (4) Access an appropriate level of academic education or
vocational training.
   (5) Obtain an adequate income.
   (6) Self-manage their illness and exert as much control as
possible over both the day-to-day and long-term decisions that affect
their lives.
   (7) Access necessary physical health care and maintain the best
possible physical health.
   (8) Reduce or eliminate serious antisocial or criminal behavior
and thereby reduce or eliminate their contact with the criminal
justice system.
   (9) Reduce or eliminate the distress caused by the symptoms of
mental illness.
   (10) Have freedom from dangerous addictive substances.
   (d) The individual personal services plan shall describe the
service array that meets the requirements of subdivision (c), and to
the extent applicable to the individual, the requirements of
subdivision (a).
  SEC. 190.  Section 5807 of the Welfare and Institutions Code is
amended to read:
   5807.  (a) The State Department of Health Care Services shall
require counties which receive funding to develop interagency
collaboration with shared responsibilities for services under this
part and achievement of the client and cost outcome goals and
interagency collaboration goals specified.
   (b) Collaborative activities shall include:
   (1) Identification of those agencies that have a significant joint
responsibility for the target population and ensuring collaboration
on planning for services to that population.
   (2) Identification of gaps in services to members of the target
population, development of policies to assure service effectiveness
and continuity, and setting priorities for interagency services.
   (3) Implementation of public and private collaborative programs
whenever possible to better serve the target population.
   (4) Provision of interagency case management services to
coordinate resources to target population members who are using the
services of more than one agency.
   (5) Coordination with federal agencies responsible for providing
veterans' services, as well as national, state, and local nonprofit
organizations that provide veterans' services, to maximize the
integration of services and to eliminate duplicative efforts.
  SEC. 191.  Section 5809 of the Welfare and Institutions Code is
amended to read:
   5809.  The State Department of Health Care Services shall continue
to work with participating counties and other interested parties to
refine and establish client and cost outcome and interagency
collaboration goals including the expected level of attainment with
participating system of care counties. These outcome measures should
include specific objectives addressing the following goals:
   (a) Client benefit outcomes.
   (b) Client and family member satisfaction.
   (c) System of care access.
   (d) Cost savings, cost avoidance, and cost-effectiveness outcomes
that measure short-term or long-term cost savings and cost avoidance
achieved in public sector expenditures to the target population.
  SEC. 192.  Article 3 (commencing with Section 5810) of Part 3 of
Division 5 of the Welfare and Institutions Code is repealed.
  SEC. 193.  Section 5813.6 of the Welfare and Institutions Code is
amended to read:
   5813.6.  (a) At the time of the release of the January 10 budget
plan and the May Revision, the Director of Health Care Services shall
submit to the Legislature information regarding the projected
expenditure of Proposition 63 funding for each state department, and
for each major program category specified in the measure, for local
assistance. This shall include actual past-year expenditures,
estimated current-year expenditures, and projected budget-year
expenditures of local assistance funding. In addition, it shall
include a complete listing of state support expenditures for the
current year and for the budget year by the State Department of
Health Care Services, including the number of state positions and any
contract funds. A description of these state expenditures shall
accompany the fiscal information the director is required to submit
to the Legislature pursuant to this section.
   (b) During each fiscal year, the Director of Health Care Services
shall submit to the fiscal committees of the Legislature, 30 days in
advance, written notice of the intention to expend Proposition 63
local assistance funding in excess of the amounts presented in its
May Revision projection for that fiscal year. The written notice
shall include information regarding the amount of the additional
spending and its purpose.
  SEC. 194.  Section 5814 of the Welfare and Institutions Code is
amended to read:
   5814.  (a) (1) This part shall be implemented only to the extent
that funds are appropriated for purposes of this part. To the extent
that funds are made available, the first priority shall go to
maintain funding for the existing programs that meet adult system of
care contract goals. The next priority for funding shall be given to
counties with a high incidence of persons who are severely mentally
ill and homeless or at risk of homelessness, and meet the criteria
developed pursuant to paragraphs (3) and (4).
   (2) The Director of Health Care Services shall establish a
methodology for awarding grants under this part consistent with the
legislative intent expressed in Section 5802, and in consultation
with the advisory committee established in this subdivision.
   (3) (A) The Director of Health Care Services shall establish an
advisory committee for the purpose of providing advice regarding the
development of criteria for the award of grants, and the
identification of specific performance measures for evaluating the
effectiveness of grants. The committee shall review evaluation
reports and make findings on evidence-based best practices and
recommendations for grant conditions. At not less than one meeting
annually, the advisory committee shall provide to the director
written comments on the performance of each of the county programs.
Upon request by the department, each participating county that is the
subject of a comment shall provide a written response to the
comment. The department shall comment on each of these responses at a
subsequent meeting.
   (B) The committee shall include, but not be limited to,
representatives from state, county, and community veterans' services
and disabled veterans outreach programs, supportive housing and other
housing assistance programs, law enforcement, county mental health
and private providers of local mental health services and mental
health outreach services, the Department of Corrections and
Rehabilitation, the State Department of Alcohol and Drug Programs,
local substance abuse services providers, the Department of
Rehabilitation, providers of local employment services, the State
Department of Social Services, the Department of Housing and
Community Development, a service provider to transition youth, the
United Advocates for Children of California, the California Mental
Health Advocates for Children and Youth, the Mental Health
Association of California, the California Alliance for the Mentally
Ill, the California Network of Mental Health Clients, the California
Mental Health Planning Council, the Mental Health Services Oversight
and Accountability Commission, and other appropriate entities.
   (4) The criteria for the award of grants shall include, but not be
limited to, all of the following:
   (A) A description of a comprehensive strategic plan for providing
outreach, prevention, intervention, and evaluation in a cost
appropriate manner corresponding to the criteria specified in
subdivision (c).
   (B) A description of the local population to be served, ability to
administer an effective service program, and the degree to which
local agencies and advocates will support and collaborate with
program efforts.
   (C) A description of efforts to maximize the use of other state,
federal, and local funds or services that can support and enhance the
effectiveness of these programs.
   (5) In order to reduce the cost of providing supportive housing
for clients, counties that receive a grant pursuant to this part
after January 1, 2004, shall enter into contracts with sponsors of
supportive housing projects to the greatest extent possible.
Participating counties are encouraged to commit a portion of their
grants to rental assistance for a specified number of housing units
in exchange for the counties' clients having the right of first
refusal to rent the assisted units.
   (b) In each year in which additional funding is provided by the
annual Budget Act the State Department of Health Care Services shall
establish programs that offer individual counties sufficient funds to
comprehensively serve severely mentally ill adults who are homeless,
recently released from a county jail or the state prison, or others
who are untreated, unstable, and at significant risk of incarceration
or homelessness unless treatment is provided to them and who are
severely mentally ill adults. For purposes of this subdivision,
"severely mentally ill adults" are those individuals described in
subdivision (b) of Section 5600.3. In consultation with the advisory
committee established pursuant to paragraph (3) of subdivision (a),
the department shall report to the Legislature on or before May 1 of
each year in which additional funding is provided, and shall
evaluate, at a minimum, the effectiveness of the strategies in
providing successful outreach and reducing homelessness, involvement
with local law enforcement, and other measures identified by the
department. The evaluation shall include for each program funded in
the current fiscal year as much of the following as available
information permits:
   (1) The number of persons served, and of those, the number who
receive extensive community mental health services.
   (2) The number of persons who are able to maintain housing,
including the type of housing and whether it is emergency,
transitional, or permanent housing, as defined by the department.
   (3) (A) The amount of grant funding spent on each type of housing.

   (B) Other local, state, or federal funds or programs used to house
clients.
   (4)  The number of persons with contacts with local law
enforcement and the extent to which local and state incarceration has
been reduced or avoided.
   (5) The number of persons participating in employment service
programs including competitive employment.
   (6) The number of persons contacted in outreach efforts who appear
to be severely mentally ill, as described in Section 5600.3, who
have refused treatment after completion of all applicable outreach
measures.
   (7) The amount of hospitalization that has been reduced or
avoided.
   (8) The extent to which veterans identified through these programs'
outreach are receiving federally funded veterans' services for which
they are eligible.
   (9) The extent to which programs funded for three or more years
are making a measurable and significant difference on the street, in
hospitals, and in jails, as compared to other counties or as compared
to those counties in previous years.
   (10) For those who have been enrolled in this program for at least
two years and who were enrolled in Medi-Cal prior to, and at the
time they were enrolled in, this program, a comparison of their
Medi-Cal hospitalizations and other Medi-Cal costs for the two years
prior to enrollment and the two years after enrollment in this
program.
   (11) The number of persons served who were and were not receiving
Medi-Cal benefits in the 12-month period prior to enrollment and, to
the extent possible, the number of emergency room visits and other
medical costs for those not enrolled in Medi-Cal in the prior
12-month period.
   (c) To the extent that state savings associated with providing
integrated services for the mentally ill are quantified, it is the
intent of the Legislature to capture those savings in order to
provide integrated services to additional adults.
   (d) Each project shall include outreach and service grants in
accordance with a contract between the state and approved counties
that reflects the number of anticipated contacts with people who are
homeless or at risk of homelessness, and the number of those who are
severely mentally ill and who are likely to be successfully referred
for treatment and will remain in treatment as necessary.
   (e) All counties that receive funding shall be subject to specific
terms and conditions of oversight and training which shall be
developed by the department, in consultation with the advisory
committee.
   (f) (1) As used in this part, "receiving extensive mental health
services" means having a personal services coordinator, as described
in subdivision (b) of Section 5806, and having an individual personal
service plan, as described in subdivision (c) of Section 5806.
   (2) The funding provided pursuant to this part shall be sufficient
to provide mental health services, medically necessary medications
to treat severe mental illnesses, alcohol and drug services,
transportation, supportive housing and other housing assistance,
vocational rehabilitation and supported employment services, money
management assistance for accessing other health care and obtaining
federal income and housing support, accessing veterans' services,
stipends, and other incentives to attract and retain sufficient
numbers of qualified professionals as necessary to provide the
necessary levels of these services. These grants shall, however, pay
for only that portion of the costs of those services not otherwise
provided by federal funds or other state funds.
   (3) Methods used by counties to contract for services pursuant to
paragraph (2) shall promote prompt and flexible use of funds,
consistent with the scope of services for which the county has
contracted with each provider.
   (g) Contracts awarded pursuant to this part shall be exempt from
the Public Contract Code and the state administrative manual and
shall not be subject to the approval of the Department of General
Services.
   (h) Notwithstanding any other provision of law, funds awarded to
counties pursuant to this part and Part 4 (commencing with Section
5850) shall not require a local match in funds.
  SEC. 195.  Section 5815 of the Welfare and Institutions Code is
amended to read:
   5815.  The State Department of Health Care Services shall seek all
available federal funding for mental health services for veterans.
  SEC. 196.  Section 5851.5 of the Welfare and Institutions Code is
amended to read:
   5851.5.  For the purposes of this part, a "system of care county"
means a county which has been approved by the State Department of
Health Care Services as having the capability to provide child- and
family-centered services in a collaborative manner, resulting in
quantitative outcome measures.
  SEC. 197.  Section 5852 of the Welfare and Institutions Code is
amended to read:
   5852.  There is hereby established an interagency system of care
for children with serious emotional and behavioral disturbances that
provides comprehensive, coordinated care based on the demonstration
project under former Chapter 7 (commencing with Section 5575), as
added by Chapter 160 of the Statutes of 1987, and the former 1983
State Department of Mental Health
           planning model for children's services. Each participating
county shall adapt the model to local needs and priorities.
  SEC. 198.  Section 5852.5 of the Welfare and Institutions Code is
amended to read:
   5852.5.  The State Department of Health Care Services, in
consultation with the Mental Health Services Oversight and
Accountability Commission shall review those counties that have been
awarded funds to implement a comprehensive system for the delivery of
mental health services to children with serious emotional
disturbance and to their families or foster families to determine
compliance with either of the following:
   (a) The total estimated cost avoidance in all of the following
categories shall equal or exceed the applications for funding award
moneys:
   (1) Group home costs paid by Aid to Families with Dependent
Children-Foster Care (AFDC-FC) program.
   (2) Children and adolescent state hospital and acute inpatient
programs.
   (3) Nonpublic school residential placement costs.
   (4) Juvenile justice reincarcerations.
   (5) Other short- and long-term savings in public funds resulting
from the applications for funding award moneys.
   (b) If the department determines that the total cost avoidance
listed in subdivision (a) does not equal or exceed applications for
funding award amounts, the department shall determine that the county
that has been awarded funding shall achieve substantial compliance
with all of the following goals:
   (1) Total cost avoidance in the categories listed in subdivision
(a) to exceed 50 percent of the applications for funding award
moneys.
   (2) A 20-percent reduction in out-of-county ordered placements of
juvenile justice wards and social service dependents.
   (3) A statistically significant reduction in the rate of
recidivism by juvenile offenders.
   (4) A 25-percent reduction in the rate of state hospitalization of
minors from placements of special education pupils.
   (5) A 10-percent reduction in out-of-county nonpublic school
residential placements of special education pupils.
   (6) Allow at least 50 percent of children at risk of imminent
placement served by the intensive in-home crisis treatment programs,
which are wholly or partially funded by applications for funding
award moneys, to remain at home at least six months.
   (7) Statistically significant improvement in school attendance and
academic performance of seriously emotionally disturbed special
education pupils treated in day treatment programs which are wholly
or partially funded by applications for funding award moneys.
   (8) Statistically significant increases in services provided in
nonclinic settings among agencies.
   (9) Increase in ethnic minority and gender access to services
proportionate to the percentage of these groups in the county's
school-age population.
  SEC. 199.  Section 5854 of the Welfare and Institutions Code is
amended to read:
   5854.  The State Department of Health Care Services may contract
with counties whose programs have been approved by the department and
selected pursuant to Article 4 (commencing with Section 5857). A
county may request to participate under this part each year according
to the terms set forth in Section 5705 for the purpose of
establishing a three-year program proposal for developing and
implementing a children's comprehensive mental health services
system. The contract shall be negotiated on a yearly basis, based on
the scope of work plan for each implementation phase.
  SEC. 200.  Section 5855 of the Welfare and Institutions Code is
amended to read:
   5855.  The State Department of Health Care Services shall adopt as
part of its overall mission the development of community-based,
comprehensive, interagency systems of care that target seriously
emotionally and behaviorally disturbed children separated from their
families or at risk of separation from their families, as defined in
Section 5856. These comprehensive, interagency systems of care shall
seek to provide the highest benefit to children, their families, and
the community at the lowest cost to the public sector. Essential
values shall be as follows:
   (a) Family preservation. Children shall be maintained in their
homes with their families whenever possible.
   (b) Least restrictive setting. Children shall be placed in the
least restrictive and least costly setting appropriate to their needs
when out-of-home placement is necessary.
   (c) Natural setting. Children benefit most from mental health
services in their natural environments, where they live and learn,
such as home, school, foster home, or a juvenile detention center.
   (d) Interagency collaboration and a coordinated service delivery
system. The primary child-serving agencies, such as social services,
probation, education, health, and mental health agencies, shall
collaborate at the policy, management, and service levels to provide
a coordinated, goal-directed system of care for seriously emotionally
disturbed children and their families.
   (e) Family involvement. Family participation is an integral part
of assessment, intervention, and evaluation.
   (f) Cultural competence. Service effectiveness is dependent upon
both culturally relevant and competent service delivery.
  SEC. 201.  Section 5855.5 of the Welfare and Institutions Code is
amended to read:
   5855.5.  (a) Projects funded pursuant to Part 4 (commencing with
Section 5850) of Division 5, as added by Chapter 89 of the Statutes
of 1991, shall continue under the terms of this part.
   (b) The State Department of Health Care Services shall negotiate
with each participating county to establish appropriate evaluation
measures for the county's children's system of care program after the
initial three-year implementation funding period as established in
Section 5854. The department shall, on an annual basis, negotiate a
performance contract with each county electing to continue its
children's system of care program. The annual performance contract
shall be consistent county to county, and shall include, but not be
limited to, a scope of work plan consistent with the provisions of
this part and shall contain a budget that has sufficient detail to
meet the requirements of the department.
  SEC. 202.  Section 5863 of the Welfare and Institutions Code is
amended to read:
   5863.  In addition to the requirements of Section 5862, each
county program proposal shall contain all of the following:
   (a) Methods and protocols for the county mental health department
to identify and screen the eligible target population children. These
protocols shall be developed with collaborative partners and shall
ensure that eligible children can be referred from all collaborating
agencies.
   (b) Measurable system performance goals for client outcome and
cost avoidance. Outcomes shall be made available to collaborating
partners and used for program improvement.
   (c) Methods to achieve interagency collaboration by all publicly
funded agencies serving children experiencing emotional disturbances.

   (d) Appropriate written interagency protocols and agreements with
all other programs in the county that serve similar populations of
children. Agreements shall exist with wrap-around programs (Chapter 4
(commencing with Section 18250) of Part 6 of Division 9), Family
Preservation programs (Part 4.4 (commencing with Section 16600) of
Division 9), Juvenile Crime Enforcement and Accountability Challenge
Grant programs (Article 18.7 (commencing with Section 749.2) of
Chapter 2 of Part 1 of Division 1), programs serving children with a
dual diagnosis including substance abuse or whose emotional
disturbance is related to family substance abuse, and programs
serving families enrolled in CalWORKs (Chapter 2 (commencing with
Section 11200.5) of Part 3 of Division 9).
   (e) A description of case management services for the target
population. Each county program proposal shall include protocols
developed in the county for case management designed to provide
assessment, linkage, case planning, monitoring, and client advocacy
to facilitate the provision of appropriate services for the child and
family in the least restrictive environment as close to home as
possible.
   (f) Mental health services that enable a child to remain in his or
her usual family setting and that offer an appropriate alternative
to out-of-home placement.
   (g) Methods to conduct joint interagency placement screening of
target population children prior to out-of-home placement.
   (h) Identification of the number and level of county evaluation
staff and the resources necessary to meet requirements established by
the State Department of Health Care Services to measure client and
cost outcome and other system performance measures.
   (i) A budget specifying all new and currently funded mental health
expenditures provided as part of the proposed system of care. The
department shall establish reporting requirements for direct and
indirect administrative overhead, to be included in the request for
proposals. Weight shall be given to counties with lower
administrative overhead costs. In no case shall administrative costs
exceed those of existing county mental health programs and services.
Expenditures for evaluation staff and resources shall not be
considered administrative costs for this purpose.
   (j) Any requirements for interagency collaboration, agreements, or
protocols contained in this section shall not diminish requirements
for the confidentiality of medical information or information
maintained by a county agency or department.
  SEC. 203.  Section 5867.5 of the Welfare and Institutions Code is
amended to read:
   5867.5.  Beginning in the 1998-99 fiscal year, county mental
health departments that receive full system of care funding, as
determined by the State Department of Health Care Services in
consultation with counties, shall provide to children served by
county social services and probation departments mental health
screening, assessment, participation in multidisciplinary placement
teams and specialty mental health treatment services for children
placed out of home in group care, for those children who meet the
definition of medical necessity, to the extent resources are
available. These counties shall give first priority to children
currently receiving psychoactive medication.
  SEC. 204.  Section 5868 of the Welfare and Institutions Code is
amended to read:
   5868.  (a) The State Department of Health Care Services shall
establish service standards that ensure that children in the target
population are identified and receive needed and appropriate services
from qualified staff in the least restrictive environment.
   (b) The standards shall include, but not be limited to:
   (1) Providing a comprehensive assessment and treatment plan for
each target population client to be served, and developing programs
and services that will meet their needs and facilitate client outcome
goals.
   (2) Providing for full participation of the family in all aspects
of assessment, case planning, and treatment.
   (3) Providing methods of assessment and services to meet the
cultural, linguistic, and special needs of minorities in the target
population.
   (4) Providing for staff with the cultural background and
linguistic skills necessary to remove barriers to mental health
services resulting from a limited ability to speak English or from
cultural differences.
   (5) Providing mental health case management for all target
population clients in, or being considered for, out-of-home
placement.
   (6) Providing mental health services in the natural environment of
the child to the extent feasible and appropriate.
   (c) The responsibility of the case managers shall be to ensure
that each child receives the following services:
   (1) A comprehensive mental health assessment.
   (2) Case planning with all appropriate interagency participation.
   (3) Linkage with all appropriate mental health services.
   (4) Service plan monitoring.
   (5) Client advocacy to ensure the provision of needed services.
  SEC. 205.  Section 5869 of the Welfare and Institutions Code is
amended to read:
   5869.  The State Department of Health Care Services shall provide
participating counties with all of the following:
   (a) Applications for funding guidelines and format, and
coordination and oversight of the selection process as described in
Article 4 (commencing with Section 5857).
   (b) Contracts with each state funded county specifying the
approved budget, performance outcomes, and a scope of work plan for
each year of participation in the children's system of care program.
   (c) Technical assistance related to system evaluation.
  SEC. 206.  Section 5872 of the Welfare and Institutions Code is
amended to read:
   5872.  In order to offset the cost of services, participating
counties shall collect reimbursement for services from the following
sources:
   (a) Fees paid by families, which shall be the same as patient fees
established pursuant to Section 14705.
   (b) Fees paid by private or public third-party payers.
   (c) Categorical funds from sources established in state or federal
law, for which persons with mental illness are eligible.
  SEC. 207.  Section 5878 of the Welfare and Institutions Code is
amended to read:
   5878.  (a) (1) The Secretary of California Health and Human
Services, the Superintendent of Public Instruction, or the Secretary
of the Department of Corrections and Rehabilitation may waive any
state regulatory obstacles to the integration of public
responsibilities and resources required for counties which have been
approved as system of care counties.
   (2) The waiver shall remain in effect as long as the local program
continues to meet standards as specified in the scope of work plan
approved by the State Department of Health Care Services.
   (b) The Secretary of California Health and Human Services, the
Superintendent of Public Instruction, and the Secretary of the
Department of Corrections and Rehabilitation, and those departments
designated as single state agencies administering federal programs,
shall make every effort to secure federal waivers and any other
changes in federal policy or law necessary to support interagency
collaboration and coordination in a system of care service delivery
system.
  SEC. 208.  Section 5880 of the Welfare and Institutions Code is
amended to read:
   5880.  For each selected county the State Department of Health
Care Services shall define and establish client and cost outcome and
other system performance goals, and negotiate the expected levels of
attainment for each year of participation. Expected levels of
attainment shall include a breakdown by ethnic origin and shall be
identified by a county in its proposal. These goals shall include,
but not be limited to, both of the following:
   (a) Client improvement and cost avoidance outcome measures, as
follows:
   (1) To reduce the number of child months in group homes,
residential placements pursuant to Chapter 26.5 (commencing with
Section 7570) of Division 7 of Title 1 of the Government Code, and
state hospital placements.
   (2) To reduce the cost of AFDC-FC group home care, residential
placements as described in paragraph (1), and state hospital
utilization, by an amount which equals at least 50 percent of the
third year project cost. Cost avoidance shall be based on data
comparisons of statewide average expenditure and population.
   (3) To increase school attendance for pupils in targeted programs.

   (4) To increase the grade level equivalent of pupils in targeted
programs from admission to discharge.
   (5) To reduce the rate of recidivism incurred for wards in
targeted juvenile justice programs.
   (6) To show measurable improvement in individual and family
functional status for a representative sample of children enrolled in
the system of care.
   (7) To achieve statistically significant increases in services
provided in nonclinic settings among agencies.
   (8) To increase ethnic minority and gender access to services
proportionate to the percentage of these groups in the county's
school-age population.
   (b) System development and operation measures, as follows:
   (1) To provide an integrated system of care that includes
multiagency programs and joint case planning, to children who are
seriously emotionally and behaviorally disturbed as defined in
Section 5856.
   (2) To identify and assess children who comprise the target
population in the county evidenced by a roster which contains all
children receiving mental health case management and treatment
services. This roster shall include necessary standardized and
uniform identifying information and demographics about the children
served.
   (3) To develop and maintain individualized service plans that will
facilitate interagency service delivery in the least restrictive
environment.
   (4) To develop or provide access to a range of intensive services
that will meet individualized service plan needs. These services
shall include, but not be limited to, case management, expanded
treatment services at schoolsites, local juvenile corrections
facilities, and local foster homes, and flexible services.
   (5) To ensure the development and operation of the interagency
policy council and the interagency case management council.
   (6) To provide culturally competent programs that recognize and
address the unique needs of ethnic populations in relation to equal
access, program design and operation, and program evaluation.
   (7) To develop parent education and support groups, and linkages
with parents to ensure their involvement in the planning process and
the delivery of services.
   (8) To provide a system of evaluation that develops outcome
criteria and which will measure performance, including client outcome
and cost avoidance.
   (9) To gather, manage, and report data in accordance with the
requirements of the state funded outcome evaluation.
  SEC. 209.  Section 5881 of the Welfare and Institutions Code is
amended to read:
   5881.  (a) Evaluation shall be conducted by participating county
evaluation staff and, subject to the availability of funds, by the
State Department of Health Care Services and the Mental Health
Services Oversight and Accountability Commission.
   (b) Evaluation at both levels shall do all of the following:
   (1) Ensure that county level systems of care are serving the
targeted population.
   (2) Ensure that the timely performance data related to client
outcome and cost avoidance is collected, analyzed, and reported.
   (3) Ensure that system of care components are implemented as
intended.
   (4) Provide information documenting needs for future planning.
  SEC. 210.  Section 5901 of the Welfare and Institutions Code is
amended to read:
   5901.  (a) The Legislature finds that the following issues
relating to program operation must be resolved prior to the full
assumption of responsibility for institutions for mental disease
program monitoring and reimbursement procedures by the counties:
   (1) The information regarding the program is inadequate to
accurately allocate funding to the counties without significant
disruption of patient care.
   (2) There is currently no administrative mechanism whereby all
counties can immediately assume these responsibilities without
endangering the health and safety of the persons being served.
   (b) (1) During the 1991-92 fiscal year, the sum of eighty-seven
million seven hundred twenty-seven thousand dollars ($87,727,000)
shall be made available from the Mental Health Subaccount of the
Sales Tax Account of the Local Revenue Fund to the department for
support of institutions for mental disease.
   (2) For the 1991-92 fiscal year, the department shall issue a
preliminary allocation of at least fifty-seven million four hundred
fifty thousand dollars ($57,450,000) of the amount identified in
paragraph (1). In developing a preliminary allocation, the department
shall utilize a methodology that will minimize disruption of
services to persons being served and that will continue access at the
1990-91 fiscal year level.
   (3) During the 1991-92 fiscal year, the department shall
administer institution for mental disease resources remaining from
the amount identified in paragraph (1) after the allocation described
in (2) has been made, as a risk pool on behalf of all the counties.
Effective July 1, 1991, the department shall enter into contracts
with institutions for mental disease providers at the 1990-91 fiscal
year contract bed level. These resources shall be made available to
all counties.
   (4) The department shall establish a method for the identification
of persons, by county, residing in institutions for mental disease,
and notification of counties of their program and fiscal
responsibilities.
   (c) The Department of Finance may authorize a loan of up to twenty
million dollars ($20,000,000) from the General Fund for deposit into
the Institutions for Mental Disease Account of the Mental Health
Facilities Fund established pursuant to Section 17602.05, for use by
the department in implementing this part.
  SEC. 211.  Section 5909 of the Welfare and Institutions Code is
amended to read:
   5909.  The Director of Health Care Services shall retain the
authority and responsibility to monitor and approve special treatment
programs in skilled nursing facilities in accordance with Sections
72443 to 72474, inclusive, of Title 22 of the California Code of
Regulations.
  SEC. 212.  Section 6002.15 of the Welfare and Institutions Code is
amended to read:
   6002.15.  (a) Prior to accepting the written authorization for
treatment, the facility shall assure that a representative of the
facility has given a full explanation of the treatment philosophy of
the facility, including, where applicable, the use of seclusion and
restraint, the use of medication, and the degree of involvement of
family members in the minor's treatment to the parent, guardian or
other person entitled to the minor's custody. This explanation shall
be given orally and in writing, and shall be documented in the minor'
s treatment record upon completion.
   (b) As part of the admission process, the professional person
responsible for the minor's admission shall affirm in writing that
the minor meets the admission criteria as specified above.
   (c) Upon admission, a facility specified in Section 6002.10 shall
do all of the following:
   (1) Inform the minor in writing of the availability of an
independent clinical review of his or her further inpatient
treatment. The notice shall be witnessed and signed by an appropriate
representative of the facility.
   (2) Within one working day, notify the patients' rights advocate,
as defined in Article 2 (commencing with Section 5540) of Chapter
5.2, regarding the admission of the minor.
   (3) Provide all minors with a booklet promulgated by the State
Department of Health Care Services outlining the specific rights of
minors in mental health facilities. The booklet shall include the
phone number of the local advocate and the hours that he or she may
be reached.
  SEC. 213.  Section 6002.40 of the Welfare and Institutions Code is
amended to read:
   6002.40.  (a) For any insurance contracts entered into after
January 1, 1990, where any private insurer, certified medical plan,
or private health service plan is liable to pay or reimburse a
professional provider or institutional provider for the costs of
medically necessary mental health services provided to the patient,
the costs of the clinical review required by Sections 6002.10 to
6002.40, inclusive, including, but not limited to, the costs of the
interpreter, if any, and the costs of the patients' rights advocate,
shall be borne by the insurer, certified medical plan, or the health
service plan. Payments to providers for the costs of the independent
clinical review shall be made promptly.
   For Medi-Cal eligible patients placed in these private facilities,
the costs of the clinical review required by Sections 6002.10 to
6002.40, inclusive, including the costs of the patients rights
advocate, shall be borne by the county.
   (b) The Legislature intends that Sections 6002.10 to 6002.40,
inclusive, affect only the rights of minors confined in private
mental health facilities on the consent of their parents or
guardians, where the costs of treatment are paid or reimbursed by a
private insurer or private health service plan.
   (c) Mental health facilities shall summarize on an annual basis,
information including, but not limited to, the number of minors
admitted by diagnosis, length of stay, and source of payment, the
number of requests for an independent clinical review by diagnosis,
source of payment, and outcome of the independent clinical review and
submit this information to the State Department of Health Care
Services. The State Department of Public Health shall monitor
compliance of this section during an inspection of the facility
pursuant to Sections 1278 and 1279 of the Health and Safety Code.
  SEC. 214.  Section 6007 of the Welfare and Institutions Code is
amended to read:
   6007.  Any person detained as of June 30, 1969, in a private
institution, pursuant to former Sections 6030 to 6033, inclusive, as
they read immediately preceding July 1, 1969, on the certification of
one physician, may be detained after July 1, 1969, for a period no
longer than 90 days.
   Any person detained as of June 30, 1969, in a private institution,
pursuant to such sections, on the certification of two physicians,
may be detained after July 1, 1969, for a period no longer than 180
days.
   Any person detained pursuant to this section after July 1, 1969,
shall be evaluated by the facility designated by the county and
approved by the State Department of Social Services pursuant to
Section 5150 as a facility for 72-hour treatment and evaluation. The
evaluation shall be made at the request of the person in charge of
the private institution in which the person is detained or by one of
the physicians who signed the certificate. If in the opinion of the
professional person in charge of the evaluation and treatment
facility or his or her designee, the evaluation of the person can be
made by the professional person or his or her designee at the private
institution in which the person is detained, the person shall not be
required to be evaluated at the evaluation and treatment facility,
but shall be evaluated at the private institution to determine if the
person is a danger to others, himself or herself, or gravely
disabled as a result of mental disorder.
   Any person evaluated under this section shall be released from the
private institution immediately upon completion of the evaluation if
in the opinion of the professional person in charge of the
evaluation and                                           treatment
facility, or his or her designee, the person evaluated is not a
danger to others, or to himself or herself, or gravely disabled as a
result of mental disorder, unless the person agrees voluntarily to
remain in the private institution.
   If in the opinion of the professional person in charge of the
facility or his or her designee, the person evaluated requires
intensive treatment or recommendation for conservatorship, the
professional person or his or her designee shall proceed under
Article 4 (commencing with Section 5250) of Chapter 2, or under
Chapter 3 (commencing with Section 5350), of Part 1 of Division 5.
  SEC. 215.  Section 6551 of the Welfare and Institutions Code is
amended to read:
   6551.  If the court is in doubt as to whether the person is
mentally disordered or mentally retarded, the court shall order the
person to be taken to a facility designated by the county and
approved by the State Department of Social Services as a facility for
72-hour treatment and evaluation. Thereupon, Article 1 (commencing
with Section 5150) of Chapter 2 of Part 1 of Division 5 applies,
except that the professional person in charge of the facility shall
make a written report to the court concerning the results of the
evaluation of the person's mental condition. If the professional
person in charge of the facility finds the person is, as a result of
mental disorder, in need of intensive treatment, the person may be
certified for not more than 14 days of involuntary intensive
treatment if the conditions set forth in subdivision (c) of Section
5250 and subdivision (b) of Section 5260 are complied with.
Thereupon, Article 4 (commencing with Section 5250) of Chapter 2 of
Part 1 of Division 5 shall apply to the person. The person may be
detained pursuant to Article 4.5 (commencing with Section 5260), or
Article 4.7 (commencing with Section 5270.10), or Article 6
(commencing with Section 5300) of Part 1 of Division 5 if that
article applies.
   If the professional person in charge of the facility finds that
the person is mentally retarded, the juvenile court may direct the
filing in any other court of a petition for the commitment of a minor
as a mentally retarded person to the State Department of
Developmental Services for placement in a state hospital. In such
case, the juvenile court shall transmit to the court in which the
petition is filed a copy of the report of the professional person in
charge of the facility in which the minor was placed for observation.
The court in which the petition for commitment is filed may accept
the report of the professional person in lieu of the appointment, or
subpoenaing, and testimony of other expert witnesses appointed by the
court, if the laws applicable to such commitment proceedings provide
for the appointment by court of medical or other expert witnesses or
may consider the report as evidence in addition to the testimony of
medical or other expert witnesses.
   If the professional person in charge of the facility for 72-hour
evaluation and treatment reports to the juvenile court that the minor
is not affected with any mental disorder requiring intensive
treatment or mental retardation, the professional person in charge of
the facility shall return the minor to the juvenile court on or
before the expiration of the 72-hour period and the court shall
proceed with the case in accordance with the Juvenile Court Law.
   Any expenditure for the evaluation or intensive treatment of a
minor under this section shall be considered an expenditure made
under Part 2 (commencing with Section 5600) of Division 5 and shall
be reimbursed by the state as are other local expenditures pursuant
to that part.
   The jurisdiction of the juvenile court over the minor shall be
suspended during the time that the minor is subject to the
jurisdiction of the court in which the petition for postcertification
treatment of an imminently dangerous person or the petition for
commitment of a mentally retarded person is filed or under remand for
90 days for intensive treatment or commitment ordered by the court.
  SEC. 216.  Section 7100 of the Welfare and Institutions Code is
amended to read:
   7100.  The board of supervisors of each county may maintain in the
county hospital or in any other hospital situated within or without
the county or in any other psychiatric health facility situated
within or without the county, suitable facilities and nonhospital or
hospital service for the detention, supervision, care, and treatment
of persons who are mentally disordered or developmentally disabled,
or who are alleged to be such.
   The county may contract with public or private hospitals for those
facilities and hospital service when they are not suitably available
in any institution, psychiatric facility, or establishment
maintained or operated by the county.
   The facilities and services for the mentally disordered and
allegedly mentally disordered shall be subject to the approval of the
State Department of Social Services, and the facilities and services
for the developmentally disabled and allegedly developmentally
disabled shall be subject to the approval of the State Department of
Developmental Services. The professional person having charge and
control of the hospital or psychiatric health facility shall allow
the department whose approval is required to make investigations
thereof as it deems necessary at any time.
   Nothing in this chapter means that mentally disordered or
developmentally disabled persons may not be detained, supervised,
cared for, or treated, subject to the right of inquiry or
investigation by the department, in their own homes, or the homes of
their relatives or friends, or in a licensed establishment.
  SEC. 217.  Section 9101 of the Welfare and Institutions Code is
amended to read:
   9101.  (a) The department shall consist of a director, and any
staff as may be necessary for proper administration.
   (b) The department shall maintain its main office in Sacramento.
   (c) The Governor, with the consent of the Senate, shall appoint
the director. The Governor shall consider, but not be limited to,
recommendations from the commission.
   (d) The director shall have the powers of a head of a department
pursuant to Chapter 2 (commencing with Section 11150) of Part 1 of
Division 3 of Title 2 of the Government Code, and shall receive the
salary provided for by Chapter 6 (commencing with Section 11550) of
Part 1 of Division 3 of Title 2 of the Government Code.
   (e) The director shall do all of the following:
   (1) Be responsible for the management of the department and
achievement of its statewide goals.
   (2) Assist the commission in carrying out its mandated duties and
responsibilities in accordance with Section 9202.
   (f) The Secretary of California Health and Human Services shall
ensure effective coordination among departments of the agency in
carrying out the mandates of this division. For this purpose, the
secretary shall regularly convene meetings concerning services to
older individuals that shall include, but not be limited to, the
State Department of Health Care Services, the State Department of
Social Services, the State Department of Public Health, and the
department.
   (g) The Secretary of California Health and Human Services shall
also encourage other state departments that have other programs for
older individuals to actively participate in periodic joint meetings
for the joint purpose of coordinating service activities. These
departments shall include, but are not limited to, the Department of
Housing and Community Development and the Department of
Transportation in the Business, Transportation and Housing Agency,
the Department of Parks and Recreation in the Natural Resources
Agency, the California Arts Council, and the Department of Veterans
Affairs.
  SEC. 218.  Section 11325.7 of the Welfare and Institutions Code is
amended to read:
   11325.7.  (a) It is the intent of the Legislature in enacting this
section to create a funding stream and program that assists certain
recipients of aid under this chapter to receive necessary mental
health services, including case management and treatment, thereby
enabling them to make the transition from welfare to work. This
funding stream shall be used specifically to serve recipients in need
of mental health services, and shall be accounted for and expended
by each county in a manner that ensures that recipients in need of
mental health services are receiving appropriate services.
   (b) The county plan required by Section 10531 shall include a plan
for the development of mental health employment assistance services,
developed jointly by the county welfare department and the county
department of mental health. The plan shall have as its goal the
treatment of mental or emotional disabilities that may limit or
impair the ability of a recipient to make the transition from
welfare-to-work, or that may limit or impair the ability to retain
employment over a long-term period. The plan shall be developed in a
manner consistent with both the county's welfare-to-work program and
the county's consolidated mental health Medi-Cal services plan. The
county may use community based providers, as necessary, that have
experience in addressing the needs of the CalWORKs population. The
county, whenever possible, shall ensure that the services provided
qualify for federal reimbursement of the nonstate share of Medi-Cal
costs.
   (c) Subject to specific expenditure authority, mental health
services available under this section shall include all of the
following elements:
   (1) Assessment for the purpose of identifying the level of the
participant's mental health needs and the appropriate level of
treatment and rehabilitation for the participant.
   (2) Case management, as appropriate, as determined by the county.
   (3) Treatment and rehabilitation services, that shall include
counseling, as necessary to overcome mental health barriers to
employment and mental health barriers to retaining employment, in
coordination with an individual's welfare-to-work plan.
   (4) In cases where a secondary diagnosis of substance abuse is
made in a person referred for mental or emotional disorders, the
welfare-to-work plan shall also address the substance abuse treatment
needs of the participant.
   (5) A process by which the county can identify those with severe
mental disabilities that may qualify them for aid under Chapter 3
(commencing with Section 12000).
   (d) Any funds appropriated by the Legislature to cover the
nonfederal costs of the mental health employment assistance services
required by this section shall be allocated consistent with the
formula used to distribute each county's CalWORKs program allocation.
Each county shall report annually to the state the number of
CalWORKs program recipients who received mental health services and
the extent to which the allocation is sufficient to meet the need for
these services as determined by the county. The State Department of
Health Care Services shall develop a uniform methodology for ensuring
that this allocation supplements and does not supplant current
expenditure levels for mental health services for this population.
  SEC. 219.  Section 11462.01 of the Welfare and Institutions Code is
amended to read:
   11462.01.  (a) Commencing July 1, 1994, a group home program shall
be classified at RCL 13 or RCL 14 if the program meets all of the
following requirements:
   (1) The group home program is providing, or has proposed to
provide, the level of care and services necessary to generate
sufficient points in the ratesetting process to be classified at RCL
13 if the rate application is for RCL 13 or to be classified at RCL
14 if the rate application is for RCL 14.
   (2) (A) (i) The group home provider shall agree not to accept for
placement into a group home program AFDC-FC funded children,
including voluntary placements and seriously emotionally disturbed
children placed out-of-home pursuant to an individualized education
program developed under Section 7572.5 of the Government Code, who
have not been approved for placement by an interagency placement
committee, as described by Section 4096. The approval shall be in
writing and shall indicate that the interagency placement committee
has determined the child is seriously emotionally disturbed, as
defined by Section 5600.3 and subject to Section 1502.4 of the Health
and Safety Code, and that the child needs the level of care provided
by the group home.
   (ii) For purposes of clause (i), group home providers who accept
seriously emotionally disturbed children who are assessed and placed
out-of-home pursuant to an individualized education program developed
under Section 7572.5 of the Government Code shall be deemed to have
met the interagency placement committee approval for placement
requirements of clause (i) if the individualized education program
assessment indicates that the child has been determined to be
seriously emotionally disturbed, as defined in Section 5600.3 and
subject to Section 1502.4 of the Health and Safety Code, and needs
the level of care described in clause (i).
   (B) (i) Nothing in this subdivision shall prevent the emergency
placement of a child into a group home program prior to the
determination by the interagency placement committee pursuant to
subclause (i) of subparagraph (A) if a licensed mental health
professional, as defined in the department's AFDC-FC ratesetting
regulations, has evaluated, in writing, the child within 72 hours of
placement, and determined the child to be seriously emotionally
disturbed and in need of the care and services provided by the group
home program.
   (ii) The interagency placement committee shall, within 30 days of
placement pursuant to clause (i), make the determination required by
clause (i) of subparagraph (A).
   (iii) If, pursuant to clause (ii), the placement is determined to
be appropriate, the committee shall transmit the approval, in
writing, to the county placing agency and the group home provider.
   (iv) If, pursuant to clause (ii) the placement is determined not
to be appropriate, the child shall be removed from the group home and
referred to a more appropriate placement, as specified in
subdivision (f).
   (C) Commencing December 15, 1992, with respect to AFDC-FC funded
children, only those children who are approved for placement by an
interagency placement committee may be accepted by a group home under
this subdivision.
   (3) The group home program is certified by the State Department of
Health Care Services pursuant to Section 4096.5.
   (b) The department shall not establish a rate for a group home
requesting a program change to RCL 13 or RCL 14 unless the group home
provider submits a recommendation from the host county or the
primary placing county that the program is needed and that the
provider is willing and capable of operating the program at the level
sought. For purposes of this subdivision, "host county," "primary
placing county," and "program change" mean the same as defined in the
department's AFDC-FC ratesetting regulations.
   (c) The effective date of rates set at RCL 13 or RCL 14 shall be
the date that all the requirements are met, but not prior to July 1
of that fiscal year. Nothing in this section shall affect RCL 13 or
RCL 14 ratesetting determinations in prior years.
   (d) Any group home program that has been classified at RCL 13 or
RCL 14 pursuant to the requirements of subdivision (a) shall be
reclassified at the appropriate lower RCL with a commensurate
reduction in rate if either of the following occurs:
   (1) The group home program fails to maintain the level of care and
services necessary to generate the necessary number of points for
RCL 13 or RCL 14, as required by paragraph (1) of subdivision (a).
The determination of points shall be made consistent with the
department's AFDC-FC ratesetting regulations for other rate
classification levels.
   (2) The group home program fails to maintain a certified mental
health treatment program as required by paragraph (3) of subdivision
(a).
   (3) In the event of a determination under paragraph (1), the group
home may appeal the finding or submit a corrective action plan. The
appeal process specified in Section 11466.6 shall be available to RCL
13 and RCL 14 group home providers. During any appeal, the group
home shall maintain the appropriate level of care.
   (e) The interagency placement committee shall periodically review,
but no less often than that required by current law, the placement
of the child. If the committee determines that the child no longer
needs, or is not benefiting from, placement in a RCL 13 or RCL 14
group home, the committee shall require the removal of the child and
a new disposition.
   (f) (1) (A) If, at any time subsequent to placement in an RCL 13
or RCL 14 group home program, the interagency placement committee
determines either that the child is not seriously emotionally
disturbed or is not in need of the care and services provided by the
group home program, it shall notify, in writing, both the county
placing agency and the group home provider within 10 days of the
determination.
   (B) The county placing agency shall notify the group home
provider, in writing, within five days from the date of the notice
from the committee, of the county's plan for removal of the child.
   (C) The county placing agency shall remove the child from the
group home program within 30 days from the date of the notice from
the interagency placement committee.
   (2) (A) If a county placing agency does not remove a child within
30 days from the date of the notice from the interagency placement
committee, the group home provider shall notify the interagency
placement committee and the department, in writing, of the county's
failure to remove the child from the group home program.
   (B) The group home provider shall make the notification required
by subparagraph (A) within five days of the expiration of the 30-day
removal period. If notification is made, a group home provider shall
not be subject to an overpayment determination due to failure of the
county placing agency to remove the child.
   (3) Any county placing agency that fails to remove a child from a
group home program under this paragraph within 30 days from the date
of the notice from the interagency placement committee shall be
assessed a penalty in the amount of the state and federal financial
participation in the AFDC-FC rate paid on behalf of the child
commencing on the 31st day and continuing until the child is removed.

   (g) (1) If any RCL 13 or RCL 14 group home provider discovers that
it does not have written approval for placement of any AFDC-FC
funded child placed on or after December 15, 1992, from the
interagency placement committee, it shall notify the county placing
agency, in writing, and shall request the county to obtain approval
from the interagency placement committee or remove the child from the
group home program. A group home provider shall have 30 days from
the child's first day of placement to discover the placement error
and to notify the county placing agency.
   (2) Any county placing agency that receives notification pursuant
to paragraph (2) of subdivision (f) shall obtain approval for
placement from the interagency placement committee or remove the
child from the group home program within 30 days from the date of the
notice from the group home provider. The program shall not be
reclassified to a lower RCL for a violation of the provisions
referred to in this paragraph.
   (3) (A) If a county placing agency does not have the placement of
a child approved by the interagency placement committee or removed
from the group home within 30 days from the date of the notice from
the group home provider, the group home provider shall notify the
county placing agency and the department, in writing, of the county's
failure to have the placement of the child approved or remove the
child from the group home program.
   (B) The group home provider shall make the notification required
by subparagraph (A) within five days after the expiration of the
30-day approval or removal period. If notification is made, a group
home provider shall not be subject to an overpayment determination
due to failure of the county placing agency to remove the child.
   (C) Any group home provider that fails to notify the county
placing agency pursuant to subparagraph (A) shall be assessed a
penalty in the amount of the AFDC-FC rate paid to the group home
provider on behalf of the child commencing on the 31st day of
placement and continuing until the county placing agency is notified.

   (4) Any county placing agency that fails to have the placement of
a child approved or to have the child removed from the group home
program within 30 days shall be assessed a penalty in the amount of
the state and federal financial participation in the AFDC-FC rate
paid on behalf of the child commencing on the 31st day of placement
and continuing until the child is removed.
   (h) The department shall develop regulations to obtain payment of
assessed penalties as provided in this section. For audit purposes
and the application of penalties for RCL 13 and RCL 14 programs, the
department shall apply statutory provisions that were in effect
during the period for which the audit was conducted.
   (i) (1) Nothing in this subparagraph shall prohibit a group home
classified at RCL 13 or RCL 14 for purposes of the AFDC-FC program,
from accepting private placements of children.
   (2) In cases where a referral is not from a public agency and no
public funding is involved, there shall be no requirement for public
agency review or determination of need.
   (3) Children subject to paragraphs (1) and (2) shall have been
assessed as seriously emotionally disturbed, as defined in Section
5600.3 and subject to Section 1502.4 of the Health and Safety Code,
by a licensed mental health professional, as defined in Sections 629
to 633, inclusive, of Title 9 of the California Code of Regulations.
   (j) A child shall not be placed in a group home program classified
at an RCL 13 or RCL 14 if the placement is paid for with county-only
funds unless the child is assessed as seriously emotionally
disturbed, as defined in Section 5600.3, subject to Section 1502.4 of
the Health and Safety Code, by a licensed mental health
professional, as defined in Sections 629 to 633, inclusive, of Title
9 of the California Code of Regulations.
  SEC. 220.  Section 11495.1 of the Welfare and Institutions Code is
amended to read:
   11495.1.  (a) The department shall convene a task force including,
but not limited to, district attorney domestic violence units,
county departments of social services, the County Welfare Directors
Association of California, the California State Association of
Counties, statewide domestic violence prevention groups, local
domestic violence prevention advocates, and service providers, the
State Department of Health Care Services, the State Department of
Public Health, and the California Emergency Management Agency. The
department shall develop, in consultation with the task force,
protocols on handling cases in which recipients are past or present
victims of abuse. The protocols shall define domestic abuse, and
shall address training standards and curricula, individual case
assessments, confidentiality procedures, notice procedures and
counseling or other appropriate participation requirements as part of
an overall plan to transition from welfare-to-work. The protocol
shall specify how counties shall do the following:
   (1) Identify applicants and recipients of assistance under this
chapter who have been or are victims of abuse, including those who
self-identify, while protecting confidentiality.
   (2) Refer these individuals to supportive services.
   (3) Waive, on a case-by-case basis, for so long as necessary,
pursuant to a determination of good cause under paragraph (2) of
subdivision (f) of Section 11320.3, any program requirements that
would make it more difficult for these individuals or their children
to escape abuse, and that would be detrimental or unfairly penalize
past or present victims of abuse. Requirements that may be waived
include, but are not limited to, time limits on receipt of
assistance, work requirements, educational requirements, paternity
establishment and child support cooperation requirements.
   (b) The department shall issue regulations describing the protocol
identified in subdivision (a) no later than January 1, 1999.
   (c) Waivers of time limits granted pursuant to this section shall
not be implemented if federal statutes or regulations clarify that
abuse victims are included in the 20 percent hardship exemptions and
that no good cause waivers of the 20 percent limit will be granted to
the state for victims of abuse, thereby incurring a penalty to the
state.
   (d) Waivers of the work requirements granted pursuant to this
section shall not be implemented if federal statutes or regulations
clarify that the state will be penalized for failing to meet work
participation requirements due to granting waivers to abuse victims.
  SEC. 221.  Section 14021.3 of the Welfare and Institutions Code, as
added by Section 2 of Chapter 1384 of the Statutes of 1987, is
amended to read:
   14021.3.  (a) The department shall amend the state plan for
medical assistance under Medicaid pursuant to Section 1915(g) of
Title 19 of the federal Social Security Act, as amended by Public Law
99-272 (42 U.S.C. Sec. 1396n(g)), to add case management services as
a covered benefit under the specialty mental health services
Medi-Cal program, and shall submit the plan for federal approval by
December 31, 1988, or, if the plan has not been submitted by that
date, shall submit a letter to the Legislature by that date
explaining the circumstances delaying the plan's submission.
   Upon federal approval for federal financial assistance, the
department shall define case management services, shall establish the
standards under which case management services qualify as a
specialty mental health reimbursable service, and shall develop an
appropriate rate of reimbursement, subject to utilization controls.
   It is the intent of the Legislature that at least 50 percent of
the total state dollars that are offset as a result of the federal
funds received for case management services be redirected to services
for those persons identified in Section 14132.44 and that the
remainder of these funds be redirected to services under the
jurisdiction of the California Health and Human Services Agency for
persons other than those persons identified in Section 14132.44.
         (b) This section shall become inoperative on July 1, 2012,
and, as of January 1, 2013, is repealed, unless a later enacted
statute, that becomes operative on or before January 1, 2013, deletes
or extends the dates on which it becomes inoperative and is
repealed.
  SEC. 222.  Section 14021.3 of the Welfare and Institutions Code, as
added by Section 1 of Chapter 1385 of the Statutes of 1987, is
amended to read:
   14021.3.  The state plan for medical assistance under Medicaid
pursuant to Section 1915(g) of Title 19 of the federal Social
Security Act, as amended by Public Law 99-272 (42 U.S.C. Section
1396n(g)), shall include targeted case management services as a
benefit under the specialty mental health services Medi-Cal program.
  SEC. 223.  Section 14021.4 of the Welfare and Institutions Code is
amended to read:
   14021.4.  (a) California's plan for federal Medi-Cal grants for
medical assistance programs, pursuant to Subchapter XIX (commencing
with Section 1396) of Title 42 of the United States Code, shall
accomplish the following objectives:
   (1) Expansion of the location and type of therapeutic services
offered to persons with mental illnesses under Medi-Cal by the
category of "other diagnostic, screening, preventative, and
rehabilitative services" which is available to states under the
federal Social Security Act and its implementing regulations (42
U.S.C. Sec. 1396d(a)(13); 42 C.F.R. 440.130).
   (2) Expansion of federal financial participation in the costs of
specialty mental health services provided by local mental health
plans or under contract with the mental health plans.
   (3) Expansion of the location where reimbursable specialty mental
health services can be provided, including home, school, and
community based sites.
   (4) Expansion of federal financial participation for services
which meet the rehabilitation needs of persons with mental illnesses,
including, but not limited to, medication management, functional
rehabilitation assessments of clients, and rehabilitative services
which include remedial services directed at restoration to the
highest possible functional level for persons with mental illnesses
and maximum reduction of symptoms of mental illness.
   (5) Improvement of fiscal systems and accountability structures
for specialty mental health services, costs, and rates, with the goal
of achieving federal fiscal requirements.
   (b) The department's state plan revision shall be completed with
review and comments by the California Mental Health Directors
Association and other appropriate groups.
   (c)  Services under the rehabilitative option shall be limited to
specialty mental health plans certified to provide Medi-Cal under
this option.
   (d) It is the intent of the Legislature that the rehabilitation
option of the state Medicaid plan be implemented to expand and
provide flexibility to treatment services and to increase the federal
participation without increasing the costs to the General Fund.
   (e) The department shall review and revise the quality assurance
standards and guidelines required by Section 14725 to ensure that
quality services are delivered to the eligible population. Any
reviews shall include, but not be limited to, appropriate use of
mental health professionals, including psychiatrists, in the
treatment and rehabilitation of clients under this model. The
existing quality assurance standards and guidelines shall remain in
effect until the adoption of the new quality assurance standards and
guidelines.
   (f) Consistent with services offered to persons with mental
illnesses under the Medi-Cal program, as required by this section, it
is the intent of the Legislature for the department to include care
and treatment of persons with mental illnesses who are eligible for
the Medi-Cal program in facilities with a bed capacity of 16 beds or
less.
  SEC. 224.  Section 14021.5 of the Welfare and Institutions Code is
amended to read:
   14021.5.  (a) Notwithstanding any other provision of law, rates
for reimbursing specialty mental health and substance use disorder
services allowable under the Medi-Cal program and rendered to
Medi-Cal beneficiaries shall continue to be based on the upper limits
allowable under federal law and regulations for services provided
prior to July 1, 1980, on the lower of reasonable cost and customary
charges for services provided July 1, 1980, through June 30, 1982,
and on the lowest of reasonable cost, customary charges, and rates
paid by the Medi-Cal program for services provided July 1, 1982,
through June 30, 1984.
   (b) The Legislature hereby states and declares that this section
does not constitute a change in, but is declaratory of, existing law
and that rates for reimbursing specialty mental health and substance
use disorder services to Medi-Cal beneficiaries under the Medi-Cal
program in previous fiscal years were based upon the lower of
reasonable costs or customary charges.
   (c) The department shall promulgate emergency regulations relating
to claims submission and establishing rates and a ratesetting
methodology for determining reimbursement of specialty mental health
and substance use disorder services allowable under the Medi-Cal
program and rendered to Medi-Cal beneficiaries. The methodology and
rates shall reflect the most recently completed cost reports and
shall be effective commencing July 1, 1984.
   (d) Notwithstanding any other law, rates for reimbursing specialty
mental health services allowable under the Medi-Cal program and
rendered to Medi-Cal beneficiaries shall be effective from July 1
through June 30 of the fiscal year in which these rates are
established.
   (e) Notwithstanding any other law, rates for reimbursing substance
use disorder services allowable under the Medi-Cal program and
rendered to Medi-Cal beneficiaries shall be effective from July 1
through June 30 of the fiscal year in which these rates are
established.
  SEC. 225.  Section 14053.3 of the Welfare and Institutions Code is
amended to read:
   14053.3.  (a) Except as provided under federal law, federal
financial participation reimbursement is not allowed for ancillary
services provided to persons residing in facilities that have been
found to be institutions for mental disease (IMD), and since,
consistent with Part 2 (commencing with Section 5600) of Division 5
and Chapter 6 (commencing with Section 17600) of Part 5, counties are
financially responsible for specialty mental health services and
related ancillary services provided to persons through county mental
health programs when Medi-Cal reimbursement is not available, when it
is determined that Medi-Cal reimbursement has been paid for
ancillary services for residents of IMDs, both the federal financial
participation reimbursement and any state funds paid for the
ancillary services provided to residents of IMDs shall be recovered
from counties by the department in accordance with applicable state
and federal statutes and regulations.
   (b) Mental health plans shall report to the department admission
and discharge dates for Medi-Cal beneficiaries in institutions for
mental diseases on a quarterly basis in a format provided by the
department.
  SEC. 226.  Section 14108.1 of the Welfare and Institutions Code is
amended to read:
   14108.1.  Any recipient receiving care in a nursing facility under
this chapter, as part of a certified special treatment program for
persons with mental illnesses, or as a part of a mental health
therapeutic and rehabilitative program approved and certified by a
local mental health director, is entitled to be temporarily absent
from those facilities. The department may develop regulations
establishing the periods of time and conditions under which temporary
absences shall be permitted. These regulations shall require that
absences be in accordance with an individual patient care plan and
also provide for absences due to hospitalization for an acute
condition. The limits on temporary leaves of absence established by
the department by regulation shall not be less than 30 days per year.

   During these temporary absences, the department shall reimburse
the facility for the cost of maintaining the vacant accommodations at
a rate to be determined by the department which shall be less than
the normal reimbursement rate.
  SEC. 227.  Section 14110.15 of the Welfare and Institutions Code is
amended to read:
   14110.15.  (a) The department shall develop, collect, and
maintain, in an electronic format, all data elements in the minimum
data set specified by the federal government. The data base shall
incorporate the data required for preadmission screening and annual
resident reviews, and Medi-Cal treatment authorization requests. The
department shall make the format of this new data base available to
the public.
   (b) All skilled nursing facilities and nursing facilities required
by federal law to complete the minimum data set form shall provide
the data to the department in a manner and form prescribed by the
director. The director may require that the submission of that data
shall be in an electronic format.
   (c) The department shall design the minimum data set data base in
a manner that maintains resident confidentiality and that allows the
use of the data by other authorized state agencies, including, but
not limited to, the Office of Statewide Health Planning and
Development. To the extent possible, those other state agencies shall
obtain the minimum data set and preadmission screening and annual
resident review data from the department's database established and
maintained pursuant to this section.
   (d) To the fullest extent possible, the department shall use the
minimum data set database to meet the requirements of the current
treatment authorization request review process and shall automate use
of the minimum data set information for that purpose.
   (e) This section shall not be construed to prohibit the department
or any other state agency from requiring additional information that
is not available from the minimum data set database in order to meet
other data needs.
   (f) The department shall implement this section no later than the
date specified by the federal government for facility completion of
automation of the minimum data set data. The department shall, within
a reasonable time, make necessary system changes to begin the use of
the automated minimum data set data to meet its treatment
authorization and preadmission screening and annual resident review
data requirements. To the fullest extent possible, these system
changes shall be anticipated and commenced in advance of the federal
government's final implementation date.
   (g) The system shall be developed and implemented in consultation
with representatives of the long-term care industry and other
interested parties, such as physicians and other health care
professionals.
   (h) The department shall implement the development of the minimum
data set database only if federal funds are available for that
purpose. Development of the data system applications for use of the
automated minimum data set database by the department are subject to
federal approval and federal financial participation for the affected
systems.
  SEC. 228.  Section 14131.07 of the Welfare and Institutions Code is
amended to read:
   14131.07.  (a) Notwithstanding any other provision of this chapter
or Chapter 8 (commencing with Section 14200), the total number of
physician office and clinic visits for physician services provided by
a physician, or under the direction of a physician, that are a
covered benefit under the Medi-Cal program shall be limited to seven
visits per beneficiary per fiscal year, excepting visits that meet
the conditions set forth in subdivision (b). For purposes of this
limit, a visit shall include physician services provided at any
federally qualified health center, rural health clinic, community
clinic, outpatient clinic, and hospital outpatient department. The
department may seek input from consumer organizations and the
provider community, as applicable, prior to implementation.
   (b) (1) Visits exceeding seven per beneficiary per fiscal year
shall be required to be certified by the physician, or other medical
professional under the supervision of a physician, attesting that one
or more of the following circumstances is applicable:
   (A) The services will prevent deterioration in a beneficiary's
condition that would otherwise foreseeably result in admission to the
emergency department.
   (B) The services will prevent deterioration in the beneficiary's
condition that would otherwise result in inpatient admission.
   (C) The services will prevent disruption in ongoing medical
therapy or surgical therapy, or both, including, but not limited to,
medications, radiation, or wound management.
   (D) The services constitute diagnostic workup in progress that
would otherwise foreseeably result in inpatient or emergency
department admission.
   (E) The services are for the purpose of assessment and form
completion for Medi-Cal recipients seeking or receiving in-home
supportive services.
   (2) The certification shall consist of a written declaration by
the physician, or other medical professional under the supervision of
the physician, that the visit meets the requirements of any one or
more of the circumstances set forth in paragraph (1), and shall
include a description of the services provided.
   (3) The certification shall be maintained onsite at the physician'
s office or clinic location at which the medical records for the
beneficiary are maintained and shall be subject to audit and
inspection by the department.
   (4) This subdivision does not authorize or direct a beneficiary to
obtain services at a physician office or clinic visit for an
emergency medical condition or that should properly be provided in
the emergency department or as hospital inpatient services.
   (c) Specialty mental health services furnished or arranged for the
provision of mental health services to Medi-Cal beneficiaries
pursuant to Chapter 8.9 (commencing with Section 14700), shall not be
subject to the limit provided in subdivision (a).
   (d) Any pregnancy-related visit, or any visit for the treatment of
any other condition that might complicate a pregnancy, shall not be
subject to the limit provided in subdivision (a).
   (e) The limit on physician office and clinic visits provided in
subdivision (a) shall not apply to any of the following:
   (1) A beneficiary under the Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT) Program.
   (2) A beneficiary receiving long-term care in a nursing facility
that is both of the following:
   (A) A skilled nursing facility or intermediate care facility as
defined in subdivisions (c), (d), (e), (g), and (h), respectively, of
Section 1250 of the Health and Safety Code, and facilities providing
continuous skilled nursing care to persons with developmental
disabilities under the pilot project established pursuant to Section
14132.20.
   (B) Licensed pursuant to subdivision (k) of Section 1250 of the
Health and Safety Code.
   (f) For managed health care plans that contract with the
department pursuant to this chapter or Chapter 8 (commencing with
Section 14200), except for the Senior Care Action Network or AIDS
Healthcare Foundation, payments shall be reduced by the actuarial
equivalent amount of the benefit reductions resulting from the
implementation of the benefit cap amounts specified in this section
pursuant to contract amendments or change orders effective on July 1,
2011, or thereafter.
   (g) This section shall be implemented only to the extent permitted
by federal law.
   (h) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement this section by means of all-county letters,
provider bulletins, or similar instructions, without taking
regulatory action.
   (i) This section shall be implemented on the first day of the
first calendar month following 180 days after the effective date of
the act that added this section, or on the first day of the calendar
month following 60 days after the date the department secures all
necessary federal approvals to implement this section, whichever is
later. If the implementation date occurs after July 1, 2011, then the
benefit caps described in subdivision (a) for the first year of
implementation shall be applied from the implementation date to June
30 of the state fiscal year in which implementation begins.
Thereafter, the benefit caps shall apply on a state fiscal year
basis.
  SEC. 229.  Section 14132.73 of the Welfare and Institutions Code is
amended to read:
   14132.73.  The State Department of Health Care Services shall
allow psychiatrists to receive fee-for-service Medi-Cal reimbursement
for services provided through telemedicine in accordance with the
Medicaid state plan.
  SEC. 230.  Section 14167.1 of the Welfare and Institutions Code is
amended to read:
   14167.1.  For purposes of this article, the following definitions
shall apply:
   (a) "Acute psychiatric days" means the total number of Medi-Cal
specialty mental health service administrative days, Medi-Cal
specialty mental health service acute care days, acute psychiatric
administrative days, and acute psychiatric acute days identified in
the Final Medi-Cal Utilization Statistics for the 2008-09 state
fiscal year as calculated by the department on September 15, 2008.
   (b) "Converted hospital" means a private hospital that becomes a
designated public hospital or a nondesignated public hospital after
the implementation date, a nondesignated public hospital that becomes
a private hospital or a designated public hospital after the
implementation date, or a designated public hospital that becomes a
private hospital or a nondesignated public hospital after the
implementation date.
   (c) "Current Section 1115 Waiver" means California's Medi-Cal
Hospital/Uninsured Care Section 1115 Waiver Demonstration in effect
on the effective date of the article.
   (d) "Designated public hospital" shall have the meaning given in
subdivision (d) of Section 14166.1 as that section may be amended
from time to time.
   (e) "General acute care days" means the total number of Medi-Cal
general acute care days paid by the department to a hospital in the
2008 calendar year, as reflected in the state paid claims files on
July 10, 2009.
   (f) "High acuity days" means Medi-Cal coronary care unit days,
pediatric intensive care unit days, intensive care unit days,
neonatal intensive care unit days, and burn unit days paid by the
department during the 2008 calendar year, as reflected in the state
paid claims files on July 10, 2009.
   (g) "Hospital inpatient services" means all services covered under
Medi-Cal and furnished by hospitals to patients who are admitted as
hospital inpatients and reimbursed on a fee-for-service basis by the
department directly or through its fiscal intermediary. Hospital
inpatient services include outpatient services furnished by a
hospital to a patient who is admitted to that hospital within 24
hours of the provision of the outpatient services that are related to
the condition for which the patient is admitted. Hospital inpatient
services do not include services for which a managed health care plan
is financially responsible.
   (h) "Hospital outpatient services" means all services covered
under Medi-Cal furnished by hospitals to patients who are registered
as hospital outpatients and reimbursed by the department on a
fee-for-service basis directly or through its fiscal intermediary.
Hospital outpatient services do not include services for which a
managed health care plan is financially responsible, or services
rendered by a hospital-based federally qualified health center for
which reimbursement is received pursuant to Section 14132.100.
   (i) (1) "Implementation date" means the latest effective date of
all federal approvals or waivers necessary for the implementation of
this article and Article 5.22 (commencing with Section 14167.31),
including, but not limited to, any approvals on amendments to
contracts between the department and managed health care plans or
mental health plans necessary for the implementation of this article.
The effective date of a federal approval or waiver shall be the
earlier of the stated effective date or the first day of the first
quarter to which the computation of the payments or fee under the
federal approval or waiver is applicable, which may be prior to the
date that the federal approval or waiver is granted or the applicable
contract is amended.
   (2) If federal approval is sought initially for only the 2008-09
federal fiscal year and separately secured for subsequent federal
fiscal years, the implementation date for the 2008-09 federal fiscal
year shall occur when all necessary federal approvals have been
secured for that federal fiscal year.
   (j) "Individual hospital acute psychiatric supplemental payment"
means the total amount of acute psychiatric hospital supplemental
payments to a subject hospital for a quarter for which the
supplemental payments are made. The "individual hospital acute
psychiatric supplemental payment" shall be calculated for subject
hospitals by multiplying the number of acute psychiatric days for the
individual hospital for which a mental health plan was financially
responsible by four hundred eighty-five dollars ($485) and dividing
the result by 4.
   (k) (1) "Managed health care plan" means a health care delivery
system that manages the provision of health care and receives prepaid
capitated payments from the state in return for providing services
to Medi-Cal beneficiaries.
   (2) (A) Managed health care plans include county organized health
systems and entities contracting with the department to provide
services pursuant to two-plan models and geographic managed care.
Entities providing these services contract with the department
pursuant to any of the following:
   (i) Article 2.7 (commencing with Section 14087.3).
   (ii) Article 2.8 (commencing with Section 14087.5).
   (iii) Article 2.81 (commencing with Section 14087.96).
   (iv) Article 2.91 (commencing with Section 14089).
   (B) Managed health care plans do not include any of the following:

   (i) Mental health plan contracting to provide mental health care
for Medi-Cal beneficiaries pursuant to Chapter 8.9 (commencing with
Section 14700).
   (ii) Health plan not covering inpatient services such as primary
care case management plans operating pursuant to Section 14088.85.
   (iii) Program of All-Inclusive Care for the Elderly organizations
operating pursuant to Chapter 8.75 (commencing with Section 14591).
   (l) "Medi-Cal managed care days" means the total number of general
acute care days, including well baby days, listed for the county
organized health system and prepaid health plans identified in the
Final Medi-Cal Utilization Statistics for the 2008-09 state fiscal
year, as calculated by the department on September 15, 2008, except
that the general acute care days, including well baby days, for the
Santa Barbara Health Care Initiative shall be derived from the Final
Medi-Cal Utilization Statistics for the 2007-08 state fiscal year.
   (m) "Medicaid inpatient utilization rate" means Medicaid inpatient
utilization rate as defined in Section 1396r-4 of Title 42 of the
United States Code and as set forth in the final disproportionate
share hospital eligibility list for the 2008-09 state fiscal year
released by the department on October 22, 2008.
   (n) "Mental health plan" means a mental health plan that contracts
with the the department to furnish or arrange for the provision of
mental health services to Medi-Cal beneficiaries pursuant to Chapter
8.9 (commencing with Section 14700).
   (o) "New hospital" means a hospital that was not in operation
under current or prior ownership as a private hospital, a
nondesignated public hospital, or a designated public hospital for
any portion of the 2008-09 state fiscal year.
   (p) "Nondesignated public hospital" means either of the following:

   (1) A public hospital that is licensed under subdivision (a) of
Section 1250 of the Health and Safety Code, is not designated as a
specialty hospital in the hospital's annual financial disclosure
report for the hospital's latest fiscal year ending in 2007, and
satisfies the definition in paragraph (25) of subdivision (a) of
Section 14105.98, excluding designated public hospitals.
   (2) A tax-exempt nonprofit hospital that is licensed under
subdivision (a) of Section 1250 of the Health and Safety Code, is not
designated as a specialty hospital in the hospital's annual
financial disclosure report for the hospital's latest fiscal year
ending in 2007, is operating a hospital owned by a local health care
district, and is affiliated with the health care district hospital
owner by means of the district's status as the nonprofit corporation'
s sole corporate member.
   (q) "Outpatient base amount" means the total amount of payments
for hospital outpatient services made to a hospital in the 2007
calendar year, as reflected in state paid claims files on January 26,
2008.
   (r) "Private hospital" means a hospital that meets all of the
following conditions:
   (1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
   (2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2007.
   (3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
   (4) Is a nonpublic hospital, nonpublic converted hospital, or
converted hospital as those terms are defined in paragraphs (26) to
(28), inclusive, respectively, of subdivision (a) of Section
14105.98.
   (s) "Subject federal fiscal year" means a federal fiscal year that
ends after the implementation date and begins before December 31,
2010.
   (t) "Subject fiscal quarter" means a fiscal quarter beginning on
or after the implementation date and ending before January 1, 2011.
   (u) "Subject fiscal year" means a state fiscal year that ends
after the implementation date and begins before December 31, 2010.
   (v) "Subject hospital" shall mean a hospital that meets all of the
following conditions:
   (1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
   (2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in
                                            the hospital's Office of
Statewide Health Planning and Development Annual Financial Disclosure
Report for the hospital's latest fiscal year ending in 2007.
   (3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
   (w) "Subject month" means a calendar month beginning on or after
the implementation date and ending before January 1, 2011.
   (x) "Upper payment limit" means a federal upper payment limit on
the amount of the Medicaid payment for which federal financial
participation is available for a class of service and a class of
health care providers, as specified in Part 447 of Title 42 of the
Code of Federal Regulations.
  SEC. 231.  Section 14167.11 of the Welfare and Institutions Code is
amended to read:
   14167.11.  (a) The department shall increase payments to mental
health plans for the subject fiscal years as set forth in this
section. The aggregate amount of the increased payments for a subject
fiscal quarter shall be the total of the individual hospital acute
psychiatric supplemental payment amounts for all hospitals for which
federal financial participation is available.
   (b) For each subject fiscal quarter, the state shall make
increased payments to each mental health plan. The department shall
consider the composition of Medi-Cal enrollees in the mental health
plan, the anticipated utilization of hospital services by the mental
health plan's Medi-Cal enrollees, and other factors that the
department determines are reasonable and appropriate to ensure access
to high-quality hospital services by the mental health plan's
enrollees.
   (c) The state shall make increased payments to mental health plans
exclusively for the purpose of making payments to hospitals, in
order to support the availability of hospital specialty mental health
services and ensure access for Medi-Cal beneficiaries to hospital
specialty mental health services. The increased payments to mental
health plans shall be made as follows:
   (1) The increased payments shall commence on or before the later
of the last day of the second month of the quarter in which federal
approval is granted or the 45th day following the day on which
federal approval is granted. Subsequent increased payments shall be
made on the last day of the second month of each quarter. The last
increased payments made pursuant to this section shall be made during
November 2010.
   (2) The increased payments made for the first quarter for which
increased payments are made under this section shall include the sum
of increased payments for all prior quarters for which payments are
due under subdivision (b).
   (3) The increased payments made during November 2010 shall include
payments computed under subdivision (b) for all quarters in the
2010-11 subject fiscal year to the extent that federal financial
participation is available for the payments.
   (4) If all necessary federal approvals are not received on or
before September 1, 2010, the department shall make semimonthly
payments starting within one month of receipt of all necessary
federal approvals until December 31, 2010.
   (d) Each mental health plan shall expend, in the form of
additional payments to hospitals, the increased payments it receives
under this section, pursuant to Section 14167.12.
   (e) In the event federal financial participation for a subject
fiscal year is not available for all of the increased acute
psychiatric payments determined for a quarter pursuant to this
section for any reason, the increased payments mandated by this
section for that quarter shall be reduced proportionately to the
amount for which federal financial participation is available.
   (f) Payments to mental health plans that would be paid in the
absence of the payments made pursuant to this section shall not be
reduced as a consequence of the payments under this section.
   (g) Notwithstanding any other provision of this article or Article
5.22 (commencing with Section 14167.31), individual hospital acute
psychiatric supplemental payments under this section and Section
14167.12 may be made directly by the department to hospitals in
accordance with Section 14167.9 when federal law does not require
that the payments be transmitted to the hospitals via mental health
plans.
   (h) The department may, as necessary, allocate money appropriated
to it from the Hospital Quality Assurance Revenue Fund for the
purposes of making increased payments to mental health plans pursuant
to this article.
   (i) The amount, if any, by which the aggregate individual hospital
acute psychiatric supplemental payment amounts for a subject fiscal
quarter, including any carryover amount under this subdivision,
exceeds the amount for which federal financial participation is
available for that quarter due to the application of a federal upper
payment limit shall be added to the aggregate individual hospital
acute psychiatric supplemental payment amounts for the succeeding
subject fiscal quarter. In the event there is a carryover amount for
the subject fiscal quarter ending December 31, 2010, the amount shall
be payable under this section for the quarter ending March 31, 2011,
and, if necessary due to the application of a federal upper payment
limit, the quarter ending June 30, 2011.
  SEC. 232.  Section 14168.1 of the Welfare and Institutions Code is
amended to read:
   14168.1.  For the purposes of this article, the following
definitions shall apply:
   (a) "Acute psychiatric days" means the total number of Medi-Cal
specialty mental health service administrative days, Medi-Cal
specialty mental health service acute care days, acute psychiatric
administrative days, and acute psychiatric acute days identified in
the Final Medi-Cal Utilization Statistics for the 2008-09 state
fiscal year as calculated by the department on September 15, 2008.
   (b) "Converted hospital" means a private hospital that becomes a
designated public hospital or a nondesignated public hospital on or
after January 1, 2011, a nondesignated public hospital that becomes a
private hospital or a designated public hospital on or after January
1, 2011, or a designated public hospital that becomes a private
hospital or a nondesignated public hospital on or after January 1,
2011.
   (c) "Days data source" means the following:
   (1) For a hospital that did not submit an Annual Financial
Disclosure Report to the Office of Statewide Health Planning and
Development for a fiscal year ending during 2007, but submitted that
report for a fiscal period ending in 2008 that includes at least 10
months of 2007, the Annual Financial Disclosure Report submitted by
the hospital to the Office of Statewide Health Planning and
Development for the fiscal period in 2008 that includes at least 10
months of 2007.
   (2) For a hospital owned by Kaiser Foundation Hospitals that
submitted corrections to reported patient days to the Office of
Statewide Health Planning and Development for its fiscal year ending
in 2007 before July 31, 2009, the corrected data.
   (3) For all other hospitals, the hospital's Annual Financial
Disclosure Report in the Office of Statewide Health Planning and
Development files as of October 31, 2008, for its fiscal year ending
during 2007.
   (d) "Designated public hospital" shall have the meaning given in
subdivision (d) of Section 14166.1 as of January 1, 2011.
   (e) "General acute care days" means the total number of Medi-Cal
general acute care days paid by the department to a hospital in the
2008 calendar year, as reflected in the state paid claims files on
July 10, 2009.
   (f) "High acuity days" means Medi-Cal coronary care unit days,
pediatric intensive care unit days, intensive care unit days,
neonatal intensive care unit days, and burn unit days paid by the
department during the 2008 calendar year, as reflected in the state
paid claims files on July 10, 2009.
   (g) "Hospital inpatient services" means all services covered under
Medi-Cal and furnished by hospitals to patients who are admitted as
hospital inpatients and reimbursed on a fee-for-service basis by the
department directly or through its fiscal intermediary. Hospital
inpatient services include outpatient services furnished by a
hospital to a patient who is admitted to that hospital within 24
hours of the provision of the outpatient services that are related to
the condition for which the patient is admitted. Hospital inpatient
services do not include services for which a managed health care plan
is financially responsible.
   (h) "Hospital outpatient services" means all services covered
under Medi-Cal furnished by hospitals to patients who are registered
as hospital outpatients and reimbursed by the department on a
fee-for-service basis directly or through its fiscal intermediary.
Hospital outpatient services do not include services for which a
managed health care plan is financially responsible, or services
rendered by a hospital-based federally qualified health center for
which reimbursement is received pursuant to Section 14132.100.
   (i) "Individual hospital acute psychiatric supplemental payment"
means the total amount of acute psychiatric hospital supplemental
payments to a subject hospital for a quarter for which the
supplemental payments are made. The "individual hospital acute
psychiatric supplemental payment" shall be calculated for subject
hospitals by multiplying the number of acute psychiatric days for the
individual hospital for which a mental health plan was financially
responsible by four hundred eighty-five dollars ($485) and dividing
the result by four.
   (j) (1) "Managed health care plan" means a health care delivery
system that manages the provision of health care and receives prepaid
capitated payments from the state in return for providing services
to Medi-Cal beneficiaries.
   (2) (A) Managed health care plans include county organized health
systems and entities contracting with the department to provide
services pursuant to two-plan models and geographic managed care.
Entities providing these services contract with the department
pursuant to any of the following:
   (i) Article 2.7 (commencing with Section 14087.3).
   (ii) Article 2.8 (commencing with Section 14087.5).
   (iii) Article 2.81 (commencing with Section 14087.96).
   (iv) Article 2.91 (commencing with Section 14089).
   (B) Managed health care plans do not include any of the following:

   (i) Mental health plans contracting to provide mental health care
for Medi-Cal beneficiaries pursuant to Chapter 8.9 (commencing with
Section 14700).
   (ii) Health plans not covering inpatient services such as primary
care case management plans operating pursuant to Section 14088.85.
   (iii) Program of All-Inclusive Care for the Elderly organizations
operating pursuant to Chapter 8.75 (commencing with Section 14591).
   (k) "Medi-Cal managed care days" means the total number of general
acute care days, including well baby days, listed for the county
organized health system and prepaid health plans identified in the
Final Medi-Cal Utilization Statistics for the 2008-09 fiscal year, as
calculated by the department on September 15, 2008, except that the
general acute care days, including well baby days, for the Santa
Barbara Health Care Initiative shall be derived from the Final
Medi-Cal Utilization Statistics for the 2007-08 fiscal year.
   (l) "Medicaid inpatient utilization rate" means Medicaid inpatient
utilization rate as defined in Section 1396r-4 of Title 42 of the
United States Code and as set forth in the final disproportionate
share hospital eligibility list for the 2008-09 fiscal year released
by the department on October 22, 2008.
   (m) "Mental health plan" means a mental health plan that contracts
with the department to furnish or arrange for the provision of
mental health services to Medi-Cal beneficiaries pursuant to Chapter
8.9 (commencing with Section 14700).
   (n) "New hospital" means a hospital operation, business, or
facility functioning under current or prior ownership as a private
hospital that does not have a days data source or a hospital that has
a days data source in whole, or in part, from a previous operator
where there is an outstanding monetary liability owed to the state in
connection with the Medi-Cal program and the new operator did not
assume liability for the outstanding monetary obligation.
   (o) "New noncontract hospital" means a private hospital that was a
contract hospital on March 1, 2011, and elects to become a
noncontract hospital at any time between March 1, 2011, and the end
of the program period.
   (p) "Nondesignated public hospital" means either of the following:

   (1) A public hospital that is licensed under subdivision (a) of
Section 1250 of the Health and Safety Code, is not designated as a
specialty hospital in the hospital's annual financial disclosure
report for the hospital's latest fiscal year ending in 2007, and
satisfies the definition in paragraph (25) of subdivision (a) of
Section 14105.98, excluding designated public hospitals.
   (2) A tax-exempt nonprofit hospital that is licensed under
subdivision (a) of Section 1250 of the Health and Safety Code, is not
designated as a specialty hospital in the hospital's annual
financial disclosure report for the hospital's latest fiscal year
ending in 2007, is operating a hospital owned by a local health care
district, and is affiliated with the health care district hospital
owner by means of the district's status as the nonprofit corporation'
s sole corporate member.
   (q) "Outpatient base amount" means the total amount of payments
for hospital outpatient services made to a hospital in the 2007
calendar year, as reflected in the state paid claims files on January
26, 2008.
   (r) "Private hospital" means a hospital that meets all of the
following conditions:
   (1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
   (2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2007.
   (3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
   (4) Is a nonpublic hospital, nonpublic converted hospital, or
converted hospital as those terms are defined in paragraphs (26) to
(28), inclusive, respectively, of subdivision (a) of Section
14105.98.
   (s) "Program period" means the period from January 1, 2011, to
June 30, 2011, inclusive.
   (t) "Subject fiscal quarter" means a state fiscal quarter
beginning on or after January 1, 2011, and ending before July 1,
2011.
   (u) "Subject hospital" means a hospital that meets all of the
following conditions:
   (1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
   (2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2007.
   (3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
   (v) "Subject month" means a calendar month beginning on or after
January 1, 2011, and ending before July 1, 2011.
   (w) "Upper payment limit" means a federal upper payment limit on
the amount of the Medicaid payment for which federal financial
participation is available for a class of service and a class of
health care providers, as specified in Part 447 of Title 42 of the
Code of Federal Regulations.
  SEC. 233.  Section 14169.1 of the Welfare and Institutions Code is
amended to read:
   14169.1.  For the purposes of this article, the following
definitions shall apply:
   (a) "Acute psychiatric days" means the total number of Medi-Cal
specialty mental health service administrative days, Medi-Cal
specialty mental health service acute care days, acute psychiatric
administrative days, and acute psychiatric acute days identified in
the Tentative Medi-Cal Utilization Statistics for the 2011-12 state
fiscal year as calculated by the department as of July 21, 2011.
   (b) "Converted hospital" means a private hospital that becomes a
designated public hospital or a nondesignated public hospital on or
after July 1, 2011.
   (c) "Days data source" means the hospital's Annual Financial
Disclosure Report filed with the Office of Statewide Health Planning
and Development as of May 5, 2011, for its fiscal year ending during
2009.
   (d) "Designated public hospital" shall have the meaning given in
subdivision (d) of Section 14166.1 as of July 1, 2011.
   (e) "General acute care days" means the total number of Medi-Cal
general acute care days paid by the department to a hospital for
services in the 2009 calendar year, as reflected in the state paid
claims file on July 15, 2011.
   (f) "High acuity days" means Medi-Cal coronary care unit days,
pediatric intensive care unit days, intensive care unit days,
neonatal intensive care unit days, and burn unit days paid by the
department during the 2009 calendar year, as reflected in the state
paid claims file prepared by the department on July 15, 2011.
   (g) "Hospital inpatient services" means all services covered under
Medi-Cal and furnished by hospitals to patients who are admitted as
hospital inpatients and reimbursed on a fee-for-service basis by the
department directly or through its fiscal intermediary. Hospital
inpatient services include outpatient services furnished by a
hospital to a patient who is admitted to that hospital within 24
hours of the provision of the outpatient services that are related to
the condition for which the patient is admitted. Hospital inpatient
services do not include services for which a managed health care plan
is financially responsible.
   (h) "Hospital outpatient services" means all services covered
under Medi-Cal furnished by hospitals to patients who are registered
as hospital outpatients and reimbursed by the department on a
fee-for-service basis directly or through its fiscal intermediary.
Hospital outpatient services do not include services for which a
managed health care plan is financially responsible, or services
rendered by a hospital-based federally qualified health center for
which reimbursement is received pursuant to Section 14132.100.
   (i) "Individual hospital acute psychiatric supplemental payment"
means the total amount of acute psychiatric hospital supplemental
payments to a subject hospital for a quarter for which the
supplemental payments are made. The "individual hospital acute
psychiatric supplemental payment" shall be calculated for subject
hospitals by multiplying the number of acute psychiatric days for the
individual hospital for which a mental health plan was financially
responsible by the amount calculated in accordance with paragraph (2)
of subdivision (b) of Section 14169.3 and dividing the result by
four.
   (j) (1) "Managed health care plan" means a health care delivery
system that manages the provision of health care and receives prepaid
capitated payments from the state in return for providing services
to Medi-Cal beneficiaries.
   (2) (A) Managed health care plans include county organized health
systems and entities contracting with the department to provide
services pursuant to two-plan models and geographic managed care.
Entities providing these services contract with the department
pursuant to any of the following:
   (i) Article 2.7 (commencing with Section 14087.3).
   (ii) Article 2.8 (commencing with Section 14087.5).
   (iii) Article 2.81 (commencing with Section 14087.96).
   (iv) Article 2.91 (commencing with Section 14089).
   (B) Managed health care plans do not include any of the following:

   (i) Mental health plans contracting to provide mental health care
for Medi-Cal beneficiaries pursuant to Chapter 8.9 (commencing with
Section 14700).
   (ii) Health plans not covering inpatient services such as primary
care case management plans operating pursuant to Section 14088.85.
   (iii) Program for All-Inclusive Care for the Elderly organizations
operating pursuant to Chapter 8.75 (commencing with Section 14591).
   (k) "Medi-Cal managed care days" means the total number of general
acute care days, including well baby days, listed for the county
organized health system and prepaid health plans identified in the
Tentative Medi-Cal Utilization Statistics for the 2011-12 fiscal
year, as calculated by the department as of July 21, 2011.
   (l) "Medicaid inpatient utilization rate" means Medicaid inpatient
utilization rate as defined in Section 1396r-4 of Title 42 of the
United States Code and as set forth in the final disproportionate
share hospital eligibility list for the 2010-11 fiscal year released
by the department as of May 1, 2011.
   (m) "Mental health plan" means a mental health plan that contracts
with the state to furnish or arrange for the provision of mental
health services to Medi-Cal beneficiaries pursuant to Chapter 8.9
(commencing with Section 14700).
   (n) "New hospital" means a hospital operation, business, or
facility functioning under current or prior ownership as a private
hospital that does not have a days data source or a hospital that has
a days data source in whole, or in part, from a previous operator
where there is an outstanding monetary liability owed to the state in
connection with the Medi-Cal program and the new operator did not
assume liability for the outstanding monetary obligation.
   (o) "New noncontract hospital" means a private hospital that was a
contract hospital on March 1, 2011, and elects to become a
noncontract hospital at any time between March 1, 2011, and the end
of the program period.
   (p) "Nondesignated public hospital" means either of the following:

   (1) A public hospital that is licensed under subdivision (a) of
Section 1250 of the Health and Safety Code, is not designated as a
specialty hospital in the hospital's Annual Financial Disclosure
Report for the hospital's latest fiscal year ending in 2009, and
satisfies the definition in paragraph (25) of subdivision (a) of
Section 14105.98, excluding designated public hospitals.
   (2) A tax-exempt nonprofit hospital that is licensed under
subdivision (a) of Section 1250 of the Health and Safety Code, is not
designated as a specialty hospital in the hospital's Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2009, is operating a hospital owned by a local health care
district, and is affiliated with the health care district hospital
owner by means of the district's status as the nonprofit corporation'
s sole corporate member.
   (q) "Outpatient base amount" means the total amount of payments
for hospital outpatient services made to a hospital in the 2009
calendar year, as reflected in the state paid claims files prepared
by the department on June 2, 2011.
   (r) "Private hospital" means a hospital that meets all of the
following conditions:
   (1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
   (2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2009.
   (3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
   (4) Is a nonpublic hospital, nonpublic converted hospital, or
converted hospital as those terms are defined in paragraphs (26) to
(28), inclusive, respectively, of subdivision (a) of Section
14105.98.
   (s) "Program period" means the period from July 1, 2011, to
December 31, 2013, inclusive.
   (t) "Subject fiscal quarter" means a state fiscal quarter
beginning on or after July 1, 2011, and ending before January 1,
2014.
   (u) "Subject fiscal year" means a state fiscal year that ends
after July 1, 2011, and begins before January 1, 2014.
   (v) "Subject hospital" means a hospital that meets all of the
following conditions:
   (1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
   (2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2009.
   (3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
   (w) "Subject month" means a calendar month beginning on or after
July 1, 2011, and ending before January 1, 2014.
   (x) "Upper payment limit" means a federal upper payment limit on
the amount of the Medicaid payment for which federal financial
participation is available for a class of service and a class of
health care providers, as specified in Part 447 of Title 42 of the
Code of Federal Regulations. The applicable upper payment limit shall
be separately calculated for inpatient and outpatient hospital
services.
  SEC. 234.  Section 14456.5 of the Welfare and Institutions Code is
amended to read:
   14456.5.  (a) For purposes of this section, Medi-Cal managed care
plan means any prepaid health plan or Medi-Cal managed care plan
contracting with the department to provide services to enrolled
Medi-Cal beneficiaries under Chapter 7 (commencing with Section
14000) or this chapter, or Part 4 (commencing with Section 101525) of
Division 101 of the Health and Safety Code.
   (b) The department shall ensure that coverage is provided for
medically necessary prescription medications and related medically
necessary medical services that are prescribed by a local mental
health plan provider, and are within the Medi-Cal scope of benefits,
but are excluded from coverage under Chapter 8.9 (commencing with
Section 14700), by doing, at least, all of the following:
   (1) Requiring Medi-Cal managed care plans to comply with the
following standards:
   (A) The decision regarding responsibility and coverage for a
prescription drug shall be made by the Medi-Cal managed care plan
within 24 hours, or one business day, from the date the request for a
decision is received by telephone or other telecommunication device.

   (B) The decision regarding responsibility and coverage for
services, such as laboratory tests, that are medically necessary
because of medications prescribed by a mental health provider, shall
be made by the                                            Medi-Cal
managed care plan within seven days following the date the request
for a decision is received by telephone or other telecommunication
device.
   (C) If the decision of the Medi-Cal managed care plan on the
request is a deferral because of a determination that the Medi-Cal
managed care plan needs more information, the Medi-Cal managed care
plan shall transmit notice of the deferral, by facsimile or by other
telecommunication system, to the pharmacist or other service
provider, to the prescribing mental health provider, and to a
designated mental health plan representative. The notice shall set
out with specificity what additional information is needed to make a
medical necessity determination.
   (D) Any denial of authorization or payment for a prescription
medication or for any services such as laboratory tests that may be
medically necessary because of medications ordered by a mental health
plan provider shall set forth the reasons for the denial with
specificity. The denial notice shall be transmitted by facsimile or
other telecommunication system to the pharmacist or other service
provider, to the prescribing mental health provider, to a designated
mental health plan representative, and by mail to the Medi-Cal
beneficiary.
   (E) For purposes of subsequent requests for a medication, the
local mental health plan provider prescribing the prescription
medication shall be treated as a plan provider under subdivision (a)
of Section 1367.22 of the Health and Safety Code.
   (F) If the decision cannot be made within five working days
because of a request for additional information, any Medi-Cal managed
care plan licensed pursuant to Division 2 (commencing with Section
1340) of the Health and Safety Code shall inform the enrollee as
required by paragraph (5) of subdivision (h) of Section 1367.01 of
the Health and Safety Code. In regard to any Medi-Cal managed care
plan contract as described pursuant to subdivision (a) that is
issued, amended, or renewed on or after January 1, 2001, with a plan
not licensed pursuant to Division 2 (commencing with Section 1340) of
the Health and Safety Code, if the decision cannot be made within
five working days because of a request for additional information as
specified in subparagraph (C), the plan shall notify the enrollee, in
writing, that the plan cannot make a decision to approve, modify, or
deny the request for authorization. All managed care plans shall,
upon receipt of all information reasonably necessary for making the
decision and that was requested by the plan, approve, modify, or deny
the request for authorization within the timeframes specified in
subparagraph (A) or (B), whichever applies.
   (2) In consultation with the Medi-Cal managed care plans and local
mental health plans, establishing a process to recognize
credentialing of local mental health plan providers, for the purpose
of expediting approval of medications prescribed by a local mental
health plan provider who is not contracting with the Medi-Cal managed
care plan. In implementing this requirement, the Medi-Cal managed
care plan shall not be required to violate licensure, accreditation,
or certification requirements of other entities.
   (3) Requiring any Medi-Cal managed care plan to enter into a
memorandum of understanding with the local mental health plan. The
memorandum of understanding shall comply with applicable regulations.

   (c) The department may sanction a Medi-Cal managed care plan for
violations of this section pursuant to Section 14088.23 or 14304.
   (d) Every Medi-Cal managed care plan that provides prescription
drug benefits and that maintains one or more drug formularies shall
provide to members of the public, upon request, a copy of the most
current list of prescription drugs on the formulary of the Medi-Cal
managed care plan, by therapeutic category, with an indication of
whether any drugs on the list are preferred over other listed drugs.
If the Medi-Cal managed care plan maintains more than one formulary,
the plan shall notify the requester that a choice of formulary lists
is available.
   (e) This section shall apply to any contracts entered into,
amended, modified, or extended on or after January 1, 2001.
  SEC. 235.  Section 14640 of the Welfare and Institutions Code is
repealed.
  SEC. 236.  Section 14680 of the Welfare and Institutions Code, as
added by Section 10 of Chapter 651 of the Statutes of 2011, is
amended to read:
   14680.  (a) The Legislature finds and declares that there is a
need to establish a standard set of guidelines that governs the
provision of managed Medi-Cal specialty mental health services at the
local level, consistent with federal law.
   (b) Therefore, in order to ensure quality and continuity, and to
efficiently utilize mental health services under the Medi-Cal
program, there shall be developed mental health plans for the
provision of those services that are consistent with guidelines
established by the department. The guidelines shall be consistent
with federal Medicaid requirements and the approved Medicaid state
plan and waivers to ensure full and timely federal reimbursement to
mental health plans for services that are rendered and reimbursed
consistent with federal Medicaid requirements.
   (c) It is the intent of the Legislature that mental health plans
be developed and implemented regardless of whether other systems of
Medi-Cal managed care are implemented.
   (d) It is further the intent of the Legislature that Sections
14681 to 14685, inclusive, shall not be construed to mandate the
participation of counties in Medi-Cal managed mental health care
plans.
   (e) This section shall become operative on July 1, 2012.
  SEC. 237.  Section 14681 of the Welfare and Institutions Code is
amended to read:
   14681.  The department shall ensure that all contracts for
Medi-Cal managed care include a process for screening, referral, and
coordination with any mental health plan established, of medically
necessary specialty mental health care services.
  SEC. 238.  Section 14682 of the Welfare and Institutions Code is
amended to read:
   14682.  (a) Notwithstanding any other provision of state law, and
to the extent permitted by federal law, the State Department of
Mental Health shall be designated as the state agency responsible for
development, consistent with the requirements of Section 4060, and
implementation of mental health plans for Medi-Cal beneficiaries.
   (b) The department shall convene a steering committee for the
purpose of providing advice and recommendations on the development of
Medi-Cal mental health managed care systems pursuant to subdivision
(a). The committee shall include work groups to advise the department
of major issues to be addressed in the managed mental health care
plan. Representatives of concerned groups, including, but not limited
to, beneficiaries, their families, providers, mental health
professionals, statewide representatives of health care service
plans, the California Mental Health Planning Council, public and
private organizations, and county mental health directors, shall be
invited to participate in the steering committee process.
   (c) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute,
that becomes operative on or before January 1, 2013, deletes or
extends the dates on which it becomes inoperative and is repealed.
  SEC. 239.  Section 14682.1 is added to the Welfare and Institutions
Code, to read:
   14682.1.  (a) The State Department of Health Care Services shall
be designated as the state agency responsible for development,
consistent with the requirements of Section 4060, and implementation
of, mental health plans for Medi-Cal beneficiaries.
   (b) The department shall convene a steering committee for the
purpose of providing advice and recommendations on the transition and
continuing development of the Medi-Cal mental health managed care
systems pursuant to subdivision (a). The committee shall include work
groups to advise the department of major issues to be addressed in
the managed mental health care plan, as well as system transition and
transformation issues pertaining to the delivery of mental health
care services to Medi-Cal beneficiaries, including services to
children provided through the Early and Periodic Screening, Diagnosis
and Treatment Program.
   (c) The committee shall consist of diverse representatives of
concerned and involved communities, including, but not limited to,
beneficiaries, their families, providers, mental health
professionals, substance use disorder treatment professionals,
statewide representatives of health care service plans,
representatives of the California Mental Health Planning Council,
public and private organizations, county mental health directors, and
others as determined by the department. The department has the
authority to structure this steering committee process in a manner
that is conducive for addressing issues effectively, and for
providing a transparent, collaborative, meaningful process to ensure
a more diverse and representative approach to problem-solving and
dissemination of information.
  SEC. 240.  Section 14683 of the Welfare and Institutions Code is
amended to read:
   14683.  The department shall ensure all of the following:
   (a) That mental health plans include a process for screening,
referral, and coordination with other necessary services, including,
but not limited to, health, housing, and vocational rehabilitation
services. For Medi-Cal eligible children, the mental health plans
shall also provide coordination with education programs and any
necessary medical or rehabilitative services, including, but not
limited to, those provided under the California Children's Services
Program (Article 5 (commencing with Section 123800) of Chapter 3 of
Part 2 of Division 106 of the Health and Safety Code) and the Child
Health and Disability Prevention Program (Article 6 (commencing with
Section 124025) of Chapter 3 of Part 2 of Division 106 of the Health
and Safety Code), and those provided by a fee-for-service provider or
a Medi-Cal managed care plan. This subdivision shall not be
construed to establish any higher level of service from a county than
is required under existing law. The mental health plan shall not be
liable for the failure of other agencies responsible for the
provision of nonmental health services to provide those services or
to participate in coordination efforts.
   (b) That mental health plans include a system of outreach to
enable Medi-Cal beneficiaries and providers to participate in and
access Medi-Cal specialty mental health services under the plans,
consistent with existing law.
   (c) That standards for quality and access developed by the
department in consultation with the steering committee established
pursuant to Section 14682.1 are included in mental health plans
serving Medi-Cal beneficiaries.
  SEC. 241.  Section 14684 of the Welfare and Institutions Code, as
added by Section 12 of Chapter 651 of the Statutes of 2011, is
amended to read:
   14684.  (a) Notwithstanding any other provision of state law, and
to the extent permitted by federal law, mental health plans, whether
administered by public or private entities, shall be governed by the
following guidelines:
   (1) State and federal Medi-Cal funds identified for the diagnosis
and treatment of mental illness shall be used solely for those
purposes. Administrative costs incurred by counties for activities
necessary for the administration of the mental health plan shall be
clearly identified and shall be reimbursed in a manner consistent
with federal Medicaid requirements and the approved Medicaid state
plan and waivers. Administrative requirements shall be based on and
limited to federal Medicaid requirements and the approved Medicaid
state plan and waivers, and shall not impose costs exceeding funds
available for that purpose.
   (2) The development of the mental health plan shall include a
public planning process that includes a significant role for Medi-Cal
beneficiaries, family members, mental health advocates, providers,
and public and private contract agencies.
   (3) The mental health plan shall include appropriate standards
relating to quality, access, and coordination of services within a
managed system of care, and costs established under the plan, and
shall provide opportunities for existing Medi-Cal providers to
continue to provide services under the mental health plan, as long as
the providers meet those standards.
   (4) Continuity of care for current recipients of services shall be
ensured in the transition to managed mental health care.
   (5) Medi-Cal covered specialty mental health services shall be
provided in the beneficiary's home community, or as close as possible
to the beneficiary's home community. Pursuant to the objectives of
the rehabilitation option described in subdivision (a) of Section
14021.4, mental health services may be provided in a facility, a
home, or other community-based site.
   (6) Medi-Cal beneficiaries whose mental or emotional condition
results or has resulted in functional impairment, as defined by the
department, shall be eligible for covered specialty mental health
services. Emphasis shall be placed on adults with serious and
persistent mental illness and children with serious emotional
disturbances, as defined by the department.
   (7) Mental health plans shall provide specialty mental health
services to eligible Medi-Cal beneficiaries, including both adults
and children. Specialty mental health services include Early and
Periodic Screening, Diagnosis, and Treatment Services to eligible
Medi-Cal beneficiaries under the age of 21 pursuant to 42 U.S.C.
Section 1396d(a)(4)(B) of Title 42 of the United States Code.
   (8) Each mental health plan shall include a mechanism for
monitoring the effectiveness of, and evaluating accessibility and
quality of, services available. The plan shall utilize and be based
upon state-adopted performance outcome measures and shall include
review of individual service plan procedures and practices, a
beneficiary satisfaction component, and a grievance system for
beneficiaries and providers.
   (9) Each mental health plan shall provide for culturally competent
and age-appropriate services, to the extent feasible. The mental
health plan shall assess the cultural competency needs of the
program. The mental health plan shall include, as part of the quality
assurance program required by Section 14725, a process to
accommodate the significant needs with reasonable timeliness. The
department shall provide demographic data and technical assistance.
Performance outcome measures shall include a reliable method of
measuring and reporting the extent to which services are culturally
competent and age-appropriate.
   (b) This section shall become operative on July 1, 2012.
  SEC. 242.  Section 14684.1 of the Welfare and Institutions Code is
amended to read:
   14684.1.  (a) The department shall establish a process for second
level treatment authorization request appeals to review and resolve
disputes between mental health plans and hospitals.
   (b) When the department establishes an appeals process, the
department shall comply with all of the following:
   (1) The department shall review appeals initiated by hospitals and
render decisions on appeals based on findings that are the result of
a review of supporting documents submitted by mental health plans
and hospitals.
   (2) If the department upholds a mental health plan denial of
payment of a hospital claim, a review fee shall be assessed on the
provider.
   (3) If the department reverses a mental health plan denial of
payment of a hospital claim, a review fee shall be assessed on the
mental health plan.
   (4) If the department decision regarding a mental health plan
denial of payment upholds the claim in part and reverses the claim in
part, the department shall prorate the review fee between the
parties accordingly.
   (c) The amount of the review fees shall be calculated and adjusted
annually. The methodology and calculation used to determine the fee
amounts shall result in an aggregate fee amount that, in conjunction
with any other outside source of funding for this function, may not
exceed the aggregate annual costs of providing second level treatment
authorization request reviews.
   (d) Fees collected by the department shall be retained by the
department and used to offset administrative and personnel services
costs associated with the appeals process.
   (e) The department may use the fees collected, in conjunction with
other available appropriate funding for this function, to contract
for the performance of the appeals process function.
  SEC. 243.  Section 14685 of the Welfare and Institutions Code is
amended to read:
   14685.  Counties shall have the right of first refusal to serve as
a mental health plan. If a county elects not to serve as a mental
health plan, the department shall ensure that these services are
provided.
  SEC. 244.  Section 14685.1 is added to the Welfare and Institutions
Code, to read:
   14685.1.  Section 14685 is hereby repealed on November 7, 2012, if
Section 36 has been added to Article XIII of the California
Constitution as of that date.
  SEC. 245.  Section 14702 is added to the Welfare and Institutions
Code, to read:
   14702.  For purposes of this chapter, the following definitions
shall apply:
   (a) "Department" means the State Department of Health Care
Services.
   (b) "Director" means the Director of Health Care Services.
  SEC. 246.  Section 14703 is added to the Welfare and Institutions
Code, to read:
   14703.  Contracts entered into pursuant to this chapter shall be
exempt from the requirements of Chapter 1 (commencing with Section
10100) and Chapter 2 (commencing with section 10290) of Part 2 of
Division 2 of the Public Contract Code.
  SEC. 247.  Section 14704 is added to the Welfare and Institutions
Code, to read:
   14704.  A regulation or order concerning Medi-Cal specialty mental
health services adopted by the State Department of Mental Health
pursuant to Division 5 (commencing with Section 5000), as in effect
preceding the effective date of this section, shall remain in effect
and shall be fully enforceable, unless and until the readoption,
amendment, or repeal of the regulation or order by the department, or
until it expires by its own terms.
  SEC. 248.  Section 14707.5 is added to the Welfare and Institutions
Code, to read:
   14707.5.  (a) It is the intent of the Legislature to develop a
performance outcome system for Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT) mental health services that will
improve outcomes at the individual and system levels and will inform
fiscal decision making related to the purchase of services.
   (b) The State Department of Health Care Services, in collaboration
with the California Health and Human Services Agency, and in
consultation with the Mental Health Services Oversight and
Accountability Commission, shall create a plan for a performance
outcome system for EPSDT mental health services provided to eligible
Medi-Cal beneficiaries under the age of 21 pursuant to 42 U.S.C.
Section 1396d(a)(4)(B).
   (1) Commencing no later than September 1, 2012, the department
shall convene a stakeholder advisory committee comprised of
representatives of child and youth clients, family members,
providers, counties, and the Legislature. This consultation shall
inform the creation of a plan for a performance outcome system for
EPSDT mental health services.
   (2) In developing a plan for a performance outcomes system for
EPSDT mental health services, the department shall consider the
following objectives, among others:
   (A) High quality and accessible EPSDT mental health services for
eligible children and youth, consistent with federal law.
   (B) Information that improves practice at the individual, program,
and system levels.
   (C) Minimization of costs by building upon existing resources to
the fullest extent possible.
   (D) Reliable data that are collected and analyzed in a timely
fashion.
   (3) At a minimum, the plan for a performance outcome system for
EPSDT mental health services shall consider evidence-based models for
performance outcome systems, such as the Child and Adolescent Needs
and Strengths (CANS), federal requirements, including the review by
the External Quality Review Organization (EQRO), and, timelines for
implementation at the provider, county, and state levels.
   (c) The State Department of Health Care Services shall provide the
performance outcomes system plan, including milestones and
timelines, for EPSDT mental health services described in subdivision
(a) to all fiscal committees and appropriate policy committees of the
Legislature no later than October 1, 2013.
   (d) The State Department of Health Care Services shall propose how
to implement the performance outcomes system plan for EPSDT mental
health services described in subdivision (a) no later than January
10, 2014.
  SEC. 249.  Section 18358.15 of the Welfare and Institutions Code is
amended to read:
   18358.15.  (a) Each foster family agency participating in the
program shall develop the child's needs and services plan, and have
it agreed to by the county interagency review team, or county placing
agency, and certified foster parents. Each foster family agency
participating in the program shall provide the services and supports
identified in the needs and services plan which are allowable under
California's foster care program in accordance with Sections 11460
and 11463, and their implementing regulations. Each foster family
agency shall also arrange for the services needed by each child and
for which the child meets eligibility criteria under applicable
publicly funded programs, including, but not limited to, mental
health, education, and health services. The foster family agency
shall arrange for these services funded by those publicly funded
programs to be delivered either by the private nonprofit organization
that also operates the foster family agency or by another qualified
provider. Children in the ITFC program who meet the public mental
health system criteria for mental health services and supports shall
have those services and supports funded by the Early Periodic
Screening, Diagnosis, and Treatment (EPSDT) program pursuant to
Section 14718 and other appropriate mental health system sources.
This subdivision shall not be construed to change the eligibility
criteria for EPSDT benefits or services pursuant to federal law. The
services that the foster family agency shall provide or arrange for
include, but are not limited to, the following:
   (1) Individualized needs and services plans that ensure continuity
and stability in the placement of participating children in
certified family homes that meet the needs of eligible children,
including children making the transition from institutional placement
to noninstitutional placement. The needs and services plan for each
child in placement shall describe the specific needs of the child and
the appropriate level of services provided to the child pursuant to
Section 18358.30.
   (2) Education and mental health services for children.
   (3) In-home and support services necessary to implement the case
plan.
   (4) Other necessary services for children in placement, including
medical and dental services.
   (b) No more than one emotionally disturbed child or child who has
a serious behavioral problem shall be placed in a certified ITFC
family home unless the participating foster family agency provides
the placing or participating county welfare department with a written
assessment of the risk and compatibility of placing together two
children who are emotionally disturbed or have a serious behavioral
problem. More than two children who are emotionally disturbed or have
serious behavioral problems who are siblings may be placed together
in the same certified family home if the placement is approved by the
county interagency review team or the county placing agency of the
participating county. However, there shall be no more than a total of
five children living in a certified family home with two adults, and
there shall be no more than a total of three children living in a
certified family home with one adult, except in cases where children
living in the home other than those placed pursuant to this chapter
are 15 years of age or older.
   (c) Any use of physical contact to manage the behavior of a child
that is reported to the foster family agency pursuant to Section
18538.25 shall in turn be reported by the foster family agency to the
Community Care Licensing Division of the department as a special
incident pursuant to Section 80061 of Title 22 of the California Code
of Regulations.
  SEC. 250.  Section 18986.40 of the Welfare and Institutions Code is
amended to read:
   18986.40.  (a) For the purposes of this chapter, "program" or
"integrated children's services programs" means a coordinated
children's service system, operating as a program that is part of a
department or State Department of Health Care Services initiative,
that offers a full range of integrated behavioral social, health, and
mental health services, including applicable educational services,
to seriously emotionally disturbed and special needs children, or
programs established by county governments, local education agencies,
or consortia of public and private agencies, to jointly provide two
or more of the following services to children or their families, or
both:
   (1) Educational services for children at risk of dropping out, or
who need additional educational services to be successful
academically.
   (2) Health care.
   (3) All mental health diagnostic and treatment services, including
medication.
   (4) Substance abuse prevention and treatment.
   (5) Child abuse prevention, identification, and treatment.
   (6) Nutrition services.
   (7) Child care and development services.
   (8) Juvenile justice services.
   (9) Child welfare services.
   (10) Early intervention and prevention services.
   (11) Crisis intervention services, as defined in subdivision (c).
   (12) Any other service which will enhance the health, development,
and well-being of children and their families.
   (b) For the purposes of this chapter, "children's
multidisciplinary services team" means a team of two or more persons
trained and qualified to provide one or more of the services listed
in subdivision (a), who are responsible in the program for
identifying the educational, health, or social service needs of a
child and his or her family, and for developing a plan to address
those needs. A family member, or the designee of a family member,
shall be invited
  to participate in team meetings and decisions, unless the team
determines that, in its professional judgment, this participation
would present a reasonable risk of a significant adverse or
detrimental effect on the minor's psychological or physical safety.
Members of the team shall be trained in the confidentiality and
information sharing provisions of this chapter.
   (c) "Crisis intervention services" means early support and
psychological assistance, to be continued as necessary, to children
who have been victims of, or whose lives have been affected by, a
violent crime or a cataclysmic incident, such as a natural disaster,
or who have been involved in school, neighborhood, or family based
critical incidents likely to cause profound psychological effects if
not addressed immediately and thoroughly.
  SEC. 251.  Section 18987.7 of the Welfare and Institutions Code is
amended to read:
   18987.7.  (a) The State Department of Social Services shall
convene a workgroup of public and private nonprofit stakeholders that
shall develop a plan for transforming the current system of group
care for foster children or youth, and for children with serious
emotional disorders (SED), into a system of residentially based
services. The stakeholders may include, but not be limited to,
representatives of the department, the State Department of Education,
the State Department of Health Care Services, the State Department
of Alcohol and Drug Programs, and the Department of Corrections and
Rehabilitation; county child welfare, probation, mental health, and
alcohol and drug programs; local education authorities; current and
former foster youth, parents of foster children or youth, and
children or youth with SED; private nonprofit agencies operating
group homes; children's advocates; and other interested parties.
   (b) The plan developed pursuant to this chapter shall utilize the
reports delivered to the Legislature pursuant to Section 75 of
Chapter 311 of the Statutes of 1998 by the Steering Committee for the
Reexamination of the Role of Group Care in a Family-Based System of
Care in June 2001 and August 2002, and the "Framework for a New
System for Residentially-Based Services in California" published in
March 2006.
   (c) In the development, implementation, and subsequent revisions
of the plan developed pursuant to subdivision (a), the knowledge and
experience gained by counties and private nonprofit agencies through
the operation of their residentially based services programs created
under voluntary agreements made pursuant to Section 18987.72,
including, but not limited to, the results of evaluations prepared
pursuant to paragraph (3) of subdivision (c) of Section 18987.72
shall be utilized.
   (d) By July 1, 2014, the department shall provide a copy of the
plan developed by the workgroup pursuant to subdivision (a) to the
Legislature. The plan shall include, in addition to other
requirements set forth in this chapter, any statutory revisions
necessary for its implementation.
  SEC. 252.  Section 18994.9 of the Welfare and Institutions Code is
amended to read:
   18994.9.  (a) There is hereby established the California Families
and Children Home Visit Program Task Force, which shall be convened
by the Office of Child Abuse Prevention.
   (b) The membership of the task force shall include, but need not
be limited to, all of the following:
   (1) The head of the Office of Child Abuse Prevention or his or her
designee.
   (2) The directors, or designees, of all of the following:
   (A) The State Department of Social Services.
   (B) The State Department of Public Health.
   (C) The Department of Corrections and Rehabilitation, Division of
Juvenile Justice.
   (D) The State Department of Education.
   (E) The California Emergency Management Agency.
   (3) At least two county administrators from counties participating
in this program, to be appointed by the director, with the consent
of the county.
   (4) The manager of this program from the Office of Child Abuse
Prevention.
   (5) Two legislative representatives, who shall be members of
policy committees with jurisdiction over social services issues
pertaining to children, with at least one each to be appointed by the
Speaker of the Assembly and the Senate Committee on Rules.
   (c) The task force shall do both of the following:
   (1) Identify permanent funding sources from federal and state
programs. Sources from which funding may be integrated for purposes
of this chapter may include, but are not limited to, Medi-Cal
Targeted Case Management and Administrative Program funds, provided
for pursuant to Sections 14132.44 and 14132.47, family preservation
funds, private health care providers, including health maintenance
organizations and nonprofit hospitals, the California Special
Supplemental Food Program for Women, Infants and Children, federal
Individuals with Disabilities Education Act funds, and Healthy
Families Program funds.
   (2) Develop recommendations for permanent funding for this
chapter, in order that eligible families who choose to participate
have access to the program.
   (d) Each member of the task force shall serve without
compensation, but shall be reimbursed, by his or her employing
agency, for actual and necessary expenses incurred in the performance
of his or her duties.
   (e) The task force shall be supported by a reasonable amount of
staff time, which shall be provided by the agencies represented on
the task force, to the extent feasible within an agency's existing
resources. The task force may request data from, and may utilize the
technical expertise of, other state agencies.
   (f) The task force, under the guidance of the Office of Child
Abuse Prevention, shall submit its report to the Legislature not
later than November 1, 1999.
  SEC. 253.  Section 25002 of the Welfare and Institutions Code is
repealed.
  SEC. 254.  (a) The amendments made by this act to Section 43.7 of
the Civil Code, to Section 1343 of the Health and Safety Code, and to
Sections 4070, 4071, 5328, 5718, 5719, 5719.5, 5720, 5721, 5722,
5723, 5724, 5776, 5775, 5777, 5777.5, 5777.6, 5777.7, 5778, 5779,
5780, 5781, 5782, 5783, 14021.3, 14021.4, 14021.5, 14053.3, 14108.1,
14110.15, 14131.07, 14167.1, 14167.11, 14168.1, 14169.1, 14456.5,
14640, 14680, 14681, 14682, 14683, 14684, 14684.1, 14685, and
18358.15 of the Welfare and Institutions Code shall be operative July
1, 2012.
   (b) The provisions of this act repealing Section 5723.5 of, and
the heading of Article 4 (commencing with Section 4070) of Chapter 2
of Part 1 of Division 4 of the Welfare and Institutions Code shall be
operative on July 1, 2012.
  SEC. 255.  The sum of $1,000 is hereby appropriated from the
General Fund to the State Department of Health Care Services for
administration.
  SEC. 256.  This act is a bill providing for appropriations related
to the Budget Bill within the meaning of subdivision (e) of Section
12 of Article IV of the California Constitution, has been identified
as related to the budget in the Budget Bill, and shall take effect
immediately.
  SEC. 257.  This act shall become operative only if Assembly Bill
1480 or Senate Bill 1020 of the 2011-12 Regular Session of the
Legislature is enacted and takes effect.