BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2547
AUTHOR: Gaines
AMENDED: May 15, 2014
HEARING DATE: June 18, 2014
CONSULTANT: Bain
SUBJECT : Placer County Integrated Health and Human Services
Program.
SUMMARY : Deletes the July 1, 2016 sunset date of a pilot program
that allows Placer County, with the assistance of the
appropriate state departments to implement a pilot program for
the funding and delivery of services and benefits through an
integrated and comprehensive county health and human services
system, thereby making authority for this program permanent.
Existing law:
1.Requires Placer County, with the assistance of the appropriate
state departments, within the existing resources of those
departments, to implement a pilot program upon approval of
that county, for the funding and delivery of services and
benefits through an integrated and comprehensive county health
and human services system. This program is known as the Placer
County Integrated Health and Human Services Pilot Program.
2.Requires the Placer County pilot project, in providing
services through an integrated system to families and
individuals, among other things, to do all of the following:
a. Implement and evaluate a system of universal
intake for those seeking services;
b. Implement and evaluate a system whereby a
family or individual eligible for more than one
service may be provided those services by as few as a
single county employee, through an integrated,
coordinated service plan.
c. Implement and evaluate a system of
administration that centralizes the management and
support of client services; and,
d. Implement and evaluate a system of reporting
and accountability that provides for the combined
provision of services, without the loss of state or
federal funds provided under current law.
Continued---
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3.Permits the integrated system to include, but need not be
limited to, any or all of the following:
a. Adoption services;
b. Child abuse prevention services;
c. Child welfare services;
d. Delinquency prevention services;
e. Drug and alcohol services;
f. Mental health services;
g. Eligibility determination;
h. Employment and training services;
i. Foster care services;
j. Health services;
aa. Public health services;
bb. Housing services;
cc. Medically indigent program services; and,
dd. All other appropriately identified and
targeted services, except for dental care.
4.Limits inclusion of programs or services in the pilot project
only to the extent that federal funding to either the state or
the county will not be reduced as a result of the inclusion of
the services in the project. Prohibits this pilot project from
generating generate any increased expenditures from the
General Fund.
5.Requires the county and the appropriate state departments to
jointly seek federal approval of the pilot project, as may be
needed to ensure its funding and allow for the integrated
provision of services.
6.Prohibits the Placer County pilot program from authorizing
Placer County to discontinue meeting its obligations under
current law to provide services or to reduce its
accountability for the provision of these services, or from
authorizing Placer County to reduce Placer County's
eligibility under current law for state funding for the
services included in the pilot project.
7.Requires Placer County to utilize any and all state general
and county funds that it is legally allocated or entitled to
receive. Requires the county to maximize federal matching
funds through the creation of integrated health and social
services structures.
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3
8.Requires the appropriate state departments that are assisting
and cooperating in the implementation of the project
authorized to have the authority to waive regulations
regarding the method of providing services and the method of
reporting and accountability, as may be required to meet the
goals of the project.
9.Sunsets the pilot program on July 1, 2016.
This bill:
1.Deletes the July 1, 2016 sunset date of a pilot program that
allows Placer County, with the assistance of the appropriate
state departments to implement a pilot program for the funding
and delivery of services and benefits through an integrated
and comprehensive county health and human services system,
thereby making authority for this program permanent.
2.Repeals an obsolete reporting requirement regarding the pilot
program.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, there are no significant costs associated with this
legislation.
PRIOR VOTES :
Assembly Human Services:7- 0
Assembly Appropriations:17- 0
Assembly Floor: 73- 0
COMMENTS :
1.Author's statement. According to the author, this bill will
allow the County of Placer to continue to operate its
integrated Health and Human Services Pilot Program
permanently. This program has demonstrated success in
implementing a family-centered and needs-based model (System
of Care) of services to children and families since 1995. This
effort has demonstrated how efficiency, streamlining and fully
integrated programming, can be achieved to provide a good
public service for families with needs in child welfare,
mental health, probation and education. Since implementation,
the approach has been centered on the understanding that
during times of crisis, families and children should focus
their efforts on getting the care and support needed, rather
than having to figure out how to navigate through multiple
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county bureaucracies. The "Placer Model" focuses on
strengthening families and meeting their needs in the most
responsive manner possible by blending child welfare, mental
health, probation, and county office of education services and
staff into one physically and functionally integrated
division, rather than families having to manage their services
through individual contacts in each system. The model
effectively shifts the burdens of access and navigation from
the family to the county.
2.Background on Placer County Integrated Health and Human
Services Pilot Program. SB 1846 (Leslie), Chapter 899,
Statutes of 1996, authorized the integrated pilot program for
Placer County. The county indicates it uses this authority to
create alternative approaches to service delivery and funding
structures and has provided the authority for a consolidated
contract for 12 health care programs.
3.Double referral. This bill is double referred. Should this
bill pass out of this committee, it will be referred to the
Senate Human Services Committee.
4.Prior legislation. AB 1766 (Gaines), Chapter 364, Statutes of
2010, extended Placer County's pilot program five years to
July 1, 2016.
AB 2039 (Logue), of 2010, would have deleted the pilot status
and made the Placer County program permanent. The bill was
vetoed by the Governor.
AB 1859 (Leslie), Chapter 268, Statutes of 2006, extended
Placer County's pilot program five years to July 1, 2011.
AB 308 (Leslie), Chapter 17, Statutes of 2001, extended Placer
County's pilot program five years to July 1, 2006.
AB 1259 (Strom-Martin), Chapter 705, Statutes of 1999, gave
specific authority to Alameda, Humboldt, and Mendocino
Counties, to operate an integration pilot similar to Placer
County's.
AB 866 (Thomson), Chapter 265, Statutes of 1997, gave specific
authority to Solano County to operate an integration pilot
similar to Placer County's.
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5
SB 1846 (Leslie), Chapter 899, Statutes of 1996, authorized
Placer County's pilot program to integrate the funding and
delivery of services and benefits for the county health and
human services system.
5.Support. Placer County writes in support that after nearly 18
years of operation and three sunset extensions, this bill
would allow Placer County to make this pilot project
permanent, thus allowing them to maintain the efficiencies
they have achieved by consolidating contracts and programs.
Placer County argues the ultimate benefit of this pilot
project are the clients themselves, who can receive more
efficient and coordinated services from multiple county
departments that are all working together to ensure
comprehensive services are delivered in a professional and
compassionate manner. Placer County states this pilot program
has been held up as a state and national model, and the
county firmly believes it is time to codify this method of
service delivery as one that is a permanent fixture for
Placer County residents who receive services from departments
participating in the pilot.
SUPPORT AND OPPOSITION :
Support: Placer County (sponsor)
California State Association of Counties
Placer Community Foundation
Oppose: None received
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