BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 2679|
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THIRD READING
Bill No: AB 2679
Author: Logue (R) and Nestande (R), et al.
Amended: 7/1/14 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 8-0, 6/25/14
AYES: Hernandez, Morrell, Beall, De León, DeSaulnier, Evans,
Monning, Nielsen
NO VOTE RECORDED: Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 73-0, 5/23/14 (Consent) - See last page for
vote
SUBJECT : County mental health services: baseline reports
SOURCE : Author
DIGEST : This bill requires the Department of Health Care
Services (DHCS) and the California Mental Health Planning
Council (CMHPC) to make specified information related to mental
health services client outcomes and cost effectiveness available
on their respective Internet Web sites.
ANALYSIS :
Existing law:
1.Makes DHCS responsible for administration of law governing the
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state's community mental health systems and for all statewide
mental health planning, research, evaluation and quality
assurance functions. Includes among these functions
implementation of a system of required performance reporting
by local mental health programs.
2.Establishes the Mental Health Services Act (MHSA), which
imposes a 1% income tax on personal income in excess of $1
million to provide for local mental health services.
3.Establishes the Mental Health Services Oversight and
Accountability Commission (MHSOAC) to oversee various mental
health programs. Among many other duties, authorizes MHSOAC
to obtain data and information from DHCS, the Office of
Statewide Health Planning and Development, or other state or
local entities that receive MHSA funds for oversight, review,
training, and technical assistance, accountability, and
evaluation of projects and programs supported with MHSA funds.
4.Requires DHCS to establish a Performance Outcome Committee and
consult with the Committee, the CMHPC, the MHSOAC, and the
California Health and Human Services Agency, to develop
uniform definitions and formats for a statewide,
non-duplicative client-based information system that meets
federal mental health grant requirements and state and federal
Medicaid reporting requirements, as well as any other state
requirements established by law. Requires the data system to
include performance measures for evaluating client outcomes
and cost effectiveness of mental health services, including a
consideration of outcome measures, as guidance only.
5.Requires counties to annually report data on these performance
measures to the local mental health advisory board and to
DHCS. Requires DHCS to annually make available to the
Legislature, no later than March 15, data on county
performance.
6.Creates the CMHPC for purposes of fulfilling mental health
planning requirements mandated by federal law and to review
program performance in delivering mental health services based
on specified data reports, and to report findings and
recommendations on programs' performance annually to the
Legislature, DHCS, and local boards.
This bill:
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1.Requires DHCS to make data reported by counties related to
MHSA client outcomes and cost effectiveness of mental health
services available on its Internet Web site.
2.Requires the CMHPC to make its findings and recommendations on
the performance of mental health services programs available
on its Internet Web site.
Comments
State audit . A 2013 audit by the State Auditor, titled "Mental
Health Services Act (MHSA): The State's Oversight Has Provided
Little Assurance of the Act's Effectiveness, and Some Counties
Can Improve Measurement of Their Program Performance," found
that, although the MHSA funded many programs and served numerous
individuals, the former Department of Mental Health and the
MHSOAC did not provide the oversight needed to demonstrate
whether the MHSA is effective. The report suggested the state
should use performance-based contracts, conduct comprehensive
on-site reviews of MHSA programs, identify and collect
meaningful data, and use the data to verify and report on
performance.
According to the author's office, Proposition 63, known as the
MHSA, was approved by voters in 2004 and placed a 1% tax on
incomes over one million dollars to fund mental health services
at the county level. In 2012, the author along with Senator
Steinberg and Assemblyman Nestande requested a state audit to
determine where and how MHSA funds were being spent. In 2013,
the State Auditor's office released the report, which found that
there was a gross lack of oversight for programs funded through
the MHSA. There was very little evidence to show that the $7.4
billion directed to county mental health service programs from
2006 through 2012 provided any direct benefit to the state.
This bill seeks to bring needed transparency and accountability
to county mental health services. Counties currently report key
information to DHCS and the CMHPC regarding their county mental
health programs. This bill will require them to compile the
data they receive and provide it on their respective Web sites.
This data is a necessary tool to properly target county spending
and determine if there are any positive changes. The State
Auditor told the Legislature that the audit results could not
ensure that MHSA programs and spending were used effectively and
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appropriately. Establishing these added annual reporting
requirements will tell a great deal about current conditions and
enable the state to develop a system to compare those results
with future conditions.
Prior Legislation
SB 585 (Steinberg, Chapter 288, Statutes of 2013) clarified that
MHSA funds and various county realignment accounts may be used
to provide mental health services under the Assisted Outpatient
Treatment Demonstration Project Act of 2002, or Laura's Law, and
allows counties to opt to implement Laura's Law through the
county budget process.
SB 82 (Senate Budget and Fiscal Review Committee, Chapter 20,
Statutes of 2013) the Investment in Mental Health Wellness Act
of 2013, was a trailer bill for the 2013-14 Budget Act that
included, among its other provisions, $206 million ($142 million
General Fund one-time) for a major investment in mental health
services, including additional residential treatment capacity,
crisis treatment teams, and triage personnel.
SB 1006 (Senate Budget and Fiscal Review Committee, Chapter 34,
Statutes of 2012) provided for a comprehensive restructuring of
community-based mental health services at both the state and
local levels and made changes necessary to effectuate the 2011
Realignment. Among other changes, required DHCS to create a
plan for a performance outcome system for Early and Periodic
Screening, Diagnosis, and Treatment mental health services
provided to eligible Medi-Cal beneficiaries under the age of 21.
AB 1288 (Bronzan and McCorquodale, Chapter 89, Statutes of 1991)
realigned financial responsibility for various state programs,
including the state's mental health programs, to local
governments.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 8/5/14)
American College of Emergency Physicians
California Mental Health Planning Council
County Behavioral Health Directors Association
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Mental Health America of California
Mental Health Association
ASSEMBLY FLOOR : 73-0, 5/23/14
AYES: Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,
Bocanegra, Bonta, Bradford, Brown, Buchanan, Ian Calderon,
Campos, Chau, Chávez, Chesbro, Conway, Cooley, Dababneh,
Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox, Frazier,
Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,
Gray, Grove, Hagman, Hall, Holden, Jones, Jones-Sawyer,
Levine, Linder, Logue, Lowenthal, Maienschein, Mansoor,
Medina, Mullin, Muratsuchi, Nazarian, Olsen, Pan, Patterson,
Perea, John A. Pérez, Quirk, Quirk-Silva, Rendon,
Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Wagner,
Waldron, Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
NO VOTE RECORDED: Bonilla, Harkey, Roger Hernández, Melendez,
Nestande, V. Manuel Pérez, Vacancy
JL:k 8/6/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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