BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 2679
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 2679 (Logue and Nestande)
          As Amended  July 1, 2014
          Majority vote
           
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          |ASSEMBLY:  |73-0 |(May 23, 2014)  |SENATE: |36-0 |(August 18,    |
          |           |     |                |        |     |2014)          |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Requires the Department of Health Care Services (DHCS)  
          to develop a baseline report of system quality and access to  
          services in each county's mental health plan.  

           The Senate amendments  remove intent language and make technical  
          changes.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

           COMMENTS  :  This bill was introduced in response to a 2013 audit  
          by the Bureau of State Audits entitled Mental Health Services  
          Act: The State's Oversight Has Provided Little Assurance of the  
          Act's Effectiveness, and Some Counties Can Improve Measurement  
          of Their Program Performance.  The author of this bill notes the  
          audit found that, although the Mental Health Services Act (MHSA)  
          funded many programs and served numerous individuals, the  
          Department of Mental Health and the Mental Health Services  
          Oversight and Accountability Commission did not provide the  
          oversight needed to demonstrate whether the MHSA is effective.   
          This bill seeks to provide the necessary oversight to ensure  
          that the funds generated through the MHSA are being used  
          effectively.

          California has a decentralized public mental health system with  
          most direct services provided through the county mental health  
          system.  Counties have the primary funding and programmatic  
          responsibility for the majority of local mental health programs.  
           Specifically, counties are responsible for:  1) all mental  
          health treatment services provided to low-income, uninsured  
          individuals with severe mental illness; 2) Medi-Cal Specialty  
          Mental Health Services for adults and children; 3) mental health  
          treatment services for individuals enrolled in other programs,  








                                                                  AB 2679
                                                                  Page  2

          including special education and CalWORKs; and, 4) programs  
          specifically associated with the MHSA.  

          The audit made several recommendations, mostly focused on urging  
          DHCS and counties to use performance contracts to achieve  
          effective oversight and accountability.  The audit report made  
          one recommendation to the Legislature, which is to clarify that  
          DHCS can withhold certain funds from a noncompliant county.  

          The California Chapter of the American College of Emergency  
          Physicians (California ACEP) argues that this bill, by  
          establishing baseline measures for county mental health  
          programs, will help increase access to mental health services.   
          California ACEP states emergency physicians know firsthand the  
          difficulties facing patients in need of psychiatric care, and  
          those patients without access to adequate mental health services  
          often find themselves in the emergency department.
            
          The California Mental Health Directors Association (CMHDA) with  
          a position of "support if amended," writes that while it  
          supports transparency and accountability in the public mental  
          health system, amendments are needed to ensure that meaningful  
          information without excessive regulation or bureaucracy is  
          reported.  CMHDA asserts counties already report vast amounts of  
          information to the state and suggests that this bill creates  
          duplicative requirements.  CMHDA requests that this bill be  
          amended to require DHCS to publish a report that makes use of  
          the extensive information already reported and collected, with  
          the aim of achieving a transformative, transparent, and useful  
          measuring tool that empowers policy makers and the public.  


           Analysis Prepared by  :    Paula Villescaz / HEALTH / (916)  
          319-2097 


          FN: 0004459