BILL ANALYSIS Ó AB 2679 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 2679 (Logue and Nestande) As Amended July 1, 2014 Majority vote ----------------------------------------------------------------- |ASSEMBLY: |73-0 |(May 23, 2014) |SENATE: |36-0 |(August 18, | | | | | | |2014) | ----------------------------------------------------------------- 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