BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 585
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          SENATE THIRD READING
          SB 585 (Steinberg and Correa)
          As Amended May 13, 2013
          Majority vote

           SENATE VOTE  :36-0  
           
           HEALTH              15-3        APPROPRIATIONS      17-0        
           
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          |Ayes:|Pan, Logue, Atkins,       |Ayes:|Gatto, Harkey, Bigelow,   |
          |     |Rendon, Bonta, Gomez,     |     |Bocanegra, Bradford, Ian  |
          |     |Roger Hernández,          |     |Calderon, Campos,         |
          |     |Lowenthal, Maienschein,   |     |Donnelly, Eggman, Gomez,  |
          |     |Mansoor, Mitchell,        |     |Hall, Holden, Linder,     |
          |     |Nazarian, V. Manuel       |     |Pan, Quirk, Wagner, Weber |
          |     |Pérez, Wagner, Wilk       |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Ammiano, Chesbro,         |     |                          |
          |     |Wieckowski                |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Clarifies that Mental Health Services Act (MHSA) funds  
          and various County Realignment accounts may be used to provide  
          mental health services under the Assisted Outpatient Treatment  
          (AOT) Demonstration Project Act of 2002, or Laura's Law, and  
          allows counties to opt to implement Laura's Law through the  
          county budget process.  Specifically,  this bill  :

          1)Allows counties to implement Laura's Law through the county  
            budget process, rather than a resolution of the board of  
            supervisors.

          2)Clarifies that counties that elect to implement Laura's Law  
            are authorized to pay for the provision of AOT services using  
            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 within the Support Services Account of the Local  
            Revenue Fund 2011, funds from the Mental Health Services Fund,  
            as specified, and any other funds from which the Controller  
            makes distributions to the counties for those purposes.








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           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, this bill has a negligible state fiscal effect.  This  
          bill makes an appropriation by authorizing a previously  
          unspecified use for continuously appropriated MHSA funds.   
          However, this bill does not result in any increased funding or  
          costs.

           COMMENTS  :  Approved by voters through Proposition 63 of 2004,  
          MHSA provides over $1 billion annually for local mental health  
          services.  As a funding source for mental health programs, MHSA  
          imposes a 1% income tax on personal income in excess of $1  
          million to expand mental health services for individuals with  
          severe mental health disorders.  Under MHSA, counties that  
          receive funds must have a three-year plan developed with  
          significant local stakeholder input and involvement.  

          In 2002, the Legislature passed AB 1421 (Thomson), Chapter 1017,  
          Statutes of 2002, also known as Laura's Law, in memory of Laura  
          Wilcox, a 19-year-old college student who was killed by a  
          severely mentally ill man who was not adhering to prescribed  
          mental health treatment.  Laura's Law gives counties the option  
          to implement involuntary AOT programs for individuals who have  
          difficulty maintaining their mental health stability in the  
          community and have frequent hospitalizations and contact with  
          law enforcement related to untreated or undertreated mental  
          illness.  Laura's Law requires a county board of supervisors to  
          authorize implementation by resolution and to make a finding  
          that access to voluntary mental health programs would not be  
          reduced as a result of implementation.

          In 2008, the Board of Supervisors of Nevada County passed a  
          resolution implementing AOT.  In a 2011 report, the state  
          Department of Mental Health found that Nevada County's AOT  
          program had served a total of four court-ordered individuals  
          over two years, with two individuals served each year.  The  
          report indicated that the program had succeeded primarily in  
          assisting clients to significantly reduce hospitalization days,  
          with total hospitalization days for all participants decreased  
          from 239 to 97, a 59% reduction.  The report noted that, as of  
          2011, Nevada County's AOT was the only county in the state that  
          had fully implemented Laura's Law.

          MHSA emphasizes the philosophy, principles, and practices of  








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          recovery for mental health clients, including personal  
          empowerment, self-responsibility, and self-determination.   
          Despite the Department of Mental Health's 2007 approval of the  
          use of MHSA funds to provide services under Laura's Law, the  
          author notes that there has historically been some confusion  
          about whether the involuntary nature of AOT under Laura's Law is  
          incompatible with the guiding principles of MHSA.  The author  
          argues that this bill will serve to mitigate these  
          misconceptions and that support for Laura's Law through MHSA  
          funding, in fact, ensures that the full continuum of needs for  
          mental health client recovery and wellness is supported.  In  
          addition, the author argues that, by allowing counties to  
          implement Laura's Law through their county budget process, this  
          bill provides flexibility without taking away the requirement  
          that voluntary services be maintained.

          The National Alliance on Mental Illness, California and the  
          California Mental Health Directors Association support the  
          clarification of fund sources available to implement Laura's  
          Law, but request that the bill be amended to delete the  
          provision allowing implementation through the county budget  
          process.  Both groups are concerned that authorization through  
          the budget process will reduce transparency and community  
          involvement in the decision to implement Laura's Law. 

          The California Psychological Association opposes the expansion  
          of Laura's Law as well as the county budget provision.  The  
          Citizens Commission on Human Rights, which opposes drug-based  
          treatments for mental health disorders broadly, opposes this  
          bill, citing their belief that it will result in human rights  
          abuses.


           Analysis Prepared by  :    Ben Russell / HEALTH / (916) 319-2097 


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