BILL ANALYSIS Ó SB 585 Page 1 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 ----------------------------------------------------------------- |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. SB 585 Page 2 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 SB 585 Page 3 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 FN: 0001692