BILL ANALYSIS Ó
AB 38
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CONCURRENCE IN SENATE AMENDMENTS
AB
38 (Eggman)
As Amended August 19, 2016
Majority vote
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|ASSEMBLY: | |(June 2, 2015) |SENATE: |39-0 |(August 29, |
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(vote not relevant)
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|COMMITTEE VOTE: | |(August 30, |RECOMMENDATION: |concur |
| |16-0 |2016) | | |
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(Health)
Original Committee Reference: HIGHER ED.
SUMMARY: Establishes the Early Diagnosis and Preventive
Treatment (EDAPT) Program Fund, for the purpose of utilizing
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integrated systems of care to provide early intervention,
assessment, diagnosis, a treatment plan, and necessary services
for individuals with severe mental illness and children with
severe emotional disturbance, as specified.
The Senate amendments delete the Assembly approved version, and
instead:
1)Establish the EDAPT Program Fund within the State Treasury,
from which moneys from private or other sources may be
deposited into the fund and used for purposes of the EDAPT
Program.
2)Define the EDAPT Programs as programs that utilizes integrated
systems of care to provide early intervention, assessment,
diagnosis, a treatment plan, and necessary services for
individuals with severe mental illness and children with
severe emotional disturbance using an interdisciplinary team
of physicians, clinicians, advocates, and staff who coordinate
care on an outpatient basis.
3)Require, once the EDAPT Program Fund has reached or exceeded
$1,200,000, the State Controller to distribute all of the
moneys in the fund to the Regents of the University of
California (UC) for the purpose of providing reimbursement to
an EDAPT Program for services provided to persons who are
referred to that program, but whose private health benefit
plan does not cover the full range of required services.
4)Require, upon acceptance of moneys from the EDAPT Program fund
by the Regents of the UC, the Regents to report, on or after
January 1, 2022, but before January 1, 2023, to the health
committees of both houses of the Legislature information on
the EDAPT Program, as specified.
5)Sunset the EDAPT Program and Program Fund on January 1, 2023.
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AS PASSED BY THE ASSEMBLY, this bill required the Legislative
Analyst's Office to conduct an initial analysis to assess the
need for a new campus of the California State University.
FISCAL EFFECT: According to the Senate Appropriations
Committee:
1)Ongoing administrative costs likely in the range of $75,000 to
$150,000 per year over the life of the EDAPT program for the
Department of Health Care Services to manage the EDAPT program
and ensure that state funding is used for the allowed uses
(General Fund (GF)).
2)Ongoing program costs of about $400,000 per year to provide
state funding for services and supports not covered by private
health care coverage (GF). Currently, the University of
California, Davis (UCD) program admits 50-60 new patients each
year, patients generally participate for two years, annual
costs are about $15,000, and roughly 40% of per-capita program
costs are not covered by private insurance.
3)One-time costs likely between $100,000 and $200,000 for an
evaluation of the UCD program (GF).
COMMENTS: According to the author, this bill establishes the
framework for the private and federal funding and studying of
the EDAPT pilot program operated by the UC. This bill requires
that UC report to the Legislature on the outcomes and cost
effectiveness of a comprehensive mental health delivery system
and early intervention in psychosis. Currently, the private
health plan system lags far behind the county mental health
system in providing comprehensive mental health care. Data
produced through the UC and backed by the state will demonstrate
to plans that a more robust range of services earlier in
treatment is not only beneficial to those in care, but to the
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health plans as well. Rather than asking that the State mandate
that plans cover services, this bill seeks to contribute to the
research necessary for plans to make that decision for
themselves, and provide it to the Legislature if action is
necessary. The author states that the longer we wait for
studies of EDAPT programs, the more Californians dealing with
severe mental illness, along with their families and
communities, will suffer without adequate care.
The sponsor of this bill, the California Psychiatric Association
(CPA), states that this bill addresses the vast gulf between the
comprehensive array of mental health services available
throughout public mental health system, and the relatively
narrow range of benefits available for privately insured
patients. Ample data from the National Institute of Mental
Health (NIMH) collected for over a decade demonstrate an array
of wrap around services necessary to stem deterioration before
it become severe disability after an initial psychotic episode.
CPA argues that the participation of managed health care
organizations in programs like EDAPT is any formal way, not only
within California but also nationally, is unknown. The UCD
EADPT program was one of the original NIMH centers contributing
to demonstrate the efficacy of early intervention. UCD's EDAPT
Program accepts privately insured patients, but reimbursement to
the program from private insurance is typically for a
traditional array of services like psychiatrist visits,
medications, and a therapist. Privately insured families then
pay out of pocket for the remainder of the wrap around service
that have been identified as effective by NIMH. With data
demonstrating expensive repeat hospitalizations, as well as
failure at school and/or work, deterioration in social
relationships and alienation from their family, the CPA hopes to
persuade health insurers that spending upfront for wraparound
services not only improves beneficiaries health and mental
health outcomes, but is ultimately less costly.
Analysis Prepared by: Paula Villescaz /
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HEALTH / (916) 319-2097 FN: 0005000