Amended in Senate June 20, 2016

Amended in Assembly January 4, 2016

California Legislature—2015–16 Regular Session

Assembly Bill No. 168

Introduced by Assembly Member Maienschein

January 22, 2015

An act to begin delete add end delete begin insert end insert begin insert amend end insert Section 14021.2 begin delete to end delete begin insert of end insert the Welfare and Institutions Code, begin insert and to amend Section 1 of Chapter 6 of the Statutes of 2016, end insert relating to mental health services.

LEGISLATIVE COUNSEL’S DIGEST

AB 168, as amended, Maienschein. Mental health: community-based services.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for specified services, including various mental health services. Existing federal law, the Protecting Access to Medicare Act of 2014, requires the United States Secretary of Health and Human Services to, among other things, begin delete select, end delete no later than September 1, 2017, begin insert select from end insert among those states awarded a planning begin delete grant to end delete begin insert grant, the states that may end insert participate in a time-limited demonstration program that is designed to improve access to community mental health and substance use treatment services provided by certified community behavioral health clinics. begin insert Existing law requires the department to develop a proposal for the United States Secretary of Health and Human Services to be selected as a participating state in this time-limited demonstration program, as specified. end insert

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This bill would require the department to develop and submit a proposal to the United States Secretary of Health and Human Services to be selected as a participating state in the time-limited demonstration program described above to receive enhanced federal matching funds for mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries. The bill would require the department to work with counties and other stakeholders in developing its proposal for participation in the demonstration program. The bill would also require the department to include in its proposal a requirement that a county shall not be selected to participate in the demonstration program unless the county includes plans to redirect a portion of the funds currently used to match federal funds to provide increased housing opportunities for individuals with severe mental illnesses, as specified.

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This bill would require the department to submit a report to the Legislature by March 1, 2017, to include specified information if the state is selected as a participating state in this time-limited demonstration program.

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Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

end insert

begin insert Section 1 of Chapter 6 of the Statutes of 2016 is
amended to read: end insert

SECTION 1.  

The Legislature finds and declares the following:

(a) In 2014 Congress enacted the federal Protecting Access to
Medicare Act of 2014.

(b) Under the Protecting Access to Medicare Act, eight states
will be selected to have their federal share of costs increased to 65
percent for two years for outpatient behavioral health care for
individuals with severe mental illnesses or serious emotional
disturbances.

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(c) This federal funding would free up substantial funds in
participating counties that are currently being used to match
federal funds. The money that is currently being used to match
federal funds would be available to be used to meet the mental
health service and housing needs of those individuals who are not
currently receiving the behavioral health care that they need.

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(c)

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begin insert ( end insert begin insert d) end insert  In October 2015, the United States Secretary of Health and
Human Services awarded California a planning grant pursuant to
Section 223 of the federal Protecting Access to Medicare Act of
2014 which partially supported California in, among other things,
developing its proposal to participate in the two-year demonstration
program.

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(e) California is among 24 states competing to be one of the
eight states chosen to participate in the two-year demonstration
program.

end insert begin delete

(d)

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begin insert ( end insert begin insert f) end insert  The Mental Health Services Act was approved by voters in
2004 for the primary purpose of addressing unmet mental health
needs.

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(e)

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begin insert ( end insert begin insert g) end insert  It is an appropriate use of Mental Health Services Act funds
to support California’s application to participate in this
demonstration program, including by using these funds to prepare
actuarial rates and provide technical assistance to counties seeking
to become certified community behavioral health centers.

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(f)

end delete

begin insert ( end insert begin insert h) end insert  This act is consistent with and furthers the intent of the
Mental Health Services Act within the meaning of Section 18 of
the Mental Health Services Act.

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 14021.2 of the end insert begin insert Welfare and Institutions Code end insert

begin insert is amended to read: end insert

14021.2.  

(a) The department shall develop a proposal for the
United States Secretary of Health and Human Services for selection
as a participating state in the time-limited demonstration program
pursuant to Section 223 of the federal Protecting Access to
Medicare Act of 2014 (Public Law 113-93) in order to improve
mental health services furnished by certified community behavioral
health clinics to Medi-Cal beneficiaries.

(b) The department shall use the funds appropriated in the act
that added this section to pay any costs that will support the
development of a competitive proposal, including, but not limited
to, establishing actuarially sound rates and providing technical
assistance to counties.

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(c) If the state is selected as a participating state in the
time-limited demonstration program described in subdivision (a),
the department, by March 1, 2017, shall submit a report to the
Legislature that includes the following information:

end insert begin insert

(1) The names of the participating counties.

end insert begin insert

(2) The estimated amount of additional funding each county is
expected to receive under the demonstration program.

end insert begin insert

(3) The proposed uses of the additional funds and the county
funds no longer required to be used as the federal match.

end insert begin insert

(4) A description of the improved partnerships with veterans
organizations, primary care providers, health plans, educational
agencies, and other organizations that the demonstration program
includes.

end insert begin insert

(5) Other identified benefits from the demonstration program
funding and planning process, and recommendations on any
components of the demonstration program that could be extended
to other counties.

end insert begin insert

(d) (1) The requirement for submitting a report imposed under
subdivision (c) is inoperative on March 1, 2021, pursuant to
Section 10231.5 of the Government Code.

end insert begin insert

(2) A report to be submitted pursuant to subdivision (c) shall
be submitted in compliance with Section 9795 of the Government
Code.

end insert

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SECTION 1.  

The Legislature finds and declares the following:

(a) In 2014 Congress enacted the federal Protecting Access to
Medicare Act of 2014.

(b) Under the Protecting Access to Medicare Act, eight states
will be selected to have their federal share of costs increased to 90
percent for two years for outpatient behavioral health care for
individuals with severe mental illnesses or serious emotional
disturbances.

(c) If successful, this federal opportunity would enable
California to serve the tens of thousands of individuals with those
conditions that it now lacks the funding to serve.

(d) A major challenge in serving that population is that many
are homeless and in need of housing assistance. Federal funding
cannot pay for that housing assistance.

(e) This federal funding would free up nearly $2 billion in
county funds now being used to match federal funds. The money
that is currently being used to match federal funds will now be
available to be used to meet the housing needs of those individuals
who are not currently receiving the behavioral health care that they
need.

(f) In October 2015, the United States Secretary of Health and
Human Services awarded California a planning grant pursuant to
Section 223 of the federal Protecting Access to Medicare Act of
2014 to support California in, among other things, developing its
proposal to participate in the two-year demonstration program.

SEC. 2.  

Section 14021.2 is added to the Welfare and
Institutions Code, to read:

14021.2.  

(a) The department shall develop and submit a
proposal to the United States Secretary of Health and Human
Services for selection as a participating state in the time-limited
demonstration program pursuant to Section 223 of the federal
Protecting Access to Medicare Act of 2014 (Public Law 113-93)
in order to improve mental health services furnished by certified
community behavioral health clinics to Medi-Cal beneficiaries.

(b) In planning to develop its proposal for the demonstration
program, the department shall work with counties and other
stakeholders to identify the unmet need for the covered services
and to estimate the number of individuals who will need housing
assistance.

(c) The proposal shall require that counties shall not be selected
to participate in the demonstration program unless they include
plans to redirect a portion of the funds that are currently used to
match federal funds but will not be needed for that purpose during
the demonstration period to provide increased housing
opportunities for individuals with severe mental illnesses.

end delete