Amended in Assembly March 26, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 253


Introduced by Assembly Member Roger Hernández

February 9, 2015


An actbegin insert to add Section 987.010 to the Military and Veterans Code, and to amend Sections 5845 and 14684 of the Welfare and Institutions Code,end insert relating to mental health.

LEGISLATIVE COUNSEL’S DIGEST

AB 253, as amended, Roger Hernández. begin deleteMental Health Services Act. end deletebegin insertMental health.end insert

Existing law, the Mental Health Services Act, an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Fund to fund various county mental health programs, and establishes the Mental Health Services Oversight and Accountability Commissionbegin insert, which consists of 16 members,end insert to oversee the administration of various parts of the act.begin insert Existing law authorizes the act to be amended by a end insertbegin insert23end insertbegin insert vote of the Legislature if the amendments are consistent with, and further the purposes of, the act.end insert

begin delete

This bill would state the intent of the Legislature to enact legislation to ensure the appropriate oversight mechanisms are in place to capture the best practices at the county level in order to ensure that veterans have access to the services provided by the act.

end delete
begin insert

This bill would expand the commission by 2 additional members who each have specified mental health knowledge and experience, to be appointed by the Governor. By amending the provisions of the Mental Health Services Act, this bill requires a 23 vote of the Legislature.

end insert
begin insert

Existing law, the Veterans Housing and Homeless Prevention Bond Act of 2014 (bond act), an initiative measure enacted by the voters as Proposition 41 at the June 3, 2014, primary election, authorized $600 million in bonds to provide multifamily housing to low-income veterans and supportive housing for homeless veterans, through the Veterans Housing and Homeless Prevention Act of 2014. Existing law, the Veterans Housing and Homeless Prevention Act of 2014, provides for the acquisition, construction, rehabilitation, and preservation of affordable multifamily supportive housing, affordable transitional housing, affordable rental housing, and related facilities for veterans and their families to allow veterans to access and maintain housing stability. Existing law requires the California Housing Finance Agency, the Department of Housing and Community Development, and the Department of Veterans Affairs, to work collaboratively for those purposes.

end insert
begin insert

This bill would require those departments to give a preference to applicants for funding pursuant to the bond act for supportive housing projects when the applicant can demonstrate a multiyear commitment of Mental Health Services Act funding for the applicant’s housing project funding plan.

end insert
begin insert

Existing law requires county mental health plans, whether administered by public or private entities, to be governed by specified guidelines, including, among other things, providing for culturally competent and age-appropriate services, to the extent feasible. Existing law requires a mental health plan to have a cultural competence plan with specified components.

end insert
begin insert

This bill would require the Department of Health Care Services to submit the cultural competence plan component of each county mental health plan to the Legislature within 30 days of the department receiving the plan.

end insert
begin insert

The bill would declare that the amendments to the provisions of the Mental Health Services Act are consistent with, and further the purposes of, that act.

end insert

Vote: begin deletemajority end deletebegin insert23end insert. Appropriation: no. Fiscal committee: begin deleteno end deletebegin insertyesend insert. State-mandated local program: no.

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

P2    1begin insert

begin insertSECTION 1.end insert  

end insert

begin insertSection 987.010 is added to the end insertbegin insertMilitary and
2Veterans Code
end insert
begin insert, end insertimmediately following Section 987.009begin insert, to read:end insert

begin insert
P3    1

begin insert987.010.end insert  

The departments shall give a preference to applicants
2for funding from the Veterans Housing and Homeless Prevention
3Bond Act of 2014 for supportive housing projects when the
4applicant can demonstrate a multiyear commitment of Mental
5Health Services Act funding for the applicant’s project funding
6plan.

end insert
7begin insert

begin insertSEC. 2.end insert  

end insert

begin insertSection 5845 of the end insertbegin insertWelfare and Institutions Codeend insertbegin insert is
8amended to read:end insert

9

5845.  

(a) The Mental Health Services Oversight and
10Accountability Commission is hereby established to oversee Part
113 (commencing with Section 5800), the Adult and Older Adult
12Mental Health System of Care Act; Part 3.1 (commencing with
13Section 5820), Human Resources, Education, and Training
14Programs; Part 3.2 (commencing with Section 5830), Innovative
15Programs; Part 3.6 (commencing with Section 5840), Prevention
16and Early Intervention Programs; and Part 4 (commencing with
17Section 5850), the Children’s Mental Health Services Act. The
18commission shall replace the advisory committee established
19pursuant to Section 5814. The commission shall consist ofbegin delete 16end deletebegin insert 18end insert
20 voting members as follows:

21(1) The Attorney General or his or her designee.

22(2) The Superintendent of Public Instruction or his or her
23designee.

24(3) The Chairperson of the Senate Health and Human Services
25Committee or another member of the Senate selected by the
26President pro Tempore of the Senate.

27(4) The Chairperson of the Assembly Health Committee or
28another member of the Assembly selected by the Speaker of the
29Assembly.

30(5) Two persons with a severe mental illness, a family member
31of an adult or senior with a severe mental illness, a family member
32of a child who has or has had a severe mental illness, a physician
33specializing in alcohol and drug treatment, a mental health
34professional, a county sheriff, a superintendent of a school district,
35a representative of a labor organization, a representative of an
36employer with less than 500 employees and a representative of an
37employer with more than 500 employees,begin insert a person with knowledge
38and experience in reducing mental health disparities, a veteran
39with knowledge about veteran’s mental health issues,end insert
and a
40representative of a health care services plan or insurer, all appointed
P4    1by the Governor. In making appointments, the Governor shall seek
2individuals who have had personal or family experience with
3mental illness.

4(b) Members shall serve without compensation, but shall be
5reimbursed for all actual and necessary expenses incurred in the
6performance of their duties.

7(c) The term of each member shall be three years, to be
8staggered so that approximately one-third of the appointments
9expire in each year.

10(d) In carrying out its duties and responsibilities, the commission
11may do all of the following:

12(1) Meet at least once each quarter at any time and location
13convenient to the public as it may deem appropriate. All meetings
14of the commission shall be open to the public.

15(2) Within the limit of funds allocated for these purposes,
16pursuant to the laws and regulations governing state civil service,
17employ staff, including any clerical, legal, and technical assistance
18as may appear necessary. The commission shall administer its
19operations separate and apart from the State Department of Health
20Care Services and the California Health and Human Services
21Agency.

22(3) Establish technical advisory committees such as a committee
23of consumers and family members.

24(4) Employ all other appropriate strategies necessary or
25convenient to enable it to fully and adequately perform its duties
26and exercise the powers expressly granted, notwithstanding any
27authority expressly granted to any officer or employee of state
28government.

29(5) Enter into contracts.

30(6) Obtain data and information from the State Department of
31Health Care Services, the Office of Statewide Health Planning and
32Development, or other state or local entities that receive Mental
33Health Services Act funds, for the commission to utilize in its
34oversight, review, training and technical assistance, accountability,
35and evaluation capacity regarding projects and programs supported
36with Mental Health Services Act funds.

37(7) Participate in the joint state-county decisionmaking process,
38as contained in Section 4061, for training, technical assistance,
39and regulatory resources to meet the mission and goals of the
40state’s mental health system.

P5    1(8) Develop strategies to overcome stigma and discrimination,
2and accomplish all other objectives of Part 3.2 (commencing with
3Section 5830), 3.6 (commencing with Section 5840), and the other
4provisions of the act establishing this commission.

5(9) At any time, advise the Governor or the Legislature regarding
6actions the state may take to improve care and services for people
7with mental illness.

8(10) If the commission identifies a critical issue related to the
9performance of a county mental health program, it may refer the
10issue to the State Department of Health Care Services pursuant to
11Section 5655.

12(11) Assist in providing technical assistance to accomplish the
13purposes of the Mental Health Services Act, Part 3 (commencing
14with Section 5800), and Part 4 (commencing with Section 5850)
15in collaboration with the State Department of Health Care Services
16and in consultation with the California Mental Health Directors
17Association.

18(12) Work in collaboration with the State Department of Health
19Care Services and the California Mental Health Planning Council,
20and in consultation with the California Mental Health Directors
21Association, in designing a comprehensive joint plan for a
22coordinated evaluation of client outcomes in the community-based
23mental health system, including, but not limited to, parts listed in
24subdivision (a). The California Health and Human Services Agency
25shall lead this comprehensive joint plan effort.

26begin insert

begin insertSEC. 3.end insert  

end insert

begin insertSection 14684 of the end insertbegin insertWelfare and Institutions Codeend insertbegin insert is
27amended to read:end insert

28

14684.  

begin delete(a)end deletebegin deleteend deleteNotwithstanding any otherbegin delete provision of stateend delete law,
29and to the extent permitted by federal law, mental health plans,
30whether administered by public or private entities, shall be
31governed by the following guidelines:

begin delete

32(1)

end delete

33begin insert(a)end insert State and federal Medi-Cal funds identified for the diagnosis
34and treatment of mental illness shall be used solely for those
35purposes. Administrative costs incurred by counties for activities
36necessary for the administration of the mental health plan shall be
37clearly identified and shall be reimbursed in a manner consistent
38with federal Medicaid requirements and the approved Medicaid
39state plan and waivers. Administrative requirements shall be based
40on and limited to federal Medicaid requirements and the approved
P6    1Medicaid state plan and waivers, and shall not impose costs
2exceeding funds available for that purpose.

begin delete

3(2)

end delete

4begin insert(b)end insert The development of the mental health plan shall include a
5public planning process that includes a significant role for
6Medi-Cal beneficiaries, family members, mental health advocates,
7providers, and public and private contract agencies.

begin delete

8(3)

end delete

9begin insert(c)end insert The mental health plan shall include appropriate standards
10relating to quality, access, and coordination of services within a
11managed system of care, and costs established under the plan, and
12shall provide opportunities for existing Medi-Cal providers to
13continue to provide services under the mental health plan, as long
14as the providers meet those standards.

begin delete

15(4)

end delete

16begin insert(d)end insert Continuity of care for current recipients of services shall be
17ensured in the transition to managed mental health care.

begin delete

18(5)

end delete

19begin insert(e)end insert Medi-Cal covered specialty mental health services shall be
20provided in the beneficiary’s home community, or as close as
21possible to the beneficiary’s home community. Pursuant to the
22objectives of the rehabilitation option described in subdivision (a)
23of Section 14021.4, mental health services may be provided in a
24facility, a home, or other community-based site.

begin delete

25(6)

end delete

26begin insert(f)end insert Medi-Cal beneficiaries whose mental or emotional condition
27results or has resulted in functional impairment, as defined by the
28department, shall be eligible for covered specialty mental health
29services. Emphasis shall be placed on adults with serious and
30persistent mental illness and children with serious emotional
31disturbances, as defined by the department.

begin delete

32(7)

end delete

33begin insert(g)end insert Mental health plans shall provide specialty mental health
34services to eligible Medi-Cal beneficiaries, including both adults
35and children. Specialty mental health services include Early and
36Periodic Screening, Diagnosis, and Treatment Services to eligible
37Medi-Cal beneficiaries under the age of 21 pursuant tobegin delete 42 U.S.C.end delete
38 Section 1396d(a)(4)(B) of Title 42 of the United States Code.

begin delete

39(8)

end delete

P7    1begin insert(h)end insert Each mental health plan shall include a mechanism for
2monitoring the effectiveness of, and evaluating accessibility and
3quality of, services available. The plan shall utilize and be based
4upon state-adopted performance outcome measures and shall
5include review of individual service plan procedures and practices,
6a beneficiary satisfaction component, and a grievance system for
7beneficiaries and providers.

begin delete

8(9)

end delete

9begin insert(i)end insert Each mental health plan shall provide for culturally
10competent and age-appropriate services, to the extent feasible. The
11mental health plan shall assess the cultural competency needs of
12the program. The mental health plan shall include, as part of the
13quality assurance program required by Section 14725, a process
14to accommodate the significant needs with reasonable timeliness.
15The department shall provide demographic data and technical
16assistance. Performance outcome measures shall include a reliable
17method of measuring and reporting the extent to which services
18are culturally competent and age-appropriate.begin insert The department shall
19submit the cultural competence plan component of each mental
20health plan to the Legislature, in compliance with Section 9795
21of the Government Code, within 30 days after the mental health
22plan has been submitted to the department for approval.end insert

begin delete

23(b) This section shall become operative on July 1, 2012.

end delete
24begin insert

begin insertSEC. 4.end insert  

end insert

begin insertThe Legislature finds and declares that Section 2 of
25this act is consistent with, and furthers the purposes of, the Mental
26Health Services Act.end insert

begin delete
27

SECTION 1.  

It is the intent of the Legislature to enact
28legislation to ensure the appropriate oversight mechanisms are in
29place to capture the best practices at the county level in order to
30ensure that veterans have access to the services provided by the
31Mental Health Services Act.

end delete


O

    98