BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 253
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|AUTHOR: |Roger Hernández |
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|VERSION: |April 30, 2015 |
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|HEARING DATE: |June 24, 2015 | | |
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|CONSULTANT: |Reyes Diaz |
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SUBJECT : Mental health.
SUMMARY : Requires specified government entities responsible for
administering the Veterans Housing and Homeless Prevention Act
of 2014 (VHHP) to give preference to applicants for funding from
the VHHP for supportive housing projects, as specified. Requires
the Governor to appoint two additional members to the Mental
Health Services Oversight and Accountability Commission with
mental health experience, as specified. Requires the Department
of Health Care Service to post specified information from mental
health plans to a dedicated Internet Web page and to notify
appropriate committees of the Legislature, as specified.
Existing law:
1)Establishes the Mental Health Services Oversight and
Accountability Commission (MHSOAC) to oversee the
implementation of the Mental Health Services Act (MHSA),
enacted by voters in 2004 as Proposition 63, which provides
funds to counties to expand services, and develop innovative
programs and integrated service plans, for mentally ill
children, adults, and seniors through a one percent income tax
on personal income above $1 million.
2)Specifies that the MHSA can only be amended by a two-thirds
vote of both houses of the Legislature and only as long as the
amendment is consistent with and furthers the intent of the
MHSA. Permits provisions clarifying the procedures and terms
of the MHSA to be added by majority vote.
3)Requires the MHSOAC to consist of 16 voting members as
follows:
a) The Attorney General or his or her designee;
AB 253 (Roger Hernández) Page 2 of ?
b) The Superintendent of Public Instruction or
his or her designee;
c) The Chair of the Senate Health and Human
Services Committee or another member of the Senate
selected by the President pro Tempore of the Senate;
d) The Chair of the Assembly Health Committee or
another member of the Assembly selected by the Speaker
of the Assembly; and,
e) 12 members appointed by the Governor that
include:
i. Two people with a severe mental
illness;
ii. A family member of an adult or
senior with a severe mental illness;
iii. A family member of a child who has
or has had a severe mental illness;
iv. A physician specializing in alcohol
and drug treatment;
v. A mental health professional;
vi. A county sheriff;
vii. A superintendent of a school
district;
viii. A representative of a labor
organization;
ix. A representative of an employer
with less than 500 employees;
x. A representative of an employer
with more than 500 employees; and,
xi. A representative of a health care
services plan or insurer.
4)Establishes the VHHP, an initiative measure enacted by the
voters in 2014 as Proposition 41, authorizing $600 million in
bonds for the acquisition, construction, rehabilitation, and
preservation of affordable multifamily supportive housing,
affordable multifamily transitional housing, or related
facilities for veterans and their families.
5)Requires the California Housing Finance Agency (CalHFA), the
Department of Housing and Community Development (HCD), and the
Department of Veterans Affairs (CalVet) to work
collaboratively to carry out the duties and functions of the
VHHP.
AB 253 (Roger Hernández) Page 3 of ?
6)Provides that Department of Health Care Services (DHCS) is
responsible for the development and implementation of mental
health plans for Medi-Cal beneficiaries.
7)Requires mental health plans, whether administered by public
or private entities, to provide culturally competent and
age-appropriate services, to the extent feasible.
This bill:
1)Requires CalHFA, HCD, and CalVet to give preference to
applicants for funding from the VHHP for supportive housing
projects when the applicant can demonstrate a multi-year
commitment of MHSA funding for the applicant's project funding
plan.
2)Requires the Governor to appoint two additional members to the
MHSOAC: a) a person with knowledge and experience in reducing
mental health disparities and b) a person who is a veteran
with knowledge about veteran's mental health issues.
3)Requires DHCS to post the cultural competence plan component
of each mental health plan on a dedicated Internet Web page
within 30 days after the mental health plan has been submitted
to DHCS for approval. Requires DHCS to notify the appropriate
fiscal and policy committees of the Legislature once the plan
is available on the Internet Web page.
FISCAL
EFFECT : According to the Assembly Appropriations Committee,
this bill has no significant new costs to HCD to award
preference to specified applicants, and there are minor and
absorbable costs to reimburse for travel and lodging for MHSOAC
meetings (MHSA administration account).
PRIOR
VOTES :
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|Assembly Floor: |79 - 0 |
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|Assembly Appropriations Committee: |16 - 1 |
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|Assembly Housing and Community |4 - 0 |
|Development Committee: | |
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AB 253 (Roger Hernández) Page 4 of ?
COMMENTS :
1)Author's statement. According to the author, AB 253
strengthens the expertise of the MHSOAC and bolsters the link
between bond funds that can be used for constructing housing
for veterans and service dollars that can assist in providing
services for veterans in those supportive housing projects. AB
253 adds two additional members to the MHSOAC to include a
veteran with knowledge about veterans' mental health issues
and a person with knowledge and expertise in reducing mental
health disparities. Doing so will help tackle these challenges
in these communities. The importance of making sure mental
health services and outreach are available to underserved
communities continues to be a challenge at the local level.
The information from the California Reducing Disparities
Project indicates communities are not receiving culturally
appropriate services. In fact, in some instances, they are not
being reached at all because they might require different
approaches to bring them into the system. Many speak about how
much they want to help veterans, and all of us are grateful
for their service. AB 253 is an opportunity for the
Legislature to make it easier to help our veterans.
2)MHSA. The MHSA provides funding for programs within five
components:
a) Community Services and Supports (CSS): provides
direct mental health services to the severely and
seriously mentally ill, such as mental health treatment,
cost of health care treatment, and housing supports. CSS
requires counties to direct the majority of its funds to
full-service partnerships, which are county-coordinated
plans, in collaboration with the client and the family to
provide the full spectrum of community services. These
services consist of mental health services and supports,
such as peer support and crisis intervention services,
and nonmental health services and supports, such as food,
clothing, housing, and the cost of medical treatment;
b) Prevention and Early Intervention: provides services
to mental health clients in order to help prevent mental
illness from becoming severe and disabling;
c) Innovation: provides services and approaches that
are creative, in an effort to address mental health
clients' persistent issues, such as improving services
for underserved or unserved populations within the
community;
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d) Capital Facilities and Technological Needs: creates
additional county infrastructure, such as additional
clinics and facilities, and/or development of a
technological infrastructure for the mental health
system, such as electronic health records for mental
health services; and;
e) Workforce Education and Training: provides training
for existing county mental health employees, outreach and
recruitment to increase employment in the mental health
system, and financial incentives to recruit or retain
employees within the public mental health system.
The MHSA requires each county mental health department to
prepare and submit a three-year plan to DHCS that must be
updated each year and approved by DHCS after review and
comment by the MHSOAC. In their three-year plans, counties are
required to include a list of all programs for which MHSA
funding is being requested and that identifies how the funds
will be spent and what populations will be served. Counties
must submit their plans for approval to the MHSOAC before the
counties may spend certain categories of funding.
3)VHHP. The VHHP restructures $600 million of the $900 million
in bonds approved by the voters for the CalVet Home Loan
Program in 2008 and uses them instead to fund the acquisition,
construction, rehabilitation, and preservation of affordable
multifamily supportive housing, affordable multifamily
transitional housing, or related facilities for veterans and
their families. The VHHP tasks HCD with administering the new
funding program in collaboration with CalVet and explicitly
restricts the use of bond proceeds to those housing units
designated for veterans and their families. The focus of the
program is on housing for veterans who are homeless or at risk
for homelessness and in need of services, such as mental
health counseling, substance abuse treatment, job training,
and physical therapy to address injuries. HCD released the
first VHHP Program Notice of Funding Availability on February
20, 2015, announcing the availability of approximately $75
million in VHHP funding. The anticipated award date will be in
June 2015.
4)Mental health plan requirements. DHCS is responsible for the
development and implementation of mental health plans for
Medi-Cal beneficiaries. Mental health plans, whether
administered by public or private entities, are governed by
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specified guidelines, including, but not limited to, how a
plan will establish appropriate care standards, how a plan
will provide specialty mental health services to eligible
adults and children, and other requirements. Mental health
plans must also assess the cultural competency needs of the
program and must include a process to accommodate the
significant needs with reasonable timeliness.
5)Data on mental illness and homelessness. In the "Current
Statistics on the Prevalence and Characteristics of People
Experiencing Homelessness in the United States," last updated
in July 2011 by the federal Substance Abuse and Mental Health
Services Administration, data from 2010 shows that,
nationally, on a given night 407,966 individuals were homeless
in shelters, transitional housing programs, or on the streets
(not including those who were sleeping at the homes of family
or friends), and 109,812 individuals were chronically homeless
(a one percent decrease from the previous year). Of these
individuals, 26.2% had a severe mental illness, and 34.7% of
adults had chronic substance use disorders. Over the course of
that year, data shows that a total of 1,593,150 individuals
experienced homelessness.
According to HCD's Web site, California is home to nearly 1.8
million veterans, the largest veteran population in the
nation. Nearly 15,000 California veterans experience
homelessness on a given night, representing nearly 26% of the
nation's homeless veterans. Homeless veterans are
overrepresented in the homeless population, and veteran status
is associated with a higher risk of homelessness. Of the
state's extremely low-income veteran renter households, 79%
have a severe cost burden, spending more than 50% of their
income on housing.
6)Double referral. This bill is double referred. Should it pass
out of this committee, it will be referred to the Senate
Committee on Transportation and Housing.
7)Related legislation. AB 745 (Chau) requires the Governor to
appoint an additional member to the MHSOAC who has experience
providing supportive housing to persons with a severe mental
illness. AB 745 is pending in the Senate Appropriations
Committee.
8)Prior legislation. AB 1929 (Chau, Chapter 674, Statutes of
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2014), allowed county mental health departments to deposit
MHSA funding with CalHFA, as specified, and allowed CalHFA to
use those funds for special housing needs for those with
mental illness. Required counties to dedicate funds to provide
housing assistance to those with serious mental illness who
are homeless or to the mentally ill at risk of being homeless.
AB 639 (Pérez, Chapter 727, Statutes of 2013), established the
VHHP.
9)Support. Supporters of this bill, including veterans'
organizations and mental health advocates, argue that this
bill would establish a more cooperative effort between state
and county behavioral health departments and private
nonprofits to obtain targeted funding for housing for veterans
with mental health conditions. Supporters further argue that
increasing the availability of housing for veterans, in
conjunction with giving them a voice on mental health plans,
offers the best chance for stability and reduced homelessness.
SUPPORT AND OPPOSITION :
Support: California Association of Veteran Service Agencies
(co-sponsor)
Racial and Ethnic Mental Health Disparities Coalition
(co-sponsor)
Steinberg Institute (co-sponsor)
American Legion-Department of California
AMVETS-Department of California
California Association of County Veteran Service
Officers
California Chapter of the National Association of
Social Workers
California Military Officer Association of America
California Pan-Ethnic Health Network
California State Commanders Veterans Council
Disability Rights California
Little Hoover Commission
Mental Health America of California
VFW-Department of California
Vietnam Veterans of America-California State Council
Oppose: None received.
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