BILL ANALYSIS Ó
SENATE COMMITTEE ON TRANSPORTATION AND HOUSING
Senator Jim Beall, Chair
2015 - 2016 Regular
Bill No: AB 253 Hearing Date: 1/12/2016
-----------------------------------------------------------------
|Author: |Roger Hernández |
|----------+------------------------------------------------------|
|Version: |4/30/2015 |
-----------------------------------------------------------------
-----------------------------------------------------------------
|Urgency: |No |Fiscal: |Yes |
-----------------------------------------------------------------
-----------------------------------------------------------------
|Consultant|Alison Dinmore |
|: | |
-----------------------------------------------------------------
SUBJECT: Mental health
DIGEST: This bill requires state agencies to give a preference
to applicants for funding under the Veterans Housing and
Homeless Prevention Act of 2014 that demonstrate a multiyear
commitment of Mental Health Services Act (MHSA) funding for the
applicant's project funding plan. This bill requires the
Governor to appoint two additional members to the Mental Health
Services Oversight and Accountability Commission with mental
health experience, as specified. This bill also requires the
Department of Health Care Services to post specified information
from mental health plans to a dedicated Internet webpage and to
notify appropriate committees of the Legislature, as specified.
ANALYSIS:
Existing law:
1)Enacts the Veterans Housing and Homeless Prevention Bond Act
of 2014 (VHHP or "the Act"), also known as Proposition 41,
which authorized the issuance of $600 million in general
obligation bonds to provide multifamily housing to veterans
pursuant to the VHHP. The VHHP required the California
Housing Finance Agency (CalHFA), California Department of
Housing and Community Development (HCD), and California
Department of Veterans Affairs (CalVet) to establish and
implement a program that focuses on veterans at risk of
homelessness or experiencing temporary or chronic
homelessness. This program will fund the acquisition,
AB 253 (Roger Hernández) Page 2 of ?
construction, rehabilitation, and preservation of affordable
multifamily supportive housing, affordable transitional
housing, affordable rental housing, or related facilities for
veterans and their families to allow veterans to access and
maintain housing stability.
2)Requires, pursuant to the VHHP, the program to do the
following:
a) Leverage public, private, and nonprofit funding sources.
b) Prioritize projects that combine housing and supportive
services, including but not limited to: job training,
mental health, drug treatment, case management, care
coordination, or physical rehabilitation.
c) Ensure that program guidelines and terms provide
requirements or scoring criteria to advance applicants that
combine permanent or transitional housing, or both, with
supportive services for veterans, or for partnering with
housing developers or service providers that offer housing
or services to veterans.
1)Defines "supportive housing" as housing occupied by the target
population and that is linked to on- or off-site services that
assist the resident in retaining the housing, improving his or
her health status, and maximizing his or her ability to live
and, when possible, work in the community. The intent is to
enable residents to maintain stable lives and places no limit
on the length of stay.
2)Defines "transitional housing" and "transitional housing
development" as a rental housing development that operates
under program requirements that call for the termination of
assistance and recirculation of the assisted unit to another
eligible program recipient at a predetermined future point in
time, but not less than six months.
3)Establishes the Mental Health Services Oversight and
Accountability Commission (MHSOAC) to oversee the
implementation of the 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 1% income tax on personal income above $1 million.
AB 253 (Roger Hernández) Page 3 of ?
4)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.
5)Requires the MHSOAC to consist of 16 voting members as
follows:
a) The Attorney General or his or her designee
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
e) 12 members appointed by the Governor that include:
Two people with a severe mental illness
A family member of an adult or senior with a severe
mental illness
A family member of a child who has or has had a
severe mental illness
A physician specializing in alcohol and drug
treatment
A mental health professional
A county sheriff
A superintendent of a school district
A representative of a labor organization
A representative of an employer with less than 500
employees
A representative of an employer with more than 500
employees
A representative of a health care services plan or
insurer
1)Provides that Department of Health Care Services (DHCS) is
responsible for the development and implementation of mental
health plans for Medi-Cal beneficiaries.
2)Requires mental health plans, whether administered by public
or private entities, to provide culturally competent and
age-appropriate services, to the extent feasible.
AB 253 (Roger Hernández) Page 4 of ?
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 multiyear
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 webpage
within 30 days after the mental health plan has been submitted
to DHCS for approval. DHCS must also notify the appropriate
fiscal and policy committees of the Legislature once the plan
is available on the Internet webpage.
COMMENTS:
1)Purpose of the bill. According to the author, the state faces
a conundrum as it invests Proposition 41 funding for the
creation of supportive housing for the most vulnerable
veterans in our homeless population: veterans with mental
health issues. As a state we have money to build the housing
structures but no state funds to provide the vital services.
It would be like building a hospital with all the equipment
but falling short by not providing doctors or nurses. Building
schools without providing counselors or teachers. AB 253
bolsters the link between Proposition 41 bond funds that can
only be used for the construction of housing and Proposition
63 funds which can be used for services. This important link
between state and local partners is fiscally prudent and
ensures our promises are kept to veterans under Proposition 41
and Proposition 63.
2)VHHP guidance about mental health services. On October 13,
2015, the implementing departments adopted their revised VHHP
program guidelines based upon feedback from interested
stakeholders following the first round of funding. Among
other things, the guidelines: 1) prioritize projects that
combine housing and supportive services, and 2) establish
application selection criteria that integrate prioritization
AB 253 (Roger Hernández) Page 5 of ?
criteria expressed through preference-point weighting. Under
these guidelines, applications are rated with a maximum total
score of 133 points for projects including supportive housing
or transitional housing, or both, and 80 points for other
projects.
Projects that have supportive housing or transitional housing,
or both, must comply with the following relevant requirements:
a) Provide case-management services on-site, providing
direct services to residents.
b) Provide the following minimum services, either directly
or through commitment letters or formal agreements with
other agencies:
Intensive case management to engage with each
veteran and jointly develop an individual service plan
Benefits counseling and advocacy, including
assistance in enrolling in Medi-Cal and obtaining other
mainstream services, as well as Veterans Affairs (VA)
system navigation and assistance in obtaining discharge
upgrade and veterans benefits
Mental health care, such as assessment, crisis
counseling, individual and group therapy, and support
groups
Substance use services, such as treatment, relapse
prevention, and support groups
Additionally, supportive housing or transitional housing
projects must prepare a Supportive Services Plan that is
appropriate for the target populations and a budget to show
that the funding is adequate (i.e., a line-item budget with
supporting documentation and services staffing charts.).
1)Flexibility to applicants. The guidelines currently give
preference to projects that can demonstrate that services are
adequately funded. If the guidelines were to give preference
to one funding source over another, projects that have
experience providing services using another funding source or
sources would be ranked lower. If this bill were enacted, a
project using MHSA funding would be given preference over
another project that has traditionally utilized local or
federal funding sources, even though the other projects may
score higher in accordance with the existing guidelines.
AB 253 (Roger Hernández) Page 6 of ?
Adding such a preference could inadvertently preclude a worthy
project from receiving funding from the VHHP program.
Presently, the guidelines do not preclude an applicant from
utilizing MHSA funding; in fact, one project in the first
round did so. The guidelines as drafted give equal weight to
different funding sources with the intent of providing
flexibility to applicants to develop an application and
program based upon the most appropriate funds available to
them.
2)Is there a problem to solve? VHHP requires HCD, CalHFA, and
CalVet to establish and implement a program that, among other
things, leverage public (federal, state, and local), private,
and nonprofit services, including mental health and drug
treatment; promote public and private partnerships; and foster
innovative financing opportunities. Additionally, the
guidelines provide flexibility to utilize MHSA funds and the
departments have received applications and funded projects
that utilize MHSA funds. The committee may wish to consider
whether this bill is an answer in search of a problem.
3)Too soon? The VHHP program recently received applications for
the second round of funding and likely will not make the
awards until the second quarter of this year. This second
round of funding followed a public process of receiving input
from stakeholders on experience from the first round.
Generally, with new programs such as this, it takes applicants
a couple of funding rounds to fully understand the
requirements that a state agency or agencies puts in place.
This program in particular places novel requirements that
applicants have not seen or experienced before. On January 5,
2016, during a joint Senate oversight hearing on covering the
progress of the program, Senators of this committee heard from
some stakeholders that they were holding off applying until
the third round to fully understand the requirements in the
current guidelines. Making changes to the statute will
require the departments to make changes to the guidelines and
undergo the public review process, which could lead to
uncertainty for those seeking funding and further delay the
awarding of funding.
4)Double-referral. This bill was double-referred. It was heard
in the Senate Health Committee on June 24, 2015, and approved
8-0.
AB 253 (Roger Hernández) Page 7 of ?
Assembly votes:
Floor: 79-0
Appr: 16-1
Health: 19-0
H&CD: 4-0
Related Legislation:
SB 384 (Leyva) - requires on or after January 1, 2017, that a
percentage of the state funds under the VHHP be reserved for
underserved veterans. This bill is currently in this Committee.
SB 689 (Huff) - requires state agencies to prioritize projects
under the VHHP that, for the purposes of providing mental health
and drug services, either: 1) accept only residents that are
prequalified to receive services from the VA, or 2) if they
accept residents who receive services from agencies other than
the VA, employ on staff or contract for a qualified mental
health professional with at least two years' full-time relevant
experience providing services to veterans. This bill is
currently in this Committee.
AB 639 (Perez, Chapter 727, Statutes of 2013) - created the VHHP
and allows for $600 million in bonds to be used for housing
homeless and low-income veterans.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes
Local: No
POSITIONS: (Communicated to the committee before noon on
Wednesday,
January 6, 2016.)
SUPPORT:
California Association of Veteran Service Agencies (co-sponsor)
The Racial and Ethnic Mental Health Disparities Coalition
(co-sponsor)
The Steinberg Institute (co-sponsor)
American Legion - Department of California
AMVETS - Department of California
California Association of County Veteran Service Officers
AB 253 (Roger Hernández) Page 8 of ?
California Pan-Ethnic Health Network
California State Commanders of Veterans Council, VFW -
Department of California
Disability Rights California
The Little Hoover Commission
Mental Health America of California
Military Officer Association of America, California Council of
Chapters
Vietnam Veterans of America - California State Council
OPPOSITION:
California Department of Veterans Affairs
California Housing Finance Agency
ARGUMENTS IN SUPPORT: Supporters of this bill state that
veterans are overrepresented in the homeless population and
often struggle to receive adequate mental health services.
County Mental Health systems are financially strapped and some
mentally ill homeless veterans are ineligible for mental health
care through the federal VA. AB 253 would establish a more
cooperative effort between the state and county behavioral
health departments and private non-profits to obtain targeted
funding for housing veterans with mental-health conditions.
ARGUMENTS IN OPPOSITION: The opposition states that by
providing priority points for projects that include Proposition
63 funding, qualified programs that utilize other funding and
service structures, such as grants from the federal government
or services provided by the federal VA, would be put at a
competitive disadvantage in the scoring process. Additionally,
this program already has a clause built into the statute that
would "prioritize projects that combine housing and supportive
services, including but not limited to, job training, mental
health and drug treatment, case management, care coordination,
or physical rehabilitation." This bill is therefore unnecessary
because mental health is already a priority factor to be
considered under the guidelines required by the program.
-- END --
AB 253 (Roger Hernández) Page 9 of ?