BILL ANALYSIS Ó AB 741 Page 1 Date of Hearing: April 21, 2015 ASSEMBLY COMMITTEE ON HEALTH Rob Bonta, Chair AB 741 Williams - As Amended April 15, 2015 SUBJECT: Medi-Cal: comprehensive mental health crisis services. SUMMARY: Requires Medi-Cal reimbursement for comprehensive mental health crisis services, including crisis intervention, crisis stabilization, crisis residential treatment, rehabilitative mental health services, and mobile crisis support teams for children and youth. Specifically, this bill: 1)Expands the definition of "social rehabilitation facility" to include residential facilities that provide treatment for individuals in a mental health crisis in addition to treatment to individuals recovering from mental illness. 2)Expands allowable services provided by a social rehabilitation facility to include children and adolescents, in addition to adults. 3)Adds specified services to the schedule of reimbursable Medi-Cal benefits. AB 741 Page 2 4)Requires the Department of Health Care Services (DHCS) to seek approval of any necessary state plan amendments necessary for implementation. 5)Specifies that federal financial participation must be available and that any necessary federal approvals must be obtained before these provisions can be implemented. EXISTING LAW: 1)Establishes in federal law the Medicaid program to provide comprehensive health benefits to low income persons. 2)Establishes the Medi-Cal program as California's Medicaid program. 3)Establishes specified Medi-Cal benefits, some required by federal law, and other benefits which are optional under federal law. 4)Defines "social rehabilitation facility" as any residential facility that provides social rehabilitation services in a group setting up to 18 months to adults recovering from mental illness who temporarily need assistance, guidance, or counseling. FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee. COMMENTS: 1)PURPOSE OF THIS BILL. According to the author, the objective for mental health services, guided by the federal Olmstead AB 741 Page 3 Act, is to provide treatment in the least restrictive setting possible. The overarching goal of existing programs is to keep youth experiencing a mental health crisis in calm, familiar environments where their mental health needs can be met. Currently, an estimated three out of every four children in the U.S. that need mental health services, do not receive them. Nearly 20% of high school students in California consider suicide at some point in their lives and more than 10% actually attempt it. With 47 out of 58 counties lacking any child/adolescent psychiatric hospital inpatient beds for children under 12 (and fewer than 70 beds statewide), the need for children's crisis residential services could not be more acute. Among the benefits already included in the State Mental Health Plan are: crisis intervention; crisis stabilization; crisis residential treatment services; and the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) supplemental Specialty Mental Health Services. Without a licensing category specific to children's crisis residential programs, however, this critically needed service - both in lieu of inpatient care and as a step down from inpatient care - is missing from the continuum of care. The author provides an example of the status quo. A nine year-old child is experiencing increased behavioral and emotional symptoms which include persistent suicidal and homicidal thoughts. Outpatient services available within the family's county are not able to meet the child's increased needs. The only immediately available intervention is psychiatric hospitalization. The child experiences six hospital stays in three weeks, all at facilities at least three to five hours away from home. As the client returns home, the lack of crisis services increase the risk of a yet another hospitalization. 2)BACKGROUND. California has a decentralized public mental health system with most direct services provided through the county mental health system. Counties (i.e., county mental health plans) have the primary funding and programmatic responsibility for the majority of local mental health AB 741 Page 4 programs. The state is required to meet certain federal requirements, including those set forth by Medicaid's child health component, known as the EPSDT program. EPSDT is a Medi-Cal benefit for individuals under the age of 21 who have full-scope Medi-Cal eligibility. Federal law - including statutes, regulations, and guidelines - requires that Medi-Cal cover a very comprehensive set of benefits and services for children, different from adult benefits. EPSDT provides eligible children access to a range of mental health services that include, but are not limited to: a) Mental health assessment; b) Therapy; c) Rehabilitation; d) Mental health services; e) Medication support services; f) Day rehabilitation; g) Day treatment intensive; h) Crisis intervention/stabilization; i) Targeted case management; j) Therapeutic behavioral services. AB 741 Page 5 3)CRISIS RESIDENTIAL PROGRAMS. According to a 2010 report by the California Mental Health Planning Council, crisis residential programs are a lower-cost, community-based treatment option in home-like settings that help reduce emergency department visits and divert hospitalization and incarcerations. These programs include peer-run programs such as crisis respites that offer safer, trauma-informed alternatives to psychiatric emergency units, or other locked facilities. The report indicates that crisis residential programs reduce unnecessary stays in psychiatric hospitals, reduce the number and expense of emergency room visits, and divert inappropriate incarcerations while producing the same or superior outcomes to those of institutionalized care. The report states that, as the costs for inpatient treatment continue to rise, the need to expand an appropriate array of acute treatment settings becomes more urgent, and state and county mental health systems should encourage and support alternatives to costly institutionalization and improve the continuum of care to better serve individuals experiencing an acute psychiatric episode. 4)MOBILE CRISIS SUPPORT TEAMS. Mobile crisis support teams can be utilized to provide crisis intervention, family support, and Welfare and Institutions Code Section 5150 involuntary psychiatric evaluations. These teams meet law enforcement in the field and, among other things, provide diversion into appropriate treatment arrangements. These teams have been used in several areas across the state (for example, Sonoma County's Mobile Support Team and the City of Berkeley's Mobile Crisis Team). A mobile crisis team typically consists of an interdisciplinary team of mental health professionals (e.g., nurses, social workers, psychiatrists, psychologists, mental health technicians, addiction specialists, or peer counselors) that respond to individuals in the community through home visits or responses to incidents at other locations. AB 741 Page 6 5)CRISIS STABILIZATION. Crisis stabilization services are those lasting less than 24 hours for individuals who are in psychiatric crisis whose needs cannot be accommodated safely in a residential service setting. Crisis stabilization must be provided onsite at a 24-hour health facility, hospital-based outpatient program, or at other certified provider sites. The goal of the crisis stabilization is to stabilize the consumer and re-integrate him or her back into the community quickly. According to various reports, costs for providing care in a crisis stabilization unit are significantly lower than inpatient hospitalization. 6)SUPPORT. According to the California Alliance of Child and Family Services, cosponsors of this bill, and other supporters, this bill is aimed at addressing a critical component missing in the continuum of specialty mental health services for children and youth in California - children's crisis residential services. This bill creates the needed licensing category to ensure that counties and their community-based providers have the ability to develop crisis residential programs with an appropriate licensing category, to ensure children and youth have access to mental health services that are responsive to their individual needs and strengths in a timely manner, and consistent with the requirements of the Medi-Cal Early Periodic Screening Diagnosis and Treatment (EPSDT) and Specialty Mental Health Services (SMHS) program standards and requirements. There is no question that a full continuum of care for children and youth with critical mental health needs is both essential and required by law. The lack of a licensing component for crisis residential services, however, is preventing the development of this much needed program which would provide a residentially-based acute care option in a less restrictive environment than inpatient hospitalization and would offer a more appropriate alternative for children that do not require AB 741 Page 7 a hospital level of care. The California Council of Community Mental Health Agencies, also a cosponsor of the bill, and others in support including the Steinberg Institute, state that this bill seeks to add to the schedule of benefits comprehensive mental health crisis services. This change would address the gaps in our state's crisis services continuum for children and youth in California. Supporters argue that crisis care for children is a significant gap in our current mental health provision, and this bill will take steps to correct this large deficiency. The National Association of Social Workers - California Chapter state in support of the bill that comprehensive mental health crisis services are currently lacking statewide. Without these services, children and youth experiencing mental health crises are forced to use emergency rooms as their only option for receiving mental health services. In counties without inpatient hospital beds, children and youth needing services are forced to try other neighboring counties. This bill expands mental health services throughout the state, making it easier for children and youth to receive timely and comprehensive services. 7)RELATED LEGISLATION. AB 1018 (Cooper) requires DHCS to allow county mental health plans to contract with LEAs to provide services for Medi-Cal eligible pupils. AB 1018 is pending in the Assembly Health Committee. 8)PREVIOUS LEGISLATION. SB 82 (Committee on Budget and Fiscal Review), Chapter 34, Statutes 2013, established the Investment in Mental Health Wellness Act of 2013 and authorizes the California Health Facilities Financing Authority to administer a program to increase capacity for mobile crisis support, crisis intervention, crisis stabilization services, crisis residential treatment, and specified personnel resources. AB 741 Page 8 REGISTERED SUPPORT / OPPOSITION: Support California Alliance of Child and Family Services (co-sponsor) California Council of Community Mental Health Agencies (co-sponsor) California Chapter of the American College of Emergency Physicians California Mental Health Advocates for Children and Youth California Primary Care Association California Psychiatric Association California Psychological Association Casa Pacifica Centers for Children and Families Crittenton Services for Children and Families Junior Blind of America Lincoln Child Center Mental Health America of California National Association of Social Workers - California Chapter Remi Vista, Inc. Seneca Family of Agencies Sierra Sacramento Valley Medical Society AB 741 Page 9 Stars Behavioral Health Group Steinberg Institute United Advocates for Children and Families Opposition None on file. Analysis Prepared by:Paula Villescaz / HEALTH / (916) 319-2097