BILL ANALYSIS Ó AB 745 Page 1 Date of Hearing: April 21, 2015 ASSEMBLY COMMITTEE ON HEALTH Rob Bonta, Chair AB 745 Chau - As Amended April 6, 2015 SUBJECT: Mental Health Services Oversight and Accountability Commission. SUMMARY: Requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission (Commission) who has experience providing supportive housing to persons with a severe mental illness. EXISTING LAW: 1)Establishes the Mental Health Services Act (MHSA), enacted by voters in 2004 as Proposition 63, to provide funds to counties to expand services, 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. 2)Establishes the Commission to oversee the implementation of MHSA. 3)Establishes the following membership requirements for the Commission, appointed by the Governor unless otherwise specified: AB 745 Page 2 a) The Attorney General and his or her designee; b) The Superintendent of Public Instruction or his or her designee; c) A member of the Senate selected by the President pro Tempore of the Senate; d) A member of the Assembly selected by the Speaker of the Assembly; e) Two persons with a severe mental illness; f) A family member of an adult or senior with a severe mental illness; g) A family member of a child who has or has had a severe mental illness; h) A physician specializing in alcohol and drug treatment; i) A mental health professional; j) A county sheriff; aa) A superintendent of a school district; bb) A representative of a labor organization; cc) A representative of an employer with less than 500 employees; dd) A representative of an employer with more than 500 employees; and, ee) A representative of a health care services plan or insurer. 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. FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee. COMMENTS: AB 745 Page 3 1)PURPOSE OF THIS BILL. According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. At any given moment more than 133 thousand Californians are homeless. The author states that of these Californians, roughly 33.8 thousand - or 25% - are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The Commission oversees the implementation of the MHSA and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the Commission to include any members with experience providing supportive housing to persons with severe mental illness. 2)BACKGROUND. MHSA requires each county mental health department to prepare and submit a three-year plan to the Department of Health Care Services (DHCS) that must be updated each year and approved by DHCS after review and comment by the Commission. DHCS is required to provide guidelines to counties related to each component of the MHSA, including, among other things, community services and support content to provide integrated mental health and other support services to those whose needs are not currently met through other funding sources; prevention and early intervention content to provide services to avert mental health crises; and, innovative program content to improve access to mental health care. 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 which populations will be served. At the time it was created, the Commission acted as a division within the Department Mental Health (DMH); however, legislative changes, effective March 2009 specified that the Commission is to administer its operations separately and apart from DMH. Currently, counties must submit their plans AB 745 Page 4 for approval to the Commission before the counties may spend certain categories of funding. 3)SUPPORT. The California Primary Care Association writes in support of this bill that research has clearly demonstrated the positive effects that supportive housing can have on an individual's employment, mental health, physical health, and school attendance, leading to decreased use of hospitals, emergency rooms, jails, and prisons. Stable housing is a critical component of engaging their patients in physical and behavioral health care management. The requirement to include a voting member on Commission with experience with supportive housing services ensures that programs and funding targeting individuals with behavioral health conditions takes the unique needs of those individuals experiencing homelessness into consideration. According to the National Association of Social Workers - California Chapter (NASW), Proposition 63 established the Commission for the purposes of overseeing the implementation of the MHSA. The NASW states in support that providing a person with experience in supportive housing to the Commission is also consistent with improving the delivery of mental health services to those in need. 4)RELATED LEGISLATION. AB 253 (Roger Hernández) makes specified changes to the MHSA, the Veterans Housing and Homeless Prevention Bond Act of 2014, and mental health plan requirements. AB 253 is pending a hearing in the Assembly Health Committee. 5)PREVIOUS LEGISLATION. SB 82 (Committee on Budget and Fiscal Review), Chapter 34, Statutes 2013, establishes the Investment in Mental Health Wellness Act of 2013 and authorized the California Health Facilities Financing Authority to administer AB 745 Page 5 a program to increase capacity for mobile crisis support, crisis intervention, crisis stabilization services, crisis residential treatment, and specified personnel resources. REGISTERED SUPPORT / OPPOSITION: Support California Primary Care Association National Association of Social Workers - California Chapter Opposition None on file. Analysis Prepared by:Paula Villescaz / HEALTH / (916) 319-2097 AB 745 Page 6