BILL ANALYSIS                                                                                                                                                                                                    ”



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          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:








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             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:












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          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  








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            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 HernŠndez) 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  








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            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



















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