BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: AB 745 --------------------------------------------------------------- |AUTHOR: |Chau | |---------------+-----------------------------------------------| |VERSION: |April 6, 2015 | --------------------------------------------------------------- --------------------------------------------------------------- |HEARING DATE: |June 10, 2015 | | | --------------------------------------------------------------- --------------------------------------------------------------- |CONSULTANT: |Reyes Diaz | --------------------------------------------------------------- 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 in existing law, who has experience providing supportive housing to people with a severe mental illness. 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)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; and, e) 12 members appointed by the Governor that include: AB 745 (Chau) Page 2 of ? 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. This bill: 1)Adds an additional voting member to the MHSOAC, to be appointed by the Governor, who has experience providing supportive housing to people with severe mental illness. FISCAL EFFECT : According to the Assembly Appropriations Committee, this bill has minor and absorbable costs to reimburse for travel and lodgings for MHSOAC meetings (from the MHSA administration account). PRIOR VOTES : ----------------------------------------------------------------- |Assembly Floor: |78 - 0 | |------------------------------------+----------------------------| |Assembly Appropriations Committee: |17 - 0 | |------------------------------------+----------------------------| |Assembly Health Committee: |18 - 0 | | | | ----------------------------------------------------------------- COMMENTS : AB 745 (Chau) Page 3 of ? 1)Author's statement. 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 133,000 Californians are homeless. Of these Californians, roughly 33,800 (25%) are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The MHSOAC 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 MHSOAC to include any members with experience providing supportive housing to persons with severe mental illness. Adding a member with supportive housing experience to the MHSOAC would further encourage the proven method of using supportive housing as a tool to reduce homelessness. 2)Background. The 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 MHSOAC. 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 services. In the 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. Counties also must submit their plans for approval to the MHSOAC before they can spend certain categories of funding. At the time it was created, the MHSOAC acted as a division within the Department of Mental Health (DMH); however, legislative changes effective March 2009 required the MHSOAC to administer its operations apart from DMH. 3)MHSA Housing Program. Executive Order S-07-06, signed by Governor Schwarzenegger on May 12, 2006, mandated the establishment of the MHSA Housing Program, with the stated goal of creating 10,000 additional units of permanent supportive housing for individuals and their families who have AB 745 (Chau) Page 4 of ? a mental illness and are homeless or at risk of homelessness. DHCS, the California Housing Finance Agency (CalHFA), and the County Behavioral Health Directors Association implemented the MHSA Housing Program, which provides funding for development, acquisition, construction, and/or rehabilitation of permanent supportive housing for this population. A total of $400 million was set aside for initial funding of the program to fund both capital costs and capitalized operating subsidies. Continued funding of the program is a locally driven decision, as a county determines whether to assign additional MHSA funding beyond the original $400 million. By including an individual on the MHSOAC who has experience in providing supportive housing to those with a severe mental illness, housing advocates hope to leverage existing MHSA funds to continue funding the MHSA Housing Program, as the initial $400 million is nearing depletion. Funds provided under this program must serve the MHSA Housing Program target population, which DHCS has defined as low-income adults, or older adults with serious mental illness, and children with severe emotional disorders and their families who, at the time of assessment for housing services, meet the criteria for MHSA services in their county of residence. Counties may use MHSA funds for supportive housing, but are not required to. Supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. Adding a member with supportive housing experience to the MHSOAC may further encourage the method of using supportive housing as a tool to reduce homelessness of those with severe mental illness. 4)National 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. AB 745 (Chau) Page 5 of ? 5)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 in the Senate. 6)Prior legislation. AB 1929 (Chau, Chapter 674, Statutes of 2014), allows county mental health departments to deposit MHSA funding with CalHFA, as specified, and allows CalHFA to use those funds for special housing needs for those with mental illness. Requires 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. SB 82 (Committee on Budget and Fiscal Review, Chapter 34, Statutes of 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. 7)Support. The California Primary Care Association writes in support and states that research has demonstrated the positive effects that supportive housing has on an individual's employment, mental health, physical health, and school attendance, leading to a decrease in the use of hospitals, emergency rooms, and jails and prisons. The California Chapter of the National Association of Social Workers writes that including an additional individual on the MHSOAC that has experience in supportive housing is consistent with improving mental health services to those in need. SUPPORT AND OPPOSITION : Support: California Chapter of the National Association of Social Workers California Primary Care Association Oppose: None received. -- END -- AB 745 (Chau) Page 6 of ?