BILL ANALYSIS                                                                                                                                                                                                    Ó

          |SENATE RULES COMMITTEE            |                        AB 745|
          |Office of Senate Floor Analyses   |                              |
          |(916) 651-1520    Fax: (916)      |                              |
          |327-4478                          |                              |


          Bill No:  AB 745
          Author:   Chau (D)
          Amended:  4/6/15 in Assembly
          Vote:     27  

           SENATE HEALTH COMMITTEE:  9-0, 6/10/15
           AYES:  Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,  
            Pan, Roth, Wolk


           ASSEMBLY FLOOR:  78-0, 5/4/15 - See last page for vote

           SUBJECT:   Mental Health Services Oversight and Accountability  

          SOURCE:    Author
          DIGEST:   This bill 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  

          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  


                                                                     AB 745  
                                                                    Page  2

            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  

             a)   The Attorney General or his or her designee;
             b)   The Superintendent of Public Instruction or his or her  
             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:

                 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  
                 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 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.


          1)Author's statement. According to the author, supportive  


                                                                     AB 745  
                                                                    Page  3

            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  

          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  


                                                                     AB 745  
                                                                    Page  4

            goal of creating 10,000 additional units of permanent  
            supportive housing for individuals and their families who have  
            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  


                                                                     AB 745  
                                                                    Page  5

            (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.

          Related Legislation
          AB 253 (Roger Hernández, 2015) makes specified changes to the  
          MHSA, the Veterans Housing and Homeless Prevention Bond Act of  
          2014, and mental health plan requirements. AB 253 is scheduled  
          to be heard in the Senate Health Committee on June 24, 2015.

          Prior Legislation
          AB 1929 (Chau, Chapter 674, Statutes of 2014), allowed 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. Required 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 authorized 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.
          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   No

          SUPPORT:   (Verified6/23/15)

          California Chapter of the National Association of Social Workers
          California Primary Care Association


                                                                     AB 745  
                                                                    Page  6

          OPPOSITION:   (Verified6/23/15)

          None received

          ARGUMENTS IN 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.

          ASSEMBLY FLOOR:  78-0, 5/4/15
          AYES:  Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,  
            Bonilla, Bonta, Brough, Brown, Burke, Calderon, Chang, Chau,  
            Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Daly, Dodd,  
            Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia,  
            Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray,  
            Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones,  
            Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,  
            Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,  
            Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea,  
            Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago,  
            Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,  
            Wilk, Williams, Wood, Atkins
          NO VOTE RECORDED:  Campos, Dahle

          Prepared by:Reyes Diaz / HEALTH / 
          6/24/15 16:08:45

                                   ****  END  ****



                                                                     AB 745  
                                                                    Page  7