BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 847|
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THIRD READING
Bill No: AB 847
Author: Mullin (D) and Ridley-Thomas (D)
Amended: 2/22/16 in Senate
Vote: 27 - Urgency
SENATE HEALTH COMMITTEE: 9-0, 6/17/15
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth, Wolk
SENATE APPROPRIATIONS COMMITTEE: 7-0, 3/7/16
AYES: Lara, Bates, Beall, De León, Hill, Mendoza, Nielsen
ASSEMBLY FLOOR: 74-0, 5/22/15 (Consent) - See last page for
vote
SUBJECT: Mental health: community-based services
SOURCE: The Steinberg Institute
DIGEST: This bill requires the Department of Health Care
Services (DHCS) to develop a proposal for the United States
Secretary of Health and Human Services (USSHHS) for selection as
a participating state in a time-limited demonstration program,
as specified, to improve mental health services provided by
specified entities to Medi-Cal beneficiaries. Requires DHCS to
use funds awarded to the state, as specified, to pay for costs
that will support this effort. Appropriates $1 million of Mental
Health Services Fund monies to support DHCS's proposal to the
USSHHS.
ANALYSIS:
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Existing federal law:
1)Enacts the Patient Protection and Affordable Care Act (ACA) to
increase access to health care through a number of measures,
including expanding Medicaid eligibility, subsidizing
insurance premiums, and setting aside funds for health
promotion and disease prevention.
2)Authorizes, in Section 223 of the Protecting Access to
Medicare Act (PAMA) of 2014 (P.L. 113-93), a two-year
demonstration program, to include up to eight states, that
creates criteria for certified community behavioral health
clinics (CCBHCs) and provides planning grants to states to
develop applications to participate in the demonstration
program.
Existing state law:
1)Establishes the Medi-Cal program, administered by DHCS, under
which qualified low-income persons receive health care
benefits. The Medi-Cal program is, in part, governed and
funded by the federal Medicaid provisions.
2)Establishes, under the terms of a federal Medicaid waiver, a
managed care program providing Medi-Cal specialty mental
health services for eligible low-income persons administered
through local county mental health plans under contract with
DHCS.
This bill:
1)Requires DHCS to develop a proposal for the USSHHS for
selection as a participating state in the time-limited
demonstration program authorized under PAMA in order to
improve mental health services provided by CCBHCs to Medi-Cal
beneficiaries.
2)Requires DHCS to use the funds awarded to the state by the
USSHHS, for purposes of the PAMA demonstration program, to pay
any costs that will support the development of a competitive
proposal, including, but not limited to, establishing
actuarially sound rates and providing technical assistance to
counties.
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3)Appropriates $1 million from the Mental Health Services Fund
to DHCS for the purpose of developing the proposal to the
USSHHS for the demonstration program.
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Comments
1)Background. Federal law authorizes PAMA to establish a
demonstration program, to include up to eight states, that
creates criteria for CCBHCs, which are facilities designed to
serve individuals with serious mental illnesses and substance
use disorders (SUDs). PAMA provides nearly $25 million that
will be available to states as planning grants to develop
applications. PAMA also directs the USSHHS to award planning
grants to states for the development of demonstration
proposals by January 1, 2016, and to select states to
participate in the demonstration program by September 1, 2017.
Section 223 of PAMA authorizes the USSHHS to:
a) Establish criteria that states will use to certify
CCBHCs for a two-year demonstration program;
b) Provide guidance on the development of a Prospective
Payment System (PPS) for payment of services provided by
CCBHCs;
c) Award grants to states for planning purposes to develop
proposals to participate in the demonstration program;
d) Select up to eight states to participate in the
demonstration program;
e) Pay states participating in the demonstration program
federal matching funds equivalent to the standard CHIP
matching rate for services provided to currently enrolled
Medicaid beneficiaries; and,
f) Evaluate the program and prepare annual reports to
Congress.
2)CCBHCs. The federal Substance Abuse and Mental Health Services
Administration (SAMHSA) developed eligibility criteria for
states to certify CCBHCs, based on a review of selected state
Medicaid Plans, standards for Federally Qualified Health
Centers and Medicaid Health Homes, and quality measures
currently in use by states. According to SAMHSA's Web site,
the criteria are intended to extend quality and to improve
outcomes of the behavioral health care system within the
authorities of state regulations, statutes, and state Medicaid
Plans; establish a basic level of services at which the CCBHCs
should, at a minimum, operate; and allow states the
flexibility in determining how to implement the criteria in a
manner best addressing the needs of the population being
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served. The criteria are designed to encourage states and
CCBHCs to further develop their abilities to offer behavioral
health services that comport with current best practices.
Populations to be served are adults with serious mental
illness, children with serious emotional disturbance, and
those with long-term and serious SUDs, as well as others with
mental illness and SUDs.
Prior Legislation
AB 861 (Maienschein, 2015), was substantially similar to this
bill. AB 861 was vetoed by Governor Brown, who stated that the
bill was premature because the state had not been awarded any
federal grants or approved as one of the eight participating
states for the demonstration program.
FISCAL EFFECT: Appropriation: Yes Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee, one-time costs
of $1.9 million for DHCS to develop a proposal (federal funds
and Mental Health Services Act Fund). DHCS indicates that the
total cost to prepare the proposal is $1.9 million. DHCS has
received a $900,000 planning grant from the federal government.
The $1 million appropriation in the bill will allow DHCS to
complete the administrative work needed to prepare the proposal
for participation in the demonstration program.
SUPPORT: (Verified 3/8/16)
The Steinberg Institute (source)
American Association for Marriage and Family Therapy, California
Division
California Chapter of the American College of Emergency
Physicians
California Coalition for Mental Health
California Council of Community Mental Health Agencies
California Primary Care Association
California Youth Empowerment Network
Disability Rights California
Mental Health America of California
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OPPOSITION: (Verified 3/8/16)
None received
ASSEMBLY FLOOR: 74-0, 5/22/15
AYES: Achadjian, Travis Allen, Baker, Bigelow, Bloom, Bonilla,
Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau,
Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, 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-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,
Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,
Nazarian, Obernolte, Patterson, Perea, Quirk, Rendon,
Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark
Stone, Thurmond, Ting, Wagner, Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Alejo, Jones, O'Donnell, Olsen, Waldron,
Weber
Prepared by:Reyes Diaz / HEALTH /
3/9/16 14:42:24
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