BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: AB 861 --------------------------------------------------------------- |AUTHOR: |Maienschein | |---------------+-----------------------------------------------| |VERSION: |May 12, 2015 | --------------------------------------------------------------- --------------------------------------------------------------- |HEARING DATE: |June 17, 2015 | | | --------------------------------------------------------------- --------------------------------------------------------------- |CONSULTANT: |Reyes Diaz | --------------------------------------------------------------- SUBJECT : Mental health: community-based services. SUMMARY : Requires the Department of Health Care Services (DHCS) to submit an application for a specified federal competitive grant for purposes of improving mental health services to Medi-Cal beneficiaries, as specified. Requires DHCS to work with counties and stakeholders, as specified, to identify the unmet need for covered services and to estimate the number of individuals who need housing assistance. Requires the competitive grant proposal to include plans for counties to redirect current funds, as specified, to provide housing for those with severe mental illnesses. Existing law: 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 develop applications to participate in the demonstration program. State law 3)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. AB 861 (Maienschein) Page 2 of ? 4)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, if it is awarded the planning grant for the purpose of improving mental health services furnished by CCBHCs to Medi-Cal beneficiaries, to submit an application for the subsequent competitive grant competition to be selected as a participating state in the demonstration program authorized under PAMA. 2)Requires DHCS, in planning to develop its proposal for the competitive grant, to work with counties and other stakeholders to identify the unmet need for the covered services and to estimate the number of individuals who will need housing assistance. 3)Requires the competitive grant proposal to include plans for counties to redirect a portion of current funds, which would be made available during the demonstration program, to provide increased housing opportunities for individuals with severe mental illness. FISCAL EFFECT : According to the Assembly Appropriations Committee, this bill has minor and absorbable costs to DHCS to ensure a grant application, if the department applies and meets the criteria. PRIOR VOTES : ----------------------------------------------------------------- |Assembly Floor: |74 - 0 | |------------------------------------+----------------------------| |Assembly Appropriations Committee: |17 - 0 | |------------------------------------+----------------------------| |Assembly Health Committee: |19 - 0 | | | | ----------------------------------------------------------------- AB 861 (Maienschein) Page 3 of ? COMMENTS : 1)Author's statement. According to the author, in 2014, Congress enacted PAMA, under which up to eight states will be selected to have their federal share of costs for outpatient behavioral health care for individuals with severe mental illnesses or serious emotional disturbances increased to be equivalent to the enhanced federal matching rate for the Children's Health Insurance Program (CHIP). The federal law would enable successful states to nearly double federal funds to support community mental health and Substance Use Disorder (SUD) services with no additional costs to the state or county. These are extremely important funds that California could use to serve some its most vulnerable populations. 2)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 SUDs. PAMA provides nearly $25 million that will be available to states as planning grants to develop applications. PAMA also directs the Secretary of the US Department of Health and Human Services (USHHS) 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 USHHS 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. AB 861 (Maienschein) Page 4 of ? As indicated on the Substance Abuse and Mental Health Services Administration's (SAMHSA) Web site, states may submit applications for the planning grants through August 5, 2015. According to DHCS, the department will apply for the planning grants. 1)CCBHCs. SAMHSA is currently in the process of determining what the eligibility criteria will be for states to certify CCBHCs. The CCBHC demonstration program and the PPS are designed to work within the scope of State Medicaid Plans and to apply only to individuals who are Medicaid enrollees. According to SAMHSA, this demonstration program provides an opportunity for states to improve the behavioral health of their residents by providing community-based mental health and SUD treatment, and by helping to further integrate behavioral health with physical health care, utilize evidence-based practices on a more consistent basis, and improve access to high quality care. According to SAMHSA, 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. 2)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 SAMHSA, 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 percent had a severe mental illness, and 34.7 percent 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. 3)Related legislation. AB 847 (Mullin), would require DHCS to apply to the Secretary of the USHHS for the PAMA federal planning grant for the purpose of developing proposals to improve mental health services provided by CCBHCs to Medi-Cal beneficiaries. AB 847 is set to be heard in the Senate Health Committee on June 17, 2015. AB 745 (Chau), would require the Governor to appoint an AB 861 (Maienschein) Page 5 of ? 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. AB 745 passed out of the Senate Health Committee on June 10, 2015, with a 9-0 vote. AB 253 (Roger Hernández), would make specified changes to the Mental Health Services Act (MHSA), the Veterans Housing and Homeless Prevention Bond Act of 2014, and mental health plan requirements. AB 253 is pending in this committee. 4)Prior legislation. AB 1929 (Chau, Chapter 674, Statutes of 2014), allows county mental health departments to deposit MHSA funding with the California Housing Finance Agency (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. AB 2287 (Monning, 2010), would have required the California Health and Human Services Agency to direct the appropriate state departments within the agency to apply for community transformation grants under the ACA. AB 2287 died in Senate Appropriations Committee. 5)Support. Supporters of the bill, including behavioral health and disability advocates, argue that the savings to counties will free up Proposition 63 funds and other county mental health funds that are now expended on hospital care. The Western Center on Law and Poverty states that homeless people often visit emergency departments for conditions that could be controlled and contained if the people had access to safe housing. SUPPORT AND OPPOSITION : Support: The Steinberg Institute (sponsor) California Chapter of the American College of Emergency Physicians Disability Rights California Easter Seals Western Center on Law and Poverty Oppose: None received. AB 861 (Maienschein) Page 6 of ? -- END --