BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 861


                                                                    Page  1


          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          861 (Maienschein)


          As Amended  September 3, 2015


          Majority vote


           -------------------------------------------------------------------- 
          |ASSEMBLY:  |74-0  |(May 22, 2015) |SENATE: | 40-0 |(September 8,    |
          |           |      |               |        |      |2015)            |
          |           |      |               |        |      |                 |
          |           |      |               |        |      |                 |
           -------------------------------------------------------------------- 


          Original Committee Reference:  HEALTH


          SUMMARY:  Requires the Department of Health Care Services (DHCS)  
          to apply to the federal Secretary of Health and Human Services  
          (HHS Secretary) for the planning grant awarded for the purpose  
          of developing proposals to participate in demonstration programs  
          to improve mental health services furnished by certified  
          community behavioral health clinics to Medi-Cal beneficiaries.


          The Senate amendments require counties participating in the  
          competitive grant proposal for funds to establish a plan to  
          ensure that any funds offset by receipt of the grant be used to  
          provide increased housing opportunities for individuals with  
          severe mental illnesses.


          FISCAL EFFECT:  According to the Senate Appropriations  
          Committee, one-time costs likely from $1 million to $2 million  
          to develop an application for the demonstration grant program by  








                                                                     AB 861


                                                                    Page  2


          the DHCS.


          COMMENTS:  According to the author, federal law enables  
          successful states to nearly double federal funds to support  
          community mental health and alcohol and drug services with no  
          additional costs to the state or county.  These additional funds  
          will significantly help California's counties serve more people  
          who are homeless due to an untreated mental illness and get them  
          off the streets, out of hospitals and jails, and into treatment.  
           The author states that if California is successful in its bid  
          for the additional funding, it would benefit the state to the  
          tune of about $2 billion.  The savings to the counties will free  
          up Proposition 63 (2004) funds and other county mental health  
          funds that are now expended on hospital care.  The author  
          concludes that those savings can then be redirected to  
          supportive housing efforts which will help make the effects of  
          these dollars more permanent.


          1)Protecting Access to Medicare Act.  On March 31, 2014,  
            Congress passed the Protecting Access to Medicare Act (H.R.  
            4302), which included a demonstration program aimed at  
            increasing Americans' access to community mental health and  
            substance use treatment services while improving Medicaid  
            reimbursement for these services. This legislation:


             a)   Creates criteria for "Certified Community Behavioral  
               Health Clinics" (CCBHCs) as entities designed to serve  
               individuals with serious mental illnesses and substance use  
               disorders that provide intensive, person-centered,  
               multidisciplinary, evidence-based screening, assessment,  
               diagnostics, treatment, prevention, and wellness services.  
               The HHS Secretary is directed to establish a process for  
               selecting states to participate in a two year pilot  
               program;


             b)   Provides $25 million that will be available to states as  
               planning grants to develop applications to participate in  
               the two year pilot.  Only states that have received a  








                                                                     AB 861


                                                                    Page  3


               planning grant will be eligible to apply to participate in  
               the pilot;


             c)   Stipulates that eight states will be selected to  
               participate in the two year pilot program.  The match rate  
               for CCBHC services is either the Enhanced Federal Medical  
               Assistance Program (FMAP) /Children's Health Insurance  
               Program  rate or, for newly eligible "expansion" Medicaid  
               beneficiaries, the current FMAP for that population - which  
               is 100% now and moves down to 90% by 2020;


             d)   Requires participating states to develop a prospective  
               payment system for reimbursing CCBHCs for required services  
               provided by these entities.


          2)Program Timeline.


             a)   September 1, 2015:  Deadline for the HHS Secretary to  
               publish:  criteria for a clinic to be certified by a State  
               as a certified community behavioral health clinic; and,  
               guidance for states on the establishment of a prospective  
               payment system for certified clinics participating in the  
               demonstration program;


             b)   January 1, 2016:  Deadline for the HHS Secretary to  
               award planning grants to states for the purpose of  
               developing proposals to participate in the demonstration  
               program; and,


             c)   September 1, 2017:  Deadline for the HHS Secretary to  
               select the states that will participate in the  
               demonstration program.  Only states that have received a  
               planning grant are eligible to participate. The states will  
               be selected through a competitive application process and  
               must represent a diverse selection of geographic areas,  
               including rural and underserved areas.








                                                                     AB 861


                                                                    Page  4




          Disability Rights California (DRC), supporters of the bill,  
          state that this bill would require DHCS to apply for a planning  
          grant and work with counties and other stakeholders in  
          developing its proposal.  DRC state that this bill would also  
          require the proposal to include plans for increasing housing  
          opportunities for individuals with severe mental health  
          disabilities.  Housing is one of the most needed options people  
          with mental health disabilities need.  DRC concludes that while  
          this grant is to plan rather than develop housing options at  
          least it brings counties closer to developing housing options  
          for people.


          There is no known opposition to this bill.


          Analysis Prepared by:                                             
                          Paula Villescaz / HEALTH / (916) 319-2097  FN:  
          0002216