BILL ANALYSIS Ó
AB 861
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GOVERNOR'S VETO
AB
861 (Maienschein)
As Enrolled September 11, 2015
2/3 vote
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|ASSEMBLY: |74-0 |(May 22, 2015) |SENATE: | 40-0 |(September 8, |
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|ASSEMBLY: |79-0 |(September 9, | | | |
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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.
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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
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:
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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
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,
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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.
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.
GOVERNOR'S VETO MESSAGE:
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This bill would require the Department of Health Care Services
to mandate counties, as a condition of participation in a
federal behavioral health demonstration program, to redirect a
portion of any local savings to increasing housing opportunities
for individuals with severe mental illness.
The department has not been awarded the federal grant nor
approved as one of eight states to participate in the federal
demonstration program. As such, this bill is premature.
Analysis Prepared by:
Paula Villescaz / HEALTH / (916) 319-2097 FN:
0002507