BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 1018 (Cooper) - Medi-Cal:  Early and Periodic Screening,  
          Diagnosis, and Treatment (EPSDT)
          
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          |Version: May 28, 2015           |Policy Vote: ED. 9 - 0, HEALTH  |
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          |Urgency: No                     |Mandate: No                     |
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          |Hearing Date: August 17, 2015   |Consultant: Brendan McCarthy    |
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          This bill meets the criteria for referral to the Suspense File.


          Bill  
          Summary:  AB 1018 would require the Department of Health Care  
          Services and the Department of Education to convene a joint  
          taskforce to examine the delivery of mental health services to  
          children.


          Fiscal  
          Impact:  
           One-time costs up to $100,000 for the Department of Health  
            Care Services to provide staff support to the taskforce and  
            develop the required report (General Fund and federal funds).

           One-time costs of $105,000 for the Department of Education to  
            provide staff support to the taskforce and develop the  
            required report (General Fund).

           One-time costs of about $20,000 for logistical support of the  
            task force, including reimbursing travel expenses for members  







          AB 1018 (Cooper)                                       Page 1 of  
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            (General Fund and federal funds).


          Background:  Under state and federal law, the Department of Health Care  
          Services operates the Medi-Cal program, which provides health  
          care coverage to low income individuals, families, and children.  
          Medi-Cal provides coverage to childless adults and parents with  
          household incomes up to 138% of the federal poverty level and to  
          children with household incomes up to 266% of the federal  
          poverty level. The federal government provides matching funds  
          that vary from 50% to 90% of expenditures depending on the  
          category of beneficiary.
          As part of the Medi-Cal program, the Early and Periodic  
          Screening, Diagnosis, and Treatment (EPSDT) program, provides  
          health care and mental health benefits to Medi-Cal enrollees  
          under age 21. Typically, mental health services covered under  
          EPSDT are considered specialty mental health services and are  
          provided (and paid for) by county mental health plans.


          Prior to 2012, students who had mental health needs documented  
          in their individualized education plan were referred by local  
          educational agencies to county mental health plans to receive  
          specialty mental health services. Budget trailer bill adopted in  
          2011 shifted responsibility for providing certain mental health  
          services from county mental health plans to local educational  
          agencies. Mental health services identified in a student's  
          individualized education plan must be provided directly by the  
          local educational agency or through contracts with outside  
          providers. (This did not eliminate the county obligation to fund  
          specialty mental health services.) While local educational  
          agencies are required to ensure that student mental health  
          service needs are met, local educational agencies can only  
          provide and bill for EPSDT services if the local educational  
          agency contracts with the county mental health plan. At this  
          time, local educational agencies may provide mental health  
          services without seeking Medi-Cal reimbursement, enroll as a  
          Medi-Cal provider and bill Medi-Cal for services provided to  
          Medi-Cal enrollees, or collaborate with a county mental health  
          plan to secure mental health services through the county mental  
          health plan.











          AB 1018 (Cooper)                                       Page 2 of  
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          Proposed Law:  
            AB 1018 would require the Department of Health Care Services  
          and the Department of Education to convene a joint taskforce to  
          examine the delivery of mental health services to children.
          The bill would require the taskforce to consider several issues  
          relating to the delivery of mental health services to students,  
          funding arrangements to pay for those services, best practices  
          for coordination between school organizations and county mental  
          health plans, and other issues.


          The bill would require a report from the taskforce to the  
          Legislature by January 1, 2017.


          The bill's provisions would sunset on January 1, 2021.




          Related  
          Legislation:  AB 1133 (Achadjian) would establish a four year  
          pilot project to provide outreach and technical assistance to  
          local educational agencies for providing mental health services  
          at school sites. That bill was held on the Assembly  
          Appropriations Committee's Suspense File.


          Staff  
          Comments:  The Joint Legislative Audit Committee recently  
          approved an audit request, requiring the Bureau of State Audits  
          to review the provision of mental health services to students.


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