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) ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: May 28, 2015 |Policy Vote: ED. 9 - 0, HEALTH | | | 7 - 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: No | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: August 17, 2015 |Consultant: Brendan McCarthy | | | | ----------------------------------------------------------------- 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 ? (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 ? 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. -- END --