BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: AB 1299 --------------------------------------------------------------- |AUTHOR: |Ridley-Thomas | |---------------+-----------------------------------------------| |VERSION: |April 21, 2015 | --------------------------------------------------------------- --------------------------------------------------------------- |HEARING DATE: |June 17, 2015 | | | --------------------------------------------------------------- --------------------------------------------------------------- |CONSULTANT: |Reyes Diaz | --------------------------------------------------------------- SUBJECT : Medi-Cal: specialty mental health services: foster children. SUMMARY : Requires the California Health and Human Services Agency to coordinate with the Departments of Health Care Services (DHCS) and Social Services to facilitate the receipt of medically necessary specialty mental health services by foster youth, as specified, and for DHCS to meet specific conditions on or before July 1, 2016. Requires the Department of Finance to set or adjust its allocation schedule of the Behavioral Health Subaccount, as specified. Requires DHCS to seek federal approval, as specified, to implement the provisions in this bill. Existing law: 1)Establishes California's Medicaid program, Medi-Cal, through which eligible low-income individuals receive health care services. 2)Establishes the federal Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program to provide comprehensive and preventive health services, including preventive, dental, Mental Health (MH), developmental, and specialty services to Medi-Cal beneficiaries under the age of 21 who have full-scope Medi-Cal eligibility. Requires states to administer EPSDT as a condition of receiving federal Medicaid funds. 3)Requires county MH departments that receive full system of care funding, as specified, to provide children who are served by county social services and probation departments with MH screening, assessment, participation in multidisciplinary placement teams, and specialty MH treatment services for AB 1299 (Ridley-Thomas) Page 2 of ? children placed out of home in group care, for those children who meet the definition of medical necessity, to the extent resources are necessary. 4)Requires each local MH plan to establish a procedure to ensure access to outpatient specialty MH services, as required by EPSDT program standards, for any child in foster care who has been placed outside his or her county of adjudication. Requires the local MH plan of the county of original jurisdiction for a foster youth to remain responsible for providing or arranging for specialty MH services, including the costs of services, unless there is a written contract in which the county of residence accepts responsibility for payment. 5)Establishes a state and local system of child welfare services, including foster care, for children who have been adjudged by the court to have been abused or neglected, or at risk of abuse or neglect, as specified. 6)Allows a juvenile court to adjudge a child a ward or a dependent of the court for specified reasons, including, but not limited to, if the child has been left without any provision for support, as specified. 7)States that the purpose of foster care law is to provide maximum safety and protection for children who are currently being physically, sexually, or emotionally abused, neglected, or exploited, and to ensure the safety, protection, and physical and emotional well-being of children who are at risk of harm. 8)Establishes rights of foster youth, including the right to receive medical, dental, vision, and MH services. 9)Establishes the Behavioral Health Subaccount, within the Support Services Account, which funds specialty MH, Drug Medi-Cal, residential perinatal drug services and treatment; drug court operations, and other non-Drug Medi-Cal programs. This bill: 1)Requires the California Health and Human Services Agency (CHHSA) to coordinate with DHCS and Department of Social Services (DSS) to facilitate the receipt of medically necessary specialty MH services by foster youth placed outside AB 1299 (Ridley-Thomas) Page 3 of ? his or her county of original jurisdiction. Requires DHCS to do the following on or before July 1, 2016: a) Issue policy guidance that establishes the "presumptive transfer," as defined, of responsibility for providing or arranging MH services to foster youth, consistent with EPSDT standards and requirements, from the county of original jurisdiction to the foster youth's county of residence; b) Establish conditions and exceptions to presumptive transfer in consultation with DSS and with input from stakeholders, including the County Welfare Directors Association of California, the California Behavioral Health Directors Association of California, provider representatives, and family and youth advocates. The conditions and exceptions to presumptive transfer are intended to ensure that the transfer or responsibility improves access to MH services and does not impede the continuity of existing care; and, c) Establish procedures for implementing presumptive transfer that are consistent with the purpose and intent of the provisions of this bill and EPSDT standards and requirements. Requires DHCS to include a procedure for expedited transfer within 48 hours. 2)Defines "presumptive transfer" as responsibility for providing or arranging for MH services being immediately transferred from the county of original jurisdiction to the county of residence, when the following occur: a) A foster child is placed in a county other than the county of original jurisdiction; and, b) The transfer of responsibility is requested by the county child welfare services agency, county probation department, foster caregiver, or any other person authorized to make medical decisions on behalf of the foster child. 3)Requires Department of Finance (DOF), by May 1, 2016, to set or adjust its allocation schedule of the Behavioral Health Subaccount so that counties that have paid, or will pay, for specialty MH services for foster youth placed out-of-county, pursuant to the provisions in this bill, are fully reimbursed AB 1299 (Ridley-Thomas) Page 4 of ? during the fiscal year in which the services were provided. 4)Requires DHCS, if it determines it is necessary, to seek approval under the state's Section 1915(b) Medicaid Waiver from the Centers for Medicare and Medicaid Services (CMS) prior to implementing the provisions in this bill. Prohibits DHCS from implementing any provision that CMS determines is not permitted under the state's 1915(b) waiver. (The state's specialty MH services are operated under a section of the 1915(b) waiver.) FISCAL EFFECT : According to the Assembly Appropriations Committee, this bill will result in annual increased costs in the EPSDT program in the low millions (approximately 50% General Fund), possibly more to the extent this bill increases access to MH services for youth who face treatment and service barriers when placed out-of-county. PRIOR VOTES : ----------------------------------------------------------------- |Assembly Floor: |80 - 0 | |------------------------------------+----------------------------| |Assembly Appropriations Committee: |17 - 0 | |------------------------------------+----------------------------| |Assembly Human Services Committee: |7 - 0 | | | | ----------------------------------------------------------------- COMMENTS : 1)Author's statement. According to the author, foster youth are three to six times more likely than non-foster youth to experience emotional, behavioral, and developmental problems. When a foster youth's MH needs are not met, the result is often placement instability; disruptions in permanency plans; school failure; costly care in group homes, residential treatment facilities, and psychiatric hospitals; delinquency; and even death. Especially at risk are foster youth placed across county lines, who often experience lengthy delays or denials in accessing MH services. According to the most recent data from the California Child Welfare Indicators Project at UC Berkeley, almost one-in-five foster youth statewide (an estimated 13,000) live in placements across county lines, or AB 1299 (Ridley-Thomas) Page 5 of ? "out-of-county." This disparity in access to MH services between in-county and out-of-county youth exists despite both having the same entitlement to MH services under federal and state law. 2)Background. The purpose of state's Child Welfare Services (CWS) system is to protect children from abuse and neglect and provide for their health and safety. When children are identified as being at risk of abuse, neglect, or abandonment, county juvenile courts hold legal jurisdiction, and children are served by the CWS system through the appointment of a social worker. Through this system, there are multiple opportunities for the custody of the child, or his or her placement outside of the home, to be evaluated, reviewed, and determined by the judicial system, in consultation with the child's social worker, to help provide the best possible services to the child. The CWS system seeks to help children who have been removed from their homes reunify with their parents or guardians, whenever appropriate, or unite them with other individuals they consider to be family. There are currently close to 63,000 children in the state's CWS. California has a decentralized public MH system with most direct services provided through the county MH system. Counties (county MH plans) have the primary funding and programmatic responsibility for the majority of local MH programs. The state is required to meet certain federal requirements, including those set forth by Medicaid's child health component, known as the EPSDT program. Federal law-including statutes, regulations, and guidelines-requires Medi-Cal to cover a very comprehensive set of benefits and services for children, different from adult benefits. EPSDT provides eligible children access to a range of MH services that include, but are not limited to, MH assessment and services, therapy, rehabilitation, medication support services, day rehabilitation, day treatment intensive, crisis intervention/stabilization, targeted case management, and therapeutic behavioral services. 3)MH needs of foster youth. Foster youth have a higher likelihood of experiencing emotional, behavioral, and developmental problems when compared to their non-foster peers. Abuse and neglect and unstable placements can contribute to and exacerbate MH issues. These problems can lead to other problems, like difficulty forming stable AB 1299 (Ridley-Thomas) Page 6 of ? relationships and succeeding in school. Research underscores the need for improved access to health and MH services for foster youth, and points to the high incidence of behavioral or MH problems necessitating intervention among foster youth. The disproportionately high rates of emotional and behavioral health issues for youth placed in foster care, youth transitioning from foster care, and former foster youth can be correlated with other barriers foster youth face, such as higher rates of incarceration and homelessness, diminished rates of high school completion and college attendance, and disproportionate prescribing of antipsychotic and psychotropic medications, as highlighted in an 2014 exposé by the San Jose Mercury News. There are indications that out-of-county foster youth may have higher needs and less access when it comes to MH treatment. A 2011 report issued by the California Child Welfare Council found that out-of-county foster youth were more likely to have been diagnosed with a serious MH disorder, yet were 10-15 percent less likely to have received any MH services compared to their in-county peers. And among those that did receive services, in-county foster youth fared better, receiving more care and more intensive treatment. 4)Double referral. This bill is double referred. Should it pass out of this committee, it will be referred to the Senate Human Services Committee. 5)Prior legislation. AB 1808 (Galgiani), of 2009, was substantially similar to this bill. AB 1808 was held on the suspense file of the Assembly Appropriations Committee. SB 785 (Steinberg), Chapter 469, Statutes of 2007, facilitates the access to MH services for foster youth who are placed outside of the original county of jurisdiction, including those being adopted or entering into a guardianship with a relative. 6)Support. Supporters of this bill, largely behavioral health and family advocates, argue that the question of which MH plan is responsible for providing much-needed services to foster youth who have been placed outside of their counties of jurisdiction has vexed California for more than 20 years. They state that foster youth go through transitions where their mental stability takes a toll and that this bill will ensure AB 1299 (Ridley-Thomas) Page 7 of ? that the MH needs of these foster youth will not be delayed or denied as the youth transition to a new county of residence. Supporters further argue that foster youth already have a rough start in life, and not being able to access MH services, which they are entitled to, in a timely and efficient manner puts them at an even greater risk of serious harm and potentially permanent negative outcomes. SUPPORT AND OPPOSITION : Support: California Alliance of Child and Family Services (co-sponsor) Steinberg Institute (co-sponsor) Women's Foundation of California/Women's Policy Institute (co-sponsor) Accessing Health Services for California's Children in Foster Care Task Force Alameda County Faith Initiative Office Faith Advisory Council Alameda County Foster Youth Alliance Alternative Family Services American Federation of State, County and Municipal Employees Association of Community Human Services Agencies Aviva Family and Children's Services Bienvenidos Children's Center Bill Wilson Center California Council of Community Mental Health Agencies California Mental Health Advocates for Children and Youth California State PTA Casa Pacifica Centers for Children and Families ChildNet Youth and Family Services Crittenton Services for Children and Families David and Margaret Youth and Family Services Ella Baker Center for Human Rights EMQ Families First Ettie Lee Youth and Family Services Families Now Family Care Network, Inc. First Place for Youth Fred Finch Youth Center Hathaway-Sycamores Child and Family Services Humboldt County Transition Age Youth Collaboration Integral Community Solutions Institute Junior Blind of America AB 1299 (Ridley-Thomas) Page 8 of ? Junior League of San Francisco Junior Leagues of California State Public Affairs Committee Lilliput Children's Services Lincoln Child Center Maryvale Mendocino County Health and Human Services Agency National Association of Social Workers - California Chapter North Star Family Center Optimist Youth Homes and Family Services Orange County Alliance for Children and Families Sacramento Children's Home San Diego Center for Children Seneca Family of Agencies Sierra Forever Families Stars Behavioral Health Group Summitview Child & Family Services, Inc. The Village Family Services TLC Child and Family Services Trinity Youth Services United Advocates for Children and Families Unity Care Group, Inc. West Coast Children's Clinic Young Minds Advocacy Project Youth Homes, Inc. Oppose: None received. -- END --