BILL ANALYSIS                                                                                                                                                                                                    



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          Date of Hearing:  April 19, 2016 


                       ASSEMBLY COMMITTEE ON HIGHER EDUCATION


                                 Jose Medina, Chair


          AB 2017  
          (McCarty) - As Amended April 7, 2016


          [Note:  This bill was heard in the Assembly Health Committee on  
          April 5, 2016, and approved by a vote of 16-0.]


          SUBJECT:  College Mental Health Services Program


          SUMMARY:  Establishes the College Mental Health Services Program  
          (CMHS Program) Act, which creates a grant program (CMHS Program  
          Grant) for California Community Colleges (CCC), the California  
          State University (CSU) and the University of California (UC) to  
          improve access to mental health services and early  
          identification or intervention programs.  Specifically, this  
          bill:  


          1)Finds and declares all of the following:


             a)   The provisions of this bill are consistent with and  
               further the purposes of the Mental Health Services Act  
               (MHSA); 


             b)   Students, faculty, health practitioners, and college  
               administrators are reporting increased rates of mental  








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               health needs by students attending public colleges in  
               California;


             c)   One in four students has a diagnosable mental illness  
               and 40 percent of students do not seek mental health when  
               they need it;


             d)   Eight out of 10 people who experience psychosis have  
               their first episode between 15 and 30 years of age;


             e)   The demand for mental health services by public college  
               students far outpaces the ability of colleges to provide  
               them. California public college campuses and higher  
               education systems do not meet national staffing standards  
               for psychiatric services and other mental health  
               professionals;


             f)   The lack of services directly impacts college students'  
               success and academic performance as well as their ability  
               to develop socially as productive members of society;


             g)   The effects of untreated mental health needs are long  
               lasting and can include college students dropping out of  
               school, experiencing homelessness, and dying of suicide;


             h)   One in 10 college students has considered suicide and  
               suicide is the second leading cause of death among college  
               students, claiming more than 1,100 lives every year  
               nationally; and,


             i)   Research shows that for each dollar invested in student  
               prevention and early intervention mental health services,  








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               California will see a return of at least $6 and up to $11  
               as a result of more students graduating.


          2)Establishes in the State Treasury the CMHS Trust Account with  
            moneys continuously appropriated to the State Department of  
            Health Care Services to fund the CMHS Grant Program and  
            transfers $40,000,000 from the MHSF into the CMHS Trust  
            Account annually.


          3)Requires the Department of Health Care Services (DHCS), in  
            consultation with the California Mental Health Services  
            Authority (CalMHSA), to create a grant program for CCC, CSU  
            and UC to improve access to mental health services and early  
            identification or intervention programs. DHCS and CalMHSA are  
            required to establish guidelines for grant funding that  
            include:


             a)   The ability of the program to fund the matching  
               component, as required;


             b)   The ability of the campus, in partnership with the local  
               county, to establish direct linkages for students to  
               community-based mental health services for which the  
               students' health coverage makes them eligible, ensuring  
               provider reimbursement;


             c)   The ability to participate in evidence-based and  
               community defined best practice programs for mental health  
               services improvements;


             d)   The ability of the campus to serve underserved and  
               vulnerable populations, including, but not limited to,  
               lesbian, gay, bisexual, transgender, questioning, and  








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               allied persons, victims of domestic violence and sexual  
               abuse, and veterans; 


             e)   The ability of the campus to reduce racial disparities  
               in access to mental health services;


             f)   The ability of the campus to fund mental health stigma  
               reduction activities; and, 


             g)   The ability of the campus to provide employees and  
               students with education and training on early  
               identification, intervention, and referral of students with  
               mental health needs.


          4)Provides that grants may be awarded to a CCC district, the CSU  
            or the UC and that the scale of the program shall determine  
            the amount awarded, but in no case shall the department award  
            more than $5,000,000 per campus, per application.  


          5)Provides that grants shall only be awarded to a campus that  
            can show a dollar-for-dollar match of funds from the campus.


          6)Provides that administrative costs for any program shall be  
            limited to 5%.


          7)Prohibits funds from supplanting existing state or county  
            funds utilized to provide mental health services.


          8)Allows DHCS and CalMHSA to provide technical assistance to  
            smaller colleges and counties in the application process to  
            ensure equitable distribution of the grant award.








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          9)Requires CCC, CSU and UC campuses that have been awarded grant  
            funds to report annually to their respective CCC Chancellor,  
            CSU Chancellor, and UC Office of the President on the uses of  
            grant funds, as specified.  Requires reports to be submitted  
            to DHCS and CalMHSA and the Legislature.


          10)Sunsets the provisions of this bill on January 1, 2022.


          EXISTING LAW:  


          1)Establishes the MHSA, enacted by voters in 2004 by Proposition  
            63, to provide funds to counties to expand services, develop  
            innovative programs, and integrated service plans for mentally  
            ill children, adults, and seniors through a 1% income tax on  
            personal income above $1 million.

          2)Establishes the Mental Health Oversight and Accountability  
            Commission (Commission) to oversee the implementation of MHSA,  
            made up of 16 members appointed by the Governor, unless  
            otherwise specified.
             
          3)Specifies that the MHSA can only be amended by a two-thirds  
            vote of both houses of the Legislature and only as long as the  
            amendment is consistent with and furthers the intent of the  
            MHSA.  Permits provisions clarifying the procedures and terms  
            of the MHSA to be added by majority vote.

          4)Requires DHCS to develop and implement mental health plans for  
            Medi-Cal beneficiaries.


          5)Requires mental health plans, whether administered by public  
            or private entities, to be governed by specified guidelines,  
            including the provision of culturally competent and  








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            age-appropriate services, to the extent feasible.


          6)Requires a mental health plan to assess the cultural  
            competency needs of the program and to include a process to  
            accommodate the significant needs with reasonable timeliness.

          FISCAL EFFECT:  Unknown.


          COMMENTS:  Purpose of this bill.  According to the author, there  
          are tremendous mental health needs that Californians face  
          related to access, care, and homelessness.  However, an often  
          forgotten part of this discussion is our college-age students.   
          Unfortunately, many of our public colleges do not have mental  
          health services for their students on campus, particularly  
          community colleges.  Due to a lack of access to care,  
          college-aged students often do not seek mental health services  
          when they need them.  The stigma around mental health is  
          something that can be improved if we increase access to mental  
          health services for students.  The author argues that if  
          students have the resources they need the more likely they will  
          seek help.





          MHSA.  Proposition 63 was passed by voters in November 2004 and  
          created the MHSA, which imposes a one percent income tax on  
          personal income in excess of $1 million and creates the 16  
          member Commission charged with overseeing the implementation.   
          MHSA addresses prevention, early intervention, and service  
          needs, as well as provided funding for infrastructure,  
          technology, and training needs for the community mental health  
          system.  MHSA requires each county mental health department to  
          prepare and submit a three-year plan to DHCS that must be  
          updated each year and approved by DHCS after review and comment  
          by the Commission.  In their three-year plans, counties are  








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          required to include a list of all programs for which MHSA  
          funding is being requested, that identify how the funds will be  
          spent, and which populations will be served.  Counties must  
          submit their plans for approval to the Commission before the  
          counties may spend certain categories of funding.








          MHSA funding for education programs.  In June 2007, the  
          Commission voted to approve $60 million in statewide initiative  
          funds in response to the mass shooting that occurred on the  
          campus of Virginia Polytechnic Institute.  This Student Mental  
          Health Initiative (SMHI) allocated $34 million to higher  
          education institutions and $26 million for K-12 programs for a  
          period of four years.  The higher education programs focused on  
          three key strategic directions:  training; peer support  
          activities; and, suicide prevention. Any college, district,  
          multi-campus collaborative, or system within one of the three  
          California public higher education systems was eligible and  
          program applications were based on demonstrated need that  
          emphasized culturally relevant and appropriate approaches. 





          CalMHSA.  The CalMHSA was established by California counties in  
          June 2009 as a Joint Powers Authority responsible for funding  
          and implementing mental health services programs and projects.   
          CalMHSA is headed by a separate Board of Member Counties and an  
          Executive Committee comprised of officers and Statewide Regional  
          Representatives.  Among other responsibilities, CalMHSA is  
          responsible for implementation and oversight of the SMHI.  









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          CSU, UC and CCC SMHI projects.  Under the SMHI, the systemwide  
          offices of the CSU and UC were each awarded approximately $7  
          million by CalMHSA for a 3-year grant (which ended in December  
          2015) to provide, primarily, outreach and education activities.   
          In October 2011, the CCC Chancellor's Office (CCCCO) was awarded  
          $7 million by CalMHSA to establish the CCC SMHI, a partnership  
          between the CCCCO and the Foundation for Community Colleges.  In  
          June of 2015, the program was awarded $1.4 million ($700,000 per  
          year) to support phase 2 of the program; implementation began on  
          October 1, 2015 and will conclude on June 30, 2017. 

          Suggested amendments and clarifications.  





          1)Clarification is needed to specify that applications are  
            submitted by and grant funds are provided to the campus of the  
            CSU and/or UC (rather than to the system office).   
            Additionally, the author and committee may wish to consider  
            whether the bill should authorize multiple campuses (and  
            districts and segments) located in the same region to  
            collaborate on an application and grant program.



          2)As previously noted, prior MHSA funding was primarily used to  
            support outreach and education activities within the higher  
            education segments.  Committee staff understands that that the  
            author intends for funding provided pursuant to this bill to  
            be used to support both direct services (decreasing wait times  
            and increasing provider-to-student ratios, etc.) as well as  
            additional outreach, as needed.  This intent could be further  
            clarified in the bill.



          3)As currently drafted, grant recipients must provide matching  








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            funds for the program.  Committee staff understands the  
            author's intent is to allow the matching component to include  
            public or private funding, or in kind donations such as  
            facilities or staffing resources.     
            


          REGISTERED SUPPORT / OPPOSITION:




          Support


          California Federation of Teachers


          California State Student Association


          Faculty Association of California Community Colleges


          National Association of Social Workers


          North Orange County Community College District


          University of California Student Association




          Opposition


          None on File








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          Analysis Prepared by:Laura Metune / HIGHER ED. / (916) 319-3960