BILL ANALYSIS                                                                                                                                                                                                    



                                                                    AB 2017


                                                                    Page  1





          Date of Hearing:  May 4, 2016


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                               Lorena Gonzalez, Chair


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


           ----------------------------------------------------------------- 
          |Policy       |Health                         |Vote:|16 - 0       |
          |Committee:   |                               |     |             |
          |             |                               |     |             |
          |             |                               |     |             |
          |-------------+-------------------------------+-----+-------------|
          |             |Higher Education               |     |13 - 0       |
          |             |                               |     |             |
          |             |                               |     |             |
          |-------------+-------------------------------+-----+-------------|
          |             |                               |     |             |
          |             |                               |     |             |
          |             |                               |     |             |
           ----------------------------------------------------------------- 


          Urgency:  No  State Mandated Local Program:  NoReimbursable:  No


          SUMMARY:


          This bill creates the College Mental Health Services Program, a  
          matching grant program to enhance the provision of mental health  
          services on state college campuses.  Specifically, this bill:









                                                                    AB 2017


                                                                    Page  2






          1)Transfers $40 million annually from the Mental Health Services  
            Fund to the College Mental Health Services Trust Account,  
            which it establishes in the state Treasury as a continuously  
            appropriated fund for purposes of the grant program.


          2)Requires the Department of Health Care Services (DHCS) to, in  
            consultation with the California Mental Health Services  
            Authority (CalMHSA), create a grant program for public  
            community colleges, colleges, and universities to improve  
            access to mental health services and early identification or  
            intervention programs.


          3)Authorizes grants to be awarded to a community college  
            district in the California Community College (CCC) system, the  
            California State University (CSU) system, or the University of  
            California (UC) system, and limits amounts to no more than  
            five million dollars ($5,000,000) per campus, per application.


          4)Requires a dollar-for-dollar match of funds from the campus,  
            limits administrative costs to 5 percent for any grantee, and  
            prohibits the funding from being used to supplant existing  
            state or county funds utilized to provide mental health  
            services.





          5)Requires CSU and CCC campuses to report to their respective  
            Chancellor's offices, and UC campuses to report to the Office  
            of the President on the use of grant funds, and requires  
            reports be submitted to DHCS.











                                                                    AB 2017


                                                                    Page  3





          6)Sunsets the program on January 1, 2022.



          FISCAL EFFECT:


          1)$40 million annually from the Mental Health Services Account  
            to fund the grant program. 


          2)Staff costs to DHCS of $240,000 for fiscal year 2016-17, and  
            $364,000 ongoing for the length of the program (Mental Health  
            Services Account). 


          3)Systems note potential difficulty in generating matching  
            funds. The UC notes in the last grant request for proposal  
            from CalMHSA for an similar program, upon which this one  
            appears to be modeled, CalMHSA insisted on a cash match,  
            requiring UC to put up "new dollars" as a match to receive  
            funding.  Furthermore, the match was specific to prevention  
            dollars, which prevented UC from matching with funds being  
            used for staffing direct services. They note the majority of  
            UC's mental health budget is allocated to staffing direct  
            services, with only about 10% going to prevention, given the  
            immense demand for services. Thus, UC appears limited if a  
            cash match of new funds was required. However, if the  
            guidelines were more flexible, allowing for student fee  
            revenue or in-kind contributions to meet the matching  
            requirement, campuses could access the grant program.


            The CCC notes note community colleges have limited ability to  
            meet the matching funds requirement due to statutory  
            restrictions on allocations of general fund expenditures. They  
            also most districts charge a health fee, which could be used  
            to provide a match if that is allowable source.  









                                                                    AB 2017


                                                                    Page  4






          COMMENTS:


          1)Purpose. The author cites significant unmet need for mental  
            health services, and indicates college-aged students often do  
            not seek mental health services when they need them.  Ensuring  
            access to mental health in our colleges will reduce stigma and  
            student success. 

          2)Background. Existing law establishes the Mental Health  
            Services Act (MHSA), enacted by voters in 2004 through  
            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. 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 required  
            to include a list of programs, identify how the funds will be  
            spent, and identify which populations will be served.  

          3)MHSA funding for education programs.  In June 2007, the  
            Commission voted to approve the $60 million Student Mental  
            Health Initiative (SMHI), which 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. The SMHI was evaluated by RAND and demonstrated a  
            positive return on investment through greater student  








                                                                    AB 2017


                                                                    Page  5





            achievement. 

          4)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.  
          


          5)Support. This bill is co-sponsored by the Steinberg Institute  
            and Faculty Association of California Community Colleges  
            (FACCC), and it is supported by a number of other groups.   
            Supporters note the mental health needs of college students  
            are great.  Studies show one in four individuals lives with a  
            mental illness, meaning at any given moment a minimum of  
            750,000 students are suffering from depression, anxiety,  
            psychosis, or some other mental health condition.  The  
            Steinberg Institute argues that establishing this program  
            would dramatically change the lives of these students by  
            providing funding to target improved linkages and increased  
            services for students. 
            


          6)Staff Comments.  This bill would benefit from clarification on  
            a number of issues:  
             a)   The MHSA has a variety of existing allocations.  Where  
               within the MHSA structure does the $40 million come from?  


             b)   This bill does not specify whether the continuously  
               appropriated fund it creates can fund the DHCS  
               administrative costs. 










                                                                    AB 2017


                                                                    Page  6





             c)   It is unclear what activities can be supported by the  
               grant funds. This should be specified.


             d)   One provision of the bill notes "smaller colleges and  
               counties" can receive technical assistance.  However,  
               counties are not specified as potential grant recipients.


             e)   It is unclear whether grants are for multiple years or  
               are annual awards.   


             f)   The bill specifies grants funding guidelines that shall  
               include the "ability" of campuses to do a number of things.  
                It is unclear whether this list comprises the activities  
               the grant will fund, prerequisites the campus must meet, or  
               a scheme for prioritizing grants by need.  Spelling each of  
               these aspects out more clearly, as appropriate, is  
               advisable.


             g)   This bill states that the scale of the program shall  
               determine the amount awarded but does not define scale. It  
               is unclear if campuses are competing based on their  
               full-time student population, total student population, or  
               some other measure.


             h)   This bill states that grants can only be awarded to  
               recipients who have demonstrated dollar-for-dollar matching  
               of funds from the campus.  Allowable matching funds and the  
               availability of in-kind donations, if applicable, should be  
               specified.


             i)   It should be specified whether grants are made to each  
               campus or to the system-wide offices. This bill requires  
               the system-wide offices to do the reporting, but implies  








                                                                    AB 2017


                                                                    Page  7





               campuses are the grant recipients. This should be clarified  
               and the entity receiving the grant should submit the  
               report.


             j)   This bill has a sunset date but no evaluation. Should it  
               be evaluated before the sunset?


             aa)  Is there a justification for a continuous appropriation  
               for this program?


          Analysis Prepared by:Lisa Murawski / APPR. / (916)  
          319-2081