BILL ANALYSIS                                                                                                                                                                                                    Ó

                                                                    AB 2017

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          2017 (McCarty)

          As Amended  May 27, 2016

          2/3 vote

          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |Health          |16-0 |Wood, Maienschein,    |                    |
          |                |     |Bonilla, Burke, Chiu, |                    |
          |                |     |Dababneh, Gomez,      |                    |
          |                |     |Roger Hernández,      |                    |
          |                |     |Lackey, Nazarian,     |                    |
          |                |     |Olsen, Ridley-Thomas, |                    |
          |                |     |Rodriguez, Santiago,  |                    |
          |                |     |Thurmond, Waldron     |                    |
          |                |     |                      |                    |
          |Higher          |13-0 |Medina, Baker, Bloom, |                    |
          |Education       |     |Chávez, Irwin,        |                    |
          |                |     |Jones-Sawyer, Levine, |                    |
          |                |     |Linder, Low, Olsen,   |                    |
          |                |     |Santiago, Weber,      |                    |
          |                |     |Williams              |                    |
          |                |     |                      |                    |
          |Appropriations  |19-0 |Gonzalez, Bigelow,    |                    |
          |                |     |Bloom, Bonilla,       |                    |
          |                |     |Bonta, Calderon,      |                    |


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          |                |     |Chang, Daly, Eggman,  |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |Eduardo Garcia,       |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |Roger Hernández,      |                    |
          |                |     |Holden, Jones,        |                    |
          |                |     |Obernolte, Quirk,     |                    |
          |                |     |Santiago, Wagner,     |                    |
          |                |     |Weber, Wood           |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |

          SUMMARY:  Establishes the College Mental Health Services Program  
          (CMHS Program) Act, which creates a grant program (CMHS Program  
          Grant) for public community colleges, colleges, and universities  
          to improve access to mental health services and early  
          identification or intervention programs.  Specifically, this  

          1)Establishes the CMSH Trust Account to be used by the  
            Department of Health Care Services (DHCS) to fund the CMHS  
            Program Grant. 

          2)Annually appropriates $40 million dollars that would otherwise  
            be allocated to the Mental Health Services Act (MHSA)  
            Prevention and Early Intervention Program fund into the CMHS  
            Trust Account beginning July 1, 2017.

          3)Requires DHCS, in collaboration with the California Mental  
            Health Services Authority (CalMHSA), to create a grant program  
            for higher education campuses to improve access to mental  
            health services and early identification or intervention  


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          4)Requires CalMHSA to establish guidelines for grant funding and  
            a request for application (RFA).  The RFA must include, but  
            not be limited to:

             a)   Eligibility standards of applicants in order to qualify  
               to be considered for a grant award;

             b)   Required program components to be included in the grant  
               application, which may include, but are not limited to:

               i)     Meeting the needs of students that cannot be met  
                 through existing funds;

               ii)    Availability of matching funds;

               iii)   The ability of the campus, in partnership with the  
                 local county, to establish direct linkages for students  
                 to community-based mental health services;

               iv)    The ability of the campus to address direct services  
                 including, but not limited to, increasing staff to  
                 student ratios and decreasing wait times;

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

             c)   Preferred program components to be included in the grant  
               application, which may include, but are not limited to  
               demonstrating the ability to:


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               i)     Serve underserved and vulnerable populations;

               ii)    Establish direct linkages for students to  
                 community-based mental health services for which  
                 reimbursement is available through the students' health  

               iii)   Reduce racial disparities in access to mental health  

               iv)    Fund mental health stigma reduction activities;

               v)     Provide employees and students with education and  
                 training on early identification, intervention, and  
                 referral of students with mental health needs;

               vi)    Screen students receiving other health care services  
                 and provide linkages to services from the appropriate  
                 mental health provider based on the insurance status of  
                 that student, for those students who are shown to have  
                 need for services; and,

               vii)    Demonstrate evidence of an existing or planned  
                 partnership between the campus and the county behavioral  
                 health department to address complex mental health needs  
                 of students based on their health insurance status and  
                 based on the extent to which there are students whose  
                 needs cannot be met through their health plan or health  
                 insurance or Medi-Cal.

             d)   The articulation of grant program goals and expected  


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               outcomes and various reporting and evaluation requirements  
               as specified.

          5)Permits grants to be awarded to a Community College District  
            in the California Community College system, a campus within  
            the California State University system, or a campus within the  
            University of California system.  

          6)Requires grants to be proportional to the number of students  
            served, and cannot exceed more than $5 million per campus, per  

          7)Requires grants to be awarded on competitive bases, only to a  
            campus that can show dollar-for dollar match of funds from the  

          8)Requires DHCS and CalMHSA to provide technical assistance to  
            smaller colleges and counties, and county behavioral health  
            departments upon request, in the application process to ensure  
            equitable distribution of grant awards.

          9)Requires grant recipients to report annually to the executive  
            office of their respective systems.  Requires the report to  
            include the following information:  a) grant funds and  
            matching revenue expenditures; b) available evaluation data,  
            including outcomes of the campus mental health programs  
            funded; c) program information regarding services being  
            offered and the number of individuals being served; and, d)  
            plans for sustainability of mental health programming beyond  
            the funding from CMHS Trust Account.

          10)Requires DHCS to develop an evaluation plan to assess the  
            impact of the program.


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          11)Requires the higher education executive offices that receive  
            the reports to annually forward the reports to DHCS, CalMHSA,  
            and the Legislature for evaluation of the grant program.

          12)Finds and declares that this measure is consistent and  
            furthers the purposes of the MHSA.

          13)Establishes a January 1, 2022 sunset of the CMHS Program.

          FISCAL EFFECT:  According to the Assembly Appropriations  

          1)Appropriates $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  

          COMMENTS:  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  


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          argues that if students have the resources they need, which is  
          the intent of this bill, the more likely they will seek help.

          Proposition 63 was passed by voters in November 2004.  The MHSA  
          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 of MHSA.  The fiscal year (FY)  
          2015-16 Governor's Budget projected that $1.776 billion would be  
          deposited into the MHSF in FY 2015-16.  The MHSA addresses a  
          broad continuum of prevention, early intervention, and service  
          needs, as well as provided funding for infrastructure,  
          technology, and training needs for the community mental health  
          system.  In addition to local programs, the MHSA authorizes up  
          to 5% of revenues for state administration.  These include  
          administrative functions performed by a variety of state  
          entities such as the DHCS and the Office of Statewide Health  
          Planning and Development (OSHPD).  It also funds evaluation of  
          the MHSA by the Commission, which was established by the MHSA.

          |  FY   | Revenue Generated  |   Estimated Revenue   |
          |       |                    |       Expended        |
          |       |                    |                       |
          |2012-13|   $1.478 billion   |    $1.632 billion     |
          |       |                    |                       |
          |       |                    |                       |
          |       |                    |                       |
          |2013-14|   $1.376 billion   |    $1.484 billion     |
          |       |                    |                       |
          |       |                    |                       |
          |       |                    |                       |
          |2014-15|   $1.588 billion   |    $1.443 billion     |
          |       |                    |                       |
          |       |                    |                       |
          |       |                    |                       |


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          |2015-16|   $1.776 billion   |          TBD          |
          |       |    (projected)     |                       |
          |       |                    |                       |
          |       |                    |                       |

          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 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.

          According to national data compiled by the Center for Collegiate  
          Mental Health over six academic years (2009-15) from over 93  
          institutions, on average, the growth in the number of students  
          seeking services at counseling centers (+29.6%) was more than  
          five times the rate of institutional enrollment (+5.6%).   
          Further, the growth in counseling center appointments (+38.4) is  
          more than seven times the rate of institutional enrollment.  The  
          lifetime prevalence rate for serious suicidal ideation among  
          college students (i.e., "I have seriously considered suicide")  
          has increased substantially over the last five years from 23.8%  
          to more than 32.9%, a considerable change, especially in the  
          context of other indices that are decreasing, at, or increasing  
          only slightly.

          According to data compiled by the California Electronic Violent  
          Death Reporting System (CalEVDRS), a total of 6,471 individuals  
          from 20 to 24 years of age were treated for a suicide attempt in  
          2014.  This represents a 17% increase (5,553 to 6,471) from 2000  
          to 2014 in individuals who attempted suicide who received  
          professional treatment by either being hospitalized or treated  


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          in an emergency department.  CalEVDRS provides detailed  
          information from participating counties on violent deaths,  
          including homicides and suicides by linking data from vital  
          statistics death files, supplementary homicide reports from the  
          California Department of Justice, and coroners' investigations. 

          Analysis Prepared by:                                             
                          Paula Villescaz / HEALTH / (916) 319-2097  FN: