BILL ANALYSIS Ó AB 2017 Page 1 ASSEMBLY THIRD READING AB 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, | | AB 2017 Page 2 | | |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 bill: 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 programs. AB 2017 Page 3 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: AB 2017 Page 4 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 coverage; iii) Reduce racial disparities in access to mental health services; 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 AB 2017 Page 5 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 application. 7)Requires grants to be awarded on competitive bases, only to a campus that can show dollar-for dollar match of funds from the campus. 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. AB 2017 Page 6 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 Committee: 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 funds. 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 AB 2017 Page 7 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 | | | | | | | | | | | | | AB 2017 Page 8 |-------+--------------------+-----------------------| |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 AB 2017 Page 9 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: 0003283