BILL ANALYSIS Ó
SENATE COMMITTEE ON EDUCATION
Senator Carol Liu, Chair
2015 - 2016 Regular
Bill No: AB 2017
-----------------------------------------------------------------
|Author: |McCarty |
|-----------+-----------------------------------------------------|
|Version: |May 27, 2016 Hearing |
| |Date: June 29, 2016 |
-----------------------------------------------------------------
-----------------------------------------------------------------
|Urgency: |No |Fiscal: |Yes |
-----------------------------------------------------------------
-----------------------------------------------------------------
|Consultant:|Lynn Lorber |
| | |
-----------------------------------------------------------------
Subject: College Mental Health Services Program
SUMMARY
This bill requires the Department of Health Care Services to
create a grant program for public postsecondary education
institutions to access mental health services, and appropriates
$40 million for this purpose.
BACKGROUND
Existing law:
1) Establishes the Mental Health Services Act (MHSA),
enacted by voters in 2004 as 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. The MHSA provides
funding for programs within five components: Community
Services and Supports, Prevention and Early Intervention,
Innovation, Capital Facilities and Technological Needs,
Workforce Education and Training.
2) Requires the Department of Health Care Services, in
coordination with counties, to establish a program designed
to prevent mental illnesses from becoming severe and
disabling. Existing law requires prevention and early
intervention programs to include specified components.
AB 2017 (McCarty) Page 2
of ?
(Welfare & Institutions Code § 5840)
ANALYSIS
This bill requires the Department of Health Care Services (DHCS)
to create a grant program for public postsecondary education
institutions to access mental health services, and appropriates
$40 million for this purpose. Specifically, this bill:
1) Requires DHCS, in collaboration with the California Mental
Health Services Authority (CalMHSA), to create a grant
program for public community colleges, colleges and
universities, in collaboration with county behavioral
health departments, to improve access to mental health
services and early identification or intervention programs.
Grant application
2) Requires CalMHSA to establish grant program guidelines and
develop a request for proposal, which is to include but not
be limited to all of the following:
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 program.
c) Preferred program components to be included in
the grant application.
d) Articulation of grant program goals and expected
outcomes.
e) Required reporting and evaluation standards to be
met by applicants that are selected for a grant award.
f) Timelines and deadlines for grant applications
and anticipated funding award determinations.
3) Requires postsecondary education institutions, in
AB 2017 (McCarty) Page 3
of ?
collaboration with their local county behavioral health
department, to submit their grant application
electronically to California Mental Health Services
Authority (CalMHSA) according to the guidelines in the
request for application.
Grant awards
4) Requires total available grant funding to colleges by
segment to be proportional to the number of students served
by that segment, and prohibits Department of Health Care
Services (DHCS) in any case from awarding more than $5
million per campus, per application.
5) Requires that grant funds only be awarded to a campus that
can show a dollar-for-dollar match of funds or another
level of match to be determined by CalMHSA, in consultation
with the applicant, based on resources and existing mental
health needs of students from the campus. This bill
authorizes matching funds to include in-kind funds, student
health fee funds, and other appropriate funds as determined
by DHCS in collaboration with CalMHSA and pursuant to the
guidelines developed by CalMHSA.
6) Requires grants to be awarded to applicants on a
competitive basis based on their ability to meet the
application standards (the guidelines developed by CalMHSA)
and prioritization of these standards as determined by
CalMHSA through the development of the request for proposal
guidelines.
7) Requires individual grant award allocations to be expended
over at least one year but not more than three years, as
determined by CalMHSA through the grant award process.
8) Authorizes grants to be awarded to a community college
district in the California Community College system, a
campus within the California State University system, a
campus within the University of California system, or a
grouping of campuses within the segments.
9) Provides that California Mental Health Services Authority
(CalMHSA) has the authority to approve grant programs and
requires DHCS to award funding in accordance with CalMHSA's
AB 2017 (McCarty) Page 4
of ?
determinations, to the extent that an application follows
the guidelines and specifically states what activities are
to be undertaken in accordance with guidelines in the
request for proposal.
Required program components
10) Authorizes the required program components to include but
not be limited to, for purposes of the request for
proposal, the following:
a) The ability of the program to meet the needs of
students that cannot be met through existing funds.
b) The ability of the program to provide the
matching funds (see #5).
c) The ability of the campus, in partnership with
the local county, to establish direct linkages for
students to community-based mental health services.
d) The ability of the campus to address direct
services including but not limited to increasing staff
to student ratios and decreasing wait times.
e) The ability to participate in evidence-based and
community defined best practice programs for mental
health services improvements.
Preferred program components
11) Authorizes the preferred program components to include but
not be limited to, for purposes of the request for
proposal, the following:
a) The ability of the campus to serve underserved
and vulnerable populations.
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 reimbursement is available through the student's
health coverage.
AB 2017 (McCarty) Page 5
of ?
c) The ability of the campus to reduce racial
disparities in access to mental health services.
d) The ability of the campus to fund mental health
stigma reduction activities.
e) 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.
f) The ability of the campus to 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 a
need for services.
g) 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, health
insurance, or Medi-Cal.
Appropriation
12) Establishes the College Mental health Services Trust
Account, and provides the moneys are to be continuously
appropriated to the Department of Health Care Services
(DHCS) to fund the grant program established by this bill.
13) Requires, beginning July 1, 2017, and annually thereafter,
$40 million to be transferred from funding that would
otherwise be allocated to Mental Health Services Act (MHSA)
Prevention and Early Intervention Programs into the College
Mental Health Services Trust Account annually.
Report and evaluation
14) Requires campuses of the California Community Colleges,
AB 2017 (McCarty) Page 6
of ?
California State University and University of California
that have been awarded grants to report annually on the use
of grant funds to DHCS. This bill requires the report to
include but not be limited to, all of the following:
a) How grant funds and matching funds are being
used.
b) Available evaluation data, including outcomes of
the campus mental health programs funded pursuant to
the grant program.
c) Program information regarding services being
offered and the number of individuals being served.
d) Plans for sustainability of mental health
programming beyond the funding from the College Mental
Health Services Trust Account.
15) Requires the campuses to electronically submit the reports,
annually, to the California Community College Chancellor's
Office, the California State University Chancellor's
Office, and the University of California Office of the
President.
16) Requires DHCS to develop an evaluation plan to assess the
impact of the grant program, requires DHCS to submit a
report to the Legislature by February 1, 2021, evaluating
the grant program and providing recommendations for further
implementation, and make the report available to the public
and post it on its Web site.
Miscellaneous
17) Requires Department of Health Care Services (DHCS) and
California Mental Health Services Authority (CalMHSA) to
provide technical assistance to smaller colleges and county
behavioral health departments upon request during the
application process to ensure equitable distribution of the
grant award.
18) Limits administrative costs associated with administering
an approved program at 5% of the total grant amount for any
grantee. This bill requires administrative costs incurred
AB 2017 (McCarty) Page 7
of ?
by DHCS to be reimbursed from the College Mental Health
Services Trust Account, and limits the reimbursement to up
to 5% of the total funds expended annually from the
account.
19) Prohibits the funding from being used to supplant existing
campus, state, or county funds use to provide mental health
services.
20) States legislative findings and declarations relative to
students' needs for mental health services.
21) Sunsets the provisions of this bill on January 1, 2022.
STAFF COMMENTS
1) Need for the bill. According to the author, "Access to
mental health services on public college campuses varies by
systems, with some offering direct access to services and
others with no mental health professional on campus.
Considering the growing number of students seeking
counseling, there is an even greater need to support
effective services, such as peer-to-peer programs, and
community and intra-campus engagement. Currently,
California college campuses and higher education systems do
not meet national staffing standards for psychiatric
services and other mental health professionals. Recent
data and reports have shown college students are
experiencing increased rates of mental health issues and
demand for treatment services. By investing in prevention
and early intervention activities for mental health
services, the state can have positive outcomes that improve
student success and have a significant return on
investment."
2) Mental Health Services Act funding for schools and
colleges. In June 2007, the Mental Health Services
Oversight and Accountability 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 from MHSA
Prevention and Early Intervention funds to higher education
institutions and $26 million for K-12 programs for a period
AB 2017 (McCarty) Page 8
of ?
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.
Under the Student Mental Health Initiative (SMHI), the
systemwide offices of the California State University and
University of California were each awarded approximately $7
million for a 3-year grant (which ended in December 2015)
to primarily provide outreach and education activities. In
October 2011, the California Community Colleges
Chancellor's Office (CCCCO) was awarded $7 million by
California Mental Health Services Authority (CalMHSA) to
establish 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.
The Mental Health Services Act (MHSA) Prevention and Early
Intervention funding for SMHI has been primarily used to
support outreach and education activities within the higher
education segments. This bill provides for funding to be
used to support both direct services as well as education
and outreach. This bill appropriates $40 million from MHSA
Prevention and Early Intervention funds, which are
currently used for a variety of programs (not only at
postsecondary education institutions).
3) Student health fee. This bill authorizes matching funds to
include in-kind funds, student health fee funds, among
other sources. The student health fee is voted upon by
students. The author wishes to amend this provision to
require notification of the student association before
using a student health fee. Staff recommends this
amendment be adopted.
4) Author's amendments. The author wishes to amend this bill
to:
AB 2017 (McCarty) Page 9
of ?
a) Add as a preferred program component, evidence of
an existing or planned partnership between the campus
and local safety net providers to ensure linkages to
primary care and community-based mental health care,
regardless of the health insurance status of the
student.
b) Add a requirement that the participating campuses
post the annual report on the use of the funds on the
campus' Web site.
5) Heard by the Senate Health Committee. This bill was heard
by the Senate Health Committee on June 22, where it passed
on an 8-0 vote.
6) Fiscal impact. This bill makes a continuous appropriation
of $40 million. The Assembly version of the 2016 Budget
included this appropriation for the purposes of this bill,
but no funding was included in the final conference
committee report.
According to the Assembly Appropriations Committee, this bill
imposes the following costs:
a) Appropriates $40 million annually from the Mental
Health Services Account to fund the grant program.
b) Staff costs to the Department of Health Care
Services of $240,000 for fiscal year 2016-17, and
$364,000 ongoing for the length of the program (Mental
Health Services Account).
c) The public systems of postsecondary education
note potential difficulty in generating matching
funds.
7) Related legislation. AB 1644 (Bonta) requires the
Department of Public Health (DPH) to establish a four-year
program to support local decisions to provide funding for
early mental health support services, requires DPH to
provide technical assistance to local educational agencies,
AB 2017 (McCarty) Page 10
of ?
and requires DPH to select and support schoolsites to
participate in the program. AB 1644 is scheduled to be
heard by this Committee on June 29.
SB 1113 (Beall) authorizes local educational agencies to enter
into partnerships, as specified, with county mental health
plans for the provision of Early and Periodic Screening,
Diagnosis, and Treatment mental health services, and to
expand the allowable uses of specified mental health funds.
SB 1113 is pending in the Senate Appropriations Committee.
8) Prior legislation. AB 1133 (Achadjian, 2015) established a
four-year pilot program, the School-Based Early Mental
Health Intervention and Prevention Services Support Program
(EMHI Support Program), to provide outreach, free regional
training, and technical assistance for local educational
agencies in providing mental health services at school
sites. AB 1133 was held in the Assembly Appropriations
Committee.
AB 1025 (Thurmond, 2015) required California Department of
Education (CDE) to establish a three-year pilot program in
school districts to encourage inclusive practices that
integrate mental health, special education, and school
climate interventions following a multi-tiered framework.
AB 1025 was held in the Senate Appropriations Committee.
AB 1018 (Cooper, 2015) required the Department of Health Care
Services and CDE to convene a joint taskforce to examine
the delivery of mental health services to children. AB
1018 was held in the Senate Appropriations Committee.
AB 580 (O'Donnell, 2015) required the CDE to develop model
referral protocols for voluntary use by schools to address
the appropriate and timely referral by school staff of
students with mental health concerns. AB 580 was vetoed by
the Governor, whose veto message read:
California does not currently have specific model
referral protocols for addressing student mental
health as outlined by this bill. However, the
California Department of Education recently
received a grant from the federal Department of
Health and Human Services, Substance Abuse and
AB 2017 (McCarty) Page 11
of ?
Mental Health Services Administration to identify
and address critical student and family mental
health needs.
It's premature to impose an additional and overly
prescriptive requirement until the current
efforts are completed and we can strategically
target resources to best address student mental
health.
SUPPORT
Faculty Association of California Community Colleges
Kern Community College District
Los Angeles Community College District
Los Rios Community College District
San Bernardino Community College District
South Orange County Community College District
West Kern Community College District
OPPOSITION
None received.
-- END --