BILL ANALYSIS                                                                                                                                                                                                    



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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          2017 (McCarty)


          As Amended  August 19, 2016


          Majority vote


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          |ASSEMBLY:  |77-0  |(June 2, 2016) |SENATE: | 39-0 |(August 23,      |
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          Original Committee Reference:  HEALTH




          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, upon appropriation by the Legislature to the  
            Mental Health Services Oversight and Accountability Commission  
            (MHSOAC), the CMHS Program Grant.


          2)Requires the MHSOAC to create a grant program for public  
            community colleges, colleges, and universities, in  
            collaboration with county behavioral health departments, to  








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            improve access to mental health services and early  
            identification or intervention programs.


          3)Requires the MHSOAC to establish guidelines for grant funding  
            and a request for application (RFA).  Establishes RFA  
            guidelines, as specified. 


          4)Permits CMHS Program 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.  


          5)Requires CMHS Program Grants to be proportional to the number  
            of students served, and cannot exceed more than $5 million per  
            campus, per application. 


          6)Requires CMHS Program Grants to be awarded on competitive  
            bases, only to a campus that can show dollar-for dollar match  
            of funds from the campus. 


          7)Requires the MHSOAC 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 CMHS Program Grant awards.


          8)Requires CMHS Program 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 the CMHS Program Grant.










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          9)Requires the MHSOAC, upon an appropriation of funds, to  
            contract with a public or private research university or  
            institute in this state to evaluate the CMHS Program.   
            Requires the MHSOAC to develop the research design and issue a  
            request for proposal for a contract for the evaluation, with  
            the assistance of the Department of Finance and requires the  
            MHSOAC to develop an evaluation plan to assess the impact of  
            the program.


          10)Requires the MHSOAC to submit the evaluation established in  
            9) above, to the Legislature by February 1, 2019, and annually  
            thereafter by no later than February 1 of each year, and  
            requires that the report be made available to the public and  
            on the MHSOAC Internet Web site.


          11)Establishes legislative findings and declarations related to  
            college mental health services.


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


          The Senate amendments delete the $40 million appropriation to  
          the College Mental Health Services Trust Account and delete the  
          requirement that CalMHSA establish CMHS Program Grant guidelines  
          and instead require DHCS to be the sole administrator of the  
          CMHS Program Grant. 


          FISCAL EFFECT:  According to the Senate Appropriations  
          Committee:


          1)Unknown ongoing costs to provide grant funds to public college  
            campuses (General Fund or other fund source). 


          2)One-time costs of $240,000 and ongoing costs of $365,000 per  
            year for DHCS to provide technical assistance to grantees and  
            to oversee the operation of the program (General Fund).








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          3)Ongoing costs likely between $1 million and $2 million per  
            year CalMHSA to develop grant guidelines, review grant  
            applications, and provide technical assistance to college  
            campuses (General Fund).


          4)Unknown costs to public college campuses to put up matching  
            funds to receive grants under the bill (General Fund or  
            special funds).  The bill would require public college  
            campuses that apply for funding to agree to provide a  
            dollar-for-dollar match or another match.  Depending on the  
            match requirement, and the extent to which colleges could  
            count existing program funds for the match requirement, the  
            bill could impose additional costs on public college campuses.


          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  
          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 1% 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  








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          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     |
          |       |                    |                       |
          |       |                    |                       |
          |       |                    |                       |
          |-------+--------------------+-----------------------|
          |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  








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          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  
          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:   
          0004768













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