BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2279


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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          2279 (Cooley)


          As Amended  August 15, 2016


          Majority vote


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          Original Committee Reference:  HEALTH




          SUMMARY:  Requires the Department of Health Care Services (DHCS)  
          to annually compile county revenue and expenditure information  
          related to the Mental Health Services Act (MHSA) based on the  
          existing Annual Mental Health Services Act Revenue and  
          Expenditure Report (Annual MHSA Report) and requires  the  
          information compiled to be made available by DHCS to the Mental  
          Health Services Oversight and Accountability Commission  
          (MHSOAC), and requires the Commission to make the information  
          publicly available online.


          The Senate amendments 


          1)Require DHCS to develop and administer instructions for the  
            compilation of information for the Annual MHSA Report by  








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            counties, in consultation with the MHSOAC and the County  
            Behavioral Health Directors Association of California and  
            require the instructions to include county certification of  
            the accuracy of the report.


          2)Require the Annual MHSA Report to be submitted electronically  
            to DHCS and to the MHSOAC and require DHCS to annually post  
            each county's report on its website in a timely manner.


          3)Specify that the purpose of the Annual MHSA Report is to  
            identify the expenditures of MHSA funds that were distributed  
            to each county, quantify the amount of additional funds  
            generated for the mental health system, and determine  
            reversion amounts, if applicable, from prior fiscal year  
            distributions.


          4)Specify that the intent of the Annual MHSA Report is to  
            provide information that allows for the evaluation of  
            children's systems of care, prevention and early intervention  
            strategies, innovative projects, workforce education and  
            training, adults and older adults systems of care, and capital  
            facilities and technology needs.


          5)Require DHCS, no later than nine months after the end of each  
            fiscal year, based on the Annual MHSA Report, to collect and  
            publicly report, by county level, the total revenue received  
            from MHSA and the amount of MHSA funds received for each  
            individual components of the act, as specified.  Require this  
            information to be reported for each fiscal year, include  
            statewide totals, and to be updated annually.


          6)Permit counties to submit to DHCS information about programs  
            that address homelessness, criminal justice diversion or  
            related programs, suicide prevention, school-based mental  
            health programs designed to reduce school failure, employment  
            or other programs intended to reduce unemployment, and other  
            information as specified. 








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          7)Require DHCS to compile the information collected from  
            counties or other local mental health agencies to promote  
            public understanding of MHSA funds that are distributed  
            statewide and for each county, as well as how those funds are  
            spent and what funds remain available for expenditure.


          8)Require DHCS to consolidate reporting requirements when  
            feasible and to propose to the appropriate policy committees  
            of the Legislature strategies to refine and consolidate  
            reporting requirements. 


          9)Require DHCS to make information related to the Annual MHSA  
            Report available on its internet website no later than July 1,  
            2018.


          10)Permit DHCS to withhold MHSA funds from counties that do not  
            submit the Annual MHSA Report until the reports are submitted.


          FISCAL EFFECT:  According to the Senate Appropriations  
          Committee, ongoing costs of $240,000 per year to compile  
          information submitted by counties, create comparisons of  
          county-by-county expenditures, and develop the required reports  
          by DHCS.


          COMMENTS:  According to the author, counties are required to  
          report information to DHCS annually about local programs,  
          expenditure plans and how MHSA funds were spent.  While some  
          counties make annual reports available to the public on their  
          own Web sites, currently there is no complete state-wide  
          financial picture of how much MHSA revenue is generated  
          annually.  The author argues that the absence of a single  
          repository for this information makes it difficult for  
          taxpayers, mental health advocates, and consumers to see which  
          mental health programs are available and how MHSA funds are  
          spent county-by-county and state-wide.  This information would  








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          make it easier for providers to identify best practices and for  
          consumers to compare services to identify programs that best  
          address their needs. 


          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 2015-16 Governor's  
          Budget projected that $1.776 billion would be deposited into the  
          Mental Health Services Fund in fiscal year (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 Office of Statewide Health  
          Planning and Development (OSHPD).  It also funds evaluation of  
          the MHSA by the Commission, which was established by the MHSA.


          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 and that identifies 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.


          The most recently available MHSA Report discusses expenditures  
          for FY 2015-16 and is available on the DHCS website, but not on  
          the Commission Web site.  The MHSA Report includes an  
          explanation of estimated revenues, general MHSA Fund  
          expenditures to counties in the aggregate and to OSHPD, and a  
          detailed summary of how the funds set aside for program  
          administration were allocated to 14 different state agencies and  
          departments.









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          The National Association of Social Workers - California Chapter  
          supports this legislation because it will increase transparency  
          regarding how MHSA funds are spent.  California Chapter of the  
          American College of Emergency Physicians states that without  
          adequate analysis of the effectiveness of MHSA programs, there  
          is no guarantee that people with mental illness are receiving  
          adequate treatment.  County-by-county comparisons of MHSA  
          program would be an important step toward determining the most  
          effective programs and increasing access to mental health  
          services.  The Steinberg Institute states, in support, that the  
          current lack of timely and accessible reporting does not align  
          with the principles set forth in Proposition 63.


          There is no known opposition to this bill.


          Analysis Prepared by:                                             
                          Paula Villescaz / HEALTH / (916) 319-2097  FN:  
          0004164