BILL ANALYSIS Ó AB 2279 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 2279 (Cooley) As Amended August 15, 2016 Majority vote -------------------------------------------------------------------- |ASSEMBLY: | 80-0 |(May 31, 2016) |SENATE: |39-0 |(August 17, | | | | | | |2016) | | | | | | | | | | | | | | | -------------------------------------------------------------------- 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 AB 2279 Page 2 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. AB 2279 Page 3 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 AB 2279 Page 4 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. AB 2279 Page 5 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