BILL ANALYSIS Ó
AB 2568
Page 1
Date of Hearing: April 26, 2016
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Susan Bonilla, Chair
AB 2568
(Atkins) - As Introduced February 19, 2016
SUBJECT: Integrated health and human services program
SUMMARY: Authorizes the County of San Diego to, upon approval
of the county board of supervisors, operate an integrated and
comprehensive health and human services system.
EXISTING LAW:
1)Permits Humboldt County, Mendocino County, Alameda County, and
any additional county or counties, as determined by the
Secretary of the California Health and Human Services Agency,
as specified, to implement a program, upon approval of the
county board of supervisors, for the funding and delivery of
services and benefits through an integrated and comprehensive
county health and human services system. (WIC 18986.86)
2)Places a number of requirements on participating counties
regarding their county integrated health and human services
programs, including, but not limited to:
a) Observing disclosure and privacy requirements related to
AB 2568
Page 2
medical information, as specified;
b) Including programs or services only to the extent that
federal funding will not be reduced, and/or General Fund
expenditures will not be increased, as a result;
c) Seeking federal approval of the program as may be needed
to ensure funding and allow for the integrated provision of
services, as specified; and
d) Utilizing any and all state general and county funds
that the county is legally allocated or entitled to receive
and further, maximizing federal matching funds.
FISCAL EFFECT: Unknown.
COMMENTS:
County integrated health and human services programs: In 1996
and 1997, respectively, California authorized Placer and Solano
Counties to operate integrated health and human services pilot
projects via AB 1846 (Leslie), Chapter 899, Statutes of 1996,
and AB 866 (Thomson), Chapter 265, Statutes of 1997. A similar
program was adopted for Humboldt, Mendocino, and Alameda
counties in 1999 by AB 1259 (Strom-Martin), Chapter 705,
Statutes of 1999. Subsequent legislation extended the sunset
date (AB 1881 (Berg), Chapter 655, Statutes of 2004) and later
made the programs permanent by repealing the sunset (AB 315
(Berg), Chapter 264, Statutes of 2007). AB 1881 also allowed
additional counties to be included if approved by the Secretary
of the Health and Human Services Agency.
AB 2568
Page 3
County integrated health and human services programs cover a
wide range of health and human services, including adoption,
child welfare, foster care, drug and alcohol, mental health,
eligibility determination, public health, housing and medically
indigent health care. These programs employ a variety of
assessment and service-delivery methods, including universal
intake, coordinated service plans, and integrated case
management and reporting. These programs enable information to
be shared between programs; however, limitations are placed on
the disclosure of medical information without authorization of
the client, and memoranda of understanding must be developed
between affected agencies.
Regarding AB 315 (Berg), Assembly Member Berg stated that, "by
consolidating such services, counties are able to demonstrate
cost savings and increase efficiency while providing quality
services?. In an era where health and human services are
targeted to be cut, innovation and cost savings are key to
maintaining an adequate level of service to those in need."
San Diego County health and human services: According to the
author's office, the County of San Diego Health and Human
Services Agency has utilized an integrated agency approach to
offering Behavioral Services and Protective Services since 1996,
when the San Diego County Board of Supervisors approved the
merging of five local organizations into a single super-agency
composed of the former Department of Health Services, Department
of Social Services, Department of Veteran Services, Area Agency
on Aging, and the Commission on Children Youth and Family.
According to the author, this Agency has authority over a broad
array of services including those dealing with aging and
independence services, behavioral health, child welfare, public
health, and self-sufficiency services, and, "bringing these many
services together into one comprehensive system has enabled a
more streamlined and effective client-focused delivery of health
and social services in San Diego County for almost two decades."
AB 2568
Page 4
Need for this bill: This bill seeks to officially designate San
Diego County's utilization of an integrated approach to offering
Behavioral Services and Protective Services in order to allow
for greater flexibility between the two accounts.
According to the author, "Existing law authorizes the Counties
of Humboldt, Mendocino and Alameda to implement a program for
the funding and delivery of services and benefits through an
integrated and comprehensive county health and human services
system, subject to certain limitations. [This bill] would
authorize the County of San Diego, upon approval of the County
Board of Supervisors, to operate an integrated and comprehensive
health and human services system."
Staff comments: As currently written, this bill differs from
other statutorily authorized integration efforts by not
including details such as requiring county compliance with
disclosure and privacy requirements related to medical
information, placing a prohibition on the inclusion of programs
that will reduce federal funding or increase General Fund
expenditures, and requiring counties to seek federal approval of
the program, as specified. Part of this difference arguably
results from the fact that the agency in San Diego County
already employs an integrated model, whereas previous efforts
were constructed after enactment. However, should this bill
move forward, the author may wish to consider including San
Diego County in already-existing provisions of law regarding
other counties' integrated health and human services programs,
thereby reducing confusion and, more importantly, avoiding
disparate treatment of various county programs by ensuring that
all programs are held to the same standards and requirements.
AB 2568
Page 5
PRIOR LEGISLATION:
AB 315 (Berg), Chapter 264, Statutes of 2007, eliminated the
January 1, 2009, repeal date for the Humboldt, Mendocino, and
Alameda County integrated health and human services programs.
AB 1881 (Berg), Chapter 655, Statutes of 2004, extended the
sunset for the Humboldt, Mendocino, and Alameda County
integrated health and human services programs to January 1,
2009, and authorized additional counties to participate in the
program if approved by the Secretary of the Health and Human
Services Agency.
AB 1259 (Strom-Martin), Chapter 705, Statutes of 1999,
established the Humboldt, Mendocino, and Alameda County
integrated health and human services programs, with a sunset
date of January 1, 2005.
AB 866 (Thomson), Chapter 265, Statutes of 1997, required Solano
County to implement an integrated health and human services
pilot program, with a sunset date of July 1, 2002.
AB 1846 (Leslie), Chapter 899, Statutes of 1996, required Placer
County to implement an integrated health and human services
pilot program, with a sunset date of July 1, 2001.
REGISTERED SUPPORT / OPPOSITION:
Support
AB 2568
Page 6
County of San Diego - sponsor
Opposition
None on file.
Analysis Prepared by:Daphne Hunt / HUM. S. / (916) 319-2089