BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2568
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|AUTHOR: |Atkins |
|---------------+-----------------------------------------------|
|VERSION: |February 19, 2016 |
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|HEARING DATE: |June 8, 2016 | | |
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|CONSULTANT: |Scott Bain |
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SUBJECT : Integrated health and human services program
SUMMARY : Authorizes the San Diego County to operate an integrated and
comprehensive health and human services system, upon approval by
the county board of supervisors.
Existing law:
1)Authorizes the Counties of Humboldt County, Mendocino County,
Alameda County, and any additional county or counties, as
determined by the Secretary of California Health and Human
Services, 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. Requires implementation of a
pilot program to occur no later than January 1, 2009 with an
evaluation required to be submitted to the Health and Human
Services Agency prior to July 1, 2008.
2)Authorizes an agency established by San Mateo County to apply
for a waiver of existing state regulations pertaining to
single agency operations and auditing and accounting
requirements that hinder the coordination of human services
provided by that agency.
3)Requires Placer County to implement a program, upon county
approval, for the funding and delivery of services and
benefits through an integrated and comprehensive county health
and human services system.
4)Establishes, under provisions implementing the 2011
Realignment, the Support Services Account. Establishes, within
the Support Services Account, the Protective Services
Subaccount, the Behavioral Health Subaccount, and the County
AB 2568 (Atkins) Page 2 of ?
Intervention Support Services Subaccount.
5)Authorizes, under provisions implementing the 2011
Realignment, each county to reallocate money between
subaccounts in the Support Services Account, provided that the
reallocation may not exceed 10% of the amount deposited in the
immediately preceding fiscal year in the subaccount in the
Support Services Account with the lowest balance.
6)Authorizes, under provisions implementing the 2011
Realignment, any county authorized to operate an integrated
and comprehensive county health and human services system
under the provisions in 1) through 3) above to reallocate
money between the Protective Services Subaccount and the
Behavioral Health Subaccount within the Support Services
Account of the County Local Revenue Fund 2011 without being
subject to the existing 10% limit on transfers in existing
law.
This bill:
1)Authorizes the San Diego County to operate an integrated and
comprehensive health and human services system, upon approval
by the county board of supervisors.
FISCAL
EFFECT : None
PRIOR
VOTES :
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|Assembly Floor: |79 - 0 |
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|Assembly Human Services Committee: | 6 - 0 |
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COMMENTS :
1)Author's statement. According to the author, the County of
San Diego Health and Human Services Agency has a longstanding
local designation as an integrated and comprehensive health
and human services system. In 1996, the San Diego County Board
of Supervisors merged five local organizations into a
super-agency comprised of the former Departments of Health
Services, Social Services, Veteran Services, Area Agency on
AB 2568 (Atkins) Page 3 of ?
Aging, and the Commission on Children Youth and Family. In
1998 the Public Administrator and Public Guardian was also
placed in the Health and Human Services Agency. The Health and
Human Services Agency has authority over a broad array of
services including aging and independence services, behavioral
health, child welfare, public health, and self-sufficiency.
Merging the services into one comprehensive system has enabled
a more streamlined and effective client-focused delivery of
health and social services for almost two decades. State 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 San Diego County to
operate an integrated and comprehensive health and human
services system.
2)Integrated health and human services system and 2011
Realignment. Legislation that enacted 2011 Realignment shifts
over $6 billion in state revenues and funding responsibilities
to local governments. Revenue from realignment comes from
state sales tax and state and local vehicle license fee.
Realignment establishes various accounts, and subaccounts
within those accounts.
One of the realignment accounts is the Support Services Account,
which includes the County Intervention Support Services
Subaccount, the Protective Services Subaccount and the
Behavioral Health Subaccount. Under existing law, counties can
annually reallocate money between subaccounts in the Support
Services Account, except that the reallocation cannot exceed
10% of the amount deposited in the immediately preceding
fiscal year in the subaccount in the Support Services Account
with the lowest balance.
SB 1020 (Committee on Budget and Fiscal Review, Chapter 40,
Statutes of 2012), furthers the implementation of the 2011
Realignment. One of the provisions of SB 1020 allowed any
county authorized to operate an integrated and comprehensive
county health and human services system to reallocate money
between the Protective Services Subaccount and the Behavioral
Health Subaccount without being subject to the 10% limit in
existing law. In 2014-15, San Diego County received over $190
million in revenue in these two accounts.
AB 2568 (Atkins) Page 4 of ?
Programs in the Protective Services Subaccount and the
Behavioral Health Subaccounts are as follows:
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| Protective Services | Behavioral Health |
| Subaccount | Subaccount |
|------------------------+-------------------------|
| Adult protective | Residential perinatal |
| services | drug services and |
| | treatment |
|------------------------+-------------------------|
| Foster care grants and | Drug court operations |
| services | and services |
|------------------------+-------------------------|
|Administrative costs of | Nondrug Medi-Cal |
| foster care services | substance abuse |
| | treatment programs |
|------------------------+-------------------------|
| Child welfare services | Drug Medi-Cal program |
|------------------------+-------------------------|
| Adoptive services | Medi-Cal specialty |
| | mental health services, |
| | including the Early and |
| | Periodic Screening, |
| |Diagnosis, and Treatment |
| | Program and mental |
| | health managed care |
|------------------------+-------------------------|
|Child abuse prevention, | Women and Children's |
| intervention and | Residential Treatment |
| treatment | Services program* |
|------------------------+-------------------------|
|Administrative costs of | |
| family adopting | |
| children with special | |
| needs | |
|------------------------+-------------------------|
| | * From funds in the |
| |Women and Children's |
| |Residential Treatment |
| |Services Special |
| |Account, which is a |
| |subaccount of the |
AB 2568 (Atkins) Page 5 of ?
| |Behavioral Health |
| |Account. |
| | |
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3)Double referral. This bill is double referred. Should this
bill pass out of this committee, it will be referred to the
Senate Human Services Committee.
4)Prior legislation.
a) AB 1846 (Leslie, Chapter 899, Statutes of 1996),
required Placer County to implement a pilot program
similar to the county integrated health and human
services program, and set a sunset date for the pilot
program of July 1, 2001.
b) AB 866 (Thomson, Chapter 265, Statutes of 1997),
required Solano County to implement a pilot program
similar to the county integrated health and human
services program, with a sunset date for the pilot
program of July 1, 2002.
c) AB 1259 (Strom-Martin, Chapter 705, Statutes of
1999), established the county integrated health and human
services program for Humboldt, Mendocino and Alameda
Counties, with a sunset date of January 1, 2005.
d) AB 1881 (Berg, Chapter 655, Statutes of 2004),
extended the county integrated health and human services
program sunset to January 1, 2009, and authorized
additional counties to participate in the program if
approved by the Secretary of Health and Human Services
Agency.
e) AB 315 (Berg, Chapter 264, Statutes of 2007),
eliminated the county integrated health and human
services program repeal date of January 1, 2009
established in AB 1881 (Berg, of 2004).
5)Support. This bill is sponsored by San Diego County, which
argues it has a long-standing designation as an integrated and
comprehensive health and human services system. San Diego
County writes that it approved the merger of multiple
organizations into a single Health and Human Services Agency,
AB 2568 (Atkins) Page 6 of ?
which has authority over a broad array of services, including
aging and independence services, behavioral health services,
child welfare services, public health services and
self-sufficiency services. San Diego County writes that this
bill would allow San Diego County to utilize the benefit of
being recognized as an integrated and comprehensive county
health and human services system as the counties of Humboldt,
Mendocino and Alameda already are.
6)Policy issues.
a) Bill limited to San Diego County. Existing law
authorized any county to establish an integrated and
comprehensive county health and human services system
upon approval of the county board of supervisors.
However, implementation of such a program had to occur
before January 1, 2009, and was subject to conditions,
including an evaluation had to be completed prior to July
1, 2008. In effect, the authority in realignment to
reallocate money between the Protective Services
Subaccount and the Behavioral Health Subaccount above 10%
across accounts is limited to those counties that already
have such a system, and under this bill, San Diego
County. Should the authority in this bill be extended to
other counties?
7)Recommended technical amendment. As drafted, this bill is
contained in a chapter that requires implementation of the
integrated and comprehensive county health and human services
system prior to January 1, 2009, and an evaluation prior to
July 1, 2008. Staff recommends a technical amendment to this
bill that would "notwithstand" the section of law with those
dates.
SUPPORT AND OPPOSITION :
Support: San Diego County (sponsor)
California State Association of Counties
Urban Counties of California
Oppose: None received
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