BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 2568|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
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THIRD READING
Bill No: AB 2568
Author: Atkins (D)
Amended: 8/17/16 in Senate
Vote: 21
SENATE HEALTH COMMITTEE: 7-0, 6/8/16
AYES: Hernandez, Nguyen, Mitchell, Monning, Nielsen, Pan, Roth
NO VOTE RECORDED: Hall, Wolk
SENATE HUMAN SERVICES COMMITTEE: 5-0, 6/28/16
AYES: McGuire, Berryhill, Hancock, Liu, Nguyen
SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/11/16
AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen
ASSEMBLY FLOOR: 79-0, 5/5/16 (Consent) - See last page for
vote
SUBJECT: Integrated health and human services program
SOURCE: San Diego County
DIGEST: This bill authorizes the San Diego County to operate an
integrated and comprehensive health and human services system,
upon approval by the county board of supervisors.
Senate Floor Amendments of 8/17/16 require reallocation on funds
under this bill to be in effect for only the fiscal year in
which the reallocation is made for all counties with an
integrated health and human services system, and require
reporting by San Diego County only if it reallocates funds under
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Page 2
its integrated and comprehensive county health and human and
services system.
ANALYSIS:
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
Intervention Support Services Subaccount.
5) Authorizes, under provisions implementing the 2011
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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 county health and human services system, upon
approval by the county board of supervisors.
2) Permits San Diego County, in providing services through an
integrated system to families and individuals, the system,
among other things, do both of the following:
a) Maintain and evaluate a system of administration that
integrates and coordinates the management and support of
client services.
b) Maintain a system of reporting and accountability that
provides for the combined provision of services without
the loss of state or federal funds provided under current
law.
3) Permits the integrated and comprehensive county health and
human services system to include, but not be limited to, any
or all of the following:
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a) Adoption services.
b) Child abuse prevention services.
c) Child welfare services.
d) Delinquency prevention services.
e) Drug and alcohol services.
f) Mental health services.
g) Eligibility determination.
h) Employment and training services.
i) Foster care services.
j) Health services.
aa) Public health services.
bb) Housing services.
cc) Medically indigent program services.
dd) Veteran's services.
ee) Aging services.
ff) Any other related program as designated by the board
of supervisors.
4) Requires San Diego County to comply with all applicable
state and federal privacy laws that govern medical and social
service information, including, but not limited to, the
Confidentiality of Medical Information Act and the federal
Health Insurance Portability and Accountability Act.
5) Requires the programs or services to be included in the
system only to the extent that federal funding to either the
state or the county will not be reduced as a result of the
inclusion of the services in the project.
6) Prohibits this bill from authorizing a county to discontinue
meeting its obligations under current law to provide services
or to reduce its accountability for the provision of these
services.
7) Requires the county to utilize any and all state general
funds and county funds that it is legally allocated or
entitled to receive. Requires the county, through the
creation of integrated health and social services structures,
to maximize federal matching funds, and prohibits the
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integration from resulting in increased expenditures from the
General Fund.
8) Requires the appropriate state departments, as designated by
the Secretary of Health and Human Services, that are
assisting, participating, and cooperating in the integrated
system to have the authority to waive regulations, with the
concurrence of the county, regarding the method of providing
services and the method of reporting and accountability, as
may be required to meet the goals set forth in this bill.
9) Prohibits departments from waiving regulations pertaining to
privacy and confidentiality of records, civil service merit
systems, or collective bargaining, and prohibits departments
from waiving regulations if the waiver results in a
diminished amount or level of services or benefits to
eligible recipients as compared to the benefits and services
that would have been provided to recipients absent the
waiver.
10)Requires San Diego County's integrated and comprehensive
county health and human services system to be subject to the
approval of the California Health and Human Services Agency.
Requires the Agency to grant approval if San Diego County
furnishes a certified copy of a current ordinance or
resolution authorizing an integrated and comprehensive health
and human services system in that county.
11)Requires any reallocation of funds made by a county with an
integrated and comprehensive health and human service systems
under 2011 Realignment to be in effect only for the fiscal
year in which the reallocation is made. This provision
applies to counties generally and is not limited to San Diego
County.
12)Prohibits the reallocation under 11) above from being either
a permanent allocation or a permanent funding source for any
program or service receiving funds from the reallocation.
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13)Requires counties or cities and counties that reallocate
funds to make an annual report to the Department of Finance
and the Secretary of the Health and Human Services Agency
describing the reallocation made for that fiscal year.
Comments
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 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 authorizes San
Diego County to operate an integrated and comprehensive health
and human services system.
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
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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.
Programs in the Protective Services Subaccount and the
Behavioral Health Subaccounts are as follows:
--------------------------------------------------
| 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 |
|------------------------+-------------------------|
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|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 |
| |Behavioral Health |
| |Account. |
| | |
--------------------------------------------------
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee:
1)No significant fiscal impact to any state department is
anticipated. This bill authorizes state agencies that interact
with the integrated program authorized in this bill to waive
state regulations as needed to allow the San Diego to operate
an integrated system. Any costs to do so by impacted state
agencies are anticipated to be minor.
2)No state fiscal impact is anticipated due to potential changes
to realignment funding within San Diego County. Under current
law, counties have the authority to move up to 10% of funds in
their Support Services Account between the various
subaccounts. Current law allows counties that operate a joint
health and human services system to move unlimited amounts of
funding between the subaccounts. Because the overall amount of
realignment funding to San Diego County would not change under
this bill, there is no state fiscal impact from this change.
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SUPPORT: (Verified8/11/16)
San Diego County (source)
California State Association of Counties
Urban Counties of California
OPPOSITION: (Verified8/11/16)
None received
ARGUMENTS IN 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,
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 allows 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.
ASSEMBLY FLOOR: 79-0, 5/5/16
AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker,
Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke,
Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley,
Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier,
Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson,
Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger
Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey,
Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes,
McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte,
O'Donnell, Olsen, Patterson, Quirk, Ridley-Thomas, Rodriguez,
Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting,
Wagner, Waldron, Weber, Wilk, Williams, Wood, Rendon
NO VOTE RECORDED: Beth Gaines
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Prepared by:Scott Bain / HEALTH / (916) 651-4111
8/18/16 16:57:28
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