BILL ANALYSIS Ó AB 2568 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 2568 (Atkins) As Amended August 17, 2016 Majority vote -------------------------------------------------------------------- |ASSEMBLY: |79-0 |(May 5, 2016) |SENATE: |39-0 |(August 22, | | | | | | |2016) | | | | | | | | | | | | | | | -------------------------------------------------------------------- Original Committee Reference: HUM. S. SUMMARY: Authorizes the County of San Diego to, upon approval of the county board of supervisors and California Health and Human Services Agency, operate an integrated and comprehensive health and human services system, and further, specifies the purview and requirements of this system. The Senate amendments: 1)Authorize the integrated and comprehensive health and human services system to, among other things, both maintain and evaluate a system of administration that integrates and coordinates the management and support of client services, and to maintain a system of reporting and accountability that provides for the combined provision of services without the loss of state or federal funds, as specified. AB 2568 Page 2 2)Delineate a range of health and human services that the system may include but not be limited to. 3)Require the county to comply with all applicable state and federal privacy laws that govern medical and social service information, as specified. 4)Permit programs or services to be included in the system only to the extent that federal funding to either the state or county will not be reduced as a result. 5)Prohibit the provisions of the bill from authorizing the county to: discontinue meeting its obligations under current law to provide services, or reduce its accountability for the provision of these services. 6)Require the county to use any and all state general funds and county funds and to maximize federal matching funds, as specified, and further, prohibit the integration from resulting in increased General Fund expenditures. 7)Authorize the appropriate state departments to waive regulations regarding the provision of services and method of reporting and accountability, with certain exceptions, as specified. 8)Require that a reallocation made by a county between the Protective Services Subaccount and the Behavioral Health Subaccount, as specified, be in effect for only the fiscal year in which that reallocation is made and prohibit the reallocation from being a permanent allocation or permanent funding source for any program or services receiving funds from the reallocation. AB 2568 Page 3 9)Require a county, or city and county, that reallocates funds between the Protective Services Subaccount and the Behavioral Health Subaccount, as specified, to make a report to the Department of Finance and the California Health and Human Services Agency describing the reallocation made for that year. 10)Require a San Diego County integrated and comprehensive health and human services system to be subject to the approval of the California Health and Human Services Agency, as specified. 11)Make technical changes. 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 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; AB 2568 Page 4 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. (WIC 18986.86) 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. 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 AB 2568 Page 5 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." 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 AB 2568 Page 6 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." 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. Analysis Prepared by: Daphne Hunt / HUM. S. / (916) 319-2089 FN: 0004570 AB 2568 Page 7