Senate BillNo. 804


Introduced by Committee on Health (Senators Hernandez (Chair), Hall, Mitchell, Monning, Nguyen, Nielsen, Pan, Roth, and Wolk)

March 26, 2015


An act to amend Sections 11801, 11830.1, 11835, 103577, 104151, and 128456 of, and to repeal Sections 130316 and 130317 of, the Health and Safety Code, and to amend Sections 4033, 4040, 4095, 4096.5, 5326.95, 5400, 5585.22, 5601, 5611, 5664, 5701.1, 5701.2, 5717, 5750, 5845, 5847, 5848, 5848.5, 5892, 5899, 5902, 11467, 11469, 14021.4, 14124.24, 14251, 14499.71, 14707, 14711, 14717, 14718, 14725, 15204.8, 15847.7, and 17604 of the Welfare and Institutions Code, relating to health.

LEGISLATIVE COUNSEL’S DIGEST

SB 804, as introduced, Committee on Health. Health.

(1) Existing law regulates provision of programs and services relating to mental health and alcohol and drug abuse at the state and local levels and serving various populations. These provisions contain various obsolete references to the California Mental Health Directors Association, the County Alcohol and Drug Program Administrators’ Association of California, and similar entities.

This bill would delete those obsolete references and would refer instead to the County Behavioral Health Directors Association of California, and would make additional conforming changes.

(2) Existing law requires the State Department of Health Care Services to provide, no later than January 10 and concurrently with the May Revision of the annual budget, the fiscal committees of the Legislature with an estimate package for the Every Woman Counts Program for early detection of breast and cervical cancer.

This bill would require the department additionally to provide to the fiscal and appropriate policy committees of the Legislature quarterly updates on caseload, estimated expenditures, and related program monitoring data for the Every Woman Counts Program, as prescribed. The bill would declare the intent of the Legislature that these provisions supersede similar reporting requirements imposed on the State Department of Public Health by specified uncodified legislation.

(3) Existing law, for purposes of Medi-Cal provisions relating to entities that provide payment for certain covered services on behalf of eligible persons, enrollees or subscribers, includes a nonprofit hospital service plan within the descriptions of a fiscal intermediary, a prepaid health plan, and group health coverage.

This bill would delete a nonprofit hospital service plan from inclusion as a fiscal intermediary, prepaid health plan, or group health coverage, under the above circumstances.

(4) Existing law establishes the State Department of Public Health and sets forth its powers and duties, including, but not limited to, duties as State Registrar relating to the uniform administration of provisions relating to vital records and health statistics. Existing law requires the State Registrar, local registrar, or county recorder to, upon request and payment of the required fee, supply to an applicant a certified copy of the record of a birth, fetal death, death, marriage, or marriage dissolution registered with the official. Existing law authorizes the issuance of certain records without payment of the fee.

Existing law, on and after July 1, 2015, requires each local registrar or county recorder to issue, without a fee, a certified record of live birth to any person who can verify his or her status as a homeless person or a homeless child or youth, as defined.

This bill would specify that no issuance or other related fee would be changed under the above circumstances.

(5) Under the Health Insurance Portability and Accountability Implementation Act of 2001, the Office of HIPAA Implementation assumes statewide leadership, coordination, policy formulation, direction, and oversight responsibilities for HIPAA implementation, and exercises full authority relative to state entities to establish policy, provide direction to state entities, monitor progress, and report on implementation efforts. Under existing law, these duties have been assumed by a successor entity, the Office of Health Information Integrity. These provisions become inoperative and are repealed as of June 30, 2016, at which time funds appropriated for purposes of the act that remain unexpended and unencumbered, revert to the General Fund.

This bill would indefinitely extend the act and the operation of the office by deleting the June 30, 2016 repeal date.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

Section 11801 of the Health and Safety Code is
2amended to read:

3

11801.  

The alcohol and drug program administrator, acting
4through administrative channels designated pursuant to Section
511795, shall do all of the following:

6(a) Coordinate and be responsible for the preparation of the
7county contract.

8(b) Ensure compliance with applicable laws relating to
9discrimination against any person because of any characteristic
10listed or defined in Section 11135 of the Government Code.

11(c) Submit an annual report to the board of supervisors reporting
12all activities of the alcohol and other drug program, including a
13financial accounting of expenditures, number of persons served,
14and a forecast of anticipated needs for the upcoming year.

15(d) Be directly responsible for the administration of all alcohol
16or other drug program funds allocated to the county under this
17part, administration of county operated programs, and coordination
18and monitoring of programs that have contracts with the county
19to provide alcohol and other drug services.

20(e) Ensure the evaluation of alcohol and other drug programs,
21including the collection of appropriate and necessary client data
22and program information, pursuant to Chapter 6 (commencing
23with Section 11825).

24(f) Ensure program quality in compliance with appropriate
25standards pursuant to Chapter 7 (commencing with Section 11830).

26(g) Participate and represent the county in meetings of the
27begin delete County Alcohol and Drug Program Administrators’end deletebegin insert County
28Behavioral Health Directorsend insert
Association of California pursuant
29to Section 11811.5 for the purposes of representing the counties
30in their relationship with the state with respect to policies,
P4    1standards, and administration for alcohol and other drug abuse
2services.

3(h) Perform any other acts that may be necessary, desirable, or
4proper to carry out the purposes of this part.

5

SEC. 2.  

Section 11830.1 of the Health and Safety Code is
6amended to read:

7

11830.1.  

In order to ensure quality assurance of alcohol and
8other drug programs and expand the availability of funding
9resources, the department shall implement a program certification
10procedure for alcohol and other drug treatment recovery services.
11The department, after consultation with thebegin delete County Alcohol and
12Drug Program Administratorsend delete
begin insert County Behavioral Health Directorsend insert
13 Association of California, and other interested organizations and
14individuals, shall develop standards and regulations for the alcohol
15and other drug treatment recovery services describing the minimal
16level of service quality required of the service providers to qualify
17for and obtain state certification. The standards shall be excluded
18from the rulemaking requirements of the Administrative Procedure
19Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of
20Division 3 of Title 2 of the Government Code). Compliance with
21these standards shall be voluntary on the part of programs. For the
22purposes of Section 2626.2 of the Unemployment Insurance Code,
23certification shall be equivalent to program review.

24

SEC. 3.  

Section 11835 of the Health and Safety Code is
25amended to read:

26

11835.  

(a) The purposes of any regulations adopted by the
27department shall be to implement, interpret, or make specific the
28provisions of this part and shall not exceed the authority granted
29to the department pursuant to this part. To the extent possible, the
30regulations shall be written in clear and concise language and
31adopted only when necessary to further the purposes of this part.

32(b) Except as provided in this section and Sections 11772,
3311798, 11798.2, 11814, 11817.8, 11852.5, the department may
34adopt regulations in accordance with the rulemaking provisions
35of the Administrative Procedure Act (Chapter 3.5 (commencing
36with Section 11340) of Part 1 of Division 3 of the Title 2 of the
37Government Code) necessary for the proper execution of the
38powers and duties granted to and imposed upon the department
39by this part. However, these regulations may be adopted only upon
40the following conditions:

P5    1(1) Prior to adoption of regulations, the department shall consult
2withbegin delete county alcohol and drug program administratorsend deletebegin insert the County
3Behavioral Health Directors Association of Californiaend insert
and may
4consult with any other appropriate persons relating to the proposed
5regulations.

6(2) If an absolute majority of the designated countybegin delete alcohol and
7drug program administratorsend delete
begin insert behavioral health directorsend insert who
8represent counties that have submitted county contracts, vote at a
9public meeting called by the department, for which 45 days’
10advance notice shall be given by the department, to reject the
11proposed regulations, the department shall refer the matter for a
12decision to a committee, consisting of a representative of the county
13begin delete alcohol and drug program administrators,end deletebegin insert behavioral health
14directors,end insert
the director, the secretary, and one designee of the
15secretary. The decision shall be made by a majority vote of this
16committee at a public meeting convened by the department. Upon
17a majority vote of the committee recommending adoption of the
18proposed regulations, the department may then adopt them. Upon
19a majority vote recommending that the department not adopt the
20proposed regulations, the department shall then consult again with
21thebegin delete county alcohol and drug program administratorsend deletebegin insert County
22Behavioral Health Directors Association of Californiaend insert
and
23resubmit the proposed regulations to the begin deleteadministrators end deletebegin insert county
24behavioral health directors end insert
for a vote pursuant to this subdivision.

25(3) In the voting process described in paragraph (2), no proxies
26shall be allowed nor may anyone other than the designated county
27begin delete alcohol and drug program administrator,end deletebegin insert behavioral health director,end insert
28 director, secretary, and secretary’s designee vote at the meetings.

29

SEC. 4.  

Section 103577 of the Health and Safety Code is
30amended to read:

31

103577.  

(a) On or after July 1, 2015, each local registrar or
32county recorder shall, withoutbegin delete aend deletebegin insert an issuance fee or any other
33associatedend insert
fee, issue a certified record of live birth to any person
34who can verify his or her status as a homeless person or a homeless
35child or youth. A homeless services provider that has knowledge
36of a person’s housing status shall verify a person’s status for the
37purposes of this subdivision. In accordance with all other
38application requirements as set forth in Section 103526, a request
39for a certified record of live birth made pursuant to this subdivision
40shall be made by a homeless person or a homeless child or youth
P6    1on behalf of themselves, or by any person lawfully entitled to
2request a certified record of live birth on behalf of a child, if the
3child has been verified as a homeless person or a homeless child
4or youth pursuant to this section. A person applying for a certified
5record of live birth under this subdivision is entitled to one birth
6record, per application, for each eligible person verified as a
7homeless person or a homeless child or youth. For purposes of this
8subdivision, an affidavit developed pursuant to subdivision (b)
9shall constitute sufficient verification that a person is a homeless
10person or a homeless child or youth. A person applying for a
11certified record of live birth under this subdivision shall not be
12charged a fee for verification of his or her eligibility.

13(b) The State Department of Public Health shall develop an
14affidavit attesting to an applicant’s status as a homeless person or
15homeless child or youth. For purposes of this section, the affidavit
16shall not be deemed complete unless it is signed by both the person
17making a request for a certified record of live birth pursuant to
18subdivision (a) and a homeless services provider that has
19knowledge of the applicant’s housing status.

20(c) Notwithstanding the rulemaking provisions of the
21Administrative Procedure Act (Chapter 3.5 (commencing with
22Section 11340) of Part 1 of Division 3 of Title 2 of the Government
23Code), the department may implement and administer this section
24through an all-county letter or similar instructions from the director
25or State Registrar without taking regulatory action.

26(d) For the purposes of this section, the following definitions
27apply:

28(1) A “homeless child or youth” has the same meaning as the
29definition of “homeless children and youths” as set forth in the
30 federal McKinney-Vento Homeless Assistance Act (42 U.S.C.
31Sec. 11301 et seq.).

32(2) A “homeless person” has the same meaning as the definition
33of that term set forth in the federal McKinney-Vento Homeless
34Assistance Act (42 U.S.C. Sec. 11301 et seq.).

35(3) A “homeless services provider” includes:

36(A) A governmental or nonprofit agency receiving federal, state,
37or county or municipal funding to provide services to a “homeless
38person” or “homeless child or youth,” or that is otherwise
39sanctioned to provide those services by a local homeless continuum
40of care organization.

P7    1(B) An attorney licensed to practice law in this state.

2(C) A local educational agency liaison for homeless children
3andbegin delete youth designated as suchend deletebegin insert youth,end insert pursuant to Section
411432(g)(1)(J)(ii) of Title 42 of the United States Code, or a school
5social worker.

6(D) A human services provider or public social services provider
7funded by the State of California to provide homeless children or
8youth services, health services, mental or behavioral health
9services, substance use disorder services, or public assistance or
10employment services.

11(E) A law enforcement officer designated as a liaison to the
12homeless population by a local police department or sheriff’s
13department within the state.

14

SEC. 5.  

Section 104151 of the Health and Safety Code is
15amended to read:

16

104151.  

begin insert(a)end insertbegin insertend insert Notwithstanding Section 10231.5 of the
17Government Code, each year, by no later than January 10 and
18concurrently with the release of the May Revision, the State
19Department of Health Care Services shall provide the fiscal
20committees of the Legislature with an estimate package for the
21Every Woman Counts Program. This estimate package shall
22include all significant assumptions underlying the estimate for the
23Every Woman Counts Program’s current-year and budget-year
24proposals, and shall contain concise information identifying
25applicable estimate components, such as caseload; a breakout of
26costs, including, but not limited to, clinical service activities,
27including office visits and consults, screening mammograms,
28diagnostic mammograms, diagnostic breast procedures, case
29management, and other clinical services; policy changes; contractor
30information; General Fund, special fund, and federal fund
31information; and other assumptions necessary to support the
32estimate.

begin insert

33(b) Notwithstanding Section 10231.5 of the Government Code,
34each year, the State Department of Health Care Services shall
35provide the fiscal and appropriate policy committees of the
36Legislature with quarterly updates on caseload, estimated
37expenditures, and related program monitoring data for the Every
38Woman Counts Program. These updates shall be provided no later
39than November 30, February 28, May 31, and August 31 of each
40year. The purpose of the updates is to provide the Legislature with
P8    1the most recent information on the program, and shall include a
2breakdown of expenditures for each quarter for clinical service
3activities, including, but not limited to, office visits and consults,
4screening mammograms, diagnostic mammograms, diagnostic
5breast procedures, case management, and other clinical services.
6This subdivision supersedes the requirements of Section 169 of
7Chapter 717 of the Statutes of 2010 (S.B. 853).

end insert
8

SEC. 6.  

Section 128456 of the Health and Safety Code is
9amended to read:

10

128456.  

In developing the program established pursuant to this
11article, the Health Professions Education Foundation shall solicit
12the advice of representatives of the Board of Behavioral Sciences,
13the Board of Psychology, the State Department of Health Care
14Services, thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors
15Associationbegin insert of Californiaend insert, the California Mental Health Planning
16Council, professional mental health care organizations, the
17California Healthcare Association, the Chancellor of the California
18Community Colleges, and the Chancellor of the California State
19University. The foundation shall solicit the advice of
20representatives who reflect the demographic, cultural, and linguistic
21diversity of the state.

22

SEC. 7.  

Section 130316 of the Health and Safety Code is
23repealed.

begin delete
24

130316.  

Any funds appropriated for the purpose of this division
25that remain unexpended or unencumbered on June 30, 2016, shall
26revert to the General Fund on that date unless a statute that is
27enacted before June 30, 2016, extends the provisions of this
28division.

end delete
29

SEC. 8.  

Section 130317 of the Health and Safety Code is
30repealed.

begin delete
31

130317.  

This division shall become inoperative on June 30,
322016, and as of that date is repealed, unless a later enacted statute,
33that is enacted before June 30, 2016, deletes or extends the dates
34on which it becomes inoperative and is repealed.

end delete
35

SEC. 9.  

Section 4033 of the Welfare and Institutions Code is
36amended to read:

37

4033.  

(a) The State Department of Health Care Services shall,
38to the extent resources are available, comply with the Substance
39Abuse and Mental Health Services Administration federal planning
40requirements. The department shall update and issue a state plan,
P9    1which may also be any federally required state service plan, so
2that citizens may be informed regarding the implementation of,
3and long-range goals for, programs to serve mentally ill persons
4in the state. The department shall gather information from counties
5necessary to comply with this section.

6(b) (1) If the State Department of Health Care Services makes
7a decision not to comply with any Substance Abuse and Mental
8Health Services Administration federal planning requirement to
9which this section applies, the State Department of Health Care
10Services shall submit the decision, for consultation, to the
11begin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors Association
12begin insert of Californiaend insert, the California Mental Health Planning Council, and
13affected mental health entities.

14(2) The State Department of Health Care Services shall not
15implement any decision not to comply with the Substance Abuse
16and Mental Health Services Administration federal planning
17requirements sooner than 30 days after notification of that decision,
18in writing, by the Department of Finance, to the chairperson of the
19committee in each house of the Legislaturebegin delete whichend deletebegin insert thatend insert considers
20appropriations, and the Chairperson of the Joint Legislative Budget
21Committee.

22

SEC. 10.  

Section 4040 of the Welfare and Institutions Code is
23amended to read:

24

4040.  

The State Department of Health Care Services or State
25Department of State Hospitals may conduct, or contract for,
26research or evaluation studies that have application to mental health
27policy and management issues. In selecting areas for study the
28department shall be guided by the information needs of state and
29local policymakers and managers, and suggestions from the
30begin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors Association
31of California.

32

SEC. 11.  

Section 4095 of the Welfare and Institutions Code is
33amended to read:

34

4095.  

(a) It is the intent of the Legislature that essential and
35culturally relevant mental health assessment, case management,
36and treatment services be available to wards of the court and
37dependent children of the court placed out of home or who are at
38risk of requiring out-of-home care. This can be best achieved at
39the community level through the active collaboration of county
P10   1social service, probation, education, mental health agencies, and
2foster care providers.

3(b) Therefore, using the Children’s Mental Health Services Act
4(Part 4 (commencing with Section 5850) of Division 5) as a
5guideline, the State Department of Health Care Services, in
6consultation with thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
7Directors Associationbegin insert of Californiaend insert, the State Department of Social
8Services, the County Welfare Directors Association, the Chief
9Probation Officers of California, begin delete county alcohol and drug program
10administrators,end delete
and foster care providers, shall do all of the
11following:

12(1) By July 1, 1994, develop an individualized mental health
13treatment needs assessment protocol for wards of the court and
14dependent children of the court.

15(2) Define supplemental services to be made available to the
16target population, including, but not limited to, services defined
17in Section 540 and following of Title 9 of the California Code of
18Regulations as of January 1, 1994, family therapy, prevocational
19services, and crisis support activities.

20(3) Establish statewide standardized rates for the various types
21of services defined by the department in accordance with paragraph
22(2), and provided pursuant to this section. The rates shall be
23designed to reduce the impact of competition for scarce treatment
24 resources on the cost and availability of care. The rates shall be
25implemented only when the state provides funding for the services
26described in this section.

27(4) By January 1, 1994, to the extent state funds are available
28to implement this section, establish, by regulation, all of the
29following:

30(A) Definitions of priority ranking of subsets of the court wards
31and dependents target population.

32(B) A procedure to certify the mental health programs.

33(c) (1) Only those individuals within the target population as
34defined in regulation and determined to be eligible for services as
35a result of a mental health treatment needs assessment may receive
36services pursuant to this section.

37(2) Allocation of funds appropriated for the purposes of this
38section shall be based on the number of wards and dependents and
39may be adjusted in subsequent fiscal years to reflect costs.

P11   1(3) The counties shall be held harmless for failure to provide
2any assessment, case management, and treatment services to those
3children identified in need of services for whom there is no funding.

4(d) (1) The State Department of Health Care Services shall
5make information available to the Legislature, on request, on the
6service populations provided mental health treatment services
7pursuant to this section, the types and costs of services provided,
8and the number of children identified in need of treatment services
9who did not receive the services.

10(2) The information required by paragraph (1) may include
11information on need, cost, and service impact experience from the
12following:

13(A) Family preservation pilot programs.

14(B) Pilot programs implemented under the former Children’s
15Mental Health Services Act, as contained in Chapter 6.8
16(commencing with Section 5565.10) of Part 1 of Division 5.

17(C) Programs implemented under Chapter 26 (commencing
18with Section 7570) of Division 7 of Title 1 of the Government
19Code and Section 11401.

20(D) County experience in the implementation of Section 4096.

21

SEC. 12.  

Section 4096.5 of the Welfare and Institutions Code
22 is amended to read:

23

4096.5.  

(a) The State Department of Health Care Services
24shall make a determination, within 45 days of receiving a request
25from a group home to be classified at RCL 13 or RCL 14 pursuant
26to Section 11462.01, to certify or deny certification that the group
27home program includes provisions for mental health treatment
28services that meet the needs of seriously emotionally disturbed
29children. The department shall issue each certification for a period
30of one year and shall specify the effective date the program met
31the certification requirements. A program may be recertified if the
32program continues to meet the criteria for certification.

33(b) The State Department of Health Care Services shall, in
34consultation withbegin delete the California Mentalend deletebegin insert County Behavioralend insert Health
35Directors Associationbegin insert of Californiaend insert and representatives of provider
36organizations, develop the criteria for the certification required by
37subdivision (a) by July 1, 1992.

38(c) (1) The State Department of Health Care Services may,
39upon the request of a county, delegate to that county the
40certification task.

P12   1(2) Any county to which the certification task is delegated
2pursuant to paragraph (1) shall use the criteria and format
3developed by the department.

4(d) The State Department of Health Care Services or delegated
5county shall notify the State Department of Social Services
6Community Care Licensing Division immediately upon the
7 termination of any certification issued in accordance with
8subdivision (a).

9(e) Upon receipt of notification from the State Department of
10Social Services Community Care Licensing Division of any adverse
11licensing action taken after the finding of noncompliance during
12an inspection conducted pursuant to Section 1538.7 of the Health
13and Safety Code, the State Department of Health Care Services or
14the delegated county shall review the certification issued pursuant
15to this section.

16

SEC. 13.  

Section 5326.95 of the Welfare and Institutions Code
17 is amended to read:

18

5326.95.  

The Director of State Hospitals shall adopt regulations
19to carry out the provisions of this chapter, including standards
20defining excessive use of convulsive treatment which shall be
21developed in consultation with the State Department of Health
22Care Services and thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
23Directors Associationbegin insert of Californiaend insert.

24

SEC. 14.  

Section 5400 of the Welfare and Institutions Code is
25amended to read:

26

5400.  

(a) The Director of Health Care Services shall administer
27this part and shall adopt rules, regulations, and standards as
28necessary. In developing rules, regulations, and standards, the
29Director of Health Care Services shall consult with thebegin delete California
30Mentalend delete
begin insert County Behavioralend insert Health Directorsbegin delete Association,end delete
31begin insert Association of California,end insert the California Mental Health Planning
32Council, and the office of the Attorney General. Adoption of these
33standards, rules, and regulations shall require approval by the
34begin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors Association
35begin insert of Californiaend insert by majority vote of those present at an official
36session.

37(b) Wherever feasible and appropriate, rules, regulations, and
38standards adopted under this part shall correspond to comparable
39rules, regulations, and standards adopted under the
40Bronzan-McCorquodale Act. These corresponding rules,
P13   1regulations, and standards shall include qualifications for
2professional personnel.

3(c) Regulations adopted pursuant to this part may provide
4standards for services for persons with chronic alcoholism that
5differ from the standards for services for persons with mental health
6disorders.

7

SEC. 15.  

Section 5585.22 of the Welfare and Institutions Code
8 is amended to read:

9

5585.22.  

The Director of Health Care Services, in consultation
10with thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors
11Associationbegin insert of Californiaend insert, may develop the appropriate educational
12materials and a training curriculum, and may provide training as
13necessary to ensure that those persons providing services pursuant
14to this part fully understand its purpose.

15

SEC. 16.  

Section 5601 of the Welfare and Institutions Code is
16amended to read:

17

5601.  

As used in this part:

18(a) “Governing body” means the county board of supervisors
19or boards of supervisors in the case of counties acting jointly; and
20in the case of a city, the city council or city councils acting jointly.

21(b) “Conference” means thebegin delete California Mentalend deletebegin insert County
22Behavioralend insert
Health Directors Associationbegin insert of Californiaend insert as
23established under former Section 5757.

24(c)  Unless the context requires otherwise, “to the extent
25resources are available” means to the extent that funds deposited
26in the mental health account of the local health and welfare fund
27are available to an entity qualified to use those funds.

28(d) “Part 1” refers to the Lanterman-Petris-Short Act (Part 1
29(commencing with Section 5000)).

30(e) “Director of Health Care Services” or “director” means the
31Director of the State Department of Health Care Services.

32(f) “Institution” includes a general acute care hospital, a state
33hospital, a psychiatric hospital, a psychiatric health facility, a
34skilled nursing facility, including an institution for mental disease
35as described in Chapter 1 (commencing with Section 5900) of Part
365, an intermediate care facility, a community care facility or other
37residential treatment facility, or a juvenile or criminal justice
38institution.

39(g) “Mental health service” means any service directed toward
40early intervention in, or alleviation or prevention of, mental
P14   1disorder, including, but not limited to, diagnosis, evaluation,
2treatment, personal care, day care, respite care, special living
3arrangements, community skill training, sheltered employment,
4socialization, case management, transportation, information,
5referral, consultation, and community services.

6

SEC. 17.  

Section 5611 of the Welfare and Institutions Code is
7amended to read:

8

5611.  

(a) The Director of Mental Health shall establish a
9Performance Outcome Committee, to be comprised of
10representatives from the PL 99-660 Planning Council and the
11begin deleteCalifornia Conference of Local Mental Health Directors.end deletebegin insert County
12Behavioral Health Directors Association of California.end insert
Any costs
13associated with the performance of the duties of the committee
14shall be absorbed within the resources of the participants.

15(b) Major mental health professional organizations representing
16licensed clinicians may participate as members of the committee
17at their own expense.

18(c) The committee may seek private funding for costs associated
19with the performance of its duties.

20

SEC. 18.  

Section 5664 of the Welfare and Institutions Code is
21amended to read:

22

5664.  

In consultation with thebegin delete California Mentalend deletebegin insert County
23Behavioralend insert
Health Directors Associationbegin insert of Californiaend insert, the State
24Department of Health Care Services, the Mental Health Services
25Oversight and Accountability Commission, the California Mental
26Health Planning Council, and the California Health and Human
27Services Agency, county mental health systems shall provide
28reports and data to meet the information needs of the state, as
29necessary.

30

SEC. 19.  

Section 5701.1 of the Welfare and Institutions Code
31 is amended to read:

32

5701.1.  

Notwithstanding Section 5701, the State Department
33of Health Care Services, in consultation with thebegin delete California Mentalend delete
34begin insert County Behavioralend insert Health Directors Associationbegin insert of Californiaend insert and
35the California Mental Health Planning Council, may utilize funding
36from the Substance Abuse and Mental Health Services
37Administration Block Grant, awarded to the State Department of
38Health Care Services, above the funding level provided in federal
39fiscal year 1998, for the development of innovative programs for
40identified target populations, upon appropriation by the Legislature.

P15   1

SEC. 20.  

Section 5701.2 of the Welfare and Institutions Code
2 is amended to read:

3

5701.2.  

(a) The State Department of Mental Health, or its
4successor, the State Department of State Hospitals, shall maintain
5records of any transfer of funds or state hospital beds made
6pursuant to Chapter 1341 of the Statutes of 1991.

7(b) Commencing with the 1991-92 fiscal year, the State
8Department of Mental Health, or its successor, the State
9Department of State Hospitals, shall maintain records that set forth
10that portion of each county’s allocation of state mental health
11moneys that represent the dollar equivalent attributed to each
12county’s state hospital beds or bed days, or both, that were
13allocated as of May 1, 1991. The State Department of Mental
14Health, or its successor, the State Department of State Hospitals,
15shall provide a written summary of these records to the appropriate
16committees of the Legislature and thebegin delete California Mentalend deletebegin insert County
17Behavioralend insert
Health Directors Associationbegin insert of Californiaend insert within 30
18days after the enactment of the annual Budget Act.

19(c) Nothing in this section is intended to change the counties’
20base allocations as provided in subdivisions (a) and (b) of Section
2117601.

22

SEC. 21.  

Section 5717 of the Welfare and Institutions Code is
23amended to read:

24

5717.  

(a) Expenditures that may be funded from amounts
25allocated to the county by the State Department of Health Care
26Services from funds appropriated to the department shall include,
27salaries of personnel, approved facilities and services provided
28through contract, and operation, maintenance, and service costs,
29including insurance costs or departmental charges for participation
30in a county self-insurance program if the charges are not in excess
31of comparable available commercial insurance premiums and on
32the condition that any surplus reserves be used to reduce future
33year contributions; depreciation of county facilities as established
34in the state’s uniform accounting manual, disregarding depreciation
35on the facility to the extent it was financed by state funds under
36this part; lease of facilities where there is no intention to, nor option
37to, purchase; expenses incurred under this act by members of the
38begin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors Association
39begin insert of Californiaend insert for attendance at regular meetings of these
40conferences; expenses incurred by either the chairperson or elected
P16   1representative of the local mental health advisory boards for
2attendance at regular meetings of the Organization of Mental Health
3Advisory Boards; expenditures included in approved countywide
4cost allocation plans submitted in accordance with the Controller’s
5guidelines, including, but not limited to, adjustments of prior year
6estimated general county overhead to actual costs, but excluding
7allowable costs otherwise compensated by state funding; net costs
8 of conservatorship investigation, approved by the Director of
9Health Care Services. Except for expenditures made pursuant to
10Article 6 (commencing with Section 129225) of Chapter 1 of Part
116 of Division 107 of the Health and Safety Code, it shall not include
12expenditures for initial capital improvements; the purchaser or
13construction of buildings except for equipment items and
14remodeling expense as may be provided for in regulations of the
15State Department of Health Care Services; compensation to
16members of a local mental health advisory board, except actual
17and necessary expenses incurred in the performance of official
18duties that may include travel, lodging, and meals while on official
19business; or expenditures for a purpose for which state
20reimbursement is claimed under any other provision of law.

21(b) The Director of Health Care Services may make
22investigations and audits of expenditures the director may deem
23necessary.

24(c) With respect to funds allocated to a county by the State
25Department of Health Care Services from funds appropriated to
26the department, the county shall repay to the state amounts found
27not to have been expended in accordance with the requirements
28set forth in this part. Repayment shall be within 30 days after it is
29determined that an expenditure has been made that is not in
30accordance with the requirements. In the event that repayment is
31not made in a timely manner, the department shall offset any
32amount improperly expended against the amount of any current
33or future advance payment or cost report settlement from the state
34for mental health services. Repayment provisions shall not apply
35to Short-Doyle funds allocated by the department for fiscal years
36up to and including the 1990-91 fiscal year.

37

SEC. 22.  

Section 5750 of the Welfare and Institutions Code is
38amended to read:

39

5750.  

The State Department of Health Care Services shall
40administer this part and shall adopt standards for the approval of
P17   1mental health services, and rules and regulations necessary thereto.
2However, these standards, rules, and regulations shall be adopted
3only after consultation with thebegin delete California Mentalend deletebegin insert County
4Behavioralend insert
Health Directors Associationbegin insert of Californiaend insert and the
5California Mental Health Planning Council.

6

SEC. 23.  

Section 5845 of the Welfare and Institutions Code is
7amended to read:

8

5845.  

(a) The Mental Health Services Oversight and
9Accountability Commission is hereby established to oversee Part
103 (commencing with Section 5800), the Adult and Older Adult
11Mental Health System of Care Act; Part 3.1 (commencing with
12Section 5820), Human Resources, Education, and Training
13Programs; Part 3.2 (commencing with Section 5830), Innovative
14Programs; Part 3.6 (commencing with Section 5840), Prevention
15and Early Intervention Programs; and Part 4 (commencing with
16Section 5850), the Children’s Mental Health Services Act. The
17commission shall replace the advisory committee established
18pursuant to Section 5814. The commission shall consist of 16
19voting members as follows:

20(1) The Attorney General or his or her designee.

21(2) The Superintendent of Public Instruction or his or her
22designee.

23(3) The Chairperson of the Senate Health and Human Services
24Committee or another member of the Senate selected by the
25President pro Tempore of the Senate.

26(4) The Chairperson of the Assembly Health Committee or
27another member of the Assembly selected by the Speaker of the
28Assembly.

29(5) Two persons with a severe mental illness, a family member
30of an adult or senior with a severe mental illness, a family member
31of a child who has or has had a severe mental illness, a physician
32specializing in alcohol and drug treatment, a mental health
33professional, a county sheriff, a superintendent of a school district,
34a representative of a labor organization, a representative of an
35employer with less than 500 employees and a representative of an
36employer with more than 500 employees, and a representative of
37a health care services plan or insurer, all appointed by the
38Governor. In making appointments, the Governor shall seek
39individuals who have had personal or family experience with
40mental illness.

P18   1(b) Members shall serve without compensation, but shall be
2reimbursed for all actual and necessary expenses incurred in the
3performance of their duties.

4(c) The term of each member shall be three years, to be
5staggered so that approximately one-third of the appointments
6expire in each year.

7(d) In carrying out its duties and responsibilities, the commission
8may do all of the following:

9(1) Meet at least once each quarter at any time and location
10convenient to the public as it may deem appropriate. All meetings
11of the commission shall be open to the public.

12(2) Within the limit of funds allocated for these purposes,
13pursuant to the laws and regulations governing state civil service,
14employ staff, including any clerical, legal, and technical assistance
15as may appear necessary. The commission shall administer its
16operations separate and apart from the State Department of Health
17Care Services and the California Health and Human Services
18Agency.

19(3) Establish technical advisory committeesbegin insert,end insert such as a committee
20of consumers and family members.

21(4) Employ all other appropriate strategies necessary or
22convenient to enable it to fully and adequately perform its duties
23and exercise the powers expressly granted, notwithstanding any
24authority expressly granted to any officer or employee of state
25government.

26(5) Enter into contracts.

27(6) Obtain data and information from the State Department of
28Health Care Services, the Office of Statewide Health Planning and
29Development, or other state or local entities that receive Mental
30Health Services Act funds, for the commission to utilize in its
31oversight, review, training and technical assistance, accountability,
32and evaluation capacity regarding projects and programs supported
33with Mental Health Services Act funds.

34(7) Participate in the joint state-county decisionmaking process,
35as contained in Section 4061, for training, technical assistance,
36and regulatory resources to meet the mission and goals of the
37state’s mental health system.

38(8) Develop strategies to overcome stigma and discrimination,
39and accomplish all other objectives of Part 3.2 (commencing with
P19   1Section 5830), 3.6 (commencing with Section 5840), and the other
2provisions of the act establishing this commission.

3(9) At any time, advise the Governor or the Legislature regarding
4actions the state may take to improve care and services for people
5with mental illness.

6(10) If the commission identifies a critical issue related to the
7performance of a county mental health program, it may refer the
8issue to the State Department of Health Care Services pursuant to
9Section 5655.

10(11) Assist in providing technical assistance to accomplish the
11purposes of the Mental Health Services Act, Part 3 (commencing
12with Section 5800), and Part 4 (commencing with Section 5850)
13in collaboration with the State Department of Health Care Services
14and in consultation with thebegin delete California Mentalend deletebegin insert County Behavioralend insert
15 Health Directorsbegin delete Association.end deletebegin insert Association of California.end insert

16(12) Work in collaboration with the State Department of Health
17Care Services and the California Mental Health Planning Council,
18and in consultation with thebegin delete California Mentalend deletebegin insert County Behavioralend insert
19 Health Directors Associationbegin insert of Californiaend insert, in designing a
20comprehensive joint plan for a coordinated evaluation of client
21outcomes in the community-based mental health system, including,
22but not limited to, parts listed in subdivision (a). The California
23Health and Human Services Agency shall lead this comprehensive
24joint plan effort.

25

SEC. 24.  

Section 5847 of the Welfare and Institutions Code is
26amended to read:

27

5847.  

Integrated Plans for Prevention, Innovation, and System
28of Care Services.

29(a) Each county mental health program shall prepare and submit
30a three-year program and expenditure plan, and annual updates,
31adopted by the county board of supervisors, to the Mental Health
32Services Oversight and Accountability Commission within 30 days
33after adoption.

34(b) The three-year program and expenditure plan shall be based
35on available unspent funds and estimated revenue allocations
36provided by the state and in accordance with established
37stakeholder engagement and planning requirements as required in
38Section 5848. The three-year program and expenditure plan and
39annual updates shall include all of the following:

P20   1(1) A program for prevention and early intervention in
2accordance with Part 3.6 (commencing with Section 5840).

3(2) A program for services to children in accordance with Part
44 (commencing with Section 5850), to include a program pursuant
5to Chapter 4 (commencing with Section 18250) of Part 6 of
6Division 9 or provide substantial evidence that it is not feasible to
7establish a wraparound program in that county.

8(3) A program for services to adults and seniors in accordance
9with Part 3 (commencing with Section 5800).

10(4) A program for innovations in accordance with Part 3.2
11(commencing with Section 5830).

12(5) A program for technological needs and capital facilities
13needed to provide services pursuant to Part 3 (commencing with
14Section 5800), Part 3.6 (commencing with Section 5840), and Part
154 (commencing with Section 5850). All plans for proposed facilities
16with restrictive settings shall demonstrate that the needs of the
17people to be served cannot be met in a less restrictive or more
18integrated setting.

19(6) Identification of shortages in personnel to provide services
20pursuant to the above programs and the additional assistance
21needed from the education and training programs established
22pursuant to Part 3.1 (commencing with Section 5820).

23(7) Establishment and maintenance of a prudent reserve to
24ensure the county program will continue to be able to serve
25children, adults, and seniors that it is currently serving pursuant
26to Part 3 (commencing with Section 5800), the Adult and Older
27Adult Mental Health System of Care Act, Part 3.6 (commencing
28with Section 5840), Prevention and Early Intervention Programs,
29and Part 4 (commencing with Section 5850), the Children’s Mental
30Health Services Act, during years in which revenues for the Mental
31Health Services Fund are below recent averages adjusted by
32changes in the state population and the California Consumer Price
33Index.

34(8) Certification by the county mental health director, which
35ensures that the county has complied with all pertinent regulations,
36laws, and statutes of the Mental Health Services Act, including
37stakeholder participation and nonsupplantation requirements.

38(9) Certification by the county mental health director and by
39the county auditor-controller that the county has complied with
40any fiscal accountability requirements as directed by the State
P21   1Department of Health Care Services, and that all expenditures are
2consistent with the requirements of the Mental Health Services
3Act.

4(c) The programs established pursuant to paragraphs (2) and
5(3) of subdivision (b) shall include services to address the needs
6of transition age youth ages 16 to 25. In implementing this
7subdivision, county mental health programs shall consider the
8needs of transition age foster youth.

9(d) Each year, the State Department of Health Care Services
10shall inform thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
11Directors Associationbegin insert of Californiaend insert and the Mental Health Services
12Oversight and Accountability Commission of the methodology
13used for revenue allocation to the counties.

14(e) Each county mental health program shall prepare expenditure
15plans pursuant to Part 3 (commencing with Section 5800) for adults
16and seniors, Part 3.2 (commencing with Section 5830) for
17innovative programs, Part 3.6 (commencing with Section 5840)
18for prevention and early intervention programs, and Part 4
19(commencing with Section 5850) for services for children, and
20updates to the plans developed pursuant to this section. Each
21expenditure update shall indicate the number of children, adults,
22and seniors to be served pursuant to Part 3 (commencing with
23Section 5800), and Part 4 (commencing with Section 5850), and
24the cost per person. The expenditure update shall include utilization
25of unspent funds allocated in the previous year and the proposed
26expenditure for the same purpose.

27(f) A county mental health program shall include an allocation
28of funds from a reserve established pursuant to paragraph (7) of
29subdivision (b) for services pursuant to paragraphs (2) and (3) of
30subdivision (b) in years in which the allocation of funds for services
31pursuant to subdivision (e) are not adequate to continue to serve
32the same number of individuals as the county had been serving in
33the previous fiscal year.

34

SEC. 25.  

Section 5848 of the Welfare and Institutions Code is
35amended to read:

36

5848.  

(a) Each three-year program and expenditure plan and
37update shall be developed with local stakeholders, including adults
38and seniors with severe mental illness, families of children, adults,
39and seniors with severe mental illness, providers of services, law
40enforcement agencies, education, social services agencies, veterans,
P22   1representatives from veterans organizations, providers of alcohol
2and drug services, health care organizations, and other important
3interests. Counties shall demonstrate a partnership with constituents
4and stakeholders throughout the process that includes meaningful
5stakeholder involvement on mental health policy, program
6planning, and implementation, monitoring, quality improvement,
7evaluation, and budget allocations. A draft plan and update shall
8be prepared and circulated for review and comment for at least 30
9days to representatives of stakeholder interests and any interested
10party who has requested a copy of the draft plans.

11(b) The mental health board established pursuant to Section
125604 shall conduct a public hearing on the draft three-year program
13and expenditure plan and annual updates at the close of the 30-day
14comment period required by subdivision (a). Each adopted
15three-year program and expenditure plan and update shall include
16any substantive written recommendations for revisions. The
17adopted three-year program and expenditure plan or update shall
18summarize and analyze the recommended revisions. The mental
19health board shall review the adopted plan or update and make
20recommendations to the county mental health department for
21revisions.

22(c) The plans shall include reports on the achievement of
23performance outcomes for services pursuant to Part 3 (commencing
24with Section 5800), Part 3.6 (commencing with Section 5840),
25and Part 4 (commencing with Section 5850) funded by the Mental
26Health Services Fund and established jointly by the State
27Department of Health Care Services and the Mental Health Services
28Oversight and Accountability Commission, in collaboration with
29thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors
30begin delete Association.end deletebegin insert Association of California.end insert

31(d) Mental health services provided pursuant to Part 3
32(commencing with Section 5800), and Part 4 (commencing with
33Section 5850), shall be included in the review of program
34 performance by the California Mental Health Planning Council
35required by paragraph (2) of subdivision (c) of Section 5772 and
36in the local mental health board’s review and comment on the
37performance outcome data required by paragraph (7) of subdivision
38(a) of Section 5604.2.

39

SEC. 26.  

Section 5848.5 of the Welfare and Institutions Code
40 is amended to read:

P23   1

5848.5.  

(a) The Legislature finds and declares all of the
2following:

3(1) California has realigned public community mental health
4services to counties and it is imperative that sufficient
5community-based resources be available to meet the mental health
6needs of eligible individuals.

7(2) Increasing access to effective outpatient and crisis
8stabilization services provides an opportunity to reduce costs
9associated with expensive inpatient and emergency room care and
10to better meet the needs of individuals with mental health disorders
11in the least restrictive manner possible.

12(3) Almost one-fifth of people with mental health disorders visit
13a hospital emergency room at least once per year. If an adequate
14array of crisis services is not available, it leaves an individual with
15little choice but to access an emergency room for assistance and,
16potentially, an unnecessary inpatient hospitalization.

17(4) Recent reports have called attention to a continuing problem
18of inappropriate and unnecessary utilization of hospital emergency
19rooms in California due to limited community-based services for
20individuals in psychological distress and acute psychiatric crisis.
21Hospitals report that 70 percent of people taken to emergency
22rooms for psychiatric evacuation can be stabilized and transferred
23to a less intensive level of crisis care. Law enforcement personnel
24report that their personnel need to stay with people in the
25emergency room waiting area until a placement is found, and that
26less intensive levels of care tend not to be available.

27(5) Comprehensive public and private partnerships at both local
28and regional levels, including across physical health services,
29mental health, substance use disorder, law enforcement, social
30services, and related supports, are necessary to develop and
31maintain high quality, patient-centered, and cost-effective care for
32individuals with mental health disorders that facilitates their
33recovery and leads towards wellness.

34(6) The recovery of individuals with mental health disorders is
35important for all levels of government, business, and the local
36community.

37(b) This section shall be known, and may be cited, as the
38Investment in Mental Health Wellness Act of 2013. The objectives
39of this section are to do all of the following:

P24   1(1) Expand access to early intervention and treatment services
2to improve the client experience, achieve recovery and wellness,
3and reduce costs.

4(2) Expand the continuum of services to address crisis
5intervention, crisis stabilization, and crisis residential treatment
6needs that are wellness, resiliency, and recovery oriented.

7(3) Add at least 25 mobile crisis support teams and at least 2,000
8crisis stabilization and crisis residential treatment beds to bolster
9capacity at the local level to improve access to mental health crisis
10services and address unmet mental health care needs.

11(4) Add at least 600 triage personnel to provide intensive case
12management and linkage to services for individuals with mental
13health care disorders at various points of access, such as at
14designated community-based service points, homeless shelters,
15and clinics.

16(5) Reduce unnecessary hospitalizations and inpatient days by
17appropriately utilizing community-based services and improving
18access to timely assistance.

19(6) Reduce recidivism and mitigate unnecessary expenditures
20of local law enforcement.

21(7) Provide local communities with increased financial resources
22to leverage additional public and private funding sources to achieve
23improved networks of care for individuals with mental health
24disorders.

25(c) Through appropriations provided in the annual Budget Act
26for this purpose, it is the intent of the Legislature to authorize the
27California Health Facilities Financing Authority, hereafter referred
28to as the authority, and the Mental Health Services Oversight and
29Accountability Commission, hereafter referred to as the
30commission, to administer competitive selection processes as
31provided in this section for capital capacity and program expansion
32to increase capacity for mobile crisis support, crisis intervention,
33crisis stabilization services, crisis residential treatment, and
34specified personnel resources.

35(d) Funds appropriated by the Legislature to the authority for
36purposes of this section shall be made available to selected
37counties, or counties acting jointly. The authority may, at its
38discretion, also give consideration to private nonprofit corporations
39and public agencies in an area or region of the state if a county, or
40counties acting jointly, affirmatively supports this designation and
P25   1collaboration in lieu of a county government directly receiving
2grant funds.

3(1) Grant awards made by the authority shall be used to expand
4local resources for the development, capital, equipment acquisition,
5and applicable program startup or expansion costs to increase
6capacity for client assistance and services in the following areas:

7(A) Crisis intervention, as authorized by Sections 14021.4,
814680, and 14684.

9(B) Crisis stabilization, as authorized by Sections 14021.4,
1014680, and 14684.

11(C) Crisis residential treatment, as authorized by Sections
1214021.4, 14680, and 14684.

13(D) Rehabilitative mental health services, as authorized by
14Sections 14021.4, 14680, and 14684.

15(E) Mobile crisis support teams, including personnel and
16equipment, such as the purchase of vehicles.

17(2) The authority shall develop selection criteria to expand local
18resources, including those described in paragraph (1), and processes
19for awarding grants after consulting with representatives and
20interested stakeholders from the mental health community,
21including, but not limited to,begin delete county mental health directors,end deletebegin insert the
22County Behavioral Health Directors Association of California,end insert

23 service providers, consumer organizations, and other appropriate
24interests, such as health care providers and law enforcement, as
25determined by the authority. The authority shall ensure that grants
26result in cost-effective expansion of the number of
27community-based crisis resources in regions and communities
28selected for funding. The authority shall also take into account at
29least the following criteria and factors when selecting recipients
30of grants and determining the amount of grant awards:

31(A) Description of need, including, at a minimum, a
32comprehensive description of the project, community need,
33population to be served, linkage with other public systems of health
34and mental health care, linkage with local law enforcement, social
35services, and related assistance, as applicable, and a description
36of the request for funding.

37(B) Ability to serve the target population, which includes
38individuals eligible for Medi-Cal and individuals eligible for county
39health and mental health services.

P26   1(C) Geographic areas or regions of the state to be eligible for
2grant awards, which may include rural, suburban, and urban areas,
3and may include use of the five regional designations utilized by
4thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors
5begin deleteAssociation.end deletebegin insert Association of California.end insert

6(D) Level of community engagement and commitment to project
7completion.

8(E) Financial support that, in addition to a grant that may be
9awarded by the authority, will be sufficient to complete and operate
10the project for which the grant from the authority is awarded.

11(F) Ability to provide additional funding support to the project,
12including public or private funding, federal tax credits and grants,
13foundation support, and other collaborative efforts.

14(G) Memorandum of understanding among project partners, if
15applicable.

16(H) Information regarding the legal status of the collaborating
17partners, if applicable.

18(I) Ability to measure key outcomes, including improved access
19to services, health and mental health outcomes, and cost benefit
20of the project.

21(3) The authority shall determine maximum grants awards,
22which shall take into consideration the number of projects awarded
23to the grantee, as described in paragraph (1), and shall reflect
24reasonable costs for the project and geographic region. The
25authority may allocate a grant in increments contingent upon the
26phases of a project.

27(4) Funds awarded by the authority pursuant to this section may
28be used to supplement, but not to supplant, existing financial and
29resource commitments of the grantee or any other member of a
30collaborative effort that has been awarded a grant.

31(5) All projects that are awarded grants by the authority shall
32be completed within a reasonable period of time, to be determined
33by the authority. Funds shall not be released by the authority until
34the applicant demonstrates project readiness to the authority’s
35satisfaction. If the authority determines that a grant recipient has
36failed to complete the project under the terms specified in awarding
37the grant, the authority may require remedies, including the return
38of all or a portion of the grant.

39(6) A grantee that receives a grant from the authority under this
40section shall commit to using that capital capacity and program
P27   1expansion project, such as the mobile crisis team, crisis
2stabilization unit, or crisis residential treatment program, for the
3duration of the expected life of the project.

4(7) The authority may consult with a technical assistance entity,
5as described in paragraph (5) of subdivision (a) of Section 4061,
6for purposes of implementing this section.

7(8) The authority may adopt emergency regulations relating to
8the grants for the capital capacity and program expansion projects
9described in this section, including emergency regulations that
10define eligible costs and determine minimum and maximum grant
11amounts.

12(9) The authority shall provide reports to the fiscal and policy
13committees of the Legislature on or before May 1, 2014, and on
14or before May 1, 2015, on the progress of implementation, that
15includes, but are not limited to, the following:

16(A) A description of each project awarded funding.

17(B) The amount of each grant issued.

18(C) A description of other sources of funding for each project.

19(D) The total amount of grants issued.

20(E) A description of project operation and implementation,
21including who is being served.

22(10) A recipient of a grant provided pursuant to paragraph (1)
23shall adhere to all applicable laws relating to scope of practice,
24licensure, certification, staffing, and building codes.

25(e) Funds appropriated by the Legislature to the commission
26for purposes of this section shall be allocated for triage personnel
27to provide intensive case management and linkage to services for
28 individuals with mental health disorders at various points of access.
29These funds shall be made available to selected counties, counties
30acting jointly, or city mental health departments, as determined
31by the commission through a selection process. It is the intent of
32the Legislature for these funds to be allocated in an efficient manner
33to encourage early intervention and receipt of needed services for
34individuals with mental health disorders, and to assist in navigating
35the local service sector to improve efficiencies and the delivery of
36services.

37(1) Triage personnel may provide targeted case management
38services face to face, by telephone, or by telehealth with the
39individual in need of assistance or his or her significant support
P28   1person, and may be provided anywhere in the community. These
2service activities may include, but are not limited to, the following:

3(A) Communication, coordination, and referral.

4(B) Monitoring service delivery to ensure the individual accesses
5and receives services.

6(C) Monitoring the individual’s progress.

7(D) Providing placement service assistance and service plan
8development.

9(2) The commission shall take into account at least the following
10criteria and factors when selecting recipients and determining the
11amount of grant awards for triage personnel as follows:

12(A) Description of need, including potential gaps in local service
13connections.

14(B) Description of funding request, including personnel and use
15of peer support.

16(C) Description of how triage personnel will be used to facilitate
17linkage and access to services, including objectives and anticipated
18outcomes.

19(D) Ability to obtain federal Medicaid reimbursement, when
20applicable.

21(E) Ability to administer an effective service program and the
22degree to which local agencies and service providers will support
23and collaborate with the triage personnel effort.

24(F) Geographic areas or regions of the state to be eligible for
25grant awards, which shall include rural, suburban, and urban areas,
26and may include use of the five regional designations utilized by
27thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors
28begin deleteAssociation.end deletebegin insert Association of California.end insert

29(3) The commission shall determine maximum grant awards,
30and shall take into consideration the level of need, population to
31be served, and related criteria, as described in paragraph (2), and
32shall reflect reasonable costs.

33(4) Funds awarded by the commission for purposes of this
34section may be used to supplement, but not supplant, existing
35financial and resource commitments of the county, counties acting
36jointly, or city mental health department that received the grant.

37(5) Notwithstanding any other law, a county, counties acting
38jointly, or city mental health department that receives an award of
39funds for the purpose of supporting triage personnel pursuant to
P29   1this subdivision is not required to provide a matching contribution
2of local funds.

3(6) Notwithstanding any other law, the commission, without
4taking any further regulatory action, may implement, interpret, or
5make specific this section by means of informational letters,
6bulletins, or similar instructions.

7(7) The commission shall provide a status report to the fiscal
8and policy committees of the Legislature on the progress of
9implementation no later than March 1, 2014.

10

SEC. 27.  

Section 5892 of the Welfare and Institutions Code is
11amended to read:

12

5892.  

(a) In order to promote efficient implementation of this
13act, the county shall use funds distributed from the Mental Health
14Services Fund as follows:

15(1) In 2005-06, 2006-07, and in 2007-08 10 percent shall be
16placed in a trust fund to be expended for education and training
17programs pursuant to Part 3.1.

18(2) In 2005-06, 2006-07 and in 2007-08 10 percent for capital
19facilities and technological needs distributed to counties in
20accordance with a formula developed in consultation with the
21begin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors Association
22begin insert of Californiaend insert to implement plans developed pursuant to Section
235847.

24(3) Twenty percent of funds distributed to the counties pursuant
25to subdivision (c) of Section 5891 shall be used for prevention and
26early intervention programs in accordance with Part 3.6
27(commencing with Section 5840) of this division.

28(4) The expenditure for prevention and early intervention may
29be increased in any county in which the department determines
30that the increase will decrease the need and cost for additional
31services to severely mentally ill persons in that county by an
32amount at least commensurate with the proposed increase.

33(5) The balance of funds shall be distributed to county mental
34health programs for services to persons with severe mental illnesses
35pursuant to Part 4 (commencing with Section 5850), for the
36children’s system of care and Part 3 (commencing with Section
375800), for the adult and older adult system of care.

38(6) Five percent of the total funding for each county mental
39health program for Part 3 (commencing with Section 5800), Part
403.6 (commencing with Section 5840), and Part 4 (commencing
P30   1with Section 5850) of this division, shall be utilized for innovative
2programs in accordance with Sections 5830, 5847, and 5848.

3(b) In any year after 2007-08, programs for services pursuant
4to Part 3 (commencing with Section 5800), and Part 4
5(commencing with Section 5850) of this division may include
6funds for technological needs and capital facilities, human resource
7needs, and a prudent reserve to ensure services do not have to be
8significantly reduced in years in which revenues are below the
9average of previous years. The total allocation for purposes
10authorized by this subdivision shall not exceed 20 percent of the
11average amount of funds allocated to that county for the previous
12five years pursuant to this section.

13(c) The allocations pursuant to subdivisions (a) and (b) shall
14include funding for annual planning costs pursuant to Section 5848.
15The total of these costs shall not exceed 5 percent of the total of
16annual revenues received for the fund. The planning costs shall
17include funds for county mental health programs to pay for the
18costs of consumers, family members, and other stakeholders to
19participate in the planning process and for the planning and
20implementation required for private provider contracts to be
21significantly expanded to provide additional services pursuant to
22Part 3 (commencing with Section 5800), and Part 4 (commencing
23with Section 5850) of this division.

24(d) Prior to making the allocations pursuant to subdivisions (a),
25(b), and (c), funds shall be reserved for the costs for the State
26Department of Health Care Services, the California Mental Health
27Planning Council, the Office of Statewide Health Planning and
28Development, the Mental Health Services Oversight and
29Accountability Commission, the State Department of Public Health,
30and any other state agency to implement all duties pursuant to the
31programs set forth in this section. These costs shall not exceed 5
32percent of the total of annual revenues received for the fund. The
33administrative costs shall include funds to assist consumers and
34family members to ensure the appropriate state and county agencies
35give full consideration to concerns about quality, structure of
36service delivery, or access to services. The amounts allocated for
37administration shall include amounts sufficient to ensure adequate
38research and evaluation regarding the effectiveness of services
39being provided and achievement of the outcome measures set forth
40in Part 3 (commencing with Section 5800), Part 3.6 (commencing
P31   1with Section 5840), and Part 4 (commencing with Section 5850)
2of this division. The amount of funds available for the purposes
3of this subdivision in any fiscal year shall be subject to
4appropriation in the annual Budget Act.

5(e) In 2004-05 funds shall be allocated as follows:

6(1)  Forty-five percent for education and training pursuant to
7Part 3.1 (commencing with Section 5820) of this division.

8(2)  Forty-five percent for capital facilities and technology needs
9in the manner specified by paragraph (2) of subdivision (a).

10(3)  Five percent for local planning in the manner specified in
11subdivision (c).

12(4) Five percent for state implementation in the manner specified
13in subdivision (d).

14(f) Each county shall place all funds received from the State
15Mental Health Services Fund in a local Mental Health Services
16Fund. The Local Mental Health Services Fund balance shall be
17invested consistent with other county funds and the interest earned
18on the investments shall be transferred into the fund. The earnings
19on investment of these funds shall be available for distribution
20from the fund in future years.

21(g) All expenditures for county mental health programs shall
22be consistent with a currently approved plan or update pursuant
23to Section 5847.

24(h) Other than funds placed in a reserve in accordance with an
25approved plan, any funds allocated to a countybegin delete whichend deletebegin insert thatend insert have
26not been spent for their authorized purpose within three years shall
27revert to the state to be deposited into the fund and available for
28other counties in future years, provided however, that funds for
29capital facilities, technological needs, or education and training
30may be retained for up to 10 years before reverting to the fund.

31(i) If there are still additional revenues available in the fund
32after the Mental Health Services Oversight and Accountability
33Commission has determined there are prudent reserves and no
34unmet needs for any of the programs funded pursuant to this
35section, including all purposes of the Prevention and Early
36Intervention Program, the commission shall develop a plan for
37expenditures of these revenues to further the purposes of this act
38and the Legislature may appropriate these funds for any purpose
39consistent with the commission’s adopted planbegin delete whichend deletebegin insert thatend insert furthers
40the purposes of this act.

P32   1(j) For the 2011-12 fiscal year, General Fund revenues will be
2insufficient to fully fund many existing mental health programs,
3including Early and Periodic Screening, Diagnosis, and Treatment
4(EPSDT), Medi-Cal Specialty Mental Health Managed Care, and
5mental health services provided for special education pupils. In
6order to adequately fund those programs for the 2011-12 fiscal
7year and avoid deeper reductions in programs that serve individuals
8with severe mental illness and the most vulnerable, medically
9needy citizens of the state, prior to distribution of funds under
10paragraphs (1) to (6), inclusive, of subdivision (a), effective July
111, 2011, moneys shall be allocated from the Mental Health Services
12Fund to the counties as follows:

13(1) Commencing July 1, 2011, one hundred eighty-three million
14six hundred thousand dollars ($183,600,000) of the funds available
15as of July 1, 2011, in the Mental Health Services Fund, shall be
16allocated in a manner consistent with subdivision (c) of Section
175778 and based on a formula determined by the state in
18consultation with thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
19Directors Associationbegin insert of Californiaend insert to meet the fiscal year 2011-12
20General Fund obligation for Medi-Cal Specialty Mental Health
21Managed Care.

22(2) Upon completion of the allocation in paragraph (1), the
23Controller shall distribute to counties ninety-eight million five
24hundred eighty-six thousand dollars ($98,586,000) from the Mental
25Health Services Fund for mental health services for special
26education pupils based on a formula determined by the state in
27consultation with thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
28Directors Associationbegin insert of Californiaend insert.

29(3) Upon completion of the allocation in paragraph (2), the
30Controller shall distribute to counties 50 percent of their 2011-12
31Mental Health Services Act component allocations consistent with
32Sections 5847 and 5891, not to exceed four hundred eighty-eight
33million dollars ($488,000,000). This allocation shall commence
34beginning August 1, 2011.

35(4) Upon completion of the allocation in paragraph (3), and as
36revenues are deposited into the Mental Health Services Fund, the
37Controller shall distribute five hundred seventy-nine million dollars
38($579,000,000) from the Mental Health Services Fund to counties
39to meet the General Fund obligation for EPSDT for fiscal year
402011-12. These revenues shall be distributed to counties on a
P33   1quarterly basis and based on a formula determined by the state in
2consultation with thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
3Directors Associationbegin insert of Californiaend insert. These funds shall not be
4subject to reconciliation or cost settlement.

5(5) The Controller shall distribute to counties the remaining
62011-12 Mental Health Services Act component allocations
7consistent with Sections 5847 and 5891, beginning no later than
8April 30, 2012. These remaining allocations shall be made on a
9monthly basis.

10(6) The total one-time allocation from the Mental Health
11Services Fund for EPSDT, Medi-Cal Specialty Mental Health
12Managed Care, and mental health services provided to special
13education pupils as referenced shall not exceed eight hundred
14sixty-two million dollars ($862,000,000). Any revenues deposited
15in the Mental Health Services Fund in fiscal year 2011-12 that
16exceed this obligation shall be distributed to counties for remaining
17fiscal year 2011-12 Mental Health Services Act component
18allocations, consistent with Sections 5847 and 5891.

19(k) Subdivision (j) shall not be subject to repayment.

20(l) Subdivision (j) shall become inoperative on July 1, 2012.

21

SEC. 28.  

Section 5899 of the Welfare and Institutions Code is
22amended to read:

23

5899.  

(a) The State Department of Health Care Services, in
24consultation with the Mental Health Services Oversight and
25Accountability Commission and thebegin delete California Mentalend deletebegin insert County
26Behavioralend insert
Health Directors Associationbegin insert of Californiaend insert, shall
27develop and administer instructions for the Annual Mental Health
28Services Act Revenue and Expenditure Report. This report shall
29be submitted electronically to the department and to the Mental
30Health Services Oversight and Accountability Commission.

31(b) The purpose of the Annual Mental Health Services Act
32Revenue and Expenditure Report is as follows:

33(1) Identify the expenditures of Mental Health Services Act
34(MHSA) funds that were distributed to each county.

35(2) Quantify the amount of additional funds generated for the
36mental health system as a result of the MHSA.

37(3) Identify unexpended funds, and interest earned on MHSA
38funds.

39(4) Determine reversion amounts, if applicable, from prior fiscal
40year distributions.

P34   1(c) This report is intended to provide information that allows
2for the evaluation of all of the following:

3(1) Children’s systems of care.

4(2) Prevention and early intervention strategies.

5(3) Innovative projects.

6(4) Workforce education and training.

7(5) Adults and older adults systems of care.

8(6) Capital facilities and technology needs.

9

SEC. 29.  

Section 5902 of the Welfare and Institutions Code is
10amended to read:

11

5902.  

(a) In the 1991-92 fiscal year, funding sufficient to
12cover the cost of the basic level of care in institutions for mental
13disease at the rate established by the State Department of Health
14Services shall be made available to the department for skilled
15nursing facilities, plus the rate established for special treatment
16programs. The department may authorize a county to administer
17institutions for mental disease services if the county with the
18consent of the affected providers makes a request to administer
19services and an allocation is made to the county for these services.
20The department shall continue to contract with these providers for
21the services necessary for the operation of the institutions for
22mental disease.

23(b) In the 1992-93 fiscal year, the department shall consider
24county-specific requests to continue to provide administrative
25services relative to institutions for mental disease facilities when
26no viable alternatives are found to exist.

27(c) (1) By October 1, 1991, the department, in consultation
28with thebegin delete California Conference of Local Mental Health Directorsend delete
29begin insert County Behavioral Health Directors Association of Californiaend insert and
30the California Association of Health Facilities, shall develop and
31publish a county-specific allocation of institutions for mental
32disease fundsbegin delete whichend deletebegin insert thatend insert will take effect on July 1, 1992.

33(2) By November 1, 1991, counties shall notify the providers
34of any intended change in service levels to be effective on July 1,
351992.

36(3) By April 1, 1992, counties and providers shall have entered
37into contracts for basic institutions for mental disease services at
38the rate described in subdivision (e) for the 1992-93 fiscal year at
39the level expressed on or before November 1, 1991, except that a
40county shall be permitted additional time, until June 1, 1992, to
P35   1complete the processing of the contract, when any of the following
2conditions are met:

3(A) The county and the affected provider have agreed on all
4substantive institutions for mental disease contract issues by April
51, 1992.

6(B) Negotiations are in process with the county on April 1, 1992,
7and the affected provider has agreed in writing to the extension.

8(C) The service level committed to on November 1, 1991,
9exceeds the affected provider’s bed capacity.

10(D) The county can document that the affected provider has
11refused to enter into negotiations by April 1, 1992, or has
12substantially delayed negotiations.

13(4) If a county and a provider are unable to reach agreement on
14substantive contract issues by June 1, 1992, the department may,
15upon request of either the affected county or the provider, mediate
16the disputed issues.

17(5) Where contracts for service at the level committed to on
18November 1, 1991, have not been completed by April 1, 1992,
19and additional time is not permitted pursuant to the exceptions
20specified in paragraph (3) the funds allocated to those counties
21shall revert for reallocation in a manner that shall promote equity
22of funding among counties. With respect to counties with
23exceptions permitted pursuant to paragraph (3), funds shall not
24revert unless contracts are not completed by June 1, 1992. In no
25event shall funds revert under this section if there is no harm to
26the provider as a result of the county contract not being completed.
27During the 1992-93 fiscal year, funds reverted under this paragraph
28shall be used to purchase institution for mental disease/skilled
29nursing/special treatment program services in existing facilities.

30(6) Nothing in this section shall apply to negotiations regarding
31supplemental payments beyond the rate specified in subdivision
32(e).

33(d) On or before April 1, 1992, counties may complete contracts
34with facilities for the direct purchase of services in the 1992-93
35fiscal year. Those counties for which facility contracts have not
36been completed by that date shall be deemed to continue to accept
37financial responsibility for those patients during the subsequent
38fiscal year at the rate specified in subdivision (a).

39(e) As long as contracts with institutions for mental disease
40providers require the facilities to maintain skilled nursing facility
P36   1licensure and certification, reimbursement for basic services shall
2be at the rate established by the State Department of Health
3Services. Except as provided in this section, reimbursement rates
4for services in institutions for mental diseases shall be the same
5as the rates in effect on July 31, 2004. Effective July 1, 2005,
6through June 30, 2008, the reimbursement rate for institutions for
7mental disease shall increase by 6.5 percent annually. Effective
8July 1, 2008, the reimbursement rate for institutions for mental
9disease shall increase by 4.7 percent annually.

10(f) (1) Providers that agree to contract with the county for
11services under an alternative mental health program pursuant to
12Section 5768 that does not require skilled nursing facility licensure
13shall retain return rights to licensure as skilled nursing facilities.

14(2) Providers participating in an alternative program that elect
15to return to skilled nursing facility licensure shall only be required
16to meet those requirements under which they previously operated
17as a skilled nursing facility.

18(g) In the 1993-94 fiscal year and thereafter, the department
19shall consider requests to continue administrative services related
20to institutions for mental disease facilities from counties with a
21population of 150,000 or less based on the most recent available
22 estimates of population data as determined by the Population
23Research Unit of the Department of Finance.

24

SEC. 30.  

Section 11467 of the Welfare and Institutions Code
25 is amended to read:

26

11467.  

(a) The State Department of Social Services, with the
27advice and assistance of the County Welfare Directors Association,
28the Chief Probation Officer’s Association, thebegin delete California Mentalend delete
29begin insert County Behavioralend insert Health Directors Associationbegin insert of Californiaend insert,
30research entities, foster youth and advocates for foster youth, foster
31care provider business entities organized and operated on a
32nonprofit basis, tribes, and other stakeholders, shall establish a
33working group to develop performance standards and outcome
34measures for providers of out-of-home care placements made under
35the AFDC-FC program, including, but not limited to, foster family
36agency, group home, and THP-Plus providers, and for the effective
37and efficient administration of the AFDC-FC program.

38(b) The performance standards and outcome measures shall
39employ the applicable performance standards and outcome
40measures as set forth in Sections 11469 and 11469.1, designed to
P37   1identify the degree to which foster care providers, including
2business entities organized and operated on a nonprofit basis, are
3providing out-of-home placement services that meet the needs of
4foster children, and the degree to which these services are
5supporting improved outcomes, including those identified by the
6California Child and Family Service Review System.

7(c) In addition to the process described in subdivision (a), the
8working group may also develop the following:

9(1) A means of identifying the child’s needs and determining
10which is the most appropriate out-of-home placement for a child.

11(2) A procedure for identifying children who have been in
12congregate care for one year or longer, determining the reasons
13each child remains in congregate care, and developing a plan for
14each child to transition to a less restrictive, more family-like setting.

15(d) The department shall provide updates regarding its progress
16toward meeting the requirements of this section during the 2013
17and 2014 budget hearings.

18(e) Notwithstanding the rulemaking provisions of the
19Administrative Procedure Act (Chapter 3.5 (commencing with
20Section 13340) of Part 1 of Division 3 of Title 2 of the Government
21Code), until the enactment of applicable state law, or October 1,
222015, whichever is earlier, the department may implement the
23changes made pursuant to this section through all-county letters,
24or similar instructions from the director.

25

SEC. 31.  

Section 11469 of the Welfare and Institutions Code
26 is amended to read:

27

11469.  

(a) The department, in consultation with group home
28providers, the County Welfare Directors Association, the Chief
29Probation Officers of California, thebegin delete California Mentalend deletebegin insert County
30Behavioralend insert
Health Directors Associationbegin insert of Californiaend insert, and the
31State Department of Health Care Services, shall develop
32performance standards and outcome measures for determining the
33effectiveness of the care and supervision, as defined in subdivision
34(b) of Section 11460, provided by group homes under the
35AFDC-FC program pursuant to Sections 11460 and 11462. These
36 standards shall be designed to measure group home program
37performance for the client group that the group home program is
38designed to serve.

39(1) The performance standards and outcome measures shall be
40designed to measure the performance of group home programs in
P38   1areas over which the programs have some degree of influence, and
2in other areas of measurable program performance that the
3department can demonstrate are areas over which group home
4programs have meaningful managerial or administrative influence.

5(2) These standards and outcome measures shall include, but
6are not limited to, the effectiveness of services provided by each
7group home program, and the extent to which the services provided
8by the group home assist in obtaining the child welfare case plan
9objectives for the child.

10(3) In addition, when the group home provider has identified
11as part of its program for licensing, ratesetting, or county placement
12purposes, or has included as a part of a child’s case plan by mutual
13agreement between the group home and the placing agency,
14specific mental health, education, medical, and other child-related
15services, the performance standards and outcome measures may
16also measure the effectiveness of those services.

17(b) Regulations regarding the implementation of the group home
18performance standards system required by this section shall be
19adopted no later than one year prior to implementation. The
20regulations shall specify both the performance standards system
21and the manner by which the AFDC-FC rate of a group home
22program shall be adjusted if performance standards are not met.

23(c) Except as provided in subdivision (d), effective July 1, 1995,
24group home performance standards shall be implemented. Any
25group home program not meeting the performance standards shall
26have its AFDC-FC rate, set pursuant to Section 11462, adjusted
27according to the regulations required by this section.

28(d) Effective July 1, 1995, group home programs shall be
29classified at rate classification level 13 or 14 only if all of the
30following are met:

31(1) The program generates the requisite number of points for
32rate classification level 13 or 14.

33(2) The program only accepts children with special treatment
34needs as determined through the assessment process pursuant to
35paragraph (2) of subdivision (a) of Section 11462.01.

36(3) The program meets the performance standards designed
37pursuant to this section.

38(e) Notwithstanding subdivision (c), the group home program
39performance standards system shall not be implemented prior to
P39   1the implementation of the AFDC-FC performance standards
2system.

3(f) By January 1, 2016, the department, in consultation with the
4County Welfare Directors Association, the Chief Probation Officers
5of California, thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
6Directors Associationbegin insert of Californiaend insert, research entities, foster youth
7and advocates for foster youth, foster care provider business entities
8organized and operated on a nonprofit basis, Indian tribes, and
9other stakeholders, shall develop additional performance standards
10and outcome measures that require group homes to implement
11programs and services to minimize law enforcement contacts and
12delinquency petition filings arising from incidents of allegedly
13unlawful behavior by minors occurring in group homes or under
14the supervision of group home staff, including individualized
15behavior management programs, emergency intervention plans,
16and conflict resolution processes.

17

SEC. 32.  

Section 14021.4 of the Welfare and Institutions Code
18 is amended to read:

19

14021.4.  

(a) California’s plan for federal Medi-Cal grants for
20medical assistance programs, pursuant to Subchapter XIX
21(commencing with Section 1396) of Title 42 of the United States
22Code, shall accomplish the following objectives:

23(1) Expansion of the location and type of therapeutic services
24offered to persons with mental illnesses under Medi-Cal by the
25category of “other diagnostic, screening, preventative, and
26rehabilitative services”begin delete whichend deletebegin insert thatend insert is available to states under the
27federal Social Security Act and its implementing regulations (42
28U.S.C. Sec. 1396d(a)(13); 42 C.F.R. 440.130).

29(2) Expansion of federal financial participation in the costs of
30specialty mental health services provided by local mental health
31plans or under contract with the mental health plans.

32(3) Expansion of the location where reimbursable specialty
33mental health services can be provided, including home, school,
34and community based sites.

35(4) Expansion of federal financial participation for services
36begin delete whichend deletebegin insert thatend insert meet the rehabilitation needs of persons with mental
37illnesses, including, but not limited to, medication management,
38functional rehabilitation assessments of clients, and rehabilitative
39servicesbegin delete whichend deletebegin insert thatend insert include remedial services directed at restoration
P40   1to the highest possible functional level for persons with mental
2illnesses and maximum reduction of symptoms of mental illness.

3(5) Improvement of fiscal systems and accountability structures
4for specialty mental health services, costs, and rates, with the goal
5of achieving federal fiscal requirements.

6(b) The department’s state plan revision shall be completed with
7review and comments by thebegin delete California Mentalend deletebegin insert County Behavioralend insert
8 Health Directors Associationbegin insert of Californiaend insert and other appropriate
9 groups.

10(c)  Services under the rehabilitative option shall be limited to
11specialty mental health plans certified to provide Medi-Cal under
12this option.

13(d) It is the intent of the Legislature that the rehabilitation option
14of the state Medicaid plan be implemented to expand and provide
15flexibility to treatment services and to increase the federal
16participation without increasing the costs to the General Fund.

17(e) The department shall review and revise the quality assurance
18standards and guidelines required by Section 14725 to ensure that
19quality services are delivered to the eligible population. Any
20reviews shall include, but not be limited to, appropriate use of
21mental health professionals, including psychiatrists, in the treatment
22and rehabilitation of clients under this model. The existing quality
23assurance standards and guidelines shall remain in effect until the
24adoption of the new quality assurance standards and guidelines.

25(f) Consistent with services offered to persons with mental
26illnesses under the Medi-Cal program, as required by this section,
27it is the intent of the Legislature for the department to include care
28and treatment of persons with mental illnesses who are eligible
29for the Medi-Cal program in facilities with a bed capacity of 16
30beds or less.

31

SEC. 33.  

Section 14124.24 of the Welfare and Institutions
32Code
is amended to read:

33

14124.24.  

(a) For purposes of this section, “Drug Medi-Cal
34reimbursable services” means the substance use disorder services
35described in the California State Medicaid Plan and includes, but
36is not limited to, all of the following services, administered by the
37department, and to the extent consistent with state and federal law:

38(1) Narcotic treatment program services, as set forth in Section
3914021.51.

40(2) Day care rehabilitative services.

P41   1(3) Perinatal residential services for pregnant women and women
2in the postpartum period.

3(4) Naltrexone services.

4(5) Outpatient drug-free services.

5(6) Other services upon approval of a federal Medicaid state
6plan amendment or waiver authorizing federal financial
7participation.

8(b) (1) While seeking federal approval for any federal Medicaid
9state plan amendment or waiver associated with Drug Medi-Cal
10services, the department shall consult with the counties and
11stakeholders in the development of the state plan amendment or
12waiver.

13(2) Upon federal approval of a federal Medicaid state plan
14amendment authorizing federal financial participation in the
15following services, and subject to appropriation of funds, “Drug
16Medi-Cal reimbursable services” shall also include the following
17services, administered by the department, and to the extent
18consistent with state and federal law:

19(A) Notwithstanding subdivision (a) of Section 14132.90, day
20care habilitative services, which, for purposes of this paragraph,
21are outpatient counseling and rehabilitation services provided to
22persons with substance use disorder diagnoses.

23(B) Case management services, including supportive services
24to assist persons with substance use disorder diagnoses in gaining
25access to medical, social, educational, and other needed services.

26(C) Aftercare services.

27(c) (1) The nonfederal share for Drug Medi-Cal services shall
28be funded through a county’s Behavioral Health Subaccount of
29the Support Services Account of the Local Revenue Fund 2011,
30and any other available county funds eligible under federal law
31for federal Medicaid reimbursement. The funds contained in each
32county’s Behavioral Health Subaccount of the Support Services
33Account of the Local Revenue Fund 2011 shall be considered state
34funds distributed by the principal state agency for the purposes of
35receipt of the federal block grant funds for prevention and treatment
36of substance abuse found at Subchapter XVII of Chapter 6A of
37Title 42 of the United States Code. Pursuant to applicable federal
38Medicaid law and regulations including Section 433.51 of Title
3942 of the Code of Federal Regulations, counties may claim
40allowable Medicaid federal financial participation for Drug
P42   1Medi-Cal services based on the counties certifying their actual
2total funds expenditures for eligible Drug Medi-Cal services to
3the department.

4(2) (A) If the director determines that a county’s provision of
5Drug Medi-Cal treatment services are disallowed by the federal
6government or by state or federal audit or review, the impacted
7county shall be responsible for repayment of all disallowed federal
8funds. In addition to any other recovery methods available,
9including, but not limited to, offset of Medicaid federal financial
10participation funds owed to the impacted county, the director may
11offset these amounts in accordance with Section 12419.5 of the
12Government Code.

13(B) A county subject to an action by the director pursuant to
14subparagraph (A) may challenge that action by requesting a hearing
15in writing no later than 30 days from receipt of notice of the
16department’s action. The proceeding shall be conducted in
17accordance with Chapter 5 (commencing with Section 11500) of
18Part 1 of Division 3 of Title 2 of the Government Code, and the
19director has all the powers granted therein. Upon a county’s timely
20request for hearing, the county’s obligation to make payment as
21determined by the director shall be stayed pending the county’s
22 exhaustion of administrative remedies provided herein but no
23longer than will ensure the department’s compliance with Section
241903(d)(2)(C) of the federal Social Security Act (42 U.S.C. Sec.
251396b).

26(d) Drug Medi-Cal services are only reimbursable to Drug
27Medi-Cal providers with an approved Drug Medi-Cal contract.

28(e) Counties shall negotiate contracts only with providers
29certified to provide Drug Medi-Cal services.

30(f) The department shall develop methods to ensure timely
31payment of Drug Medi-Cal claims.

32(g) (1) A county or a contracted provider, except for a provider
33to whom subdivision (h) applies, shall submit accurate and
34complete cost reports for the previous fiscal year by November 1,
35following the end of the fiscal year. The department may settle
36Drug Medi-Cal reimbursable services, based on the cost report as
37the final amendment to the approved county Drug Medi-Cal
38contract.

P43   1(2) Amounts paid for services provided to Drug Medi-Cal
2beneficiaries shall be audited by the department in the manner and
3form described in Section 14170.

4(3) Administrative appeals to review grievances or complaints
5arising from the findings of an audit or examination made pursuant
6to this section shall be subject to Section 14171.

7(h) Certified narcotic treatment program providers that are
8exclusively billing the state or the county for services rendered to
9persons subject to Section 1210.1 or 3063.1 of the Penal Code or
10Section 14021.52 of this code shall submit accurate and complete
11performance reports for the previous state fiscal year by November
121 following the end of that fiscal year. A provider to which this
13subdivision applies shall estimate its budgets using the uniform
14state daily reimbursement rate. The format and content of the
15performance reports shall be mutually agreed to by the department,
16the Countybegin delete Alcohol and Drug Program Administrators’end deletebegin insert Behavioral
17Health Directorsend insert
Association of California, and representatives
18of the treatment providers.

19(i) Contracts entered into pursuant to this section shall be exempt
20from the requirements of Chapter 1 (commencing with Section
2110100) and Chapter 2 (commencing with Section 10290) of Part
222 of Division 2 of the Public Contract Code.

23(j) Annually, the department shall publish procedures for
24contracting for Drug Medi-Cal services with certified providers
25and for claiming payments, including procedures and specifications
26for electronic data submission for services rendered.

27(k) If the department commences a preliminary criminal
28investigation of a certified provider, the department shall promptly
29notify each county that currently contracts with the provider for
30Drug Medi-Cal services that a preliminary criminal investigation
31has commenced. If the department concludes a preliminary criminal
32investigation of a certified provider, the department shall promptly
33notify each county that currently contracts with the provider for
34Drug Medi-Cal services that a preliminary criminal investigation
35has concluded.

36(1) Notice of the commencement and conclusion of a
37preliminary criminal investigation pursuant to this section shall
38be made to the county behavioral health director or his or her
39equivalent.

P44   1(2) Communication between the department and a county
2specific to the commencement or conclusion of a preliminary
3criminal investigation pursuant to this section shall be deemed
4confidential and shall not be subject to any disclosure request,
5including, but not limited to, the Information Practices Act of 1997
6(Chapter 1 (commencing with Section 1798) of Title 1.8 of Part
74 of Division 3 of the Code of Civil Procedure), the California
8Public Records Act (Chapter 3.5 (commencing with Section 6250)
9of Division 7 of Title 1 of the Government Code), requests pursuant
10to a subpoena, or for any other public purpose, including, but not
11limited to, court testimony.

12(3) Information shared by the department with a county
13regarding a preliminary criminal investigation shall be maintained
14in a manner to ensure protection of the confidentiality of the
15criminal investigation.

16(4) The information provided to a county pursuant to this section
17shall only include the provider name, national provider identifier
18(NPI) number, address, and the notice that an investigation has
19commenced or concluded.

20(5) A county shall not take any adverse action against a provider
21based solely upon the preliminary criminal investigation
22information disclosed to the county pursuant to this section.

23(6) In the event of a preliminary criminal investigation of a
24county owned or operated program, the department has the option
25to, but is not required to, notify the county pursuant to this section
26when the department commences or concludes a preliminary
27criminal investigation.

28(7) This section shall not limit the voluntary or otherwise legally
29mandated or contractually mandated sharing of information
30between the department and a county of information regarding
31audits and investigations of Drug Medi-Cal providers.

32(8) “Commenced” means the time at which a complaint or
33allegation is assigned to an investigator for a field investigation.

34(9) “Preliminary criminal investigation” means an investigation
35to gather information to determine if criminal law or statutes have
36been violated.

37

SEC. 34.  

Section 14251 of the Welfare and Institutions Code
38 is amended to read:

39

14251.  

begin insert(a)end insertbegin insertend insertbegin insert(1)end insertbegin insertend insert “Prepaid health plan” meansbegin delete any plan whichend delete
40begin insert a plan thatend insert meets all of the following criteria:

begin delete

P45   1(a)

end delete

2begin insert(A)end insertbegin deleteLicensedend deletebegin insert Is licensedend insert as a health care service plan by the
3Director of the Department of Managed Health Care pursuant to
4the Knox-Keene Health Care Service Plan Act of 1975 (Chapter
52.2 (commencing with Section 1340), Division 2, Health and Safety
6Code), other than a plan organized and operating pursuant to
7Section 10810 of the Corporations Codebegin delete whichend deletebegin insert thatend insert substantially
8indemnifies subscribers or enrollees for the cost of provided
9services, or has an application for licensure pending and was
10registered under the Knox-Mills Health Plan Act prior to itsbegin delete repeal
11(Chapter 941, Statutes of 1975) or licensed as a nonprofit hospital
12service plan by the Insurance Commissioner pursuant to Section
1311493(e) and Sections 11501 to 11505 of the Insurance Code.end delete

14begin insert repeal.end insert

begin delete

15(b)

end delete

16begin insert(B)end insert Meets the requirements for participation in the Medicaid
17Program (Title XIX of the Social Security Act) on an at risk basis.

begin delete

18(c)

end delete

19begin insert(C)end insert Agrees with the State Department of Healthbegin insert Careend insert Services
20to furnish directly or indirectly health services to Medi-Cal
21beneficiaries on a predetermined periodic rate basis.begin delete “Prepaidend delete

22begin insert(2)end insertbegin insertend insert“Prepaid health plan” includes any organizationbegin delete whichend deletebegin insert thatend insert
23 is licensed as a plan pursuant to the Knox-Keene Health Care
24Service Plan Act of 1975 and is subject to regulation by the
25Department of Managed Health Care pursuant to that act, and
26begin delete whichend deletebegin insert thatend insert contracts with the State Department of Healthbegin insert Careend insert
27 Services solely as a fiscal intermediary at risk.begin delete Exceptend delete

28begin insert(b)end insertbegin insertend insertbegin insert(1)end insertbegin insertend insert Except for the requirement of licensure pursuant to the
29Knox-Keene Act, the State Director of Healthbegin insert Careend insert Services may
30waive any provision of this chapterbegin delete whichend deletebegin insert thatend insert the director
31determines is inappropriate for a fiscal intermediary at risk.begin delete Any
32suchend delete
begin insert Anend insert exemption or waiver shall be set forth in the fiscal
33intermediary at risk contract with the State Department of Health
34begin insert Careend insert Services.begin delete “Fiscalend delete

35begin insert(2)end insertbegin insertend insert“Fiscal intermediary at risk” means any entitybegin delete whichend deletebegin insert thatend insert
36 entered into a contract with the State Department of Healthbegin insert Careend insert
37 Services on a pilot basis pursuant to subdivision (f) of Section
3814000, as in effect June 1, 1973, in accordance with which the
39entity received capitated payments from the state and reimbursed
40providers of health care services on a fee-for-service or other basis
P46   1for at least the basic scope of health care services, as defined in
2Section 14256, provided to all beneficiaries covered by the contract
3residing within a specified geographic region of the state. The
4fiscal intermediary at risk shall be at risk for the cost of
5administration and utilization of services or the cost of services,
6or both, for at least the basic scope of health care services, as
7defined in Section 14256, provided to all beneficiaries covered by
8the contract residing within a specified geographic region of the
9state. The fiscal intermediary at risk may share the risk with
10providers or reinsuring agencies or both. Eligibility of beneficiaries
11shall be determined by the State Department of Healthbegin insert Careend insert
12 Services and capitation payments shall be based on the number of
13beneficiaries so determined.

14

SEC. 35.  

Section 14499.71 of the Welfare and Institutions
15Code
is amended to read:

16

14499.71.  

For the purposes of this article, “fiscal intermediary”
17means an entity that agrees to pay for covered services provided
18to Medi-Cal eligibles in exchange for a premium, subscription
19charge, or capitation payment; to assume an underwriting risk; and
20isbegin delete eitherend delete licensed by the Director of the Department of Managed
21Health Care under the Knox-Keene Health Care Service Plan Act
22of 1975begin delete (Chapter 2.2 (commencing with Section 1340) of Division
232 of the Health and Safety Code) or is licensed as a nonprofit
24hospital service plan by the Insurance Commissioner pursuant to
25subdivision (e) of Section 11493 of the Insurance Code and
26Sections 11501 to 11505, inclusive, of the Insurance Code.end delete

27begin insert (Chapter 2.2 (commencing with Section 1340) of Division 2 of the
28Health and Safety Code).end insert

29

SEC. 36.  

Section 14707 of the Welfare and Institutions Code
30 is amended to read:

31

14707.  

(a) In the case of federal audit exceptions, the
32department shall follow federal audit appeal processes unless the
33department, in consultation with thebegin delete California Mentalend deletebegin insert County
34Behavioralend insert
Health Directors Associationbegin insert of Californiaend insert, determines
35that those appeals are not cost beneficial.

36(b) Whenever there is a final federal audit exception against the
37state resulting from expenditure of federal funds by individual
38counties, the department may offset federal reimbursement and
39request the Controller’s office to offset the distribution of funds
40to the counties from the Mental Health Subaccount, the Mental
P47   1Health Equity Subaccount, and the Vehicle License Collection
2Account of the Local Revenue Fund, funds from the Mental Health
3Account and the Behavioral Health Subaccount of the Local
4Revenue Fund 2011, and any other mental health realignment
5funds from which the Controller makes distributions to the counties
6by the amount of the exception. The department shall provide
7evidence to the Controller that the county has been notified of the
8amount of the audit exception no less than 30 days before the offset
9is to occur. The department shall involve the appropriate counties
10in developing responses to any draft federal audit reports that
11directly impact the county.

12

SEC. 37.  

Section 14711 of the Welfare and Institutions Code
13 is amended to read:

14

14711.  

(a) The department shall develop, in consultation with
15thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors
16Associationbegin insert of Californiaend insert, a reimbursement methodology for use
17in the Medi-Cal claims processing and interim payment system
18that maximizes federal funding and utilizes, as much as practicable,
19federal Medicaid and Medicare reimbursement principles. The
20department shall work with the federal Centers for Medicare and
21Medicaid Services in the development of the methodology required
22by this section.

23(b) Reimbursement amounts developed through the methodology
24required by this section shall be consistent with federal Medicaid
25requirements and the approved Medicaid state plan and waivers.

26(c) Administrative costs shall be claimed separately in a manner
27consistent with federal Medicaid requirements and the approved
28Medicaid state plan and waivers and shall be limited to 15 percent
29of the total actual cost of direct client services.

30(d) The cost of performing quality assurance and utilization
31review activities shall be reimbursed separately and shall not be
32included in administrative cost.

33(e) The reimbursement methodology established pursuant to
34this section shall be based upon certified public expenditures,
35which encourage economy and efficiency in service delivery.

36(f) The reimbursement amounts established for direct client
37services pursuant to this section shall be based on increments of
38time for all noninpatient services.

39(g) The reimbursement methodology shall not be implemented
40until it has received any necessary federal approvals.

P48   1(h) This section shall become operative on July 1, 2012.

2

SEC. 38.  

Section 14717 of the Welfare and Institutions Code
3 is amended to read:

4

14717.  

(a) In order to facilitate the receipt of medically
5necessary specialty mental health services by a foster child who
6is placed outside his or her county of original jurisdiction, the
7department shall take all of the following actions:

8(1) On or before July 1, 2008, create all of the following items,
9in consultation with stakeholders, including, but not limited to,
10the California Institute for Mental Health, the Child and Family
11Policy Institute, thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
12Directors Associationbegin insert of Californiaend insert, and the California Alliance
13of Child and Family Services:

14(A) A standardized contract for the purchase of medically
15necessary specialty mental health services from organizational
16providers, when a contract is required.

17(B) A standardized specialty mental health service authorization
18procedure.

19(C) A standardized set of documentation standards and forms,
20including, but not limited to, forms for treatment plans, annual
21treatment plan updates, day treatment intensive and day treatment
22rehabilitative progress notes, and treatment authorization requests.

23(2) On or before January 1, 2009, use the standardized items as
24described in paragraph (1) to provide medically necessary specialty
25mental health services to a foster child who is placed outside his
26or her county of original jurisdiction, so that organizational
27providers who are already certified by a mental health plan are not
28required to be additionally certified by the mental health plan in
29the county of original jurisdiction.

30(3) (A) On or before January 1, 2009, use the standardized
31items described in paragraph (1) to provide medically necessary
32specialty mental health services to a foster child placed outside
33his or her county of original jurisdiction to constitute a complete
34contract, authorization procedure, and set of documentation
35standards and forms, so that no additional documents are required.

36(B) Authorize a county mental health plan to be exempt from
37subparagraph (A) and have an addendum to a contract,
38authorization procedure, or set of documentation standards and
39forms, if the county mental health plan has an externally placed
P49   1requirement, such as a requirement from a federal integrity
2agreement, that would affect one of these documents.

3(4) Following consultation with stakeholders, including, but not
4limited to, the California Institute for Mental Health, the Child and
5Family Policy Institute, thebegin delete California Mentalend deletebegin insert County Behavioralend insert
6 Health Directors Associationbegin insert of Californiaend insert, the California State
7Association of Counties, and the California Alliance of Child and
8Family Services, require the use of the standardized contracts,
9authorization procedures, and documentation standards and forms
10as specified in paragraph (1) in the 2008-09 state-county mental
11health plan contract and each state-county mental health plan
12contract thereafter.

13(5) The mental health plan shall complete a standardized
14contract, as provided in paragraph (1), if a contract is required, or
15another mechanism of payment if a contract is not required, with
16a provider or providers of the county’s choice, to deliver approved
17specialty mental health services for a specified foster child, within
1830 days of an approved treatment authorization request.

19(b) The California Health and Human Services Agency shall
20coordinate the efforts of the department and the State Department
21of Social Services to do all of the following:

22(1) Participate with the stakeholders in the activities described
23in this section.

24(2) During budget hearings in 2008 and 2009, report to the
25Legislature regarding the implementation of this section and
26subdivision (c) of Section 14716.

27(3) On or before July 1, 2008, establish the following, in
28consultation with stakeholders, including, but not limited to, the
29begin delete California Mentalend deletebegin insert County Behavioralend insert Health Directors Association
30begin insert of Californiaend insert, the California Alliance of Child and Family Services,
31and the County Welfare Directors Association of California:

32(A) Informational materials that explain to foster care providers
33how to arrange for specialty mental health services on behalf of
34 the beneficiary in their care.

35(B) Informational materials that county child welfare agencies
36can access relevant to the provision of services to children in their
37care from the out-of-county local mental health plan that is
38responsible for providing those services, including, but not limited
39to, receiving a copy of the child’s treatment plan within 60 days
40after requesting services.

P50   1(C) It is the intent of the Legislature to ensure that foster children
2who are adopted or placed permanently with relative guardians,
3and who move to a county outside their original county of
4residence, can access specialty mental health services in a timely
5manner. It is the intent of the Legislature to enact this section as
6a temporary means of ensuring access to these services, while the
7appropriate stakeholders pursue a long-term solution in the form
8of a change to the Medi-Cal Eligibility Data System that will allow
9these children to receive specialty mental health services through
10their new county of residence.

11

SEC. 39.  

Section 14718 of the Welfare and Institutions Code
12 is amended to read:

13

14718.  

(a) This section shall be limited to specialty mental
14health services reimbursed to a mental health plan that certifies
15public expenditures subject to cost settlement or specialty mental
16health services reimbursed through the department’s fiscal
17intermediary.

18(b) The following provisions shall apply to matters related to
19specialty mental health services provided under the approved
20Medi-Cal state plan and the Specialty Mental Health Services
21Waiver, including, but not limited to, reimbursement and claiming
22procedures, reviews and oversight, and appeal processes for mental
23health plans (MHPs) and MHP subcontractors.

24(1) As determined by the department, the MHP shall submit
25claims for reimbursement to the Medi-Cal program for eligible
26services.

27(2) The department may offset the amount of any federal
28disallowance, audit exception, or overpayment against subsequent
29claims from the MHP. The department may offset the amount of
30any state disallowance, or audit exception or overpayment against
31subsequent claims from the mental health plan, through the
322010-11 fiscal year. This offset may be done at any time, after the
33department has invoiced or otherwise notified the mental health
34plan about the audit exception, disallowance, or overpayment. The
35department shall determine the amount that may be withheld from
36each payment to the mental health plan. The maximum withheld
37amount shall be 25 percent of each payment as long as the
38department is able to comply with the federal requirements for
39repayment of federal financial participation pursuant to Section
401903(d)(2) of the federal Social Security Act (42 U.S.C. Sec.
P51   11396b(d)(2)). The department may increase the maximum amount
2when necessary for compliance with federal laws and regulations.

3(3) (A) Oversight by the department of the MHPs may include
4client record reviews of Early Periodic Screening Diagnosis and
5Treatment (EPSDT) specialty mental health services rendered by
6MHPs and MHP subcontractors under the Medi-Cal specialty
7mental health services waiver in addition to other audits or reviews
8that are conducted.

9(B) The department may contract with an independent,
10nongovernmental entity to conduct client record reviews. The
11contract awarded in connection with this section shall be on a
12competitive bid basis, pursuant to the Department of General
13Services contracting requirements, and shall meet both of the
14following additional requirements:

15(i) Require the entity awarded the contract to comply with all
16federal and state privacy laws, including, but not limited to, the
17federal Health Insurance Portability and Accountability Act
18(HIPAA; 42 U.S.C. Sec. 1320d et seq.) and its implementing
19regulations, the Confidentiality of Medical Information Act (Part
202.6 (commencing with Section 56) of Division 1 of the Civil Code),
21and Section 1798.81.5 of the Civil Code. The entity shall be subject
22to existing penalties for violation of these laws.

23(ii) Prohibit the entity awarded the contract from using or
24disclosing client records or client information for a purpose other
25than the one for which the record was given.

26(iii) Prohibit the entity awarded the contract from selling client
27records or client information.

28(C) For purposes of this paragraph, the following terms shall
29have the following meanings:

30(i) “Client record” means a medical record, chart, or similar
31file, as well as other documents containing information regarding
32an individual recipient of services, including, but not limited to,
33clinical information, dates and times of services, and other
34information relevant to the individual and services provided and
35that evidences compliance with legal requirements for Medi-Cal
36reimbursement.

37(ii) “Client record review” means examination of the client
38record for a selected individual recipient for the purpose of
39confirming the existence of documents that verify compliance with
P52   1legal requirements for claims submitted for Medi-Cal
2reimbursement.

3(D) The department shall recover overpayments of federal
4financial participation from MHPs within the timeframes required
5by federal law and regulation for repayment to the federal Centers
6for Medicare and Medicaid Services.

7(4) (A) The department, in consultation with mental health
8stakeholders, thebegin delete California Mentalend deletebegin insert County Behavioralend insert Health
9Directors Associationbegin insert of Californiaend insert, and MHP subcontractor
10representatives, shall provide an appeals process that specifies a
11progressive process for resolution of disputes about claims or
12recoupments relating to specialty mental health services under the
13Medi-Cal specialty mental health services waiver.

14(B) The department shall provide MHPs and MHP
15subcontractors the opportunity to directly appeal findings in
16 accordance with procedures that are similar to those described in
17Article 1.5 (commencing with Section 51016) of Chapter 3 of
18Subdivision 1 of Division 3 of Title 22 of the California Code of
19Regulations, until new regulations for a progressive appeals process
20are promulgated. When an MHP subcontractor initiates an appeal,
21it shall give notice to the MHP. The department shall propose a
22rulemaking package consistent with the department’s appeals
23process that is in effect on July 1, 2012 by no later than the end of
24the 2013-14 fiscal year. The reference in this subparagraph to the
25procedures described in Article 1.5 (commencing with Section
2651016) of Chapter 3 of Subdivision 1 of Division 3 of Title 22 of
27the California Code of Regulations, shall only apply to those
28appeals addressed in this subparagraph.

29(C) The department shall develop regulations as necessary to
30implement this paragraph.

31(5) The department shall conduct oversight of utilization controls
32as specified in Section 14133. The MHP shall include a
33requirement in any subcontracts that all inpatient subcontractors
34maintain necessary licensing and certification. MHPs shall require
35that services delivered by licensed staff are within their scope of
36practice. Nothing in this chapter shall prohibit the MHPs from
37establishing standards that are in addition to the federal and state
38requirements, provided that these standards do not violate federal
39and state requirements and guidelines.

P53   1(6) (A)  Subject to federal approval and consistent with state
2requirements, the MHP may negotiate rates with providers of
3specialty mental health services.

4(B) Any excess in the distribution of funds over the expenditures
5for services by the mental health plan shall be spent for the
6provision of specialty mental health services and related
7administrative costs.

8(7) Nothing in this chapter shall limit the MHP from being
9reimbursed appropriate federal financial participation for any
10qualified services. To receive federal financial participation, the
11mental health plan shall certify its public expenditures for specialty
12mental health services to the department.

13(8) Notwithstanding Section 14115, claims for federal
14reimbursement for service pursuant to this chapter shall be
15submitted by MHPs within the timeframes required by federal
16Medicaid requirements and the approved Medicaid state plan and
17waivers.

18(9) The MHP shall use the fiscal intermediary of the Medi-Cal
19program of the State Department of Health Care Services for the
20processing of claims for inpatient psychiatric hospital services
21rendered in fee-for-service Medi-Cal hospitals. The department
22shall request the Controller to offset the distribution of funds to
23the counties from the Mental Health Subaccount, the Mental Health
24Equity Subaccount, or the Vehicle License Collection Account of
25the Local Revenue Fund, or funds from the Mental Health Account
26or the Behavioral Health Subaccount of the Local Revenue Fund
272011 for the nonfederal financial participation share for these
28claims.

29(c) Counties may set aside funds for self-insurance, audit
30settlement, and statewide program risk pools. The counties shall
31assume all responsibility and liability for appropriate administration
32of the funds. Special consideration may be given to small counties
33with a population of less than 200,000. Nothing in the paragraph
34shall in any way make the state or department liable for
35mismanagement or loss of funds by the entity designated by
36counties under this subdivision.

37(d) The department shall consult with the California Mental
38Health Directors Association in February and September of each
39year to obtain data and methodology necessary to forecast future
40fiscal trends in the provision of specialty mental health services
P54   1provided under the Medi-Cal specialty mental health services
2waiver, to estimate yearly specialty mental health services related
3costs, and to estimate the annual amount of federal funding
4participation to reimburse costs of specialty mental health services
5provided under the Medi-Cal specialty mental health services
6waiver. This shall include a separate presentation of the data and
7methodology necessary to forecast future fiscal trends in the
8provision of Early Periodic Screening, Diagnosis, and Treatment
9specialty mental health services provided under the Medi-Cal
10specialty mental health services waiver, to estimate annual EPSDT
11specialty mental health services related costs, and to estimate the
12 annual amount of EPSDT specialty mental health services provided
13under the state Medi-Cal specialty mental health services waiver,
14including federal funding participation to reimburse costs of
15EPSDT.

16(e) When seeking federal approval for any federal Medicaid
17state plan amendment or waiver associated with Medi-Cal specialty
18mental health services, the department shall consult with staff of
19the Legislature, counties, providers, and other stakeholders in the
20development of the state plan amendment or waiver.

21(f) This section shall become operative on July 1, 2012.

22

SEC. 40.  

Section 14725 of the Welfare and Institutions Code
23 is amended to read:

24

14725.  

(a) The State Department of Health Care Services shall
25develop a quality assurance program to govern the delivery of
26Medi-Cal specialty mental health services, in order to assure quality
27patient care based on community standards of practice.

28(b) The department shall issue standards and guidelines for local
29quality assurance activities. These standards and guidelines shall
30be reviewed and revised in consultation with thebegin delete California Mentalend delete
31begin insert County Behavioralend insert Health Directors Associationbegin insert of California,end insert as
32well as other stakeholders from the mental health community,
33including, but not limited to, individuals who receive services,
34family members, providers, mental health advocacy groups, and
35other interested parties. The standards and guidelines shall be based
36on federal Medicaid requirements.

37(c) The standards and guidelines developed by the department
38shall reflect the special problems that small rural counties have in
39undertaking comprehensive quality assurance systems.

P55   1

SEC. 41.  

Section 15204.8 of the Welfare and Institutions Code
2 is amended to read:

3

15204.8.  

(a) The Legislature may appropriate annually in the
4Budget Act funds to support services provided pursuant to Sections
511325.7 and 11325.8.

6(b) Funds appropriated pursuant to subdivision (a) shall be
7allocated to the counties separately and shall be available for
8expenditure by the counties for services provided during the budget
9year. A county may move funds between the two accounts during
10the budget year for expenditure if necessary to meet the particular
11circumstances in the county. Any unexpended funds may be
12retained by each county for expenditure for the same purposes
13during the succeeding fiscal year. By November 20, 1998, each
14county shall report to the department on the use of these funds.

15(c) Beginning January 10, 1999, the Department of Finance
16shall report annually to the Legislature on the extent to which funds
17available under subdivision (a) have not been spent and may
18reallocate the unexpended balances so as to better meet the need
19for services.

20(d) No later than September 1, 2001, the department in
21consultation with relevant stakeholders, which may include the
22County Welfare Directorsbegin delete Association, the California Association
23of Mental Health Directors, and the County Alcohol and Drug
24Program Administrators Association,end delete
begin insert Association and the County
25Behavioral Health Directors Association of California,end insert
shall
26develop the allocation methodology for these funds, including the
27 specific components to be considered in allocating the funds.

28

SEC. 42.  

Section 15847.7 of the Welfare and Institutions Code
29 is amended to read:

30

15847.7.  

(a) For purposes of Sections 15847, 15847.3, and
3115847.5, “group health coverage” includes anybegin delete nonprofit hospital
32service plan,end delete
health care service plan, self-insured employee
33welfare benefit plan, or disability insurance providing medical or
34hospital benefits.

35(b) This section shall become operative on July 1, 2014.

36

SEC. 43.  

Section 17604 of the Welfare and Institutions Code
37 is amended to read:

38

17604.  

(a) All motor vehicle license fee revenues collected in
39the 1991-92 fiscal year that are deposited to the credit of the Local
P56   1Revenue Fund shall be credited to the Vehicle License Fee Account
2of that fund.

3(b) (1) For the 1992-93 fiscal year and fiscal years thereafter,
4from vehicle license fee proceeds from revenues deposited to the
5credit of the Local Revenue Fund, the Controller shall make
6monthly deposits to the Vehicle License Fee Account of the Local
7Revenue Fund until the deposits equal the amounts that were
8allocated to counties, cities, and cities and counties as general
9purpose revenues in the prior fiscal year pursuant to this chapter
10from the Vehicle License Fee Account in the Local Revenue Fund
11and the Vehicle License Fee Account and the Vehicle License Fee
12Growth Account in the Local Revenue Fund.

13(2) Any excess vehicle fee revenues deposited into the Local
14Revenue Fund pursuant to Section 11001.5 of the Revenue and
15Taxation Code shall be deposited in the Vehicle License Fee
16Growth Account of the Local Revenue Fund.

17(3) The Controller shall calculate the difference between the
18total amount of vehicle license fee proceeds deposited to the credit
19of the Local Revenue Fund, pursuant to paragraph (1) of
20subdivision (a) of Section 11001.5 of the Revenue and Taxation
21Code, and deposited into the Vehicle License Fee Account for the
22period of July 16, 2009, to July 15, 2010, inclusive, and the amount
23deposited for the period of July 16, 2010, to July 15, 2011,
24inclusive.

25(4) Of vehicle license fee proceeds deposited to the Vehicle
26License Fee Account after July 15, 2011, an amount equal to the
27difference calculated in paragraph (3) shall be deemed to have
28been deposited during the period of July 16, 2010, to July 15, 2011,
29inclusive, and allocated to cities, counties, and a city and county
30as if those proceeds had been received during the 2010-11 fiscal
31year.

32(c) (1) On or before the 27th day of each month, the Controller
33shall allocate to each county, city, or city and county, as general
34purpose revenues the amounts deposited and remaining unexpended
35and unreserved on the 15th day of the month in the Vehicle License
36Fee Account of the Local Revenue Fund, in accordance with
37paragraphs (2) and (3).

38(2) For the 1991-92 fiscal year, allocations shall be made in
39accordance with the following schedule:


P58  24

 

Jurisdiction

Allocation
Percentage

Alameda   

4.5046

Alpine   

0.0137

Amador   

0.1512

Butte   

0.8131

Calaveras   

0.1367

Colusa   

0.1195

Contra Costa   

2.2386

Del Norte   

0.1340

El Dorado   

0.5228

Fresno   

2.3531

Glenn   

0.1391

Humboldt   

0.8929

Imperial   

0.8237

Inyo   

0.1869

Kern   

1.6362

Kings   

0.4084

Lake   

0.1752

Lassen   

0.1525

Los Angeles   

37.2606 

Madera   

0.3656

Marin   

1.0785

Mariposa   

0.0815

Mendocino   

0.2586

Merced   

0.4094

Modoc   

0.0923

Mono   

0.1342

Monterey   

0.8975

Napa   

0.4466

Nevada   

0.2734

Orange   

5.4304

Placer   

0.2806

Plumas   

0.1145

Riverside   

2.7867

Sacramento   

2.7497

San Benito   

0.1701

San Bernardino   

2.4709

San Diego   

4.7771

San Francisco   

7.1450

San Joaquin   

1.0810

San Luis Obispo   

0.4811

San Mateo   

1.5937

Santa Barbara   

0.9418

Santa Clara   

3.6238

Santa Cruz   

0.6714

Shasta   

0.6732

Sierra   

0.0340

Siskiyou   

0.2246

Solano   

0.9377

Sonoma   

1.6687

Stanislaus   

1.0509

Sutter   

0.4460

Tehama   

0.2986

Trinity   

0.1388

Tulare   

0.7485

Tuolumne   

0.2357

Ventura   

1.3658

Yolo   

0.3522

Yuba   

0.3076

Berkeley   

0.0692

Long Beach   

0.2918

Pasadena   

0.1385

35P58   8

 

25(3) For the 1992-93, 1993-94, and 1994-95 fiscal years and
26fiscal years thereafter, allocations shall be made in the same
27amounts as were distributed from the Vehicle License Fee Account
28and the Vehicle License Fee Growth Account in the prior fiscal
29year.

30(4) For the 1995-96 fiscal year, allocations shall be made in the
31same amounts as distributed in the 1994-95 fiscal year from the
32Vehicle License Fee Account and the Vehicle License Fee Growth
33Account after adjusting the allocation amounts by the amounts
34specified for the following counties:

 

Alpine   

  $(11,296)

Amador   

25,417

Calaveras   

49,892

Del Norte   

39,537

Glenn   

 (12,238)

Lassen   

17,886

Mariposa   

  (6,950)

Modoc   

 (29,182)

Mono   

  (6,950)

San Benito   

20,710

Sierra   

 (39,537)

Trinity   

 (48,009)

P58   8

 

9(5) (A) For the 1996-97 fiscal year and fiscal years thereafter,
10allocations shall be made in the same amounts as were distributed
11from the Vehicle License Fee Account and the Vehicle License
12Fee Growth Account in the prior fiscal year.

13(B) Initial proceeds deposited in the Vehicle License Fee
14Account in the 2003-04 fiscal year in the amount that would
15otherwise have been transferred pursuant to former Section 10754
16of the Revenue and Taxation Code for the period June 20, 2003,
17to July 15, 2003, inclusive, shall be deemed to have been deposited
18during the period June 16, 2003, to July 15, 2003, inclusive, and
19allocated to cities, counties, and a city and county during the
20 2002-03 fiscal year.

21(d) The Controller shall make monthly allocations from the
22amount deposited in the Vehicle License Collection Account of
23the Local Revenue Fund to each county in accordance with a
24schedule to be developed by the State Department of State
25Hospitals in consultation with thebegin delete California Mentalend deletebegin insert County
26Behavioralend insert
Health Directors Associationbegin insert of Californiaend insert, which is
27compatible with the intent of the Legislature expressed in the act
28adding this subdivision.

29(e) Before making the monthly allocations in accordance with
30paragraph (5) of subdivision (c) and subdivision (d), and pursuant
31to a schedule provided by the Department of Finance, the
32Controller shall adjust the monthly distributions from the Vehicle
33License Fee Account to reflect an equal exchange of sales and use
34tax funds from the Social Services Subaccount to the Health
35Subaccount, as required by subdivisions (d) and (e) of Section
3617600.15, and of Vehicle License Fee funds from the Health
37Account to the Social Services Account. Adjustments made to the
38Vehicle License Fee distributions pursuant to this subdivision shall
P60   1not be used in calculating future year allocations to the Vehicle
2License Fee Account.



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