Amended in Assembly September 4, 2015

Amended in Assembly September 1, 2015

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 Sectionsbegin delete 1366.22,end delete 11801, 11811.6, 11830.1, 11835,begin delete 24100,end delete 103577, 104151, 128456, 130302, and 130304 of,begin delete to amend, repeal, and add Sections 1366.24 and 1366.25 of,end delete and to repeal Sections 130316 and 130317 of, the Health and Safety Code,begin delete to amend Section 10128.52 of, and to amend, repeal, and add Sections 10128.54 and 10128.55 of, the Insurance Code,end delete and to amend Sections 729.12, 4033, 4040, 4095,begin delete 4096.5,end delete 4117, 5121, 5150, 5152.1, 5152.2, 5250.1, 5305, 5306.5, 5307, 5308, 5326.95, 5328, 5328.2, 5346, 5400, 5585.22, 5601, 5611, 5664, 5694.7, 5701.1, 5701.2, 5717, 5750, 5814.5,begin delete5845,end delete 5847, 5848, 5848.5, 5892, 5899, 5902, 6002.25, 8103, 11467, 11469, 14021.4, 14124.24, 14251, 14499.71, 14682.1, 14707, 14711, 14717, 14718, 14725, 15204.8, and 15847.7 of the Welfare and Institutions Code, relating to public health.

LEGISLATIVE COUNSEL’S DIGEST

SB 804, as amended, Committee on Health. Public health.

begin delete

(1) The Knox-Keene Health Care Service Plan Act of 1975 provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. The California Continuation Benefits Replacement Act (Cal-COBRA) requires health care service plans and health insurers providing coverage under a group benefit plan to employers of 2 to 19 eligible employees to offer a continuation of that coverage for a specified period of time to certain qualified beneficiaries, as specified. Existing law requires a group benefit plan that is subject to Cal-COBRA to make specified disclosures to covered employees, including that a covered employee who is considering declining continuation of coverage should be aware that companies selling individual health insurance may require a review of the employee’s medical history that could result in a higher premium or denial of coverage.

end delete
begin delete

This bill would eliminate the disclosure requirement described above. If federal law requiring an individual to maintain minimum health coverage is repealed or amended to no longer apply to the individual market, as specified, the bill would reenact that disclosure requirement to become operative 12 months after that repeal or amendment. The bill would also, under those same conditions, require a contract between a group benefit plan that is subject to Cal-COBRA and an employer to require the employer to make the same disclosure to a qualified beneficiary in connection with a notice regarding election of continuation coverage. The bill would require a group benefit plan that is subject to Cal-COBRA and that issues, amends, or renews a disclosure on or after July 1, 2016, to include a notice regarding additional health care coverage options in that disclosure, as specified. The bill would require a group contract that is issued, amended, or renewed on or after July 1, 2016, between a group benefit plan that is subject to Cal-COBRA and an employer to require the employer to give that notice regarding additional health care coverage options to a qualified beneficiary of the contract in connection with a notice regarding election of continuation coverage. The bill would make conforming changes to related provisions.

end delete
begin delete

Because a willful violation of the bill’s requirements relative to health care service plans would be a crime, this bill would impose a state-mandated local program.

end delete
begin delete

(2)

end delete

begin insert(1)end insert 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 to certain provisions relating to mental health directors and alcohol and drug program administrators.

begin delete

(3)

end delete

begin insert(2)end insert 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.

begin delete

(4)

end delete

begin insert(3)end insert 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.

begin delete

(5)

end delete

begin insert(4)end insert 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 charged under the above circumstances.

begin delete

(6)

end delete

begin insert(5)end insert 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. The bill would update references to the office to refer instead to the Office of Health Information Integrity.

begin delete

(7) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

end delete
begin delete

This bill would provide that no reimbursement is required by this act for a specified reason.

end delete

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: begin deleteyes end deletebegin insertnoend insert.

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

begin delete
P4    1

SECTION 1.  

Section 1366.22 of the Health and Safety Code
2 is amended to read:

3

1366.22.  

The continuation coverage requirements of this article
4do not apply to the following individuals:

5(a) Individuals who are entitled to Medicare benefits or become
6entitled to Medicare benefits pursuant to Title XVIII of the United
7States Social Security Act, as amended or superseded. Entitlement
8to Medicare Part A only constitutes entitlement to benefits under
9Medicare.

P5    1(b) Individuals who have other hospital, medical, or surgical
2coverage or who are covered or become covered under another
3group benefit plan, including a self-insured employee welfare
4benefit plan, that provides coverage for individuals and that does
5not impose any exclusion or limitation with respect to any
6preexisting condition of the individual, other than a preexisting
7condition limitation or exclusion that does not apply to or is
8satisfied by the qualified beneficiary pursuant to Sections 1357
9and 1357.06. A group conversion option under any group benefit
10plan shall not be considered as an arrangement under which an
11individual is or becomes covered.

12(c) Individuals who are covered, become covered, or are eligible
13for federal COBRA coverage pursuant to Section 4980B of the
14United States Internal Revenue Code or Chapter 18 of the
15Employee Retirement Income Security Act (29 U.S.C. Sec. 1161
16et seq.).

17(d) Individuals who are covered, become covered, or are eligible
18for coverage pursuant to Chapter 6A of the Public Health Service
19Act (42 U.S.C. Section 300bb-1 et seq.).

20(e) Qualified beneficiaries who fail to meet the requirements of
21subdivision (b) of Section 1366.24 or subdivision (i) of Section
221366.25 regarding notification of a qualifying event or election of
23continuation coverage within the specified time limits.

24(f) Except as provided in Section 3001 of ARRA, qualified
25beneficiaries who fail to submit the correct premium amount
26required by subdivision (b) of Section 1366.24 and Section
271366.26, in accordance with the terms and conditions of the plan
28contract, or fail to satisfy other terms and conditions of the plan
29contract.

30

SEC. 2.  

Section 1366.24 of the Health and Safety Code is
31amended to read:

32

1366.24.  

(a) Every health care service plan evidence of
33coverage, provided for group benefit plans subject to this article,
34that is issued, amended, or renewed on or after January 1, 1999,
35shall disclose to covered employees of group benefit plans subject
36to this article the ability to continue coverage pursuant to this
37article, as required by this section.

38(b) This disclosure shall state that all enrollees who are eligible
39to be qualified beneficiaries, as defined in subdivision (c) of
40Section 1366.21, shall be required, as a condition of receiving
P6    1benefits pursuant to this article, to notify, in writing, the health
2care service plan, or the employer if the employer contracts to
3perform the administrative services as provided for in Section
41366.25, of all qualifying events as specified in paragraphs (1),
5(3), (4), and (5) of subdivision (d) of Section 1366.21 within 60
6days of the date of the qualifying event. This disclosure shall
7inform enrollees that failure to make the notification to the health
8care service plan, or to the employer when under contract to
9provide the administrative services, within the required 60 days
10will disqualify the qualified beneficiary from receiving continuation
11coverage pursuant to this article. The disclosure shall further state
12that a qualified beneficiary who wishes to continue coverage under
13the group benefit plan pursuant to this article shall request the
14continuation in writing and deliver the written request, by first-class
15mail, or other reliable means of delivery, including personal
16delivery, express mail, or private courier company, to the health
17care service plan, or to the employer if the plan has contracted
18with the employer for administrative services pursuant to
19subdivision (d) of Section 1366.25, within the 60-day period
20following the later of (1) the date that the enrollee’s coverage under
21the group benefit plan terminated or will terminate by reason of a
22qualifying event, or (2) the date the enrollee was sent notice
23pursuant to subdivision (e) of Section 1366.25 of the ability to
24continue coverage under the group benefit plan. The disclosure
25required by this section shall also state that a qualified beneficiary
26electing continuation shall pay to the health care service plan, in
27accordance with the terms and conditions of the plan contract,
28which shall be set forth in the notice to the qualified beneficiary
29pursuant to subdivision (d) of Section 1366.25, the amount of the
30required premium payment, as set forth in Section 1366.26. The
31disclosure shall further require that the qualified beneficiary’s first
32premium payment required to establish premium payment be
33delivered by first-class mail, certified mail, or other reliable means
34of delivery, including personal delivery, express mail, or private
35courier company, to the health care service plan, or to the employer
36if the employer has contracted with the plan to perform the
37administrative services pursuant to subdivision (d) of Section
381366.25, within 45 days of the date the qualified beneficiary
39provided written notice to the health care service plan or the
40employer, if the employer has contracted to perform the
P6    1administrative services, of the election to continue coverage in
2order for coverage to be continued under this article. This
3disclosure shall also state that the first premium payment shall
4equal an amount sufficient to pay any required premiums and all
5premiums due, and that failure to submit the correct premium
6amount within the 45-day period will disqualify the qualified
7beneficiary from receiving continuation coverage pursuant to this
8article.

9(c) The disclosure required by this section shall also describe
10separately how qualified beneficiaries whose continuation coverage
11terminates under a prior group benefit plan pursuant to subdivision
12(b) of Section 1366.27 may continue their coverage for the balance
13of the period that the qualified beneficiary would have remained
14covered under the prior group benefit plan, including the
15requirements for election and payment. The disclosure shall clearly
16state that continuation coverage shall terminate if the qualified
17beneficiary fails to comply with the requirements pertaining to
18enrollment in, and payment of premiums to, the new group benefit
19plan within 30 days of receiving notice of the termination of the
20prior group benefit plan.

21(d) Prior to August 1, 1998, every health care service plan shall
22provide to all covered employees of employers subject to this
23article a written notice containing the disclosures required by this
24section, or shall provide to all covered employees of employers
25subject to this section a new or amended evidence of coverage that
26includes the disclosures required by this section. Any specialized
27health care service plan that, in the ordinary course of business,
28maintains only the addresses of employer group purchasers of
29benefits and does not maintain addresses of covered employees,
30may comply with the notice requirements of this section through
31the provision of the notices to its employer group purchasers of
32benefits.

33(e) Every plan disclosure form issued, amended, or renewed on
34and after January 1, 1999, for a group benefit plan subject to this
35article shall provide a notice that, under state law, an enrollee may
36be entitled to continuation of group coverage and that additional
37information regarding eligibility for this coverage may be found
38in the plan’s evidence of coverage.

P8    1(f) A disclosure issued, amended, or renewed on or after July
21, 2016, for a group benefit plan subject to this article shall include
3the following notice:

4“In addition to your coverage continuation options, you may be
5eligible for the following:

61. Coverage through the state health insurance marketplace, also
7known as Covered California. By enrolling through Covered
8California, you may qualify for lower monthly premiums and lower
9out-of-pocket costs. Your family members may also qualify for
10coverage through Covered California.

112. Coverage through Medi-Cal. Depending on your income, you
12may qualify for low- or no-cost coverage through Medi-Cal. Your
13family members may also qualify for Medi-Cal.

143. Coverage through an insured spouse. If your spouse has
15coverage that extends to family members, you may be able to be
16added on that benefit plan.

17Be aware that there is a deadline to enroll in Covered California
18although you can apply for Medi-Cal anytime. To find out more
19about how to apply for Covered California and Medi-Cal, visit the
20Covered California Internet Web site at

21http://www.coveredca.com.”

22(g) (1) If Section 5000A of the Internal Revenue Code, as added
23by Section 1501 of PPACA, is repealed or amended to no longer
24apply to the individual market, as defined in Section 2791 of the
25federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this
26section shall become inoperative and is repealed 12 months after
27the date of that repeal or amendment.

28(2) For purposes of this subdivision, “PPACA” means the federal
29Patient Protection and Affordable Care Act (Public Law 111-148),
30as amended by the federal Health Care and Education
31Reconciliation Act of 2010 (Public Law 111-152), and any rules,
32regulations, or guidance issued pursuant to that law.

33

SEC. 3.  

Section 1366.24 is added to the Health and Safety
34Code
, to read:

35

1366.24.  

(a) Every health care service plan evidence of
36coverage, provided for group benefit plans subject to this article,
37that is issued, amended, or renewed on or after January 1, 1999,
38shall disclose to covered employees of group benefit plans subject
39to this article the ability to continue coverage pursuant to this
40article, as required by this section.

P9    1(b) This disclosure shall state that all enrollees who are eligible
2to be qualified beneficiaries, as defined in subdivision (c) of
3Section 1366.21, shall be required, as a condition of receiving
4benefits pursuant to this article, to notify, in writing, the health
5care service plan, or the employer if the employer contracts to
6perform the administrative services as provided for in Section
7 1366.25, of all qualifying events as specified in paragraphs (1),
8(3), (4), and (5) of subdivision (d) of Section 1366.21 within 60
9days of the date of the qualifying event. This disclosure shall
10inform enrollees that failure to make the notification to the health
11care service plan, or to the employer when under contract to
12provide the administrative services, within the required 60 days
13will disqualify the qualified beneficiary from receiving continuation
14coverage pursuant to this article. The disclosure shall further state
15that a qualified beneficiary who wishes to continue coverage under
16the group benefit plan pursuant to this article must request the
17continuation in writing and deliver the written request, by first-class
18mail, or other reliable means of delivery, including personal
19delivery, express mail, or private courier company, to the health
20care service plan, or to the employer if the plan has contracted
21with the employer for administrative services pursuant to
22subdivision (d) of Section 1366.25, within the 60-day period
23following the later of either (1) the date that the enrollee’s coverage
24under the group benefit plan terminated or will terminate by reason
25of a qualifying event, or (2) the date the enrollee was sent notice
26pursuant to subdivision (e) of Section 1366.25 of the ability to
27continue coverage under the group benefit plan. The disclosure
28required by this section shall also state that a qualified beneficiary
29electing continuation shall pay to the health care service plan, in
30accordance with the terms and conditions of the plan contract,
31which shall be set forth in the notice to the qualified beneficiary
32pursuant to subdivision (d) of Section 1366.25, the amount of the
33required premium payment, as set forth in Section 1366.26. The
34disclosure shall further require that the qualified beneficiary’s first
35premium payment required to establish premium payment be
36delivered by first-class mail, certified mail, or other reliable means
37of delivery, including personal delivery, express mail, or private
38courier company, to the health care service plan, or to the employer
39if the employer has contracted with the plan to perform the
40administrative services pursuant to subdivision (d) of Section
P9    11366.25, within 45 days of the date the qualified beneficiary
2provided written notice to the health care service plan or the
3employer, if the employer has contracted to perform the
4administrative services, of the election to continue coverage in
5order for coverage to be continued under this article. This
6disclosure shall also state that the first premium payment must
7equal an amount sufficient to pay any required premiums and all
8premiums due, and that failure to submit the correct premium
9amount within the 45-day period will disqualify the qualified
10beneficiary from receiving continuation coverage pursuant to this
11article.

12(c) The disclosure required by this section shall also describe
13separately how qualified beneficiaries whose continuation coverage
14terminates under a prior group benefit plan pursuant to subdivision
15(b) of Section 1366.27 may continue their coverage for the balance
16of the period that the qualified beneficiary would have remained
17covered under the prior group benefit plan, including the
18requirements for election and payment. The disclosure shall clearly
19state that continuation coverage shall terminate if the qualified
20beneficiary fails to comply with the requirements pertaining to
21enrollment in, and payment of premiums to, the new group benefit
22plan within 30 days of receiving notice of the termination of the
23prior group benefit plan.

24(d) Prior to August 1, 1998, every health care service plan shall
25provide to all covered employees of employers subject to this
26article a written notice containing the disclosures required by this
27section, or shall provide to all covered employees of employers
28subject to this section a new or amended evidence of coverage that
29includes the disclosures required by this section. Any specialized
30health care service plan that, in the ordinary course of business,
31maintains only the addresses of employer group purchasers of
32benefits and does not maintain addresses of covered employees,
33may comply with the notice requirements of this section through
34the provision of the notices to its employer group purchasers of
35benefits.

36(e) Every plan disclosure form issued, amended, or renewed on
37or after January 1, 1999, for a group benefit plan subject to this
38article shall provide a notice that, under state law, an enrollee may
39be entitled to continuation of group coverage and that additional
P11   1information regarding eligibility for this coverage may be found
2in the plan’s evidence of coverage.

3(f) Every disclosure issued, amended, or renewed on or after
4the operative date of this section for a group benefit plan subject
5to this article shall include the following notice:

6“Please examine your options carefully before declining this
7coverage. You should be aware that companies selling individual
8health insurance typically require a review of your medical history
9that could result in a higher premium or you could be denied
10coverage entirely.”

11(g) A disclosure issued, amended, or renewed on or after July
121, 2016, for a group benefit plan subject to this article shall include
13the following

14notice:

15“In addition to your coverage continuation options, you may be
16eligible for the following:

171. Coverage through the state health insurance marketplace, also
18known as Covered California. By enrolling through Covered
19California, you may qualify for lower monthly premiums and lower
20out-of-pocket costs. Your family members may also qualify for
21coverage through Covered California.

222. Coverage through Medi-Cal. Depending on your income, you
23may qualify for low- or no-cost coverage through Medi-Cal. Your
24family members may also qualify for Medi-Cal.

253. Coverage through an insured spouse. If your spouse has
26coverage that extends to family members, you may be able to be
27added on that benefit plan.

28Be aware that there is a deadline to enroll in Covered California
29although you can apply for Medi-Cal anytime. To find out more
30about how to apply for Covered California and Medi-Cal, visit the
31Covered California Internet Web site at

32http://www.coveredca.com.”

33(h) (1) If Section 5000A of the Internal Revenue Code, as added
34by Section 1501 of PPACA, is repealed or amended to no longer
35apply to the individual market, as defined in Section 2791 of the
36federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this
37section shall become operative 12 months after the date of that
38repeal or amendment.

39(2) For purposes of this subdivision, “PPACA” means the federal
40Patient Protection and Affordable Care Act (Public Law 111-148),
P12   1as amended by the federal Health Care and Education
2Reconciliation Act of 2010 (Public Law 111-152), and any rules,
3regulations, or guidance issued pursuant to that law.

4

SEC. 4.  

Section 1366.25 of the Health and Safety Code is
5amended to read:

6

1366.25.  

(a) Every group contract between a health care service
7plan and an employer subject to this article that is issued, amended,
8or renewed on or after July 1, 1998, shall require the employer to
9notify the plan, in writing, of any employee who has had a
10qualifying event, as defined in paragraph (2) of subdivision (d) of
11Section 1366.21, within 30 days of the qualifying event. The group
12contract shall also require the employer to notify the plan, in
13writing, within 30 days of the date, when the employer becomes
14subject to Section 4980B of the United States Internal Revenue
15Code or Chapter 18 of the Employee Retirement Income Security
16Act (29 U.S.C. Sec. 1161 et seq.).

17(b) Every group contract between a plan and an employer subject
18to this article that is issued, amended, or renewed on or after July
191, 1998, shall require the employer to notify qualified beneficiaries
20currently receiving continuation coverage, whose continuation
21coverage will terminate under one group benefit plan prior to the
22end of the period the qualified beneficiary would have remained
23covered, as specified in Section 1366.27, of the qualified
24beneficiary’s ability to continue coverage under a new group
25benefit plan for the balance of the period the qualified beneficiary
26would have remained covered under the prior group benefit plan.
27This notice shall be provided either 30 days prior to the termination
28or when all enrolled employees are notified, whichever is later.

29Every health care service plan and specialized health care service
30plan shall provide to the employer replacing a health care service
31plan contract issued by the plan, or to the employer’s agent or
32broker representative, within 15 days of any written request,
33information in possession of the plan reasonably required to
34administer the notification requirements of this subdivision and
35subdivision (c).

36(c) Notwithstanding subdivision (a), the group contract between
37the health care service plan and the employer shall require the
38employer to notify the successor plan in writing of the qualified
39beneficiaries currently receiving continuation coverage so that the
40successor plan, or contracting employer or administrator, may
P13   1provide those qualified beneficiaries with the necessary premium
2information, enrollment forms, and instructions consistent with
3the disclosure required by subdivision (c) of Section 1366.24 and
4subdivision (e) of this section to allow the qualified beneficiary to
5continue coverage. This information shall be sent to all qualified
6beneficiaries who are enrolled in the plan and those qualified
7beneficiaries who have been notified, pursuant to Section 1366.24,
8of their ability to continue their coverage and may still elect
9coverage within the specified 60-day period. This information
10shall be sent to the qualified beneficiary’s last known address, as
11provided to the employer by the health care service plan or
12disability insurer currently providing continuation coverage to the
13qualified beneficiary. The successor plan shall not be obligated to
14provide this information to qualified beneficiaries if the employer
15or prior plan or insurer fails to comply with this section.

16(d) A health care service plan may contract with an employer,
17or an administrator, to perform the administrative obligations of
18the plan as required by this article, including required notifications
19and collecting and forwarding premiums to the health care service
20plan. Except for the requirements of subdivisions (a), (b), and (c),
21this subdivision shall not be construed to permit a plan to require
22an employer to perform the administrative obligations of the plan
23as required by this article as a condition of the issuance or renewal
24of coverage.

25(e) Every health care service plan, or employer or administrator
26that contracts to perform the notice and administrative services
27pursuant to this section, shall, within 14 days of receiving a notice
28of a qualifying event, provide to the qualified beneficiary the
29necessary benefits information, premium information, enrollment
30forms, and disclosures consistent with the notice requirements
31contained in subdivisions (b) and (c) of Section 1366.24 to allow
32the qualified beneficiary to formally elect continuation coverage.
33This information shall be sent to the qualified beneficiary’s last
34known address.

35(f) Every health care service plan, or employer or administrator
36that contracts to perform the notice and administrative services
37pursuant to this section, shall, during the 180-day period ending
38on the date that continuation coverage is terminated pursuant to
39paragraphs (1), (3), and (5) of subdivision (a) of Section 1366.27,
40notify a qualified beneficiary who has elected continuation
P14   1coverage pursuant to this article of the date that his or her coverage
2will terminate, and shall notify the qualified beneficiary of any
3conversion coverage available to that qualified beneficiary. This
4requirement shall not apply when the continuation coverage is
5terminated because the group contract between the plan and the
6employer is being terminated.

7(g) (1) A health care service plan shall provide to a qualified
8beneficiary who has a qualifying event during the period specified
9in subparagraph (A) of paragraph (3) of subdivision (a) of Section
103001 of ARRA, a written notice containing information on the
11availability of premium assistance under ARRA. This notice shall
12be sent to the qualified beneficiary’s last known address. The notice
13shall include clear and easily understandable language to inform
14the qualified beneficiary that changes in federal law provide a new
15opportunity to elect continuation coverage with a 65-percent
16premium subsidy and shall include all of the following:

17(A) The amount of the premium the person will pay. For
18qualified beneficiaries who had a qualifying event between
19September 1, 2008, and May 12, 2009, inclusive, if a health care
20service plan is unable to provide the correct premium amount in
21the notice, the notice may contain the last known premium amount
22and an opportunity for the qualified beneficiary to request, through
23a toll-free telephone number, the correct premium that would apply
24to the beneficiary.

25(B) Enrollment forms and any other information required to be
26included pursuant to subdivision (e) to allow the qualified
27beneficiary to elect continuation coverage. This information shall
28not be included in notices sent to qualified beneficiaries currently
29enrolled in continuation coverage.

30(C) A description of the option to enroll in different coverage
31as provided in subparagraph (B) of paragraph (1) of subdivision
32(a) of Section 3001 of ARRA. This description shall advise the
33qualified beneficiary to contact the covered employee’s former
34employer for prior approval to choose this option.

35(D) The eligibility requirements for premium assistance in the
36amount of 65 percent of the premium under Section 3001 of
37ARRA.

38(E) The duration of premium assistance available under ARRA.

P15   1(F) A statement that a qualified beneficiary eligible for premium
2assistance under ARRA may elect continuation coverage no later
3than 60 days of the date of the notice.

4(G) A statement that a qualified beneficiary eligible for premium
5assistance under ARRA who rejected or discontinued continuation
6coverage prior to receiving the notice required by this subdivision
7has the right to withdraw that rejection and elect continuation
8coverage with the premium assistance.

9(H) A statement that reads as follows:


11“IF YOU ARE HAVING ANY DIFFICULTIES READING OR
12UNDERSTANDING THIS NOTICE, PLEASE CONTACT [name
13of health plan] at [insert appropriate telephone number].”
14


15(2) With respect to qualified beneficiaries who had a qualifying
16event between September 1, 2008, and May 12, 2009, inclusive,
17the notice described in this subdivision shall be provided by the
18later of May 26, 2009, or seven business days after the date the
19plan receives notice of the qualifying event.

20(3) With respect to qualified beneficiaries who had or have a
21qualifying event between May 13, 2009, and the later date specified
22in subparagraph (A) of paragraph (3) of subdivision (a) of Section
233001 of ARRA, inclusive, the notice described in this subdivision
24shall be provided within the period of time specified in subdivision
25(e).

26(4) Nothing in this section shall be construed to require a health
27care service plan to provide the plan’s evidence of coverage as a
28part of the notice required by this subdivision, and nothing in this
29section shall be construed to require a health care service plan to
30amend its existing evidence of coverage to comply with the changes
31made to this section by the enactment of Assembly Bill 23 of the
322009-10 Regular Session or by the act amending this section during
33the second year of the 2009-10 Regular Session.

34(5) The requirement under this subdivision to provide a written
35notice to a qualified beneficiary and the requirement under
36paragraph (1) of subdivision (i) to provide a new opportunity to a
37qualified beneficiary to elect continuation coverage shall be deemed
38satisfied if a health care service plan previously provided a written
39notice and additional election opportunity under Section 3001 of
P16   1ARRA to that qualified beneficiary prior to the effective date of
2the act adding this paragraph.

3(h) A group contract between a group benefit plan and an
4employer subject to this article that is issued, amended, or renewed
5on or after July 1, 2016, shall require the employer to give the
6following notice to a qualified beneficiary in connection with a
7notice regarding election of continuation coverage:

8“In addition to your coverage continuation options, you may be
9eligible for the following:

101. Coverage through the state health insurance marketplace, also
11known as Covered California. By enrolling through Covered
12California, you may qualify for lower monthly premiums and lower
13out-of-pocket costs. Your family members may also qualify for
14coverage through Covered California.

152. Coverage through Medi-Cal. Depending on your income, you
16may qualify for low- or no-cost coverage through Medi-Cal. Your
17family members may also qualify for Medi-Cal.

183. Coverage through an insured spouse. If your spouse has
19coverage that extends to family members, you may be able to be
20added on that benefit plan.

21Be aware that there is a deadline to enroll in Covered California
22although you can apply for Medi-Cal anytime. To find out more
23about how to apply for Covered California and Medi-Cal, visit the
24Covered California Internet Web site at

25http://www.coveredca.com.”

26(i) (1) Notwithstanding any other law, a qualified beneficiary
27eligible for premium assistance under ARRA may elect
28continuation coverage no later than 60 days after the date of the
29notice required by subdivision (g).

30(2) For a qualified beneficiary who elects to continue coverage
31pursuant to this subdivision, the period beginning on the date of
32the qualifying event and ending on the effective date of the
33continuation coverage shall be disregarded for purposes of
34calculating a break in coverage in determining whether a
35preexisting condition provision applies under subdivision (c) of
36Section 1357.06 or subdivision (e) of Section 1357.51.

37(3) For a qualified beneficiary who had a qualifying event
38between September 1, 2008, and February 16, 2009, inclusive, and
39who elects continuation coverage pursuant to paragraph (1), the
P17   1continuation coverage shall commence on the first day of the month
2following the election.

3(4) For a qualified beneficiary who had a qualifying event
4between February 17, 2009, and May 12, 2009, inclusive, and who
5elects continuation coverage pursuant to paragraph (1), the effective
6date of the continuation coverage shall be either of the following,
7at the option of the beneficiary, provided that the beneficiary pays
8the applicable premiums:

9(A) The date of the qualifying event.

10(B) The first day of the month following the election.

11(5) Notwithstanding any other law, a qualified beneficiary who
12is eligible for the special election opportunity described in
13paragraph (17) of subdivision (a) of Section 3001 of ARRA may
14elect continuation coverage no later than 60 days after the date of
15the notice required under subdivision (k). For a qualified
16beneficiary who elects coverage pursuant to this paragraph, the
17continuation coverage shall be effective as of the first day of the
18first period of coverage after the date of termination of
19employment, except, if federal law permits, coverage shall take
20effect on the first day of the month following the election.
21However, for purposes of calculating the duration of continuation
22coverage pursuant to Section 1366.27, the period of that coverage
23shall be determined as though the qualifying event was a reduction
24of hours of the employee.

25(6) Notwithstanding any other law, a qualified beneficiary who
26is eligible for any other special election opportunity under ARRA
27may elect continuation coverage no later than 60 days after the
28date of the special election notice required under ARRA.

29(j) A health care service plan shall provide a qualified
30beneficiary eligible for premium assistance under ARRA written
31notice of the extension of that premium assistance as required
32under Section 3001 of ARRA.

33(k) A health care service plan, or an administrator or employer
34if administrative obligations have been assumed by those entities
35pursuant to subdivision (d), shall give the qualified beneficiaries
36described in subparagraph (C) of paragraph (17) of subdivision
37(a) of Section 3001 of ARRA the written notice required by that
38paragraph by implementing the following procedures:

39(1) The health care service plan shall, within 14 days of the
40effective date of the act adding this subdivision, send a notice to
P18   1employers currently contracting with the health care service plan
2for a group benefit plan subject to this article. The notice shall do
3all of the following:

4(A) Advise the employer that employees whose employment is
5terminated on or after March 2, 2010, who were previously enrolled
6in any group health care service plan or health insurance policy
7offered by the employer may be entitled to special health coverage
8rights, including a subsidy paid by the federal government for a
9portion of the premium.

10(B) Ask the employer to provide the health care service plan
11with the name, address, and date of termination of employment
12for any employee whose employment is terminated on or after
13March 2, 2010, and who was at any time covered by any health
14care service plan or health insurance policy offered to their
15employees on or after September 1, 2008.

16(C) Provide employers with a format and instructions for
17submitting the information to the health care service plan, or their
18administrator or employer who has assumed administrative
19obligations pursuant to subdivision (d), by telephone, fax,
20electronic mail, or mail.

21(2) Within 14 days of receipt of the information specified in
22paragraph (1) from the employer, the health care service plan shall
23send the written notice specified in paragraph (17) of subdivision
24(a) of Section 3001 of ARRA to those individuals.

25(3) If an individual contacts his or her health care service plan
26and indicates that he or she experienced a qualifying event that
27entitles him or her to the special election period described in
28paragraph (17) of subdivision (a) of Section 3001 of ARRA or any
29other special election provision of ARRA, the plan shall provide
30the individual with the written notice required under paragraph
31(17) of subdivision (a) of Section 3001 of ARRA or any other
32applicable provision of ARRA, regardless of whether the plan
33receives information from the individual’s previous employer
34regarding that individual pursuant to Section 24100. The plan shall
35review the individual’s application for coverage under this special
36election notice to determine if the individual qualifies for the
37special election period and the premium assistance under ARRA.
38The plan shall comply with paragraph (5) if the individual does
39not qualify for either the special election period or premium
40assistance under ARRA.

P19   1(4) The requirement under this subdivision to provide the written
2notice described in paragraph (17) of subdivision (a) of Section
33001 of ARRA to a qualified beneficiary and the requirement
4under paragraph (5) of subdivision (i) to provide a new opportunity
5to a qualified beneficiary to elect continuation coverage shall be
6deemed satisfied if a health care service plan previously provided
7the written notice and additional election opportunity described in
8paragraph (17) of subdivision (a) of Section 3001 of ARRA to that
9qualified beneficiary prior to the effective date of the act adding
10this paragraph.

11(5) If an individual does not qualify for either a special election
12period or the premium assistance under ARRA, the health care
13service plan shall provide a written notice to that individual that
14shall include information on the right to appeal as set forth in
15Section 3001 of ARRA.

16(6) A health care service plan shall provide information on its
17publicly accessible Internet Web site regarding the premium
18assistance made available under ARRA and any special election
19period provided under that law. A plan may fulfill this requirement
20by linking or otherwise directing consumers to the information
21regarding COBRA continuation coverage premium assistance
22located on the Internet Web site of the United States Department
23of Labor. The information required by this paragraph shall be
24located in a section of the plan’s Internet Web site that is readily
25accessible to consumers, such as the Web site’s Frequently Asked
26Questions section.

27(l) For purposes of implementing federal premium assistance
28for continuation coverage, the department may designate a model
29notice or notices that may be used by health care service plans.
30Use of the model notice or notices shall not require prior approval
31of the department. Any model notice or notices designated by the
32department for purposes of this subdivision shall not be subject to
33the Administrative Procedure Act (Chapter 3.5 (commencing with
34Section 11340) of Part 1 of Division 3 of Title 2 of the Government
35Code).

36(m) Notwithstanding any other law, a qualified beneficiary
37eligible for premium assistance under ARRA may elect to enroll
38in different coverage subject to the criteria provided under
39subparagraph (B) of paragraph (1) of subdivision (a) of Section
403001 of ARRA.

P20   1(n) A qualified beneficiary enrolled in continuation coverage
2as of February 17, 2009, who is eligible for premium assistance
3under ARRA may request application of the premium assistance
4as of March 1, 2009, or later, consistent with ARRA.

5(o) A health care service plan that receives an election notice
6from a qualified beneficiary eligible for premium assistance under
7ARRA, pursuant to subdivision (i), shall be considered a person
8entitled to reimbursement, as defined in Section 6432(b)(3) of the
9Internal Revenue Code, as amended by paragraph (12) of
10subdivision (a) of Section 3001 of ARRA.

11(p) (1) For purposes of compliance with ARRA, in the absence
12of guidance from, or if specifically required for state-only
13continuation coverage by, the United States Department of Labor,
14the Internal Revenue Service, or the Centers for Medicare and
15Medicaid Services, a health care service plan may request
16verification of the involuntary termination of a covered employee’s
17employment from the covered employee’s former employer or the
18qualified beneficiary seeking premium assistance under ARRA.

19(2) A health care service plan that requests verification pursuant
20to paragraph (1) directly from a covered employee’s former
21employer shall do so by providing a written notice to the employer.
22This written notice shall be sent by mail or facsimile to the covered
23employee’s former employer within seven business days from the
24date the plan receives the qualified beneficiary’s election notice
25pursuant to subdivision (i). Within 10 calendar days of receipt of
26written notice required by this paragraph, the former employer
27shall furnish to the health care service plan written verification as
28to whether the covered employee’s employment was involuntarily
29terminated.

30(3) A qualified beneficiary requesting premium assistance under
31ARRA may furnish to the health care service plan a written
32document or other information from the covered employee’s former
33employer indicating that the covered employee’s employment was
34involuntarily terminated. This document or information shall be
35deemed sufficient by the health care service plan to establish that
36the covered employee’s employment was involuntarily terminated
37for purposes of ARRA, unless the plan makes a reasonable and
38timely determination that the documents or information provided
39by the qualified beneficiary are legally insufficient to establish
40involuntary termination of employment.

P21   1(4) If a health care service plan requests verification pursuant
2to this subdivision and cannot verify involuntary termination of
3employment within 14 business days from the date the employer
4receives the verification request or from the date the plan receives
5documentation or other information from the qualified beneficiary
6pursuant to paragraph (3), the health care service plan shall either
7provide continuation coverage with the federal premium assistance
8to the qualified beneficiary or send the qualified beneficiary a
9denial letter which shall include notice of his or her right to appeal
10that determination pursuant to ARRA.

11(5) No person shall intentionally delay verification of
12involuntary termination of employment under this subdivision.

13(q) The provision of information and forms related to the
14premium assistance available pursuant to ARRA to individuals by
15a health care service plan shall not be considered a violation of
16this chapter provided that the plan complies with all of the
17requirements of this article.

18(r) (1) If Section 5000A of the Internal Revenue Code, as added
19by Section 1501 of PPACA, is repealed or amended to no longer
20apply to the individual market, as defined in Section 2791 of the
21federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this
22section shall become inoperative and is repealed 12 months after
23the date of that repeal or amendment.

24(2) For purposes of this subdivision, “PPACA” means the federal
25Patient Protection and Affordable Care Act (Public Law 111-148),
26as amended by the federal Health Care and Education
27Reconciliation Act of 2010 (Public Law 111-152), and any rules,
28regulations, or guidance issued pursuant to that law.

29

SEC. 5.  

Section 1366.25 is added to the Health and Safety
30Code
, to read:

31

1366.25.  

(a) Every group contract between a health care service
32plan and an employer subject to this article that is issued, amended,
33or renewed on or after July 1, 1998, shall require the employer to
34notify the plan, in writing, of any employee who has had a
35qualifying event, as defined in paragraph (2) of subdivision (d) of
36Section 1366.21, within 30 days of the qualifying event. The group
37contract shall also require the employer to notify the plan, in
38writing, within 30 days of the date, when the employer becomes
39subject to Section 4980B of the United States Internal Revenue
P22   1Code or Chapter 18 of the Employee Retirement Income Security
2Act (29 U.S.C. Sec. 1161 et seq.).

3(b) Every group contract between a plan and an employer subject
4to this article that is issued, amended, or renewed on or after July
51, 1998, shall require the employer to notify qualified beneficiaries
6currently receiving continuation coverage, whose continuation
7coverage will terminate under one group benefit plan prior to the
8end of the period the qualified beneficiary would have remained
9covered, as specified in Section 1366.27, of the qualified
10beneficiary’s ability to continue coverage under a new group
11benefit plan for the balance of the period the qualified beneficiary
12would have remained covered under the prior group benefit plan.
13This notice shall be provided either 30 days prior to the termination
14or when all enrolled employees are notified, whichever is later.

15Every health care service plan and specialized health care service
16plan shall provide to the employer replacing a health care service
17plan contract issued by the plan, or to the employer’s agent or
18broker representative, within 15 days of any written request,
19 information in possession of the plan reasonably required to
20administer the notification requirements of this subdivision and
21subdivision (c).

22(c) Notwithstanding subdivision (a), the group contract between
23the health care service plan and the employer shall require the
24employer to notify the successor plan in writing of the qualified
25beneficiaries currently receiving continuation coverage so that the
26successor plan, or contracting employer or administrator, may
27provide those qualified beneficiaries with the necessary premium
28information, enrollment forms, and instructions consistent with
29the disclosure required by subdivision (c) of Section 1366.24 and
30subdivision (e) of this section to allow the qualified beneficiary to
31continue coverage. This information shall be sent to all qualified
32beneficiaries who are enrolled in the plan and those qualified
33beneficiaries who have been notified, pursuant to Section 1366.24,
34of their ability to continue their coverage and may still elect
35coverage within the specified 60-day period. This information
36shall be sent to the qualified beneficiary’s last known address, as
37provided to the employer by the health care service plan or
38disability insurer currently providing continuation coverage to the
39qualified beneficiary. The successor plan shall not be obligated to
P23   1provide this information to qualified beneficiaries if the employer
2or prior plan or insurer fails to comply with this section.

3(d) A health care service plan may contract with an employer,
4or an administrator, to perform the administrative obligations of
5the plan as required by this article, including required notifications
6and collecting and forwarding premiums to the health care service
7plan. Except for the requirements of subdivisions (a), (b), and (c),
8this subdivision shall not be construed to permit a plan to require
9an employer to perform the administrative obligations of the plan
10 as required by this article as a condition of the issuance or renewal
11of coverage.

12(e) Every health care service plan, or employer or administrator
13that contracts to perform the notice and administrative services
14pursuant to this section, shall, within 14 days of receiving a notice
15of a qualifying event, provide to the qualified beneficiary the
16necessary benefits information, premium information, enrollment
17forms, and disclosures consistent with the notice requirements
18contained in subdivisions (b) and (c) of Section 1366.24 to allow
19the qualified beneficiary to formally elect continuation coverage.
20This information shall be sent to the qualified beneficiary’s last
21known address.

22(f) Every health care service plan, or employer or administrator
23that contracts to perform the notice and administrative services
24pursuant to this section, shall, during the 180-day period ending
25on the date that continuation coverage is terminated pursuant to
26paragraphs (1), (3), and (5) of subdivision (a) of Section 1366.27,
27notify a qualified beneficiary who has elected continuation
28coverage pursuant to this article of the date that his or her coverage
29will terminate, and shall notify the qualified beneficiary of any
30conversion coverage available to that qualified beneficiary. This
31requirement shall not apply when the continuation coverage is
32terminated because the group contract between the plan and the
33employer is being terminated.

34(g) (1) A health care service plan shall provide to a qualified
35beneficiary who has a qualifying event during the period specified
36in subparagraph (A) of paragraph (3) of subdivision (a) of Section
373001 of ARRA, a written notice containing information on the
38availability of premium assistance under ARRA. This notice shall
39be sent to the qualified beneficiary’s last known address. The notice
40shall include clear and easily understandable language to inform
P24   1the qualified beneficiary that changes in federal law provide a new
2opportunity to elect continuation coverage with a 65-percent
3premium subsidy and shall include all of the following:

4(A) The amount of the premium the person will pay. For
5qualified beneficiaries who had a qualifying event between
6September 1, 2008, and May 12, 2009, inclusive, if a health care
7service plan is unable to provide the correct premium amount in
8the notice, the notice may contain the last known premium amount
9and an opportunity for the qualified beneficiary to request, through
10a toll-free telephone number, the correct premium that would apply
11to the beneficiary.

12(B) Enrollment forms and any other information required to be
13included pursuant to subdivision (e) to allow the qualified
14beneficiary to elect continuation coverage. This information shall
15not be included in notices sent to qualified beneficiaries currently
16enrolled in continuation coverage.

17(C) A description of the option to enroll in different coverage
18as provided in subparagraph (B) of paragraph (1) of subdivision
19(a) of Section 3001 of ARRA. This description shall advise the
20qualified beneficiary to contact the covered employee’s former
21employer for prior approval to choose this option.

22(D) The eligibility requirements for premium assistance in the
23amount of 65 percent of the premium under Section 3001 of
24ARRA.

25(E) The duration of premium assistance available under ARRA.

26(F) A statement that a qualified beneficiary eligible for premium
27assistance under ARRA may elect continuation coverage no later
28than 60 days of the date of the notice.

29(G) A statement that a qualified beneficiary eligible for premium
30assistance under ARRA who rejected or discontinued continuation
31coverage prior to receiving the notice required by this subdivision
32has the right to withdraw that rejection and elect continuation
33coverage with the premium assistance.

34(H) A statement that reads as follows:

35“IF YOU ARE HAVING ANY DIFFICULTIES READING OR
36UNDERSTANDING THIS NOTICE, PLEASE CONTACT [name
37of health plan] at [insert appropriate telephone number].”

38(2) With respect to qualified beneficiaries who had a qualifying
39event between September 1, 2008, and May 12, 2009, inclusive,
40the notice described in this subdivision shall be provided by the
P25   1later of May 26, 2009, or seven business days after the date the
2plan receives notice of the qualifying event.

3(3) With respect to qualified beneficiaries who had or have a
4qualifying event between May 13, 2009, and the later date specified
5in subparagraph (A) of paragraph (3) of subdivision (a) of Section
63001 of ARRA, inclusive, the notice described in this subdivision
7shall be provided within the period of time specified in subdivision
8(e).

9(4) Nothing in this section shall be construed to require a health
10care service plan to provide the plan’s evidence of coverage as a
11part of the notice required by this subdivision, and nothing in this
12section shall be construed to require a health care service plan to
13amend its existing evidence of coverage to comply with the changes
14made to this section by the enactment of Assembly Bill 23 of the
152009-10 Regular Session or by the act amending this section during
16the second year of the 2009-10 Regular Session.

17(5) The requirement under this subdivision to provide a written
18notice to a qualified beneficiary and the requirement under
19paragraph (1) of subdivision (k) to provide a new opportunity to
20a qualified beneficiary to elect continuation coverage shall be
21deemed satisfied if a health care service plan previously provided
22a written notice and additional election opportunity under Section
233001 of ARRA to that qualified beneficiary prior to the effective
24date of the act adding this paragraph.

25(h) A group contract between a group benefit plan and an
26employer subject to this article that is issued, amended, or renewed
27on or after the operative date of this section shall require the
28employer to give the following notice to a qualified beneficiary in
29connection with a notice regarding election of continuation
30coverage:

31“Please examine your options carefully before declining this
32coverage. You should be aware that companies selling individual
33health insurance typically require a review of your medical history
34that could result in a higher premium or you could be denied
35coverage entirely.”

36(i) A group contract between a group benefit plan and an
37employer subject to this article that is issued, amended, or renewed
38on or after July 1, 2016, shall require the employer to give the
39following notice to a qualified beneficiary in connection with a
40notice regarding election of continuation coverage:

P26   1“In addition to your coverage continuation options, you may be
2eligible for the following:

31. Coverage through the state health insurance marketplace, also
4known as Covered California. By enrolling through Covered
5California, you may qualify for lower monthly premiums and lower
6out-of-pocket costs. Your family members may also qualify for
7coverage through Covered California.

82. Coverage through Medi-Cal. Depending on your income, you
9may qualify for low- or no-cost coverage through Medi-Cal. Your
10family members may also qualify for Medi-Cal.

113. Coverage through an insured spouse. If your spouse has
12coverage that extends to family members, you may be able to be
13added on that benefit plan.

14Be aware that there is a deadline to enroll in Covered California
15although you can apply for Medi-Cal anytime. To find out more
16about how to apply for Covered California and Medi-Cal, visit the
17Covered California Internet Web site at
18http://www.coveredca.com.”

19(j) (1) Notwithstanding any other law, a qualified beneficiary
20eligible for premium assistance under ARRA may elect
21continuation coverage no later than 60 days after the date of the
22notice required by subdivision (g).

23(2) For a qualified beneficiary who elects to continue coverage
24pursuant to this subdivision, the period beginning on the date of
25the qualifying event and ending on the effective date of the
26continuation coverage shall be disregarded for purposes of
27calculating a break in coverage in determining whether a
28preexisting condition provision applies under subdivision (c) of
29Section 1357.06 or subdivision (e) of Section 1357.51.

30(3) For a qualified beneficiary who had a qualifying event
31between September 1, 2008, and February 16, 2009, inclusive, and
32who elects continuation coverage pursuant to paragraph (1), the
33continuation coverage shall commence on the first day of the month
34following the election.

35(4) For a qualified beneficiary who had a qualifying event
36between February 17, 2009, and May 12, 2009, inclusive, and who
37elects continuation coverage pursuant to paragraph (1), the effective
38date of the continuation coverage shall be either of the following,
39at the option of the beneficiary, provided that the beneficiary pays
40the applicable premiums:

P27   1(A) The date of the qualifying event.

2(B) The first day of the month following the election.

3(5) Notwithstanding any other law, a qualified beneficiary who
4is eligible for the special election opportunity described in
5paragraph (17) of subdivision (a) of Section 3001 of ARRA may
6elect continuation coverage no later than 60 days after the date of
7the notice required under subdivision (l). For a qualified beneficiary
8who elects coverage pursuant to this paragraph, the continuation
9coverage shall be effective as of the first day of the first period of
10coverage after the date of termination of employment, except, if
11federal law permits, coverage shall take effect on the first day of
12the month following the election. However, for purposes of
13calculating the duration of continuation coverage pursuant to
14Section 1366.27, the period of that coverage shall be determined
15as though the qualifying event was a reduction of hours of the
16employee.

17(6) Notwithstanding any other law, a qualified beneficiary who
18is eligible for any other special election opportunity under ARRA
19may elect continuation coverage no later than 60 days after the
20date of the special election notice required under ARRA.

21(k) A health care service plan shall provide a qualified
22beneficiary eligible for premium assistance under ARRA written
23notice of the extension of that premium assistance as required
24under Section 3001 of ARRA.

25(l) A health care service plan, or an administrator or employer
26if administrative obligations have been assumed by those entities
27pursuant to subdivision (d), shall give the qualified beneficiaries
28described in subparagraph (C) of paragraph (17) of subdivision
29(a) of Section 3001 of ARRA the written notice required by that
30paragraph by implementing the following procedures:

31(1) The health care service plan shall, within 14 days of the
32effective date of the act adding this subdivision, send a notice to
33employers currently contracting with the health care service plan
34for a group benefit plan subject to this article. The notice shall do
35all of the following:

36(A) Advise the employer that employees whose employment is
37terminated on or after March 2, 2010, who were previously enrolled
38in any group health care service plan or health insurance policy
39offered by the employer may be entitled to special health coverage
P28   1rights, including a subsidy paid by the federal government for a
2portion of the premium.

3(B) Ask the employer to provide the health care service plan
4with the name, address, and date of termination of employment
5for any employee whose employment is terminated on or after
6March 2, 2010, and who was at any time covered by any health
7care service plan or health insurance policy offered to their
8employees on or after September 1, 2008.

9(C) Provide employers with a format and instructions for
10submitting the information to the health care service plan, or their
11administrator or employer who has assumed administrative
12obligations pursuant to subdivision (d), by telephone, fax,
13electronic mail, or mail.

14(2) Within 14 days of receipt of the information specified in
15paragraph (1) from the employer, the health care service plan shall
16send the written notice specified in paragraph (17) of subdivision
17(a) of Section 3001 of ARRA to those individuals.

18(3) If an individual contacts his or her health care service plan
19and indicates that he or she experienced a qualifying event that
20entitles him or her to the special election period described in
21paragraph (17) of subdivision (a) of Section 3001 of ARRA or any
22other special election provision of ARRA, the plan shall provide
23the individual with the written notice required under paragraph
24(17) of subdivision (a) of Section 3001 of ARRA or any other
25applicable provision of ARRA, regardless of whether the plan
26receives information from the individual’s previous employer
27regarding that individual pursuant to Section 24100. The plan shall
28review the individual’s application for coverage under this special
29election notice to determine if the individual qualifies for the
30special election period and the premium assistance under ARRA.
31The plan shall comply with paragraph (5) if the individual does
32not qualify for either the special election period or premium
33assistance under ARRA.

34(4) The requirement under this subdivision to provide the written
35notice described in paragraph (17) of subdivision (a) of Section
363001 of ARRA to a qualified beneficiary and the requirement
37under paragraph (5) of subdivision (j) to provide a new opportunity
38to a qualified beneficiary to elect continuation coverage shall be
39deemed satisfied if a health care service plan previously provided
40the written notice and additional election opportunity described in
P29   1paragraph (17) of subdivision (a) of Section 3001 of ARRA to that
2qualified beneficiary prior to the effective date of the act adding
3this paragraph.

4(5) If an individual does not qualify for either a special election
5period or the premium assistance under ARRA, the health care
6service plan shall provide a written notice to that individual that
7shall include information on the right to appeal as set forth in
8Section 3001 of ARRA.

9(6) A health care service plan shall provide information on its
10publicly accessible Internet Web site regarding the premium
11assistance made available under ARRA and any special election
12period provided under that law. A plan may fulfill this requirement
13by linking or otherwise directing consumers to the information
14regarding COBRA continuation coverage premium assistance
15located on the Internet Web site of the United States Department
16of Labor. The information required by this paragraph shall be
17located in a section of the plan’s Internet Web site that is readily
18accessible to consumers, such as the Web site’s Frequently Asked
19Questions section.

20(m) For purposes of implementing federal premium assistance
21for continuation coverage, the department may designate a model
22notice or notices that may be used by health care service plans.
23Use of the model notice or notices shall not require prior approval
24of the department. Any model notice or notices designated by the
25department for purposes of this subdivision shall not be subject to
26the Administrative Procedure Act (Chapter 3.5 (commencing with
27Section 11340) of Part 1 of Division 3 of Title 2 of the Government
28Code).

29(n) Notwithstanding any other law, a qualified beneficiary
30eligible for premium assistance under ARRA may elect to enroll
31in different coverage subject to the criteria provided under
32subparagraph (B) of paragraph (1) of subdivision (a) of Section
333001 of ARRA.

34(o) A qualified beneficiary enrolled in continuation coverage
35as of February 17, 2009, who is eligible for premium assistance
36under ARRA may request application of the premium assistance
37as of March 1, 2009, or later, consistent with ARRA.

38(p) A health care service plan that receives an election notice
39from a qualified beneficiary eligible for premium assistance under
40ARRA, pursuant to subdivision (j), shall be considered a person
P30   1entitled to reimbursement, as defined in Section 6432(b)(3) of the
2Internal Revenue Code, as amended by paragraph (12) of
3subdivision (a) of Section 3001 of ARRA.

4(q) (1) For purposes of compliance with ARRA, in the absence
5of guidance from, or if specifically required for state-only
6continuation coverage by, the United States Department of Labor,
7the Internal Revenue Service, or the Centers for Medicare and
8Medicaid Services, a health care service plan may request
9verification of the involuntary termination of a covered employee’s
10employment from the covered employee’s former employer or the
11qualified beneficiary seeking premium assistance under ARRA.

12(2) A health care service plan that requests verification pursuant
13to paragraph (1) directly from a covered employee’s former
14employer shall do so by providing a written notice to the employer.
15This written notice shall be sent by mail or facsimile to the covered
16employee’s former employer within seven business days from the
17date the plan receives the qualified beneficiary’s election notice
18pursuant to subdivision (j). Within 10 calendar days of receipt of
19written notice required by this paragraph, the former employer
20shall furnish to the health care service plan written verification as
21to whether the covered employee’s employment was involuntarily
22terminated.

23(3) A qualified beneficiary requesting premium assistance under
24ARRA may furnish to the health care service plan a written
25document or other information from the covered employee’s former
26employer indicating that the covered employee’s employment was
27involuntarily terminated. This document or information shall be
28deemed sufficient by the health care service plan to establish that
29the covered employee’s employment was involuntarily terminated
30for purposes of ARRA, unless the plan makes a reasonable and
31timely determination that the documents or information provided
32by the qualified beneficiary are legally insufficient to establish
33involuntary termination of employment.

34(4) If a health care service plan requests verification pursuant
35to this subdivision and cannot verify involuntary termination of
36employment within 14 business days from the date the employer
37receives the verification request or from the date the plan receives
38documentation or other information from the qualified beneficiary
39pursuant to paragraph (3), the health care service plan shall either
40provide continuation coverage with the federal premium assistance
P31   1to the qualified beneficiary or send the qualified beneficiary a
2denial letter which shall include notice of his or her right to appeal
3that determination pursuant to ARRA.

4(5) No person shall intentionally delay verification of
5involuntary termination of employment under this subdivision.

6(r) The provision of information and forms related to the
7premium assistance available pursuant to ARRA to individuals by
8a health care service plan shall not be considered a violation of
9this chapter provided that the plan complies with all of the
10requirements of this article.

11(s) (1) If Section 5000A of the Internal Revenue Code, as added
12by Section 1501 of PPACA, is repealed or amended to no longer
13apply to the individual market, as defined in Section 2791 of the
14federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this
15section shall become operative 12 months after the date of that
16repeal or amendment.

17(2) For purposes of this subdivision, “PPACA” means the federal
18Patient Protection and Affordable Care Act (Public Law 111-148),
19as amended by the federal Health Care and Education
20Reconciliation Act of 2010 (Public Law 111-152), and any rules,
21regulations, or guidance issued pursuant to that law.

end delete
22

begin deleteSEC. 6.end delete
23begin insertSECTION 1.end insert  

Section 11801 of the Health and Safety Code is
24amended to read:

25

11801.  

The alcohol and drug program administrator, acting
26through administrative channels designated pursuant to Section
2711795, shall do all of the following:

28(a) Coordinate and be responsible for the preparation of the
29county contract.

30(b) Ensure compliance with applicable laws relating to
31discrimination against any person because of any characteristic
32listed or defined in Section 11135 of the Government Code.

33(c) Submit an annual report to the board of supervisors reporting
34all activities of the alcohol and other drug program, including a
35financial accounting of expenditures, number of persons served,
36and a forecast of anticipated needs for the upcoming year.

37(d) Be directly responsible for the administration of all alcohol
38or other drug program funds allocated to the county under this
39part, administration of county operated programs, and coordination
P32   1and monitoring of programs that have contracts with the county
2to provide alcohol and other drug services.

3(e) Ensure the evaluation of alcohol and other drug programs,
4including the collection of appropriate and necessary client data
5and program information, pursuant to Chapter 6 (commencing
6with Section 11825).

7(f) Ensure program quality in compliance with appropriate
8standards pursuant to Chapter 7 (commencing with Section 11830).

9(g) Participate and represent the county in meetings of the
10 County Behavioral Health Directors Association of California
11pursuant to Section 11811.5 for the purposes of representing the
12counties in their relationship with the state with respect to policies,
13standards, and administration for alcohol and other drug abuse
14services.

15(h) Perform any other acts that may be necessary, desirable, or
16proper to carry out the purposes of this part.

17

begin deleteSEC. 7.end delete
18begin insertSEC. 2.end insert  

Section 11811.6 of the Health and Safety Code is
19amended to read:

20

11811.6.  

The department shall consult with county behavioral
21health directors, alcohol and drug program administrators, or both,
22in establishing standards pursuant to Chapter 7 (commencing with
23Section 11830) and regulations pursuant to Chapter 8 (commencing
24with Section 11835), shall consult with alcohol and drug program
25administrators on matters of major policy and administration, and
26may consult with alcohol and drug program administrators on other
27matters affecting persons with alcohol and other drug problems.
28 The administrators shall consist of all legally appointed alcohol
29and drug administrators in the state as designated pursuant to
30subdivision (a) of Section 11800.

31

begin deleteSEC. 8.end delete
32begin insertSEC. 3.end insert  

Section 11830.1 of the Health and Safety Code is
33amended to read:

34

11830.1.  

In order to ensure quality assurance of alcohol and
35other drug programs and expand the availability of funding
36resources, the department shall implement a program certification
37procedure for alcohol and other drug treatment recovery services.
38The department, after consultation with the County Behavioral
39Health Directors Association of California, and other interested
40organizations and individuals, shall develop standards and
P33   1regulations for the alcohol and other drug treatment recovery
2services describing the minimal level of service quality required
3of the service providers to qualify for and obtain state certification.
4The standards shall be excluded from the rulemaking requirements
5of the Administrative Procedure Act (Chapter 3.5 (commencing
6with Section 11340) of Part 1 of Division 3 of Title 2 of the
7Government Code). Compliance with these standards shall be
8voluntary on the part of programs. For the purposes of Section
92626.2 of the Unemployment Insurance Code, certification shall
10be equivalent to program review.

11

begin deleteSEC. 9.end delete
12begin insertSEC. 4.end insert  

Section 11835 of the Health and Safety Code is
13amended to read:

14

11835.  

(a) The purposes of any regulations adopted by the
15department shall be to implement, interpret, or make specific the
16provisions of this part and shall not exceed the authority granted
17to the department pursuant to this part. To the extent possible, the
18regulations shall be written in clear and concise language and
19adopted only when necessary to further the purposes of this part.

20(b) Except as provided in this section and Sections 11772,
2111798, 11798.2, 11814, 11817.8, and 11852.5, the department
22may adopt regulations in accordance with the rulemaking
23provisions of the Administrative Procedure Act (Chapter 3.5
24(commencing with Section 11340) of Part 1 of Division 3 of Title
252 of the Government Code) necessary for the proper execution of
26the powers and duties granted to and imposed upon the department
27by this part. However, these regulations may be adopted only upon
28the following conditions:

29(1) Prior to adoption of regulations, the department shall consult
30with the County Behavioral Health Directors Association of
31California and may consult with any other appropriate persons
32relating to the proposed regulations.

33(2) If an absolute majority of the designated county behavioral
34health directors who represent counties that have submitted county
35contracts, vote at a public meeting called by the department, for
36which 45 days’ advance notice shall be given by the department,
37to reject the proposed regulations, the department shall refer the
38matter for a decision to a committee, consisting of a representative
39of the county behavioral health directors, the director, the secretary,
40and one designee of the secretary. The decision shall be made by
P34   1a majority vote of this committee at a public meeting convened
2by the department. Upon a majority vote of the committee
3recommending adoption of the proposed regulations, the
4department may then adopt them. Upon a majority vote
5recommending that the department not adopt the proposed
6regulations, the department shall then consult again with the County
7Behavioral Health Directors Association of California and resubmit
8the proposed regulations to the county behavioral health directors
9for a vote pursuant to this subdivision.

10(3) In the voting process described in paragraph (2), no proxies
11shall be allowed nor may anyone other than the designated county
12 behavioral health director, director, secretary, and secretary’s
13designee vote at the meetings.

begin delete
14

SEC. 10.  

Section 24100 of the Health and Safety Code is
15amended to read:

16

24100.  

(a) For purposes of this section, the following
17definitions apply:

18(1) “ARRA” means Title III of Division B of the federal
19American Recovery and Reinvestment Act of 2009 or any
20amendment to that federal law extending federal premium
21assistance to qualified beneficiaries, as defined in Section 1366.21
22of this code or Section 10128.51 of the Insurance Code.

23(2) “Employer” means an employer as defined in Section
241366.21 of this code or an employer as defined in Section 10128.51
25of the Insurance Code.

26(b) An employer shall provide the information described in
27subparagraph (B) of paragraph (1) of subdivision (k) of Section
281366.25 of this code or subparagraph (B) of paragraph (1) of
29subdivision (k) of Section 10128.55 of the Insurance Code, as
30applicable, with respect to any employee whose employment is
31terminated on or after March 2, 2010, and who was enrolled at any
32time in a health care service plan or health insurance policy offered
33by the employer on or after September 1, 2008. This information
34shall be provided to the requesting health care service plan or
35health insurer within 14 days of receipt of the notification described
36in paragraph (1) of subdivision (k) of Section 1366.25 of this code
37or paragraph (1) of subdivision (k) of Section 10128.55 of the
38Insurance Code. The employer shall continue to provide the
39information to the health care service plan or health insurer within
4014 days after the end of each month for any employee whose
P35   1employment is terminated in the prior month until the last date
2specified in subparagraph (A) of paragraph (3) of subdivision (a)
3of Section 3001 of ARRA.

end delete
4

begin deleteSEC. 11.end delete
5begin insertSEC. 5.end insert  

Section 103577 of the Health and Safety Code is
6amended to read:

7

103577.  

(a) On or after July 1, 2015, each local registrar or
8county recorder shall, without an issuance fee or any other
9associated fee, issue a certified record of live birth to any person
10who can verify his or her status as a homeless person or a homeless
11child or youth. A homeless services provider that has knowledge
12of a person’s housing status shall verify a person’s status for the
13purposes of this subdivision. In accordance with all other
14application requirements as set forth in Section 103526, a request
15for a certified record of live birth made pursuant to this subdivision
16shall be made by a homeless person or a homeless child or youth
17on behalf of themselves, or by any person lawfully entitled to
18request a certified record of live birth on behalf of a child, if the
19child has been verified as a homeless person or a homeless child
20or youth pursuant to this section. A person applying for a certified
21record of live birth under this subdivision is entitled to one birth
22record, per application, for each eligible person verified as a
23homeless person or a homeless child or youth. For purposes of this
24subdivision, an affidavit developed pursuant to subdivision (b)
25shall constitute sufficient verification that a person is a homeless
26person or a homeless child or youth. A person applying for a
27certified record of live birth under this subdivision shall not be
28charged a fee for verification of his or her eligibility.

29(b) The State Department of Public Health shall develop an
30affidavit attesting to an applicant’s status as a homeless person or
31homeless child or youth. For purposes of this section, the affidavit
32shall not be deemed complete unless it is signed by both the person
33making a request for a certified record of live birth pursuant to
34subdivision (a) and a homeless services provider that has
35knowledge of the applicant’s housing status.

36(c) Notwithstanding the rulemaking provisions of the
37Administrative Procedure Act (Chapter 3.5 (commencing with
38Section 11340) of Part 1 of Division 3 of Title 2 of the Government
39Code), the department may implement and administer this section
P36   1through an all-county letter or similar instructions from the director
2or State Registrar without taking regulatory action.

3(d) For the purposes of this section, the following definitions
4apply:

5(1) A “homeless child or youth” has the same meaning as the
6definition of “homeless children and youths” as set forth in the
7 federal McKinney-Vento Homeless Assistance Act (42 U.S.C.
8Sec. 11301 et seq.).

9(2) A “homeless person” has the same meaning as the definition
10of that term set forth in the federal McKinney-Vento Homeless
11Assistance Act (42 U.S.C. Sec. 11301 et seq.).

12(3) A “homeless services provider” includes:

13(A) A governmental or nonprofit agency receiving federal, state,
14or county or municipal funding to provide services to a “homeless
15person” or “homeless child or youth,” or that is otherwise
16sanctioned to provide those services by a local homeless continuum
17of care organization.

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

19(C) A local educational agency liaison for homeless children
20and youth, pursuant to Section 11432(g)(1)(J)(ii) of Title 42 of the
21United States Code, or a school social worker.

22(D) A human services provider or public social services provider
23funded by the State of California to provide homeless children or
24youth services, health services, mental or behavioral health
25services, substance use disorder services, or public assistance or
26employment services.

27(E) A law enforcement officer designated as a liaison to the
28homeless population by a local police department or sheriff’s
29department within the state.

30

begin deleteSEC. 12.end delete
31begin insertSEC. 6.end insert  

Section 104151 of the Health and Safety Code is
32amended to read:

33

104151.  

(a) Notwithstanding Section 10231.5 of the
34Government Code, each year, by no later than January 10 and
35concurrently with the release of the May Revision, the State
36Department of Health Care Services shall provide the fiscal
37committees of the Legislature with an estimate package for the
38Every Woman Counts Program. This estimate package shall
39include all significant assumptions underlying the estimate for the
40Every Woman Counts Program’s current-year and budget-year
P37   1proposals, and shall contain concise information identifying
2applicable estimate components, such as caseload; a breakout of
3costs, including, but not limited to, clinical service activities,
4including office visits and consults, screening mammograms,
5diagnostic mammograms, diagnostic breast procedures, case
6management, and other clinical services; policy changes; contractor
7information; General Fund, special fund, and federal fund
8information; and other assumptions necessary to support the
9estimate.

10(b) Notwithstanding Section 10231.5 of the Government Code,
11each year, the State Department of Health Care Services shall
12provide the fiscal and appropriate policy committees of the
13Legislature with quarterly updates on caseload, estimated
14expenditures, and related program monitoring data for the Every
15Woman Counts Program. These updates shall be provided no later
16than November 30, February 28, May 31, and August 31 of each
17year. The purpose of the updates is to provide the Legislature with
18the most recent information on the program, and shall include a
19breakdown of expenditures for each quarter for clinical service
20activities, including, but not limited to, office visits and consults,
21screening mammograms, diagnostic mammograms, diagnostic
22breast procedures, case management, and other clinical services.
23This subdivision supersedes the requirements of Section 169 of
24Chapter 717 of the Statutes of 2010 (SB 853).

25

begin deleteSEC. 13.end delete
26begin insertSEC. 7.end insert  

Section 128456 of the Health and Safety Code is
27amended to read:

28

128456.  

In developing the program established pursuant to this
29article, the Health Professions Education Foundation shall solicit
30the advice of representatives of the Board of Behavioral Sciences,
31the Board of Psychology, the State Department of Health Care
32Services, the County Behavioral Health Directors Association of
33California, the California Mental Health Planning Council,
34professional mental health care organizations, the California
35Healthcare Association, the Chancellor of the California
36Community Colleges, and the Chancellor of the California State
37University. The foundation shall solicit the advice of
38representatives who reflect the demographic, cultural, and linguistic
39diversity of the state.

P38   1

begin deleteSEC. 14.end delete
2begin insertSEC. 8.end insert  

Section 130302 of the Health and Safety Code is
3amended to read:

4

130302.  

For the purposes of this division, the following
5definitions apply:

6(a) “Director” means the Director of the Office of Health
7Information Integrity.

8(b) “HIPAA” means the federal Health Insurance Portability
9and Accountability Act.

10(c) “Office” means the Office of Health Information Integrity
11established by the office of the Governor in the Health and Human
12Services Agency.

13(d) “State entities” means all state departments, boards,
14commissions, programs, and other organizational units of the
15executive branch of state government.

16

begin deleteSEC. 15.end delete
17begin insertSEC. 9.end insert  

Section 130304 of the Health and Safety Code is
18amended to read:

19

130304.  

The office shall be under the supervision and control
20of a director, known as the Director of the Office of Health
21Information Integrity, who shall be appointed by, and serve at the
22pleasure of, the Secretary of the Health and Human Services
23Agency.

24

begin deleteSEC. 16.end delete
25begin insertSEC. 10.end insert  

Section 130316 of the Health and Safety Code is
26repealed.

27

begin deleteSEC. 17.end delete
28begin insertSEC. 11.end insert  

Section 130317 of the Health and Safety Code is
29repealed.

begin delete
30

SEC. 18.  

Section 10128.52 of the Insurance Code is amended
31to read:

32

10128.52.  

The continuation coverage requirements of this
33article do not apply to the following individuals:

34(a) Individuals who are entitled to Medicare benefits or become
35entitled to Medicare benefits pursuant to Title XVIII of the United
36States Social Security Act, as amended or superseded. Entitlement
37to Medicare Part A only constitutes entitlement to benefits under
38Medicare.

39(b) Individuals who have other hospital, medical, or surgical
40coverage, or who are covered or become covered under another
P39   1group benefit plan, including a self-insured employee welfare
2benefit plan, that provides coverage for individuals and that does
3not impose any exclusion or limitation with respect to any
4preexisting condition of the individual, other than a preexisting
5condition limitation or exclusion that does not apply to or is
6satisfied by the qualified beneficiary pursuant to Sections 10198.6
7and 10198.7. A group conversion option under any group benefit
8plan shall not be considered as an arrangement under which an
9individual is or becomes covered.

10(c) Individuals who are covered, become covered, or are eligible
11for federal COBRA coverage pursuant to Section 4980B of the
12United States Internal Revenue Code or Chapter 18 of the
13Employee Retirement Income Security Act (29 U.S.C. Sec. 1161
14et seq.).

15(d) Individuals who are covered, become covered, or are eligible
16for coverage pursuant to Chapter 6A of the Public Health Service
17Act (42 U.S.C. Sec. 300bb-1 et seq.).

18(e) Qualified beneficiaries who fail to meet the requirements of
19subdivision (b) of Section 10128.54 or subdivision (i) of Section
2010128.55 regarding notification of a qualifying event or election
21of continuation coverage within the specified time limits.

22(f) Except as provided in Section 3001 of ARRA, qualified
23beneficiaries who fail to submit the correct premium amount
24required by subdivision (b) of Section 10128.55 and Section
2510128.57, in accordance with the terms and conditions of the policy
26or contract, or fail to satisfy other terms and conditions of the
27policy or contract.

28

SEC. 19.  

Section 10128.54 of the Insurance Code is amended
29to read:

30

10128.54.  

(a) Every insurer’s evidence of coverage for group
31benefit plans subject to this article, that is issued, amended, or
32renewed on or after January 1, 1999, shall disclose to covered
33employees of group benefit plans subject to this article the ability
34to continue coverage pursuant to this article, as required by this
35section.

36(b) This disclosure shall state that all insureds who are eligible
37to be qualified beneficiaries, as defined in subdivision (c) of
38Section 10128.51, shall be required, as a condition of receiving
39benefits pursuant to this article, to notify, in writing, the insurer,
40or the employer if the employer contracts to perform the
P40   1administrative services as provided for in Section 10128.55, of all
2qualifying events as specified in paragraphs (1), (3), (4), and (5)
3of subdivision (d) of Section 10128.51 within 60 days of the date
4of the qualifying event. This disclosure shall inform insureds that
5failure to make the notification to the insurer, or to the employer
6when under contract to provide the administrative services, within
7the required 60 days will disqualify the qualified beneficiary from
8receiving continuation coverage pursuant to this article. The
9disclosure shall further state that a qualified beneficiary who wishes
10to continue coverage under the group benefit plan pursuant to this
11article shall request the continuation in writing and deliver the
12written request, by first-class mail, or other reliable means of
13delivery, including personal delivery, express mail, or private
14courier company, to the disability insurer, or to the employer if
15the plan has contracted with the employer for administrative
16services pursuant to subdivision (d) of Section 10128.55, within
17the 60-day period following the later of either (1) the date that the
18insured’s coverage under the group benefit plan terminated or will
19terminate by reason of a qualifying event, or (2) the date the insured
20was sent notice pursuant to subdivision (e) of Section 10128.55
21of the ability to continue coverage under the group benefit plan.
22The disclosure required by this section shall also state that a
23qualified beneficiary electing continuation shall pay to the disability
24insurer, in accordance with the terms and conditions of the policy
25or contract, which shall be set forth in the notice to the qualified
26beneficiary pursuant to subdivision (d) of Section 10128.55, the
27amount of the required premium payment, as set forth in Section
2810128.56. The disclosure shall further require that the qualified
29beneficiary’s first premium payment required to establish premium
30payment be delivered by first-class mail, certified mail, or other
31reliable means of delivery, including personal delivery, express
32mail, or private courier company, to the disability insurer, or to
33the employer if the employer has contracted with the insurer to
34perform the administrative services pursuant to subdivision (d) of
35Section 10128.55, within 45 days of the date the qualified
36beneficiary provided written notice to the insurer or the employer,
37if the employer has contracted to perform the administrative
38services, of the election to continue coverage in order for coverage
39to be continued under this article. This disclosure shall also state
40that the first premium payment shall equal an amount sufficient
P40   1to pay all required premiums and all premiums due, and that failure
2to submit the correct premium amount within the 45-day period
3will disqualify the qualified beneficiary from receiving continuation
4coverage pursuant to this article.

5(c) The disclosure required by this section shall also describe
6separately how qualified beneficiaries whose continuation coverage
7terminates under a prior group benefit plan pursuant to Section
810128.57 may continue their coverage for the balance of the period
9that the qualified beneficiary would have remained covered under
10the prior group benefit plan, including the requirements for election
11and payment. The disclosure shall clearly state that continuation
12coverage shall terminate if the qualified beneficiary fails to comply
13with the requirements pertaining to enrollment in, and payment of
14 premiums to, the new group benefit plan within 30 days of
15receiving notice of the termination of the prior group benefit plan.

16(d) Prior to August 1, 1998, every insurer shall provide to all
17covered employees of employers subject to this article written
18notice containing the disclosures required by this section, or shall
19provide to all covered employees of employers subject to this
20article a new or amended evidence of coverage that includes the
21disclosures required by this section. Any insurer that, in the
22ordinary course of business, maintains only the addresses of
23employer group purchasers of benefits, and does not maintain
24addresses of covered employees, may comply with the notice
25requirements of this section through the provision of the notices
26to its employer group purchases of benefits.

27(e) Every disclosure form issued, amended, or renewed on and
28after January 1, 1999, for a group benefit plan subject to this article
29shall provide a notice that, under state law, an insured may be
30 entitled to continuation of group coverage and that additional
31information regarding eligibility for this coverage may be found
32in the evidence of coverage.

33(f) A disclosure issued, amended, or renewed on or after July
341, 2016, for a group benefit plan subject to this article shall include
35the following notice:

36“In addition to your coverage continuation options, you may be
37eligible for the following:

381. Coverage through the state health insurance marketplace, also
39known as Covered California. By enrolling through Covered
40California, you may qualify for lower monthly premiums and lower
P42   1out-of-pocket costs. Your family members may also qualify for
2coverage through Covered California.

32. Coverage through Medi-Cal. Depending on your income, you
4may qualify for low- or no-cost coverage through Medi-Cal. Your
5family members may also qualify for Medi-Cal.

63. Coverage through an insured spouse. If your spouse has
7coverage that extends to family members, you may be able to be
8added on that benefit plan.

9Be aware that there is a deadline to enroll in Covered California
10although you can apply for Medi-Cal at anytime. To find out more
11about how to apply for Covered California and Medi-Cal, visit the
12Covered California Internet Web site at

13http://www.coveredca.com.”

14(g) (1) If Section 5000A of the Internal Revenue Code, as added
15by Section 1501 of PPACA, is repealed or amended to no longer
16apply to the individual market, as defined in Section 2791 of the
17federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this
18section shall become inoperative and is repealed 12 months after
19the date of that repeal or amendment.

20(2) For purposes of this subdivision, “PPACA” means the federal
21Patient Protection and Affordable Care Act (Public Law 111-148),
22as amended by the federal Health Care and Education
23Reconciliation Act of 2010 (Public Law 111-152), and any rules,
24regulations, or guidance issued pursuant to that law.

25

SEC. 20.  

Section 10128.54 is added to the Insurance Code, to
26read:

27

10128.54.  

(a) Every insurer’s evidence of coverage for group
28benefit plans subject to this article, that is issued, amended, or
29renewed on or after January 1, 1999, shall disclose to covered
30employees of group benefit plans subject to this article the ability
31to continue coverage pursuant to this article, as required by this
32section.

33(b) This disclosure shall state that all insureds who are eligible
34to be qualified beneficiaries, as defined in subdivision (c) of
35Section 10128.51, shall be required, as a condition of receiving
36benefits pursuant to this article, to notify, in writing, the insurer,
37or the employer if the employer contracts to perform the
38administrative services as provided for in Section 10128.55, of all
39qualifying events as specified in paragraphs (1), (3), (4), and (5)
40of subdivision (d) of Section 10128.51 within 60 days of the date
P43   1of the qualifying event. This disclosure shall inform insureds that
2failure to make the notification to the insurer, or to the employer
3when under contract to provide the administrative services, within
4the required 60 days will disqualify the qualified beneficiary from
5receiving continuation coverage pursuant to this article. The
6disclosure shall further state that a qualified beneficiary who wishes
7to continue coverage under the group benefit plan pursuant to this
8article must request the continuation in writing and deliver the
9written request, by first-class mail, or other reliable means of
10delivery, including personal delivery, express mail, or private
11courier company, to the disability insurer, or to the employer if
12the plan has contracted with the employer for administrative
13services pursuant to subdivision (d) of Section 10128.55, within
14the 60-day period following the later of either (1) the date that the
15insured’s coverage under the group benefit plan terminated or will
16terminate by reason of a qualifying event, or (2) the date the insured
17was sent notice pursuant to subdivision (e) of Section 10128.55
18of the ability to continue coverage under the group benefit plan.
19The disclosure required by this section shall also state that a
20qualified beneficiary electing continuation shall pay to the disability
21insurer, in accordance with the terms and conditions of the policy
22or contract, which shall be set forth in the notice to the qualified
23beneficiary pursuant to subdivision (d) of Section 10128.55, the
24amount of the required premium payment, as set forth in Section
2510128.56. The disclosure shall further require that the qualified
26beneficiary’s first premium payment required to establish premium
27payment be delivered by first-class mail, certified mail, or other
28reliable means of delivery, including personal delivery, express
29mail, or private courier company, to the disability insurer, or to
30the employer if the employer has contracted with the insurer to
31perform the administrative services pursuant to subdivision (d) of
32Section 10128.55, within 45 days of the date the qualified
33beneficiary provided written notice to the insurer or the employer,
34if the employer has contracted to perform the administrative
35services, of the election to continue coverage in order for coverage
36to be continued under this article. This disclosure shall also state
37that the first premium payment must equal an amount sufficient
38to pay all required premiums and all premiums due, and that failure
39to submit the correct premium amount within the 45-day period
P43   1will disqualify the qualified beneficiary from receiving continuation
2coverage pursuant to this article.

3(c) The disclosure required by this section shall also describe
4separately how qualified beneficiaries whose continuation coverage
5terminates under a prior group benefit plan pursuant to Section
610128.57 may continue their coverage for the balance of the period
7that the qualified beneficiary would have remained covered under
8the prior group benefit plan, including the requirements for election
9and payment. The disclosure shall clearly state that continuation
10coverage shall terminate if the qualified beneficiary fails to comply
11with the requirements pertaining to enrollment in, and payment of
12premiums to, the new group benefit plan within 30 days of
13receiving notice of the termination of the prior group benefit plan.

14(d) Prior to August 1, 1998, every insurer shall provide to all
15covered employees of employers subject to this article written
16notice containing the disclosures required by this section, or shall
17provide to all covered employees of employers subject to this
18article a new or amended evidence of coverage that includes the
19disclosures required by this section. Any insurer that, in the
20ordinary course of business, maintains only the addresses of
21 employer group purchasers of benefits, and does not maintain
22addresses of covered employees, may comply with the notice
23requirements of this section through the provision of the notices
24to its employer group purchases of benefits.

25(e) Every disclosure form issued, amended, or renewed on or
26after January 1, 1999, for a group benefit plan subject to this article
27shall provide a notice that, under state law, an insured may be
28entitled to continuation of group coverage and that additional
29information regarding eligibility for this coverage may be found
30in the evidence of coverage.

31(f) Every disclosure issued, amended, or renewed on or after
32the operative date of this section for a group benefit plan subject
33to this article shall include the following notice:

34“Please examine your options carefully before declining this
35coverage. You should be aware that companies selling individual
36health insurance typically require a review of your medical history
37that could result in a higher premium or you could be denied
38coverage entirely.”

P45   1(g) A disclosure issued, amended, or renewed on or after July
21, 2016, for a group benefit plan subject to this article shall include
3the following notice:

4“In addition to your coverage continuation options, you may be
5eligible for the following:

61. Coverage through the state health insurance marketplace, also
7known as Covered California. By enrolling through Covered
8California, you may qualify for lower monthly premiums and lower
9out-of-pocket costs. Your family members may also qualify for
10coverage through Covered California.

112. Coverage through Medi-Cal. Depending on your income, you
12may qualify for low- or no-cost coverage through Medi-Cal. Your
13family members may also qualify for Medi-Cal.

143. Coverage through an insured spouse. If your spouse has
15coverage that extends to family members, you may be able to be
16added on that benefit plan.

17Be aware that there is a deadline to enroll in Covered California
18although you can apply for Medi-Cal anytime. To find out more
19about how to apply for Covered California and Medi-Cal, visit the
20Covered California Internet Web site at

21http://www.coveredca.com.”

22(h) (1) If Section 5000A of the Internal Revenue Code, as added
23by Section 1501 of PPACA, is repealed or amended to no longer
24apply to the individual market, as defined in Section 2791 of the
25federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this
26section shall become operative 12 months after the date of that
27repeal or amendment.

28(2) For purposes of this subdivision, “PPACA” means the federal
29Patient Protection and Affordable Care Act (Public Law 111-148),
30as amended by the federal Health Care and Education
31Reconciliation Act of 2010 (Public Law 111-152), and any rules,
32regulations, or guidance issued pursuant to that law.

33

SEC. 21.  

Section 10128.55 of the Insurance Code is amended
34to read:

35

10128.55.  

(a) Every group benefit plan contract between a
36disability insurer and an employer subject to this article that is
37issued, amended, or renewed on or after July 1, 1998, shall require
38the employer to notify the insurer in writing of any employee who
39has had a qualifying event, as defined in paragraph (2) of
40subdivision (d) of Section 10128.51, within 30 days of the
P46   1qualifying event. The group contract shall also require the employer
2to notify the insurer, in writing, within 30 days of the date when
3the employer becomes subject to Section 4980B of the United
4States Internal Revenue Code or Chapter 18 of the Employee
5Retirement Income Security Act (29 U.S.C. Sec. 1161 et seq.).

6(b) Every group benefit plan contract between a disability insurer
7and an employer subject to this article that is issued, amended, or
8renewed after July 1, 1998, shall require the employer to notify
9qualified beneficiaries currently receiving continuation coverage,
10whose continuation coverage will terminate under one group
11benefit plan prior to the end of the period the qualified beneficiary
12would have remained covered, as specified in Section 10128.57,
13of the qualified beneficiary’s ability to continue coverage under a
14new group benefit plan for the balance of the period the qualified
15beneficiary would have remained covered under the prior group
16benefit plan. This notice shall be provided either 30 days prior to
17the termination or when all enrolled employees are notified,
18whichever is later.

19Every disability insurer shall provide to the employer replacing
20a group benefit plan policy issued by the insurer, or to the
21employer’s agent or broker representative, within 15 days of any
22written request, information in possession of the insurer reasonably
23required to administer the notification requirements of this
24subdivision and subdivision (c).

25(c) Notwithstanding subdivision (a), the group benefit plan
26contract between the insurer and the employer shall require the
27employer to notify the successor plan in writing of the qualified
28beneficiaries currently receiving continuation coverage so that the
29successor plan, or contracting employer or administrator, may
30provide those qualified beneficiaries with the necessary premium
31information, enrollment forms, and instructions consistent with
32the disclosure required by subdivision (c) of Section 10128.54 and
33subdivision (e) of this section to allow the qualified beneficiary to
34continue coverage. This information shall be sent to all qualified
35beneficiaries who are enrolled in the group benefit plan and those
36qualified beneficiaries who have been notified, pursuant to Section
3710128.54 of their ability to continue their coverage and may still
38elect coverage within the specified 60-day period. This information
39shall be sent to the qualified beneficiary’s last known address, as
40provided to the employer by the health care service plan or,
P47   1disability insurer currently providing continuation coverage to the
2qualified beneficiary. The successor insurer shall not be obligated
3to provide this information to qualified beneficiaries if the
4employer or prior insurer or health care service plan fails to comply
5with this section.

6(d) A disability insurer may contract with an employer, or an
7administrator, to perform the administrative obligations of the plan
8as required by this article, including required notifications and
9collecting and forwarding premiums to the insurer. Except for the
10requirements of subdivisions (a), (b), and (c), this subdivision shall
11not be construed to permit an insurer to require an employer to
12perform the administrative obligations of the insurer as required
13by this article as a condition of the issuance or renewal of coverage.

14(e) Every insurer, or employer or administrator that contracts
15to perform the notice and administrative services pursuant to this
16section, shall, within 14 days of receiving a notice of a qualifying
17event, provide to the qualified beneficiary the necessary premium
18information, enrollment forms, and disclosures consistent with the
19notice requirements contained in subdivisions (b) and (c) of Section
2010128.54 to allow the qualified beneficiary to formally elect
21continuation coverage. This information shall be sent to the
22qualified beneficiary’s last known address.

23(f) Every insurer, or employer or administrator that contracts
24to perform the notice and administrative services pursuant to this
25section, shall, during the 180-day period ending on the date that
26continuation coverage is terminated pursuant to paragraphs (1),
27(3), and (5) of subdivision (a) of Section 10128.57, notify a
28qualified beneficiary who has elected continuation coverage
29pursuant to this article of the date that his or her coverage will
30terminate, and shall notify the qualified beneficiary of any
31conversion coverage available to that qualified beneficiary. This
32requirement shall not apply when the continuation coverage is
33terminated because the group contract between the insurer and the
34employer is being terminated.

35(g) (1) An insurer shall provide to a qualified beneficiary who
36has a qualifying event during the period specified in subparagraph
37(A) of paragraph (3) of subdivision (a) of Section 3001 of ARRA,
38a written notice containing information on the availability of
39premium assistance under ARRA. This notice shall be sent to the
40qualified beneficiary’s last known address. The notice shall include
P48   1clear and easily understandable language to inform the qualified
2beneficiary that changes in federal law provide a new opportunity
3to elect continuation coverage with a 65-percent premium subsidy
4and shall include all of the following:

5(A) The amount of the premium the person will pay. For
6qualified beneficiaries who had a qualifying event between
7September 1, 2008, and May 12, 2009, inclusive, if an insurer is
8unable to provide the correct premium amount in the notice, the
9notice may contain the last known premium amount and an
10opportunity for the qualified beneficiary to request, through a
11toll-free telephone number, the correct premium that would apply
12to the beneficiary.

13(B) Enrollment forms and any other information required to be
14included pursuant to subdivision (e) to allow the qualified
15beneficiary to elect continuation coverage. This information shall
16not be included in notices sent to qualified beneficiaries currently
17enrolled in continuation coverage.

18(C) A description of the option to enroll in different coverage
19as provided in subparagraph (B) of paragraph (1) of subdivision
20(a) of Section 3001 of ARRA. This description shall advise the
21qualified beneficiary to contact the covered employee’s former
22employer for prior approval to choose this option.

23(D) The eligibility requirements for premium assistance in the
24amount of 65 percent of the premium under Section 3001 of
25ARRA.

26(E) The duration of premium assistance available under ARRA.

27(F) A statement that a qualified beneficiary eligible for premium
28assistance under ARRA may elect continuation coverage no later
29than 60 days of the date of the notice.

30(G) A statement that a qualified beneficiary eligible for premium
31assistance under ARRA who rejected or discontinued continuation
32coverage prior to receiving the notice required by this subdivision
33has the right to withdraw that rejection and elect continuation
34coverage with the premium assistance.

35(H) A statement that reads as follows:


37“IF YOU ARE HAVING ANY DIFFICULTIES READING OR
38UNDERSTANDING THIS NOTICE, PLEASE CONTACT [name
39of insurer] at [insert appropriate telephone number].”
40


P49   1(2) With respect to qualified beneficiaries who had a qualifying
2event between September 1, 2008, and May 12, 2009, inclusive,
3the notice described in this subdivision shall be provided by the
4later of May 26, 2009, or seven business days after the date the
5insurer receives notice of the qualifying event.

6(3) With respect to qualified beneficiaries who had or have a
7qualifying event between May 13, 2009, and the later date specified
8in subparagraph (A) of paragraph (3) of subdivision (a) of Section
93001 of ARRA, inclusive, the notice described in this subdivision
10shall be provided within the period of time specified in subdivision
11(e).

12(4) Nothing in this section shall be construed to require an
13insurer to provide the insurer’s evidence of coverage as a part of
14the notice required by this subdivision, and nothing in this section
15shall be construed to require an insurer to amend its existing
16evidence of coverage to comply with the changes made to this
17section by the enactment of Assembly Bill 23 of the 2009-10
18Regular Session or by the act amending this section during the
19second year of the 2009-10 Regular Session.

20(5) The requirement under this subdivision to provide a written
21notice to a qualified beneficiary and the requirement under
22paragraph (1) of subdivision (i) to provide a new opportunity to a
23qualified beneficiary to elect continuation coverage shall be deemed
24satisfied if an insurer previously provided a written notice and
25additional election opportunity under Section 3001 of ARRA to
26that qualified beneficiary prior to the effective date of the act
27adding this paragraph.

28(h) A group contract between a group benefit plan and an
29employer subject to this article that is issued, amended, or renewed
30on or after July 1, 2016, shall require the employer to give the
31following notice to a qualified beneficiary in connection with a
32notice regarding election of continuation coverage:

33“In addition to your coverage continuation options, you may be
34eligible for the following:

351. Coverage through the state health insurance marketplace, also
36known as Covered California. By enrolling through Covered
37California, you may qualify for lower monthly premiums and lower
38out-of-pocket costs. Your family members may also qualify for
39coverage through Covered California.

P50   12. Coverage through Medi-Cal. Depending on your income, you
2may qualify for low- or no-cost coverage through Medi-Cal. Your
3family members may also qualify for Medi-Cal.

43. Coverage through an insured spouse. If your spouse has
5coverage that extends to family members, you may be able to be
6added on that benefit plan.

7Be aware that there is a deadline to enroll in Covered California
8although you can apply for Medi-Cal anytime. To find out more
9about how to apply for Covered California and Medi-Cal, visit the
10Covered California Internet Web site at

11http://www.coveredca.com.”

12(i) (1) Notwithstanding any other law, a qualified beneficiary
13eligible for premium assistance under ARRA may elect
14continuation coverage no later than 60 days after the date of the
15notice required by subdivision (g).

16(2) For a qualified beneficiary who elects to continue coverage
17pursuant to this subdivision, the period beginning on the date of
18the qualifying event and ending on the effective date of the
19continuation coverage shall be disregarded for purposes of
20calculating a break in coverage in determining whether a
21preexisting condition provision applies under subdivision (e) of
22Section 10198.7 or subdivision (c) of Section 10708.

23(3) For a qualified beneficiary who had a qualifying event
24between September 1, 2008, and February 16, 2009, inclusive, and
25who elects continuation coverage pursuant to paragraph (1), the
26continuation coverage shall commence on the first day of the month
27following the election.

28(4) For a qualified beneficiary who had a qualifying event
29between February 17, 2009, and May 12, 2009, inclusive, and who
30elects continuation coverage pursuant to paragraph (1), the effective
31date of the continuation coverage shall be either of the following,
32at the option of the beneficiary, provided that the beneficiary pays
33the applicable premiums:

34(A) The date of the qualifying event.

35(B) The first day of the month following the election.

36(5) Notwithstanding any other law, a qualified beneficiary who
37is eligible for the special election period described in paragraph
38(17) of subdivision (a) of Section 3001 of ARRA may elect
39continuation coverage no later than 60 days after the date of the
40notice required under subdivision (k). For a qualified beneficiary
P51   1who elects coverage pursuant to this paragraph, the continuation
2coverage shall be effective as of the first day of the first period of
3coverage after the date of termination of employment, except, if
4federal law permits, coverage shall take effect on the first day of
5the month following the election. However, for purposes of
6calculating the duration of continuation coverage pursuant to
7Section 10128.57, the period of that coverage shall be determined
8as though the qualifying event was a reduction of hours of the
9employee.

10(6) Notwithstanding any other law, a qualified beneficiary who
11is eligible for any other special election period under ARRA may
12elect continuation coverage no later than 60 days after the date of
13the special election notice required under ARRA.

14(j) An insurer shall provide a qualified beneficiary eligible for
15premium assistance under ARRA written notice of the extension
16of that premium assistance as required under Section 3001 of
17ARRA.

18(k) A health insurer, or an administrator or employer if
19administrative obligations have been assumed by those entities
20pursuant to subdivision (d), shall give the qualified beneficiaries
21described in subparagraph (C) of paragraph (17) of subdivision
22(a) of Section 3001 of ARRA the written notice required by that
23paragraph by implementing the following procedures:

24(1) The insurer shall, within 14 days of the effective date of the
25act adding this subdivision, send a notice to employers currently
26contracting with the insurer for a group benefit plan subject to this
27article. The notice shall do all of the following:

28(A) Advise the employer that employees whose employment is
29terminated on or after March 2, 2010, who were previously enrolled
30in any group health care service plan or health insurance policy
31offered by the employer may be entitled to special health coverage
32rights, including a subsidy paid by the federal government for a
33portion of the premium.

34(B) Ask the employer to provide the insurer with the name,
35address, and date of termination of employment for any employee
36whose employment is terminated on or after March 2, 2010, and
37who was at any time covered by any health care service plan or
38health insurance policy offered to their employees on or after
39September 1, 2008.

P52   1(C) Provide employers with a format and instructions for
2submitting the information to the insurer, or their administrator or
3employer who has assumed administrative obligations pursuant
4to subdivision (d), by telephone, fax, electronic mail, or mail.

5(2) Within 14 days of receipt of the information specified in
6paragraph (1) from the employer, the insurer shall send the written
7notice specified in paragraph (17) of subdivision (a) of Section
83001 of ARRA to those individuals.

9(3) If an individual contacts his or her health insurer and
10indicates that he or she experienced a qualifying event that entitles
11him or her to the special election period described in paragraph
12(17) of subdivision (a) of Section 3001 of ARRA or any other
13special election provision of ARRA, the insurer shall provide the
14individual with the notice required under paragraph (17) of
15subdivision (a) of Section 3001 of ARRA or any other applicable
16provision of ARRA, regardless of whether the insurer receives or
17received information from the individual’s previous employer
18regarding that individual pursuant to Section 24100 of the Health
19and Safety Code. The insurer shall review the individual’s
20application for coverage under this special election notice to
21determine if the individual qualifies for the special election period
22and the premium assistance under ARRA. The insurer shall comply
23with paragraph (5) if the individual does not qualify for either the
24special election period or premium assistance under ARRA.

25(4) The requirement under this subdivision to provide the written
26notice described in paragraph (17) of subdivision (a) of Section
273001 of ARRA to a qualified beneficiary and the requirement
28under paragraph (5) of subdivision (i) to provide a new opportunity
29to a qualified beneficiary to elect continuation coverage shall be
30deemed satisfied if a health insurer previously provided the written
31notice and additional election opportunity described in paragraph
32(17) of subdivision (a) of Section 3001 of ARRA to that qualified
33beneficiary prior to the effective date of the act adding this
34paragraph.

35(5) If an individual does not qualify for either a special election
36period or the subsidy under ARRA, the insurer shall provide a
37written notice to that individual that shall include information on
38the right to appeal as set forth in Section 3001 of ARRA.

39(6) A health insurer shall provide information on its publicly
40accessible Internet Web site regarding the premium assistance
P53   1made available under ARRA and any special election period
2provided under that law. An insurer may fulfill this requirement
3by linking or otherwise directing consumers to the information
4regarding COBRA continuation coverage premium assistance
5located on the Internet Web site of the United States Department
6of Labor. The information required by this paragraph shall be
7located in a section of the insurer’s Internet Web site that is readily
8accessible to consumers, such as the Web site’s Frequently Asked
9Questions section.

10(l) Notwithstanding any other law, a qualified beneficiary
11eligible for premium assistance under ARRA may elect to enroll
12in different coverage subject to the criteria provided under
13subparagraph (B) of paragraph (1) of subdivision (a) of Section
143001 of ARRA.

15(m) A qualified beneficiary enrolled in continuation coverage
16as of February 17, 2009, who is eligible for premium assistance
17under ARRA may request application of the premium assistance
18as of March 1, 2009, or later, consistent with ARRA.

19(n) An insurer that receives an election notice from a qualified
20beneficiary eligible for premium assistance under ARRA, pursuant
21to subdivision (i), shall be considered a person entitled to
22reimbursement, as defined in Section 6432(b)(3) of the Internal
23Revenue Code, as amended by paragraph (12) of subdivision (a)
24of Section 3001 of ARRA.

25(o) (1) For purposes of compliance with ARRA, in the absence
26of guidance from, or if specifically required for state-only
27continuation coverage by, the United States Department of Labor,
28the Internal Revenue Service, or the Centers for Medicare and
29Medicaid Services, an insurer may request verification of the
30involuntary termination of a covered employee’s employment from
31the covered employee’s former employer or the qualified
32beneficiary seeking premium assistance under ARRA.

33(2) An insurer that requests verification pursuant to paragraph
34(1) directly from a covered employee’s former employer shall do
35so by providing a written notice to the employer. This written
36notice shall be sent by mail or facsimile to the covered employee’s
37former employer within seven business days from the date the
38insurer receives the qualified beneficiary’s election notice pursuant
39to subdivision (i). Within 10 calendar days of receipt of written
40notice required by this paragraph, the former employer shall furnish
P54   1to the insurer written verification as to whether the covered
2employee’s employment was involuntarily terminated.

3(3) A qualified beneficiary requesting premium assistance under
4ARRA may furnish to the insurer a written document or other
5information from the covered employee’s former employer
6indicating that the covered employee’s employment was
7involuntarily terminated. This document or information shall be
8deemed sufficient by the insurer to establish that the covered
9employee’s employment was involuntarily terminated for purposes
10of ARRA, unless the insurer makes a reasonable and timely
11determination that the documents or information provided by the
12qualified beneficiary are legally insufficient to establish involuntary
13termination of employment.

14(4) If an insurer requests verification pursuant to this subdivision
15and cannot verify involuntary termination of employment within
1614 business days from the date the employer receives the
17verification request or from the date the insurer receives
18 documentation or other information from the qualified beneficiary
19pursuant to paragraph (3), the insurer shall either provide
20continuation coverage with the federal premium assistance to the
21qualified beneficiary or send the qualified beneficiary a denial
22letter which shall include notice of his or her right to appeal that
23determination pursuant to ARRA.

24(5) No person shall intentionally delay verification of
25involuntary termination of employment under this subdivision.

26(p) (1) If Section 5000A of the Internal Revenue Code, as added
27by Section 1501 of PPACA, is repealed or amended to no longer
28apply to the individual market, as defined in Section 2791 of the
29federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this
30section shall become inoperative and is repealed 12 months after
31the date of that repeal or amendment.

32(2) For purposes of this subdivision, “PPACA” means the federal
33Patient Protection and Affordable Care Act (Public Law 111-148),
34as amended by the federal Health Care and Education
35Reconciliation Act of 2010 (Public Law 111-152), and any rules,
36regulations, or guidance issued pursuant to that law.

37

SEC. 22.  

Section 10128.55 is added to the Insurance Code, to
38read:

39

10128.55.  

(a) Every group benefit plan contract between a
40disability insurer and an employer subject to this article that is
P55   1issued, amended, or renewed on or after July 1, 1998, shall require
2the employer to notify the insurer in writing of any employee who
3has had a qualifying event, as defined in paragraph (2) of
4subdivision (d) of Section 10128.51, within 30 days of the
5qualifying event. The group contract shall also require the employer
6to notify the insurer, in writing, within 30 days of the date when
7the employer becomes subject to Section 4980B of the United
8States Internal Revenue Code or Chapter 18 of the Employee
9Retirement Income Security Act (29 U.S.C. Sec. 1161 et seq.).

10(b) Every group benefit plan contract between a disability insurer
11and an employer subject to this article that is issued, amended, or
12renewed after July 1, 1998, shall require the employer to notify
13qualified beneficiaries currently receiving continuation coverage,
14whose continuation coverage will terminate under one group
15benefit plan prior to the end of the period the qualified beneficiary
16would have remained covered, as specified in Section 10128.57,
17of the qualified beneficiary’s ability to continue coverage under a
18new group benefit plan for the balance of the period the qualified
19beneficiary would have remained covered under the prior group
20benefit plan. This notice shall be provided either 30 days prior to
21the termination or when all enrolled employees are notified,
22whichever is later.

23Every disability insurer shall provide to the employer replacing
24a group benefit plan policy issued by the insurer, or to the
25employer’s agent or broker representative, within 15 days of any
26written request, information in possession of the insurer reasonably
27required to administer the notification requirements of this
28subdivision and subdivision (c).

29(c) Notwithstanding subdivision (a), the group benefit plan
30contract between the insurer and the employer shall require the
31employer to notify the successor plan in writing of the qualified
32beneficiaries currently receiving continuation coverage so that the
33successor plan, or contracting employer or administrator, may
34provide those qualified beneficiaries with the necessary premium
35information, enrollment forms, and instructions consistent with
36the disclosure required by subdivision (c) of Section 10128.54 and
37subdivision (e) of this section to allow the qualified beneficiary to
38continue coverage. This information shall be sent to all qualified
39beneficiaries who are enrolled in the group benefit plan and those
40qualified beneficiaries who have been notified, pursuant to Section
P56   110128.54 of their ability to continue their coverage and may still
2elect coverage within the specified 60-day period. This information
3shall be sent to the qualified beneficiary’s last known address, as
4provided to the employer by the health care service plan or,
5disability insurer currently providing continuation coverage to the
6qualified beneficiary. The successor insurer shall not be obligated
7to provide this information to qualified beneficiaries if the
8employer or prior insurer or health care service plan fails to comply
9with this section.

10(d) A disability insurer may contract with an employer, or an
11administrator, to perform the administrative obligations of the plan
12as required by this article, including required notifications and
13collecting and forwarding premiums to the insurer. Except for the
14requirements of subdivisions (a), (b), and (c), this subdivision shall
15not be construed to permit an insurer to require an employer to
16perform the administrative obligations of the insurer as required
17by this article as a condition of the issuance or renewal of coverage.

18(e) Every insurer, or employer or administrator that contracts
19to perform the notice and administrative services pursuant to this
20section, shall, within 14 days of receiving a notice of a qualifying
21event, provide to the qualified beneficiary the necessary premium
22information, enrollment forms, and disclosures consistent with the
23notice requirements contained in subdivisions (b) and (c) of Section
2410128.54 to allow the qualified beneficiary to formally elect
25continuation coverage. This information shall be sent to the
26qualified beneficiary’s last known address.

27(f) Every insurer, or employer or administrator that contracts
28to perform the notice and administrative services pursuant to this
29section, shall, during the 180-day period ending on the date that
30continuation coverage is terminated pursuant to paragraphs (1),
31(3), and (5) of subdivision (a) of Section 10128.57, notify a
32qualified beneficiary who has elected continuation coverage
33pursuant to this article of the date that his or her coverage will
34terminate, and shall notify the qualified beneficiary of any
35conversion coverage available to that qualified beneficiary. This
36requirement shall not apply when the continuation coverage is
37terminated because the group contract between the insurer and the
38 employer is being terminated.

39(g) (1) An insurer shall provide to a qualified beneficiary who
40has a qualifying event during the period specified in subparagraph
P57   1(A) of paragraph (3) of subdivision (a) of Section 3001 of ARRA,
2a written notice containing information on the availability of
3premium assistance under ARRA. This notice shall be sent to the
4qualified beneficiary’s last known address. The notice shall include
5clear and easily understandable language to inform the qualified
6beneficiary that changes in federal law provide a new opportunity
7to elect continuation coverage with a 65-percent premium subsidy
8and shall include all of the following:

9(A) The amount of the premium the person will pay. For
10qualified beneficiaries who had a qualifying event between
11 September 1, 2008, and May 12, 2009, inclusive, if an insurer is
12unable to provide the correct premium amount in the notice, the
13notice may contain the last known premium amount and an
14opportunity for the qualified beneficiary to request, through a
15toll-free telephone number, the correct premium that would apply
16to the beneficiary.

17(B) Enrollment forms and any other information required to be
18included pursuant to subdivision (e) to allow the qualified
19beneficiary to elect continuation coverage. This information shall
20not be included in notices sent to qualified beneficiaries currently
21 enrolled in continuation coverage.

22(C) A description of the option to enroll in different coverage
23as provided in subparagraph (B) of paragraph (1) of subdivision
24(a) of Section 3001 of ARRA. This description shall advise the
25qualified beneficiary to contact the covered employee’s former
26employer for prior approval to choose this option.

27(D) The eligibility requirements for premium assistance in the
28amount of 65 percent of the premium under Section 3001 of
29ARRA.

30(E) The duration of premium assistance available under ARRA.

31(F) A statement that a qualified beneficiary eligible for premium
32assistance under ARRA may elect continuation coverage no later
33than 60 days of the date of the notice.

34(G) A statement that a qualified beneficiary eligible for premium
35assistance under ARRA who rejected or discontinued continuation
36coverage prior to receiving the notice required by this subdivision
37has the right to withdraw that rejection and elect continuation
38coverage with the premium assistance.

39(H) A statement that reads as follows:

P58   1“IF YOU ARE HAVING ANY DIFFICULTIES READING OR
2UNDERSTANDING THIS NOTICE, PLEASE CONTACT [name
3of insurer] at [insert appropriate telephone number].”

4(2) With respect to qualified beneficiaries who had a qualifying
5event between September 1, 2008, and May 12, 2009, inclusive,
6the notice described in this subdivision shall be provided by the
7later of May 26, 2009, or seven business days after the date the
8insurer receives notice of the qualifying event.

9(3) With respect to qualified beneficiaries who had or have a
10qualifying event between May 13, 2009, and the later date specified
11in subparagraph (A) of paragraph (3) of subdivision (a) of Section
123001 of ARRA, inclusive, the notice described in this subdivision
13shall be provided within the period of time specified in subdivision
14(e).

15(4) Nothing in this section shall be construed to require an
16insurer to provide the insurer’s evidence of coverage as a part of
17the notice required by this subdivision, and nothing in this section
18shall be construed to require an insurer to amend its existing
19evidence of coverage to comply with the changes made to this
20section by the enactment of Assembly Bill 23 of the 2009-10
21Regular Session or by the act amending this section during the
22second year of the 2009-10 Regular Session.

23(5) The requirement under this subdivision to provide a written
24notice to a qualified beneficiary and the requirement under
25paragraph (1) of subdivision (h) to provide a new opportunity to
26a qualified beneficiary to elect continuation coverage shall be
27deemed satisfied if an insurer previously provided a written notice
28and additional election opportunity under Section 3001 of ARRA
29to that qualified beneficiary prior to the effective date of the act
30adding this paragraph.

31(h) A group contract between a group benefit plan and an
32employer subject to this article that is issued, amended, or renewed
33 on or after the operative date of this section shall require the
34employer to give the following notice to a qualified beneficiary in
35connection with a notice regarding election of continuation
36coverage:

37“Please examine your options carefully before declining this
38coverage. You should be aware that companies selling individual
39health insurance typically require a review of your medical history
P59   1that could result in a higher premium or you could be denied
2coverage entirely.”

3(i) A group contract between a group benefit plan and an
4employer subject to this article that is issued, amended, or renewed
5on or after July 1, 2016, shall require the employer to give the
6following notice to a qualified beneficiary in connection with a
7notice regarding election of continuation coverage:

8“In addition to your coverage continuation options, you may be
9eligible for the following:

101. Coverage through the state health insurance marketplace, also
11known as Covered California. By enrolling through Covered
12California, you may qualify for lower monthly premiums and lower
13out-of-pocket costs. Your family members may also qualify for
14coverage through Covered California.

152. Coverage through Medi-Cal. Depending on your income, you
16may qualify for low- or no-cost coverage through Medi-Cal. Your
17family members may also qualify for Medi-Cal.

183. Coverage through an insured spouse. If your spouse has
19coverage that extends to family members, you may be able to be
20added on that benefit plan.

21Be aware that there is a deadline to enroll in Covered California
22although you can apply for Medi-Cal anytime. To find out more
23about how to apply for Covered California and Medi-Cal, visit the
24Covered California Internet Web site at
25http://www.coveredca.com.”

26(j) (1) Notwithstanding any other law, a qualified beneficiary
27eligible for premium assistance under ARRA may elect
28continuation coverage no later than 60 days after the date of the
29notice required by subdivision (g).

30(2) For a qualified beneficiary who elects to continue coverage
31pursuant to this subdivision, the period beginning on the date of
32the qualifying event and ending on the effective date of the
33continuation coverage shall be disregarded for purposes of
34calculating a break in coverage in determining whether a
35preexisting condition provision applies under subdivision (e) of
36Section 10198.7 or subdivision (c) of Section 10708.

37(3) For a qualified beneficiary who had a qualifying event
38between September 1, 2008, and February 16, 2009, inclusive, and
39who elects continuation coverage pursuant to paragraph (1), the
P60   1continuation coverage shall commence on the first day of the month
2following the election.

3(4) For a qualified beneficiary who had a qualifying event
4between February 17, 2009, and May 12, 2009, inclusive, and who
5 elects continuation coverage pursuant to paragraph (1), the effective
6date of the continuation coverage shall be either of the following,
7at the option of the beneficiary, provided that the beneficiary pays
8the applicable premiums:

9(A) The date of the qualifying event.

10(B) The first day of the month following the election.

11(5) Notwithstanding any other law, a qualified beneficiary who
12is eligible for the special election period described in paragraph
13(17) of subdivision (a) of Section 3001 of ARRA may elect
14continuation coverage no later than 60 days after the date of the
15notice required under subdivision (l). For a qualified beneficiary
16who elects coverage pursuant to this paragraph, the continuation
17coverage shall be effective as of the first day of the first period of
18coverage after the date of termination of employment, except, if
19federal law permits, coverage shall take effect on the first day of
20the month following the election. However, for purposes of
21calculating the duration of continuation coverage pursuant to
22Section 10128.57, the period of that coverage shall be determined
23as though the qualifying event was a reduction of hours of the
24employee.

25(6) Notwithstanding any other law, a qualified beneficiary who
26is eligible for any other special election period under ARRA may
27elect continuation coverage no later than 60 days after the date of
28the special election notice required under ARRA.

29(k) An insurer shall provide a qualified beneficiary eligible for
30premium assistance under ARRA written notice of the extension
31of that premium assistance as required under Section 3001 of
32ARRA.

33(l) A health insurer, or an administrator or employer if
34administrative obligations have been assumed by those entities
35pursuant to subdivision (d), shall give the qualified beneficiaries
36described in subparagraph (C) of paragraph (17) of subdivision
37(a) of Section 3001 of ARRA the written notice required by that
38paragraph by implementing the following procedures:

39(1) The insurer shall, within 14 days of the effective date of the
40act adding this subdivision, send a notice to employers currently
P61   1contracting with the insurer for a group benefit plan subject to this
2article. The notice shall do all of the following:

3(A) Advise the employer that employees whose employment is
4terminated on or after March 2, 2010, who were previously enrolled
5in any group health care service plan or health insurance policy
6offered by the employer may be entitled to special health coverage
7rights, including a subsidy paid by the federal government for a
8portion of the premium.

9(B) Ask the employer to provide the insurer with the name,
10address, and date of termination of employment for any employee
11whose employment is terminated on or after March 2, 2010, and
12who was at any time covered by any health care service plan or
13health insurance policy offered to their employees on or after
14September 1, 2008.

15(C) Provide employers with a format and instructions for
16submitting the information to the insurer, or their administrator or
17employer who has assumed administrative obligations pursuant
18to subdivision (d), by telephone, fax, electronic mail, or mail.

19(2) Within 14 days of receipt of the information specified in
20paragraph (1) from the employer, the insurer shall send the written
21notice specified in paragraph (17) of subdivision (a) of Section
22 3001 of ARRA to those individuals.

23(3) If an individual contacts his or her health insurer and
24indicates that he or she experienced a qualifying event that entitles
25him or her to the special election period described in paragraph
26(17) of subdivision (a) of Section 3001 of ARRA or any other
27special election provision of ARRA, the insurer shall provide the
28individual with the notice required under paragraph (17) of
29subdivision (a) of Section 3001 of ARRA or any other applicable
30provision of ARRA, regardless of whether the insurer receives or
31received information from the individual’s previous employer
32regarding that individual pursuant to Section 24100 of the Health
33and Safety Code. The insurer shall review the individual’s
34application for coverage under this special election notice to
35determine if the individual qualifies for the special election period
36and the premium assistance under ARRA. The insurer shall comply
37with paragraph (5) if the individual does not qualify for either the
38special election period or premium assistance under ARRA.

39(4) The requirement under this subdivision to provide the written
40notice described in paragraph (17) of subdivision (a) of Section
P62   13001 of ARRA to a qualified beneficiary and the requirement
2under paragraph (5) of subdivision (j) to provide a new opportunity
3to a qualified beneficiary to elect continuation coverage shall be
4deemed satisfied if a health insurer previously provided the written
5notice and additional election opportunity described in paragraph
6(17) of subdivision (a) of Section 3001 of ARRA to that qualified
7beneficiary prior to the effective date of the act adding this
8paragraph.

9(5) If an individual does not qualify for either a special election
10period or the subsidy under ARRA, the insurer shall provide a
11written notice to that individual that shall include information on
12the right to appeal as set forth in Section 3001 of ARRA.

13(6) A health insurer shall provide information on its publicly
14accessible Internet Web site regarding the premium assistance
15made available under ARRA and any special election period
16provided under that law. An insurer may fulfill this requirement
17by linking or otherwise directing consumers to the information
18regarding COBRA continuation coverage premium assistance
19located on the Internet Web site of the United States Department
20of Labor. The information required by this paragraph shall be
21located in a section of the insurer’s Internet Web site that is readily
22accessible to consumers, such as the Web site’s Frequently Asked
23Questions section.

24(m) Notwithstanding any other law, a qualified beneficiary
25eligible for premium assistance under ARRA may elect to enroll
26in different coverage subject to the criteria provided under
27subparagraph (B) of paragraph (1) of subdivision (a) of Section
283001 of ARRA.

29(n) A qualified beneficiary enrolled in continuation coverage
30as of February 17, 2009, who is eligible for premium assistance
31under ARRA may request application of the premium assistance
32as of March 1, 2009, or later, consistent with ARRA.

33(o) An insurer that receives an election notice from a qualified
34beneficiary eligible for premium assistance under ARRA, pursuant
35to subdivision (j), shall be considered a person entitled to
36reimbursement, as defined in Section 6432(b)(3) of the Internal
37Revenue Code, as amended by paragraph (12) of subdivision (a)
38of Section 3001 of ARRA.

39(p) (1) For purposes of compliance with ARRA, in the absence
40of guidance from, or if specifically required for state-only
P63   1 continuation coverage by, the United States Department of Labor,
2the Internal Revenue Service, or the Centers for Medicare and
3Medicaid Services, an insurer may request verification of the
4involuntary termination of a covered employee’s employment from
5the covered employee’s former employer or the qualified
6beneficiary seeking premium assistance under ARRA.

7(2) An insurer that requests verification pursuant to paragraph
8(1) directly from a covered employee’s former employer shall do
9so by providing a written notice to the employer. This written
10notice shall be sent by mail or facsimile to the covered employee’s
11former employer within seven business days from the date the
12insurer receives the qualified beneficiary’s election notice pursuant
13to subdivision (h). Within 10 calendar days of receipt of written
14notice required by this paragraph, the former employer shall furnish
15to the insurer written verification as to whether the covered
16employee’s employment was involuntarily terminated.

17(3) A qualified beneficiary requesting premium assistance under
18ARRA may furnish to the insurer a written document or other
19information from the covered employee’s former employer
20indicating that the covered employee’s employment was
21involuntarily terminated. This document or information shall be
22deemed sufficient by the insurer to establish that the covered
23employee’s employment was involuntarily terminated for purposes
24of ARRA, unless the insurer makes a reasonable and timely
25determination that the documents or information provided by the
26qualified beneficiary are legally insufficient to establish involuntary
27termination of employment.

28(4) If an insurer requests verification pursuant to this subdivision
29and cannot verify involuntary termination of employment within
3014 business days from the date the employer receives the
31verification request or from the date the insurer receives
32documentation or other information from the qualified beneficiary
33pursuant to paragraph (3), the insurer shall either provide
34continuation coverage with the federal premium assistance to the
35qualified beneficiary or send the qualified beneficiary a denial
36letter which shall include notice of his or her right to appeal that
37determination pursuant to ARRA.

38(5) No person shall intentionally delay verification of
39involuntary termination of employment under this subdivision.

P64   1(q) (1) If Section 5000A of the Internal Revenue Code, as added
2by Section 1501 of PPACA, is repealed or amended to no longer
3apply to the individual market, as defined in Section 2791 of the
4federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this
5section shall become operative 12 months after the date of that
6repeal or amendment.

7(2) For purposes of this subdivision, “PPACA” means the federal
8Patient Protection and Affordable Care Act (Public Law 111-148),
9as amended by the federal Health Care and Education
10Reconciliation Act of 2010 (Public Law 111-152), and any rules,
11regulations, or guidance issued pursuant to that law.

end delete
12

begin deleteSEC. 23.end delete
13begin insertSEC. 12.end insert  

Section 729.12 of the Welfare and Institutions Code
14 is amended to read:

15

729.12.  

(a) It is the intent of the Legislature to authorize an
16Assessment, Orientation, and Volunteer Mentor Pilot Program in
17San Diego County. The pilot project will operate under the
18authority of the county behavioral health director in conjunction
19with the San Diego Juvenile Court and the County of San Diego
20Probation Department.

21(b) Whenever a judge of the San Diego County Juvenile Court
22or a referee of the San Diego Juvenile Court finds a minor to be a
23person described in Section 601 or 602 for any reason, the minor
24may be assessed and screened for drug and alcohol use and abuse;
25and if the assessment and screening determines the need for drug
26and alcohol education and intervention, the minor may be required
27to participate in, and successfully complete, an alcohol and drug
28orientation, and to participate in, and successfully complete, an
29alcohol or drug program with a local community-based service
30provider, as designated by the court.

31(c) The Assessment, Orientation, and Volunteer Mentor Pilot
32Program may operate for a minimum of three years and may screen
33and assess for drug and alcohol problems, minors who are declared
34wards of San Diego Juvenile Court.

35(d) Drug and alcohol assessments may be conducted utilizing
36a standardized instrument that shall be approved by the county
37 behavioral health director in conjunction with San Diego Juvenile
38Court and the San Diego County Probation Department.

39(e) Those minors who are determined to have drug and alcohol
40problems, may be required to participate in, and successfully
P65   1complete, a drug and alcohol orientation. The orientation may
2provide drug and alcohol education and intervention, referral to
3community resources for followup education and intervention and
4arrange for volunteers to serve as mentors to assist each minor in
5addressing their drug and alcohol problem. Parents or guardians
6of minors will have the opportunity to participate in the orientation
7program in order to help juveniles address drug and alcohol use
8or abuse problems.

9(f) As a condition of probation, each minor may be required to
10submit to drug testing. Drug testing may be conducted on a random
11basis by a qualified drug and alcohol service provider in
12coordination with the county probation department. All contested
13drug tests may be confirmed by a National Institute for Drug Abuse
14certified drug laboratory and the findings may be reported to the
15probation officer for appropriate action. The drug testing protocol
16may be approved by the county behavioral health director in
17conjunction with San Diego Juvenile Court and the County of San
18Diego Probation Department.

19(g) An evaluation of the pilot program shall be conducted and
20results of the program shall be submitted to state alcohol and drug
21programs and to the Legislature at the conclusion of the pilot
22program. The evaluation shall include, but not be limited to, all of
23the following:

24(1) The number and percentage of juveniles screened.

25(2) The number and percentage of juveniles given followup
26education and intervention.

27(3) The number of mentors recruited and trained.

28(4) The number and percentage of juveniles assigned to a
29mentor.

30(5) The length of time in an education and intervention program.

31(6) The program completion rates.

32(7) The number of subsequent violations.

33(8) The number of re-arrests.

34(9) The urine test results.

35(10) The subsequent drug or alcohol use.

36(11) The participant’s perceptions of program utility.

37(12) The provider’s perceptions of program utility.

38(13) The mentor’s perceptions of program utility.

P66   1

begin deleteSEC. 24.end delete
2begin insertSEC. 13.end insert  

Section 4033 of the Welfare and Institutions Code is
3amended to read:

4

4033.  

(a) The State Department of Health Care Services shall,
5to the extent resources are available, comply with the Substance
6Abuse and Mental Health Services Administration federal planning
7requirements. The department shall update and issue a state plan,
8which may also be any federally required state service plan, so
9that citizens may be informed regarding the implementation of,
10and long-range goals for, programs to serve mentally ill persons
11in the state. The department shall gather information from counties
12necessary to comply with this section.

13(b) (1) If the State Department of Health Care Services makes
14a decision not to comply with any Substance Abuse and Mental
15Health Services Administration federal planning requirement to
16which this section applies, the State Department of Health Care
17Services shall submit the decision, for consultation, to the County
18Behavioral Health Directors Association of California, the
19California Mental Health Planning Council, and affected mental
20health entities.

21(2) The State Department of Health Care Services shall not
22implement any decision not to comply with the Substance Abuse
23and Mental Health Services Administration federal planning
24requirements sooner than 30 days after notification of that decision,
25in writing, by the Department of Finance, to the chairperson of the
26committee in each house of the Legislature that considers
27appropriations, and the Chairperson of the Joint Legislative Budget
28Committee.

29

begin deleteSEC. 25.end delete
30begin insertSEC. 14.end insert  

Section 4040 of the Welfare and Institutions Code is
31amended to read:

32

4040.  

The State Department of Health Care Services or State
33Department of State Hospitals may conduct, or contract for,
34research or evaluation studies that have application to mental health
35policy and management issues. In selecting areas for study the
36department shall be guided by the information needs of state and
37local policymakers and managers, and suggestions from the County
38Behavioral Health Directors Association of California.

P67   1

begin deleteSEC. 26.end delete
2begin insertSEC. 15.end insert  

Section 4095 of the Welfare and Institutions Code is
3amended to read:

4

4095.  

(a) It is the intent of the Legislature that essential and
5culturally relevant mental health assessment, case management,
6and treatment services be available to wards of the court and
7dependent children of the court placed out of home or who are at
8risk of requiring out-of-home care. This can be best achieved at
9the community level through the active collaboration of county
10social service, probation, education, mental health agencies, and
11foster care providers.

12(b) Therefore, using the Children’s Mental Health Services Act
13(Part 4 (commencing with Section 5850) of Division 5) as a
14guideline, the State Department of Health Care Services, in
15consultation with the County Behavioral Health Directors
16Association of California, the State Department of Social Services,
17the County Welfare Directors Association of California, the Chief
18Probation Officers of California, and foster care providers, shall
19do all of the following:

20(1) By July 1, 1994, develop an individualized mental health
21treatment needs assessment protocol for wards of the court and
22dependent children of the court.

23(2) Define supplemental services to be made available to the
24target population, including, but not limited to, services defined
25in Section 540 and following of Title 9 of the California Code of
26Regulations as of January 1, 1994, family therapy, prevocational
27services, and crisis support activities.

28(3) Establish statewide standardized rates for the various types
29of services defined by the department in accordance with paragraph
30(2), and provided pursuant to this section. The rates shall be
31designed to reduce the impact of competition for scarce treatment
32 resources on the cost and availability of care. The rates shall be
33implemented only when the state provides funding for the services
34described in this section.

35(4) By January 1, 1994, to the extent state funds are available
36to implement this section, establish, by regulation, all of the
37following:

38(A) Definitions of priority ranking of subsets of the court wards
39and dependents target population.

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

P68   1(c) (1) Only those individuals within the target population as
2defined in regulation and determined to be eligible for services as
3a result of a mental health treatment needs assessment may receive
4services pursuant to this section.

5(2) Allocation of funds appropriated for the purposes of this
6section shall be based on the number of wards and dependents and
7may be adjusted in subsequent fiscal years to reflect costs.

8(3) The counties shall be held harmless for failure to provide
9any assessment, case management, and treatment services to those
10children identified in need of services for whom there is no funding.

11(d) (1) The State Department of Health Care Services shall
12make information available to the Legislature, on request, on the
13service populations provided mental health treatment services
14pursuant to this section, the types and costs of services provided,
15and the number of children identified in need of treatment services
16who did not receive the services.

17(2) The information required by paragraph (1) may include
18information on need, cost, and service impact experience from the
19following:

20(A) Family preservation pilot programs.

21(B) Pilot programs implemented under the former Children’s
22Mental Health Services Act, as contained in Chapter 6.8
23(commencing with Section 5565.10) of Part 1 of Division 5.

24(C) Programs implemented under Chapter 26 (commencing
25with Section 7570) of Division 7 of Title 1 of the Government
26Code and Section 11401.

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

begin delete
28

SEC. 27.  

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

30

4096.5.  

(a) The State Department of Health Care Services
31shall make a determination, within 45 days of receiving a request
32from a group home to be classified at RCL 13 or RCL 14 pursuant
33to Section 11462.01, to certify or deny certification that the group
34home program includes provisions for mental health treatment
35services that meet the needs of seriously emotionally disturbed
36children. The department shall issue each certification for a period
37of one year and shall specify the effective date the program met
38the certification requirements. A program may be recertified if the
39program continues to meet the criteria for certification.

P69   1(b) The State Department of Health Care Services shall, in
2consultation with County Behavioral Health Directors Association
3of California and representatives of provider organizations, develop
4the criteria for the certification required by subdivision (a) by July
51, 1992.

6(c) (1) The State Department of Health Care Services may,
7upon the request of a county, delegate to that county the
8certification task.

9(2) Any county to which the certification task is delegated
10pursuant to paragraph (1) shall use the criteria and format
11developed by the department.

12(d) The State Department of Health Care Services or delegated
13county shall notify the State Department of Social Services
14Community Care Licensing Division immediately upon the
15 termination of any certification issued in accordance with
16subdivision (a).

17(e) Upon receipt of notification from the State Department of
18Social Services Community Care Licensing Division of any adverse
19licensing action taken after the finding of noncompliance during
20an inspection conducted pursuant to Section 1538.7 of the Health
21and Safety Code, the State Department of Health Care Services or
22the delegated county shall review the certification issued pursuant
23to this section.

end delete
24

begin deleteSEC. 28.end delete
25begin insertSEC. 16.end insert  

Section 4117 of the Welfare and Institutions Code,
26as amended by Section 47 of Chapter 26 of the Statutes of 2015,
27is amended to read:

28

4117.  

(a) Whenever a trial is had of any person charged with
29escape or attempt to escape from a state hospital, whenever a
30hearing is had on the return of a writ of habeas corpus prosecuted
31by or on behalf of any person confined in a state hospital except
32in a proceeding to which Section 5110 applies, whenever a hearing
33is had on a petition under Section 1026.2, subdivision (b) of Section
341026.5, Section 2966, or Section 2972 of the Penal Code, Section
357361 of this code, or former Section 6316.2 of this code for the
36release of a person confined in a state hospital, whenever a hearing
37is had for an order seeking involuntary treatment with psychotropic
38medication, or any other medication for which an order is required,
39of a person confined in a state hospital pursuant to Section 2962
40of the Penal Code, and whenever a person confined in a state
P70   1hospital is tried for a crime committed therein, the appropriate
2financial officer or other designated official of the county in which
3the trial or hearing is had shall make out a statement of all mental
4health treatment costs and shall make out a separate statement of
5all nontreatment costs incurred by the county for investigation and
6other preparation for the trial or hearing, and the actual trial or
7hearing, all costs of maintaining custody of the patient and
8transporting him or her to and from the hospital, and costs of
9appeal. The statements shall be properly certified by a judge of
10the superior court of that county. The statement of mental health
11treatment costs shall be sent to the State Department of State
12Hospitals and the statement of all nontreatment costs, except as
13provided in subdivision (c), shall be sent to the Controller for
14approval. After approval, the department shall cause the amount
15of mental health treatment costs incurred on or after July 1, 1987,
16to be paid to the county behavioral health director or his or her
17designee when the trial or hearing was held out of the money
18appropriated for this purpose by the Legislature. In addition, the
19Controller shall cause the amount of all nontreatment costs incurred
20on and after July 1, 1987, to be paid out of the money appropriated
21by the Legislature, to the county treasurer of the county where the
22trial or hearing was had.

23(b) Commencing January 1, 2012, the nontreatment costs
24associated with Section 2966 of the Penal Code and approved by
25the Controller, as required by subdivision (a), shall be paid by the
26Department of Corrections and Rehabilitation pursuant to Section
274750 of the Penal Code.

28(c) The nontreatment costs associated with any hearing for an
29order seeking involuntary treatment with psychotropic medication,
30or any other medication for which an order is required, of a person
31confined in a state hospital pursuant to Section 1026, 1026.5, or
322972 of the Penal Code, as provided in subdivision (a), shall be
33paid by the county of commitment. As used in this subdivision,
34“county of commitment” means the county seeking the continued
35treatment of a mentally disordered offender pursuant to Section
362972 of the Penal Code or the county committing a patient who
37has been found not guilty by reason of insanity pursuant to Section
381026 or 1026.5 of the Penal Code. The appropriate financial officer
39or other designated official of the county in which the proceeding
40is held shall make out a statement of all of the costs incurred by
P71   1the county for the investigation, preparation, and conduct of the
2proceedings, and the costs of appeal, if any. The statement shall
3be certified by a judge of the superior court of the county. The
4statement shall then be sent to the county of commitment, which
5shall reimburse the county providing the services.

6(d) (1) Whenever a hearing is held pursuant to Section 1604,
71608, 1609, or 2966 of the Penal Code, all transportation costs to
8and from a state hospital or a facility designated by the community
9program director during the hearing shall be paid by the Controller
10as provided in this subdivision. The appropriate financial officer
11or other designated official of the county in which a hearing is
12held shall make out a statement of all transportation costs incurred
13by the county. The statement shall be properly certified by a judge
14of the superior court of that county and sent to the Controller for
15approval. The Controller shall cause the amount of transportation
16costs incurred on and after July 1, 1987, to be paid to the county
17 treasurer of the county where the hearing was had out of the money
18appropriated by the Legislature.

19(2) As used in this subdivision, “community program director”
20means the person designated pursuant to Section 1605 of the Penal
21Code.

22

begin deleteSEC. 29.end delete
23begin insertSEC. 17.end insert  

Section 5121 of the Welfare and Institutions Code is
24amended to read:

25

5121.  

The county behavioral health director may develop
26procedures for the county’s designation and training of
27professionals who will be designated to perform functions under
28Section 5150. These procedures may include, but are not limited
29to, the following:

30(a) The license types, practice disciplines, and clinical
31experience of professionals eligible to be designated by the county.

32(b) The initial and ongoing training and testing requirements
33for professionals eligible to be designated by the county.

34(c) The application and approval processes for professionals
35seeking to be designated by the county, including the timeframe
36for initial designation and procedures for renewal of the
37designation.

38(d) The county’s process for monitoring and reviewing
39professionals designated by the county to ensure appropriate
40compliance with state law, regulations, and county procedures.

P72   1

begin deleteSEC. 30.end delete
2begin insertSEC. 18.end insert  

Section 5150 of the Welfare and Institutions Code is
3amended to read:

4

5150.  

(a) When a person, as a result of a mental health
5disorder, is a danger to others, or to himself or herself, or gravely
6disabled, a peace officer, professional person in charge of a facility
7designated by the county for evaluation and treatment, member of
8the attending staff, as defined by regulation, of a facility designated
9by the county for evaluation and treatment, designated members
10of a mobile crisis team, or professional person designated by the
11county may, upon probable cause, take, or cause to be taken, the
12person into custody for a period of up to 72 hours for assessment,
13evaluation, and crisis intervention, or placement for evaluation
14and treatment in a facility designated by the county for evaluation
15and treatment and approved by the State Department of Health
16Care Services. At a minimum, assessment, as defined in Section
175150.4, and evaluation, as defined in subdivision (a) of Section
185008, shall be conducted and provided on an ongoing basis. Crisis
19intervention, as defined in subdivision (e) of Section 5008, may
20be provided concurrently with assessment, evaluation, or any other
21service.

22(b) The professional person in charge of a facility designated
23by the county for evaluation and treatment, member of the
24attending staff, or professional person designated by the county
25shall assess the person to determine whether he or she can be
26properly served without being detained. If in the judgment of the
27professional person in charge of the facility designated by the
28county for evaluation and treatment, member of the attending staff,
29or professional person designated by the county, the person can
30be properly served without being detained, he or she shall be
31provided evaluation, crisis intervention, or other inpatient or
32outpatient services on a voluntary basis. Nothing in this subdivision
33shall be interpreted to prevent a peace officer from delivering
34individuals to a designated facility for assessment under this
35section. Furthermore, the assessment requirement of this
36subdivision shall not be interpreted to require peace officers to
37perform any additional duties other than those specified in Sections
385150.1 and 5150.2.

39(c) Whenever a person is evaluated by a professional person in
40charge of a facility designated by the county for evaluation or
P73   1treatment, member of the attending staff, or professional person
2designated by the county and is found to be in need of mental
3health services, but is not admitted to the facility, all available
4alternative services provided pursuant to subdivision (b) shall be
5offered as determined by the county behavioral health director.

6(d) If, in the judgment of the professional person in charge of
7the facility designated by the county for evaluation and treatment,
8member of the attending staff, or the professional person designated
9by the county, the person cannot be properly served without being
10detained, the admitting facility shall require an application in
11writing stating the circumstances under which the person’s
12condition was called to the attention of the peace officer,
13professional person in charge of the facility designated by the
14county for evaluation and treatment, member of the attending staff,
15or professional person designated by the county, and stating that
16the peace officer, professional person in charge of the facility
17designated by the county for evaluation and treatment, member of
18the attending staff, or professional person designated by the county
19has probable cause to believe that the person is, as a result of a
20mental health disorder, a danger to others, or to himself or herself,
21or gravely disabled. If the probable cause is based on the statement
22of a person other than the peace officer, professional person in
23charge of the facility designated by the county for evaluation and
24treatment, member of the attending staff, or professional person
25designated by the county, the person shall be liable in a civil action
26for intentionally giving a statement that he or she knows to be
27false.

28(e) At the time a person is taken into custody for evaluation, or
29within a reasonable time thereafter, unless a responsible relative
30or the guardian or conservator of the person is in possession of the
31person’s personal property, the person taking him or her into
32custody shall take reasonable precautions to preserve and safeguard
33the personal property in the possession of or on the premises
34occupied by the person. The person taking him or her into custody
35shall then furnish to the court a report generally describing the
36person’s property so preserved and safeguarded and its disposition,
37in substantially the form set forth in Section 5211, except that if
38a responsible relative or the guardian or conservator of the person
39is in possession of the person’s property, the report shall include
40only the name of the relative or guardian or conservator and the
P74   1location of the property, whereupon responsibility of the person
2taking him or her into custody for that property shall terminate.
3As used in this section, “responsible relative” includes the spouse,
4parent, adult child, domestic partner, grandparent, grandchild, or
5adult brother or sister of the person.

6(f) (1) Each person, at the time he or she is first taken into
7custody under this section, shall be provided, by the person who
8takes him or her into custody, the following information orally in
9a language or modality accessible to the person. If the person
10cannot understand an oral advisement, the information shall be
11provided in writing. The information shall be in substantially the
12following form:


13

 

My name is    .

I am a     .

(peace officer/mental health professional)

with     .

(name of agency)

You are not under criminal arrest, but I am taking you for an examination by mental health professionals at     .

   

(name of facility)

You will be told your rights by the mental health staff.

P74  2415

 

25(2) If taken into custody at his or her own residence, the person
26shall also be provided the following information:


28You may bring a few personal items with you, which I will have
29to approve. Please inform me if you need assistance turning off
30any appliance or water. You may make a phone call and leave a
31note to tell your friends or family where you have been taken.


33(g) The designated facility shall keep, for each patient evaluated,
34a record of the advisement given pursuant to subdivision (f) which
35shall include all of the following:

36(1) The name of the person detained for evaluation.

37(2) The name and position of the peace officer or mental health
38professional taking the person into custody.

39(3) The date the advisement was completed.

P75   1(4) Whether the advisement was completed.

2(5) The language or modality used to give the advisement.

3(6) If the advisement was not completed, a statement of good
4cause, as defined by regulations of the State Department of Health
5Care Services.

6(h) (1) Each person admitted to a facility designated by the
7county for evaluation and treatment shall be given the following
8information by admission staff of the facility. The information
9shall be given orally and in writing and in a language or modality
10accessible to the person. The written information shall be available
11to the person in English and in the language that is the person’s
12primary means of communication. Accommodations for other
13disabilities that may affect communication shall also be provided.
14The information shall be in substantially the following form:

 

My name is    .

My position here is    .

 You are being placed into this psychiatric facility because it is our professional opinion that, as a result of a mental health disorder, you are likely to (check applicable):

  â—» Harm yourself.
  â—» Harm someone else.
  â—» Be unable to take care of your own food, clothing, and housing needs.
We believe this is true because

   

(list of the facts upon which the allegation of dangerous
or gravely disabled due to mental health disorder is based, including pertinent
facts arising from the admission interview).

 You will be held for a period up to 72 hours. During the 72 hours you may also be transferred to another facility. You may request to be evaluated or treated at a facility of your choice. You may request to be evaluated or treated by a mental health professional of your choice. We cannot guarantee the facility or mental health professional you choose will be available, but we will honor your choice if we can.

 During these 72 hours you will be evaluated by the facility staff, and you may be given treatment, including medications. It is possible for you to be released before the end of the 72 hours. But if the staff decides that you need continued treatment you can be held for a longer period of time. If you are held longer than 72 hours, you have the right to a lawyer and a qualified interpreter and a hearing before a judge. If you are unable to pay for the lawyer, then one will be provided to you free of charge.

 If you have questions about your legal rights, you may contact the county Patients’ Rights Advocate at    .

(phone number for the county Patients’ Rights Advocacy office)

Your 72-hour period began    .

(date/time)

 

11(2) If the notice is given in a county where weekends and
12holidays are excluded from the 72-hour period, the patient shall
13be informed of this fact.

14(i) For each patient admitted for evaluation and treatment, the
15facility shall keep with the patient’s medical record a record of the
16advisement given pursuant to subdivision (h), which shall include
17all of the following:

18(1) The name of the person performing the advisement.

19(2) The date of the advisement.

20(3) Whether the advisement was completed.

21(4) The language or modality used to communicate the
22advisement.

23(5) If the advisement was not completed, a statement of good
24cause.

25

begin deleteSEC. 31.end delete
26begin insertSEC. 19.end insert  

Section 5152.1 of the Welfare and Institutions Code
27 is amended to read:

28

5152.1.  

The professional person in charge of the facility
29providing 72-hour evaluation and treatment, or his or her designee,
30shall notify the county behavioral health director or the director’s
31designee and the peace officer who makes the written application
32pursuant to Section 5150 or a person who is designated by the law
33enforcement agency that employs the peace officer, when the
34person has been released after 72-hour detention, when the person
35is not detained, or when the person is released before the full period
36of allowable 72-hour detention if all of the following conditions
37apply:

38(a) The peace officer requests such notification at the time he
39or she makes the application and the peace officer certifies at that
40time in writing that the person has been referred to the facility
P77   1under circumstances which, based upon an allegation of facts
2regarding actions witnessed by the officer or another person, would
3support the filing of a criminal complaint.

4(b) The notice is limited to the person’s name, address, date of
5admission for 72-hour evaluation and treatment, and date of release.

6If a police officer, law enforcement agency, or designee of the
7law enforcement agency, possesses any record of information
8obtained pursuant to the notification requirements of this section,
9the officer, agency, or designee shall destroy that record two years
10after receipt of notification.

11

begin deleteSEC. 32.end delete
12begin insertSEC. 20.end insert  

Section 5152.2 of the Welfare and Institutions Code
13 is amended to read:

14

5152.2.  

Each law enforcement agency within a county shall
15arrange with the county behavioral health director a method for
16giving prompt notification to peace officers pursuant to Section
175152.1.

18

begin deleteSEC. 33.end delete
19begin insertSEC. 21.end insert  

Section 5250.1 of the Welfare and Institutions Code
20 is amended to read:

21

5250.1.  

The professional person in charge of a facility
22providing intensive treatment, pursuant to Section 5250 or 5270.15,
23or that person’s designee, shall notify the county behavioral health
24director, or the director’s designee, and the peace officer who made
25the original written application for 72-hour evaluation pursuant to
26Section 5150 or a person who is designated by the law enforcement
27agency that employs the peace officer, that the person admitted
28pursuant to the application has been released unconditionally if
29all of the following conditions apply:

30(a) The peace officer has requested notification at the time he
31or she makes the application for 72-hour evaluation.

32(b) The peace officer has certified in writing at the time he or
33she made the application that the person has been referred to the
34facility under circumstances which, based upon an allegation of
35facts regarding actions witnessed by the officer or another person,
36would support the filing of a criminal complaint.

37(c) The notice is limited to the person’s name, address, date of
38admission for 72-hour evaluation, date of certification for intensive
39treatment, and date of release.

P78   1If a police officer, law enforcement agency, or designee of the
2law enforcement agency, possesses any record of information
3obtained pursuant to the notification requirements of this section,
4the officer, agency, or designee shall destroy that record two years
5after receipt of notification.

6

begin deleteSEC. 34.end delete
7begin insertSEC. 22.end insert  

Section 5305 of the Welfare and Institutions Code is
8amended to read:

9

5305.  

(a) Any person committed pursuant to Section 5300
10may be placed on outpatient status if all of the following conditions
11are satisfied:

12(1) In the evaluation of the superintendent or professional person
13in charge of the licensed health facility, the person named in the
14petition will no longer be a danger to the health and safety of others
15while on outpatient status and will benefit from outpatient status.

16(2) The county behavioral health director advises the court that
17the person named in the petition will benefit from outpatient status
18and identifies an appropriate program of supervision and treatment.

19(b) After actual notice to the public officer, pursuant to Section
205114, and to counsel of the person named in the petition, to the
21court and to the county behavioral health director, the plan for
22outpatient treatment shall become effective within five judicial
23days unless a court hearing on that action is requested by any of
24the aforementioned parties, in which case the release on outpatient
25status shall not take effect until approved by the court after a
26hearing. This hearing shall be held within five judicial days of the
27actual notice required by this subdivision.

28(c) The county behavioral health director shall be the outpatient
29supervisor of persons placed on outpatient status under this section.
30The county behavioral health director may delegate outpatient
31 supervision responsibility to a designee.

32(d) The outpatient treatment supervisor shall, when the person
33is placed on outpatient status at least three months, submit at 90-day
34intervals to the court, the public officer, pursuant to Section 5114,
35and counsel of the person named in the petition and to the
36supervisor or professional person in charge of the licensed health
37facility, when appropriate, a report setting forth the status and
38progress of the person named in the petition. Notwithstanding the
39length of the outpatient status, a final report shall be submitted by
P79   1the outpatient treatment supervisor at the conclusion of the 180-day
2commitment setting forth the status and progress of the person.

3

begin deleteSEC. 35.end delete
4begin insertSEC. 23.end insert  

Section 5306.5 of the Welfare and Institutions Code
5 is amended to read:

6

5306.5.  

(a)  If at any time during the outpatient period, the
7outpatient treatment supervisor is of the opinion that the person
8receiving treatment requires extended inpatient treatment or refuses
9to accept further outpatient treatment and supervision, the county
10behavioral health director shall notify the superior court in either
11the county that approved outpatient status or in the county where
12outpatient treatment is being provided of that opinion by means
13of a written request for revocation of outpatient status. The county
14behavioral health director shall furnish a copy of this request to
15the counsel of the person named in the request for revocation and
16to the public officer, pursuant to Section 5114, in both counties if
17the request is made in the county of treatment, rather than the
18county of commitment.

19(b)  Within 15 judicial days, the court where the request was
20filed shall hold a hearing and shall either approve or disapprove
21the request for revocation of outpatient status. If the court approves
22the request for revocation, the court shall order that the person be
23confined in a state hospital or other treatment facility approved by
24the county behavioral health director. The court shall transmit a
25copy of its order to the county behavioral health director or a
26designee and to the Director of State Hospitals. When the county
27of treatment and the county of commitment differ and revocation
28occurs in the county of treatment, the court shall enter the name
29of the committing county and its case number on the order of
30revocation and shall send a copy of the order to the committing
31 court and the public officer, pursuant to Section 5114, and counsel
32of the person named in the request for revocation in the county of
33commitment.

34

begin deleteSEC. 36.end delete
35begin insertSEC. 24.end insert  

Section 5307 of the Welfare and Institutions Code is
36amended to read:

37

5307.  

If at any time during the outpatient period the public
38officer, pursuant to Section 5114, is of the opinion that the person
39is a danger to the health and safety of others while on outpatient
40status, the public officer, pursuant to Section 5114, may petition
P80   1the court for a hearing to determine whether the person shall be
2continued on outpatient status. Upon receipt of the petition, the
3court shall calendar the case for further proceedings within 15
4judicial days and the clerk shall notify the person, the county
5behavioral health director, and the attorney of record for the person
6of the hearing date. Upon failure of the person to appear as noticed,
7if a proper affidavit of service and advisement has been filed with
8the court, the court may issue a body attachment for that person.
9If, after a hearing in court the judge determines that the person is
10a danger to the health and safety of others, the court shall order
11that the person be confined in a state hospital or other treatment
12facility that has been approved by the county behavioral health
13director.

14

begin deleteSEC. 37.end delete
15begin insertSEC. 25.end insert  

Section 5308 of the Welfare and Institutions Code is
16amended to read:

17

5308.  

Upon the filing of a request for revocation of outpatient
18status under Section 5306.5 or 5307 and pending the court’s
19decision on revocation, the person subject to revocation may be
20confined in a state hospital or other treatment facility by the county
21behavioral health director when it is the opinion of that director
22that the person will now be a danger to self or to another while on
23outpatient status and that to delay hospitalization until the
24revocation hearing would pose a demonstrated danger of harm to
25the person or to another. Upon the request of the county behavioral
26health director or a designee, a peace officer shall take, or cause
27to be taken, the person into custody and transport the person to a
28treatment facility for hospitalization under this section. The county
29behavioral health director shall notify the court in writing of the
30admission of the person to inpatient status and of the factual basis
31for the opinion that immediate return to inpatient treatment was
32necessary. The court shall supply a copy of these documents to
33the public officer, pursuant to Section 5114, and counsel of the
34person subject to revocation.

35A person hospitalized under this section shall have the right to
36judicial review of the detention in the manner prescribed in Article
375 (commencing with Section 5275) of Chapter 2 and to an
38explanation of rights in the manner prescribed in Section 5252.1.

39Nothing in this section shall prevent hospitalization pursuant to
40the provisions of Section 5150, 5250, 5350, or 5353.

P81   1A person whose confinement in a treatment facility under Section
25306.5 or 5307 is approved by the court shall not be released again
3to outpatient status unless court approval is obtained under Section
45305.

5

begin deleteSEC. 38.end delete
6begin insertSEC. 26.end insert  

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

8

5326.95.  

The Director of State Hospitals shall adopt regulations
9to carry out the provisions of this chapter, including standards
10defining excessive use of convulsive treatment, which shall be
11developed in consultation with the State Department of Health
12Care Services and the County Behavioral Health Directors
13Association of California.

14

begin deleteSEC. 39.end delete
15begin insertSEC. 27.end insert  

Section 5328 of the Welfare and Institutions Code is
16amended to read:

17

5328.  

All information and records obtained in the course of
18providing services under Division 4 (commencing with Section
194000), Division 4.1 (commencing with Section 4400), Division
204.5 (commencing with Section 4500), Division 5 (commencing
21with Section 5000), Division 6 (commencing with Section 6000),
22or Division 7 (commencing with Section 7100), to either voluntary
23or involuntary recipients of services shall be confidential.
24Information and records obtained in the course of providing similar
25services to either voluntary or involuntary recipients prior to 1969
26shall also be confidential. Information and records shall be
27disclosed only in any of the following cases:

28(a) In communications between qualified professional persons
29in the provision of services or appropriate referrals, or in the course
30of conservatorship proceedings. The consent of the patient, or his
31or her guardian or conservator, shall be obtained before information
32or records may be disclosed by a professional person employed
33by a facility to a professional person not employed by the facility
34who does not have the medical or psychological responsibility for
35the patient’s care.

36(b) When the patient, with the approval of the physician and
37surgeon, licensed psychologist, social worker with a master’s
38degree in social work, licensed marriage and family therapist, or
39licensed professional clinical counselor, who is in charge of the
40patient, designates persons to whom information or records may
P82   1be released, except that nothing in this article shall be construed
2to compel a physician and surgeon, licensed psychologist, social
3worker with a master’s degree in social work, licensed marriage
4and family therapist, licensed professional clinical counselor, nurse,
5attorney, or other professional person to reveal information that
6has been given to him or her in confidence by members of a
7patient’s family. Nothing in this subdivision shall be construed to
8authorize a licensed marriage and family therapist or licensed
9professional clinical counselor to provide services or to be in charge
10of a patient’s care beyond his or her lawful scope of practice.

11(c) To the extent necessary for a recipient to make a claim, or
12for a claim to be made on behalf of a recipient for aid, insurance,
13or medical assistance to which he or she may be entitled.

14(d) If the recipient of services is a minor, ward, dependent, or
15conservatee, and his or her parent, guardian, guardian ad litem,
16conservator, or authorized representative designates, in writing,
17persons to whom records or information may be disclosed, except
18that nothing in this article shall be construed to compel a physician
19and surgeon, licensed psychologist, social worker with a master’s
20degree in social work, licensed marriage and family therapist,
21licensed professional clinical counselor, nurse, attorney, or other
22professional person to reveal information that has been given to
23him or her in confidence by members of a patient’s family.

24(e) For research, provided that the Director of Health Care
25Services, the Director of State Hospitals, the Director of Social
26Services, or the Director of Developmental Services designates
27by regulation, rules for the conduct of research and requires the
28research to be first reviewed by the appropriate institutional review
29board or boards. The rules shall include, but need not be limited
30to, the requirement that all researchers shall sign an oath of
31confidentiality as follows:


32

 

 

   

 

      Date

P82  35

 

36As a condition of doing research concerning persons who have
37received services from ____ (fill in the facility, agency or person),
38I, ____, agree to obtain the prior informed consent of such persons
39who have received services to the maximum degree possible as
40determined by the appropriate institutional review board or boards
P83   1for protection of human subjects reviewing my research, and I
2further agree not to divulge any information obtained in the course
3of such research to unauthorized persons, and not to publish or
4otherwise make public any information regarding persons who
5have received services such that the person who received services
6is identifiable.

7I recognize that the unauthorized release of confidential
8information may make me subject to a civil action under provisions
9of the Welfare and Institutions Code.


11(f) To the courts, as necessary to the administration of justice.

12(g) To governmental law enforcement agencies as needed for
13the protection of federal and state elective constitutional officers
14and their families.

15(h) To the Senate Committee on Rules or the Assembly
16Committee on Rules for the purposes of legislative investigation
17authorized by the committee.

18(i) If the recipient of services who applies for life or disability
19insurance designates in writing the insurer to which records or
20information may be disclosed.

21(j) To the attorney for the patient in any and all proceedings
22upon presentation of a release of information signed by the patient,
23except that when the patient is unable to sign the release, the staff
24of the facility, upon satisfying itself of the identity of the attorney,
25and of the fact that the attorney does represent the interests of the
26patient, may release all information and records relating to the
27patient except that nothing in this article shall be construed to
28compel a physician and surgeon, licensed psychologist, social
29worker with a master’s degree in social work, licensed marriage
30and family therapist, licensed professional clinical counselor, nurse,
31attorney, or other professional person to reveal information that
32has been given to him or her in confidence by members of a
33 patient’s family.

34(k) Upon written agreement by a person previously confined in
35or otherwise treated by a facility, the professional person in charge
36of the facility or his or her designee may release any information,
37except information that has been given in confidence by members
38of the person’s family, requested by a probation officer charged
39with the evaluation of the person after his or her conviction of a
40crime if the professional person in charge of the facility determines
P84   1that the information is relevant to the evaluation. The agreement
2shall only be operative until sentence is passed on the crime of
3which the person was convicted. The confidential information
4released pursuant to this subdivision shall be transmitted to the
5court separately from the probation report and shall not be placed
6in the probation report. The confidential information shall remain
7confidential except for purposes of sentencing. After sentencing,
8the confidential information shall be sealed.

9(l) (1) Between persons who are trained and qualified to serve
10on multidisciplinary personnel teams pursuant to subdivision (d)
11of Section 18951. The information and records sought to be
12disclosed shall be relevant to the provision of child welfare services
13or the investigation, prevention, identification, management, or
14treatment of child abuse or neglect pursuant to Chapter 11
15(commencing with Section 18950) of Part 6 of Division 9.
16Information obtained pursuant to this subdivision shall not be used
17in any criminal or delinquency proceeding. Nothing in this
18subdivision shall prohibit evidence identical to that contained
19within the records from being admissible in a criminal or
20delinquency proceeding, if the evidence is derived solely from
21means other than this subdivision, as permitted by law.

22(2) As used in this subdivision, “child welfare services” means
23those services that are directed at preventing child abuse or neglect.

24(m) To county patients’ rights advocates who have been given
25knowing voluntary authorization by a client or a guardian ad litem.
26The client or guardian ad litem, whoever entered into the
27agreement, may revoke the authorization at any time, either in
28writing or by oral declaration to an approved advocate.

29(n) To a committee established in compliance with Section
3014725.

31(o) In providing information as described in Section 7325.5.
32Nothing in this subdivision shall permit the release of any
33information other than that described in Section 7325.5.

34(p) To the county behavioral health director or the director’s
35designee, or to a law enforcement officer, or to the person
36designated by a law enforcement agency, pursuant to Sections
375152.1 and 5250.1.

38(q) If the patient gives his or her consent, information
39specifically pertaining to the existence of genetically handicapping
40conditions, as defined in Section 125135 of the Health and Safety
P85   1Code, may be released to qualified professional persons for
2purposes of genetic counseling for blood relatives upon request of
3the blood relative. For purposes of this subdivision, “qualified
4professional persons” means those persons with the qualifications
5necessary to carry out the genetic counseling duties under this
6subdivision as determined by the genetic disease unit established
7in the State Department of Health Care Services under Section
8125000 of the Health and Safety Code. If the patient does not
9respond or cannot respond to a request for permission to release
10information pursuant to this subdivision after reasonable attempts
11have been made over a two-week period to get a response, the
12information may be released upon request of the blood relative.

13(r) When the patient, in the opinion of his or her psychotherapist,
14presents a serious danger of violence to a reasonably foreseeable
15victim or victims, then any of the information or records specified
16in this section may be released to that person or persons and to
17law enforcement agencies and county child welfare agencies as
18 the psychotherapist determines is needed for the protection of that
19person or persons. For purposes of this subdivision,
20“psychotherapist” means anyone so defined within Section 1010
21of the Evidence Code.

22(s) (1) To the designated officer of an emergency response
23employee, and from that designated officer to an emergency
24response employee regarding possible exposure to HIV or AIDS,
25but only to the extent necessary to comply with provisions of the
26federal Ryan White Comprehensive AIDS Resources Emergency
27Act of 1990 (Public Law 101-381; 42 U.S.C. Sec. 201).

28(2) For purposes of this subdivision, “designated officer” and
29“emergency response employee” have the same meaning as these
30terms are used in the federal Ryan White Comprehensive AIDS
31Resources Emergency Act of 1990 (Public Law 101-381; 42 U.S.C.
32Sec. 201).

33(3) The designated officer shall be subject to the confidentiality
34requirements specified in Section 120980, and may be personally
35liable for unauthorized release of any identifying information about
36the HIV results. Further, the designated officer shall inform the
37exposed emergency response employee that the employee is also
38subject to the confidentiality requirements specified in Section
39120980, and may be personally liable for unauthorized release of
40any identifying information about the HIV test results.

P86   1(t) (1) To a law enforcement officer who personally lodges with
2a facility, as defined in paragraph (2), a warrant of arrest or an
3abstract of such a warrant showing that the person sought is wanted
4 for a serious felony, as defined in Section 1192.7 of the Penal
5Code, or a violent felony, as defined in Section 667.5 of the Penal
6Code. The information sought and released shall be limited to
7whether or not the person named in the arrest warrant is presently
8confined in the facility. This paragraph shall be implemented with
9minimum disruption to health facility operations and patients, in
10accordance with Section 5212. If the law enforcement officer is
11informed that the person named in the warrant is confined in the
12facility, the officer may not enter the facility to arrest the person
13without obtaining a valid search warrant or the permission of staff
14of the facility.

15(2) For purposes of paragraph (1), a facility means all of the
16following:

17(A) A state hospital, as defined in Section 4001.

18(B) A general acute care hospital, as defined in subdivision (a)
19of Section 1250 of the Health and Safety Code, solely with regard
20to information pertaining to a person with mental illness subject
21to this section.

22(C) An acute psychiatric hospital, as defined in subdivision (b)
23of Section 1250 of the Health and Safety Code.

24(D) A psychiatric health facility, as described in Section 1250.2
25of the Health and Safety Code.

26(E) A mental health rehabilitation center, as described in Section
275675.

28(F) A skilled nursing facility with a special treatment program
29for individuals with mental illness, as described in Sections 51335
30and 72445 to 72475, inclusive, of Title 22 of the California Code
31of Regulations.

32(u) Between persons who are trained and qualified to serve on
33multidisciplinary personnel teams pursuant to Section 15610.55,
3415753.5, or 15761. The information and records sought to be
35disclosed shall be relevant to the prevention, identification,
36management, or treatment of an abused elder or dependent adult
37pursuant to Chapter 13 (commencing with Section 15750) of Part
383 of Division 9.

P87   1(v) The amendment of subdivision (d) enacted at the 1970
2Regular Session of the Legislature does not constitute a change
3in, but is declaratory of, the preexisting law.

4(w) This section shall not be limited by Section 5150.05 or 5332.

5(x) (1) When an employee is served with a notice of adverse
6action, as defined in Section 19570 of the Government Code, the
7following information and records may be released:

8(A) All information and records that the appointing authority
9relied upon in issuing the notice of adverse action.

10(B) All other information and records that are relevant to the
11adverse action, or that would constitute relevant evidence as
12defined in Section 210 of the Evidence Code.

13(C) The information described in subparagraphs (A) and (B)
14may be released only if both of the following conditions are met:

15(i) The appointing authority has provided written notice to the
16consumer and the consumer’s legal representative or, if the
17consumer has no legal representative or if the legal representative
18is a state agency, to the clients’ rights advocate, and the consumer,
19the consumer’s legal representative, or the clients’ rights advocate
20has not objected in writing to the appointing authority within five
21business days of receipt of the notice, or the appointing authority,
22upon review of the objection has determined that the circumstances
23on which the adverse action is based are egregious or threaten the
24health, safety, or life of the consumer or other consumers and
25without the information the adverse action could not be taken.

26(ii) The appointing authority, the person against whom the
27adverse action has been taken, and the person’s representative, if
28any, have entered into a stipulation that does all of the following:

29(I) Prohibits the parties from disclosing or using the information
30or records for any purpose other than the proceedings for which
31the information or records were requested or provided.

32(II) Requires the employee and the employee’s legal
33representative to return to the appointing authority all records
34provided to them under this subdivision, including, but not limited
35to, all records and documents from any source containing
36confidential information protected by this section, and all copies
37of those records and documents, within 10 days of the date that
38the adverse action becomes final except for the actual records and
39documents or copies thereof that are no longer in the possession
40of the employee or the employee’s legal representative because
P88   1they were submitted to the administrative tribunal as a component
2of an appeal from the adverse action.

3(III) Requires the parties to submit the stipulation to the
4administrative tribunal with jurisdiction over the adverse action
5at the earliest possible opportunity.

6(2) For the purposes of this subdivision, the State Personnel
7Board may, prior to any appeal from adverse action being filed
8with it, issue a protective order, upon application by the appointing
9authority, for the limited purpose of prohibiting the parties from
10disclosing or using information or records for any purpose other
11than the proceeding for which the information or records were
12requested or provided, and to require the employee or the
13employee’s legal representative to return to the appointing authority
14all records provided to them under this subdivision, including, but
15not limited to, all records and documents from any source
16containing confidential information protected by this section, and
17all copies of those records and documents, within 10 days of the
18date that the adverse action becomes final, except for the actual
19records and documents or copies thereof that are no longer in the
20possession of the employee or the employee’s legal representatives
21because they were submitted to the administrative tribunal as a
22component of an appeal from the adverse action.

23(3) Individual identifiers, including, but not limited to, names,
24social security numbers, and hospital numbers, that are not
25necessary for the prosecution or defense of the adverse action,
26shall not be disclosed.

27(4) All records, documents, or other materials containing
28confidential information protected by this section that have been
29submitted or otherwise disclosed to the administrative agency or
30other person as a component of an appeal from an adverse action
31shall, upon proper motion by the appointing authority to the
32 administrative tribunal, be placed under administrative seal and
33shall not, thereafter, be subject to disclosure to any person or entity
34except upon the issuance of an order of a court of competent
35jurisdiction.

36(5) For purposes of this subdivision, an adverse action becomes
37final when the employee fails to answer within the time specified
38in Section 19575 of the Government Code, or, after filing an
39answer, withdraws the appeal, or, upon exhaustion of the
P89   1administrative appeal or of the judicial review remedies as
2otherwise provided by law.

3(y) To the person appointed as the developmental services
4decisionmaker for a minor, dependent, or ward pursuant to Section
5319, 361, or 726.

6

begin deleteSEC. 40.end delete
7begin insertSEC. 28.end insert  

Section 5328.2 of the Welfare and Institutions Code
8 is amended to read:

9

5328.2.  

Notwithstanding Section 5328, movement and
10identification information and records regarding a patient who is
11committed to the department, state hospital, or any other public
12or private mental health facility approved by the county behavioral
13health director for observation or for an indeterminate period as a
14mentally disordered sex offender, or for a person who is civilly
15committed as a sexually violent predator pursuant to Article 4
16(commencing with Section 6600) of Chapter 2 of Part 2 of Division
176, or regarding a patient who is committed to the department, to a
18state hospital, or any other public or private mental health facility
19approved by the county behavioral health director under Section
201026 or 1370 of the Penal Code or receiving treatment pursuant
21to Section 5300 of this code, shall be forwarded immediately
22without prior request to the Department of Justice. Except as
23otherwise provided by law, information automatically reported
24under this section shall be restricted to name, address, fingerprints,
25date of admission, date of discharge, date of escape or return from
26escape, date of any home leave, parole or leave of absence and, if
27known, the county in which the person will reside upon release.
28The Department of Justice may in turn furnish information reported
29under this section pursuant to Section 11105 or 11105.1 of the
30Penal Code. It shall be a misdemeanor for recipients furnished
31with this information to in turn furnish the information to any
32person or agency other than those specified in Section 11105 or
3311105.1 of the Penal Code.

34

begin deleteSEC. 41.end delete
35begin insertSEC. 29.end insert  

Section 5346 of the Welfare and Institutions Code is
36amended to read:

37

5346.  

(a) In any county in which services are available as
38provided in Section 5348, a court may order a person who is the
39subject of a petition filed pursuant to this section to obtain assisted
40outpatient treatment if the court finds, by clear and convincing
P90   1evidence, that the facts stated in the verified petition filed in
2accordance with this section are true and establish that all of the
3requisite criteria set forth in this section are met, including, but
4not limited to, each of the following:

5(1) The person is 18 years of age or older.

6(2) The person is suffering from a mental illness as defined in
7paragraphs (2) and (3) of subdivision (b) of Section 5600.3.

8(3) There has been a clinical determination that the person is
9unlikely to survive safely in the community without supervision.

10(4) The person has a history of lack of compliance with
11treatment for his or her mental illness, in that at least one of the
12following is true:

13(A) The person’s mental illness has, at least twice within the
14last 36 months, been a substantial factor in necessitating
15hospitalization, or receipt of services in a forensic or other mental
16health unit of a state correctional facility or local correctional
17facility, not including any period during which the person was
18hospitalized or incarcerated immediately preceding the filing of
19the petition.

20(B) The person’s mental illness has resulted in one or more acts
21of serious and violent behavior toward himself or herself or
22another, or threats, or attempts to cause serious physical harm to
23himself or herself or another within the last 48 months, not
24including any period in which the person was hospitalized or
25incarcerated immediately preceding the filing of the petition.

26(5) The person has been offered an opportunity to participate
27in a treatment plan by the director of the local mental health
28department, or his or her designee, provided the treatment plan
29includes all of the services described in Section 5348, and the
30person continues to fail to engage in treatment.

31(6) The person’s condition is substantially deteriorating.

32(7) Participation in the assisted outpatient treatment program
33would be the least restrictive placement necessary to ensure the
34person’s recovery and stability.

35(8) In view of the person’s treatment history and current
36behavior, the person is in need of assisted outpatient treatment in
37order to prevent a relapse or deterioration that would be likely to
38result in grave disability or serious harm to himself or herself, or
39to others, as defined in Section 5150.

P91   1(9) It is likely that the person will benefit from assisted
2outpatient treatment.

3(b) (1) A petition for an order authorizing assisted outpatient
4treatment may be filed by the county behavioral health director,
5or his or her designee, in the superior court in the county in which
6the person who is the subject of the petition is present or reasonably
7believed to be present.

8(2) A request may be made only by any of the following persons
9to the county mental health department for the filing of a petition
10to obtain an order authorizing assisted outpatient treatment:

11(A) Any person 18 years of age or older with whom the person
12who is the subject of the petition resides.

13(B) Any person who is the parent, spouse, or sibling or child
1418 years of age or older of the person who is the subject of the
15petition.

16(C) The director of any public or private agency, treatment
17facility, charitable organization, or licensed residential care facility
18providing mental health services to the person who is the subject
19of the petition in whose institution the subject of the petition
20resides.

21(D) The director of a hospital in which the person who is the
22subject of the petition is hospitalized.

23(E) A licensed mental health treatment provider who is either
24supervising the treatment of, or treating for a mental illness, the
25person who is the subject of the petition.

26(F) A peace officer, parole officer, or probation officer assigned
27to supervise the person who is the subject of the petition.

28(3) Upon receiving a request pursuant to paragraph (2), the
29county behavioral health director shall conduct an investigation
30into the appropriateness of the filing of the petition. The director
31shall file the petition only if he or she determines that there is a
32reasonable likelihood that all the necessary elements to sustain the
33petition can be proven in a court of law by clear and convincing
34evidence.

35(4) The petition shall state all of the following:

36(A) Each of the criteria for assisted outpatient treatment as set
37forth in subdivision (a).

38(B) Facts that support the petitioner’s belief that the person who
39is the subject of the petition meets each criterion, provided that
40the hearing on the petition shall be limited to the stated facts in
P92   1the verified petition, and the petition contains all the grounds on
2which the petition is based, in order to ensure adequate notice to
3the person who is the subject of the petition and his or her counsel.

4(C) That the person who is the subject of the petition is present,
5or is reasonably believed to be present, within the county where
6the petition is filed.

7(D) That the person who is the subject of the petition has the
8right to be represented by counsel in all stages of the proceeding
9under the petition, in accordance with subdivision (c).

10(5) The petition shall be accompanied by an affidavit of a
11licensed mental health treatment provider designated by the local
12mental health director who shall state, if applicable, either of the
13following:

14(A) That the licensed mental health treatment provider has
15personally examined the person who is the subject of the petition
16no more than 10 days prior to the submission of the petition, the
17facts and reasons why the person who is the subject of the petition
18meets the criteria in subdivision (a), that the licensed mental health
19treatment provider recommends assisted outpatient treatment for
20the person who is the subject of the petition, and that the licensed
21mental health treatment provider is willing and able to testify at
22the hearing on the petition.

23(B) That no more than 10 days prior to the filing of the petition,
24the licensed mental health treatment provider, or his or her
25designee, has made appropriate attempts to elicit the cooperation
26of the person who is the subject of the petition, but has not been
27successful in persuading that person to submit to an examination,
28that the licensed mental health treatment provider has reason to
29believe that the person who is the subject of the petition meets the
30criteria for assisted outpatient treatment, and that the licensed
31mental health treatment provider is willing and able to examine
32the person who is the subject of the petition and testify at the
33hearing on the petition.

34(c) The person who is the subject of the petition shall have the
35right to be represented by counsel at all stages of a proceeding
36commenced under this section. If the person so elects, the court
37shall immediately appoint the public defender or other attorney to
38assist the person in all stages of the proceedings. The person shall
39pay the cost of the legal services if he or she is able.

P93   1(d) (1) Upon receipt by the court of a petition submitted
2pursuant to subdivision (b), the court shall fix the date for a hearing
3at a time not later than five days from the date the petition is
4received by the court, excluding Saturdays, Sundays, and holidays.
5The petitioner shall promptly cause service of a copy of the
6petition, together with written notice of the hearing date, to be
7made personally on the person who is the subject of the petition,
8and shall send a copy of the petition and notice to the county office
9of patient rights, and to the current health care provider appointed
10for the person who is the subject of the petition, if any such
11provider is known to the petitioner. Continuances shall be permitted
12only for good cause shown. In granting continuances, the court
13shall consider the need for further examination by a physician or
14the potential need to provide expeditiously assisted outpatient
15treatment. Upon the hearing date, or upon any other date or dates
16to which the proceeding may be continued, the court shall hear
17testimony. If it is deemed advisable by the court, and if the person
18who is the subject of the petition is available and has received
19notice pursuant to this section, the court may examine in or out of
20court the person who is the subject of the petition who is alleged
21to be in need of assisted outpatient treatment. If the person who is
22the subject of the petition does not appear at the hearing, and
23appropriate attempts to elicit the attendance of the person have
24failed, the court may conduct the hearing in the person’s absence.
25If the hearing is conducted without the person present, the court
26shall set forth the factual basis for conducting the hearing without
27the person’s presence.

28(2) The court shall not order assisted outpatient treatment unless
29an examining licensed mental health treatment provider, who has
30personally examined, and has reviewed the available treatment
31history of, the person who is the subject of the petition within the
32time period commencing 10 days before the filing of the petition,
33testifies in person at the hearing.

34(3) If the person who is the subject of the petition has refused
35to be examined by a licensed mental health treatment provider,
36the court may request that the person consent to an examination
37by a licensed mental health treatment provider appointed by the
38court. If the person who is the subject of the petition does not
39consent and the court finds reasonable cause to believe that the
40allegations in the petition are true, the court may order any person
P94   1designated under Section 5150 to take into custody the person who
2is the subject of the petition and transport him or her, or cause him
3or her to be transported, to a hospital for examination by a licensed
4mental health treatment provider as soon as is practicable.
5Detention of the person who is the subject of the petition under
6the order may not exceed 72 hours. If the examination is performed
7by another licensed mental health treatment provider, the
8examining licensed mental health treatment provider may consult
9with the licensed mental health treatment provider whose
10affirmation or affidavit accompanied the petition regarding the
11issues of whether the allegations in the petition are true and whether
12the person meets the criteria for assisted outpatient treatment.

13(4) The person who is the subject of the petition shall have all
14of the following rights:

15(A) To adequate notice of the hearings to the person who is the
16subject of the petition, as well as to parties designated by the person
17who is the subject of the petition.

18(B) To receive a copy of the court-ordered evaluation.

19(C) To counsel. If the person has not retained counsel, the court
20shall appoint a public defender.

21(D) To be informed of his or her right to judicial review by
22habeas corpus.

23(E) To be present at the hearing unless he or she waives the
24right to be present.

25(F) To present evidence.

26(G) To call witnesses on his or her behalf.

27(H) To cross-examine witnesses.

28(I) To appeal decisions, and to be informed of his or her right
29to appeal.

30(5) (A) If after hearing all relevant evidence, the court finds
31that the person who is the subject of the petition does not meet the
32criteria for assisted outpatient treatment, the court shall dismiss
33the petition.

34(B) If after hearing all relevant evidence, the court finds that
35the person who is the subject of the petition meets the criteria for
36assisted outpatient treatment, and there is no appropriate and
37feasible less restrictive alternative, the court may order the person
38who is the subject of the petition to receive assisted outpatient
39treatment for an initial period not to exceed six months. In
40fashioning the order, the court shall specify that the proposed
P95   1treatment is the least restrictive treatment appropriate and feasible
2for the person who is the subject of the petition. The order shall
3state the categories of assisted outpatient treatment, as set forth in
4Section 5348, that the person who is the subject of the petition is
5to receive, and the court may not order treatment that has not been
6recommended by the examining licensed mental health treatment
7provider and included in the written treatment plan for assisted
8outpatient treatment as required by subdivision (e). If the person
9has executed an advance health care directive pursuant to Chapter
102 (commencing with Section 4650) of Part 1 of Division 4.7 of
11the Probate Code, any directions included in the advance health
12care directive shall be considered in formulating the written
13treatment plan.

14(6) If the person who is the subject of a petition for an order for
15assisted outpatient treatment pursuant to subparagraph (B) of
16paragraph (5) of subdivision (d) refuses to participate in the assisted
17outpatient treatment program, the court may order the person to
18meet with the assisted outpatient treatment team designated by the
19director of the assisted outpatient treatment program. The treatment
20team shall attempt to gain the person’s cooperation with treatment
21ordered by the court. The person may be subject to a 72-hour hold
22pursuant to subdivision (f) only after the treatment team has
23attempted to gain the person’s cooperation with treatment ordered
24by the court, and has been unable to do so.

25(e) Assisted outpatient treatment shall not be ordered unless the
26licensed mental health treatment provider recommending assisted
27outpatient treatment to the court has submitted to the court a written
28treatment plan that includes services as set forth in Section 5348,
29and the court finds, in consultation with the county behavioral
30health director, or his or her designee, all of the following:

31(1) That the services are available from the county, or a provider
32approved by the county, for the duration of the court order.

33(2) That the services have been offered to the person by the
34local director of mental health, or his or her designee, and the
35person has been given an opportunity to participate on a voluntary
36basis, and the person has failed to engage in, or has refused,
37treatment.

38(3) That all of the elements of the petition required by this article
39have been met.

P96   1(4) That the treatment plan will be delivered to the county
2behavioral health director, or to his or her appropriate designee.

3(f) If, in the clinical judgment of a licensed mental health
4treatment provider, the person who is the subject of the petition
5has failed or has refused to comply with the treatment ordered by
6the court, and, in the clinical judgment of the licensed mental health
7treatment provider, efforts were made to solicit compliance, and,
8in the clinical judgment of the licensed mental health treatment
9 provider, the person may be in need of involuntary admission to
10a hospital for evaluation, the provider may request that persons
11designated under Section 5150 take into custody the person who
12is the subject of the petition and transport him or her, or cause him
13or her to be transported, to a hospital, to be held up to 72 hours for
14examination by a licensed mental health treatment provider to
15determine if the person is in need of treatment pursuant to Section
165150. Any continued involuntary retention in a hospital beyond
17the initial 72-hour period shall be pursuant to Section 5150. If at
18any time during the 72-hour period the person is determined not
19to meet the criteria of Section 5150, and does not agree to stay in
20the hospital as a voluntary patient, he or she shall be released and
21any subsequent involuntary detention in a hospital shall be pursuant
22to Section 5150. Failure to comply with an order of assisted
23outpatient treatment alone may not be grounds for involuntary
24civil commitment or a finding that the person who is the subject
25of the petition is in contempt of court.

26(g) If the director of the assisted outpatient treatment program
27determines that the condition of the patient requires further assisted
28outpatient treatment, the director shall apply to the court, prior to
29the expiration of the period of the initial assisted outpatient
30treatment order, for an order authorizing continued assisted
31outpatient treatment for a period not to exceed 180 days from the
32date of the order. The procedures for obtaining any order pursuant
33to this subdivision shall be in accordance with subdivisions (a) to
34(f), inclusive. The period for further involuntary outpatient
35treatment authorized by any subsequent order under this
36subdivision may not exceed 180 days from the date of the order.

37(h) At intervals of not less than 60 days during an assisted
38outpatient treatment order, the director of the outpatient treatment
39program shall file an affidavit with the court that ordered the
40outpatient treatment affirming that the person who is the subject
P97   1of the order continues to meet the criteria for assisted outpatient
2treatment. At these times, the person who is the subject of the order
3shall have the right to a hearing on whether or not he or she still
4meets the criteria for assisted outpatient treatment if he or she
5disagrees with the director’s affidavit. The burden of proof shall
6be on the director.

7(i) During each 60-day period specified in subdivision (h), if
8the person who is the subject of the order believes that he or she
9is being wrongfully retained in the assisted outpatient treatment
10program against his or her wishes, he or she may file a petition for
11a writ of habeas corpus, thus requiring the director of the assisted
12outpatient treatment program to prove that the person who is the
13subject of the order continues to meet the criteria for assisted
14outpatient treatment.

15(j) Any person ordered to undergo assisted outpatient treatment
16pursuant to this article, who was not present at the hearing at which
17the order was issued, may immediately petition the court for a writ
18of habeas corpus. Treatment under the order for assisted outpatient
19treatment may not commence until the resolution of that petition.

20

begin deleteSEC. 42.end delete
21begin insertSEC. 30.end insert  

Section 5400 of the Welfare and Institutions Code is
22amended to read:

23

5400.  

(a) The Director of Health Care Services shall administer
24this part and shall adopt rules, regulations, and standards as
25necessary. In developing rules, regulations, and standards, the
26Director of Health Care Services shall consult with the County
27Behavioral Health Directors Association of California, the
28California Mental Health Planning Council, and the office of the
29Attorney General. Adoption of these standards, rules, and
30regulations shall require approval by the County Behavioral Health
31Directors Association of California by majority vote of those
32present at an official session.

33(b) Wherever feasible and appropriate, rules, regulations, and
34standards adopted under this part shall correspond to comparable
35rules, regulations, and standards adopted under the
36Bronzan-McCorquodale Act. These corresponding rules,
37regulations, and standards shall include qualifications for
38professional personnel.

39(c) Regulations adopted pursuant to this part may provide
40standards for services for persons with chronic alcoholism that
P98   1differ from the standards for services for persons with mental health
2disorders.

3

begin deleteSEC. 43.end delete
4begin insertSEC. 31.end insert  

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

6

5585.22.  

The Director of Health Care Services, in consultation
7with the County Behavioral Health Directors Association of
8California, may develop the appropriate educational materials and
9a training curriculum, and may provide training as necessary to
10ensure that those persons providing services pursuant to this part
11fully understand its purpose.

12

begin deleteSEC. 44.end delete
13begin insertSEC. 32.end insert  

Section 5601 of the Welfare and Institutions Code is
14amended to read:

15

5601.  

As used in this part:

16(a) “Governing body” means the county board of supervisors
17or boards of supervisors in the case of counties acting jointly; and
18in the case of a city, the city council or city councils acting jointly.

19(b) “Conference” means the County Behavioral Health Directors
20Association of California as established under former Section
215757.

22(c) Unless the context requires otherwise, “to the extent
23resources are available” means to the extent that funds deposited
24in the mental health account of the local health and welfare fund
25are available to an entity qualified to use those funds.

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

28(e) “Director of Health Care Services” or “director” means the
29Director of the State Department of Health Care Services.

30(f) “Institution” includes a general acute care hospital, a state
31hospital, a psychiatric hospital, a psychiatric health facility, a
32skilled nursing facility, including an institution for mental disease
33as described in Chapter 1 (commencing with Section 5900) of Part
345, an intermediate care facility, a community care facility or other
35residential treatment facility, or a juvenile or criminal justice
36institution.

37(g) “Mental health service” means any service directed toward
38early intervention in, or alleviation or prevention of, mental
39disorder, including, but not limited to, diagnosis, evaluation,
40treatment, personal care, day care, respite care, special living
P99   1arrangements, community skill training, sheltered employment,
2socialization, case management, transportation, information,
3referral, consultation, and community services.

4

begin deleteSEC. 45.end delete
5begin insertSEC. 33.end insert  

Section 5611 of the Welfare and Institutions Code is
6amended to read:

7

5611.  

(a) The Director of State Hospitals shall establish a
8Performance Outcome Committee, to be comprised of
9representatives from the Public Law 99-660 Planning Council and
10the County Behavioral Health Directors Association of California.
11Any costs associated with the performance of the duties of the
12committee shall be absorbed within the resources of the
13 participants.

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

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

19

begin deleteSEC. 46.end delete
20begin insertSEC. 34.end insert  

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

22

5664.  

In consultation with the County Behavioral Health
23Directors Association of California, the State Department of Health
24Care Services, the Mental Health Services Oversight and
25Accountability Commission, the California Mental Health Planning
26Council, and the California Health and Human Services Agency,
27county behavioral health systems shall provide reports and data
28to meet the information needs of the state, as necessary.

29

begin deleteSEC. 47.end delete
30begin insertSEC. 35.end insert  

Section 5694.7 of the Welfare and Institutions Code
31 is amended to read:

32

5694.7.  

When the director of behavioral health in a county is
33notified pursuant to Section 319.1 or 635.1, or Section 7572.5 of
34the Government Code about a specific case, the county behavioral
35health director shall assign the responsibility either directly or
36through contract with a private provider, to review the information
37and assess whether or not the child is seriously emotionally
38disturbed as well as to determine the level of involvement in the
39case needed to assure access to appropriate mental health treatment
40services and whether appropriate treatment is available through
P100  1the minor’s own resources, those of the family or another private
2party, including a third-party payer, or through another agency,
3and to ensure access to services available within the county’s
4program. This determination shall be submitted in writing to the
5notifying agency within 30 days. If in the course of evaluating the
6minor, the county behavioral health director determines that the
7minor may be dangerous, the county behavioral health director
8may request the court to direct counsel not to reveal information
9to the minor relating to the name and address of the person who
10prepared the subject report. If appropriate treatment is not available
11within the county’s Bronzan-McCorquodale program, nothing in
12this section shall prevent the court from ordering treatment directly
13or through a family’s private resources.

14

begin deleteSEC. 48.end delete
15begin insertSEC. 36.end insert  

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

17

5701.1.  

Notwithstanding Section 5701, the State Department
18of Health Care Services, in consultation with the County Behavioral
19Health Directors Association of California and the California
20Mental Health Planning Council, may utilize funding from the
21Substance Abuse and Mental Health Services Administration Block
22Grant, awarded to the State Department of Health Care Services,
23above the funding level provided in federal fiscal year 1998, for
24the development of innovative programs for identified target
25populations, upon appropriation by the Legislature.

26

begin deleteSEC. 49.end delete
27begin insertSEC. 37.end insert  

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

29

5701.2.  

(a) The State Department of Mental Health, or its
30successor, the State Department of State Hospitals, shall maintain
31records of any transfer of funds or state hospital beds made
32pursuant to Chapter 1341 of the Statutes of 1991.

33(b) Commencing with the 1991-92 fiscal year, the State
34Department of Mental Health, or its successor, the State
35Department of State Hospitals, shall maintain records that set forth
36that portion of each county’s allocation of state mental health
37moneys that represent the dollar equivalent attributed to each
38county’s state hospital beds or bed days, or both, that were
39allocated as of May 1, 1991. The State Department of Mental
40Health, or its successor, the State Department of State Hospitals,
P101  1shall provide a written summary of these records to the appropriate
2committees of the Legislature and the County Behavioral Health
3Directors Association of California within 30 days after the
4enactment of the annual Budget Act.

5(c) Nothing in this section is intended to change the counties’
6base allocations as provided in subdivisions (a) and (b) of Section
717601.

8

begin deleteSEC. 50.end delete
9begin insertSEC. 38.end insert  

Section 5717 of the Welfare and Institutions Code is
10amended to read:

11

5717.  

(a) Expenditures that may be funded from amounts
12allocated to the county by the State Department of Health Care
13Services from funds appropriated to the department shall include,
14salaries of personnel, approved facilities and services provided
15through contract, and operation, maintenance, and service costs,
16including insurance costs or departmental charges for participation
17in a county self-insurance program if the charges are not in excess
18of comparable available commercial insurance premiums and on
19the condition that any surplus reserves be used to reduce future
20year contributions; depreciation of county facilities as established
21in the state’s uniform accounting manual, disregarding depreciation
22on the facility to the extent it was financed by state funds under
23this part; lease of facilities where there is no intention to, nor option
24to, purchase; expenses incurred under this act by members of the
25County Behavioral Health Directors Association of California for
26attendance at regular meetings of these conferences; expenses
27incurred by either the chairperson or elected representative of the
28local mental health advisory boards for attendance at regular
29meetings of the organization of mental health advisory boards;
30expenditures included in approved countywide cost allocation
31plans submitted in accordance with the Controller’s guidelines,
32including, but not limited to, adjustments of prior year estimated
33general county overhead to actual costs, but excluding allowable
34costs otherwise compensated by state funding; net costs of
35conservatorship investigation, approved by the Director of Health
36Care Services. Except for expenditures made pursuant to Article
376 (commencing with Section 129225) of Chapter 1 of Part 6 of
38Division 107 of the Health and Safety Code, it shall not include
39expenditures for initial capital improvements; the purchaser or
40construction of buildings except for equipment items and
P102  1remodeling expense as may be provided for in regulations of the
2State Department of Health Care Services; compensation to
3members of a local mental health advisory board, except actual
4and necessary expenses incurred in the performance of official
5duties that may include travel, lodging, and meals while on official
6business; or expenditures for a purpose for which state
7reimbursement is claimed under any other provision of law.

8(b) The Director of Health Care Services may make
9investigations and audits of expenditures the director may deem
10necessary.

11(c) With respect to funds allocated to a county by the State
12Department of Health Care Services from funds appropriated to
13the department, the county shall repay to the state amounts found
14not to have been expended in accordance with the requirements
15set forth in this part. Repayment shall be within 30 days after it is
16determined that an expenditure has been made that is not in
17accordance with the requirements. In the event that repayment is
18not made in a timely manner, the department shall offset any
19amount improperly expended against the amount of any current
20or future advance payment or cost report settlement from the state
21for mental health services. Repayment provisions shall not apply
22to Short-Doyle funds allocated by the department for fiscal years
23up to and including the 1990-91 fiscal year.

24

begin deleteSEC. 51.end delete
25begin insertSEC. 39.end insert  

Section 5750 of the Welfare and Institutions Code is
26amended to read:

27

5750.  

The State Department of Health Care Services shall
28administer this part and shall adopt standards for the approval of
29mental health services, and rules and regulations necessary thereto.
30However, these standards, rules, and regulations shall be adopted
31only after consultation with the County Behavioral Health Directors
32Association of California and the California Mental Health
33Planning Council.

34

begin deleteSEC. 52.end delete
35begin insertSEC. 40.end insert  

Section 5814.5 of the Welfare and Institutions Code
36 is amended to read:

37

5814.5.  

(a) (1) In any year in which funds are appropriated
38for this purpose through the annual Budget Act, counties funded
39under this part in the 1999-2000 fiscal year are eligible for funding
40to continue their programs if they have successfully demonstrated
P103  1the effectiveness of their grants received in that year and to expand
2their programs if they also demonstrate significant continued unmet
3need and capacity for expansion without compromising quality or
4effectiveness of care.

5(2) In any year in which funds are appropriated for this purpose
6through the annual Budget Act, other counties or portions of
7counties, or cities that operate independent public mental health
8programs pursuant to Section 5615 of the Welfare and Institutions
9Code, are eligible for funding to establish programs if a county or
10eligible city demonstrates that it can provide comprehensive
11services, as set forth in this part, to a substantial number of adults
12who are severely mentally ill, as defined in Section 5600.3, and
13are homeless or recently released from the county jail or who are
14untreated, unstable, and at significant risk of incarceration or
15homelessness unless treatment is provided.

16(b) (1) Counties eligible for funding pursuant to subdivision
17(a) shall be those that have or can develop integrated adult service
18programs that meet the criteria for an adult system of care, as set
19forth in Section 5806, and that have, or can develop, integrated
20forensic programs with similar characteristics for parolees and
21those recently released from county jail who meet the target
22population requirements of Section 5600.3 and are at risk of
23incarceration unless the services are provided. Before a city or
24county submits a proposal to the state to establish or expand a
25program, the proposal shall be reviewed by a local advisory
26committee or mental health board, which may be an existing body,
27that includes clients, family members, private providers of services,
28and other relevant stakeholders. Local enrollment for integrated
29adult service programs and for integrated forensic programs funded
30pursuant to subdivision (a) shall adhere to all conditions set forth
31by the department, including the total number of clients to be
32enrolled, the providers to which clients are enrolled and the
33maximum cost for each provider, the maximum number of clients
34to be served at any one time, the outreach and screening process
35used to identify enrollees, and the total cost of the program. Local
36enrollment of each individual for integrated forensic programs
37shall be subject to the approval of the county behavioral health
38director or his or her designee.

39(2) Each county shall ensure that funds provided by these grants
40are used to expand existing integrated service programs that meet
P104  1the criteria of the adult system of care to provide new services in
2accordance with the purpose for which they were appropriated and
3allocated, and that none of these funds shall be used to supplant
4existing services to severely mentally ill adults. In order to ensure
5that this requirement is met, the department shall develop methods
6and contractual requirements, as it determines necessary. At a
7minimum, these assurances shall include that state and federal
8requirements regarding tracking of funds are met and that patient
9records are maintained in a manner that protects privacy and
10confidentiality, as required under federal and state law.

11(c) Each county selected to receive a grant pursuant to this
12section shall provide data as the department may require, that
13demonstrates the outcomes of the adult system of care programs,
14shall specify the additional numbers of severely mentally ill adults
15to whom they will provide comprehensive services for each million
16dollars of additional funding that may be awarded through either
17an integrated adult service grant or an integrated forensic grant,
18and shall agree to provide services in accordance with Section
195806. Each county’s plan shall identify and include sufficient
20funding to provide housing for the individuals to be served, and
21shall ensure that any hospitalization of individuals participating
22in the program are coordinated with the provision of other mental
23health services provided under the program.

begin delete
24

SEC. 53.  

Section 5845 of the Welfare and Institutions Code is
25amended to read:

26

5845.  

(a) The Mental Health Services Oversight and
27Accountability Commission is hereby established to oversee Part
283 (commencing with Section 5800), the Adult and Older Adult
29Mental Health System of Care Act; Part 3.1 (commencing with
30Section 5820), Human Resources, Education, and Training
31Programs; Part 3.2 (commencing with Section 5830), Innovative
32Programs; Part 3.6 (commencing with Section 5840), Prevention
33and Early Intervention Programs; and Part 4 (commencing with
34Section 5850), the Children’s Mental Health Services Act. The
35commission shall replace the advisory committee established
36pursuant to Section 5814. The commission shall consist of 16
37voting members as follows:

38(1) The Attorney General or his or her designee.

39(2) The Superintendent of Public Instruction or his or her
40designee.

P105  1(3) The Chairperson of the Senate Health and Human Services
2Committee or another Member of the Senate selected by the
3President pro Tempore of the Senate.

4(4) The Chairperson of the Assembly Health Committee or
5another member of the Assembly selected by the Speaker of the
6Assembly.

7(5) Two persons with a severe mental illness, a family member
8of an adult or senior with a severe mental illness, a family member
9of a child who has or has had a severe mental illness, a physician
10specializing in alcohol and drug treatment, a mental health
11professional, a county sheriff, a superintendent of a school district,
12a representative of a labor organization, a representative of an
13employer with less than 500 employees and a representative of an
14employer with more than 500 employees, and a representative of
15a health care services plan or insurer, all appointed by the
16Governor. In making appointments, the Governor shall seek
17individuals who have had personal or family experience with
18mental illness.

19(b) Members shall serve without compensation, but shall be
20reimbursed for all actual and necessary expenses incurred in the
21performance of their duties.

22(c) The term of each member shall be three years, to be
23staggered so that approximately one-third of the appointments
24expire in each year.

25(d) In carrying out its duties and responsibilities, the commission
26may do all of the following:

27(1) Meet at least once each quarter at any time and location
28convenient to the public as it may deem appropriate. All meetings
29of the commission shall be open to the public.

30(2) Within the limit of funds allocated for these purposes,
31pursuant to the laws and regulations governing state civil service,
32employ staff, including any clerical, legal, and technical assistance
33as may appear necessary. The commission shall administer its
34operations separate and apart from the State Department of Health
35Care Services and the California Health and Human Services
36Agency.

37(3) Establish technical advisory committees, such as a committee
38of consumers and family members.

39(4) Employ all other appropriate strategies necessary or
40convenient to enable it to fully and adequately perform its duties
P106  1and exercise the powers expressly granted, notwithstanding any
2authority expressly granted to any officer or employee of state
3government.

4(5) Enter into contracts.

5(6) Obtain data and information from the State Department of
6Health Care Services, the Office of Statewide Health Planning and
7Development, or other state or local entities that receive Mental
8Health Services Act funds, for the commission to utilize in its
9oversight, review, training and technical assistance, accountability,
10and evaluation capacity regarding projects and programs supported
11 with Mental Health Services Act funds.

12(7) Participate in the joint state-county decisionmaking process,
13as contained in Section 4061, for training, technical assistance,
14and regulatory resources to meet the mission and goals of the
15state’s mental health system.

16(8) Develop strategies to overcome stigma and discrimination,
17and accomplish all other objectives of Part 3.2 (commencing with
18Section 5830), Part 3.6 (commencing with Section 5840), and the
19other provisions of the act establishing this commission.

20(9) At any time, advise the Governor or the Legislature regarding
21actions the state may take to improve care and services for people
22with mental illness.

23(10) If the commission identifies a critical issue related to the
24performance of a county mental health program, it may refer the
25issue to the State Department of Health Care Services pursuant to
26Section 5655.

27(11) Assist in providing technical assistance to accomplish the
28purposes of the Mental Health Services Act, Part 3 (commencing
29with Section 5800) and Part 4 (commencing with Section 5850)
30in collaboration with the State Department of Health Care Services
31and in consultation with the County Behavioral Health Directors
32Association of California.

33(12) Work in collaboration with the State Department of Health
34Care Services and the California Mental Health Planning Council,
35and in consultation with the County Behavioral Health Directors
36Association of California, in designing a comprehensive joint plan
37for a coordinated evaluation of client outcomes in the
38community-based mental health system, including, but not limited
39to, parts listed in subdivision (a). The California Health and Human
40Services Agency shall lead this comprehensive joint plan effort.

end delete
P107  1

begin deleteSEC. 54.end delete
2begin insertSEC. 41.end insert  

Section 5847 of the Welfare and Institutions Code is
3amended to read:

4

5847.  

Integrated Plans for Prevention, Innovation, and System
5of Care Services.

6(a) Each county mental health program shall prepare and submit
7a three-year program and expenditure plan, and annual updates,
8adopted by the county board of supervisors, to the Mental Health
9Services Oversight and Accountability Commission within 30 days
10after adoption.

11(b) The three-year program and expenditure plan shall be based
12on available unspent funds and estimated revenue allocations
13provided by the state and in accordance with established
14stakeholder engagement and planning requirements as required in
15Section 5848. The three-year program and expenditure plan and
16annual updates shall include all of the following:

17(1) A program for prevention and early intervention in
18accordance with Part 3.6 (commencing with Section 5840).

19(2) A program for services to children in accordance with Part
204 (commencing with Section 5850), to include a program pursuant
21to Chapter 4 (commencing with Section 18250) of Part 6 of
22Division 9 or provide substantial evidence that it is not feasible to
23establish a wraparound program in that county.

24(3) A program for services to adults and seniors in accordance
25with Part 3 (commencing with Section 5800).

26(4) A program for innovations in accordance with Part 3.2
27(commencing with Section 5830).

28(5) A program for technological needs and capital facilities
29needed to provide services pursuant to Part 3 (commencing with
30Section 5800), Part 3.6 (commencing with Section 5840), and Part
314 (commencing with Section 5850). All plans for proposed facilities
32with restrictive settings shall demonstrate that the needs of the
33people to be served cannot be met in a less restrictive or more
34integrated setting.

35(6) Identification of shortages in personnel to provide services
36pursuant to the above programs and the additional assistance
37needed from the education and training programs established
38pursuant to Part 3.1 (commencing with Section 5820).

39(7) Establishment and maintenance of a prudent reserve to
40ensure the county program will continue to be able to serve
P108  1children, adults, and seniors that it is currently serving pursuant
2to Part 3 (commencing with Section 5800), the Adult and Older
3Adult Mental Health System of Care Act, Part 3.6 (commencing
4with Section 5840), Prevention and Early Intervention Programs,
5and Part 4 (commencing with Section 5850), the Children’s Mental
6Health Services Act, during years in which revenues for the Mental
7Health Services Fund are below recent averages adjusted by
8changes in the state population and the California Consumer Price
9Index.

10(8) Certification by the county behavioral health director, which
11ensures that the county has complied with all pertinent regulations,
12laws, and statutes of the Mental Health Services Act, including
13stakeholder participation and nonsupplantation requirements.

14(9) Certification by the county behavioral health director and
15by the county auditor-controller that the county has complied with
16any fiscal accountability requirements as directed by the State
17Department of Health Care Services, and that all expenditures are
18consistent with the requirements of the Mental Health Services
19Act.

20(c) The programs established pursuant to paragraphs (2) and
21(3) of subdivision (b) shall include services to address the needs
22of transition age youth 16 to 25 years of age. In implementing this
23subdivision, county mental health programs shall consider the
24needs of transition age foster youth.

25(d) Each year, the State Department of Health Care Services
26shall inform the County Behavioral Health Directors Association
27of California and the Mental Health Services Oversight and
28Accountability Commission of the methodology used for revenue
29allocation to the counties.

30(e) Each county mental health program shall prepare expenditure
31plans pursuant to Part 3 (commencing with Section 5800) for adults
32and seniors, Part 3.2 (commencing with Section 5830) for
33innovative programs, Part 3.6 (commencing with Section 5840)
34for prevention and early intervention programs, and Part 4
35(commencing with Section 5850) for services for children, and
36updates to the plans developed pursuant to this section. Each
37expenditure update shall indicate the number of children, adults,
38and seniors to be served pursuant to Part 3 (commencing with
39Section 5800), and Part 4 (commencing with Section 5850), and
40the cost per person. The expenditure update shall include utilization
P109  1of unspent funds allocated in the previous year and the proposed
2expenditure for the same purpose.

3(f) A county mental health program shall include an allocation
4of funds from a reserve established pursuant to paragraph (7) of
5subdivision (b) for services pursuant to paragraphs (2) and (3) of
6subdivision (b) in years in which the allocation of funds for services
7pursuant to subdivision (e) are not adequate to continue to serve
8the same number of individuals as the county had been serving in
9the previous fiscal year.

10

begin deleteSEC. 55.end delete
11begin insertSEC. 42.end insert  

Section 5848 of the Welfare and Institutions Code is
12amended to read:

13

5848.  

(a) Each three-year program and expenditure plan and
14update shall be developed with local stakeholders, including adults
15and seniors with severe mental illness, families of children, adults,
16and seniors with severe mental illness, providers of services, law
17enforcement agencies, education, social services agencies, veterans,
18representatives from veterans organizations, providers of alcohol
19and drug services, health care organizations, and other important
20interests. Counties shall demonstrate a partnership with constituents
21and stakeholders throughout the process that includes meaningful
22stakeholder involvement on mental health policy, program
23planning, and implementation, monitoring, quality improvement,
24evaluation, and budget allocations. A draft plan and update shall
25be prepared and circulated for review and comment for at least 30
26days to representatives of stakeholder interests and any interested
27party who has requested a copy of the draft plans.

28(b) The mental health board established pursuant to Section
295604 shall conduct a public hearing on the draft three-year program
30and expenditure plan and annual updates at the close of the 30-day
31comment period required by subdivision (a). Each adopted
32three-year program and expenditure plan and update shall include
33any substantive written recommendations for revisions. The
34adopted three-year program and expenditure plan or update shall
35summarize and analyze the recommended revisions. The mental
36health board shall review the adopted plan or update and make
37recommendations to the county mental health department for
38revisions.

39(c) The plans shall include reports on the achievement of
40performance outcomes for services pursuant to Part 3 (commencing
P110  1with Section 5800), Part 3.6 (commencing with Section 5840),
2and Part 4 (commencing with Section 5850) funded by the Mental
3Health Services Fund and established jointly by the State
4Department of Health Care Services and the Mental Health Services
5Oversight and Accountability Commission, in collaboration with
6the County Behavioral Health Directors Association of California.

7(d) Mental health services provided pursuant to Part 3
8(commencing with Section 5800) and Part 4 (commencing with
9Section 5850) shall be included in the review of program
10performance by the California Mental Health Planning Council
11required by paragraph (2) of subdivision (c) of Section 5772 and
12in the local mental health board’s review and comment on the
13performance outcome data required by paragraph (7) of subdivision
14(a) of Section 5604.2.

15

begin deleteSEC. 56.end delete
16begin insertSEC. 43.end insert  

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

18

5848.5.  

(a) The Legislature finds and declares all of the
19following:

20(1) California has realigned public community mental health
21services to counties and it is imperative that sufficient
22community-based resources be available to meet the mental health
23needs of eligible individuals.

24(2) Increasing access to effective outpatient and crisis
25stabilization services provides an opportunity to reduce costs
26associated with expensive inpatient and emergency room care and
27to better meet the needs of individuals with mental health disorders
28in the least restrictive manner possible.

29(3) Almost one-fifth of people with mental health disorders visit
30a hospital emergency room at least once per year. If an adequate
31array of crisis services is not available, it leaves an individual with
32little choice but to access an emergency room for assistance and,
33potentially, an unnecessary inpatient hospitalization.

34(4) Recent reports have called attention to a continuing problem
35of inappropriate and unnecessary utilization of hospital emergency
36rooms in California due to limited community-based services for
37individuals in psychological distress and acute psychiatric crisis.
38Hospitals report that 70 percent of people taken to emergency
39rooms for psychiatric evaluation can be stabilized and transferred
40to a less intensive level of crisis care. Law enforcement personnel
P111  1report that their personnel need to stay with people in the
2 emergency room waiting area until a placement is found, and that
3less intensive levels of care tend not to be available.

4(5) Comprehensive public and private partnerships at both local
5and regional levels, including across physical health services,
6mental health, substance use disorder, law enforcement, social
7services, and related supports, are necessary to develop and
8maintain high quality, patient-centered, and cost-effective care for
9individuals with mental health disorders that facilitates their
10recovery and leads towards wellness.

11(6) The recovery of individuals with mental health disorders is
12important for all levels of government, business, and the local
13community.

14(b) This section shall be known, and may be cited, as the
15Investment in Mental Health Wellness Act of 2013. The objectives
16of this section are to do all of the following:

17(1) Expand access to early intervention and treatment services
18to improve the client experience, achieve recovery and wellness,
19and reduce costs.

20(2) Expand the continuum of services to address crisis
21intervention, crisis stabilization, and crisis residential treatment
22needs that are wellness, resiliency, and recovery oriented.

23(3) Add at least 25 mobile crisis support teams and at least 2,000
24crisis stabilization and crisis residential treatment beds to bolster
25capacity at the local level to improve access to mental health crisis
26services and address unmet mental health care needs.

27(4) Add at least 600 triage personnel to provide intensive case
28management and linkage to services for individuals with mental
29health care disorders at various points of access, such as at
30designated community-based service points, homeless shelters,
31and clinics.

32(5) Reduce unnecessary hospitalizations and inpatient days by
33appropriately utilizing community-based services and improving
34access to timely assistance.

35(6) Reduce recidivism and mitigate unnecessary expenditures
36of local law enforcement.

37(7) Provide local communities with increased financial resources
38to leverage additional public and private funding sources to achieve
39improved networks of care for individuals with mental health
40disorders.

P112  1(c) Through appropriations provided in the annual Budget Act
2for this purpose, it is the intent of the Legislature to authorize the
3California Health Facilities Financing Authority, hereafter referred
4to as the authority, and the Mental Health Services Oversight and
5Accountability Commission, hereafter referred to as the
6commission, to administer competitive selection processes as
7provided in this section for capital capacity and program expansion
8to increase capacity for mobile crisis support, crisis intervention,
9crisis stabilization services, crisis residential treatment, and
10specified personnel resources.

11(d) Funds appropriated by the Legislature to the authority for
12purposes of this section shall be made available to selected
13counties, or counties acting jointly. The authority may, at its
14discretion, also give consideration to private nonprofit corporations
15and public agencies in an area or region of the state if a county, or
16counties acting jointly, affirmatively supports this designation and
17collaboration in lieu of a county government directly receiving
18grant funds.

19(1) Grant awards made by the authority shall be used to expand
20local resources for the development, capital, equipment acquisition,
21and applicable program startup or expansion costs to increase
22capacity for client assistance and services in the following areas:

23(A) Crisis intervention, as authorized by Sections 14021.4,
2414680, and 14684.

25(B) Crisis stabilization, as authorized by Sections 14021.4,
2614680, and 14684.

27(C) Crisis residential treatment, as authorized by Sections
2814021.4, 14680, and 14684.

29(D) Rehabilitative mental health services, as authorized by
30Sections 14021.4, 14680, and 14684.

31(E) Mobile crisis support teams, including personnel and
32equipment, such as the purchase of vehicles.

33(2) The authority shall develop selection criteria to expand local
34resources, including those described in paragraph (1), and processes
35for awarding grants after consulting with representatives and
36interested stakeholders from the mental health community,
37including, but not limited to, the County Behavioral Health
38Directors Association of California, service providers, consumer
39organizations, and other appropriate interests, such as health care
40providers and law enforcement, as determined by the authority.
P113  1The authority shall ensure that grants result in cost-effective
2expansion of the number of community-based crisis resources in
3regions and communities selected for funding. The authority shall
4also take into account at least the following criteria and factors
5when selecting recipients of grants and determining the amount
6of grant awards:

7(A) Description of need, including, at a minimum, a
8comprehensive description of the project, community need,
9population to be served, linkage with other public systems of health
10and mental health care, linkage with local law enforcement, social
11services, and related assistance, as applicable, and a description
12of the request for funding.

13(B) Ability to serve the target population, which includes
14individuals eligible for Medi-Cal and individuals eligible for county
15health and mental health services.

16(C) Geographic areas or regions of the state to be eligible for
17grant awards, which may include rural, suburban, and urban areas,
18and may include use of the five regional designations utilized by
19the County Behavioral Health Directors Association of California.

20(D) Level of community engagement and commitment to project
21completion.

22(E) Financial support that, in addition to a grant that may be
23awarded by the authority, will be sufficient to complete and operate
24the project for which the grant from the authority is awarded.

25(F) Ability to provide additional funding support to the project,
26including public or private funding, federal tax credits and grants,
27foundation support, and other collaborative efforts.

28(G) Memorandum of understanding among project partners, if
29applicable.

30(H) Information regarding the legal status of the collaborating
31partners, if applicable.

32(I) Ability to measure key outcomes, including improved access
33to services, health and mental health outcomes, and cost benefit
34of the project.

35(3) The authority shall determine maximum grants awards,
36which shall take into consideration the number of projects awarded
37to the grantee, as described in paragraph (1), and shall reflect
38reasonable costs for the project and geographic region. The
39authority may allocate a grant in increments contingent upon the
40phases of a project.

P114  1(4) Funds awarded by the authority pursuant to this section may
2be used to supplement, but not to supplant, existing financial and
3resource commitments of the grantee or any other member of a
4collaborative effort that has been awarded a grant.

5(5) All projects that are awarded grants by the authority shall
6be completed within a reasonable period of time, to be determined
7by the authority. Funds shall not be released by the authority until
8the applicant demonstrates project readiness to the authority’s
9satisfaction. If the authority determines that a grant recipient has
10failed to complete the project under the terms specified in awarding
11the grant, the authority may require remedies, including the return
12of all or a portion of the grant.

13(6) A grantee that receives a grant from the authority under this
14section shall commit to using that capital capacity and program
15expansion project, such as the mobile crisis team, crisis
16stabilization unit, or crisis residential treatment program, for the
17duration of the expected life of the project.

18(7) The authority may consult with a technical assistance entity,
19as described in paragraph (5) of subdivision (a) of Section 4061,
20for purposes of implementing this section.

21(8) The authority may adopt emergency regulations relating to
22the grants for the capital capacity and program expansion projects
23described in this section, including emergency regulations that
24define eligible costs and determine minimum and maximum grant
25amounts.

26(9) The authority shall provide reports to the fiscal and policy
27committees of the Legislature on or before May 1, 2014, and on
28or before May 1, 2015, on the progress of implementation, that
29include, but are not limited to, the following:

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

31(B) The amount of each grant issued.

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

33(D) The total amount of grants issued.

34(E) A description of project operation and implementation,
35including who is being served.

36(10) A recipient of a grant provided pursuant to paragraph (1)
37shall adhere to all applicable laws relating to scope of practice,
38licensure, certification, staffing, and building codes.

39(e) Funds appropriated by the Legislature to the commission
40for purposes of this section shall be allocated for triage personnel
P115  1to provide intensive case management and linkage to services for
2 individuals with mental health disorders at various points of access.
3These funds shall be made available to selected counties, counties
4acting jointly, or city mental health departments, as determined
5by the commission through a selection process. It is the intent of
6the Legislature for these funds to be allocated in an efficient manner
7to encourage early intervention and receipt of needed services for
8individuals with mental health disorders, and to assist in navigating
9the local service sector to improve efficiencies and the delivery of
10services.

11(1) Triage personnel may provide targeted case management
12services face to face, by telephone, or by telehealth with the
13individual in need of assistance or his or her significant support
14person, and may be provided anywhere in the community. These
15service activities may include, but are not limited to, the following:

16(A) Communication, coordination, and referral.

17(B) Monitoring service delivery to ensure the individual accesses
18and receives services.

19(C) Monitoring the individual’s progress.

20(D) Providing placement service assistance and service plan
21development.

22(2) The commission shall take into account at least the following
23criteria and factors when selecting recipients and determining the
24amount of grant awards for triage personnel as follows:

25(A) Description of need, including potential gaps in local service
26connections.

27(B) Description of funding request, including personnel and use
28of peer support.

29(C) Description of how triage personnel will be used to facilitate
30linkage and access to services, including objectives and anticipated
31outcomes.

32(D) Ability to obtain federal Medicaid reimbursement, when
33applicable.

34(E) Ability to administer an effective service program and the
35degree to which local agencies and service providers will support
36and collaborate with the triage personnel effort.

37(F) Geographic areas or regions of the state to be eligible for
38grant awards, which shall include rural, suburban, and urban areas,
39and may include use of the five regional designations utilized by
40the County Behavioral Health Directors Association of California.

P116  1(3) The commission shall determine maximum grant awards,
2and shall take into consideration the level of need, population to
3be served, and related criteria, as described in paragraph (2), and
4shall reflect reasonable costs.

5(4) Funds awarded by the commission for purposes of this
6section may be used to supplement, but not supplant, existing
7financial and resource commitments of the county, counties acting
8jointly, or city mental health department that received the grant.

9(5) Notwithstanding any other law, a county, counties acting
10jointly, or city mental health department that receives an award of
11funds for the purpose of supporting triage personnel pursuant to
12this subdivision is not required to provide a matching contribution
13of local funds.

14(6) Notwithstanding any other law, the commission, without
15taking any further regulatory action, may implement, interpret, or
16make specific this section by means of informational letters,
17bulletins, or similar instructions.

18(7) The commission shall provide a status report to the fiscal
19and policy committees of the Legislature on the progress of
20implementation no later than March 1, 2014.

21

begin deleteSEC. 57.end delete
22begin insertSEC. 44.end insert  

Section 5892 of the Welfare and Institutions Code is
23amended to read:

24

5892.  

(a) In order to promote efficient implementation of this
25act, the county shall use funds distributed from the Mental Health
26Services Fund as follows:

27(1) In 2005-06, 2006-07, and in 2007-08, 10 percent shall be
28placed in a trust fund to be expended for education and training
29programs pursuant to Part 3.1.

30(2) In 2005-06, 2006-07, and in 2007-08, 10 percent for capital
31facilities and technological needs distributed to counties in
32accordance with a formula developed in consultation with the
33County Behavioral Health Directors Association of California to
34implement plans developed pursuant to Section 5847.

35(3) Twenty percent of funds distributed to the counties pursuant
36to subdivision (c) of Section 5891 shall be used for prevention and
37early intervention programs in accordance with Part 3.6
38(commencing with Section 5840) of this division.

39(4) The expenditure for prevention and early intervention may
40be increased in any county in which the department determines
P117  1that the increase will decrease the need and cost for additional
2services to severely mentally ill persons in that county by an
3amount at least commensurate with the proposed increase.

4(5) The balance of funds shall be distributed to county mental
5health programs for services to persons with severe mental illnesses
6pursuant to Part 4 (commencing with Section 5850) for the
7children’s system of care and Part 3 (commencing with Section
85800) for the adult and older adult system of care.

9(6) Five percent of the total funding for each county mental
10health program for Part 3 (commencing with Section 5800), Part
113.6 (commencing with Section 5840), and Part 4 (commencing
12with Section 5850) of this division, shall be utilized for innovative
13 programs in accordance with Sections 5830, 5847, and 5848.

14(b) In any year after 2007-08, programs for services pursuant
15to Part 3 (commencing with Section 5800) and Part 4 (commencing
16with Section 5850) of this division may include funds for
17technological needs and capital facilities, human resource needs,
18and a prudent reserve to ensure services do not have to be
19significantly reduced in years in which revenues are below the
20average of previous years. The total allocation for purposes
21authorized by this subdivision shall not exceed 20 percent of the
22average amount of funds allocated to that county for the previous
23five years pursuant to this section.

24(c) The allocations pursuant to subdivisions (a) and (b) shall
25include funding for annual planning costs pursuant to Section 5848.
26The total of these costs shall not exceed 5 percent of the total of
27annual revenues received for the fund. The planning costs shall
28include funds for county mental health programs to pay for the
29costs of consumers, family members, and other stakeholders to
30participate in the planning process and for the planning and
31implementation required for private provider contracts to be
32significantly expanded to provide additional services pursuant to
33Part 3 (commencing with Section 5800) and Part 4 (commencing
34with Section 5850) of this division.

35(d) Prior to making the allocations pursuant to subdivisions (a),
36(b), and (c), funds shall be reserved for the costs for the State
37Department of Health Care Services, the California Mental Health
38Planning Council, the Office of Statewide Health Planning and
39Development, the Mental Health Services Oversight and
40Accountability Commission, the State Department of Public Health,
P118  1and any other state agency to implement all duties pursuant to the
2programs set forth in this section. These costs shall not exceed 5
3percent of the total of annual revenues received for the fund. The
4administrative costs shall include funds to assist consumers and
5family members to ensure the appropriate state and county agencies
6give full consideration to concerns about quality, structure of
7service delivery, or access to services. The amounts allocated for
8administration shall include amounts sufficient to ensure adequate
9research and evaluation regarding the effectiveness of services
10being provided and achievement of the outcome measures set forth
11in Part 3 (commencing with Section 5800), Part 3.6 (commencing
12with Section 5840), and Part 4 (commencing with Section 5850)
13of this division. The amount of funds available for the purposes
14of this subdivision in any fiscal year shall be subject to
15appropriation in the annual Budget Act.

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

17(1)  Forty-five percent for education and training pursuant to
18Part 3.1 (commencing with Section 5820) of this division.

19(2)  Forty-five percent for capital facilities and technology needs
20in the manner specified by paragraph (2) of subdivision (a).

21(3)  Five percent for local planning in the manner specified in
22subdivision (c).

23(4) Five percent for state implementation in the manner specified
24in subdivision (d).

25(f) Each county shall place all funds received from the State
26Mental Health Services Fund in a local Mental Health Services
27Fund. The Local Mental Health Services Fund balance shall be
28invested consistent with other county funds and the interest earned
29on the investments shall be transferred into the fund. The earnings
30on investment of these funds shall be available for distribution
31from the fund in future years.

32(g) All expenditures for county mental health programs shall
33be consistent with a currently approved plan or update pursuant
34to Section 5847.

35(h) Other than funds placed in a reserve in accordance with an
36approved plan, any funds allocated to a county that have not been
37spent for their authorized purpose within three years shall revert
38to the state to be deposited into the fund and available for other
39counties in future years, provided however, that funds for capital
P119  1facilities, technological needs, or education and training may be
2retained for up to 10 years before reverting to the fund.

3(i) If there are still additional revenues available in the fund
4after the Mental Health Services Oversight and Accountability
5Commission has determined there are prudent reserves and no
6unmet needs for any of the programs funded pursuant to this
7section, including all purposes of the Prevention and Early
8Intervention Program, the commission shall develop a plan for
9expenditures of these revenues to further the purposes of this act
10and the Legislature may appropriate these funds for any purpose
11consistent with the commission’s adopted plan that furthers the
12purposes of this act.

13(j) For the 2011-12 fiscal year, General Fund revenues will be
14insufficient to fully fund many existing mental health programs,
15including Early and Periodic Screening, Diagnosis, and Treatment
16(EPSDT), Medi-Cal Specialty Mental Health Managed Care, and
17mental health services provided for special education pupils. In
18order to adequately fund those programs for the 2011-12 fiscal
19year and avoid deeper reductions in programs that serve individuals
20with severe mental illness and the most vulnerable, medically
21needy citizens of the state, prior to distribution of funds under
22paragraphs (1) to (6), inclusive, of subdivision (a), effective July
231, 2011, moneys shall be allocated from the Mental Health Services
24Fund to the counties as follows:

25(1) Commencing July 1, 2011, one hundred eighty-three million
26six hundred thousand dollars ($183,600,000) of the funds available
27as of July 1, 2011, in the Mental Health Services Fund, shall be
28allocated in a manner consistent with subdivision (c) of Section
295778 and based on a formula determined by the state in
30consultation with the County Behavioral Health Directors
31Association of California to meet the fiscal year 2011-12 General
32Fund obligation for Medi-Cal Specialty Mental Health Managed
33Care.

34(2) Upon completion of the allocation in paragraph (1), the
35Controller shall distribute to counties ninety-eight million five
36hundred eighty-six thousand dollars ($98,586,000) from the Mental
37Health Services Fund for mental health services for special
38education pupils based on a formula determined by the state in
39consultation with the County Behavioral Health Directors
40Association of California.

P120  1(3) Upon completion of the allocation in paragraph (2), the
2Controller shall distribute to counties 50 percent of their 2011-12
3Mental Health Services Act component allocations consistent with
4Sections 5847 and 5891, not to exceed four hundred eighty-eight
5million dollars ($488,000,000). This allocation shall commence
6beginning August 1, 2011.

7(4) Upon completion of the allocation in paragraph (3), and as
8revenues are deposited into the Mental Health Services Fund, the
9Controller shall distribute five hundred seventy-nine million dollars
10($579,000,000) from the Mental Health Services Fund to counties
11to meet the General Fund obligation for EPSDT for the 2011-12
12fiscal year. These revenues shall be distributed to counties on a
13quarterly basis and based on a formula determined by the state in
14consultation with the County Behavioral Health Directors
15Association of California. These funds shall not be subject to
16 reconciliation or cost settlement.

17(5) The Controller shall distribute to counties the remaining
182011-12 Mental Health Services Act component allocations
19consistent with Sections 5847 and 5891, beginning no later than
20April 30, 2012. These remaining allocations shall be made on a
21monthly basis.

22(6) The total one-time allocation from the Mental Health
23Services Fund for EPSDT, Medi-Cal Specialty Mental Health
24Managed Care, and mental health services provided to special
25education pupils as referenced shall not exceed eight hundred
26sixty-two million dollars ($862,000,000). Any revenues deposited
27in the Mental Health Services Fund in the 2011-12 fiscal year that
28exceed this obligation shall be distributed to counties for remaining
29fiscal year 2011-12 Mental Health Services Act component
30allocations, consistent with Sections 5847 and 5891.

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

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

33

begin deleteSEC. 58.end delete
34begin insertSEC. 45.end insert  

Section 5899 of the Welfare and Institutions Code is
35amended to read:

36

5899.  

(a) The State Department of Health Care Services, in
37consultation with the Mental Health Services Oversight and
38Accountability Commission and the County Behavioral Health
39Directors Association of California, shall develop and administer
40instructions for the Annual Mental Health Services Act Revenue
P121  1and Expenditure Report. This report shall be submitted
2electronically to the department and to the Mental Health Services
3Oversight and Accountability Commission.

4(b) The purpose of the Annual Mental Health Services Act
5Revenue and Expenditure Report is as follows:

6(1) Identify the expenditures of Mental Health Services Act
7(MHSA) funds that were distributed to each county.

8(2) Quantify the amount of additional funds generated for the
9mental health system as a result of the MHSA.

10(3) Identify unexpended funds, and interest earned on MHSA
11funds.

12(4) Determine reversion amounts, if applicable, from prior fiscal
13year distributions.

14(c) This report is intended to provide information that allows
15for the evaluation of all of the following:

16(1) Children’s systems of care.

17(2) Prevention and early intervention strategies.

18(3) Innovative projects.

19(4) Workforce education and training.

20(5) Adults and older adults systems of care.

21(6) Capital facilities and technology needs.

22

begin deleteSEC. 59.end delete
23begin insertSEC. 46.end insert  

Section 5902 of the Welfare and Institutions Code is
24amended to read:

25

5902.  

(a) In the 1991-92 fiscal year, funding sufficient to
26cover the cost of the basic level of care in institutions for mental
27disease at the rate established by the State Department of Health
28Care Services shall be made available to the department for skilled
29nursing facilities, plus the rate established for special treatment
30programs. The department may authorize a county to administer
31institutions for mental disease services if the county with the
32consent of the affected providers makes a request to administer
33services and an allocation is made to the county for these services.
34The department shall continue to contract with these providers for
35the services necessary for the operation of the institutions for
36mental disease.

37(b) In the 1992-93 fiscal year, the department shall consider
38county-specific requests to continue to provide administrative
39services relative to institutions for mental disease facilities when
40no viable alternatives are found to exist.

P122  1(c) (1) By October 1, 1991, the department, in consultation
2with the County Behavioral Health Directors Association of
3California and the California Association of Health Facilities, shall
4develop and publish a county-specific allocation of institutions for
5mental disease funds that will take effect on July 1, 1992.

6(2) By November 1, 1991, counties shall notify the providers
7of any intended change in service levels to be effective on July 1,
81992.

9(3) By April 1, 1992, counties and providers shall have entered
10into contracts for basic institutions for mental disease services at
11the rate described in subdivision (e) for the 1992-93 fiscal year at
12the level expressed on or before November 1, 1991, except that a
13county shall be permitted additional time, until June 1, 1992, to
14complete the processing of the contract, when any of the following
15conditions are met:

16(A) The county and the affected provider have agreed on all
17substantive institutions for mental disease contract issues by April
181, 1992.

19(B) Negotiations are in process with the county on April 1, 1992,
20and the affected provider has agreed in writing to the extension.

21(C) The service level committed to on November 1, 1991,
22exceeds the affected provider’s bed capacity.

23(D) The county can document that the affected provider has
24refused to enter into negotiations by April 1, 1992, or has
25substantially delayed negotiations.

26(4) If a county and a provider are unable to reach agreement on
27substantive contract issues by June 1, 1992, the department may,
28upon request of either the affected county or the provider, mediate
29the disputed issues.

30(5) When contracts for service at the level committed to on
31November 1, 1991, have not been completed by April 1, 1992,
32and additional time is not permitted pursuant to the exceptions
33specified in paragraph (3) the funds allocated to those counties
34shall revert for reallocation in a manner that shall promote equity
35of funding among counties. With respect to counties with
36exceptions permitted pursuant to paragraph (3), funds shall not
37revert unless contracts are not completed by June 1, 1992. In no
38event shall funds revert under this section if there is no harm to
39the provider as a result of the county contract not being completed.
40During the 1992-93 fiscal year, funds reverted under this paragraph
P123  1shall be used to purchase institution for mental disease/skilled
2nursing/special treatment program services in existing facilities.

3(6) Nothing in this section shall apply to negotiations regarding
4supplemental payments beyond the rate specified in subdivision
5(e).

6(d) On or before April 1, 1992, counties may complete contracts
7with facilities for the direct purchase of services in the 1992-93
8fiscal year. Those counties for which facility contracts have not
9been completed by that date shall be deemed to continue to accept
10financial responsibility for those patients during the subsequent
11fiscal year at the rate specified in subdivision (a).

12(e) As long as contracts with institutions for mental disease
13providers require the facilities to maintain skilled nursing facility
14licensure and certification, reimbursement for basic services shall
15be at the rate established by the State Department of Health Care
16Services. Except as provided in this section, reimbursement rates
17for services in institutions for mental diseases shall be the same
18as the rates in effect on July 31, 2004. Effective July 1, 2005,
19through June 30, 2008, the reimbursement rate for institutions for
20mental disease shall increase by 6.5 percent annually. Effective
21July 1, 2008, the reimbursement rate for institutions for mental
22disease shall increase by 4.7 percent annually.

23(f) (1) Providers that agree to contract with the county for
24services under an alternative mental health program pursuant to
25Section 5768 that does not require skilled nursing facility licensure
26shall retain return rights to licensure as skilled nursing facilities.

27(2) Providers participating in an alternative program that elect
28to return to skilled nursing facility licensure shall only be required
29to meet those requirements under which they previously operated
30as a skilled nursing facility.

31(g) In the 1993-94 fiscal year and thereafter, the department
32shall consider requests to continue administrative services related
33to institutions for mental disease facilities from counties with a
34population of 150,000 or less based on the most recent available
35 estimates of population data as determined by the Population
36Research Unit of the Department of Finance.

37

begin deleteSEC. 60.end delete
38begin insertSEC. 47.end insert  

Section 6002.25 of the Welfare and Institutions Code
39 is amended to read:

P124  1

6002.25.  

The independent clinical review shall be conducted
2by a licensed psychiatrist with training and experience in treating
3psychiatric adolescent patients, who is a neutral party to the review,
4having no direct financial relationship with the treating clinician,
5nor a personal or financial relationship with the patient, or his or
6her parents or guardian. Nothing in this section shall prevent a
7psychiatrist affiliated with a health maintenance organization, as
8defined in subdivision (b) of Section 1373.10 of the Health and
9Safety Code, from providing the independent clinical review where
10the admitting, treating, and reviewing psychiatrists are affiliated
11with a health maintenance organization that predominantly serves
12members of a prepaid health care service plan. The independent
13clinical reviewer shall be assigned, on a rotating basis, from a list
14prepared by the facility, and submitted to the county behavioral
15health director prior to March 1, 1990, and annually thereafter, or
16more frequently when necessary. The county behavioral health
17director shall, on an annual basis, or at the request of the facility,
18review the facility’s list of independent clinical reviewers. The
19county behavioral health director shall approve or disapprove the
20list of reviewers within 30 days of submission. If there is no
21response from the county behavioral health director, the facility’s
22list shall be deemed approved. If the county behavioral health
23director disapproves one or more of the persons on the list of
24reviewers, the county behavioral health director shall notify the
25facility in writing of the reasons for the disapproval. The county
26 behavioral health director, in consultation with the facility, may
27develop a list of one or more additional reviewers within 30 days.
28The final list shall be mutually agreeable to the county behavioral
29health director and the facility. Sections 6002.10 to 6002.40,
30inclusive, shall not be construed to prohibit the treatment of minors
31prior to the existence of an approved list of independent clinical
32reviewers. The independent clinical reviewer may be an active
33member of the medical staff of the facility who has no direct
34financial relationship, including, but not limited to, an employment
35or other contract arrangement with the facility except for
36compensation received for the service of providing clinical reviews.

37

begin deleteSEC. 61.end delete
38begin insertSEC. 48.end insert  

Section 8103 of the Welfare and Institutions Code is
39amended to read:

P125  1

8103.  

(a) (1) No person who after October 1, 1955, has been
2adjudicated by a court of any state to be a danger to others as a
3result of a mental disorder or mental illness, or who has been
4adjudicated to be a mentally disordered sex offender, shall purchase
5or receive, or attempt to purchase or receive, or have in his or her
6possession, custody, or control a firearm or any other deadly
7weapon unless there has been issued to the person a certificate by
8the court of adjudication upon release from treatment or at a later
9date stating that the person may possess a firearm or any other
10deadly weapon without endangering others, and the person has
11not, subsequent to the issuance of the certificate, again been
12adjudicated by a court to be a danger to others as a result of a
13mental disorder or mental illness.

14(2) The court shall notify the Department of Justice of the court
15order finding the individual to be a person described in paragraph
16(1) as soon as possible, but not later than one court day after issuing
17the order. The court shall also notify the Department of Justice of
18any certificate issued as described in paragraph (1) as soon as
19possible, but not later than one court day after issuing the
20certificate.

21(b) (1) No person who has been found, pursuant to Section
221026 of the Penal Code or the law of any other state or the United
23States, not guilty by reason of insanity of murder, mayhem, a
24violation of Section 207, 209, or 209.5 of the Penal Code in which
25the victim suffers intentionally inflicted great bodily injury,
26carjacking or robbery in which the victim suffers great bodily
27injury, a violation of Section 451 or 452 of the Penal Code
28involving a trailer coach, as defined in Section 635 of the Vehicle
29Code, or any dwelling house, a violation of paragraph (1) or (2)
30of subdivision (a) of Section 262 or paragraph (2) or (3) of
31subdivision (a) of Section 261 of the Penal Code, a violation of
32Section 459 of the Penal Code in the first degree, assault with
33intent to commit murder, a violation of Section 220 of the Penal
34Code in which the victim suffers great bodily injury, a violation
35of Section 18715, 18725, 18740, 18745, 18750, or 18755 of the
36Penal Code, or of a felony involving death, great bodily injury, or
37an act which poses a serious threat of bodily harm to another
38person, or a violation of the law of any other state or the United
39States that includes all the elements of any of the above felonies
40as defined under California law, shall purchase or receive, or
P126  1attempt to purchase or receive, or have in his or her possession or
2under his or her custody or control any firearm or any other deadly
3weapon.

4(2) The court shall notify the Department of Justice of the court
5order finding the person to be a person described in paragraph (1)
6as soon as possible, but not later than, one court day after issuing
7the order.

8(c) (1) No person who has been found, pursuant to Section 1026
9of the Penal Code or the law of any other state or the United States,
10not guilty by reason of insanity of any crime other than those
11described in subdivision (b) shall purchase or receive, or attempt
12to purchase or receive, or shall have in his or her possession,
13custody, or control any firearm or any other deadly weapon unless
14the court of commitment has found the person to have recovered
15sanity, pursuant to Section 1026.2 of the Penal Code or the law of
16any other state or the United States.

17(2) The court shall notify the Department of Justice of the court
18order finding the person to be a person described in paragraph (1)
19as soon as possible, but not later than one court day after issuing
20the order. The court shall also notify the Department of Justice
21when it finds that the person has recovered his or her sanity as
22soon as possible, but not later than one court day after making the
23finding.

24(d) (1) No person found by a court to be mentally incompetent
25to stand trial, pursuant to Section 1370 or 1370.1 of the Penal Code
26or the law of any other state or the United States, shall purchase
27or receive, or attempt to purchase or receive, or shall have in his
28or her possession, custody, or control, any firearm or any other
29deadly weapon, unless there has been a finding with respect to the
30person of restoration to competence to stand trial by the committing
31court, pursuant to Section 1372 of the Penal Code or the law of
32any other state or the United States.

33(2) The court shall notify the Department of Justice of the court
34order finding the person to be mentally incompetent as described
35in paragraph (1) as soon as possible, but not later than one court
36day after issuing the order. The court shall also notify the
37Department of Justice when it finds that the person has recovered
38his or her competence as soon as possible, but not later than one
39 court day after making the finding.

P127  1(e) (1) No person who has been placed under conservatorship
2by a court, pursuant to Section 5350 or the law of any other state
3or the United States, because the person is gravely disabled as a
4result of a mental disorder or impairment by chronic alcoholism,
5shall purchase or receive, or attempt to purchase or receive, or
6shall have in his or her possession, custody, or control, any firearm
7or any other deadly weapon while under the conservatorship if, at
8the time the conservatorship was ordered or thereafter, the court
9that imposed the conservatorship found that possession of a firearm
10or any other deadly weapon by the person would present a danger
11to the safety of the person or to others. Upon placing a person
12under conservatorship, and prohibiting firearm or any other deadly
13weapon possession by the person, the court shall notify the person
14of this prohibition.

15(2) The court shall notify the Department of Justice of the court
16order placing the person under conservatorship and prohibiting
17firearm or any other deadly weapon possession by the person as
18described in paragraph (1) as soon as possible, but not later than
19one court day after placing the person under conservatorship. The
20notice shall include the date the conservatorship was imposed and
21the date the conservatorship is to be terminated. If the
22conservatorship is subsequently terminated before the date listed
23in the notice to the Department of Justice or the court subsequently
24finds that possession of a firearm or any other deadly weapon by
25the person would no longer present a danger to the safety of the
26person or others, the court shall notify the Department of Justice
27as soon as possible, but not later than one court day after
28terminating the conservatorship.

29(3) All information provided to the Department of Justice
30pursuant to paragraph (2) shall be kept confidential, separate, and
31apart from all other records maintained by the Department of
32Justice, and shall be used only to determine eligibility to purchase
33or possess firearms or other deadly weapons. A person who
34knowingly furnishes that information for any other purpose is
35guilty of a misdemeanor. All the information concerning any person
36shall be destroyed upon receipt by the Department of Justice of
37notice of the termination of conservatorship as to that person
38pursuant to paragraph (2).

39(f) (1) No person who has been (A) taken into custody as
40provided in Section 5150 because that person is a danger to himself,
P128  1herself, or to others, (B) assessed within the meaning of Section
25151, and (C) admitted to a designated facility within the meaning
3of Sections 5151 and 5152 because that person is a danger to
4himself, herself, or others, shall own, possess, control, receive, or
5purchase, or attempt to own, possess, control, receive, or purchase
6any firearm for a period of five years after the person is released
7from the facility. A person described in the preceding sentence,
8however, may own, possess, control, receive, or purchase, or
9attempt to own, possess, control, receive, or purchase any firearm
10if the superior court has, pursuant to paragraph (5), found that the
11people of the State of California have not met their burden pursuant
12to paragraph (6).

13(2) (A) For each person subject to this subdivision, the facility
14shall, within 24 hours of the time of admission, submit a report to
15the Department of Justice, on a form prescribed by the Department
16of Justice, containing information that includes, but is not limited
17to, the identity of the person and the legal grounds upon which the
18person was admitted to the facility.

19Any report submitted pursuant to this paragraph shall be
20confidential, except for purposes of the court proceedings described
21in this subdivision and for determining the eligibility of the person
22to own, possess, control, receive, or purchase a firearm.

23(B) Commencing July 1, 2012, facilities shall submit reports
24pursuant to this paragraph exclusively by electronic means, in a
25manner prescribed by the Department of Justice.

26(3) Prior to, or concurrent with, the discharge, the facility shall
27inform a person subject to this subdivision that he or she is
28prohibited from owning, possessing, controlling, receiving, or
29purchasing any firearm for a period of five years. Simultaneously,
30the facility shall inform the person that he or she may request a
31hearing from a court, as provided in this subdivision, for an order
32permitting the person to own, possess, control, receive, or purchase
33a firearm. The facility shall provide the person with a form for a
34request for a hearing. The Department of Justice shall prescribe
35the form. Where the person requests a hearing at the time of
36discharge, the facility shall forward the form to the superior court
37unless the person states that he or she will submit the form to the
38superior court.

39(4) The Department of Justice shall provide the form upon
40request to any person described in paragraph (1). The Department
P129  1of Justice shall also provide the form to the superior court in each
2county. A person described in paragraph (1) may make a single
3request for a hearing at any time during the five-year period. The
4request for hearing shall be made on the form prescribed by the
5department or in a document that includes equivalent language.

6(5) A person who is subject to paragraph (1) who has requested
7a hearing from the superior court of his or her county of residence
8for an order that he or she may own, possess, control, receive, or
9purchase firearms shall be given a hearing. The clerk of the court
10shall set a hearing date and notify the person, the Department of
11Justice, and the district attorney. The people of the State of
12California shall be the plaintiff in the proceeding and shall be
13represented by the district attorney. Upon motion of the district
14attorney, or on its own motion, the superior court may transfer the
15hearing to the county in which the person resided at the time of
16his or her detention, the county in which the person was detained,
17or the county in which the person was evaluated or treated. Within
18seven days after the request for a hearing, the Department of Justice
19shall file copies of the reports described in this section with the
20superior court. The reports shall be disclosed upon request to the
21person and to the district attorney. The court shall set the hearing
22within 30 days of receipt of the request for a hearing. Upon
23showing good cause, the district attorney shall be entitled to a
24continuance not to exceed 14 days after the district attorney was
25notified of the hearing date by the clerk of the court. If additional
26continuances are granted, the total length of time for continuances
27shall not exceed 60 days. The district attorney may notify the
28county behavioral health director of the hearing who shall provide
29information about the detention of the person that may be relevant
30to the court and shall file that information with the superior court.
31That information shall be disclosed to the person and to the district
32attorney. The court, upon motion of the person subject to paragraph
33(1) establishing that confidential information is likely to be
34discussed during the hearing that would cause harm to the person,
35shall conduct the hearing in camera with only the relevant parties
36present, unless the court finds that the public interest would be
37better served by conducting the hearing in public. Notwithstanding
38any other law, declarations, police reports, including criminal
39history information, and any other material and relevant evidence
P130  1that is not excluded under Section 352 of the Evidence Code shall
2be admissible at the hearing under this section.

3(6) The people shall bear the burden of showing by a
4preponderance of the evidence that the person would not be likely
5to use firearms in a safe and lawful manner.

6(7) If the court finds at the hearing set forth in paragraph (5)
7that the people have not met their burden as set forth in paragraph
8(6), the court shall order that the person shall not be subject to the
9five-year prohibition in this section on the ownership, control,
10receipt, possession, or purchase of firearms, and that person shall
11comply with the procedure described in Chapter 2 (commencing
12with Section 33850) of Division 11 of Title 4 of Part 6 of the Penal
13Code for the return of any firearms. A copy of the order shall be
14submitted to the Department of Justice. Upon receipt of the order,
15the Department of Justice shall delete any reference to the
16prohibition against firearms from the person’s state mental health
17firearms prohibition system information.

18(8) Where the district attorney declines or fails to go forward
19in the hearing, the court shall order that the person shall not be
20subject to the five-year prohibition required by this subdivision
21on the ownership, control, receipt, possession, or purchase of
22firearms. A copy of the order shall be submitted to the Department
23of Justice. Upon receipt of the order, the Department of Justice
24shall, within 15 days, delete any reference to the prohibition against
25firearms from the person’s state mental health firearms prohibition
26system information, and that person shall comply with the
27procedure described in Chapter 2 (commencing with Section
2833850) of Division 11 of Title 4 of Part 6 of the Penal Code for
29the return of any firearms.

30(9) Nothing in this subdivision shall prohibit the use of reports
31filed pursuant to this section to determine the eligibility of persons
32to own, possess, control, receive, or purchase a firearm if the person
33is the subject of a criminal investigation, a part of which involves
34the ownership, possession, control, receipt, or purchase of a
35firearm.

36(g) (1) No person who has been certified for intensive treatment
37under Section 5250, 5260, or 5270.15 shall own, possess, control,
38receive, or purchase, or attempt to own, possess, control, receive,
39or purchase, any firearm for a period of five years.

P131  1Any person who meets the criteria contained in subdivision (e)
2or (f) who is released from intensive treatment shall nevertheless,
3if applicable, remain subject to the prohibition contained in
4subdivision (e) or (f).

5(2) (A) For each person certified for intensive treatment under
6paragraph (1), the facility shall, within 24 hours of the certification,
7submit a report to the Department of Justice, on a form prescribed
8by the department, containing information regarding the person,
9including, but not limited to, the legal identity of the person and
10the legal grounds upon which the person was certified. A report
11submitted pursuant to this paragraph shall only be used for the
12purposes specified in paragraph (2) of subdivision (f).

13(B) Commencing July 1, 2012, facilities shall submit reports
14pursuant to this paragraph exclusively by electronic means, in a
15manner prescribed by the Department of Justice.

16(3) Prior to, or concurrent with, the discharge of each person
17certified for intensive treatment under paragraph (1), the facility
18shall inform the person of that information specified in paragraph
19(3) of subdivision (f).

20(4) A person who is subject to paragraph (1) may petition the
21superior court of his or her county of residence for an order that
22he or she may own, possess, control, receive, or purchase firearms.
23At the time the petition is filed, the clerk of the court shall set a
24hearing date and notify the person, the Department of Justice, and
25the district attorney. The people of the State of California shall be
26the respondent in the proceeding and shall be represented by the
27district attorney. Upon motion of the district attorney, or on its
28own motion, the superior court may transfer the petition to the
29county in which the person resided at the time of his or her
30detention, the county in which the person was detained, or the
31county in which the person was evaluated or treated. Within seven
32days after receiving notice of the petition, the Department of Justice
33shall file copies of the reports described in this section with the
34superior court. The reports shall be disclosed upon request to the
35person and to the district attorney. The district attorney shall be
36entitled to a continuance of the hearing to a date of not less than
3714 days after the district attorney was notified of the hearing date
38by the clerk of the court. The district attorney may notify the county
39behavioral health director of the petition, and the county behavioral
40health director shall provide information about the detention of
P132  1the person that may be relevant to the court and shall file that
2information with the superior court. That information shall be
3disclosed to the person and to the district attorney. The court, upon
4motion of the person subject to paragraph (1) establishing that
5confidential information is likely to be discussed during the hearing
6that would cause harm to the person, shall conduct the hearing in
7camera with only the relevant parties present, unless the court finds
8that the public interest would be better served by conducting the
9hearing in public. Notwithstanding any other law, any declaration,
10police reports, including criminal history information, and any
11other material and relevant evidence that is not excluded under
12Section 352 of the Evidence Code, shall be admissible at the
13hearing under this section. If the court finds by a preponderance
14of the evidence that the person would be likely to use firearms in
15a safe and lawful manner, the court may order that the person may
16own, control, receive, possess, or purchase firearms, and that person
17shall comply with the procedure described in Chapter 2
18(commencing with Section 33850) of Division 11 of Title 4 of Part
196 of the Penal Code for the return of any firearms. A copy of the
20order shall be submitted to the Department of Justice. Upon receipt
21of the order, the Department of Justice shall delete any reference
22to the prohibition against firearms from the person’s state mental
23health firearms prohibition system information.

24(h) (1) For all persons identified in subdivisions (f) and (g),
25facilities shall report to the Department of Justice as specified in
26those subdivisions, except facilities shall not report persons under
27subdivision (g) if the same persons previously have been reported
28under subdivision (f).

29(2) Additionally, all facilities shall report to the Department of
30Justice upon the discharge of persons from whom reports have
31been submitted pursuant to subdivision (f) or (g). However, a report
32shall not be filed for persons who are discharged within 31 days
33after the date of admission.

34(i) Every person who owns or possesses or has under his or her
35custody or control, or purchases or receives, or attempts to purchase
36or receive, any firearm or any other deadly weapon in violation of
37this section shall be punished by imprisonment pursuant to
38subdivision (h) of Section 1170 of the Penal Code or in a county
39jail for not more than one year.

P133  1(j) “Deadly weapon,” as used in this section, has the meaning
2prescribed by Section 8100.

3(k) Any notice or report required to be submitted to the
4Department of Justice pursuant to this section shall be submitted
5in an electronic format, in a manner prescribed by the Department
6of Justice.

7

begin deleteSEC. 62.end delete
8begin insertSEC. 49.end insert  

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

10

11467.  

(a) The State Department of Social Services, with the
11advice and assistance of the County Welfare Directors Association
12of California, the Chief Probation Officers of California, the
13County Behavioral Health Directors Association of California,
14research entities, foster youth and advocates for foster youth, foster
15care provider business entities organized and operated on a
16nonprofit basis, tribes, and other stakeholders, shall establish a
17working group to develop performance standards and outcome
18measures for providers of out-of-home care placements made under
19the AFDC-FC program, including, but not limited to, foster family
20agency, group home, and THP-Plus providers, and for the effective
21and efficient administration of the AFDC-FC program.

22(b) The performance standards and outcome measures shall
23employ the applicable performance standards and outcome
24measures as set forth in Sections 11469 and 11469.1, designed to
25identify the degree to which foster care providers, including
26business entities organized and operated on a nonprofit basis, are
27providing out-of-home placement services that meet the needs of
28foster children, and the degree to which these services are
29supporting improved outcomes, including those identified by the
30California Child and Family Service Review System.

31(c) In addition to the process described in subdivision (a), the
32working group may also develop the following:

33(1) A means of identifying the child’s needs and determining
34which is the most appropriate out-of-home placement for a child.

35(2) A procedure for identifying children who have been in
36congregate care for one year or longer, determining the reasons
37each child remains in congregate care, and developing a plan for
38each child to transition to a less restrictive, more family-like setting.

P134  1(d) The department shall provide updates regarding its progress
2toward meeting the requirements of this section during the 2013
3and 2014 budget hearings.

4(e) Notwithstanding the rulemaking provisions of the
5Administrative Procedure Act (Chapter 3.5 (commencing with
6Section 13340) of Part 1 of Division 3 of Title 2 of the Government
7Code), until the enactment of applicable state law, or October 1,
82015, whichever is earlier, the department may implement the
9changes made pursuant to this section through all-county letters,
10or similar instructions from the director.

11

begin deleteSEC. 63.end delete
12begin insertSEC. 50.end insert  

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

14

11469.  

(a) The department, in consultation with group home
15providers, the County Welfare Directors Association of California,
16the Chief Probation Officers of California, the County Behavioral
17Health Directors Association of California, and the State
18Department of Health Care Services, shall develop performance
19standards and outcome measures for determining the effectiveness
20of the care and supervision, as defined in subdivision (b) of Section
2111460, provided by group homes under the AFDC-FC program
22pursuant to Sections 11460 and 11462. These standards shall be
23designed to measure group home program performance for the
24client group that the group home program is designed to serve.

25(1) The performance standards and outcome measures shall be
26designed to measure the performance of group home programs in
27areas over which the programs have some degree of influence, and
28in other areas of measurable program performance that the
29department can demonstrate are areas over which group home
30programs have meaningful managerial or administrative influence.

31(2) These standards and outcome measures shall include, but
32are not limited to, the effectiveness of services provided by each
33group home program, and the extent to which the services provided
34by the group home assist in obtaining the child welfare case plan
35objectives for the child.

36(3) In addition, when the group home provider has identified
37as part of its program for licensing, ratesetting, or county placement
38purposes, or has included as a part of a child’s case plan by mutual
39agreement between the group home and the placing agency,
40specific mental health, education, medical, and other child-related
P135  1services, the performance standards and outcome measures may
2also measure the effectiveness of those services.

3(b) Regulations regarding the implementation of the group home
4performance standards system required by this section shall be
5adopted no later than one year prior to implementation. The
6regulations shall specify both the performance standards system
7and the manner by which the AFDC-FC rate of a group home
8program shall be adjusted if performance standards are not met.

9(c) Except as provided in subdivision (d), effective July 1, 1995,
10group home performance standards shall be implemented. Any
11group home program not meeting the performance standards shall
12have its AFDC-FC rate, set pursuant to Section 11462, adjusted
13according to the regulations required by this section.

14(d) Effective July 1, 1995, group home programs shall be
15classified at rate classification level 13 or 14 only if all of the
16following are met:

17(1) The program generates the requisite number of points for
18rate classification level 13 or 14.

19(2) The program only accepts children with special treatment
20needs as determined through the assessment process pursuant to
21paragraph (2) of subdivision (a) of Section 11462.01.

22(3) The program meets the performance standards designed
23pursuant to this section.

24(e) Notwithstanding subdivision (c), the group home program
25performance standards system shall not be implemented prior to
26the implementation of the AFDC-FC performance standards
27system.

28(f) By January 1, 2016, the department, in consultation with the
29County Welfare Directors Association of California, the Chief
30Probation Officers of California, the County Behavioral Health
31Directors Association of California, research entities, foster youth
32and advocates for foster youth, foster care provider business entities
33organized and operated on a nonprofit basis, Indian tribes, and
34other stakeholders, shall develop additional performance standards
35and outcome measures that require group homes to implement
36programs and services to minimize law enforcement contacts and
37delinquency petition filings arising from incidents of allegedly
38unlawful behavior by minors occurring in group homes or under
39the supervision of group home staff, including individualized
P136  1behavior management programs, emergency intervention plans,
2and conflict resolution processes.

3

begin deleteSEC. 64.end delete
4begin insertSEC. 51.end insert  

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

6

14021.4.  

(a) California’s plan for federal Medi-Cal grants for
7medical assistance programs, pursuant to Subchapter XIX
8(commencing with Section 1396) of Title 42 of the United States
9Code, shall accomplish the following objectives:

10(1) Expansion of the location and type of therapeutic services
11offered to persons with mental illnesses under Medi-Cal by the
12category of “other diagnostic, screening, preventative, and
13rehabilitative services” that is available to states under the federal
14Social Security Act and its implementing regulations (42 U.S.C.
15Sec. 1396d(a)(13); 42 C.F.R. 440.130).

16(2) Expansion of federal financial participation in the costs of
17specialty mental health services provided by local mental health
18plans or under contract with the mental health plans.

19(3) Expansion of the location where reimbursable specialty
20mental health services can be provided, including home, school,
21and community-based sites.

22(4) Expansion of federal financial participation for services that
23meet the rehabilitation needs of persons with mental illnesses,
24including, but not limited to, medication management, functional
25rehabilitation assessments of clients, and rehabilitative services
26that include remedial services directed at restoration to the highest
27possible functional level for persons with mental illnesses and
28maximum reduction of symptoms of mental illness.

29(5) Improvement of fiscal systems and accountability structures
30for specialty mental health services, costs, and rates, with the goal
31of achieving federal fiscal requirements.

32(b) The department’s state plan revision shall be completed with
33review and comments by the County Behavioral Health Directors
34Association of California and other appropriate groups.

35(c)  Services under the rehabilitative option shall be limited to
36specialty mental health plans certified to provide Medi-Cal under
37this option.

38(d) It is the intent of the Legislature that the rehabilitation option
39of the state Medicaid plan be implemented to expand and provide
P137  1flexibility to treatment services and to increase the federal
2participation without increasing the costs to the General Fund.

3(e) The department shall review and revise the quality assurance
4standards and guidelines required by Section 14725 to ensure that
5quality services are delivered to the eligible population. Any
6reviews shall include, but not be limited to, appropriate use of
7mental health professionals, including psychiatrists, in the treatment
8and rehabilitation of clients under this model. The existing quality
9assurance standards and guidelines shall remain in effect until the
10adoption of the new quality assurance standards and guidelines.

11(f) Consistent with services offered to persons with mental
12illnesses under the Medi-Cal program, as required by this section,
13it is the intent of the Legislature for the department to include care
14and treatment of persons with mental illnesses who are eligible
15for the Medi-Cal program in facilities with a bed capacity of 16
16beds or less.

17

begin deleteSEC. 65.end delete
18begin insertSEC. 52.end insert  

Section 14124.24 of the Welfare and Institutions
19Code
is amended to read:

20

14124.24.  

(a) For purposes of this section, “Drug Medi-Cal
21reimbursable services” means the substance use disorder services
22described in the California Medicaid State Plan and includes, but
23is not limited to, all of the following services, administered by the
24department, and to the extent consistent with state and federal law:

25(1) Narcotic treatment program services, as set forth in Section
2614021.51.

27(2) Day care rehabilitative services.

28(3) Perinatal residential services for pregnant women and women
29in the postpartum period.

30(4) Naltrexone services.

31(5) Outpatient drug-free services.

32(6) Other services upon approval of a federal Medicaid state
33plan amendment or waiver authorizing federal financial
34participation.

35(b) (1) While seeking federal approval for any federal Medicaid
36state plan amendment or waiver associated with Drug Medi-Cal
37services, the department shall consult with the counties and
38stakeholders in the development of the state plan amendment or
39waiver.

P138  1(2) Upon federal approval of a federal Medicaid state plan
2amendment authorizing federal financial participation in the
3following services, and subject to appropriation of funds, “Drug
4 Medi-Cal reimbursable services” shall also include the following
5services, administered by the department, and to the extent
6consistent with state and federal law:

7(A) Notwithstanding subdivision (a) of Section 14132.90, day
8care habilitative services, which, for purposes of this paragraph,
9are outpatient counseling and rehabilitation services provided to
10persons with substance use disorder diagnoses.

11(B) Case management services, including supportive services
12to assist persons with substance use disorder diagnoses in gaining
13access to medical, social, educational, and other needed services.

14(C) Aftercare services.

15(c) (1) The nonfederal share for Drug Medi-Cal services shall
16be funded through a county’s Behavioral Health Subaccount of
17the Support Services Account of the Local Revenue Fund 2011,
18and any other available county funds eligible under federal law
19for federal Medicaid reimbursement. The funds contained in each
20county’s Behavioral Health Subaccount of the Support Services
21Account of the Local Revenue Fund 2011 shall be considered state
22funds distributed by the principal state agency for the purposes of
23receipt of the federal block grant funds for prevention and treatment
24of substance abuse found at Subchapter XVII of Chapter 6A of
25Title 42 of the United States Code. Pursuant to applicable federal
26Medicaid law and regulations including Section 433.51 of Title
2742 of the Code of Federal Regulations, counties may claim
28allowable Medicaid federal financial participation for Drug
29Medi-Cal services based on the counties certifying their actual
30total funds expenditures for eligible Drug Medi-Cal services to
31the department.

32(2) (A) If the director determines that a county’s provision of
33Drug Medi-Cal treatment services are disallowed by the federal
34government or by state or federal audit or review, the impacted
35county shall be responsible for repayment of all disallowed federal
36funds. In addition to any other recovery methods available,
37including, but not limited to, offset of Medicaid federal financial
38participation funds owed to the impacted county, the director may
39offset these amounts in accordance with Section 12419.5 of the
40Government Code.

P139  1(B) A county subject to an action by the director pursuant to
2subparagraph (A) may challenge that action by requesting a hearing
3in writing no later than 30 days from receipt of notice of the
4department’s action. The proceeding shall be conducted in
5accordance with Chapter 5 (commencing with Section 11500) of
6Part 1 of Division 3 of Title 2 of the Government Code, and the
7director has all the powers granted therein. Upon a county’s timely
8request for hearing, the county’s obligation to make payment as
9determined by the director shall be stayed pending the county’s
10 exhaustion of administrative remedies provided herein but no
11longer than will ensure the department’s compliance with Section
121903(d)(2)(C) of the federal Social Security Act (42 U.S.C. Sec.
131396b).

14(d) Drug Medi-Cal services are only reimbursable to Drug
15Medi-Cal providers with an approved Drug Medi-Cal contract.

16(e) Counties shall negotiate contracts only with providers
17certified to provide Drug Medi-Cal services.

18(f) The department shall develop methods to ensure timely
19payment of Drug Medi-Cal claims.

20(g) (1) A county or a contracted provider, except for a provider
21to whom subdivision (h) applies, shall submit accurate and
22complete cost reports for the previous fiscal year by November 1,
23following the end of the fiscal year. The department may settle
24Drug Medi-Cal reimbursable services, based on the cost report as
25the final amendment to the approved county Drug Medi-Cal
26contract.

27(2) Amounts paid for services provided to Drug Medi-Cal
28beneficiaries shall be audited by the department in the manner and
29form described in Section 14170.

30(3) Administrative appeals to review grievances or complaints
31arising from the findings of an audit or examination made pursuant
32to this section shall be subject to Section 14171.

33(h) Certified narcotic treatment program providers that are
34exclusively billing the state or the county for services rendered to
35persons subject to Section 1210.1 or 3063.1 of the Penal Code or
36Section 14021.52 of this code shall submit accurate and complete
37performance reports for the previous state fiscal year by November
381 following the end of that fiscal year. A provider to which this
39subdivision applies shall estimate its budgets using the uniform
40state daily reimbursement rate. The format and content of the
P140  1performance reports shall be mutually agreed to by the department,
2the County Behavioral Health Directors Association of California,
3and representatives of the treatment providers.

4(i) Contracts entered into pursuant to this section shall be exempt
5from the requirements of Chapter 1 (commencing with Section
610100) and Chapter 2 (commencing with Section 10290) of Part
72 of Division 2 of the Public Contract Code.

8(j) Annually, the department shall publish procedures for
9contracting for Drug Medi-Cal services with certified providers
10and for claiming payments, including procedures and specifications
11for electronic data submission for services rendered.

12(k) If the department commences a preliminary criminal
13investigation of a certified provider, the department shall promptly
14notify each county that currently contracts with the provider for
15Drug Medi-Cal services that a preliminary criminal investigation
16has commenced. If the department concludes a preliminary criminal
17investigation of a certified provider, the department shall promptly
18notify each county that currently contracts with the provider for
19Drug Medi-Cal services that a preliminary criminal investigation
20has concluded.

21(1) Notice of the commencement and conclusion of a
22preliminary criminal investigation pursuant to this section shall
23be made to the county behavioral health director or his or her
24equivalent.

25(2) Communication between the department and a county
26specific to the commencement or conclusion of a preliminary
27criminal investigation pursuant to this section shall be deemed
28confidential and shall not be subject to any disclosure request,
29including, but not limited to, the Information Practices Act of 1977
30(Chapter 1 (commencing with Section 1798) of Title 1.8 of Part
314 of Division 3 of the Civil Code), the California Public Records
32Act (Chapter 3.5 (commencing with Section 6250) of Division 7
33of Title 1 of the Government Code), requests pursuant to a
34subpoena, or for any other public purpose, including, but not
35limited to, court testimony.

36(3) Information shared by the department with a county
37regarding a preliminary criminal investigation shall be maintained
38in a manner to ensure protection of the confidentiality of the
39criminal investigation.

P141  1(4) The information provided to a county pursuant to this section
2shall only include the provider name, national provider identifier
3(NPI) number, address, and the notice that an investigation has
4commenced or concluded.

5(5) A county shall not take any adverse action against a provider
6based solely upon the preliminary criminal investigation
7information disclosed to the county pursuant to this section.

8(6) In the event of a preliminary criminal investigation of a
9county owned or operated program, the department has the option
10to, but is not required to, notify the county pursuant to this section
11when the department commences or concludes a preliminary
12criminal investigation.

13(7) This section shall not limit the voluntary or otherwise legally
14mandated or contractually mandated sharing of information
15between the department and a county of information regarding
16audits and investigations of Drug Medi-Cal providers.

17(8) “Commenced” means the time at which a complaint or
18allegation is assigned to an investigator for a field investigation.

19(9) “Preliminary criminal investigation” means an investigation
20to gather information to determine if criminal law or statutes have
21been violated.

22

begin deleteSEC. 66.end delete
23begin insertSEC. 53.end insert  

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

25

14251.  

(a) (1) “Prepaid health plan” means a plan that meets
26all of the following criteria:

27(A)  Is licensed as a health care service plan by the Director of
28the Department of Managed Health Care pursuant to the
29Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2
30(commencing with Section 1340) of Division 2 of the Health and
31Safety Code), other than a plan organized and operating pursuant
32to Section 10810 of the Corporations Code that substantially
33indemnifies subscribers or enrollees for the cost of provided
34services, or has an application for licensure pending and was
35registered under the Knox-Mills Health Plan Act prior to its repeal.

36(B) Meets the requirements for participation in the Medicaid
37Program (Title XIX of the Social Security Act) on an at risk basis.

38(C) Agrees with the State Department of Health Care Services
39to furnish directly or indirectly health services to Medi-Cal
40beneficiaries on a predetermined periodic rate basis.

P142  1(2) “Prepaid health plan” includes any organization that is
2licensed as a plan pursuant to the Knox-Keene Health Care Service
3Plan Act of 1975 and is subject to regulation by the Department
4of Managed Health Care pursuant to that act, and that contracts
5with the State Department of Health Care Services solely as a fiscal
6intermediary at risk.

7(b) (1) Except for the requirement of licensure pursuant to the
8Knox-Keene Health Care Service Plan Act of 1975, the State
9Director of Health Care Services may waive any provision of this
10chapter that the director determines is inappropriate for a fiscal
11intermediary at risk. An exemption or waiver shall be set forth in
12the fiscal intermediary at-risk contract with the State Department
13of Health Care Services.

14(2) “Fiscal intermediary at risk” means any entity that entered
15into a contract with the State Department of Health Care Services
16on a pilot basis pursuant to subdivision (f) of Section 14000, as in
17effect June 1, 1973, in accordance with which the entity received
18capitated payments from the state and reimbursed providers of
19health care services on a fee-for-service or other basis for at least
20the basic scope of health care services, as defined in Section 14256,
21provided to all beneficiaries covered by the contract residing within
22a specified geographic region of the state. The fiscal intermediary
23at risk shall be at risk for the cost of administration and utilization
24of services or the cost of services, or both, for at least the basic
25scope of health care services, as defined in Section 14256, provided
26to all beneficiaries covered by the contract residing within a
27specified geographic region of the state. The fiscal intermediary
28at risk may share the risk with providers or reinsuring agencies or
29both. Eligibility of beneficiaries shall be determined by the State
30Department of Health Care Services and capitation payments shall
31be based on the number of beneficiaries so determined.

32

begin deleteSEC. 67.end delete
33begin insertSEC. 54.end insert  

Section 14499.71 of the Welfare and Institutions
34Code
is amended to read:

35

14499.71.  

For the purposes of this article, “fiscal intermediary”
36means an entity that agrees to pay for covered services provided
37to Medi-Cal eligibles in exchange for a premium, subscription
38charge, or capitation payment; to assume an underwriting risk; and
39is licensed by the Director of the Department of Managed Health
40Care under the Knox-Keene Health Care Service Plan Act of 1975
P143  1 (Chapter 2.2 (commencing with Section 1340) of Division 2 of
2 the Health and Safety Code).

3

begin deleteSEC. 68.end delete
4begin insertSEC. 55.end insert  

Section 14682.1 of the Welfare and Institutions Code
5 is amended to read:

6

14682.1.  

(a) The State Department of Health Care Services
7shall be designated as the state agency responsible for development,
8consistent with the requirements of Section 4060, and
9implementation of, mental health plans for Medi-Cal beneficiaries.

10(b) The department shall convene a steering committee for the
11purpose of providing advice and recommendations on the transition
12and continuing development of the Medi-Cal mental health
13managed care systems pursuant to subdivision (a). The committee
14shall include work groups to advise the department of major issues
15to be addressed in the managed mental health care plan, as well
16as system transition and transformation issues pertaining to the
17delivery of mental health care services to Medi-Cal beneficiaries,
18including services to children provided through the Early and
19Periodic Screening, Diagnosis and Treatment Program.

20(c) The committee shall consist of diverse representatives of
21concerned and involved communities, including, but not limited
22to, beneficiaries, their families, providers, mental health
23professionals, substance use disorder treatment professionals,
24statewide representatives of health care service plans,
25representatives of the California Mental Health Planning Council,
26public and private organizations, county behavioral health directors,
27and others as determined by the department. The department has
28the authority to structure this steering committee process in a
29manner that is conducive for addressing issues effectively, and for
30providing a transparent, collaborative, meaningful process to ensure
31a more diverse and representative approach to problem-solving
32and dissemination of information.

33

begin deleteSEC. 69.end delete
34begin insertSEC. 56.end insert  

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

36

14707.  

(a) In the case of federal audit exceptions, the
37department shall follow federal audit appeal processes unless the
38department, in consultation with the County Behavioral Health
39Directors Association of California, determines that those appeals
40are not cost beneficial.

P144  1(b) Whenever there is a final federal audit exception against the
2state resulting from expenditure of federal funds by individual
3counties, the department may offset federal reimbursement and
4request the Controller’s office to offset the distribution of funds
5to the counties from the Mental Health Subaccount, the Mental
6Health Equity Subaccount, and the Vehicle License Collection
7Account of the Local Revenue Fund, funds from the Mental Health
8Account and the Behavioral Health Subaccount of the Local
9Revenue Fund 2011, and any other mental health realignment
10funds from which the Controller makes distributions to the counties
11by the amount of the exception. The department shall provide
12evidence to the Controller that the county has been notified of the
13amount of the audit exception no less than 30 days before the offset
14is to occur. The department shall involve the appropriate counties
15in developing responses to any draft federal audit reports that
16directly impact the county.

17

begin deleteSEC. 70.end delete
18begin insertSEC. 57.end insert  

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

20

14711.  

(a) The department shall develop, in consultation with
21the County Behavioral Health Directors Association of California,
22a reimbursement methodology for use in the Medi-Cal claims
23processing and interim payment system that maximizes federal
24funding and utilizes, as much as practicable, federal Medicaid and
25Medicare reimbursement principles. The department shall work
26with the federal Centers for Medicare and Medicaid Services in
27the development of the methodology required by this section.

28(b) Reimbursement amounts developed through the methodology
29required by this section shall be consistent with federal Medicaid
30requirements and the approved Medicaid state plan and waivers.

31(c) Administrative costs shall be claimed separately in a manner
32consistent with federal Medicaid requirements and the approved
33Medicaid state plan and waivers and shall be limited to 15 percent
34of the total actual cost of direct client services.

35(d) The cost of performing quality assurance and utilization
36review activities shall be reimbursed separately and shall not be
37included in administrative cost.

38(e) The reimbursement methodology established pursuant to
39this section shall be based upon certified public expenditures,
40which encourage economy and efficiency in service delivery.

P145  1(f) The reimbursement amounts established for direct client
2services pursuant to this section shall be based on increments of
3time for all noninpatient services.

4(g) The reimbursement methodology shall not be implemented
5until it has received any necessary federal approvals.

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

7

begin deleteSEC. 71.end delete
8begin insertSEC. 58.end insert  

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

10

14717.  

(a) In order to facilitate the receipt of medically
11necessary specialty mental health services by a foster child who
12is placed outside his or her county of original jurisdiction, the
13department shall take all of the following actions:

14(1) On or before July 1, 2008, create all of the following items,
15in consultation with stakeholders, including, but not limited to,
16the California Institute for Mental Health, the Child and Family
17Policy Institute of California, the County Behavioral Health
18Directors Association of California, and the California Alliance
19of Child and Family Services:

20(A) A standardized contract for the purchase of medically
21necessary specialty mental health services from organizational
22providers when a contract is required.

23(B) A standardized specialty mental health service authorization
24procedure.

25(C) A standardized set of documentation standards and forms,
26including, but not limited to, forms for treatment plans, annual
27treatment plan updates, day treatment intensive and day treatment
28rehabilitative progress notes, and treatment authorization requests.

29(2) On or before January 1, 2009, use the standardized items as
30described in paragraph (1) to provide medically necessary specialty
31mental health services to a foster child who is placed outside his
32or her county of original jurisdiction, so that organizational
33providers who are already certified by a mental health plan are not
34required to be additionally certified by the mental health plan in
35the county of original jurisdiction.

36(3) (A) On or before January 1, 2009, use the standardized
37items described in paragraph (1) to provide medically necessary
38specialty mental health services to a foster child placed outside
39his or her county of original jurisdiction to constitute a complete
P146  1contract, authorization procedure, and set of documentation
2standards and forms, so that no additional documents are required.

3(B) Authorize a county mental health plan to be exempt from
4subparagraph (A) and have an addendum to a contract,
5authorization procedure, or set of documentation standards and
6forms, if the county mental health plan has an externally placed
7requirement, such as a requirement from a federal integrity
8agreement, that would affect one of these documents.

9(4) Following consultation with stakeholders, including, but not
10limited to, the California Institute for Mental Health, the Child and
11Family Policy Institute of California, the County Behavioral Health
12Directors Association of California, the California State
13Association of Counties, and the California Alliance of Child and
14Family Services, require the use of the standardized contracts,
15authorization procedures, and documentation standards and forms
16as specified in paragraph (1) in the 2008-09 state-county mental
17health plan contract and each state-county mental health plan
18contract thereafter.

19(5) The mental health plan shall complete a standardized
20contract, as provided in paragraph (1), if a contract is required, or
21another mechanism of payment if a contract is not required, with
22a provider or providers of the county’s choice, to deliver approved
23specialty mental health services for a specified foster child, within
2430 days of an approved treatment authorization request.

25(b) The California Health and Human Services Agency shall
26coordinate the efforts of the department and the State Department
27of Social Services to do all of the following:

28(1) Participate with the stakeholders in the activities described
29in this section.

30(2) During budget hearings in 2008 and 2009, report to the
31Legislature regarding the implementation of this section and
32subdivision (c) of Section 14716.

33(3) On or before July 1, 2008, establish the following, in
34consultation with stakeholders, including, but not limited to, the
35County Behavioral Health Directors Association of California, the
36California Alliance of Child and Family Services, and the County
37Welfare Directors Association of California:

38(A) Informational materials that explain to foster care providers
39how to arrange for specialty mental health services on behalf of
40 the beneficiary in their care.

P147  1(B) Informational materials that county child welfare agencies
2can access relevant to the provision of services to children in their
3care from the out-of-county local mental health plan that is
4responsible for providing those services, including, but not limited
5to, receiving a copy of the child’s treatment plan within 60 days
6after requesting services.

7(C) It is the intent of the Legislature to ensure that foster children
8who are adopted or placed permanently with relative guardians,
9and who move to a county outside their original county of
10residence, can access specialty mental health services in a timely
11manner. It is the intent of the Legislature to enact this section as
12a temporary means of ensuring access to these services, while the
13appropriate stakeholders pursue a long-term solution in the form
14of a change to the Medi-Cal Eligibility Data System that will allow
15these children to receive specialty mental health services through
16their new county of residence.

17

begin deleteSEC. 72.end delete
18begin insertSEC. 59.end insert  

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

20

14718.  

(a) This section shall be limited to specialty mental
21health services reimbursed to a mental health plan that certifies
22public expenditures subject to cost settlement or specialty mental
23health services reimbursed through the department’s fiscal
24intermediary.

25(b) The following provisions shall apply to matters related to
26specialty mental health services provided under the approved
27Medi-Cal state plan and the Specialty Mental Health Services
28Waiver, including, but not limited to, reimbursement and claiming
29procedures, reviews and oversight, and appeal processes for mental
30health plans (MHPs) and MHP subcontractors.

31(1) As determined by the department, the MHP shall submit
32claims for reimbursement to the Medi-Cal program for eligible
33services.

34(2) The department may offset the amount of any federal
35disallowance, audit exception, or overpayment against subsequent
36claims from the MHP. The department may offset the amount of
37any state disallowance, or audit exception or overpayment against
38subsequent claims from the mental health plan, through the
392010-11 fiscal year. This offset may be done at any time, after the
40department has invoiced or otherwise notified the mental health
P148  1plan about the audit exception, disallowance, or overpayment. The
2department shall determine the amount that may be withheld from
3each payment to the mental health plan. The maximum withheld
4amount shall be 25 percent of each payment as long as the
5department is able to comply with the federal requirements for
6repayment of federal financial participation pursuant to Section
71903(d)(2) of the federal Social Security Act (42 U.S.C. Sec.
81396b(d)(2)). The department may increase the maximum amount
9when necessary for compliance with federal laws and regulations.

10(3) (A) Oversight by the department of the MHPs may include
11client record reviews of Early and Periodic Screening, Diagnosis,
12and Treatment (EPSDT) specialty mental health services rendered
13by MHPs and MHP subcontractors under the Medi-Cal specialty
14mental health services waiver in addition to other audits or reviews
15that are conducted.

16(B) The department may contract with an independent,
17nongovernmental entity to conduct client record reviews. The
18contract awarded in connection with this section shall be on a
19competitive bid basis, pursuant to the Department of General
20Services contracting requirements, and shall meet both of the
21following additional requirements:

22(i) Require the entity awarded the contract to comply with all
23federal and state privacy laws, including, but not limited to, the
24federal Health Insurance Portability and Accountability Act
25(HIPAA; 42 U.S.C. Sec. 1320d et seq.) and its implementing
26regulations, the Confidentiality of Medical Information Act (Part
272.6 (commencing with Section 56) of Division 1 of the Civil Code),
28and Section 1798.81.5 of the Civil Code. The entity shall be subject
29to existing penalties for violation of these laws.

30(ii) Prohibit the entity awarded the contract from using or
31disclosing client records or client information for a purpose other
32than the one for which the record was given.

33(iii) Prohibit the entity awarded the contract from selling client
34records or client information.

35(C) For purposes of this paragraph, the following terms shall
36have the following meanings:

37(i) “Client record” means a medical record, chart, or similar
38file, as well as other documents containing information regarding
39an individual recipient of services, including, but not limited to,
40clinical information, dates and times of services, and other
P149  1information relevant to the individual and services provided and
2that evidences compliance with legal requirements for Medi-Cal
3reimbursement.

4(ii) “Client record review” means examination of the client
5record for a selected individual recipient for the purpose of
6confirming the existence of documents that verify compliance with
7legal requirements for claims submitted for Medi-Cal
8reimbursement.

9(D) The department shall recover overpayments of federal
10financial participation from MHPs within the timeframes required
11by federal law and regulation for repayment to the federal Centers
12for Medicare and Medicaid Services.

13(4) (A) The department, in consultation with mental health
14stakeholders, the County Behavioral Health Directors Association
15of California, and MHP subcontractor representatives, shall provide
16an appeals process that specifies a progressive process for
17resolution of disputes about claims or recoupments relating to
18specialty mental health services under the Medi-Cal specialty
19mental health services waiver.

20(B) The department shall provide MHPs and MHP
21subcontractors the opportunity to directly appeal findings in
22 accordance with procedures that are similar to those described in
23Article 1.5 (commencing with Section 51016) of Chapter 3 of
24Subdivision 1 of Division 3 of Title 22 of the California Code of
25Regulations, until new regulations for a progressive appeals process
26are promulgated. When an MHP subcontractor initiates an appeal,
27it shall give notice to the MHP. The department shall propose a
28rulemaking package consistent with the department’s appeals
29process that is in effect on July 1, 2012, by no later than the end
30of the 2013-14 fiscal year. The reference in this subparagraph to
31the procedures described in Article 1.5 (commencing with Section
3251016) of Chapter 3 of Subdivision 1 of Division 3 of Title 22 of
33the California Code of Regulations, shall only apply to those
34appeals addressed in this subparagraph.

35(C) The department shall develop regulations as necessary to
36implement this paragraph.

37(5) The department shall conduct oversight of utilization controls
38as specified in Section 14133. The MHP shall include a
39requirement in any subcontracts that all inpatient subcontractors
40maintain necessary licensing and certification. MHPs shall require
P150  1that services delivered by licensed staff are within their scope of
2practice. Nothing in this chapter shall prohibit the MHPs from
3establishing standards that are in addition to the federal and state
4requirements, provided that these standards do not violate federal
5and state requirements and guidelines.

6(6) (A)  Subject to federal approval and consistent with state
7requirements, the MHP may negotiate rates with providers of
8specialty mental health services.

9(B) Any excess in the distribution of funds over the expenditures
10for services by the mental health plan shall be spent for the
11provision of specialty mental health services and related
12administrative costs.

13(7) Nothing in this chapter shall limit the MHP from being
14reimbursed appropriate federal financial participation for any
15qualified services. To receive federal financial participation, the
16mental health plan shall certify its public expenditures for specialty
17mental health services to the department.

18(8) Notwithstanding Section 14115, claims for federal
19reimbursement for service pursuant to this chapter shall be
20submitted by MHPs within the timeframes required by federal
21Medicaid requirements and the approved Medicaid state plan and
22waivers.

23(9) The MHP shall use the fiscal intermediary of the Medi-Cal
24program of the State Department of Health Care Services for the
25processing of claims for inpatient psychiatric hospital services
26rendered in fee-for-service Medi-Cal hospitals. The department
27shall request the Controller to offset the distribution of funds to
28the counties from the Mental Health Subaccount, the Mental Health
29Equity Subaccount, or the Vehicle License Collection Account of
30the Local Revenue Fund, or funds from the Mental Health Account
31or the Behavioral Health Subaccount of the Local Revenue Fund
322011 for the nonfederal financial participation share for these
33claims.

34(c) Counties may set aside funds for self-insurance, audit
35settlement, and statewide program risk pools. The counties shall
36assume all responsibility and liability for appropriate administration
37of the funds. Special consideration may be given to small counties
38with a population of less than 200,000. This subdivision shall not
39make the state or department liable for mismanagement or loss of
40funds by the entity designated by counties under this subdivision.

P151  1(d) The department shall consult with the County Behavioral
2Health Directors Association of California in February and
3September of each year to obtain data and methodology necessary
4to forecast future fiscal trends in the provision of specialty mental
5health services provided under the Medi-Cal specialty mental
6health services waiver, to estimate yearly specialty mental health
7services related costs, and to estimate the annual amount of federal
8funding participation to reimburse costs of specialty mental health
9services provided under the Medi-Cal specialty mental health
10services waiver. This shall include a separate presentation of the
11data and methodology necessary to forecast future fiscal trends in
12the provision of Early Periodic Screening, Diagnosis, and
13Treatment specialty mental health services provided under the
14Medi-Cal specialty mental health services waiver, to estimate
15annual EPSDT specialty mental health services related costs, and
16to estimate the annual amount of EPSDT specialty mental health
17services provided under the state Medi-Cal specialty mental health
18services waiver, including federal funding participation to
19reimburse costs of EPSDT.

20(e) When seeking federal approval for any federal Medicaid
21state plan amendment or waiver associated with Medi-Cal specialty
22mental health services, the department shall consult with staff of
23the Legislature, counties, providers, and other stakeholders in the
24development of the state plan amendment or waiver.

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

26

begin deleteSEC. 73.end delete
27begin insertSEC. 60.end insert  

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

29

14725.  

(a) The State Department of Health Care Services shall
30develop a quality assurance program to govern the delivery of
31Medi-Cal specialty mental health services, in order to ensure
32quality patient care based on community standards of practice.

33(b) The department shall issue standards and guidelines for local
34quality assurance activities. These standards and guidelines shall
35be reviewed and revised in consultation with the County Behavioral
36Health Directors Association of California, as well as other
37stakeholders from the mental health community, including, but
38not limited to, individuals who receive services, family members,
39providers, mental health advocacy groups, and other interested
P152  1parties. The standards and guidelines shall be based on federal
2Medicaid requirements.

3(c) The standards and guidelines developed by the department
4shall reflect the special problems that small rural counties have in
5undertaking comprehensive quality assurance systems.

6

begin deleteSEC. 74.end delete
7begin insertSEC. 61.end insert  

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

9

15204.8.  

(a) The Legislature may appropriate annually in the
10Budget Act funds to support services provided pursuant to Sections
1111325.7 and 11325.8.

12(b) Funds appropriated pursuant to subdivision (a) shall be
13allocated to the counties separately and shall be available for
14expenditure by the counties for services provided during the budget
15year. A county may move funds between the two accounts during
16the budget year for expenditure if necessary to meet the particular
17circumstances in the county. Any unexpended funds may be
18retained by each county for expenditure for the same purposes
19during the succeeding fiscal year. By November 20, 1998, each
20county shall report to the department on the use of these funds.

21(c) Beginning January 10, 1999, the Department of Finance
22shall report annually to the Legislature on the extent to which funds
23available under subdivision (a) have not been spent and may
24reallocate the unexpended balances so as to better meet the need
25for services.

26(d) No later than September 1, 2001, the department in
27consultation with relevant stakeholders, which may include the
28County Welfare Directors Association and the County Behavioral
29Health Directors Association of California, shall develop the
30allocation methodology for these funds, including the specific
31components to be considered in allocating the funds.

32

begin deleteSEC. 75.end delete
33begin insertSEC. 62.end insert  

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

35

15847.7.  

(a) For purposes of Sections 15847, 15847.3, and
3615847.5, “group health coverage” includes any health care service
37plan, self-insured employee welfare benefit plan, or disability
38insurance providing medical or hospital benefits.

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

begin delete
P153  1

SEC. 76.  

No reimbursement is required by this act pursuant to
2Section 6 of Article XIII B of the California Constitution because
3the only costs that may be incurred by a local agency or school
4district will be incurred because this act creates a new crime or
5infraction, eliminates a crime or infraction, or changes the penalty
6for a crime or infraction, within the meaning of Section 17556 of
7the Government Code, or changes the definition of a crime within
8the meaning of Section 6 of Article XIII B of the California
9Constitution.

end delete


O

    97