Amended in Assembly June 23, 2016

Amended in Assembly June 8, 2016

Amended in Senate April 14, 2016

Amended in Senate April 12, 2016

Amended in Senate March 28, 2016

Senate Bill No. 1113

Introduced by Senator Beall

February 17, 2016

An act to amend Section 14707.5 of, and to add Part 6 (commencing with Section 5920) to Division 5 of, the Welfare and Institutions Code, relating to pupil health.

LEGISLATIVE COUNSEL’S DIGEST

SB 1113, as amended, Beall. Pupil health: mental health.

Existing law requires school districts, county offices of education, and special education local plan areas (SELPAs) to comply with state laws that conform to the federal Individuals with Disabilities Education Act, in order that the state may qualify for federal funds available for the education of individuals with exceptional needs. Existing law requires school districts, county offices of education, and SELPAs to identify, locate, and assess individuals with exceptional needs and to provide those pupils with a free appropriate public education in the least restrictive environment, and with special education and related services, including mental health services, as reflected in an individualized education program.

Existing law contains provisions governing the operation and financing of community mental health services for the mentally disordered in every county through locally administered and locally controlled community mental health programs. Existing law, the Mental Health Services Act (MHSA), an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, funds a system of county mental health plans for the provision of mental health services, as specified. The MHSA establishes the Mental Health Services Oversight and Accountability Commission to oversee the administration of various provisions of the act.

This bill would specifically authorize a county, or a qualified provider operating as part of the county mental health plan network, and a local educational agency to enter into a partnership that includes, among other things, an agreement between the county mental health plan, or the qualified provider, and the local educational agency that establishes a Medi-Cal mental health provider that is county operated or county contracted for the provision of mental health services to pupils of the local educational agency and in which there are provisions for the delivery of campus-based mental health services through qualified providers or qualified professionals to provide on-campus support to identify pupils not in special education who a teacher believes may require those services and, with parental consent, to provide mental health services to those pupils. The bill would create the County and Local Educational Agency Partnership Fund in the State Treasury, which would be available, upon appropriation by the Legislature, to the State Department of Education for the purpose of funding these partnerships, as specified, and would require the State Department of Education to fund these partnerships through a competitive grant program.

The bill would require funds made available in the annual Budget Act for the purpose of providing educationally related mental health services required by an individualized education program to be used only for that purpose begin delete unless the State Board of Education grants a waiver allowing those funds to be expended for other purposes. end delete begin insert and would prohibit those funds from being deposited into the County and Local Educational Agency Partnership Fund. end insert

Existing law requires the State Department of Health Care Services, in collaboration with the California Health and Human Services Agency, and in consultation with the Mental Health Services Oversight and Accountability Commission, to create a plan for a performance outcome system for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services provided to specified eligible Medi-Cal beneficiaries.

This bill would additionally require the State Department of Health Care Services to identify children with an individualized education program who have a primary mental health diagnosis as emotional disturbance and to collect, utilize in the performance outcome system, and include in its reporting academic performance data and other specified data for those children. The bill would also require the State Department of Health Care Services to enter into an agreement with the State Department of Education for the State Department of Education to provide to the State Department of Health Care Services relevant academic performance data.

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

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

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert The Legislature finds and declares that pilot
projects are demonstrating that schools have significantly lower
special education costs when schools partner with county-funded
Medi-Cal mental health services providers to address the mental
health problems of pupils in a comprehensive multitiered model
that includes services for pupils at the earliest time, usually years
before they would require special education, which can often be
prevented. Thus, the Legislature encourages the partnerships
authorized by this act to, whenever possible, look for opportunities
and funding to provide pupils who do not have individualized
education programs, but are in need of, and could benefit from,
prevention and early intervention services, with those services. end insert

begin delete SECTION 1. end delete

begin insert SEC. 2. end insert   

Part 6 (commencing with Section 5920) is added to
Division 5 of the Welfare and Institutions Code, to read:

 

PART 6.  County and Local Educational Agency
Partnerships

 

5920.  

(a) Notwithstanding any other law, a county, or a
qualified provider operating as part of the county mental health
plan network, and a local educational agency may enter into a
partnership that includes all of the following:

(1) An agreement between the county mental health plan, or the
qualified provider, and the local educational agency that establishes
a Medi-Cal mental health provider that is county operated or county
contracted for the provision of mental health services to pupils of
the local educational agency. The agreement may include
provisions for the delivery of campus-based mental health services
through qualified providers or qualified professionals to provide
on-campus support to identify pupils not in special education who
a teacher believes may require those services and, with parental
consent, to provide mental health services to those pupils.

(2) The county mental health plan, or the qualified provider,
and the local educational agency utilize designated governmental
funds for eligible Medi-Cal Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT) services provided to pupils
enrolled in Medi-Cal for mental health service costs for
non-Medi-Cal enrolled pupils in special education with
individualized education programs (IEPs) pursuant to the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400
et seq.), and for pupils not part of special education if the services
are provided by a provider specified in paragraph (1).

(3) The local educational agency, with permission of the pupil’s
parent, provides the county mental health plan provider with the
information of the health insurance carrier for each pupil.

(4) The agreement between the county mental health plan, or
the qualified provider, and the local educational agency addresses
how to cover the costs of mental health provider services not
covered by funds pursuant to paragraph (2) in the event that mental
health service costs exceed the agreed-upon funding outlined in
the partnership agreement between the county mental health plan,
or the qualified provider, and the local educational agency
following a yearend cost reconciliation process, and in the event
that the local educational agency does not elect to provide the
services through other means.

(5) The agreement between the county mental health plan, or
the qualified provider, and the local educational agency fulfills
reporting requirements under state and federal Individuals with
Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.) and
Medi-Cal EPSDT provisions, and measures the effect of the mental
health intervention and how that intervention meets the goals in a
pupil’s IEP or relevant plan for non-IEP pupils.

(6) The county mental health plan, or the qualified provider,
and the local educational agency participate in the performance
outcome system established by the State Department of Health
Care Services pursuant to Section 14707.5 to measure results of
services provided under the partnership agreement between the
county mental health plan, or the qualified provider, and the local
educational agency.

(7) A plan to establish a partnership described in this section in
at least one school within the local educational agency in the first
year and to expand the partnership to three additional schools
within three years.

(b) For purposes of this section, “local educational agency” has
the same meaning as that term is defined in Section 56026.3 of
the Education Code.

(c) Where applicable, and to the extent mutually agreed to by
a school district and a plan or insurer, it is the intent of the
Legislature that a health care service plan or a health insurer be
authorized to participate in the partnerships described in this part.

5921.  

(a) The County and Local Educational Agency
Partnership Fund is hereby created in the State Treasury. Moneys
in the fund are available, upon appropriation by the Legislature,
to the State Department of Education for the purpose of funding
the partnerships described in this part. The State Department of
Education shall fund partnerships described in this part through a
competitive grant program.

(b) (1) For the 2017-18 fiscal year and each fiscal year
thereafter, to the extent there is an appropriation in the annual
Budget Act or another measure for purposes of this part, the
Superintendent of Public Instruction shall allocate funds from that
appropriation to the County and Local Educational Agency
Partnership Fund.

(2) Other funds identified and appropriated by the Legislature
may also be deposited into the County and Local Educational
Agency Partnership Fund and used for the purposes specified in
subdivision (a).

(c) Funds made available in the annual Budget Act for the
purpose of providing educationally related mental health services,
including out-of-home residential services for emotionally
disturbed pupils, required by an individualized education program,
shall be used only for that begin delete purpose unless the State Board of
Education grants a waiver allowing those funds to be expended
for other purposes. end delete begin insert purpose and shall not be deposited into the
County and Local Educational Agency Partnership Fund. end insert

begin delete SEC. 2. end delete

begin insert SEC. 3. end insert   

Section 14707.5 of the Welfare and Institutions Code
is amended to read:

14707.5.  

(a) It is the intent of the Legislature to develop a
performance outcome system for Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT) mental health services that
will improve outcomes at the individual and system levels and will
inform fiscal decisionmaking related to the purchase of services.

(b) The State Department of Health Care Services, in
collaboration with the California Health and Human Services
Agency, and in consultation with the Mental Health Services
Oversight and Accountability Commission, shall create a plan for
a performance outcome system for EPSDT mental health services
provided to eligible Medi-Cal beneficiaries under the age of 21
pursuant to 42 U.S.C. Section 1396d(a)(4)(B).

(1) Commencing no later than September 1, 2012, the
department shall convene a stakeholder advisory committee
comprised of representatives of child and youth clients, family
members, providers, counties, and the Legislature. This
consultation shall inform the creation of a plan for a performance
outcome system for EPSDT mental health services.

(2) In developing a plan for a performance outcomes system
for EPSDT mental health services, the department shall consider
the following objectives, among others:

(A) High quality and accessible EPSDT mental health services
for eligible children and youth, consistent with federal law.

(B) Information that improves practice at the individual,
program, and system levels.

(C) Minimization of costs by building upon existing resources
to the fullest extent possible.

(D) Reliable data that are collected and analyzed in a timely
fashion.

(3) At a minimum, the plan for a performance outcome system
for EPSDT mental health services shall consider evidence-based
models for performance outcome systems, such as the Child and
Adolescent Needs and Strengths (CANS), federal requirements,
including the review by the External Quality Review Organization
(EQRO), and, timelines for implementation at the provider, county,
and state levels.

(c) The State Department of Health Care Services shall provide
the performance outcomes system plan, including milestones and
timelines, for EPSDT mental health services described in
subdivision (a) to all fiscal committees and appropriate policy
committees of the Legislature no later than October 1, 2013.

(d) The State Department of Health Care Services shall propose
how to implement the performance outcomes system plan for
EPSDT mental health services described in subdivision (a) no later
than January 10, 2014.

(e) Commencing no later than February 1, 2014, the department
shall convene a stakeholder advisory committee comprised of
advocates for and representatives of, child and youth clients, family
members, managed care health plans, providers, counties, and the
Legislature. The committee shall develop methods to routinely
measure, assess, and communicate program information regarding
informing, identifying, screening, assessing, referring, and linking
Medi-Cal eligible beneficiaries to mental health services and
supports. The committee shall also review health plan screenings
for mental health illness, health plan referrals to Medi-Cal
fee-for-service providers, and health plan referrals to county mental
health plans, among others. The committee shall make
recommendations to the department regarding performance and
outcome measures that will contribute to improving timely access
to appropriate care for Medi-Cal eligible beneficiaries.

(1) The department shall incorporate into the performance
outcomes system established pursuant to this section the screenings
and referrals described in this subdivision, including milestones
and timelines, and shall provide an updated performance outcomes
system plan to all fiscal committees and the appropriate policy
committees of the Legislature no later than October 1, 2014.

(2) The department shall propose how to implement the updated
performance systems outcome plan described in paragraph (1) no
later than January 10, 2015.

(f) The department shall identify children with an individualized
education program who have a primary mental health diagnosis
as emotional disturbance, and do both of the following:

(1) (A) Collect and utilize in the performance outcome system
academic performance data and any other data required for the
measures included within the performance outcome system for
these children.

(B) The department shall enter into an agreement with the State
Department of Education for the State Department of Education
to provide to the department relevant academic performance data,
as determined by the department, in consultation with the State
Department of Education, for utilization in the performance
outcome system pursuant to subparagraph (A).

(2) Within 18 months of the department completing the first
report on comprehensive performance outcomes pursuant to this
section, the department shall begin to include the data specified
in paragraph (1) in its reporting.