BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 1113|
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THIRD READING
Bill No: SB 1113
Author: Beall (D)
Amended: 4/14/16
Vote: 21
SENATE EDUCATION COMMITTEE: 8-1, 4/6/16
AYES: Liu, Block, Hancock, Huff, Leyva, Mendoza, Monning, Pan
NOES: Vidak
SENATE HEALTH COMMITTEE: 9-0, 4/20/16
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth, Wolk
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/27/16
AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen
SUBJECT: Pupil health: mental health
SOURCE: California Council of Community Behavioral Health
Agencies
DIGEST: This bill authorizes local educational agencies (LEAs)
to enter into partnerships, as specified, with county mental
health plans for the provision of Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT) mental health services and to
expand the allowable uses of specified mental health funds, and
requires the California Department of Education (CDE) to expand
its reporting system for mental health services to include
academic performance and other measures.
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ANALYSIS:
Existing law:
1)Requires the Superintendent of Public Instruction (SPI) to
ensure that student and program performance results are
monitored at the state and local levels by evaluating student
performance against key performance indicators.
2)Requires the SPI, as part of state monitoring and enforcement,
to use quantifiable indicators, and qualitative indicators as
needed, to adequately measure performance in the indicators
established by the United States Secretary of Education in the
priority areas described in 1) above. (Education Code §
56600.6)
3)Establishes the Medi-Cal EPSDT program for eligible people
under 21 years of age to provide periodic screenings to
determine health care needs and based upon the identified
health care need and diagnosis, treatment services are
provided. Existing law provides that EPSDT services are to be
administered through local county mental health plans under
contract with the State Department of Health Care Services
(DHCS). (Welfare and Institutions Code § 14700, et seq.)
This bill:
1)Authorizes an LEA to enter into a partnership that includes
all of the following:
a) An agreement between the county mental health plan and
the LEA that establishes a Medi-Cal mental health provider
that is county operated or county contracted, for the
provision of mental health services to students of the LEA.
This bill authorizes the agreement to include provisions
for the delivery of campus-based mental health services
through qualified providers or qualified professionals to
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provide on-campus support to identify a student not in
special education who a teacher believes may require those
services and, with parental consent, to provide mental
health services to those students.
b) The county mental health plan and the LEA use designated
governmental funds as required match for eligible Medi-Cal
EPSDT reimbursement for services provided to students
enrolled in Medi-Cal, for mental health service costs for
non-Medi-Cal enrolled students in special education, and
for students not part of special education if the services
are provided by a provider pursuant to the agreement
described above.
c) The LEA, with permission of the student's parent,
provides the county mental health plan provider with the
information of the health insurance carrier for each
student.
d) The agreement between the county mental health plan and
the LEA addresses how to cover the costs of mental health
provider services not reimbursed by governmental funds in
the event that mental health service costs exceed the
agreed upon funding outlined in the partnership agreement
between the county mental health plan and the LEA following
a year-end cost reconciliation process, and in the event
that the LEA does not elect to provide the services through
other means.
e) The agreement between the county mental health plan and
the LEA fulfills reporting requirements under state and
federal law and Medi-Cal EPSDT provisions, and measures the
effect of the mental health intervention and how that
intervention meets the goals in a student's individualized
education program (IEP) or relevant plan for students
without an IEP.
f) The county mental health plan participates in any
performance outcome system established by the DHCS to
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measure results of services provided under the partnership
agreement between the county mental health plan and the
LEA.
g) The LEA participates in any performance system
established by the CDE to measure performance of special
education mental health services and other mental health
services provided under the partnership agreement between
the county mental health plan and the LEA.
h) The LEA also reports applicable information to the
performance outcome system established by the DHCS for
those students whose information is not reported pursuant
to (f).
i) A plan to establish a partnership in at least one school
within the LEA in the first year and to expand the
partnership to three additional schools within three years.
2)Requires funds made available in the annual Budget Act for the
purpose of providing educationally related mental health
services required by an IEP to be used only for that purpose
unless the State Board of Education grants a waiver allowing
those funds to be expended for other purposes.
3)Requires the SPI, for the 2017-18 fiscal year and each fiscal
year thereafter, to the extent there is an appropriation in
the annual Budget Act for purposes of educationally related
mental health services, to allocate funds from that
appropriation to the County and Local Educational Agency
Partnership Fund (Partnership Fund).
4)Authorizes other funds identified and appropriated by the
Legislature to also be deposited into the Partnership Fund.
5)Requires the CDE to expand its reporting system for mental
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health services provided pursuant to a student's IEP to
include academic performance and any measures included within
the EPSDT mental health services performance outcome system.
6)Requires the CDE to enter into an agreement with the DHCS to
provide academic performance data to DHCS for use in its
performance outcome system regarding students who are enrolled
in Medi-Cal and special education who receive mental health
services.
7)Requires the Mental Health Services Oversight and
Accountability Commission to provide guidance and
best-practices guidelines for counties that choose to
implement partnership programs for early intervention and
prevention with LEAs and public schools.
8)States legislative intent, where applicable and to the extent
mutually agreed to by a school district and a plan or insurer,
that a health care service plan or a health insurer be
authorized to participate in the partnerships pursuant to this
bill.
Comments
Recent state audit and EPSDT. The Bureau of State Audits
released a report in January 2016, titled Student Mental Health
Services: Some Students' Services Were Affected by a New State
Law, and the State Needs to Analyze Student Outcomes and Track
Service Costs. This bill relates to the section of the audit
that is specific to the EPSDT program, which is a Medi-Cal
benefit for people under the age of 21 who have "full-scope"
Medi-Cal eligibility. The EPSDT program provides eligible
children access to a range of mental health services that
include, among other things, mental health assessment, mental
health services, therapy, rehabilitation, therapeutic behavioral
services, crisis intervention/stabilization, day
rehabilitation/day treatment, medication support and case
management. EPSDT services are administered through county
mental health plans under contract with the DHCS; LEAs may
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provide and bill for EPSDT mental health services only pursuant
to a contract with the county mental health plan (either the
county mental health plan provides and bills for the service, or
the LEA becomes a certified provider via the county mental
health plan and the LEA provides and bills for the service).
The audit noted that although LEAs cannot access funding for
EPSDT services unless they contract with their respective
counties, such collaborations could financially benefit both
counties and LEAs and increase the provision of services to
children. This audit recommended that the Legislature require
counties to enter into agreements with special education local
plan areas (SELPAs) to allow SELPAs and their LEAs to access
EPSDT funding through the county mental health programs by
providing EPSDT mental health services.
[http://www.bsa.ca.gov/pdfs/reports/2015-112.pdf]
Partnerships. According to the recent State audit, the
Children's Center at Desert Mountain SELPA's collaboration with
San Bernardino County is financially beneficial for both the
SELPA and the county. The SELPA contributes a portion of San
Bernardino's match of federal reimbursements, saving the county
funds that it would otherwise have to contribute as the local
entity. Under the terms of its agreement with San Bernardino,
Desert Mountain was able to access approximately $4 million in
federal EPSDT funds to provide mental health services in fiscal
year 2014-15. This arrangement enables Desert Mountain to
provide mental health services to Medi-Cal-eligible students
with and without IEPs. The State audit also describes a
contractual agreement between Mt. Diablo Unified School District
and the county mental health department for Mt. Diablo to
receive Medi-Cal funds as a provider of EPSDT services to
Medi-Cal-eligible students.
IEP funds for non-IEP based services? Existing law restricts
the use of AB 114 (Budget Committee, Chapter 43, Statutes of
2011) funds by providing that they may only be used to provide
IEP-based mental health services. The audit found that some
LEAs had not spent all of the state mental health funds it had
received, but did not specifically recommend expanding the
allowable uses of AB 114 funds. This bill contains conflicting
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provisions regarding the use of AB 114 funds for non-IEP-based
mental health services.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee:
Unknown costs to implement the grant program as it would
depend upon the amount of funding that is transferred into the
Partnership Fund. (Proposition 98)
To the extent Partnership funds are used for mental health
services not required by an IEP, there would be a cost
pressure to increase state funds by a similar amount that is
transferred, to backfill the special education program to meet
the federal maintenance of effort requirement. (Proposition
98)
CDE estimates the costs to prepare and report required data
and to administer the competitive grant process, to be up to
$150,000 General Fund across several positions. Unknown,
potentially significant costs to the DHCS and CDE to enter
into a data sharing agreement. Associated cost pressures and
potential significant mandate for LEAs to report the required
data to CDE (Proposition 98).
To the extent the use of moneys from the Partnership Fund
leads to increased access to federal Medi-Cal funds, LEAs
would presumably be able to provide additional services to
eligible students in their jurisdiction. (Federal funds)
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SUPPORT: (Verified5/27/16)
California Council of Community Behavioral Health Agencies
(source)
California Association of Marriage and Family Therapists
California Youth Empowerment Network
Community Health Partnership
Mental Health America of California
Steinberg Institute
OPPOSITION: (Verified5/27/16)
None received
Prepared by:Lynn Lorber / ED. / (916) 651-4105
5/28/16 16:45:59
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