BILL ANALYSIS Ó
SB 1113
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SENATE THIRD READING
SB
1113 (Beall)
As Amended August 15, 2016
Majority vote
SENATE VOTE: 39-0
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Education |7-0 |O'Donnell, Olsen, | |
| | |Kim, McCarty, | |
| | |Santiago, Thurmond, | |
| | |Weber | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |17-0 |Wood, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Campos, Chiu, Gomez, | |
| | |Roger Hernández, | |
| | |Lackey, Nazarian, | |
| | |Patterson, | |
| | | | |
| | | | |
| | |Ridley-Thomas, | |
| | |Rodriguez, Santiago, | |
| | |Steinorth, Thurmond, | |
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| | |Waldron | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |20-0 |Gonzalez, Bigelow, | |
| | |Bloom, Bonilla, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, Eggman, | |
| | |Gallagher, Eduardo | |
| | |Garcia, Holden, | |
| | |Jones, Obernolte, | |
| | |Quirk, Santiago, | |
| | |Wagner, Weber, Wood, | |
| | |McCarty | |
| | | | |
| | | | |
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SUMMARY: 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 establishes
the County and Local Educational Agency Partnership Fund in the
State Treasury. Specifically, this bill:
1)Authorizes an LEA to enter into a partnership with a county,
or a qualified provider operating as part of the county mental
health plan network, that includes all of the following:
a) The county mental health plan, or the qualified
provider, and the LEA use designated governmental funds for
eligible Medi-Cal EPSDT program 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.
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b) An agreement between the county mental health plan, or
the qualified provider, 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. Authorizes the agreement
to include provisions for the delivery of campus-based
mental health services through qualified providers or
qualified professionals to provide on-campus support to
identify a student with a 504 plan and students not in
special education who a teacher believes may require those
services and, with parental consent, to provide mental
health services to those students.
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, or
the qualified provider, and the LEA addresses how to cover
the costs of mental health provider services not covered 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, or the qualified provider, 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, or
the qualified provider, and the LEA fulfills reporting and
all other 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
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the goals in a student's individualized education program
(IEP) or relevant plan for students without an IEP.
f) The county mental health plan, or the qualified
provider, and LEA participate in the EPSDT performance
outcome system to measure results of services provided
under the partnership agreement.
g) 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.
1)Establishes the County and Local Educational Agency
Partnership Fund in the State Treasury. States that moneys in
the fund, upon appropriation by the Legislature, would be
available to the California Department of Education (CDE) for
the purpose of funding the partnerships established by the
bill, through a competitive grant program.
2)Requires the Superintendent of Public Instruction (SPI),
starting in the 2017-18 fiscal year, to allocate funds
appropriated in the Budget Act or another measure for purposes
of the partnerships established by this bill to the County and
Local Educational Agency Partnership Fund.
3)Authorizes other funds identified and appropriated by the
Legislature to be deposited into the County and Local
Educational Agency Partnership Fund.
4)Requires that funds made available in the annual Budget Act
for the purpose of providing educationally related mental
health services, including out-of-home residential services
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for emotionally disturbed pupils, required by an
individualized education program, be used only for that
purpose and not be deposited into the County and Local
Educational Agency Partnership Fund.
FISCAL EFFECT:
According to the Assembly Appropriations Committee:
1)Proposition 98/General Fund (GF) cost pressure, in the
millions of dollars, to implement a competitive grant program
to fund county and LEA partnerships. The author's office
estimates approximately $1.8 million would be needed per LEA.
This bill intends for at least three LEAs to be funded.
Actual costs could be higher or lower depending upon available
funding.
This bill establishes a Partnership Fund to provide
competitive grants to partnerships, available upon
appropriation by the Legislature. The 2016-17 Budget Act does
not provide funding for this purpose. The bill does not
specify a fund source for the Partnership Fund and does not
expressly prohibit the use of Proposition 98/GF, thereby
creating cost pressure on state funds.
2)Annual administrative costs to the CDE of approximately
$150,000 to administer the competitive grant process.
COMMENTS:
Need for the bill. According to the author, "A key finding of
the audit (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; January
2016) was that LEAs and counties could benefit financially and
improve student access to mental health services by
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collaborating to provide services to Medi-Cal eligible students.
Although successful models have demonstrated partnerships like
SB 1113 benefit both the counties and LEAs by increasing access
to necessary mental health services for all Medi-Cal eligible
school-age children, they are rarely implemented by LEAs. LEAs
cannot access funding for those EPSDT services unless they
contract with their respective counties. Some LEAs and counties
disagree over who should pay for the state match as required
under the EPSDT program."
Recent state audit on student mental health services. AB 114
(Committee on Budget), Chapter 43, Statutes of 2011, transferred
the responsibility for providing mental health services for
students with IEPs from county mental health departments to
LEAs.
In January, 2016, the Bureau of State Audits released a report,
requested by the author and other members of the Legislature, on
the effect of AB 114 on mental health services for students.
The report, 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,
found that:
1)The most commonly offered types of mental health services and
the providers of those services generally did not change.
2)The number of students who received these mental health
services remained steady or grew.
3)The provider of the most common mental health services
generally had already been, and continues to be, the LEA.
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4)The majority of changes to services were unrelated to AB 114,
though IEP teams did not always record in the IEP document
their rationale for why a service was removed.
The audit recommended that the Legislature require counties to
enter into agreements with California Special Education Local
Plan Areas (SELPAs) to allow SELPAs and LEAs to access EPSDT
funding through the county mental health programs by providing
EPSDT mental health services.
Audit recommendation regarding EPSDT program. This bill relates
to the section of the audit that is specific to the EPSDT
program. The audit recommended that the Legislature require
counties to enter into agreements with SELPAs to allow SELPAs
and LEAs to access EPSDT funding. This bill does not require
that counties to enter into these agreements, but authorizes a
specific kind of such an agreement, and suggests that there will
be additional state funding to incentivize such agreements.
EPSDT 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 Department of Healthcare Services (DHCS). LEAs may
provide and bill for EPSDT mental health services only pursuant
to a contract with the county mental health plan. EPSDT federal
funds must be matched by county funds.
The audit noted that although LEAs cannot access funding for
EPSDT services unless they contract with their respective
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counties, such collaborations could financially benefit both
counties and LEAs and increase the provision of services to
children. The audit cited the case of Desert Mountain SELPA,
which contracts with San Bernardino County to provide mental
health services to Medi-Cal eligible students using EPSDT funds.
Under this arrangement, Desert Mountain SELPA contributes to
the county's required match of federal funds. According to the
Auditor, this arrangement is mutually beneficial: San
Bernardino County does not need to provide the full match, and
Desert Mountain is able to access EPSDT funding to provide
mental health services to Medi-Cal eligible students with and
without IEPs. The audit noted that "if California's other
SELPAs established agreements with their county mental health
plans, these entities in total could potentially receive
millions of dollars in federal reimbursements for mental health
services provided to Medi-Cal eligible children."
According to the Special Opportunities for Access and Reform
Coalition (SOAR), a coalition which includes seven SELPAs, there
are several barriers to developing these partnerships. They
note, "In those regions that have not been able to develop a
partnership, some of the hurdles center on county mental health
not being willing to contract/vendorize the LEA/SELPAs to
provide EPSDT services, or the county mental health agency
charging the LEA/SELPA a high indirect cost for developing this
partnership." They note that there is no state policy on how an
LEA can seek direct access to the Medi-Cal funding for the EPSDT
program through county managed care, and that instead it is up
to each individual LEA or SELPA to negotiate directly with their
county mental health program. They also note that under current
law there is no appeal or mediation process for circumstances
when the two agencies do not agree.
Analysis Prepared by:
Tanya Lieberman / ED. / (916) 319-2087 FN:
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