BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 1113|
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UNFINISHED BUSINESS
Bill No: SB 1113
Author: Beall (D)
Amended: 8/15/16
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
SENATE FLOOR: 39-0, 5/31/16
AYES: Allen, Anderson, Bates, Beall, Berryhill, Block,
Cannella, De León, Fuller, Gaines, Galgiani, Glazer, Hall,
Hancock, Hernandez, Hertzberg, Hill, Hueso, Huff, Jackson,
Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning,
Moorlach, Morrell, Nguyen, Nielsen, Pan, Pavley, Roth, Stone,
Vidak, Wieckowski, Wolk
NO VOTE RECORDED: Runner
ASSEMBLY FLOOR: 77-0, 8/18/16 - See last page for vote
SUBJECT: Pupil health: mental health
SOURCE: California Council of Community Behavioral Health
Agencies
DIGEST: This bill authorizes a county, or a qualified provider
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operating as part of the county mental health plan network, and
a local educational agency (LEA) to enter into a partnership for
the provision of Early and Periodic Screening, Diagnosis, and
Treatment (EPSDT) mental health services.
Assembly Amendments expand the authority to enter into
partnerships to include a qualified provider operating as part
of the county mental health plan network; add, delete, and
modify required elements of the partnership; eliminate the
condition on the use of specified educationally-related mental
health funds and thereby prohibit those funds for the purposes
of this bill; and, make other changes.
ANALYSIS:
Existing law:
1)Shifts responsibility for providing mental health services to
students from counties to LEAs. (Government Code § 7570 et
seq)
2)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.
3)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)
4)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.
(Welfare & Institutions Code § 14700, et seq.)
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This bill:
1)Authorizes a county, or a qualified provider operating as part
of the county mental health plan network, and a LEA to enter
into a partnership that includes all of the following:
a) The county mental health plan, or the qualified
provider, and the LEA utilize designated governmental funds
for eligible Medi-Cal EPSDT services provided to students
enrolled in Medi-Cal for mental health service costs, for
non-Medi-Cal enrolled students in special education with
individualized education programs (IEPs), and for students
not part of special education if the services are provided
by a provider specified in (b).
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. 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
students 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 addresses how to cover the costs of mental
health provider services not reimbursed by governmental
funds or from insurers 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.
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e) The agreement fulfills reporting and all other
requirements under state and federal Individuals with
Disabilities Education Act 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
IEP or relevant plan for students without an IEP.
f) The county mental health plan, or the qualified
provider, and the LEA participate in the performance
outcome system established by the Department of Health Care
Services to measure results of services provided under the
partnership agreement between the county mental health
plan, or the qualified provider, and the LEA.
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.
2)Establishes the County and Local Educational Agency
Partnership Fund in the State Treasury, and provides that
moneys in the fund are available, upon appropriation by the
Legislature, to the California Department of Education (CDE)
for the purpose of funding the partnerships pursuant to this
bill. This bill requires the CDE to fund partnerships through
a competitive grant program.
3)Requires the SPI, for the 2017-18 fiscal year and each fiscal
year thereafter, to the extent there is an appropriation for
this purpose, to allocate funds from that appropriation to the
County and Local Educational Agency Partnership Fund. This
bill authorizes other funds identified and appropriated by the
Legislature to also be deposited into the Fund and used for
partnerships.
4)Limits the use of funds for providing educationally related
mental health services required by an IEP to only be used for
that purpose, and prohibits those funds from being deposited
in the County and Local Educational Agency Partnership Fund.
5)Encourages partnerships to look for opportunities and funding
to provide students who do not have IEPs, but are in need of
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and could benefit from prevention and early intervention
services, with those services. This bill also encourages the
CDE and Department of Health Care Services to work toward the
development of protocols to identify students who are Medi-Cal
beneficiaries receiving educationally related mental health
services as part of an IEP for the purposes of data tracking.
Comments
Recent State Audit and EPSDT. The Bureau of State Audits
released a report in January 2016, 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 California
Department of Health Care Services; LEAs may 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]
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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.
This bill establishes a framework for partnerships and
authorizes a county, or a qualified provider operating as part
of the county mental health plan network, and LEAs to enter into
such partnerships.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
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
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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.
SUPPORT: (Verified8/19/16)
California Council of Community Behavioral Health Agencies
(source)
OPPOSITION: (Verified8/19/16)
None received
ASSEMBLY FLOOR: 77-0, 8/18/16
AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker,
Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke,
Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley,
Cooper, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines,
Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson,
Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Holden,
Irwin, Jones, Jones-Sawyer, Lackey, Levine, Linder, Lopez,
Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez,
Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson,
Quirk, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth,
Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk,
Williams, Wood, Rendon
NO VOTE RECORDED: Dababneh, Roger Hernández, Kim
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Prepared by:Lynn Lorber / ED. / (916) 651-4105
8/19/16 19:37:27
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