BILL ANALYSIS Ó
SB 1273
Page 1
SENATE THIRD READING
SB
1273 (Moorlach)
As Amended June 30, 2016
Majority vote
SENATE VOTE: 38-0
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |18-0 |Wood, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Campos, Chiu, Gomez, | |
| | |Roger Hernández, | |
| | |Lackey, Nazarian, | |
| | |Olsen, Patterson, | |
| | |Ridley-Thomas, | |
| | |Rodriguez, Santiago, | |
| | |Steinorth, McCarty, | |
| | |Waldron | |
| | | | |
| | | | |
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SUMMARY: Clarifies that Mental Health Services Act (MHSA) funds
may be used for the provision of outpatient crisis stabilization
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services (CSS) to individuals who are voluntarily receiving
those services, even when facilities colocate services to
individuals who are receiving services involuntarily and
specifies that crisis stabilization (CS) services provided at a
location where involuntary and voluntary services are colocated
and are currently being provided by collectively bargained
employees, must continue to be provided as such.
FISCAL EFFECT: None.
COMMENTS: According to the author, this bill clarifies that
counties can direct local MHSA funds to outpatient CSS that
colocate voluntary and involuntary patients. The author argues
that California is facing a mental health crisis and lacks
enough infrastructure dedicated for the rapid assessment and
stabilization of individuals in psychiatric crisis. As a
result, individuals in mental health crisis are often
transported to local emergency rooms (ERs) that are high stress,
chaotic environments designed for split-second lifesaving
decision-making, rather than thoughtful therapeutic treatment.
The author states that patients are often boarded in the ERs
against their will while waiting for assessment or transfer to a
psychiatric bed. The boarding of psychiatric patients in the
ERs also results in lost access to beds for patients with
medical emergencies. When the ERs are full, ambulances are
diverted and patients leave the waiting rooms without being seen
by a physician. Because law enforcement officers are often the
first responders, the hours spent in the ER represents "out of
service" time from the field. These issues are significant
public health and safety issues in California. The author
concludes that additional outpatient resources will support
rapid patient stabilization, while preserving ER access for
medical emergencies and minimizing out of service time for law
enforcement.
Proposition 63. Proposition 63 was passed by voters in November
2004. The MHSA imposes a 1% income tax on personal income in
excess of $1 million and creates the 16 member Commission
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charged with overseeing the implementation of MHSA. The 2015-16
Governor's Budget projected that $1.776 billion would be
deposited into the Mental Health Services Fund (in fiscal year
2015-16). The MHSA addresses a broad continuum of prevention,
early intervention, and service needs as well as providing
funding for infrastructure, technology, and training needs for
the community mental health system.
CS. California Code of Regulations (regulations) defines CS as
a service lasting less than 24 hours, to or on behalf of, a
beneficiary for a condition that requires more timely response
than a regularly scheduled visit. Services are required to be
provided on-site at a licensed 24-hour health care facility or
hospital-based outpatient program or a provider site certified
by the DHCS or a mental health plan. All beneficiaries
receiving CS are required to receive an assessment of their
physical and mental health. If CS services are colocated with
other specialty mental health services, persons providing CS
must be separate and distinct from persons providing other
services.
Voluntary vs. Involuntary. Regulations regarding the
implementation of MHSA state that programs and/or services
provided with MHSA funds shall be designed for voluntary
participation and that no person shall be denied access based
solely on his/her previous voluntary or involuntary legal
status. However, state laws amending MHSA have permitted funds
to be used for services related to Assisted Outpatient
Treatment, which is an involuntary program.
The California State Association of Counties, the County
Behavioral Health Directors Association of California, the Urban
Counties of California, and the Rural Counties Representatives
of California state that this bill would provide counties
additional flexibility in the use of MHSA funds for outpatient
CSS by clarifying that counties may use MHSA funds for
outpatient CSS which are often in high demand.
The California State Sheriffs' Association (CSSA) states that
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statutory clarification will allow existing funds to be utilized
to address outpatient mental health care, thereby easing
pressure on hospital ERs. CSSA states that the frequency with
which law enforcement deals with the effects of mental illness
grows by the day. Jail inmates suffer from mental health issues
at alarming rates and there are a limited number of tools
available to first responders and practitioners to address
mental illness encountered in the community. Proposition 63
expanded county mental health programs but problems still exist.
One glaring deficiency is the lack of treatment and placement
options for persons who could be a danger to themselves or
others.
Disability Rights California (DRC) states that this bill could
allow MHSA funds to pay for involuntary hold facilities. Any
use of MHSA funds for crisis programs must be voluntary, further
the purpose of MHSA, be used to expand mental health services
and not used to supplant funding from other sources. DRC argues
that a change in the statute may not be necessary to fund
voluntary crisis intervention programs.
Analysis Prepared by:
Paula Villescaz / HEALTH / (916) 319-2097 FN:
0003574