BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          SB 1291 (Beall) - Medi-Cal:  specialty mental health:  children  
          and youth
          
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          |Version: April 14, 2016         |Policy Vote: HEALTH 9 - 0,      |
          |                                |          HUMAN S. 5 - 0        |
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          |Urgency: No                     |Mandate: No                     |
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          |Hearing Date: May 27, 2016      |Consultant: Brendan McCarthy    |
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          Bill  
          Summary:  SB 1291 would require county mental health plans to  
          submit an annual foster care mental health service plan to the  
          Department of Health Care Services. The bill would require  
          county mental health plans to be reviewed by an external quality  
          review organization with specified requirements. The bill would  
          require the Department to conduct annual audits of county mental  
          health plans to assess the provision of services to foster  
          youth.


          *********** ANALYSIS ADDENDUM - SUSPENSE FILE ***********
             The following information is revised to reflect amendments 
                      adopted by the committee on May 27, 2016




          Fiscal  
          Impact:  
           Ongoing costs likely in the hundreds of thousands per year for  







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            the Department of Health Care Services to review county plans,  
            EQRO reports, and take necessary enforcement actions (General  
            Fund and federal funds).

           Ongoing costs of about $450,000 per year for additional items  
            to be reviewed by the external quality review organization  
            (General Fund and federal funds).

           Likely administrative costs in the low millions for county  
            mental health plans to develop the required foster youth  
            mental health service plans (General Fund and federal funds).  
            Much of the information required for the plans is already  
            possessed by county mental health plans. However, there are  
            likely to be administrative costs to compile that information  
            and develop the required plans. Under the state constitution,  
            the state would be responsible for reimbursing counties for  
            any additional administrative costs incurred due to the bill.

           Unknown impact on the costs for counties to provide additional  
            specialty mental health services (local funds or General Fund  
            and federal funds). By increasing the scrutiny on the  
            provision of services to Medi-Cal beneficiaries by county  
            mental health plans, the bill may bring to light shortcomings  
            in the provision of those services (such as delays in access  
            to services or provider shortages). To the extent that occurs,  
            it may result in counties providing additional services. To  
            the extent that there is an increase is services due to the  
            bill and to the extent that counties could demonstrate that  
            the increase in utilization was due to the effects of the  
            bill, the state could be responsible for those costs. Whether  
            that would actually occur is unknown, as there is no formal  
            process yet in place for determining when and how the state  
            should reimburse counties for additional costs relating to  
            realigned programs.


          Committee  
          Amendments:  Delete the requirement for the Department of Health  
          Care Services to review county foster care mental health service  
          plans and delete the requirement for the Department to audit  
          county mental health plan provision of services to foster youth.


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