BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 1466 (Mitchell) - Early and Periodic Screening, Diagnosis,
and Treatment Program: trauma screening
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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 1466 would require additional screening for trauma
in Medi-Cal eligible children. The bill would require Medi-Cal
eligible children who are found to have experienced trauma and
children who have been abused, neglected, or removed from the
home to be referred to county mental health plans for assessment
for specialty mental health services.
*********** ANALYSIS ADDENDUM - SUSPENSE FILE ***********
The following information is revised to reflect amendments
adopted by the committee on May 27, 2016
Fiscal
Impact:
Increased costs in the low millions per year for additional
screening provided to Medi-Cal eligible children (General Fund
and federal funds). Under current federal and state law,
SB 1466 (Mitchell) Page 1 of
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children enrolled in Medi-Cal are eligible for the Early and
Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit.
This benefit covers screening for both physical and mental
health issues. By specifically requiring screening for trauma,
the bill is likely to increase the costs to provide screening
services due to additional time spent by providers with
eligible children. It is not clear to what extent children are
already being screened for trauma. It is likely that the
specific requirement in the bill will lead to increased focus
on trauma during screening. For example, if the cost to
provide trauma screening increased the overall cost of
screening under EPSDT by 5%, the cost would be about $2
million per year.
Increased costs of $5 million to $10 million per year to
provide assessments for specialty mental health services by
county mental health plans (General Fund and federal funds).
The bill would require all children who have been removed from
the home to be assessed by a county mental health plan for
specialty mental health services. There are about 15,000 new
foster care placements per year in the stat. The cost to
provide an assessment for specialty mental health services is
around $500.
Likely increase in specialty mental health services in the
hundreds of millions per year (General Fund and federal
funds). Under the bill, about 6.5 million children are likely
to get additional screening for trauma. Currently, there is a
very low rate of utilization of specialty mental health
services by Medi-Cal eligible children. It is likely that the
requirement for additional screening in the bill will result
in a significant number of children receiving being referred
for specialty mental health services who are not currently
receiving those services. Currently, 4.4% of children receive
specialty mental health services, at an average annual costs
of $6,000. If 5% of the children who are likely to be found to
have experienced trauma under the bill are subsequently found
to be eligible for specialty mental health services, the cost
would be about $500 million per year.
Unknown potential future costs savings for Medi-Cal services
(General Fund, federal funds, local funds). Under the bill, it
is likely that a significant number of Medi-Cal children will
be determined to have experienced trauma and are in need of
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mental health services - over and above those who are
currently being identified. By identifying those children, it
is possible that early mental health interventions could
improve those children's long-term prognoses and reduce future
costs, such as psychiatric hospitalizations and other health
care costs associated with trauma (for example health care
services related to alcohol or substance abuse). The extent to
which those would occur is unknown.
Committee
Amendments: Delete the requirement that children found to have
experienced trauma through EPSDT screening shall be
automatically assessed for specialty mental health services and
limit automatic referral for specialty mental health screening
to children removed from the home.
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