BILL ANALYSIS Ó
SB 1466
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SENATE THIRD READING
SB
1466 (Mitchell)
As Amended August 15, 2016
Majority vote
SENATE VOTE: 39-0
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |15-0 |Wood, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Campos, Chiu, | |
| | | | |
| | | | |
| | |Roger Hernández, | |
| | |Lackey, Nazarian, | |
| | |Olsen, Patterson, | |
| | |Ridley-Thomas, | |
| | |Rodriguez, Thurmond, | |
| | |Waldron | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Human Services |7-0 |Bonilla, Grove, | |
| | |Arambula, Lopez, | |
| | |Maienschein, | |
| | | | |
SB 1466
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| | | | |
| | |Mark Stone, Thurmond | |
| | | | |
|----------------+-----+----------------------+--------------------|
|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: Requires that screening services provided under the
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)
Program include screening for trauma as consistent with
protocols developed by the Department of Health Care Services
(DHCS). Establishes trauma to mean an event, series of events,
or set of circumstances that is experienced by an individual as
physically or emotionally harmful or threatening and that has
lasting adverse effects on the individual's functioning and
physical, social, emotional, or spiritual well-being.
EXISTING STATE LAW:
1)Establishes the Medi-Cal program, administered by DHCS, under
which qualified low-income individuals receive health care
services.
2)Establishes a schedule of benefits under the Medi-Cal program,
which includes EPSDT for any individual less than 21 years of
age, consistent with federal Medicaid requirements. Defines,
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through regulation, "screening services" for purposes of EPSDT
to mean:
a) An initial, periodic, or additional health assessment
of a Medi-Cal eligible individual under 21 years of age
provided in accordance with the requirements of the Child
Health and Disability Prevention (CHDP) program;
b) A health assessment, examination, or evaluation of a
Medi-Cal eligible individual under 21 years of age by a
licensed health care professional acting within his or her
scope of practice, at intervals other than the CHDP
intervals, to determine the existence of physical or
mental illnesses or conditions; or,
c) Any other encounter with a licensed health care
professional that results in the determination of the
existence of a suspected illness or condition or a change
or complication in a condition for a Medi-Cal eligible
person under 21 years of age.
3)Requires mental health plans to provide specialty mental
health services to eligible Medi-Cal beneficiaries, including
both adults and children. Includes EPSDT within the scope of
specialty mental health services for eligible Medi-Cal
beneficiaries under the age of 21 pursuant to federal Medicaid
law.
4)Requires DHCS, in collaboration with the California Health and
Human Services Agency, and in consultation with the Mental
Health Services Oversight and Accountability Commission, to
create a plan for a performance outcome system for EPSDT
mental health services provided to eligible Medi-Cal
beneficiaries under the age of 21.
Establishes the Mental Health Services Act, enacted by voters in
2004 by Proposition 63, to provide funds to counties to expand
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services, develop innovative programs, and integrated service
plans for mentally ill children, adults, and seniors through a
1% income tax on personal income above $1 million.
FISCAL EFFECT: According to the Assembly Appropriations
Committee, unknown local assistance costs, potentially in the
range of $1 million annually, for additional screening services
provided to Medi-Cal-eligible children (General Fund
(GF)/federal). Staff assumes the state would be responsible for
any nonfederal share of costs under this bill based on the
requirements of Article XIII, Section 36 of the California
Constitution (Proposition 30). Additionally, DHCS and DSS will
incur minor staff costs to consult with stakeholders and provide
guidance to operationalize the required trauma screening
(GF/federal).
COMMENTS: According to the author, children in foster care have
suffered from abuse, neglect, or exploitation, and have suffered
secondary trauma as a result of being removed from their
parents. This bill is needed to ensure that distressed children
are appropriately screened for trauma without delay. Under
California law, the treatment of children's mental health needs
is determined by the severity of the diagnosis. Because we do
not currently screen under EPSTD for trauma, we run the risk of
delaying treatment to this vulnerable population because of this
complicated delivery model. By requiring trauma screening by a
designated agency on the front-end, we minimize possible delays
in critically-needed treatment.
Californians for Safety and Justice (CSJ) writes in support that
this bill ensures that medical professionals conducting already
mandated health screenings look for signs of trauma to ensure
that children who have suffered trauma receive the care they
need - care they are legally entitled to receive. In light of
the overwhelming evidence confirming the traumatic nature of
child abuse and neglect and the secondary trauma of removal from
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one's home, this measure unambiguously establishes that foster
children have suffered trauma and should be assessed for
appropriate EPSDT services. CSJ argues that the state has the
legal and moral obligation to act as the parent of all children
in the child welfare system, and this bill is consistent with
long-standing policies that ensure children in the child welfare
system receive the best possible care that will help them thrive
as adults.
The San Luis Obispo County Department of Social Services
(SLOCDSS) states that it serves, in conjunction with its
partners in the County Probation Department, over 300 foster
children who have experienced abuse or neglect that span the
spectrum of severity. SLOCDSS states it has encountered
difficulties in ensuring that these children receive the
therapeutic services they need, as mental health providers
debate with one another over the relative severity of the trauma
these children have endured. Too often, these
children-especially those who suffered secondary trauma as a
result of being removed from their caregivers-are shuffled back
and forth between unresponsive systems of care, are denied the
therapy they need to heal from the impacts of trauma, and
ultimately suffer the cumulative effects of untreated trauma as
they transition to adulthood.Analysis Prepared by:
Paula Villescaz /
HEALTH / (916) 319-2097 FN: 0004146
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