BILL NUMBER: AB 2034 CHAPTERED
BILL TEXT
CHAPTER 518
FILED WITH SECRETARY OF STATE SEPTEMBER 19, 2000
APPROVED BY GOVERNOR SEPTEMBER 17, 2000
PASSED THE ASSEMBLY AUGUST 29, 2000
PASSED THE SENATE AUGUST 28, 2000
AMENDED IN SENATE AUGUST 25, 2000
AMENDED IN SENATE AUGUST 7, 2000
AMENDED IN SENATE JUNE 22, 2000
AMENDED IN ASSEMBLY MAY 26, 2000
AMENDED IN ASSEMBLY APRIL 11, 2000
AMENDED IN ASSEMBLY MARCH 23, 2000
INTRODUCED BY Assembly Members Steinberg and Baugh
(Principal coauthors: Assembly Members Scott and Shelley)
(Principal coauthors: Senators Burton and Perata)
(Coauthors: Assembly Members Alquist, Aroner, Bock, Cardoza, Cox,
Hertzberg, Honda, Keeley, Knox, Kuehl, Longville, Lowenthal, Machado,
Mazzoni, Pescetti, Strom-Martin, Thomson, and Torlakson)
(Coauthors: Senators Alpert, Chesbro, Rainey, Solis, and
Vasconcellos)
FEBRUARY 18, 2000
An act to amend Sections 5806, 5811, 5814, and 5814.5 of the
Welfare and Institutions Code, relating to mental health, and
declaring the urgency thereof, to take effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 2034, Steinberg. Mental health funding: local grants.
Existing law requires the State Department of Mental Health to
establish service standards relating to mental health programs.
These standards include plans for services and evaluation strategies
to coordinate and provide access to housing assistance, vocational
rehabilitation, and veterans' services.
This bill would add to the target population and implement
additional service standards.
Existing law requires the director to establish a methodology for
awarding grants and to establish a designated advisory committee.
The department is also required to select up to 3 counties for
eligibility for demonstration grants to be used to provide
comprehensive services to the severely mentally ill.
This bill would require the director to include additional
advisory committee members. This bill would also require additional
criteria to be used in awarding grants. The department would be
authorized to continue funding previously selected counties and to
select additional counties, as well as cities that operate
independent public mental health programs, to provide comprehensive
services to the severely mentally ill. The 3-county limitation would
be deleted.
Existing law requires counties receiving grants to provide the
department with program outcome data.
This bill would also require the counties receiving grants to
provide the department with information relating to funding for
housing.
Existing law reappropriates $10,000,000 to the department from a
specified item in the Budget Act of 1999 for the purpose of funding
grants.
This bill would revise these provisions regarding the funding of
grants.
This bill would declare that it is to take effect immediately as
an urgency statute.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. (a) The Legislature finds and declares as follows:
(1) In 1999, the Legislature recognized the longstanding problem
of the underfunded community mental health care system and the
consequences of severely mentally ill adults not getting treatment
resulting in these adults being homeless, incarcerated in jails, and
hospitalized.
(2) The Legislature began to address this problem by funding three
pilot programs in Los Angeles, Sacramento, and Stanislaus Counties
to provide extended community mental health services and outreach to
mentally ill adults who are homeless or at risk of homelessness.
(3) The legislation, Chapter 617 of the Statutes of 1999 (AB 34),
required the State Department of Mental Health to evaluate these
programs and determine if they were effective in reducing the risk of
continued homelessness, incarceration, or hospitalization.
(4) The response to the offer of outreach services to severely
mentally ill persons has been overwhelming, with more than 1,000
additional people now stabilized and in treatment with a greatly
reduced risk of further homelessness, incarcerations, or
hospitalizations.
(5) Based upon this success and the dramatic and unfortunate
consequences of two decades of not providing adequate community
mental health services, it is now time for the state to make a
significant effort to substantially increase these programs and
realize a measurable reduction in homelessness of people with mental
illness by dramatically expanding these programs.
(b) It is the intent of the Legislature to enact legislation that
will do all of the following:
(1) Provide funds in the 2000-01 fiscal year to allow the three
counties that currently conduct programs to continue successful
program expansions, based upon remaining unmet needs.
(2) Permit, in addition to the initial demonstration counties,
counties that have or can develop adult system of care programs to
have an opportunity to participate in these programs, based upon
unmet needs, successful existing programs, and each county's capacity
to increase services.
SEC. 2. Section 5806 of the Welfare and Institutions Code is
amended to read:
5806. The State Department of Mental Health shall establish
service standards that ensure that members of the target population
are identified, and services provided to assist them to live
independently, work, and reach their potential as productive
citizens. The department shall provide annual oversight of grants
issued pursuant to this part for compliance with these standards.
These standards shall include, but are not limited to:
(a) A service planning and delivery process that is target
population based and includes the following:
(1) Determination of the numbers of clients to be served and the
programs and services that will be provided to meet their needs. The
local director of mental health shall consult with the sheriff, the
police chief, the probation officer, the mental health board,
contract agencies, and family, client, ethnic and citizen
constituency groups as determined by the director.
(2) Plans for services, including outreach to families whose
severely mentally ill adult is living with them, design of mental
health services, coordination and access to medications, psychiatric
and psychological services, substance abuse services, supportive
housing or other housing assistance, vocational rehabilitation, and
veterans' services. Plans shall also contain evaluation strategies,
that shall consider cultural, linguistic, gender, age, and special
needs of minorities in the target populations. Provision shall be
made for staff with the cultural background and linguistic skills
necessary to remove barriers to mental health services due to
limited-English-speaking ability and cultural differences.
(3) Provisions for services to meet the needs of target population
clients who are physically disabled.
(4) Provision for services to meet the special needs of older
adults.
(5) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, where appropriate.
(6) Provision for services to be client-directed and that employ
psychosocial rehabilitation and recovery principles.
(7) Provision for psychiatric and psychological services that are
integrated with other services and for psychiatric and psychological
collaboration in overall service planning.
(8) Provision for services specifically directed to seriously
mentally ill young adults 25 years of age or younger who are homeless
or at significant risk of becoming homeless. These provisions may
include continuation of services that would still be received through
other funds had eligibility not been terminated due to age.
(9) Services reflecting special needs of women from diverse
cultural backgrounds, including supportive housing that accepts
children, personal services coordinator therapeutic treatment, and
substance treatment programs that address gender specific trauma and
abuse in the lives of persons with mental illness, and vocational
rehabilitation programs that offer job training programs free of
gender bias and sensitive to the needs of women.
(10) Provision for housing for clients that is immediate,
transitional, permanent, or all of these.
(b) Each client shall have a clearly designated mental health
personal services coordinator who may be part of a multidisciplinary
treatment team who is responsible for providing or assuring needed
services. Responsibilities include complete assessment of the client'
s needs, development of the client's personal services plan, linkage
with all appropriate community services, monitoring of the quality
and follow through of services, and necessary advocacy to ensure each
client receives those services which are agreed to in the personal
services plan. Each client shall participate in the development of
his or her personal services plan, and responsible staff shall
consult with the designated conservator, if one has been appointed,
and, with the consent of the client, consult with the family and
other significant persons as appropriate.
(c) The individual personal services plan shall ensure that
members of the target population involved in the system of care
receive age, gender, and culturally appropriate services, to the
extent feasible, that are designed to enable recipients to:
(1) Live in the most independent, least restrictive housing
feasible in the local community, and for clients with children, to
live in a supportive housing environment that strives for
reunification with their children or assists clients in maintaining
custody of their children as is appropriate.
(2) Engage in the highest level of work or productive activity
appropriate to their abilities and experience.
(3) Create and maintain a support system consisting of friends,
family, and participation in community activities.
(4) Access an appropriate level of academic education or
vocational training.
(5) Obtain an adequate income.
(6) Self-manage their illness and exert as much control as
possible over both the day-to-day and long-term decisions which
affect their lives.
(7) Access necessary physical health care and maintain the best
possible physical health.
(8) Reduce or eliminate serious antisocial or criminal behavior
and thereby reduce or eliminate their contact with the criminal
justice system.
(9) Reduce or eliminate the distress caused by the symptoms of
mental illness.
(10) Have freedom from dangerous addictive substances.
(d) The individual personal services plan shall describe the
service array that meets the requirements of subdivision (c), and to
the extent applicable to the individual, the requirements of
subdivision (a).
SEC. 3. Section 5811 of the Welfare and Institutions Code is
amended to read:
5811. The State Department of Mental Health shall provide
participating counties all of the following:
(a) Request for proposals, application guidelines, and format, and
coordination and oversight of the selection process as described in
Article 2 (commencing with Section 5803).
(b) Contracts with each state funded county stipulating the
approved budget, performance outcomes, and scope of work.
(c) Training, consultation, and technical assistance for county
applicants.
SEC. 4. Section 5814 of the Welfare and Institutions Code is
amended to read:
5814. (a) (1) This part shall be implemented only to the extent
that funds are appropriated for purposes of this part. To the extent
that funds are made available, the first priority shall go to
maintain funding for the existing programs that meet adult system of
care contract goals. The next priority for funding shall be given to
counties with a high incidence of persons who are severely mentally
ill and homeless or at risk of homelessness, and meet the criteria
developed pursuant to paragraphs (3) and (4).
(2) The director shall establish a methodology for awarding grants
under this part consistent with the legislative intent expressed in
Section 5802, and in consultation with the advisory committee
established in this subdivision.
(3) The director shall establish an advisory committee for the
purpose of providing advice regarding the development of criteria for
the award of grants, and the identification of specific performance
measures for evaluating the effectiveness of grants. The committee
shall review evaluation reports and make findings on evidence based
on best practices and recommendations for grant conditions. The
committee shall include, but not be limited to, representatives from
state, county, and community veterans' services and disabled veterans
outreach programs, supportive housing and other housing assistance
programs, law enforcement, county mental health and private providers
of local mental health services and mental health outreach services,
the Board of Corrections, the State Department of Alcohol and Drug
Programs, local substance abuse services providers, the Department of
Rehabilitation, providers of local employment services, the State
Department of Social Services, the Department of Housing and
Community Development, a service provider to transition youth, the
United Advocates for Children of California, the California Mental
Health Advocates for Children and Youth, the Mental Health
Association of California, the California Alliance for the Mentally
Ill, the California Network of Mental Health Clients, the Mental
Health Planning Council, and other appropriate entities.
(4) The criteria for the award of grants shall include, but not be
limited to, all of the following:
(A) A description of a comprehensive strategic plan for providing
outreach, prevention, intervention, and evaluation in a cost
appropriate manner corresponding to the criteria specified in
subdivision (c).
(B) A description of the local population to be served, ability to
administer an effective service program, and the degree to which
local agencies and advocates will support and collaborate with
program efforts.
(C) A description of efforts to maximize the use of other state,
federal, and local funds or services that can support and enhance the
effectiveness of these programs.
(b) In each year in which additional funding is provided by the
State Budget the department shall establish programs that offer
individual counties sufficient funds to comprehensively serve
severely mentally ill adults who are homeless, recently released from
a county jail or the state prison, or others who are untreated,
unstable, and at significant risk of incarceration or homelessness
unless treatment is provided to them and who are severely mentally
ill adults. For purposes of this subdivision, "severely mentally ill
adults" are those individuals described in subdivision (b) of
Section 5600.3. In consultation with the advisory committee
established pursuant to paragraph (3) of subdivision (a), the
department shall report to the Legislature on or before May 1 of each
year in which additional funding is provided, and shall evaluate, at
a minimum, the effectiveness of the strategies in providing
successful outreach and reducing homelessness, involvement with local
law enforcement, and other measures identified by the department.
The evaluation shall include, as much of the following as available
information permits:
(1) The number of persons served, and of those, the number who are
able to maintain housing, and the number who receive extensive
community mental health services.
(2) The number of persons with contacts with local law enforcement
and the extent to which local and state incarceration has been
reduced or avoided.
(3) The number of persons participating in employment service
programs including competitive employment.
(4) The number of persons contacted in outreach efforts who appear
to be severely mentally ill, as described in Section 5600.3, who
have refused treatment after completion of all applicable outreach
measures.
(5) The amount of hospitalization that has been reduced or
avoided.
(6) The extent to which veterans identified through these programs'
outreach are receiving federally funded veterans' services for which
they are eligible.
(c) Each project shall include outreach and service grants in
accordance with a contract between the state and approved counties
that reflects the number of anticipated contacts with people who are
homeless or at risk of homelessness, and the number of those who are
severely mentally ill and who are likely to be successfully referred
for treatment and will remain in treatment as necessary.
(d) All counties that receive funding shall be subject to specific
terms and conditions of oversight and training which shall be
developed by the department, in consultation with the advisory
committee.
(e) (1) As used in this part, "receiving extensive mental health
services" means having a personal services coordinator, as described
in subdivision (b) of Section 5806, and having an individual personal
service plan, as described in subdivision (c) of Section 5806.
(2) The funding provided pursuant to this part shall be sufficient
to provide mental health services, medically necessary medications
to treat severe mental illnesses, alcohol and drug services,
transportation, supportive housing and other housing assistance,
vocational rehabilitation and supported employment services, money
management assistance for accessing other health care and obtaining
federal income and housing support, accessing veterans' services,
stipends, and other incentives to attract and retain sufficient
numbers of qualified professionals as necessary to provide the
necessary levels of these services. These grants shall, however, pay
for only that portion of the costs of those services not otherwise
provided by federal funds or other state funds.
(3) Methods used by counties to contract for services pursuant to
paragraph (2) shall promote prompt and flexible use of funds,
consistent with the scope of services for which the county has
contracted with each provider.
(f) Contracts awarded pursuant to this part shall be exempt from
the Public Contract Code and the state administrative manual and
shall not be subject to the approval of the Department of General
Services.
(g) Notwithstanding any other provision of law, funds awarded to
counties pursuant to this part and Part 4 (commencing with Section
5850) shall not require a local match in funds.
SEC. 5. Section 5814.5 of the Welfare and Institutions Code is
amended to read:
5814.5. (a) (1) In any year in which funds are appropriated for
this purpose through the annual Budget Act, counties funded under
this part in the 1999-2000 fiscal year are eligible for funding to
continue their programs if they have successfully demonstrated the
effectiveness of their grants received in that year and to expand
their programs if they also demonstrate significant continued unmet
need and capacity for expansion without compromising quality or
effectiveness of care.
(2) In any year in which funds are appropriated for this purpose
through the annual Budget Act, other counties or portions of
counties, or cities that operate independent public mental health
programs pursuant to Section 5615 of the Welfare and Institutions
Code, are eligible for funding to establish programs if a county or
eligible city demonstrates that it can provide comprehensive
services, as set forth in this part, to a substantial number of
adults who are severely mentally ill, as defined in Section 5600.3,
and are homeless or recently released from the county jail or who are
untreated, unstable, and at significant risk of incarceration or
homelessness unless treatment is provided.
(b) (1) Counties eligible for funding pursuant to subdivision (a)
shall be those that have or can develop integrated adult service
programs that meet the criteria for an adult system of care, as set
forth in Section 5806, and that have, or can develop, integrated
forensic programs with similar characteristics for parolees and those
recently released from county jail who meet the target population
requirements of Section 5600.3 and are at risk of incarceration
unless the services are provided. Local enrollment for integrated
adult service programs and for integrated forensic programs funded
pursuant to subdivision (a) shall adhere to all conditions set forth
by the department, including the total number of clients to be
enrolled, the providers to which clients are enrolled and the maximum
cost for each provider, the maximum number of clients to be served
at any one time, the outreach and screening process used to identify
enrollees, and the total cost of the program. Local enrollment of
each individual for integrated forensic programs shall be subject to
the approval of the county mental health director or his or her
designee.
(2) Each county shall ensure that funds provided by these grants
are used to expand existing integrated service programs that meet the
criteria of adults system of care to provide new services in
accordance with the purpose for which they were appropriated and
allocated, and that none of these funds shall be used to supplant
existing services to severely mentally ill adults. In order to
ensure that this requirement is met, the department shall develop
methods and contractual requirements, as it determines necessary. At
a minimum, these assurances shall include that state and federal
requirements regarding tracking of funds are met and that patient
records are maintained in a manner that protects privacy and
confidentiality, as required under federal and state law.
(c) Each county selected to receive a grant pursuant to this
section shall provide data as the department may require, that
demonstrates the outcomes of these adult system of care programs,
shall specify the additional numbers of severely mentally ill adults
to whom they will provide comprehensive services for each million
dollars of additional funding that may be awarded through either an
integrated adult service grant or an integrated forensic grant, and
shall agree to provide services in accordance with Section 5806.
Each county's plan shall identify and include sufficient funding to
provide housing for the individuals to be served, and shall ensure
that any hospitalization of individuals participating in the program
are coordinated with the provision of other mental health services
provided under the program.
SEC. 6. This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect. The facts constituting the necessity are:
In order to maintain the pilot programs and funding for the
homeless mentally ill as indicated within this act without
disruption, it is necessary that this act go into effect immediately.