BILL ANALYSIS
AB 1571
Page 1
ASSEMBLY THIRD READING
AB 1571 (Veterans Affairs Committee)
As Introduced March 16, 2009
2/3 vote
HEALTH 14-2 VETERANS AFFAIRS 8-1
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|Ayes:|Jones, Fletcher, Adams, |Ayes:|Salas, Cook, DeVore, |
| |Ammiano, Block, Carter, | |Gilmore, Lieu, V. Manuel |
| |De Leon, Hall, Hernandez, | |Perez, Saldana, Yamada |
| |Bonnie Lowenthal, Nava, | | |
| |V. Manuel Perez, Salas, | | |
| |Audra Strickland | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Conway, Hayashi |Nays:|Huber |
| | | | |
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APPROPRIATIONS 15-0
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|Ayes:|De Leon, Nielsen, |
| |Ammiano, |
| |Charles Calderon, Davis, |
| |Duvall, Fuentes, Hall, |
| |Harkey, John A. Perez, |
| |Price, Skinner, Solorio, |
| |Audra Strickland, |
| |Torlakson |
|-----+--------------------------|
| | |
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SUMMARY : Prohibits the Department of Mental Health (DMH) from
approving a county's plan for the expenditure of funds from the
Mental Health Services Act (MHSA), as specified, unless it
includes verifiable representation from a legitimate veterans
group in the stakeholder planning process and includes a
separate section that specifically addresses how the mental
health needs of veterans are, or are not, being met.
Specifically, this bill :
1)Prohibits DMH from approving a county's plan for the
expenditure of MHSA funds for prevention and early
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intervention and innovation programs unless it includes
verifiable representation from a legitimate veterans group in
the required stakeholder planning process and includes a
section that addresses the specific mental health issues of
veterans and how the plan will, or will not, address those
issues.
2)Requires each county's expenditure update report for MHSA
funds allocated to services for children, adults, and seniors
to include the number of veterans to be served.
3)Revises the list of local stakeholders required to be
consulted in the development and update of each county's MHSA
plan to include representatives from a legitimate veterans
organization.
4)Specifies that the reports of achievement outcomes that are
required to be included in each county's MHSA plan must
specifically include recognition of the mental health needs of
veterans and how those needs are, or are not, being met.
EXISTING LAW :
1)Establishes DMH to direct and coordinate statewide efforts for
the treatment of mental disabilities.
2)Establishes the MHSA, enacted by voters in 2004 as Proposition
63, to provide funds to counties to expand services and
develop innovative programs and integrated service plans for
mentally ill children, adults, and seniors through a 1% tax on
personal income above $1 million.
3)Requires each county mental health department to prepare and
submit to DMH a three-year program and expenditure plan for
MHSA funding that addresses specified components, including
prevention and early intervention, and innovation. Requires
DMH to establish guidelines for the content of each of the
components and approval of county plans.
4)Requires each county plan and update to be developed with
local stakeholders, including adults and seniors with severe
mental illness, families of children, adults, and seniors with
severe mental illness, providers of services, law enforcement
agencies, educators, social services agencies, and other
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important interests.
5)Specifies that the MHSA may only be amended by a two-thirds
vote of both houses of the Legislature and only so long as the
amendment is consistent with and furthers the intent of the
MHSA. Permits provisions clarifying the procedures and terms
of the MHSA to be added by majority vote of the Legislature.
6)Establishes, under federal law, the Veterans Health
Administration (VA) within the U.S. Department of Veterans
Affairs, to provide health care and other benefits to veterans
and their families and administer VA medical centers and
outpatient clinics.
7)Requires counties to provide mental health services to target
populations to the extent resources are available. Includes
in the target populations California veterans in need of
mental health services who are not eligible for care by the VA
or other federal health care provider. Specifies the minimum
array of services that must be provided to target populations.
8)Clarifies that counties are required to provide mental health
services to California veterans in need of services and who
meet existing eligibility requirements, to the extent services
are available to other adults and to the extent resources are
available.
9)Requires counties to refer a veteran to the county veterans
service officer to determine the veteran's eligibility for,
and the availability of, mental health services provided by
the VA or other federal health care provider.
10)Prohibits an eligible veteran from being denied county mental
health services based solely on his or her status as a
veteran.
FISCAL EFFECT : According to the Assembly Appropriations
Committee analysis, absorbable workload of less than $50,000 to
DMH to add veteran review to the local plan review process and
unknown special fund costs to county MHSA stakeholder groups to
increase the specificity of planning and reporting regarding
veterans' mental health. Up to 5% of MHSA funding is available
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for county planning and other administrative activities.
COMMENTS : The author states that this bill is needed to ensure
that veterans receive their fair share of state and county
mental health resources. The author points out that there has
been a longstanding gap in mental health services for
California's veterans who have been referred to the VA for
services without regard to their actual eligibility for VA
services and the VA's actual capacity to deliver those services.
The author notes that veterans are disproportionately
represented among the homeless and mentally ill populations and
targeting veterans in the provision of county mental health
services will help to reduce the overall burden mental health
need places on our state and our communities.
According to the VA Web site, one of the more important VA
benefits is health care. The VA has about 1,300 health care
facilities, including 153 hospitals, 745 ambulatory care and
community-based outpatient clinics, and 209 counseling centers.
The VA provides a standardized, enhanced health benefits plan to
all enrolled veterans, which includes mental health and
substance abuse treatment. Veterans can apply for enrollment at
any VA health care facility or veterans' benefits office. As of
2007, more than seven million veterans are enrolled in the VA
health care system and a quarter of the nation's population,
approximately 70 million people, are potentially eligible for
benefits and services because they are veterans, family members,
or survivors of veterans.
The VA notes that many of the more than 631,000 soldiers who
have been discharged from the conflicts in Iraq and Afghanistan
have experienced multiple injuries including injuries to several
organs, limb loss, sensory loss, burns, and chronic pain.
Moreover, combat veterans of the Iraq and Afghanistan wars are
at higher risk for post-traumatic stress disorder and other
mental health disorders, such as adjustment disorder, anxiety,
depression, and substance abuse. The VA states that war
veterans are eligible for two years of free health care from the
VA for any condition that may be related to combat, and VA
clinicians are informed to evaluate veterans for war-related
mental disorders.
In November 2004, voters passed Proposition 63 or MHSA. MHSA
imposes a 1% state income surtax on incomes exceeding $1 million
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to be used to create new county mental health programs and
expand existing programs. MHSA requires each county mental
health program to prepare and submit a three-year plan to DMH
that must be updated each year and approved by DMH after review
and comment by the Mental Health Services Oversight and
Accountability Commission. In their three-year plans, counties
are required to submit a listing of all work plans for which
MHSA funding is being requested that identifies how the funds
will be spent and which populations will be served. This bill
requires counties to include in their revenue and expenditure
reports the number of veterans being served.
The California Mental Health Directors Association (CMHDA) and
the California State Association of Counties (CSAC) object to
this bill. They contend this bill singles out veterans for
special attention, which, they assert, could be very divisive at
the local level. CMHDA and CSAC also argue that, in many cases,
veterans come to county mental health departments and choose not
to self-identify as a veteran or as having been in the military.
They point out that many veterans are, in fact, being served
through adult mental health service programs, but are not
specifically identified as veterans, and may not want to be.
Analysis Prepared by : Cassie Rafanan / HEALTH / (916)
319-2097 FN: 0000894