BILL ANALYSIS
AB 1808
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Date of Hearing: May 5, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1808 (Galgiani) - As Amended: April 19, 2010
Policy Committee: Human
ServicesVote:6-0
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill shifts responsibility for the provision of mental
health services for foster youth placed out-of-county.
Specifically, this bill shifts the responsibility for the
provision of medically necessary mental health services from the
county-of-origin to the host county in order to increase access
to mental heath services for youth.
FISCAL EFFECT
1)Annual increased costs in the Early Periodic Screening
Treatment and Diagnosis Program (EPSDT) in excess of $10
million (50% GF) to $20 million (50% GF) to the extent this
bill increases access to mental health services for youth who
face treatment and service barriers when placed out-of-county.
2)This estimate likely underestimates the actual need for mental
health treatment for many foster youth placed out-of-county.
This bill addresses a complex, longstanding, and costly issue
by switching responsibilities from one set of counties to
another. The actual costs associated with this bill may be
much greater depending on whether access is truly improved for
foster youth benefiting from this change.
3)Foster children have a high rate of mental health diagnosis,
treatment needs, and associated expenditures compared to other
children. Large studies have shown mental health costs accrue
for foster youth at five to ten times the rate for comparison
children.
AB 1808
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COMMENTS
1)Rationale . This bill moves responsibility for the provision of
mental health services for foster youth from the
county-of-origin to the host county. The author indicates
current law arrangements result in treatment delays and
denials when a child is placed out-of-county and the host
county must recover mental health funding from the county from
which the child was removed.
2)Background . The Early and Periodic Screening, Diagnosis and
Treatment Program (EPSDT), is a federally-mandated benefit
under Medi-Cal. States must provide medically necessary
services to specified children. If a physician screening
determines a child needs additional treatment, Medi-Cal must
provide the service according to the federal mandate. EPSDT is
the source of funding for a majority of mental health
treatment for children in foster care. Mental health services
provided to foster youth include outpatient services,
medication support, behavioral therapy, and 24-hour care.
3)Related Legislation . The most recent among numerous attempts
to resolve the issue of access to mental health treatment for
out-of-county foster youth was SB 785 (Steinberg), Chapter
469, Statutes of 2007. SB 785 required the California
Department of Mental Health (DMH) to create standardized
contracts, forms, and procedures to facilitate the receipt of
medically necessary specialty mental health services to foster
youth in out-of-county placements. DMH provided counties with
the standard agreement and forms for the provision of
out-of-county services in May of 2009. Counties are in the
process of implementing protocols established by SB 785.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081