BILL ANALYSIS
SENATE HUMAN
SERVICES COMMITTEE
Senator Carol Liu, Chair
BILL NO: AB 2039
A
AUTHOR: Logue
B
VERSION: February 17, 2010
HEARING DATE: June 10, 2010
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FISCAL: Appropriations
0
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CONSULTANT:
9
Park
SUBJECT
Placer County integrated health and human services program
SUMMARY
Makes permanent the authority for Placer County to operate
its pilot program to integrate the funding and delivery of
services and benefits for the county health and human
services system.
ABSTRACT
Existing law:
1.Authorizes Placer County, upon approval of the county, to
implement a pilot program for the funding of services and
benefits through an integrated and comprehensive county
health and human services system, as specified.
2.Requires Placer County to evaluate the pilot program and
submit the final evaluation of the pilot to the Governor
and Legislature not later than six months following the
third year of the implementation of the pilot program.
Continued---
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3.Provides that the program shall become inoperative on
July 1, 2011, and repeals the authorizing statute as of
January 1, 2012, unless the dates are repealed or
extended by statute on or before January 1, 2012.
4.Authorizes Humboldt County, Mendocino County, Alameda
County, and any additional county or counties, as
determined by the Secretary of California Health and
Human Services, to implement, prior to January 1, 2009, a
similar pilot program as Placer County, with requirements
for evaluation, but with no sunset date.
This bill:
1.Deletes the dates upon which the Placer County pilot
program become inoperative and makes permanent such
authority for operating its pilot to integrate the
funding and delivery of services and benefits for the
county health and human services system.
FISCAL IMPACT
According to the Assembly Appropriations Committee
analysis, no significant costs are associated with this
legislation.
BACKGROUND AND DISCUSSION
Author's statement
The author states that in 1996, a pilot program in Placer
County was authorized (SB 1846 (Leslie), Chapter 899,
Statutes of 1996) to address the uncoordinated, separately
funded, and narrowly targeted categorical programs of the
child welfare, probation, and mental health systems, which
did not address the broader needs of children and families.
According to the author, the statute allowed Placer County
to create a county child and family services fund that
implemented the California Blue Ribbon Commission's goal of
building an integrated service model for children in
multiple service sectors, and also provided the mechanism
to request waivers of regulations and policies to support
these integration efforts. The author notes that Placer
County has utilized the statutory authority to do the
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following:
o Implement a single, integrated service-planning
approach which utilizes child welfare, mental health,
probation and others to have one universal case with a
team approach, rather than one case and one plan in
each system.
o Authorize the county office of education to operate
a school program in the county's emergency shelter to
facilitate a team based approach to child welfare and
education.
o Develop and implement a strengths-based outcome
tool based on the family's assessment of its
strengths, rather than on the historically determined
"sickness" of the child or parent.
o Consolidate claiming for multiple public health
programs into one universal approach.
The author notes that many families that enter the foster
care system have multiple issues that affect the
environment for the child, including risk of abuse and
neglect, mental health and substance abuse issues,
probation, courts, etc. The author believes the pilot
program has achieved excellent outcomes, including improved
service delivery to children and families, reduced demand
for services, and a seamless integrated program model, in
addition to other efficiencies.
Evaluation of the pilot
According to committee analyses of the first extension of
the pilot in 2001, the evaluation of the pilot, funded by
Placer County and completed in July 2000 by the Public
Health Institute, focused primarily on the effectiveness of
the pilot program implementation process and the
adjustments necessary to produce desired outcomes in the
future. The evaluation also included recommendations
intended to be useful to the state and other counties in
the process of developing similar integrated and
coordinated health and human service delivery systems.
The evaluation included several suggestions for future
program operation, none of which were included in the
legislation to extend the sunset. Examples included the
creation of clear communication linkages with the state,
increased funding for the development of consolidated
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information systems, the creation of a common set of
accountability measures to assist with evaluation efforts,
and state-supported training and technical assistance for
county administrators and staff.
Arguments in support
According to Placer County Board of Supervisors, the
sponsor of the measure, the County has successfully
implemented a family-centered and needs-based model of
services to children and families, including blending the
child welfare, mental health, probation, and education
services into a single team approach. The County states
the Placer model of integrating child welfare, mental
health, probation, and education case management has
resulted in significant efficiencies and improved outcomes
reducing the recurrence of abuse and neglect. Placer
County notes that, since 2005, the integrated approach has
resulted in a 20 percent reduction in the number of
children needing to enter foster care and contributed to
more than 100 children finding stable, loving homes with
adoptive parents. The County also notes that it has
implemented consolidated claiming of 14 public health
programs into one claim, reducing administrative complexity
and prioritizing service delivery to residents.
The California State Association of Counties writes that
the bill would allow Placer County's nationally recognized
and proven approach to health and human services claiming
and service delivery to operate indefinitely, which saves
both the state and county money, and also ensures the
health and welfare of the county's most vulnerable
residents.
The California Medical Association (CMA) writes that the
bill will assist Placer Nevada County Medical Society
members to effectively utilize state and federal funding
streams for an array of services that benefit Placer and
Nevada county residents.
Related/prior legislation
AB 1859 (Leslie), Chapter 268, Statutes of 2006, extended
Placer County's pilot program five years to July 1, 2011.
AB 392 (Chan) of 2005 permits any county, with the
assistance and participation of the appropriate state
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departments, to implement a program for the funding and
delivery of services and benefits through an integrated and
comprehensive county health and human services system, as
specified. Provisions were amended out of the bill.
AB 308 (Leslie), Chapter 17, Statutes of 2001, extended
Placer County's pilot program five years to July 1, 2006.
AB 1259 (Strom-Martin), Chapter 705, Statutes of 1999, gave
specific authority to Alameda, Humboldt, and Mendocino
Counties, to operate an integration pilot similar to Placer
County's.
AB 866 (Thomson), Chapter 265, Statutes of 1997, gave
specific authority to Solano County to operate an
integration pilot similar to Placer County's.
SB 1846 (Leslie), Chapter 899, Statutes of 1996, authorized
Placer County's pilot program to integrate the funding and
delivery of services and benefits for the county health and
human services system.
PRIOR VOTES
Assembly Floor: 74 - 0
Assembly Appropriations:15 - 0
Assembly Human Services: 6 - 0
COMMENTS
1. Removal of other "pilot program" language. The author
may wish to consider removing other references to the pilot
status of this program, in addition to removing the sunset
date.
POSITIONS
Support: Placer County Board of Supervisors (sponsor)
California Medical Association
California State Association of Counties
Child Abuse Prevention Center
County Health Executives Association of
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California
County Welfare Directors Association of
California
Regional Council of Rural Counties
Oppose:None received
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