BILL ANALYSIS
AB 2234
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Date of Hearing: April 28, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 2234 (Lowenthal) - As Amended: March 15, 2010
Policy Committee: Health Vote:19-0
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill modifies definitions for "adults," "serious mental
disorder," and "functional impairment" in several areas of
mental health statutes including Bronzan-McCorquodale (county
realignment), the Mental Health Services Act (MHSA/Proposition
63), and statutes addressing court-ordered treatment.
Specifically, this bill:
1)Changes "adults and older adults" under realignment and
Proposition 63 target population categories to adults 18 to
59, inclusive, and older adults 60 years of age and older.
2)Links definitions added by this bill for older adults, serious
mental disorder, and functional impairments to realignment,
Proposition 63, and court ordered mental health treatment
statutes.
3)Changes the definition for "functional impairment" related to
a mental illness from a general definition to one that defines
impairment to mean impairment in two of several areas
including activities of daily living, employment, and leisure
activities.
FISCAL EFFECT
1)On-going cost pressure or reallocation of $100 million to $200
million (realignment or Proposition 63 funds) to the extent
this bill leads to more or different Californians receiving
mental health treatment and services under county-administered
programs. There are six million Californians older than 60
years of age. Mental health programs serve people of all ages.
Therefore, if this bill increases services provided to older
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individuals, as is the author's intention, services for
children or non-elderly adults may be reduced. This estimate
assumes a mental health fund shift to older adults of about
5%.
2)In 2009-10 more than $2 billion in realignment and Proposition
63 funding is provided to counties. These funding sources are
capped and there is significant unmet need statewide for
mental health treatment across all age categories and target
populations.
3)This bill contains a substantive change to the definition of
"functional impairment" as it applies to older adults. While
the definition allows for additional areas of impairment to be
considered for establishing eligibility, it requires two areas
of specific impairment be demonstrated rather than one general
category. It appears this change in definition may both
increase and reduce access and may increase a burden for both
patient and administrator in documenting impairment, as
required necessary in several other health programs.
COMMENTS
1)Rationale . This bill is co-sponsored by the California
Commission on Aging and the California Mental Health Planning
Council to increase the provision of mental health treatment
and services to older adults. According to the author and
sponsors, although older Californians have significant mental
health needs and more complex needs than younger counterparts,
their needs are often overlooked. This bill increases the
specificity of statutes to address older adults and to elevate
their target population status within county funded
realignment and Proposition 63 programs.
2)Realignment . The Bronzan-McCorquodale Act, Chapter 89,
Statutes of 1991, refers to realignment of mental health
funding and programs. Realignment transferred financial
responsibility for many mental health, public health, and
social service program from the state to local governments,
and provided counties with a dedicated revenue source to pay
for these changes. For mental health, realignment transferred
funding associated with categorical programs, general
community mental health funding, state hospital civil
commitment funding, and institutions for mental disease.
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3)Proposition 63 , approved by voters in November 2004, enacted a
state personal income tax surcharge of 1% that applies to
taxpayers with annual taxable incomes of more than $1 million.
The funds are used to provide mental health services
statewide.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081