BILL NUMBER: SB 1136 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Steinberg
FEBRUARY 21, 2012
An act to amend Sections 21, 4030, 4031, 4032, 4033, 4040, 4050,
4051, 4052, 4060, 4061, 4090, 4091, 4094, 5370.2, 5510, 5513, 5514,
5530, 5585.22, 5601, 5602, 5604, 5610, 5652.7, 5653, 5653.1, 5654,
5655, 5664, 5664.5, 5692, 5701, 5701.1, 5707, 5715, 5717, 5751,
5751.1, 5751.2, 5770, 5770.5, 5771, 5771.3, 5772, 5815, 5840, 5845,
5851.5, 5852.5, 5854, 5855, 5855.5, 5868, 5869, 5878, 5878.3, 5880,
5890, 11325.7, 11462.01, and 18986.40 of, and to add Section 4024.7
to, the Welfare and Institutions Code, relating to health.
LEGISLATIVE COUNSEL'S DIGEST
SB 1136, as introduced, Steinberg. Health: mental health: health
equity.
Under existing law, the State Department of Mental Health is
authorized and required to perform various functions relating to the
care and treatment of persons with mental disorders.
Existing law, the Mental Health Services Act, an initiative
measure enacted by the voters as Proposition 63 at the November 2,
2004, statewide general election, establishes the Mental Health
Services Fund to fund various county mental health programs. The act
provides that it may be amended by the Legislature by a 2/3 vote of
each house as long as the amendment is consistent with and furthers
the intent of the act, and that the Legislature may also clarify
procedures and terms of the act by majority vote.
This bill would transfer various functions of the State Department
of Mental Health to the State Department of Health Care Services.
This bill would make various technical and conforming changes to
reflect the transfer of state mental health responsibilities.
This bill would authorize the Governor or the Director of Health
Care Services to appoint, subject to confirmation by the Senate, a
Deputy Director of Mental Health and Substance Use Disorder Services
of the State Department of Health Care Services.
This bill also would state the intent of the Legislature to
create an Office of Health Equity to comprehensively address issues
of health disparity, promote healthy communities, and improve
individual health outcomes.
Existing law requires the State Department of Mental Health to
adopt as part of its overall mission the development of
community-based, comprehensive, interagency systems of care that
target seriously emotionally and behaviorally disturbed children, as
specified.
This bill would instead authorize, rather than require, these
provisions to be implemented.
This bill would declare that it clarifies procedures and terms of
the Mental Health Services Act.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. It is the intent of the Legislature to enact
legislation to realign state administration of community-based mental
health services. By enacting this legislation, it is the intent of
the Legislature to do all of the following:
(a) Improve access to culturally appropriate community-based
mental health services, including a focus on client recovery, social
rehabilitation services, and peer support.
(b) Offer fuller integration of health, mental health, and
behavioral health services to individuals in need of these critical
services.
(c) Offer constructive opportunities for a more inclusive and
comprehensive delivery system for individuals needing access to the
full continuum of prevention and treatment services.
(d) Establish a qualitative process of seeking meaningful
stakeholder participation in policy development and policy
decisionmaking.
(e) Increase accountability and program effectiveness for publicly
funded mental health systems and the health care purchasing
functions of state government.
(f) Effectively integrate the financing of services, including the
receipt of federal funds, to more effectively provide services.
(g) Provide focused, high-level leadership for mental health and
behavioral health services within the state administrative structure.
(h) Eliminate administrative redundancies and inefficiencies
across programs.
SEC. 2. It is the intent of the Legislature to enact legislation
to create an Office of Health Equity to comprehensively address
issues of health disparity, promote healthy communities, and improve
individual health outcomes. By enacting this legislation, it is the
intent of the Legislature to do all of the following:
(a) Provide consultation to increase public awareness of health
disparities, both in terms of public health, mental health, substance
use disorders, and the health care purchasing functions of state
government.
(b) Identify and recommend policies and actions to improve social
and environmental conditions.
(c) Implement policies and programs that result in a sustainable
improvement in the health and mental health status of underserved and
disparate communities by working with local communities, local
agencies, policymakers, insurers, health care providers, mental
health providers, state departments, and others.
(d) Provide technical assistance to state departments, boards, and
agencies on incorporating a health equity framework into
health-related planning processes, programs, and policy efforts.
(e) Conduct research, data collection, and analysis to identify
health disparities and develop policy priorities and efforts to
improve health equity.
SEC. 3. Section 21 of the Welfare and Institutions Code is amended
to read:
21. (a) Whenever any reference is made in any provision of this
code to the "State Department of Benefit Payments" or the "Department
of Benefit Payments" with respect to aid, it means the State
Department of Social Services.
Whenever any reference is made to the "State Department of Benefit
Payments" or "Department of Benefit Payments" with respect to mental
disorders, it means the State Department of Mental
Health Care Services . Whenever reference is made to the
"State Department of Benefit Payments" or "Department of Benefit
Payments" with respect to developmental disabilities, it means the
State Department of Developmental Services.
(b) Whenever any reference is made in any provision of this code
to the "State Department of Health" or the "Department of Health"
with respect to health services, medical assistance, or benefits, it
means the State Department of Health Services
either the State Department of Health Care Services or the State
Department of Public Health, as applicable .
Whenever any reference is made to the "State Department of Health"
or the "Department of Health" with respect to mental disorders, it
means the State Department of Mental Health
Care Services . Whenever any reference is made to the "State
Department of Health" or "Department of Health" in respect to
developmental disabilities, it means the State Department of
Developmental Services.
(c) Whenever any reference is made in any provision of this code
to the "Director of Benefit Payments" with respect to aid, it means
the Director of Social Services.
Whenever any reference is made to the "Director of Benefit
Payments" with respect to mental disorders, it means the Director of
Mental Health Care Services . Whenever
any reference is made to the "Director of Benefit Payments" with
respect to developmental disabilities, it means the Director of
Developmental Services.
(d) Whenever any reference is made in any provision of this code
to the "State Director of Health" or "Director of Health" with
respect to health services, medical assistance, or benefits, it means
the State Director of Health Services
Director of Health Care Services or the State Public Health Officer,
as applicable .
Whenever any reference is made to the "State Director of Health"
or "Director of Health" with respect to mental disorders, it means
Director of Mental Health Care Services
. Whenever any reference is made to the "State Director of Health"
or "Director of Health" with reference to developmental disabilities,
it means the Director of Developmental Services.
SEC. 4. Section 4024.7 is added to the Welfare and Institutions
Code, to read:
4024.7. The Governor or the Director of Health Care Services may
appoint, subject to confirmation by the Senate, a Deputy Director of
Mental Health and Substance Use Disorder Services of the Department
of Health Care Services. The salary for the deputy director shall be
fixed in accordance with law.
SEC. 5. Section 4030 of the Welfare and Institutions Code is
amended to read:
4030. The Director of Mental Health Care
Services shall organize appropriate staff of the department to
ensure implementation of the planning, research, evaluation,
technical assistance, and quality assurance responsibilities set
forth in this chapter.
SEC. 6. Section 4031 of the Welfare and Institutions Code is
amended to read:
4031. The State Department of Mental Health
Care Services shall, to the extent resources are
available, do all of the following:
(a) Conduct, sponsor, coordinate, and disseminate results of
research and evaluation directed to the public policy issues entailed
in the selection of resource utilization and service delivery in the
state.
(b) Make available technical assistance to local mental health
programs incorporating the results of research, evaluation, and
quality assurance to local mental health programs.
(c) Implement a system of required performance reporting by local
mental health programs.
(d) Perform any other activities useful to improving and
maintaining the quality of state mental hospital and
community mental health programs.
SEC. 7. Section 4032 of the Welfare and Institutions Code is
amended to read:
4032. The department State Department of
Health Care Services shall, when appropriate, give and receive
grants and contracts for research, evaluation, and quality assurance
efforts.
SEC. 8. Section 4033 of the Welfare and Institutions Code is
amended to read:
4033. (a) The State Department of Mental
Health Care Services shall, to the extent resources are
available, comply with Substance Abuse and Mental Health
Services Administration federal planning requirements. The
department shall update and issue a state plan, which may also be any
federally required state service plan, so that citizens may be
informed regarding the implementation of, and long-range goals for,
programs to serve mentally ill persons in the state. The department
shall gather information from counties necessary to comply with this
section.
(b) (1) If the State Department of Mental
Health Care Services makes a decision not to comply with
any Substance Abuse and Mental Health Services Administration
federal planning requirement to which this section applies, the
State Department of Mental Health Care
Services shall submit the decision, for consultation, to the
California Conference of Local Mental Health
Directors Association , the California Council on Mental
Health, and affected mental health entities.
(2) The State Department of Mental Health
Care Services shall not implement any decision not to comply
with the Substance Abuse and Mental Health Services
Administration federal planning requirements sooner than 30
days after notification of that decision, in writing, by the
Department of Finance, to the chairperson of the committee in each
house of the Legislature which considers appropriations, and the
Chairperson of the Joint Legislative Budget Committee.
SEC. 9. Section 4040 of the Welfare and Institutions Code is
amended to read:
4040. The State Department of Mental Health
Care Services may conduct, or contract for, research or
evaluation studies which that have
application to mental health policy and management issues.
In selecting areas for study , the department shall be
guided by the information needs of state and local policymakers and
managers, and suggestions from the Mental Health Services
Oversight and Accountability Commission established in Section 5845
and the California Conference of Local
Mental Health Directors Association .
SEC. 10. Section 4050 of the Welfare and Institutions Code is
amended to read:
4050. The State Department of Mental Health
Care Services shall provide, to the extent resources are
available, technical assistance, through its own staff, or by
contract, to county mental health programs and other local mental
health agencies in the areas of program operations, research,
evaluation, demonstration, or quality assurance projects. The
State Department of Health Care Services shall actively seek
foundation support and federal grant opportunities for these
purposes, and may utilize other federal financial participation when
allowed by federal law.
SEC. 11. Section 4051 of the Welfare and Institutions Code is
amended to read:
4051. The State Department of Mental Health
Care Services shall, to the extent resources are
available, provide program development guidelines, evaluation models,
and operational assistance on all aspects of services to mentally
ill persons of all ages. These services include, but are not limited
to, the following:
(a) Self-help programs.
(b) Housing development.
(c) Disaster preparation.
(d) Vocational services.
(e) Regional programs.
(f) Multiple diagnosis programs.
SEC. 12. Section 4052 of the Welfare and Institutions Code is
amended to read:
4052. The State Department of Mental Health
Care Services shall, to the extent resources are
available, provide training in performance standards, model programs,
cultural competency, and program development.
SEC. 13. Section 4060 of the Welfare and Institutions Code is
amended to read:
4060. The department State Department of
Health Care Services shall, in order to implement Section 4050,
utilize a joint state-county decisionmaking process that shall
include local mental health directors and representatives of local
mental health boards. The purpose of this collaboration shall be to
promote effective and efficient quality mental health services to the
residents of the state under the realigned mental health system.
SEC. 14. Section 4061 of the Welfare and Institutions Code is
amended to read:
4061. (a) The department State Department
of Health Care Services shall utilize a joint state-county
decisionmaking process to determine the appropriate use of state and
local training, technical assistance, and regulatory resources to
meet the mission and goals of the state's mental health system. The
department shall use the decisionmaking collaborative process
required by this section in all of the following areas:
(1) Providing technical assistance to the State Department of
Mental Health Care Services and local
mental health departments through direction of existing state and
local mental health staff and other resources.
(2) Analyzing mental health programs, policies, and procedures.
(3) Providing forums on specific topics as they relate to the
following:
(A) Identifying current level of services.
(B) Evaluating existing needs and gaps in current services.
(C) Developing strategies for achieving statewide goals and
objectives in the provision of services for the specific area.
(D) Developing plans to accomplish the identified goals and
objectives.
(4) Providing forums on policy development and direction with
respect to mental health program operations and clinical issues.
(5) Identifying and funding a statewide training and technical
assistance entity jointly governed by local mental health directors
and mental health constituency representation, which can do all of
the following:
(A) Coordinate state and local resources to support training and
technical assistance to promote quality mental health programs.
(B) Coordinate training and technical assistance to ensure
efficient and effective program development.
(C) Provide essential training and technical assistance, as
determined by the state-county decisionmaking process.
(b) Local mental health board members shall be included in
discussions pursuant to Section 4060 when the following areas are
discussed:
(1) Training and education program recommendations.
(2) Establishment of statewide forums for all organizations and
individuals involved in mental health matters to meet and discuss
program and policy issues.
(3) Distribution of information between the state, local programs,
local mental health boards, and other organizations as appropriate.
(c) The State Department of Mental Health
Care Services and local mental health departments
may provide staff or other resources, including travel reimbursement,
for consultant and advisory services; for the training of personnel,
board members, or consumers and families in state and local programs
and in educational institutions and field training centers approved
by the department; and for the establishment and maintenance of field
training centers.
SEC. 15. Section 4090 of the Welfare and Institutions Code is
amended to read:
4090. (a) The State Department of Mental
Health Care Services shall establish, by regulation,
standards for the programs listed in Chapter 2.5 (commencing with
Section 5670) of Part 2 of Division 5. These standards shall also be
applied by the department to any facility licensed as a social
rehabilitation facility pursuant to paragraph (7) of subdivision (a)
of Section 1502 of the Health and Safety Code.
(b) In establishing the standards required by this section, the
department shall not establish standards which
that in themselves impose any new or increased costs on
the programs or facilities affected by the standards.
SEC. 16. Section 4091 of the Welfare and Institutions Code is
amended to read:
4091. Nothing in Section 4090 limits the authority of the State
Department of Mental Health Care Services
to delegate the evaluation and enforcement of the program
standards to a county mental health program when a licensed social
rehabilitation facility has a contractual relationship with a county
mental health program and the county has requested the delegation.
SEC. 17. Section 4094 of the Welfare and Institutions Code is
amended to read:
4094. (a) The State Department of Mental Health shall establish,
by regulations adopted at the earliest possible date, but no later
than December 31, 1994, program standards for any facility licensed
as a community treatment facility. This section shall apply only to
community treatment facilities described in this subdivision.
(b) Commencing July 1, 2012, the State Department of Health Care
Services may adopt or amend regulations pertaining to the program
standards for any facility licensed as a community treatment
facility.
(b)
(c) A certification of compliance issued by the State
Department of Mental Health Care Services
shall be a condition of licensure for the community treatment
facility by the State Department of Social Services. The department
may, upon the request of a county, delegate the certification and
supervision of a community treatment facility to the county
department of mental health.
(c)
(d) The State Department of Mental
Health Care Services shall adopt regulations to include,
but not be limited to, the following:
(1) Procedures by which the Director of Mental
Health Care Servi ces shall certify that a
facility requesting licensure as a community treatment facility
pursuant to Chapter 3 (commencing with Section 1500) of Division 2 of
the Health and Safety Code is in compliance with program standards
established pursuant to this section.
(2) Procedures by which the Director of Mental
Health Care Services shall deny a certification to a
facility or decertify a facility that is licensed as a community
treatment facility pursuant to Chapter 3 (commencing with Section
1500) of Division 2 of the Health and Safety Code, but no longer
complying with program standards established pursuant to this
section, in accordance with Chapter 5 (commencing with Section 11500)
of Part 1 of Division 3 of Title 2 of the Government Code.
(3) Provisions for site visits by the State Department of
Mental Health Care Services for the purpose of
reviewing a facility's compliance with program standards established
pursuant to this section.
(4) Provisions for the community care licensing staff of the State
Department of Social Services to report to the State Department of
Mental Health Care Services when there
is reasonable cause to believe that a community treatment facility is
not in compliance with program standards established pursuant to
this section.
(5) Provisions for the State Department of Mental
Health Care Services to provide consultation and
documentation to the State Department of Social Services in any
administrative proceeding regarding denial, suspension, or revocation
of a community treatment facility license.
(d)
(e) The standards adopted by regulations pursuant to
subdivision subdivisions (a) and
(b) shall include, but not be limited to, standards for
treatment, staffing, and for the use of psychotropic medication,
discipline, and restraints in the facilities. The standards shall
also meet the requirements of Section 4094.5.
(e)
(f) (1) Until January 1, 2013, all of the following are
applicable:
(A) A community treatment facility shall not be required by the
State Department of Mental Health Care
Services to have 24-hour onsite licensed nursing staff, but
shall retain at least one full-time, or full-time-equivalent,
registered nurse onsite if both of the following are applicable:
(i) The facility does not use mechanical restraint.
(ii) The facility only admits children who have been assessed, at
the point of admission, by a licensed primary care provider and a
licensed psychiatrist, who have concluded, with respect to each
child, that the child does not require medical services that require
24-hour nursing coverage. For purposes of this section, a "primary
care provider" includes a person defined in Section 14254, or a nurse
practitioner who has the responsibility for providing initial and
primary care to patients, for maintaining the continuity of care, and
for initiating referral for specialist care.
(B) Other medical or nursing staff shall be available on call to
provide appropriate services, when necessary, within one hour.
(C) All direct care staff shall be trained in first aid and
cardiopulmonary resuscitation, and in emergency intervention
techniques and methods approved by the Community Care Licensing
Division of the State Department of Social Services.
(2) The State Department of Mental Health may adopt emergency
regulations as necessary to implement this subdivision. The adoption
of these regulations shall be deemed to be an emergency and necessary
for the immediate preservation of the public peace, health and
safety, and general welfare. The regulations shall be exempt from
review by the Office of Administrative Law and shall become effective
immediately upon filing with the Secretary of State. The regulations
shall not remain in effect more than 180 days unless the adopting
agency complies with all the provisions of Chapter 3.5 (commencing
with Section 11340) of Part 1 of Division 3 of Title 2 of the
Government Code, as required by subdivision (e) of Section 11346.1 of
the Government Code.
(f)
(g) During the initial public comment period for the
adoption of the regulations required by this section, the community
care facility licensing regulations proposed by the State Department
of Social Services and the program standards proposed by the State
Department of Mental Health shall be presented simultaneously.
(g)
(h) A minor shall be admitted to a community treatment
facility only if the requirements of Section 4094.5 and either of the
following conditions are met:
(1) The minor is within the jurisdiction of the juvenile court,
and has made voluntary application for mental health services
pursuant to Section 6552.
(2) Informed consent is given by a parent, guardian, conservator,
or other person having custody of the minor.
(h)
(i) Any minor admitted to a community treatment
facility shall have the same due process rights afforded to a minor
who may be admitted to a state hospital, pursuant to the holding in
In re Roger S. (1977) 19 Cal.3d 921. Minors who are wards or
dependents of the court and to whom this subdivision applies shall be
afforded due process in accordance with Section 6552 and related
case law, including In re Michael E. (1975) 15 Cal.3d 183.
Regulations adopted pursuant to Section 4094
this section shall specify the procedures for ensuring these
rights, including provisions for notification of rights and the time
and place of hearings.
(i)
(j) Notwithstanding Section 13340 of the Government
Code, the sum of forty-five thousand dollars ($45,000) is hereby
appropriated annually from the General Fund to the State Department
of Mental Health for one personnel year to carry out the provisions
of this section.
SEC. 18. Section 5370.2 of the Welfare and Institutions Code is
amended to read:
5370.2. (a) Beginning January 1, 1996, the
The State Department of Mental Health
State Hospitals and the State Department of Health Care Services
shall have a single comprehensive contract with a
single nonprofit agency that meets the criteria specified in
subdivision (b) of Section 5510 to conduct the following activities:
(1) Provide patients' rights advocacy services for, and conduct
investigations of alleged or suspected abuse and neglect of,
including deaths of, persons with mental disabilities residing in
state hospitals.
(2) Investigate and take action as appropriate and necessary to
resolve complaints from or concerning recipients of mental health
services residing in licensed health or community care facilities
regarding abuse, and unreasonable denial, or punitive withholding of
rights guaranteed under this division that cannot be resolved by
county patients' rights advocates.
(3) Provide consultation, technical assistance, and support to
county patients' rights advocates in accordance with their duties
under Section 5520.
(4) Conduct program review of patients' rights programs.
(b) The services shall be provided in coordination with the
appropriate mental health patients' rights advocates.
(c) (1) The contractor shall develop a plan to provide patients'
rights advocacy services for, and conduct investigations of alleged
or suspected abuse and neglect of, including the deaths of, persons
with mental disabilities residing in state hospitals.
(2) The contractor shall develop the plan in consultation with the
statewide organization of mental health patients' rights advocates,
the statewide organization of mental health clients, and the
statewide organization of family members of persons with mental
disabilities, and the statewide organization of county mental health
directors.
(3) In order to ensure that persons with mental disabilities have
access to high quality advocacy services, the contractor shall
establish a grievance procedure and shall advise persons receiving
services under the contract of the availability of other advocacy
services, including services provided by the protection and advocacy
agency specified in Section 4901 and the county patients' rights
advocates specified in Section 5520.
(d) Nothing contained in this section shall be construed to
restrict or limit the authority of the department to conduct the
reviews and investigations it deems necessary for personnel,
criminal, and litigation purposes.
(e) The State Department of Mental Health
State Hospitals and the State Department of Health Care
Services shall have a single comprehe nsive
contract on a multiyear basis for a contract term of up to five
years.
SEC. 19. Section 5510 of the Welfare and Institutions Code is
amended to read:
5510. (a) The Legislature finds and declares as follows:
(1) The State of California accepts its responsibility to ensure
and uphold the right of persons with mental disabilities and an
obligation, to be executed by the State Department of Mental
Health Care Services and the State Department of State
Hospitals , to ensure that mental health laws, regulations and
policies on the rights of recipients of mental health services are
observed and protected in state hospitals and in licensed health and
community care facilities.
(2) Persons with mental disabilities are vulnerable to abuse,
neglect, and unreasonable and unlawful deprivations of their rights.
(3) Patients' rights advocacy and investigative services
concerning patient abuse and neglect currently
formerly provided by the State Department of Mental
Health, including the department's Office of Human Rights and
investigator, and state hospital patients' rights advocates and state
hospital investigators may have had conflicts of interest
or the appearance of a conflict of
interest.
(4) The services provided to patients and their families is of
such a special and unique nature that they must be contracted out
pursuant to paragraph (3) of subdivision (b) of Section 19130 of the
Government Code.
(b) Therefore, to avoid the potential for a conflict of interest
or the appearance of a conflict of interest, it is the intent of the
Legislature that the patients' rights advocacy and investigative
services described in this article be provided by a single contractor
specified in Section 5370.2 that meets both of the following
criteria:
(1) The contractor can demonstrate the capability to provide
statewide advocacy services for persons with mental disabilities.
(2) The contractor has no direct or indirect responsibility for
providing services to persons with mental disabilities, except
advocacy services.
(c) For the purposes of this article, the Legislature further
finds and declares, because of a potential conflict of interest or
the appearance of a conflict of interest, that the goals and purposes
of the state patients' rights advocacy and investigative services
cannot be accomplished through the utilization of persons selected
pursuant to the regular state civil service system. Accordingly, the
contracts into which the department enters
departments enter pursuant to this section are permitted and
authorized by paragraphs (3) and (5) of subdivision (b) of Section
19130 of the Government Code. The State Department of Mental
Health Care Services and the State Department of
State Hospitals shall have a single comprehensive
contract with a single nonprofit entity to provide for the protection
and advocacy services to persons with mental disabilities. The
entity shall be responsible for ensuring that mental health laws,
regulations, and policies on the rights of recipients of mental
health services are observed in state hospitals and in licensed
health and community care facilities.
(d) The findings and declarations of potential conflict of
interest provided in this section shall not apply to advocacy
services provided under Article 3 (commencing with Section 5520).
SEC. 20. Section 5513 of the Welfare and Institutions Code is
amended to read:
5513. The Patients' Rights Office shall serve as a liaison
between county patients' rights advocates and the State Department of
Mental Health Care Services .
SEC. 21. Section 5514 of the Welfare and Institutions Code is
amended to read:
5514. There shall be a five-person Patients' Rights Subcommittee
of the California Council on Mental Health. This subcommittee,
supplemented by two ad hoc members appointed by the chairperson of
the subcommittee, shall advise the Director of Mental
Health Care Services and the Director of State
Hospitals regarding department policies and practices that
affect patients' rights. The subcommittee shall also review the
advocacy and patients' rights components of each county
Short-Doyle plan and advise the Director of Mental
Health Care Services and the Director of State
Hospitals concerning the adequacy of each plan in protecting
patients' rights. The ad hoc members of the subcommittee shall be
persons with substantial experience in establishing and providing
independent advocacy services to recipients of mental health
services.
SEC. 22. Section 5530 of the Welfare and Institutions Code is
amended to read:
5530. (a) County patients' rights advocates shall have access to
all clients and other recipients of mental health services in any
mental health facility, program, or service at all times as are
necessary to investigate or resolve specific complaints and in accord
with subdivision (b) of Section 5523. County patients' rights
advocates shall have access to mental health facilities, programs,
and services, and recipients of services therein during normal
working hours and visiting hours for other advocacy purposes.
Advocates may appeal any denial of access directly to the head of any
facility, the director of a county mental health program or the
State Department of Mental Health Care
Services or may seek appropriate relief in the courts. If a
petition to a court sets forth prima facie evidence for relief, a
hearing on the merits of the petition shall be held within two
judicial days of the filing of the petition. The superior court for
the county in which the facility is located shall have jurisdiction
to review petitions filed pursuant to this chapter.
(b) County patients' rights advocates shall have the right to
interview all persons providing the client with diagnostic or
treatment services.
(c) Upon request, all mental health facilities shall, when
available, provide reasonable space for county patients' rights
advocates to interview clients in privacy and shall make appropriate
staff persons available for interview with the advocates in
connection with pending matters.
(d) Individual patients shall have a right to privacy which shall
include the right to terminate any visit by persons who have access
pursuant to this chapter and the right to refuse to see any patient
advocate.
(e) Notice of the availability of advocacy services and
information about patients' rights may be provided by county patients'
rights advocates by means of distribution of educational materials
and discussions in groups and with individual patients.
SEC. 23. Section 5585.22 of the Welfare and Institutions Code is
amended to read:
5585.22. The Director of Mental Health
Care Services , in consultation with the California
Conference of Local Mental Health Directors
Association , may develop the appropriate educational materials
and a training curriculum, and may provide training as necessary to
assure those persons providing services pursuant to this part fully
understand its purpose.
SEC. 24. Section 5601 of the Welfare and Institutions Code is
amended to read:
5601. As used in this part:
(a) "Governing body" means the county board of supervisors or
boards of supervisors in the case of counties acting jointly; and in
the case of a city, the city council or city councils acting jointly.
(b) "Conference" means the California Conference of Local
Mental Health Directors as established under
Section 5757 Association .
(c) Unless the context requires otherwise, "to the extent
resources are available" means to the extent that funds deposited in
the mental health account of the local health and welfare fund are
available to an entity qualified to use those funds.
(d) "Part 1" refers to the Lanterman-Petris-Short Act (Part 1
(commencing with Section 5000)).
(e) "Director of Mental Health Care
Services " or "director" means the Director of the
State Department of Mental Health Care Services
.
(f) "Institution" includes a general acute care hospital, a state
hospital, a psychiatric hospital, a psychiatric health facility, a
skilled nursing facility, including an institution for mental disease
as described in Chapter 1 (commencing with Section 5900) of Part 5,
an intermediate care facility, a community care facility or other
residential treatment facility, or a juvenile or criminal justice
institution.
(g) "Mental health service" means any service directed toward
early intervention in, or alleviation or prevention of, mental
disorder, including, but not limited to, diagnosis, evaluation,
treatment, personal care, day care, respite care, special living
arrangements, community skill training, sheltered employment,
socialization, case management, transportation, information,
referral, consultation, and community services.
SEC. 25. Section 5602 of the Welfare and Institutions Code is
amended to read:
5602. The board of supervisors of every county, or the boards of
supervisors of counties acting under the joint powers provisions of
Article 1 (commencing with Section 6500) of Chapter 5 of Division 7
of Title 1 of the Government Code shall establish a community mental
health service to cover the entire area of the county or counties.
Services of the State Department of Mental Health
Care Services shall be provided to the county, or counties
acting jointly, or, if both parties agree, the state facilities may,
in whole or in part, be leased, rented or sold to the county or
counties for county operation, subject to terms and conditions
approved by the Director of General Services.
SEC. 26. Section 5604 of the Welfare and Institutions Code is
amended to read:
5604. (a) (1) Each community mental health service shall have a
mental health board consisting of 10 to 15 members, depending on the
preference of the county, appointed by the governing body, except
that boards in counties with a population of less than 80,000 may
have a minimum of five members. One member of the board shall be a
member of the local governing body. Any county with more than five
supervisors shall have at least the same number of members as the
size of its board of supervisors. Nothing in this section shall be
construed to limit the ability of the governing body to increase the
number of members above 15. Local mental health boards may recommend
appointees to the county supervisors. Counties are encouraged to
appoint individuals who have experience and knowledge of the mental
health system. The board membership should reflect the ethnic
diversity of the client population in the county.
(2) Fifty percent of the board membership shall be consumers or
the parents, spouses, siblings, or adult children of consumers, who
are receiving or have received mental health services. At least 20
percent of the total membership shall be consumers, and at least 20
percent shall be families of consumers.
(3) (A) In counties under 80,000 population, at least one member
shall be a consumer, and at least one member shall be a parent,
spouse, sibling, or adult child of a consumer, who is receiving, or
has received, mental health services.
(B) Notwithstanding subparagraph (A), a board in a county with a
population under 80,000 that elects to have the board exceed the
five-member minimum permitted under paragraph (1) shall be required
to comply with paragraph (2).
(b) The term of each member of the board shall be for three years.
The governing body shall equitably stagger the appointments so that
approximately one-third of the appointments expire in each year.
(c) If two or more local agencies jointly establish a community
mental health service under Article 1 (commencing with Section 6500)
of Chapter 5 of Division 7 of Title 1 of the Government Code, the
mental health board for the community mental health service shall
consist of an additional two members for each additional agency, one
of whom shall be a consumer or a parent, spouse, sibling, or adult
child of a consumer who has received mental health services.
(d) No member of the board or his or her spouse shall be a
full-time or part-time county employee of a county mental health
service, an employee of the State Department of Mental
Health Care Services , or an employee of, or a
paid member of the governing body of, a mental health contract
agency.
(e) Members of the board shall abstain from voting on any issue in
which the member has a financial interest as defined
specified in Section 87103 of the Government
Code.
(f) If it is not possible to secure membership as specified from
among persons who reside in the county, the governing body may
substitute representatives of the public interest in mental health
who are not full-time or part-time employees of the county mental
health service, the State Department of Mental
Health Care Services , or on the staff of, or a paid
member of the governing body of, a mental health contract agency.
(g) The mental health board may be established as an advisory
board or a commission, depending on the preference of the county.
SEC. 27. Section 5610 of the Welfare and Institutions Code is
amended to read:
5610. (a) Each county mental health system shall comply with
reporting requirements developed by the State Department of
Mental Health which Care Services
that shall be uniform and simplified. The department shall
review existing data requirements to eliminate unnecessary
requirements and consolidate requirements which are necessary. These
requirements shall provide comparability between counties in reports.
(b) The department shall develop, in consultation with the
Performance Outcome Committee pursuant to Section 5611, and with the
California Health and Welfare
Human Services Agency, uniform definitions and formats for a
statewide, nonduplicative client-based information system that
includes all information necessary to meet federal mental health
grant requirements and state and federal medicaid reporting
requirements, as well as any other state requirements established by
law. The data system, including performance outcome measures reported
pursuant to Section 5613, shall be developed by July 1, 1992.
(c) Unless determined necessary by the department to comply with
federal law and regulations, the data system developed pursuant to
subdivision (b) shall not be more costly than that in place during
the 1990-91 fiscal year.
(d) (1) The department shall develop unique client identifiers
that permit development of client-specific cost and outcome measures
and related research and analysis.
(2) The department's collection and use of client information, and
the development and use of client identifiers, shall be consistent
with clients' constitutional and statutory rights to privacy and
confidentiality.
(3) Data reported to the department may include name and other
personal identifiers. That information is confidential and subject to
Section 5328 and any other state and federal laws regarding
confidential client information.
(4) Personal client identifiers reported to the department shall
be protected to ensure confidentiality during transmission and
storage through encryption and other appropriate means.
(5) Information reported to the department may be shared with
local public mental health agencies submitting records for the same
person and that information is subject to Section 5328.
(e) All client information reported to the department pursuant to
Chapter 2 (commencing with Section 4030) of Part 1 of Division 4 and
Sections 5328 to 5780, inclusive, and any other state and federal
laws regarding reporting requirements, consistent with Section 5328,
shall not be used for purposes other than those purposes expressly
stated in the reporting requirements referred to in this subdivision.
(f) The department may adopt emergency regulations to implement
this section in accordance with the Administrative Procedure Act,
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code. The adoption of emergency
regulations to implement this section that are filed with the Office
of Administrative Law within one year of the date on which the act
that added this subdivision took effect shall be deemed to be an
emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare and shall remain in
effect for no more than 180 days.
SEC. 28. Section 5652.7 of the Welfare and Institutions Code is
amended to read:
5652.7. A county shall have only 60 days from the date of
submission of an application to review and certify or deny an
application to establish a new mental health care provider. If an
application requires review by the State Department of Health
Care Services, the department shall also have only 60 days from
the date of submission of the application to review and certify or
deny an application to establish a new mental health care provider.
SEC. 29. Section 5653 of the Welfare and Institutions Code is
amended to read:
5653. In developing the county Short-Doyle plan, optimum
Optimum use shall be made of appropriate local
public and private organizations, community professional personnel,
and state agencies. Optimum use shall also be made of federal, state,
county, and private funds which may be available for mental health
planning.
In order that maximum utilization be made of federal and other
funds made available to the Department of Rehabilitation, the
Department of Rehabilitation may serve as a contractual provider
under the provisions of a county Short-Doyle plan
of vocational rehabilitation services for the mentally disordered.
SEC. 30. Section 5653.1 of the Welfare and Institutions Code is
amended to read:
5653.1. In conducting evaluation, planning, and research
activities to develop and implement the county Short-Doyle plan,
counties Counties may contract with public or
private agencies.
SEC. 31. Section 5654 of the Welfare and Institutions Code is
amended to read:
5654. In order to serve the increasing needs of children and
adolescents with mental and emotional problems, county mental health
programs may use funds allocated under the Short-Doyle Act
for the purposes of consultation and training.
SEC. 32. Section 5655 of the Welfare and Institutions Code is
amended to read:
5655. All departments of state government and all local public
agencies shall cooperate with county officials to assist them in
mental health planning. The State Department of Mental
Health Care Services shall, upon request and
with available staff, provide consultation services to the local
mental health directors, local governing bodies, and local mental
health advisory boards.
If the Director of Mental Health Care
Services considers any county to be failing, in a
substantial manner, to comply with any provision of this code or any
regulation, or with the approved county Short-Doyle plan,
the director shall order the county to appear at a hearing,
before the director or the director's designee, to show cause why
the department should not take action as set forth in this section.
The county shall be given at least 20 days' notice of such hearing.
The director shall consider the case on the record established at the
hearing and make final findings and decision.
If the director determines that there is or has been a failure, in
a substantial manner, on the part of the county to comply with any
provision of this code or any regulations or the approved
county Short-Doyle plan , and that administrative sanctions
are necessary, the department may invoke any, or any combination of,
the following sanctions:
(a) Withhold part or all of state mental health funds from such
county.
(b) Require the county to enter into negotiations for the purpose
of assuring ensuring county
Short-Doyle plan compliance with such
these laws and regulations.
(c) Bring an action in mandamus or such other
action in court as may be appropriate to compel compliance. Any such
action shall be entitled to a preference in setting a date for a
hearing.
SEC. 33. Section 5664 of the Welfare and Institutions Code is
amended to read:
5664. (a) County mental health systems shall provide reports and
data to meet the information needs of the state.
(b) The department State Department of
Health Care Services shall not implement this section in a
manner requiring a higher level of service for state reporting needs
than that which it was authorized to require prior to July 1, 1991.
SEC. 34. Section 5664.5 of the Welfare and Institutions Code is
amended to read:
5664.5. (a) County mental health systems shall continue to
provide data required by the State Department of Mental
Health Care Services to establish uniform
definitions and time increments for reporting type and cost of
services received by local mental health program clients.
(b) This section shall remain in effect only until January 1,
1994, and as of that date is repealed, unless a later enacted
statute, which becomes effective on or before January 1, 1994,
deletes or extends the dates on which it is repealed; or until the
date upon which the director informs the Legislature that the new
data system is established pursuant to Section 5610, whichever is
later, unless the provisions of the section are required by the
federal government as a condition of funding for the
Short-Doyle Medi-Cal program .
SEC. 35. Section 5692 of the Welfare and Institutions Code is
amended to read:
5692. The State Department of Mental Health
Care Services shall, to the extent resources are
available, have responsibility for the provision of technical
assistance, maximizing federal revenue, and ensuring coordination
with other state agencies including implementing and coordinating
interagency agreements between the Department of Rehabilitation and
the State Department of Mental Health Care
Services .
SEC. 36. Section 5701 of the Welfare and Institutions Code is
amended to read:
5701. (a) To achieve equity of funding, available funding for
local mental health programs beyond the funding provided pursuant to
Section 17601 shall be distributed to cities, counties, and cities
and counties pursuant to the procedures described in subdivision (c)
of Section 17606.05.
(b) Funding provided pursuant to Section 6 of Article XIII B of
the California Constitution, funding provided pursuant to subdivision
(c), and funding provided for future pilot projects shall be exempt
from the requirements of subdivision (a).
(c) Effective in the 1994-95 fiscal year and each year thereafter:
(1) The State Department of Mental Health
Care Services shall annually identify from mental health block
grant funds provided by the federal government, the maximum amount
that federal law and regulation permit to be allocated to counties
and cities and counties pursuant to this subdivision. This section
shall apply to any federal mental health block grant funds in excess
of the following:
(A) The amount allocated to counties and cities and counties from
the alcohol, drug abuse, and mental health block grant in the 1991-92
fiscal year.
(B) Funds for departmental support.
(C) Amounts awarded to counties and cities and counties for
children's systems of care programs pursuant to Part 4 (commencing
with Section 5850).
(D) Amounts allocated to small counties for the development of
alternatives to state hospitalization in the 1993-94 fiscal year.
(E) Amounts appropriated by the Legislature for the purposes of
this part.
(2) Notwithstanding subdivision (a), annually the State Department
of Mental Health Care Services shall
allocate to counties and cities and counties the funds identified in
paragraph (1), not to exceed forty million dollars ($40,000,000) in
any year. The allocations shall be proportional to each county's and
each city and county's percentage of the forty million dollars
($40,000,000) in Cigarette and Tobacco Products Surtax funds that
were allocated to local mental health programs in the 1991-92 fiscal
year.
(3) Monthly, the Controller shall allocate funds from the Vehicle
License Collection Account of the Local Revenue Fund to counties and
cities and counties for mental health services. Allocations shall be
made to each county or city and county in the same percentages as
described in paragraph (2), until the total of the funds allocated to
all counties in each year pursuant to paragraph (2) and this
paragraph reaches forty million dollars ($40,000,000).
(4) Funds allocated to counties and cities and counties pursuant
to paragraphs (2) and (3) shall not be subject to Section 17606.05.
(5) Funds that are available for allocation in any year in excess
of the forty million dollar ($40,000,000) limits described in
paragraph (2) or (3) shall be deposited into the Mental Health
Subaccount of the Local Revenue Fund.
(6) Nothing in this section is intended to, nor shall it, change
the base allocation of any city, county, or city and county as
provided in Section 17601.
SEC. 37. Section 5701.1 of the Welfare and Institutions Code is
amended to read:
5701.1. Notwithstanding Section 5701, the State Department of
Mental Health Care Services , in
consultation with the California Mental Health Directors Association,
may utilize funding from the Substance Abuse and Mental Health
Services Administration Block Grant, awarded to the State Department
of Mental Health Care Services , above
the funding level provided in federal fiscal year 1998, for the
development of innovative programs for identified target populations,
upon appropriation by the Legislature.
SEC. 38. Section 5707 of the Welfare and Institutions Code is
amended to read:
5707. Funds appropriated to the department which
State Department of Health Care Services that
are designated for local mental health services and funds
which that the department
State Depart ment of Health Care Services is
responsible for allocating or administering, including, but not
limited to, federal block grants funds, shall be expended in
accordance with this section and Sections 5708 to 5717, inclusive,
except when there are conflicting federal requirements, in which case
the federal requirements shall be controlling.
SEC. 39. Section 5715 of the Welfare and Institutions Code is
amended to read:
5715. Subject to the approval of the department
State Department of Health Care Services , at the
end of the fiscal year, a county may retain unexpended funds
allocated to it by the department from funds appropriated to the
department, with the exception of block grant funds, exclusive of the
amount required to pay for the care of patients in state hospitals,
for 12 months for expenditure for mental health services in
accordance with this part.
SEC. 40. Section 5717 of the Welfare and Institutions Code is
amended to read:
5717. (a) Expenditures that may be funded from amounts allocated
to the county by the department State
Department of Health Care Services from funds appropriated to
the department shall include negotiated rates and net
amounts; salaries of personnel; approved facilities and
services provided through contract; operation, maintenance and
service costs including insurance costs or departmental charges for
participation in a county self-insurance program if the charges are
not in excess of comparable available commercial insurance premiums
and on the condition that any surplus reserves be used to reduce
future year contributions; depreciation of county facilities as
established in the state's uniform accounting manual, disregarding
depreciation on the facility to
the extent it was financed by state funds under this part;
lease of facilities where there is no intention to, nor option to,
purchase; expenses incurred under this act by members of the
California Conference of Local Mental Health
Directors Association for attendance at regular meetings
of these conferences; expenses incurred by either the chairperson or
elected representative of the local mental health advisory boards for
attendance at regular meetings of the Organization of Mental Health
Advisory Boards; expenditures included in approved countywide cost
allocation plans submitted in accordance with the Controller's
guidelines, including, but not limited to, adjustments of prior year
estimated general county overhead to actual costs, but excluding
allowable costs otherwise compensated by state funding; net costs of
conservatorship investigation, approved by the Director of
Mental Health Care Services . Except for
expenditures made pursuant to Article 6 (commencing with Section
129225) of Chapter 1 of Part 6 of Division 107 of the Health and
Safety Code, it shall not include expenditures for initial capital
improvements; the purchaser or construction of buildings except for
equipment items and remodeling expense as may be provided for in
regulations of the State Department of Mental
Health Care Services ; compensation to members of a local
mental health advisory board, except actual and necessary expenses
incurred in the performance of official duties that may include
travel, lodging, and meals while on official business; or
expenditures for a purpose for which state reimbursement is claimed
under any other provision of law.
(b) The director Director of Health Care
Services may make investigations and audits of expenditures the
director may deem necessary.
(c) With respect to funds allocated to a county by the
department State Department of Health Care Services
from funds appropriated to the department, the county shall
repay to the state amounts found not to have been expended in
accordance with the requirements set forth in this part. Repayment
shall be within 30 days after it is determined that an expenditure
has been made that is not in accordance with the requirements. In the
event that repayment is not made in a timely manner, the department
shall offset any amount improperly expended against the amount of any
current or future advance payment or cost report settlement from the
state for mental health services. Repayment provisions shall not
apply to Short-Doyle funds allocated by the department for fiscal
years up to and including the 1990-91 fiscal year.
SEC. 41. Section 5751 of the Welfare and Institutions Code is
amended to read:
5751. (a) Regulations pertaining to the qualifications of
directors of local mental health services shall be administered in
accordance with Section 5607. These standards may include the
maintenance of records of service which shall be reported to the
State Department of Mental Health Care
Services in a manner and at times as it may specify.
(b) Regulations pertaining to the position of director of local
mental health services, where the local director is other than the
local health officer or medical administrator of the county
hospitals, shall require that the director be a psychiatrist,
psychologist, clinical social worker, marriage and family therapist,
professional clinical counselor, registered nurse, or hospital
administrator, who meets standards of education and experience
established by the Director of Mental Health
Care Services . Where the director is not a psychiatrist, the
program shall have a psychiatrist licensed to practice medicine in
this state and who shall provide to patients medical care and
services as authorized by Section 2051 of the Business and
Professions Code.
(c) The regulations shall be adopted in accordance with the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
SEC. 42. Section 5751.1 of the Welfare and Institutions Code is
amended to read:
5751.1. Regulations pertaining to the position of director of
local mental health services, where the local director is other than
the local health officer or medical administrator of the county
hospitals, shall require that the director meet the standards of
education and experience established by the Director of
Mental Health Care Services and that the
appointment be open on the basis of competence to all eligible
disciplines pursuant to Section 5751. Regulations pertaining to the
qualifications of directors of local mental health services shall be
administered in accordance with Section 5607.
Where the director of local mental health services is not a
psychiatrist, the program shall have a psychiatrist licensed to
practice medicine in this state and who shall provide to patients
medical care and services as authorized by Section 2137
2051 of the Business and Professions Code.
SEC. 43. Section 5751.2 of the Welfare and Institutions Code is
amended to read:
5751.2. (a) Except as provided in this section, persons employed
or under contract to provide mental health services pursuant to this
part shall be subject to all applicable requirements of law regarding
professional licensure, and no person shall be employed in local
mental health programs pursuant to this part to provide services for
which a license is required, unless the person possesses a valid
license.
(b) Persons employed as psychologists and clinical social workers,
while continuing in their employment in the same class as of January
1, 1979, in the same program or facility, including those persons on
authorized leave, but not including intermittent personnel, shall be
exempt from the requirements of subdivision (a).
(c) While registered with the licensing board of jurisdiction for
the purpose of acquiring the experience required for licensure,
persons employed or under contract to provide mental health services
pursuant to this part as clinical social workers, marriage and family
therapists, or professional clinical counselors shall be exempt from
subdivision (a). Registration shall be subject to regulations
adopted by the appropriate licensing board.
(d) The requirements of subdivision (a) shall be waived by the
department State Department of Health Care
Services for persons employed or under contract to provide
mental health services pursuant to this part as psychologists who are
gaining the experience required for licensure. A waiver granted
under this subdivision may not exceed five years from the date of
employment by, or contract with, a local mental health program for
persons in the profession of psychology.
(e) The requirements of subdivision (a) shall be waived by the
department State Department of Health Care
Services for persons who have been recruited for employment
from outside this state as psychologists, clinical social workers,
marriage and family therapists, or professional clinical counselors
and whose experience is sufficient to gain admission to a licensing
examination. A waiver granted under this subdivision may not exceed
three years from the date of employment by, or contract with, a local
mental health program for persons in these four professions who are
recruited from outside this state.
SEC. 44. Section 5770 of the Welfare and Institutions Code is
amended to read:
5770. Notwithstanding any other provision of law, the
department State Department of Health Care Services
may directly, or by contract , with any
public or private agency, provide any of the services under this
division when the director state
determines that the services are necessary to protect the public
health, safety, or welfare.
SEC. 45. Section 5770.5 of the Welfare and Institutions Code is
amended to read:
5770.5. The department State Department
of Health Care Services shall encourage county mental health
programs to develop and support local programs designed to provide
technical assistance to self-help groups for the purposes of
maintaining existing groups, as well as to stimulate development of
new self-help groups from locally defined needs.
SEC. 46. Section 5771 of the Welfare and Institutions Code is
amended to read:
5771. (a) Pursuant to Public Law 102-321, there is the California
Mental Health Planning Council. The purpose of the planning council
shall be to fulfill those mental health planning requirements
mandated by federal law.
(b) (1) The planning council shall have 40 members, to be
comprised of members appointed from both the local and state levels
in order to ensure a balance of state and local concerns relative to
planning.
(2) As required by federal law, eight members of the planning
council shall represent various state departments.
(3) Members of the planning council shall be appointed in a manner
that will ensure that at least one-half are persons with mental
disabilities, family members of persons with mental disabilities, and
representatives of organizations advocating on behalf of persons
with mental disabilities. Persons with mental disabilities and family
members shall be represented in equal numbers.
(4) The Director of Mental Health Care
Services shall make appointments from among nominees from
various mental health constituency organizations, which shall include
representatives of consumer-related advocacy organizations,
representatives of mental health professional and provider
organizations, and representatives who are direct service providers
from both the public and private sectors. The director shall also
appoint one representative of the California Coalition on Mental
Health.
(c) Members should be balanced according to demography, geography,
gender, and ethnicity. Members should include representatives with
interest in all target populations, including, but not limited to,
children and youth, adults, and older adults.
(d) The planning council shall annually elect a chairperson and a
chair-elect.
(e) The term of each member shall be three years, to be staggered
so that approximately one-third of the appointments expire in each
year.
(f) In the event of changes in the federal requirements regarding
the structure and function of the planning council, or the
discontinuation of federal funding, the State Department of
Mental Health Care Services shall propose to the
Legislature modifications in the structure of the planning council
that the department deems appropriate.
SEC. 47. Section 5771.3 of the Welfare and Institutions Code is
amended to read:
5771.3. The California Mental Health Planning Council may utilize
staff of the State Department of Mental Health
Care Services , to the extent they are available, and the
staff of any other public or private agencies that have an interest
in the mental health of the public and that are able and willing to
provide those services.
SEC. 48. Section 5772 of the Welfare and Institutions Code is
amended to read:
5772. The California Mental Health Planning Council shall have
the powers and authority necessary to carry out the duties imposed
upon it by this chapter, including, but not limited to, the
following:
(a) To advocate for effective, quality mental health programs.
(b) To review, assess, and make recommendations regarding all
components of California's mental health system, and to report as
necessary to the Legislature, the State Department of Mental
Health Care Services , local boards, and local
programs.
(c) To review program performance in delivering mental health
services by annually reviewing performance outcome data as follows:
(1) To review and approve the performance outcome measures.
(2) To review the performance of mental health programs based on
performance outcome data and other reports from the State Department
of Mental Health Care Services and
other sources.
(3) To report findings and recommendations on programs'
performance annually to the Legislature, the State Department of
Mental Health Care Services , and the
local boards.
(4) To identify successful programs for recommendation and for
consideration of replication in other areas. As data and technology
are available, identify programs experiencing difficulties.
(d) When appropriate, make a finding pursuant to Section 5655 that
a county's performance is failing in a substantive manner. The State
Department of Mental Health Care Services
shall investigate and review the finding, and report the action
taken to the Legislature.
(e) To advise the Legislature, the State Department of
Mental Health Care Services , and county boards
on mental health issues and the policies and priorities that this
state should be pursuing in developing its mental health system.
(f) To periodically review the state's data systems and paperwork
requirements to ensure that they are reasonable and in compliance
with state and federal law.
(g) To make recommendations to the State Department of
Mental Health Care Services on the award of
grants to county programs to reward and stimulate innovation in
providing mental health services.
(h) To conduct public hearings on the state mental health plan,
the Substance Abuse and Mental Health Services Administration block
grant, and other topics, as needed.
(i) To participate in the recruitment of candidates for the
position of Director of Mental Health Care
Services and provide advice on the final selection.
(j) In conjunction with other statewide and local mental health
organizations, assist in the coordination of training and information
to local mental health boards as needed to ensure that they can
effectively carry out their duties.
(k) To advise the Director of Mental Health
Care Services on the development of the state mental
health plan and the system of priorities contained in that plan.
( l ) To assess periodically the effect of realignment
of mental health services and any other important changes in the
state's mental health system, and to report its findings to the
Legislature, the State Department of Mental Health
Care Services , local programs, and local boards, as
appropriate.
(m) To suggest rules, regulations, and standards for the
administration of this division.
(n) When requested, to mediate disputes between counties and the
state arising under this part.
(o) To employ administrative, technical, and other personnel
necessary for the performance of its powers and duties, subject to
the approval of the Department of Finance.
(p) To accept any federal fund granted, by act of Congress or by
executive order, for purposes within the purview of the California
Mental Health Planning Council, subject to the approval of the
Department of Finance.
(q) To accept any gift, donation, bequest, or grants of funds from
private and public agencies for all or any of the purposes within
the purview of the California Mental Health Planning Council, subject
to the approval of the Department of Finance.
SEC. 49. Section 5815 of the Welfare and Institutions Code is
amended to read:
5815. The State Department of Health Care Services , in
conjunction with the State Department of Mental Health,
shall seek all available federal funding for mental health services
for veterans.
SEC. 50. Section 5840 of the Welfare and Institutions Code is
amended to read:
5840. (a) The State Department of Mental
Health Care Services shall establish a program designed to
prevent mental illnesses from becoming severe and disabling. The
program shall emphasize improving timely access to services for
underserved populations.
(b) The program shall include the following components:
(1) Outreach to families, employers, primary care health care
providers, and others to recognize the early signs of potentially
severe and disabling mental illnesses.
(2) Access and linkage to medically necessary care provided by
county mental health programs for children with severe mental
illness, as defined in Section 5600.3, and for adults and seniors
with severe mental illness, as defined in Section 5600.3, as early in
the onset of these conditions as practicable.
(3) Reduction in stigma associated with either being diagnosed
with a mental illness or seeking mental health services.
(4) Reduction in discrimination against people with mental
illness.
(c) The program shall include mental health services similar to
those provided under other programs effective in preventing mental
illnesses from becoming severe, and shall also include components
similar to programs that have been successful in reducing the
duration of untreated severe mental illnesses and assisting people in
quickly regaining productive lives.
(d) The program shall emphasize strategies to reduce the following
negative outcomes that may result from untreated mental illness:
(1) Suicide.
(2) Incarcerations.
(3) School failure or dropout.
(4) Unemployment.
(5) Prolonged suffering.
(6) Homelessness.
(7) Removal of children from their homes.
(e) In consultation with the Mental Health Services Oversight
and Accountability Commission and mental health stakeholders,
and consistent with evaluation data, the department shall
revise the program elements in Section 5840 applicable to all county
mental health programs in future years to reflect what is learned
about the most effective prevention and intervention programs for
children, adults, and seniors.
SEC. 51. Section 5845 of the Welfare and Institutions Code is
amended to read:
5845. (a) The Mental Health Services Oversight and Accountability
Commission is hereby established to oversee Part 3 (commencing with
Section 5800), the Adult and Older Adult Mental Health System of Care
Act; Part 3.1 (commencing with Section 5820), Human Resources,
Education, and Training Programs; Part 3.2 (commencing with Section
5830), Innovative Programs; Part 3.6 (commencing with Section 5840),
Prevention and Early Intervention Programs; and Part 4 (commencing
with Section 5850), the Children's Mental Health Services Act. The
commission shall replace the advisory committee established pursuant
to Section 5814. The commission shall consist of 16 voting members as
follows:
(1) The Attorney General or his or her designee.
(2) The Superintendent of Public Instruction or his or her
designee.
(3) The Chairperson of the Senate Health and Human Services
Committee or another member of the Senate selected by the President
pro Tempore of the Senate.
(4) The Chairperson of the Assembly Health Committee or another
member of the Assembly selected by the Speaker of the Assembly.
(5) Two persons with a severe mental illness, a family member of
an adult or senior with a severe mental illness, a family member of a
child who has or has had a severe mental illness, a physician
specializing in alcohol and drug treatment, a mental health
professional, a county sheriff, a superintendent of a school
district, a representative of a labor organization, a representative
of an employer with less than 500 employees and a representative of
an employer with more than 500 employees, and a representative of a
health care services plan or insurer, all appointed by the Governor.
In making appointments, the Governor shall seek individuals who have
had personal or family experience with mental illness.
(b) Members shall serve without compensation, but shall be
reimbursed for all actual and necessary expenses incurred in the
performance of their duties.
(c) The term of each member shall be three years, to be staggered
so that approximately one-third of the appointments expire in each
year.
(d) In carrying out its duties and responsibilities, the
commission may do all of the following:
(1) Meet at least once each quarter at any time and location
convenient to the public as it may deem appropriate. All meetings of
the commission shall be open to the public.
(2) Within the limit of funds allocated for these purposes,
pursuant to the laws and regulations governing state civil service,
employ staff, including any clerical, legal, and technical assistance
as may appear necessary. The commission shall administer its
operations separate and apart from the State Department of
Mental Health Care Services .
(3) Establish technical advisory committees such as a committee of
consumers and family members.
(4) Employ all other appropriate strategies necessary or
convenient to enable it to fully and adequately perform its duties
and exercise the powers expressly granted, notwithstanding any
authority expressly granted to any officer or employee of state
government.
(5) Enter into contracts.
(6) Obtain data and information from the State Department of
Mental Health Care Services, the Office of
Statewide Health Planning and Development , or other state or
local entities that receive Mental Health Services Act funds, for the
commission to utilize in its oversight, review, and evaluation
capacity regarding projects and programs supported with Mental Health
Services Act funds.
(7) Participate in the joint state-county decisionmaking process,
as contained in Section 4061, for training, technical assistance, and
regulatory resources to meet the mission and goals of the state's
mental health system.
(8) Develop strategies to overcome stigma and accomplish all other
objectives of Part 3.2 (commencing with Section 5830), 3.6
(commencing with Section 5840), and the other provisions of the act
establishing this commission.
(9) At any time, advise the Governor or the Legislature regarding
actions the state may take to improve care and services for people
with mental illness.
(10) If the commission identifies a critical issue related to the
performance of a county mental health program, it may refer the issue
to the State Department of Mental Health
Care Services pursuant to Section 5655.
SEC. 52. Section 5851.5 of the Welfare and Institutions Code is
amended to read:
5851.5. For the purposes of this part, a "system of care county"
means a county which that has been
approved by the State Department of Mental Health
Care Services as having the capability to provide child-
and family-centered services in a collaborative manner, resulting in
quantitative outcome measures.
SEC. 53. Section 5852.5 of the Welfare and Institutions Code is
amended to read:
5852.5. The department State Department
of Health Care Services shall review those counties that have
been awarded funds to implement a comprehensive system for the
delivery of mental health services to children with serious emotional
disturbance and to their families or foster families to determine
compliance with either of the following:
(a) The total estimated cost avoidance in all of the following
categories shall equal or exceed the applications for funding award
moneys:
(1) Group home costs paid by Aid to Families with Dependent
Children-Foster Care (AFDC-FC) program.
(2) Children and adolescent state hospital and acute inpatient
programs.
(3) Nonpublic school residential placement costs.
(4) Juvenile justice reincarcerations.
(5) Other short- and long-term savings in public funds resulting
from the applications for funding award moneys.
(b) If the department determines that the total cost avoidance
listed in subdivision (a) does not equal or exceed applications for
funding award amounts, the department shall determine that the county
that has been awarded funding shall achieve substantial compliance
with all of the following goals:
(1) Total cost avoidance in the categories listed in subdivision
(a) to exceed 50 percent of the applications for funding award
moneys.
(2) A 20-percent reduction in out-of-county ordered placements of
juvenile justice wards and social service dependents.
(3) A statistically significant reduction in the rate of
recidivism by juvenile offenders.
(4) A 25-percent reduction in the rate of state hospitalization of
minors from placements of special education pupils.
(5) A 10-percent reduction in out-of-county nonpublic school
residential placements of special education pupils.
(6) Allow at least 50 percent of children at risk of imminent
placement served by the intensive in-home crisis treatment programs,
which are wholly or partially funded by applications for funding
award moneys, to remain at home at least six months.
(7) Statistically significant improvement in school attendance and
academic performance of seriously emotionally disturbed special
education pupils treated in day treatment programs which are wholly
or partially funded by applications for funding award moneys.
(8) Statistically significant increases in services provided in
nonclinic settings among agencies.
(9) Increase in ethnic minority and gender access to services
proportionate to the percentage of these groups in the county's
school-age population.
SEC. 54. Section 5854 of the Welfare and Institutions Code is
amended to read:
5854. The State Department of Mental Health
Care Services may contract with counties whose programs
have been approved by the department and selected pursuant to Article
4 (commencing with Section 5857). A county may request to
participate under this part each year according to the terms set
forth in Section 5705 for the purpose of establishing a three-year
program proposal for developing and implementing a children's
comprehensive mental health services system. The contract shall be
negotiated on a yearly basis, based on the scope of work plan for
each implementation phase.
SEC. 55. Section 5855 of the Welfare and Institutions Code is
amended to read:
5855. The department shall State
Department of Health Care Services may adopt as part of its
overall mission the development of community-based, comprehensive,
interagency systems of care that target seriously emotionally and
behaviorally disturbed children separated from their families or at
risk of separation from their families, as defined
specified in Section 5856. These comprehensive,
interagency systems of care shall seek to provide the highest benefit
to children, their families, and the community at the lowest cost to
the public sector. Essential values shall be as follows:
(a) Family preservation. Children shall be maintained in their
homes with their families whenever possible.
(b) Least restrictive setting. Children shall be placed in
the least restrictive and least costly setting appropriate to their
needs when out-of-home placement is necessary.
(c) Natural setting. Children benefit most from mental health
services in their natural environments, where they live and learn,
such as home, school, foster home, or a juvenile detention center.
(d) Interagency collaboration and a coordinated service delivery
system. The primary child-serving agencies, such as social services,
probation, education, health, and mental health agencies, shall
collaborate at the policy, management, and service levels to provide
a coordinated, goal-directed system of care for seriously emotionally
disturbed children and their families.
(e) Family involvement. Family participation is an integral part
of assessment, intervention, and evaluation.
(f) Cultural competence. Service effectiveness is dependent upon
both culturally relevant and competent service delivery.
SEC. 56. Section 5855.5 of the Welfare and Institutions Code is
amended to read:
5855.5. (a) Projects funded pursuant to Part 4 (commencing with
Section 5850) of Division 5, as added by Chapter 89 of the Statutes
of 1991, shall continue under the terms of this part.
(b) The department State Department of
Health Care Services shall negotiate with each participating
county to establish appropriate evaluation measures for the county's
children's system of care program after the initial three-year
implementation funding period as established in Section 5854. The
department shall, on an annual basis, negotiate a performance
contract with each county electing to continue its children's system
of care program. The annual performance contract shall be consistent
county to county, and shall include, but not be limited to, a scope
of work plan consistent with the provisions of this part and shall
contain a budget that has sufficient detail to meet the requirements
of the department.
SEC. 57. Section 5868 of the Welfare and Institutions Code is
amended to read:
5868. (a) The department State Department
of Health Care Services shall establish service standards that
ensure that children in the target population are identified and
receive needed and appropriate services from qualified staff in the
least restrictive environment.
(b) The standards shall include, but not be limited to:
(1) Providing a comprehensive assessment and treatment plan for
each target population client to be served, and developing programs
and services that will meet their needs and facilitate client outcome
goals.
(2) Providing for full participation of the family in all aspects
of assessment, case planning, and treatment.
(3) Providing methods of assessment and services to meet the
cultural, linguistic, and special needs of minorities in the target
population.
(4) Providing for staff with the cultural background and
linguistic skills necessary to remove barriers to mental health
services resulting from a limited ability to speak English or from
cultural differences.
(5) Providing mental health case management for all target
population clients in, or being considered for, out-of-home
placement.
(6) Providing mental health services in the natural environment of
the child to the extent feasible and appropriate.
(c) The responsibility of the case managers shall be to ensure
that each child receives the following services:
(1) A comprehensive mental health assessment.
(2) Case planning with all appropriate interagency participation.
(3) Linkage with all appropriate mental health services.
(4) Service plan monitoring.
(5) Client advocacy to ensure the provision of needed services.
SEC. 58. Section 5869 of the Welfare and Institutions Code is
amended to read:
5869. The department State Department of
Health Care Services shall provide participating counties with
all of the following:
(a) Applications for funding guidelines and format, and
coordination and oversight of the selection process as described in
Article 4 (commencing with Section 5857).
(b) Contracts with each state funded county specifying the
approved budget, performance outcomes, and a scope of work plan for
each year of participation in the children's system of care program.
(c) Technical assistance related to system evaluation.
SEC. 59. Section 5878 of the Welfare and Institutions Code is
amended to read:
5878. (a) (1) The Secretary of the
California Health and Welfare Agency
Human Services , the Superintendent of Public Instruction, or
the Secretary of the Youth and Corrections Agency
Department of Corrections and Rehabilitation may waive any
state regulatory obstacles to the integration of public
responsibilities and resources required for counties which have been
approved as system of care counties.
(2) The waiver shall remain in effect as long as the local program
continues to meet standards as specified in the scope of work plan
approved by the State Department of Mental Health
Care Services .
(b) The Secretary of California Health and
Welfare Human Services , the Superintendent of
Public Instruction, and the Secretary of the Youth and
Corrections Agency Department of Corrections and
Rehabilitation , and those departments designated as single
state agencies administering federal programs, shall make every
effort to secure federal waivers and any other changes in federal
policy or law necessary to support interagency collaboration and
coordination in a system of care service delivery system.
SEC. 60. Section 5878.3 of the Welfare and Institutions Code is
amended to read:
5878.3. (a) Subject to the availability of funds as determined
pursuant to Part 4.5 (commencing with Section 5890) of this division,
county mental health programs shall offer services to severely
mentally ill children for whom services under any other public or
private insurance or other mental health or entitlement program is
inadequate or unavailable. Other entitlement programs include but are
not limited to mental health services available pursuant to
Medi-Cal, child welfare, and special education programs. The funding
shall cover only those portions of care that cannot be paid for with
public or private insurance, other mental health funds or other
entitlement programs.
(b) Funding shall be at sufficient levels to ensure that counties
can provide each child served all of the necessary services set forth
in the applicable treatment plan developed in accordance with this
part, including services where appropriate and necessary to prevent
an out of home placement, such as services pursuant to Chapter 4
(commencing with Section 18250) of Part 6 of Division 9.
(c) The State Department of Mental Health
Care Services shall contract with county mental health programs
for the provision of services under this article in the manner set
forth in Section 5897.
SEC. 61. Section 5880 of the Welfare and Institutions Code is
amended to read:
5880. For each selected county , the
department State Department of Health Care Services
shall define and establish client and cost outcome and other
system performance goals, and negotiate the expected levels of
attainment for each year of participation. Expected levels of
attainment shall include a breakdown by ethnic origin and shall be
identified by a county in its proposal. These goals shall include,
but not be limited to, both of the following:
(a) Client improvement and cost avoidance outcome measures, as
follows:
(1) To reduce the number of child months in group homes,
residential placements pursuant to Chapter 26.5 (commencing with
Section 7570) of Division 7 of Title 1 of the Government Code, and
state hospital placements.
(2) To reduce the cost of AFDC-FC group home care, residential
placements as described in paragraph (1), and state hospital
utilization, by an amount which equals at least 50 percent of the
third year project cost. Cost avoidance shall be based on data
comparisons of statewide average expenditure and population.
(3) To increase school attendance for pupils in targeted programs.
(4) To increase the grade level equivalent of pupils in targeted
programs from admission to discharge.
(5) To reduce the rate of recidivism incurred for wards in
targeted juvenile justice programs.
(6) To show measurable improvement in individual and family
functional status for a representative sample of children enrolled in
the system of care.
(7) To achieve statistically significant increases in services
provided in nonclinic settings among agencies.
(8) To increase ethnic minority and gender access to services
proportionate to the percentage of these groups in the county's
school-age population.
(b) System development and operation measures, as follows:
(1) To provide an integrated system of care that includes
multiagency programs and joint case planning, to children who are
seriously emotionally and behaviorally disturbed as defined
specified in Section 5856.
(2) To identify and assess children who comprise the target
population in the county evidenced by a roster which contains all
children receiving mental health case management and treatment
services. This roster shall include necessary standardized and
uniform identifying information and demographics about the children
served.
(3) To develop and maintain individualized service plans that will
facilitate interagency service delivery in the least restrictive
environment.
(4) To develop or provide access to a range of intensive services
that will meet individualized service plan needs. These services
shall include, but not be limited to, case management, expanded
treatment services at schoolsites, local juvenile corrections
facilities, and local foster homes, and flexible services.
(5) To ensure the development and operation of the interagency
policy council and the interagency case management council.
(6) To provide culturally competent programs that recognize and
address the unique needs of ethnic populations in relation to equal
access, program design and operation, and program evaluation.
(7) To develop parent education and support groups, and linkages
with parents to ensure their involvement in the planning process and
the delivery of services.
(8) To provide a system of evaluation that develops outcome
criteria and which that will measure
performance, including client outcome and cost avoidance.
(9) To gather, manage, and report data in accordance with the
requirements of the state funded outcome evaluation.
SEC. 62. Section 5890 of the Welfare and Institutions Code is
amended to read:
5890. (a) The Mental Health Services Fund is hereby created in
the State Treasury. The fund shall be administered by the state.
Notwithstanding Section 13340 of the Government Code, all moneys in
the fund are, except as provided in subdivision (d) of Section 5892,
continuously appropriated, without regard to fiscal years, for the
purpose of funding the following programs and other related
activities as designated by other provisions of this division:
(1) Part 3 (commencing with Section 5800), the Adult and Older
Adult System of Care Act.
(2) Part 3.6 (commencing with Section 5840), Prevention and Early
Intervention Programs.
(3) Part 4 (commencing with Section 5850), the Children's Mental
Health Services Act.
(b) Nothing in the establishment of this fund, nor any other
provisions of the act establishing it or the programs funded shall be
construed to modify the obligation of health care service plans and
disability insurance policies to provide coverage for mental health
services, including those services required under Section 1374.72 of
the Health and Safety Code and Section 10144.5 of the Insurance Code,
related to mental health parity. Nothing in this act shall be
construed to modify the oversight duties of the Department of Managed
Health Care or the duties of the Department of Insurance with
respect to enforcing these obligations of plans and insurance
policies.
(c) Nothing in this act shall be construed to modify or reduce the
existing authority or responsibility of the State Department of
Mental Health Care Services .
(d) The State Department of
Health Care Services , in consultation with the State
Department of Mental Health, shall seek approval of all
applicable federal Medicaid approvals to maximize the availability of
federal funds and eligibility of participating children, adults, and
seniors for medically necessary care.
(e)
(d) Share of costs for services pursuant to Part 3
(commencing with Section 5800), and Part 4 (commencing with Section
5850) of this division, shall be determined in accordance with the
Uniform Method for Determining Ability to Pay applicable to other
publicly funded mental health services, unless this Uniform Method is
replaced by another method of determining co-payments, in which case
the new method applicable to other mental health services shall be
applicable to services pursuant to Part 3 (commencing with Section
5800), and Part 4 (commencing with Section 5850) of this division.
SEC. 63. Section 11325.7 of the Welfare and Institutions Code is
amended to read:
11325.7. (a) It is the intent of the Legislature in enacting this
section to create a funding stream and program that assists certain
recipients of aid under this chapter to receive necessary mental
health services, including case management and treatment, thereby
enabling them to make the transition from welfare to work. This
funding stream shall be used specifically to serve recipients in need
of mental health services, and shall be accounted for and expended
by each county in a manner that ensures that recipients in need of
mental health services are receiving appropriate services.
(b) The county plan required by Section 10531 shall include a plan
for the development of mental health employment assistance services,
developed jointly by the county welfare department and the county
department of mental health. The plan shall have as its goal the
treatment of mental or emotional disabilities that may limit or
impair the ability of a recipient to make the transition from
welfare-to-work, or that may limit or impair the ability to retain
employment over a long-term period. The plan shall be developed in a
manner consistent with both the county's welfare-to-work program and
the county's consolidated mental health Medi-Cal services plan. The
county may use community based providers, as necessary, that have
experience in addressing the needs of the CalWORKs population. The
county, whenever possible, shall ensure that the services provided
qualify for federal reimbursement of the nonstate share of Medi-Cal
costs.
(c) Subject to specific expenditure authority, mental health
services available under this section shall include all of the
following elements:
(1) Assessment for the purpose of identifying the level of the
participant's mental health needs and the appropriate level of
treatment and rehabilitation for the participant.
(2) Case management, as appropriate, as determined by the county.
(3) Treatment and rehabilitation services, that shall include
counseling, as necessary to overcome mental health barriers to
employment and mental health barriers to retaining employment, in
coordination with an individual's welfare-to-work plan.
(4) In cases where a secondary diagnosis of substance abuse is
made in a person referred for mental or emotional disorders, the
welfare-to-work plan shall also address the substance abuse treatment
needs of the participant.
(5) A process by which the county can identify those with severe
mental disabilities that may qualify them for aid under Chapter 3
(commencing with Section 12000).
(d) Any funds appropriated by the Legislature to cover the
nonfederal costs of the mental health employment assistance services
required by this section shall be allocated consistent with the
formula used to distribute each county's CalWORKs program allocation.
Each county shall report annually to the state the number of
CalWORKs program recipients who received mental health services and
the extent to which the allocation is sufficient to meet the need for
these services as determined by the county. The State Department of
Mental Health Care Services shall
develop a uniform methodology for ensuring that this allocation
supplements and does not supplant current expenditure levels for
mental health services for this population.
SEC. 64. Section 11462.01 of the Welfare and Institutions Code is
amended to read:
11462.01. (a) Commencing July 1, 1994, a group home program shall
be classified at RCL 13 or RCL 14 if the program meets all of the
following requirements:
(1) The group home program is providing, or has proposed to
provide, the level of care and services necessary to generate
sufficient points in the ratesetting process to be classified at RCL
13 if the rate application is for RCL 13 or to be classified at RCL
14 if the rate application is for RCL 14.
(2) (A) (i) The group home provider shall agree not to accept for
placement into a group home program AFDC-FC funded children,
including voluntary placements and seriously emotionally disturbed
children placed out-of-home pursuant to an individualized education
program developed under former Section 7572.5 of the
Government Code, who have not been approved for placement by an
interagency placement committee, as described by Section 4096. The
approval shall be in writing and shall indicate that the interagency
placement committee has determined the child is seriously emotionally
disturbed, as defined by specified in
Section 5600.3 and subject to Section 1502.4 of the Health and Safety
Code, and that the child needs the level of care provided by the
group home.
(ii) For purposes of clause (i), group home providers who accept
seriously emotionally disturbed children who are assessed and placed
out-of-home pursuant to an individualized education program developed
under former Section 7572.5 of the Government Code shall
be deemed to have met the interagency placement committee approval
for placement requirements of clause (i) if the individualized
education program assessment indicates that the child has been
determined to be seriously emotionally disturbed, as defined
specified in Section 5600.3 and subject to
Section 1502.4 of the Health and Safety Code, and needs the level of
care described in clause (i).
(B) (i) Nothing in this subdivision shall prevent the emergency
placement of a child into a group home program prior to the
determination by the interagency placement committee pursuant to
subclause (i) of subparagraph (A) if a licensed mental health
professional, as defined in the department's AFDC-FC ratesetting
regulations, has evaluated, in writing, the child within 72 hours of
placement, and determined the child to be seriously emotionally
disturbed and in need of the care and services provided by the group
home program.
(ii) The interagency placement committee shall, within 30 days of
placement pursuant to clause (i), make the determination required by
clause (i) of subparagraph (A).
(iii) If, pursuant to clause (ii), the placement is determined to
be appropriate, the committee shall transmit the approval, in
writing, to the county placing agency and the group home provider.
(iv) If, pursuant to clause (ii) the placement is determined not
to be appropriate, the child shall be removed from the group home and
referred to a more appropriate placement, as specified in
subdivision (f).
(C) Commencing December 15, 1992, with respect to AFDC-FC funded
children, only those children who are approved for placement by an
interagency placement committee may be accepted by a group home under
this subdivision.
(3) The group home program is certified by the State Department of
Mental Health Care Services pursuant
to Section 4096.5.
(b) The department shall not establish a rate for a group home
requesting a program change to RCL 13 or RCL 14 unless the group home
provider submits a recommendation from the host county or the
primary placing county that the program is needed and that the
provider is willing and capable of operating the program at the level
sought. For purposes of this subdivision, "host county," "primary
placing county," and "program change" mean the same as defined in the
department's AFDC-FC ratesetting regulations.
(c) The effective date of rates set at RCL 13 or RCL 14 shall be
the date that all the requirements are met, but not prior to July 1
of that fiscal year. Nothing in this section shall affect RCL 13 or
RCL 14 ratesetting determinations in prior years.
(d) Any group home program that has been classified at RCL 13 or
RCL 14 pursuant to the requirements of subdivision (a) shall be
reclassified at the appropriate lower RCL with a commensurate
reduction in rate if either of the following occurs:
(1) The group home program fails to maintain the level of care and
services necessary to generate the necessary number of points for
RCL 13 or RCL 14, as required by paragraph (1) of subdivision (a).
The determination of points shall be made consistent with the
department's AFDC-FC ratesetting regulations for other rate
classification levels.
(2) The group home program fails to maintain a certified mental
health treatment program as required by paragraph (3) of subdivision
(a).
(3) In the event of a determination under paragraph (1), the group
home may appeal the finding or submit a corrective action plan. The
appeal process specified in Section 11466.6 shall be available to RCL
13 and RCL 14 group home providers. During any appeal, the group
home shall maintain the appropriate level of care.
(e) The interagency placement committee shall periodically review,
but no less often than that required by current law, the placement
of the child. If the committee determines that the child no longer
needs, or is not benefiting from, placement in a RCL 13 or RCL 14
group home, the committee shall require the removal of the child and
a new disposition.
(f) (1) (A) If, at any time subsequent to placement in an RCL 13
or RCL 14 group home program, the interagency placement committee
determines either that the child is not seriously emotionally
disturbed or is not in need of the care and services provided by the
group home program, it shall notify, in writing, both the county
placing agency and the group home provider within 10 days of the
determination.
(B) The county placing agency shall notify the group home
provider, in writing, within five days from the date of the notice
from the committee, of the county's plan for removal of the child.
(C) The county placing agency shall remove the child from the
group home program within 30 days from the date of the notice from
the interagency placement committee.
(2) (A) If a county placing agency does not remove a child within
30 days from the date of the notice from the interagency placement
committee, the group home provider shall notify the interagency
placement committee and the department, in writing, of the county's
failure to remove the child from the group home program.
(B) The group home provider shall make the notification required
by subparagraph (A) within five days of the expiration of the 30-day
removal period. If notification is made, a group home provider shall
not be subject to an overpayment determination due to failure of the
county placing agency to remove the child.
(3) Any county placing agency that fails to remove a child from a
group home program under this paragraph within 30 days from the date
of the notice from the interagency placement committee shall be
assessed a penalty in the amount of the state and federal financial
participation in the AFDC-FC rate paid on behalf of the child
commencing on the 31st day and continuing until the child is removed.
(g) (1) If any RCL 13 or RCL 14 group home provider discovers that
it does not have written approval for placement of any AFDC-FC
funded child placed on or after December 15, 1992, from the
interagency placement committee, it shall notify the county placing
agency, in writing, and shall request the county to obtain approval
from the interagency placement committee or remove the child from the
group home program. A group home provider shall have 30 days from
the child's first day of placement to discover the placement error
and to notify the county placing agency.
(2) Any county placing agency that receives notification pursuant
to paragraph (2) of subdivision (f) shall obtain approval for
placement from the interagency placement committee or remove the
child from the group home program within 30 days from the date of the
notice from the group home provider. The program shall not be
reclassified to a lower RCL for a violation of the provisions
referred to in this paragraph.
(3) (A) If a county placing agency does not have the placement of
a child approved by the interagency placement committee or removed
from the group home within 30 days from the date of the notice from
the group home provider, the group home provider shall notify the
county placing agency and the department, in writing, of the county's
failure to have the placement of the child approved or remove the
child from the group home program.
(B) The group home provider shall make the notification required
by subparagraph (A) within five days after the expiration of the
30-day approval or removal period. If notification is made, a group
home provider shall not be subject to an overpayment determination
due to failure of the county placing agency to remove the child.
(C) Any group home provider that fails to notify the county
placing agency pursuant to subparagraph (A) shall be assessed a
penalty in the amount of the AFDC-FC rate paid to the group home
provider on behalf of the child commencing on the 31st day of
placement and continuing until the county placing agency is notified.
(4) Any county placing agency that fails to have the placement of
a child approved or to have the child removed from the group home
program within 30 days shall be assessed a penalty in the amount of
the state and federal financial participation in the AFDC-FC rate
paid on behalf of the child commencing on the 31st day of placement
and continuing until the child is removed.
(h) The department shall develop regulations to obtain payment of
assessed penalties as provided in this section. For audit purposes
and the application of penalties for RCL 13 and
RCL 14 programs, the department shall apply
statutory provisions that were in effect during the period for which
the audit was conducted.
(i) (1) Nothing in this subparagraph shall prohibit a group home
classified at RCL 13 or RCL 14 for purposes of the AFDC-FC program,
from accepting private placements of children.
(2) In cases where a referral is not from a public agency and no
public funding is involved, there shall be no requirement for public
agency review or determination of need.
(3) Children subject to paragraphs (1) and (2) shall have been
assessed as seriously emotionally disturbed, as defined
specified in Section 5600.3 and subject to
Section 1502.4 of the Health and Safety Code, by a licensed mental
health professional, as defined in Sections 629 to 633,
inclusive, specified in Article 8 (commencing with
Section 620) of Title 9 of the California Code of Regulations.
(j) A child shall not be placed in a group home program classified
at an RCL 13 or RCL 14 if the placement is paid for with county-only
funds unless the child is assessed as seriously emotionally
disturbed, as defined specified in
Section 5600.3, subject to Section 1502.4 of the Health and Safety
Code, by a licensed mental health professional, as defined
in Sections 629 to 633, inclusive, specified in
Article 8 (commencing with Section 620) of Title 9 of the
California Code of Regulations.
SEC. 65. Section 18986.40 of the Welfare and Institutions Code is
amended to read:
18986.40. (a) For the purposes of this chapter, "program" or
"integrated children's services programs" means a coordinated
children's service system, operating as a program that is part of a
department or State Department of Mental Health
Care Service s initiative, that offers a full
range of integrated behavioral social, health, and mental health
services, including applicable educational services, to seriously
emotionally disturbed and special needs children, or programs
established by county governments, local education agencies, or
consortia of public and private agencies, to jointly provide two or
more of the following services to children or their families, or
both:
(1) Educational services for children at risk of dropping out, or
who need additional educational services to be successful
academically.
(2) Health care.
(3) All mental health diagnostic and treatment services, including
medication.
(4) Substance abuse prevention and treatment.
(5) Child abuse prevention, identification, and treatment.
(6) Nutrition services.
(7) Child care and development services.
(8) Juvenile justice services.
(9) Child welfare services.
(10) Early intervention and prevention services.
(11) Crisis intervention services, as defined in subdivision (c).
(12) Any other service which will enhance the health, development,
and well-being of children and their families.
(b) For the purposes of this chapter, "children's
multidisciplinary services team" means a team of two or more persons
trained and qualified to provide one or more of the services listed
in subdivision (a), who are responsible in the program for
identifying the educational, health, or social service needs of a
child and his or her family, and for developing a plan to address
those needs. A family member, or the designee of a family member,
shall be invited to participate in team meetings and decisions,
unless the team determines that, in its professional judgment, this
participation would present a reasonable risk of a significant
adverse or detrimental effect on the minor's psychological or
physical safety. Members of the team shall be trained in the
confidentiality and information sharing provisions of this chapter.
(c) "Crisis intervention services" means early support and
psychological assistance, to be continued as necessary, to children
who have been victims of, or whose lives have been affected by, a
violent crime or a cataclysmic incident, such as a natural disaster,
or who have been involved in school, neighborhood, or family based
critical incidents likely to cause profound psychological effects if
not addressed immediately and thoroughly.
SEC. 66. The Legislature finds and declares that Sections 50 and
51 of this act clarify procedures and terms of the Mental Health
Services Act within the meaning of Section 18 of the Mental Health
Services Act.