BILL ANALYSIS �
AB 1790
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Date of Hearing: May 7, 2014
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 1790 (Dickinson) - As Amended: April 24, 2014
Policy Committee: HealthVote:17-1
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill requires county mental health plans to take steps to
increase the pool of specialty mental health providers who meet
specified criteria and who are available to meet the needs of
children formerly in foster care who have been adopted or placed
with a guardian. It also:
1)Specifies criteria personnel should meet.
2)Requires the Department of Social Services to convene a
stakeholder group to facilitate the development of a process
to approve curricula and determine criteria for trainers, and
to facilitate the establishment of a process by which mental
health practitioners can meet criteria specified in the bill.
FISCAL EFFECT
1)State cost pressure to provide funding to counties for
increased costs for the Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT) Program. The bill does not
specify what steps should be taken by county mental health
plans, but if each of 56 plans allocated 0.25 PY one-time to
take steps, this would result in increased costs of $1.4
million statewide (GF/federal). This bill appears to require
a higher level of service to be provided through EPSDT. As
EPSDT was realigned under 2011 Realignment, counties, who
administer the program, are not required to provide higher
levels of service through this program unless the state funds
these costs annually, as discussed below.
2)Minor staff costs, less than $100,000, to DSS to convene a
AB 1790
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stakeholder panel, and minor staff costs to Department of
Health Care Services to participate.
3)Potential, likely minor, one-time or ongoing cost pressure to
the state to develop processes and implement oversight
mechanisms pursuant to the stakeholder panel recommendations.
While the duties of the panel are to facilitate the
establishment of various processes, actually establishing
those processes could result in state costs. For example, if
the Board of Behavioral Sciences (BBS) was tasked with new
duties related to educational standards for adoption
competency as a result of this stakeholder process, BBS may
incur related indirect costs.
COMMENTS
1)Purpose. The author states this bill addresses the need to
increase the number of child welfare professionals and
clinicians with an in-depth understanding of adoption and
permanency issues.
2)Background. The need for increased competency for mental
health professionals treating adopted children has been
recognized nationally. For example, the federal Department of
Health & Human Services (HHS) Children's Bureau has released a
National Adoption Competency Mental Health Training Initiative
(Initiative), providing a small amount of grant funding
through a cooperative agreement to enhance training in this
areas. The initiative appears to address many of the issues
in this bill, asking recipients to assess existing training
curricula and develop a national adoption competency mental
health certification process.
3)EPSDT and Protection of Local Realignment Structure . The
mental health portion of EPSDT is a set of services which
include group therapy, family therapy, case management, crisis
counseling, medication, and other medically necessary services
for children with serious mental illness. In the 2012-13
Budget, EPSDT was realigned to the counties, providing
counties the responsibility and a dedicated funding source to
support the provision of specified services to qualifying
children.
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Proposition 30 (2012) provides protection for the realigned
revenue source and other protections for programs that were
realigned to counties. It specifies that legislation enacted
after September 30, 2012, "that has an overall effect of
increasing the costs already borne by a local agency for
programs or levels of service mandated by the 2011 Realignment
Legislation shall apply to local agencies only to the extent
that the State provides annual funding for the cost increase."
Thus, as the bill mandates higher level of service in a
realigned program that is protected by this Proposition 30
structure, the bill would only apply to county mental health
plans to the extent additional funding was provided.
4)Related Legislation .
a) SB 1009 (Committee on Budget), Chapter 34, Statutes of
2012 realigned EPSDT services to counties, including it as
a realigned program within 2011 Realignment.
b) SB 1020 (Committee on Budget), Chapter 34, Statutes of
2012 establishes a permanent financial and account
structure for 2011 Realignment.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081