BILL NUMBER: AB 34 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY FEBRUARY 4, 1999
INTRODUCED BY Assembly Member Steinberg
(Coauthor: Assembly Member Thomson)
DECEMBER 7, 1998
An act to amend Sections 5802, 5806, and 5814 of the Welfare
and Institutions Code, relating to mental health , and
making an appropriation therefor .
LEGISLATIVE COUNSEL'S DIGEST
AB 34, as amended, Steinberg. Mental health funding : local
grants .
Existing law provides for the allocation of state funds to
counties for mental health programs.
This bill would provide that, commencing with the 2000-01
fiscal year, every county shall receive an unspecified amount of
funds based upon the net increase in the number of persons the county
has provided with mental health services during the previous fiscal
year make various statements of legislative findings
and intent regarding the need to provide sufficient funds to counties
for adult mental health and related services.
Existing law requires the State Department of Mental Health to
establish service standards relating to mental health services.
These standards are required to include, among other things, plans
for services and evaluation strategies.
This bill would also require these standards to include
coordination and access to related medications, substance abuse
services, housing assistance, and vocational rehabilitation services.
The bill would also provide for planning grants and service
expansion grants to counties for adult mental health programs.
The bill would appropriate $10,000,000 from the General Fund to
the department for provision of planning grants during the 1999-2000
fiscal year, and would express legislative intent that at least
$50,000,000 be appropriated each fiscal year thereafter pursuant to
the annual Budget Act for these planning and service expansion grants
.
Vote: majority 2/3 .
Appropriation: no yes . Fiscal
committee: yes. State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Presently there are no financial incentives for counties to
increase the number of people they serve with severe mental illness.
(b) County dollars are generally fixed, so that treatment of a
higher than expected number of Medi-Cal recipients, who are entitled
to treatment by the county, reduces the amount of funds available to
serve other individuals.
(c) Counties should be provided an amount of funds to
establish systems of care for severely mentally ill adults, and
provide mental health services and related medications for
indigents not yet qualified for Medi-Cal, and for ,
substance abuse services, housing assistance, vocational
rehabilitation, and other nonmedical programs necessary to stabilize
homeless mentally ill persons and get them into regular treatment and
off the streets.
SEC. 2. Commencing with the 2000-01 fiscal year and each fiscal
year thereafter, every county shall receive $____ based upon the net
increase in the number of persons the county has provided with mental
health services during the previous year.
SEC. 2. Section 5802 of the Welfare and Institutions Code is
amended to read:
5802. (a) The Legislature finds that a mental health system of
care for adults and older adults with severe and persistent mental
illness is vital for the success of mental health managed care in
California. Specifically:
(1) A comprehensive and coordinated system of care includes
community-based treatment, case management, and interagency system
components required by adults and older adults with severe and
persistent mental illness.
(2) Mentally ill adults and older adults receive service from many
different state and county agencies, particularly criminal justice,
employment, housing, public welfare, health, and mental health. In a
system of care these agencies collaborate in order to deliver
integrated and cost-effective programs.
(3) The management of the risk for persons with severe mental
illness and related financial risks is important for all levels of
government, business, and the community.
(4) System of care services which ensure culturally competent care
for persons with severe mental illness in the most appropriate,
least restrictive level of care are necessary to achieve the desired
performance outcomes.
(5) Mental health service providers need to increase
accountability and further develop methods to measure progress
towards client outcome goals and cost-effectiveness as required by a
system of care.
(b) The Legislature further finds that the integrated service
agency model developed in Los Angeles and Stanislaus Counties and the
countywide systems model developed in Ventura County, beginning in
the 1989-90 fiscal year through the implementation of Chapter 982 of
the Statutes of 1988, provides models for managing care for adults
and older adults with severe mental illness that are vital to the
implementation and success of the mental health managed care plan in
California, and have successfully met the performance outcomes
required by the Legislature.
(c) The Legislature also finds that the system components
established in these three programs can be replicated and expanded to
additional clients in order to provide greater benefit to adults and
older adults with severe and persistent mental illness at a lower
cost in California.
(d) Therefore, using the guidelines developed under the
demonstration projects implemented under the adult system of care
legislation in 1989, it is the intent of the Legislature to
accomplish the following:
(1) Encourage each county to implement a system of care as
described in this legislation for the delivery of mental health
services to seriously mentally disordered adults and older adults.
(2) To promote system of care accountability for performance
outcomes which enable adults with severe mental illness to reduce
symptoms which impair their ability to live independently, work,
maintain community supports, care for their children, stay in good
health, not abuse drugs or alcohol, and not commit crimes.
(3) Maintain funding for the existing programs developed in Los
Angeles, Stanislaus, and Ventura Counties as models and technical
assistance resources for future expansion of system of care programs
to other counties as funding becomes available.
(4) Provide sufficient funds for counties to establish outreach
programs and to provide mental health services and related
medications, substance abuse services, housing assistance, vocational
rehabilitation, and other nonmedical programs necessary to stabilize
homeless mentally ill persons, get them off the street, and into
treatment and recovery.
SEC. 3. Section 5806 of the Welfare and Institutions Code is
amended to read:
5806. The State Department of Mental Health shall establish
service standards that assure ensure
that members of the target population are identified, and services
provided to assist them to live independently, work, and reach their
potential as productive citizens. These standards include but are
not limited to:
(a) A service planning process that is target population based and
includes the following:
(1) Determination of the numbers of clients to be served and the
programs and services that will be provided to meet their needs. The
local director of mental health shall consult with the mental health
board, contract agencies, family, client, ethnic and citizen
constituency groups as determined by the director.
(2) Plans for services including outreach, services
design , and of mental health
services, coordination and access to medications, substance abuse
services, housing assistance, and vocational rehabilitation services.
Plans shall also contain evaluation strategies , which
shall consider cultural, linguistic, gender, age, and special
needs of minorities in the target populations. Provision shall be
made for staff with the cultural background and linguistic skills
necessary to remove barriers to mental health services due to limited
English speaking ability and cultural differences.
(3) Provisions for services to meet the needs of target population
clients who are physically disabled.
(4) Provision for services to meet the special needs of older
adults.
(5) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, where appropriate.
(b) Each client shall have either a clearly designated mental
health case manager or a multidisciplinary treatment team who is
responsible for providing or assuring needed services.
Responsibilities include complete assessment of the client's needs,
development of the client's personal services plan, linkage with all
appropriate community services, monitoring of the quality and
followthrough of services, and necessary advocacy to ensure each
client receives those services which are agreed to in the personal
services plan. Each client shall participate in the development of
his or her personal services plan, and responsible staff shall
consult with the designated conservator and, with the consent of the
client, consult with the family and other significant persons as
appropriate.
(c) The individual personal services plan shall assure that
members of the target population involved in the system of care
receive services which are designed to:
(1) Reduce the disabling symptoms of mental illness.
(2) Live in the most normal housing feasible in the local
community.
(3) Have an adequate income and an appropriate level of work or
vocational training.
(4) Are in good health.
(5) Have a support system, with friendships and participation in
community activities.
(6) Have freedom from dangerous, addictive substances.
(7) Maintain socially responsible behavior.
(8) Obtain an appropriate level of education and learning.
(9) Receive culturally appropriate services.
(10) Receive gender and age appropriate services.
SEC. 4. Section 5814 of the Welfare and Institutions Code is
amended to read:
5814. (a) This part shall be implemented only to the
extent that funds are appropriated for purposes of this part in the
Budget Act. To the extent that funds are made available, the first
priority shall go to maintain funding for the existing programs
developed in Los Angeles, Stanislaus, and Ventura Counties
with any excess directed to the expansion of the program to other
qualifying counties .
(b) As funds become available, this program shall be expanded to
provide funding for counties with significant populations of homeless
mentally ill persons consisting of both of the following types of
grants:
(1) Planning grants for new counties to create, and for existing
system of care counties to expand, an adult system of care that meets
the requirements of this part.
(2) (A) Four-year service expansion grants in accordance with a
contract between the state and approved counties that provides a
formula for annual increased funding reflecting net increases in the
total annual number of severely mentally ill adults who receive
extensive community mental health services in at least four
consecutive months.
(B) The formula incentive funding provided pursuant to
subparagraph (A) shall be sufficient to provide mental health
services, medically necessary medications to treat severe mental
illnesses, alcohol and drug services, housing assistance, and
vocational rehabilitation. These grants shall, however, pay for only
the portion of the costs of those services not likely to be provided
by federal funds or other state funds.
SEC. 5. (a) The sum of ten million dollars ($10,000,000) is hereby
appropriated from the General Fund to the State Department of Mental
Health for implementation of paragraph (1) of subdivision (b) of
Section 5814 of the Welfare and Institutions Code during the
1999-2000 fiscal year.
(b) It is the intent of the Legislature that, commencing with the
2000-01 fiscal year, at least fifty million dollars ($50,000,000) be
provided each fiscal year, pursuant to the annual Budget Act, for
implementation of subdivision (b) of Section 5814 of the Welfare and
Institutions Code.