BILL ANALYSIS                                                                                                                                                                                                    



                                                          AB 34
                                                          Page  1

Date of Hearing:   May 19, 1999

              ASSEMBLY COMMITTEE ON APPROPRIATIONS 
                    Carole Migden, Chairwoman

         AB 34 (Steinberg) - As Amended: April 26, 1999 

Policy Committee:                              Health Vote:14-0

Urgency:     No                   State Mandated Local  
Program:NoReimbursable:           -

  SUMMARY  

This bill expands funding for mental health services to  
seriously mentally ill adults over an eight-year period.  The  
bill:

1)Requires, as funds become available, the three existing  
  demonstration projects established in the Adult and Older  
  Adult Mental Health System of Care Act to be expanded to  
  counties with a significant number of homeless mentally ill  
  persons.

2)Permits the Department of Mental Health (DMH) to reduce grants  
  under the program if counties that receive them are unable to  
  demonstrate at least a 20 percent reduction in incarceration  
  rates over a four-year period.

3)Permits conditions for improvement to be imposed upon a county  
  that receives a grant, but does not reduce criminal justice  
  expenditures as a result, including imposing limitations on  
  future funds. 

4)Requires, beginning in 2004-2005, the DMH to report to the  
  Legislature about the impact of grants in reducing  
  incarceration of severely mentally ill persons.

  FISCAL EFFECT  

The bill appropriates $3 million General Fund in 1999-2000.  In  
addition, the bill appropriates $50 million (GF) beginning in  
2000-2001, and increases the annual appropriation by $50 million  
each year through 2006-07 (thereby appropriating $350 million in  
2006-07). 








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This committee generally does not approve continuous  
appropriations. 

  COMMENTS  

  1)Purpose of the Bill  .  The author proposes this bill to provide  
  substantial financial incentives to counties to address the  
  needs of homeless individuals with severe mental illnesses.   
  The author notes the severely mentally ill, especially those  
  with schizophrenia and bipolar disorder, frequently become  
  completely disoriented and are not able to recognize or accept  
  the need for medical assistance.  When medical attention is  
  not sought, the condition worsens, and a cycle of emergency  
  hospitalization, return to the streets, arrest, incarceration  
  and return to homelessness ensues.  The author argues the  
  mentally ill are often the most vulnerable and helpless  
  members of society, and need government intervention and  
  assistance to restore their health and independence.  

  The Los Angeles County Sheriff's Department indicates that its  
  jail system effectively serves as the largest mental health  
  facility in the nation, providing mental health services for  
  over 2,400 inmates each day.  The LA Sheriff's Department  
  believes this bill will provide necessary resources to keep  
  mentally ill patients from committing crimes and unnecessarily  
  crowding our criminal justice system.  The California Mental  
  Health Planning Council argues this bill will addresses the  
  sustained under-funding of community mental health care that  
  has continued since large numbers of the mentally ill were  
  released from state institutions in the early 1970's.

  2)Prior Legislation  .  AB 3777 (Wright, Chaptered 1988)  
  authorized pilot programs to serve seriously mentally ill  
  adults and older adults.  The projects were funded In Ventura,  
  Stanislaus, and Los Angeles counties.  The focus of these  
  programs has been to help clients reach functional status  
  through access to coordinated services to address multiple  
  problems.  Under the 1988 law, the projects must demonstrate  
  quantifiable reductions in incarceration rates, increased  
  stability in housing, and improved employment rates among  
  individuals served.  The programs were patterned after a  
  similar effort to improve services to seriously emotionally  
  disturbed children that has been expanded statewide.  However,  
  due to funding limitations, a parallel expansion of mental  








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  health services to adults has not occurred.

  Analysis Prepared by  :    William Wehrle / APPR. / (916) 319-2081