BILL NUMBER: AB 1969 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 13, 2000
INTRODUCED BY Assembly Member Steinberg
(Coauthor: Senator Perata)
FEBRUARY 18, 2000
An act to add Section 4044 Sections 4044.5
and 5908.5 to the Welfare and Institutions Code, relating to
mental health , and making an appropriation therefor .
LEGISLATIVE COUNSEL'S DIGEST
AB 1969, as amended, Steinberg. Mental health: housing.
Existing law requires the State Department of Mental Health, to
the extent resources are available, to provide program development
guidelines, evaluation models, and operational assistance on all
aspects of services to mentally ill persons, including housing
development.
Existing law authorizes, until January 1, 2001, counties to
voluntarily participate in a pilot project for the operation of a
shared mental health rehabilitation center to provide community care
and treatment for persons with mental disorders who are placed in a
state hospital or another health facility. Existing law requires the
State Department of Mental Health to establish standards for the
pilot project.
Existing law provides for the regulation of health facilities,
including skilled nursing facilities, by the State Department of
Health Services. Existing law requires that the regulations adopted
by the department prescribe standards based on the type of health
facility and the needs of the persons served. In this regard, the
regulations set forth the requirements for a skilled nursing facility
to provide special treatment programs to serve certain mentally ill
patients.
This bill would require the department
State Department of Mental Health , in conjunction with
various other entities, to develop protocols to review,
monitor, and report on existing and potential skilled nursing
facilities that have or could have special treatment programs. The
bill would prescribe various requirements of the department regarding
developing a program for conducting local reviews concerning these
facilities, developing a mechanism that allows public access,
including Internet access, to information regarding the reviews and
developing a mechanism that allows public access to information
related to any citations issued to these facilities by the State
Department of Health Services or the State Department of Social
Services the State Department of Health Services (1)
to establish a long-term care mental health working group to develop
a specific plan for the development of certain long-term care
facilities that are able to provide diagnosis, treatment, and care of
persons with mental diseases and (2) to develop a state-level plan
for a single evaluation and monitoring program under one regulating
authority for the review of mental health rehabilitation centers and
skilled nursing facilities with special treatment programs .
The bill would require the long-term care mental health working
group to provide a report with recommendations to the Legislature on
or before January 1, 2002.
The bill would require the State Department of Mental Health to
forward copies of any citations issued to a skilled nursing facility
that has a special treatment program or to a mental health
rehabilitation center, to the county in which the skilled nursing
facility or mental health rehabilitation center is located.
Existing law sets forth procedures under which mental health
services in skilled nursing facilities designated as institutions for
mental disease are organized and financed.
This bill would require counties that contract for services from
institutions for mental disease to establish a designated clinical
quality support program, to the extent funds are made available from
the state.
The bill would appropriate an unspecified sum from the General
Fund to the State Department of Mental Health to be allocated to
county departments of mental health based on the total number of
clients placed in institutions for mental disease by each county.
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 as follows:
(a) There is a nexus between homelessness among the seriously
mentally ill and adequate and affordable housing.
(b) Twenty-four-hour housing for the seriously mentally ill is a
continuum that includes the following alternatives:
(1) State hospital.
(2) Institute for mental disease.
(3) Mental health rehabilitation centers.
(4) Board and care.
(5) Supported living.
(6) Independent living.
(c) The monitoring of living situations for the seriously mentally
ill needs to include more than monitoring "bricks and mortar,"
square footage requirements, or local zoning regulations.
SEC. 2. Section 4044 is added to the Welfare and Institutions
Code, to read:
4044. (a)
SEC. 2. It is the intent of the Legislature to enact legislation
that requires that skilled nursing facilities licensed by the State
Department of Health Services that are designated as institutions for
mental disease receive stringent monitoring and enhanced penalties
for licensing violations.
SEC. 3. Section 4044.5 is added to the Welfare and Institutions
Code, to read:
4044.5. (a) (1) The State Department of Mental Health, in
conjunction with county mental health programs, county
mental health boards and commissions, the National Alliance for the
Mentally Ill-California, and the California Client Network shall
develop protocols to review, monitor, and report on existing and
potential skilled nursing facilities that have or could have a
special treatment program, as described in Sections 72443 to 72475,
inclusive, of Title 22 of the California Code of Regulations, to
serve patients who have a chronic psychiatric impairment and whose
adaptive functioning is moderately impaired.
(b) The department shall establish a program for conducting local
reviews of a skilled nursing facility described in subdivision (a)
using the protocols developed pursuant to subdivision (a). The
reviews conducted locally shall be conducted by a group that shall
include, but not be limited to, representatives from all of the
entities specified in subdivision (a). conjunction
with the State Department of Health Services, shall establish a
long-term care mental health working group that includes
representatives of county mental health programs, consumers, family
members of residents with mental disease who are in long-term care
facilities, and long-term care providers.
(2) The long-term care mental health working group shall develop a
specific plan for the development of long-term care facilities that
are able to provide diagnosis, treatment, and care of persons with
mental diseases, that are community-based, and serve no more than 16
persons. The plan shall include consideration of whether a new
licensure category is needed and the specific elements of monitoring
and evaluation that would be included in the development of a new
licensure category. The long-term care mental health working group
shall provide a report with recommendations to the Legislature on or
before January 1, 2002.
(b) The State Department of Mental Health, in conjunction with the
State Department of Health Services, shall develop a state-level
plan for a single evaluation and monitoring program under one
regulating authority for the review of mental health rehabilitation
centers and skilled nursing facilities with special treatment
programs. The plan shall include the cost of, and a timeline for,
implementing the plan. The plan shall be developed in consultation
with the long-term care mental health working group established
pursuant to subdivision (a). The plan shall review resident safety
and quality programming, ensure that long-term care facilities
engaged primarily in the diagnosis, treatment, and care of persons
with mental diseases are available and appropriately evaluated, and
ensure that strong linkages are built to local communities and other
treatment resources for residents and their families. The plan shall
be submitted to the Legislature on or before March 1, 2001.
(c) The department shall develop a mechanism that allows public
access, including Internet access, to information regarding the
results of the reviews conducted pursuant to subdivision (b) and
related to any citations issued to a skilled nursing facility
described in subdivision (a) by the State Department of Health
Services or the State Department of Social Services.
(d) (1) The State Department of Health Services
and the State Department of Social Services shall
forward copies of citations issued to a skilled nursing facility
described in subdivision (a) that has a
special treatment program certified by the State Department of Health
Services to the State Department of Mental Health and the
county in which the facility or program is located.
(e) The reviews and licensing information collected pursuant to
this section shall be used to develop an assessment of the statewide
housing options available to persons with mental illness.
(e) The State Department of Mental Health shall forward copies of
citations issued to a skilled nursing facility that has a special
treatment program, as described in Section 51335 and Sections 72443
to 72475, inclusive, of Title 22 of the California Code of
Regulations, or issued to a mental health rehabilitation center, as
described in Section 5675 of this code and Section 781.00 and
following of Title 9 of the California Code of Regulations, to the
county in which the skilled nursing facility or mental health
rehabilitation center is located.
SEC. 4. Section 5908.5 is added to the Welfare and Institutions
Code, to read:
5908.5. To the extent designated funds are available from the
state to do so, counties that contract for services from any
institutions for mental disease shall establish a clinical quality
support program that includes the following elements:
(a) Regular visits by county clinical staff to assess the clinical
needs of residents of institutions for mental disease placed by the
county.
(b) Chart reviews by county clinical staff to ensure that the
clinical needs of the residents are met, including, but not limited
to, ancillary health care needs.
(c) Regular meetings with client case managers to assess service
needs and outcomes.
(d) Clinical case consultation as needed by staff or consulting
clinical staff of the institution for mental disease.
SEC. 5. There is hereby appropriated from the General Fund the sum
of ____ dollars ($____) from the General Fund to the State
Department of Mental Health to be allocated to county departments of
mental health based on the total number of clients placed in
institutions for mental disease by each county.