BILL ANALYSIS
AB 1969
Page 1
ASSEMBLY THIRD READING
AB 1969 (Steinberg)
As Amended May 30, 2000
2/3 vote
HEALTH 14-0 APPROPRIATIONS 21-0
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|Ayes:|Gallegos, Bates, |Ayes:|Migden, Campbell, |
| |Aanestad, Corbett, Cox, | |Ackerman, Alquist, |
| |Firebaugh, Kuehl, Runner, | |Aroner, Ashburn, Brewer, |
| |Thomson, Honda, Wayne, | |Cedillo, Corbett, Davis, |
| |Wesson, Wildman, Zettel | |Kuehl, Maldonado, Papan, |
| | | |Romero, Runner, Shelley, |
| | | |Thomson, Wesson, Wiggins, |
| | | |Wright, Zettel |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Establishes a long-term mental health care working group
to further coordination and monitoring of treatment of persons with
mental illness in long-term care facilities, appropriates an
unspecified sum for counties for caring for patients in
institutions with mental disease. Specifically, this bill :
1)Makes findings and declarations relative to the nexus between
homelessness among the mentally ill and affordable housing, the
continuum of services that comprise housing for the mentally ill,
and the need for monitoring of the living situations of the
mentally ill to include more than monitoring "bricks and mortar."
2)Requires the Department of Mental Health (DMH), in conjunction
with DHS, to establish a long-term mental health care 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.
3)Requires the long-term mental health care working group to
develop a plan for the development of long-term mental health
care facilities that are community-based and serve no more than
sixteen people. Requires the plan to consider whether a new
licensure category is needed and the elements of monitoring and
evaluation that would be included in the development of a new
licensure category. Requires the long-term mental health care
AB 1969
Page 2
working group to make recommendations to the Legislature on or
before January 1, 2002.
4)Requires DMH, in conjunction with DHS, to develop and submit to
the Legislature, on or before March 1, 2001, a state plan for a
consolidated and streamlined evaluation and monitoring program
under one regulating authority for the review of mental health
rehabilitation centers and SNFs with special treatment programs,
as specified. Requires the plan to include the cost and timeline
for implementation.
5)Requires DHS to forward to DMH and the county in which the
facility is located, citations issued to a SNF that has a special
treatment program. Requires DMH to forward to the county in
which a facility is located, copies of SNF and mental health
rehabilitation center citations, as specified.
6)Requires, to the extent state funds are available, counties that
contract for services from institutions for mental disease to
establish a clinical quality support program as specified.
7)Requires, on or before July 1, 2001, DHS to develop a mechanism
to allow public access, including internet access, to information
regarding long-term care facilities licensed or certified by DHS,
including mental health rehabilitation centers and special
treatment programs, as specified.
8)Appropriates $3 million from the General Fund to DMH in 2000-2001
to be allocated to counties based on the number of clients in
institutions for mental disease by each county.
EXISTING LAW :
1)Authorizes DHS to license and regulate health facilities,
including SNFs that provide services to persons with severe
mental illness.
2)Establishes DMH, with the jurisdiction over execution of laws
relating to the care, custody, and treatment of mentally ill
persons, as set forth in the Welfare and Institutions Code.
3)Permits counties to determine whether to place severely mentally
ill persons in state-run hospitals, or to contract for these
services with local private providers.
AB 1969
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FISCAL EFFECT : According to the Assembly Appropriations Committee
analysis, GF costs to DMH, estimated at $3 million annually, to
allocate funds to counties for clinical quality support programs in
institutions for mental disease.
COMMENTS : According to the author, this bill is intended to
improve coordination of oversight of SNFs that also serve persons
with mental illness. The author cites a lack of coordination
between DHS and DMH, noting that DMH may find a deficiency with one
of these facilities, but have no authority to issue a citation or
impose fines.
The Union of American Physicians and Dentists notes that
establishing a mechanism that allows public access to health care
facility information will enable an assessment of the housing
options available to persons with mental illness. Protection and
Advocacy, Inc. (PAI) believes that this bill will greatly improve
mental health services in California by enhancing monitoring of
certain facilities.
Following the realignment of responsibility and payment for mental
health services in 1991, counties gained the option of paying to
place noncriminal persons with severe mental illness in state-run
hospitals, or contracting out with private providers at the local
level to provide care. A recent Los Angeles Times article
indicates that many counties have chosen to redirect patients to
private facilities that tend to be less expensive than state
hospital care. This redirection has also resulted in a large
increase in the number of citations issued to a select group of
private facilities. DHS has issued 200 citations against 35 of the
45 facilities certified to provide care for the mentally ill since
1992. DMH was apparently unaware of, or ill-equipped to intervene
in these situations where DHS had issued citations.
Analysis Prepared by : Ann Blackwood / HEALTH / (916) 319-2097 FN:
0005149