BILL ANALYSIS
AB 2034
Page 1
Date of Hearing: March 28, 2000
ASSEMBLY COMMITTEE ON HEALTH
Martin Gallegos, Chair
AB 2034 (Steinberg and Baugh) - As Amended: March 23, 2000
SUBJECT : Mental Health: Community Services.
SUMMARY : Appropriates an unspecified amount to continue and
expand community mental health services. Adds transition youth
and families living with a severely mentally ill adult to the
target population for these services. Specifically, this bill :
1)Adds transition youth and families with a severely mentally
ill adult living with them, to the population targeted in
outreach programs to homeless mentally ill persons.
2)Adds to the requirements for treatment planning for the target
population, diagnostic and assessment services designed to
meet the needs of 18 to 25 year olds, inclusive. Provision of
these services may include continuation of services that would
still be received through other funds had eligibility not been
terminated due to age.
3)Includes provision of psychiatric services that are integrated
with other services and for psychiatric collaboration in
overall service planning.
4)Requires the Department of Social Services, a service provider
to transition youth, the United Advocates for Children of
California, and the California Mental Health Advocates for
Children and Youth to be represented on the existing advisory
board to the Director of Mental Health for the purpose of
providing advice regarding criteria for grant awards to
counties.
5)Adds to the criteria for grant awards, a description of
efforts to maximize utilization of other state, federal and
local funds, and a description of efforts to obtain health
foundation charitable funds.
6)Requires counties seeking expansion grants for programs that
were funded prior to January 1, 2001, to provide:
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a) Data on the total number of adults and transition youth
receiving extensive community mental health services not
funded through these grants;
b) Data for each type of program on the funds expended per
person;
c) To the extent available, outcome measures for other
programs that serve populations similar to those served
with grant funds;
d) An analysis comparing cost and outcomes for services
provided under the adult system of care programs and
services provided under other programs; and
e) An explanation of the reasons for those receiving care
outside the adult system of care, and to the extent
possible, the county's plan for expansion of system of care
services.
7)Permits, if sufficient funds have been made available to
counties that have received demonstration grant funding,
additional funding to be made available for other counties
that do not have an integrated services program but meet adult
system of care criteria. To the extent funds are available,
permits counties to apply for a start-up program to serve
approximately 100 people.
8)Requires grants to counties to be used to expand existing
integrated service programs that meet the adult system of care
criteria to provide new services.
9)Requires each county to identify, as the Department of Mental
Health (DMH) may require, the amount of funding required for
housing market conditions, the estimated number of people who
will be eligible for income from Social Security, and types of
housing and support services that will be required.
10)Requires DMH to conduct a study of the public education
program in Norway that utilizes schools, physicians and public
education to ensure that people suffering from
schizophrenia-related illnesses seek treatment, as specified.
Requires DMH to make recommendations for California
implementation of a similar program, including an analysis of
how program costs might be offset by savings in the cost to
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society. Requires DMH to report to the Legislature on or
before July 1, 2001.
11)Appropriates an unspecified amount from the General Fund in
2000-2001 for continuation and expansion of county mental
health grants funded in 1999-2000, as specified.
EXISTING LAW :
1)Requires counties to relieve and support incompetent, poor,
indigent persons, and those incapacitated by age, disease, or
accident, when such persons are not supported and relieved by
relatives, friends, or other public or private institutions.
2)Establishes a target population for county mental health
services that includes severely mentally ill adults, and
children with severe emotional disturbances. This population
includes homeless mentally ill persons, person requiring acute
inpatient psychiatric care, persons arrested or convicted of a
crime, and those with symptoms of psychosis, suicidality or
violence.
3)Requires DMH to establish service standards for mental health
services provided through county demonstration projects to
serve the mentally ill. Provides $10 million in 1999-2000 for
the purposes of demonstration projects in Los Angeles,
Sacramento and Stanislaus counties.
FISCAL EFFECT : Unknown
COMMENTS :
1)PURPOSE OF THIS BILL . The author is proposing this bill to
continue and expand upon the successful community mental
health programs established under AB 34 (Steinberg), Chapter
617, Statutes of 1999. Through county programs and contracts
with Sacramento, Los Angeles and Stanislaus counties, as of
February 1, 2000, the author reports that more than 900
severely mentally ill people have received services and are on
their way to stabilization. Yet, the author estimates that
there are about 50,000 severely mentally ill people living on
California streets. Additionally, thousands of mentally ill
adults and transitional youth live in marginal situations.
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2)SUPPORT . The California Catholic Conference notes that one
need only peruse the newspaper or walk through the center of
town to see the need for this bill. The Conference points out
that the $10 million that was appropriated for the current
budget year is not a lot of money in a state the size of
California, and that a larger allocation will do a great deal
to provide assistance to those in greatest need. Sacramento
County supports this bill to extend the 1999-2000 medically
indigent homeless pilot program and expand the program to
other counties as well as to transition youth.
3)PROGRESS IN EXISTING PROGRAMS . AB 34 (Steinberg) provided
funding for mental health outreach demonstration projects in
Los Angeles ($4.8 million), Stanislaus ($2.8 million) and
Sacramento ($1.9 million) counties. In Sacramento County,
outreach teams go to parks, levees and other places to find
homeless persons to whom they can offer services. The teams
identify immediate needs and provide transportation to those
services. Sacramento County has enrolled 196 people in mental
health services as a result of this program. In Stanislaus,
88 people are being served by programs funded through AB 34.
According to the author, Stanislaus is working to serve adults
who are periodically homeless, and young adults who are
transitioning from foster care and the juvenile justice
system. Stanislaus County is also developing housing options
for seriously mentally ill adults. Los Angeles County is
serving 790 people through programs funded with AB 34
demonstration dollars.
4)HISTORY OF UNDER-FUNDING . AB 3777 (Wright), Chapter 982,
Statutes of 1988, authorized two types of pilot programs for
delivering mental health services to seriously mentally ill
adults: a system of care model, and the integrated services
agencies model. The focus of these programs has been to help
clients reach functional status through access to coordinated
services to address multiple problems that tend to be
concurrent, such as mental illness, substance abuse and
homelessness. SB 659 (Wright), Chapter 153, Statutes of 1996,
reauthorized these projects and required DMH to issue requests
for proposals for additional projects in any year in which the
state budget provides the funds. Funding to expand beyond
these demonstration projects had not been provided until the
enactment of AB 34 (Steinberg) which provided $10 million for
three projects.
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5)UNSPECIFIED APPROPRIATION . This bill contains an
appropriation of an unspecified amount of General Fund dollars
in 2000-2001 year for continuation and expansion of community
mental health programs. The author may wish to consider
specifying the amount of this appropriation. The author notes
that the Governor's Proposed Budget contains a $20 million
appropriation for community mental health services.
6)STUDYING NORWAY . This bill requires DMH to conduct a study of
a public education program in Norway that utilizes schools,
physicians and public education to ensure that people
suffering from schizophrenia-related illnesses seek treatment.
This bill also requires DMH to make recommendations for
implementation of a similar program in California. As
drafted, this bill presupposes an outcome to this study
(positive) by requiring recommendations for implementation of
a similar program. Also, it is likely that studies of the
referenced programs have already occurred. The author may
wish to consider some technical amendments to either remove
the study and conduct a literature review of such programs, or
simply require DMH to issue a report outlining steps necessary
to implementing such a program here.
7)DEFINING TRANSITIONAL YOUTH . This bill adds "transitional
youth," defined as those 18 to 25 years old, to the target
population for mental health outreach services. This bill
also states that provision of these services may include
continuation of services that would still be received through
other funds had "eligibility" not been terminated due to age.
The author should clarify the intent of the bill at this
point. It is unclear what services a youth might have been
eligible for that the youth would be transitioning from,
although it may be intended to refer to foster child programs
or Healthy Families.
8)RELATED LEGISLATION . At least 27 bills relating to mental
health are pending before the Legislature. These proposals
address subjects including involuntary treatment, school
intervention and prevention, police officer training, patient
advocacy, suicide treatment and prevention, advance
directives, discharge planning, mental health courts, dual
diagnoses of mental illness and substance abuse, and funding
for outreach and treatment services. As these proposals
progress through the legislative process, amendments to avoid
policy conflicts and chaptering problems will need to be
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developed.
REGISTERED SUPPORT / OPPOSITION :
Support
California Catholic Conference
California Mental Health Directors Association
California Psychological Association
California Rural Legal Assistance Foundation
County of Sacramento Board of Supervisors
Gray Panthers of Northern California
Homeless Action Center
Orange County Coalition for Mental Health
Project Return: The Next Stop
Protection and Advocacy, Inc.
Regional Psychological Society for Kaiser Permanente Northern
California
Sacramento County Sheriff's Department
Western Center on Law and Poverty
Opposition
None on file
Analysis Prepared by : Ann Blackwood / HEALTH / (916) 319-2097