BILL ANALYSIS
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THIRD READING
Bill No: AB 2034
Author: Steinberg (D), et al
Amended: 8/25/00 in Senate
Vote: 27 - Urgency
SENATE HEALTH & HUMAN SERV. COMMITTEE : 6-0, 6/28/00
AYES: Escutia, Figueroa, Hughes, Morrow, Mountjoy,
Vasconcellos
SENATE APPROPRIATIONS COMMITTEE : 13-0, 8/23/00
AYES: Johnston, Alpert, Bowen, Burton, Escutia, Johnson,
Karnette, Kelley, Leslie, McPherson, Mountjoy, Perata,
Vasconcellos
ASSEMBLY FLOOR : 69-7, 5/31/00 - See last page for vote
SUBJECT : Mental health funding: local grants
SOURCE : Mental Health Association in California
DIGEST : This bill continues and expands a demonstration
program initiated in fiscal year 1999-2000, in AB 34
(Steinberg), that provides mental health outreach, case
management, and other services to persons with mental
illness who are homeless or at-risk of homelessness.
Funding is contingent on funds appropriated in the annual
Budget Act.
ANALYSIS :
Existing law:
CONTINUED
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1.Requires counties to be the providers of last resort for
relief and support of incompetent, poor, indigent
persons, and those incapacitated by age, disease, or
accident, when such persons are not supported and
relieved by their own means, relatives, friends, or other
public or private institutions.
2.Establishes, in certain counties, an adult system of care
program, that provides county mental health services to
severely mentally ill adults and children with severe
emotional disturbances, as defined.
3.Requires the State Department of Mental Health (DMH) to
establish demonstration programs in three counties, as
specified in AB 34 (Ch. 617, Statutes of 1999), providing
mental health services to adults with severe mental
illness who are homeless, recently released from county
jail or who are at significant risk of incarceration or
homelessness, unless treatment is provided.
4.Provides $10 million in FY 1999-2000 for the three
demonstration projects in Los Angeles, Sacramento and
Stanislaus counties
5.Specifies a number of service standards for the three
demonstration projects including, plans for mental health
services and housing assistance to the target population,
and plans for outreach to transition youth
6.Requires that the demonstration projects be evaluated to
determine effectiveness and that a report be submitted to
the Legislature by May 1, 2000.
This bill:
1.In any year funds are appropriated in the annual Budget
Act, permits counties currently operating AB 34
demonstration projects to be eligible for continued
funding, if they have demonstrated effectiveness, and
also permits these counties to expand the projects if
they demonstrate continued unmet need and the capacity
to expand without compromising effectiveness.
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2.In any year funds are appropriated in the annual budget
Act, makes any other counties, or portions of counties,
or cities that operate independent public mental health
programs, as specified, eligible for funding to
establish an AB 34 program if the county or eligible
city can develop an integrated adult systems of care
program that provides comprehensive services to a
substantial number adults who meet the target criteria
(i.e., severely mentally ill adults who are homeless,
recently released from county jail or who are at
significant risk of incarceration or homelessness,
unless treatment is provided).
3.Requires provision of AB 34 program services to youth 25
years and younger who are seriously mentally ill and
homeless or at significant risk of becoming homeless.
4.Requires that program services reflect the special needs
of women with mental illness from diverse cultural
backgrounds, including supportive housing that accepts
children and substance treatment programs that address
gender-specific trauma and abuse.
5.Requires the AB 34 project's service and delivery
process to include provision of housing for clients,
including immediate, transitional and permanent housing.
6.Requires that services also include provision of
psychiatric and psychological services, integrated with
other services, and includes psychiatric and
psychological collaboration in overall service planning.
7.Requires certain entities - the State Department of
Social Services (DSS), a service provider to transition
youth and specific advocacy groups, the United Advocates
for Children of California and the California Mental
Health Advocates for Children and Youth and other
appropriate entities- to be represented on the existing
DMH advisory board which recommends criteria for grant
awards to counties.
8.Requires counties ensure any client hospitalizations are
coordinated with other services.
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9.Includes an urgency clause in order to maintain funding
for the existing demonstration programs without
disruption.
Comments
Background . Legislation enacted in 1999, AB 34
(Steinberg), Chapter 617 Statutes of 1999, established
demonstration projects in several counties to provide
specified mental health and related services to homeless
mentally ill persons. The legislation specified that only
those counties with an existing adult system of care
program were eligible to operate a demonstration project.
The target population under the existing AB 34
demonstration projects are adults with severe mental
illness who are homeless, recently released from a county
jail or state prison, or others who are untreated, unstable
and at significant risk of incarceration or homelessness,
unless treatment is provided.
Through the demonstration projects, counties were provided
funds to establish outreach programs and to provide mental
health services, related medication, substance abuse
services, housing assistance, vocational rehabilitation and
other services to the target population.
AB 34 provided funding for the 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.
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. Los Angeles County is serving 790 people with
demonstration project dollars.
In addition to the provisions described in the Abstract
above, AB 2034 contains the following provisions:
1.Requires participating counties to designate for each
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client a "personal services coordinator", who may be part
of an multidisciplinary team. Under current law, clients
may be provided a case manager or a multidisciplinary
team.
2.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.
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.
Evaluation of AB 34 . As required by AB 34, the
demonstration projects were evaluated by the DMH and a
report submitted to the Legislature ("Effectiveness of
Integrated Services for Homeless Adults with Serious Mental
Illness", May, 2000). The DMH's findings include the
following:
1.Fewer than 15 percent of eligible clients refused
enrollment in the program and less than four percent left
the program.
2.Approximately two-thirds of the clients were male.
3.Most clients were between the ages of 22 and 59 years (90
percent).
4.The ethnic distribution of the clients was 43 percent
Caucasian, 37 percent African American, 12 percent
Hispanic, one percent Asian and seven percent
unspecified.
5.The percent of enrollees hospitalized dropped 64 percent.
6.The number of days of incarceration dropped 74 percent.
7.The number of days of homelessness dropped 59 percent.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
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According to the Senate Appropriations Committee, cost to
General Fund of $250,000 in 2000-01 and $500,000 each in
2001-02 and 2002-03. Expansion is contingent upon future
appropriations.
SUPPORT : (Verified 6/28/00)(Unable to verify at time of
this writing)
Mental Health Association in California (source)
50+ and Strong
ACCESS Campaign for Mental Healthcare
AFSCME, AFL-CIO
All Saints Parish
Calaveras County Mental Health Board
California Catholic Conference
California Child, Youth and Family Coalition
California Coalition for Ethical Mental Health Care
California Council of Community Mental Health Agencies
California Healthcare Association
California Medical Association
California Mental Health Directors Association
California Mental Health Planning Council
California Psychological Association
California Psychiatric Association
California Rural Legal Assistance Foundation
California Seniors Coalition
California Society for Clinical Social Work
California State Association of Counties
Catholic Charities of California
Changing Lives Through Jobs
Chief Probation Officers of California
City and County of San Francisco
CLARE Foundation, Inc.
Common Ground
Congress of California Seniors
County of Los Angeles
County of Sacramento
Didi Hirsch Community Mental Health Center
Gray Panthers
Homeless Action Center
Jericho: A Voice for Justice
Jesuit Volunteer Corps - San Jose
Los Angeles Youth Network
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Mental Health Advocacy Project
Mental Health Association in Los Angeles County
Mental Health Association in Santa Barbara
National Association of Social Workers
New Directions, Inc.
Ocean Park Community Center
Orange County Coalition for Mental Health
Project Return: The Next Step
Protection and Advocacy, Inc.
Regional Psychological Society
Sacramento County Board of Supervisors
San Diego County Board of Supervisors
Santa Clara County Board of Supervisors
Sacramento County Sheriff's Department
San Bernardino County Sheriff's Department
San Fernando Valley Community Mental Health Center, Inc.
Union of American Physicians & Dentists
Upward Bound House
Urban Counties Caucus
Verdugo Mental Health Center
Westside Shelter and Hunger Coalition
Western Center on Law and Poverty
OPPOSITION : (Verified 8/1/00)
Department of Finance (prior version)
ARGUMENTS IN SUPPORT : Sacramento County supports this
bill to extend the 1999-2000 demonstration program to other
counties as well as to youth in transition.
The California Psychiatric Association, writing in support
of this bill, states that with AB 34, California is
"finally beginning to develop the community care system"
envisioned 30 years ago and that the program has succeeded
beyond expectations. The California Healthcare Association
states there is ample evidence that "wraparound"
(comprehensive) services for the seriously mentally ill is
cost effective and humane and that: "We know how to
effectively treat this population. What we need now is
additional funding to ensure that more mentally ill
individuals at risk of homelessness or incarceration are
given the chance to participate....".
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ARGUMENTS IN OPPOSITION : According to the Department of
Finance (prior version), it opposes the General Fund
pressure created by the bill and, additionally, notes the
following concerns:
1.The bill would create new and unfunded administrative
workload in DMH.
2.The required literature review and resultant
recommendation could result in fiscal pressures and
expectations of future funding for new programs.
3.This bill could be construed as creating a new
categorical program. That could result in pressure to
provide additional funding for the newly defined
population in need of services even though that
population is already eligible for services under a
different program.
ASSEMBLY FLOOR :
AYES: Aanestad, Ackerman, Alquist, Aroner, Bates, Battin,
Bock, Brewer, Briggs, Calderon, Campbell, Cardenas,
Cardoza, Cedillo, Corbett, Correa, Cox, Cunneen, Davis,
Dickerson, Ducheny, Dutra, Firebaugh, Florez, Frusetta,
Gallegos, Granlund, Havice, Honda, House, Jackson,
Keeley, Knox, Kuehl, Leach, Lempert, Leonard, Longville,
Lowenthal, Machado, Maddox, Maldonado, Margett, Mazzoni,
Migden, Nakano, Olberg, Robert Pacheco, Papan, Pescetti,
Reyes, Romero, Scott, Shelley, Steinberg, Strickland,
Strom-Martin, Thomson, Torlakson, Villaraigosa, Vincent,
Washington, Wayne, Wesson, Wiggins, Wildman, Wright,
Zettel, Hertzberg
NOES: Ashburn, Kaloogian, McClintock, Oller, Rod Pacheco,
Runner, Thompson
CP:cm 8/27/00 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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