BILL ANALYSIS                                                                                                                                                                                                    



                                                                       


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          |SENATE RULES COMMITTEE            |                  SB 1770|
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                                 THIRD READING
                                        

          Bill No:  SB 1770
          Author:   Chesbro (D)
          Amended:  4/13/00
          Vote:     21

            
           SENATE HEALTH & HUMAN SERV. COMMITTEE  :  5-1, 4/26/00
          AYES:  Escutia, Figueroa, Hughes, Solis, Vasconcellos
          NOES:  Haynes
          NOT VOTING:  Morrow, Mountjoy, Polanco

           SENATE APPROPRIATIONS COMMITTEE  :  8-4, 5/25/00
          AYES:  Johnston, Alpert, Bowen, Burton, Escutia, Karnette,  
            Perata, Vasconcellos
          NOES:  Johnson, Kelley, Leslie, Mountjoy
          NOT VOTING:  McPherson
           

           SUBJECT  :    Mental health:  client and family member  
          empowerment
                      programs

           SOURCE  :     Author

           
           DIGEST  :    This bill establishes a mental health client and  
          family empowerment grant program to enhance the role of  
          clients and families in the mental health system, as well  
          as improving the responsiveness of the mental health system  
          to clients and family members.

           ANALYSIS :    Existing law:

          1.Requires the State Department of Mental Health (DMH) and  
                                                           CONTINUED





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            county mental health departments to administer a number  
            of programs to provide services to persons who have a  
            mental illness.

          2.Provides that under realignment, federal and state  
            Medi-Cal funds plus a portion of tax proceeds, are  
            provided to county mental health departments, which have  
            primary responsibility to provide mental health care to  
            county residents.

          This bill makes a number of Legislative findings including:

          1.Persons with mental illness and their families make  
            significant contributions toward the development of a  
            cohesive, high-quality mental health system, which is  
            enhanced when clients and family members are afforded  
            choices about methods of service delivery.

          2.Clients and families should have a leadership role in the  
            development, implementation, and oversight of mental  
            health policies.

          3.Counties should improve the exercise of consumer choice  
            in the determination of mental health treatment and  
            service programs.

          4.Delivery of appropriate and effective mental health  
            services and supports is improved by the involvement of  
            clients and families in the development of  treatment and  
            service plans.

          5.Peer supports improve the participation of both clients  
            and family members in the mental health system.

          This bill requires DMH to administer a program of  
          competitive grants for county mental health programs that  
          improve services and supports for clients and families.   
          Proposals would be required to contain, among other  
          requirements, descriptions of how funds would result in:

          1.Establishment, expansion or improvement of training,  
            information and referral services for clients and for  
            family members.








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          2.Expansion of the role of clients and family members in  
            the development of local policy.

          3.Establishment or expansion of self-help and other  
            client-run programs as well as family-to-family support  
            activities.

          4.Improved decision making and choices of clients and  
            family members.

          Proposals also would be required to demonstrate that (1)  
          clients and family members participated in the development  
          of the proposal and (2) how the programs will continue  
          after state funding is terminated.

           Comments  

           County Mental Health Program Services
           
          Existing law establishes the county mental health  
          departments as the primary providers of mental health care.  
           Under realignment, counties currently serve approximately  
          200,000 persons with mental health disorders annually. 

           Joint Committee on Mental Health Reform
           
          In January, 2000, the Legislature created, through SCR 59,  
          a Joint Committee on Mental Health Reform with the purpose  
          of identifying promising strategies and policy  
          recommendations relating to mental health treatment.  The  
          Joint Committee has held public hearings in Sacramento, Los  
          Angeles, Santa Rosa and Oakland to receive testimony of  
          clients, family members, service providers and advocates on  
          recommendations for improvement of California's mental  
          health system. 

          The Joint Committee received testimony on the status of the  
          mental health system and gaps in needed services.  A number  
          of witnesses testified to lack of information about, and  
          access to, the mental health system.  Also, clients  
          testified to the value of peer support activities,  
          including self-help groups and family-to-family support  
          programs.








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           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions             2000-01     2001-02       
           2002-03   Fund  

          County grants    Unknown                         General

          Staff comments:

          Based on previous experience of DMH with similar grants  
          funded by other sources, grants to individual counties  
          could range between $200,000 and $400,000.

           SUPPORT  :   (Verified  5/26/00)

          California Child, Youth and Family Coalition
          California Network of Mental Health Clients
          National Alliance for the Mentally Ill California
          Protection and Advocacy, Inc.
          California Mental Health Directors Association
          Mental Health Advocacy Project

           ARGUMENTS IN SUPPORT  :    According to the author's office,  
          the stated purpose in introducing this bill is to address a  
          recurring theme noted during hearings of the Joint  
          Committee on Mental Health Reform:  

            "?there is a lack of respect and partnership felt by  
            clients and family members in the mental health system.   
            They lack information, access and a meaningful role in  
            system design and implementation.  The committee also  
            repeatedly heard from clients and families who had  
            benefited through peer support activities, including  
            self-help programs and family-to-family support  
            programs".

          In support of this bill, the California Network of Mental  
          Health Clients argues that:  "Self-help groups, instead of  
          treating individuals as diagnoses and labels, respect them  







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          as human beings?thus developing service responses that deal  
          with the whole person.  Self-help groups work for many  
          reasons, not the least of which is that clients see other  
          clients in positions of authority, as role models, and thus  
          have more confidence in their own capabilities."   
          Protection and Advocacy, Inc. comments in support of this  
          bill that it:  "?is consistent with the principle that  
          persons receiving mental health services should be allowed  
          to participate in every aspect of their treatment, as are  
          persons who receive other kinds of health services."


          CP:sl  5/26/00   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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