BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1770
                                                                  Page  1

          Date of Hearing:  June 27, 2000

                            ASSEMBLY COMMITTEE ON HEALTH 
                               Martin Gallegos, Chair
                    SB 1770 (Chesbro) - As Amended:  June 22, 2000

           SENATE VOTE  :  22-11
           
          SUBJECT  :  Mental health: client and family member empowerment  
          programs

           SUMMARY  :  Requires the Department of Mental Health (DMH) to  
          issue a request for proposals (RFP) in order to establish and  
          expand empowerment programs for mental health clients and their  
          family members, as specified.  Specifically,  this bill  :

          1)Requires DMH to issue an RFP in order to establish and expand  
            empowerment programs for mental health clients and their  
            family members by no later than September 1 in any year in  
            which funds are provided in the annual Budget Act for this  
            purpose.  Requires DMH to implement the RFP and award grants  
            in consultation with a working group, as specified.

          2)Provides that proposals solicited under this bill be submitted  
            by any county or multiple county mental health department(s)  
            in partnership with local organizations, as specified.   
            Specifies information that each proposal is required to  
            include and information each proposal may include.

          3)Requires DMH to make grants to county mental health  
            departments on the basis of proposals meeting the criteria set  
            forth in this bill.

          4)Requires DMH, in consultation with the working group, to  
            develop a process by which grantees submit reports in order to  
            assure the appropriate monitoring and oversight occurs.   
            Requires DHS to use these reports to provide information to  
            the Legislature, by April 1 in each year programs are funded,  
            regarding the implementation of the programs established by  
            this bill.

          5)Makes specified findings and declarations regarding mental  
            health services in California. 

          6)States the intent of the Legislature to improve the role and  








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            leadership of mental health system clients and their family  
            members in the development, implementation, and oversight of  
            California's mental health policies, as specified.

           EXISTING LAW  :

          1)Establishes the Department of Mental Health to administer a  
            variety of mental health programs throughout California.

          2)Establishes the Bronzan-McCorquodale Act, which provides for  
            the organization and finance of community mental health  
            services, as specified, in every county through locally  
            administered and locally controlled community mental health  
            programs. 

           FISCAL EFFECT  : According to the Senate Appropriations Committee,  
          unknown general fund costs for county grants.  Based on previous  
          experience of the DMH with similar grants funded by other  
          sources, grants to individual counties could range between  
          $200,000 and $400,000.

           COMMENTS  :

           1)PURPOSE OF THE BILL  .  The author states this bill requires DMH  
            to issue a request for proposals to counties or  
            community-based organizations in order to establish and expand  
            empowerment programs and activities for mental health clients  
            and their family members.   Programs and activities funded  
            under this program may include, but are not limited to, the  
            establishment, expansion or improvement of self-help, peer  
            counseling and other client-run programs; family-to-family  
            support programs; training, information, and referral services  
            for clients and families; use of clients and family members in  
            staff positions within county departments and community-based  
            programs; and use of clients and family members on policy  
            development and oversight boards, commissions and task forces.  
             The author states that grant proposals must demonstrate that  
            clients and families played a substantive role in the  
            development of the proposal.

            The author states a recent Joint Committee on Mental Health  
            Reform hearing has illustrated the lack of involvement and  
            partnership felt by clients and family members in the mental  
            health system.   They often lack information, access and a  
            meaningful role in system design and implementation.  Client  








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            and family estrangement from the mental health system often  
            hampers participation in treatment and impedes recovery.   The  
            Committee also repeatedly heard from clients and families who  
            have benefited from peer support activities, including  
            self-help programs and family-to-family support programs, as  
            well as efforts to include clients and families as  
            professional staff in county mental health departments and in  
            community-based programs.  The author also states that studies  
            have shown that self-help and peer counseling groups result in  
            improved client outcomes, including decreased hospitalizations  
            and reduced lengths of stay when hospitalization does occur;  
            reduced stress on families of persons with mental  
            disabilities; less need to continue to attend certain  
            programs; high satisfaction with life and health, as well as  
            their satisfaction with work, leisure, and community;  
            reduction of the family's sense of burden; ability to obtain  
            information about mental illness and coping strategies; and  
            supportive social bonds with others who were experiencing  
            similar problems.

           2)SUPPORT  .  The National Alliance for the Mentally Ill (NAMI)  
            California writes in support stating this bill will empower  
            clients and family members to participate more fully with the  
            county mental health departments in local policy development,  
            implementation and oversight activities in treatment and  
            service plans for the mental health system.  NAMI California  
            states they have long held the position that direct feedback  
            from clients and family members is essential input to the  
            process of developing and maintaining an effective mental  
            health care delivery system.  NAMI states that clients and  
            family members should participate in their own or their family  
            member's treatment planning as well as the overall mental  
            health system planning, policy-making, development and  
            implementation at all levels.  NAMI California concludes that  
            proactive efforts by the county mental health departments to  
            seek out better ways to tap these invaluable resources will  
            surely improve our mental health system.  Protection &  
            Advocacy Inc., (PI) writes that this bill will greatly improve  
            mental health services in California, by establishing and  
            expanding empowerment programs for mental health clients and  
            their family members.  In doing so, PI writes, this bill is  
            respectful of the rights and preferences of mental health  
            clients and 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  








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            who receive other kinds of health services.

           REGISTERED SUPPORT / OPPOSITION  :

           Support  

          California Child, Youth and Family Coalition
          California Mental Health Directors Association
          California Network of Mental Health Clients
          Mental Health Advocacy Project
          NAMI California
          Protection & Advocacy, Inc.
           
          Opposition  

          None on file

           Analysis Prepared by  :  Ellen McCormick / HEALTH / (916) 319-2097