BILL ANALYSIS                                                                                                                                                                                                    



                                                                       


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          |SENATE RULES COMMITTEE            |                  SB 1770|
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                              UNFINISHED BUSINESS
                                        

          Bill No:  SB 1770
          Author:   Chesbro (D)
          Amended:  8/7/00
          Vote:     21

            
           SENATE HEALTH & HUMAN SERV. COMMITTEE  :  5-1, 4/26/00
          AYES:  Escutia, Figueroa, Hughes, Solis, Vasconcellos
          NOES:  Haynes

           SENATE APPROPRIATIONS COMMITTEE  :  8-4, 5/25/00
          AYES:  Johnston, Alpert, Bowen, Burton, Escutia, Karnette,  
            Perata, Vasconcellos
          NOES:  Johnson, Kelley, Leslie, Mountjoy

           SENATE FLOOR  :  22-11, 5/30/00
          AYES:  Alarcon, Alpert, Bowen, Burton, Chesbro, Costa,  
            Dunn, Figueroa, Hayden, Hughes, Karnette, McPherson,  
            Murray, O'Connell, Ortiz, Rainey, Schiff, Solis, Soto,  
            Speier, Vasconcellos, Wright
          NOES:  Brulte, Haynes, Johannessen, Kelley, Knight, Leslie,  
            Lewis, Monteith, Morrow, Mountjoy, Poochigian

           ASSEMBLY FLOOR  :  50-24, 8/28/00 - See last page for vote
           

           SUBJECT  :    Mental health:  client and family member  
          empowerment
                      programs

           SOURCE  :     Author

           
           DIGEST  :    This bill requires the Department of Mental  
                                                           CONTINUED





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          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.

           Assembly Amendments  make various revisions including:

          1. Change legislative declarations and findings.

          2. Require the department to implement the request for  
             proposal and award grants in consultation with a working  
             group, as specified.

          3. Requires proposals to be submitted by any county mental  
             health department in partnership with specified local  
             organizations.

           ANALYSIS  :    Existing law:

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

          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  







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

           Comments 

          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.  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.  Often, the author  
          states, families lack information, access and a meaningful  
          role in system design and implementation.  Client and  
          family estrangement from the mental health system often  
          hampers participation in treatment and impedes recovery.   
          According to the author, the Joint 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  







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          community-based programs.  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 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 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.

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

          According to the Assembly Appropriations Committee  
          analysis, unknown costs, likely over $1 million annually,  
          for DMH to establish and administer the grant program.  In  
          the Budget for fiscal year 2000-2001, the Legislature  
          included a $4.9 million augmentation to be used for Client  
          and Family Empowerment Challenge Grants, using federal  
          substance abuse funds.  However, the governor vetoed the  
          augmentation because he felt it would create an expectation  
          of establishing a new statewide, state-funded program.

           SUPPORT  :   (Verified  5/26/00) (Unable to reverify at time  
          of this writing)

          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

           OPPOSITION  :    (Verified  8/7/00) (Unable to reverify at  
          time of this writing)







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          Department of Finance

           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  
          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."

           ARGUMENTS IN OPPOSITION  :    According to the Department of  
          Finance, this bill would create an expectation of funding  
          to implement empowerment programs.  The Legislature  
          approved $4.9 million for this purpose for 2000-01, but it  
          was vetoed because the program lacked specific details and  
          goals and the counties already have funding flexibility and  
          authority to provide such local programs.  Counties have  
          been given responsibility for and currently have the  
          funding flexibility under State-Local Realignment to design  
          and implement specific treatment services necessary to meet  
          the needs of clients at the local level.
           
          ASSEMBLY FLOOR  :







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          AYES:  Alquist, Aroner, Bock, Calderon, Cardenas, Cardoza,  
            Cedillo, Corbett, Correa, Cox, Cunneen, Davis, Dickerson,  
            Ducheny, Dutra, Firebaugh, Florez, Gallegos, Honda,  
            Jackson, Keeley, Knox, Kuehl, Lempert, Longville,  
            Lowenthal, Machado, Maldonado, Margett, Mazzoni, Migden,  
            Nakano, Papan, Reyes, Romero, Scott, Shelley, Steinberg,  
            Strickland, Strom-Martin, Thomson, Torlakson,  
            Villaraigosa, Vincent, Washington, Wayne, Wesson,  
            Wiggins, Wright, Hertzberg
          NOES:  Aanestad, Ackerman, Ashburn, Baldwin, Bates, Baugh,  
            Brewer, Briggs, Campbell, Granlund, Havice, House, Leach,  
            Leonard, Maddox, McClintock, Olberg, Oller, Robert  
            Pacheco, Rod Pacheco, Pescetti, Runner, Thompson, Zettel


          CP:sl  8/29/00   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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