Existing law, the Mental Health Services Act, an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Oversight and Accountability Commission, and requires the commission to consist of 16 voting members, including, among others, two persons with a severe mental illness and a mental health professional, all appointed by the Governor. The act may be amended by the Legislature by a ²/₃ vote of both houses and only so long as the amendment is consistent with and furthers the intent of the act. The Legislature may clarify procedures and terms of the act by majority vote.

The bill would require the Governor to appoint an additional member to the commission who has experience providing supportive housing to persons with a severe mental illness. The bill would state the findings and declarations of the Legislature that this change is consistent with and furthers the intent of the act.

Existing law, the Mental Health Services Act, an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Oversight and Accountability Commission, and requires the commission to consist of 16 voting members, including, among others, two persons with a severe mental illness and a mental health professional, all appointed by the Governor. The act may be amended by the Legislature by a ²/₃ vote of both houses and only so long as the amendment is consistent with and furthers the intent of the act. The Legislature may clarify procedures and terms of the act by majority vote.

The bill would require the Governor to appoint an additional member to the commission who has experience providing supportive housing to persons with a severe mental illness. The bill would state the findings and declarations of the Legislature that this change is consistent with and furthers the intent of the act.

Existing law, the Mental Health Services Act, an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Oversight and Accountability Commission, and requires the commission to consist of 16 voting members, including, among others, two persons with a severe mental illness and a mental health professional. professional, all appointed by the Governor. The act may be amended by the Legislature by a ²/₃ vote of both houses and only so long as the amendment is consistent with and furthers the intent of the act. The Legislature may clarify procedures and terms of the act by majority vote.

The bill would require the Speaker of the Assembly Governor to appoint an additional member to the commission who has experience providing supportive housing to persons with a severe mental illness. The bill would state the findings and declarations of the Legislature that this change is consistent with and furthers the intent of the act.

Existing law, the Mental Health Services Act, an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Oversight and Accountability Commission, and requires the commission to consist of 16 voting members, including, among others, two persons with a severe mental illness and a mental health professional. The act may be amended by the Legislature by a ²/₃ vote of both houses and only so long as the amendment is consistent with and furthers the intent of the act. The Legislature may clarify procedures and terms of the act by majority vote.

The bill would require the Speaker of the Assembly to appoint an additional member to the commission who has experience providing supportive housing to persons with a severe mental illness. The bill would state the findings and declarations of the Legislature that this change is consistent with and furthers the intent of the act.

GOVERNOR'S VETO

GV Bill Id:AB 745

Author:(Chau)

As Enrolled Ver:September 4, 2015

2/3 vote

Original Committee Reference: HEALTH

SUMMARY: Requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission (Commission) who has experience providing supportive housing to persons with a severe mental illness.

The Senate amendments are technical, non-substantive amendments reflecting County Mental Health Directors Association's name change to the County Behavioral Health Directors Association of California.

FISCAL EFFECT: According to the Senate Appropriations Committee, pursuant to Senate Rule 28.8, negligible state costs.

COMMENTS: According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. At any given moment more than 133,000 Californians are homeless. The author states that of these Californians, roughly 33,800 or 25% - are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The Commission oversees the implementation of the Mental Health Services Act (MHSA) and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the Commission to include any members with experience providing supportive housing to persons with severe mental illness.

Background: MHSA requires each county mental health department to prepare and submit a three-year plan to the Department of Health Care Services (DHCS) that must be updated each year and approved by DHCS after review and comment by the Commission. The Commission consists of 16 individuals, 12 of which are appointed by the Governor. DHCS is required to provide guidelines to counties related to each component of the MHSA, including, among other things, community services and support content to provide integrated mental health and other support services to those whose needs are not currently met through other funding sources; prevention and early intervention content to provide services to avert mental health crises; and, innovative program content to improve access to mental health care. In their three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served.

At the time it was created, the Commission acted as a division within the Department Mental Health (DMH); however, legislative changes, effective March 2009 specified that the Commission is to administer its operations separately and apart from DMH. Currently, counties must submit their plans for approval to the Commission before the counties may spend certain categories of funding.

Support. The California Primary Care Association writes in support of this bill that research has clearly demonstrated the positive effects that supportive housing can have on an individual's employment, mental health, physical health, and school attendance, leading to decreased use of hospitals, emergency rooms, jails, and prisons. Stable housing is a critical component of engaging their patients in physical and behavioral health care management. The requirement to include a voting member on Commission with experience with supportive housing services ensures that programs and funding targeting individuals with behavioral health conditions takes the unique needs of those individuals experiencing homelessness into consideration.

According to the National Association of Social Workers – California Chapter (NASW), Proposition 63 of 2004 established the Commission for the purposes of overseeing the implementation of the MHSA. The NASW states in support that providing a person with experience in supportive housing to the Commission is also consistent with improving the delivery of mental health services to those in need.

There is no opposition on file.

GOVERNOR'S VETO MESSAGE:

This bill would add an additional member to the Mental Health Services Oversight and Accountability Commission with experience in supportive housing.

While supportive housing can help improve the lives of those with serious mental illness, I believe that the current commission -- with sixteen members -- is adequate to the task.

Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097 FN: 0002506

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 745

Author:(Chau)

As Amended Ver:August 26, 2015

2/3 vote

Original Committee Reference: HEALTH

SUMMARY: Requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission (Commission) who has experience providing supportive housing to persons with a severe mental illness.

The Senate amendments are technical, non-substantive amendments reflecting County Mental Health Directors Association's name change to the County Behavioral Health Directors Association of California.

FISCAL EFFECT: According to the Senate Appropriations Committee, pursuant to Senate Rule 28.8, negligible state costs.

COMMENTS: According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. At any given moment more than 133,000 Californians are homeless. The author states that of these Californians, roughly 33,800 or 25% - are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The Commission oversees the implementation of the Mental Health Services Act (MHSA) and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the Commission to include any members with experience providing supportive housing to persons with severe mental illness.

Background: MHSA requires each county mental health department to prepare and submit a three-year plan to the Department of Health Care Services (DHCS) that must be updated each year and approved by DHCS after review and comment by the Commission. The Commission consists of 16 individuals, 12 of which are appointed by the Governor. DHCS is required to provide guidelines to counties related to each component of the MHSA, including, among other things, community services and support content to provide integrated mental health and other support services to those whose needs are not currently met through other funding sources; prevention and early intervention content to provide services to avert mental health crises; and, innovative program content to improve access to mental health care. In their three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served.

At the time it was created, the Commission acted as a division within the Department Mental Health (DMH); however, legislative changes, effective March 2009 specified that the Commission is to administer its operations separately and apart from DMH. Currently, counties must submit their plans for approval to the Commission before the counties may spend certain categories of funding.

Support. The California Primary Care Association writes in support of this bill that research has clearly demonstrated the positive effects that supportive housing can have on an individual's employment, mental health, physical health, and school attendance, leading to decreased use of hospitals, emergency rooms, jails, and prisons. Stable housing is a critical component of engaging their patients in physical and behavioral health care management. The requirement to include a voting member on Commission with experience with supportive housing services ensures that programs and funding targeting individuals with behavioral health conditions takes the unique needs of those individuals experiencing homelessness into consideration.

According to the National Association of Social Workers – California Chapter (NASW), Proposition 63 of 2004 established the Commission for the purposes of overseeing the implementation of the MHSA. The NASW states in support that providing a person with experience in supportive housing to the Commission is also consistent with improving the delivery of mental health services to those in need.

There is no opposition on file.

Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097 FN: 0001849

 THIRD READING  

Bill No: AB 745

Author: Chau (D)

Amended: 8/26/15 in Assembly

Vote: 27

SENATE HEALTH COMMITTEE: 9-0, 6/10/15

AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen, Pan, Roth, Wolk

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

SENATE FLOOR: 37-0, 6/25/15

AYES: Allen, Anderson, Bates, Berryhill, Block, Cannella, De León, Fuller, Gaines, Galgiani, Glazer, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso, Huff, Jackson, Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning, Moorlach, Morrell, Nguyen, Nielsen, Pan, Pavley, Roth, Stone, Vidak, Wieckowski

NO VOTE RECORDED: Beall, Runner, Wolk

ASSEMBLY FLOOR: 78-0, 5/4/15 - See last page for vote

SUBJECT: Mental Health Services Oversight and Accountability Commission

SOURCE: Author

DIGEST: This bill requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission (MHSOAC), in existing law, who has experience providing supportive housing to people with a severe mental illness.

Senate Floor Amendments of 8/26/15: As part of its duties, in existing law, the MHSOAC is responsible for consulting with specified entities to assist in meeting the goals of the Mental Health Services Act (MHSA), one of which is the California Mental Health Directors Association (CMHDA). The amendments reflect CMHDA’s name change to the County Behavioral Health Directors Association of California.

ANALYSIS:

Existing law:

1. Establishes the MHSOAC to oversee the implementation of the MHSA, enacted by voters in 2004 as Proposition 63, which provides funds to counties to expand services, and develop innovative programs and integrated service plans, for mentally ill children, adults, and seniors through a one percent income tax on personal income above $1 million.

2. Requires the MHSOAC to consist of 16 voting members as follows:

1. The Attorney General or his or her designee;

2. The Superintendent of Public Instruction or his or her designee;

3. The Chair of the Senate Health and Human Services Committee or another member of the Senate selected by the President pro Tempore of the Senate;

4. The Chair of the Assembly Health Committee or another member of the Assembly selected by the Speaker of the Assembly; and,

5. 12 members appointed by the Governor that include:

1. Two people with a severe mental illness;

2. A family member of an adult or senior with a severe mental illness;

3. A family member of a child who has or has had a severe mental illness;

4. A physician specializing in alcohol and drug treatment;

5. A mental health professional;

6. A county sheriff;

7. A superintendent of a school district;

8. A representative of a labor organization;

9. A representative of an employer with less than 500 employees;

10. A representative of an employer with more than 500 employees; and,

11. A representative of a health care services plan or insurer.

This bill adds an additional voting member to the MHSOAC, to be appointed by the Governor, who has experience providing supportive housing to people with severe mental illness.

Comments

1. Author’s statement. According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. At any given moment, more than 133,000 Californians are homeless. Of these Californians, roughly 33,800 (25%) are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The MHSOAC oversees the implementation of the MHSA and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the MHSOAC to include any members with experience providing supportive housing to persons with severe mental illness. Adding a member with supportive housing experience to the MHSOAC would further encourage the proven method of using supportive housing as a tool to reduce homelessness.

2. Background. The MHSA requires each county mental health department to prepare and submit a three-year plan to the Department of Health Care Services (DHCS) that must be updated each year and approved by DHCS after review and comment by the MHSOAC. DHCS is required to provide guidelines to counties related to each component of the MHSA, including, among other things, community services and support content to provide integrated mental health and other support services to those whose needs are not currently met through other funding sources; prevention and early intervention content to provide services to avert mental health crises; and innovative program content to improve access to mental health services.

In the three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served. Counties also must submit their plans for approval to the MHSOAC before they can spend certain categories of funding. At the time it was created, the MHSOAC acted as a division within the Department of Mental Health (DMH); however, legislative changes effective March 2009 required the MHSOAC to administer its operations apart from DMH.

3. MHSA Housing Program. Executive Order S-07-06, signed by Governor Schwarzenegger on May 12, 2006, mandated the establishment of the MHSA Housing Program, with the stated goal of creating 10,000 additional units of permanent supportive housing for individuals and their families who have a mental illness and are homeless or at risk of homelessness. DHCS, the California Housing Finance Agency, and the County Behavioral Health Directors Association implemented the MHSA Housing Program, which provides funding for development, acquisition, construction, and/or rehabilitation of permanent supportive housing for this population. A total of $400 million was set aside for initial funding of the program to fund both capital costs and capitalized operating subsidies. Continued funding of the program is a locally driven decision, as a county determines whether to assign additional MHSA funding beyond the original $400 million. By including an individual on the MHSOAC who has experience in providing supportive housing to those with a severe mental illness, housing advocates hope to leverage existing MHSA funds to continue funding the MHSA Housing Program, as the initial $400 million is nearing depletion.

Funds provided under this program must serve the MHSA Housing Program target population, which DHCS has defined as low-income adults, or older adults with serious mental illness, and children with severe emotional disorders and their families who, at the time of assessment for housing services, meet the criteria for MHSA services in their county of residence. Counties may use MHSA funds for supportive housing, but are not required to. Supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. Adding a member with supportive housing experience to the MHSOAC may further encourage the method of using supportive housing as a tool to reduce homelessness of those with severe mental illness.

4. National data on mental illness and homelessness. In the “Current Statistics on the Prevalence and Characteristics of People Experiencing Homelessness in the United States,” last updated in July 2011 by the federal Substance Abuse and Mental Health Services Administration, data from 2010 shows that, nationally, on a given night 407,966 individuals were homeless in shelters, transitional housing programs, or on the streets (not including those who were sleeping at the homes of family or friends), and 109,812 individuals were chronically homeless (a one percent decrease from the previous year). Of these individuals, 26.2% had a severe mental illness, and 34.7% of adults had chronic substance use disorders. Over the course of that year, data shows that a total of 1,593,150 individuals experienced homelessness.

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

SUPPORT: (Verified 8/27/15)

California Chapter of the National Association of Social Workers

California Primary Care Association

OPPOSITION: (Verified 8/27/15)

None received

ARGUMENTS IN SUPPORT: The California Primary Care Association writes in support and states that research has demonstrated the positive effects that supportive housing has on an individual’s employment, mental health, physical health, and school attendance, leading to a decrease in the use of hospitals, emergency rooms, and jails and prisons. The California Chapter of the National Association of Social Workers writes that including an additional individual on the MHSOAC that has experience in supportive housing is consistent with improving mental health services to those in need.

ASSEMBLY FLOOR: 78-0, 5/4/15

AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins

NO VOTE RECORDED: Campos, Dahle

Prepared by: Reyes Diaz / HEALTH /

8/28/15 15:47:34

**** END ****

 CONSENT  

Bill No: AB 745

Author: Chau (D)

Amended: 4/6/15 in Assembly

Vote: 27

SENATE HEALTH COMMITTEE: 9-0, 6/10/15

AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen, Pan, Roth, Wolk

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

ASSEMBLY FLOOR: 78-0, 5/4/15 - See last page for vote

SUBJECT: Mental Health Services Oversight and Accountability Commission

SOURCE: Author

DIGEST: This bill requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission in existing law, who has experience providing supportive housing to people with a severe mental illness.

ANALYSIS:

Existing law:

1. Establishes the Mental Health Services Oversight and Accountability Commission (MHSOAC) to oversee the implementation of the Mental Health Services Act (MHSA), enacted by voters in 2004 as Proposition 63, which provides funds to counties to expand services, and develop innovative programs and integrated service plans, for mentally ill children, adults, and seniors through a one percent income tax on personal income above $1 million.

2. Requires the MHSOAC to consist of 16 voting members as follows:

1. The Attorney General or his or her designee;

2. The Superintendent of Public Instruction or his or her designee;

3. The Chair of the Senate Health and Human Services Committee or another member of the Senate selected by the President pro Tempore of the Senate;

4. The Chair of the Assembly Health Committee or another member of the Assembly selected by the Speaker of the Assembly; and,

5. 12 members appointed by the Governor that include:

1. Two people with a severe mental illness;

2. A family member of an adult or senior with a severe mental illness;

3. A family member of a child who has or has had a severe mental illness;

4. A physician specializing in alcohol and drug treatment;

5. A mental health professional;

6. A county sheriff;

7. A superintendent of a school district;

8. A representative of a labor organization;

9. A representative of an employer with less than 500 employees;

10. A representative of an employer with more than 500 employees; and,

11. A representative of a health care services plan or insurer.

This bill adds an additional voting member to the MHSOAC, to be appointed by the Governor, who has experience providing supportive housing to people with severe mental illness.

Comments

1. Author’s statement. According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. At any given moment, more than 133,000 Californians are homeless. Of these Californians, roughly 33,800 (25%) are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The MHSOAC oversees the implementation of the MHSA and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the MHSOAC to include any members with experience providing supportive housing to persons with severe mental illness. Adding a member with supportive housing experience to the MHSOAC would further encourage the proven method of using supportive housing as a tool to reduce homelessness.

2. Background. The MHSA requires each county mental health department to prepare and submit a three-year plan to the Department of Health Care Services (DHCS) that must be updated each year and approved by DHCS after review and comment by the MHSOAC. DHCS is required to provide guidelines to counties related to each component of the MHSA, including, among other things, community services and support content to provide integrated mental health and other support services to those whose needs are not currently met through other funding sources; prevention and early intervention content to provide services to avert mental health crises; and innovative program content to improve access to mental health services.

In the three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served. Counties also must submit their plans for approval to the MHSOAC before they can spend certain categories of funding. At the time it was created, the MHSOAC acted as a division within the Department of Mental Health (DMH); however, legislative changes effective March 2009 required the MHSOAC to administer its operations apart from DMH.

3. MHSA Housing Program. Executive Order S-07-06, signed by Governor Schwarzenegger on May 12, 2006, mandated the establishment of the MHSA Housing Program, with the stated goal of creating 10,000 additional units of permanent supportive housing for individuals and their families who have a mental illness and are homeless or at risk of homelessness. DHCS, the California Housing Finance Agency (CalHFA), and the County Behavioral Health Directors Association implemented the MHSA Housing Program, which provides funding for development, acquisition, construction, and/or rehabilitation of permanent supportive housing for this population. A total of $400 million was set aside for initial funding of the program to fund both capital costs and capitalized operating subsidies. Continued funding of the program is a locally driven decision, as a county determines whether to assign additional MHSA funding beyond the original $400 million. By including an individual on the MHSOAC who has experience in providing supportive housing to those with a severe mental illness, housing advocates hope to leverage existing MHSA funds to continue funding the MHSA Housing Program, as the initial $400 million is nearing depletion.

Funds provided under this program must serve the MHSA Housing Program target population, which DHCS has defined as low-income adults, or older adults with serious mental illness, and children with severe emotional disorders and their families who, at the time of assessment for housing services, meet the criteria for MHSA services in their county of residence. Counties may use MHSA funds for supportive housing, but are not required to. Supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. Adding a member with supportive housing experience to the MHSOAC may further encourage the method of using supportive housing as a tool to reduce homelessness of those with severe mental illness.

4. National data on mental illness and homelessness. In the “Current Statistics on the Prevalence and Characteristics of People Experiencing Homelessness in the United States,” last updated in July 2011 by the federal Substance Abuse and Mental Health Services Administration, data from 2010 shows that, nationally, on a given night 407,966 individuals were homeless in shelters, transitional housing programs, or on the streets (not including those who were sleeping at the homes of family or friends), and 109,812 individuals were chronically homeless (a one percent decrease from the previous year). Of these individuals, 26.2% had a severe mental illness, and 34.7% of adults had chronic substance use disorders. Over the course of that year, data shows that a total of 1,593,150 individuals experienced homelessness.

Related Legislation

AB 253 (Roger Hernández, 2015) makes specified changes to the MHSA, the Veterans Housing and Homeless Prevention Bond Act of 2014, and mental health plan requirements. AB 253 is scheduled to be heard in the Senate Health Committee on June 24, 2015.

Prior Legislation

AB 1929 (Chau, Chapter 674, Statutes of 2014), allowed county mental health departments to deposit MHSA funding with CalHFA, as specified, and allows CalHFA to use those funds for special housing needs for those with mental illness. Required counties to dedicate funds to provide housing assistance to those with serious mental illness who are homeless or to the mentally ill at risk of being homeless.

SB 82 (Committee on Budget and Fiscal Review, Chapter 34, Statutes of 2013), established the Investment in Mental Health Wellness Act of 2013 and authorized the California Health Facilities Financing Authority to administer a program to increase capacity for mobile crisis support, crisis intervention, crisis stabilization services, crisis residential treatment, and specified personnel resources.

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

SUPPORT: (Verified 6/23/15)

California Chapter of the National Association of Social Workers

California Primary Care Association

OPPOSITION: (Verified 6/23/15)

None received

ARGUMENTS IN SUPPORT: The California Primary Care Association writes in support and states that research has demonstrated the positive effects that supportive housing has on an individual’s employment, mental health, physical health, and school attendance, leading to a decrease in the use of hospitals, emergency rooms, and jails and prisons. The California Chapter of the National Association of Social Workers writes that including an additional individual on the MHSOAC that has experience in supportive housing is consistent with improving mental health services to those in need.

ASSEMBLY FLOOR: 78-0, 5/4/15

AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins

NO VOTE RECORDED: Campos, Dahle

Prepared by: Reyes Diaz / HEALTH /

6/24/15 16:08:45

**** END ****

SENATE COMMITTEE ON HEALTH

Senator Ed Hernandez, O.D., Chair

BILL NO: AB 745

SUBJECT: Mental Health Services Oversight and Accountability Commission.

SUMMARY:

Requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission in existing law, who has experience providing supportive housing to people with a severe mental illness.

Existing law:

1. Establishes the Mental Health Services Oversight and Accountability Commission (MHSOAC) to oversee the implementation of the Mental Health Services Act (MHSA), enacted by voters in 2004 as Proposition 63, which provides funds to counties to expand services, and develop innovative programs and integrated service plans, for mentally ill children, adults, and seniors through a one percent income tax on personal income above $1 million.

2. Requires the MHSOAC to consist of 16 voting members as follows:

1. The Attorney General or his or her designee;

2. The Superintendent of Public Instruction or his or her designee;

3. The Chair of the Senate Health and Human Services Committee or another member of the Senate selected by the President pro Tempore of the Senate;

4. The Chair of the Assembly Health Committee or another member of the Assembly selected by the Speaker of the Assembly; and,

5. 12 members appointed by the Governor that include:

1. Two people with a severe mental illness;

2. A family member of an adult or senior with a severe mental illness;

3. A family member of a child who has or has had a severe mental illness;

4. A physician specializing in alcohol and drug treatment;

5. A mental health professional;

6. A county sheriff;

7. A superintendent of a school district;

8. A representative of a labor organization;

9. A representative of an employer with less than 500 employees;

10. A representative of an employer with more than 500 employees; and,

11. A representative of a health care services plan or insurer.

This bill:

1. Adds an additional voting member to the MHSOAC, to be appointed by the Governor, who has experience providing supportive housing to people with severe mental illness.

FISCAL EFFECT:

According to the Assembly Appropriations Committee, this bill has minor and absorbable costs to reimburse for travel and lodgings for MHSOAC meetings (from the MHSA administration account).

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. At any given moment, more than 133,000 Californians are homeless. Of these Californians, roughly 33,800 (25%) are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The MHSOAC oversees the implementation of the MHSA and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the MHSOAC to include any members with experience providing supportive housing to persons with severe mental illness. Adding a member with supportive housing experience to the MHSOAC would further encourage the proven method of using supportive housing as a tool to reduce homelessness.

2. Background. The MHSA requires each county mental health department to prepare and submit a three-year plan to the Department of Health Care Services (DHCS) that must be updated each year and approved by DHCS after review and comment by the MHSOAC. DHCS is required to provide guidelines to counties related to each component of the MHSA, including, among other things, community services and support content to provide integrated mental health and other support services to those whose needs are not currently met through other funding sources; prevention and early intervention content to provide services to avert mental health crises; and innovative program content to improve access to mental health services.

In the three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served. Counties also must submit their plans for approval to the MHSOAC before they can spend certain categories of funding. At the time it was created, the MHSOAC acted as a division within the Department of Mental Health (DMH); however, legislative changes effective March 2009 required the MHSOAC to administer its operations apart from DMH.

3. MHSA Housing Program. Executive Order S-07-06, signed by Governor Schwarzenegger on May 12, 2006, mandated the establishment of the MHSA Housing Program, with the stated goal of creating 10,000 additional units of permanent supportive housing for individuals and their families who have a mental illness and are homeless or at risk of homelessness. DHCS, the California Housing Finance Agency (CalHFA), and the County Behavioral Health Directors Association implemented the MHSA Housing Program, which provides funding for development, acquisition, construction, and/or rehabilitation of permanent supportive housing for this population. A total of $400 million was set aside for initial funding of the program to fund both capital costs and capitalized operating subsidies. Continued funding of the program is a locally driven decision, as a county determines whether to assign additional MHSA funding beyond the original $400 million. By including an individual on the MHSOAC who has experience in providing supportive housing to those with a severe mental illness, housing advocates hope to leverage existing MHSA funds to continue funding the MHSA Housing Program, as the initial $400 million is nearing depletion.

Funds provided under this program must serve the MHSA Housing Program target population, which DHCS has defined as low-income adults, or older adults with serious mental illness, and children with severe emotional disorders and their families who, at the time of assessment for housing services, meet the criteria for MHSA services in their county of residence. Counties may use MHSA funds for supportive housing, but are not required to. Supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. Adding a member with supportive housing experience to the MHSOAC may further encourage the method of using supportive housing as a tool to reduce homelessness of those with severe mental illness.

4. National data on mental illness and homelessness. In the “Current Statistics on the Prevalence and Characteristics of People Experiencing Homelessness in the United States,” last updated in July 2011 by the federal Substance Abuse and Mental Health Services Administration, data from 2010 shows that, nationally, on a given night 407,966 individuals were homeless in shelters, transitional housing programs, or on the streets (not including those who were sleeping at the homes of family or friends), and 109,812 individuals were chronically homeless (a one percent decrease from the previous year). Of these individuals, 26.2% had a severe mental illness, and 34.7% of adults had chronic substance use disorders. Over the course of that year, data shows that a total of 1,593,150 individuals experienced homelessness.

5. Related legislation. AB 253 (Roger Hernández), makes specified changes to the MHSA, the Veterans Housing and Homeless Prevention Bond Act of 2014, and mental health plan requirements. AB 253 is pending in the Senate.

6. Prior legislation. AB 1929 (Chau, Chapter 674, Statutes of 2014), allows county mental health departments to deposit MHSA funding with CalHFA, as specified, and allows CalHFA to use those funds for special housing needs for those with mental illness. Requires counties to dedicate funds to provide housing assistance to those with serious mental illness who are homeless or to the mentally ill at risk of being homeless.

SB 82 (Committee on Budget and Fiscal Review, Chapter 34, Statutes of 2013), established the Investment in Mental Health Wellness Act of 2013 and authorizes the California Health Facilities Financing Authority to administer a program to increase capacity for mobile crisis support, crisis intervention, crisis stabilization services, crisis residential treatment, and specified personnel resources.

7. Support. The California Primary Care Association writes in support and states that research has demonstrated the positive effects that supportive housing has on an individual’s employment, mental health, physical health, and school attendance, leading to a decrease in the use of hospitals, emergency rooms, and jails and prisons. The California Chapter of the National Association of Social Workers writes that including an additional individual on the MHSOAC that has experience in supportive housing is consistent with improving mental health services to those in need.

SUPPORT AND OPPOSITION:

Support: California Chapter of the National Association of Social Workers

California Primary Care Association

Oppose: None received.

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 745

Author:(Chau)

As Amended Ver:April 6, 2015

2/3 vote

SUMMARY: Requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission (Commission) who has experience providing supportive housing to persons with a severe mental illness.

FISCAL EFFECT: According to the Assembly Appropriations Committee, this bill has minor and absorbable costs to reimburse for travel and lodgings for Commission meetings (Mental Health Services Act (MHSA) administration account).

COMMENTS: According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. At any given moment more than 133,000 Californians are homeless. The author states that of these Californians, roughly 33,800 - or 25% - are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The Commission oversees the implementation of the MHSA and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the Commission to include any members with experience providing supportive housing to persons with severe mental illness.

BACKGROUND: MHSA requires each county mental health department to prepare and submit a three-year plan to the Department of Health Care Services (DHCS) that must be updated each year and approved by DHCS after review and comment by the Commission. The Commission consists of 16 individuals, 12 of which are appointed by the Governor. DHCS is required to provide guidelines to counties related to each component of the MHSA, including, among other things, community services and support content to provide integrated mental health and other support services to those whose needs are not currently met through other funding sources; prevention and early intervention content to provide services to avert mental health crises; and, innovative program content to improve access to mental health care. In their three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served.

At the time it was created, the Commission acted as a division within the Department Mental Health (DMH); however, legislative changes, effective March 2009 specified that the Commission is to administer its operations separately and apart from DMH. Currently, counties must submit their plans for approval to the Commission before the counties may spend certain categories of funding.

Support. The California Primary Care Association writes in support of this bill that research has clearly demonstrated the positive effects that supportive housing can have on an individual's employment, mental health, physical health, and school attendance, leading to decreased use of hospitals, emergency rooms, jails, and prisons. Stable housing is a critical component of engaging their patients in physical and behavioral health care management. The requirement to include a voting member on Commission with experience with supportive housing services ensures that programs and funding targeting individuals with behavioral health conditions takes the unique needs of those individuals experiencing homelessness into consideration.

According to the National Association of Social Workers – California Chapter (NASW), Proposition 63 of 2004 established the Commission for the purposes of overseeing the implementation of the MHSA. The NASW states in support that providing a person with experience in supportive housing to the Commission is also consistent with improving the delivery of mental health services to those in need.

There is no opposition on file.

Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097 FN: 0000228

Date of Hearing: April 29, 2015

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Jimmy Gomez, Chair

ABPCA Bill Id:AB 745

Author:(Chau) – As Amended Ver:April 6, 2015

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission (Commission) who has experience providing supportive housing to persons with a severe mental illness.

FISCAL EFFECT:

Minor and absorbable costs to reimburse for travel and lodgings for Commission meetings (Mental Health Services Act (MHSA) administration account).

COMMENTS:

1. Purpose. According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. The Commission oversees the implementation of the MHSA and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the Commission to include any members with experience providing supportive housing to persons with severe mental illness.

2. Background. Proposition 63 of 2004 established the MHSA, and placed a 1% tax on personal income above 1 million dollars to fund community-based mental health services. The MHSA is administered locally. The Commission oversees local MHSA implementation, provides training and technical assistance for county mental health planning, approves local implementation plans, and evaluates local efforts.

Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081

Date of Hearing: April 21, 2015

ASSEMBLY COMMITTEE ON HEALTH

Rob Bonta, Chair

ABPCA Bill Id:AB 745

Author:Chau – As Amended Ver:April 6, 2015

SUBJECT: Mental Health Services Oversight and Accountability Commission.

SUMMARY: Requires the Governor to appoint an additional member to the Mental Health Services Oversight and Accountability Commission (Commission) who has experience providing supportive housing to persons with a severe mental illness.

EXISTING LAW:

1. Establishes the Mental Health Services Act (MHSA), enacted by voters in 2004 as Proposition 63, to provide funds to counties to expand services, develop innovative programs, and integrated service plans for mentally ill children, adults, and seniors through a 1% income tax on personal income above $1 million.

2. Establishes the Commission to oversee the implementation of MHSA.

3. Establishes the following membership requirements for the Commission, appointed by the Governor unless otherwise specified:

   1. The Attorney General and his or her designee;

   2. The Superintendent of Public Instruction or his or her designee;

   3. A member of the Senate selected by the President pro Tempore of the Senate;

   4. A member of the Assembly selected by the Speaker of the Assembly;

   5. Two persons with a severe mental illness;

   6. A family member of an adult or senior with a severe mental illness;

   7. A family member of a child who has or has had a severe mental illness;

   8. A physician specializing in alcohol and drug treatment;

   9. A mental health professional;

   10. A county sheriff;

   11. A superintendent of a school district;

   12. A representative of a labor organization;

   13. A representative of an employer with less than 500 employees;

   14. A representative of an employer with more than 500 employees; and,

   15. A representative of a health care services plan or insurer.
       
       

4. Specifies that the MHSA can only be amended by a two-thirds vote of both houses of the Legislature and only as long as the amendment is consistent with and furthers the intent of the MHSA. Permits provisions clarifying the procedures and terms of the MHSA to be added by majority vote.
   
   

FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, supportive housing has proven to be an effective strategy for reducing homelessness among people with mental illness. At any given moment more than 133 thousand Californians are homeless. The author states that of these Californians, roughly 33.8 thousand - or 25% - are considered chronically homeless. According to researchers, at least one-third of chronically homeless people are mentally ill. The Commission oversees the implementation of the MHSA and may advise the Governor or the Legislature on mental health policy. However, existing law does not require the Commission to include any members with experience providing supportive housing to persons with severe mental illness.
   
   

2. BACKGROUND. MHSA requires each county mental health department to prepare and submit a three-year plan to the Department of Health Care Services (DHCS) that must be updated each year and approved by DHCS after review and comment by the Commission. DHCS is required to provide guidelines to counties related to each component of the MHSA, including, among other things, community services and support content to provide integrated mental health and other support services to those whose needs are not currently met through other funding sources; prevention and early intervention content to provide services to avert mental health crises; and, innovative program content to improve access to mental health care. In their three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served.
   
   At the time it was created, the Commission acted as a division within the Department Mental Health (DMH); however, legislative changes, effective March 2009 specified that the Commission is to administer its operations separately and apart from DMH. Currently, counties must submit their plans for approval to the Commission before the counties may spend certain categories of funding.
   
   

3. SUPPORT. The California Primary Care Association writes in support of this bill that research has clearly demonstrated the positive effects that supportive housing can have on an individual's employment, mental health, physical health, and school attendance, leading to decreased use of hospitals, emergency rooms, jails, and prisons. Stable housing is a critical component of engaging their patients in physical and behavioral health care management. The requirement to include a voting member on Commission with experience with supportive housing services ensures that programs and funding targeting individuals with behavioral health conditions takes the unique needs of those individuals experiencing homelessness into consideration.
   
   According to the National Association of Social Workers – California Chapter (NASW), Proposition 63 established the Commission for the purposes of overseeing the implementation of the MHSA. The NASW states in support that providing a person with experience in supportive housing to the Commission is also consistent with improving the delivery of mental health services to those in need.
   
   

4. RELATED LEGISLATION. AB 253 (Roger Hernández) makes specified changes to the MHSA, the Veterans Housing and Homeless Prevention Bond Act of 2014, and mental health plan requirements. AB 253 is pending a hearing in the Assembly Health Committee.
   
   

5. PREVIOUS LEGISLATION. SB 82 (Committee on Budget and Fiscal Review), Chapter 34, Statutes 2013, establishes the Investment in Mental Health Wellness Act of 2013 and authorized the California Health Facilities Financing Authority to administer a program to increase capacity for mobile crisis support, crisis intervention, crisis stabilization services, crisis residential treatment, and specified personnel resources.

REGISTERED SUPPORT / OPPOSITION:

Support

California Primary Care Association
National Association of Social Workers – California Chapter

Opposition

None on file.

Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097