AB 847: Mental health: community-based services.
- Session Year: 2015-2016
- House: Assembly
- Latest Version Date: 2016-04-11
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 continuously appropriated Mental Health Services Fund to fund various county mental health programs. The act provides that it may be amended by the Legislature by a 2/3 vote of each house as long as the amendment is consistent with and furthers the intent of the act, and that the Legislature may clarify procedures and terms of the act by majority vote.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for specified services, including various mental health services. Existing federal law, the Protecting Access to Medicare Act of 2014, requires the United States Secretary of Health and Human Services to, among other things, no later than September 1, 2017, select from among those states awarded a planning grant, the states that may participate in a time-limited demonstration program that is designed to improve access to community mental health and substance use treatment services provided by certified community behavioral health clinics.
This bill would require the department to develop a proposal for the United States Secretary of Health and Human Services to be selected as a participating state in the time-limited demonstration program described above to receive enhanced federal matching funds for mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries. The bill would appropriate $1,000,000 from the Mental Health Services Act Fund to the State Department of Health Care Services to develop that proposal. The bill would make findings and declarations of the Legislature, including that the changes the bill would make are consistent with and further the intent of the act.
This bill would declare that it is to take effect immediately as an urgency statute.
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 continuously appropriated Mental Health Services Fund to fund various county mental health programs. The act provides that it may be amended by the Legislature by a 2/3 vote of each house as long as the amendment is consistent with and furthers the intent of the act, and that the Legislature may clarify procedures and terms of the act by majority vote.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for specified services, including various mental health services. Existing federal law, the Protecting Access to Medicare Act of 2014, requires the United States Secretary of Health and Human Services to, among other things, no later than September 1, 2017, select from among those states awarded a planning grant, the states that may participate in a time-limited demonstration program that is designed to improve access to community mental health and substance use treatment services provided by certified community behavioral health clinics.
This bill would require the department to develop a proposal for the United States Secretary of Health and Human Services to be selected as a participating state in the time-limited demonstration program described above to receive enhanced federal matching funds for mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries. The bill would appropriate $1,000,000 from the Mental Health Services Act Fund to the State Department of Health Care Services to develop that proposal. The bill would make findings and declarations of the Legislature, including that the changes the bill would make are consistent with and further the intent of the act.
This bill would declare that it is to take effect immediately as an urgency statute.
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 continuously appropriated Mental Health Services Fund to fund various county mental health programs. The act provides that it may be amended by the Legislature by a 2/3 vote of each house as long as the amendment is consistent with and furthers the intent of the act, and that the Legislature may also clarify procedures and terms of the act by majority vote.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for specified services, including various mental health services. Existing federal law, the Protecting Access to Medicare Act of 2014, requires the United States Secretary of Health and Human Services to, among other things, select, no later than September 1, 2017, select from among those states awarded a planning grant to grant, the states that may participate in a time-limited demonstration program that is designed to improve access to community mental health and substance use treatment services provided by certified community behavioral health clinics.
This bill would require the department to develop and submit a proposal to for the United States Secretary of Health and Human Services to be selected as a participating state in the time-limited demonstration program described above to receive enhanced federal matching funds for mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries. The bill would appropriate $1,000,000 from the Mental Health Services Act Fund to the State Department of Health Care Services to develop that proposal. The bill would make findings and declarations of the Legislature, including that the changes the bill would make are consistent with and further the intent of the act.
This bill would declare that it is to take effect immediately as an urgency statute.
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 continuously appropriated Mental Health Services Fund to fund various county mental health programs. The act provides that it may be amended by the Legislature by a 2/3 vote of each house as long as the amendment is consistent with and furthers the intent of the act, and that the Legislature may also clarify procedures and terms of the act by majority vote.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for specified services, including various mental health services. Existing federal law, the Protecting Access to Medicare Act of 2014, requires the United States Secretary of Health and Human Services to, among other things, select, no later than September 1, 2017, among those states awarded a planning grant to participate in a time-limited demonstration program that is designed to improve access to community mental health and substance use treatment services provided by certified community behavioral health clinics.
This bill would require the department to develop and submit a proposal to the United States Secretary of Health and Human Services to be selected as a participating state in the time-limited demonstration program described above to receive enhanced federal matching funds for mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries. The bill would appropriate $1,000,000 from the Mental Health Services Act Fund to the State Department of Health Care Services to develop that proposal.
This bill would declare that it is to take effect immediately as an urgency statute.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for specified services, including various mental health services. Existing federal law, the Protecting Access to Medicare Act of 2014, requires the United States Secretary of Health and Human Services to, among other things, award, no later than January 1, 2016, planning grants to states for the purpose of developing proposals to participate in time-limited demonstration programs to improve mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries.
This bill would require the department to apply to the United States Secretary of Health and Human Services for that planning grant.
This bill would declare that it is to take effect immediately as an urgency statute.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for specified services, including various mental health services. Existing federal law, the Protecting Access to Medicare Act of 2014, requires the federal United States Secretary of Health and Human Services to, among other things, award, no later than January 1, 2016, planning grants to states for the purpose of developing proposals to participate in time-limited demonstration programs to improve mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries.
This bill would require the department to apply to the federal United States Secretary of Health and Human Services for that planning grant.
This bill would declare that it is to take effect immediately as an urgency statute.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for specified services, including various mental health services. Existing federal law, the Protecting Access to Medicare Act of 2014, requires the federal Secretary of Health and Human Services to, among other things, award, no later than January 1, 2016, planning grants to states for the purpose of developing proposals to participate in time-limited demonstration programs to improve mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries.
This bill would require the department to apply to the federal Secretary of Health and Human Services for that planning grant.
Existing law establishes the State Department of Health Care Services and prescribes the departments powers and duties, including with respect to mental health services. Existing federal law, the Excellence in Mental Health Act, establishes criteria for the certification of federally qualified community behavioral health centers, and requires the administrator of the federal Substance Abuse and Mental Health Service Administration to certify centers that meet those criteria. The act also authorizes the Secretary of Health and Human Services to award matching grants to states to expend funds for the construction or modernization of facilities used to provide community-based mental health and substance abuse services.
This bill would state the intent of the Legislature to enact legislation that would require the State Department of Health Care Services to initiate planning and apply for one of those grants.
Existing law establishes the State Department of Health Care Services and prescribes the departments powers and duties, including with respect to mental health services. Existing federal law, the Excellence in Mental Health Act, establishes criteria for the certification of federally qualified community behavioral health centers, and requires the administrator of the federal Substance Abuse and Mental Health Service Administration to certify centers that meet those criteria. The act also authorizes the Secretary of Health and Human Services to award matching grants to states to expend funds for the construction or modernization of facilities used to provide community-based mental health and substance abuse services.
This bill would state the intent of the Legislature to enact legislation that would require the State Department of Health Care Services to initiate planning and apply for one of those grants.
The Legislature finds and declares the following:
(a)In 2014 Congress enacted the federal Protecting Access to Medicare Act of 2014.
(b)Under the Protecting Access to Medicare Act, eight states will be selected to have their federal share of costs increased to 65 percent for two years for outpatient behavioral health care for individuals with severe mental illnesses or serious emotional disturbances.
(c)In October 2015, the United States Secretary of Health and Human Services awarded California a planning grant pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 which partially supported California in, among other things, developing its proposal to participate in the two-year demonstration program.
(d)The Mental Health Services Act was approved by voters in 2004 for the primary purpose of addressing unmet mental health needs.
(e)It is an appropriate use of Mental Health Services Act funds to support Californias application to participate in this demonstration program, including by using these funds to prepare actuarial rates and provide technical assistance to counties seeking to become certified community behavioral health centers.
(f)This act is consistent with and furthers the intent of the Mental Health Services Act within the meaning of Section 18 of the Mental Health Services Act.
SEC. 2.Section 14021.2 is added to the Welfare and Institutions Code, to read:14021.2.(a)The department shall develop a proposal for the United States Secretary of Health and Human Services for selection as a participating state in the time-limited demonstration program pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 (Public Law 113-93) in order to improve mental health services furnished by certified community behavioral health clinics to Medi-Cal beneficiaries.
(b)The department shall use the funds appropriated in the act that added this section to pay any costs that will support the development of a competitive proposal, including, but not limited to, establishing actuarially sound rates and providing technical assistance to counties.
SEC. 3.The sum of one million dollars ($1,000,000) is hereby appropriated from the Mental Health Services Fund to the State Department of Health Care Services for the purpose of developing the proposal described in Section 14021.2 of the Welfare and Institutions Code.
SEC. 4.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to provide necessary funding to the State Department of Health Care Services for the development of a proposal to participate in the federal Protecting Access to Medicare Act of 2014 demonstration program before the deadline to apply for participation in the demonstration program, it is necessary that this bill go into immediate effect.
The Legislature finds and declares the following:
(a)In 2014 Congress enacted the federal Protecting Access to Medicare Act of 2014.
(b)Under the Protecting Access to Medicare Act, eight states will be selected to have their federal share of costs increased to 65 percent for two years for outpatient behavioral health care for individuals with severe mental illnesses or serious emotional disturbances.
(c)In October 2015, the United States Secretary of Health and Human Services awarded California a planning grant pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 which partially supported California in, among other things, developing its proposal to participate in the two-year demonstration program.
(d)The Mental Health Services Act was approved by voters in 2004 for the primary purpose of addressing unmet mental health needs.
(e)It is an appropriate use of Mental Health Services Act funds to support Californias application to participate in this demonstration program, including by using these funds to prepare actuarial rates and provide technical assistance to counties seeking to become certified community behavioral health centers.
(f)This act is consistent with and furthers the intent of the Mental Health Services Act within the meaning of Section 18 of the Mental Health Services Act.
SEC. 2.Section 14021.2 is added to the Welfare and Institutions Code, to read:14021.2.(a)The department shall develop a proposal for the United States Secretary of Health and Human Services for selection as a participating state in the time-limited demonstration program pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 (Public Law 113-93) in order to improve mental health services furnished by certified community behavioral health clinics to Medi-Cal beneficiaries.
(b)The department shall use the funds appropriated in the act that added this section to pay any costs that will support the development of a competitive proposal, including, but not limited to, establishing actuarially sound rates and providing technical assistance to counties.
SEC. 3.The sum of one million dollars ($1,000,000) is hereby appropriated from the Mental Health Services Fund to the State Department of Health Care Services for the purpose of developing the proposal described in Section 14021.2 of the Welfare and Institutions Code.
SEC. 4.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to provide necessary funding to the State Department of Health Care Services for the development of a proposal to participate in the federal Protecting Access to Medicare Act of 2014 demonstration program before the deadline to apply for participation in the demonstration program, it is necessary that this bill go into immediate effect.
The Legislature finds and declares the following:
(a)In 2014 Congress enacted the federal Protecting Access to Medicare Act of 2014.
(b)Under the Protecting Access to Medicare Act, eight states will be selected to have their federal share of costs increased to 65 percent for two years for outpatient behavioral health care for individuals with severe mental illnesses or serious emotional disturbances.
(c)If successful, this federal opportunity would enable California to serve the tens of thousands of individuals with those conditions that it now lacks the funding to serve.
(d)A major challenge in serving that population is that many are homeless and in need of housing assistance. Federal funding cannot pay for that housing assistance.
(e)This federal funding would free up nearly $2 billion in county funds now being used to match federal funds. The money that is currently being used to match federal funds will now be available to be used to meet the housing and other needs of those individuals who are not currently receiving the behavioral health care that they need.
(f)
(c)In October 2015, the United States Secretary of Health and Human Services awarded California a planning grant pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 to support which partially supported California in, among other things, developing its proposal to participate in the two-year demonstration program.
(g)
(d)The Mental Health Services Act was approved by voters in 2004 for the primary purpose of addressing unmet mental health needs.
(h)
(e)It is an appropriate use of Mental Health Services Act funds to support Californias application to participate in this demonstration program program, including the use of by using these funds to prepare actuarial rates and provide technical assistance to counties seeking to become certified community behavioral health centers.
(i)Successful participation in this demonstration program will also result in significant General Fund savings due to reduced hospitalizations of people with severe mental illnesses who do not receive the behavioral health treatment they need, as well as savings from the portion of mental health care that is paid for by Medi-Cal managed care plans.
(f)This act is consistent with and furthers the intent of the Mental Health Services Act within the meaning of Section 18 of the Mental Health Services Act.
SEC. 2.Section 14021.2 is added to the Welfare and Institutions Code, to read:14021.2.(a)The department shall develop and submit a proposal to for the United States Secretary of Health and Human Services for selection as a participating state in the time-limited demonstration program pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 (Public Law 113-93) in order to improve mental health services furnished by certified community behavioral health clinics to Medi-Cal beneficiaries.
(b)The department shall use the funds appropriated in the act that added this section to pay any costs that will support the development of a competitive proposal, including, but not limited to, establishing actuarially sound rates and providing technical assistance to counties.
SEC. 3.The sum of one million dollars ($1,000,000) is hereby appropriated from the Mental Health Services Fund to the State Department of Health Care Services for the purpose of developing the proposal described in Section 14021.2 of the Welfare and Institutions Code.
SEC. 4.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to require provide necessary funding to the State Department of Health Care Services to develop and submit for the development of a proposal to participate in the federal Protecting Access to Medicare Act of 2014 demonstration program, and to fund the development of that proposal, program before the deadline to apply for participation in the demonstration program, it is necessary that this bill go into immediate effect.
The Legislature finds and declares the following:
(a)In 2014 Congress enacted the federal Protecting Access to Medicare Act of 2014.
(b)Under the Protecting Access to Medicare Act, eight states will be selected to have their federal share of costs increased to 65 percent for two years for outpatient behavioral health care for individuals with severe mental illnesses or serious emotional disturbances.
(c)If successful, this federal opportunity would enable California to serve the tens of thousands of individuals with those conditions that it now lacks the funding to serve.
(d)A major challenge in serving that population is that many are homeless and in need of housing assistance. Federal funding cannot pay for that housing assistance.
(e)This federal funding would free up nearly $2 billion in county funds now being used to match federal funds. The money that is currently being used to match federal funds will now be available to be used to meet the housing and other needs of those individuals who are not currently receiving the behavioral health care that they need.
(f)In October 2015, the United States Secretary of Health and Human Services awarded California a planning grant pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 to support California in, among other things, developing its proposal to participate in the two-year demonstration program.
(g)The Mental Health Services Act was approved by voters in 2004 for the primary purpose of addressing unmet mental health needs.
(h)It is an appropriate use of Mental Health Services Act funds to support Californias application to participate in this demonstration program including the use of these funds to prepare actuarial rates and provide technical assistance to counties seeking to become certified community behavioral health centers.
(i)Successful participation in this demonstration program will also result in significant General Fund savings due to reduced hospitalizations of people with severe mental illnesses who do not receive the behavioral health treatment they need, as well as savings from the portion of mental health care that is paid for by Medi-Cal managed care plans.
SEC. 2.Section 14021.2 is added to the Welfare and Institutions Code, to read:14021.2.(a)The department shall develop and submit a proposal to the United States Secretary of Health and Human Services for selection as a participating state in the time-limited demonstration program pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 (Public Law 113-93) in order to improve mental health services furnished by certified community behavioral health clinics to Medi-Cal beneficiaries.
(b)The department shall use the funds appropriated in the act that added this section to pay any costs that will support the development of a competitive proposal, including, but not limited to, establishing actuarially sound rates and providing technical assistance to counties.
SEC. 3.The sum of one million dollars ($1,000,000) is hereby appropriated from the Mental Health Services Fund to the State Department of Health Care Services for the purpose of developing the proposal described in Section 14021.2 of the Welfare and Institutions Code.
SEC. 4.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to require the State Department of Health Care Services to develop and submit a proposal to participate in the federal Protecting Access to Medicare Act of 2014 demonstration program, and to fund the development of that proposal, before the deadline to apply for participation in the demonstration program, it is necessary that this bill go into immediate effect.
SECTION 1.The State Department of Health Care Services shall apply to the United States Secretary of Health and Human Services for the planning grant awarded pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 for the purpose of developing proposals to participate in time-limited demonstration programs to improve mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries.
SEC. 2.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are:
The federal Protecting Access to Medicare Act of 2014 requires the United States Secretary of Health and Human Services to award planning grants no later than January 1, 2016. In order to require the State Department of Health Care Services to apply for a planning grant before the secretary awards the planning grants to states, it is necessary that this bill go into immediate effect.
The State Department of Health Care Services shall apply to the federal United States Secretary of Health and Human Services for the planning grant awarded pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 for the purpose of developing proposals to participate in time-limited demonstration programs to improve mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries.
SEC. 2.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are:
The federal Protecting Access to Medicare Act of 2014 requires the United States Secretary of Health and Human Services to award planning grants no later than January 1, 2016. In order to require the State Department of Health Care Services to apply for a planning grant before the secretary awards the planning grants to states, it is necessary that this bill go into immediate effect.
The State Department of Health Care Services shall apply to the federal Secretary of Health and Human Services for the planning grant awarded pursuant to Section 223 of the federal Protecting Access to Medicare Act of 2014 for the purpose of developing proposals to participate in time-limited demonstration programs to improve mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries.
SECTION 1.It is the intent of the Legislature to enact legislation that would require the State Department of Health Care Services to initiate planning and apply to the federal Secretary of Health and Human Services for a federal matching grant, under the federal Excellence in Mental Health Act, to expend funds for the construction or modernization of facilities used to provide community-based mental health and substance abuse services.
It is the intent of the Legislature to enact legislation that would require the State Department of Health Care Services to initiate planning and apply to the federal Secretary of Health and Human Services for a federal matching grant, under the federal Excellence in Mental Health Act, to expend funds for the construction or modernization of facilities used to provide community-based mental health and substance abuse services.
|
Date
|
Status
|
|---|---|
| Jun 4, 2015 | Referred to Com. on HEALTH. |
| Apr 11, 2016 | Chaptered by Secretary of State - Chapter 6, Statutes of 2016. |
| Apr 11, 2016 | Approved by the Governor. |
| Mar 28, 2016 | Enrolled and presented to the Governor at 4 p.m. |
| Mar 17, 2016 | Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 68. Noes 0. Page 3974.). |
| Mar 10, 2016 | Read third time. Urgency clause adopted. Passed. Ordered to the Assembly. (Ayes 39. Noes 0. Page 3204.). |
| Mar 10, 2016 | Read third time. Passed. Ordered to the Assembly. |
| Mar 10, 2016 | In Assembly. Concurrence in Senate amendments pending. May be considered on or after March 12 pursuant to Assembly Rule 77. |
| Mar 8, 2016 | Read second time. Ordered to third reading. |
| Mar 7, 2016 | From committee: Do pass. (Ayes 7. Noes 0.) (March 7). |
| Feb 22, 2016 | From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on APPR. |
| Feb 10, 2016 | From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on APPR. |
| Jun 30, 2015 | In committee: Set, first hearing. Hearing canceled at the request of author. |
| Jun 18, 2015 | From committee: Do pass and re-refer to Com. on APPR. (Ayes 9. Noes 0.) (June 17). Re-referred to Com. on APPR. |
| Feb 26, 2015 | Read first time. To print. |
| May 22, 2015 | Read third time. Urgency clause adopted. Passed. Ordered to the Senate. (Ayes 74. Noes 0. Page 1562.). |
| May 22, 2015 | Read third time. Urgency clause adopted. Passed. Ordered to the Senate. |
| May 22, 2015 | In Senate. Read first time. To Com. on RLS. for assignment. |
| May 14, 2015 | Read second time. Ordered to Consent Calendar. |
| May 13, 2015 | From committee: Do pass. To Consent Calendar. (Ayes 17. Noes 0.) (May 13). |
| May 5, 2015 | In committee: Hearing postponed by committee. |
| May 4, 2015 | Re-referred to Com. on APPR. |
| Apr 30, 2015 | Read second time and amended. |
| Apr 29, 2015 | From committee: Amend, and do pass as amended and re-refer to Com. on APPR. with recommendation: To Consent Calendar. (Ayes 19. Noes 0.) (April 28). |
| Apr 6, 2015 | Re-referred to Com. on HEALTH. |
| Mar 26, 2015 | Referred to Com. on HEALTH. |
| Mar 26, 2015 | From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended. |
| Feb 27, 2015 | From printer. May be heard in committee March 29. |
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Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Mar 17, 2016 | AB 847 MULLIN Concurrence in Senate Amendments | Assembly Floor |
Passed |
|
| Mar 10, 2016 | Assembly 3rd Reading AB847 Mullin By Beall Urgency Clause | Senate Floor |
Passed |
|
| Mar 7, 2016 | Do pass | Senate Standing Committee on Appropriations |
Passed |
|
| Jun 17, 2015 | Do pass, but first be re-referred to the Committee on [Appropriations] | Senate Standing Committee on Health |
Passed |
|
| May 22, 2015 | AB 847 MULLIN Consent Calendar Second Day Regular Session | Assembly Floor |
Passed |
|
| May 13, 2015 | Do pass. To Consent Calendar. | Assembly Standing Committee on Appropriations |
Passed |
|
| Apr 28, 2015 | Do pass as amended, and be re-referred to the Committee on [Appropriations] with recommendation: To Consent Calendar | Assembly Standing Committee on Health |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| California Chapter of the American College of Emergency Physicians | ** Support | Mar 10, 2016 |
| California Coalition for Mental Health | ** Support | Mar 10, 2016 |
| California Council Of Community Mental Health Agencies | ** Support | Mar 10, 2016 |
| California Council of the Community Health Agencies and Mental Health America | * Indeterminate | Jun 17, 2015 |
| California Division of the American Association for Marriage and Family Therapy | * Indeterminate | Jun 17, 2015 |
| California Primary Care Association | ** Support | Mar 10, 2016 |
| California Youth Empowerment Network | ** Support | Mar 10, 2016 |
| Disability Rights California | ** Support | Mar 10, 2016 |
| Mental Health America of California | ** Support | Mar 10, 2016 |
| Steinburg Institute | * Indeterminate | Jun 17, 2015 |
CONCURRENCE IN SENATE AMENDMENTS
CSA1 Bill Id:AB 847
Author:(Mullin and Ridley-Thomas)
As Amended Ver:February 22, 2016
2/3 vote. Urgency
ASSEMBLY: | 74-0 | May 22, 2015 | SENATE: | 39-0 | March 10, 2016 |
Original Committee Reference: HEALTH
SUMMARY: Requires the Department of Health Care Services (DHCS) to develop a proposal to participate in demonstration programs administered by the federal Secretary of Health and Human Services (HHS Secretary) to improve mental health services furnished by certified community behavioral health clinics to Medi-Cal beneficiaries.
The Senate amendments appropriate $1 million from the Mental Health Services Fund for the purpose of developing a competitive proposal including, but not limited to, establishing actuarially sound rates and providing technical assistance to counties and add an urgency clause.
EXISTING FEDERAL LAW:
- Federal law authorizes the Patient Protection and Affordable Care Act (ACA) to increase access to health care through a number of measures, including expanding Medicaid eligibility, subsidizing insurance premiums, and setting aside funds for health promotion and disease prevention, among others.
- Federal law authorizes the Protecting Access to Medicare Act (H.R. 4302) to establish an eight-state demonstration project that creates criteria for "Certified Community Behavioral Health Clinics" (CCBHCs), entities designed to serve individuals with serious mental illnesses and substance use disorders, and provides $25 million that will be available to states as planning grants to develop applications to participate in the two year pilot.
EXISTING STATE LAW:
- Establishes the Medi-Cal Program, administered by DHCS, which provides comprehensive health benefits to low-income children, their parents or caretaker relatives, pregnant women, elderly, blind or disabled persons, nursing home residents, and refugees who meet specified eligibility criteria.
- Establishes, under the terms of a federal Medicaid waiver, a managed care program providing Medi-Cal specialty mental health services for eligible low-income persons administered through local county MHPs under contract with the state.
FISCAL EFFECT: According to the Senate Appropriations Committee, one-time costs of $1.9 million for DHCS to develop a proposal. DHCS indicates that the total cost to prepare the proposal is $1.9 million. DHCS has received a $900,000 planning grant from the federal government. The $1 million appropriation in the bill will allow DHCS to complete the administrative work needed to prepare proposal for participation in the demonstration program.
COMMENTS: According to the author, the federal Protecting Access to Medicare Act would enable successful states to nearly double federal funds to support community mental health and alcohol and drug services with no additional state or county cost. The law currently allows for eight states to be selected for two years to have the federal share of costs increased for outpatient mental health and alcohol and drug services increased from the current level of 50% to at least 65%. The author states that this would mostly affect people who are disabled due to a severe mental illness. If successful, this would have a value to California of about $2 billion. It would significantly help California's counties get more people, who are homeless due to untreated mental illness, off the streets, out of hospitals and jails and into treatment. The author concludes that it would also likely generate additional savings to Medi-Cal from reduced physical health hospitalizations.
- Protecting Access to Medicare Act. On March 31, 2014, Congress passed the Protecting Access to Medicare Act (H.R. 4302), which included a demonstration program aimed at increasing Americans’ access to community mental health and substance use treatment services while improving Medicaid reimbursement for these services. This legislation:
- Creates criteria for CCBHCs as entities designed to serve individuals with serious mental illnesses and substance use disorders that provide intensive, person-centered, multidisciplinary, evidence-based screening, assessment, diagnostics, treatment, prevention, and wellness services. The HHS Secretary is directed to establish a process for selecting states to participate in a two year pilot program;
- Provides $25 million that will be available to states as planning grants to develop applications to participate in the two year pilot. Only states that have received a planning grant will be eligible to apply to participate in the pilot;
- Stipulates that eight states will be selected to participate in the two year pilot program. The match rate for CCBHC services is either the Enhanced Federal Medical Assistance Program (FMAP) /Children's Health Insurance Program rate or, for newly eligible “expansion” Medicaid beneficiaries, the current FMAP for that population – which is 100% now and moves down to 90% by 2020; and,
- Requires participating states to develop a Prospective Payment System for reimbursing CCBHCs for required services provided by these entities.
- Program Timeline.
- September 1, 2015: Deadline for the HHS Secretary to publish: criteria for a clinic to be certified by a State as a certified community behavioral health clinic; and, guidance for states on the establishment of a prospective payment system for certified clinics participating in the demonstration program.
- January 1, 2016: Deadline for the HHS Secretary to award planning grants to states for the purpose of developing proposals to participate in the demonstration program.
- September 1, 2017: Deadline for the HHS Secretary to select the states that will participate in the demonstration program. Only states that have received a planning grant are eligible to participate. The states will be selected through a competitive application process and must represent a diverse selection of geographic areas, including rural and underserved areas.
- Certified Community Behavioral Health Clinics. The Substance Abuse and Mental Health Services Administration (SAMHSA) is currently in the process of determining what the eligibility criteria will be for the CCBHC. The CCBHC demonstration program and Prospective Payment System are designed to work within the scope of State Medicaid Plans and to apply specifically to individuals who are Medicaid enrollees. The statute also requires that the CCBHCs not refuse service to any person based either on ability to pay or residence. According to SAMHSA, this requirement, together with the fact that improving access to and the quality of health care for the Medicaid population may also positively affect the health of others, means that the CCBHC demonstration program may have long-lasting and beneficial effects beyond the realm of Medicaid enrollees. Further, while the statute is clear that the CCBHCs are to provide services to all who seek help, it is anticipated that the CCBHCs will prove particularly valuable for individuals with serious mental illness, children and adolescents with serious emotional disturbance and those with co-occurring mental health, substance use and/or physical health disorders. Finally, the statute directs that the care provided be "patient-centered." It is expected that CCBHCs will offer care that is person-centered and family-centered in accordance with the requirements of the ACA.
The Steinberg Institute, sponsor of this bill, states in support that this bill directs DHCS to develop and submit a proposal to compete to become one of the eight designated states to receive significantly enhanced federal mental health funds under the Excellence in Mental Health Act – enacted as Section 223 of the Protecting Access to Medicare Act of 2014. This federal law would enable selected states to nearly double federal funds to support community mental health and alcohol and drug services with no additional state or county cost. The law currently allows eight states to have the federal share of costs increased for outpatient mental health and alcohol and drug services increased from the current level of 50% to at least 65% over a two year period of time. If DHCS is successful, this would bring an additional $2 billion in funding to California, which would significantly impact California's ability to ensure that those who are homeless, due to untreated mental illness, get off the streets, out of hospitals and jails, and into treatment. Participating in the Act would also likely generate additional savings to Medi-Cal from reduced physical health hospitalizations.
There is no opposition on file.
Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097 FN: 0002655
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB 847 |
THIRD READING
Bill No: AB 847
Author: Mullin (D) and Ridley-Thomas (D)
Amended: 2/22/16 in Senate
SENATE HEALTH COMMITTEE: 9-0, 6/17/15
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen, Pan, Roth, Wolk
SENATE APPROPRIATIONS COMMITTEE: 7-0, 3/7/16
AYES: Lara, Bates, Beall, De León, Hill, Mendoza, Nielsen
ASSEMBLY FLOOR: 74-0, 5/22/15 (Consent) - See last page for vote
SUBJECT: Mental health: community-based services
SOURCE: The Steinberg Institute
DIGEST: This bill requires the Department of Health Care Services (DHCS) to develop a proposal for the United States Secretary of Health and Human Services (USSHHS) for selection as a participating state in a time-limited demonstration program, as specified, to improve mental health services provided by specified entities to Medi-Cal beneficiaries. Requires DHCS to use funds awarded to the state, as specified, to pay for costs that will support this effort. Appropriates $1 million of Mental Health Services Fund monies to support DHCS’s proposal to the USSHHS.
Existing federal law:
- Enacts the Patient Protection and Affordable Care Act (ACA) to increase access to health care through a number of measures, including expanding Medicaid eligibility, subsidizing insurance premiums, and setting aside funds for health promotion and disease prevention.
- Authorizes, in Section 223 of the Protecting Access to Medicare Act (PAMA) of 2014 (P.L. 113-93), a two-year demonstration program, to include up to eight states, that creates criteria for certified community behavioral health clinics (CCBHCs) and provides planning grants to states to develop applications to participate in the demonstration program.
Existing state law:
- Establishes the Medi-Cal program, administered by DHCS, under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by the federal Medicaid provisions.
- Establishes, under the terms of a federal Medicaid waiver, a managed care program providing Medi-Cal specialty mental health services for eligible low-income persons administered through local county mental health plans under contract with DHCS.
This bill:
- Requires DHCS to develop a proposal for the USSHHS for selection as a participating state in the time-limited demonstration program authorized under PAMA in order to improve mental health services provided by CCBHCs to Medi-Cal beneficiaries.
- Requires DHCS to use the funds awarded to the state by the USSHHS, for purposes of the PAMA demonstration program, to pay any costs that will support the development of a competitive proposal, including, but not limited to, establishing actuarially sound rates and providing technical assistance to counties.
- Appropriates $1 million from the Mental Health Services Fund to DHCS for the purpose of developing the proposal to the USSHHS for the demonstration program.
Comments
- Background. Federal law authorizes PAMA to establish a demonstration program, to include up to eight states, that creates criteria for CCBHCs, which are facilities designed to serve individuals with serious mental illnesses and substance use disorders (SUDs). PAMA provides nearly $25 million that will be available to states as planning grants to develop applications. PAMA also directs the USSHHS to award planning grants to states for the development of demonstration proposals by January 1, 2016, and to select states to participate in the demonstration program by September 1, 2017. Section 223 of PAMA authorizes the USSHHS to:
- Establish criteria that states will use to certify CCBHCs for a two-year demonstration program;
- Provide guidance on the development of a Prospective Payment System (PPS) for payment of services provided by CCBHCs;
- Award grants to states for planning purposes to develop proposals to participate in the demonstration program;
- Select up to eight states to participate in the demonstration program;
- Pay states participating in the demonstration program federal matching funds equivalent to the standard CHIP matching rate for services provided to currently enrolled Medicaid beneficiaries; and,
- Evaluate the program and prepare annual reports to Congress.
- CCBHCs. The federal Substance Abuse and Mental Health Services Administration (SAMHSA) developed eligibility criteria for states to certify CCBHCs, based on a review of selected state Medicaid Plans, standards for Federally Qualified Health Centers and Medicaid Health Homes, and quality measures currently in use by states. According to SAMHSA’s Web site, the criteria are intended to extend quality and to improve outcomes of the behavioral health care system within the authorities of state regulations, statutes, and state Medicaid Plans; establish a basic level of services at which the CCBHCs should, at a minimum, operate; and allow states the flexibility in determining how to implement the criteria in a manner best addressing the needs of the population being served. The criteria are designed to encourage states and CCBHCs to further develop their abilities to offer behavioral health services that comport with current best practices. Populations to be served are adults with serious mental illness, children with serious emotional disturbance, and those with long-term and serious SUDs, as well as others with mental illness and SUDs.
Prior Legislation
AB 861 (, 2015), was substantially similar to this bill. AB 861 was vetoed by Governor Brown, who stated that the bill was premature because the state had not been awarded any federal grants or approved as one of the eight participating states for the demonstration program.
FISCAL EFFECT: Appropriation: Yes Fiscal Com.: Yes Local: No
According to the Senate Appropriations Committee, one-time costs of $1.9 million for DHCS to develop a proposal (federal funds and Mental Health Services Act Fund). DHCS indicates that the total cost to prepare the proposal is $1.9 million. DHCS has received a $900,000 planning grant from the federal government. The $1 million appropriation in the bill will allow DHCS to complete the administrative work needed to prepare the proposal for participation in the demonstration program.
The Steinberg Institute (source)
American Association for Marriage and Family Therapy, California Division
California Chapter of the American College of Emergency Physicians
California Coalition for Mental Health
California Council of Community Mental Health Agencies
California Primary Care Association
California Youth Empowerment Network
Disability Rights California
Mental Health America of California
None received
ASSEMBLY FLOOR: 74-0, 5/22/15
AYES: Achadjian, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, 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-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Alejo, Jones, O'Donnell, Olsen, Waldron, Weber
3/9/16 14:42:24
**** END ****
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 847 (Mullin) - Mental health: community-based services
Version: February 22, 2016 | Policy Vote: HEALTH 9-0 |
Urgency: Yes | Mandate: No |
Hearing Date: March 7, 2016 | Consultant: Brendan McCarthy |
This bill meets the criteria for referral to the Suspense File.
Bill Summary:
AB 847 would require the Department of Health Care Services to develop a proposal for a specific federal demonstration program that provides enhanced federal funding for mental health services provided to Medi-Cal beneficiaries. The bill would appropriate $1 million from the Mental Health Services Fund to pay for a portion of the costs to develop the proposal.
Fiscal Impact:
- One-time costs of $1.9 million for the Department of Health Care Services to develop a proposal (federal funds and Mental Health Services Fund). The Department indicates that the total cost to prepare the proposal is $1.9 million. The Department has received a $900,000 planning grant from the federal government. The $1 million appropriation in the bill will allow the Department to complete the administrative work needed to prepare proposal for participation in the demonstration program.
Background:
Under federal law, the United States Health and Human Services Agency is authorized to implement a demonstration program in eight states, for two years, to provide enhanced federal financial participation for mental health services provided by certified community behavioral health clinics to Medicaid beneficiaries. Federal law authorizes states to apply for an initial planning grant to pay for the costs to develop a proposal to participate in the demonstration program. The state applied for such a planning grant and received an award of $900,000 in late 2015. However, the Department indicates that the costs to develop a competitive proposal for participation in the demonstration program will be about $1.9 million. Because the Department did not receive sufficient federal funding to develop a proposal, it has not undertaken any of the administrative activities that would be necessary to develop a proposal – such as identifying participating counties, request client information from clinics that are likely to participate, establish payment rates, etc.
The Mental Health Services Act (Proposition 63 of 2004) imposes an additional 1% personal income tax on incomes over $1 million. Most of the funding from the Mental Health Services Act is transferred to counties to provide support for mental health services. The Mental Health Services Act limits state administrative spending to 5% of revenues.
Proposed Law:
AB 847 would require the Department of Health Care Services to develop a proposal for a specific federal demonstration program that provides enhanced federal funding for mental health services provided to Medi-Cal beneficiaries. The bill would appropriate $1 million from the Mental Health Services Fund to pay for a portion of the costs to develop the proposal.
The bill includes a legislative finding that the expenditure of funds from the Mental Health Services Fund for the purpose of implementing the bill is consistent with the intent of the Mental Health Services Act.
The bill contains an urgency clause.
Related Legislation:
AB 861 (Maienschein) would have required the Department of Health Care Services to apply for participation in the federal demonstration program addressed by this bill, if the Department had received a planning grant from the federal government. That bill was vetoed by Governor Brown.
Staff Comments:
By appropriating $1 million from the Mental Health Services Fund for the purposes of the bill, the bill will reduce the funding available under the administrative cap for other state spending priorities that are authorized under the Mental Health Services Act.
State proposals to participate in the demonstration program are due in October 2016. Because the Department has not taken any action to develop a proposal since the fall of 2015, it is not clear whether the Department will be able to develop a competitive proposal in the remaining time available. The bill requires the Department to develop a proposal for participation in the demonstration project; the bill does not require the Department to submit an application – this is intended to provide flexibility to the Department if it cannot develop an application that it feels would be workable for the state and counties.
If the state applies to participate in the demonstration program and is selected for inclusion, enhanced federal financial participation will be available to support mental health and substance abuse disorder services for Medi-Cal beneficiaries. Under the program, federal financial participation for those services would increase from 50% to 65% for the two-year duration of the demonstration program. Because mental health benefits for Medi-Cal beneficiaries with severe mental illness are paid for with non-state funds (generally county realignment funds, county Mental Health Services Act funds, and federal funds), additional federal funding will flow to the counties, rather than the state.
-- END --
AB 847 (Mullin) Page 4 of 4
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 847
AUTHOR: |
Mullin |
||
VERSION: |
April 30, 2015 |
||
HEARING DATE: |
June 17, 2015 |
|
|
CONSULTANT: |
Reyes Diaz |
||
SUBJECT: Mental health: community-based services.
SUMMARY:
Requires the Department of Health Care Services to apply to the Secretary of the U.S. Health and Human Services for a specified federal planning grant for the purpose of developing proposals to improve mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries. Contains an urgency clause that will make this bill effective upon enactment
Existing law:
Federal law
Enacts the Patient Protection and Affordable Care Act (ACA) to increase access to health care through a number of measures, including expanding Medicaid eligibility, subsidizing insurance premiums, and setting aside funds for health promotion and disease prevention.
Authorizes, in Section 223 of the Protecting Access to Medicare Act (PAMA) of 2014 (P.L. 113-93), a two-year demonstration program, to include up to eight states, that creates criteria for by certified community behavioral health clinics (CCBHCs) and provides planning grants to develop applications to participate in the demonstration program.
State law
Establishes the Medi-Cal program, administered by the Department of Health Care Services (DHCS), under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by the federal Medicaid provisions.
Establishes, under the terms of a federal Medicaid waiver, a managed care program providing Medi-Cal specialty mental health services for eligible low-income persons administered through local county mental health plans under contract with DHCS.
This bill:
Requires DHCS to apply for planning grants available pursuant to PAMA for purposes of developing proposals to participate in the demonstration program to improve mental health services provided by CCBHCs to Medi-Cal beneficiaries.
Contains an urgency clause that will make this bill effective upon enactment.
FISCAL EFFECT:
According to the Assembly Appropriations Committee, this bill includes administrative costs to DHCS estimated at under $100,000 (General Fund/federal) to apply for the planning grant. This is subject to uncertainty, as the grant application has not yet been released. If this grant is received, federal planning grant funds would pay for the development of the demonstration program grant.
PRIOR VOTES:
Assembly Floor: |
74 - 0 |
Assembly Appropriations Committee: |
17 - 0 |
Assembly Health Committee: |
19 - 0 |
COMMENTS:
Author’s statement. According to the author, the federal Excellence in Mental Health Act will enable successful states to nearly double federal funds to support community mental health and substance use disorder (SUD) services with no additional state or county cost. The law currently allows for up to eight states to be selected for two years to have the federal matching funds increased for outpatient mental health and SUD services from the current level of 50% to be equivalent to the enhanced federal matching rate for the Children’s Health Insurance Program (CHIP). This would mostly affect people who are disabled due to a severe mental illness. If California is successful in its application for the increased funding, this would have a value of about $2 billion and would significantly help California's counties get more people who are homeless due to untreated mental illness off the streets and out of hospitals and jails and into treatment. It would also likely generate additional savings to Medi-Cal from reduced physical health hospitalizations for this population.
Background. Federal law authorizes PAMA to establish a demonstration program, to include up to eight states, that creates criteria for CCBHCs, which are facilities designed to serve individuals with serious mental illnesses and SUDs. PAMA provides nearly $25 million that will be available to states as planning grants to develop applications. PAMA also directs the Secretary of the U.S. Health and Human Services (USHHS) to award planning grants to states for the development of demonstration proposals by January 1, 2016, and to select states to participate in the demonstration program by September 1, 2017. Section 223 of PAMA authorizes the USHHS to:
Establish criteria that states will use to certify CCBHCs for a two-year demonstration program;
Provide guidance on the development of a Prospective Payment System (PPS) for payment of services provided by CCBHCs;
Award grants to states for planning purposes to develop proposals to participate in the demonstration program;
Select up to eight states to participate in the demonstration program;
Pay states participating in the demonstration program federal matching funds equivalent to the standard CHIP matching rate for services provided to currently enrolled Medicaid beneficiaries; and,
Evaluate the program and prepare annual reports to Congress.
As indicated on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Web site, states may submit applications for the planning grants through August 5, 2015. According to DHCS, the department will apply for the planning grants.
CCBHCs. SAMHSA is currently in the process of determining what the eligibility criteria will be for states to certify CCBHCs. The CCBHC demonstration program and the PPS are designed to work within the scope of State Medicaid Plans and to apply only to individuals who are Medicaid enrollees. According to SAMHSA, this demonstration program provides an opportunity for states to improve the behavioral health of their residents by providing community-based mental health and SUD treatment, and by helping to further integrate behavioral health with physical health care, utilize evidence-based practices on a more consistent basis, and improve access to high quality care. According to SAMHSA, populations to be served are adults with serious mental illness, children with serious emotional disturbance, and those with long term and serious SUDs, as well as others with mental illness and SUDs.
Related legislation. AB 861 (Maienschein), would require DHCS to submit an application for a subsequent grant under PAMA, if it applies for and is awarded the PAMA planning grant, and requires DHCS to work with counties and stakeholders to identify the unmet need for covered services and to estimate the number of individuals who need housing assistance. AB 861 also requires the competitive grant proposal to include plans for counties to redirect current funds to provide housing for those with severe mental illnesses. AB 861 is set for hearing in the Senate Health Committee on June 17, 2015.
Prior legislation. AB 2287 (Monning, 2010), would have required the California Health and Human Services Agency to direct the appropriate state departments within the agency to apply for community transformation grants under the ACA. AB 2287 died in Senate Appropriations Committee.
Support. Supporters of this bill, which include health, behavioral health, and disability rights advocates, argue that PAMA enables selected states to nearly double federal funds to support community mental health and SUD services. They argue that the added funding is an important complement to the current behavioral health care funding and will significantly expand the number of people in need that could be served. The California Chapter of the American College of Emergency Physicians (California ACEP) states that a 2012 study in the Annals of Emergency Medicine found that patients having psychiatric emergencies wait approximately 42 percent longer in the emergency department than other emergency patients. Therefore, California ACEP supports this bill because it has the potential to help improve access to MH services provided to Medi-Cal patients at CCBHCs.
SUPPORT AND OPPOSITION:
Support: The Steinberg Institute (sponsor)
American Association for Marriage and Family Therapy, California Division
California Chapter of the American College of Emergency Physicians
California Coalition for Mental Health
California Council of Community Mental Health Agencies
California Primary Care Association
California Youth Empowerment Network
Disability Rights California
Mental Health America of California
Oppose: None received.
-- END --
AB 847
Page 2
Date of Hearing: May 13, 2015
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Jimmy Gomez, Chair
AB 847
(Mullin) – As Amended April 30, 2015
Policy Committee: |
Health |
Vote: |
19 - 0 |
|
|
|
|
|
|
|
|
Urgency: Yes State Mandated Local Program: No Reimbursable: No
SUMMARY:
This bill requires the Department of Health Care Services (DHCS) to apply to the United States Secretary of Health and Human Services for a specified federal planning grant, for the purpose of developing proposals to improve mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries.
FISCAL EFFECT:
Administrative costs to DHCS estimated at under $100,000 (GF/federal) to apply for the planning grant. This is subject to uncertainty, as the grant application has not yet been released. If this grant is received, federal planning grant funds would pay for the development of the demonstration project grant.
COMMENTS:
Purpose. According to the author, receiving the federal demonstration project grant, for which planning funds are sought through this bill, would nearly double federal funds to support community mental health and alcohol and drug services, with no additional state or county cost. The law allows for eight states to be selected for two years to have the federal share of costs increased for outpatient behavioral health services. The author contends it would also reduce costs for hospitalization and incarceration.
Background. Federal law authorizes the Protecting Access to Medicare Act of 2014 (H.R. 4302) (Act) to establish an eight-state demonstration project that creates criteria for “Certified Community Behavioral Health Clinics,” facilities designed to serve individuals with serious mental illnesses and substance use disorders. The Act provides $25 million that will be available to states as planning grants to develop applications, and the National Conference of State Legislatures indicates federal cost estimates for the actual demonstration project are $600 million nationally over five years. This Act also directs the secretary to award planning grants to states for the development of demonstration proposals by January 1, 2016, and to select states to participate in the demonstration program by September 1, 2017.
Related Legislation. AB 861 (Maienschein), also on today's agenda, is very similar to this bill.
Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081
AB 847
Page 4
Date of Hearing: April 28, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
AB 847
(Mullin) – As Amended March 26, 2015
SUBJECT: Mental health: community-based services.
SUMMARY: Requires the Department of Health Care Services (DHCS) to apply to the federal Secretary of Health and Human Services (HHS Secretary) for the planning grant awarded for the purpose of developing proposals to participate in demonstration programs to improve mental health services furnished by certified community behavioral health clinics to Medi-Cal beneficiaries.
EXISTING FEDERAL LAW:
Federal law authorizes the Patient Protection and Affordable Care Act (ACA) to increase access to health care through a number of measures, including expanding Medicaid eligibility, subsidizing insurance premiums, and setting aside funds for health promotion and disease prevention, among others.
Federal law authorizes the Protecting Access to Medicare Act (H.R. 4302) to establish an eight-state demonstration project that creates criteria for “Certified Community Behavioral Health Clinics” (CCBHCs), entities designed to serve individuals with serious mental illnesses and substance use disorders, and provides $25 million that will be available to states as planning grants to develop applications to participate in the two year pilot.
EXISTING STATE LAW:
Establishes the Medi-Cal Program, administered by DHCS, which provides comprehensive health benefits to low-income children, their parents or caretaker relatives, pregnant women, elderly, blind or disabled persons, nursing home residents, and refugees who meet specified eligibility criteria.
Establishes, under the terms of a federal Medicaid waiver, a managed care program providing Medi-Cal specialty mental health services for eligible low-income persons administered through local county MHPs under contract with the state.
FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee.
COMMENTS:
PURPOSE OF THIS BILL. According to the author, the federal Protecting Access to Medicare Act would enable successful states to nearly double federal funds to support community mental health and alcohol and drug services with no additional state or county cost. The law currently allows for eight states to be selected for two years to have the federal share of costs increased for outpatient mental health and alcohol and drug services increased from the current level of 50% to at least 65%. The author states that this would mostly affect people who are disabled due to a severe mental illness. If successful, this would have a value to California of about $2 billion. It would significantly help California's counties get more people, who are homeless due to untreated mental illness, off the streets, out of hospitals and jails and into treatment. The author concludes that it would also likely generate additional savings to Medi-Cal from reduced physical health hospitalizations.
BACKGROUND.
Protecting Access to Medicare Act. On March 31, 2014, Congress passed the Protecting Access to Medicare Act (H.R. 4302), which included a demonstration program aimed at increasing Americans’ access to community mental health and substance use treatment services while improving Medicaid reimbursement for these services. This legislation:
Creates criteria for CCBHCs as entities designed to serve individuals with serious mental illnesses and substance use disorders that provide intensive, person-centered, multidisciplinary, evidence-based screening, assessment, diagnostics, treatment, prevention, and wellness services. The HHS Secretary is directed to establish a process for selecting states to participate in a two year pilot program;
Provides $25 million that will be available to states as planning grants to develop applications to participate in the two year pilot. Only states that have received a planning grant will be eligible to apply to participate in the pilot;
Stipulates that eight states will be selected to participate in the two year pilot program. The match rate for CCBHC services is either the Enhanced Federal Medical Assistance Program (FMAP) /Children's Health Insurance Program rate or, for newly eligible “expansion” Medicaid beneficiaries, the current FMAP for that population – which is 100% now and moves down to 90% by 2020; and,
Requires participating states to develop a Prospective Payment System for reimbursing CCBHCs for required services provided by these entities.
Program Timeline.
September 1, 2015: Deadline for the HHS Secretary to publish: criteria for a clinic to be certified by a State as a certified community behavioral health clinic; and, guidance for states on the establishment of a prospective payment system for certified clinics participating in the demonstration program.
January 1, 2016: Deadline for the HHS Secretary to award planning grants to states for the purpose of developing proposals to participate in the demonstration program.
September 1, 2017: Deadline for the HHS Secretary to select the states that will participate in the demonstration program. Only states that have received a planning grant are eligible to participate. The states will be selected through a competitive application process and must represent a diverse selection of geographic areas, including rural and underserved areas.
Certified Community Behavioral Health Clinics. The Substance Abuse and Mental Health Services Administration (SAMHSA) is currently in the process of determining what the eligibility criteria will be for the CCBHC. The CCBHC demonstration program and Prospective Payment System are designed to work within the scope of State Medicaid Plans and to apply specifically to individuals who are Medicaid enrollees. The statute also requires that the CCBHCs not refuse service to any person based either on ability to pay or residence. According to SAMHSA, this requirement, together with the fact that improving access to and the quality of health care for the Medicaid population may also positively affect the health of others, means that the CCBHC demonstration program may have long-lasting and beneficial effects beyond the realm of Medicaid enrollees. Further, while the statute is clear that the CCBHCs are to provide services to all who seek help, it is anticipated that the CCBHCs will prove particularly valuable for individuals with serious mental illness, children and adolescents with serious emotional disturbance and those with co-occurring mental health, substance use and/or physical health disorders. Finally, the statute directs that the care provided be “patient-centered.” It is expected that CCBHCs will offer care that is person-centered and family-centered in accordance with the requirements of the Affordable Care Act.
SUPPORT. The Steinberg Institute, sponsor of this bill, states in support that this bill directs DHCS to develop and submit a proposal to compete to become one of the eight designated states to receive significantly enhanced federal mental health funds under the Excellence in Mental Health Act – enacted as Section 223 of the Protecting Access to Medicare Act of 2014. This federal law would enable selected states to nearly double federal funds to support community mental health and alcohol and drug services with no additional state or county cost. The law currently allows eight states to have the federal share of costs increased for outpatient mental health and alcohol and drug services increased from the current level of 50% to at least 65% over a two year period of time. If DHCS is successful, this would bring an additional $2 billion in funding to California, which would significantly impact California's ability to ensure that those who are homeless, due to untreated mental illness, get off the streets, out of hospitals and jails, and into treatment. Participating in the Act would also likely generate additional savings to Medi-Cal from reduced physical health hospitalizations.
RELATED LEGISLATION. This bill is substantially similar to AB 861 (Maienschein) and is currently pending in the Assembly Health Committee.
PREVIOUS LEGISLATION. AB 2287 (Monning) of 2010 required the California Health and Human Services Agency (CHHSA) to direct the appropriate state departments within the agency to apply for Community Transformation Grants under the ACA. This bill died in Senate Appropriations Committee.
AMENDMENTS. The Committee is adopting amendments to add an urgency clause to the bill to ensure the provisions of this bill go into immediate effect upon enactment.
REGISTERED SUPPORT / OPPOSITION:
Support
The Steinberg
Institute (sponsor)
California Coalition for Mental
Health
California Council of Community Mental Health
Agencies
Disability Rights California
Mental Health America of California
Opposition
None on file.
Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097
Discussed in Hearing
3MIN
Assembly Floor
3MIN
Senate Floor
6MIN
Senate Standing Committee on Appropriations
3MIN
Senate Standing Committee on Health
Bill Co-Author(s):