AB 2325: County mental health services: veterans.
- Session Year: 2017-2018
- House: Assembly
- Latest Version Date: 2018-07-18
Existing law contains provisions governing the operation and financing of community mental health services for the mentally disordered in every county through locally administered and locally controlled community mental health programs. Existing law further provides that, to the extent resources are available, the primary goal of the use of funds deposited in the mental health account of the local health and welfare trust fund should be to serve specified target populations, including, among others, California veterans in need of mental health services who meet specified eligibility requirements. Existing law prohibits a county from denying county mental health services to an eligible veteran based solely on his or her status as a veteran. Existing law requires a county to refer a veteran to the county veterans service officer, if any, to determine the veterans eligibility for, and the availability of, mental health services provided by the United States Department of Veterans Affairs or any other federal health care provider.
This bill would prevent a county from denying an eligible veteran county mental or behavioral health services while the veteran is waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the United States Department of Veterans Affairs. The bill would make specific findings and declarations about the countys duty to provide mental and behavioral health services to veterans.
Existing law contains provisions governing the operation and financing of community mental health services for the mentally disordered in every county through locally administered and locally controlled community mental health programs. Existing law further provides that, to the extent resources are available, the primary goal of the use of funds deposited in the mental health account of the local health and welfare trust fund should be to serve specified target populations, including, among others, California veterans in need of mental health services who meet specified eligibility requirements. Existing law prohibits a county from denying county mental health services to an eligible veteran based solely on his or her status as a veteran. Existing law requires a county to refer a veteran to the county veterans service officer, if any, to determine the veterans eligibility for, and the availability of, mental health services provided by the United States Department of Veterans Affairs or any other federal health care provider.
This bill would prevent a county from denying an eligible veteran county mental or behavioral health services while the veteran is waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the United States Department of Veterans Affairs. The bill would make specific findings and declarations about the countys duty to provide mental and behavioral health services to veterans.
Existing law contains provisions governing the operation and financing of community mental health services for the mentally disordered in every county through locally administered and locally controlled community mental health programs. Existing law further provides that, to the extent resources are available, the primary goal of the use of funds deposited in the mental health account of the local health and welfare trust fund should be to serve specified target populations, including, among others, California veterans in need of mental health services who meet specified eligibility requirements. Existing law prohibits a county from denying county mental health services to an eligible veteran based solely on his or her status as a veteran. Existing law requires a county to refer a veteran to the county veterans service officer, if any, to determine the veterans eligibility for, and the availability of, mental health services provided by the United States Department of Veterans Affairs or any other federal health care provider.
This bill would prevent a county from denying an eligible veteran county mental or behavioral health services while the veteran is waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the United States Department of Veterans Affairs. The bill would make specific findings and declarations about the countys duty to provide mental and behavioral health services to veterans.
(a)It is the intent of the Legislature to do both of the following:
(1)Enact legislation to make statutory changes to address the mental and behavioral health needs of veterans in California and to explore the opportunities for meeting those needs by improving access to mental health services for veterans in California.
(2)Improve access for veterans by connecting them to mental and behavioral health care services closer to home regardless of insurance coverage or eligibility for Medi-Cal or any other federal health care services, including, but not limited to, federal Veterans Administration eligibility.
(b)The Legislature finds and declares all of the following:
(1)Veterans in the counties are eligible for county mental and behavioral health services in the same manner as any other adult in the county, whether or not they are eligible for mental and behavioral health services from the federal Department of Veterans Affairs.
(2)The process of determining eligibility for services through the federal Department of Veterans Affairs can sometimes be a time-consuming process. Veterans should not have to wait to receive needed mental and behavioral health care while they await federal eligibility determination if another similarly situated adult could receive those services in his or her county.
(3)Mental and behavioral health services may not be available in a timely manner or in an accessible location when a veteran is eligible for benefits from the federal Department of Veterans Affairs. Veterans who need services in a county and cannot receive them in an adequate, timely, or accessible manner from another source should be treated like any other adult in the county and provided with those services through county mental health.
(4)Veterans who are eligible for and in need of county mental and behavioral health services should be treated in the same manner as any other adult in need of those services and should be provided those services through county mental health programs, irrespective of funding source.
SEC. 2.Section 5600.3 of the Welfare and Institutions Code is amended to read:5600.3.To the extent resources are available, the primary goal of the use of funds deposited in the mental health account of the local health and welfare trust fund should be to serve the target populations identified in the following categories, which shall not be construed as establishing an order of priority:
(a)(1)Seriously emotionally disturbed children or adolescents.
(2)For the purposes of this part, seriously emotionally disturbed children or adolescents means minors under the age of 18 years who have a mental disorder as identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, other than a primary substance use disorder or developmental disorder, which results in behavior inappropriate to the childs age according to expected developmental norms. Members of this target population shall meet one or more of the following criteria:
(A)As a result of the mental disorder, the child has substantial impairment in at least two of the following areas: self-care, school functioning, family relationships, or ability to function in the community; and either of the following occur:
(i)The child is at risk of removal from home or has already been removed from the home.
(ii)The mental disorder and impairments have been present for more than six months or are likely to continue for more than one year without treatment.
(B)The child displays one of the following: psychotic features, risk of suicide or risk of violence due to a mental disorder.
(C)The child has been assessed pursuant to Article 2 (commencing with Section 56320) of Chapter 4 of Part 30 of Division 4 of Title 2 of the Education Code and determined to have an emotional disturbance, as defined in paragraph (4) of subdivision (c) of Section 300.8 of Title 34 of the Code of Federal Regulations.
(b)(1)Adults and older adults who have a serious mental disorder.
(2)For the purposes of this part, serious mental disorder means a mental disorder that is severe in degree and persistent in duration, which may cause behavioral functioning which interferes substantially with the primary activities of daily living, and which may result in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time. Serious mental disorders include, but are not limited to, schizophrenia, bipolar disorder, post-traumatic stress disorder, as well as major affective disorders or other severely disabling mental disorders. This section shall not be construed to exclude persons with a serious mental disorder and a diagnosis of substance abuse, developmental disability, or other physical or mental disorder.
(3)Members of this target population shall meet all of the following criteria:
(A)The person has a mental disorder as identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, other than a substance use disorder or developmental disorder or acquired traumatic brain injury pursuant to subdivision (a) of Section 4354 unless that person also has a serious mental disorder as defined in paragraph (2).
(B)(i)As a result of the mental disorder, the person has substantial functional impairments or symptoms, or a psychiatric history demonstrating that without treatment there is an imminent risk of decompensation to having substantial impairments or symptoms.
(ii)For the purposes of this part, functional impairment means being substantially impaired as the result of a mental disorder in independent living, social relationships, vocational skills, or physical condition.
(C)As a result of a mental functional impairment and circumstances, the person is likely to become so disabled as to require public assistance, services, or entitlements.
(4)For the purpose of organizing outreach and treatment options, to the extent resources are available, this target population includes, but is not limited to, persons who are any of the following:
(A)Homeless persons who are mentally ill.
(B)Persons evaluated by appropriately licensed persons as requiring care in acute treatment facilities including state hospitals, acute inpatient facilities, institutes for mental disease, and crisis residential programs.
(C)Persons arrested or convicted of crimes.
(D)Persons who require acute treatment as a result of a first episode of mental illness with psychotic features.
(5)California veterans in need of mental health services and who meet the existing eligibility requirements of this section, shall be provided services to the extent services are available to other adults pursuant to this section. Veterans who may be eligible for mental health services through the United States Department of Veterans Affairs should be advised of these services by the county and assisted in linking to those services, but the eligible veteran shall not be denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the United States Department of Veterans Affairs.
(A)An eligible veteran shall not be denied county mental health services based solely on his or her status as a veteran, including whether or not the person is eligible for services provided by the United States Department of Veterans Affairs.
(B)Counties shall refer a veteran to the county veterans service officer, if any, to determine the veterans eligibility for, and the availability of, mental health services provided by the United States Department of Veterans Affairs or other federal health care provider.
(C)Counties should consider contracting with community-based veterans services agencies, where possible, to provide high-quality, veteran specific mental health services.
(c)Adults or older adults who require or are at risk of requiring acute psychiatric inpatient care, residential treatment, or outpatient crisis intervention because of a mental disorder with symptoms of psychosis, suicidality, or violence.
(d)Persons who need brief treatment as a result of a natural disaster or severe local emergency.
(a)It is the intent of the Legislature to do both of the following:
(1)Enact legislation to make statutory changes to address the mental and behavioral health needs of veterans in California and to explore the opportunities for meeting those needs by improving access to mental health services for veterans in California.
(2)Improve access for veterans by connecting them to mental and behavioral health care services closer to home regardless of insurance coverage or eligibility for Medi-Cal or any other federal health care services, including, but not limited to, federal Veterans Administration eligibility.
(b)The Legislature finds and declares all of the following:
(1)Veterans in the counties are eligible for county mental and behavioral health services in the same manner as any other adult in the county, whether or not they are eligible for mental and behavioral health services from the federal Department of Veterans Affairs.
(2)The process of determining eligibility for services through the federal Department of Veterans Affairs can sometimes be a time-consuming process. Veterans should not have to wait to receive needed mental and behavioral health care while they await federal eligibility determination if another similarly situated adult could receive those services in his or her county.
(3)Mental and behavioral health services may not be available in a timely manner or in an accessible location when a veteran is eligible for benefits from the federal Department of Veterans Affairs. Veterans who need services in a county and cannot receive them in an adequate, timely, or accessible manner from another source should be treated like any other adult in the county and provided with those services through county mental health.
(4)Veterans who are eligible for and in need of county mental and behavioral health services should be treated in the same manner as any other adult in need of those services and should be provided those services through county mental health programs, irrespective of funding source.
SEC. 2.Section 5600.3 of the Welfare and Institutions Code is amended to read:5600.3.To the extent resources are available, the primary goal of the use of funds deposited in the mental health account of the local health and welfare trust fund should be to serve the target populations identified in the following categories, which shall not be construed as establishing an order of priority:
(a)(1)Seriously emotionally disturbed children or adolescents.
(2)For the purposes of this part, seriously emotionally disturbed children or adolescents means minors under the age of 18 years who have a mental disorder as identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, other than a primary substance use disorder or developmental disorder, which results in behavior inappropriate to the childs age according to expected developmental norms. Members of this target population shall meet one or more of the following criteria:
(A)As a result of the mental disorder, the child has substantial impairment in at least two of the following areas: self-care, school functioning, family relationships, or ability to function in the community; and either of the following occur:
(i)The child is at risk of removal from home or has already been removed from the home.
(ii)The mental disorder and impairments have been present for more than six months or are likely to continue for more than one year without treatment.
(B)The child displays one of the following: psychotic features, risk of suicide or risk of violence due to a mental disorder.
(C)The child has been assessed pursuant to Article 2 (commencing with Section 56320) of Chapter 4 of Part 30 of Division 4 of Title 2 of the Education Code and determined to have an emotional disturbance, as defined in paragraph (4) of subdivision (c) of Section 300.8 of Title 34 of the Code of Federal Regulations.
(b)(1)Adults and older adults who have a serious mental disorder.
(2)For the purposes of this part, serious mental disorder means a mental disorder that is severe in degree and persistent in duration, which may cause behavioral functioning which interferes substantially with the primary activities of daily living, and which may result in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time. Serious mental disorders include, but are not limited to, schizophrenia, bipolar disorder, post-traumatic stress disorder, as well as major affective disorders or other severely disabling mental disorders. This section shall not be construed to exclude persons with a serious mental disorder and a diagnosis of substance abuse, developmental disability, or other physical or mental disorder.
(3)Members of this target population shall meet all of the following criteria:
(A)The person has a mental disorder as identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, other than a substance use disorder or developmental disorder or acquired traumatic brain injury pursuant to subdivision (a) of Section 4354 unless that person also has a serious mental disorder as defined in paragraph (2).
(B)(i)As a result of the mental disorder, the person has substantial functional impairments or symptoms, or a psychiatric history demonstrating that without treatment there is an imminent risk of decompensation to having substantial impairments or symptoms.
(ii)For the purposes of this part, functional impairment means being substantially impaired as the result of a mental disorder in independent living, social relationships, vocational skills, or physical condition.
(C)As a result of a mental functional impairment and circumstances, the person is likely to become so disabled as to require public assistance, services, or entitlements.
(4)For the purpose of organizing outreach and treatment options, to the extent resources are available, this target population includes, but is not limited to, persons who are any of the following:
(A)Homeless persons who are mentally ill.
(B)Persons evaluated by appropriately licensed persons as requiring care in acute treatment facilities including state hospitals, acute inpatient facilities, institutes for mental disease, and crisis residential programs.
(C)Persons arrested or convicted of crimes.
(D)Persons who require acute treatment as a result of a first episode of mental illness with psychotic features.
(5)California veterans in need of mental health services and who meet the existing eligibility requirements of this section, shall be provided services to the extent services are available to other adults pursuant to this section. Veterans who may be eligible for mental health services through the United States Department of Veterans Affairs should be advised of these services by the county and assisted in linking to those services, but the eligible veteran shall not be denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the United States Department of Veterans Affairs.
(A)An eligible veteran shall not be denied county mental health services based solely on his or her status as a veteran, including whether or not the person is eligible for services provided by the United States Department of Veterans Affairs.
(B)Counties shall refer a veteran to the county veterans service officer, if any, to determine the veterans eligibility for, and the availability of, mental health services provided by the United States Department of Veterans Affairs or other federal health care provider.
(C)Counties should consider contracting with community-based veterans services agencies, where possible, to provide high-quality, veteran specific mental health services.
(c)Adults or older adults who require or are at risk of requiring acute psychiatric inpatient care, residential treatment, or outpatient crisis intervention because of a mental disorder with symptoms of psychosis, suicidality, or violence.
(d)Persons who need brief treatment as a result of a natural disaster or severe local emergency.
(a)It is the intent of the Legislature to do both of the following:
(1)Enact legislation to make statutory changes to address the mental and behavioral health needs of veterans in California and to explore the opportunities for meeting those needs by improving access to mental health services for veterans in California.
(2)Improve access for veterans by connecting them to mental and behavioral health care services closer to home regardless of insurance coverage or eligibility for Medi-Cal or any other federal health care services, including, but not limited to, federal Veterans Administration eligibility.
(b)The Legislature finds and declares all of the following:
(1)Veterans in the counties are eligible for county mental and behavioral health services in the same manner as any other adult in the county, whether or not they are eligible for mental and behavioral health services from the federal Department of Veterans Affairs.
(2)The process of determining eligibility for services through the federal Department of Veterans Affairs can sometimes be a time-consuming process. Veterans should not have to wait to receive needed mental and behavioral health care while they await federal eligibility determination if another similarly situated adult could receive those services in his or her county.
(3)Mental and behavioral health services may not be available in a timely manner or in an accessible location when a veteran is eligible for benefits from the federal Department of Veterans Affairs. Veterans who need services in a county and cannot receive them in an adequate, timely, or accessible manner from another source should be treated like any other adult in the county and provided with those services through county mental health.
(4)Veterans who are eligible for and in need of county mental and behavioral health services should be treated in the same manner as any other adult in need of those services and should be provided those services through county mental health programs, irrespective of funding source.
SEC. 2.Section 5600.3 of the Welfare and Institutions Code is amended to read:5600.3.To the extent resources are available, the primary goal of the use of funds deposited in the mental health account of the local health and welfare trust fund should be to serve the target populations identified in the following categories, which shall not be construed as establishing an order of priority:
(a)(1)Seriously emotionally disturbed children or adolescents.
(2)For the purposes of this part, seriously emotionally disturbed children or adolescents means minors under the age of 18 years who have a mental disorder as identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, other than a primary substance use disorder or developmental disorder, which results in behavior inappropriate to the childs age according to expected developmental norms. Members of this target population shall meet one or more of the following criteria:
(A)As a result of the mental disorder, the child has substantial impairment in at least two of the following areas: self-care, school functioning, family relationships, or ability to function in the community; and either of the following occur:
(i)The child is at risk of removal from home or has already been removed from the home.
(ii)The mental disorder and impairments have been present for more than six months or are likely to continue for more than one year without treatment.
(B)The child displays one of the following: psychotic features, risk of suicide or risk of violence due to a mental disorder.
(C)The child has been assessed pursuant to Article 2 (commencing with Section 56320) of Chapter 4 of Part 30 of Division 4 of Title 2 of the Education Code and determined to have an emotional disturbance, as defined in paragraph (4) of subdivision (c) of Section 300.8 of Title 34 of the Code of Federal Regulations.
(b)(1)Adults and older adults who have a serious mental disorder.
(2)For the purposes of this part, serious mental disorder means a mental disorder that is severe in degree and persistent in duration, which may cause behavioral functioning which interferes substantially with the primary activities of daily living, and which may result in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time. Serious mental disorders include, but are not limited to, schizophrenia, bipolar disorder, post-traumatic stress disorder, as well as major affective disorders or other severely disabling mental disorders. This section shall not be construed to exclude persons with a serious mental disorder and a diagnosis of substance abuse, developmental disability, or other physical or mental disorder.
(3)Members of this target population shall meet all of the following criteria:
(A)The person has a mental disorder as identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, other than a substance use disorder or developmental disorder or acquired traumatic brain injury pursuant to subdivision (a) of Section 4354 unless that person also has a serious mental disorder as defined in paragraph (2).
(B)(i)As a result of the mental disorder, the person has substantial functional impairments or symptoms, or a psychiatric history demonstrating that without treatment there is an imminent risk of decompensation to having substantial impairments or symptoms.
(ii)For the purposes of this part, functional impairment means being substantially impaired as the result of a mental disorder in independent living, social relationships, vocational skills, or physical condition.
(C)As a result of a mental functional impairment and circumstances, the person is likely to become so disabled as to require public assistance, services, or entitlements.
(4)For the purpose of organizing outreach and treatment options, to the extent resources are available, this target population includes, but is not limited to, persons who are any of the following:
(A)Homeless persons who are mentally ill.
(B)Persons evaluated by appropriately licensed persons as requiring care in acute treatment facilities including state hospitals, acute inpatient facilities, institutes for mental disease, and crisis residential programs.
(C)Persons arrested or convicted of crimes.
(D)Persons who require acute treatment as a result of a first episode of mental illness with psychotic features.
(5)California veterans in need of mental health services and who meet the existing eligibility requirements of this section, shall be provided services to the extent services are available to other adults pursuant to this section. Veterans who may be eligible for mental health services through the United States Department of Veterans Affairs should be advised of these services by the county and assisted in linking to those services. services, but the eligible veteran shall not be denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the United States Department of Veterans Affairs.
(A)No An eligible veteran shall not be denied county mental health services based solely on his or her status as a veteran. veteran, including whether or not the person is eligible for services provided by the United States Department of Veterans Affairs.
(B)Counties shall refer a veteran to the county veterans service officer, if any, to determine the veterans eligibility for, and the availability of, mental health services provided by the United States Department of Veterans Affairs or other federal health care provider.
(C)Counties should consider contracting with community-based veterans services agencies, where possible, to provide high-quality, veteran specific mental health services.
(c)Adults or older adults who require or are at risk of requiring acute psychiatric inpatient care, residential treatment, or outpatient crisis intervention because of a mental disorder with symptoms of psychosis, suicidality, or violence.
(d)Persons who need brief treatment as a result of a natural disaster or severe local emergency.
REVISIONS: HeadingLine 2.|
Date
|
Status
|
|---|---|
| Jul 18, 2018 | Chaptered by Secretary of State - Chapter 128, Statutes of 2018. |
| Jul 18, 2018 | Approved by the Governor. |
| Jul 10, 2018 | Enrolled and presented to the Governor at 3 p.m. |
| Jul 3, 2018 | In Assembly. Ordered to Engrossing and Enrolling. |
| Jul 2, 2018 | Read third time. Passed. Ordered to the Assembly. |
| Jun 27, 2018 | Read second time. Ordered to Consent Calendar. |
| Jun 26, 2018 | From committee: Do pass. To Consent Calendar. (Ayes 6. Noes 0.) (June 26). |
| Jun 6, 2018 | From committee: Do pass and re-refer to Com. on V.A. with recommendation: To Consent Calendar. (Ayes 8. Noes 0.) (June 6). Re-referred to Com. on V.A. |
| May 17, 2018 | Referred to Coms. on HEALTH and V.A. |
| May 3, 2018 | In Senate. Read first time. To Com. on RLS. for assignment. |
| Apr 26, 2018 | Read second time. Ordered to Consent Calendar. |
| May 3, 2018 | Read third time. Passed. Ordered to the Senate. |
| Apr 25, 2018 | Coauthors revised. |
| Mar 1, 2018 | Referred to Com. on HEALTH. |
| Feb 14, 2018 | From printer. May be heard in committee March 16. |
| Feb 13, 2018 | Read first time. To print. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Jul 2, 2018 | Consent Calendar AB2325 | Senate Floor |
Passed |
|
| Jun 26, 2018 | Do pass and be ordered to the Consent Calendar | Senate Standing Committee on Veterans Affairs |
Passed |
|
| Jun 6, 2018 | Do pass, but first be re-referred to the Committee on [Veterans Affairs] with the recommendation: To Consent Calendar | Senate Standing Committee on Health |
Passed |
|
| May 3, 2018 | AB 2325 IRWIN Consent Calendar Second Day Regular Session | Assembly Floor |
Passed |
|
| Apr 24, 2018 | Do pass. 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
|
|---|---|---|
| American Legion Department of California | ** Support | Jun 27, 2018 |
| American Red Cross | ** Support | Jun 27, 2018 |
| AMVETS Department of California | ** Support | Jun 27, 2018 |
| California Access Coalition | ** Support | Jun 27, 2018 |
| California Association of Veteran Service Agencies | ** Support | Jun 27, 2018 |
| California Medical Association | ** Support | Jun 27, 2018 |
| California State Commanders Veterans Council | ** Support | Jun 27, 2018 |
| Mental Health Services Oversight and Accountability Commission | ** Support | Jun 27, 2018 |
| Military Officers Association of America-California Council of Chapters | ** Support | Jun 27, 2018 |
| National Alliance On Mental Illness-California | ** Support | Jun 27, 2018 |
| Steinberg Institute | ** Support | Jun 27, 2018 |
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB |
CONSENT
Bill No: AB 2325
:
SENATE HEALTH COMMITTEE: 8-0, 6/6/18
AYES: Hernandez, Nguyen, Leyva, Mitchell, Monning, Nielsen, Pan, Roth
NO VOTE RECORDED: Newman
SENATE VETERANS AFFAIRS COMMITTEE: 6-0, 6/26/18
AYES: Roth, Nielsen, Dodd, Hueso, Nguyen, Wilk
ASSEMBLY FLOOR: 71-0, 5/3/18 (Consent) - See last page for vote
SOURCE: California Association of Veteran Service Agencies
DIGEST:
This bill prohibits eligible California veterans from being denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, services provided by the U.S. Department of Veterans Affairs (VA). Clarifies that existing law prohibiting veterans from being denied county mental health services includes whether or not the person is eligible for services provided by the VA.
Existing law:
- Establishes the Bronzan-McCorquodale Act to organize and finance community mental health services for persons with mental health disorders in every county through locally administered and controlled community mental health programs. [WIC §5600]
- Specifies, to the extent resources are available, the primary goal of the use of funds in the mental health account of the local health and welfare trust fund is to serve target populations, which include California veterans. [WIC §5600.3]
- 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, to provide funds to counties to expand services, develop innovative programs, and integrate service plans for mentally ill children, adults, and seniors through a 1% income tax on personal income above $1 million. [WIC §5845]
- Requires services to be provided to California veterans in need of mental health services who meet eligibility requirements to the extent services are available to other adults. Encourages veterans who may be eligible for mental health services through the VA to be advised of those services by the county and to be assisted in linking to those services. [WIC §5600.3]
- Prohibits eligible veterans from being denied county mental health services based solely on his or her status as a veteran. [WIC §5600.3]
- Requires counties to refer veterans to the county veterans service officer, if any, to determine eligibility for, and availability of, mental health services provided by the VA or other federal health care provider. Encourages counties to consider contracting with community-based veterans’ services agencies, where possible, to provide high-quality, veteran-specific mental health services. [WIC §5600.3]
- Requires each county mental health program (counties) to prepare and submit a three-year program and expenditure plan, and annual updates, as specified, to the MHSOAC and the Department of Health Care Services within 30 days after adoption by the county board of supervisors. [WIC §5847]
This bill:
- Prohibits eligible California veterans from being denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the VA.
- Clarifies that existing law prohibiting veterans from being denied county mental health services based solely on their status as a veteran includes whether or not the person is eligible for services provided by the VA.
- States legislative intent to address the mental and behavioral health needs of California veterans by improving access to services closer to the veteran’s home regardless of insurance coverage or eligibility for Medi-Cal or any other federal health care service.
- Makes findings and declarations about veterans being eligible for county mental and behavioral health services and being treated in the same manner as any other adult in the county, as well as the time-consuming process of determining eligibility for services through the VA.
Comments
- Author’s statement. According to the author, providing for the mental health of service members returning from deployment and easing their transition into society is of great importance to California. The VA is constantly in the news for backlogged claims, missing paperwork, and months-long wait times for appointments. If a veteran takes the step to ask for help at a county mental health agency in California, we should make sure they are not denied just because of bureaucratic red tape at the federal level.
- Barriers to service and efforts to support veterans. According to the MHSOAC, there are anecdotes of veterans trying to access care through county programs who are told they first need to establish whether they are eligible for care through the VA. There have also been reports that veterans are being advised of VA services, but the services are not being provided. The MHSA requires three-year program and expenditure plans and updates to be developed with local stakeholders, including veterans and representatives from veterans’ organizations. It also requires counties to demonstrate a partnership with constituents and stakeholders throughout the planning process, including meaningful stakeholder involvement on mental health policy, program planning and implementation, monitoring, quality improvement, evaluation, and budget allocations. In order to ensure that these voices and concerns are recognized in the planning process, the MHSOAC awarded a three-year $2 million contract to the California Association of Veteran Service Agencies to provide outreach, training and education, and mental health advocacy on behalf of veterans.
According to its Web site, the California Department of Veterans Affairs (CalVet) provides assistance and services to veterans in six primary areas: education, employment, health, housing, assistance/advocacy, and assistance with VA coordination. There are county CalVet offices throughout the state that assist veterans through the process of applying for benefits from the VA. The VA’s Web site states that it offers treatment and support for mental health issues such as posttraumatic stress disorder, depression, suicide prevention, substance use disorders, and schizophrenia, as well as anxiety-related conditions, like panic disorder and social anxiety. The VA offers services such as short-term inpatient care, outpatient care, rehabilitation treatment and residential programs, and supported work settings. The VA states in order to be eligible most veterans must have served 24 continuous months or the full period for which they were called to active duty. The minimum duty requirements may not apply to veterans who were discharged for a disability incurred or aggravated in the line of duty, for a hardship or early out, or those who served prior to September 7, 1980. Since there are other exceptions, the VA encourages all veterans to apply for services so that it may determine enrollment eligibility. In March 2018, the VA announced it is increasing veterans’ access to mental health services by giving all new veterans access to mental health care for at least one year after their completed military service, regardless of disability status, to help veterans transition to civilian life. Currently, the VA requires patients to be enrolled in the VA health care system in order to receive full counseling options.
- Veterans and mental health. According to the federal Substance Abuse and Mental Health Services Administration’s (SAMHSA) Web site, there are an estimated 23.4 million veterans in the United States, and about 2.2 million military service members and 3.1 million immediate family members. A 2017 Legislative Analyst’s Office report estimated about 1.8 million veterans live in California, more than in any other state. CalVet estimates that California anticipates receiving an additional 30,000 discharged members of the armed services each year for the next several years, more than any other state. The demanding environments of military life and experiences of combat, during which many veterans experience psychological distress, can be further complicated by substance use and related disorders. Many service members face such critical issues as trauma, suicide, homelessness, and/or involvement with the criminal justice system. According to SAMHSA, approximately 50% of returning service members who need treatment for mental health conditions seek it but only slightly more than half who receive treatment receive adequate care. SAMHSA states that although active duty troops and their families are eligible for care from the U.S. Department of Defense, a significant number choose not to access those services due to fear of discrimination or the harm receiving treatment for behavioral health issues may have on their military career or that of their spouse. An April 2016 study by the University of California, Los Angeles, Center for Health Policy Research found that, between 2011 and 2013, 90,000 California veterans (3.5%) who served in the military for at least a year needed mental health care, and only about 40% of veterans are enrolled in VA programs. The study also found that nearly 46% of all veterans with mental health needs did not receive adequate care, which the study defined as four or more visits with a health professional and use of prescription medication for mental health within the previous year.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
California Association of Veteran Service Agencies (source)
American Legion Department of California
American Red Cross
AMVETS Department of California
California Access Coalition
California Medical Association
California State Commanders Veterans Council
Mental Health Services Oversight and Accountability Commission
Military Officers Association of America-California Council of Chapters
National Alliance on Mental Illness-California
Steinberg Institute
OPPOSITION: (Verified 6/27/18)
None received
ARGUMENTS IN SUPPORT: Supporters of this bill, largely mental health and veterans’ advocates, argue that the prevalence of mental and behavioral health conditions among veterans is demonstrated by the comparatively high veteran suicide rate, and that national data shows veterans make up about 7% of the U.S. population but about 18% of suicides nationwide. Supporters state that in 2014 the VA estimated that veterans were 21% more likely to die by suicide than their civilian adult peer groups. Supporters further argue that barriers to care after civilian reentry further disadvantage the veteran population, as mental health resources are not always readily available at VA facilities.
ASSEMBLY FLOOR: 71-0, 5/3/18
AYES: Acosta, Aguiar-Curry, Arambula, Baker, Berman, Bigelow, Bloom, Bonta, Brough, Burke, Calderon, Carrillo, Cervantes, Chau, Chávez, Chen, Chiu, Chu, Cooley, Cooper, Cunningham, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gallagher, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Patterson, Quirk, Reyes, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Waldron, Weber, Wood, Rendon
NO VOTE RECORDED: Travis Allen, Caballero, Choi, Cristina Garcia, Grayson, Quirk-Silva, Voepel
6/27/18 15:01:33
**** END ****
SENATE COMMITTEE ON
Senator Richard Roth, Chair
2017 - 2018 Regular
Bill No: Hearing Date: 6/26/18
Author: | Irwin | ||
Version: | Introduced | ||
Urgency: | Fiscal: | ||
Consultant: | |||
Subject:
DESCRIPTION
Summary:
This bill prohibits eligible California veterans from being denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, services provided by the U.S. Department of Veterans Affairs (USDVA).
Existing law:
- Establishes the Bronzan-McCorquodale Act to organize and finance community mental health services for persons with mental health disorders in every county through locally administered and controlled community mental health programs.
- Specifies, to the extent resources are available, the primary goal of the use of funds in the mental health account of the local health and welfare trust fund is to serve target populations, which include California veterans.
- 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, to provide funds to counties to expand services, develop innovative programs, and integrate service plans for mentally ill children, adults, and seniors through a 1% income tax on personal income above $1 million.
- Requires services to be provided to California veterans in need of mental health services who meet eligibility requirements to the extent services are available to other adults. Encourages veterans who may be eligible for mental health services through the USDVA to be advised of those services by the county and be assisted in linking to those services.
- Prohibits eligible veterans from being denied county mental health services based solely on his or her status as a veteran.
- Requires counties to refer veterans to the county veterans service officer, if any, to determine eligibility for, and availability of, mental health services provided by the VA or other federal health care provider. Encourages counties to consider contracting with community-based veterans’ services agencies, where possible, to provide high-quality, veteran-specific mental health services.
- Requires each county mental health program (counties) to prepare and submit a three-year program and expenditure plan, and annual updates, as specified, to the MHSOAC and the Department of Health Care Services within 30 days after adoption by the county board of supervisors.
This bill:
- Prohibits eligible California veterans from being denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the USDVA.
- Clarifies that existing law prohibiting veterans from being denied county mental health services based solely on their status as a veteran includes whether or not the person is eligible for services provided by the USDVA.
- States the Legislature’s intent to address the mental and behavioral health needs of veterans by improving access to services closer to the veteran’s home regardless of insurance coverage or eligibility for Medi-Cal or other federal health care service.
- Makes findings and declarations about veterans being eligible for county mental and behavioral health services and being treated in the same manner as any other adult in the county, as well as the time-consuming process of determining eligibility for services through the USDVA.
BACKGROUND
Barriers to service and efforts to support veterans. According to the MHSOAC, there are anecdotes of veterans trying to access care through county programs who are told they first need to establish whether they are eligible for care through the USDVA. There have also been reports that veterans are being advised of USDVA services, but the services are not being provided.
The MHSA requires three-year program and expenditure plans and updates to be developed with local stakeholders, including veterans and representatives from veterans’ organizations. It also requires counties to demonstrate a partnership with constituents and stakeholders throughout the planning process, including meaningful stakeholder involvement on mental health policy, program planning and implementation, monitoring, quality improvement, evaluation, and budget allocations. In order to ensure that these voices and concerns are recognized in the planning process, the MHSOAC awarded a three-year $2 million contract to the California Association of Veteran Service Agencies to provide outreach, training and education, and mental health advocacy on behalf of veterans.
According to its Website, the California Department of Veterans Affairs (CalVet) provides assistance and services to veterans in six primary areas: education, employment, health, housing, assistance/advocacy, and assistance with VA coordination. There are county CalVet offices throughout the state that assist veterans through the process of applying for benefits from the USDVA. The USDVA’s Website states that it offers treatment and support for mental health issues such as post-traumatic stress disorder, depression, suicide prevention, substance use disorders, and schizophrenia, as well as anxiety-related conditions, like panic disorder and social anxiety. The USDVA offers services such as short-term inpatient care, outpatient care, rehabilitation treatment and residential programs, and supported work settings.
The USDVA states in order to be eligible most veterans must have served on qualifying Title 10 active duty for 24 continuous months or the full period for which they were called to active duty. The minimum duty requirements may not apply to veterans who were discharged for a disability incurred or aggravated in the line of duty, for a hardship or early out, or those who served prior to September 7, 1980.
Since there are other exceptions, the USDVA encourages all veterans to apply for services so that it may determine enrollment eligibility. In March 2018, the USDVA announced it is increasing veterans’ access to mental health services by giving all new veterans access to mental health care for at least one year after their completed military service, regardless of disability status, to help veterans transition to civilian life. Currently, the USDVA requires patients to be enrolled in the USDVA health care system in order to receive full counseling options.
Veterans and mental health. According to the federal SAMHSA Website, there are an estimated 23.4 million veterans in the United States, and about 2.2 million military service members and 3.1 million immediate family members. A 2017 Legislative Analyst’s Office report estimated about 1.8 million veterans live in California, more than in any other state. CalVet estimates that California anticipates receiving an additional 30,000 discharged members of the armed services each year for the next several years, more than any other state.
The demanding environments of military life and experiences of combat, during which many veterans experience psychological distress, can be further complicated by substance use and related disorders. Many service members face such critical issues as trauma, suicide, homelessness, and/or involvement with the criminal justice system. According to SAMHSA, approximately half of all returning service members who need treatment for mental health conditions seek it, but only slightly more than half who receive treatment actually receive adequate care. SAMHSA states that although active duty troops and their families are eligible for care from the U.S. Department of Defense, a significant number choose not to access those services due to fear of discrimination or the harm receiving treatment for behavioral health issues may have on their military career or that of their spouse.
Much of what is known about the mental health of veterans is based on USDVA data, which exclude veterans not connected with the USDVA health system and/or those not eligible for USDVA care. As a result, information on the mental health needs of the majority of veterans who obtain health care outside of USDVA is limited, and other sources are needed to understand the mental health burden of all veterans living in California.
An April 2016 study by the University of California, Los Angeles, Center for Health Policy Research found that, between 2011 and 2013, 90,000 California veterans (3.5%) who served in the military for at least a year needed mental health care, and only about 40% of veterans are enrolled in USDVA programs. The study also found that nearly 46% of all veterans with mental health needs did not receive adequate care, which the study defined as four or more visits with a health professional and use of prescription medication for mental health within the previous year.
Currently, the Congress is considering H.R. 918, the Veteran Urgent Access to Mental Healthcare Act, which is co-sponsored by U.S. Representatives Eric Swalwell (D-CA-15) and Ed Royce (R-CA-39). This federal legislation would require the USDVA to provide initial mental health assessments and services deemed necessary, including for those at risk of suicide and or of harming others, regardless of whether the individual has an "other than honorable" discharge. Currently, individuals who have such discharges, known as "bad paper," are not eligible for veteran benefits beyond some emergency mental health services. Veterans who received a dishonorable or bad-conduct discharge would still be ineligible to access the USDVA services.
COMMENT
Prior/Related Legislation:
SB 1314 (Nguyen, 2018) requires CalVet to conduct a survey to assess the ability of veterans homes to assist veterans with complex mental and behavioral health needs, and develop a plan to accommodate that population and provide recommendations to the Legislature to achieve plan objectives, as specified. (Currently pending, Assembly.)
SB 409 (Nguyen, 2017) was substantially similar to SB 1314. (Held, suspense, Assembly Appropriations Committee.)
AB 1314 (Irwin, 2018) would have required a county to provide mental health services to any veteran who requests treatment, without regard to veteran status or eligibility for health services provided by USDVA or any other federal health care provider; and would have specified that a veteran seeking treatment by a county is not required to first seek health services provided by USDVA or any other federal health care provider before receiving treatment from the county. (Held without hearing, Assembly Health Committee.)
AB 974 (Quirk-Silva, Chapter 411, Statutes of 2017) requires counties to report spending on mental health services for veterans from MHSA funds.
SB 112 (Roth, 2015) would have established a California Veterans’ Bill of Rights that proclaimed the rights of veterans in the state, including, among others, that veterans have the right to be treated with dignity, understanding, and respect, and have the right to housing, education, job training, and physical and mental health services. (Held without hearing, Assembly Veterans Affairs Committee.)
AB 253 (Roger Hernández, 2015) would have required the Governor to appoint two additional members to the MHSOAC with mental health experience, including a veteran with knowledge about veterans’ mental health issues. Required specified government entities responsible for administering the Veterans Housing and Homeless Prevention Act of 2014 to give preference to applicants for funding for supportive housing projects, as specified. (Held without hearing, Senate Transportation and Housing Committee.)
POSITIONS
Sponsor: California Association of Veteran Service Agencies
Support:
American Legion Department of California
American Red Cross
AMVETS Department of California
California Access Coalition
California Medical Association
California State Commanders Veterans Council
Mental Health Services Oversight and Accountability Commission
Military Officers Association of America-California Council of Chapters
National Alliance on Mental Illness-California
Steinberg Institute
Oppose: None received.
-- END --
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2325
AUTHOR: | Irwin | ||
VERSION: | February 13, 2018 | ||
HEARING DATE: | June 6, 2018 | ||
CONSULTANT: | Reyes Diaz | ||
SUBJECT: County mental health services: veterans
SUMMARY:
Prohibits eligible California veterans from being denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, services provided by the U.S. Department of Veterans Affairs (VA). Clarifies that existing law prohibiting veterans from being denied county mental health services includes whether or not the person is eligible for services provided by the VA.
Existing law:
- Establishes the Bronzan-McCorquodale Act to organize and finance community mental health services for persons with mental health disorders in every county through locally administered and controlled community mental health programs. [WIC §5600]
- Specifies, to the extent resources are available, the primary goal of the use of funds in the mental health account of the local health and welfare trust fund is to serve target populations, which include California veterans. [WIC §5600.3]
- 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, to provide funds to counties to expand services, develop innovative programs, and integrate service plans for mentally ill children, adults, and seniors through a 1% income tax on personal income above $1 million. [WIC §5845]
- Requires services to be provided to California veterans in need of mental health services who meet eligibility requirements to the extent services are available to other adults. Encourages veterans who may be eligible for mental health services through the VA to be advised of those services by the county and to be assisted in linking to those services. [WIC §5600.3]
- Prohibits eligible veterans from being denied county mental health services based solely on his or her status as a veteran. [WIC §5600.3]
- Requires counties to refer veterans to the county veterans service officer, if any, to determine eligibility for, and availability of, mental health services provided by the VA or other federal health care provider. Encourages counties to consider contracting with community-based veterans’ services agencies, where possible, to provide high-quality, veteran-specific mental health services. [WIC §5600.3]
- Requires each county mental health program (counties) to prepare and submit a three-year program and expenditure plan, and annual updates, as specified, to the MHSOAC and the Department of Health Care Services within 30 days after adoption by the county board of supervisors. [WIC §5847]
This bill:
- Prohibits eligible California veterans from being denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the VA.
- Clarifies that existing law prohibiting veterans from being denied county mental health services based solely on their status as a veteran includes whether or not the person is eligible for services provided by the VA.
- States legislative intent to address the mental and behavioral health needs of California veterans by improving access to services closer to the veteran’s home regardless of insurance coverage or eligibility for Medi-Cal or any other federal health care service.
- Makes findings and declarations about veterans being eligible for county mental and behavioral health services and being treated in the same manner as any other adult in the county, as well as the time-consuming process of determining eligibility for services through the VA.
FISCAL EFFECT:
This bill has been keyed nonfiscal.
PRIOR VOTES:
Assembly Floor: | 71 - 0 |
Assembly Health Committee: | 15 - 0 |
COMMENTS:
- Author’s statement. According to the author, providing for the mental health of service members returning from deployment and easing their transition into society is of great importance to California. The VA is constantly in the news for backlogged claims, missing paperwork, and months-long wait times for appointments. If a veteran takes the step to ask for help at a county mental health agency in California, we should make sure they are not denied just because of bureaucratic red tape at the federal level.
- Barriers to service and efforts to support veterans. According to the MHSOAC, there are anecdotes of veterans trying to access care through county programs who are told they first need to establish whether they are eligible for care through the VA. There have also been reports that veterans are being advised of VA services, but the services are not being provided. The MHSA requires three-year program and expenditure plans and updates to be developed with local stakeholders, including veterans and representatives from veterans’ organizations. It also requires counties to demonstrate a partnership with constituents and stakeholders throughout the planning process, including meaningful stakeholder involvement on mental health policy, program planning and implementation, monitoring, quality improvement, evaluation, and budget allocations. In order to ensure that these voices and concerns are recognized in the planning process, the MHSOAC awarded a three-year $2 million contract to the California Association of Veteran Service Agencies to provide outreach, training and education, and mental health advocacy on behalf of veterans.
According to its Web site, the California Department of Veterans Affairs (CalVet) provides assistance and services to veterans in six primary areas: education, employment, health, housing, assistance/advocacy, and assistance with VA coordination. There are county CalVet offices throughout the state that assist veterans through the process of applying for benefits from the VA. The VA’s Web site states that it offers treatment and support for mental health issues such as posttraumatic stress disorder, depression, suicide prevention, substance use disorders, and schizophrenia, as well as anxiety-related conditions, like panic disorder and social anxiety. The VA offers services such as short-term inpatient care, outpatient care, rehabilitation treatment and residential programs, and supported work settings. The VA states in order to be eligible most veterans must have served 24 continuous months or the full period for which they were called to active duty. The minimum duty requirements may not apply to veterans who were discharged for a disability incurred or aggravated in the line of duty, for a hardship or early out, or those who served prior to September 7, 1980. Since there are other exceptions, the VA encourages all veterans to apply for services so that it may determine enrollment eligibility. In March 2018, the VA announced it is increasing veterans’ access to mental health services by giving all new veterans access to mental health care for at least one year after their completed military service, regardless of disability status, to help veterans transition to civilian life. Currently, the VA requires patients to be enrolled in the VA health care system in order to receive full counseling options.
- Veterans and mental health. According to the federal Substance Abuse and Mental Health Services Administration’s (SAMHSA) Web site, there are an estimated 23.4 million veterans in the United States, and about 2.2 million military service members and 3.1 million immediate family members. A 2017 Legislative Analyst’s Office report estimated about 1.8 million veterans live in California, more than in any other state. CalVet estimates that California anticipates receiving an additional 30,000 discharged members of the armed services each year for the next several years, more than any other state. The demanding environments of military life and experiences of combat, during which many veterans experience psychological distress, can be further complicated by substance use and related disorders. Many service members face such critical issues as trauma, suicide, homelessness, and/or involvement with the criminal justice system. According to SAMHSA, approximately 50% of returning service members who need treatment for mental health conditions seek it but only slightly more than half who receive treatment receive adequate care. SAMHSA states that although active duty troops and their families are eligible for care from the U.S. Department of Defense, a significant number choose not to access those services due to fear of discrimination or the harm receiving treatment for behavioral health issues may have on their military career or that of their spouse. An April 2016 study by the University of California, Los Angeles, Center for Health Policy Research found that, between 2011 and 2013, 90,000 California veterans (3.5%) who served in the military for at least a year needed mental health care, and only about 40% of veterans are enrolled in VA programs. The study also found that nearly 46% of all veterans with mental health needs did not receive adequate care, which the study defined as four or more visits with a health professional and use of prescription medication for mental health within the previous year.
- Double referral. This bill is double-referred. Should it pass out of this Committee, it will be referred to the Senate Veterans Affairs Committee.
- Related legislation. SB 1314 (Nguyen) requires CalVet to conduct a survey to assess the ability of veterans homes to assist veterans with complex mental and behavioral health needs, and develop a plan to accommodate that population and provide recommendations to the Legislature to achieve the plan’s objectives, as specified. SB 1314 is pending in the Assembly.
- Prior legislation. SB 409 (Nguyen of 2017) was substantially similar to SB 1314. SB 409 was held on the Assembly Appropriations Committee suspense file.
AB 974 (Quirk-Silva, Chapter 411, Statutes of 2017) requires counties to report spending on mental health services for veterans from MHSA funds.
SB 112 (Roth of 2015) would have established a California Veterans’ Bill of Rights that proclaimed the rights of veterans in the state, including, among others, that veterans have the right to be treated with dignity, understanding, and respect, and have the right to housing, education, job training, and physical and mental health services. SB 112 was not heard in the Assembly Veterans Affairs Committee.
AB 253 (Roger Hernández of 2015) would have required the Governor to appoint two additional members to the MHSOAC with mental health experience, including a veteran with knowledge about veterans’ mental health issues. Required specified government entities responsible for administering the Veterans Housing and Homeless Prevention Act of 2014 to give preference to applicants for funding for supportive housing projects, as specified. AB 253 was not heard in the Senate Transportation and Housing Committee.
- Support. Supporters of this bill, largely mental health and veterans’ advocates, argue that the prevalence of mental and behavioral health conditions among veterans is demonstrated by the comparatively high veteran suicide rate, and that national data shows veterans make up about 7% of the U.S. population but about 18% of suicides nationwide. Supporters state that in 2014 the VA estimated that veterans were 21% more likely to die by suicide than their civilian adult peer groups. Supporters further argue that barriers to care after civilian reentry further disadvantage the veteran population, as mental health resources are not always readily available at VA facilities.
SUPPORT AND OPPOSITION:
Support: California Association of Veteran Service Agencies (sponsor)
American Legion Department of California
American Red Cross
AMVETS Department of California
California Access Coalition
California State Commanders Veterans Council
Mental Health Services Oversight and Accountability Commission
Military Officers Association of America-California Council of Chapters
National Alliance on Mental Illness-California
Steinberg Institute
Oppose: None received
-- END --
Date of Hearing: April 24, 2018
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
ABPCA Bill Id:AB 2325
Author:(Irwin) – As Introduced Ver:February 13, 2018
SUBJECT: County mental health services: veterans.
SUMMARY: Clarifies existing law that requires county mental or behavioral health services be provided to veterans who are eligible for services through county mental health programs while a determination of eligibility for, and availability of, mental or behavioral health services by the U.S. Department of Veterans Affairs (VA) is pending. Expands the existing prohibition against denying county mental or behavioral health services to an eligible veteran based solely on his or her status as a veteran, to also include whether or not the person is eligible for services provided by the VA.
EXISTING LAW:
- Establishes the Bronzan-McCorquodale Act (Realignment) intended to organize and finance community mental health services for persons with mental health disorders in every county through locally administered and locally controlled community mental health programs.
- Prioritizes the use of funds under Realignment to serve target populations as specified: California veterans in need of mental health services and who meet the existing eligibility requirements, be provided services to the extent services are available to other adults.
- Encourages county mental health services to advise veterans of services available through the VA and to assist in linking them to those services.
- Prohibits denial of county mental or behavioral health services to an eligible veteran based solely on his or her status as a veteran.
- Establishes the Mental Health Services Act (MHSA), enacted by voters in 2004, as Proposition 53, to provide funds to counties to expand services, develop innovative programs, and integrate service plans for mentally ill children, adults, and seniors through a 1% income tax on personal income above $1 million.
- Establishes the Mental Health Services Oversight and Accountability Commission (Commission) to oversee the implementation of MHSA, made up of 16 individuals appointed by the Governor, as specified.
- Requires The Department of Health Care Services, in consultation with the Commission and the County Behavioral Health Directors Association of California (CBHDA), to develop and administer instructions for an MHSA Report to, among requirements, identity the amount of MSHA funds spend on mental health services for veterans.
FISCAL EFFECT: None
COMMENTS:
- PURPOSE OF THIS BILL. According to the author, providing for the mental health of service members returning from deployment and easing their transition into society is of great importance to California. The VA is constantly in the news for backlogged claims, missing paperwork, and months-long wait times for appointments. If a veteran takes the step to ask for help at a county mental health agency in California, every effort should be made to make sure they are not denied just because of bureaucratic red tape at the federal level.
- BACKGROUND. According to a January 2017, report published by the California Legislative Analyst’s Office entitled “Understanding the Veterans Services Landscape in California,” an estimated 1.8 million veterans reside in California— more than in any other state. Veterans returning to civilian life face a myriad of barriers to employment, including mental health challenges and access to affordable housing. Based on the most recent Point-In-Time Count conducted by the U.S. Department of Housing and Urban Development (HUD), as of January 2017, approximately 40,056 veterans across the country experienced homelessness each night. Based on HUD’s data, as of January 2017, 11,472 veterans in California experienced homelessness, which accounts for nearly 29% of the homeless veteran population across the country. Of those 11,472 homeless veterans, 7657 (66.7%) were unsheltered. The numbers of homeless veterans in California has varied over the past five years from a high of 12,895 in 2013 to a low of 9,612 in 2014.
- VA. The VA operates the nation's largest integrated health care system, with more than 1,700 hospitals, clinics, community living centers, domiciles, readjustment counseling centers, and other facilities. The VA provides specialty inpatient and outpatient mental health services at its medical centers and community-based outpatient clinics. Service members who deploy to combat areas are at heightened risk of mental health problems. Since 2001, the U.S. has deployed 2.8 million individuals to support military operations in Afghanistan and Iraq. While most veterans adjust successfully to post deployment life, the mental health and behavioral challenges confronted by many have been well documented. Out of the 2.8 million service members deployed, 13% to 20% experience post-traumatic stress disorder (PTSD), 10% to 15% experience depression, and 19% to 23% have a traumatic brain injury. As the extent of veterans’ mental health needs has become clearer, efforts to expand access to care and improve quality have become national priorities. The VA’s goal is to support recovery and enable veterans who experience mental health problems to live meaningful lives
At the VA, the needs to improve wait times and scheduling has been an ongoing issue and has been the source of much controversy and critique. In multiple reports since 2005 the VA Office of Inspector General and the Government Accountability Office (GAO) have both called for improved scheduling practices, decreased wait times, and improved wait-time data collection at the VA. The Institute of Medicine found that veterans face a variety of timely access to care issues when seeking mental health care for PTSD. Problems related to access to care were found at many facilities, including wait times of weeks or months when seeking PTSD care, long wait times for evidence-based treatments for PTSD, evidence-based PTSD treatment not being offered at the required frequency, inadequate after hours and weekend appointments for PTSD treatment, and gaps in service.
In addition, the applications process for eligibility determination within the VA can be lengthy and cumbersome. That process coupled with the potential for homelessness, loss of pertinent personal and financial data, and the presence of an underlying mental or behavioral condition can be an overwhelming challenge to veterans in need of help but unable to navigate complex, bureaucratic systems. Couple those challenges with delays in wait time and availability of services, the time between submission of application and entry into treatment with the VA could be lengthy.
Currently, veterans who may be eligible for mental health services through the VA are advised of these services by the county and assisted in linking to those services. During the time VA eligibility is being determined, California veterans in need of mental health services and who meet the eligibility requirements for services through county mental health programs are entitled to services to the extent services are available to other eligible adults.
- California Department of Veterans Affairs (Cal Vet). Cal Vet works to serve California veterans and their families. With nearly 1.8 million veterans living in the state, Cal Vet strives to ensure that its veterans and their families get the state and federal benefits and services they have earned. Cal Vet provides assistance and services to veterans in six primary areas: education, employment, health, housing, assistance/advocacy and assistance with VA coordination. There are county Cal Vet offices throughout the states and one of their primary roles is to assist veterans through the process of applying for benefits from VA. When county health services refer veterans to agencies for support in determining their eligibility for VA benefits, Cal Vet is the primary referral.
- Realignment. In 1990, California faced a multi-billion dollar state budget shortfall which severely threatened the still evolving Community Mental Health System established by the Short-Doyle Act. The Short-Doyle Act called for a shift in funding away from state hospitals to community programs. However, in the early 1970’s provisions to accomplish the shift in funding were vetoed so the savings achieved through the closures of state hospitals never materialized in the community mental health system. The budget shortfall in 1990, would have resulted in even more drastic cuts to mental health services. This crisis resulted in the enactment in 1991 with the passage of AB 1288 (Brozan), Chapter 89, Statutes of 1991, of the Realignment Act or the Bronzan-McCorquodale Act. The Realignment Act resulted in community mental health services being funded by new “realignment” revenues which flowed directly to counties – monies derived from a (at that time) one-half cent increase in state sales tax and the state vehicle license fee. Realignment also represented a major shift of authority from state to counties for mental health programs. Programs that were realigned from the state to counties included all community-based mental health services, state hospital service for civil commitments, and institutions for mental disease which provided long-term nursing facility care.
- SUPPORT. The California Association of Veteran Service Agencies (CAVSA), sponsor, of this bill, states that the prevalence of mental and behavioral health conditions among veterans is demonstrated by the comparatively high veteran suicide rate. Barriers to care after civilian reentry further disadvantage this already vulnerable population. Mental health resources are not always readily available at VA facilities, due to a shortage of critical mental health personnel. CAVSA goes on to state that this lack of access to critical mental health services may exacerbate suicidal behavior, especially among young military veterans who have completed multiple combat tours. The Steinberg Institute (TSI) states there are currently 107,000 veterans who are homeless on any given night in the U.S. In California, veterans comprise 25% or more of California’s homeless population, an estimated 35,000 men and women, who once proudly serviced our nation. TSI further states that the prevalence of mental health conditions among veterans is also demonstrated by the comparatively high veteran suicide rate. National data shows that veterans make up about 7% of the U.S. population but about 18% of suicides nationwide. According to TSI, the VA estimated that in 2014, veterans were 21% more likely to die from suicide than their civilian adult peer groups.
- RELATED LEGISLATION. SB 1314 (Nguyen) requires Cal Vet to conduct a survey to assess the ability of veterans homes to assist veterans with complex mental and behavioral health needs, and develop a plan to accommodate the populations with a plan by January 1, 2020 with implementation as appropriate beginning by July 1, 2020. SB 1314 will be heard in the Senate Committee on Veterans Affairs on April 24.
- PREVIOUS LEGISLATION.
- AB 1314 (Irwin) of 2017 would have required a county to provide mental health services to any veteran who requests treatment, without regard to his or her status as a veteran or eligibility for health services.
- AB 974 (Quirk-Silva), Chapter 411, Statutes of 2017, required counties to report spending on mental health services for veterans from the Mental Health Services Act funds.
- SB 409 (Nguyen) of 2017 would have required Cal Vet to conduct a survey to assess the ability of veterans’ homes to assist veterans with complex mental and behavioral health needs and to develop a plan and submit recommendations to the Legislation by January 1, 2019. SB 409 was held under submission in Assembly Appropriations Committee.
- SB 112 (Roth) of 2015 would have established a California Veterans’ Bill of Rights that proclaimed the rights of veterans in the state of California, including that veterans have the right to be treated with dignity, understanding and respect and have the right to housing, education, job training, and physical and mental health services.
REGISTERED SUPPORT / OPPOSITION:
Support
California Association of Veteran Service Agencies (sponsor)
American Legion-Department of California
AMVETS-Department of California
California State Commanders Veterans Council
Mental Health Services Oversight & Accountability Commission
Military Officers Association of America-California Council of Chapters
The Steinberg Institute
Opposition
None on file.
Analysis Prepared by: Judith Babcock / HEALTH / (916) 319-2097
Bill Author
