Existing law authorizes any licensed mental health service provider, as defined, including a marriage and family therapist, associate marriage and family therapist, licensed clinical social worker, and associate clinical social worker, who provides direct patient care in a publicly funded facility or a mental health professional shortage area, as defined, to apply for grants under the Licensed Mental Health Service Provider Education Program to reimburse his or her educational loans related to a career as a licensed mental health service provider, as specified. Existing law establishes the Mental Health Practitioner Education Fund and provides that moneys in that fund are available, upon appropriation by the Legislature, for purposes of the Licensed Mental Health Service Provider Education Program.

This bill would require an account to be created within the Mental Health Practitioner Education Fund and, upon appropriation by the Legislature, would require moneys in that account to be used solely to fund grants to repay educational loans for applicants who commit to practice in specified facilities for at least 24 months, who are marriage and family therapists, associate marriage and family therapists, licensed clinical social workers, associate clinical social workers, licensed professional clinical counselors, or associate professional clinical counselors, and who were formerly in Californias foster youth care system.

Existing law authorizes any licensed mental health service provider, as defined, including a marriage and family therapist, associate marriage and family therapist, licensed clinical social worker, and associate clinical social worker, who provides direct patient care in a publicly funded facility or a mental health professional shortage area, as defined, to apply for grants under the Licensed Mental Health Service Provider Education Program to reimburse his or her educational loans related to a career as a licensed mental health service provider, as specified. Existing law establishes the Mental Health Practitioner Education Fund and provides that moneys in that fund are available, upon appropriation by the Legislature, for purposes of the Licensed Mental Health Service Provider Education Program.

This bill would require an account to be created within the Mental Health Practitioner Education Fund and, upon appropriation by the Legislature, would require moneys in that account to be used solely to fund grants to repay educational loans for applicants who commit to practice in specified facilities for at least 24 months, who are marriage and family therapists, associate marriage and family therapists, licensed clinical social workers, associate clinical social workers, licensed professional clinical counselors, or associate professional clinical counselors, and who were formerly in Californias foster youth care system.

Existing law authorizes any licensed mental health service provider, as defined, including a marriage and family therapist, associate marriage and family therapist, licensed clinical social worker, and associate clinical social worker, who provides direct patient care in a publicly funded facility or a mental health professional shortage area, as defined, to apply for grants under the Licensed Mental Health Service Provider Education Program to reimburse his or her educational loans related to a career as a licensed mental health service provider, as specified. Existing law establishes the Mental Health Practitioner Education Fund and provides that moneys in that fund are available, upon appropriation by the Legislature, for purposes of the Licensed Mental Health Service Provider Education Program.

This bill, commencing on July 1, 2019, would also require the Board of Behavioral Sciences to collect an additional ($5) fee for deposit into the bill would require an account to be created within the Mental Health Practitioner Education Fund. The bill would require the ($5) fee Fund and, upon appropriation by the Legislature, would require moneys in that account to be used solely to fund grants to repay educational loans for applicants who commit to practice in specified facilities for at least 24 months, who are marriage and family therapists, associate marriage and family therapists, licensed clinical social workers, associate clinical social workers, licensed professional clinical counselors, or associate professional clinical counselors, and who were formerly in Californias foster youth care system.

Existing law authorizes any licensed mental health service provider, as defined, including a marriage and family therapist, associate marriage and family therapist, licensed clinical social worker, and associate clinical social worker, who provides direct patient care in a publicly funded facility or a mental health professional shortage area, as defined, to apply for grants under the Licensed Mental Health Service Provider Education Program to reimburse his or her educational loans related to a career as a licensed mental health service provider, as specified. Existing law establishes the Mental Health Practitioner Education Fund and provides that moneys in that fund are available, upon appropriation by the Legislature, for purposes of the Licensed Mental Health Service Provider Education Program.

The Licensed Marriage and Family Therapist Act, the Clinical Social Worker Practice Act, and the Licensed Professional Clinical Counselor Act make the Board of Behavioral Sciences responsible for the licensure and regulation of marriage and family therapists, associate marriage and family therapists, clinical social workers, associate clinical social workers, licensed professional clinical counselors, and associate professional clinical counselors, respectively. Those acts require the board to establish and assess biennial license renewal fees, as specified. Those acts also require the board to collect an additional fee at the time of renewal of those licenses and direct the deposit of that additional fee into the Mental Health Practitioner Education Fund.

This bill, commencing on July 1, 2019, would also require the Board of Behavioral Sciences to collect an additional ($5) fee for deposit into the Mental Health Practitioner Education Fund. The bill would require the ($5) fee to be used solely to fund grants to repay educational loans for applicants who commit to practice in specified facilities for at least 24 months, who are marriage and family therapists, associate marriage and family therapists, licensed clinical social workers, associate clinical social workers, licensed professional clinical counselors, or associate professional clinical counselors, and who were formerly in Californias foster youth care system. The bill would authorize those grants to be combined with other grants provided under the Licensed Mental Health Service Provider Education Program to provide up to $20,000 in grant funding per applicant.

This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of ²/₃ of the membership of each house of the Legislature.

Existing law authorizes any licensed mental health service provider, as defined, including a marriage and family therapist, associate marriage and family therapist, licensed clinical social worker, and associate clinical social worker, who provides direct patient care in a publicly funded facility or a mental health professional shortage area, as defined, to apply for grants under the Licensed Mental Health Service Provider Education Program to reimburse his or her educational loans related to a career as a licensed mental health service provider, as specified. Existing law establishes the Mental Health Practitioner Education Fund and provides that moneys in that fund are available, upon appropriation by the Legislature, for purposes of the Licensed Mental Health Service Provider Education Program.

The Licensed Marriage and Family Therapist Act and Act, the Clinical Social Worker Practice Act, and the Licensed Professional Clinical Counselor Act make the Board of Behavioral Sciences responsible for the licensure and regulation of marriage and family therapists, associate marriage and family therapists, clinical social workers, and associate clinical social workers, licensed professional clinical counselors, and associate professional clinical counselors, respectively. Those acts require the board to establish and assess biennial license renewal fees, as specified. Those acts also require the board to collect an additional fee at the time of renewal of those licenses and directs direct the deposit of that additional fee into the Mental Health Practitioner Education Fund.

With respect to grants funded with that fee under the Licensed Mental Health Service Provider Education Program, the bill would require applicants who were formerly in Californias foster youth care system to receive priority over other applicants. This bill bill, commencing on July 1, 2019, would also require the Board of Behavioral Sciences to collect an additional $10 ($5) fee for deposit into the Mental Health Practitioner Education Fund. The bill would require the $10 ($5) fee to be used solely to fund grants to repay educational loans for applicants who commit to practice in specified facilities for at least 24 months, who are marriage and family therapists, associate marriage and family therapists, licensed clinical social workers, or associate clinical social workers, licensed professional clinical counselors, or associate professional clinical counselors, and who were formerly in Californias foster youth care system. The bill would authorize those grants to be combined with other grants provided under the Licensed Mental Health Service Provider Education Program to provide up to $20,000 in grant funding per applicant.

This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of ²/₃ of the membership of each house of the Legislature.

Existing law authorizes any licensed mental health service provider, as defined, including a marriage and family therapist, associate marriage and family therapist, licensed clinical social worker, and associate clinical social worker, who provides direct patient care in a publicly funded facility or a mental health professional shortage area, as defined, to apply for grants under the Licensed Mental Health Service Provider Education Program to reimburse his or her educational loans related to a career as a licensed mental health service provider, as specified. Existing law establishes the Mental Health Practitioner Education Fund and provides that moneys in that fund are available, upon appropriation by the Legislature, for purposes of the Licensed Mental Health Service Provider Education Program.

The Licensed Marriage and Family Therapist Act and the Clinical Social Worker Practice Act make the Board of Behavioral Sciences responsible for the licensure and regulation of marriage and family therapists, associate marriage and family therapists, clinical social workers, and associate clinical social workers, respectively. Those acts require the board to establish and assess biennial license renewal fees, as specified. Those acts also require the board to collect an additional fee at the time of renewal of those licenses and directs the deposit of that additional fee into the Mental Health Practitioner Education Fund.

With respect to grants funded with that fee under the Licensed Mental Health Service Provider Education Program, the bill would require applicants who were formerly in Californias foster youth care system to receive priority over other applicants. This bill would also require the Board of Behavioral Sciences to collect an additional $10 fee for deposit into the Mental Health Practitioner Education Fund. The bill would require the $10 fee to be used solely to fund grants to repay educational loans for applicants who commit to practice in specified facilities for up to at least 24 months, who are marriage and family therapists, associate marriage and family therapists, licensed clinical social workers, or associate clinical social workers, and who were formerly in Californias foster youth care system. The bill would authorize those grants to be combined with other grants provided under the Licensed Mental Health Service Provider Education Program to provide up to $20,000 in grant funding per applicant.

This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of ²/₃ of the membership of each house of the Legislature.

Existing law provides for the establishment of a statewide electronic benefits transfer (EBT) system, administered by the State Department of Social Services, for the purpose of providing financial and food assistance benefits.

This bill would make technical, nonsubstantive changes to those provisions.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2608

Author:(Mark Stone)

As Amended Ver:July 5, 2018

Majority vote

Original Committee Reference: B. & P.

SUMMARY: Creates a new account within the Mental Health Practitioner Education Fund, where future appropriations by the Legislature could be deposited to a fund grant program to repay educational loans for applicants who were formerly in California's foster youth care system and commit to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months as marriage and family therapists (LMFTs), associate marriage and family therapists (AMFTs), licensed clinical social workers (LFSWs), associate clinical social workers (ACSWs), licensed professional clinical counselors (LPCCs), or associate professional clinical counselors (APCCs).

The Senate amendments delete the bill's specified fee increases for Board of Behavioral Sciences (BBS) licensees, which would have established a revenue stream for the former foster youth education grant program, and instead simply create a framework for future budget appropriations to fund the grant program.

EXISTING LAW:

1. Establishes the Board of Behavioral Sciences (BBS) within the Department of Consumer Affairs. (Business and Professions Code (BPC) Section 4990 et seq.)
2. Establishes the Licensed Mental Health Service Provider Education Program within the Health Professions Education Foundation. (Health and Safety Code (HSC) Section 128454)
3. Defines "licensed mental health service provider" as:
   1. A specified licensee under the Board of Psychology;
   2. An LMFT or AMFT;
   3. An LCSW or ACSW; and
   4. After July 1, 2018, an LPCC or APCC.

(HSC Section 128454(b)(1))

1. Authorizes a licensed mental health service provider who provides direct patient care in a publicly funded facility or a mental health professional shortage area to apply for grants under the loan repayment program to reimburse related educational loans. (HSC Section 128454(c))
2. Requires the BBS to collect, as of July 1, 2018, a fee of $20 to be deposited in the Mental Health Practitioner Education Fund. (BPC Section 4984.75, 4996.65)

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

COMMENTS:

Purpose. This bill is sponsored by Journey House. According to the author:

Although over 93% of foster youth aspire to get a college degree, only 3% will ever earn a Bachelor's degree, and less than 1% will get a Masters or a Doctorate. Given the exceptional disadvantages, dismal educational outcomes that foster youth are facing today, and the obligation of the State to support foster youth as they transition into adulthood, California needs to provide increased support to youth, especially those who aim to work with the same communities they may have originated. AB 2608 creates a fund that has the ability to specifically target former foster youth who are earning graduate degrees to become social workers to better provide them with opportunities to succeed.

Background. The Licensed Mental Health Service Provider Education Program (LMHSPEP) is one of several scholarship and loan repayment programs administered by the Health Professions Education Foundation (HPEF) under the Office of Statewide Health Planning and Development (OSHPD). Like other HPEF programs, the LMHSPEP was statutorily created to encourage individuals from underrepresented communities to become health professionals and increase access to health providers in medically underserved areas.

According to the HPEF, an awardee under the LMHSPEP may receive up to $15,000 to repay educational loans in exchange for not less than a 12-month commitment to practicing and providing direct patient care in an eligible site. Qualified facilities include publicly funded or public mental health facilities, non-profit mental health facilities that contract with a county entity to provide mental health services, and designated mental health professions shortage areas.

The state has long made investments into programs designed to provide long-term economic opportunities to former foster youth. This vulnerable population is often deprived of the resources necessary to successfully pursue a college education and begin a professional career, despite the fact that the overwhelming majority of foster youth wish to do so. For many former foster youth who interacted with social workers throughout their early years and who wish to provide the same service to others in their situation, a degree and career in social work is frequently identified as a natural goal. However, this demographic is all too often unable to afford the costs of a graduate education program necessary to effectuate this objective.

By leveraging an existing program to make education loan repayment grants to those who enter into the mental health profession, this bill would attempt to assist former foster youth with becoming graduate level social workers. This effort would no longer receive dedicated funding through the bill; however, a special fund account would be created for the deposit of any future appropriations, allowing for a grant program to be swiftly implemented. The author and sponsor indicate that such an investment would be worthwhile as more social workers would be available in high-need communities that would benefit from licensees who have personal experience with the foster system.

Analysis Prepared by: Robert Sumner / B. & P. / (916) 319-3301 FN: 0003954

 THIRD READING  

Bill No: AB 2608

Author:

:

Vote:

SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 6-0, 6/18/18

AYES: Hill, Allen, Dodd, Galgiani, Glazer, Hernandez

NO VOTE RECORDED: Fuller, Pan, Wilk

SENATE HEALTH COMMITTEE: 6-2, 6/27/18

AYES: Beall, Hernandez, Leyva, Mitchell, Monning, Roth

NOES: Nguyen, Nielsen

NO VOTE RECORDED: Pan

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

ASSEMBLY FLOOR: 54-24, 5/31/18 - See last page for vote

SUBJECT:

SOURCE: Journey House

DIGEST:

This bill requires an account to be created within the Mental Health Practitioner Education Fund to fund grants to repay educational loans for applicants who were formerly in California’s foster youth care system and commit to provide direct patient mental health care in a publicly funded facility or a mental health professional shortage area for at least 24 months.

ANALYSIS:

Existing law:

1. Establishes the Board of Behavioral Sciences (BBS) within the Department of Consumer Affairs (DCA) to administer the Marriage and Family Therapist (MFT) Act, the Educational Psychologist (EP) Practice Act, the Clinical Social Worker (CSW) Practice Act, and the Licensed Professional Clinical Counselor (PCC) Act. (Business and Professions Code (BPC) § 4990.12)
2. Requires the BBS to collect until July 1, 2018, a $10 fee at the time of a licensee’s renewal and to transfer the fee to the Controller for deposit in the Mental Health Practitioner Education Fund. After July 1, 2018, the fee increases to $20. (BPC §§ 4984.75, 4996.65)
3. Defines the practice of professional clinical counseling to mean the application of counseling interventions and psychotherapeutic techniques to identify and remediate cognitive, mental, and emotional issues, including personal growth, adjustment to disability, crisis intervention, and psychosocial and environmental problems, and the use, application, and integration of required coursework and training. (BPC § 4999.20)
4. Defines the practice of clinical social work as a service in which a special knowledge of social resources, human capabilities, and the part that unconscious motivation plays in determining behavior, is directed at helping people to achieve more adequate, satisfying, and productive social adjustments. (BPC § 4996.9)
5. Defines the practice of marriage and family therapy to mean that service performed with individuals, couples, or groups wherein interpersonal relationships are examined for the purpose of achieving more adequate, satisfying, and productive marriage and family adjustments. This practice includes relationship and premarriage counseling. (BPC § 4980.02)
6. Establishes the Health Professions Education Foundation (HPEF) within the Office of Statewide Health Planning and Development (OSHPD) to administer the Health Professions Education Fund (Fund) and related scholarship and loan programs for students from underrepresented groups. (Health and Safety Code (HSC) §§ 128330, 128371)
7. Establishes the Licensed Mental Health Service Provider Education Program (Program) that provides licensed mental health service providers with grants to reimburse his or her educational loans related to a career as a licensed mental health service provider. (HSC § 128454)
8. Defines a “licensed mental health service provider” as a licensed psychologist, registered psychologist, postdoctoral psychological assistant, postdoctoral psychology trainee, MFT, associate MFT, licensed CSW, associate CSW, licensed PCC, and associate PCC. (HSC § 128454)
9. Requires a licensed mental health service provider, in order to be eligible for a grant, to be employed at a publicly funded mental health facility, a public or nonprofit private mental health facility that contracts with a county mental health entity or facility to provide mental health services, who provides direct patient care in a publicly funded facility or a mental health professional shortage area. (HSC § 128454)

This bill requires an account to be created within the Mental Health Practitioner Education Fund and, upon appropriation by the Legislature, moneys in that account shall be used solely to fund grants to repay educational loans for applicants who meet all of the following requirements:

1. Commit to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months.
2. Are MFTs, associate MFTs, licensed CSWs, associate CSWs, licensed PCCs, or associate PCCs.
3. Were formerly in California’s foster youth care system.

Background

HPEF and the Program. HPEF was established in 1987 to encourage persons from underrepresented communities to become health professionals and increase access to health providers in medically underserved areas. Supported by grants, donations, licensing fees, and special funds, HPEF provides scholarship, loan repayment and programs to students and graduates who agree to practice in California's medically underserved communities.

The Program is administered by the Health Professions Education Foundation and became operational in 2005. An awardee may receive up to $15,000 to repay educational loans for not less than a 12-month commitment practicing and providing direct client care in an eligible site. Eligible sites include publicly funded or public mental health facilities, non-profit mental health facilities that contract with a county entity to provide mental health services, and/or designated mental health professions shortage areas. The United States Department of Health and Human Services develops shortage designation criteria to determine whether a geographic area, population group or facility is a Health Professional Shortage Area (HPSA) or a Medically Underserved Area/Population (MUA/P). HPSAs may be designated as having a shortage of primary medical care, dental or mental health providers. They may be urban or rural areas, population groups, or medical or other public facilities. MUAs may be a whole county or a group of contiguous counties, a group of counties or civil divisions, or a group of urban census tracts in which residents have a shortage of health services. MUPs may include groups of persons who face economic, cultural or linguistic barriers to health care.

According to the HPEF, award selection is based solely on the information and documents contained in the Program application. Selection for awards is based on work experience, cultural and linguistic competence, career goals, community background, and fluency in a language other than English. HPEF indicates that priority is given to individuals whose community background and commitment indicates the likelihood of long-term employment in a qualified facility even after the service obligation has ended. A Program recipient may receive up to three awards from HPEF.

Comments

Foster youth. According to the author’s office, “When most foster youth age out of the foster care system, they are academically unprepared for college, they lack family support, financial, emotional or otherwise, and many of them struggle with mental health issues. All these factors make it challenging for youths to meet their independent living needs, let alone the costs associated with attending graduate school.

“When California foster youth age out from the foster care system, 36% will become homeless within a year and a half, and 25% of them will be incarcerated within two years. Although more than 93% of foster youth aspire to get a college degree, they are unlikely to have access to postsecondary education. Less than half of foster youth will ever graduate from high school, and only 20% will move on to attend college (compared to 60% of the general youth population). And even when a former foster youth successfully makes the uphill climb to attend college, most will never see graduation. Only 3% will earn a Bachelor’s degree, and less than 1% will earn a Master or Doctoral degree.

“Although the problems of student debt and the rapidly rising cost of postsecondary education are not specific to foster youth, they are uniquely impeded by these issues. As the burden for paying for college has shifted from the state and federal government to the family and the student, foster youth have found that the burden rests squarely on their shoulders.”

Policy considerations. The author has not demonstrated why former foster youth need a separate grant fund under the existing Program. While the author’s office paints an unfortunate picture of foster youth outcomes, there is no indication that the Program has specifically failed these individuals to date -- no information has been provided that foster youth are presently denied access to Program funding at all, or at rates higher than the general applicant population.  HPEF notes that selection for current awards is based on many factors, including cultural and linguistic competence, career goals, and community background – factors that may already favor a former foster youth’s application. 

It is also unclear why this bill does not include all the license types presently considered as licensed mental health service provider – it does not include psychologists.

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

SUPPORT: (Verified 8/7/18)

Journey House (source)

Aspiranet

Crittention

Echoes of Hope

Inside Out Writers

One individual

OPPOSITION: (Verified 8/7/18)

Board of Behavioral Sciences

ARGUMENTS IN SUPPORT: Journey House writes, “By reducing and alleviating the costs for foster youth to become social workers, the state would allow for people who have lived through the foster care system to become leaders in the field and in return strengthening the profession as a whole.”

ARGUMENTS IN OPPOSITION: The Board of Behavioral Sciences writes, “While the Board is fully supportive of foster youth and their efforts to further their education and careers, it has concerns about the precedent this bill sets by granting one particular group a separate grant fund and special priority, when there are other existing groups that are equally disadvantaged and who also have limited opportunity.”

ASSEMBLY FLOOR: 54-24, 5/31/18

AYES: Aguiar-Curry, Arambula, Berman, Bloom, Bonta, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooley, Cooper, Daly, Eggman, Frazier, Friedman, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Levine, Limón, Low, Maienschein, McCarty, Medina, Mullin, Muratsuchi, Nazarian, O'Donnell, Quirk, Quirk-Silva, Reyes, Rodriguez, Rubio, Salas, Santiago, Mark Stone, Thurmond, Ting, Weber, Wood, Rendon

NOES: Acosta, Travis Allen, Baker, Bigelow, Brough, Chávez, Chen, Choi, Cunningham, Dahle, Flora, Fong, Gallagher, Harper, Kiley, Lackey, Mathis, Mayes, Melendez, Obernolte, Patterson, Steinorth, Voepel, Waldron

Prepared by:

8/8/18 12:40:07

**** END ****

SENATE COMMITTEE ON HEALTH

Senator Dr. Richard Pan, Chair

BILL NO: AB 2608

SUBJECT: Licensed Mental Health Service Provider Education Program: former foster youth.

SUMMARY:

Adds $5, commencing July 1, 2019, to the biennial license renewal fees for specified licensed mental health (LMH) service providers for purposes of the LMH Service Provider Education Program (LMH Program) for applicants who meet specified requirements, particularly those who were formerly in California’s foster youth care system.

Existing law:

1. Establishes the Board of Behavioral Sciences (BBS) within the Department of Consumer Affairs (DCA) to administer the Marriage and Family Therapist (LMFT) Act, the Educational Psychologist Practice Act, the Clinical Social Worker (LCSW) Practice Act, and the Professional Clinical Counselor (LPCC) Act. [BPC §4990.12]
2. Requires the BBS to collect an additional $10 fee from an LMFT and LCSW at the time of licensure renewal for transfer to the Mental Health Practitioner Education Fund (MHPEF). [BPC §4984.75 and 4996.65]
3. Requires, beginning July, 1, 2018, the BBS to collect an additional $20 fee from an LPCC at the time of licensure renewal for transfer to the MHPEF. [BPC §4999.121]
4. Establish the Health Professions Education Foundation (HPEF) within the Office of Statewide Health Planning and Development (OSHPD) to administer the Health Professions Education Fund (Fund) and related scholarship and loan programs for students from underrepresented groups. [HSC §128330 and 128371]
5. Establishes the LMH Program that provides LMH service providers with grants to reimburse educational loans related to a career as a LMH service provider. [HSC §128454]
6. Defines a “LMH service provider” as a licensed psychologist, registered psychologist, postdoctoral psychological assistant, postdoctoral psychology trainee, LMFT, associate MFT, LCSW, and associate CSW. [HSC §128454]
7. Requires a LMH service provider, in order to be eligible for a grant, to be employed at a publicly funded mental health facility, a public or nonprofit private mental health facility that contracts with a county mental health entity or facility to provide mental health services, who provides direct patient care in a publicly funded facility or a mental health professional shortage area. [HSC §128454]

This bill: Adds $5, commencing July 1, 2019, to the biennial license renewal fees for LMFTs, LCSWs, and LPCCs for transfer to the MHPEF to be used solely to repay educational loans, for purposes of the LMH Program, for applicants who meet all of the following requirements:

• 1. Commit to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months;
  2. Are LMFTs, associate MFTs, LCSWs, associate CSWs, LPCCs, or associate PCCs; and,
  3. Were formerly in California’s foster youth care system.

FISCAL EFFECT:

According to the Assembly Appropriations Committee:

1. One-time information technology costs to the Board of Behavioral Sciences (BBS) in the range of $20,000 (Behavioral Sciences Fund).
2. Minor and absorbable ongoing costs to the BBS to collect the additional revenue are expected to be minor and absorbable (Behavioral Sciences Fund).
3. Minor one-time costs to the Health Professions Educational Foundation within the Office of Statewide Health Planning and Development (OSHPD) to develop application materials and processes specific to the program created under this bill (Mental Health Practitioner Education Fund).
4. About $260,000 in additional revenue annually to the Mental Health Practitioner Education Fund, of which about $235,000 "which this analysis assumes" will be spent on additional grants and $25,000 on administrative costs to the Health Professions Educational Foundation within OSHPD (Mental Health Practitioner Education Fund).

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, although over 93% of foster youth aspire to get a college degree, only 3% ever earn a bachelor’s degree, and less than 1% earn a master’s or doctorate. Given the exceptional disadvantages and dismal educational outcomes that foster youth face today, and the obligation of the state to support foster youth as they transition into adulthood, California needs to provide increased support to youth, especially those who aim to work with the same communities they may have originated from. This bill will provide much needed financial support to former foster youth who are earning graduate degrees to become mental health professionals in underserved areas. This bill will create a sub-fund under the MHPEF earmarked specifically for loan repayment for former foster youth. Former foster youth are uniquely positioned to provide tremendous support and perspective to their communities and other children in the child welfare system. This bill will not only incentivize former foster youth to reach graduate school and become LCSWs but will also provide the social services system with an incredible resource of qualified and dedicated mental health professionals.
2. LMH Program. AB 938 (Yee, Chapter 437, Statutes of 2003) established the LMH Program, which became operational in 2005. The LMH Program is administered by HPEF and is supported by grants, donations, licensing fees, and special funds. HPEF provides scholarship and loan repayment programs to students and graduates who agree to practice in California's medically underserved communities. For a 24-month service obligation in a medically underserved area, providing a minimum of 32 hours of direct patient care, an individual may receive up to $15,000 for loan repayment for practicing and providing direct care in a publicly funded or public mental health facility, a non-profit mental health facility, or a MHPSA. Applicants can receive three awards for a total possible award of up to $45,000 for loan repayment. Selection for awards is based on the following criteria: work experience; cultural and linguistic competence; career goals; community service; community background; and, fluency in a language other than English. Priority is given to individuals whose community background and commitment indicates the likelihood of long-term employment in a qualified facility even after the service obligation has ended.
3. LMH Program additional fee increase. AB 1188 (Nazarian, Chapter 557, Statutes of 2017) increases, beginning July 1, 2018, from $10 to $20 the additional license renewal fee collected by the BOP from licensed psychologists and by the BBS from LMFTs and LCSWs for the LMH Program. AB 1188 also adds, beginning July 1, 2018, LPCCs to the definition of “LMH service provider” for participation in the LMH Program and requires the BBS to collect the additional $20 licensure renewal fee from LPCCs.
4. Behavioral health workforce in California. According to the March 2018 California Health Care Foundation (CHCF) Almanac, Mental Health in California: For Too Many, Care Not There, in 2016 California had about 75,000 licensed mental health professionals, with marriage and family therapists (31,349) comprising the greatest share, almost double the number of licensed psychologists (16,683). This workforce does not reflect the racial and ethnic diversity of the state, and many professionals, particularly psychiatrists (5,806) and psychologists will reach retirement age within the next decade (45% of psychiatrists and 37% of psychologists are over age 60.) Per-population rates of behavioral health professionals varied by California region: the Greater Bay Area’s rates were 38% to 67% greater than the state average while the Inland Empire and San Joaquin Valley regions had rates that were 39% to 88% lower than average. The Northern and Sierra regions had rates of psychiatrists and psychologists that were at least 40% lower than average. Under the Health Professional Shortage Area (HPSA) designation, areas are identified as having a shortage of primary care, dental care, or mental health providers. For mental health providers, the shortage is based on the availability of psychiatrists and other mental health professionals. Approximately 16% of Californians live in a mental health HPSA. According to OSHPD’s Web site, to qualify for designation as a mental health HPSA, an area must be a rational service area; the population-to-core mental health professional and/or the population-to-psychiatrist ratio meet established shortage criteria; and there is a lack of access to mental health care in surrounding areas because of excessive distance, overutilization, or access barriers. 
5. Foster youth challenges. According to the U.S. Department of Education, there are approximately 400,000 children and youth in foster care today, and each year about 20,000 of these students age out of foster care. A positive pre-kindergarten to grade 12 education experience has the potential to be a powerful counterweight to the abuse, neglect, separation, impermanence, and other barriers these vulnerable students face. Participation in and persistence to a postsecondary credential can enhance their well-being, help them make more successful transitions to adulthood, and increase their chances for personal fulfillment and economic self-sufficiency. According to a September 2017 report by California College Pathways, “Stepping up for Foster Youth,” while 93% of foster youth state they want to attend college, just 4% of former foster youth obtain a bachelor’s degree by age 26, as compared to 50% of the same-age, non-foster youth population. For those fortunate enough to attend college, there are many challenges that make earning a degree difficult, as most of them lack financial resources, have little to no family support, are academically underprepared, struggle with mental health issues, and often lack the emotional support of a caring adult.
6. Double referral. This bill was heard in the Senate Business, Professions, and Economic Development Committee on June 18, 2018, and passed with a 6-0 vote.
7. Related legislation. AB 2143 (Caballero) expands the definition of a LMH service provider to include a LMH service provider who is currently fully licensed by his or her respective board and who has subsequently attained further education and now practices as either a psychiatric mental health nurse practitioner or a physician assistant, as specified. AB 2143 is set to be heard in this Committee on June 27, 2018.
8. Prior legislation. AB 1188 increases from $10 to $20 the additional license renewal fee for purposes of the LMH Program, and expanded the types of professionals on whom the fee is assessed.

AB 938 established the LMH Program.

1. Support. Journey House, the sponsor of this bill, and the other supporters state that child welfare is a program area of the social work profession that has proven to be ineffective in California, and workers with cultural competency are more effective in investigating cases of abuse, conducting assessments, and helping foster youth prepare for their transition out of foster care and into adulthood. Supporters argue that low wages and high degree costs discourage people from entering social work, and turnover rates for social workers have reached up to 75% in some California counties. Supporters argue that individuals who have personally experienced the child welfare system are particularly suited to increase the effectiveness of the field and have unique insight on the policies and programs that affect social work practice, as well as understand the challenges foster children face.
2. Oppose unless amended. The BBS states that it has concerns about the precedent this bill sets by granting one particular group a separate grant fund and special priority when there are other existing groups that are equally disadvantaged and who also have limited opportunities. The BBS requests this bill be amended to instead permit an applicant’s history as a foster youth to be considered as a factor when awarding the loan repayment grant.

SUPPORT AND OPPOSITION:

Support: Journey House (sponsor)

Aspiranet

One individual

Oppose: Board of Behavioral Sciences (unless amended)

-- END --

SENATE COMMITTEE ON

BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT

Senator Jerry Hill, Chair

2017 - 2018 Regular

Bill No: AB 2608 Hearing Date: June 18, 2018

Subject: Licensed Mental Health Service Provider Education Program: former foster youth

SUMMARY:

Adds five dollars to specified mental health license renewal fees to create a special fund within the Licensed Mental Health Service Provider Education Program to benefit former foster youth in repaying educational loans.

Existing law:

1. Establishes the Board of Behavioral Sciences (BBS) within the Department of Consumer Affairs (DCA) to administer the Marriage and Family Therapist (MFT) Act, the Educational Psychologist (EP) Practice Act, the Clinical Social Worker (CSW) Practice Act, and the Licensed Professional Clinical Counselor (PCC) Act. (Business and Professions Code (BPC) § 4990.12)
2. Requires the BBS to collect until July 1, 2018, a $10 fee at the time of a licensee’s renewal and to transfer the fee to the Controller for deposit in the Mental Health Practitioner Education Fund. After July 1, 2018, the fee increases to $20.
   (BPC §§ 4984.75, 4996.65)
3. Defines the practice of professional clinical counseling to mean the application of counseling interventions and psychotherapeutic techniques to identify and remediate cognitive, mental, and emotional issues, including personal growth, adjustment to disability, crisis intervention, and psychosocial and environmental problems, and the use, application, and integration of required coursework and training.
   (BPC § 4999.20)
4. Defines the practice of clinical social work as a service in which a special knowledge of social resources, human capabilities, and the part that unconscious motivation plays in determining behavior, is directed at helping people to achieve more adequate, satisfying, and productive social adjustments. (BPC § 4996.9)
5. Defines the practice of marriage and family therapy to mean that service performed with individuals, couples, or groups wherein interpersonal relationships are examined for the purpose of achieving more adequate, satisfying, and productive marriage and family adjustments. This practice includes relationship and premarriage counseling. (BPC § 4980.02)
6. Establish the Health Professions Education Foundation (HPEF) within the Office of Statewide Health Planning and Development (OSHPD) to administer the Health Professions Education Fund (Fund) and related scholarship and loan programs for students from underrepresented groups. (Health and Safety Code (HSC) §§ 128330, 128371)
7. Establishes the Licensed Mental Health Service Provider Education Program (Program) that provides licensed mental health service providers with grants to reimburse his or her educational loans related to a career as a licensed mental health service provider. (HSC § 128454)
8. Defines a “licensed mental health service provider” as a licensed psychologist, registered psychologist, postdoctoral psychological assistant, postdoctoral psychology trainee, MFT, associate MFT, licensed CSW, associate CSW, licensed PCC, and associate PCC. (HSC § 128454)
9. Requires a licensed mental health service provider, in order to be eligible for a grant, to be employed at a publicly funded mental health facility, a public or nonprofit private mental health facility that contracts with a county mental health entity or facility to provide mental health services, who provides direct patient care in a publicly funded facility or a mental health professional shortage area.
   (HSC § 128454)

This bill:

1. Adds $5 to the biennial license renewal fees for MFTs, CSWs, and PCCs which shall be transferred to the Mental Health Practitioner Education Fund to be used solely to repay educational loans for applicants who meet all of the following requirements:
   1. Commit to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months.
   2. Are MFTs, associate MFTs, licensed CSWs, associate clinical social workers, licensed PCCs, or associate PCCs.
   3. Were formerly in California’s foster youth care system.
2. States that a grant may be combined with other HPEF grants to provide a total of up to twenty thousand dollars ($20,000) in grant funding per applicant.

FISCAL EFFECT:

This bill is keyed fiscal by the Legislative Counsel. According to the Assembly Appropriations Committee analysis dated May 9, 2018, this bill has the following costs:

1. One-time information technology costs to the BBS in the range of $20,000 (Behavioral Sciences Fund).
2. Minor and absorbable ongoing costs to the BBS to collect the additional revenue are expected to be minor and absorbable (Behavioral Sciences Fund).
3. Minor one-time costs to HPEF within OSHPD to develop application materials and processes specific to the program created under this bill (Mental Health Practitioner Education Fund).
4. About $260,000 in additional revenue annually to the Fund, of which about $235,000 “which this analysis assumes” will be spent on additional grants and $25,000 on administrative costs to HPEF within OSHPD (Mental Health Practitioner Education Fund).

COMMENTS:

1. Purpose. This bill is sponsored by Journey House. According to the Author’s office, “Former foster youth who are attending graduate school have already struggled to beat the odds and have usually done so with minimal support. By increasing the amount of financial support California offers to graduate students who are former foster youth, the state can improve their quality of life, equip them for success, and enable them to give back to their community. Given the poor outcomes that most emancipated youth are currently experiencing, expanding financial support to former foster youth as they pursue their graduate degrees will make a significant difference in their futures.”
2. HPEF and the Program. HPEF was established in 1987 to encourage persons from underrepresented communities to become health professionals and increase access to health providers in medically underserved areas. Supported by grants, donations, licensing fees, and special funds, HPEF provides scholarship, loan repayment and programs to students and graduates who agree to practice in California's medically underserved communities.

The Program is administered by the Health Professions Education Foundation and became operational in 2005. An awardee may receive up to $15,000 to repay educational loans for not less than a 12-month commitment practicing and providing direct client care in an eligible site. Eligible sites include publicly funded or public mental health facilities, non-profit mental health facilities that contract with a county entity to provide mental health services, and/or designated mental health professions shortage areas. The United States Department of Health and Human Services develops shortage designation criteria to determine whether a geographic area, population group or facility is a Health Professional Shortage Area (HPSA) or a Medically Underserved Area/Population (MUA/P). HPSAs may be designated as having a shortage of primary medical care, dental or mental health providers. They may be urban or rural areas, population groups, or medical or other public facilities. MUAs may be a whole county or a group of contiguous counties, a group of counties or civil divisions, or a group of urban census tracts in which residents have a shortage of health services. MUPs may include groups of persons who face economic, cultural or linguistic barriers to health care.

According to the Health Professions Education Foundation, award selection is based solely on the information and documents contained in the Program application. Selection for awards is based on work experience, cultural and linguistic competence, career goals, community background, and fluency in a language other than English. HPES indicates that priority is given to individuals whose community background and commitment indicates the likelihood of long-term employment in a qualified facility even after the service obligation has ended. A Program recipient may receive up to three awards from HPEF.

1. Foster Youth. According to the Author’s office, “When most foster youth age out of the foster care system, they are academically unprepared for college, they lack family support, financial, emotional or otherwise, and many of them struggle with mental health issues. All these factors make it challenging for youths to meet their independent living needs, let alone the costs associated with attending graduate school.

“When California foster youth age out from the foster care system, 36% will become homeless within a year and a half, and 25% of them will be incarcerated within two years. Although more than 93% of foster youth aspire to get a college degree, they are unlikely to have access to postsecondary education. Less than half of foster youth will ever graduate from high school, and only 20% will move on to attend college (compared to 60% of the general youth population). And even when a former foster youth successfully makes the uphill climb to attend college, most will never see graduation. Only 3% will earn a Bachelor’s degree, and less than 1% will earn a Master or Doctoral degree.

“Although the problems of student debt and the rapidly rising cost of postsecondary education are not specific to foster youth, they are uniquely impeded by these issues. As the burden for paying for college has shifted from the state and federal government to the family and the student, foster youth have found that the burden rests squarely on their shoulders.”

1. Related Legislation This Session. AB 2143 (Caballero) of 2018 clarifies that specified licensed mental health professionals who are also licensed as a certified nurse practitioner or physician assistant are eligible for scholarship and loan programs through the Licensed Mental Health Service Provider Education Program (Program).
2. Prior Related Legislation. AB 1188 (Nazarian, Chapter 557, Statutes of 2017), increased from $10 to $20 the additional license renewal fee for purposes of the Program and expanded the types of professionals on whom the fee is assessed.

AB 938 (Yee, Chapter 437, Statutes of 2003), established the Program, which became operational in 2005.

1. Arguments in Support. Journey House writes, “By reducing and alleviating the costs for foster youth to become social workers, the state would allow for people who have lived through the foster care system to become leaders in the field and in return strengthening the profession as a whole.”
2. Arguments in Opposition. BBS writes, “While the Board is fully supportive of foster youth and their efforts to further their education and careers, it has concerns about the precedent this bill sets by granting one particular group a separate grant fund and special priority, when there are other existing groups that are equally disadvantaged and who also have limited opportunity.”
3. Policy Considerations. The Author has not demonstrated why former foster youth need a separate grant fund under the existing Program. While the Author’s office paints an unfortunate picture of foster youth outcomes, there is no indication that the Program has specifically failed these individuals to date -- no information has been provided that foster youth are presently denied access to Program funding at all, or at rates higher than the general applicant population.  HPEF notes that selection for current awards is based on many factors, including cultural and linguistic competence, career goals, and community background – factors that may already favor a former foster youth’s application. 

Alarmingly, the fund created by this bill may inadvertently disadvantage recipients. This bill authorizes grant recipients to combine other HPEF awards up to $20,000.  However, the current Program does not place a ceiling on the potential funds to be awarded, but rather limits grant recipients to three HPEF awards.  Under existing law, a mental health licensee targeted by this program could take advantage of both the Program, which provides up to $15,000, and HPEF’s Mental Health Loan Assumption Program, which provides up to $10,000, for a total of $25,000.  A beneficiary of this bill is only eligible for $20,000 – a loss of $5,000 for an individual already struggling to fund his or her education. 

It is also unclear why this bill does not include all the license types presently considered as licensed mental health service provider – it does not include psychologists.

1. Author’s Proposed Amendments. In consideration of the restricted funds issue noted above, the Author is proposing the following amendment to delete the $20,000 cap on awards. This would allow recipients to be eligible for the existing limit of 3 total HPEF awards.

On page 7, delete lines 2-5.

NOTE:

Double-referral to Senate Committee on Health.

SUPPORT AND OPPOSITION:

Support:

Journey House (Sponsor)

An individual

Aspiranet

Crittention

Echoes of Hope

Inside Out Writers

Opposition:

Board of Behavioral Sciences

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2608

Author:(Mark Stone)

As Amended Ver:April 3, 2018

2/3 vote

SUMMARY: Increases revenue for the Mental Health Practitioner Education Program to fund prioritized grants for former foster youth to repay educational loans for graduate social work education in exchange for a grantee's commitment to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months. Specifically, this bill:

1. Collects an additional $10 fee from biennial licensed marriage and family therapist (LMFT), associate marriage and family therapist (AMFT), licensed clinical social worker (LCSW), and associate clinical social workers (ACSW) license renewals for the Mental Health Practitioner Education Fund.
2. States that funds collected from this additional fee shall be used solely to fund grants to repay educational loans for applicants who meet all of the following requirements:
   1. Commit to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months.
   2. Are LMFTs, AMFTs, LCSWs, or ACSWs.
   3. Were formerly in California's foster youth care system.
3. Allows grants provided under this newly established program to be combined with other grants for a maximum of $20,000 in funding per applicant.
4. Prioritizes grant funding for applicants who qualify under this bill.

FISCAL EFFECT: According to the Assembly Appropriations Committee:

1. One-time information technology costs to the Board of Behavioral Sciences (BBS) in the range of $20,000 (Behavioral Sciences Fund).
2. Minor and absorbable ongoing costs to the BBS to collect the additional revenue are expected to be minor and absorbable (Behavioral Sciences Fund).
3. Minor one-time costs to the Health Professions Educational Foundation within the Office of Statewide Health Planning and Development (OSHPD) to develop application materials and processes specific to the program created under this bill (Mental Health Practitioner Education Fund).
4. About $260,000 in additional revenue annually to the Mental Health Practitioner Education Fund, of which about $235,000 "which this analysis assumes" will be spent on additional grants and $25,000 on administrative costs to the Health Professions Educational Foundation within OSHPD (Mental Health Practitioner Education Fund).

COMMENTS:

Purpose. This bill is sponsored by Journey House. According to the author:

Although over 93% of foster youth aspire to get a college degree, only 3% will ever earn a Bachelor's degree, and less than 1% will get a Masters or a Doctorate. Given the exceptional disadvantages, dismal educational outcomes that foster youth are facing today, and the obligation of the State to support foster youth as they transition into adulthood, California needs to provide increased support to youth, especially those who aim to work with the same communities they may have originated. AB 2608 will provide much needed financial support to former foster youth who are earning graduate degrees to become social workers. This bill will increase the loan-repayment grant funding available to foster youth and will prioritize them in the application process for the Licensed Mental Health Service Provider Education Program. Former foster youth are uniquely positioned to provide tremendous support and perspective to their communities and other children in the system. This bill will not only provide former foster youth incentive to reach graduate school and to become a social worker but will provide the social services system with an incredible resource.

Background. The LMHSPEP is one of several scholarship and loan repayment programs administered by the Health Professions Education Foundation (HPEF) under OSHPD. Like other HPEF programs, the LMHSPEP was statutorily created to encourage individuals from underrepresented communities to become health professionals and increase access to health providers in medically underserved areas.

The state has long made investments into programs designed to provide long-term economic opportunities to former foster youth. This vulnerable population is often deprived of the resources necessary to successfully pursue a college education and begin a professional career, despite the fact that the overwhelming majority of foster youth wish to do so. For many former foster youth who interacted with social workers throughout their early years and who wish to provide the same service to others in their situation, a degree and career in social work is frequently identified as a natural goal. However, this demographic is all too often unable to afford the costs of a graduate education program necessary to effectuate this objective.

By leveraging an existing program to make education loan repayment grants to those who enter into the mental health profession, this bill would attempt to assist former foster youth with becoming graduate level social workers. This effort would be funded through additional license fees. The author and sponsor indicate that the investment would be worthwhile as more social workers would be available in high-need communities that would benefit from licensees who have personal experience with the foster system.

Analysis Prepared by: Robert Sumner / B. & P. / (916) 319-3301 FN: 0003331

Date of Hearing: May 9, 2018

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez Fletcher, Chair

ABPCA Bill Id:AB 2608

Author:(Mark Stone) – As Amended Ver:April 3, 2018

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

SUMMARY:

This bill adds an additional $10 fee on biennial license renewal for Licensed Marriage and Family Therapists (LMFTs) and Licensed Clinical Social Workers (LCSWs). The bill dedicates the revenue to a grant program to repay educational loans for former foster youth in these professions who commit to working in a publicly funded facility or a mental health professional shortage area for at least 24 months.

It also gives former foster youth priority over other grant applicants for the existing mental health loan repayment program.

FISCAL EFFECT:

1. One-time information technology costs to the Board of Behavioral Sciences (BBS) in the range of $20,000 (Behavioral Sciences Fund).
2. Minor and absorbable ongoing costs to the BBS to collect the additional revenue are expected to be minor and absorbable (Behavioral Sciences Fund).
3. Minor one-time costs to the Health Professions Educational Foundation within the Office of Statewide Health Planning and Development (OSHPD) to develop application materials and processes specific to the program created under this bill (Mental Health Practitioner Education Fund).
4. About $260,000 in additional revenue annually to the Mental Health Practitioner Education Fund, of which about $235,000 “which this analysis assumes” will be spent on additional grants and $25,000 on administrative costs to the Health Professions Educational Foundation within OSHPD (Mental Health Practitioner Education Fund).

COMMENTS:

1. Purpose. According to Journey House, the sponsor of this legislation, less than 1% of former foster youth will earn a master's degree or a doctorate. This bill is intended to provide financial support to former foster youth who are earning graduate degrees to become social workers.
2. Background. The Licensed Mental Health Service Provider Education Program (mental health loan repayment program) is currently funded through license fees on mental health professionals and administered by the Health Professions Education Foundation within OSHPD. The program awards up to $15,000 in loan repayment, on a competitive basis, to qualified applicants who work in specified publicly funded mental health facilities or in a provider shortage area for two years. The program was created by AB 938 (Yee), Chapter 437, Statutes of 2003, and has been modified and expanded several times since then. This bill would augment the program by setting aside revenue for awards to otherwise qualified former foster youth and would also prioritize former foster youth for awards through the existing program.
3. Related Legislation. AB 2143 (Caballero), pending in this committee, adds physician assistants who specialize in mental health services and psychiatric-mental health nurse practitioners to the list of licensed mental health service providers eligible for educational loan repayment grants under the existing mental health loan repayment program.
4. Prior Legislation. AB 1188 (Nazarian), Chapter 557, Statutes of 2017, increased from $10 to $20 the additional license renewal fee for purposes of the mental health loan repayment program and expanded the types of professionals on which the fee is assessed.

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

Date of Hearing: April 24, 2018

ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS

Evan Low, Chair

ABPCA Bill Id:AB 2608

Author:(Mark Stone) – As Amended Ver:April 3, 2018

SUBJECT: Licensed Mental Health Service Provider Education Program: former foster youth.

SUMMARY: Increases revenue for the Mental Health Practitioner Education Program to fund prioritized grants for former foster youth to repay educational loans for graduate social work education in exchange for a grantee’s commitment to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months.

EXISTING LAW:

1. Establishes the Board of Behavioral Sciences (BBS) within the Department of Consumer Affairs. (Business and Professions Code (BPC) § 4990 et seq.)
2. Provides for the licensure of Licensed Marriage and Family Therapists (LMFTs) by the BBS following completion of required hours of supervised experience as a registered associate, as specified. (BPC § 4980 et seq.)
3. Provides for the licensure of Licensed Clinical Social Workers (LCSWs) by the BBS following completion of required hours of supervised experience as a registered associate, as specified. (BPC § 4996 et seq.)
4. Requires the Office of Statewide Health Planning and Development (OSHPD) to establish the Health Professions Education Foundation, a nonprofit public benefit corporation, to administer the Health Professions Education Fund and related scholarship and loan programs for students from underrepresented groups. (Health and Safety Code (HSC) §§ 128330 – 128371)
5. Establishes the Licensed Mental Health Service Provider Education Program (LMHSPEP) within the Health Professions Education Foundation (HPEF). (HSC § 128454)
6. Defines “licensed mental health service provider” as:
   1. A specified licensee under the Board of Psychology (BOP);
   2. An LMFT or associate marriage and family therapist (AMFT);
   3. An LCSW or associate clinical social worker (ACSW); and
   4. After July 1, 2018, a licensed professional clinical counselor or associate professional clinical counselor. (HSC § 128454(b)(1))
7. Authorizes a licensed mental health service provider who provides direct patient care in (1) a publicly funded facility or (2) a mental health professional shortage area to apply for grants under the loan repayment program to reimburse related educational loans. (HSC § 128454(c))
8. Requires the BBS to collect, until July 1, 2018, a $10 fee from biennial LMFT and LCSW license renewals and transfers the fee to the Controller for deposit in the Mental Health Practitioner Education Fund. After July 1, 2018, the fee increases to $20. (BPC §§ 4984.75, 4996.65)

THIS BILL:

1. Collects an additional $10 fee from biennial LMFT and LCSW license renewals for the Mental Health Practitioner Education Fund.
2. States that funds collected from this additional fee shall be used solely to fund grants to repay educational loans for applicants who meet all of the following requirements:
   1. Commit to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months.
   2. Are marriage and family therapists, associate marriage and family therapists, licensed clinical social workers, or associate clinical social workers.
   3. Were formerly in California’s foster youth care system.
3. Allows grants provided under this newly established program to be combined with other grants for a maximum of $20,000 in funding per applicant.
4. Prioritizes grant funding for applicants who are LMFTs, AMFTs, LCSWs, or ACSWs who were formerly in California’s foster youth care system.

FISCAL EFFECT: Unknown; this bill is keyed fiscal by the Legislative Counsel.

COMMENTS:

Purpose. This bill is sponsored by Journey House. According to the author:

Although over 93% of foster youth aspire to get a college degree, only 3% will ever earn a Bachelor’s degree, and less than 1% will get a Masters or a Doctorate. Given the exceptional disadvantages, dismal educational outcomes that foster youth are facing today, and the obligation of the State to support foster youth as they transition into adulthood, California needs to provide increased support to youth, especially those who aim to work with the same communities they may have originated. AB 2608 will provide much needed financial support to former foster youth who are earning graduate degrees to become social workers. This bill will increase the loan-repayment grant funding available to foster youth and will prioritize them in the application process for the Licensed Mental Health Service Provider Education Program. Former foster youth are uniquely positioned to provide tremendous support and perspective to their communities and other children in the system. This bill will not only provide former foster youth incentive to reach graduate school and to become a social worker but will provide the social services system with an incredible resource.

Background. The LMHSPEP is one of several scholarship and loan repayment programs administered by the HPEF under OSHPD. Like other HPEF programs, the LMHSPEP was statutorily created to encourage individuals from underrepresented communities to become health professionals and increase access to health providers in medically underserved areas.

According to the HPEF, an awardee under the LMHSPEP may receive up to $10,000 to repay educational loans for up to a 24-month commitment practicing and providing direct patient care in a qualified facility. Qualified facilities include publicly funded or public mental health facilities, non-profit mental health facilities that contract with a county entity to provide mental health services, and designated mental health professions shortage areas.

The state has long made investments into programs designed to provide long-term economic opportunities to former foster youth. This vulnerable population is often deprived of the resources necessary to successfully pursue a college education and begin a professional career, despite the fact that the overwhelming majority of foster youth wish to do so. For many former foster youth who interacted with social workers throughout their early years and who wish to provide the same service to others in their situation, a degree and career in social work is frequently identified as a natural goal. However, this demographic is all too often unable to afford the costs of a graduate education program necessary to effectuate this objective.

By leveraging an existing program to make education loan repayment grants to those who enter into the mental health profession, this bill would attempt to assist former foster youth with becoming graduate level social workers. This effort would be funded through additional license fees. The author and sponsor indicate that the investment would be worthwhile as more social workers would be available in high-need communities that would benefit from licensees who have personal experience with the foster system.

Current Related Legislation. AB 2117 (Arambula) would make clarifications and technical changes to the licensing process for LMFTs and LCSWs.

AB 2143 (Caballero) would add physician assistants who specialize in mental health services and psychiatric-mental health nurse practitioners to the list of licensed mental health service providers eligible for educational loan repayment grants under the LMHSPEP.

Prior Related Legislation. AB 1188 (Nazarian, Chapter 557, Statutes of 2017) increased from $10 to $20 the additional license renewal fee collected by the BOP from psychologists and by the BBS from LMFTs and LCSWs for the Licensed Mental Health Service Provider Education Program; added LPCCs to the definition of “licensed mental health service provider” for participation in the Licensed Mental Health Service Provider Education Program (Loan Program); and required the BBS to collect the additional $20 licensure renewal fee from Licensed Professional Clinical Counselors (LPCCs).

SB 1204 (Hernandez) of 2016, would have increased from $10 to $20 the additional licensure renewal fee for Psychologists, LMFTs, and LCSWs, and required the BBS to collect the additional $20 renewal fee from LPCCs for deposit and participation in the Loan Program and would have increased the license application and renewal charge from $25 to $50 for physicians and osteopathic physicians to fund the Steven M. Thompson Physician Corps Loan Repayment Program. This bill was held in the Senate Committee on Business, Professions and Economic Development.

AB 1852 (Yee, Chapter 557, Statutes of 2006) revised the definition of “licensed mental health care practitioner” related to the Loan Program to include a marriage and family therapist intern, associate clinical social worker, a psychologist licensed by the BOP, and a registered psychologist, postdoctoral psychological assistant, or postdoctoral psychology trainee employed in an exempt setting, as specified.

AB 938 (Yee, Chapter 437, Statutes of 2003) established the Licensed Mental Health Provider Education Program, to be developed by the Health Professions Education Foundation after soliciting advice from specified boards and agencies, to provide grants to specified practicing mental health providers in return for service in medically underserved areas. The Loan Program became operational January 1, 2005 and funded by a $10 surcharge on specified mental health professionals’ licensing fees, which would be deposited in the Mental Health Practitioner Education Fund.

REGISTERED SUPPORT:

Journey House (Sponsor)

REGISTERED OPPOSITION:

None on file.

Analysis Prepared by: Robert Sumner / B. & P. / (916) 319-3301