Existing law, the Mental Health Services Act (MHSA), an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Oversight and Accountability Commission, which consists of 16 members, to oversee the administration of various parts of the act. Existing law authorizes the commission to undertake specified activities in carrying out its duties and responsibilities. Existing law authorizes the MHSA to be amended by a ²/₃ vote of the Legislature if the amendments are consistent with, and further the purposes of, the MHSA, and also permits the Legislature to clarify procedures and terms of the MHSA by a majority vote.

Under existing law, the information obtained in the administration of the Unemployment Insurance Code is for the exclusive use and information of the Director of Employment Development in the discharge of his or her duties and is not open to the public. However, existing law permits the use of the information for specified purposes, and allows the director to require reimbursement for direct costs incurred.

This bill would declare the intent of the Legislature to authorize the commission to receive information held by other state agencies, as it relates to outcomes established under the MHSA or adopted by the commission under the MHSA for the purposes of monitoring those outcomes and improving the mental health system. The bill would authorize the Director of Employment Development to share information to enable the commission to receive quarterly wage data of mental health consumers served by the California public mental health system for the purpose of monitoring and evaluating employment outcomes to determine the effectiveness of those services.

This bill would declare that it clarifies procedures and terms of the Mental Health Services Act.

Existing law, the Mental Health Services Act (MHSA), an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Oversight and Accountability Commission, which consists of 16 members, to oversee the administration of various parts of the act. Existing law authorizes the commission to undertake specified activities in carrying out its duties and responsibilities. Existing law authorizes the MHSA to be amended by a ²/₃ vote of the Legislature if the amendments are consistent with, and further the purposes of, the MHSA, and also permits the Legislature to clarify procedures and terms of the MHSA by a majority vote.

Under existing law, the information obtained in the administration of the Unemployment Insurance Code is for the exclusive use and information of the Director of Employment Development in the discharge of his or her duties and is not open to the public. However, existing law permits the use of the information for specified purposes, and allows the director to require reimbursement for direct costs incurred.

This bill would declare the intent of the Legislature to authorize the commission to receive information held by other state agencies, as it relates to outcomes established under the MHSA or adopted by the commission under the MHSA for the purposes of monitoring those outcomes and improving the mental health system. The bill would authorize the Director of Employment Development to share information to enable the commission to receive quarterly wage data of mental health consumers served by the California public mental health system for the purpose of monitoring and evaluating employment outcomes to determine the effectiveness of those services.

This bill would declare that it clarifies procedures and terms of the Mental Health Services Act.

Existing law, the Mental Health Services Act (MHSA), an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Oversight and Accountability Commission, which consists of 16 members, to oversee the administration of various parts of the act. Existing law authorizes the commission to undertake specified activities in carrying out its duties and responsibilities. Existing law authorizes the MHSA to be amended by a ²/₃ vote of the Legislature if the amendments are consistent with, and further the purposes of, the MHSA, and also permits the Legislature to clarify procedures and terms of the MHSA by a majority vote.

Under existing law, the information obtained in the administration of the Unemployment Insurance Code is for the exclusive use and information of the Director of Employment Development in the discharge of his or her duties and is not open to the public. However, existing law permits the use of the information for specified purposes, and allows the director to require reimbursement for direct costs incurred.

This bill would declare the intent of the Legislature to authorize the commission to receive information held by other state agencies, as it relates to outcomes established under the MHSA or adopted by the commission under the MHSA for the purposes of monitoring those outcomes and improving the mental health system. The bill would authorize the Director of Employment Development to share information to enable the commission to receive quarterly wage data to assist the commission in fulfilling its duties under the MHSA. of mental health consumers served by the California public mental health system for the purpose of monitoring and evaluating employment outcomes to determine the effectiveness of those services.

This bill would declare that it clarifies procedures and terms of the Mental Health Services Act.

Existing law, the Mental Health Services Act (MHSA), an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the Mental Health Services Oversight and Accountability Commission, which consists of 16 members, to oversee the administration of various parts of the act. Existing law authorizes the commission to undertake specified activities in carrying out its duties and responsibilities. Existing law authorizes the MHSA to be amended by a ²/₃ vote of the Legislature if the amendments are consistent with, and further the purposes of, the MHSA, and also permits the Legislature to clarify procedures and terms of the MHSA by a majority vote.

Under existing law, the information obtained in the administration of the Unemployment Insurance Code is for the exclusive use and information of the Director of Employment Development in the discharge of his or her duties and is not open to the public. However, existing law permits the use of the information for specified purposes, and allows the director to require reimbursement for direct costs incurred.

This bill would declare the intent of the Legislature to authorize the commission to receive information held by other state agencies, as it relates to outcomes established under the MHSA or adopted by the commission under the MHSA for the purposes of monitoring those outcomes and improving the mental health system. The bill would authorize the Director of Employment Development to share information to enable the commission to receive quarterly wage data to assist the commission in fulfilling its duties under the MHSA.

This bill would declare that it clarifies procedures and terms of the Mental Health Services Act.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 462

Author:(Thurmond)

As Amended Ver:September 1, 2017

Majority vote

Original Committee Reference: HEALTH

SUMMARY: Authorizes the Director of Employment Development Department (EDD) to share information with the Mental Health Services Oversight and Accountability Commission (the Commission) related to quarterly wage data to assist the Commission in fulfilling its duties under the Mental Health Services Act (MHSA), to the extent permitted under applicable federal statute and regulation. Declares it the intent of the Legislature to authorize the Commission to receive information held by other state agencies, as it relates to outcomes established under the MHSA, for purposes of monitoring outcomes and improving the mental health system.

The Senate amendments clarify that the Director of EDD be authorized to share information with the Commission, as specified, for the purpose of monitoring and evaluating employment outcomes to determine the effectiveness of those services, and permits EDD to require reimbursement for all direct costs incurred in providing any and all information.

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

COMMENTS: According to the author, California's MHSA, passed by voters in 2004, established the Commission to promote transformational change for California's mental health system and to develop the tools and strategies needed to ensure oversight and accountability. Among other goals, the MHSA identifies reducing unemployment as a key goal for mental health services as part of a broad range of other outcomes.

This bill authorizes the Director of the EDD to share specified employment-related information with the Commission, to the extent permitted under federal rules and regulations, to allow the Commission to better track employment outcomes for people receiving public mental health services. That information will also enable the Commission to evaluate the effectiveness of services intended to lead to employment and to report those results to the public and policymakers as part of the Commission's broad oversight role.

Information provided by the author also indicates that among people served by public mental health systems, unemployment is more than three times greater than unemployment for the general population. Half of those served in public mental health programs are not in the labor force, discouraged by public policy barriers, and have no prospects for work. Mental health advocates have called for improved strategies to measure and report employment outcomes for mental health clients. The author argues that without the EDD data, the Commission cannot evaluate whether the services under the MHSA are achieving the goal of decreasing unemployment for individuals living with mental illness.

1. Proposition 63. Proposition 63 was passed by voters in November 2004. The MHSA imposes a 1% income tax on personal income in excess of $1 million and creates the 16 member Commission charged with overseeing the implementation of MHSA. The 2017-18 Governor's Budget projected that $1.34 billion would be deposited into the Mental Health Services Fund in fiscal year 2015-16. The MHSA addresses a broad continuum of prevention, early intervention and service needs as well as providing funding for infrastructure, technology and training needs for the community mental health system.
2. EDD Wage Data. UI Code Section 1095 governs when and under what circumstances EDD may permit the use of otherwise confidential information within its possession, including wage data. Other entities that have access to wage data include Chancellor of the California Community Colleges, DHCS, the Department of Motor Vehicles, the Department of Corrections and Rehabilitation, Contractors' State License Board, the Agricultural Labor Relations Board, and the Public Employment Retirement System. The data may include information regarding unemployment claims and benefits, wages, and the receipt of public benefits. Generally, quarterly wage data is used by public social service agencies to determine trends in employment.

The Commission, sponsor of the bill, states that this bill will allow the Commission to receive employment information held by EDD to enable the Commission to document and monitor employment outcomes for persons with mental health needs. The MHSA identifies employment as a key outcome for mental health care. This bill will equip the Commission to develop the tools and standards needed to ensure that California's mental health consumers have access to the services and support needed to obtain and retain employment, a key aspect of a recovery-oriented mental health system.

The California Association of Veteran Services Agencies (CAVSA) states that the information authorized by this bill for transfer from the EDD to the Commission will allow the Commission to evaluate the effectiveness of services intended to lead to employment and to report those results to the public and policymakers as part of the Commission's broad oversight role. While CAVSA agencies provide extensive supportive services, including mental health and employment services, we often lack the data necessary to document why this gap for employment for veterans in need of mental health services still exists.

There is no opposition to this bill.

Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097 FN: 0001929

 THIRD READING 

Bill No: AB 462

Author: Thurmond (D)

Amended: 9/1/17 in Senate

Vote: 21

SENATE HEALTH COMMITTEE: 9-0, 6/7/17

AYES: Hernandez, Nguyen, Atkins, Leyva, Mitchell, Monning, Newman, Nielsen, Roth

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

ASSEMBLY FLOOR: 74-0, 4/20/17 (Consent) - See last page for vote

SUBJECT: Mental Health Services Oversight and Accountability Commission: wage information data access

SOURCE: Mental Health Services Oversight and Accountability Commission

DIGEST:

This bill authorizes the Director of the Employment Development Department to share specified information with the Mental Health Services Oversight and Accountability Commission (MHSOAC) to receive quarterly wage data from consumers, as specified.

Senate Floor Amendments of 9/1/17 are technical and clarify that the MHSOAC is permitted to access wage information data for those who receive public mental health services for the purpose of determining the effectiveness of the services.

ANALYSIS:

Existing law:

1. Establishes the Mental Health Services Act (MHSA), enacted by voters in 2004 as Proposition 63, to provide funds to counties to expand services, develop innovative programs, and integrate service plans for mentally ill children, adults, and seniors through a 1% income tax on personal income above $1 million.
2. Establishes the MHSOAC to oversee the implementation of the MHSA, develop strategies to overcome stigma, and advise the Governor and the Legislature on ways the state can improve care and services to people with mental illness.
3. Requires the Department of Health Care Services (DHCS), pursuant to the MHSA and in coordination with counties, to establish a program designed to prevent mental illnesses from becoming severe and disabling, and requires the program to emphasize strategies to reduce the following negative outcomes that may result from untreated mental illness:
   1. Suicide;
   2. Incarcerations;
   3. School failure or dropout;
   4. Unemployment;
   5. Prolonged suffering;
   6. Homelessness; and,
   7. Removal of children from their homes.
4. Provides for the Unemployment Insurance program, a federal-state program administered by the Employment Development Department (EDD), which provides weekly unemployment insurance payments for workers who lose their employment.
5. Authorizes EDD to maintain the possession and control of, among other things, all records and papers held in the performance of the duties, powers, purposes, responsibilities, and jurisdiction that are vested in EDD. Provides that a person who knowingly accesses, uses, or discloses this confidential information without authorization is guilty of a misdemeanor.
6. Allows EDD to share quarterly wage data with specified entities, including the Department of Motor Vehicles, California’s public colleges, the Department of Corrections and Rehabilitation (CDCR), and DHCS, for specified purposes, including the evaluation and reporting of their respective program performance outcomes.

This bill:

1. Authorizes the Director of EDD to share quarterly wage data with the MHSOAC, to the extent permitted under applicable federal statute and regulations, of mental health consumers served by the California public mental health system for the purpose of monitoring and evaluating employment outcomes to determine the effectiveness of those services.
2. Declares it the intent of the Legislature to authorize the MHSOAC to receive information held by other state agencies, as it relates to outcomes established under the MHSA, for purposes of monitoring outcomes and improving the mental health system.

Comments

1. Author’s statement. According to the author, the MHSA established the MHSOAC to promote transformational change for California's mental health system and to develop the tools and strategies needed to ensure oversight and accountability. Among other goals, the MHSA identifies reducing unemployment as a key goal for mental health services as part of a broad range of other outcomes. This bill authorizes the Director of EDD to share specified employment-related information with the MHSOAC, to the extent permitted under federal rules and regulations, to allow for better tracking of employment outcomes for people receiving public mental health services. That information also will enable the MHSOAC to evaluate the effectiveness of services intended to lead to employment, and to report those results to the public and policymakers as part of the MHSOAC’s broad oversight role.
2. MHSA. The MHSA requires each county mental health program to prepare and submit a three-year plan to DHCS that must be updated each year and approved by DHCS after review and comment by the MHSOAC. DHCS is required to provide guidelines to counties related to each component of the MHSA. In the three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served. Counties also must submit their plans for approval to the MHSOAC before they can spend innovation program funds. The MHSA provides funding for programs within five components:
   1. Community Services and Supports (CSS): Provides direct mental health services to the severely and seriously mentally ill, such as mental health treatment, cost of health care treatment, and housing supports. Regulations require counties to direct the majority of its CSS funds to Full‑Service Partnerships (FSPs). FSPs are county coordinated plans, in collaboration with the client and the family, to provide the full spectrum of community services. These services consist of mental health services and supports, such as peer support and crisis intervention services; and non-mental health services and supports, such as food, clothing, housing, and the cost of medical treatment. Outside of FSPs, counties do not use CSS funds to assist with housing;
   2. Prevention and Early Intervention: Provides services to mental health clients in order to help prevent mental illness from becoming severe and disabling;
   3. Innovation: Provides services and approaches that are creative in an effort to address mental health clients’ persistent issues, such as improving services for underserved or unserved populations within the community;
   4. Capital Facilities and Technological Needs: Creates additional county infrastructure such as additional clinics and facilities and/or development of a technological infrastructure for the mental health system, such as electronic health records for mental health services; and
   5. Workforce Education and Training: Provides training for existing county mental health employees, outreach and recruitment to increase employment in the mental health system, and financial incentives to recruit or retain employees within the public mental health system.
3. Employment rates and mental illness. According to a 2014 report, “Road to Recovery: Employment and Mental Illness,” by the National Alliance on Mental Illness (NAMI), one of the best steps in recovery from mental illness is a job, yet the national unemployment rate for those who receive public mental health services was approximately 80%. California’s rate, which ranked fifth-highest in the nation, was higher than the national average with a 90% unemployment rate among those with mental illness. The four other states with rates higher than California were Pennsylvania, Hawaii, West Virginia, and Maine. According to the NAMI report, about 60% of the 7.1 million people receiving public mental health services want to work, but less than 2% received supported employment opportunities provided by states. The NAMI report states that about six out of 10 people with mental illness could succeed at employment with appropriate supports, yet only 1.7% of people served in state mental health systems received supported employment services in 2012.

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

SUPPORT: (Verified 9/5/17)

Mental Health Services Oversight and Accountability Commission (source)

California Association of Veteran Service Agencies

California Forward Action Fund

CaliforniaHealth+Advocates

California Mental Health Planning Council

Mental Health America of California

National Association of Social Workers California Chapter

United Advocates for Children and Families

OPPOSITION: (Verified 9/5/17)

None received

ARGUMENTS IN SUPPORT: The sponsor and other supporters, largely mental health advocates, argue that intended outcomes of the MHSA include reducing incarcerations, school failure and dropout, unemployment, suicide, prolonged suffering, and homelessness for people living with mental illness. Supporters argue that this bill would enable the MHSOAC to document, monitor, and evaluate employment outcomes from those receiving services from the public mental health system, as well as ensure that mental health consumers have access to services and supports needed to obtain and retain employment, which is a key aspect of a recovery-oriented mental health system. The California Association of Veteran Service Agencies states that California is home to the lion’s share of the nation’s veterans, who continue to be affected by unemployment more than the general public due to physical and mental health injuries.

ASSEMBLY FLOOR: 74-0, 4/20/17

AYES: Acosta, Aguiar-Curry, Travis Allen, Arambula, Baker, Berman, Bigelow, Bloom, Bocanegra, Bonta, Burke, Caballero, Calderon, Cervantes, Chau, Chávez, Chen, Chiu, Chu, Cooley, Cooper, Cunningham, Dababneh, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gomez, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Quirk, Quirk-Silva, Reyes, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon

NO VOTE RECORDED: Brough, Choi, Gallagher, Mathis, Patterson, Ridley-Thomas

Prepared by: Reyes Diaz / HEALTH / (916) 651-4111

9/5/17 18:57:11

**** END ****

 THIRD READING 

Bill No: AB 462

Author: Thurmond (D)

Introduced: 2/13/17

Vote: 21

SENATE HEALTH COMMITTEE: 9-0, 6/7/17

AYES: Hernandez, Nguyen, Atkins, Leyva, Mitchell, Monning, Newman, Nielsen, Roth

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

ASSEMBLY FLOOR: 74-0, 4/20/17 (Consent) - See last page for vote

SUBJECT: Mental Health Services Oversight and Accountability Commission: wage information data access

SOURCE: Mental Health Services Oversight and Accountability Commission

DIGEST:

This bill authorizes the Director of the Employment Development Department to share specified information with the Mental Health Services Oversight and Accountability Commission (MHSOAC) to assist the MHSOAC in fulfilling its duties under the Mental Health Services Act.

ANALYSIS:

Existing law:

1. Establishes the Mental Health Services Act (MHSA), enacted by voters in 2004 as Proposition 63, to provide funds to counties to expand services, develop innovative programs, and integrate service plans for mentally ill children, adults, and seniors through a 1% income tax on personal income above $1 million.
2. Establishes the MHSOAC to oversee the implementation of the MHSA, develop strategies to overcome stigma, and advise the Governor and the Legislature on ways the state can improve care and services to people with mental illness.
3. Requires the Department of Health Care Services (DHCS), pursuant to the MHSA and in coordination with counties, to establish a program designed to prevent mental illnesses from becoming severe and disabling, and requires the program to emphasize strategies to reduce the following negative outcomes that may result from untreated mental illness:
   1. Suicide;
   2. Incarcerations;
   3. School failure or dropout;
   4. Unemployment;
   5. Prolonged suffering;
   6. Homelessness; and,
   7. Removal of children from their homes.
4. Provides for the Unemployment Insurance program, a federal-state program administered by the Employment Development Department (EDD), which provides weekly unemployment insurance payments for workers who lose their employment.
5. Authorizes EDD to maintain the possession and control of, among other things, all records and papers held in the performance of the duties, powers, purposes, responsibilities, and jurisdiction that are vested in EDD. Provides that a person who knowingly accesses, uses, or discloses this confidential information without authorization is guilty of a misdemeanor.
6. Allows EDD to share quarterly wage data with specified entities, including the Department of Motor Vehicles, California’s public colleges, the Department of Corrections and Rehabilitation (CDCR), and DHCS, for specified purposes, including the evaluation and reporting of their respective program performance outcomes.

This bill:

1. Authorizes the Director of EDD to share quarterly wage data with the MHSOAC, to the extent permitted under applicable federal statute and regulations, to assist in fulfilling its duties under the MHSA.
2. Declares it the intent of the Legislature to authorize the MHSOAC to receive information held by other state agencies, as it relates to outcomes established under the MHSA, for purposes of monitoring outcomes and improving the mental health system.

Comments

1. Author’s statement. According to the author, the MHSA established the MHSOAC to promote transformational change for California's mental health system and to develop the tools and strategies needed to ensure oversight and accountability. Among other goals, the MHSA identifies reducing unemployment as a key goal for mental health services as part of a broad range of other outcomes. This bill authorizes the Director of EDD to share specified employment-related information with the MHSOAC, to the extent permitted under federal rules and regulations, to allow for better tracking of employment outcomes for people receiving public mental health services. That information also will enable the MHSOAC to evaluate the effectiveness of services intended to lead to employment, and to report those results to the public and policymakers as part of the MHSOAC’s broad oversight role.
2. MHSA. The MHSA requires each county mental health program to prepare and submit a three-year plan to DHCS that must be updated each year and approved by DHCS after review and comment by the MHSOAC. DHCS is required to provide guidelines to counties related to each component of the MHSA. In the three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served. Counties also must submit their plans for approval to the MHSOAC before they can spend innovation program funds. The MHSA provides funding for programs within five components:
   1. Community Services and Supports (CSS): Provides direct mental health services to the severely and seriously mentally ill, such as mental health treatment, cost of health care treatment, and housing supports. Regulations require counties to direct the majority of its CSS funds to Full‑Service Partnerships (FSPs). FSPs are county coordinated plans, in collaboration with the client and the family, to provide the full spectrum of community services. These services consist of mental health services and supports, such as peer support and crisis intervention services; and non-mental health services and supports, such as food, clothing, housing, and the cost of medical treatment. Outside of FSPs, counties do not use CSS funds to assist with housing;
   2. Prevention and Early Intervention: Provides services to mental health clients in order to help prevent mental illness from becoming severe and disabling;
   3. Innovation: Provides services and approaches that are creative in an effort to address mental health clients’ persistent issues, such as improving services for underserved or unserved populations within the community;
   4. Capital Facilities and Technological Needs: Creates additional county infrastructure such as additional clinics and facilities and/or development of a technological infrastructure for the mental health system, such as electronic health records for mental health services; and
   5. Workforce Education and Training: Provides training for existing county mental health employees, outreach and recruitment to increase employment in the mental health system, and financial incentives to recruit or retain employees within the public mental health system.
3. Employment rates and mental illness. According to a 2014 report, “Road to Recovery: Employment and Mental Illness,” by the National Alliance on Mental Illness (NAMI), one of the best steps in recovery from mental illness is a job, yet the national unemployment rate for those who receive public mental health services was approximately 80%. California’s rate, which ranked fifth-highest in the nation, was higher than the national average with a 90% unemployment rate among those with mental illness. The four other states with rates higher than California were Pennsylvania, Hawaii, West Virginia, and Maine. According to the NAMI report, about 60% of the 7.1 million people receiving public mental health services want to work, but less than 2% received supported employment opportunities provided by states. The NAMI report states that about six out of 10 people with mental illness could succeed at employment with appropriate supports, yet only 1.7% of people served in state mental health systems received supported employment services in 2012.

Related/Prior Legislation

AB 1134 (Gloria, 2017) authorizes the MHSOAC to establish a fellowship program for the purpose of providing an experiential learning opportunity for a mental health consumer and a mental health professional. AB 1134 passed out of the Senate Health Committee by a vote of 9-0 on June 14, 2017.

AB 860 (Cooley, 2017) authorizes the MHSOAC to conduct a fact-finding tour of a facility or location that is not open to the public, as specified. AB 860 passed out of the Senate Health Committee by a vote of 9-0 on June 21, 2017.

AB 850 (Chau, 2017) adds a Governor-appointed member to the MHSOAC who has knowledge and experience in reducing mental health disparities, especially for racial and ethnic communities. AB 850 passed out of the Senate Health Committee by a vote of 9-0 on June 7, 2017.

SB 1141 (Hancock, Chapter 751, Statutes of 2014) allowed CDCR to access EDD information to assess the impact of rehabilitation services on the employment and earnings of former inmates.

AB 908 (Bonilla, Chapter 553, Statutes of 2013) allowed the Department of Motor Vehicles to access EDD information in the course of identity theft investigations.

AB 174 (Monning, Chapter 815, Statutes of 2012) allowed, among other things, DHCS, the California Health Benefit Exchange, the Managed Risk Medical Insurance Board, and county departments and agencies to access EDD information, as specified.

SB 691 (Lieu, Chapter 832, Statutes of 2012) allowed the Contractors’ State License Board and the Agricultural Labor Relations Board to access EDD information, as specified.

AB 1844 (Hernandez, Chapter 369, Statutes of 2008) allowed, among other things, the Director of EDD to release specified information to the Public Employees’ Retirement System, as specified, in connection with the unlawful application for, or receipt of, benefits.

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

SUPPORT: (Verified 6/27/17)

Mental Health Services Oversight and Accountability Commission (source)

California Association of Veteran Service Agencies

California Forward Action Fund

CaliforniaHealth+Advocates

California Mental Health Planning Council

Mental Health America of California

National Association of Social Workers California Chapter

United Advocates for Children and Families

OPPOSITION: (Verified 6/27/17)

None received

ARGUMENTS IN SUPPORT: The sponsor and other supporters, largely mental health advocates, argue that intended outcomes of the MHSA include reducing incarcerations, school failure and dropout, unemployment, suicide, prolonged suffering, and homelessness for people living with mental illness. Supporters argue that this bill would enable the MHSOAC to document, monitor, and evaluate employment outcomes from those receiving services from the public mental health system, as well as ensure that mental health consumers have access to services and supports needed to obtain and retain employment, which is a key aspect of a recovery-oriented mental health system. The California Association of Veteran Service Agencies states that California is home to the lion’s share of the nation’s veterans, who continue to be affected by unemployment more than the general public due to physical and mental health injuries.

ASSEMBLY FLOOR: 74-0, 4/20/17

AYES: Acosta, Aguiar-Curry, Travis Allen, Arambula, Baker, Berman, Bigelow, Bloom, Bocanegra, Bonta, Burke, Caballero, Calderon, Cervantes, Chau, Chávez, Chen, Chiu, Chu, Cooley, Cooper, Cunningham, Dababneh, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gomez, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Quirk, Quirk-Silva, Reyes, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon

NO VOTE RECORDED: Brough, Choi, Gallagher, Mathis, Patterson, Ridley-Thomas

Prepared by: Reyes Diaz / HEALTH / (916) 651-4111

6/29/17 10:40:38

**** END ****

SENATE COMMITTEE ON HEALTH

Senator Ed Hernandez, O.D., Chair

BILL NO: AB 462

SUBJECT: Mental Health Services Oversight and Accountability Commission: wage information data access.

SUMMARY:

Authorizes the Director of the Employment Development Department to share specified information with the Mental Health Services Oversight and Accountability Commission (MHSOAC) to assist the MHSOAC in fulfilling its duties under the Mental Health Services Act.

Existing law:

1. Establishes the Mental Health Services Act (MHSA), enacted by voters in 2004 as Proposition 63, to provide funds to counties to expand services, develop innovative programs, and integrate service plans for mentally ill children, adults, and seniors through a 1% income tax on personal income above $1 million.
2. Establishes the MHSOAC to oversee the implementation of the MHSA, develop strategies to overcome stigma, and advise the Governor and the Legislature on ways the state can improve care and services to people with mental illness.
3. Requires the Department of Health Care Services, pursuant to the MHSA and in coordination with counties, to establish a program designed to prevent mental illnesses from becoming severe and disabling, and requires the program to emphasize strategies to reduce the following negative outcomes that may result from untreated mental illness:
   1. Suicide;
   2. Incarcerations;
   3. School failure or dropout;
   4. Unemployment;
   5. Prolonged suffering;
   6. Homelessness; and,
   7. Removal of children from their homes.
4. Provides for the Unemployment Insurance program, a federal-state program administered by the Employment Development Department (EDD), which provides weekly unemployment insurance payments for workers who lose their employment.
5. Authorizes EDD to maintain the possession and control of, among other things, all records and papers held in the performance of the duties, powers, purposes, responsibilities, and jurisdiction that are vested in EDD. Provides that a person who knowingly accesses, uses, or discloses this confidential information without authorization is guilty of a misdemeanor.
6. Allows EDD to share quarterly wage data with specified entities, including the Department of Motor Vehicles, California’s public colleges, the Department of Corrections and Rehabilitation (CDCR), and the Department of Health Care Services (DHCS), for specified purposes, including the evaluation and reporting of their respective program performance outcomes.

This bill:

1. Authorizes the Director of EDD to share quarterly wage data with the MHSOAC, to the extent permitted under applicable federal statute and regulations, to assist in fulfilling its duties under the MHSA.
2. Declares it the intent of the Legislature to authorize the MHSOAC to receive information held by other state agencies, as it relates to outcomes established under the MHSA, for purposes of monitoring outcomes and improving the mental health system.

FISCAL EFFECT:

According to the Assembly Appropriations Committee, the MHSOAC will likely incur costs in the range of $10,000 (Mental Health Services Fund) to reimburse EDD for data that will assist the MHSOAC in conducting ongoing research to evaluate the effectiveness of spending under the MHSA. The MHSOAC allocates about $2.7 million annually to various research projects.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, the MHSA established the MHSOAC to promote transformational change for California's mental health system and to develop the tools and strategies needed to ensure oversight and accountability. Among other goals, the MHSA identifies reducing unemployment as a key goal for mental health services as part of a broad range of other outcomes. This bill authorizes the Director of EDD to share specified employment-related information with the MHSOAC, to the extent permitted under federal rules and regulations, to allow for better tracking of employment outcomes for people receiving public mental health services. That information also will enable the MHSOAC to evaluate the effectiveness of services intended to lead to employment, and to report those results to the public and policymakers as part of the MHSOAC’s broad oversight role.
2. MHSA. The MHSA requires each county mental health program to prepare and submit a three-year plan to DHCS that must be updated each year and approved by DHCS after review and comment by the MHSOAC. DHCS is required to provide guidelines to counties related to each component of the MHSA. In the three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served. Counties also must submit their plans for approval to the MHSOAC before they can spend innovation program funds. The MHSA provides funding for programs within five components:
   1. Community Services and Supports (CSS): Provides direct mental health services to the severely and seriously mentally ill, such as mental health treatment, cost of health care treatment, and housing supports. Regulations require counties to direct the majority of its CSS funds to Full‑Service Partnerships (FSPs). FSPs are county coordinated plans, in collaboration with the client and the family, to provide the full spectrum of community services. These services consist of mental health services and supports, such as peer support and crisis intervention services; and non-mental health services and supports, such as food, clothing, housing, and the cost of medical treatment. Outside of FSPs, counties do not use CSS funds to assist with housing;
   2. Prevention and Early Intervention: Provides services to mental health clients in order to help prevent mental illness from becoming severe and disabling;
   3. Innovation: Provides services and approaches that are creative in an effort to address mental health clients’ persistent issues, such as improving services for underserved or unserved populations within the community;
   4. Capital Facilities and Technological Needs: Creates additional county infrastructure such as additional clinics and facilities and/or development of a technological infrastructure for the mental health system, such as electronic health records for mental health services; and
   5. Workforce Education and Training: Provides training for existing county mental health employees, outreach and recruitment to increase employment in the mental health system, and financial incentives to recruit or retain employees within the public mental health system.
3. Employment rates and mental illness. According to a 2014 report, “Road to Recovery: Employment and Mental Illness,” by the National Alliance on Mental Illness (NAMI), one of the best steps in recovery from mental illness is a job, yet the national unemployment rate for those who receive public mental health services was approximately 80%. California’s rate, which ranked fifth-highest in the nation, was higher than the national average with a 90% unemployment rate among those with mental illness. The four other states with rates higher than California were Pennsylvania, Hawaii, West Virginia, and Maine. According to the NAMI report, about 60% of the 7.1 million people receiving public mental health services want to work, but less than 2% received supported employment opportunities provided by states. The NAMI report states that about six out of 10 people with mental illness could succeed at employment with appropriate supports, yet only 1.7% of people served in state mental health systems received supported employment services in 2012.
4. Related legislation. AB 1134 (Gloria) would authorize the MHSOAC to establish a fellowship program for the purpose of providing an experiential learning opportunity for a mental health consumer and a mental health professional. AB 1134 is scheduled to be heard in this committee on June 7, 2017.

AB 860 (Cooley) would authorize the MHSOAC to conduct a fact-finding tour of a facility or location that is not open to the public, as specified. AB 860 is pending in this committee.

AB 850 (Chau) would add a Governor-appointed member to the MHSOAC who has knowledge and experience in reducing mental health disparities, especially for racial and ethnic communities. AB 850 is scheduled to be heard in this committee on June 7, 2017.

1. Prior legislation. SB 1141 (Hancock, Chapter 751, Statutes of 2014) allows CDCR to access EDD information to assess the impact of rehabilitation services on the employment and earnings of former inmates.

AB 908 (Bonilla, Chapter 553, Statutes of 2013) allows the Department of Motor Vehicles to access EDD information in the course of identity theft investigations.

AB 174 (Monning, Chapter 815, Statutes of 2012) allows, among other things, DHCS, the California Health Benefit Exchange, the Managed Risk Medical Insurance Board, and county departments and agencies to access EDD information, as specified.

SB 691 (Lieu, Chapter 832, Statutes of 2012) allows the Contractors’ State License Board and the Agricultural Labor Relations Board to access EDD information, as specified.

AB 1844 (Hernandez, Chapter 369, Statutes of 2008) allows, among other things, the Director of EDD to release specified information to the Public Employees’ Retirement System, as specified, in connection with the unlawful application for, or receipt of, benefits.

1. Support. The sponsor and other supporters, largely mental health advocates, argue that intended outcomes of the MHSA include reducing incarcerations, school failure and dropout, unemployment, suicide, prolonged suffering, and homelessness for people living with mental illness. Supporters argue that this bill would enable the MHSOAC to document, monitor, and evaluate employment outcomes from those receiving services from the public mental health system, as well as ensure that mental health consumers have access to services and supports needed to obtain and retain employment, which is a key aspect of a recovery-oriented mental health system. The California Association of Veteran Service Agencies states that California is home to the lion’s share of the nation’s veterans, who continue to be affected by unemployment more than the general public due to physical and mental health injuries.

SUPPORT AND OPPOSITION:

Support: Mental Health Services Oversight and Accountability Commission (sponsor)

California Association of Veteran Service Agencies

California Forward Action Fund

California Mental Health Planning Council

Mental Health America of California

National Association of Social Workers California Chapter

United Advocates for Children and Families

Oppose: None received

-- END --

Date of Hearing: April 5, 2017

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez Fletcher, Chair

ABPCA Bill Id:AB 462

Author:(Thurmond) – As Introduced Ver:February 13, 2017

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

This bill authorizes the Employment Development Department (EDD) to provide quarterly wage data to the Mental Health Services Oversight and Accountability Commission (Commission), in order to assist the Commission in fulfilling its duties under the Mental Health Services Act (MHSA).

FISCAL EFFECT:

The Commission will likely incur costs in the range of $10,000 (Mental Health Services Fund) to reimburse EDD for data. The data will assist the Commission to conduct ongoing research to evaluate the effectiveness of spending under MHSA. The Commission allocates about $2.7 million annually to various research projects.

COMMENTS:

1. Purpose. This bill allows EDD to provide wage data that will assist the Commission to examine employment outcomes for purposes of assessing the impact of MHSA-funded programs.
2. Background. Proposition 63, also called the MHSA, was approved by voters in 2004 and enacted into law on January 1, 2005. It places a 1% tax on personal income above $1 million to fund community mental health services. Prior to making allocations to counties, up to 5% of total of annual revenues is set aside for administrative costs, which includes the Commission's annual operating costs. Counties use MHSA dollars to expand mental health services, provide prevention and early intervention services, offer innovative programs, and educate, train and retain mental health professionals. In 2017-18, the MHSA is projected to generate nearly $1.9 billion.

Wage data collected by EDD is a robust data source for research. EDD has established protocols to share data pursuant to existing privacy protections. This bill adds the Commission to a long list of entities with which EDD is statutorily authorized to share data.

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

Date of Hearing: March 28, 2017

ASSEMBLY COMMITTEE ON HEALTH

Jim Wood, Chair

ABPCA Bill Id:AB 462

Author:(Thurmond) – As Introduced Ver:February 13, 2017

SUBJECT: Mental Health Services Oversight and Accountability Commission: wage information data access.

SUMMARY: Authorizes the Director of Employment Development Department (EDD) to share information with the Mental Health Services Oversight and Accountability Commission (the Commission) related to quarterly wage data to assist the Commission in fulfilling its duties under the Mental Health Services Act (MHSA), to the extent permitted under applicable federal statute and regulation. Declares it the intent of the Legislature to authorize the Commission to receive information held by other state agencies, as it relates to outcomes established under the MHSA, for purposes of monitoring outcomes and improving the mental health system.

EXISTING LAW:

1. Establishes the 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.
2. Requires the California Department of Health Care Services (DHCS), pursuant to the MHSA and in coordination with counties, to establish a program designed to prevent mental illnesses from becoming severe and disabling and requires the program to emphasize strategies to reduce the following negative outcomes that may result from untreated mental illness:
   1. Suicide;
   2. Incarcerations;
   3. School failure or dropout;
   4. Unemployment;
   5. Prolonged suffering;
   6. Homelessness; and,
   7. Removal of children from their homes.
3. Provides for the Unemployment Insurance (UI) program, a federal-state program administered by EDD, which provides weekly unemployment insurance payments for workers who lose their job through no fault of their own.
4. Requires every employer to keep and report to EDD true and accurate work records, including workers status (i.e., employed, on layoff or leave of absence), of the wages paid to each worker and other such information that the director of EDD deems necessary for administration of its programs.
5. Authorizes the EDD to maintain the possession and control of, among other things, all records and papers held in the performance of the duties, powers, purposes, responsibilities, and jurisdiction that are vested in EDD. Provides that a person who knowingly accesses, uses, or discloses this confidential information without authorization is guilty of a misdemeanor.
6. Permits the Director of EDD to use any of the information in his/her possession to the extent necessary for specified purposes and may require reimbursement for all direct costs incurred in providing any and all information to specified entities, with some exceptions.
7. Allows EDD to share information for the following specified purposes, including:
   1. To provide any law enforcement agency with identifiable information and work history of a victim, suspect, missing person, potential witness, or persons with pending warrants.
   2. To provide public employee retirement systems in California with information relating to the earnings of any person who has applied for or is receiving an income or allowance.
   3. To enable the Division of Labor Standards Enforcement to seek criminal, civil, or administrative remedies in connection with the failure to pay wages.
   4. To enable federal, state or, local governmental departments or agencies to administer child support enforcement programs.
   5. To enable DHCS, the California Health Benefit Exchange (HBE), the Managed Risk Medical Insurance Board, and county departments and agencies to obtain information regarding employee wages, California employer names and account numbers, employer reports of wages and number of employees, and disability insurance and unemployment insurance claim information, for the purpose of verifying or determining the eligibility of an applicant for, or a recipient of, state health subsidy programs, including: the Medi-Cal program and the Access for Infants and Mothers Program; subsidies offered through the HBE, including federal tax credits and cost-sharing assistance pursuant to the federal Patient Protection and Affordable Care Act; and verifying or determining the eligibility of employees and employers for health coverage through the Small Business Health Options Program and when the verification or determination is directly connected with, and limited to, the administration of the state health programs, as specified.
   6. To enable the California Department of Education, the University of California, the California State University, and the Chancellor of the California Community Colleges to obtain quarterly wage data on students who have attended their respective systems to assess the impact of education on the employment and earnings of those students.

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

COMMENTS:

1) PURPOSE OF THIS BILL. According to the author, California's MHSA, passed by voters in 2004, established the Commission to promote transformational change for California's mental health system and to develop the tools and strategies needed to ensure oversight and accountability. Among other goals, the MHSA identifies reducing unemployment as a key goal for mental health services as part of a broad range of other outcomes.

This bill authorizes the Director of the EDD to share specified employment-related information with the Commission, to the extent permitted under federal rules and regulations, to allow the Commission to better track employment outcomes for people receiving public mental health services. That information will also enable the Commission to evaluate the effectiveness of services intended to lead to employment and to report those results to the public and policymakers as part of the Commission's broad oversight role.

Information provided by the author also indicates that among people served by public mental health systems, unemployment is more than three times greater than unemployment for the general population. Half of those served in public mental health programs are not in the labor force, discouraged by public policy barriers, and have no prospects for work. Mental Health advocates have called for improved strategies to measure and report employment outcomes for mental health clients. The author argues that without the EDD data, the Commission cannot evaluate whether the services under the MHSA are achieving the goal of decreasing unemployment for individuals living with mental illness.

2) BACKGROUND.

• 1. Proposition 63. Proposition 63 was passed by voters in November 2004. The MHSA imposes a 1% income tax on personal income in excess of $1 million and creates the 16 member Commission charged with overseeing the implementation of MHSA. The 2017-18 Governor’s Budget projected that $1.34 billion would be deposited into the Mental Health Services Fund in fiscal year 2015-16. The MHSA addresses a broad continuum of prevention, early intervention and service needs as well as providing funding for infrastructure, technology and training needs for the community mental health system.
     1. Commission. MHSA requires each county mental health department to prepare and submit a three-year plan to DHCS that must be updated each year and approved by DHCS after review and comment by the Commission. In their three-year plans, counties are required to include a list of all programs for which MHSA funding is being requested and that identifies how the funds will be spent and which populations will be served. Counties must submit their plans for approval to the Commission before the counties may spend certain categories of funding.
     2. Funding. The MHSA provides funding for programs within five components:
        1. Community Services and Supports: Provides direct mental health services to the severely and seriously mentally ill, such as mental health treatment, cost of health care treatment, and housing supports. Regulation requires counties to direct the majority of its Community Services and Supports funds to Full‑Service Partnerships (FSPs). FSPs are county coordinated plans, in collaboration with the client and the family to provide the full spectrum of community services. These services consist of mental health services and supports, such as peer support and crisis intervention services; and non‑mental health services and supports, such as food, clothing, housing, and the cost of medical treatment;
        2. Prevention and Early Intervention: Provides services to mental health clients in order to help prevent mental illness from becoming severe and to improve timely access for underserved populations. Prevention and early intervention programs emphasize strategies to reduce negative outcomes that may result from untreated mental illness: suicide, incarcerations, school failure or dropout, unemployment, prolonged suffering, homelessness, and removal of children from their homes;
        3. Innovation: Provides services and approaches that are creative in an effort to address mental health clients’ persistent issues, such as improving services for underserved or unserved populations within the community;
        4. Capital Facilities and Technological Needs: Creates additional county infrastructure such as additional clinics and facilities and/or development of a technology infrastructure for the mental health system, such as electronic health records for mental health services; and,
        5. Workforce Education and Training: Provides training for existing county mental health employees, outreach, and recruitment to increase employment in the mental health system, and financial incentives to recruit or retain employees within the public mental health system.
  2. EDD Wage Data. UI Code Section 1095 governs when and under what circumstances EDD may permit the use of otherwise confidential information within its possession, including wage data. Other entities that have access to wage data include Chancellor of the California Community Colleges, DHCS, the Department of Motor Vehicles, the Department of Corrections and Rehabilitation, Contractors’ State License Board, the Agricultural Labor Relations Board, and the Public Employment Retirement System. The data may include information regarding unemployment claims and benefits, wages, and the receipt of public benefits. Generally, quarterly wage data is used by public social service agencies to determine trends in employment.

3) SUPPORT. The Commission, sponsor of the bill, states that this bill will allow the Commission to receive employment information held by EDD to enable the Commission to document and monitor employment outcomes for persons with mental health needs. The MHSA identifies employment as a key outcome for mental health care. This bill will equip the Commission to develop the tools and standards needed to ensure that California's mental health consumers have access to the services and support needed to obtain and retain employment, a key aspect of a recovery-oriented mental health system.

The California Association of Veteran Services Agencies (CAVSA) states that the information authorized by this bill for transfer from the EDD to the Commission will allow the Commission to evaluate the effectiveness of services intended to lead to employment and to report those results to the public and policymakers as part of the Commission's broad oversight role. While CAVSA agencies provide extensive supportive services, including mental health and employment services, we often lack the data necessary to document why this gap for employment for veterans in need of mental health services still exists.

4) RELATED LEGISLATION.

a) AB 488 (Kiley) establishes the Mental Health Services Fund Transparency and Accountability Office within the California Health and Human Services Agency and would transfer various functions of DHCS under the MHSA to the office, as specified. AB 488 is pending in the Assembly Health Committee.

b) AB 727 (Nazarian) clarifies that counties may spend MHSA monies on housing assistance, as defined, for people in the target population identified in the MHSA. AB 727 is pending in the Assembly Health Committee.

• 1. AB 850 (Chau) requires the Governor to appoint an additional member to the Commission who has knowledge and experience in reducing mental health disparities, especially for racial and ethnic communities. AB 850 is pending in the Assembly Health Committee.
  2. AB 860 (Cooley) authorizes the Commission to conduct a fact-finding tour of a facility or location that is not open to the public, as specified. AB 860 is pending in the Assembly Health Committee.
  3. AB 834 (Gloria) authorizes the Commission to establish a fellowship program for the purpose of providing an experiential learning opportunity for a mental health consumer and a mental health professional. AB 834 is pending in the Assembly Health Committee.

REGISTERED SUPPORT / OPPOSITION:

Support

Mental Health Services Oversight and Accountability Commission (sponsor)

California Association of Veteran Service Agencies

Opposition

None on file.

Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2323