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AB-1126 Mental Health Services Oversight and Accountability Commission.(2019-2020)

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Date Published: 04/02/2019 04:00 AM
AB1126:v98#DOCUMENT

Amended  IN  Assembly  April 01, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 1126


Introduced by Assembly Member Members O’Donnell and Kiley
(Coauthor: Assembly Member Chu)

February 21, 2019


An act to add Section 49428.5 to the Education Code, relating to pupil health. Sections 5830.1, 5845.2, and 5845.3 to the Welfare and Institutions Code, relating to mental health.


LEGISLATIVE COUNSEL'S DIGEST


AB 1126, as amended, O’Donnell. Pupil health: mental health services. Mental Health Services Oversight and Accountability Commission.
(1) 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, among other things, establishes the Mental Health Services Oversight and Accountability Commission to oversee the administration of various parts of the MHSA. The MHSA authorizes the commission to, among other things, establish technical advisory committees, assist in providing technical assistance to accomplish the purposes of the MHSA, and employ all other strategies necessary or convenient to enable it to perform its duties. 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.
This bill would require the commission, by January 1, 2021, to establish technical assistance centers and one or more clearinghouses to support counties in addressing mental health issues of statewide concern, with a focus on school mental health and reducing unemployment and criminal justice involvement due to untreated mental health issues.
The bill would also require the commission to develop a fiscal transparency and accountability strategy, a program transparency and accountability strategy for local government mental health programs, and an outcome transparency and accountability strategy for local government mental health programs in order to support public understanding of mental health funding, access to mental health services, and outcomes achieved by publicly funded or supported mental health programs. The bill would give the commission access to data, information, policies, procedures, and practices held or maintained by state and local agencies in order to develop these strategies and would require the commission to comply with applicable privacy and confidentiality laws with respect to this data. By requiring local agencies to provide access to the commission, this bill would impose a state-mandated local program.
(2) The MHSA also requires counties to create plans for innovative programs, funds for which may be expended upon approval by the commission.
This bill would, subject to the availability of funds, require the commission, by January 1, 2021, to establish an innovation incubator to support implementation of those innovative programs.
(3) By authorizing a new use of MHSA moneys, this bill would amend the MHSA. The bill would state the findings and declarations of the Legislature that this change is consistent with and furthers the intent of the MHSA.
(4) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law requires the governing board of any school district to give diligent care to the health and physical development of pupils and authorizes the governing board of a school district to employ properly certified persons for the work. Existing law requires a school of a school district or county office of education and a charter school to notify pupils and parents or guardians of pupils no less than twice during the school year on how to initiate access to available pupil mental health services on campus or in the community, or both, as provided.

This bill would require the State Department of Education to collaborate with the State Department of Health Care Services to streamline and simplify the processes whereby local educational agencies and county behavioral health agencies collaborate to leverage available funding to provide mental health services to pupils.

Vote: MAJORITY2/3   Appropriation: NO   Fiscal Committee: YES   Local Program: NOYES  

The people of the State of California do enact as follows:


SECTION 1.

 The Legislature finds and declares all both of the following:

(a)Twenty percent of youth 13 to 18 years of age, inclusive, residing in the United States live with a mental health condition, and 50 percent of all lifetime cases of mental illness begin by 14 years of age.

(b)In California, one in five children have a mental health disorder and, of those children, approximately two-thirds do not receive mental health treatment or services.

(c)The rate of mental health related hospitalizations for youth in California has increased by 50 percent since 2007.

(d)

(a) Mental health problems that are not addressed early in life can have severe consequences, including increased difficulties at home, with peers, and in school, and youths with mental health problems are at a higher risk of dropping out of school and engaging in illegal substance use, criminal behavior, and other risk-taking behaviors.

(e)

(b) Early diagnoses and appropriate services for children and their families can make a difference in the lives of children with mental disorders.

(f)Mental health needs among children and youths are effectively served by a multitiered systems of support framework with a continuum of support services, including education and prevention services for all students and targeted or intensive interventions for those identified as most in need.

(g)Research confirms that access to school-based physical and mental health services provides high value to children, schools, and the state, and approximately 70 percent of children in the United States receiving mental health services receive these services at school.

(h)California provides fewer physical and mental health services in schools than almost any other state.

SEC. 2.Section 49428.5 is added to the Education Code, to read:
49428.5.

The department shall collaborate with the State Department of Health Care Services to streamline and simplify the processes whereby local educational agencies and county behavioral health agencies collaborate to leverage available funding to provide mental health services to pupils, including, but not limited to, funding for early and periodic screening, diagnosis, and treatment, funding for prevention and early intervention provided pursuant to the Children’s Mental Health Services Act (Part 4 (commencing with Section 5850) of Division 5 of the Welfare and Institutions Code), and funding available through the local educational agency Medi-Cal billing option program.

SEC. 2.

 Section 5830.1 is added to the Welfare and Institutions Code, to read:

5830.1.
 (a) Subject to the availability of funds, the commission shall, by January 1, 2021, establish an innovation incubator to support implementation of innovative programs as described in Section 5830.
(b) The innovation incubator shall provide all of the following:
(1) Strategic guidance to facilitate the provision of mental health services to students through partnerships between counties and school districts, county offices of education, charter schools, and other entities.
(2) Strategic guidance to facilitate multicounty innovation investment in high-priority needs.
(3) Technical assistance and training to successfully plan, design, and implement innovations to improve the effectiveness and efficiency of county innovation component processes.
(4) Support for the design of evaluations to ensure that counties and other stakeholders understand the impact of individual innovations and of the broader innovation program.
(5) Assistance in disseminating information on the lessons learned from innovative programs to encourage replication and continuous improvement and translating that information into systemic change necessary for statewide impact.
(6) Any other support and assistance deemed necessary by the commission.

SEC. 3.

 Section 5845.2 is added to the Welfare and Institutions Code, to read:

5845.2.
 Subject to the availability of funds, the commission shall, by January 1, 2021, establish technical assistance centers and one or more clearinghouses to support counties in addressing mental health issues of statewide concern, including youth mental health, with a focus on school mental health and reducing unemployment and criminal justice involvement due to untreated mental health issues the commission identifies as being of statewide concern.

SEC. 4.

 Section 5845.3 is added to the Welfare and Institutions Code, to read:

5845.3.
 (a) The commission shall develop a fiscal transparency and accountability strategy to support public understanding of how mental health services are funded, revenue and expenditure trends, and the availability of mental health funds to support the needs of mental health consumers and California’s communities. The commission shall include sufficient information to allow for public awareness and monitoring of current and historical statewide local government mental health spending, aggregated by county, counties acting jointly, county-school partnerships, or by another type of jurisdiction, as determined by the commission. This fiscal transparency and accountability strategy shall also include information on revenues, expenditures, and unspent funds available for state administration of mental health services. To support this strategy, the commission shall include information on both of the following:
(1) Total mental health revenues, expenditures, and unspent funds from all sources, including, but not limited to, the Mental Health Services Fund, the Local Revenue Fund, the Local Revenue Fund 2011, and federal financial participation for the Medi-Cal program.
(2) Additional information the commission determines will support this strategy.
(b) The commission shall develop a program transparency and accountability strategy for local government mental health programs to support public understanding of how people are accessing services and care and how local governments and schools are spending mental health funds. This strategy shall allow for public awareness and monitoring of publicly funded or supported mental health programs statewide, aggregated by county, counties acting jointly, county-school partnerships, or by another type of jurisdiction, as determined by the commission. To support this strategy, the commission shall include information on both of the following:
(1) The nature of services available, the geographic location where services are provided, the intended population to be served, and if the services are available through the county, school-based or school-linked entities, other public entities, or private contracts.
(2) The number of persons served and information on demographic characteristics, including, but not limited to, age, race, ethnicity, gender, sexual orientation, language spoken, veteran status, and other characteristics intended to improve public understanding of who is served by mental health programs.
(c) (1) The commission shall develop an outcome transparency and accountability strategy for local government mental health programs to support public awareness and monitoring of outcomes achieved statewide by publicly funded or supported mental health programs, aggregated by county, counties acting jointly, county-school partnerships, or by another type of jurisdiction, as determined by the commission. To the extent information is available, historical information on mental health outcomes and information on mental health outcomes for the most recently completed fiscal year shall be available.
(2) The commission shall, as it deems necessary, identify or develop the outcomes and measures to be addressed in the strategy required pursuant to paragraph (1), which may include, but are not limited to, the outcomes identified in subdivision (d) of Section 5840, including school failure or dropout, reductions in homelessness, unemployment, removal of children from their homes, suicide, incarcerations, and prolonged suffering, and other measures associated with access to mental health services and supports, the quality of those services and supports, and the outcomes that result from accessing those services and supports. For purposes of this strategy, “removal of children from their homes,” means involvement with the child welfare system, the juvenile justice system, or other out-of-home placement, as determined by the commission.
(d) (1) Notwithstanding any other law, the commission shall have access to data, information, policies, procedures, and practices held or maintained by the departments within the California Health and Human Services Agency, the Department of Justice, the State Department of Education, and the Employment Development Department, and other state and local agencies, as necessary to comply with the requirements of this section. In accessing data pursuant to this subdivision, the commission shall comply with all applicable federal and state privacy and confidentiality laws.
(2) The departments within the California Health and Human Services Agency, and the Department of Justice, the State Department of Education, the Employment Development Department, and other state and local agencies shall cooperate and share data with the commission to accomplish the intent of this section.
(e) The commission shall consider whether existing regulatory reporting requirements are adequate to develop the strategies described in subdivisions (a), (b), and (c), and shall revise those regulatory reporting requirements that are under the commission’s jurisdiction, and recommend revisions of the requirements that are not under the regulatory jurisdiction of the commission, if the commission determines it is necessary, to support enhanced reporting, transparency, and accountability.
(f) Consistent with subdivision (b) of Section 5846, the State Department of Health Care Services shall issue, and periodically update, regulations regarding demographic reporting or other requirements that are consistent with regulations adopted by the commission and support the transparency and accountability strategy developed by the commission.

SEC. 5.

 If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.

SEC. 6.

 The Legislature finds and declares that this act is consistent with and furthers the intent of the Mental Health Services Act within the meaning of Section 18 of the Mental Health Services Act.