Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed by, and funded pursuant to, federal Medicaid program provisions. Existing law provides that specified services provided by local educational agencies (LEAs) are covered Medi-Cal benefits, including, but not limited to, mental health evaluations, mental health education, and mental health and counseling services. Existing law provides that an LEA may be reimbursed for the provision of those benefits on a fee-for-service basis through the Medi-Cal billing option for LEAs.

This bill would require the department to establish the Local Educational Agency Behavioral Health Integration Pilot Program for the purpose of improving the behavioral health outcomes of students through a whole person care approach that is accomplished by providing funding to an eligible participant for the provision by improving the delivery of direct behavioral health services, as defined. The bill would require the department to encourage eligible participants to participate in the program, to provide technical assistance to eligible participants, to develop a request for a proposals process to determine funding allocation, and to formulate any necessary Medi-Cal State Plan amendments, and award grants pursuant to these provisions. The bill would require an LEA receiving funding through the program to use funds received to undertake specified activities in support of the program, including, among others, providing, or building capacity for the provision of, direct behavioral health services to all students with a demonstrated need, with a concerted effort toward improving the delivery of underutilized services to students enrolled in the Medi-Cal program. The bill would authorize an LEA to provide direct behavioral health services through direct employment of health care providers, or by contracting, as specified, with health care providers or school health centers, as defined. The bill would provide for implementation of the program to the extent that any necessary federal approvals have been obtained. The bill would require the department, upon termination of the program and depletion of appropriated funds, to report to the Legislature, as specified, on the outcomes of the program and the need for funding school-based health services and their connection to early behavioral health outcomes. The bill would make related legislative findings and declarations.

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, funds a system of county mental health plans for the provision of mental health services, as specified. The MHSA provides that it may be amended by the Legislature by a ²/₃ vote of each house as long as the amendment is consistent with and furthers the intent of the MHSA. Existing law establishes the Mental Health Services Fund (MHSF), continuously appropriated to and administered by the department, to fund specified county mental health programs, including prevention and early intervention programs and programs implemented under the Adult and Older Adult Mental Health System of Care Act. The MHSA authorizes the payment of administrative costs of the state from the fund in an amount not greater than 5% of the annual total deposited in the fund and otherwise specifies the distribution of moneys in the fund.

To implement the pilot program, this bill would appropriate $15 $10 million per year for the fiscal years from the 2018–19 fiscal year through and including the 2021–22 fiscal year to the department, subject to availability, from the MHSF moneys reserved for administrative costs described above. The bill would provide that funds not fully expended in a single fiscal year shall be available for the purpose of implementing this article in any one, or across one or more of, subsequent fiscal years, as specified. The bill would require the program to operate for 4 years from the date of that appropriation. By changing the use of the reserved administrative funds from that approved by the voters, the bill would amend the MHSA.