AB 253 (Roger Hernández) Page 2 of 2
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 253
AUTHOR: / Roger HernándezVERSION: / April 30, 2015
HEARING DATE: / June 24, 2015
CONSULTANT: / Reyes Diaz
SUBJECT: Mental health.
SUMMARY:
Requires specified government entities responsible for administering the Veterans Housing and Homeless Prevention Act of 2014 (VHHP) to give preference to applicants for funding from the VHHP for supportive housing projects, as specified. Requires the Governor to appoint two additional members to the Mental Health Services Oversight and Accountability Commission with mental health experience, as specified. Requires the Department of Health Care Service to post specified information from mental health plans to a dedicated Internet Web page and to notify appropriate committees of the Legislature, as specified.
Existing law:
1) Establishes the Mental Health Services Oversight and Accountability Commission (MHSOAC) to oversee the implementation of the Mental Health Services Act (MHSA), enacted by voters in 2004 as Proposition 63, which provides funds to counties to expand services, and develop innovative programs and integrated service plans, for mentally ill children, adults, and seniors through a one percent income tax on personal income above $1 million.
2) Specifies that the MHSA can only be amended by a two-thirds vote of both houses of the Legislature and only as long as the amendment is consistent with and furthers the intent of the MHSA. Permits provisions clarifying the procedures and terms of the MHSA to be added by majority vote.
3) Requires the MHSOAC to consist of 16 voting members as follows:
a) The Attorney General or his or her designee;
b) The Superintendent of Public Instruction or his or her designee;
c) The Chair of the Senate Health and Human Services Committee or another member of the Senate selected by the President pro Tempore of the Senate;
d) The Chair of the Assembly Health Committee or another member of the Assembly selected by the Speaker of the Assembly; and,
e) 12 members appointed by the Governor that include:
i. Two people with a severe mental illness;
ii. A family member of an adult or senior with a severe mental illness;
iii. A family member of a child who has or has had a severe mental illness;
iv. A physician specializing in alcohol and drug treatment;
v. A mental health professional;
vi. A county sheriff;
vii. A superintendent of a school district;
viii. A representative of a labor organization;
ix. A representative of an employer with less than 500 employees;
x. A representative of an employer with more than 500 employees; and,
xi. A representative of a health care services plan or insurer.
4) Establishes the VHHP, an initiative measure enacted by the voters in 2014 as Proposition 41, authorizing $600 million in bonds for the acquisition, construction, rehabilitation, and preservation of affordable multifamily supportive housing, affordable multifamily transitional housing, or related facilities for veterans and their families.
5) Requires the California Housing Finance Agency (CalHFA), the Department of Housing and Community Development (HCD), and the Department of Veterans Affairs (CalVet) to work collaboratively to carry out the duties and functions of the VHHP.
6) Provides that Department of Health Care Services (DHCS) is responsible for the development and implementation of mental health plans for Medi-Cal beneficiaries.
7) Requires mental health plans, whether administered by public or private entities, to provide culturally competent and age-appropriate services, to the extent feasible.
This bill:
1) Requires CalHFA, HCD, and CalVet to give preference to applicants for funding from the VHHP for supportive housing projects when the applicant can demonstrate a multi-year commitment of MHSA funding for the applicant’s project funding plan.
2) Requires the Governor to appoint two additional members to the MHSOAC: a) a person with knowledge and experience in reducing mental health disparities and b) a person who is a veteran with knowledge about veteran’s mental health issues.
3) Requires DHCS to post the cultural competence plan component of each mental health plan on a dedicated Internet Web page within 30 days after the mental health plan has been submitted to DHCS for approval. Requires DHCS to notify the appropriate fiscal and policy committees of the Legislature once the plan is available on the Internet Web page.
FISCAL EFFECT:
According to the Assembly Appropriations Committee, this bill has no significant new costs to HCD to award preference to specified applicants, and there are minor and absorbable costs to reimburse for travel and lodging for MHSOAC meetings (MHSA administration account).
PRIOR VOTES:
Assembly Floor: / 79 - 0Assembly Appropriations Committee: / 16 - 1
Assembly Housing and Community Development Committee: / 4 - 0
COMMENTS:
1) Author’s statement. According to the author, AB 253 strengthens the expertise of the MHSOAC and bolsters the link between bond funds that can be used for constructing housing for veterans and service dollars that can assist in providing services for veterans in those supportive housing projects. AB 253 adds two additional members to the MHSOAC to include a veteran with knowledge about veterans’ mental health issues and a person with knowledge and expertise in reducing mental health disparities. Doing so will help tackle these challenges in these communities. The importance of making sure mental health services and outreach are available to underserved communities continues to be a challenge at the local level. The information from the California Reducing Disparities Project indicates communities are not receiving culturally appropriate services. In fact, in some instances, they are not being reached at all because they might require different approaches to bring them into the system. Many speak about how much they want to help veterans, and all of us are grateful for their service. AB 253 is an opportunity for the Legislature to make it easier to help our veterans.
2) MHSA. The MHSA provides funding for programs within five components:
a) 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. CSS requires counties to direct the majority of its funds to full-service partnerships, which 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;
b) Prevention and Early Intervention: provides services to mental health clients in order to help prevent mental illness from becoming severe and disabling;
c) 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;
d) 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;
e) 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.
The 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 MHSOAC. 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 what populations will be served. Counties must submit their plans for approval to the MHSOAC before the counties may spend certain categories of funding.
3) VHHP. The VHHP restructures $600 million of the $900 million in bonds approved by the voters for the CalVet Home Loan Program in 2008 and uses them instead to fund the acquisition, construction, rehabilitation, and preservation of affordable multifamily supportive housing, affordable multifamily transitional housing, or related facilities for veterans and their families. The VHHP tasks HCD with administering the new funding program in collaboration with CalVet and explicitly restricts the use of bond proceeds to those housing units designated for veterans and their families. The focus of the program is on housing for veterans who are homeless or at risk for homelessness and in need of services, such as mental health counseling, substance abuse treatment, job training, and physical therapy to address injuries. HCD released the first VHHP Program Notice of Funding Availability on February 20, 2015, announcing the availability of approximately $75 million in VHHP funding. The anticipated award date will be in June 2015.
4) Mental health plan requirements. DHCS is responsible for the development and implementation of mental health plans for Medi-Cal beneficiaries. Mental health plans, whether administered by public or private entities, are governed by specified guidelines, including, but not limited to, how a plan will establish appropriate care standards, how a plan will provide specialty mental health services to eligible adults and children, and other requirements. Mental health plans must also assess the cultural competency needs of the program and must include a process to accommodate the significant needs with reasonable timeliness.
5) Data on mental illness and homelessness. In the “Current Statistics on the Prevalence and Characteristics of People Experiencing Homelessness in the United States,” last updated in July 2011 by the federal Substance Abuse and Mental Health Services Administration, data from 2010 shows that, nationally, on a given night 407,966 individuals were homeless in shelters, transitional housing programs, or on the streets (not including those who were sleeping at the homes of family or friends), and 109,812 individuals were chronically homeless (a one percent decrease from the previous year). Of these individuals, 26.2% had a severe mental illness, and 34.7% of adults had chronic substance use disorders. Over the course of that year, data shows that a total of 1,593,150 individuals experienced homelessness.
According to HCD’s Web site, California is home to nearly 1.8 million veterans, the largest veteran population in the nation. Nearly 15,000 California veterans experience homelessness on a given night, representing nearly 26% of the nation’s homeless veterans. Homeless veterans are overrepresented in the homeless population, and veteran status is associated with a higher risk of homelessness. Of the state’s extremely low-income veteran renter households, 79% have a severe cost burden, spending more than 50% of their income on housing.
6) Double referral. This bill is double referred. Should it pass out of this committee, it will be referred to the Senate Committee on Transportation and Housing.
7) Related legislation. AB 745 (Chau) requires the Governor to appoint an additional member to the MHSOAC who has experience providing supportive housing to persons with a severe mental illness. AB 745 is pending in the Senate Appropriations Committee.
8) Prior legislation. AB 1929 (Chau, Chapter 674, Statutes of 2014), allowed county mental health departments to deposit MHSA funding with CalHFA, as specified, and allowed CalHFA to use those funds for special housing needs for those with mental illness. Required counties to dedicate funds to provide housing assistance to those with serious mental illness who are homeless or to the mentally ill at risk of being homeless.
AB 639 (Pérez, Chapter 727, Statutes of 2013), established the VHHP.
9) Support. Supporters of this bill, including veterans’ organizations and mental health advocates, argue that this bill would establish a more cooperative effort between state and county behavioral health departments and private nonprofits to obtain targeted funding for housing for veterans with mental health conditions. Supporters further argue that increasing the availability of housing for veterans, in conjunction with giving them a voice on mental health plans, offers the best chance for stability and reduced homelessness.
SUPPORT AND OPPOSITION:
Support: California Association of Veteran Service Agencies (co-sponsor)
Racial and Ethnic Mental Health Disparities Coalition (co-sponsor)
Steinberg Institute (co-sponsor)
American Legion-Department of California
AMVETS-Department of California
California Association of County Veteran Service Officers
California Chapter of the National Association of Social Workers
California Military Officer Association of America
California Pan-Ethnic Health Network
California State Commanders Veterans Council
Disability Rights California
Little Hoover Commission
Mental Health America of California
VFW-Department of California
Vietnam Veterans of America-California State Council
Oppose: None received.
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