Bill Text: CA SB326 | 2023-2024 | Regular Session | Amended
Bill Title: The Behavioral Health Services Act.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Passed) 2023-10-12 - Chaptered by Secretary of State. Chapter 790, Statutes of 2023. [SB326 Detail]
Download: California-2023-SB326-Amended.html
Amended
IN
Assembly
September 08, 2023 |
Amended
IN
Assembly
September 05, 2023 |
Amended
IN
Assembly
August 23, 2023 |
Amended
IN
Assembly
August 15, 2023 |
Amended
IN
Assembly
July 13, 2023 |
Amended
IN
Assembly
June 19, 2023 |
Amended
IN
Senate
March 21, 2023 |
Introduced by Senator Eggman (Coauthor: Assembly Member Wood) |
February 07, 2023 |
LEGISLATIVE COUNSEL'S DIGEST
Digest Key
Vote: 2/3 Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
The people of the State of California hereby find and declare all the following:
(a)The data is alarming. In 2022, one in 20 adults in California is living with a serious mental illness (SMI), representing a nearly 50-percent increase in the last decade. One in 13 children in California has a serious emotional disturbance (SED), which is more common in children in low-income families, and 30 percent of youth 12 to 24 years of age experience serious psychological distress. One in 10 Californians meet the criteria for a substance use disorder (SUD), and the rate of SUDs among youth 18 to 25 years of age is nearly twice that of adults and more
than three times that of adolescents.
(b)The number of amphetamine-related emergency department (ED) visits increased nearly 50 percent between 2018 and 2020, while the number of non-heroin-related opioid, including fentanyl, ED visits more than doubled in the same period. The total cost of care for individuals with behavioral health conditions who use emergency departments and inpatient services is roughly two times higher than those who do not. Hospitals have reported a significant increase in the number of adolescents seeking psychiatric treatment in emergency departments.
(c)Black, indigenous, and communities of color, younger and older individuals, people who are LGBTQ+, victims of domestic violence or sexual abuse, veterans, people involved with the justice system,
and people who are experiencing homelessness, among others, are the most impacted.
(d)Black, indigenous, and people of color (BIPOC) experience disparities in access to health care, which may contribute to and sustain racial inequities in behavioral health care. Latinx, Asian, and Pacific Islander Medi-Cal enrollees have the lowest rates of access to services of all racial and ethnic groups and are less likely to have continued engagement with behavioral health services across both managed care and county specialty plans.
(e)Nationally, suicide rates among youth between 10 and 18 years of age have increased, as has the rate for Black and Latinx youth between 10 and 24 years of age in California. LGBTQ+ youth are over four times more likely to attempt suicide than non-LGBTQ+
peers, while multiple suicide risk factors may affect adults 65 years of age and older, including psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, and physical illnesses.
(f)Veterans have a higher rate of suicide than the general population and experience higher rates of mental illness or substance use disorder. In 2020, there were over 10,000 Californian veterans experiencing homelessness.
(g)Nearly one-quarter of California’s homeless population have an SMI and are at higher risk of justice involvement. Among recently incarcerated individuals, data suggests that close to one in three people experiencing homelessness are living with an SMI. Overdose is the leading cause of death for people recently released from
incarceration.
(h)Meeting the growing demand for behavioral health care has exposed strained infrastructure. There are workforce challenges across professional classifications that do not easily facilitate a career pathway to meet the need for holistic and compassionate behavioral health care and positions that provide a living wage. The current workforce is not diverse enough or culturally representative of those in need. The limited availability of clinically appropriate, culturally competent, community-based care facilities and residential settings to support rehabilitation and recovery contributes to the growing crisis of homelessness and incarceration among those living with a mental health disorder and an SUD. Research in 2021 indicates that the state has a shortage of over 2,700 subacute and nearly 3,000 community residential beds.
(i)More can be done to support capacity, access, and quality of required behavioral health care for individuals who are insured. Enhanced fiscal and programmatic oversight is needed to prevent insured individuals experiencing behavioral health challenges from needing publicly resourced care through the county specialty behavioral health system. By improving planning and administration, performance monitoring, and accountability, individual service and system level outcomes will improve.
The purposes and intent in enacting this act are as follows:
(a)The state intends to transform its behavioral health system while strengthening the continuum of community-based care options for Californians living with the most significant mental health and substance use disorder (SUD) needs. These efforts include, but are not limited to, California Advancing and Innovating Medi-Cal (CalAIM), Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT), the California Reducing Disparities Project (CRDP), Children and Youth Behavioral Health Initiative (CYBHI), Behavioral Health Continuum Infrastructure
Program (BHCIP), Community Assistance, Recovery, and Empowerment (CARE) Act, the 988 Suicide and Crisis Lifeline, and the Crisis Care Continuum.
(b)Further transformation of the behavioral health system requires modernization to account for changes in the health care and behavioral health landscape since the Mental Health Services Act was enacted 20 years ago, including the passage and implementation of the federal Patient Protection and Affordable Care Act, which expanded coverage and required essential health benefits, including behavioral health benefits, for individuals insured under Medicaid. In addition, federal and state parity laws have expanded access to services and affordable coverage. Funding sources should not only be maximized to the fullest extent possible, but must be blended and braided, to leverage public resources
for where the unmet need is greatest.
(c)The state continues to align goals and further policies that support delivery system improvements. This includes advancing the use of evidence-based and community-defined evidence programs, taking a whole person approach that is trauma informed, developmentally tailored across the lifespan, streamlined and seamless service delivery, supports the individual in the recovery process, reduces health disparities, and acts in partnership with families and support systems.
(d)The state intends to strengthen oversight over key outcomes so that investments are being made in equitable and high-quality care. Outcome measures, not just process measures, will drive toward meaningful and measurable system change, including the reduction of
behavioral health disparities. Transparency will increase and revised planning processes will allow strategic alignment of funding and local cross-system collaboration.
(e)The state recognizes the critical role that safe, stable, and affordable housing play in supporting individuals with a mental health disorder and an SUD to thrive in their communities. The state also acknowledges that LGBTQ+ youth, justice involved youth and adults, and older adults have heightened challenges obtaining and maintaining housing. Therefore, dedicated resources towards essential housing interventions for those experiencing a mental health disorder and an SUD are needed for those experiencing or who are at risk of experiencing homelessness.
(f)Additionally, the state will lead
enhanced efforts to address workforce challenges by recruiting, training, and creating a pathway to high-quality jobs that can meet the growing behavioral health care needs of Californians with culturally competent care provided in multiple languages by a diverse workforce. Investments to address the growing demand for quality behavioral health care services across professional classifications should be additive to the workforce and not cause the displacement of any county employee providing direct behavioral health services.
(g)Efforts to streamline the process for approving projects and renovating or building new facilities to accelerate the delivery of care in residential settings made available through additional Behavioral Health Services Act and bond financing is a priority.
(h)Overall, this measure furthers California’s transformation of the behavioral health care system, specifically strengthening the continuum of care for the most vulnerable Californians and the system as a whole. It provides substantial state investment and streamlines the construction of community behavioral health residential settings, modernizes the Mental Health Services Act, and improves statewide accountability and access to behavioral health services. Collectively these connected initiatives provide tools to help Californians with their unique behavioral health challenges.
SECTION 1.
The people of the State of California hereby find and declare all of the following:SEC. 2.
The purposes and intent in enacting this act are as follows:SEC. 3.
Section 99277 of the Education Code is amended to read:99277.
(a) Upon receiving funding for purposes of this chapter, UCSF, the UC college named in Section 92200, and the UC/CSU California Collaborative on Neurodiversity and Learning shall each appoint one member from the respective institutions. This group shall be charged with the development and oversight of the initiative, and shall function as the institute’s management committee. The management committee shall be permitted, but not obligated, to retain a program director to assist in the implementation of the initiative.SEC. 4.
Section 99277 is added to the Education Code, to read:99277.
(a) Upon receiving funding for purposes of this chapter, UCSF, the UC college named in Section 92200, and the UC/CSU California Collaborative on Neurodiversity and Learning shall each appoint one member from the respective institutions. This group shall be charged with the development and oversight of the initiative and shall function as the institute’s management committee. The management committee shall be permitted, but not obligated, to retain a program director to assist in the implementation of the initiative.SEC. 5.
Section 131315 of the Health and Safety Code is amended to read:131315.
If the Office of Suicide Prevention is established pursuant to Section 131300, all of the following shall apply:SEC. 6.
Section 131315 is added to the Health and Safety Code, to read:131315.
(a) If the Office of Suicide Prevention is established pursuant to Section 131300, both of the following shall apply:SEC. 7.
Section 19602.5 of the Revenue and Taxation Code is amended to read:19602.5.
(a) There is in the State Treasury the Mental Health Services Fund (MHS Fund). The estimated revenue from the additional tax imposed under Section 17043 for the applicable fiscal year, as determined under subparagraph (B) of paragraph (3) of subdivision (c), shall be deposited to the MHS Fund on a monthly basis, subject to an annual adjustment as described in this section.Tax Year | Estimated Tax Liability Increase from the Additional Tax |
2005 | $634
million |
2006 | $672 million |
2007 | $713 million |
2008 | $758 million |
Applicable Fiscal Year | Estimated Revenue from Additional Tax |
2004–05 | $254 million |
2005–06 | $683 million |
2006–07 | $690 million |
2007–08 | $733 million |
SEC. 8.
Section 19602.5 is added to the Revenue and Taxation Code, to read:19602.5.
(a) There is in the State Treasury the Behavioral Health Services (BHS) Fund. The estimated revenue from the additional tax imposed under Section 17043 for the applicable fiscal year, as determined under subparagraph (B) of paragraph (3) of subdivision (c), shall be deposited to the BHS Fund on a monthly basis, subject to an annual adjustment as described in this section.SEC. 9.
Section 1095.5 of the Unemployment Insurance Code is amended to read:1095.5.
(a) (1) The director shall permit the use of any information in their possession to the extent necessary to enable the Mental Health Services Oversight and Accountability 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.SEC. 10.
Section 1095.5 is added to the Unemployment Insurance Code, to read:1095.5.
(a) (1) The director shall permit the use of any information in their possession to the extent necessary to enable the Behavioral Health Services Oversight and Accountability Commission to receive quarterly wage data of individuals with a mental health disorder or a substance use disorder, or both, served by the California public mental health and substance use disorder system for the purpose of monitoring and evaluating employment outcomes to determine the effectiveness of those services.SEC. 11.
Section 4090 of the Welfare and Institutions Code is amended to read:4090.
(a) The State Department of Health Care Services shall establish, by regulation, standards for the programs listed in Chapter 2.5 (commencing with Section 5670) of Part 2 of Division 5. These standards shall also be applied by the department to any facility licensed as a social rehabilitation facility pursuant to paragraph (7) of subdivision (a) of Section 1502 of the Health and Safety Code.SEC. 12.
Section 4094 of the Welfare and Institutions Code is amended to read:4094.
(a) The State Department of Mental Health shall establish, by regulations adopted at the earliest possible date, but no later than December 31, 1994, program standards for any facility licensed as a community treatment facility. This section shall apply only to community treatment facilities described in this subdivision.SEC. 13.
Section 4096.5 of the Welfare and Institutions Code is amended to read:4096.5.
(a) This section governs standards for the mental health program approval for short-term residential therapeutic programs, which is required under subdivision (c) of Section 1562.01 of the Health and Safety Code.SEC. 14.
Section 5604 of the Welfare and Institutions Code is amended to read:5604.
(a) (1) Each community mental health service shall have a mental health board consisting of 10 to 15 members, depending on the preference of the county, appointed by the governing body, except that boards in counties with a population of fewer than 80,000 may have a minimum of five members. A county with more than five supervisors shall have at least the same number of members as the size of its board of supervisors. This section does not limit the ability of the governing body to increase the number of members above 15.SEC. 15.
Section 5604 is added to the Welfare and Institutions Code, to read:5604.
(a) (1) (A) Each community mental health service shall have a behavioral health board consisting of 10 to 15 members, depending on the preference of the county, appointed by the governing body, except that a board in a county with a population of fewer than 80,000 may have a minimum of 5 members.SEC. 16.
Section 5604.1 of the Welfare and Institutions Code is amended to read:5604.1.
(a) Local mental health advisory boards shall be subject to the provisions of Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code, relating to meetings of local agencies.SEC. 17.
Section 5604.1 is added to the Welfare and Institutions Code, to read:5604.1.
(a) Local behavioral health boards are subject to the provisions of Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code, relating to meetings of local agencies.SEC. 18.
Section 5604.2 of the Welfare and Institutions Code is amended to read:5604.2.
(a) The local mental health board shall do all of the following:SEC. 19.
Section 5604.2 is added to the Welfare and Institutions Code, to read:5604.2.
(a) The local behavioral health board shall do all of the following:SEC. 20.
Section 5604.3 of the Welfare and Institutions Code is amended to read:5604.3.
(a) The board of supervisors may pay from any available funds the actual and necessary expenses of the members of the mental health board of a community mental health service incurred incident to the performance of their official duties and functions. The expenses may include travel, lodging, childcare, and meals for the members of an advisory board while on official business as approved by the director of the local mental health program.SEC. 21.
Section 5604.3 is added to the Welfare and Institutions Code, to read:5604.3.
(a) (1) The board of supervisors may pay from available funds the actual and necessary expenses of the members of the behavioral health board of a community mental health service incurred incident to the performance of their official duties and functions.SEC. 22.
Section 5604.5 of the Welfare and Institutions Code is amended to read:5604.5.
The local mental health board shall develop bylaws to be approved by the governing body which shall do all of the following:SEC. 23.
Section 5604.5 is added to the Welfare and Institutions Code, to read:5604.5.
The local behavioral health board shall develop bylaws to be approved by the governing body that shall do all of the following:SEC. 24.
Section 5610 of the Welfare and Institutions Code is amended to read:5610.
(a) Each county mental health system shall comply with reporting requirements developed by the State Department of Health Care Services, in consultation with the California Behavioral Health Planning Council and the Mental Health Services Oversight and Accountability Commission, which shall be uniform and simplified. The department shall review existing data requirements to eliminate unnecessary requirements and consolidate requirements that are necessary. These requirements shall provide comparability between counties in reports.SEC. 25.
Section 5610 is added to the Welfare and Institutions Code, to read:5610.
(a) (1) Each county behavioral health system shall comply with reporting requirements developed by the State Department of Health Care Services, in consultation with the California Behavioral Health Planning Council and the Behavioral Health Services Oversight and Accountability Commission, which shall be uniform and simplified.(a)Counties shall annually report data on performance measures established pursuant to Section 5612 to the local behavioral health board and to the Director of Health Care Services.
(b)The Director of Health Care Services shall annually make data on county performance available to the Legislature and post that data on the department’s internet website by no later than March 15 of each year.
SEC. 26.
Section 5613 of the Welfare and Institutions Code is amended to read:5613.
(a) Counties shall annually report data on performance measures established pursuant to Section 5612 to the local mental health advisory board and to the Director of Health Care Services.SEC. 27.
Section 5613 is added to the Welfare and Institutions Code, to read:5613.
(a) Counties shall annually report data on performance measures established pursuant to Section 5612 to the local behavioral health board and to the Director of Health Care Services.SEC. 27.SEC. 28.
Section 5614 of the Welfare and Institutions Code is amended to read:5614.
(a) The department, in consultation with the Compliance Advisory Committee that shall have representatives from relevant stakeholders, including, but not limited to, local behavioral health departments, local behavioral health boards and commissions, private and community-based providers, consumers and family members of consumers, local educational agency representatives including, but not limited to, educators and school staff, and advocates, shall establish a protocol for ensuring that local behavioral health departments meet statutory and regulatory requirements for the provision of publicly funded community mental health services provided under this part.SEC. 28.SEC. 29.
Section 5614 is added to the Welfare and Institutions Code, to read:5614.
(a) The department, in consultation with the Compliance Advisory Committee that shall have representatives from relevant stakeholders, including, but not limited to, local behavioral health departments, local behavioral health boards and commissions, private and community-based providers, consumers and family members of consumers, local education agency representatives including, but not limited to, educators and school staff, and advocates, shall establish a protocol for ensuring that local behavioral health departments meet statutory and regulatory requirements for the provision of publicly funded community mental health services provided under this part.SEC. 29.SEC. 30.
Section 5664 of the Welfare and Institutions Code is amended to read:5664.
(a) In consultation with the County Behavioral Health Directors Association of California, the State Department of Health Care Services, the Mental Health Services Oversight and Accountability Commission, the California Behavioral Health Planning Council, and the California Health and Human Services Agency, county behavioral health systems shall provide reports and data to meet the information needs of the state, as necessary.SEC. 30.SEC. 31.
Section 5664 is added to the Welfare and Institutions Code, to read:5664.
(a) In consultation with the County Behavioral Health Directors Association of California, the State Department of Health Care Services, the Behavioral Health Services Oversight and Accountability Commission, the California Behavioral Health Planning Council, and the California Health and Human Services Agency, county behavioral health systems shall provide reports and data to meet the information needs of the state, as necessary.SEC. 31.SEC. 32.
Section 5675 of the Welfare and Institutions Code is amended to read:5675.
(a) (1) Mental health rehabilitation centers shall only be licensed by the State Department of Health Care Services subsequent to application by counties, county contract providers, or other organizations.SEC. 32.SEC. 33.
Section 5771.1 of the Welfare and Institutions Code is amended to read:5771.1.
(a) The members of the Mental Health Services Oversight and Accountability Commission established pursuant to Section 5845 are members of the California Behavioral Health Planning Council. They serve in an ex officio capacity when the council is performing its statutory duties pursuant to Section 5772. This membership does not affect the composition requirements for the council specified in Section 5771.SEC. 33.SEC. 34.
Section 5771.1 is added to the Welfare and Institutions Code, to read:5771.1.
(a) The members of the Behavioral Health Services Oversight and Accountability Commission established pursuant to Section 5845 are members of the California Behavioral Health Planning Council.SEC. 34.SEC. 35.
Section 5805 of the Welfare and Institutions Code is amended to read:5805.
(a) The State Department of Health Care Services shall require counties to use available state and matching funds for the client target population as defined in Section 5600.3 to develop a comprehensive array of services as defined in Sections 5600.6 and 5600.7.SEC. 35.SEC. 36.
Section 5805 is added to the Welfare and Institutions Code, to read:5805.
(a) The State Department of Health Care Services shall require counties to useSEC. 36.SEC. 37.
Section 5806 of the Welfare and Institutions Code is amended to read:5806.
The State Department of Health Care Services shall establish service standards that ensure that members of the target population are identified, and services provided to assist them to live independently, work, and reach their potential as productive citizens. The department shall provide annual oversight of grants issued pursuant to this part for compliance with these standards. These standards shall include, but are not limited to, all of the following:SEC. 37.SEC. 38.
Section 5806 is added to the Welfare and Institutions Code, to read:5806.
(a) The State Department of Health Care Services shall establish service standards so that adults and older adults in the target population are identified and receive needed and appropriate services from qualified staff in the least restrictive environment to assist them to live independently, work, and thrive in their communities. This section shall not apply to services covered by the Medi-Cal program and services covered by a health care service plan or other insurance coverage. These standards shall include, but are not limited to, all of the following:SEC. 38.SEC. 39.
Section 5813.5 of the Welfare and Institutions Code is amended to read:5813.5.
Subject to the availability of funds from the Mental Health Services Fund, the state shall distribute funds for the provision of services under Sections 5801, 5802, and 5806 to county mental health programs. Services shall be available to adults and seniors with severe illnesses who meet the eligibility criteria in subdivisions (b) and (c) of Section 5600.3. For purposes of this act, “seniors” means older adult persons identified in Part 3 (commencing with Section 5800) of this division.SEC. 39.SEC. 40.
Section 5813.5 is added to the Welfare and Institutions Code, to read:5813.5.
(a) Counties shall use funds distributed pursuant to subdivision (c) of Section 5891 for the provision of behavioral health services under Sections 5801, 5802, 5806, and 5891.5 to county behavioral health programs. This part does not obligate the counties to use funds from any other source for services pursuant to this part.SEC. 40.SEC. 41.
Section 5813.6 of the Welfare and Institutions Code is amended to read:5813.6.
(a) (1) By July 1 of each year, the Director of Health Care Services shall submit to the Legislature final budget enactment information regarding the expenditure of Proposition 63 funding for each state department, and for each major program category specified in the measure, for local assistance.SEC. 41.SEC. 42.
Section 5830 of the Welfare and Institutions Code is amended to read:5830.
County mental health programs shall develop plans for innovative programs to be funded pursuant to paragraph (6) of subdivision (a) of Section 5892.SEC. 42.SEC. 43.
Section 5830 is added to the Welfare and Institutions Code, to read:5830.
(a) (1) Each county shall establish and administer a program for housing interventions to serve persons who are chronically homeless or experiencing homelessness or are at risk of homelessness, as defined in(f)
SEC. 43.SEC. 44.
Section 5831 is added to the Welfare and Institutions Code, to read:5831.
(a) (1) Notwithstanding any other law, a capital development project funded, in whole or in part, pursuant to Section 5892 shall be a use by right that shall be subject to the streamlined, ministerial review process, pursuant to subdivision (b), if it meets all of the following criteria:SEC. 44.SEC. 45.
Section 5835 of the Welfare and Institutions Code is amended to read:5835.
(a) This part shall be known, and may be cited, as the Early Psychosis Intervention Plus (EPI Plus) Program to encompass early psychosis and mood disorder detection and intervention.SEC. 45.SEC. 46.
Section 5835 is added to the Welfare and Institutions Code, to read:5835.
(a) This part shall be known, and may be cited, as the Early Psychosis Intervention (EPI) Plus Program to encompass early psychosis and mood disorder detection and intervention.SEC. 46.SEC. 47.
Section 5835.2 of the Welfare and Institutions Code is amended to read:5835.2.
(a) There is hereby established an advisory committee to the commission. The Mental Health Services Oversight and Accountability Commission shall accept nominations and applications to the committee, and the chair of the Mental Health Services Oversight and Accountability Commission shall appoint members to the committee, unless otherwise specified. Membership on the committee shall be as follows:SEC. 47.SEC. 48.
Section 5835.2 is added to the Welfare and Institutions Code, to read:5835.2.
(a) There is hereby established an advisory committee to the commission. The Behavioral Health Services Oversight and Accountability Commission shall accept nominations and applications to the committee, and the chair of the Behavioral Health Services Oversight and Accountability Commission shall appoint members to the committee, unless otherwise specified. Membership on the committee shall be as follows:SEC. 48.SEC. 49.
Section 5840 of the Welfare and Institutions Code is amended to read:5840.
(a) The State Department of Health Care Services, in coordination with counties, shall establish a program designed to prevent mental illnesses from becoming severe and disabling. The program shall emphasize improving timely access to services for underserved populations.SEC. 49.SEC. 50.
Section 5840 is added to the Welfare and Institutions Code, to read:5840.
(a) (1) Each county shall establish and administer an early intervention program that is designed to prevent mental illnesses and substance use disorders from becoming severe and disabling and to reduce disparities in behavioral health.(1)Suicide.
SEC. 50.SEC. 51.
Section 5840.5 of the Welfare and Institutions Code is amended to read:5840.5.
It is the intent of the Legislature that this chapter achieve all of the following:SEC. 51.SEC. 52.
Section 5840.6 of the Welfare and Institutions Code is amended to read:5840.6.
For purposes of this chapter, the following definitions shall apply:SEC. 52.SEC. 53.
Section 5840.6 is added to the Welfare and Institutions Code, to read:5840.6.
For purposes of this chapter, the following definitions shall apply:SEC. 53.SEC. 54.
Section 5840.7 of the Welfare and Institutions Code is amended to read:5840.7.
(a) On or before January 1, 2020, the commission shall establish priorities for the use of prevention and early intervention funds. These priorities shall include, but are not limited to, the following:SEC. 54.SEC. 55.
Section 5840.7 is added to the Welfare and Institutions Code, to read:5840.7.
(a) The State Department of Health Care Services, in consultation with the Behavioral Health Services Oversight and Accountability Commission, shall establish priorities for the use of early intervention funds. These priorities shall include, but are not limited to, the following:SEC. 55.SEC. 56.
Section 5840.8 of the Welfare and Institutions Code is amended to read:5840.8.
(a) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the commission may implement this chapter without taking regulatory action until regulations are adopted. The commission may use information notices or related communications to implement this chapter.SEC. 56.SEC. 57.
Section 5845 of the Welfare and Institutions Code is amended to read:5845.
(a) The Mental Health Services Oversight and Accountability Commission is hereby established to oversee Part 3 (commencing with Section 5800), the Adult and Older Adult Mental Health System of Care Act; Part 3.1 (commencing with Section 5820), Human Resources, Education, and Training Programs; Part 3.2 (commencing with Section 5830), Innovative Programs; Part 3.6 (commencing with Section 5840), Prevention and Early Intervention Programs; and Part 4 (commencing with Section 5850), the Children’s Mental Health Services Act. The commission shall replace the advisory committee established pursuant to Section 5814. The commission shall consist of 16 voting members as follows:SEC. 57.SEC. 58.
Section 5845 is added to the Welfare and Institutions Code, to read:5845.
(a) The Behavioral Health Services Oversight and Accountability Commission is hereby established to promote transformational change in California’s behavioral health system through research, evaluation and tracking outcomes, and other strategies to assess and report progress. The commission shall use this information and analyses to inform the commission’s grant making, identify key policy issues and emerging best practices, provide technical assistance and training, promote high-quality programs implemented, and advise the Governor and the Legislature, pursuant to the Behavioral Health Services Act and related components of California’s behavioral health system. For this purpose, the commission shall collaborate with the California Health and Human Services Agency, its departments and other state entities.SEC. 58.SEC. 59.
Section 5845.1 is added to the Welfare and Institutions Code, to read:5845.1.
(a) (1) The Behavioral Health Services Act Innovation Partnership Fund is hereby created in the State Treasury.SEC. 59.SEC. 60.
Section 5845.5 of the Welfare and Institutions Code is amended to read:5845.5.
In addition to the activities authorized under Section 5845, the commission may establish a fellowship program in accordance with this section for the purpose of providing an experiential learning opportunity for a mental health consumer and a mental health professional.SEC. 60.SEC. 61.
Section 5845.5 is added to the Welfare and Institutions Code, to read:5845.5.
In addition to the activities authorized under Section 5845, the commission may establish a fellowship program in accordance with this section for the purpose of providing an experiential learning opportunity for mental health or substance use disorder consumers and mental health or substance use disorder professionals.SEC. 61.SEC. 62.
Section 5846 of the Welfare and Institutions Code is amended to read:5846.
(a) The commission shall adopt regulations for programs and expenditures pursuant to Part 3.2 (commencing with Section 5830), for innovative programs, and Part 3.6 (commencing with Section 5840), for prevention and early intervention.SEC. 62.SEC. 63.
Section 5847 of the Welfare and Institutions Code is amended to read:5847.
Integrated Plans for Prevention, Innovation, and System of Care Services.SEC. 63.SEC. 64.
Section 5848 of the Welfare and Institutions Code is amended to read:5848.
(a) Each three-year program and expenditure plan and update shall be developed with local stakeholders, including adults and seniors with severe mental illness, families of children, adults, and seniors with severe mental illness, providers of services, law enforcement agencies, education, social services agencies, veterans, representatives from veterans organizations, providers of alcohol and drug services, health care organizations, and other important interests. Counties shall demonstrate a partnership with constituents and stakeholders throughout the process that includes meaningful stakeholder involvement on mental health policy, program planning, and implementation, monitoring, quality improvement, evaluation, and budget allocations. A draft plan and update shall be prepared and circulated for review and comment for at least 30 days to representatives of stakeholder interests and any interested party who has requested a copy of the draft plans.SEC. 64.SEC. 65.
Section 5848.5 of the Welfare and Institutions Code is amended to read:5848.5.
(a) The Legislature finds and declares all of the following:SEC. 65.SEC. 66.
Section 5848.5 is added to the Welfare and Institutions Code, to read:5848.5.
(a) The Legislature finds and declares all of the following:SEC. 66.SEC. 67.
Section 5849.1 of the Welfare and Institutions Code is amended to read:5849.1.
(a) The Legislature finds and declares that this part is consistent with and furthers the purposes of the Mental Health Services Act, enacted by Proposition 63 at the November 2, 2004, statewide general election, within the meaning of Section 18 of that measure.SEC. 67.SEC. 68.
Section 5849.1 is added to the Welfare and Institutions Code, to read:5849.1.
(a) The Legislature finds and declares that this part is consistent with and furthers the purposes of the Mental Health Services Act, enacted by Proposition 63 at the November 2, 2004, statewide general election, within the meaning of Section 18 of that measure.SEC. 68.SEC. 69.
Section 5849.2 of the Welfare and Institutions Code is amended to read:5849.2.
As used in this part, the following definitions shall apply:SEC. 69.SEC. 70.
Section 5849.2 is added to the Welfare and Institutions Code, to read:5849.2.
As used in this part, the following definitions shall apply:SEC. 70.SEC. 71.
Section 5849.3 of the Welfare and Institutions Code is amended to read:5849.3.
(a) There is hereby established the No Place Like Home Program Advisory Committee. Membership on the committee shall be as follows:SEC. 71.SEC. 72.
Section 5849.3 is added to the Welfare and Institutions Code, to read:5849.3.
(a) There is hereby established the No Place Like Home Program Advisory Committee. Membership on the committee shall be as follows:SEC. 72.SEC. 73.
Section 5852.5 of the Welfare and Institutions Code is amended to read:5852.5.
The State Department of Health Care Services, in consultation with the Mental Health Services Oversight and Accountability Commission shall review those counties that have been awarded funds to implement a comprehensive system for the delivery of mental health services to children with serious emotional disturbance and to their families or foster families to determine compliance with either of the following:SEC. 73.SEC. 74.
Section 5852.5 is added to the Welfare and Institutions Code, to read:5852.5.
The State Department of Health Care Services, in consultation with the Behavioral Health Services Oversight and Accountability Commission, shall review those counties that have been awarded funds to implement a comprehensive system for the delivery of mental healthSEC. 74.SEC. 75.
Section 5868 of the Welfare and Institutions Code is amended to read:5868.
(a) The State Department of Health Care Services shall establish service standards that ensure that children in the target population are identified and receive needed and appropriate services from qualified staff in the least restrictive environment.SEC. 75.SEC. 76.
Section 5868 is added to the Welfare and Institutions Code, to read:5868.
(a) The State Department of Health Care Services shall establish service standards so that children and youth in the target population are identified and receive needed and appropriate services from qualified staff in the least restrictive environment to correct or ameliorate their behavioral health condition. This section shall not apply to services covered by the Medi-Cal program and services covered by a health care service plan or other insurance coverage.SEC. 76.SEC. 77.
Section 5878.1 of the Welfare and Institutions Code is amended to read:5878.1.
(a) It is the intent of this article to establish programs that ensure services will be provided to severely mentally ill children as defined in Section 5878.2 and that they be part of the children’s system of care established pursuant to this part. It is the intent of this act that services provided under this chapter to severely mentally ill children are accountable, developed in partnership with youth and their families, culturally competent, and individualized to the strengths and needs of each child and their family.SEC. 77.SEC. 78.
Section 5878.1 is added to the Welfare and Institutions Code, to read:5878.1.
(a) It is the intent of this article to establish programs that ensure services will be provided to eligible children and youth, as defined in Section 5892, and that they are part of the children and youth system of care established pursuant to this part.SEC. 78.SEC. 79.
Section 5878.2 of the Welfare and Institutions Code is amended to read:5878.2.
(a) For purposes of this article, “children with a serious emotional disturbance” means minors under 18 years of age who meet the criteria set forth in subdivision (a) of Section 5600.3.SEC. 79.SEC. 80.
Section 5878.3 of the Welfare and Institutions Code is amended to read:5878.3.
(a) Subject to the availability of funds as determined pursuant to Part 4.5 (commencing with Section 5890) of this division, county mental health programs shall offer services to severely mentally ill children for whom services under any other public or private insurance or other mental health or entitlement program is inadequate or unavailable. Other entitlement programs include but are not limited to mental health services available pursuant to Medi-Cal, child welfare, and special education programs. The funding shall cover only those portions of care that cannot be paid for with public or private insurance, other mental health funds or other entitlement programs.SEC. 80.SEC. 81.
Section 5878.3 is added to the Welfare and Institutions Code, to read:5878.3.
(a) (1) (A) Counties shall use funds distributed pursuant to subdivision (c) of Section 5891 to offer services to eligible children and youth, as defined in of Section 5892, for whom services under other public or private insurance or other mental health, substance use disorder, or other entitlement program is inadequate or unavailable. Counties are not required to spend funds for services pursuant to this part from any other source, including funds deposited in the mental health account of the local health and welfare fund.SEC. 81.SEC. 82.
Section 5881 of the Welfare and Institutions Code is amended to read:5881.
(a) Evaluation shall be conducted by participating county evaluation staff and, subject to the availability of funds, by the State Department of Health Care Services and the Mental Health Services Oversight and Accountability Commission.SEC. 82.SEC. 83.
Section 5881 is added to the Welfare and Institutions Code, to read:5881.
(a) Evaluation shall be conducted by participating county evaluation staff and, subject to the availability of funds, by the State Department of Health Care Services and the Behavioral Health Services Oversight and Accountability Commission.SEC. 83.SEC. 84.
Section 5886 of the Welfare and Institutions Code is amended to read:5886.
(a) The Mental Health Student Services Act is hereby established as a mental health partnership grant program for the purpose of establishing mental health partnerships between a county’s mental health or behavioral health departments and school districts, charter schools, and the county office of education within the county.SEC. 84.SEC. 85.
Section 5886 is added to the Welfare and Institutions Code, to read:5886.
(a) The Behavioral Health Student Services Act is hereby established as a mental health partnership grant program for the purpose of establishing mental health partnerships between a county’s mental health or behavioral health departments and school districts, charter schools, and the county office of education within the county.SEC. 85.SEC. 86.
Part 4.1 (commencing with Section 5887) is added to Division 5 of the Welfare and Institutions Code, to read:PART 4.1. Full-Service Partnership
5887.
(a) Each county shall establish and administer a full service partnership program that include the following services:(4)
(5)
(6)
5887.1.
This part shall become operative on July 1, 2026, if amendments to the Mental Health Services Act are approved by the voters at the March 5, 2024, statewide primary election.SEC. 86.SEC. 87.
Section 5890 of the Welfare and Institutions Code is amended to read:5890.
(a) The Mental Health Services Fund is hereby created in the State Treasury. The fund shall be administered by the state. Notwithstanding Section 13340 of the Government Code, all moneys in the fund are, except as provided in subdivision (d) of Section 5892, continuously appropriated, without regard to fiscal years, for the purpose of funding the following programs and other related activities as designated by other provisions of this division:SEC. 87.SEC. 88.
Section 5890 is added to the Welfare and Institutions Code, to read:5890.
(a) (1) The Behavioral Health Services Fund is hereby created in the State Treasury.SEC. 88.SEC. 89.
Section 5891 of the Welfare and Institutions Code is amended to read:5891.
(a) (1) (A) The funding established pursuant to this act shall be utilized to expand mental health services.SEC. 89.SEC. 90.
Section 5891 is added to the Welfare and Institutions Code, to read:5891.
(a) (1) (A) The funding established pursuant to this act shall be utilized by counties to expand mental health and substance use disorder treatment services.SEC. 90.SEC. 91.
Section 5891.5 of the Welfare and Institutions Code is amended to read:5891.5.
(a) (1) The programs in paragraphs (1) to (3), inclusive, and paragraph (5) of subdivision (a) of Section 5890 may include substance use disorder treatment for children, adults, and older adults with cooccurring mental health and substance use disorders who are eligible to receive mental health services pursuant to those programs. The MHSA includes persons with a serious mental disorder and a diagnosis of substance abuse in the definition of persons who are eligible for MHSA services in Sections 5878.2 and 5813.5, which reference paragraph (2) of subdivision (b) of Section 5600.3.SEC. 91.SEC. 92.
Section 5891.5 is added to the Welfare and Institutions Code, to read:5891.5.
(a) (1) Notwithstanding any other law, the programs and services and supports in paragraphs (1), (2), and (3) of subdivision (a) of Section 5892 may include substance use disorder treatment services, as defined in this section for children, youth, adults, and older adults.SEC. 92.SEC. 93.
Section 5892 of the Welfare and Institutions Code is amended to read:5892.
(a) In order to promote efficient implementation of this act, the county shall use funds distributed from the Mental Health Services Fund as follows:SEC. 93.SEC. 94.
Section 5892 is added to the Welfare and Institutions Code, to read:5892.
(a) To promote efficient implementation of this act, the county shall use funds distributed from the Mental Health Services Fund as follows:SEC. 94.SEC. 95.
Section 5892 is added to the Welfare and Institutions Code, to read:5892.
(a) To promote efficient implementation of this act, subject to subdivision (c), the county shall use funds distributed from the Behavioral Health Services Fund as follows:(vii)A prudent reserve established pursuant to subdivision (b).
(2)
(3)
(4)
(5)
(c)(1)A county may change the allocation percentages specified in paragraphs (1), (2), and (3) of subdivision (a), subject to the approval of the State Department of Health Care Services as follows:
(A)For the integrated plan covering fiscal years 2026–27, 2027–28, and 2028–29, a
(B)For the integrated plan covering fiscal years 2029–30, 2030–31, and 2031–32, a county may transfer up to 12 percent of the total funds allocated to the county in a fiscal year between one or more of the purposes authorized in paragraphs (1), (2) and (3) of subdivision (a). A county shall not decrease the allocation for any one of the purposes authorized in paragraph (1), (2) or (3) by more than 6 percent of the total funds allocated to the county in a fiscal year.
(C)For the integrated plan covering fiscal year 2032–33 and subsequent integrated plans, a county may transfer up to 10 percent of the total funds allocated to the county in a fiscal year between one or more of the purposes authorized in paragraphs (1), (2) and (3) of subdivision (a). A county shall not decrease the allocation for any one of the purposes authorized in paragraph (1), (2) or (3) by more than 5 percent of the total funds allocated to the county in a fiscal year.
(D)
(2)
(3)
(VI)
(VII)Population-based prevention programs may be community led, trauma informed, and include cultural affirming strategies.
(iii)
(iv)
(v)
(vi)
SEC. 95.SEC. 96.
Section 5892.1 of the Welfare and Institutions Code is amended to read:5892.1.
(a) All unspent funds subject to reversion pursuant to subdivision (h) of Section 5892 as of July 1, 2017, are deemed to have been reverted to the fund and reallocated to the county of origin for the purposes for which they were originally allocated.SEC. 96.SEC. 97.
Section 5892.1 is added to the Welfare and Institutions Code, to read:5892.1.
(a) All unspent funds subject to reversion pursuant to subdivision (i) of Section 5892 as of July 1, 2017, are deemed to have been reverted to the fund and reallocated to the county of origin for the purposes for which they were originally allocated.SEC. 97.SEC. 98.
Section 5892.3 is added to the Welfare and Institutions Code, to read:5892.3.
(a) There is hereby created a Behavioral Health Services Act Revenue Stability Workgroup to assess year-over-year fluctuations in tax revenues generated by the Behavioral Health Services Act, in recognition of the need for a reliable strategy for short- and long-term fiscal stability, commencing no later than June 30, 2024.(h)This section shall become inoperative on June 30, 2026, and, as of January 1, 2027, is repealed.
SEC. 98.SEC. 99.
Section 5892.5 of the Welfare and Institutions Code is amended to read:5892.5.
(a) (1) The California Housing Finance Agency, with the concurrence of the State Department of Health Care Services, shall release unencumbered Mental Health Services Fund moneys dedicated to the Mental Health Services Act housing program upon the written request of the respective county. The county shall use these Mental Health Services Fund moneys released by the agency to provide housing assistance to the target populations who are identified in Section 5600.3.SEC. 99.SEC. 100.
Section 5892.5 is added to the Welfare and Institutions Code, to read:5892.5.
(a) (1) The California Housing Finance Agency, with the concurrence of the State Department of Health Care Services, shall release unencumbered Behavioral Health Services Fund moneys dedicated to the Mental Health Services Act housing program upon the written request of the respective county.SEC. 100.SEC. 101.
Section 5893 of the Welfare and Institutions Code is amended to read:5893.
(a) In any year in which the funds available exceed the amount allocated to counties, such funds shall be carried forward to the next fiscal year to be available for distribution to counties in accordance with Section 5892 in that fiscal year.SEC. 101.SEC. 102.
Section 5893 is added to the Welfare and Institutions Code, to read:5893.
(a) In a year that the funds available exceed the amount allocated to counties, the excess funds shall be carried forward to the next fiscal year to be available for distribution to counties in accordance with Section 5892 in that fiscal year.SEC. 102.SEC. 103.
Section 5895 of the Welfare and Institutions Code is amended to read:5895.
(a) If any provisions of Part 3 (commencing with Section 5800) or Part 4 (commencing with Section 5850) are repealed or modified so the purposes of this act cannot be accomplished, the funds in the Mental Health Services Fund shall be administered in accordance with those sections as they read on January 1, 2004.SEC. 103.SEC. 104.
Section 5897 of the Welfare and Institutions Code is amended to read:5897.
(a) Notwithstanding any other state law, the State Department of Health Care Services shall implement the mental health services provided by Part 3 (commencing with Section 5800), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) through contracts with county mental health programs or counties acting jointly. A contract may be exclusive and may be awarded on a geographic basis. For purposes of this section, a county mental health program includes a city receiving funds pursuant to Section 5701.5.SEC. 104.SEC. 105.
Section 5897 is added to the Welfare and Institutions Code, to read:5897.
(a) (1) Notwithstanding any other state law, the State Department of Health Care Services shall implement the programs and services specified in subdivision (a) of Section 5892, and related activities, through contracts with a county or counties acting jointly.SEC. 105.SEC. 106.
Section 5898 of the Welfare and Institutions Code is amended to read:5898.
(a) The State Department of Health Care Services, in consultation with the Mental Health Services Oversight and Accountability Commission, shall develop regulations, as necessary, for the State Department of Health Care Services, the Mental Health Services Oversight and Accountability Commission, or designated state and local agencies to implement this act. Regulations adopted pursuant to this section shall be developed with the maximum feasible opportunity for public participation and comments.SEC. 106.SEC. 107.
Section 5898 is added to the Welfare and Institutions Code, to read:5898.
(a) (1) The State Department of Health Care Services shall develop regulations, as necessary, to implement this act.SEC. 107.SEC. 108.
Section 5899 of the Welfare and Institutions Code is amended to read:5899.
(a) (1) The State Department of Health Care Services, in consultation with the Mental Health Services Oversight and Accountability Commission and the County Behavioral Health Directors Association of California, shall develop and administer instructions for the Annual Mental Health Services Act Revenue and Expenditure Report.SEC. 108.SEC. 109.
Chapter 3 (commencing with Section 5963) is added to Part 7 of Division 5 of the Welfare and Institutions Code, to read:CHAPTER 3. Behavioral Health Modernization Act
Article 2. Behavioral Health Planning and Reporting
5963.
(a) It is the intent of the Legislature that this article establish the Integrated Plan for Behavioral Health Services and Outcomes, which each county shall develop every three years to include all of the following:5963.01.
(a) A county shall work with each Medi-Cal managed care plan, as defined in subdivision (j) of Section 14184.101, that covers residents of the county on development of the managed care plan’s population needs assessment.5963.02.
(a) (1) Each county shall prepare and submit an integrated plan and annual updates to the Behavioral Health Services Oversight and Accountability Commission and the department.5963.03.
(a) (1) Each integrated plan shall be developed with local stakeholders, including, but not limited to, all of the following:5963.04.
(a) (1) Annually, counties and Medi-Cal behavioral health delivery systems, as defined in subdivision (i) of Section 14184.101, shall submit the County Behavioral Health Outcomes, Accountability, and Transparency Report to the department.5963.05.
(a) Notwithstanding Chapter 3.5 (commencing Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific the amendments made pursuant to this act by means of plan or county letters, information notices, plan or provider bulletins, or other similar instructions without taking further regulatory action.5963.06.
(a) The California State Auditor shall, no later than December 31, 2029, issue to the Governor, the Legislature, the Senate and Assembly Committees on Health, the Assembly Committee on Housing and Community Development, and the Senate Committee on Housing, a comprehensive report on the progress and effectiveness of the implementation of the Behavioral Health Services Act.SEC. 109.SEC. 110.
Section 14197.7 of the Welfare and Institutions Code is amended to read:14197.7.
(a) Notwithstanding any other law, if the director finds that any entity that contracts with the department for the delivery of health care services (contractor), including a Medi-Cal managed care plan or a prepaid health plan, fails to comply with contract requirements, state or federal law or regulations, or the state plan or approved waivers, or for other good cause, the director may terminate the contract or impose sanctions as set forth in this section. Good cause includes, but is not limited to, a finding of deficiency that results in improper denial or delay in the delivery of health care services, potential endangerment to patient care, disruption in the contractor’s provider network, failure to approve continuity of care, that claims accrued or to accrue have not or will not be recompensed, or a delay in required contractor reporting to the department.SEC. 110.SEC. 111.
Section 14197.7 is added to the Welfare and Institutions Code, to read:14197.7.
(a) (1) Notwithstanding any other law, if the director finds that an entity that contracts with the department for the delivery of health care services (contractor), including a Medi-Cal managed care plan or a prepaid health plan, fails to comply with contract requirements, state or federal law or regulations, or the state plan or approved waivers, or for other good cause, the director may terminate the contract or impose sanctions as set forth in this section.SEC. 111.SEC. 112.
Section 14197.71 is added to the Welfare and Institutions Code, to read:14197.71.
(a) The department may, at its discretion, align relevant terms of its contract with a Medi-Cal behavioral health delivery system with the terms of its contract with a Medi-Cal managed care plan, as defined in subdivision (j) of Section 14184.101, for those requirements that apply to both entities. Requirements that apply to both entities include, but are not limited to, all of the following:SEC. 112.SEC. 113.
Section 14707.5 of the Welfare and Institutions Code is amended to read:14707.5.
(a) It is the intent of the Legislature to develop a performance outcome system for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services that will improve outcomes at the individual and system levels and will inform fiscal decisionmaking related to the purchase of services.SEC. 113.SEC. 114.
Section 14707.5 is added to the Welfare and Institutions Code, to read:14707.5.
(a) It is the intent of the Legislature to develop a performance outcome system for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services that will improve outcomes at the individual and system levels and will inform fiscal decisionmaking related to the purchase of services.SEC. 114.SEC. 115.
(a) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the State Department of Health Care Services may implement, interpret, or make specific the amendments made pursuant to this measure by means of plan or county letters, information notices, plan or provider bulletins, or other similar instructions without taking further regulatory action.SEC. 115.SEC. 116.
The provisions of this act are severable. If any provision of this act or its application is held invalid or unconstitutional by a decision of a court of competent jurisdiction, such decision shall not affect the validity of the remaining portions or applications of this act. The Legislature declares that it would have enacted this act and each portion thereof not declared invalid or unconstitutional without regard to whether any other portion of this act or its application thereof would be subsequently declared invalid or
unconstitutional.SEC. 116.SEC. 117.
This act shall take effect on January 1, 2025, upon approval by the voters of the amendments to the Mental Health Services Act at the March 5, 2024, statewide primary election.Sections ____ of this act and Sections ____