California Senate Bill SB1136 Latest Draft

 BILL NUMBER: SB 1136AMENDED BILL TEXT AMENDED IN SENATE APRIL 16, 2012 INTRODUCED BY Senator Steinberg FEBRUARY 21, 2012 An act to amend Sections  21, 4030, 4031, 4032, 4033, 4040, 4050, 4051, 4052, 4060, 4061, 4090, 4091, 4094, 5370.2, 5510, 5513, 5514, 5530, 5585.22, 5601, 5602, 5604, 5610, 5652.7, 5653, 5653.1, 5654, 5655, 5664, 5664.5, 5692, 5701, 5701.1, 5707, 5715, 5717, 5751, 5751.1, 5751.2, 5770, 5770.5, 5771, 5771.3, 5772, 5815, 5840, 5845, 5851.5, 5852.5, 5854, 5855, 5855.5, 5868, 5869, 5878, 5878.3, 5880, 5890, 11325.7, 11462.01, and 18986.40   5820, 5821, 5822, 5830, 5840, 5845, 5846, 5847, 5848, 5878.1, 5878.3, 5890, 5891, 5892, 5897, and 5898  of, and to add  Section   Sections  4024.7  and 5899  to, the Welfare and Institutions Code, relating to health. LEGISLATIVE COUNSEL'S DIGEST SB 1136, as amended, Steinberg. Health: mental health:  health equity.   Mental Health Services Act.  Under existing law, the State Department of Mental Health is authorized and required to perform various functions relating to the care and treatment of persons with mental disorders. Existing law, the Mental Health Services Act, an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the  continuously appropriated  Mental Health Services Fund to fund various county mental health programs.  Existing law establishes the Mental Health Services Oversight and Accountability Commission (commission) to oversee the administration of various parts of the Mental Health Services Act.  The act 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 act, and that the Legislature may also clarify procedures and terms of the act by majority vote.  This bill would require the commission to assist in providing technical assistance, as specified, and would require the commission to work in collaboration with, and in consultation with, various entities in designing a comprehensive joint plan for coordinated evaluation of client outcomes. This bill would require the California Health and Human Services Agency to lead the comprehensive joint plan effort.  This bill would transfer various functions of the State Department of Mental Health  under the Mental Health Services Act  to the State Department of Health Care Services  and the Office of Statewide Health Planning and Development  . This bill would make various technical and conforming changes to reflect the transfer of  state   those  mental health responsibilities.  This bill would require all projects included in the innovative programs portion of the county plan to meet specified requirements.   Existing law requires each county mental health program to prepare and submit a 3-year plan that includes specified components.   This bill, in this regard, would require the plan to be a 3-year program and expenditure plan adopted by the county board of supervisors and submitted to the commission, would require annual updates, and would require plans to be certified by the county mental health director and the county auditor controller, as specified. This bill would require the State Department of Health Care Services to inform the California Mental Health Directors Association and the commission of the methodology used for revenue allocation to the counties. This bill would require the State Department of Health Care Services, in consultation with the commission and the California Welfare Directors Association, to develop and administer instructions for the Annual Mental Health Services Act Revenue and Expenditure Report, as prescribed.  This bill would authorize   require  the Governor or the Director of Health Care Services to appoint, subject to confirmation by the Senate, a Deputy Director of Mental Health and Substance Use Disorder Services of the State Department of Health Care Services.  This bill also would state the intent of the Legislature to create an Office of Health Equity to comprehensively address issues of health disparity, promote healthy communities, and improve individual health outcomes.   Existing law requires the State Department of Mental Health to adopt as part of its overall mission the development of community-based, comprehensive, interagency systems of care that target seriously emotionally and behaviorally disturbed children, as specified.   This bill would instead authorize, rather than require, these provisions to be implemented.  This bill would declare that it clarifies procedures and terms of the Mental Health Services Act. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:  SECTION 1.   Section 4024.7 is added to the   Welfare and Institutions Code   , to read:   4024.7. The Governor or the Director of Health Care Services shall appoint, subject to confirmation by the Senate, a Deputy Director of Mental Health and Substance Use Disorder Services of the State Department of Health Care Services. The salary for the deputy director shall be fixed in accordance with law.   SEC. 2.   Section 5820 of the   Welfare and Institutions Code   is amended to read:  5820. (a) It is the intent of this part to establish a program with dedicated funding to remedy the shortage of qualified individuals to provide services to address severe mental illnesses. (b) Each county mental health program shall submit to the  department   Office of Statewide Health Planning and Development  a needs assessment identifying its shortages in each professional and other occupational category in order to increase the supply of professional staff and other staff that county mental health programs anticipate they will require in order to provide the increase in services projected to serve additional individuals and families pursuant to Part 3 (commencing with Section 5800), Part 3.2 (commencing with Section 5830), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) of this division. For purposes of this part, employment in California's public mental health system includes employment in private organizations providing publicly funded mental health services. (c) The  department   Office of Statewide Health Planning and Development, in coordination with the California Mental Health Planning Council,  shall identify the total statewide needs for each professional and other occupational category  utilizing county needs assessment information  and develop a five-year education and training development plan. (d) Development of the first five-year plan shall commence upon enactment of the initiative. Subsequent plans shall be adopted every five years  , with the next five-year plan due as of April 1, 2014  . (e) Each five-year plan shall be reviewed and approved by the California Mental Health Planning Council.  SEC. 3.   Section 5821 of the   Welfare and Institutions Code   is amended to read:  5821. (a) The California Mental Health Planning Council shall advise the  State Department of Mental Health   Office of Statewide Health Planning and Development  on education and training policy development and provide oversight for the  department's  education and training plan development. (b) The  State Department of Mental Health   Office of Statewide Health Planning and Development  shall work with the California Mental Health Planning Council so that council staff is increased appropriately to fulfill its duties required by Sections 5820 and 5821.  SEC. 4.   Section 5822 of the   Welfare and Institutions Code   is amended to read:  5822. The  State Department of Mental Health   Office of Statewide Health Planning and Development  shall include in the five-year plan: (a) Expansion plans for the capacity of postsecondary education to meet the needs of identified mental health occupational shortages. (b) Expansion plans for the forgiveness and scholarship programs offered in return for a commitment to employment in California's public mental health system and make loan forgiveness programs available to current employees of the mental health system who want to obtain Associate of Arts, Bachelor of Arts, master's degrees, or doctoral degrees. (c) Creation of a stipend program modeled after the federal Title IV-E program for persons enrolled in academic institutions who want to be employed in the mental health system. (d) Establishment of regional partnerships  among   between  the mental health system and the educational system to expand outreach to multicultural communities, increase the diversity of the mental health workforce, to reduce the stigma associated with mental illness, and to promote the use of web-based technologies, and distance learning techniques. (e) Strategies to recruit high school students for mental health occupations, increasing the prevalence of mental health occupations in high school career development programs such as health science academies, adult schools, and regional occupation centers and programs, and increasing the number of human service academies. (f) Curriculum to train and retrain staff to provide services in accordance with the provisions and principles of Part 3 (commencing with Section 5800), Part 3.2 (commencing with Section 5830), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) of this division. (g) Promotion of the employment of mental health consumers and family members in the mental health system. (h) Promotion of the meaningful inclusion of mental health consumers and family members and incorporating their viewpoint and experiences in the training and education programs in subdivisions (a) through (f). (i) Promotion of the inclusion of cultural competency in the training and education programs in subdivisions (a) through (f).  SEC. 5.   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. (a) The innovative programs shall have the following purposes: (1) To increase access to underserved groups. (2) To increase the quality of services, including better outcomes. (3) To promote interagency collaboration. (4) To increase access to services.  (b) All projects included in the innovative program portion of the county plan shall meet the following requirements:   (1) Address one of the following purposes as its primary purpose:   (A) Increase access to underserved groups.   (B) Increase the quality of services, including measurable outcomes.   (C) Promote interagency and community collaboration.   (D) Increase access to services.   (2) Support innovative approaches by doing one of the following:   (A) Introducing new mental health practices or approaches, including, but not limited to, prevention and early intervention.   (B) Making a change to an existing mental health practice or approach, including, but not limited to, adaptation for a new setting or community.   (C) Introducing a new application to the mental health system of a promising community-driven practice or an approach that has been successful in nonmental health contexts or settings.   (c) An innovative project may affect virtually any aspect of mental health practices or assess a new or changed application of a promising approach to solving persistent, seemingly intractable mental health challenges, including, but not limited to, any of the following:   (1) Administrative, governance, and organizational practices, processes, or procedures.   (2) Advocacy.   (3) Education and training for service providers, including nontraditional mental health practitioners.   (4) Outreach, capacity building, and community development.   (5) System development.   (6) Public education efforts.   (7) Research.   (8) Services and interventions, including prevention, early intervention, and treatment.   (d) If an innovative project has proven to be successful and a county chooses to continue it, the project work plan shall transition to another category of funding as appropriate.   (b)   (e)  County mental health programs shall  receive   expend  funds for their innovation programs upon approval by the Mental Health Services Oversight and Accountability Commission.  SEC. 6.   Section 5840 of the   Welfare and Institutions Code   is amended to read:  5840. (a) The State Department of  Mental  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. (b) The program shall include the following components: (1) Outreach to families, employers, primary care health care providers, and others to recognize the early signs of potentially severe and disabling mental illnesses. (2) Access and linkage to medically necessary care provided by county mental health programs for children with severe mental illness, as defined in Section 5600.3, and for adults and seniors with severe mental illness, as defined in Section 5600.3, as early in the onset of these conditions as practicable. (3) Reduction in stigma associated with either being diagnosed with a mental illness or seeking mental health services. (4) Reduction in discrimination against people with mental illness. (c) The program shall include mental health services similar to those provided under other programs effective in preventing mental illnesses from becoming severe, and shall also include components similar to programs that have been successful in reducing the duration of untreated severe mental illnesses and assisting people in quickly regaining productive lives. (d) The program shall emphasize strategies to reduce the following negative outcomes that may result from untreated mental illness: (1) Suicide. (2) Incarcerations. (3) School failure or dropout. (4) Unemployment. (5) Prolonged suffering. (6) Homelessness. (7) Removal of children from their homes.  (e) Prevention and early intervention funds may be used to broaden the provision of community-based mental health services by adding prevention and early intervention services or activities to these services.   (e)   (f)  In consultation with mental health stakeholders,  and consistent with guidelines from the Mental Health Services Oversight and Accountability Commission, pursuant to Section 5846,  the department shall revise the program elements in Section 5840 applicable to all county mental health programs in future years to reflect what is learned about the most effective prevention and intervention programs for children, adults, and seniors.  SEC. 7.   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: (1) The Attorney General or his or her designee. (2) The Superintendent of Public Instruction or his or her designee. (3) The Chairperson of the Senate Health and Human Services Committee or another member of the Senate selected by the President pro Tempore of the Senate. (4) The Chairperson of the Assembly Health Committee or another member of the Assembly selected by the Speaker of the Assembly. (5) Two persons with a severe mental illness, a family member of an adult or senior with a severe mental illness, a family member of a child who has or has had a severe mental illness, a physician specializing in alcohol and drug treatment, a mental health professional, a county sheriff, a superintendent of a school district, a representative of a labor organization, a representative of an employer with less than 500 employees and a representative of an employer with more than 500 employees, and a representative of a health care services plan or insurer, all appointed by the Governor. In making appointments, the Governor shall seek individuals who have had personal or family experience with mental illness. (b) Members shall serve without compensation, but shall be reimbursed for all actual and necessary expenses incurred in the performance of their duties. (c) The term of each member shall be three years, to be staggered so that approximately one-third of the appointments expire in each year. (d) In carrying out its duties and responsibilities, the commission may do all of the following: (1) Meet at least once each quarter at any time and location convenient to the public as it may deem appropriate. All meetings of the commission shall be open to the public. (2) Within the limit of funds allocated for these purposes, pursuant to the laws and regulations governing state civil service, employ staff, including any clerical, legal, and technical assistance as may appear necessary. The commission shall administer its operations separate and apart from the State Department of  Mental  Health  Care Services  . (3) Establish technical advisory committees such as a committee of consumers and family members. (4) Employ all other appropriate strategies necessary or convenient to enable it to fully and adequately perform its duties and exercise the powers expressly granted, notwithstanding any authority expressly granted to any officer or employee of state government. (5) Enter into contracts. (6) Obtain data and information from the State Department of  Mental  Health  Care Services  ,  the Office of Statewide Health Planning and Development,  or other state or local entities that receive Mental Health Services Act funds, for the commission to utilize in its oversight, review,  training and technical assistance, accountability,  and evaluation capacity regarding projects and programs supported with Mental Health Services Act funds. (7) Participate in the joint state-county decisionmaking process, as contained in Section 4061, for training, technical assistance, and regulatory resources to meet the mission and goals of the state's mental health system. (8) Develop strategies to overcome stigma  and discrimination,  and accomplish all other objectives of Part 3.2 (commencing with Section 5830), 3.6 (commencing with Section 5840), and the other provisions of the act establishing this commission. (9) At any time, advise the Governor or the Legislature regarding actions the state may take to improve care and services for people with mental illness. (10) If the commission identifies a critical issue related to the performance of a county mental health program, it may refer the issue to the State Department of  Mental  Health  Care Services  pursuant to Section 5655.  (11) Assist in providing technical assistance to accomplish the purposes of the Mental Health Services Act, Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850) in collaboration with the State Department of Health Care Services and in consultation with the California Mental Health Directors Association.   (12) Work in collaboration with the State Department of Health Care Services and the California Mental Health Planning Council, and in consultation with the California Mental Health Directors Association, in designing a comprehensive joint plan for a coordinated evaluation of client outcomes in the community-based mental health system, including, but not limited to, parts listed in subdivision (a). The California Health and Human Services Agency shall lead this comprehensive joint plan effort.   SEC. 8.   Section 5846 of the   Welfare and Institutions Code   is amended to read:  5846. (a) The commission shall issue guidelines for 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, no later than 180 days before the fiscal year for which the funds will apply. (b) The commission may provide technical assistance to any county mental health plan as needed to address concerns or recommendations of the commission or when local programs could benefit from technical assistance for improvement of their plans. (c) The commission shall ensure that the perspective and participation of members and others suffering from  ,   or at risk for,  severe mental illness and their family members is a significant factor in all of its decisions and recommendations.  SEC. 9.   Section 5847 of the   Welfare and Institutions Code   is amended to read:  5847. Integrated Plans for Prevention, Innovation, and System of Care Services.  (a) It is the intent of the Legislature to streamline the approval processes of the State Department of Mental Health and the Mental Health Services Oversight and Accountability Commission of programs developed pursuant to Sections 5891 and 5892.   (b)   (   a)  Each county mental health program shall prepare and submit a three-year  program and expenditure  plan  , and annual updates, adopted by the county board of supervisors, to the Mental Health Services Oversight and Accountability Commission within 30 days after adoption  .  The   (b)     The three-year program and expenditure plan shall be based on available unspent funds and estimated revenue allocations provided by the state   and in accordance with established stakeholder engagement and planning requirements as required in Section 5848. The three-year program and expenditure  plan  and annual updates  shall include all of the following: (1) A program for prevention and early intervention in accordance with Part 3.6 (commencing with Section 5840). (2) A program for services to children in accordance with Part 4 (commencing with Section 5850), to include a program pursuant to Chapter 4 (commencing with Section 18250) of Part 6 of Division 9 or provide substantial evidence that it is not feasible to establish a wraparound program in that county. (3) A program for services to adults and seniors in accordance with Part 3 (commencing with Section 5800). (4) A program for innovations in accordance with Part 3.2 (commencing with Section 5830). (5) A program for technological needs and capital facilities needed to provide services pursuant to Part 3 (commencing with Section 5800), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850). All plans for proposed facilities with restrictive settings shall demonstrate that the needs of the people to be served cannot be met in a less restrictive or more integrated setting. (6) Identification of shortages in personnel to provide services pursuant to the above programs and the additional assistance needed from the education and training programs established pursuant to Part 3.1 (commencing with Section 5820). (7) Establishment and maintenance of a prudent reserve to ensure the county program will continue to be able to serve children, adults, and seniors that it is currently serving pursuant to Part 3 (commencing with Section 5800), the Adult and Older Adult Mental Health System of Care Act, 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, during years in which revenues for the Mental Health Services Fund are below recent averages adjusted by changes in the state population and the California Consumer Price Index.  (8) Certification by the county mental health director, which ensures that the county has complied with all pertinent regulations, laws, and statutes of the Mental Health Services Act, including stakeholder participation and nonsupplantation requirements.   (9) Certification by the county mental health director and by the county auditor controller that the county has complied with any fiscal accountability requirements as directed by the State Department of Health Care Services, and that all expenditures are consistent with the requirements of the Mental Health Services Act.   (c) The State Department of Mental Health shall not issue guidelines for the Integrated Plans for Prevention, Innovation, and System of Care Services before January 1, 2012.   (d)   (   c)  The programs established pursuant to paragraphs (2) and (3) of subdivision (b) shall include services to address the needs of transition age youth ages 16 to 25. In implementing this subdivision, county mental health programs shall consider the needs of transition age foster youth.  (d) Each year the State Department of Health Care Services shall inform the California Mental Health Directors Association and the Mental Health Services Oversight and Accountability Commission of the methodology used for revenue allocation to the counties.  (e)  Each year the State Department of Mental Health, in consultation with the California Mental Health Directors Association, the Mental Health Services Oversight and Accountability Commission, and the Mental Health Planning Council, shall inform counties of the amounts of funds available for services to children pursuant to Part 4 (commencing with Section 5850), and to adults and seniors pursuant to Part 3 (commencing with Section 5800).  Each county mental health program shall prepare expenditure plans pursuant to Part 3 (commencing with Section 5800)  for adults and seniors  ,  Part 3.2 (commencing with Section 5830) for innovative programs, Part   3.6 (commencing with Section 5840) for prevention and early intervention programs,  and Part 4 (commencing with Section 5850)  for services for children  , and updates to the plans developed pursuant to this section. Each expenditure update shall indicate the number of children, adults, and seniors to be served pursuant to Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850), and the cost per person. The expenditure update shall include utilization of unspent funds allocated in the previous year and the proposed expenditure for the same purpose. (f) A county mental health program shall include an allocation of funds from a reserve established pursuant to paragraph (7) of subdivision (b) for services pursuant to paragraphs (2) and (3) of subdivision (b) in years in which the allocation of funds for services pursuant to subdivision (e) are not adequate to continue to serve the same number of individuals as the county had been serving in the previous fiscal year.  SEC. 10.   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. 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. (b) The mental health board established pursuant to Section 5604 shall conduct a public hearing on the draft  three-year program and expenditure  plan and annual updates at the close of the 30-day comment period required by subdivision (a). Each adopted  three-year program and expenditure  plan and update shall include any substantive written recommendations for revisions. The adopted  three-year program and expenditure  plan or update shall summarize and analyze the recommended revisions. The mental health board shall review the adopted plan or update and make recommendations to the county mental health department for revisions. (c)  The department shall establish requirements for the content of the plans.  The plans shall include reports on the achievement of performance outcomes for services pursuant to Part 3 (commencing with Section 5800), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) funded by the Mental Health Services Fund and established  jointly  by the  department   Department of Health Care Services and the Mental Health Services Oversight and Accountability Commission, in collaboration with the California   Mental Health Directors Association  . (d) Mental health services provided pursuant to Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850), shall be included in the review of program performance by the California Mental Health Planning Council required by paragraph (2) of subdivision (c) of Section 5772 and in the local mental health board' s review and comment on the performance outcome data required by paragraph (7) of subdivision (a) of Section 5604.2.  SEC. 11.   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  assure   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   his or her  family. (b) Nothing in this act shall be construed to authorize any services to be provided to a minor without the consent of the child's parent or legal guardian beyond those already authorized by existing statute.  SEC. 12.   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. (b) Funding shall be at sufficient levels to ensure that counties can provide each child served all of the necessary services set forth in the applicable treatment plan developed in accordance with this part, including services where appropriate and necessary to prevent an out of home placement, such as services pursuant to Chapter 4 (commencing with Section 18250) of Part 6 of Division 9. (c) The State Department of  Mental Health  Care Services  shall contract with county mental health programs for the provision of services under this article in the manner set forth in Section 5897.  SEC. 13.   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: (1) Part 3 (commencing with Section 5800), the Adult and Older Adult System of Care Act.  (2) Part 3.2 (commencing with Section 5830), Innovative Programs.   (2)   (3)  Part 3.6 (commencing with Section 5840), Prevention and Early Intervention Programs.  (3)   (4)  Part 4 (commencing with Section 5850), the Children' s Mental Health Services Act. (b) Nothing in the establishment of this fund, nor any other provisions of the act establishing it or the programs funded shall be construed to modify the obligation of health care service plans and disability insurance policies to provide coverage for mental health services, including those services required under Section 1374.72 of the Health and Safety Code and Section 10144.5 of the Insurance Code, related to mental health parity. Nothing in this act shall be construed to modify the oversight duties of the Department of Managed Health Care or the duties of the Department of Insurance with respect to enforcing these obligations of plans and insurance policies. (c) Nothing in this act shall be construed to modify or reduce the existing authority or responsibility of the State Department of  Mental  Health  Care Services  . (d) The State Department of Health Care Services  , in consultation with the State Department of Mental Health,  shall seek approval of all applicable federal Medicaid approvals to maximize the availability of federal funds and eligibility of participating children, adults, and seniors for medically necessary care. (e) Share of costs for services pursuant to Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850) of this division, shall be determined in accordance with the Uniform Method for Determining Ability to Pay applicable to other publicly funded mental health services, unless this Uniform Method is replaced by another method of determining co-payments, in which case the new method applicable to other mental health services shall be applicable to services pursuant to Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850) of this division.  SEC. 14.   Section 5891 of the   Welfare and Institutions Code  is amende   d to read:  5891. (a) The funding established pursuant to this act shall be utilized to expand mental health services. Except as provided in subdivision (j) of Section 5892 due to the state's fiscal crisis, these funds shall not be used to supplant existing state or county funds utilized to provide mental health services. The state shall continue to provide financial support for mental health programs with not less than the same entitlements, amounts of allocations from the General Fund or from the Local Revenue Fund 2011 in the State Treasury, and formula distributions of dedicated funds as provided in the last fiscal year which ended prior to the effective date of this act. The state shall not make any change to the structure of financing mental health services, which increases a county's share of costs or financial risk for mental health services unless the state includes adequate funding to fully compensate for such increased costs or financial risk. These funds shall only be used to pay for the programs authorized in Section 5892. These funds may not be used to pay for any other program. These funds may not be loaned to the state General Fund or any other fund of the state, or a county general fund or any other county fund for any purpose other than those authorized by Section 5892. (b) Notwithstanding subdivision (a), the Controller may use the funds created pursuant to this part for loans to the General Fund as provided in Sections 16310 and 16381 of the Government Code. Any such loan shall be repaid from the General Fund with interest computed at 110 percent of the Pooled Money Investment Account rate, with interest commencing to accrue on the date the loan is made from the fund. This subdivision does not authorize any transfer that would interfere with the carrying out of the object for which these funds were created. (c) Commencing July 1, 2012, on or before the 15th day of each month,  pursuant to a methodology provided by the State Department of Health Care Services,  the Controller shall distribute to each Local Mental Health Service Fund established by counties pursuant to subdivision (f) of Section 5892, all unexpended and unreserved funds on deposit as of the last day of the prior month in the Mental Health Services Fund, established pursuant to Section 5890, for the provision of programs and other related activities set forth in Part 3 (commencing with Section 5800), Part 3.2 (commencing with Section 5830), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850).  Funding distributions   (d)     Counties    shall  be based   base their expenditures  on the  amount specified in the  county mental health program's three-year  program and expenditure  plan or  annual  update, as required by Section 5847. Nothing in this subdivision shall affect subdivision (a) or (b).  SEC. 15.   Section 5892 of the   Welfare and Institutions Code   is amended to read:  5892. (a) In order to promote efficient implementation of this act  allocate the following portions of funds available in   , the county shall use funds distributed from  the Mental Health Services Fund  in 2005-06 and each year thereafter   as follows  : (1) In 2005-06, 2006-07, and in 2007-08 10 percent shall be placed in a trust fund to be expended for education and training programs pursuant to Part 3.1. (2) In 2005-06, 2006-07 and in 2007-08 10 percent for capital facilities and technological needs distributed to counties in accordance with a formula developed in consultation with the California Mental Health Directors Association to implement plans developed pursuant to Section 5847. (3) Twenty percent  of funds distributed to the counties pursuant to subdivision (c) of Section 5891 shall be used  for prevention and early intervention programs  distributed to counties  in accordance with a formula developed in consultation with the California Mental Health Directors Association pursuant to Part 3.6 (commencing with Section 5840) of this division. (4) The  allocation   expenditure  for prevention and early intervention may be increased in any county  in  which the department determines that the increase will decrease the need and cost for additional services to severely mentally ill persons in that county by an amount at least commensurate with the proposed increase.  The statewide allocation for prevention and early intervention may be increased whenever the Mental Health Services Oversight and Accountability Commission determines that all counties are receiving all necessary funds for services to severely mentally ill persons and have established prudent reserves and there are additional revenues available in the fund.  (5) The balance of funds shall be distributed to county mental health programs for services to persons with severe mental illnesses pursuant to Part 4 (commencing with Section 5850), for the children's system of care and Part 3 (commencing with Section 5800), for the adult and older adult system of care. (6) Five percent of the total funding for each county mental health program for Part 3 (commencing with Section 5800), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) of this division, shall be utilized for innovative programs in accordance with Sections 5830, 5847, and 5848. (b) In any year after 2007-08, programs for services pursuant to Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850) of this division may include funds for technological needs and capital facilities, human resource needs, and a prudent reserve to ensure services do not have to be significantly reduced in years in which revenues are below the average of previous years. The total allocation for purposes authorized by this subdivision shall not exceed 20 percent of the average amount of funds allocated to that county for the previous five years pursuant to this section. (c) The allocations pursuant to subdivisions (a) and (b) shall include funding for annual planning costs pursuant to Section 5848. The total of these costs shall not exceed 5 percent of the total of annual revenues received for the fund. The planning costs shall include funds for county mental health programs to pay for the costs of consumers, family members, and other stakeholders to participate in the planning process and for the planning and implementation required for private provider contracts to be significantly expanded to provide additional services pursuant to Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850) of this division. (d) Prior to making the allocations pursuant to subdivisions (a), (b)  ,  and (c), funds shall be reserved for the costs for the State Department of  Mental  Health  Care Services  , the California Mental Health Planning Council,  and   the Office of Statewide Health Planning and Development, the Mental Health Services Oversight and Accountability Commission  , the State Department of Public Health, and any other state agency  to implement all duties pursuant to the programs set forth in this section. These costs shall not exceed 3.5 percent of the total of annual revenues received for the fund. The administrative costs shall include funds to assist consumers and family members to ensure the appropriate state and county agencies give full consideration to concerns about quality, structure of service delivery, or access to services. The amounts allocated for administration shall include amounts sufficient to ensure adequate research and evaluation regarding the effectiveness of services being provided and achievement of the outcome measures set forth in Part 3 (commencing with Section 5800), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) of this division. The amount of funds available for the purposes of this subdivision in any fiscal year shall be subject to appropriation in the annual Budget Act. (e) In 2004-05 funds shall be allocated as follows: (1) Forty-five percent for education and training pursuant to Part 3.1 (commencing with Section 5820) of this division. (2) Forty-five percent for capital facilities and technology needs in the manner specified by paragraph (2) of subdivision (a). (3) Five percent for local planning in the manner specified in subdivision (c). (4) Five percent for state implementation in the manner specified in subdivision (d). (f) Each county shall place all funds received from the State Mental Health Services Fund in a local Mental Health Services Fund. The Local Mental Health Services Fund balance shall be invested consistent with other county funds and the interest earned on the investments shall be transferred into the fund. The earnings on investment of these funds shall be available for distribution from the fund in future years. (g) All expenditures for county mental health programs shall be consistent with a currently approved plan or update pursuant to Section 5847. (h) Other than funds placed in a reserve in accordance with an approved plan, any funds allocated to a county which have not been spent for their authorized purpose within three years shall revert to the state to be deposited into the fund and available for other counties in future years, provided however, that funds for capital facilities, technological needs, or education and training may be retained for up to 10 years before reverting to the fund. (i) If there are still additional revenues available in the fund after the Mental Health Services Oversight and Accountability Commission has determined there are prudent reserves and no unmet needs for any of the programs funded pursuant to this section, including all purposes of the Prevention and Early Intervention Program, the commission shall develop a plan for expenditures of these revenues to further the purposes of this act and the Legislature may appropriate these funds for any purpose consistent with the commission's adopted plan which furthers the purposes of this act. (j) For the 2011-12 fiscal year, General Fund revenues will be insufficient to fully fund many existing mental health programs, including Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), Medi-Cal Specialty Mental Health Managed Care, and mental health services provided for special education pupils. In order to adequately fund those programs for the 2011-12 fiscal year and avoid deeper reductions in programs that serve individuals with severe mental illness and the most vulnerable, medically needy citizens of the state, prior to distribution of funds under paragraphs (1) to (6), inclusive, of subdivision (a), effective July 1, 2011, moneys shall be allocated from the Mental Health Services Fund to the counties as follows: (1) Commencing July 1, 2011, one hundred eighty-three million six hundred thousand dollars ($183,600,000) of the funds available as of July 1, 2011, in the Mental Health Services Fund, shall be allocated in a manner consistent with subdivision (c) of Section 5778 and based on a formula determined by the state in consultation with the California Mental Health Directors Association to meet the fiscal year 2011-12 General Fund obligation for Medi-Cal Specialty Mental Health Managed Care. (2) Upon completion of the allocation in paragraph (1), the Controller shall distribute to counties ninety-eight million five hundred eighty-six thousand dollars ($98,586,000) from the Mental Health Services Fund for mental health services for special education pupils based on a formula determined by the state in consultation with the California Mental Health Directors Association. (3) Upon completion of the allocation in paragraph (2), the Controller shall distribute to counties 50 percent of their 2011-12 Mental Health Services Act component allocations consistent with Sections 5847 and 5891, not to exceed four hundred eighty-eight million dollars ($488,000,000). This allocation shall commence beginning August 1, 2011. (4) Upon completion of the allocation in paragraph (3), and as revenues are deposited into the Mental Health Services Fund, the Controller shall distribute five hundred seventy-nine million dollars ($579,000,000) from the Mental Health Services Fund to counties to meet the General Fund obligation for EPSDT for fiscal year 2011-12. These revenues shall be distributed to counties on a quarterly basis and based on a formula determined by the state in consultation with the California Mental Health Directors Association. These funds shall not be subject to reconciliation or cost settlement. (5) The Controller shall distribute to counties the remaining 2011-12 Mental Health Services Act component allocations consistent with Sections 5847 and 5891, beginning no later than April 30, 2012. These remaining allocations shall be made on a monthly basis. (6) The total one-time allocation from the Mental Health Services Fund for EPSDT, Medi-Cal Specialty Mental Health Managed Care, and mental health services provided to special education pupils as referenced shall not exceed eight hundred sixty-two million dollars ($862,000,000). Any revenues deposited in the Mental Health Services Fund in fiscal year 2011-12 that exceed this obligation shall be distributed to counties for remaining fiscal year 2011-12 Mental Health Services Act component allocations, consistent with Sections 5847 and 5891. (k) Subdivision (j) shall not be subject to repayment. (l) Subdivision (j) shall become inoperative on July 1, 2012.  SEC. 16.   Section 5897 of the   Welfare and Institutions Code   is amended to read:  5897. (a) Notwithstanding any other provision of state law, the State Department of  Mental  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) of this division through contracts with county mental health programs or counties acting jointly. A contract may be exclusive and may be awarded on a geographic basis. As used herein a county mental health program includes a city receiving funds pursuant to Section 5701.5. (b) Two or more counties acting jointly may agree to deliver or subcontract for the delivery of such mental health services. The agreement may encompass all or any part of the mental health services provided pursuant to these parts. Any agreement between counties shall delineate each county's responsibilities and fiscal liability. (c) The department shall implement the provisions of Part 3 (commencing with Section 5800), Part 3.2 (commencing with Section 5830), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) of this division through the annual county mental health services performance contract, as specified in Chapter 2 (commencing with Section 5650) of Part 2 of Division 5. (d) When a county mental health program is not in compliance with its performance contract, the department may request a plan of correction with a specific timeline to achieve improvements. (e) Contracts awarded by the State Department of  Mental  Health  Care Services  , the California Mental Health Planning Council,  the Office of Statewide Health Planning and Development,  and the Mental Health Services Oversight and Accountability Commission pursuant to Part 3 (commencing with Section 5800), Part 3.1 (commencing with Section 5820), Part 3.2 (commencing with Section 5830), Part 3.6 (commencing with Section 5840), Part 3.7 (commencing with Section 5845), Part 4 (commencing with Section 5850), and Part 4.5 (commencing with Section 5890) of this division, may be awarded in the same manner in which contracts are awarded pursuant to Section 5814 and the provisions of subdivisions (g) and (h) of Section 5814 shall apply to such contracts. (f) For purposes of Section 5775, the allocation of funds pursuant to Section 5892 which are used to provide services to Medi-Cal beneficiaries shall be included in calculating anticipated county matching funds and the transfer to the  department   State Department of Health Care Services  of the anticipated county matching funds needed for community mental health programs.  SEC. 17.   Section 5898 of the   Welfare and Institutions Code   is amended to read:  5898. The  state   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  Mental  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. 18.   Section 5899 is added to the   Welfare and Institutions Code   , to read:   5899. (a) The State Department of Health Care Services, in consultation with the Mental Health Services Oversight and Accountability Commission and the California Mental Health Directors Association, shall develop and administer instructions for the Annual Mental Health Services Act Revenue and Expenditure Report. This report shall be submitted electronically to the department and to the Mental Health Services Oversight and Accountability Commission. (b) The purpose of the Annual Mental Health Services Act Revenue and Expenditure Report is as follows: (1) Identify the expenditures of Mental Health Services Act (MHSA) funds that were distributed to each county. (2) Quantify the amount of additional funds generated for the mental health system as a result of the MHSA. (3) Identify unexpended funds, and interest earned on MHSA funds. (4) Determine reversion amounts, if applicable, from prior fiscal year distributions. (c) This report is intended to provide information that allows for the evaluation of all of the following: (1) Children's systems of care. (2) Prevention and early intervention strategies. (3) Innovative projects. (4) Workforce education and training. (5) Adults and older adults systems of care. (6) Capital facilities and technology needs.   SEC. 19.   The Legislature finds and declares that this act clarifies procedures and terms of the Mental Health Services Act within the meaning of Section 18 of the Mental Health Services Act.  All matter omitted in this version of the bill appears in the bill as introduced in the Senate, February 21, 2012. (JR11)