California Senate Bill SB893 Latest Draft

 BILL NUMBER: SB 893AMENDED BILL TEXT AMENDED IN SENATE JUNE 20, 2011 AMENDED IN SENATE MAY 11, 2011 AMENDED IN SENATE MARCH 22, 2011 INTRODUCED BY Senator Wolk FEBRUARY 18, 2011 An act to add Chapter 7 (commencing with Section 8300) to Division 8 of the Welfare and Institutions Code, relating to governmental efficiency, and declaring the urgency thereof, to take effect immediately. LEGISLATIVE COUNSEL'S DIGEST SB 893, as amended, Wolk. Health and Human Services System Improvement and Accountability Act of 2011. Existing law establishes the California Health and Human Services Agency within state government, which oversees various health and human services programs, including mental health, substance abuse  treatment, rehabilitation, developmental programs, public health, child support  ,  adult protective services, and child welfare  programs  for the aging, health care, children's programs, and other programs  . This bill, the Health and Human Services System Improvement and Accountability Act of 2011, would require the agency to establish, by December 1, 2013, the California Health and Human Services Review System in order to periodically review  the   specified  health and human services programs administered by the state and local agencies, as specified. The bill would require the agency convene  a   an advisory  workgroup to design and draft a work plan to  implement   guide the agenc   y in implementing  the system. The bill would require the agency to report specified information to the Legislature. The bill would require the Secretary of California Health and Human Services to establish an information sharing plan to enable the exchange of information among state and local agencies to support the implementation of the California Health and Human Services Review System. This bill would declare that it is to take effect immediately as an urgency statute. Vote: 2/3. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares all of the following: (a) The State of California has struggled to deliver high-quality, effective, and efficient services through its health and human services programs. (b) Despite incremental legislative efforts and laudable pilot projects in a range of areas, publicly funded programs are not systematically evaluated, performance and outcomes are not routinely documented, and successful programs are not consistently replicated. (c) Lack of information on performance, the cost-effectiveness of programs, best practices, and evidence-based approaches undermines opportunities to improve programs, enhance prevention and early intervention, and ensure the best use of limited resources. (d) Barriers to information sharing prevent efforts to leverage existing data to guide programmatic and fiscal decisions, recognize opportunities to integrate services and improve outcomes, and communicate information on performance to policymakers and the public. (e) Inadequate attention to accomplishments, challenges, performance, and outcomes undermines statewide accountability and limits public understanding of and support for California's health and human services programs. (f) The state has made notable progress in some areas, including the development of an outcomes and accountability review system for the child welfare system, the adoption of select health outcome measures, and the identification of a limited number of performance measures for specific mental health and substance abuse treatment programs. (g) Research indicates a relationship between inadequate access to effective health and human services programs and increased public sector costs for preventable hospitalizations, unemployment, homelessness, and incarceration. Conversely, effective health and human services programs, sufficiently focused on prevention, early intervention, and effective practices, can reduce school failure, improve employment opportunities, prevent suicide, and support the ability of adults and families to achieve and sustain self-reliance, and thus reduce public sector costs. (h) Accordingly, in order to provide greater accountability for health and human  service   services  outcomes, to encourage the statewide leadership necessary to identify and replicate best practices, to ensure that the unique and critical needs of children and families are met, and to be consistent with the California's efforts with the child welfare system, it is the intent of the Legislature to enact the Health and Human Services System Improvement and Accountability Act of 2011. SEC. 2. Chapter 7 (commencing with Section 8300) is added to Division 8 of the Welfare and Institutions Code, to read: CHAPTER 7. CALIFORNIA HEALTH AND HUMAN SERVICES REVIEW SYSTEM 8300. (a) This chapter shall be known, and may be cited, as the Health and Human Services System Improvement and Accountability Act of 2011. (b) For purposes of this chapter, the following definitions apply: (1) "Agency" means the California Health and Human Services Agency. (2) "Secretary" means the Secretary of California Health and Human Services. (3) "Workgroup" means the workgroup established pursuant to Section 8302. 8301. (a) The agency shall establish, by December 1, 2013, the California Health and Human Services Review System in order to periodically review the health and human  service   services  programs administered by the state and local agencies  subject to Realignment 2011  . These reviews shall include  , but not be limited to,  mental health, substance  abuse treatment, rehabilitation, developmental programs, public health, child support, programs for the aging, health care, children's programs, and other   abuse, adult protective services, and child welfare  programs established under state law or funded by the state that are under the jurisdiction of the agency, including, but not limited to, programs that are provided by, or substantially provided by, local agencies, including cities, counties, cities and counties, joint powers agencies, regional agencies, or nonprofit entities under contract with local agencies. (b) Health and human  service   services  reviews shall maximize compliance with federal regulations for the receipt of money from federal sources and shall ensure compliance with state plan requirements where established in response to state and federal law. (c) Reviews shall recognize and be coordinated with federal requirements for reviews, performance improvement plans, and outcome and performance reporting to reduce the duplication of reporting requirements and improve coordination with federal agencies working to improve the performance of public programs, including, but not limited to, reporting requirements linked to the federal Accountable Government Initiative and the Government Performance and Results Act Modernization Act of 2010. (d) In keeping with the intent of this chapter, reviews shall recognize existing review and performance accountability policies and practices and, to the extent feasible and practical as determined by the agency, shall be coordinated with and consistent with those policies and practices. (e) In designing the system, the agency shall emphasize the collection and reporting of information that provides meaningful information to the public on investments in health and human services programs, outputs delivered through health and human  service   services programs, and outcomes achieved through those programs. 8302. (a) By June 1, 2012, the agency shall convene  a   an advisory  workgroup that shall design and draft a work plan  to implement   to guide the agency in implementing  the system, as authorized by this chapter. (b) The membership for the workgroup shall include the following: (1) Representatives of the departments under the jurisdiction of the agency, as determined by the secretary. (2) Representatives of other entities within state government, including  , but not limited to,  the Judicial Council, the Mental Health Services Oversight and Accountability Commission, the State Department of Education, the Department of Justice, the Little Hoover Commission, the First 5 California Commission, the State Council on Developmental Disabilities, the California Commission on Aging, the State Independent Living Council,  and   or  other entities as determined by the secretary. (3) Representatives of cities, counties, city and counties, regional entities, schools, special districts, or other local agencies that deliver services or administer programs under the authority of departments under the jurisdiction of the agency, including  , but not limited to,  the California State Association of Counties, the County Mental Health Directors Association,  the County Alcohol and Drug Program Administration Association of California,  the County Welfare Directors Association of California,  the California Association of Area Agencies on Aging,  the Chief Probation Officers of California, and other entities  ,  as determined by the secretary. (4) Representatives of one or more tribal entities that directly provide health and human services to California's tribal population, including organizations that are formally sanctioned by California tribes, and ensuring representation from entities that provide services to tribal communities in predominantly rural areas and entities that provide services to tribal communities in predominantly urban areas. (5) Representatives of organizations that provide advocacy on behalf of children, youth, adults, older adults, and their families. (6) Representatives of organizations or experts working to address racial and ethnic disparities in access to health and human services or the outcomes achieved through those programs. (7) Researchers and other experts in areas associated with public sector accountability, including experts in the areas of data, indicators, performance measures, results-based accountability, outcome reporting, and community indicators. (c) The secretary shall determine how best to organize the workgroup, including establishing subgroups, where appropriate, to meet the goals of this chapter. (d) At a minimum, in establishing the work plan, the workgroup shall consider the outcomes to be monitored; performance measures and indicators to be used; minimum thresholds for each indicator or measure; strategies to report disparities by geographic and demographic indicators; timelines for implementation; the process for implementation among affected local agencies; the role of peer-to-peer technical assistance and support; review cycles; the uniform processes, procedures, and review instruments to be used; the role of public reporting; planning for performance improvement and any funding or staffing increases; and statutory changes needed to implement the requirements of this chapter. The agency shall broadly consider collaboration with relevant entities to allow the adequate exchange of information and coordination of efforts to improve health and human services outcomes for Californians. (e) The outcomes established by the workgroup, as referenced in subdivision (d) shall include, but not be limited to, measures of employment, education, housing and homelessness, health, safety, and criminal justice involvement, and related information that is useful for communicating to the public and policymakers the quality, effectiveness, and value of health and human services. 8303. The agency shall report on  it's   its  progress in implementing the California Health and Human Services Review System, including, but not limited to, the timelines for implementation, the process to be used, and funding or staffing increases needed at the state or local level to implement the requirements of this chapter, to the budget and appropriate policy committees of the Legislature annually for three fiscal years, beginning with the 2013-14 fiscal year and ending with the 2016-17 fiscal year. 8304. (a) Consistent with the intent of this chapter, the agency shall establish mechanisms to identify and promote the replication of best practices in the delivery of health and human services under the jurisdiction of the agency. Those mechanisms shall include all of the following: (1) Identification of goals and objectives of efforts to promote best practices, including the major functions of the agency, departments, local agencies, and other entities involved in identifying and promoting the use of best practices in the administration and delivery of health and human services programs  as referenced in subdivision (a) of   Section 8301  . (2) A management strategy that supports the ability of the agency, and the departments that make up the agency, to identify and promote the use of best practices, including strategic planning; identification of operational processes and procedures; and the role of technology, information, evaluations, data sharing, and other resources and strategies necessary to achieve the goals and objectives established pursuant to paragraph (1). (3) A fiscal strategy, including budget proposals, to staff and support the ability of the agency and the departments that make up the agency to evaluate existing practices, document best practices in use around the state and elsewhere, and provide technical assistance, outreach, education, and support to promote the replication of best practices and achieve the goals and objectives established pursuant to paragraph (1). (4) A staffing plan to ensure that the agency and the departments that make up the agency have sufficient staff, with the necessary skill sets, knowledge, and training to achieve the goals and objectives established pursuant to paragraph (1). (5) Identification of those factors external to the agency and the departments that make up the agency that are beyond their control that could significantly affect the achievement of the goals and objectives established pursuant to paragraph (1), and proposals to reduce or mitigate those factors where appropriate. (b) The agency shall report to the budget and appropriate legislative policy committees of the Legislature annually for three fiscal years, beginning with the 2013-14 fiscal year and ending with the 2016-17 fiscal year, on the agency's progress in identifying and promoting the replication of best practices in the delivery of health and human services under the jurisdiction of the agency  , as referenced in subdivision (a) of Section 8301  , including information on investments made to achieve these goals, the accomplishments to date, and barriers to making additional progress. 8305. (a) To support the implementation of the California Health and Human Services Review System and the identification and replication of best practices, as specified under this chapter, the secretary shall establish an information sharing plan that accomplishes all of the following: (1) Enables the exchange of information among state agencies, among local agencies, and between state and local agencies as necessary for tracking costs, conducting research on best practices, and improving the efficiency and effectiveness of public services, including prioritizing access to prevention and early intervention services. (2) Provides state and local agencies and the public with information on the costs and effectiveness of publicly supported health and human services programs in California. (3) Permits the Legislature and the public to monitor the outcomes accomplished for the individuals receiving services, including disparities by geography and demographic factors, as established pursuant to this chapter. (4) Establishes a memorandum of understanding, or one or more related mechanisms, that permit the sharing of information between the agency, and the departments that make up the agency, and the California Research Bureau that enable the bureau to conduct research on data held by the agency or the departments that make up the agency, including data otherwise deemed confidential, without reducing the privacy protections in place to protect personal and confidential information. (b) To develop the information sharing plan, the secretary shall consult with state and local officials, clients and consumers who receive government services, service providers, researchers, privacy experts, the public, and others, as determined by the secretary. (c) By January 30, 2013, the agency shall transmit the information sharing plan to the Legislature, including any recommendations for statutory, regulatory, or other reforms that are needed to achieve the goals of that plan. (d) The information sharing plan shall include provisions to protect the privacy of individuals. SEC. 3. This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are: The state is facing historic fiscal challenges that undermine the safety net system on which many Californians rely to meet their basic health and safety needs. The state must put in place a system for determining which programs are effective, and for promoting the use of evidence-based practices to ensure that California is making the best use of available resources. In order to preserve the programs that are most effective in providing needed services, it is necessary that this bill take effect immediately. ____ CORRECTIONS Text--Page 4. ____