Bill Text: CA AB270 | 2021-2022 | Regular Session | Introduced
Bill Title: Core Behavioral Health Crisis Services System.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2022-02-01 - From committee: Filed with the Chief Clerk pursuant to Joint Rule 56. [AB270 Detail]
Download: California-2021-AB270-Introduced.html
CALIFORNIA LEGISLATURE—
2021–2022 REGULAR SESSION
Assembly Bill
No. 270
| Introduced by Assembly Member Ramos |
January 19, 2021 |
An act to add Article 6.2 (commencing with Section 53124) to Chapter 1 of Part 1 of Division 2 of Title 5 of the Government Code, relating to behavioral health, and making an appropriation therefor.
LEGISLATIVE COUNSEL'S DIGEST
AB 270, as introduced, Ramos.
Core Behavioral Health Crisis Services System.
Existing law, the Warren-911-Emergency Assistance Act, requires every local public agency, as defined, to have an emergency communication system and requires the digits “911” to be the primary emergency telephone number within the system.
Existing law contains provisions governing the operation and financing of community mental health services for the mentally disordered in every county through locally administered and locally controlled community mental health programs. Existing law specifies that county mental health services should be organized to provide immediate response to individuals in precrisis and crisis and to members of the individual’s support system, on a 24-hour, 7-day-a-week basis and authorizes provision of crisis services offsite as mobile services.
Existing federal law, the National
Suicide Hotline Designation Act, designated the three-digit telephone number “988” as the universal number within the United States for the purpose of the national suicide prevention and mental health crisis hotline system operating through the National Suicide Prevention Lifeline maintained by the Assistant Secretary for Mental Health and Substance Abuse and the Veterans Crisis Line maintained by the Secretary of Veterans Affairs.
This bill would create the Core Behavioral Health Crisis Services System, using the digits “988” for the 988 Suicide Prevention and Behavioral Health Crisis Hotline, in compliance with existing federal law and standards governing the National Suicide Prevention Lifeline. The bill would require the department, as defined, to take specified actions to implement the hotline system. The bill would require the department to charge a fee on each resident of the state that is a subscriber of commercial mobile or IP-enabled voice services to pay
for the costs of the program. The bill would create the 988 Fund, a new continuously appropriated fund, and would require the fees to be deposited along with other specified moneys into the 988 Fund. By creating a new continuously appropriated fund and establishing a fee as a new source of revenue for the continuously appropriated fund, the bill would make an appropriation.
The bill would also require local jurisdictions, in collaboration with the department, to create Mobile Crisis Teams, as specified, to provide onsite response services to crisis calls made through the hotline. By imposing this new requirement on local jurisdictions, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIII A of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.
Digest Key
Vote: 2/3 Appropriation: YES Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Article 6.2 (commencing with Section 53124) is added to Chapter 1 of Part 1 of Division 2 of Title 5 of the Government Code, to read:Article 6.2. Core Behavioral Health Crisis Services System
53124.
For purposes of this article, the following terms have the following meanings:(a) “988 Crisis Hotline Center” means a state-identified and funded center participating in the National Suicide Prevention Lifeline network to respond to statewide or regional 988 calls.
(b) “Crisis receiving and stabilization services” means facilities providing short-term observation for less than 24 hours and crisis stabilization services to all referrals in a home-like environment.
(c) “Department” means the Office of Suicide Prevention within the State Department of Public Health, to the extent that funding is available for the operation of the Office of
Suicide Prevention. In the absence of the necessary funding for the Office of Suicide Prevention, as determined by the State Department of Public Health, “department” means the State Department of Health Care Services, in coordination with the Office of Emergency Services.
(d) “Federal Communications Commission” or “Commission” means the independent United States agency overseen by Congress that regulates interstate and international communications by radio, television, wire, satellite, and cable in all 50 states, the District of Columbia, and United States territories. The Commission is the United States’ primary authority for communications law, regulation, and technological innovation.
(e) “Mobile Crisis Team” means a team providing professional onsite community-based intervention for an individual who is experiencing a behavioral health crisis.
(f) “National Suicide Prevention Lifeline” or “NSPL” means the national network of local crisis centers that provide free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week.
(g) “Peer” means an individual employed on the basis of their personal lived experience of mental illness or addiction and recovery who meets the state’s peer certification requirements, if applicable.
(h) “Substance Abuse and Mental Health Services Administration” or “SAMHSA” means that agency within the United States Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation.
(i) “988 Suicide Prevention and Behavioral Health Crisis Hotline” means the National
Suicide Prevention Lifeline or its successor maintained by the Assistant Secretary for Mental Health and Substance Use under Section 520E–3 of the Public Health Service Act (42 U.S.C. 290bb–36c).
(j) “Veterans Crisis Line” or “VCL” means Veterans Crisis Line maintained by the Secretary of Veterans Affairs under subdivision (h) of Section 1720F of Title 38 of the United States Code.
(k) “Uninsured” means an individual is not covered by any of the following types of health care coverage:
(1) Medi-Cal.
(2) Medicare.
(3) A health care service plan contract or health insurance policy that covers crisis stabilization services.
53124.1.
(a) The department shall, prior to July 16, 2022, designate a 988 Crisis Hotline Center or centers to provide crisis intervention services and crisis care coordination to individuals accessing the 988 Suicide Prevention and Behavioral Health Crisis Hotline from any jurisdiction within California 24 hours a day, 7 days a week. The 988 Crisis Hotline Center or centers shall meet all of the following requirements:(1) A designated 988 Crisis Hotline Center shall have an active agreement with the administrator of the National Suicide Prevention Lifeline (NSPL) for participation within the network.
(2) A designated 988 Crisis Hotline Center shall meet NSPL requirements and best
practices guidelines for operational and clinical standards.
(3) To ensure cohesive, coordinated crisis care, a designated 988 Crisis Hotline Center shall utilize technology that is interoperable between and across crisis and emergency response systems used throughout the state, including, but not limited to, 911, emergency medical services (EMS), and other nonbehavioral health crisis services.
(4) A designated 988 Crisis Hotline Center shall have the authority to deploy crisis and outgoing services, including mobile crisis teams, and coordinate access to crisis receiving and stabilization services, as appropriate, and according to guidelines and best practices established by the NSPL.
(5) A designated 988 Crisis Hotline Center shall coordinate access to crisis receiving and stabilization services for individuals
accessing the 988 Suicide Prevention and Behavioral Health Crisis Hotline through appropriate information sharing regarding availability of services.
(6) A designated 988 Crisis Hotline Center shall meet the requirements set forth by NSPL for serving high-risk and specialized populations as identified by the Substance Abuse and Mental Health Services Administration (SAMHSA), including training requirements and policies for transferring hotline callers to an appropriate specialized center or subnetworks within, or external to, the NSPL network.
(7) A designated 988 Crisis Hotline Center shall provide followup services to individuals accessing the 988 Suicide Prevention and Behavioral Health Crisis Hotline consistent with guidance and policies established by the NSPL.
(b) The department shall use its authority to
promulgate rules and regulations to allow appropriate information sharing and communication between and across crisis and emergency response systems for the purpose of real-time crisis care coordination including, but not limited to, deployment of crisis and outgoing services and linked, flexible services specific to crisis response.
(c) The department having primary oversight of suicide prevention and crisis service activities and essential coordination with designated 988 Crisis Hotline Centers shall work in concert with the NSPL and VCL networks for the purposes of ensuring consistency of public messaging about 988 services.
(d) The department shall annually submit a report to the Legislature and SAMHSA on the usage of the 988 Suicide Prevention and Behavioral Health Crisis Hotline and the services provided by the designated 988 Crisis Hotline
Centers.
53124.2.
(a) A local jurisdiction, in collaboration with the department, shall create Mobile Crisis Teams to provide onsite response services to crisis calls.(b) The Mobile Crisis Teams shall be any of the following:
(1) Jurisdiction-based behavioral health teams that include licensed behavioral health professionals and peers.
(2) Behavioral health teams embedded in emergency medical services (EMS) that include peers.
(3) Police department-based coresponder behavioral health teams including peace officers, licensed behavioral health professionals, and
peers.
53124.3.
The department shall fund treatment for crisis receiving and stabilization services as related to the 988 Suicide Prevention and Behavioral Health Crisis Hotline call according to the following:(a) Crisis receiving and stabilization services as related to the 988 Suicide Prevention and Behavioral Health Crisis Hotline call shall be funded by the department if the individual meets the definition of uninsured in subdivision (k) of Section 53124, or if the crisis receiving and stabilization service is not a covered service by the individual’s health coverage.
(b) The department shall determine how payment will be made to the provider.
53124.4.
(a) The 988 Fund is hereby created in the State Treasury for the purposes of creating and maintaining a statewide 988 Suicide Prevention and Behavioral Health Crisis Hotline system, pursuant to the National Suicide Hotline Designation Act of 2020, the Federal Communication Commission’s rules adopted July 16, 2020, and national guidelines for crisis care.(b) The 988 Fund shall consist of moneys from any of the following sources:
(1) The statewide 988 fee assessed on users pursuant to Section 53124.5.
(2) Appropriations made by the Legislature for the purposes of this article.
(3) Grants and gifts intended for deposit in the fund.
(4) Interest, premiums, gains, or other earnings on the 988 Fund.
(5) Money from any other source that is deposited in or transferred to the 988 Fund.
(c) Moneys allocated to the department for the 988 Suicide Prevention and Behavioral Health Crisis Hotline system in a fiscal year that are not encumbered by the department in that fiscal year shall revert to the 988 Fund.
(d) Moneys in the 988 Fund shall not be subject to transfer to any other fund or to transfer, assignment, or reassignment for any other use or purpose outside of those specified in Section 53124.5.
(e) The
988 Fund shall be continuously appropriated for the purposes of this article.
(f) The department shall annually submit a report to the Legislature and the Federal Communications Commission on the 988 Fund deposits and expenditures.
53124.5.
(a) The department, in compliance with the National Suicide Hotline Designation Act of 2020, shall establish a monthly statewide 988 fee on each resident that is a subscriber of commercial mobile or IP-enabled voice services at a rate that provides for the robust creation, operation, and maintenance of a statewide 988 Suicide Prevention and Behavioral Health Crisis Hotline system and the continuum of services provided pursuant to national guidelines for crisis services.(b) The revenue generated by a 988 fee shall be sequestered in trust, as specified in Section 53124.4, to be obligated or expended only in support of 988 Suicide Prevention and Behavioral Health Crisis Hotline system services, or enhancements of such services.
(c) The revenue generated by a 988 fee shall only be used to offset costs that are, or will be reasonably attributed to, any of the following:
(1) Primarily ensuring the efficient and effective routing of calls made to the 988 Suicide Prevention and Behavioral Health Crisis Hotline to the designated 988 Crisis Hotline Center or centers, including staffing and technological infrastructure enhancements necessary to achieve operational and clinical standards and best practices set forth by the National Suicide Prevention Lifeline.
(2) Personnel and the provision of acute behavioral health, crisis outreach, and stabilization services by directly responding to the 988 Suicide Prevention and Behavioral Health Crisis Hotline.
(3) Administration, oversight, and
evaluation of the 988 Fund.
(d) The department shall annually submit a report to the Legislature and the Federal Communications Commission on the revenue generated by the 988 fee.
