Bill Text: CA SB1009 | 2011-2012 | Regular Session | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Health and human services.
Spectrum: Unknown
Status: (Passed) 2012-06-27 - Chaptered by Secretary of State. Chapter 34, Statutes of 2012. [SB1009 Detail]
Download: California-2011-SB1009-Amended.html
Bill Title: Health and human services.
Spectrum: Unknown
Status: (Passed) 2012-06-27 - Chaptered by Secretary of State. Chapter 34, Statutes of 2012. [SB1009 Detail]
Download: California-2011-SB1009-Amended.html
BILL NUMBER: SB 1009 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 25, 2012
INTRODUCED BY Committee on Budget and Fiscal Review
FEBRUARY 6, 2012
An act relating to the Budget Act of 2012.
An act to amend Section 680 of the Business and Professions Code, to
amend Section 43.7 of the Civil Code, to amend Sections
1179.3, 1180.6, 1250.2, 1254, 1254.1, 1266.1, 1275.1, 1275.5,
1324.20, 1343, 1373, 1422.1, 1502, 1502.4, 1507, 1522.08, 1522.41,
1522.42, 1530.9, 1562.3, 11217, 11998.1, 50451, 50685.5, 50687.5,
50689, 120840, 124174.4, 128454, 128456, and 129230 of, and to repeal
Section 1565 of, the Health and Safety Code, to amend Sections
10125, 10127, and 12693.61 of the Insurance Code, and to amend
Sections 21, 359, 708, 4005.1, 4011, 4030, 4031, 4032, 4033, 4040,
4050, 4051, 4052, 4060, 4061, 4080, 4090, 4091, 4094, 4094.1, 4094.2,
4094.7, 4095, 4096.5, 4098.2, 4340, 4369.4, 4681, 4681.1, 4696.1,
4835, 4844, 5150, 5151, 5152, 5157, 5202, 5270.12, 5325,
5326, 5326.1, 5326.15, 5326.3, 5326.8, 5326.9, 5326.91, 5326.95,
5328, 5348, 5349, 5349.1, 5358, 5366.1, 5370.2, 5400, 5402, 5404,
5405, 5510, 5513, 5514, 5520, 5530, 5585.21, 5585.22, 5585.50,
5585.55, 5601, 5602, 5604, 5607, 5610, 5650, 5651, 5652.7, 5653,
5653.1, 5654, 5655, 5664, 5664.5, 5666, 5675, 5675.1, 5675.2, 5676,
5688.6, 5692, 5701, 5701.1, 5705, 5707, 5709, 5710, 5714, 5715, 5717,
5750, 5751, 5751.1, 5751.2, 5751.7, 5768, 5770, 5770.5, 5771,
5771.3, 5772, 5803, 5805, 5806, 5807, 5809, 5813.6, 5814, 5815,
5851.5, 5852, 5852.5, 5854, 5855, 5855.5, 5863, 5867.5, 5868, 5869,
5872, 5878, 5880, 5881, 5901, 5909, 6002.15, 6002.40, 6007, 6551,
7100, 9101, 11325.7, 11462.01, 11495.1, 14021.4, 14021.5, 14053.3,
14108.1, 14110.15, 14131.07, 14132.73, 14167.1, 14167.11, 14168.1,
14169.1, 14456.5, 14680, 14681, 14683, 14684, 14684.1, 14685,
18358.15, 18986.40, 18987.7, and 18994.9 of, to amend the heading of
Article 2 (commencing with Section 5510) of Chapter 6.2 of
Part 1 of Division 5 of, to amend and renumber Sections 4070, 4071,
5711, 5716, 5718, 5719, 5720, 5721, 5722, 5723, 5724, 5775, 5776,
5777, 5777.5, 5777.6, 5777.7, 5778, 5778.3, 5780, 5781, and 5783 of,
to amend and repeal Sections 5779, 5782, 14021.3, and 14682, of, to
amend, renumber, and repeal Section 5719.5 of, to add Sections
4005.6, 4005.7, 14682.1, 14685.1, 14702, 14703, 14704, and
14707.5 to, to repeal Sections 5600.8, 5673, 5708, 5712, 5723.5,
5750.1, 5804, 14640, and 25002 of, to repeal the heading of Article 4
(commencing with Section 4070) of Chapter 2 of Part 1 of Division 4
of, to repeal Article 1 (commencing with Section 4074) and Article 2
(commencing with Section 4075) of Chapter 3 of Part 1 of Division 4
of, to repeal Article 2.5 (commencing with Section 5689) of Chapter
2.5 of Part 2 of Division 5 of, to repeal Article 3 (commencing with
Section 5810) of Part 3 of Division 5 of, and to repeal Chapter 5
(commencing with Section 4097) of Part 1 of Division 4 of, the
Welfare and Institutions Code, relating to health and
human services, and making an appropriation therefor, to take effect
immediately, bill related to the budget.
LEGISLATIVE COUNSEL'S DIGEST
SB 1009, as amended, Committee on Budget and Fiscal Review.
Budget Act of 2012. Health and human
services.
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. Under existing
law, services for these individuals may be provided in psychiatric
hospitals or other types of facilities, as well as in community
settings.
This bill would eliminate or modify certain duties of, and
programs administered by, the State Department of Mental Health, and
would transfer the functions of the State Department of Mental Health
to other state departments. The transferred responsibilities would
include, among others, transferring licensing authority for
psychiatric health facilities, as defined, to the State Department of
Social Services, transferring authority for oversight of group homes
for seriously emotionally disturbed children and community treatment
facilities, and certain duties relating to drug and alcohol abuse
programs, to the State Department of Health Care Services, and
transferring to the State Department of State Hospitals jurisdiction
over individuals under the treatment of state hospitals.
This bill would abolish the existing Licensing and Certification
Fund, Mental Health, and would create in its place the Mental Health
Facility Licensing Fund, which, upon appropriation by the
Legislature, would fund administrative and other activities in
support of the mental health licensing and certification functions of
the State Department of Social Services.
This bill would make various related, technical, and conforming
changes to reflect the transfer of state mental health
responsibilities.
Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are provided to qualified low-income persons. The
Medi-Cal program is, in part, governed and funded by federal Medicaid
provisions. Under existing law, the State Department of Mental
Health is required to implement mental health care services, as
specified, for Medi-Cal recipients. Existing law, commencing July 1,
2012, requires state administrative functions for the operation of
Medi-Cal specialty mental health managed care, the Early and
Periodic, Screening, Diagnosis, and Treatment (EPSDT) Program, and
applicable functions related to federal Medicaid requirements that
are performed by the State Department of Mental Health to be
transferred to the State Department of Health Care Services.
This bill would transfer the administration of mental health
services described above for Medi-Cal beneficiaries to the State
Department of Health Care Services, effective July 1, 2012, and would
make related changes.
Existing law provides that clinics providing Medi-Cal specialty
mental health services are not required to be licensed as a condition
to reimbursement.
This bill would require instead that clinics providing those
services be certified as a condition to reimbursement.
Existing law, to the extent permitted under federal law,
authorizes funds deposited into a local health and welfare trust fund
from the Sales Tax Account of the Local Revenue Fund to be used to
match federal Medicaid funds in order to achieve the maximum federal
reimbursement possible.
This bill would instead authorize, to the extent permitted under
specified provisions of law, that funds distributed to counties from
the Mental Health Subaccount, the Mental Health Equity Subaccount,
and the Vehicle License Collection Account of the Local Revenue Fund,
funds from the Mental Health Account and the Behavioral Health
Subaccount from the Local Revenue Fund 2011, funds from the Mental
Health Services Fund, and any other funds from which the Controller
makes distributions to the counties be used to pay for services
provided by these funds that the counties may certify as public
expenditures in order to achieve the maximum federal reimbursement
possible.
This bill would make related and conforming changes relating to
federal audit exceptions.
Existing law requires the State Department of Mental Health to
implement managed mental health care for Medi-Cal beneficiaries
through fee-for-service or capitated rate contracts with mental
health plans, as specified.
This bill would instead require the State Department of Health
Care Services to implement managed mental health care for Medi-Cal
beneficiaries through contracts with mental health plans. The bill
would make various changes to associated contracting procedures and
would specify the sources from which fines and penalties for
noncompliance with specialty mental health service requirements may
be satisfied.
Existing law provides that a contract with a mental health plan
may be renewed, for a period not to exceed 3 years, if the mental
health plan continues to meet specified requirements.
This bill would delete the 3-year limitation on renewed contracts.
Existing law specifies responsibilities and procedures for audit
exceptions, disallowances, and appeals for Medi-Cal specialty mental
health services provided by mental health plans and mental health
plan subcontractors. Existing law limits the maximum amount withheld
for purposes of audit exceptions or disallowances to 25% of each
payment, as specified.
This bill would revise the responsibilities and procedures
relating to audit exceptions, disallowances, and appeals, would
eliminate obsolete language, and would make conforming and clarifying
changes. The bill would authorize the department to increase the
amount withheld to an amount greater than 25% of each payment in
order to comply with federal laws and regulations.
Existing law requires the State Department of Mental Health to
allocate funds for the provision of mental health services to
Medi-Cal eligible persons over 20 years of age to counties of over
one million population that own and operate an acute psychiatric
health facility, as specified.
This bill would delete that provision.
Existing law provides that counties have the right of first
refusal to serve as a mental health plan.
This bill would repeal these provisions on November 7, 2012, if a
specified provision of law takes effect.
Existing law requires the Secretary for California Health and
Human Services to establish a process by which options for achieving
universal health care coverage are developed.
This bill would delete these provisions.
This bill would delete obsolete provisions of law, and would make
conforming, clarifying, and technical changes.
This bill would appropriate the sum of $1,000 from the General
Fund to the State Department of Health Care Services for
administration.
This bill would declare that it is to take effect immediately as a
bill providing for appropriations related to the Budget Bill.
This bill would become operative contingent upon the enactment of
AB 1480 or SB 1020 of the 2011-12 Regular Session.
This bill would express the intent of the Legislature to enact
statutory changes relating to the Budget Act of 2012.
Vote: majority. Appropriation: no yes
. Fiscal committee: no yes .
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. This act is titled and may be cited as
2011 Realignment Legislation.
SEC. 2. Section 680 of the Business and
Professions Code is amended to read:
680. (a) Except as otherwise provided in this section, a health
care practitioner shall disclose, while working, his or her name and
practitioner's license status, as granted by this state, on a name
tag in at least 18-point type. A health care practitioner in a
practice or an office, whose license is prominently displayed, may
opt to not wear a name tag. If a health care practitioner or a
licensed clinical social worker is working in a psychiatric setting
or in a setting that is not licensed by the state, the employing
entity or agency shall have the discretion to make an exception from
the name tag requirement for individual safety or therapeutic
concerns. In the interest of public safety and consumer awareness, it
shall be unlawful for any person to use the title "nurse" in
reference to himself or herself and in any capacity, except for an
individual who is a registered nurse or a licensed vocational nurse,
or as otherwise provided in Section 2800. Nothing in this section
shall prohibit a certified nurse assistant from using his or her
title.
(b) Facilities licensed by the State Department of Social Services
, the State Department of Mental Health, or the
State Department of Public Health Services
shall develop and implement policies to ensure that health
care practitioners providing care in those facilities are in
compliance with subdivision (a). The State Department of Social
Services , the State Department of Mental Health,
and the State Department of Public Health
Services shall verify through periodic inspections that the
policies required pursuant to subdivision (a) have been developed
and implemented by the respective licensed facilities.
(c) For purposes of this article, "health care practitioner" means
any person who engages in acts that are the subject of licensure or
regulation under this division or under any initiative act referred
to in this division.
SEC. 3. Section 43.7 of the Civil Code
is amended to read:
43.7. (a) There shall be no monetary liability on the part of,
and no cause of action for damages shall arise against, any member of
a duly appointed mental health professional quality assurance
committee that is established in compliance with Section
4070 14725 of the Welfare and Institutions Code,
for any act or proceeding undertaken or performed within the scope
of the functions of the committee which is formed to review and
evaluate the adequacy, appropriateness, or effectiveness of the care
and treatment planned for, or provided to, mental health patients in
order to improve quality of care by mental health professionals if
the committee member acts without malice, has made a reasonable
effort to obtain the facts of the matter as to which he or she acts,
and acts in reasonable belief that the action taken by him or her is
warranted by the facts known to him or her after the reasonable
effort to obtain facts.
(b) There shall be no monetary liability on the part of, and no
cause of action for damages shall arise against, any professional
society, any member of a duly appointed committee of a medical
specialty society, or any member of a duly appointed committee of a
state or local professional society, or duly appointed member of a
committee of a professional staff of a licensed hospital (provided
the professional staff operates pursuant to written bylaws that have
been approved by the governing board of the hospital), for any act or
proceeding undertaken or performed within the scope of the functions
of the committee which is formed to maintain the professional
standards of the society established by its bylaws, or any member of
any peer review committee whose purpose is to review the quality of
medical, dental, dietetic, chiropractic, optometric, acupuncture,
psychotherapy, or veterinary services rendered by physicians and
surgeons, dentists, dental hygienists, podiatrists, registered
dietitians, chiropractors, optometrists, acupuncturists,
veterinarians, marriage and family therapists, professional clinical
counselors, or psychologists, which committee is composed chiefly of
physicians and surgeons, dentists, dental hygienists, podiatrists,
registered dietitians, chiropractors, optometrists, acupuncturists,
veterinarians, marriage and family therapists, professional clinical
counselors, or psychologists for any act or proceeding undertaken or
performed in reviewing the quality of medical, dental, dietetic,
chiropractic, optometric, acupuncture, psychotherapy, or veterinary
services rendered by physicians and surgeons, dentists, dental
hygienists, podiatrists, registered dietitians, chiropractors,
optometrists, acupuncturists, veterinarians, marriage and family
therapists, professional clinical counselors, or psychologists or any
member of the governing board of a hospital in reviewing the quality
of medical services rendered by members of the staff if the
professional society, committee, or board member acts without malice,
has made a reasonable effort to obtain the facts of the matter as to
which he, she, or it acts, and acts in reasonable belief that the
action taken by him, her, or it is warranted by the facts known to
him, her, or it after the reasonable effort to obtain facts.
"Professional society" includes legal, medical, psychological,
dental, dental hygiene, dietetic, accounting, optometric,
acupuncture, podiatric, pharmaceutic, chiropractic, physical
therapist, veterinary, licensed marriage and family therapy, licensed
clinical social work, licensed professional clinical counselor, and
engineering organizations having as members at least 25 percent of
the eligible persons or licentiates in the geographic area served by
the particular society. However, if the society has fewer than 100
members, it shall have as members at least a majority of the eligible
persons or licentiates in the geographic area served by the
particular society.
"Medical specialty society" means an organization having as
members at least 25 percent of the eligible physicians and surgeons
within a given professionally recognized medical specialty in the
geographic area served by the particular society.
(c) This section does not affect the official immunity of an
officer or employee of a public corporation.
(d) There shall be no monetary liability on the part of, and no
cause of action for damages shall arise against, any physician and
surgeon, podiatrist, or chiropractor who is a member of an
underwriting committee of an interindemnity or reciprocal or
interinsurance exchange or mutual company for any act or proceeding
undertaken or performed in evaluating physicians and surgeons,
podiatrists, or chiropractors for the writing of professional
liability insurance, or any act or proceeding undertaken or performed
in evaluating physicians and surgeons for the writing of an
interindemnity, reciprocal, or interinsurance contract as specified
in Section 1280.7 of the Insurance Code, if the evaluating physician
and surgeon, podiatrist, or chiropractor acts without malice, has
made a reasonable effort to obtain the facts of the matter as to
which he or she acts, and acts in reasonable belief that the action
taken by him or her is warranted by the facts known to him or her
after the reasonable effort to obtain the facts.
(e) This section shall not be construed to confer immunity from
liability on any quality assurance committee established in
compliance with Section 4070 14725 of
the Welfare and Institutions Code or hospital. In any case in which,
but for the enactment of the preceding provisions of this section, a
cause of action would arise against a quality assurance committee
established in compliance with Section 4070
14725 of the Welfare and Institutions Code or hospital, the
cause of action shall exist as if the preceding provisions of this
section had not been enacted.
SEC. 4. Section 1179.3 of the Health
and Safety Code is amended to read:
1179.3. (a) (1) The Office of Statewide Health Planning and
Development shall develop and administer a competitive grants program
for projects located in rural areas of California.
(2) The office shall define "rural area" for the purposes of this
section after receiving public input and upon recommendation of the
Interdepartmental Rural Health Coordinating Committee and the Rural
Health Programs Liaison.
(3) The purpose of the grants program shall be to fund innovative,
collaborative, cost-effective, and efficient projects that pertain
to the delivery of health and medical services in rural areas of the
state.
(4) The office shall develop and establish uses for the funds to
fund special projects that alleviate problems of access to quality
health care in rural areas and to compensate public and private
health care providers associated with direct delivery of patient
care. The funds shall be used for medical and hospital care and
treatment of patients who cannot afford to pay for services and for
whom payment will not be made through private or public programs.
(5) The office shall administer the funds appropriated by the
Legislature for purposes of this section. Entities eligible for these
funds shall include rural health providers served by the programs
operated by the office, the State Department of Alcohol and Drug
Programs, the Emergency Medical Services Authority, the State
Department of Health Care Services, the State Department of Public
Health, the State Department of Mental Health, and
the Managed Risk Medical Insurance Board. The grant funds shall be
used to expand existing services or establish new services and shall
not be used to supplant existing levels of service. Funds
appropriated by the Legislature for this purpose may be expended in
the fiscal year of the appropriation or the subsequent fiscal year.
(b) The Office of Statewide Health Planning and Development shall
establish the criteria and standards for eligibility to be used in
requests for proposals or requests for application, the application
review process, determining the maximum amount and number of grants
to be awarded, preference and priority of projects, compliance
monitoring, and the measurement of outcomes achieved after receiving
comment from the public at a meeting held pursuant to the
Bagley-Keene Open Meeting Act (Article 9 (commencing with Section
11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of the
Government Code).
(c) The Office of Statewide Health Planning and Development shall
make information regarding the status of the funded projects
available at the public meetings described in subdivision (b).
SEC. 5. Section 1180.6 of the Health
and Safety Code is amended to read:
1180.6. The State Department of Public Health
Services , the State Department of Mental Health
State Hospitals , the State Department of Social
Services, and the State Department of Developmental Services shall
annually provide information to the Legislature, during Senate and
Assembly budget committee hearings, about the progress made in
implementing this division. This information shall include the
progress of implementation and barriers to achieving full
implementation.
SEC. 6. Section 1250.2 of the Health
and Safety Code is amended to read:
1250.2. (a) As defined in Section 1250, "health facility"
includes a "psychiatric health facility," defined to mean a health
facility, licensed by the State Department of Mental Health
Social Services , that provides 24-hour
inpatient care for mentally disordered, incompetent, or other persons
described in Division 5 (commencing with Section 5000) or Division 6
(commencing with Section 6000) of the Welfare and Institutions Code.
This care shall include, but not be limited to, the following basic
services: psychiatry, clinical psychology, psychiatric nursing,
social work, rehabilitation, drug administration, and appropriate
food services for those persons whose physical health needs can be
met in an affiliated hospital or in outpatient settings.
It is the intent of the Legislature that the psychiatric health
facility shall provide a distinct type of service to psychiatric
patients in a 24-hour acute inpatient setting. The State Department
of Mental Health Social Services shall
require regular utilization reviews of admission and discharge
criteria and lengths of stay in order to assure that these patients
are moved to less restrictive levels of care as soon as appropriate.
(b) The State Department of Mental Health
Social Services may issue a special permit to a psychiatric
health facility for it to provide structured outpatient services
(commonly referred to as SOPS) consisting of morning, afternoon, or
full daytime organized programs, not exceeding 10 hours, for acute
daytime care for patients admitted to the facility. This subdivision
shall not be construed as requiring a psychiatric health facility to
apply for a special permit to provide these alternative levels of
care.
The Legislature recognizes that, with access to structured
outpatient services, as an alternative to 24-hour inpatient care,
certain patients would be provided with effective intervention and
less restrictive levels of care. The Legislature further recognizes
that, for certain patients, the less restrictive levels of care
eliminate the need for inpatient care, enable earlier discharge from
inpatient care by providing a continuum of care with effective
aftercare services, or reduce or prevent the need for a subsequent
readmission to inpatient care.
(c) Any reference in any statute to Section 1250 of the Health and
Safety Code shall be deemed and construed to also be a reference to
this section.
(d) Notwithstanding any other provision of law, and to the extent
consistent with federal law, a psychiatric health facility shall be
eligible to participate in the medicare program under Title XVIII of
the federal Social Security Act (42 U.S.C. Sec. 1395 et seq.), and
the medicaid program under Title XIX of the federal Social Security
Act (42 U.S.C. Sec. 1396 et seq.), if all of the following conditions
are met:
(1) The facility is a licensed facility.
(2) The facility is in compliance with all related statutes and
regulations enforced by the State Department of Mental
Health Social Services , including regulations
contained in Chapter 9 (commencing with Section 77001) of Division 5
of Title 22 of the California Code of Regulations.
(3) The facility meets the definitions and requirements contained
in subdivisions (e) and (f) of Section 1861 of the federal Social
Security Act (42 U.S.C. Sec. 1395x (e) 1395x
(e) and (f)), including the approval process specified in
Section 1861(e)(7)(B) of the federal Social Security Act
(42 U.S.C. Sec. 1395x(e)(7)(B)), which requires that the state agency
responsible for licensing hospitals has assured that the facility
meets licensing requirements.
(4) The facility meets the conditions of participation for
hospitals pursuant to Part 482 of Title 42 of the Code of Federal
Regulations.
SEC. 7. Section 1254 of the Health and
Safety Code is amended to read:
1254. (a) Except as provided in subdivision (e), the state
department shall inspect and license health facilities. The state
department shall license health facilities to provide their
respective basic services specified in Section 1250. Except as
provided in Section 1253, the state department shall inspect and
approve a general acute care hospital to provide special services as
specified in Section 1255. The state department shall develop and
adopt regulations to implement the provisions contained in this
section.
(b) Upon approval, the state department shall issue a separate
license for the provision of the basic services enumerated in
subdivision (c) or (d) of Section 1250 whenever these basic services
are to be provided by an acute care hospital, as defined in
subdivision (a), (b), or (f) of that section, where the services
enumerated in subdivision (c) or (d) of Section 1250 are to be
provided in any separate freestanding facility, whether or not the
location of the separate freestanding facility is contiguous to the
acute care hospital. The same requirement shall apply to any new
freestanding facility constructed for the purpose of providing basic
services, as defined in subdivision (c) or (d) of Section 1250, by
any acute care hospital on or after January 1, 1984.
(c) (1) Those beds licensed to an acute care hospital which, prior
to January 1, 1984, were separate freestanding beds and were not
part of the physical structure licensed to provide acute care, and
which beds were licensed to provide those services enumerated in
subdivision (c) or (d) of Section 1250, are exempt from the
requirements of subdivision (b).
(2) All beds licensed to an acute care hospital and located within
the physical structure in which acute care is provided are exempt
from the requirements of subdivision (b) irrespective of the date of
original licensure of the beds, or the licensed category of the beds.
(3) All beds licensed to an acute care hospital owned and operated
by the State of California or any other public agency are exempt
from the requirements of subdivision (b).
(4) All beds licensed to an acute care hospital in a rural area as
defined by Chapter 1010, of the Statutes of 1982, are exempt from
the requirements of subdivision (b), except where there is a
freestanding skilled nursing facility or intermediate care facility
which has experienced an occupancy rate of 95 percent or less during
the past 12 months within a 25-mile radius or which may be reached
within 30 minutes using a motor vehicle.
(5) All beds licensed to an acute care hospital which meet the
criteria for designation within peer group six or eight, as defined
in the report entitled Hospital Peer Grouping for Efficiency
Comparison, dated December 20, 1982, and published by the California
Health Facilities Commission, and all beds in hospitals which have
fewer than 76 licensed acute care beds and which are located in a
census designation place of 15,000 or less population, are exempt
from the requirements of subdivision (b), except where there is a
free-standing skilled nursing facility or intermediate care facility
which has experienced an occupancy rate of 95 percent or less during
the past 12 months within a 25-mile radius or which may be reached
within 30 minutes using a motor vehicle.
(6) All beds licensed to an acute care hospital which has had a
certificate of need approved by a health systems agency on or before
July 1, 1983, are exempt from the requirements of subdivision (b).
(7) All beds licensed to an acute care hospital are exempt from
the requirements of subdivision (b), if reimbursement from the
Medi-Cal program for beds licensed for the provision of services
enumerated in subdivision (c) or (d) of Section 1250 and not
otherwise exempt does not exceed the reimbursement which would be
received if the beds were in a separately licensed facility.
(d) Except as provided in Section 1253, the state department shall
inspect and approve a general acute care hospital to provide special
services as specified in Section 1255. The state department shall
develop and adopt regulations to implement subdivisions (a) to (d),
inclusive, of this section.
(e) The State Department of Mental Health
So cial Services shall inspect and license
psychiatric health facilities. The State Department of
Mental Health Social Services shall license
psychiatric health facilities to provide their basic services
specified in Section 1250.2. The State Department of Mental
Health Social Services shall develop and adopt
regulations to implement this subdivision.
SEC. 8. Section 1254.1 of the Health
and Safety Code is amended to read:
1254.1. (a) The State Department of Mental Health
Social Services shall license psychiatric health
facilities to provide their basic services specified in Section
1250.
(b) Any reference in any statute to Section 1254 shall be deemed
and construed to also be a reference to this section.
SEC. 9. Section 1266.1 of the Health
and Safety Code is amended to read:
1266.1. (a) Each new or renewal application for a license for a
psychiatric health facility shall be accompanied by a fee
equal in amount to the fee for an acute psychiatric hospital as
specified in subdivision (a) of Section 1266 or, as modified by
subdivision (e) credited to the State Department of
Social Services for its costs incurred in the review of psychiatric
health facility programs, in connection with the licensing of these
facilities. The amount of the fees shall be determined and collected
by the State Department of Social Services, but the total amount of
the fees collected shall not exceed the actual costs of
licensure and review of psychiatric health facility programs,
including, but not limited to, the costs of processing the
application, inspection costs, and other related costs .
(b) New or renewal licensure application fees for psychiatric
health facilities shall be collected by the State Department of
Mental Health Social Services .
(c) The State Department of Mental Health shall make available to
the Legislature and other interested parties, on or before January
17 of each year, information describing program costs within the
State Department of Mental Health for licensure, regulation, and
monitoring of psychiatric health facilities.
(d)
(c) The annual fees shall be waived for any psychiatric
health facility conducted, maintained, or operated by this state or
any state department, authority, bureau, commission, or officer, or
by the Regents of the University of California, or by a local
hospital district, city, county, or city and county.
(e)
(d) If additional private psychiatric health facilities
seek new licensure on or after January 1, 1991, the State Department
of Mental Health Social Services may
increase the fees for all private psychiatric health facilities with
more than nine beds sufficient to accommodate the increased level of
workload and costs.
(f)
(e) (1) Any licensee desiring to obtain a special
permit to offer and provide structured outpatient services shall file
an application with the State Department of Mental Health
Social Services .
(2) The application for a special permit, if any, shall be
submitted with each new or renewal application for a license for a
psychiatric health facility, and shall be accompanied by a reasonable
fee, as determined by the State Department of Mental Health
Social Services , not to exceed the actual
costs of administration related to the special permit. An application
for a special permit submitted by a psychiatric health facility
operated by a public entity shall be exempt from the fee required
pursuant to this section for the issuance of the special permit.
(3) The State Department of Mental Health
Social Services shall not issue a special permit unless the
applicant furnishes all of the following:
(A) Its annual licensing fee required pursuant to subdivision (a).
(B) A completed application submitted on forms furnished by the
department.
(C) A written agreement ensuring that the facility will have
additional staffing for the services to be provided under the special
permit, that the additional staffing will meet the same professional
standards as required by regulation for inpatient services, and that
a coordinator of these services will be appointed.
(D) Any other information or documentation as may be required by
the department for its proper and efficient administration and
enforcement of special permit services.
(4) The provision of structured outpatient services pursuant to a
special permit may be as an alternative to admission to inpatient
services, as aftercare services following discharge from inpatient
care, or as both.
SEC. 10. Section 1275.1 of the Health
and Safety Code is amended to read:
1275.1. (a) Notwithstanding any rules or regulations governing
other health facilities, the regulations developed by the State
Department of Mental Health Social Services
for psychiatric health facilities shall prevail. The
regulations applying to psychiatric health facilities shall prescribe
standards of adequacy, safety, and sanitation of the physical plant,
of staffing with duly qualified licensed personnel, and of services
based on the needs of the persons served thereby.
(b) The regulations shall include standards appropriate for two
levels of disorder:
(1) Involuntary ambulatory psychiatric patients.
(2) Voluntary ambulatory psychiatric patients.
For purposes of this subdivision, "ambulatory patients" shall
include, but not be limited to, deaf, blind, and physically
handicapped persons. Disoriented persons who are not bedridden or
confined to a wheelchair shall also be considered as ambulatory
patients.
(c) The regulations shall not require, but may permit building and
services requirements for hospitals which are only applicable to
physical health care needs of patients that can be met in an
affiliated hospital or in outpatient settings including, but not
limited to, such requirements as surgical, dietary, laboratory,
laundry, central supply, radiologic, and pharmacy.
(d) The regulations shall include provisions for an "open planning"
architectural concept.
(e) The regulations shall exempt from seismic requirements all
structures of Type V and of one-story construction.
(f) Standards for involuntary patients shall include provisions to
allow for restraint and seclusion of patients. Such
These standards shall provide for adequate
safeguards for patient safety and protection of patient rights.
(g) The regulations shall provide for the retention by the
psychiatric health facility of a consultant pharmacist, who shall
supervise and review pharmaceutical services within the facility and
perform such any other services,
including prevention of the unlawful diversion of controlled
substances subject to abuse, as the state department may by
regulation require. Regulations adopted pursuant to this subdivision
shall take into consideration the varying bed sizes of psychiatric
health facilities.
SEC. 11. Section 1275.5 of the Health
and Safety Code is amended to read:
1275.5. (a) The regulations relating to the licensing of
hospitals, heretofore adopted by the State Department of
Public Health pursuant to Chapter 2 (commencing with Section 1400) of
Division 2, and in effect immediately prior to July 1, 1973, shall
remain in effect and shall be fully enforceable with respect to any
hospital required to be licensed by this chapter, unless and until
the regulations are readopted, amended, or repealed by the director.
(b) The regulations relating to private institutions receiving or
caring for any mentally disordered persons, mentally retarded
persons, and other incompetent persons, heretofore adopted by the
Department of Mental Hygiene pursuant to Chapter 1 (commencing with
Section 7000) of Division 7 of the Welfare and Institutions Code, and
in effect immediately prior to July 1, 1973, shall remain in effect
and shall be fully enforceable with respect to any facility,
establishment, or institution for the reception and care of mentally
disordered persons, mentally retarded persons and other incompetent
persons, required to be licensed by the provisions of this chapter
unless and until said regulations are readopted, amended, or repealed
by the director.
(c) (1) All regulations relating to the
licensing of psychiatric health facilities heretofore adopted by the
State Department of Health Services, pursuant to authority now vested
in the State Department of Mental Health by Section 5652.5 of the
Welfare and Institutions Code, and in effect immediately preceding
September 20, 1988, shall remain in effect and shall be fully
enforceable by the State Department of Mental Health with respect to
any facility or program required to be licensed as a psychiatric
health facility, unless and until readopted, amended, or repealed by
the Director of Mental Health.
(2) The State Department of Social
Services shall succeed to and be vested with all duties, powers,
purposes, functions, responsibilities, and jurisdiction of the State
Department of Mental Health, described in paragraph (1), as they
relate to licensing psychiatric health facilities.
SEC. 12. Section 1324.20 of the Health
and Safety Code is amended to read:
1324.20. For purposes of this article, the following definitions
shall apply:
(a) (1) "Continuing care retirement community" means a provider of
a continuum of services, including independent living services,
assisted living services as defined in paragraph (5) of subdivision
(a) of Section 1771, and skilled nursing care, on a single campus,
that is subject to Section 1791, or a provider of such a continuum of
services on a single campus that has not received a Letter of
Exemption pursuant to subdivision (d) of Section 1771.3.
(2) Notwithstanding paragraph (1), beginning with the 2010-11 rate
year and for every rate year thereafter, the term "continuing care
retirement community" shall have the definition contained in
paragraph (11) of subdivision (c) of Section 1771.
(b) "Department," unless otherwise specified, means the State
Department of Health Care Services.
(c) (1) "Exempt facility" means a skilled nursing facility that is
part of a continuing care retirement community, a skilled nursing
facility operated by the state or another public entity, a unit that
provides pediatric subacute services in a skilled nursing facility, a
skilled nursing facility that is certified by the State
Department of Mental Health department for a
special treatment program and is an institution for mental disease as
defined in Section 1396d(i) of Title 42 of the United States Code,
or a skilled nursing facility that is a distinct part of a facility
that is licensed as a general acute care hospital.
(2) Notwithstanding paragraph (1), beginning with the 2010-11 rate
year and for every rate year thereafter, the term "exempt facility"
shall mean a skilled nursing facility that is part of a continuing
care retirement community, as defined in paragraph (2) of subdivision
(a), a skilled nursing facility operated by the state or another
public entity, a unit that provides pediatric subacute services in a
skilled nursing facility, a skilled nursing facility that is
certified by the State Department of Mental Health
department for a special treatment program and is an
institution for mental disease as defined in Section 1396d(i) of
Title 42 of the United States Code, or a skilled nursing facility
that is a distinct part of a facility that is licensed as a general
acute care hospital.
(3) Notwithstanding paragraph (1), beginning with the 2010-11 rate
year and every rate year thereafter, a multilevel facility, as
described in paragraph (1) of subdivision (a), shall not be exempt
from the quality assurance fee requirements pursuant to this article,
unless it meets the definition of a continuing care retirement
community in paragraph (11) of subdivision (c) of Section 1771.
(4) (A) Notwithstanding paragraph (1), beginning with the 2011-12
rate year, and every rate year thereafter, a unit that provides
freestanding pediatric subacute care services in a skilled nursing
facility, as described in paragraph (1) of subdivision (c), shall not
be exempt from the quality assurance fee requirements pursuant to
this article.
(B) For the purposes of this article, "freestanding pediatric
subacute care unit" has the same meaning as defined in Section
51215.8 of Title 22 of the California Code of Regulations.
(d) (1) "Net revenue" means gross resident revenue for routine
nursing services and ancillary services provided to all residents by
a skilled nursing facility, less Medicare revenue for routine and
ancillary services, including Medicare revenue for services provided
to residents covered under a Medicare managed care plan, less payer
discounts and applicable contractual allowances as permitted under
federal law and regulation.
(2) Notwithstanding paragraph (1), for the 2009-10, 2010-11, and
2011-12 rate years, and each rate year thereafter, "net revenue"
means gross resident revenue for routine nursing services and
ancillary services provided to all residents by a skilled nursing
facility, including Medicare revenue for routine and ancillary
services and Medicare revenue for services provided to residents
covered under a Medicare managed care plan, less payer discounts and
applicable contractual allowances as permitted under federal law and
regulation. To implement this paragraph, the department shall request
federal approval pursuant to Section 1324.27.
(3) "Net revenue" does not mean charitable contributions and bad
debt.
(e) "Payer discounts and contractual allowances" means the
difference between the facility's resident charges for routine or
ancillary services and the actual amount paid.
(f) "Skilled nursing facility" means a licensed facility as
defined in subdivision (c) of Section 1250.
SEC. 13. Section 1343 of the Health and
Safety Code is amended to read:
1343. (a) This chapter shall apply to health care service plans
and specialized health care service plan contracts as defined in
subdivisions (f) and (o) of Section 1345.
(b) The director may by the adoption of rules or the issuance of
orders deemed necessary and appropriate, either unconditionally or
upon specified terms and conditions or for specified periods, exempt
from this chapter any class of persons or plan contracts if the
director finds the action to be in the public interest and not
detrimental to the protection of subscribers, enrollees, or persons
regulated under this chapter, and that the regulation of the persons
or plan contracts is not essential to the purposes of this chapter.
(c) The director, upon request of the Director of Health Care
Services, shall exempt from this chapter any county-operated pilot
program contracting with the State Department of Health Care Services
pursuant to Article 7 (commencing with Section 14490) of Chapter 8
of Part 3 of Division 9 of the Welfare and Institutions Code. The
director may exempt noncounty-operated pilot programs upon request of
the Director of Health Care Services. Those exemptions may be
subject to conditions the Director of Health Care Services deems
appropriate.
(d) Upon the request of the Director of Mental
Health Care Services , the director may exempt from this
chapter any mental health plan contractor or any capitated rate
contract under Part 2.5 (commencing with Section 5775) of
Division 5 Chapter 8.9 (commencing with Section 14700)
of Part 3 of Division 9 of the Welfare and Institutions Code.
Those exemptions may be subject to conditions the Director of
Mental Health Care Services deems
appropriate.
(e) This chapter shall not apply to:
(1) A person organized and operating pursuant to a certificate
issued by the Insurance Commissioner unless the entity is directly
providing the health care service through those entity-owned or
contracting health facilities and providers, in which case this
chapter shall apply to the insurer's plan and to the insurer.
(2) A plan directly operated by a bona fide public or private
institution of higher learning which directly provides health care
services only to its students, faculty, staff, administration, and
their respective dependents.
(3) A person who does all of the following:
(A) Promises to provide care for life or for more than one year in
return for a transfer of consideration from, or on behalf of, a
person 60 years of age or older.
(B) Has obtained a written license pursuant to Chapter 2
(commencing with Section 1250) or Chapter 3.2 (commencing with
Section 1569).
(C) Has obtained a certificate of authority from the State
Department of Social Services.
(4) The Major Risk Medical Insurance Board when engaging in
activities under Chapter 8 (commencing with Section 10700) of Part 2
of Division 2 of the Insurance Code, Part 6.3 (commencing with
Section 12695) of Division 2 of the Insurance Code, and Part 6.5
(commencing with Section 12700) of Division 2 of the Insurance Code.
(5) The California Small Group Reinsurance Fund.
SEC. 14. Section 1373 of the Health and
Safety Code is amended to read:
1373. (a) A plan contract may not provide an exception for other
coverage if the other coverage is entitlement to Medi-Cal benefits
under Chapter 7 (commencing with Section 14000) or Chapter 8
(commencing with Section 14200) of Part 3 of Division 9 of the
Welfare and Institutions Code, or Medicaid benefits under Subchapter
19 (commencing with Section 1396) of Chapter 7 of Title 42 of the
United States Code.
Each plan contract shall be interpreted not to provide an
exception for the Medi-Cal or Medicaid benefits.
A plan contract shall not provide an exemption for enrollment
because of an applicant's entitlement to Medi-Cal benefits under
Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing
with Section 14200) of Part 3 of Division 9 of the Welfare and
Institutions Code, or Medicaid benefits under Subchapter 19
(commencing with Section 1396) of Chapter 7 of Title 42 of the United
States Code.
A plan contract may not provide that the benefits payable
thereunder are subject to reduction if the individual insured has
entitlement to the Medi-Cal or Medicaid benefits.
(b) A plan contract that provides coverage, whether by specific
benefit or by the effect of general wording, for sterilization
operations or procedures shall not impose any disclaimer, restriction
on, or limitation of, coverage relative to the covered individual's
reason for sterilization.
As used in this section, "sterilization operations or procedures"
shall have the same meaning as that specified in Section 10120 of the
Insurance Code.
(c) Every plan contract that provides coverage to the spouse or
dependents of the subscriber or spouse shall grant immediate accident
and sickness coverage, from and after the moment of birth, to each
newborn infant of any subscriber or spouse covered and to each minor
child placed for adoption from and after the date on which the
adoptive child's birth parent or other appropriate legal authority
signs a written document, including, but not limited to, a health
facility minor release report, a medical authorization form, or a
relinquishment form, granting the subscriber or spouse the right to
control health care for the adoptive child or, absent this written
document, on the date there exists evidence of the subscriber's or
spouse's right to control the health care of the child placed for
adoption. No plan may be entered into or amended if it contains any
disclaimer, waiver, or other limitation of coverage relative to the
coverage or insurability of newborn infants of, or children placed
for adoption with, a subscriber or spouse covered as required by this
subdivision.
(d) (1) Every plan contract that provides that coverage of a
dependent child of a subscriber shall terminate upon attainment of
the limiting age for dependent children specified in the plan, shall
also provide that attainment of the limiting age shall not operate to
terminate the coverage of the child while the child is and continues
to meet both of the following criteria:
(A) Incapable of self-sustaining employment by reason of a
physically or mentally disabling injury, illness, or condition.
(B) Chiefly dependent upon the subscriber for support and
maintenance.
(2) The plan shall notify the subscriber that the dependent child'
s coverage will terminate upon attainment of the limiting age unless
the subscriber submits proof of the criteria described in
subparagraphs (A) and (B) of paragraph (1) to the plan within 60 days
of the date of receipt of the notification. The plan shall send this
notification to the subscriber at least 90 days prior to the date
the child attains the limiting age. Upon receipt of a request by the
subscriber for continued coverage of the child and proof of the
criteria described in subparagraphs (A) and (B) of paragraph (1), the
plan shall determine whether the child meets that criteria before
the child attains the limiting age. If the plan fails to make the
determination by that date, it shall continue coverage of the child
pending its determination.
(3) The plan may subsequently request information about a
dependent child whose coverage is continued beyond the limiting age
under this subdivision but not more frequently than annually after
the two-year period following the child's attainment of the limiting
age.
(4) If the subscriber changes carriers to another plan or to a
health insurer, the new plan or insurer shall continue to provide
coverage for the dependent child. The new plan or insurer may request
information about the dependent child initially and not more
frequently than annually thereafter to determine if the child
continues to satisfy the criteria in subparagraphs (A) and (B) of
paragraph (1). The subscriber shall submit the information requested
by the new plan or insurer within 60 days of receiving the request.
(5) (A) Except as set forth in subparagraph (B), under no
circumstances shall the limiting age be less than 26 years of age
with respect to plan years beginning on or after September 23, 2010.
(B) For plan years beginning before January 1, 2014, a group
health care service plan contract that qualifies as a grandfathered
health plan under Section 1251 of the federal Patient Protection and
Affordable Care Act (Public Law 111-148) and that makes available
dependent coverage of children may exclude from coverage an adult
child who has not attained 26 years of age only if the adult child is
eligible to enroll in an eligible employer-sponsored health plan, as
defined in Section 5000A(f)(2) of the Internal Revenue Code, other
than a group health plan of a parent.
(C) (i) With respect to a child (I) whose coverage under a group
or individual plan contract ended, or who was denied or not eligible
for coverage under a group or individual plan contract, because under
the terms of the contract the availability of dependent coverage of
children ended before the attainment of 26 years of age, and (II) who
becomes eligible for that coverage by reason of the application of
this paragraph, the health care service plan shall give the child an
opportunity to enroll that shall continue for at least 30 days. This
opportunity and the notice described in clause (ii) shall be provided
not later than the first day of the first plan year beginning on or
after September 23, 2010, consistent with the federal Patient
Protection and Affordable Care Act (Public Law 111-148), as amended
by the federal Health Care and Education Reconciliation Act of 2010
(Public Law 111-152), and any additional federal guidance or
regulations issued by the United States Secretary of Health and Human
Services.
(ii) The health care service plan shall provide written notice
stating that a dependent described in clause (i) who has not attained
26 years of age is eligible to enroll in the plan for coverage. This
notice may be provided to the dependent's parent on behalf of the
dependent. If the notice is included with other enrollment materials
for a group plan, the notice shall be prominent.
(iii) In the case of an individual who enrolls under this
subparagraph, coverage shall take effect no later than the first day
of the first plan year beginning on or after September 23, 2010.
(iv) A dependent enrolling in a group health plan for coverage
pursuant to this subparagraph shall be treated as a special enrollee
as provided under the rules of Section 146.117(d) of Title 45 of the
Code of Federal Regulations. The health care service plan shall offer
the recipient of the notice all of the benefit packages available to
similarly situated individuals who did not lose coverage by reason
of cessation of dependent status. Any difference in benefits or
cost-sharing requirements shall constitute a different benefit
package. A dependent enrolling in a group health plan for coverage
pursuant to this subparagraph shall not be required to pay more for
coverage than similarly situated individuals who did not lose
coverage by reason of cessation of dependent status.
(D) Nothing in this section shall require a health care service
plan to make coverage available for a child of a child receiving
dependent coverage. Nothing in this section shall be construed to
modify the definition of "dependent" as used in the Revenue and
Taxation Code with respect to the tax treatment of the cost of
coverage.
(e) A plan contract that provides coverage, whether by specific
benefit or by the effect of general wording, for both an employee and
one or more covered persons dependent upon the employee and provides
for an extension of the coverage for any period following a
termination of employment of the employee shall also provide that
this extension of coverage shall apply to dependents upon the same
terms and conditions precedent as applied to the covered employee,
for the same period of time, subject to payment of premiums, if any,
as required by the terms of the policy and subject to any applicable
collective bargaining agreement.
(f) A group contract shall not discriminate against handicapped
persons or against groups containing handicapped persons. Nothing in
this subdivision shall preclude reasonable provisions in a plan
contract against liability for services or reimbursement of the
handicap condition or conditions relating thereto, as may be allowed
by rules of the director.
(g) Every group contract shall set forth the terms and conditions
under which subscribers and enrollees may remain in the plan in the
event the group ceases to exist, the group contract is terminated, or
an individual subscriber leaves the group, or the enrollees'
eligibility status changes.
(h) (1) A health care service plan or specialized health care
service plan may provide for coverage of, or for payment for,
professional mental health services, or vision care services, or for
the exclusion of these services. If the terms and conditions include
coverage for services provided in a general acute care hospital or an
acute psychiatric hospital as defined in Section 1250 and do not
restrict or modify the choice of providers, the coverage shall extend
to care provided by a psychiatric health facility as defined in
Section 1250.2 operating pursuant to licensure by the State
Department of Mental Health Social Services
. A health care service plan that offers outpatient mental
health services but does not cover these services in all of its group
contracts shall communicate to prospective group contractholders as
to the availability of outpatient coverage for the treatment of
mental or nervous disorders.
(2) No plan shall prohibit the member from selecting any
psychologist who is licensed pursuant to the Psychology Licensing Law
(Chapter 6.6 (commencing with Section 2900) of Division 2 of the
Business and Professions Code), any optometrist who is the holder of
a certificate issued pursuant to Chapter 7 (commencing with Section
3000) of Division 2 of the Business and Professions Code or, upon
referral by a physician and surgeon licensed pursuant to the Medical
Practice Act (Chapter 5 (commencing with Section 2000) of Division 2
of the Business and Professions Code), (A) any marriage and family
therapist who is the holder of a license under Section 4980.50 of the
Business and Professions Code, (B) any licensed clinical social
worker who is the holder of a license under Section 4996 of the
Business and Professions Code, (C) any registered nurse licensed
pursuant to Chapter 6 (commencing with Section 2700) of Division 2 of
the Business and Professions Code, who possesses a master's degree
in psychiatric-mental health nursing and is listed as a
psychiatric-mental health nurse by the Board of Registered Nursing,
(D) any advanced practice registered nurse certified as a clinical
nurse specialist pursuant to Article 9 (commencing with Section 2838)
of Chapter 6 of Division 2 of the Business and Professions Code who
participates in expert clinical practice in the specialty of
psychiatric-mental health nursing, to perform the particular services
covered under the terms of the plan, and the certificate holder is
expressly authorized by law to perform these services, or (E) any
professional clinical counselor who is the holder of a license under
Chapter 16 (commencing with Section 4999.10) of Division 2 of the
Business and Professions Code.
(3) Nothing in this section shall be construed to allow any
certificate holder or licensee enumerated in this section to perform
professional mental health services beyond his or her field or fields
of competence as established by his or her education, training, and
experience.
(4) For the purposes of this section:
(A) "Marriage and family therapist" means a licensed marriage and
family therapist who has received specific instruction in assessment,
diagnosis, prognosis, and counseling, and psychotherapeutic
treatment of premarital, marriage, family, and child relationship
dysfunctions, which is equivalent to the instruction required for
licensure on January 1, 1981.
(B) "Professional clinical counselor" means a licensed
professional clinical counselor who has received specific instruction
in assessment, diagnosis, prognosis, counseling, and
psychotherapeutic treatment of mental and emotional disorders, which
is equivalent to the instruction required for licensure on January 1,
2012.
(5) Nothing in this section shall be construed to allow a member
to select and obtain mental health or psychological or vision care
services from a certificate holder or licenseholder who is not
directly affiliated with or under contract to the health care service
plan or specialized health care service plan to which the member
belongs. All health care service plans and individual practice
associations that offer mental health benefits shall make reasonable
efforts to make available to their members the services of licensed
psychologists. However, a failure of a plan or association to comply
with the requirements of the preceding sentence shall not constitute
a misdemeanor.
(6) As used in this subdivision, "individual practice association"
means an entity as defined in subsection (5) of Section 1307 of the
federal Public Health Service Act (42 U.S.C. Sec. 300e-1(5)).
(7) Health care service plan coverage for professional mental
health services may include community residential treatment services
that are alternatives to inpatient care and that are directly
affiliated with the plan or to which enrollees are referred by
providers affiliated with the plan.
(i) If the plan utilizes arbitration to settle disputes, the plan
contracts shall set forth the type of disputes subject to
arbitration, the process to be utilized, and how it is to be
initiated.
(j) A plan contract that provides benefits that accrue after a
certain time of confinement in a health care facility shall specify
what constitutes a day of confinement or the number of consecutive
hours of confinement that are requisite to the commencement of
benefits.
(k) If a plan provides coverage for a dependent child who is over
26 years of age and enrolled as a full-time student at a secondary or
postsecondary educational institution, the following shall apply:
(1) Any break in the school calendar shall not disqualify the
dependent child from coverage.
(2) If the dependent child takes a medical leave of absence, and
the nature of the dependent child's injury, illness, or condition
would render the dependent child incapable of self-sustaining
employment, the provisions of subdivision (d) shall apply if the
dependent child is chiefly dependent on the subscriber for support
and maintenance.
(3) (A) If the dependent child takes a medical leave of absence
from school, but the nature of the dependent child's injury, illness,
or condition does not meet the requirements of paragraph (2), the
dependent child's coverage shall not terminate for a period not to
exceed 12 months or until the date on which the coverage is scheduled
to terminate pursuant to the terms and conditions of the plan,
whichever comes first. The period of coverage under this paragraph
shall commence on the first day of the medical leave of absence from
the school or on the date the physician and surgeon determines the
illness prevented the dependent child from attending school,
whichever comes first. Any break in the school calendar shall not
disqualify the dependent child from coverage under this paragraph.
(B) Documentation or certification of the medical necessity for a
leave of absence from school shall be submitted to the plan at least
30 days prior to the medical leave of absence from the school, if the
medical reason for the absence and the absence are foreseeable, or
30 days after the start date of the medical leave of absence from
school and shall be considered prima facie evidence of entitlement to
coverage under this paragraph.
(4) This subdivision shall not apply to a specialized health care
service plan or to a Medicare supplement plan.
SEC. 15. Section 1422.1 of the Health
and Safety Code is amended to read:
1422.1. (a) Notwithstanding Section 1422, the State Department of
Public Health Services shall conduct,
when feasible, annual licensing inspections of licensed long-term
health care facilities providing special treatment programs for the
mentally disordered, concurrently with inspections conducted by the
State Department of Mental Health Care
Services for the purposes of approving the special treatment
program.
(b) The State Department of Public Health
Services survey teams conducting inspections pursuant to
this section shall include at least one licensed mental health
professional if the inspections are not done concurrently pursuant to
subdivision (a).
(c) Survey team members shall receive training specific to the
mental health treatment needs of mentally disordered residents served
in these facilities.
SEC. 16. Section 1502 of the Health and
Safety Code is amended to read:
1502. As used in this chapter:
(a) "Community care facility" means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, or foster family
agency services for children, adults, or children and adults,
including, but not limited to, the physically handicapped, mentally
impaired, incompetent persons, and abused or neglected children, and
includes the following:
(1) "Residential facility" means any family home, group care
facility, or similar facility determined by the director, for 24-hour
nonmedical care of persons in need of personal services,
supervision, or assistance essential for sustaining the activities of
daily living or for the protection of the individual.
(2) "Adult day program" means any community-based facility or
program that provides care to persons 18 years of age or older in
need of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of
these individuals on less than a 24-hour basis.
(3) "Therapeutic day services facility" means any facility that
provides nonmedical care, counseling, educational or vocational
support, or social rehabilitation services on less than a 24-hour
basis to persons under 18 years of age who would otherwise be placed
in foster care or who are returning to families from foster care.
Program standards for these facilities shall be developed by the
department, pursuant to Section 1530, in consultation with
therapeutic day services and foster care providers.
(4) "Foster family agency" means any organization engaged in the
recruiting, certifying, and training of, and providing professional
support to, foster parents, or in finding homes or other places for
placement of children for temporary or permanent care who require
that level of care as an alternative to a group home. Private foster
family agencies shall be organized and operated on a nonprofit basis.
(5) "Foster family home" means any residential facility providing
24-hour care for six or fewer foster children that is owned, leased,
or rented and is the residence of the foster parent or parents,
including their family, in whose care the foster children have been
placed. The placement may be by a public or private child placement
agency or by a court order, or by voluntary placement by a parent,
parents, or guardian. It also means a foster family home described in
Section 1505.2.
(6) "Small family home" means any residential facility, in the
licensee's family residence, that provides 24-hour care for six or
fewer foster children who have mental disorders or developmental or
physical disabilities and who require special care and supervision as
a result of their disabilities. A small family home may accept
children with special health care needs, pursuant to subdivision (a)
of Section 17710 of the Welfare and Institutions Code. In addition to
placing children with special health care needs, the department may
approve placement of children without special health care needs, up
to the licensed capacity.
(7) "Social rehabilitation facility" means any residential
facility that provides social rehabilitation services for no longer
than 18 months in a group setting to adults recovering from mental
illness who temporarily need assistance, guidance, or counseling.
Program components shall be subject to program standards pursuant to
Article 1 (commencing with Section 5670) of Chapter 2.5 of Part 2 of
Division 5 of the Welfare and Institutions Code.
(8) "Community treatment facility" means any residential facility
that provides mental health treatment services to children in a group
setting and that has the capacity to provide secure containment.
Program components shall be subject to program standards developed
and enforced by the State Department of Mental
Health Care Services pursuant to Section 4094 of the
Welfare and Institutions Code.
Nothing in this section shall be construed to prohibit or
discourage placement of persons who have mental or physical
disabilities into any category of community care facility that meets
the needs of the individual placed, if the placement is consistent
with the licensing regulations of the department.
(9) "Full-service adoption agency" means any licensed entity
engaged in the business of providing adoption services, that does all
of the following:
(A) Assumes care, custody, and control of a child through
relinquishment of the child to the agency or involuntary termination
of parental rights to the child.
(B) Assesses the birth parents, prospective adoptive parents, or
child.
(C) Places children for adoption.
(D) Supervises adoptive placements.
Private full-service adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a full-service adoption agency shall
be accredited and in good standing according to Part 96 of Title 22
of the Code of Federal Regulations, or supervised by an accredited
primary provider, or acting as an exempted provider, in compliance
with Subpart F (commencing with Section 96.29) of Part 96 of Title 22
of the Code of Federal Regulations.
(10) "Noncustodial adoption agency" means any licensed entity
engaged in the business of providing adoption services, that does all
of the following:
(A) Assesses the prospective adoptive parents.
(B) Cooperatively matches children freed for adoption, who are
under the care, custody, and control of a licensed adoption agency,
for adoption, with assessed and approved adoptive applicants.
(C) Cooperatively supervises adoptive placements with a
full-service adoptive agency, but does not disrupt a placement or
remove a child from a placement.
Private noncustodial adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a noncustodial adoption agency shall
be accredited and in good standing according to Part 96 of Title 22
of the Code of Federal Regulations, or supervised by an accredited
primary provider, or acting as an exempted provider, in compliance
with Subpart F (commencing with Section 96.29) of Part 96 of Title 22
of the Code of Federal Regulations.
(11) "Transitional shelter care facility" means any group care
facility that provides for 24-hour nonmedical care of persons in need
of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of
the individual. Program components shall be subject to program
standards developed by the State Department of Social Services
pursuant to Section 1502.3.
(12) "Transitional housing placement facility" means a community
care facility licensed by the department pursuant to Section 1559.110
to provide transitional housing opportunities to persons at least 16
years of age, and not more than 18 years of age unless the
requirements of Section 11403 and paragraph (1) of subdivision (a) of
Section 11403.2 of the Welfare and Institutions Code are met, who
are in out-of-home placement under the supervision of the county
department of social services or the county probation department, and
who are participating in an independent living program.
(b) "Department" or "state department" means the State Department
of Social Services.
(c) "Director" means the Director of Social Services.
SEC. 17. Section 1502.4 of the Health
and Safety Code is amended to read:
1502.4. (a) (1) A community care facility licensed as a group
home for children pursuant to this chapter may accept for placement,
and provide care and supervision to, a child assessed as seriously
emotionally disturbed as long as the child does not need inpatient
care in a licensed health facility.
(2) For the purpose of this chapter, the following definitions
shall apply:
(A) "Inpatient care in a licensed health facility" means care and
supervision at a level greater than incidental medical services as
specified in Section 1507.
(B) "Seriously emotionally disturbed" means the same as paragraph
(2) of subdivision (a) of Section 5600.3 of the Welfare and
Institutions Code.
(b) If a child described in subdivision (a) is placed into a group
home program classified at rate classification level 13 or rate
classification level 14 pursuant to Section 11462.01 of the Welfare
and Institutions Code, the licensee shall meet both of the following
requirements:
(1) The licensee shall agree to accept, for placement into its
group home program, only children who have been assessed as seriously
emotionally disturbed by either of the following:
(A) An interagency placement committee, as described in Section
4096 of the Welfare and Institutions Code or by a licensed mental
health professional, as defined in Sections 629 to 633, inclusive, of
Title 9 of the California Code of Regulations.
(B) A licensed mental health professional pursuant to paragraph
(3) of subdivision (i), or subdivision (j), of Section 11462.01 of
the Welfare and Institutions Code if the child is privately placed or
only county funded.
(2) The program is certified by the State Department of
Mental Health Care Services , pursuant to
Section 4096.5 of the Welfare and Institutions Code, as a program
that provides mental health treatment services for seriously
emotionally disturbed children.
(c) The department shall not evaluate, or have any responsibility
or liability with regard to the evaluation of, the mental health
treatment services provided pursuant to this section and paragraph
(3) of subdivision (f) of Section 11462.01 of the Welfare and
Institutions Code.
SEC. 18. Section 1507 of the Health and
Safety Code is amended to read:
1507. (a) Notwithstanding any other provision of law, incidental
medical services may be provided in a community care facility. If the
medical services constitute a substantial component of the services
provided by the community care facility as defined by the director in
regulations, the medical services component shall be approved as set
forth in Chapter 1 (commencing with Section 1200) or Chapter 2
(commencing with Section 1250).
(b) Notwithstanding any other provision of law, if the
requirements of subdivision (c) are met, the department shall permit
incidental medical services to be provided in community care
facilities for adults by facility staff who are not licensed health
care professionals but who are trained by a licensed health care
professional and supervised according to the client's individualized
health care plan prepared pursuant to subdivision (c). Incidental
medical services provided by trained facility staff for the following
conditions shall be limited as follows:
(1) Colostomy and ileostomy: changing bags and cleaning stoma.
(2) Urinary catheter: emptying bags in day care facilities;
emptying and changing bags in residential facilities.
(3) Gastrostomy: feeding, hydration, cleaning stoma, and adding
medication per physician's or nurse practitioner's orders for the
routine medication of patients with chronic, stable conditions.
(c) Facility staff may provide incidental medical services if the
following conditions have been met:
(1) For regional center clients the following shall apply:
(A) An individualized health care plan, which may be part of a
client's individual program plan, shall be prepared for each client
by a health care team that shall include the client or his or her
designee if the client is not able to participate in planning his or
her health care, the client's primary care physician or nurse
practitioner or other health care professional designated by the
physician or nurse practitioner, the licensee or licensee's designee,
any involved social worker or regional center worker, and any health
care professional designated to monitor the client's individualized
health care plan.
(B) The client's individualized health care plan shall be
reassessed at least every 12 months or more frequently as determined
by the client's physician or nurse practitioner during the time the
client receives incidental medical services in the facility.
(C) The client's regional center, primary care physician or nurse
practitioner, or other health care professional designated by the
physician or nurse practitioner shall identify the health care
professional who shall be responsible for training facility staff in
the provision of incidental medical services.
(D) Facility staff shall be trained by the identified health care
professional practicing within his or her scope of practice who shall
monitor, according to the individualized health care plan, the staff'
s ability to provide incidental medical services and who shall
review, correct, or update facility staff training as the health care
professional deems necessary.
(E) The regional center or placing agency shall evaluate, monitor,
and have responsibility for oversight of the incidental medical
services provided in the facility by facility staff. However, nothing
in this section shall preclude the department from taking an
administrative action against a licensee or facility staff member for
failure or refusal to carry out, or negligence in carrying out, his
or her duties in providing these incidental medical services.
(2) For persons who are not regional center clients, the following
shall apply:
(A) An individualized health care plan shall be prepared that
includes the physician's or nurse practitioner's order for services
to be provided during the time the client is in the day care
facility. The plan shall be prepared by a team that includes the
client or his or her designee if the client is not able to
participate in planning his or her care, the client's social worker,
conservator, or legal guardian, as appropriate, a licensed health
care professional, and the licensee or the licensee's designee.
(B) The client's individualized health care plan shall be
reassessed at least every 12 months or more frequently as determined
by the client's physician or nurse practitioner during the time the
client receives incidental medical services in the facility.
(C) A licensed health care professional practicing within his or
her scope of practice shall train the staff of the facility on
procedures for caring for clients who require incidental medical
services and shall periodically review, correct, or update facility
staff training as the health care professional deems necessary.
(d) Facilities providing incidental medical services shall remain
in substantial compliance with all other applicable regulations of
the department.
(e) The department shall adopt emergency regulations for community
care facilities for adults by February 1, 1997, to do all of the
following:
(1) Specify incidental medical services that may be provided.
These incidental medical services shall include, but need not be
limited to, any of the following: gastrostomy, colostomy, ileostomy,
and urinary catheters.
(2) Specify the conditions under which incidental medical services
may be provided.
(3) Specify the medical services that, due to the level of care
required, are prohibited services.
(f) The department shall consult with the State Department of
Developmental Services, the State Department of Mental
Health Care Services , the Association of
Regional Center Agencies, and provider associations in the
development of the regulations required by subdivision (e).
SEC. 19. Section 1522.08 of the Health
and Safety Code , as amended by Section 16 of
Chapter 483 of the Statutes of 2007, is amended to read:
1522.08. (a) In order to protect the health and safety of persons
receiving care or services from individuals or facilities licensed
or certified by the state, the California Department of Aging, State
Department of Public Health, State Department of Alcohol and Drug
Programs, State Department of Mental Health
Care Services , State Department of Social Services, and the
Emergency Medical Services Authority may share information with
respect to applicants, licensees, certificates, or individuals who
have been the subject of any administrative action resulting in the
denial, suspension, probation, or revocation of a license, permit, or
certificate, or in the exclusion of any person from a facility who
is subject to a background check, as otherwise provided by law.
(b) The State Department of Social Services shall maintain a
centralized system for the monitoring and tracking of final
administrative actions, to be used by the California Department of
Aging, State Department of Public Health, State Department of Alcohol
and Drug Programs, State Department of Mental
Health Care Se rvices , State Department of
Social Services, and the Emergency Medical Services Authority as a
part of the background check process. The State Department of Social
Services may charge a fee to departments under the jurisdiction of
the California Health and Human Services Agency sufficient to cover
the cost of providing those departments with the final administrative
action specified in subdivision (a). To the extent that additional
funds are needed for this purpose, implementation of this subdivision
shall be contingent upon a specific appropriation provided for this
purpose in the annual Budget Act.
(c) The State Department of Social Services, in consultation with
the other departments under the jurisdiction of the California Health
and Human Services Agency, may adopt regulations to implement this
section.
(d) For the purposes of this section and Section 1499,
"administrative action" means any proceeding initiated by the
California Department of Aging, State Department of Public Health,
State Department of Alcohol and Drug Programs, State Department of
Mental Health Care Services , State
Department of Social Services, and the Emergency Medical Services
Authority to determine the rights and duties of an applicant,
licensee, or other individual or entity over which the department has
jurisdiction. "Administrative action" may include, but is not
limited to, action involving the denial of an application for, or the
suspension or revocation of, any license, special permit,
administrator certificate, criminal record clearance, or exemption.
SEC. 20. Section 1522.41 of the Health
and Safety Code is amended to read:
1522.41. (a) The director, in consultation and collaboration with
county placement officials, group home provider organizations, the
Director of Mental Health Care Services
, and the Director of Developmental Services, shall develop and
establish a certification program to ensure that administrators of
group home facilities have appropriate training to provide the care
and services for which a license or certificate is issued.
(b) (1) In addition to any other requirements or qualifications
required by the department, an administrator of a group home facility
shall successfully complete a department-approved certification
program, pursuant to subdivision (c), prior to employment. An
administrator employed in a group home on the effective date of this
section shall meet the requirements of paragraph (2) of subdivision
(c).
(2) In those cases where the individual is both the licensee and
the administrator of a facility, the individual shall comply with all
of the licensee and administrator requirements of this section.
(3) Failure to comply with this section shall constitute cause for
revocation of the license of the facility.
(4) The licensee shall notify the department within 10 days of any
change in administrators.
(c) (1) The administrator certification programs shall require a
minimum of 40 hours of classroom instruction that provides training
on a uniform core of knowledge in each of the following areas:
(A) Laws, regulations, and policies and procedural standards that
impact the operations of the type of facility for which the applicant
will be an administrator.
(B) Business operations.
(C) Management and supervision of staff.
(D) Psychosocial and educational needs of the facility residents.
(E) Community and support services.
(F) Physical needs for facility residents.
(G) Administration, storage, misuse, and interaction of medication
used by facility residents.
(H) Resident admission, retention, and assessment procedures,
including the right of a foster child to have fair and equal access
to all available services, placement, care, treatment, and benefits,
and to not be subjected to discrimination or harassment on the basis
of actual or perceived race, ethnic group identification, ancestry,
national origin, color, religion, sex, sexual orientation, gender
identity, mental or physical disability, or HIV status.
(I) Nonviolent emergency intervention and reporting requirements.
(J) Basic instruction on the existing laws and procedures
regarding the safety of foster youth at school and the ensuring of a
harassment- and violence-free school environment contained in the
School Safety and Violence Prevention Act (Article 3.6 (commencing
with Section 32228) of Chapter 2 of Part 19 of Division 1 of Title 1
of the Education Code).
(2) The department shall adopt separate program requirements for
initial certification for persons who are employed as group home
administrators on the effective date of this section. A person
employed as an administrator of a group home facility on the
effective date of this section shall obtain a certificate by
completing the training and testing requirements imposed by the
department within 12 months of the effective date of the regulations
implementing this section. After the effective date of this section,
these administrators shall meet the requirements imposed by the
department on all other group home administrators for certificate
renewal.
(3) Individuals applying for certification under this section
shall successfully complete an approved certification program, pass a
written test administered by the department within 60 days of
completing the program, and submit to the department the
documentation required by subdivision (d) within 30 days after being
notified of having passed the test. The department may extend these
time deadlines for good cause. The department shall notify the
applicant of his or her test results within 30 days of administering
the test.
(d) The department shall not begin the process of issuing a
certificate until receipt of all of the following:
(1) A certificate of completion of the administrator training
required pursuant to this chapter.
(2) The fee required for issuance of the certificate. A fee of one
hundred dollars ($100) shall be charged by the department to cover
the costs of processing the application for certification.
(3) Documentation from the applicant that he or she has passed the
written test.
(4) Submission of fingerprints pursuant to Section 1522. The
department may waive the submission for those persons who have a
current clearance on file.
(5) That person is at least 21 years of age.
(e) It shall be unlawful for any person not certified under this
section to hold himself or herself out as a certified administrator
of a group home facility. Any person willfully making any false
representation as being a certified administrator or facility manager
is guilty of a misdemeanor.
(f) (1) Certificates issued under this section shall be renewed
every two years and renewal shall be conditional upon the certificate
holder submitting documentation of completion of 40 hours of
continuing education related to the core of knowledge specified in
subdivision (c). No more than one-half of the required 40 hours of
continuing education necessary to renew the certificate may be
satisfied through online courses. All other continuing education
hours shall be completed in a classroom setting. For purposes of this
section, an individual who is a group home facility administrator
and who is required to complete the continuing education hours
required by the regulations of the State Department of Developmental
Services, and approved by the regional center, may have up to 24 of
the required continuing education course hours credited toward the
40-hour continuing education requirement of this section. Community
college course hours approved by the regional centers shall be
accepted by the department for certification.
(2) Every administrator of a group home facility shall complete
the continuing education requirements of this subdivision.
(3) Certificates issued under this section shall expire every two
years on the anniversary date of the initial issuance of the
certificate, except that any administrator receiving his or her
initial certification on or after July 1, 1999, shall make an
irrevocable election to have his or her recertification date for any
subsequent recertification either on the date two years from the date
of issuance of the certificate or on the individual's birthday
during the second calendar year following certification.
The department shall send a renewal
notice to the certificate holder 90 days prior to the expiration date
of the certificate. If the certificate is not renewed prior to its
expiration date, reinstatement shall only be permitted after the
certificate holder has paid a delinquency fee equal to three times
the renewal fee and has provided evidence of completion of the
continuing education required.
(4) To renew a certificate, the certificate holder shall, on or
before the certificate expiration date, request renewal by submitting
to the department documentation of completion of the required
continuing education courses and pay the renewal fee of one hundred
dollars ($100), irrespective of receipt of the department's
notification of the renewal. A renewal request postmarked on or
before the expiration of the certificate shall be proof of compliance
with this paragraph.
(5) A suspended or revoked certificate shall be subject to
expiration as provided for in this section. If reinstatement of the
certificate is approved by the department, the certificate holder, as
a condition precedent to reinstatement, shall submit proof of
compliance with paragraphs (1) and (2) of subdivision (f), and shall
pay a fee in an amount equal to the renewal fee, plus the delinquency
fee, if any, accrued at the time of its revocation or suspension.
Delinquency fees, if any, accrued subsequent to the time of its
revocation or suspension and prior to an order for reinstatement,
shall be waived for a period of 12 months to allow the individual
sufficient time to complete the required continuing education units
and to submit the required documentation. Individuals whose
certificates will expire within 90 days after the order for
reinstatement may be granted a three-month extension to renew their
certificates during which time the delinquency fees shall not accrue.
(6) A certificate that is not renewed within four years after its
expiration shall not be renewed, restored, reissued, or reinstated
except upon completion of a certification training program, passing
any test that may be required of an applicant for a new certificate
at that time, and paying the appropriate fees provided for in this
section.
(7) A fee of twenty-five dollars ($25) shall be charged for the
reissuance of a lost certificate.
(8) A certificate holder shall inform the department of his or her
employment status and change of mailing address within 30 days of
any change.
(g) Unless otherwise ordered by the department, the certificate
shall be considered forfeited under either of the following
conditions:
(1) The department has revoked any license held by the
administrator after the department issued the certificate.
(2) The department has issued an exclusion order against the
administrator pursuant to Section 1558, 1568.092, 1569.58, or
1596.8897, after the department issued the certificate, and the
administrator did not appeal the exclusion order or, after the
appeal, the department issued a decision and order that upheld the
exclusion order.
(h) (1) The department, in consultation and collaboration with
county placement officials, provider organizations, the State
Department of Mental Health Care Services
, and the State Department of Developmental Services, shall
establish, by regulation, the program content, the testing
instrument, the process for approving certification training
programs, and criteria to be used in authorizing individuals,
organizations, or educational institutions to conduct certification
training programs and continuing education courses. The department
may also grant continuing education hours for continuing courses
offered by accredited educational institutions that are consistent
with the requirements in this section. The department may deny vendor
approval to any agency or person in any of the following
circumstances:
(A) The applicant has not provided the department with evidence
satisfactory to the department of the ability of the applicant to
satisfy the requirements of vendorization set out in the regulations
adopted by the department pursuant to subdivision (j).
(B) The applicant person or agency has a conflict of interest in
that the person or agency places its clients in group home
facilities.
(C) The applicant public or private agency has a conflict of
interest in that the agency is mandated to place clients in group
homes and to pay directly for the services. The department may deny
vendorization to this type of agency only as long as there are other
vendor programs available to conduct the certification training
programs and conduct education courses.
(2) The department may authorize vendors to conduct the
administrator's certification training program pursuant to this
section. The department shall conduct the written test pursuant to
regulations adopted by the department.
(3) The department shall prepare and maintain an updated list of
approved training vendors.
(4) The department may inspect certification training programs and
continuing education courses, including online courses, at no charge
to the department, to determine if content and teaching methods
comply with regulations. If the department determines that any vendor
is not complying with the requirements of this section, the
department shall take appropriate action to bring the program into
compliance, which may include removing the vendor from the approved
list.
(5) The department shall establish reasonable procedures and
timeframes not to exceed 30 days for the approval of vendor training
programs.
(6) The department may charge a reasonable fee, not to exceed one
hundred fifty dollars ($150) every two years, to certification
program vendors for review and approval of the initial 40-hour
training program pursuant to subdivision (c). The department may also
charge the vendor a fee, not to exceed one hundred dollars ($100)
every two years, for the review and approval of the continuing
education courses needed for recertification pursuant to this
subdivision.
(7) (A) A vendor of online programs for continuing education shall
ensure that each online course contains all of the following:
(i) An interactive portion in which the participant receives
feedback, through online communication, based on input from the
participant.
(ii) Required use of a personal identification number or personal
identification information to confirm the identity of the
participant.
(iii) A final screen displaying a printable statement, to be
signed by the participant, certifying that the identified participant
completed the course. The vendor shall obtain a copy of the final
screen statement with the original signature of the participant prior
to the issuance of a certificate of completion. The signed statement
of completion shall be maintained by the vendor for a period of
three years and be available to the department upon demand. Any
person who certifies as true any material matter pursuant to this
clause that he or she knows to be false is guilty of a misdemeanor.
(B) Nothing in this subdivision shall prohibit the department from
approving online programs for continuing education that do not meet
the requirements of subparagraph (A) if the vendor demonstrates to
the department's satisfaction that, through advanced technology, the
course and the course delivery meet the requirements of this section.
(i) The department shall establish a registry for holders of
certificates that shall include, at a minimum, information on
employment status and criminal record clearance.
(j) Subdivisions (b) to (i), inclusive, shall be implemented upon
regulations being adopted by the department, by January 1, 2000.
(k) Notwithstanding any provision of law to the contrary, vendors
approved by the department who exclusively provide either initial or
continuing education courses for certification of administrators of a
group home facility as defined by regulations of the department, an
adult residential facility as defined by regulations of the
department, or a residential care facility for the elderly as defined
in subdivision (k) of Section 1569.2, shall be regulated solely by
the department pursuant to this chapter. No other state or local
governmental entity shall be responsible for regulating the activity
of those vendors.
SEC. 21. Section 1522.42 of the Health
and Safety Code is amended to read:
1522.42. (a) The department, in consultation and collaboration
with county placement officials, provider organizations, the State
Department of Mental Health Care Services
, and the State Department of Developmental Services, shall
adopt regulations that establish standardized training and continuing
education curricula for facility managers and direct child care
workers in group homes.
(b) The regulations required by subdivision (a) shall specify the
date by which new and current employees shall be required to meet the
standardized training and continuing education requirements. For
persons employed as child care staff and facility managers on the
effective date of the regulations, the department shall provide
adequate time for these persons to comply with the regulatory
requirements.
SEC. 22. Section 1530.9 of the Health
and Safety Code is amended to read:
1530.9. (a) The department shall, with the advice and assistance
of the State Department of Mental Health Care
Services , counties, parent and children's advocacy groups, and
group home providers, adopt regulations for the licensing of
licensed community treatment facilities at the earliest possible date
, but no later than December 31, 1994 .
(b) The regulations adopted pursuant to this section shall specify
requirements for facility operation and maintenance.
(c) Program certification and standards enforcement shall be the
responsibility of the State Department of Mental
Health Care Services , pursuant to Section 4094 of the
Welfare and Institutions Code. The State Department of Social
Services shall not issue a community treatment facility license
unless the applicant has obtained certification of compliance from
the State Department of Mental Health Care
Services .
SEC. 23. Section 1562.3 of the Health
and Safety Code is amended to read:
1562.3. (a) The Director of Social Services, in consultation with
the Director of Mental Health Care Services
and the Director of Developmental Services, shall establish a
training program to ensure that licensees, operators, and staffs of
adult residential facilities, as defined in paragraph (1) of
subdivision (a) of Section 1502, have appropriate training to provide
the care and services for which a license or certificate is issued.
The training program shall be developed in consultation with provider
organizations.
(b) (1) An administrator of an adult residential care facility, as
defined in paragraph (1) of subdivision (a) of Section 1502, shall
successfully complete a department-approved certification program
pursuant to subdivision (c) prior to employment.
(2) In those cases where the individual is both the licensee and
the administrator of a facility, the individual shall comply with
both the licensee and administrator requirements of this section.
(3) Failure to comply with this section shall constitute cause for
revocation of the license of the facility.
(4) The licensee shall notify the department within 30 days of any
change in administrators.
(c) (1) The administrator certification program shall require a
minimum of 35 hours of classroom instruction that provides training
on a uniform core of knowledge in each of the following areas:
(A) Laws, regulations, and policies and procedural standards that
impact the operations of the type of facility for which the applicant
will be an administrator.
(B) Business operations.
(C) Management and supervision of staff.
(D) Psychosocial needs of the facility residents.
(E) Community and support services.
(F) Physical needs for facility residents.
(G) Use, misuse, and interaction of medication commonly used by
facility residents.
(H) Resident admission, retention, and assessment procedures.
(I) Nonviolent crisis intervention for administrators.
(2) The requirement for 35 hours of classroom instruction pursuant
to this subdivision shall not apply to persons who were employed as
administrators prior to July 1, 1996. A person holding the position
of administrator of an adult residential facility on June 30, 1996,
shall file a completed application for certification with the
department on or before April 1, 1998. In order to be exempt from the
35-hour training program and the test component, the application
shall include documentation showing proof of continuous employment as
the administrator of an adult residential facility between, at a
minimum, June 30, 1994, and June 30, 1996. An administrator of an
adult residential facility who became certified as a result of
passing the department-administered challenge test, that was offered
between October 1, 1996, and December 23, 1996, shall be deemed to
have fulfilled the requirements of this paragraph.
(3) Unless an extension is granted to the applicant by the
department, an applicant for an administrator's certificate shall,
within 60 days of the applicant's completion of classroom
instruction, pass the written test provided in this section.
(d) The department shall not begin the process of issuing a
certificate until receipt of all of the following:
(1) A certificate of completion of the administrator training
required pursuant to this chapter.
(2) The fee required for issuance of the certificate. A fee of one
hundred dollars ($100) shall be charged by the department to cover
the costs of processing the application for certification.
(3) Documentation from the applicant that he or she has passed the
written test.
(4) Submission of fingerprints. The department and the Department
of Justice shall expedite the criminal record clearance for holders
of certificates of completion. The department may waive the
submission for those persons who have a current clearance on file.
(e) It shall be unlawful for any person not certified under this
section to hold himself or herself out as a certified administrator
of an adult residential facility. Any person willfully making any
false representation as being a certified administrator is guilty of
a misdemeanor.
(f) (1) Certificates issued under this section shall be renewed
every two years and renewal shall be conditional upon the certificate
holder submitting documentation of completion of 40 hours of
continuing education related to the core of knowledge specified in
subdivision (c). No more than one-half of the required 40 hours of
continuing education necessary to renew the certificate may be
satisfied through online courses. All other continuing education
hours shall be completed in a classroom setting. For purposes of this
section, an individual who is an adult residential facility
administrator and who is required to complete the continuing
education hours required by the regulations of the State Department
of Developmental Services, and approved by the regional center, shall
be permitted to have up to 24 of the required continuing education
course hours credited toward the 40-hour continuing education
requirement of this section. Community college course hours approved
by the regional centers shall be accepted by the department for
certification.
(2) Every licensee and administrator of an adult residential
facility is required to complete the continuing education
requirements of this subdivision.
(3) Certificates issued under this section shall expire every two
years, on the anniversary date of the initial issuance of the
certificate, except that any administrator receiving his or her
initial certification on or after January 1, 1999, shall make an
irrevocable election to have his or her recertification date for any
subsequent recertification either on the date two years from the date
of issuance of the certificate or on the individual's birthday
during the second calendar year following certification. The
department shall send a renewal notice to the certificate holder 90
days prior to the expiration date of the certificate. If the
certificate is not renewed prior to its expiration date,
reinstatement shall only be permitted after the certificate holder
has paid a delinquency fee equal to three times the renewal fee and
has provided evidence of completion of the continuing education
required.
(4) To renew a certificate, the certificate holder shall, on or
before the certificate expiration date, request renewal by submitting
to the department documentation of completion of the required
continuing education courses and pay the renewal fee of one hundred
dollars ($100), irrespective of receipt of the department's
notification of the renewal. A renewal request postmarked on or
before the expiration of the certificate is proof of compliance with
this paragraph.
(5) A suspended or revoked certificate is subject to expiration as
provided for in this section. If reinstatement of the certificate is
approved by the department, the certificate holder, as a condition
precedent to reinstatement, shall submit proof of compliance with
paragraphs (1) and (2) of subdivision (f) and shall pay a fee in an
amount equal to the renewal fee, plus the delinquency fee, if any,
accrued at the time of its revocation or suspension. Delinquency
fees, if any, accrued subsequent to the time of its revocation or
suspension and prior to an order for reinstatement, shall be waived
for one year to allow the individual sufficient time to complete the
required continuing education units and to submit the required
documentation. Individuals whose certificates will expire within 90
days after the order for reinstatement may be granted a three-month
extension to renew their certificates during which time the
delinquency fees shall not accrue.
(6) A certificate that is not renewed within four years after its
expiration shall not be renewed, restored, reissued, or reinstated
except upon completion of a certification training program, passing
any test that may be required of an applicant for a new certificate
at that time, and paying the appropriate fees provided for in this
section.
(7) A fee of twenty-five dollars ($25) shall be charged for the
reissuance of a lost certificate.
(8) A certificate holder shall inform the department of his or her
employment status within 30 days of any change.
(g) The certificate shall be considered forfeited under the
following conditions:
(1) The administrator has had a license revoked, suspended, or
denied as authorized under Section 1550.
(2) The administrator has been denied employment, residence, or
presence in a facility based on action resulting from an
administrative hearing pursuant to Section 1522 or Section 1558.
(h) (1) The department, in consultation with the State Department
of Mental Health Care Services and the
State Department of Developmental Services, shall establish, by
regulation, the program content, the testing instrument, the process
for approving certification training programs, and criteria to be
used in authorizing individuals, organizations, or educational
institutions to conduct certification training programs and
continuing education courses. These regulations shall be developed in
consultation with provider organizations, and shall be made
available at least six months prior to the deadline required for
certification. The department may deny vendor approval to any agency
or person in any of the following circumstances:
(A) The applicant has not provided the department with evidence
satisfactory to the department of the ability of the applicant to
satisfy the requirements of vendorization set out in the regulations
adopted by the department pursuant to subdivision (i).
(B) The applicant person or agency has a conflict of interest in
that the person or agency places its clients in adult residential
facilities.
(C) The applicant public or private agency has a conflict of
interest in that the agency is mandated to place clients in adult
residential facilities and to pay directly for the services. The
department may deny vendorization to this type of agency only as long
as there are other vendor programs available to conduct the
certification training programs and conduct education courses.
(2) The department may authorize vendors to conduct the
administrator's certification training program pursuant to provisions
set forth in this section. The department shall conduct the written
test pursuant to regulations adopted by the department.
(3) The department shall prepare and maintain an updated list of
approved training vendors.
(4) The department may inspect certification training programs and
continuing education courses, including online courses, at no charge
to the department, to determine if content and teaching methods
comply with regulations. If the department determines that any vendor
is not complying with the intent of this section, the department
shall take appropriate action to bring the program into compliance,
which may include removing the vendor from the approved list.
(5) The department shall establish reasonable procedures and
timeframes not to exceed 30 days for the approval of vendor training
programs.
(6) The department may charge a reasonable fee, not to exceed one
hundred fifty dollars ($150) every two years to certification program
vendors for review and approval of the initial 35-hour training
program pursuant to subdivision (c). The department may also charge
the vendor a fee not to exceed one hundred dollars ($100) every two
years for the review and approval of the continuing education courses
needed for recertification pursuant to this subdivision.
(7) (A) A vendor of online programs for continuing education shall
ensure that each online course contains all of the following:
(i) An interactive portion in which the participant receives
feedback, through online communication, based on input from the
participant.
(ii) Required use of a personal identification number or personal
identification information to confirm the identity of the
participant.
(iii) A final screen displaying a printable statement, to be
signed by the participant, certifying that the identified participant
completed the course. The vendor shall obtain a copy of the final
screen statement with the original signature of the participant prior
to the issuance of a certificate of completion. The signed statement
of completion shall be maintained by the vendor for a period of
three years and be available to the department upon demand. Any
person who certifies as true any material matter pursuant to this
clause that he or she knows to be false is guilty of a misdemeanor.
(B) Nothing in this subdivision shall prohibit the department from
approving online programs for continuing education that do not meet
the requirements of subparagraph (A) if the vendor demonstrates to
the department's satisfaction that, through advanced technology, the
course and the course delivery meet the requirements of this section.
(i) This section shall be operative upon regulations being adopted
by the department, no later than July 1, 1996, to implement the
administrator certification program as provided for in this section.
If regulations are not adopted by the department, or are adopted
after July 1, 1996, this section shall not become operative.
(j)
(i) The department shall establish a registry for
holders of certificates that shall include, at a minimum, information
on employment status and criminal record clearance.
SEC. 24. Section 1565 of the Health and
Safety Code is repealed.
1565. (a) The Health and Welfare Agency shall establish the Task
Force on Accreditation of Services for Children and shall convene a
meeting of that body on or before January 1, 1993.
(b) Membership of the Task Force on Accreditation of Services for
Children shall include, but not be limited to, all of the following:
(1) Two providers of residential services for children.
(2) Representatives from the California Association of Children's
Homes, California Association of Private Specialized Education and
Services, the California Association of Services for Children, the
California Probation Parole and Correctional Officers Association,
the County Mental Health Directors Association, and the County
Welfare Directors Association.
(3) Representatives from the State Department of Social Services,
the State Department of Mental Health, the Youth Authority, the
State Department of Developmental Services, and the State Department
of Education.
(4) Two representatives from university research schools with
expertise in children's services, specifically standards of care.
(5) One representative with experience in the accreditation of
agencies servicing children.
(6) Two legislative representatives of policy committees dealing
with social service issues pertaining to children.
(c) The goals of the task force shall be the development of a
plan for voluntary accreditation of all facilities for children in
out-of-home care, including group homes, foster family agencies,
foster family homes, and community treatment facilities, in order to
encourage the maximum quality of residential services for children.
(d) It is the intent of the Legislature that accreditation be
voluntary and differ from, but complement, community care licensing
that is a governmental activity focused upon the enforcement of
minimum standards for health and safety.
(e) The task force may consult with additional persons, advisory
entities, and governmental agencies, as the task force determines
necessary.
(f) Members of the task force shall not receive any compensation
related to their service on the task force that goes above or beyond
any compensation that they may already receive from other public or
private sources.
(g) The plan shall include, but not be limited to, all of the
following:
(1) Proof that the development of standards for accreditation
have been written with the participation of a diverse group
of service providers, advocacy
organizations, and placement agency personnel.
(2) A draft of accreditation standards that are comprehensive and
detailed, concerned with optimal achievement rather than minimal
quality, and that provide for continuing and objective evaluation of
services through a process that allows for self-appraisal and
self-education.
(3) A recommended schedule for implementation of accreditation of
a percentage of residential facilities for children in every county,
and a fiscal incentive strategy for programs that become accredited.
(4) Proposed financial incentive plan for county welfare
departments to participate in and encourage accreditation activities,
including, but not limited to, a reduction in county administrative
oversight responsibilities.
(5) Recommendations on what type of organization or entity should
be responsible for carrying out the accreditation functions.
(6) A recommended fee schedule for the support of voluntary
accreditation activities.
(7) A proposed method of providing an initial orientation and
ongoing technical assistance to enable and support those desiring
accreditation to become accredited.
(8) Recommendations for encouraging minority involvement in
accreditation activities, including outreach and technical assistance
targeted to agencies that are culturally and ethnically sensitive to
the population served, as determined by the task force.
(h) The Legislature finds and declares that the necessary
expertise for development of an accreditation plan is most available
through peers and colleagues. Therefore, it is the intent of the
Legislature that the accreditation plan may be developed by utilizing
private or public resources, and may be funded through revenues
generated by private fees, public or private grants, or public funds
provided by federal, state, county, or other governmental entities.
SEC. 25. Section 11217 of the Health
and Safety Code is amended to read:
11217. No person shall treat an addict for addiction to a
narcotic drug except in one of the following:
(a) An institution approved by the State Department of
Mental Health Social Services and the State Department
of Health Care Services , and where the patient is at all
times kept under restraint and control.
(b) A city or county jail.
(c) A state prison.
(d) A facility designated by a county and approved by the State
Department of Mental Health Social Services
pursuant to Division 5 (commencing with Section 5000) of the
Welfare and Institutions Code.
(e) A state hospital.
(f) A county hospital.
(g) A facility licensed by the State Department of Alcohol and
Drug Programs pursuant to Division 10.5 (commencing with Section
11750).
(h) A facility as defined in subdivision (a) or (b) of Section
1250 and Section 1250.3.
A narcotic controlled substance in the continuing treatment of
addiction to a controlled substance shall be used only in those
programs licensed by the State Department of Alcohol and Drug
Programs pursuant to Article 3 (commencing with Section 11875) of
Chapter 1 of Part 3 of Division 10.5 on either an inpatient or
outpatient basis, or both.
This section does not apply during emergency treatment, or where
the patient's addiction is complicated by the presence of incurable
disease, serious accident, or injury, or the infirmities of old age.
Neither this section nor any other provision of this division
shall be construed to prohibit the maintenance of a place in which
persons seeking to recover from addiction to a controlled substance
reside and endeavor to aid one another and receive aid from others in
recovering from that addiction, nor does this section or this
division prohibit that aid, provided that no person is treated for
addiction in a place by means of administering, furnishing, or
prescribing of controlled substances. The preceding sentence is
declaratory of preexisting law.
Neither this section or any other provision of this division shall
be construed to prohibit short-term narcotic detoxification
treatment in a controlled setting approved by the director and
pursuant to rules and regulations of the director. Facilities and
treatment approved by the director under this paragraph shall not be
subject to approval or inspection by the Medical Board of California,
nor shall persons in those facilities be required to register with,
or report the termination of residence with, the police department or
sheriff's office.
SEC. 26. Section 11998.1 of the Health
and Safety Code is amended to read:
11998.1. It is the intent of the Legislature that the following
long-term five-year goals be achieved:
(a) With regard to education and prevention of drug and alcohol
abuse programs, the following goals:
(1) Drug and alcohol abuse education has been included within the
mandatory curriculum in kindergarten and grades 1 to 12, inclusive,
in every public school in California.
(2) Basic training on how to recognize, and understand what to do
about, drug and alcohol abuse has been provided to administrators and
all teachers of kindergarten and grades 1 to 12, inclusive.
(3) All school counselors and school nurses have received
comprehensive drug and alcohol abuse training.
(4) Each school district with kindergarten and grades 1 to 12,
inclusive, has appointed a drug and alcohol abuse advisory team of
school administrators, teachers, counselors, students, parents,
community representatives, and health care professionals, all of whom
have expertise in drug and alcohol abuse prevention. The team
coordinates with and receives consultation from the county alcohol
and drug program administrators.
(5) Every school board member has received basic drug and alcohol
abuse information.
(6) Each school district has a drug and alcohol abuse specialist
to assist the individual schools.
(7) Each school in grades 7 to 12, inclusive, has student peer
group drug and alcohol abuse programs.
(8) Every school district with kindergarten and grades 1 to 12,
inclusive, has updated written drug and alcohol abuse policies and
procedures including disciplinary procedures which will be given to
every school employee, every student, and every parent.
(9) The California State University and the University of
California have evaluated and, if feasible, established educational
programs and degrees in the area of drug and alcohol abuse.
(10) Every school district with kindergarten and grades 1 to 12,
inclusive, has an established parent teachers group with drug and
alcohol abuse prevention goals.
(11) Every school district has instituted a drug and alcohol abuse
education program for parents.
(12) Drug and alcohol abuse training has been imposed as a
condition for teacher credentialing and license renewal, and
knowledge on the issue is measured on the California Basic Education
Skills Test.
(13) Drug and alcohol abuse knowledge has been established as a
component on standardized competency tests as a requirement for
graduation.
(14) Every school district has established a parent support group.
(15) Every school district has instituted policies that address
the special needs of children who have been rehabilitated for drug or
alcohol abuse problems and who are reentering school. These policies
shall consider the loss of schooltime, the loss of academic credits,
and the sociological problems associated with drug and alcohol
abuse, its rehabilitation, and the educational delay it causes.
(16) The number of drug and alcohol abuse related incidents on
school grounds has decreased by 20 percent.
(b) With regard to community programs, the following goals:
(1) Every community-based social service organization that
receives state and local financial assistance has drug and alcohol
abuse information available for clients.
(2) All neighborhood watch, business watch, and community conflict
resolution programs have included drug and alcohol abuse prevention
efforts.
(3) All community-based programs that serve schoolaged children
have staff trained in drug and alcohol abuse and give a clear, drug-
and alcohol-free message.
(c) With regard to drug and alcohol abuse programs of the media,
the following goals:
(1) The state has established a comprehensive media campaign that
involves all facets of the drug and alcohol abuse problem, including
treatment, education, prevention, and intervention that will result
in increasing the public's knowledge and awareness of the detrimental
effects of alcohol and drug use, reducing the use of alcohol and
drugs, and increasing healthy lifestyle choices.
(2) The department on a statewide basis, and the county board of
supervisors or its designees at the local level, have:
(A) Assisted the entertainment industry in identifying ways to use
the entertainment industry effectively to encourage lifestyles free
of substance abuse.
(B) Assisted the manufacturers of drug and alcohol products in
identifying ways to use product advertising effectively to discourage
substance abuse.
(C) Assisted television stations in identifying ways to use
television programming effectively to encourage lifestyles free of
substance abuse.
(3) A statewide cooperative fundraising program with recording
artists and the entertainment industry has been encouraged to fund
drug and alcohol abuse prevention efforts in the state.
(d) With regard to drug and alcohol abuse health care programs,
the following goals:
(1) The number of drug and alcohol abuse-related medical
emergencies has decreased by 4 percent per year.
(2) All general acute care hospitals and AIDS medical service
providers have provided information to their patients on drug and
alcohol abuse.
(3) The Medical Board of California, the Psychology Examining
Committee, the Board of Registered Nursing, and the Board of
Behavioral Science Examiners have developed and implemented the
guidelines or regulations requiring drug and alcohol abuse training
for their licensees, and have developed methods of providing training
for those professionals.
(e) With regard to private sector drug and alcohol abuse programs,
the following goals:
(1) A significant percentage of businesses in the private sector
have developed personnel policies that discourage drug and alcohol
abuse and encourage supervision, training, and employee education.
(2) Noteworthy and publicly recognized figures and private
industry have been encouraged to sponsor fundraising events for drug
and alcohol abuse prevention.
(3) Every public or private athletic team has been encouraged to
establish policies forbidding drug and alcohol abuse.
(4) The private sector has established personnel policies that
discourage drug and alcohol abuse but encourage treatment for those
employees who require this assistance.
(f) With regard to local government drug and alcohol abuse
programs, the following goals:
(1) Every county has a five-year master plan to eliminate drug and
alcohol abuse developed jointly by the county-designated alcohol and
drug program administrators, reviewed jointly by the advisory boards
set forth in paragraph (2), and approved by the board of
supervisors. For those counties in which the alcohol and drug
programs are jointly administered, the administrator shall develop
the five-year master plan. To the degree possible, all existing local
plans relating to drug or alcohol abuse shall be incorporated into
the master plan.
(2) Every county has an advisory board on alcohol problems and an
advisory board on drug programs. The membership of these advisory
boards is representative of the county's population and is
geographically balanced. To the maximum extent possible, the county
advisory board on alcohol problems and the county advisory board on
drug programs will have representatives of the following:
(A) Law enforcement.
(B) Education.
(C) The treatment and recovery community, including a
representative with expertise in AIDS treatment services.
(D) Judiciary.
(E) Students.
(F) Parents.
(G) Private industry.
(H) Other community organizations involved in drug and alcohol
services.
(I) A representative of organized labor responsible for the
provision of Employee Assistance Program services.
If any of these areas is not represented on the advisory bodies,
the administrator designated in paragraph (1) shall solicit input
from a representative of the nonrepresented area prior to the
development of a master plan pursuant to paragraph (1).
(3) Every county public social service agency has established
policies that discourage drug and alcohol abuse and encourage
treatment and recovery services when necessary.
(4) Every local unit of government has an employee assistance
program that addresses drug and alcohol abuse problems.
(5) Every local unit of government has considered the potential
for drug and alcohol abuse problems when developing zoning ordinances
and issuing conditional use permits.
(6) Every county master plan includes treatment and recovery
services.
(6.5) Every county master plan includes specialized provisions to
ensure optimum alcohol and drug abuse service delivery for
handicapped and disabled persons.
(7) Every local unit of government has been encouraged to
establish an employee assistance program that includes the treatment
of drug and alcohol abuse-related programs.
(8) Every local governmental social service provider has
established a referral system under which clients with drug and
alcohol abuse problems can be referred for treatment.
(9) Every county drug and alcohol abuse treatment or recovery
program that serves women gives priority for services to pregnant
women.
(10) Every alcohol and drug abuse program provides
acquired immune deficiency syndrome (AIDS) AIDS
information to all program participants.
(g) With regard to state and federal government drug and alcohol
abuse programs, the following goals:
(1) The Department of Alcoholic Beverage Control has informed all
alcohol retailers of the laws governing liquor sales and has provided
training available to all personnel selling alcoholic beverages, on
identifying and handling minors attempting to purchase alcohol.
(2) The California Emergency Management Agency has required all
applicants for crime prevention and juvenile justice and delinquency
prevention funds to include drug and alcohol abuse prevention efforts
in their programs.
(3) All county applications for direct or indirect drug and
alcohol services funding from the department include a prevention
component.
(4) The Superintendent of Public Instruction has employed drug and
alcohol abuse school prevention specialists and assisted school
districts with the implementation of prevention programs.
(5) The State Department of Mental Health
Health Care Services has staff trained in drug and alcohol
abuse prevention who can assist local mental health programs with
prevention efforts.
(6) The Department of the California Highway Patrol, as permitted
by the United States Constitution, has established routine statewide
sobriety checkpoints for driving while under the influence.
(7) The Department of Corrections and the Department of the Youth
Authority have provided drug and alcohol abuse education and
prevention services for all inmates, wards, and parolees. Both
departments have provided drug and alcohol abuse treatment services
for any inmate, ward, or parolee determined to be in need of these
services, or who personally requests these services.
(8) The Department of Motor Vehicles has distributed prevention
materials with each driver's license or certificate of renewal and
each vehicle registration renewal mailed by the Department of Motor
Vehicles.
(9) Federal prevention programs have been encouraged to follow the
master plan.
(10) State licensing and program regulations for drug and alcohol
abuse treatment programs have been consolidated and administered by
one state agency.
(11) State treatment funding priorities have been included to
specially recognize the multiple diagnosed client who would be
eligible for services from more than one state agency.
(12) Every state agency has formalized employee assistance
programs that include the treatment of drug and alcohol abuse-related
problems.
(13) The state master plan includes specialized provisions to
ensure optimum drug and alcohol abuse service delivery for
handicapped and disabled persons.
(h) With regard to private sector direct service providers, the
following goals:
(1) Drinking drivers programs have provided clear measurements of
successful completion of the program to the courts for each
court-ordered client.
(2) Sufficient drug and alcohol treatment and recovery services
exist throughout the state to meet all clients' immediate and
long-range needs.
(3) Each county to the extent possible provides localized alcohol
and drug treatment and recovery services designed for individuals
seeking assistance for polydrug abuse.
(4) Adequate nonresidential and residential services are available
statewide for juveniles in need of alcohol or drug abuse services.
(5) Each provider of alcohol or drug services has been certified
by the state.
(6) Drug and alcohol abuse treatment providers provide general
acquired immune deficiency syndrome (AIDS)
AIDS information during treatment.
(i) With regard to supply regulation and reduction in conjunction
with drug and alcohol abuse, the following goals:
(1) The California National Guard supports federal, state, and
local drug enforcement agencies in counternarcotic operations as
permitted by applicable laws and regulations.
(2) Each county has a drug and alcohol abuse enforcement team,
designated by the board of supervisors. This team includes all
components of the criminal justice system. This team shall be
responsible to the board of supervisors, shall coordinate with the
drug and alcohol abuse advisory board and the county on all criminal
justice matters relating to drug and alcohol abuse, and shall
coordinate, and actively participate, with the county alcohol and
drug program administrators throughout the development and
implementation of the five-year master plan.
(3) The California Emergency Management Agency, the Youth and
Adult Correctional Agency, the Department of the California Highway
Patrol, the Office of Traffic Safety, and the Department of Justice
have established a state level drug and alcohol abuse enforcement
team that includes representatives from all facets of criminal
justice. The lead agency for the enforcement team has been designated
by the Governor. This team advises the state and assists the local
teams.
(4) The California Emergency Management Agency, the Youth and
Adult Correctional Agency, and the Department of Justice have, as a
priority when determining training subjects, prevention seminars on
drug and alcohol abuse. The Commission on Peace Officer Standards and
Training has, as a priority, when determining training subjects,
drug and alcohol enforcement.
(5) The Department of the California Highway Patrol, as permitted
by the United States Constitution, will, in conjunction with
establishing sobriety checkpoints statewide, assist local law
enforcement agencies with the establishment of local programs.
(6) Counties with more than 10 superior court judgeships have
established programs under which drug cases receive swift prosecution
by well-trained prosecutors before judges who are experienced in the
handling of drug cases.
(7) The courts, when determining bail eligibility and the amount
of bail for persons suspected of a crime involving a controlled
substance, shall consider the quantity of the substance involved when
measuring the danger to society if the suspect is released.
(8) Drunk driving jails have been established that provide
offender education and treatment during incarceration.
(9) All probation and parole officers have received drug and
alcohol abuse training, including particular training on drug
recognition.
(10) All parolees and persons on probation with a criminal history
that involves drug or alcohol abuse have conditions of parole or
probation that prohibit drug and alcohol abuse.
(11) The Judicial Council has provided training on drug and
alcohol abuse for the judges.
(12) The courts, when sentencing offenders convicted of selling
drugs, consider "street value" of the drugs involved in the
underlying crime.
(13) Judges have been encouraged to include drug and alcohol abuse
treatment and prevention services in sentences for all offenders.
Judges are requiring, as a condition of sentencing, drug and alcohol
abuse education and treatment services for all persons convicted of
driving under the influence of alcohol or drugs.
(14) Juvenile halls and jails provide clients with information on
drug and alcohol abuse.
(15) The estimated number of clandestine labs operating in
California has decreased by 10 percent per year.
(16) Each local law enforcement agency has developed, with the
schools, protocol on responding to school drug and alcohol abuse
problems.
(17) Every county has instituted a mandatory
driving-under-the-influence presentence offender evaluation program.
SEC. 27. Section 50451 of the Health
and Safety Code is amended to read:
50451. The California Statewide Housing Plan shall incorporate a
statement of housing goals, policies, and objectives, as well as all
of the following segments:
(a) An evaluation and summary of housing conditions throughout the
state, with particular emphasis upon the availability of housing for
all economic segments of the state. The evaluation shall include
summary statistics for all counties, all multicounty metropolitan
areas, and rural areas, as defined and designated by the Bureau of
the Census of the United States Department of Commerce, rather than
as defined in Section 50101. The evaluation shall include the
existing distribution of housing by type, size, gross rent, value,
and, to the extent data is available, condition, and the existing
distribution of households by gross income, size, and ethnic
character for each of those areas.
(b) A determination of the statewide need for housing development
for the year the plan is revised and projected four additional years
ahead. The determination of statewide need shall be established as
the minimum number of units necessary to be built or rehabilitated in
order to provide sufficient housing to house all residents of the
state in standard, uncrowded units in suitable locations.
(c) Goals for the provision of housing assistance for the year the
plan is revised and projected four additional years ahead. The goals
shall be established as the minimum number of households to be
assisted that will result in achieving, by the fourth subsequent
year, a substantial reduction in the number of very low income
households and other persons and families of low or moderate income
constrained to pay more than 30 percent of their gross income for
housing. Income groups to be considered in establishing the goals
shall be designated by the department and shall include households a
significant number of which are required to pay more than 30 percent
of their gross income for housing in the fiscal year the plan is
revised, as determined by the department.
(d) An identification of governmental and nongovernmental
constraints and obstacles and specific recommendations for their
removal.
(e) An analysis of state and local housing and building codes and
their enforcement. The analysis shall include consideration of
whether those codes contain sufficient flexibility to respond to new
methods of construction and new materials.
(f) Recommendations for actions by federal, state, and local
governments and the private sector that will contribute to the
attainment of the housing goals established for California.
(g) A housing strategy that coordinates the housing assistance and
activities of state and local agencies, including the provision of
housing assistance for various population groups including, but not
limited to, elderly persons, persons with disabilities, large
families, families where a female is the head of the household,
farmworker households, and other specific population groups as deemed
appropriate by the department. To inform the strategy, the
department shall, to the extent possible, do the following:
(1) Consider information compiled by the University of California
pursuant to Section 9101.5 of the Welfare and Institutions Code, and
from provider and consumer organizations as available.
(2) Consult with various state departments, including the
California Department of Aging, the State Department of Social
Services, the State Department of Health Care Services,
the State Department of Mental Health, the
Employment Development Department, the State Department of
Developmental Services, and other state departments or agencies to
obtain information deemed relevant to the housing needs of
populations addressed in the housing strategy. This paragraph shall
not be construed to require activity beyond the customary scope of
the department's planning process.
(h) A review of housing assistance policies, goals, and objectives
affecting the homeless.
SEC. 28. Section 50685.5 of the Health
and Safety Code is amended to read:
50685.5. As used in this chapter, "persons requiring supportive
services" means persons who are eligible to receive housing
assistance pursuant to federal law because of financial inability to
provide adequate housing for themselves or persons dependent upon
them, who are or will be participating in programs of rehabilitation,
education, or social services, and who meet any of the following
criteria:
(a) The person shall have been determined to be developmentally
disabled, but not requiring institutional care, by the State
Department of Developmental Services, a regional center established
pursuant to Section 4620 of the Welfare and Institutions Code, or by
the designated representative thereof.
(b) The person shall have been determined to be mentally
disordered, but not requiring institutional care, by a local director
of mental health services, by the State Department of
Mental Health Care Services , or
by the designated representatives
thereof.
(c) The person shall have been determined to be physically
disabled by the State Department of Rehabilitation
or by the designated representatives thereof.
SEC. 29. Section 50687.5 of the Health
and Safety Code is amended to read:
50687.5. The department, after consultation with the State
Department of Developmental Services, the State
Department of Rehabilitation, or the State Department of
Mental Health Care Services , may adopt, amend
or repeal regulations for the administration of this chapter.
The department shall submit applications for federal housing
subsidies for persons requiring supportive services.
SEC. 30. Section 50689 of the Health
and Safety Code is amended to read:
50689. (a) It is the intent of the Legislature in enacting this
section to provide housing assistance for the developmentally or
physically disabled, and mentally disordered where such assistance is
for the purpose of providing a transition from an institutional to
an independent setting, and where such that
assistance is administered in the context of ongoing local
programs leading to rehabilitation and independence.
(b) The department shall establish a program for the purpose of
housing assistance for the physically or developmentally disabled, or
mentally disordered. The department shall contract with local
agencies or nonprofit corporations incorporated pursuant to Part 1
(commencing with Section 9000) of Division 2 of Title 1 of the
Corporations Code which provide supportive services for such
individuals, where such those services
are designed to provide a transition to independent living. The local
agencies or nonprofit corporation shall ensure that recipients of
housing assistance are income qualified under guidelines for programs
of the federal Department of Housing and Urban Development under
Section 8 of the United States Housing Act of 1937, as amended (42
United States Code U.S.C. Sec. 1437
(f)), and shall not contract for housing which exceeds such
guidelines for fair market rents for the Section 8 program. Public
and private agencies participating in the program established
pursuant to this section shall be those whose program philosophies
and activities conform substantially to the principles of community
living under Chapter 12 (commencing with Section 4830) of Division
4.5, community residential treatment under Chapter 5 (commencing with
Section 5450) of Part 1 of Division 5, and independent living under
Chapter 8 (commencing with Section 19800) of Part 2 of Division 10,
of the Welfare and Institutions Code.
(c) Any local agency making application for housing assistance
payments to the department shall, in its application, explain how
such the housing assistance payments
are part of its ongoing programs to establish independent living for
its disabled clientele. The department, in reviewing such
these applications, may consult with the
Department of Developmental Disabilities, the State
Department of Mental Health Care Services
, and the Department of Rehabilitation.
(d) In order to receive housing assistance payments for any
specific structure pursuant to the provisions of this section, the
local agency or nonprofit corporation shall not contract for rental
of more than 12 units, or for rental of space for more than 24
persons, in the structure. No individual shall remain in a payment
assisted unit for more than 18 months.
SEC. 31. Section 120840 of the Health
and Safety Code is amended to read:
120840. The State Department of Mental
Health Care Services shall establish an AIDS
mental health project, as described in this section.
(a) The program should include, but need not be limited to, the
following:
(1) The conduct of a statewide needs assessment of AIDS-related
mental health issues.
(2) The conduct of education and training for mental health
professionals throughout the state.
(3) The conduct, through the Office of Promotion, of a media
campaign on such issues as the use of support groups, the
relationship between stress and the immune system, and dealing with
grief.
(b) The State Department of Mental
Health Care Services shall coordinate projects and
resources directly with the department.
(c) The Director of the Department of Mental
Health Care Services may appoint advisory groups for this
project as needed.
(d) Notwithstanding any provision of Chapter 2 (commencing with
Section 10290) of Part 2 of Division 2 of the Public Contract Code,
if the Director of Mental Health Care Services
determines that it is in the best interest of the state to
enter into a contract for the purposes specified in this section
without competitive bids, then the director may, during the 1985-86
fiscal year, enter into a sole source contract for these purposes.
SEC. 32. Section 124174.4 of the Health
and Safety Code is amended to read:
124174.4. The State Department of Education, in collaboration
with the department, shall perform the following functions:
(a) Coordination of programs within the State Department of
Education that support school health centers and programs within the
State Department of Mental Health Care
Services and the State Department of Alcohol and Drug Programs,
where appropriate.
(b) The provision of technical assistance to facilitate and
encourage the establishment, retention, and expansion of school
health centers in public schools. For purposes of this subdivision,
"technical assistance" may include the provision of information to
local educational agencies and other entities regarding the
utilization of facilities, liability insurance, cooperative
agreements with community-based providers, and other issues pertinent
to school health centers.
SEC. 33. Section 128454 of the Health
and Safety Code is amended to read:
128454. (a) There is hereby created the Licensed Mental Health
Service Provider Education Program within the Health Professions
Education Foundation.
(b) For purposes of this article, the following definitions shall
apply:
(1) "Licensed mental health service provider" means a psychologist
licensed by the Board of Psychology, registered psychologist,
postdoctoral psychological assistant, postdoctoral psychology trainee
employed in an exempt setting pursuant to Section 2910 of the
Business and Professions Code, or employed pursuant to a State
Department of Mental Health Care Services
waiver pursuant to Section 5751.2 of the Welfare and
Institutions Code, marriage and family therapist, marriage and family
therapist intern, licensed clinical social worker, and associate
clinical social worker.
(2) "Mental health professional shortage area" means an area
designated as such by the Health Resources and Services
Administration (HRSA) of the United States Department of Health and
Human Services.
(c) Commencing January 1, 2005, any licensed mental health service
provider, including a mental health service provider who is employed
at a publicly funded mental health facility or a public or nonprofit
private mental health facility that contracts with a county mental
health entity or facility to provide mental health services, who
provides direct patient care in a publicly funded facility or a
mental health professional shortage area may apply for grants under
the program to reimburse his or her educational loans related to a
career as a licensed mental health service provider.
(d) The Health Professions Education Foundation shall make
recommendations to the director of the office concerning all of the
following:
(1) A standard contractual agreement to be signed by the director
and any licensed mental health service provider who is serving in a
publicly funded facility or a mental health professional shortage
area that would require the licensed mental health service provider
who receives a grant under the program to work in the publicly funded
facility or a mental health professional shortage area for at least
one year.
(2) The maximum allowable total grant amount per individual
licensed mental health service provider.
(3) The maximum allowable annual grant amount per individual
licensed mental health service provider.
(e) The Health Professions Education Foundation shall develop the
program, which shall comply with all of the following requirements:
(1) The total amount of grants under the program per individual
licensed mental health service provider shall not exceed the amount
of educational loans related to a career as a licensed mental health
service provider incurred by that provider.
(2) The program shall keep the fees from the different licensed
providers separate to ensure that all grants are funded by those fees
collected from the corresponding licensed provider groups.
(3) A loan forgiveness grant may be provided in installments
proportionate to the amount of the service obligation that has been
completed.
(4) The number of persons who may be considered for the program
shall be limited by the funds made available pursuant to Section
128458.
SEC. 34. Section 128456 of the Health
and Safety Code is amended to read:
128456. In developing the program established pursuant to this
article, the Health Professions Education Foundation shall solicit
the advice of representatives of the Board of Behavioral Sciences,
the Board of Psychology, the State Department of Mental
Health Care Services , the California Mental
Health Directors Association, the California Mental Health Planning
Council, professional mental health care organizations, the
California Healthcare Association, the Chancellor of the California
Community Colleges, and the Chancellor of the California State
University. The foundation shall solicit the advice of
representatives who reflect the demographic, cultural, and linguistic
diversity of the state.
SEC. 35. Section 129230 of the Health
and Safety Code is amended to read:
129230. It is the intent of the Legislature in enacting this
article to encourage the development of facilities for
community-based programs that assist mental health clients living in
any institutional setting, including state and local inpatient
hospitals, skilled nursing homes, intermediate care facilities, and
community care facilities to move to more independent living
arrangements. It is further the intent of the Legislature to
encourage local programs to seek funding for facility development
from private sources and with the assistance provided pursuant to
this chapter.
To achieve this purpose in determining eligibility for loan
insurance pursuant to this chapter, the following special provisions
apply to facilities approved in the county Short-Doyle plan
local mental health program and meeting the
intentions of this article:
(a) Facilities shall not require approval pursuant to Section
129295 by the statewide system of health facility planning, the area
health planning agency, or the Health Advisory Council, for the
issuance of loan insurance, unless specifically required for the
facilities by the facility category of licensure.
(b) Notwithstanding subdivision (i) of Section 129050, any loan of
under three hundred thousand dollars ($300,000) for a nonprofit
corporation as well as a political subdivision may be fully insured
equal to the total construction cost, except a loan to any
proprietary corporation that is insured pursuant to subdivision (d)
of this section.
(c) The State Department of Mental Health or the
local mental health program may provide all application
fees, inspection fees, premiums and other administrative payments
required by this chapter, except with respect to any loan to a
proprietary corporation that is insured pursuant to subdivision (d)
of this section.
(d) The borrower may be a proprietary corporation, provided that
the facility is leased to the local mental health program for the
duration of the insurance agreement. In these instances, all
provisions in this chapter and this article that apply to a nonprofit
corporation shall apply to the proprietary corporation, except as
provided in subdivisions (b) and (c) of this section.
(e) For the purposes of this article, subdivision (c) of Section
129010 shall include the purchase of existing buildings.
(f) Facilities shall not require approval pursuant to Section
129020 by the statewide system of health facility planning, the area
health planning agency, or the Health Advisory Council, for the
issuance of loan insurance, until the director of the office
and the Director of the Department of Mental Health determine
determines that the state plan developed
pursuant to Section 129020 adequately and comprehensively addresses
the need for community mental health facilities and that finding is
reported to the appropriate policy committees of the Legislature.
SEC. 36. Sect ion 10125 of the
Insurance Code is amended to read:
10125. (a) On and after January 1, 1974, every insurer issuing
group disability insurance which covers hospital, medical, or
surgical expenses shall offer coverage for expenses incurred as a
result of mental or nervous disorders, under the terms and conditions
which may be agreed upon between the group policyholder and the
insurer. If the terms and conditions include coverage for inpatient
care for nervous or mental disorders, the coverage shall extend to
treatment provided at all of the following facilities:
(1) A general acute care hospital as defined in subdivision (a) of
Section 1250 of the Health and Safety Code.
(2) An acute psychiatric hospital as defined in subdivision (b) of
Section 1250 of the Health and Safety Code.
(3) A psychiatric health facility as defined by Section 1250.2 of
the Health and Safety Code operating pursuant to licensure by the
State Department of Mental Health Social
Services .
Nothing in this subdivision prohibits an insurer which negotiates
and enters into a contract with a professional or institutional
provider for alternative rates of payment pursuant to Sections 10133
and 11512 of this code from restricting or modifying the choice of
providers.
(b) Every insurer shall communicate to prospective group
policyholders as to the availability of outpatient coverage for the
treatment of mental or nervous disorders. Every insurer shall
communicate the availability of that coverage to all group
policyholders and to all prospective group policyholders with whom
they are negotiating. This coverage may include community residential
treatment services, as described in Section 5458 of the Welfare and
Institutions Code, which are alternatives to institutional care.
SEC. 37. Section 10127 of the Insurance
Code is amended to read:
10127. On and after January 1, 1974, every self-insured employee
welfare benefit plan which provides coverage for hospital, medical,
or surgical expenses shall offer coverage for expenses incurred as a
result of mental or nervous disorders, under the terms and conditions
which may be agreed upon between the self-insured welfare benefit
plan and the member. If the terms and conditions include coverage for
services provided in a general acute care hospital, or an acute
psychiatric hospital as defined in Section 1250 of the Health and
Safety Code, and do not restrict or modify the choice of providers,
the coverage shall extend to care provided by a psychiatric health
facility, as defined by Section 1250.2 of the Health and Safety Code,
operating pursuant to licensure by the State Department of
Mental Health Social Services . Every plan shall
communicate to prospective members as to the availability of
outpatient coverage for the treatment of mental or nervous disorders.
Every self-insured welfare benefit plan shall communicate the
availability of this coverage to all members and prospective members.
This coverage may include community residential treatment services,
as described in Section 5458 of the Welfare and Institutions Code,
which are alternatives to institutional care.
SEC. 38. Section 12693.61 of the
Insurance Code is amended to read:
12693.61. The following provisions apply for subscribers who have
been identified by the participating health plans as potentially
seriously emotionally disturbed.
(a) Participating plans, to the extent feasible, including plans
receiving purchasing credits shall develop memoranda of
understanding, consistent with criteria established by the board in
consultation with the State Department of Mental Health
Health Care Services , for referral of
subscribers who are seriously emotionally disturbed to a county
mental health department. This referral does not relieve a
participating plan from providing the mental health coverage
specified in its contract, including assessment of, and development
of, a treatment plan for serious emotional disturbance. Plans may
contract with county mental health departments to provide for all, or
a portion of, the services provided under the program's mental
health benefit.
(b) The board shall establish an accounting process under which
counties providing services to subscribers who have been determined
to be seriously emotionally disturbed pursuant to Section 5600.3 of
the Welfare and Institutions Code can claim federal reimbursement for
the services. The board shall reimburse counties pursuant to the
rates set by the State Department of Mental Health
State Department of Health Care Services in accordance
with Sections 5705, 5716, 5718, 5720, 5724, and 5778
14705.7, 14705, 14708, 14711, and 14718 of the
Welfare and Institutions Code. The actual amount reimbursed by the
board shall be the federal share of the cost of the subscriber.
(c) This section shall only become operative with federal approval
of the State Child Health Plan and the approval of federal financial
participation.
(d) Counties choosing to enter into a memorandum of understanding
pursuant to subdivision (a) shall provide the nonfederal share of
cost for the subscriber.
SEC. 39. Section 21 of the Welfare and
Institutions Code is amended to read:
21. (a) Whenever any reference is made in any provision of this
code to the "State Department of Benefit Payments" or the "Department
of Benefit Payments" with respect to aid, it means the State
Department of Social Services.
Whenever any reference is made to the "State Department of Benefit
Payments" or "Department of Benefit Payments" with respect to mental
disorders, it means the State Department of Mental
Health Care Services . Whenever reference is
made to the "State Department of Benefit Payments" or "Department of
Benefit Payments" with respect to developmental disabilities, it
means the State Department of Developmental Services.
(b) Whenever any reference is made in any provision of this code
to the "State Department of Health" or the "Department of Health"
with respect to health services, medical assistance, or benefits, it
means the State Department of Health Care Services or
the State Department of Public Health, as applicable
.
Whenever any reference is made to the "State Department of Health"
or the "Department of Health" with respect to mental disorders, it
means the State Department of Mental Health
Care Services . Whenever any reference is made to the "State
Department of Health" or "Department of Health" in respect to
developmental disabilities, it means the State Department of
Developmental Services.
(c) Whenever any reference is made in any provision of this code
to the "Director of Benefit Payments" with respect to aid, it means
the Director of Social Services.
Whenever any reference is made to the "Director of Benefit
Payments" with respect to mental disorders, it means the Director of
Mental Health Care Services . Whenever
any reference is made to the "Director of Benefit Payments" with
respect to developmental disabilities, it means the Director of
Developmental Services.
(d) Whenever any reference is made in any provision of this code
to the "State Director of Health" or "Director of Health" with
respect to health services, medical assistance, or benefits, it means
the State Director of Health Care
Services.
Whenever any reference is made to the "State Director of Health"
or "Director of Health" with respect to mental disorders, it means
the Director of Mental Health Care
Services . Whenever any reference is made to the "State
Director of Health" or "Director of Health" with reference to
developmental disabilities, it means the Director of Developmental
Services.
SEC. 40. Section 359 of the Welfare and
Institutions Code is amended to read:
359. Whenever a minor who appears to be a danger to himself or
others as a result of the use of narcotics (as defined in Section
11001 of the Health and Safety Code), or a restricted dangerous drug
(as defined in Section 11901 of the Health and Safety Code), is
brought before any judge of the juvenile court, the judge may
continue the hearing and proceed pursuant to this section. The court
may order the minor taken to a facility designated by the county and
approved by the State Department of Mental Health
Social Services as a facility for 72-hour treatment and
evaluation. Thereupon the provisions of Section 11922 of the Health
and Safety Code shall apply, except that the professional person in
charge of the facility shall make a written report to the court
concerning the results of the evaluation of the minor.
If the professional person in charge of the facility for 72-hour
evaluation and treatment reports to the juvenile court that the minor
is not a danger to himself or others as a result of the use of
narcotics or restricted dangerous drugs or that the minor does not
require 14-day intensive treatment, or if the minor has been
certified for not more than 14 days of intensive treatment and the
certification is terminated, the minor shall be released if the
juvenile court proceedings have been dismissed; referred for further
care and treatment on a voluntary basis, subject to the disposition
of the juvenile court proceedings; or returned to the juvenile court,
in which event the court shall proceed with the case pursuant to
this chapter.
Any expenditure for the evaluation or intensive treatment of a
minor under this section shall be considered an expenditure made
under Part 2 (commencing with Section 5600) of Division 5, and shall
be reimbursed by the state as are other local expenditures pursuant
to that part.
SEC. 41. Section 708 of the Welfare and
Institutions Code is amended to read:
708. Whenever a minor who appears to be a danger to himself or
herself or others as a result of the use of controlled substances (as
defined in Division 10 (commencing with Section 11000) of the Health
and Safety Code), is brought before any judge of the juvenile court,
the judge may continue the hearing and proceed pursuant to this
section. The court may order the minor taken to a facility designated
by the county and approved by the State Department of
Mental Health Social Services as a facility for
72-hour treatment and evaluation. Thereupon the provisions of Section
5343 of the Welfare and Institutions Code shall apply, except that
the professional person in charge of the facility shall make a
written report to the court concerning the results of the evaluation
of the minor.
If the professional person in charge of the facility for 72-hour
evaluation and treatment reports to the juvenile court that the minor
is not a danger to himself or herself or others as a result of the
use of controlled substances or that the minor does not require
14-day intensive treatment, or if the minor has been certified for
not more than 14 days of intensive treatment and the certification is
terminated, the minor shall be released if the juvenile court
proceedings have been dismissed; referred for further care and
treatment on a voluntary basis, subject to the disposition of the
juvenile court proceedings; or returned to the juvenile court, in
which event the court shall proceed with the case pursuant to this
chapter.
Any expenditure for the evaluation or intensive treatment of a
minor under this section shall be considered an expenditure made
under Part 2 (commencing with Section 5600) of Division 5, and shall
be reimbursed by the state as are other local expenditures pursuant
to that part.
SEC. 42. Section 4005.1 of the Welfare
and Institutions Code is amended to read:
4005.1. The department The State
Department of State Hospitals, the State Department of Health Care
Services, and the State Department of Social Services may adopt
and enforce rules and regulations necessary to carry out
its their respective duties under this division.
SEC. 43. Section 4005.6 is added to the
Welfare and Institutions Code , to read:
4005.6. All regulations heretofore adopted by the State
Department of Mental Health pursuant to authority vested in the State
Department of Health Care Services by Section 4005.1 and in effect
immediately preceding the operative date of the act that added this
section shall remain in effect and shall be fully enforceable unless
and until readopted, amended, or repealed by the Director of Health
Care Services.
SEC. 44. Section 4005.7 is added to the
Welfare and Institutions Code , to read:
4005.7. All regulations heretofore adopted by the State
Department of Mental Health pursuant to authority vested in the State
Department of Social Services by Section 4005.1 and in effect
immediately preceding the operative date of the act that added this
section shall remain in effect and shall be fully enforceable unless
and until readopted, amended, or repealed by the Director of Social
Services.
SEC. 45. Section 4011 of the Welfare
and Institutions Code is amended to read:
4011. Unless otherwise indicated in this code, the
The State Department of Mental
Health Care Services has jurisdiction over the
execution of the laws relating to the care, custody, and treatment of
mentally disordered persons , as only to the
extent and in the manner provided in this code. The State
Department of State
Hospitals shall have jurisdiction over the execution of the laws
relating to care and treatment of the mentally ill individuals under
the custody of the State Department of State Hospitals.
As used in this division, "establishment" and "institution"
include every hospital, sanitarium, boarding home, or other place
receiving or caring for mentally disordered persons.
SEC. 46. Section 4030 of the Welfare
and Institutions Code is amended to read:
4030. The Director of Mental Health Care
Services shall organize appropriate staff of the department to
ensure implementation of the planning, research, evaluation,
technical assistance, and quality assurance responsibilities set
forth in this chapter.
SEC. 47. Section 4031 of the Welfare and
Institutions Code is amended to read:
4031. The State Department of Mental Health
Care Services shall, to the extent resources are
available, do all of the following:
(a) Conduct, sponsor, coordinate, and disseminate results of
research and evaluation directed to the public policy issues entailed
in the selection of resource utilization and service delivery in the
state.
(b) Make available technical assistance to local mental health
programs incorporating the results of research, evaluation, and
quality assurance to local mental health programs.
(c) Implement a system of required performance reporting by local
mental health programs.
(d) Perform any other activities useful to improving and
maintaining the quality of state mental hospital and
community mental health programs.
SEC. 48. Section 4032 of the Welfare
and Institutions Code is amended to read:
4032. The department The State Department
of Health Care Services shall, when appropriate,
give and receive grants and contracts for research, evaluation, and
quality assurance efforts.
SEC. 49. Section 4033 of the Welfare
and Institutions Code is amended to read:
4033. (a) The State Department of Mental
Health Care Services shall, to the extent resources are
available, comply with the Substance Abuse and Mental Health
Services Administration federal planning requirements. The
department shall update and issue a state plan, which may also be any
federally required state service plan, so that citizens may be
informed regarding the implementation of, and long-range goals for,
programs to serve mentally ill persons in the state. The department
shall gather information from counties necessary to comply with this
section.
(b) (1) If the State Department of Mental
Health Care Services makes a decision not to comply with
any Substance Abuse and Mental Health Services Administration
federal planning requirement to which this section applies, the
State Department of Mental Health Care
Services shall submit the decision, for consultation, to the
California Conference of Local Mental Health
Directors Association , the California Council on
Mental Health Planning Council , and affected
mental health entities.
(2) The State Department of Mental Health
Care Services shall not implement any decision not to comply
with the Substance Abuse and Mental Health Services
Administration federal planning requirements sooner than 30
days after notification of that decision, in writing, by the
Department of Finance, to the chairperson of the committee in each
house of the Legislature which considers appropriations, and the
Chairperson of the Joint Legislative Budget Committee.
SEC. 50. Section 4040 of the Welfare
and Institutions Code is amended to read:
4040. The State Department of Mental Health
Care Services or State Department of State Hospitals may
conduct, or contract for, research or evaluation studies
which that have application to mental
health policy and management issues. In selecting areas for
study the department shall be guided by the information needs of
state and local policymakers and managers, and suggestions from the
California Conference of Local Mental Health
Directors Association .
SEC. 51. Section 4050 of the Welfare
and Institutions Code is amended to read:
4050. The State Department of Mental Health
Care Services shall provide, to the extent resources are
available, technical assistance, through its own staff, or by
contract, to county mental health programs and other local mental
health agencies in the areas of program operations, research,
evaluation, demonstration, or quality assurance projects.
SEC. 52. Section 4051 of the Welfare
and Institutions Code is amended to read:
4051. The State Department of Mental Health
Care Services shall, to the extent resources are
available, provide program development guidelines, evaluation models,
and operational assistance on all aspects of services to mentally
ill persons of all ages. These services include, but are not limited
to, the following:
(a) Self-help programs.
(b) Housing development.
(c) Disaster preparation.
(d) Vocational services.
(e) Regional programs.
(f) Multiple diagnosis programs.
SEC. 53. Section 4052 of the Welfare
and Institutions Code is amended to read:
4052. The State Department of Mental Health
Care Services shall, to the extent resources are
available, provide training in performance standards, model programs,
cultural competency, and program development.
SEC. 54. Section 4060 of the Welfare
and Institutions Code is amended to read:
4060. The department State Department of
Health Care Services shall, in order to implement Section 4050,
utilize a joint state-county meaningful
decisionmaking process that shall include
includes local mental health directors and representatives
of local mental health boards as well as other stakeholders as
determined by the department . The purpose of this
collaboration shall be to promote effective and efficient quality
mental health services to the residents of the state under the
realigned mental health system.
SEC. 55. Section 4061 of the Welfare
and Institutions Code is amended to read:
4061. (a) The department The State
Department of Health Care Services shall utilize a joint
state-county decisionmaking process to determine the appropriate use
of state and local training, technical assistance, and regulatory
resources to meet the mission and goals of the state's mental health
system. The department shall use the decisionmaking collaborative
process required by this section in all of the following areas:
(1) Providing technical assistance to personnel of the
State Department of Mental Health Care
Services and local mental health departments through direction
of existing state and local mental health staff and other resources.
(2) Analyzing mental health programs, policies, and procedures.
(3) Providing forums on specific topics as they relate to the
following:
(A) Identifying current level of services.
(B) Evaluating existing needs and gaps in current services.
(C) Developing strategies for achieving statewide goals and
objectives in the provision of services for the specific area.
(D) Developing plans to accomplish the identified goals and
objectives.
(4) Providing forums on policy development and direction with
respect to mental health program operations and clinical issues.
(5) Identifying and funding a statewide training and technical
assistance entity jointly governed by local mental health directors
and mental health constituency representation, which can do all of
the following:
(A) Coordinate state and local resources to support training and
technical assistance to promote quality mental health programs.
(B) Coordinate training and technical assistance to ensure
efficient and effective program development.
(C) Provide essential training and technical assistance, as
determined by the state-county decisionmaking process.
(b) Local mental health board members shall be included in
discussions pursuant to Section 4060 when the following areas are
discussed:
(1) Training and education program recommendations.
(2) Establishment of statewide forums for all organizations and
individuals involved in mental health matters to meet and discuss
program and policy issues.
(3) Distribution of information between the state, local programs,
local mental health boards, and other organizations as appropriate.
(c) The State Department of Mental Health
Care Services and local mental health departments
may provide staff or other resources, including travel reimbursement,
for consultant and advisory services; for the training of personnel,
board members, or consumers and families in state and local programs
and in educational institutions and field training centers approved
by the department; and for the establishment and maintenance of field
training centers.
SEC. 56. The heading of Article 4 (commencing with
Section 4070) of Chapter 2 of Part 1 of Division 4 of the
Welfare and Institutions Code is repealed.
Article 4. Medi-Cal Quality Assurance
SEC. 57. Section 4070 of the Welfare
and Institutions Code is amended and renumbered to read:
4070. 14725. (a) The State
Department of Mental Health Health Care
Services shall develop a quality assurance program to govern
the delivery of Short-Doyle Medi-Cal
specialty mental health services, in order to assure quality
patient care based on community standards of practice.
(b) The department shall issue standards and guidelines for local
quality assurance activities. These standards and guidelines shall be
reviewed and revised in consultation with the Conference of
Local California Mental Health Directors
Association as well as other stakeholders from the mental health
community, including, but not limited to, individuals who receive
services, family members, providers, mental health ad
vocacy groups, and other interested parties . The standards and
guidelines shall be based on federal medicaid
Medicaid requirements.
(c) The standards and guidelines developed by the department shall
reflect the special problems that small rural counties have in
undertaking comprehensive quality assurance systems.
SEC. 58. Section 4071 of the Welfare
and Institutions Code is amended and renumbered to read:
4071. 14726. The department shall
approve each local program's initial quality assurance plan, and
shall thereafter review and approve each program's
Short-Doyle Medi-Cal specialty mental health services
quality assurance plan whenever the plan is amended or changed.
SEC. 59. Article 1 (commencing with Section 4074)
of Chapter 3 of Part 1 of Division 4 of the Welfare and
Institutions Code is repealed.
SEC. 60. Article 2 (commencing with Section 4075)
of Chapter 3 of Part 1 of Division 4 of the Welfare and
Institutions Code is repealed.
SEC. 61. Section 4080 of the Welfare
and Institutions Code is amended to read:
4080. (a) Psychiatric health facilities, as defined in Section
1250.2 of the Health and Safety Code, shall only be licensed by the
State Department of Mental Health Social
Services subsequent to application by counties, county contract
providers, or other organizations pursuant to this part.
(b) (1) For counties or county contract providers that choose to
apply, the local mental health director shall first present to the
local mental health advisory board for its review an explanation of
the need for the facility and a description of the services to be
provided. The local mental health director shall then submit to the
governing body the explanation and description. The governing body,
upon its approval, may submit the application to the State Department
of Mental Health Social Services .
(2) Other organizations that will be applying for licensure and do
not intend to use any Bronzan-McCorquodale funds pursuant to Section
5707 shall submit to the local mental health director and the
governing body in the county in which the facility is to be located a
written and dated proposal of the services to be provided. The local
mental health director and governing body shall have 30 days during
which to provide any advice and recommendations regarding licensure,
as they deem appropriate. At any time after the 30-day period, the
organizations may then submit their applications, along with the
mental health director's and governing body's advice and
recommendations, if any, to the State Department of Mental
Health Social Services .
(c) The State Fire Marshal and other appropriate state agencies,
to the extent required by law, shall cooperate fully with the State
Department of Mental Health Social Services
to ensure that the State Department of Mental Health
Social Services approves or disapproves the
licensure applications not later than 90 days after the application
submission by a county, county contract provider, or other
organization.
(d) Every psychiatric health facility and program for which a
license has been issued shall be periodically inspected by a
multidisciplinary team appointed or designated by the State
Department of Mental Health Social Services
. The inspection shall be conducted no less than once every two
years and as often as necessary to ensure the quality of care
provided. During the inspections the review team shall offer such
advice and assistance to the psychiatric health facility as it deems
appropriate.
(e) (1) The program aspects of a psychiatric health facility that
shall be reviewed and may be approved by the State Department of
Mental Health Social Services shall
include, but not be limited to:
(A) Activities programs.
(B) Administrative policies and procedures.
(C) Admissions, including provisions for a mental evaluation.
(D) Discharge planning.
(E) Health records content.
(F) Health records services.
(G) Interdisciplinary treatment teams.
(H) Nursing services.
(I) Patient rights.
(J) Pharmaceutical services.
(K) Program space requirements.
(L) Psychiatrist and clinical psychological services.
(M) Rehabilitation services.
(N) Restraint and seclusion.
(O) Social work services.
(P) Space, supplies, and equipment.
(Q) Staffing standards.
(R) Unusual occurrences.
(S) Use of outside resources, including agreements with general
acute care hospitals.
(T) Linguistic access and cultural competence.
(U) Structured outpatient services to be provided under special
permit.
(2) The State Department of Mental Health
Social Services has the sole authority to grant
program flexibility.
(f) The Commencing July 1, 2012, the
State Department of Mental Health Social
Services shall adopt regulations that shall include, but not be
limited to, all of the following:
(1) Procedures by which the State Department of Mental
Health Social Services shall review and may
approve the program and facility requesting licensure as a
psychiatric health facility as being in compliance with program
standards established by the department.
(2) Procedures by which the Director of Mental Health
Social Services shall approve, or deny approval
of, the program and facility licensed as a psychiatric health
facility pursuant to this section.
(3) Provisions for site visits by the State Department of
Mental Health Social Services for the purpose
of reviewing a facility's compliance with program and facility
standards.
(4) Provisions for the State Department of Mental Health
Social Services for any administrative proceeding
regarding denial, suspension, or revocation of a psychiatric health
facility license.
(5) Procedures for the appeal of an administrative finding or
action pursuant to paragraph (4) of this subdivision and subdivision
(j).
(g) Regulations shall be adopted by the State Department of
Mental Health Social Services , which
shall establish standards for pharmaceutical services in psychiatric
health facilities. Licensed psychiatric health facilities shall be
exempt from requirements to obtain a separate pharmacy license or
permit.
(h) (1) It is the intent of the Legislature that the State
Department of Mental Health Social Services
shall license the facility in order to establish innovative and
more competitive and specialized acute care services.
(2) The State Department of Mental Health
Social Services shall review and may approve the program
aspects of public or private facilities, with the exception of those
facilities that are federally certified or accredited by a nationally
recognized commission that accredits health care facilities, only if
the average per diem charges or costs of service provided in the
facility is approximately 60 percent of the average per diem charges
or costs of similar psychiatric services provided in a general
hospital.
(3) (A) When a private facility is accredited by a nationally
recognized commission that accredits health care facilities, the
department State Department of Social
Services shall review and may approve the program aspects only
if the average per diem charges or costs of service provided in the
facility do not exceed approximately 75 percent of the average per
diem charges or costs of similar psychiatric service provided in a
psychiatric or general hospital.
(B) When a private facility serves county patients, the
department State Department of Social Services
shall review and may approve the program aspects only if the facility
is federally certified by the Health Care Financing
Administration federal Centers for Medicare and
Medicaid Services and serves a population mix that includes a
proportion of Medi-Cal patients sufficient to project an overall cost
savings to the county, and the average per diem charges or costs of
service provided in the facility do not exceed approximately 75
percent of the average per diem charges or costs of similar
psychiatric service provided in a psychiatric or general hospital.
(4) When a public facility is federally certified by the
Health Care Financing Administration federal Centers
for Medicare and Medicaid Services and serves a population mix
that includes a proportion of Medi-Cal patients sufficient to project
an overall program cost savings with certification, the
department State Department of Social Services
shall approve the program aspects only if the average per diem
charges or costs of service provided in the facility do not exceed
approximately 75 percent of the average per diem charges or costs of
similar psychiatric service provided in a psychiatric or general
hospital.
(5) (A) The State Department of Mental Health
Care Services may set a lower rate for private or public
facilities than that required by paragraph (3) or paragraph (4),
respectively if so required by the federal Health Care
Financing Administration Centers for Medicare and
Medicaid Services as a condition for the receipt of
federal matching funds.
(B) This section does not impose any obligation on any private
facility to contract with a county for the provision of services to
Medi-Cal beneficiaries, and any contract for that purpose is subject
to the agreement of the participating facility.
(6) (A) In using the guidelines specified in this subdivision, the
department State Department of Social
Services shall take into account local conditions affecting the
costs or charges.
(B) In those psychiatric health facilities authorized by special
permit to offer structured outpatient services not exceeding 10
daytime hours, the following limits on per diem rates shall apply:
(i) The per diem charge for patients in both a morning and an
afternoon program on the same day shall not exceed 60 percent of the
facility's authorized per diem charge for inpatient services.
(ii) The per diem charge for patients in either a morning or
afternoon program shall not exceed 30 percent of the facility's
authorized per diem charge for inpatient services.
(i) The licensing fees charged for these facilities shall be
credited to the State Department of Mental Health
Social Services for its costs incurred in the review of
psychiatric health facility programs, in connection with the
licensing of these facilities.
(j) (1) The State Department of Mental Health
Social Services shall establish a system for the
imposition of prompt and effective civil sanctions against
psychiatric health facilities in violation of the laws and
regulations of this state pertaining to psychiatric health
facilities. If the State Department of Mental Health
Social Services determines that there is or has
been a failure, in a substantial manner, on the part of a psychiatric
health facility to comply with the laws and regulations, the
director Director of Social Services
may impose the following sanctions:
(A) Cease and desist orders.
(B) Monetary sanctions, which may be imposed in addition to the
penalties of suspension, revocation, or cease and desist orders. The
amount of monetary sanctions permitted to be imposed pursuant to this
subparagraph shall not be less than fifty dollars ($50) nor more
than one hundred dollars ($100) multiplied by the licensed bed
capacity, per day, for each violation. However, the monetary sanction
shall not exceed three thousand dollars ($3,000) per day. A facility
that is assessed a monetary sanction under this subparagraph, and
that repeats the deficiency, may, in accordance with the regulations
adopted pursuant to this subdivision, be subject to immediate
suspension of its license until the deficiency is corrected.
(2) The department The State
Department of Social Services shall adopt regulations necessary
to implement this subdivision and paragraph (5) of subdivision (f)
in accordance with the Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code). No later than January 1, 1998, the
department shall adopt emergency regulations necessary to implement
this subdivision and paragraph (5) of subdivision (f) in accordance
with the Administrative Procedure Act (Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code). This initial adoption of emergency regulations shall be deemed
to be an emergency and necessary for the immediate preservation of
the public peace, health and safety, or general welfare. These
emergency regulations shall remain in effect for no more than 180
days. The certificate of compliance, as provided for in subdivision
(e) of Section 11346.1 of the Government Code, for the emergency
regulations adopted pursuant to this paragraph shall be submitted to
the Office of Administrative Law no later than July 1, 1998.
(k) Proposed changes in the standards or regulations affecting
health facilities that serve the mentally disordered shall be
effected only with the review and coordination of the California
Health and Welfare Human Services
Agency.
(l) In psychiatric health facilities where the clinical director
is not a physician, a psychiatrist, or if one is temporarily not
available, a physician shall be designated who shall direct those
medical treatments and services that can only be provided by, or
under the direction of, a physician.
SEC. 62. Section 4090 of the Welfare
and Institutions Code is amended to read:
4090. (a) The State Department of Mental
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.
(b) In establishing the standards required by this section, the
department shall not establish standards which in themselves impose
any new or increased costs on the programs or facilities affected by
the standards.
SEC. 63. Section 4091 of the Welfare
and Institutions Code is amended to read:
4091. Nothing in Section 4090 limits the authority of the State
Department of Mental Health Care Services
to delegate the evaluation and enforcement of the program
standards to a county mental health program when a licensed social
rehabilitation facility has a contractual relationship with a county
mental health program and the county has requested the delegation.
SEC. 64. 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.
(b) Commencing July 1, 2012, the State Department of Health Care
Services may adopt or amend regulations pertaining to the program
standards for any facility licensed as a community treatment
facility.
(b)
(c) A certification of compliance issued by the State
Department of Mental Health Care Services
shall be a condition of licensure for the community treatment
facility by the State Department of Social Services. The department
may, upon the request of a county, delegate the certification and
supervision of a community treatment facility to the county
department of mental health.
(c)
(d) The State Department of Mental
Health Care Services shall adopt regulations to include,
but not be limited to, the following:
(1) Procedures by which the Director of Mental
Health Care Services shall certify that a facility
requesting licensure as a community treatment facility pursuant to
Chapter 3 (commencing with Section 1500)
of Division 2 of the Health and Safety Code is in
compliance with program standards established pursuant to this
section.
(2) Procedures by which the Director of Mental
Health Care Services shall deny a certification to a
facility or decertify a facility that is licensed as a community
treatment facility pursuant to Chapter 3 (commencing with Section
1500) of Division 2 of the Health and Safety Code, but no longer
complying with program standards established pursuant to this
section, in accordance with Chapter 5 (commencing with Section 11500)
of Part 1 of Division 3 of Title 2 of the Government Code.
(3) Provisions for site visits by the State Department of
Mental Health Care Services for the purpose of
reviewing a facility's compliance with program standards established
pursuant to this section.
(4) Provisions for the community care licensing staff of the State
Department of Social Services to report to the State Department of
Mental Health Care Services when there
is reasonable cause to believe that a community treatment facility is
not in compliance with program standards established pursuant to
this section.
(5) Provisions for the State Department of Mental
Health Care Services to provide consultation and
documentation to the State Department of Social Services in any
administrative proceeding regarding denial, suspension, or revocation
of a community treatment facility license.
(d)
(e) The standards adopted by regulations pursuant to
subdivision subdivisions (a) and
(b) shall include, but not be limited to, standards for
treatment, staffing, and for the use of psychotropic medication,
discipline, and restraints in the facilities. The standards shall
also meet the requirements of Section 4094.5.
(e)
(f) (1) Until January 1, 2013
2014 , all of the following are applicable:
(A) A community treatment facility shall not be required by the
State Department of Mental Health Care
Services to have 24-hour onsite licensed nursing staff, but
shall retain at least one full-time, or full-time-equivalent,
registered nurse onsite if both of the following are applicable:
(i) The facility does not use mechanical restraint.
(ii) The facility only admits children who have been assessed, at
the point of admission, by a licensed primary care provider and a
licensed psychiatrist, who have concluded, with respect to each
child, that the child does not require medical services that require
24-hour nursing coverage. For purposes of this section, a "primary
care provider" includes a person defined in Section 14254, or a nurse
practitioner who has the responsibility for providing initial and
primary care to patients, for maintaining the continuity of care, and
for initiating referral for specialist care.
(B) Other medical or nursing staff shall be available on call to
provide appropriate services, when necessary, within one hour.
(C) All direct care staff shall be trained in first aid and
cardiopulmonary resuscitation, and in emergency intervention
techniques and methods approved by the Community Care Licensing
Division of the State Department of Social Services.
(2) The State Department of Mental Health
Care Services may adopt emergency regulations as necessary to
implement this subdivision. The adoption of these regulations shall
be deemed to be an emergency and necessary for the immediate
preservation of the public peace, health and safety, and general
welfare. The regulations shall be exempt from review by the Office of
Administrative Law and shall become effective immediately upon
filing with the Secretary of State. The regulations shall not remain
in effect more than 180 days unless the adopting agency complies with
all the provisions of Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, as required
by subdivision (e) of Section 11346.1 of the Government Code.
(f)
(g ) During the initial public comment
period for the adoption of the regulations required by this section,
the community care facility licensing regulations proposed by the
State Department of Social Services and the program standards
proposed by the State Department of Mental Health
Care Services shall be presented simultaneously.
(g)
(h) A minor shall be admitted to a community treatment
facility only if the requirements of Section 4094.5 and either of the
following conditions are met:
(1) The minor is within the jurisdiction of the juvenile court,
and has made voluntary application for mental health services
pursuant to Section 6552.
(2) Informed consent is given by a parent, guardian, conservator,
or other person having custody of the minor.
(h)
(i) Any minor admitted to a community treatment
facility shall have the same due process rights afforded to a minor
who may be admitted to a state hospital, pursuant to the holding in
In re Roger S. (1977) 19 Cal.3d 921. Minors who are wards or
dependents of the court and to whom this subdivision applies shall be
afforded due process in accordance with Section 6552 and related
case law, including In re Michael E. (1975) 15 Cal.3d 183.
Regulations adopted pursuant to Section 4094 shall specify the
procedures for ensuring these rights, including provisions for
notification of rights and the time and place of hearings.
(i)
(j) Notwithstanding Section 13340 of the Government
Code, the sum of forty-five thousand dollars ($45,000) is hereby
appropriated annually from the General Fund to the State Department
of Mental Health Care Services for one
personnel year to carry out the provisions of this section.
SEC. 65. Section 4094.1 of the Welfare
and Institutions Code is amended to read:
4094.1. (a) (1)
The department
The State Department of He alth Care Services and
the State Department of Social Services, in consultation with
community treatment providers, local mental health departments, and
county welfare departments, shall develop joint protocols for the
oversight of community treatment facilities.
(2) Subject to subdivision (b), until the protocols and regulatory
changes required by paragraph (1) are implemented, entities
operating community treatment facilities shall comply with the
current reporting requirements and other procedural and
administrative mandates established in State Department of Mental
Health regulations governing community treatment facilities.
(b) In accordance with all of the following, the State Department
of Social Services shall modify existing regulations governing
reporting requirements and other procedural and administrative
mandates, to take into account the seriousness and frequency of
behaviors that are likely to be exhibited by children placed in
community treatment facilities. The modifications required by this
subdivision shall apply for the entire 2000-01 fiscal year.
(1) Notwithstanding existing regulations, the State Department of
Social Services shall issue alternative training and education
requirements for community treatment facility managers and staff,
which shall be developed in consultation with the State Department of
Mental Health, patients' rights advocates, local mental health
departments, county welfare offices, and providers.
(2) The department and the State Department of Social Services
shall conduct joint bimonthly visits to licensed community treatment
facilities to monitor operational progress and to provide technical
assistance.
(3) The appropriate department shall centrally review any
certification or licensure deficiency before notice of the citation
is issued to the community care facility.
(4) A community treatment facility shall be exempt from reporting
any occurrence of the use of restraint to the State Department of
Social Services, unless physical injury is sustained or
unconsciousness or other medical conditions arise from the restraint.
All other reporting requirements shall apply.
SEC. 66. Section 4094.2 of the Welfare
and Institutions Code is amended to read:
4094.2. (a) For the purpose of establishing payment rates for
community treatment facility programs, the private nonprofit agencies
selected to operate these programs shall prepare a budget that
covers the total costs of providing residential care and supervision
and mental health services for their proposed programs. These costs
shall include categories that are allowable under California's Foster
Care program and existing programs for mental health services. They
shall not include educational, nonmental health medical, and dental
costs.
(b) Each agency operating a community treatment facility program
shall negotiate a final budget with the local mental health
department in the county in which its facility is located (the host
county) and other local agencies, as appropriate. This budget
agreement shall specify the types and level of care and services to
be provided by the community treatment facility program and a payment
rate that fully covers the costs included in the negotiated budget.
All counties that place children in a community treatment facility
program shall make payments using the budget agreement negotiated by
the community treatment facility provider and the host county.
(c) A foster care rate shall be established for each community
treatment facility program by the State Department of Social
Services. These rates shall be established using the existing foster
care ratesetting system for group homes, with modifications designed
as necessary. It is anticipated that all community treatment facility
programs will offer the level of care and services required to
receive the highest foster care rate provided for under the current
group home ratesetting system.
(d) For the 2001-02 fiscal year, the 2002-03 fiscal year, the
2003-04 fiscal year, and the 2004-05 fiscal year, community treatment
facility programs shall also be paid a community treatment facility
supplemental rate of up to two thousand five hundred dollars ($2,500)
per child per month on behalf of children eligible under the foster
care program and children placed out of home pursuant to an
individualized education program developed under Section 7572.5 of
the Government Code. Subject to the availability of funds, the
supplemental rate shall be shared by the state and the counties.
Counties shall be responsible for paying a county share of cost equal
to 60 percent of the community treatment rate for children placed by
counties in community treatment facilities and the state shall be
responsible for 40 percent of the community treatment facility
supplemental rate. The community treatment facility supplemental rate
is intended to supplement, and not to supplant, the payments for
which children placed in community treatment facilities are eligible
to receive under the foster care program and the existing programs
for mental health services.
(e) For initial ratesetting purposes for community treatment
facility funding, the cost of mental health services shall be
determined by deducting the foster care rate and the community
treatment facility supplemental rate from the total allowable cost of
the community treatment facility program. Payments to certified
providers for mental health services shall be based on eligible
services provided to children who are Medi-Cal beneficiaries, up to
the statewide maximum allowances approved
federal rate for these services.
(f) The department The State Department of
Health Care Services shall provide the community treatment
facility supplemental rates to the counties for advanced payment to
the community treatment facility providers in the same manner as the
regular foster care payment and within the same required payment time
limits.
(g) In order to facilitate the study of the costs of community
treatment facilities, licensed community treatment facilities shall
provide all documents regarding facility operations, treatment, and
placements requested by the department.
(h) It is the intent of the Legislature that the
department State Department of Health Care Services
and the State Department of Social Services work to maximize
federal financial participation in funding for children placed in
community treatment facilities through funds available pursuant to
Titles IV-E and XIX of the federal Social Security Act (Title 42
U.S.C. Sec. 670 and following et seq.
and Sec. 1396 and following et seq. )
and other appropriate federal programs.
(i) The department The State Department of
Health Care Services and the State Department of Social
Services may adopt emergency regulations necessary to implement joint
protocols for the oversight of community treatment facilities, to
modify existing licensing regulations governing reporting
requirements and other procedural and administrative mandates to take
into account the seriousness and frequency of behaviors that are
likely to be exhibited by the seriously emotionally disturbed
children placed in community treatment facility programs, to modify
the existing foster care ratesetting regulations, and to pay the
community treatment facility supplemental rate. The adoption of these
regulations shall be deemed to be an emergency and necessary for the
immediate preservation of the public peace, health and safety, and
general welfare. The regulations shall become effective immediately
upon filing with the Secretary of State. The regulations shall not
remain in effect more than 180 days unless the adopting agency
complies with all the provisions of Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code, as required by subdivision (e) of Section 11346.1 of the
Government Code.
SEC. 67. Section 4094.7 of the Welfare
and Institutions Code is amended to read:
4094.7. (a) A community treatment facility may have both secure
and nonsecure beds. However, the State Department of Mental
Health Care Services shall limit the total
number of beds in community treatment facilities to not more than 400
statewide. The State Department of Mental Health
Care Services shall certify community treatment facilities
in such a manner as to ensure an adequate dispersal of these
facilities within the state. The State Department of Mental
Health Care Services shall ensure that there is
at least one facility in each of the State Department of Social
Services' four regional licensing divisions.
(b) The State Department of Mental Health
Care Services shall notify the State Department of Social
Services when a facility has been certified and has met the program
standards pursuant to Section 4094. The State Department of Social
Services shall license a community treatment facility for a specified
number of secure beds and a specified number of nonsecure beds. The
number of secure and nonsecure beds in a facility shall be modified
only with the approval of both the State Department of Social
Services and the State Department of Mental Health
Care Services .
(c) The State Department of Mental Health
Care Services shall develop, with the advice of the State
Department of Social Services, county representatives, providers, and
interested parties, the criteria to be used to determine which
programs among applicant providers shall be licensed. The State
Department of Mental Health Care Services
shall determine which agencies best meet the criteria, certify
them in accordance with Section 4094, and refer them to the State
Department of Social Services for licensure.
(d) Any community treatment facility proposing to serve seriously
emotionally disturbed foster children shall be incorporated as a
nonprofit organization.
(e) No later than January 1, 1996, the State Department of Mental
Health shall submit its recommendation to the appropriate policy
committees of the Legislature relative to the limitation on the
number of beds set forth in this section.
SEC. 68. Section 4095 of the Welfare
and Institutions Code is amended to read:
4095. (a) It is the intent of the Legislature that essential and
culturally relevant mental health assessment, case management, and
treatment services be available to wards of the court and dependent
children of the court placed out of home or who are at risk of
requiring out-of-home care. This can be best achieved at the
community level through the active collaboration of county social
service, probation, education, mental health agencies, and foster
care providers.
(b) Therefore, using the Children's Mental Health Services Act
(Part 4 (commencing with Section 5850) of Division 5) as a guideline,
the State Department of Mental Health Care
Services , in consultation with the California
Conference of Local Mental Health Directors
Association , the State Department of Social Services, the
County Welfare Directors Association, the Chief Probation
Officer's Association Officers of California ,
county alcohol and drug program administrators, and foster care
providers, shall do all of the following:
(1) By July 1, 1994, develop an individualized mental health
treatment needs assessment protocol for wards of the court and
dependent children of the court.
(2) Define supplemental services to be made available to the
target population, including, but not limited to, services defined in
Section 540 and following of Title 9 of the California Code of
Regulations as of January 1, 1994, family therapy, prevocational
services, and crisis support activities.
(3) Establish statewide standardized rates for the various types
of services defined by the department in accordance with paragraph
(2), and provided pursuant to this section. The rates shall be
designed to reduce the impact of competition for scarce treatment
resources on the cost and availability of care. The rates shall be
implemented only when the state provides funding for the services
described in this section.
(4) By January 1, 1994, to the extent state funds are available to
implement this section, establish, by regulation, all of the
following:
(A) Definitions of priority ranking of subsets of the court wards
and dependents target population.
(B) A procedure to certify the mental health programs.
(c) (1) Only those individuals within the target population as
defined in regulation and determined to be eligible for services as a
result of a mental health treatment needs assessment may receive
services pursuant to this section.
(2) Allocation of funds appropriated for the purposes of this
section shall be based on the number of wards and dependents and may
be adjusted in subsequent fiscal years to reflect costs.
(3) The counties shall be held harmless for failure to provide any
assessment, case management, and treatment services to those
children identified in need of services for whom there is no funding.
(d) (1) The department The State
Department of Health Care Services shall make information
available to the Legislature, on request, on the service populations
provided mental health treatment services pursuant to this section,
the types and costs of services provided, and the number of children
identified in need of treatment services who did not receive the
services.
(2) The information required by paragraph (1) may include
information on need, cost, and service impact experience from the
following:
(A) Family preservation pilot programs.
(B) Pilot programs implemented under the former Children's Mental
Health Services Act, as contained in Chapter 6.8 (commencing with
Section 5565.10) of Part 1 of Division 5.
(C) Programs implemented under Chapter 26 (commencing with Section
7570) of Division 7 of Title 1 of the Government Code and Section
11401.
(D) County experience in the implementation of Section 4096.
SEC. 69. Section 4096.5 of the Welfare
and Institutions Code is amended to read:
4096.5. (a) The department The State
Department of Health Care Services shall make a determination,
within 45 days of receiving a request from a group home to be
classified at RCL 13 or RCL 14 pursuant to Section 11462.01, to
certify or deny certification that the group home program includes
provisions for mental health treatment services that meet the needs
of seriously emotionally disturbed children. The department shall
issue each certification for a period of one year and shall specify
the effective date the program met the certification requirements. A
program may be recertified if the program continues to meet the
criteria for certification.
(b) The department The State Department of
Health Care Services shall, in consultation with the
Conference of Local California Mental Health
Directors Association and representatives of provider
organizations, develop the criteria for the certification required by
subdivision (a) by July 1, 1992.
(c) (1) The department The
State Department of Health Care Services may, upon the request
of a county, delegate to that county the certification task.
(2) Any county to which the certification task is delegated
pursuant to paragraph (1) shall use the criteria and format developed
by the department.
(d) The department The State Department of
Health Care Services or delegated county shall notify the
State Department of Social Services Community Care Licensing Division
immediately upon the termination of any certification issued in
accordance with subdivision (a).
SEC. 70. Chapter 5 (commencing with Section 4097)
of Part 1 of Division 4 of the Welfare and Institutions
Code is repealed.
SEC. 71. Section 4098.2 of the Welfare
and Institutions Code is amended to read:
4098.2. (a) The State Department of Mental Health
Health Care Services , contingent upon
appropriation in the annual Budget Act, may establish and implement a
suicide prevention, education, and gatekeeper training program to
reduce the severity, duration, and incidence of suicidal behaviors.
(b) In developing and implementing the components of this program,
the department shall build upon the existing network of nonprofit
suicide prevention programs in the state, and shall utilize the
expertise of existing suicide prevention programs that meet any of
the following criteria:
(1) Have been identified by a county as providing suicide
prevention services for that county.
(2) Are certified by the American Association of Suicidology.
(3) Meet criteria for suicide prevention programs that may be
established by the department.
(c) The program established by this section shall be consistent
with the public health model proposed by the Surgeon General of the
United States, and the system of care approach pursuant to the
Bronzan-McCorquodale Act, Part Act (Part
2 (commencing with Section 5600) of Division 5.
5).
SEC. 72. Section 4340 of the
Welfare and Institutions Code is amended to read:
4340. The department shall The State
Department of Health Care Services may maintain a statewide
mental health prevention program directed toward a reduction in the
need for utilization of the treatment system and the development and
strengthening of community support and self-help networks. The
department shall State Department of State
Hospitals may support the establishment of self-help groups,
which may be facilitated by an outside entity, subject to the
approval of the hospital administrator, at state hospitals.
SEC. 73. Section 4369.4 of the Welfare
and Institutions Code is amended to read:
4369.4. All state agencies, including, but not limited to, the
California Horse Racing Board, the California Gambling Control
Commission, the Department of Justice, and any other agency that
regulates casino gambling or cardrooms within the state, and the
Department of Corrections and Rehabilitation ,
the California Youth Authority the Department of
Corrections and Rehabilitation, Division of Juvenile Justice ,
the State Departments Department of
Health Care Services, State Department of
Alcohol and Drug Programs, and Mental Health, and
the California State Lottery, shall coordinate with the office to
ensure that state programs take into account, as much as practicable,
problem and pathological gamblers. The office shall also coordinate
and work with other entities involved in gambling and the treatment
of problem and pathological gamblers.
SEC. 74. Section 4681 of the Welfare
and Institutions Code is amended to read:
4681. By July 1, 1977, and each year thereafter, the
department State Department of Developmental Services
shall establish rates, which shall be reviewed by the state
council. Such rates shall annually be proposed to the Legislature by
March 1 and shall be operative on July 1 of each year, subject to the
appropriation of sufficient funds for such purpose in the Budget
Act. In reviewing the sufficiency of these rates that is required by
March 1, 1985, the department shall take into account the findings
and recommendations of the study conducted by the State Council on
Developmental Disabilities pursuant to Section 4541.
In establishing rates to be paid for out-of-home care, the
department shall include each of the cost elements in this section as
follows:
(a) Rates established for all facilities shall include an adequate
amount to care for "basic living needs" of a person with
developmental disabilities. "Basic living needs" are defined to
include housing (shelter, utilities, and furnishings), food, and
personal care. The amount required for basic living needs shall be
calculated each year as the average cost of an additional normal
child, of the ages of 12 to 17, inclusive, living at home. The amount
for basic living needs shall be adjusted depending on the size of
the out-of-home facility. These amounts shall be adjusted annually to
reflect cost-of-living changes. A redetermination of basic living
costs shall be undertaken every three years by the State Department
of Developmental Services, using the best available estimating
methods.
(b) Rates established for all facilities that provide
direct supervision for persons with developmental disabilities shall
include an amount for "direct supervision." The cost of "direct
supervision" shall reflect the ability of the persons in the facility
to function with minimal, moderate, or intensive supervision.
Minimal supervision means that a developmentally disabled person
needs the assistance of other persons with certain daily activities.
Moderate supervision means that a developmentally disabled person
needs the assistance of other persons with daily activities most of
the time. Intensive supervision means that all the personal and
physical needs of a developmentally disabled person are provided by
other persons. The individual program plan developed pursuant to
Section 4646 shall determine the amount of "direct supervision"
required for each individual. The cost of "direct supervision" is
calculated as the wage costs of care-giving staff depending on the
needs of the person with developmental disabilities. These rates
shall be adjusted annually to reflect wage changes and shall comply
with all federal regulations for hospitals and residential-care
establishments under provisions of the federal Fair Labor Standards
Act.
(c) Rates established for all facilities that provide "special
services" for persons with developmental disabilities shall include
an amount to pay for these "special services" for each person
receiving special services. "Special services" include medical and
dental care and therapeutic, educational, training, or other services
required in the individual program plan of each person. Facilities
shall be paid for providing special services for each individual to
the extent that such services are specified in the person's
individual program plan and the facility is designated provider of
such those special services. Rates of
payment for special services shall be the same as prevailing rates
paid for similar services in the area.
(d) To the extent applicable, rates established for facilities
shall include a reasonable amount for "unallocated services." Such
costs shall be determined using generally accepted accounting
principles. "Unallocated services" means the indirect costs of
managing a facility and includes costs of managerial personnel,
facility operation, maintenance and repair, employee benefits, taxes,
interest, insurance, depreciation, and general and administrative
support. If a facility serves other persons in addition to
developmentally disabled persons, unallocated services expenses shall
be reimbursed under the provision of this section, only for the
proportion of the costs associated with the care of developmentally
disabled persons.
(e) Rates established for facilities shall include an amount to
reimburse facilities for the depreciation of "mandated capital
improvements and equipment" as established in the state's uniform
accounting manual. For purposes of this section, "mandated capital
improvements and equipment" are only those remodeling and equipment
costs incurred by a facility because an agency of government has
required such remodeling or equipment as a condition for the use of
the facility as a provider of out-of-home care to persons with
developmental disabilities.
(f) When applicable, rates established for proprietary facilities
shall include a reasonable "proprietary fee."
(g) Rates established for all facilities shall include as a
"factor" an amount to reflect differences in the cost of living for
different geographic areas in the state.
(h) Rates established for developmentally disabled persons who are
also mentally disordered may be fixed at a higher rate. The
State Department of Mental Health shall establish criteria upon
which higher rates may be fixed pursuant to this subdivision.
The higher rate for developmentally disabled persons who
are also mentally disordered may be paid when requested by the
director of the regional center and approved by the Director of
Developmental Services.
This section shall apply to rates for facilities not participating
in the alternative residential care rate model originally authorized
in Item 4300-101-001 of the Budget Act of 1985, and as identified in
the department's report of April 1987 entitled Alternative
Residential Model (ARM).
(i) Except as provided in subdivision (j), this section shall
remain in effect only until January 1, 1991, and as of that date is
repealed, unless a later enacted statute, which is enacted before
January 1, 1991, deletes or extends that date.
(j) This section shall not be repealed until the State Department
of Developmental Services achieves statewide implementation of the
Alternative Residential Model.
SEC. 75. Section 4681.1 of the Welfare
and Institutions Code is amended to read:
4681.1. (a) The department shall adopt regulations that specify
rates for community care facilities serving persons with
developmental disabilities. The implementation of the regulations
shall be contingent upon an appropriation in the annual Budget Act
for this purpose. These rates shall be calculated on the basis of a
cost model designed by the department which ensures that aggregate
facility payments support the provision of services to each person in
accordance with his or her individual program plan and applicable
program requirements. The cost model shall reflect cost elements that
shall include, but are not limited to, all of the following:
(1) "Basic living needs" include utilities, furnishings, food,
supplies, incidental transportation, housekeeping, personal care
items, and other items necessary to ensure a quality environment for
persons with developmental disabilities. The amount identified for
the basic living needs element of the rate shall be calculated as the
average projected cost of these items in an economically and
efficiently operated community care facility.
(2) "Direct care" includes salaries, wages, benefits, and other
expenses necessary to supervise or support the person's functioning
in the areas of self-care and daily living skills, physical
coordination mobility, and behavioral self-control, choice making,
and integration. The amount identified for direct care shall be
calculated as the average projected cost of providing the level of
service required to meet each person's functional needs in an
economically and efficiently operated community care facility. The
direct care portion of the rate shall reflect specific service levels
defined by the department on the basis of relative resident need and
the individual program plan.
(3) "Special services" include specialized training, treatment,
supervision, or other services which a person's individual program
plan requires to be provided by the residential facility in addition
to the direct care provided under paragraph (2). The amount
identified for special services shall be calculated for each
individual based on the additional services specified in the person's
individual program plan and the prevailing rates paid for similar
services in the area. The special services portion of the rate shall
reflect a negotiated agreement between the facility and the regional
center in accordance with Section 4648.
(4) "Indirect costs" include managerial personnel, facility
operation, maintenance and repair, other nondirect care, employee
benefits, contracts, training, travel, licenses, taxes, interest,
insurance, depreciation, and general administrative expenses. The
amount identified for indirect costs shall be calculated as the
average projected cost for these expenses in an economically and
efficiently operated community care facility.
(5) "Property costs" include mortgages, leases, rent, taxes,
capital or leasehold improvements, depreciation, and other expenses
related to the physical structure. The amount identified for property
costs shall be based on the fair rental value of a model facility
which is adequately designed, constructed, and maintained to meet the
needs of persons with developmental disabilities. The amount
identified for property costs shall be calculated as the average
projected fair rental value of an economically and efficiently
operated community care facility.
(b) The cost model shall take into account factors which include,
but are not limited to, all of the following:
(1) Facility size, as defined by the department on the basis of
the number of facility beds licensed by the State Department of
Social Services and vendorized by the regional center.
(2) Specific geographic areas, as defined by the department on the
basis of cost of living and other pertinent economic indicators.
(3) Common levels of direct care, as defined by the department on
the basis of services specific to an identifiable group of persons as
determined through the individual program plan.
(4) Positive outcomes, as defined by the department on the basis
of increased integration, independence, and productivity at the
aggregate facility and individual consumer level.
(5) Owner-operated and staff-operated reimbursement which shall,
not differ for facilities that are required to comply with the same
program requirements.
(c) The rates established for individual community care facilities
serving persons with developmental disabilities shall reflect all of
the model cost elements and rate development factors described in
this section. The cost model design shall include a process for
updating the cost model elements that address variables, including,
but not limited to, all of the following:
(1) Economic trends in California.
(2) New state or federal program requirements.
(3) Changes in the state or federal minimum wage.
(4) Increases in fees, taxes, or other business costs.
(5) Increases in federal supplemental security income/state
supplementary program for the aged, blind, and disabled payments.
(d) Rates established for developmentally disabled persons who are
also dually diagnosed with a mental disorder may be fixed at a
higher rate. The department shall work with the State Department of
Mental Health Care Services to
establish criteria upon which higher rates may be fixed pursuant to
this subdivision. The higher rate for developmentally disabled
persons who are also dually diagnosed with a mental disorder may be
paid when requested by the director of the regional center and
approved by the Director of Developmental Services.
(e) By January 1, 2001, the department shall prepare proposed
regulations to implement the changes outlined in this section. The
department may use a private firm to assist in the development of
these changes and shall confer with consumers, providers, and other
interested parties concerning the proposed regulations. By May 15,
2001, and each year thereafter, the department shall provide the
Legislature with annual community care facility rates, including any
draft amendments to the regulations as required. By July 1, 2001, and
each year thereafter, contingent upon an appropriation in the annual
Budget Act for this purpose, the department shall adopt emergency
regulations which establish the annual rates for community care
facilities serving persons with developmental disabilities for each
fiscal year.
(f) During the first year of operation under the revised rate
model, individual facilities shall be held harmless for any reduction
in aggregate facility payments caused solely by the change in
reimbursement methodology.
SEC. 76. Section 4696.1 of the Welfare
and Institutions Code is amended to read:
4696.1. (a) The Legislature finds and declares that improved
cooperative efforts between regional centers and county mental health
agencies are necessary in order to achieve each of the following:
(1) Increased leadership, communication, and organizational
effectiveness between regional centers and county mental health
agencies.
(2) Decreased costs and minimized fiscal risk in serving persons
who are dually diagnosed with mental illness and developmental
disabilities.
(3) Continuity of services.
(4) Improved quality of mental health outcomes for persons who are
dually diagnosed.
(5) Optimized utilization of agency resources by building on the
strengths of each organization.
(6) Timely resolution of conflicts.
(b) In order to achieve the outcomes specified in subdivision (a),
by July 1, 1999, each regional center and county mental health
agency shall develop a memorandum of understanding to do all of the
following:
(1) Identify staff who will be responsible for all of the
following:
(A) Coordinate service activity between the two agencies.
(B) Identify dually diagnosed consumers of mutual concern.
(C) Conduct problem resolution for those consumers serviced by
both systems.
(2) Develop a general plan for crisis intervention for persons
served by both systems. The plan shall include after-hours emergency
response systems, interagency notification guidelines, and followup
protocols.
(3) Develop a procedure by which each dually diagnosed consumer
shall be the subject of a case conference conducted jointly by both
regional center staff and county mental health as soon as possible
after admission into a county operated or contracted acute, inpatient
mental health facility. The case conference shall confirm the
diagnosis and the treatment plan.
(4) Develop a procedure by which planning for dually diagnosed
consumers admitted to a mental health inpatient facility shall be
conducted collaboratively by both the regional center and the local
mental health agency and shall commence as soon as possible or as
deemed appropriate by the treatment staff. The discharge plan shall
include subsequent treatment needs and the agency responsible for
those services.
(5) Develop a procedure by which regional center staff and county
mental health staff shall collaborate to plan and provide training to
community service providers, including day programs, residential
facilities, and intermediate care facilities, regarding effective
services to persons who are dually diagnosed. This training shall
include crisis prevention with a focus on proactively recognizing
crisis and intervening effectively with consumers who are dually
diagnosed.
(6) Develop a procedure by which the regional center and the
county mental health agency shall work toward agreement on a
consumer-by-consumer basis on the presenting diagnosis and medical
necessity, as defined by regulations of the State Department of
Mental Health Care Services .
(c) The department and the State Department of Mental
Health Care Services shall collaborate to
provide a statewide perspective and technical assistance to local
service regions when local problem resolution mechanisms have been
exhausted and state level participation has been requested by both
local agencies.
(d) The director of the local regional center and the director of
the county mental health agency or their designees shall meet as
needed but no less than annually to do all of the following:
(1) Review the effectiveness of the interagency collaboration.
(2) Address any outstanding policy issues between the two
agencies.
(3) Establish the direction and priorities for ongoing
collaboration efforts between the two agencies.
(e) Copies of each memorandum of understanding shall be forwarded
to the State Department of Developmental Services upon completion or
whenever amended. The department shall make copies of the memorandum
of understanding available to the public upon request.
(f) By May 15 of each year, the department shall provide all of
the following information to the Legislature:
(1) The status of the memorandums of understanding developed
jointly by each regional center and the county mental health agency
and identify any barriers to meeting the outcomes specified in this
section.
(2) The availability of mobile crisis intervention services,
including generic services, by regional center catchment area,
including the names of vendors and rates paid.
(3) A description of each regional center's funded emergency
housing options, including the names and types of vendors, the number
of beds and rates, including, but not limited to, crisis emergency
group homes, crisis beds in a regular group home, crisis foster
homes, motel or hotel or psychiatric facility beds, and whether each
emergency housing option serves minors or adults and whether it is
physically accessible.
SEC. 77. Section 4835 of the Welfare
and Institutions Code is amended to read:
4835. The Director of Developmental Services may establish
uniform operational procedures, performance and evaluation standards
and utilization criteria for designated agencies pursuant to this
chapter.
These standards and criteria shall be developed with participation
by consumer organizations, area boards on developmental
disabilities, the Association of Regional Center Agencies, the
State Department of Social Services, the State
Department of Health Care Services, the State
Department of Education, and the Department of
Rehabilitation, and the Department of Mental Health
and consultations with individuals with experience in
developmental services programming.
SEC. 78. Section 4844 of the Welfare
and Institutions Code is amended to read:
4844. The Director of Developmental Services shall initiate and
monitor interagency performance agreements between the Department of
Rehabilitation, the Department of Mental Health,
the State Department of Health Care Services,
the State Department of Social Services, and the
Department of Housing and Community Development to assure
ensure planning, coordination , and
resource sharing.
SEC. 79. Section 5150 of the Welfare
and Institutions Code is amended to read:
5150. When any person, as a result of mental disorder, is a
danger to others, or to himself or herself, or gravely disabled, a
peace officer, member of the attending staff, as defined by
regulation, of an evaluation facility designated by the county,
designated members of a mobile crisis team provided by Section
5651.7, or other professional person designated by the county may,
upon probable cause, take, or cause to be taken, the person into
custody and place him or her in a facility designated by the county
and approved by the State Department of Mental Health
Social Services as a facility for 72-hour
treatment and evaluation.
Such
The facility shall require an application in writing
stating the circumstances under which the person's condition was
called to the attention of the officer, member of the attending
staff, or professional person, and stating that the officer, member
of the attending staff, or professional person has probable cause to
believe that the person is, as a result of mental disorder, a danger
to others, or to himself or herself, or gravely disabled. If the
probable cause is based on the statement of a person other than the
officer, member of the attending staff, or professional person,
such the person shall be liable in a
civil action for intentionally giving a statement which he or she
knows to be false.
SEC. 80. Section 5151 of the Welfare
and Institutions Code is amended to read:
5151. If the facility for 72-hour treatment and evaluation admits
the person, it may detain him or her for evaluation and treatment
for a period not to exceed 72 hours. Saturdays, Sundays, and holidays
may be excluded from the 72-hour period if the State
Department of Mental Health Social Services
certifies for each facility that evaluation and treatment
services cannot reasonably be made available on those days. The
certification by the department is subject to renewal every two
years. The department shall adopt regulations defining criteria for
determining whether a facility can reasonably be expected to make
evaluation and treatment services available on Saturdays, Sundays,
and holidays.
Prior to admitting a person to the facility for 72-hour treatment
and evaluation pursuant to Section 5150, the professional person in
charge of the facility or his or her designee shall assess the
individual in person to determine the appropriateness of the
involuntary detention.
If in the judgment of the professional person in charge of the
facility providing evaluation and treatment, or his or her designee,
the person can be properly served without being detained, he or she
shall be provided evaluation, crisis intervention, or other inpatient
or outpatient services on a voluntary basis.
Nothing in this section shall be interpreted to prevent a peace
officer from delivering individuals to a designated facility for
assessment under Section 5150. Furthermore, the preadmission
assessment requirement of this section shall not be interpreted to
require peace officers to perform any additional duties other than
those specified in Sections 5150.1 and 5150.2.
SEC. 81. Section 5152 of the Welfare
and Institutions Code is amended to read:
5152. (a) Each person admitted to a facility for 72-hour
treatment and evaluation under the provisions of this article shall
receive an evaluation as soon as possible after he or she is admitted
and shall receive whatever treatment and care his or her condition
requires for the full period that he or she is held. The person shall
be released before 72 hours have elapsed only if the psychiatrist
directly responsible for the person's treatment believes, as a result
of the psychiatrist's personal observations, that the person no
longer requires evaluation or treatment. However, in those situations
in which both a psychiatrist and psychologist have personally
evaluated or examined a person who is placed under a 72-hour hold and
there is a collaborative treatment relationship between the
psychiatrist and psychologist, either the psychiatrist or
psychologist may authorize the release of the person from the hold,
but only after they have consulted with one another. In the event of
a clinical or professional disagreement regarding the early release
of a person who has been placed under a 72-hour hold, the hold shall
be maintained unless the facility's medical director overrules the
decision of the psychiatrist or psychologist opposing the release.
Both the psychiatrist and psychologist shall enter their findings,
concerns, or objections into the person's medical record. If any
other professional person who is authorized to release the person
believes the person should be released before 72 hours have elapsed,
and the psychiatrist directly responsible for the person's treatment
objects, the matter shall be referred to the medical director of the
facility for the final decision. However, if the medical director is
not a psychiatrist, he or she shall appoint a designee who is a
psychiatrist. If the matter is referred, the person shall be released
before 72 hours have elapsed only if the psychiatrist making the
final decision believes, as a result of the psychiatrist's personal
observations, that the person no longer requires evaluation or
treatment.
(b) Any person who has been detained for evaluation and treatment
shall be released, referred for further care and treatment on a
voluntary basis, or certified for intensive treatment, or a
conservator or temporary conservator shall be appointed pursuant to
this part as required.
(c) A person designated by the mental health facility shall give
to any person who has been detained at that facility for evaluation
and treatment and who is receiving medication as a result of his or
her mental illness, as soon as possible after detention, written and
oral information about the probable effects and possible side effects
of the medication. The State Department of Mental Health
Health Care Services shall develop and
promulgate written materials on the effects of medications, for use
by county mental health programs as disseminated or as modified by
the county mental health program, addressing the probable effects and
the possible side effects of the medication. The following
information shall be given orally to the patient:
(1) The nature of the mental illness, or behavior, that is the
reason the medication is being given or recommended.
(2) The likelihood of improving or not improving without the
medication.
(3) Reasonable alternative treatments available.
(4) The name and type, frequency, amount, and method of dispensing
the medication, and the probable length of time the medication will
be taken.
The fact that the information has or has not been given shall be
indicated in the patient's chart. If the information has not been
given, the designated person shall document in the patient's chart
the justification for not providing the information. A failure to
give information about the probable effects and possible side effects
of the medication shall not constitute new grounds for release.
(d) The amendments to this section made by Assembly Bill 348 of
the 2003-04 Regular Session shall not be construed to revise or
expand the scope of practice of psychologists, as defined in Chapter
6.6 (commencing with Section 2900) of Division 2 of the Business and
Professions Code.
SEC. 82. Section 5157 of the Welfare
and Institutions Code is amended to read:
5157. (a) Each person, at the time he or she is first taken into
custody under provisions of Section 5150, shall be provided, by the
person who takes such other person into custody, the following
information orally. The information shall be in substantially the
following form:
My name is ___________________________________ .
I am a ______________________________
(peace officer, mental health
______________ .
professional)
with ________________________ .
(name of agency)
You are not under criminal arrest, but I am
taking you for examination by mental health
professionals at _____________________________ .
____________________
(name of facility)
You will be told your rights by the mental
health staff.
If taken into custody at his or her residence,
the person shall also be told the following
information in substantially the following form:
You may bring a few personal items with you
which I will have to approve. You can make a
phone call and/or leave a note to tell your
friends and/or family where you have been taken.
(b) The designated facility shall keep, for each patient
evaluated, a record of the advisement given pursuant to subdivision
(a) which shall include:
(1) Name of
person detained for evaluation.
(2) Name and position of peace officer or mental health
professional taking person into custody.
(3) Date.
(4) Whether advisement was completed.
(5) If not given or completed, the mental health professional at
the facility shall either provide the information specified in
subdivision (a), or include a statement of good cause, as defined by
regulations of the State Department of Mental Health
Social Services , which shall be kept with the
patient's medical record.
(c) Each person admitted to a designated facility for 72-hour
evaluation and treatment shall be given the following information by
admission staff at the evaluation unit. The information shall be
given orally and in writing and in a language or modality accessible
to the person. The written information shall be available in the
person's native language or the language which is the person's
principal means of communication. The information shall be in
substantially the following form:
My name is ____________________________________.
My position here is____________________________.
You are being placed into the psychiatric unit
because it is our professional opinion that as
a result of mental disorder, you are likely to:
(check
applicable)
harm yourself
____
harm someone else
____
be unable to take care of your
own
food, clothing, and housing needs
____
We feel this is true because
________________________________________________
(herewith a listing of the facts upon which the
allegation of dangerous
or gravely disabled due to mental disorder is
based, including pertinent
facts arising from the admission interview.)
You will be held on the ward for a period up
to 72
hours.
This does not include weekends or holidays.
Your 72-hour period will begin ____________
(day
__________________
and time.)
During these 72 hours you will be evaluated by
the hospital staff, and you may be given
treatment, including medications. It is
possible for you to be released before the end
of the 72 hours. But if the staff decides that
you need continued treatment you can be
held for a longer period of time. If you are
held longer than 72 hours you have the right to
a lawyer and a qualified interpreter and a
hearing before a judge. If you are unable to
pay for the lawyer, then one will be provided
free.
(d) For each patient admitted for 72-hour evaluation and
treatment, the facility shall keep with the patient's medical record
a record of the advisement given pursuant to subdivision (c) which
shall include:
(1) Name of person performing advisement.
(2) Date.
(3) Whether advisement was completed.
(4) If not completed, a statement of good cause.
If the advisement was not completed at admission, the advisement
process shall be continued on the ward until completed. A record of
the matters prescribed by subdivisions (a), (b), and (c) shall be
kept with the patient's medical record.
SEC. 83. Section 5202 of the Welfare
and Institutions Code is amended to read:
5202. The person or agency designated by the county shall prepare
the petition and all other forms required in the proceeding, and
shall be responsible for filing the petition. Before filing the
petition, the person or agency designated by the county shall request
the person or agency designated by the county and approved by the
State Department of Mental Health Social
Services to provide prepetition screening to determine whether
there is probable cause to believe the allegations. The person or
agency providing prepetition screening shall conduct a reasonable
investigation of the allegations and make a reasonable effort to
personally interview the subject of the petition. The screening shall
also determine whether the person will agree voluntarily to receive
crisis intervention services or an evaluation in his own home or in a
facility designated by the county and approved by the State
Department of Mental Health Social Services
. Following prepetition screening, the person or agency
designated by the county shall file the petition if satisfied that
there is probable cause to believe that the person is, as a result of
mental disorder, a danger to others, or to himself or herself, or
gravely disabled, and that the person will not voluntarily receive
evaluation or crisis intervention.
If the petition is filed, it shall be accompanied by a report
containing the findings of the person or agency designated by the
county to provide prepetition screening. The prepetition screening
report submitted to the superior court shall be confidential and
shall be subject to the provisions of Section 5328.
SEC. 84. Section 5270.12 of the Welfare
and Institutions Code is amended to read:
5270.12. This article shall be operative only in those counties
in which the county board of supervisors, by resolution, authorizes
its application and, by resolution, makes a finding that any
additional costs incurred by the county in the implementation of this
article are funded either by new funding sufficient to cover the
costs incurred by the county resulting from this article, or funds
redirected from cost savings resulting from this article, or a
combination thereof, so that no current service reductions will occur
as a result of the enactment of this article. Compliance with this
section shall be monitored by the State Department of
Mental Health Care Services as part of
their its review and approval of
county Short-Doyle plans mental health plans
and performance contracts .
SEC. 85. Section 5325 of the Welfare
and Institutions Code is amended to read:
5325. Each person involuntarily detained for evaluation or
treatment under provisions of this part, and each person
admitted as a voluntary patient for psychiatric evaluation or
treatment to any health facility, as defined in Section 1250 of the
Health and Safety Code, in which psychiatric evaluation or treatment
is offered, and each mentally retarded shall
have the following rights, a list of which shall be prominently
posted in the predominant languages of the community and explained in
a language or modality accessible to the patient in all
facilities providing those services, and otherwise brought to his or
her attention by any additional means as the Director of Health Care
Services may designate by regulation. Each person committed to
a state hospital pursuant to Article 5 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6 shall
also have the following rights, a list of which shall be
prominently posted in the predominant languages of the community and
explained in a language or modality accessible to the patient in all
facilities providing such those
services and otherwise brought to his or her attention by
such any additional means as the Director of
Mental Health State Hospitals may
designate by regulation:
(a) To wear his or her own clothes; to keep and use his or her own
personal possessions including his or her toilet articles; and to
keep and be allowed to spend a reasonable sum of his or her own money
for canteen expenses and small purchases.
(b) To have access to individual storage space for his or her
private use.
(c) To see visitors each day.
(d) To have reasonable access to telephones, both to make and
receive confidential calls or to have such calls made for them.
(e) To have ready access to letterwriting materials, including
stamps, and to mail and receive unopened correspondence.
(f) To refuse convulsive treatment including, but not limited to,
any electroconvulsive treatment, any treatment of the mental
condition which depends on the induction of a convulsion by any
means, and insulin coma treatment.
(g) To refuse psychosurgery. Psychosurgery is defined as those
operations currently referred to as lobotomy, psychiatric surgery,
and behavioral surgery , and all other forms of brain
surgery if the surgery is performed for the purpose of any of the
following:
(1) Modification or control of thoughts, feelings, actions, or
behavior rather than the treatment of a known and diagnosed physical
disease of the brain.
(2) Modification of normal brain function or normal brain tissue
in order to control thoughts, feelings, actions, or behavior.
(3) Treatment of abnormal brain function or abnormal brain tissue
in order to modify thoughts, feelings, actions or behavior when the
abnormality is not an established cause for those thoughts, feelings,
actions, or behavior.
Psychosurgery does not include prefrontal sonic treatment wherein
there is no destruction of brain tissue. The Director of
Mental Health Care Services and the Director of State
Hospitals shall promulgate appropriate regulations to assure
adequate protection of patients' rights in such treatment.
(h) To see and receive the services of a patient advocate who has
no direct or indirect clinical or administrative responsibility for
the person receiving mental health services.
(i) Other rights, as specified by regulation.
Each patient shall also be given notification in a language or
modality accessible to the patient of other constitutional and
statutory rights which are found by the State Department of
Mental Health Care Services and the State Department
of State Hospitals to be frequently misunderstood, ignored, or
denied.
Upon admission to a facility each patient , involuntarily
detained for evaluation or treatment under provisions of this part,
or as a voluntary patient for psychiatric evaluation or treatment to
a health facility, as defined in Section 1250 of the Health and
Safety Code, in which psychiatric evaluation or treatment is offered,
shall immediately be given a copy of a State Department of
Mental Health Care Services prepared
patients' rights handbook. Each person committed to a state
hospital, upon admission, shall immediately be given a copy of a
State Department of State Hospitals prepared patients' rights
handbook.
The State Department of Mental Health Care
Services and the State Department of State Hospitals shall
prepare and provide the forms specified in this section and
. The State Department of Health Care
Services shall prepare and provide the forms specified in
Section 5157.
The rights specified in this section may not be waived by the
person's parent, guardian, or conservator.
SEC. 86. Section 5326 of the Welfare
and Institutions Code is amended to read:
5326. The professional person in charge of the facility or
state hospital or his or her designee may, for good cause, deny
a person any of the rights under Section 5325, except under
subdivisions (g) and (h) and the rights under subdivision (f) may be
denied only under the conditions specified in Section 5326.7. To
ensure that these rights are denied only for good cause, the Director
of Mental Health Care Services and Director
of State Hospitals shall adopt regulations specifying the
conditions under which they may be denied. Denial of a person's
rights shall in all cases be entered into the person's treatment
record.
SEC. 87. Section 5326.1 of the Welfare
and Institutions Code is amended to read:
5326.1. Quarterly, each local mental health director shall
furnish to the Director of Mental Health Care
Services , the facility reports of the number of persons whose
rights were denied and the right or rights which were denied. The
content of the reports from facilities shall enable the local mental
health director and Director of Mental Health
Care Services to identify individual treatment records, if
necessary, for further analysis and investigation. These quarterly
reports, except for the identity of the person whose rights are
denied, shall be available, upon request, to Members of the State
Legislature, or a member of a county board of supervisors.
Notwithstanding any other provision of law, information pertaining
to denial of rights contained in the person's treatment record shall
be made available, on request, to the person, his or her attorney,
his or her conservator or guardian, the local mental health director,
or his or her designee, or the Patient's Rights Office
Patients' Rights program of the State Department
of Mental Health Care Services . The
information may include consent forms, required documentation for
convulsive treatment, documentation regarding the use of restraints
and seclusion, physician's orders, nursing notes, and involuntary
detention and conservatorship papers. The information, except for the
identity of the person whose rights are denied, shall be made
available to the Members of the State Legislature or a member of a
county board of supervisors.
SEC. 88. Section 5326.15 of the
Welfare and Institutions Code is amended to read:
5326.15. (a) Quarterly, any doctor or facility which administers
convulsive treatments or psychosurgery, shall report to the local
mental health director, who shall transmit a copy to the Director of
Mental Health Care Services , the
number of persons who received such treatments wherever administered,
in each of the following categories:
(1) Involuntary patients who gave informed consent.
(2) Involuntary patients who were deemed incapable of giving
informed consent and received convulsive treatment against their
will.
(3) Voluntary patients who gave informed consent.
(4) Voluntary patients deemed incapable of giving consent.
(b) Quarterly, the State Department of State Hospitals shall
report to the Director of Health Care Services the number of persons
who received such treatments wherever administered, in each of the
following categories:
(1) Involuntary patients who gave informed consent.
(2) Involuntary patients who were deemed incapable of giving
informed consent and received convulsive treatment against their
will.
(3) Voluntary patients who gave informed consent.
(4) Voluntary patients deemed incapable of giving consent.
(b)
(c) Quarterly, the Director of Mental
Health Care Services shall forward to the
Medical Board of California any records or information received from
such these reports indicating violation
of the law, and the regulations which have been adopted thereto.
SEC. 89. Section 5326.3 of the Welfare
and Institutions Code is amended to read:
5326.3. The State Department of Mental Health
Care Services and State Department of State Hospitals
shall promulgate a standard written consent form, setting forth
clearly and in detail the matters listed in Section 5326.2, and
such any further information with
respect to each item as deemed generally appropriate to all patients.
The treating physician shall utilize the standard written consent
form and in writing supplement it with those details which pertain to
the particular patient being treated.
SEC. 90. Section 5326.8 of the Welfare
and Institutions Code is amended to read:
5326.8. Under no circumstances shall convulsive treatment be
performed on a minor under 12 years of age. Persons 16 and 17 years
of age shall personally have and exercise the rights under this
article.
Persons 12 years of age and over, and under 16, may be
administered convulsive treatment only if all the other provisions of
this law are complied with and in addition:
(a) It is an emergency situation and convulsive treatment is
deemed a lifesaving treatment.
(b) This fact and the need for and appropriateness of the
treatment are unanimously certified to by a review board of three
board-eligible or board-certified child psychiatrists appointed by
the local mental health director.
(c) It is otherwise performed in full compliance with regulations
promulgated by the Director of Mental Health
State Hospitals under Section 5326.95.
(d) It is thoroughly documented and reported immediately to the
Director of Mental Health Care Services
.
SEC. 91. Section 5326.9 of the Welfare
and Institutions Code is amended to read:
5326.9. (a) Any alleged or suspected violation of the rights
described in Chapter 2 (commencing with Section 5150) shall be
investigated by the local director of mental health, or his or her
designee. Violations of Sections 5326.2 to 5326.8, inclusive,
concerning patients involuntarily detained for evaluation
or treatment under this part, or as a voluntary patient for
psychiatric evaluation or treatment to a health facility, as defined
in Section 1250 of the Health and Safety Code, in which psychiatric
evaluation or treatment is offered, shall also be investigated
by the Director of Mental Health Care
Services , or his or her designee. Violations of Sections
5326.2 to 5326.8, inclusive, concerning persons committed to a state
hospital shall also be investigated by the Director of State
Hospitals, or his or her designee. If it is determined by the
local director of mental health or , the
Director of Mental Health Care
Services, or the Director of State Hospitals that a right has
been violated, a formal notice of violation shall be issued.
(b) Either the local director of mental health or the Director of
Mental Health Care Services, upon
issuing a notice of violation , may take any or all of the
following action:
(1) Assign a specified time period during which the violation
shall be corrected.
(2) Referral to the Medical Board of California or other
professional licensing agency. Such board shall investigate further,
if warranted, and shall subject the individual practitioner to any
penalty the board finds necessary and is authorized to impose.
(3) Revoke Make a
recommendation to the State Department of Social Services to revoke
the approval of the county facility designation. The local director
of mental health may revoke a facility's designation and
authorization under Section 5404 to evaluate and treat persons
detained involuntarily.
(4) Refer any violation of law to a local district attorney or the
Attorney General for prosecution in any court with jurisdiction.
(c) The Director of State Hospitals, upon issuing a notice of
violation, may take any or all of the following actions:
(1) Assign a specified time period during which the violation
shall be corrected.
(2) Make a referral to the Medical Board of California or other
professional licensing agency. The board or agency shall investigate
further, if warranted, and shall subject the individual practitioner
to any penalty the board finds necessary and is authorized to impose.
(3) Refer any violation of law to a local district attorney or the
Attorney General for prosecution in any court with jurisdiction.
(c)
(d) Any physician who intentionally violates Sections
5326.2 to 5326.8, inclusive, shall be subject to a civil penalty of
not more than five thousand dollars ($5,000) for each violation.
Such The penalty may be assessed and
collected in a civil action brought by the Attorney General in a
superior court. Such intentional violation shall be grounds for
revocation of license.
(d)
(e) Any person or facility found to have knowingly
violated the provisions of the first paragraph of Section 5325.1 or
to have denied without good cause any of the rights specified in
Section 5325 shall pay a civil penalty, as determined by the court,
of fifty dollars ($50) per day during the time in which the violation
is not corrected, commencing on the day on which a notice of
violation was issued, not to exceed one thousand dollars ($1,000),
for each and every violation, except that any liability under this
provision shall be offset by an amount equal to a fine or penalty
imposed for the same violation under the provisions of Sections 1423
to 1425, inclusive, or 1428 of the Health and Safety Code. These
penalties shall be deposited in the general fund of the county in
which the violation occurred. The local district attorney or the
Attorney General shall enforce this section in any court with
jurisdiction. Where the State Department of Public Health
Services , under the provisions of Sections 1423
to 1425, inclusive, of the Health and Safety Code, determines that no
violation has occurred, the provisions of paragraph (4) of
subdivision (b) shall not apply.
(e)
(f) The remedies provided by this subdivision shall be
in addition to and not in substitution for any other remedies which
an individual may have under law.
SEC. 92. Section 5326.91 of the Welfare
and Institutions Code is amended to read:
5326.91. In any facility in which convulsive treatment is
performed on a person whether admitted to the facility as an
involuntary or voluntary patient, the facility will designate a
qualified committee to review all such treatments and to verify the
appropriateness and need for such treatment. The local mental health
director shall establish a postaudit review committee for convulsive
treatments administered anywhere other than in any facility as
defined in Section 1250 of the Health and Safety Code in which
psychiatric evaluation or treatment is offered. Records of these
committees will be subject to availability in the same manner as are
the records of other hospital utilization and audit committees and to
such other regulations as are
promulgated by the Director of Mental Health . Persons
serving on such these review committees
will enjoy the same immunities as other persons serving on
utilization, peer review, and audit committees of health care
facilities.
SEC. 93. Section 5326.95 of the Welfare
and Institutions Code is amended to read:
5326.95. The Director of Mental Health
State Hospitals shall adopt regulations to carry out the
provisions of this chapter, including standards defining excessive
use of convulsive treatment which shall be developed in consultation
with the conference of local mental health directors
State Department of Health Care Services and the
California Mental Health Directors Association .
SEC. 94. Section 5328 of the Welfare
and Institutions Code is amended to read:
5328. All information and records obtained in the course of
providing services under Division 4 (commencing with Section 4000),
Division 4.1 (commencing with Section 4400), Division 4.5 (commencing
with Section 4500), Division 5 (commencing with Section 5000),
Division 6 (commencing with Section 6000), or Division 7 (commencing
with Section 7100), to either voluntary or involuntary recipients of
services shall be confidential. Information and records obtained in
the course of providing similar services to either voluntary or
involuntary recipients prior to 1969 shall also be confidential.
Information and records shall be disclosed only in any of the
following cases:
(a) In communications between qualified professional persons in
the provision of services or appropriate referrals, or in the course
of conservatorship proceedings. The consent of the patient, or his or
her guardian or conservator, shall be obtained before information or
records may be disclosed by a professional person employed by a
facility to a professional person not employed by the facility who
does not have the medical or psychological responsibility for the
patient's care.
(b) When the patient, with the approval of the physician and
surgeon, licensed psychologist, social worker with a master's degree
in social work, licensed marriage and family therapist, or licensed
professional clinical counselor, who is in charge of the patient,
designates persons to whom information or records may be released,
except that nothing in this article shall be construed to compel a
physician and surgeon, licensed psychologist, social worker with a
master's degree in social work, licensed marriage and family
therapist, licensed professional clinical counselor, nurse, attorney,
or other professional person to reveal information that has been
given to him or her in confidence by members of a patient's family.
Nothing in this subdivision shall be construed to authorize a
licensed marriage and family therapist or licensed professional
clinical counselor to provide services or to be in charge of a
patient's care beyond his or her lawful scope of practice.
(c) To the extent necessary for a recipient to make a claim, or
for a claim to be made on behalf of a recipient for aid, insurance,
or medical assistance to which he or she may be entitled.
(d) If the recipient of services is a minor, ward, dependent, or
conservatee, and his or her parent, guardian, guardian ad litem,
conservator, or authorized representative designates, in writing,
persons to whom records or information may be disclosed, except that
nothing in this article shall be construed to compel a physician and
surgeon, licensed psychologist, social worker with a master's degree
in social work, licensed marriage and family therapist, licensed
professional clinical counselor, nurse, attorney, or other
professional person to reveal information that has been given to him
or her in confidence by members of a patient's family.
(e) For research, provided that the Director of Mental
Health Care Services, the Director of State Hospitals,
the Director of Social Services, or the Director of
Developmental Services designates by regulation, rules for the
conduct of research and requires the research to be first reviewed by
the appropriate institutional review board or boards. The rules
shall include, but need not be limited to, the requirement that all
researchers shall sign an oath of confidentiality as follows:
Date
As a condition of doing research concerning persons who have
received services from ____ (fill in the facility, agency or person),
I, ____, agree to obtain the prior informed consent of such persons
who have received services to the maximum degree possible as
determined by the
appropriate institutional review board or boards for protection of
human subjects reviewing my research, and I further agree not to
divulge any information obtained in the course of such research to
unauthorized persons, and not to publish or otherwise make public any
information regarding persons who have received services such that
the person who received services is identifiable.
I recognize that the unauthorized release of confidential
information may make me subject to a civil action under provisions of
the Welfare and Institutions Code.
(f) To the courts, as necessary to the administration of justice.
(g) To governmental law enforcement agencies as needed for the
protection of federal and state elective constitutional officers and
their families.
(h) To the Senate Committee on Rules or the Assembly Committee on
Rules for the purposes of legislative investigation authorized by the
committee.
(i) If the recipient of services who applies for life or
disability insurance designates in writing the insurer to which
records or information may be disclosed.
(j) To the attorney for the patient in any and all proceedings
upon presentation of a release of information signed by the patient,
except that when the patient is unable to sign the release, the staff
of the facility, upon satisfying itself of the identity of the
attorney, and of the fact that the attorney does represent the
interests of the patient, may release all information and records
relating to the patient except that nothing in this article shall be
construed to compel a physician and surgeon, licensed psychologist,
social worker with a master's degree in social work, licensed
marriage and family therapist, licensed professional clinical
counselor, nurse, attorney, or other professional person to reveal
information that has been given to him or her in confidence by
members of a patient's family.
(k) Upon written agreement by a person previously confined in or
otherwise treated by a facility, the professional person in charge of
the facility or his or her designee may release any information,
except information that has been given in confidence by members of
the person's family, requested by a probation officer charged with
the evaluation of the person after his or her conviction of a crime
if the professional person in charge of the facility determines that
the information is relevant to the evaluation. The agreement shall
only be operative until sentence is passed on the crime of which the
person was convicted. The confidential information released pursuant
to this subdivision shall be transmitted to the court separately from
the probation report and shall not be placed in the probation
report. The confidential information shall remain confidential except
for purposes of sentencing. After sentencing, the confidential
information shall be sealed.
(l) (1) Between persons who are trained and qualified to serve on
multidisciplinary personnel teams pursuant to subdivision (d) of
Section 18951. The information and records sought to be disclosed
shall be relevant to the provision of child welfare services or the
investigation, prevention, identification, management, or treatment
of child abuse or neglect pursuant to Chapter 11 (commencing with
Section 18950) of Part 6 of Division 9. Information obtained pursuant
to this subdivision shall not be used in any criminal or delinquency
proceeding. Nothing in this subdivision shall prohibit evidence
identical to that contained within the records from being admissible
in a criminal or delinquency proceeding, if the evidence is derived
solely from means other than this subdivision, as permitted by law.
(2) As used in this subdivision, "child welfare services" means
those services that are directed at preventing child abuse or
neglect.
(m) To county patients' rights advocates who have been given
knowing voluntary authorization by a client or a guardian ad litem.
The client or guardian ad litem, whoever entered into the agreement,
may revoke the authorization at any time, either in writing or by
oral declaration to an approved advocate.
(n) To a committee established in compliance with Section
4070 14725 .
(o) In providing information as described in Section 7325.5.
Nothing in this subdivision shall permit the release of any
information other than that described in Section 7325.5.
(p) To the county mental health director or the director's
designee, or to a law enforcement officer, or to the person
designated by a law enforcement agency, pursuant to Sections 5152.1
and 5250.1.
(q) If the patient gives his or her consent, information
specifically pertaining to the existence of genetically handicapping
conditions, as defined in Section 125135 of the Health and Safety
Code, may be released to qualified professional persons for purposes
of genetic counseling for blood relatives upon request of the blood
relative. For purposes of this subdivision, "qualified professional
persons" means those persons with the qualifications necessary to
carry out the genetic counseling duties under this subdivision as
determined by the genetic disease unit established in the State
Department of Health Care Services under Section 125000 of the Health
and Safety Code. If the patient does not respond or cannot respond
to a request for permission to release information pursuant to this
subdivision after reasonable attempts have been made over a two-week
period to get a response, the information may be released upon
request of the blood relative.
(r) When the patient, in the opinion of his or her
psychotherapist, presents a serious danger of violence to a
reasonably foreseeable victim or victims, then any of the information
or records specified in this section may be released to that person
or persons and to law enforcement agencies and county child welfare
agencies as the psychotherapist determines is needed for the
protection of that person or persons. For purposes of this
subdivision, "psychotherapist" means anyone so defined within Section
1010 of the Evidence Code.
(s) (1) To the designated officer of an emergency response
employee, and from that designated officer to an emergency response
employee regarding possible exposure to HIV or AIDS, but only to the
extent necessary to comply with provisions of the federal Ryan White
Comprehensive AIDS Resources Emergency Act of 1990 (Public Law
101-381; 42 U.S.C. Sec. 201).
(2) For purposes of this subdivision, "designated officer" and
"emergency response employee" have the same meaning as these terms
are used in the federal Ryan White Comprehensive AIDS Resources
Emergency Act of 1990 (Public Law 101-381; 42 U.S.C. Sec. 201).
(3) The designated officer shall be subject to the confidentiality
requirements specified in Section 120980, and may be personally
liable for unauthorized release of any identifying information about
the HIV results. Further, the designated officer shall inform the
exposed emergency response employee that the employee is also subject
to the confidentiality requirements specified in Section 120980, and
may be personally liable for unauthorized release of any identifying
information about the HIV test results.
(t) (1) To a law enforcement officer who personally lodges with a
facility, as defined in paragraph (2), a warrant of arrest or an
abstract of such a warrant showing that the person sought is wanted
for a serious felony, as defined in Section 1192.7 of the Penal Code,
or a violent felony, as defined in Section 667.5 of the Penal Code.
The information sought and released shall be limited to whether or
not the person named in the arrest warrant is presently confined in
the facility. This paragraph shall be implemented with minimum
disruption to health facility operations and patients, in accordance
with Section 5212. If the law enforcement officer is informed that
the person named in the warrant is confined in the facility, the
officer may not enter the facility to arrest the person without
obtaining a valid search warrant or the permission of staff of the
facility.
(2) For purposes of paragraph (1), a facility means all of the
following:
(A) A state hospital, as defined in Section 4001.
(B) A general acute care hospital, as defined in subdivision (a)
of Section 1250 of the Health and Safety Code, solely with regard to
information pertaining to a mentally disordered
person with mental illness subject to this section.
(C) An acute psychiatric hospital, as defined in subdivision (b)
of Section 1250 of the Health and Safety Code.
(D) A psychiatric health facility, as described in Section 1250.2
of the Health and Safety Code.
(E) A mental health rehabilitation center, as described in Section
5675.
(F) A skilled nursing facility with a special treatment program
for chronically mentally disordered patients
individuals with mental illness , as described in Sections
51335 and 72445 to 72475, inclusive, of Title 22 of the California
Code of Regulations.
(u) Between persons who are trained and qualified to serve on
multidisciplinary personnel teams pursuant to Section 15610.55,
15753.5, or 15761. The information and records sought to be disclosed
shall be relevant to the prevention, identification, management, or
treatment of an abused elder or dependent adult pursuant to Chapter
13 (commencing with Section 15750) of Part 3 of Division 9.
(v) The amendment of subdivision (d) enacted at the 1970 Regular
Session of the Legislature does not constitute a change in, but is
declaratory of, the preexisting law.
(w) This section shall not be limited by Section 5150.05 or 5332.
(x) (1) When an employee is served with a notice of adverse
action, as defined in Section 19570 of the Government Code, the
following information and records may be released:
(A) All information and records that the appointing authority
relied upon in issuing the notice of adverse action.
(B) All other information and records that are relevant to the
adverse action, or that would constitute relevant evidence as defined
in Section 210 of the Evidence Code.
(C) The information described in subparagraphs (A) and (B) may be
released only if both of the following conditions are met:
(i) The appointing authority has provided written notice to the
consumer and the consumer's legal representative or, if the consumer
has no legal representative or if the legal representative is a state
agency, to the clients' rights advocate, and the consumer, the
consumer's legal representative, or the clients' rights advocate has
not objected in writing to the appointing authority within five
business days of receipt of the notice, or the appointing authority,
upon review of the objection has determined that the circumstances on
which the adverse action is based are egregious or threaten the
health, safety, or life of the consumer or other consumers and
without the information the adverse action could not be taken.
(ii) The appointing authority, the person against whom the adverse
action has been taken, and the person's representative, if any, have
entered into a stipulation that does all of the following:
(I) Prohibits the parties from disclosing or using the information
or records for any purpose other than the proceedings for which the
information or records were requested or provided.
(II) Requires the employee and the employee's legal representative
to return to the appointing authority all records provided to them
under this subdivision, including, but not limited to, all records
and documents from any source containing confidential information
protected by this section, and all copies of those records and
documents, within 10 days of the date that the adverse action becomes
final except for the actual records and documents or copies thereof
that are no longer in the possession of the employee or the employee'
s legal representative because they were submitted to the
administrative tribunal as a component of an appeal from the adverse
action.
(III) Requires the parties to submit the stipulation to the
administrative tribunal with jurisdiction over the adverse action at
the earliest possible opportunity.
(2) For the purposes of this subdivision, the State Personnel
Board may, prior to any appeal from adverse action being filed with
it, issue a protective order, upon application by the appointing
authority, for the limited purpose of prohibiting the parties from
disclosing or using information or records for any purpose other than
the proceeding for which the information or records were requested
or provided, and to require the employee or the employee's legal
representative to return to the appointing authority all records
provided to them under this subdivision, including, but not limited
to, all records and documents from any source containing confidential
information protected by this section, and all copies of those
records and documents, within 10 days of the date that the adverse
action becomes final, except for the actual records and documents or
copies thereof that are no longer in the possession of the employee
or the employee's legal representatives because they were submitted
to the administrative tribunal as a component of an appeal from the
adverse action.
(3) Individual identifiers, including, but not limited to, names,
social security numbers, and hospital numbers, that are not necessary
for the prosecution or defense of the adverse action, shall not be
disclosed.
(4) All records, documents, or other materials containing
confidential information protected by this section that have been
submitted or otherwise disclosed to the administrative agency or
other person as a component of an appeal from an adverse action
shall, upon proper motion by the appointing authority to the
administrative tribunal, be placed under administrative seal and
shall not, thereafter, be subject to disclosure to any person or
entity except upon the issuance of an order of a court of competent
jurisdiction.
(5) For purposes of this subdivision, an adverse action becomes
final when the employee fails to answer within the time specified in
Section 19575 of the Government Code, or, after filing an answer,
withdraws the appeal, or, upon exhaustion of the administrative
appeal or of the judicial review remedies as otherwise provided by
law.
(y) To the person appointed as the developmental services
decisionmaker for a minor, dependent, or ward pursuant to Section
319, 361, or 726.
SEC. 95. Section 5348 of the Welfare
and Institutions Code is amended to read:
5348. (a) For purposes of subdivision (e) of Section 5346, a
county that chooses to provide assisted outpatient treatment services
pursuant to this article shall offer assisted outpatient treatment
services including, but not limited to, all of the following:
(1) Community-based, mobile, multidisciplinary, highly trained
mental health teams that use high staff-to-client ratios of no more
than 10 clients per team member for those subject to court-ordered
services pursuant to Section 5346.
(2) A service planning and delivery process that includes the
following:
(A) Determination of the numbers of persons to be served and the
programs and services that will be provided to meet their needs. The
local director of mental health shall consult with the sheriff, the
police chief, the probation officer, the mental health board,
contract agencies, and family, client, ethnic, and citizen
constituency groups as determined by the director.
(B) Plans for services, including outreach to families whose
severely mentally ill adult is living with them, design of mental
health services, coordination and access to medications, psychiatric
and psychological services, substance abuse services, supportive
housing or other housing assistance, vocational rehabilitation, and
veterans' services. Plans shall also contain evaluation strategies,
which shall consider cultural, linguistic, gender, age, and special
needs of minorities and those based on any characteristic listed or
defined in Section 11135 of the Government Code in the target
populations. Provision shall be made for staff with the cultural
background and linguistic skills necessary to remove barriers to
mental health services as a result of having limited-English-speaking
ability and cultural differences. Recipients of outreach services
may include families, the public, primary care physicians, and others
who are likely to come into contact with individuals who may be
suffering from an untreated severe mental illness who would be likely
to become homeless if the illness continued to be untreated for a
substantial period of time. Outreach to adults may include adults
voluntarily or involuntarily hospitalized as a result of a severe
mental illness.
(C) Provision for services to meet the needs of persons who are
physically disabled.
(D) Provision for services to meet the special needs of older
adults.
(E) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, where appropriate.
(F) Provision for services to be client-directed and that employ
psychosocial rehabilitation and recovery principles.
(G) Provision for psychiatric and psychological services that are
integrated with other services and for psychiatric and psychological
collaboration in overall service planning.
(H) Provision for services specifically directed to seriously
mentally ill young adults 25 years of age or younger who are homeless
or at significant risk of becoming homeless. These provisions may
include continuation of services that still would be received through
other funds had eligibility not been terminated as a result of age.
(I) Services reflecting special needs of women from diverse
cultural backgrounds, including supportive housing that accepts
children, personal services coordinator therapeutic treatment, and
substance treatment programs that address gender-specific trauma and
abuse in the lives of persons with mental illness, and vocational
rehabilitation programs that offer job training programs free of
gender bias and sensitive to the needs of women.
(J) Provision for housing for clients that is immediate,
transitional, permanent, or all of these.
(K) Provision for clients who have been suffering from an
untreated severe mental illness for less than one year, and who do
not require the full range of services, but are at risk of becoming
homeless unless a comprehensive individual and family support
services plan is implemented. These clients shall be served in a
manner that is designed to meet their needs.
(3) Each client shall have a clearly designated mental health
personal services coordinator who may be part of a multidisciplinary
treatment team who is responsible for providing or assuring needed
services. Responsibilities include complete assessment of the client'
s needs, development of the client's personal services plan, linkage
with all appropriate community services, monitoring of the quality
and followthrough of services, and necessary advocacy to ensure each
client receives those services that are agreed to in the personal
services plan. Each client shall participate in the development of
his or her personal services plan, and responsible staff shall
consult with the designated conservator, if one has been appointed,
and, with the consent of the client, shall consult with the family
and other significant persons as appropriate.
(4) The individual personal services plan shall ensure that
persons subject to assisted outpatient treatment programs receive
age-appropriate, gender-appropriate, and culturally appropriate
services, to the extent feasible, that are designed to enable
recipients to:
(A) Live in the most independent, least restrictive housing
feasible in the local community, and, for clients with children, to
live in a supportive housing environment that strives for
reunification with their children or assists clients in maintaining
custody of their children as is appropriate.
(B) Engage in the highest level of work or productive activity
appropriate to their abilities and experience.
(C) Create and maintain a support system consisting of friends,
family, and participation in community activities.
(D) Access an appropriate level of academic education or
vocational training.
(E) Obtain an adequate income.
(F) Self-manage their illnesses and exert as much control as
possible over both the day-to-day and long-term decisions that affect
their lives.
(G) Access necessary physical health care and maintain the best
possible physical health.
(H) Reduce or eliminate serious antisocial or criminal behavior,
and thereby reduce or eliminate their contact with the criminal
justice system.
(I) Reduce or eliminate the distress caused by the symptoms of
mental illness.
(J) Have freedom from dangerous addictive substances.
(5) The individual personal services plan shall describe the
service array that meets the requirements of paragraph (4), and to
the extent applicable to the individual, the requirements of
paragraph (2).
(b) A county that provides assisted outpatient treatment services
pursuant to this article also shall offer the same services on a
voluntary basis.
(c) Involuntary medication shall not be allowed absent a separate
order by the court pursuant to Sections 5332 to 5336, inclusive.
(d) A county that operates an assisted outpatient treatment
program pursuant to this article shall provide data to the State
Department of Mental Health Care Services
and, based on the data, the department shall report to the
Legislature on or before May 1 of each year in which the county
provides services pursuant to this article. The report shall include,
at a minimum, an evaluation of the effectiveness of the strategies
employed by each program operated pursuant to this article in
reducing homelessness and hospitalization of persons in the program
and in reducing involvement with local law enforcement by persons in
the program. The evaluation and report shall also include any other
measures identified by the department regarding persons in the
program and all of the following, based on information that is
available:
(1) The number of persons served by the program and, of those, the
number who are able to maintain housing and the number who maintain
contact with the treatment system.
(2) The number of persons in the program with contacts with local
law enforcement, and the extent to which local and state
incarceration of persons in the program has been reduced or avoided.
(3) The number of persons in the program participating in
employment services programs, including competitive employment.
(4) The days of hospitalization of persons in the program that
have been reduced or avoided.
(5) Adherence to prescribed treatment by persons in the program.
(6) Other indicators of successful engagement, if any, by persons
in the program.
(7) Victimization of persons in the program.
(8) Violent behavior of persons in the program.
(9) Substance abuse by persons in the program.
(10) Type, intensity, and frequency of treatment of persons in the
program.
(11) Extent to which enforcement mechanisms are used by the
program, when applicable.
(12) Social functioning of persons in the program.
(13) Skills in independent living of persons in the program.
(14) Satisfaction with program services both by those receiving
them and by their families, when relevant.
SEC. 96. Section 5349 of the Welfare
and Institutions Code is amended to read:
5349. This article shall be operative in those counties in which
the county board of supervisors, by resolution, authorizes its
application and makes a finding that no voluntary mental health
program serving adults, and no children's mental health program, may
be reduced as a result of the implementation of this article.
Compliance with this section shall be monitored by the State
Department of Mental Health Care Services
as part of its review and approval of county
Short-Doyle plans performance contracts .
SEC. 97. Section 5349.1 of the Welfare
and Institutions Code is amended to read:
5349.1. (a) Counties that elect to implement this article, shall,
in consultation with the department State
Department of Health Care Services , client and family advocacy
organizations, and other stakeholders, develop a training and
education program for purposes of improving the delivery of services
to mentally ill individuals who are, or who are at risk of being,
involuntarily committed under this part. This training shall be
provided to mental health treatment providers contracting with
participating counties and to other individuals, including, but not
limited to, mental health professionals, law enforcement officials,
and certification hearing officers involved in making treatment and
involuntary commitment decisions.
(b) The training shall include both of the following:
(1) Information relative to legal requirements for detaining a
person for involuntary inpatient and outpatient treatment, including
criteria to be considered with respect to determining if a person is
considered to be gravely disabled.
(2) Methods for ensuring that decisions regarding involuntary
treatment as provided for in this part direct patients toward the
most effective treatment. Training shall include an emphasis on each
patient's right to provide informed consent to assistance.
SEC. 98. Section 5358 of the Welfare
and Institutions Code is amended to read:
5358. (a) (1) When ordered by the court after the hearing
required by this section, a conservator appointed pursuant to this
chapter shall place his or her conservatee as follows:
(A) For a conservatee who is gravely disabled, as defined in
subparagraph (A) of paragraph (1) of subdivision (h) of Section 5008,
in the least restrictive alternative placement, as designated by the
court.
(B) For a conservatee who is gravely disabled, as defined in
subparagraph (B) of paragraph (1) of subdivision (h) of Section 5008,
in a placement that achieves the purposes of treatment of the
conservatee and protection of the public.
(2) The placement may include a medical, psychiatric, nursing, or
other state-licensed facility, or a state hospital, county hospital,
hospital operated by the Regents of the University of California, a
United States government hospital, or other nonmedical facility
approved by the State Department of Mental Health
Social Services or an agency accredited by the State
Department of Mental Health Care
Services , or in addition to any
of the foregoing, in cases of chronic alcoholism, to a county
alcoholic treatment center.
(b) A conservator shall also have the right, if specified in the
court order, to require his or her conservatee to receive treatment
related specifically to remedying or preventing the recurrence of the
conservatee's being gravely disabled, or to require his or her
conservatee to receive routine medical treatment unrelated to
remedying or preventing the recurrence of the conservatee's being
gravely disabled. Except in emergency cases in which the conservatee
faces loss of life or serious bodily injury, no surgery shall be
performed upon the conservatee without the conservatee's prior
consent or a court order obtained pursuant to Section 5358.2
specifically authorizing that surgery.
(c) (1) For a conservatee who is gravely disabled, as defined in
subparagraph (A) of paragraph (1) of subdivision (h) of Section 5008,
if the conservatee is not to be placed in his or her own home or the
home of a relative, first priority shall be to placement in a
suitable facility as close as possible to his or her home or the home
of a relative. For the purposes of this section, suitable facility
means the least restrictive residential placement available and
necessary to achieve the purpose of treatment. At the time that the
court considers the report of the officer providing conservatorship
investigation specified in Section 5356, the court shall consider
available placement alternatives. After considering all the evidence
the court shall determine the least restrictive and most appropriate
alternative placement for the conservatee. The court shall also
determine those persons to be notified of a change of placement. The
fact that a person for whom conservatorship is recommended is not an
inpatient shall not be construed by the court as an indication that
the person does not meet the criteria of grave disability.
(2) For a conservatee who is gravely disabled, as defined in
subparagraph (B) of paragraph (1) of subdivision (h) of Section 5008,
first priority shall be placement in a facility that achieves the
purposes of treatment of the conservatee and protection of the
public. The court shall determine the most appropriate placement for
the conservatee. The court shall also determine those persons to be
notified of a change of placement, and additionally require the
conservator to notify the district attorney or attorney representing
the originating county prior to any change of placement.
(3) For any conservatee, if requested, the local mental health
director shall assist the conservator or the court in selecting a
placement facility for the conservatee. When a conservatee who is
receiving services from the local mental health program is placed,
the conservator shall inform the local mental health director of the
facility's location and any movement of the conservatee to another
facility.
(d) (1) Except for a conservatee who is gravely disabled, as
defined in subparagraph (B) of paragraph (1) of subdivision (h) of
Section 5008, the conservator may transfer his or her conservatee to
a less restrictive alternative placement without a further hearing
and court approval. In any case in which a conservator has reasonable
cause to believe that his or her conservatee is in need of immediate
more restrictive placement because the condition of the conservatee
has so changed that the conservatee poses an immediate and
substantial danger to himself or herself or others, the conservator
shall have the right to place his or her conservatee in a more
restrictive facility or hospital. Notwithstanding Section 5328, if
the change of placement is to a placement more restrictive than the
court-determined placement, the conservator shall provide written
notice of the change of placement and the reason therefor to the
court, the conservatee's attorney, the county patient's rights
advocate and any other persons designated by the court pursuant to
subdivision (c).
(2) For a conservatee who is gravely disabled, as defined in
subparagraph (B) of paragraph (1) of subdivision (h) of Section 5008,
the conservator may not transfer his or her conservatee without
providing written notice of the proposed change of placement and the
reason therefor to the court, the conservatee's attorney, the county
patient's rights advocate, the district attorney of the county that
made the commitment, and any other persons designated by the court to
receive notice. If any person designated to receive notice objects
to the proposed transfer within 10 days after receiving notice, the
matter shall be set for a further hearing and court approval. The
notification and hearing is not required for the transfer of persons
between state hospitals.
(3) At a hearing where the conservator is seeking placement to a
less restrictive alternative placement pursuant to paragraph (2), the
placement shall not be approved where it is determined by a
preponderance of the evidence that the placement poses a threat to
the safety of the public, the conservatee, or any other individual.
(4) A hearing as to placement to a less restrictive alternative
placement, whether requested pursuant to paragraph (2) or pursuant to
Section 5358.3, shall be granted no more frequently than is provided
for in Section 5358.3.
SEC. 99. Section 5366.1 of the Welfare
and Institutions Code is amended to read:
5366.1. Any person detained as of June 30, 1969, under court
commitment, in a private institution, a county psychiatric hospital,
facility of the Veterans Administration, or other agency of the
United States government, community mental health service, or
detained in a state hospital or facility of the Veterans
Administration upon application of a local health officer, pursuant
to former Section 5567 or Sections 6000 to 6019, inclusive, as they
read immediately preceding July 1, 1969, may be detained, after
January 1, 1972, for a period no longer than 180 days, except as
provided in this section.
Any person detained pursuant to this section on the effective date
of this section shall be evaluated by the facility designated by the
county and approved by the State Department of Mental
Health Social Services pursuant to Section 5150
as a facility for 72-hour treatment and evaluation. Such
The evaluation shall be made at the request of
the person in charge of the institution in which the person is
detained. If in the opinion of the professional person in charge of
the evaluation and treatment facility or his or her
designee, the evaluation of the person can be made by such
the professional person or his or her
designee at the institution in which the person is detained, the
person shall not be required to be evaluated at the evaluation and
treatment facility, but shall be evaluated at the institution where
he or she is detained, or other place to determine if the
person is a danger to others, himself or herself , or
gravely disabled as a result of mental disorder.
Any person evaluated under this section shall be released from the
institution in which he or she is detained immediately
upon completion of the evaluation if in the opinion of the
professional person in charge of the evaluation and treatment
facility, or his or her designee, the person evaluated is
not a danger to others, or to himself or herself , or
gravely disabled as a result of mental disorder, unless the person
agrees voluntarily to remain in the institution in which he or
she has been detained.
If in the opinion of the professional person in charge of the
facility or his or her designee, the person evaluated
requires intensive treatment or recommendation for conservatorship,
such the professional person or his
or her designee shall proceed under Article 4 (commencing
with Section 5250) of Chapter 2, or under Chapter 3 (commencing with
Section 5350), of Part 1 of Division 5.
If it is determined from the evaluation that the person is gravely
disabled and a recommendation for conservatorship is made, and if
the petition for conservatorship for such the
person is not filed by June 30, 1972, the court commitment or
detention under a local health officer application for such
the person shall terminate and the patient shall
be released unless he or she agrees to accept treatment
on a voluntary basis.
SEC. 100. Section 5370.2 of the Welfare
and Institutions Code is amended to read:
5370.2. (a) Beginning January 1, 1996, the
The State Department of Mental Health
State Hospitals and the State Department of Health Care Services
shall contract with a single nonprofit agency that meets the
criteria specified in subdivision (b) of Section 5510 to conduct the
following activities specified in paragraphs
(1) to (4), inclusive. These two state departments shall enter into a
memorandum of understanding to ensure the effective management of
the contract and the required activities affecting county patients'
rights programs :
(1) Provide patients' rights advocacy services for, and conduct
investigations of alleged or suspected abuse and neglect of,
including deaths of, persons with mental disabilities residing in
state hospitals.
(2) Investigate and take action as appropriate and necessary to
resolve complaints from or concerning recipients of mental health
services residing in licensed health or community care facilities
regarding abuse, and unreasonable denial, or punitive withholding of
rights guaranteed under this division that cannot be resolved by
county patients' rights advocates.
(3) Provide consultation, technical assistance, and support to
county patients' rights advocates in accordance with their duties
under Section 5520.
(4) Conduct program review of patients' rights programs.
(b) The services shall be provided in coordination with the
appropriate mental health patients' rights advocates.
(c) (1) The contractor shall develop a plan to provide patients'
rights advocacy services for, and conduct investigations of alleged
or suspected abuse and neglect of, including the deaths of, persons
with mental disabilities residing in state hospitals.
(2) The contractor shall develop the plan in consultation with the
statewide organization of mental health patients' rights advocates,
the statewide organization of mental health clients, and the
statewide organization of family members of persons with mental
disabilities, and the statewide organization of county mental health
directors.
(3) In order to ensure that persons with mental disabilities have
access to high quality advocacy services, the contractor shall
establish a grievance procedure and shall advise persons receiving
services under the contract of the availability of other advocacy
services, including services provided by the protection and advocacy
agency specified in Section 4901 and the county patients' rights
advocates specified in Section 5520.
(d) Nothing contained in this section shall be construed to
restrict or limit the authority of the department to conduct the
reviews and investigations it deems necessary for personnel,
criminal, and litigation purposes.
(e) The State Department of Mental Health
State Hospitals and the State Department of Health Care Services
shall jointly contract on a multiyear basis for a
contract term of up to five years.
SEC. 101. Section 5400 of the Welfare
and Institutions Code is amended to read:
5400. The Director of Mental Health Care
Services shall administer this part and shall adopt rules,
regulations , and standards as necessary. In developing
rules, regulations, and standards, the Director of Mental
Health Care Services shall consult with the
California Conference of Local Mental Health
Directors Association , the California Council on
Mental Health Planning Council , and the office
of the Attorney General. Adoption of such
these standards, rules , and regulations shall
require approval by the California Conference of Local
Mental Health Directors Association by majority
vote of those present at an official session.
Wherever feasible and appropriate, rules, regulations ,
and standards adopted under this part shall correspond to comparable
rules, regulations, and standards adopted under the
Short-Doyle Bronzan-McCorquodale Act.
Such These corresponding rules, regulations, and
standards shall include qualifications for professional personnel.
Regulations adopted pursuant to this part may provide standards
for services for chronic alcoholics which differ from the standards
for services for the mentally disordered.
SEC. 102. Section 5402 of the Welfare
and Institutions Code is amended to read:
5402. (a) The State Department of Mental
Health Care Services shall collect and publish annually
quantitative information concerning the operation of this division
including the number of persons admitted for 72-hour evaluation and
treatment, 14-day and 30-day periods of intensive treatment, and
180-day postcertification intensive treatment, the number of persons
transferred to mental health facilities pursuant to Section 4011.6 of
the Penal Code, the number of persons for whom temporary
conservatorships are established, and the number of persons for whom
conservatorships are established in each county.
(b) Each local mental health director, and each facility providing
services to persons pursuant to this division, shall provide the
department, upon its request, with any information, records, and
reports which the department deems necessary for the purposes of this
section. The department shall not have access to any patient name
identifiers.
(c) Information published pursuant to this section shall not
contain patient name identifiers and shall contain statistical data
only.
(d) The department shall make the reports available to medical,
legal, and other professional groups involved in the implementation
of this division.
SEC. 103. Section 5404 of the Welfare
and Institutions Code is amended to read:
5404. (a) Each county may designate
facilities, which are not hospitals or clinics, as 72-hour evaluation
and treatment facilities and as 14-day intensive treatment
facilities if such the facilities meet
such those requirements as the Director
of Mental Health Social Services shall
establish by regulation. The Director of Mental Health
Social Services shall encourage the use by
counties of appropriate facilities, which are not hospitals or
clinics, for the evaluation and treatment of patients pursuant to
this part.
(b) All regulations relating to the approval of facilities
designated by the county for 72-hour treatment and evaluation and
14-day intensive treatment facilities, heretofore adopted by the
State Department of Mental Health, shall remain in effect and shall
be fully enforceable by the State Department of Social Services with
respect to any facility or program required to be approved as a
facility for 72-hour treatment and evaluation and 14-day intensive
treatment facilities, unless and until readopted, amended, or
repealed by the Director of Social Services. The State Department of
Social Services shall succeed to and be vested with all duties,
powers, purposes, functions, responsibilities, and jurisdiction of
the State Department of Mental Health as they relate to approval of
facilities for 72-hour treatment and evaluation and 14-day intensive
treatment facilities.
SEC. 104. Section 5405 of the Welfare
and Institutions Code is amended to read:
5405. (a) This section shall apply to each facility licensed by
the State Department of Mental Health
Department of Social Services , or its delegated agent, on or
after January 1, 2003. For purposes of this section, "facility"
includes means psychiatric health
facilities, as defined in Section 1250.2 of the Health and Safety
Code, licensed pursuant to Chapter 9 (commencing with Section 77001)
of Division 5 of Title 22 of the California Code of Regulations and
mental health rehabilitation centers licensed pursuant to Chapter 3.5
(commencing with Section 781.00) of Division 1 of Title 9 of the
California Code of Regulations.
(b) (1) (A) Prior to the initial licensure or first renewal of a
license on or after January 1, 2003, of any person to operate or
manage a facility specified in subdivision (a), the department shall
submit fingerprint images and related information pertaining to the
applicant or licensee to the Department of Justice for purposes of a
criminal record check, as specified in paragraph (2), at the expense
of the applicant or licensee. The Department of Justice shall provide
the results of the criminal record check to the department. The
department may take into consideration information obtained from or
provided by other government agencies. The department shall determine
whether the applicant or licensee has ever been convicted of a crime
specified in subdivision (c). The department shall submit
fingerprint images and related information each time the position of
administrator, manager, program director, or fiscal officer of a
facility is filled and prior to actual employment for initial
licensure or an individual who is initially hired on or after January
1, 2003. For purposes of this subdivision, "applicant" and "licensee"
include the administrator, manager, program director, or fiscal
officer of a facility.
(B) Commencing January 1, 2003 July 1,
2012 , upon the employment of, or contract with or for, any
direct care staff the department State
Department of Social Services shall submit fingerprint images
and related information pertaining to the direct care staff person to
the Department of Justice for purposes of a criminal record check,
as specified in paragraph (2), at the expense of the direct care
staff person or licensee. The Department of Justice shall provide the
results of the criminal record check to the department. The
department shall determine whether the direct care staff person has
ever been convicted of a crime specified in subdivision (c). The
department shall notify the licensee of these results. No direct
client contact by the trainee or newly hired staff, or by any direct
care contractor shall occur prior to clearance by the department
unless the trainee, newly hired employee, contractor, or employee of
the contractor is constantly supervised.
(C) Commencing January 1, 2003 July 1,
2012 , any contract for services provided directly to patients
or residents shall contain provisions to ensure that the direct
services contractor submits to the department
State Department of Social Services fingerprint images and
related information pertaining to the direct services contractor for
submission to the Department of Justice for purposes of a criminal
record check, as specified in paragraph (2), at the expense of the
direct services contractor or licensee. The Department of Justice
shall provide the results of the criminal record check to the
department. The department shall determine whether the direct
services contractor has ever been convicted of a crime specified in
subdivision (c). The department shall notify the licensee of these
results.
(2) If the applicant, licensee, direct care staff person, or
direct services contractor specified in paragraph (1) has resided in
California for at least the previous seven years, the
department State Department of Social Services
shall only require the submission of one set of fingerprint images
and related information. The Department of Justice shall charge a fee
sufficient to cover the reasonable cost of processing the
fingerprint submission. Fingerprints and related information
submitted pursuant to this subdivision include fingerprint images
captured and transmitted electronically. When requested, the
Department of Justice shall forward one set of fingerprint images to
the Federal Bureau of Investigation for the purpose of obtaining any
record of previous convictions or arrests pending adjudication of the
applicant, licensee, direct care staff person, or direct services
contractor. The results of a criminal record check provided by the
Department of Justice shall contain every conviction rendered against
an applicant, licensee, direct care staff person, or direct services
contractor, and every offense for which the applicant, licensee,
direct care staff person, or direct services contractor is presently
awaiting trial, whether the person is incarcerated or has been
released on bail or on his or her own recognizance pending trial. The
department shall request subsequent arrest notification from the
Department of Justice pursuant to Section 11105.2 of the Penal Code.
(3) An applicant and any other person specified in this
subdivision, as part of the background clearance process, shall
provide information as to whether or not the person has any prior
criminal convictions, has had any arrests within the past 12-month
period, or has any active arrests, and shall certify that, to the
best of his or her knowledge, the information provided is true. This
requirement is not intended to duplicate existing requirements for
individuals who are required to submit fingerprint images as part of
a criminal background clearance process. Every applicant shall
provide information on any prior administrative action taken against
him or her by any federal, state, or local government agency and
shall certify that, to the best of his or her knowledge, the
information provided is true. An applicant or other person required
to provide information pursuant to this section that knowingly or
willfully makes false statements, representations, or omissions may
be subject to administrative action, including, but not limited to,
denial of his or her application or exemption or revocation of any
exemption previously granted.
(c) (1) The department The State
Department of Social Services shall deny any application for
any license, suspend or revoke any existing license, and disapprove
or revoke any employment or contract for direct services, if the
applicant, licensee, employee, or direct services contractor has been
convicted of, or incarcerated for, a felony defined in subdivision
(c) of Section 667.5 of, or subdivision (c) of Section 1192.7 of, the
Penal Code, within the preceding 10 years.
(2) The application for licensure or renewal of any license shall
be denied, and any employment or contract to provide direct services
shall be disapproved or revoked, if the criminal record of the person
includes a conviction in another jurisdiction for an offense that,
if committed or attempted in this state, would have been punishable
as one or more of the offenses referred to in paragraph (1).
(d) (1) The department The State
Department of Social Services may approve an application for,
or renewal of, a license, or continue any employment or contract for
direct services, if the person has been convicted of a misdemeanor
offense that is not a crime upon the person of another, the nature of
which has no bearing upon the duties for which the person will
perform as a licensee, direct care staff person, or direct services
contractor. In determining whether to approve the application,
employment, or contract for direct services, the department shall
take into consideration the factors enumerated in paragraph (2).
(2) Notwithstanding subdivision (c), if the criminal record of a
person indicates any conviction other than a minor traffic violation,
the department State Department of Social
Services may deny the application for license or renewal, and
may disapprove or revoke any employment or contract for direct
services. In determining whether or not to deny the application for
licensure or renewal, or to disapprove or revoke any employment or
contract for direct services, the department shall take into
consideration the following factors:
(A) The nature and seriousness of the offense under consideration
and its relationship to the person's employment, duties, and
responsibilities.
(B) Activities since conviction, including employment or
participation in therapy or education, that would indicate changed
behavior.
(C) The time that has elapsed since the commission of the conduct
or offense and the number of offenses.
(D) The extent to which the person has complied with any terms of
parole, probation, restitution, or any other sanction lawfully
imposed against the person.
(E) Any rehabilitation evidence, including character references,
submitted by the person.
(F) Employment history and current employer recommendations.
(G) Circumstances surrounding the commission of the offense that
would demonstrate the unlikelihood of repetition.
(H) The granting by the Governor of a full and unconditional
pardon.
(I) A certificate of rehabilitation from a superior court.
(e) Denial, suspension, or revocation of a license, or disapproval
or revocation of any employment or contract for direct services
specified in subdivision (c) and paragraph (2) of subdivision (d) are
not subject to appeal, except as provided in subdivision (f).
(f) After a review of the record, the director may grant an
exemption from denial, suspension, or revocation of any license, or
disapproval of any employment or contract for direct services, if the
crime for which the person was convicted was a property crime that
did not involve injury to any person and the director has substantial
and convincing evidence to support a reasonable belief that the
person is of such good character as to justify issuance or renewal of
the license or approval of the employment or contract.
(g) A plea or verdict of guilty, or a conviction following a plea
of nolo contendere shall be deemed a conviction within the meaning of
this section. The department State
Department of Social Services may deny any application, or
deny, suspend, or revoke a license, or disapprove or revoke any
employment or contract for direct services based on a conviction
specified in subdivision (c) when the judgment of conviction is
entered or when an order granting probation is made suspending the
imposition of sentence.
(h) (1) For purposes of this section, "direct care staff" means
any person who is an employee, contractor, or volunteer who has
contact with other patients or residents
in the provision of services. Administrative and
licensed personnel shall be considered direct care staff when
directly providing program services to participants.
(2) An additional background check shall not be required pursuant
to this section if the direct care staff or licensee has received a
prior criminal history background check while working in a mental
health rehabilitation center or psychiatric health facility licensed
by the department State Department of Social
Services , and provided the department has maintained
continuous subsequent arrest notification on the individual from the
Department of Justice since the prior criminal background check was
initiated.
(3) When an application is denied on the basis of a conviction
pursuant to this section, the department
State Department of Social Services shall provide the
individual whose application was denied with notice, in writing, of
the specific grounds for the proposed denial.
SEC. 105. The heading of Article 2 (commencing
with Section 5510) of Chapter 6.2 of Part 1 of Division 5 of the
Welfare and Institutions Code is
amended to read:
Article 2. Patients' Rights Office
Program
SEC. 106. Section 5510 of the Welfare
and Institutions Code is amended to read:
5510. (a) The Legislature finds and declares as follows:
(1) The State of California accepts its responsibility to ensure
and uphold the right of persons with mental disabilities and an
obligation, to be executed by the State Department of Mental
Health State Hospitals and the State Department of
Health Care Services , to ensure that mental health laws,
regulations and policies on the rights of recipients of mental health
services are observed and protected in state hospitals and in
licensed health and community care facilities.
(2) Persons with mental disabilities
illness are vulnerable to abuse, neglect, and unreasonable and
unlawful deprivations of their rights.
(3) Patients' rights advocacy and investigative services
concerning patient abuse and neglect currently
previously provided by the State Department of Mental
Health, including the Office of Human Rights and investigator, and
state hospitals' patients' rights advocates and state hospital
investigators and transferred to the State Department of Health Care
Services and the State Department of Mental Health,
including the department's Office of Human Rights and investigator,
and state hospital patients' rights advocates and state hospital
investigators State Hospitals, may have had
or have conflicts of interest or the appearance of a conflict
of interest.
(4) The services provided to patients and their families
is are of such a special and unique nature that
they must be contracted out pursuant to paragraph (3) of subdivision
(b) of Section 19130 of the Government Code.
(b) Therefore, to avoid the potential for a conflict of interest
or the appearance of a conflict of interest, it is the intent of the
Legislature that the patients' rights advocacy and investigative
services described in this article be provided by a single contractor
specified in Section 5370.2 that meets both of the following
criteria:
(1) The contractor can demonstrate the capability to provide
statewide advocacy services for persons with mental disabilities.
(2) The contractor has no direct or indirect responsibility for
providing services to persons with mental disabilities, except
advocacy services.
(c) For the purposes of this article, the Legislature further
finds and declares, because of a potential conflict of interest or
the appearance of a conflict of interest, that the goals and purposes
of the state patients' rights advocacy and investigative services
cannot be accomplished through the utilization of persons selected
pursuant to the regular state civil service system. Accordingly, the
contracts into which the department enters pursuant to this section
are permitted and authorized by paragraphs (3) and (5) of subdivision
(b) of Section 19130 of the Government Code. The
(d) The State Department of
Mental Health State Hospitals and the State
Department of Health Care Services shall contract with a single
nonprofit entity to provide for the protection and advocacy services
to persons with mental disabilities , as specified in Section
5370.2. The State Department of Health Care Services and the State
Department of State Hospitals shall enter into a memorandum of
understanding to ensure the effective management of the contract and
the required activities affecting county patients' rights
programs . The entity shall be responsible for ensuring that
mental health laws, regulations, and policies on the rights of
recipients of mental health services are observed in state hospitals
and in licensed health and community care facilities.
(d)
(e) The findings and declarations of potential conflict
of interest provided in this section shall not apply to advocacy
services provided under Article 3 (commencing with Section 5520).
SEC. 107. Section 5513 of the Welfare
and Institutions Code is amended to read:
5513. The Patients' Rights Office
patients' rights program shall serve as a liaison between
county patients' rights advocates and the State Department of
Mental Health Care Services .
SEC. 108. Section 5514 of the Welfare
and Institutions Code is amended to read:
5514. There shall be a five-person Patients' Rights
Subcommittee of the California Council on Mental Health
Committee formed through the California Mental Health Planning
Council . This subcommittee committee
, supplemented by two ad hoc members appointed by the
chairperson of the subcommittee committee
, shall advise the Director of Mental Health
Care Services and the Director of State Hospitals
regarding department policies and practices that affect patients'
rights. The subcommittee committee
shall also review the advocacy and patients' rights components of
each county Short-Doyle mental health
plan or performance contract and advise the Director of
Mental Health Care Services and the Director
of State Hospitals concerning the adequacy of each plan or
performance contract in protecting patients' rights. The ad
hoc members of the subcommittee committee
shall be persons with substantial experience in establishing
and providing independent advocacy services to recipients of mental
health services.
SEC. 109. Section 5520 of the Welfare
and Institutions Code is amended to read:
5520. Each local mental health director shall appoint, or
contract for the services of, one or more county patients' rights
advocates. The duties of these advocates shall include, but not be
limited to, the following:
(a) To receive and investigate complaints from or concerning
recipients of mental health services residing in licensed health or
community care facilities regarding abuse, unreasonable denial or
punitive withholding of rights guaranteed under the provisions of
Division 5 (commencing with Section 5000).
(b) To monitor mental health facilities, services and programs for
compliance with statutory and regulatory patients' rights
provisions.
(c) To provide training and education about mental health law and
patients' rights to mental health providers.
(d) To ensure that recipients of mental health services in all
licensed health and community care facilities are notified of their
rights.
(e) To exchange information and cooperate with the
Patients' Rights Office patients' rights program
.
This section does not constitute a change in, but is declarative
of the existing law.
SEC. 110. Section 5530 of the Welfare
and Institutions Code is amended to read:
5530. (a) County patients' rights advocates shall have access to
all clients and other recipients of mental health services in any
mental health facility, program, or service at all times as are
necessary to investigate or resolve specific complaints and in accord
with subdivision (b) of Section 5523. County patients' rights
advocates shall have access to mental health facilities, programs,
and services, and recipients of services therein during normal
working hours and visiting hours for other advocacy purposes.
Advocates may appeal any denial of access directly to the head of any
facility, the director of a county mental health program ,
or the State Department of Mental Health
Care Services, or may seek appropriate relief in the courts. If
a petition to a court sets forth prima facie evidence for relief, a
hearing on the merits of the petition shall be held within two
judicial days of the filing of the petition. The superior court for
the county in which the facility is located shall have jurisdiction
to review petitions filed pursuant to this chapter.
(b) County patients' rights advocates shall have the right to
interview all persons providing the client with diagnostic or
treatment services.
(c) Upon request, all mental health facilities shall, when
available, provide reasonable space for county patients' rights
advocates to interview clients in privacy and shall make appropriate
staff persons available for interview with the advocates in
connection with pending matters.
(d) Individual patients shall have a right to privacy which shall
include the right to terminate any visit by persons who have access
pursuant to this chapter and the right to refuse to see any patient
advocate.
(e) Notice of the availability of advocacy services and
information about patients' rights may be provided by county patients'
rights advocates by means of distribution of educational materials
and discussions in groups and with individual patients.
SEC. 111. Section 5585.21 of the Welfare
and Institutions Code is amended to read:
5585.21. The Director of Mental Health
Social Services may promulgate regulations as necessary to
implement and clarify the provisions of this part as they relate to
minors.
SEC. 112. Section 5585.22 of the
Welfare and Institutions Code is amended to read:
5585.22. The Director of Mental Health
Health Care Services , in consultation with the California
Conference of Local Mental Health Directors
Association , may develop the appropriate educational materials
and a training curriculum, and may provide training as necessary to
assure ensure that those persons
providing services pursuant to this part fully understand its
purpose.
SEC. 113. Section 5585.50 of the
Welfare and Institutions Code is amended to read:
5585.50. When any minor, as a result of mental disorder, is a
danger to others, or to himself or herself, or gravely disabled and
authorization for voluntary treatment is not available, a peace
officer, member of the attending staff, as defined by regulation, of
an evaluation facility designated by the county, designated members
of a mobile crisis team provided by Section 5651.7, or other
professional person designated by the county may, upon probable
cause, take, or cause to be taken, the minor into custody and place
him or her in a facility designated by the county and approved by the
State Department of Mental Health Social
Services as a facility for seventy-two hour
72-hour treatment and evaluation of minors. The facility
shall make every effort to notify the minor's parent or legal
guardian as soon as possible after the minor is detained.
The facility shall require an application in writing stating the
circumstances under which the minor's condition was called to the
attention of the officer, member of the attending staff, or
professional person, and stating that the officer, member of the
attending staff, or professional person has probable cause to believe
that the minor is, as a result of mental disorder, a danger to
others, or to himself or herself, or gravely disabled and
authorization for voluntary treatment is not available. If the
probable cause is based on the statement of a person other than the
officer, member of the attending staff, or professional person, the
person shall be liable in a civil action for intentionally giving a
statement which he or she knows to be false.
SEC. 114. Section 5585.55 of the
Welfare and Institutions Code is amended to read:
5585.55. The minor committed for involuntary treatment under this
part shall be placed in a health facility designated by the county
and approved by the State Department of Mental Health
Social Services as a facility for 72-hour
evaluation and treatment. Except as provided for in Section 5751.7,
each county shall assure ensure that
minors under the age of 16 years of age
are not held with adults receiving psychiatric treatment under the
provisions of the Lanterman-Petris-Short Act (Part 1 (commencing with
Section 5000)).
SEC. 115. Section 5600.8 of the Welfare
and Institutions Code is repealed.
5600.8. (a) The department may allocate the funds appropriated in
Schedule (2) of Item 4440-101-0001 of the annual Budget Act, to
county mental health programs that meet programmatic goals and model
adult system of care programs to the satisfaction of the department.
The department shall audit and monitor the use of these funds to
ensure they are used solely in support of Adult System of Care
programming. If county programs receiving adult system of care
funding do not comply with program and audit requirements determined
by the department, funding shall be redistributed to other counties
to implement, expand, or model adult systems of care.
(b) The department may allocate the funds appropriated in Schedule
(3) of Item 4440-101-0001 of the annual Budget Act, to county mental
health programs for Children's System of Care programming. These
funds shall be utilized by counties only in support of a mental
health system serving seriously emotionally disturbed children, in
accordance with the principles and program requirements associated
with the system of care model, as set forth in Part 4 (commencing
with Section 5850). The department shall audit and monitor the use of
these funds to ensure they are used solely in support of the
Children's System of Care program. If county programs receiving
children's system of care funding do not comply with program and
audit requirements determined by the department, funds shall be
redistributed to other counties to implement, expand, or model
children's system of care programming.
SEC. 116. Section 5601 of the Welfare
and Institutions Code is amended to read:
5601. As used in this part:
(a) "Governing body" means the county board of supervisors or
boards of supervisors in the case of counties acting jointly; and in
the case of a city, the city council or city councils acting jointly.
(b) "Conference" means the California Conference of Local
Mental Health Directors Association as
established under former Section 5757.
(c) Unless the context requires otherwise, "to the extent
resources are available" means to the extent that funds deposited in
the mental health account of the local health and welfare fund are
available to an entity qualified to use those funds.
(d) "Part 1" refers to the Lanterman-Petris-Short Act (Part 1
(commencing with Section 5000)).
(e) "Director of Mental Health" Health
Care Services" or "director" means the Director of the State
Department of Mental Health Care Services
.
(f) "Institution" includes a general acute care hospital, a state
hospital, a psychiatric hospital, a psychiatric health facility, a
skilled nursing facility, including an institution for mental disease
as described in Chapter 1 (commencing with Section 5900) of Part 5,
an intermediate care facility, a community care facility or other
residential treatment facility, or a juvenile or criminal justice
institution.
(g) "Mental health service" means any service directed toward
early intervention in, or alleviation or prevention of, mental
disorder, including, but not limited to, diagnosis, evaluation,
treatment, personal care, day care, respite care, special living
arrangements, community skill training, sheltered employment,
socialization, case management, transportation, information,
referral, consultation, and community services.
SEC. 117. Section 5602 of the Welfare
and Institutions Code is amended to read:
5602. The board of supervisors of every county, or the boards of
supervisors of counties acting under the joint powers provisions of
Article 1 (commencing with Section 6500) of Chapter 5 of Division 7
of Title 1 of the Government Code shall establish a community mental
health service to cover the entire area of the county or counties.
Services of the State Department of Mental Health
Care Services shall be provided to the county, or counties
acting jointly, or, if both parties agree, the state facilities may,
in whole or in part, be leased, rented or sold to the county or
counties for county operation, subject to terms and conditions
approved by the Director of General Services.
SEC. 118. 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 less than 80,000 may
have a minimum of five members. One member of the board shall be a
member of the local governing body. Any county with more than five
supervisors shall have at least the same number of members as the
size of its board of supervisors. Nothing in this section shall be
construed to limit the ability of the governing body to increase the
number of members above 15. Local mental health boards may recommend
appointees to the county supervisors. Counties are encouraged to
appoint individuals who have experience and knowledge of the mental
health system. The board membership should reflect the ethnic
diversity of the client population in the county.
(2) Fifty percent of the board membership shall be consumers or
the parents, spouses, siblings, or adult children of consumers, who
are receiving or have received mental health services. At least 20
percent of the total membership shall be consumers, and at least 20
percent shall be families of consumers.
(3) (A) In counties under 80,000 population, at least one member
shall be a consumer, and at least one member shall be a parent,
spouse, sibling, or adult child of a consumer, who is receiving, or
has received, mental health services.
(B) Notwithstanding subparagraph (A), a board in a county with a
population under 80,000 that elects to have the board exceed the
five-member minimum permitted under paragraph (1) shall be required
to comply with paragraph (2).
(b) The term of each member of the board shall be for three years.
The governing body shall equitably stagger the appointments so that
approximately one-third of the appointments expire in each year.
(c) If two or more local agencies jointly establish a community
mental health service under Article 1 (commencing with Section 6500)
of Chapter 5 of Division 7 of Title 1 of the Government Code, the
mental health board for the community mental health service shall
consist of an additional two members for each additional agency, one
of whom shall be a consumer or a parent, spouse, sibling, or adult
child of a consumer who has received mental health services.
(d) No member of the board or his or her spouse shall be a
full-time or part-time county employee of a county mental health
service, an employee of the State Department of Mental
Health Care Services , or an employee of, or a
paid member of the governing body of, a mental health contract
agency.
(e) Members of the board shall abstain from voting on any issue in
which the member has a financial interest as defined in Section
87103 of the Government Code.
(f) If it is not possible to secure membership as specified from
among persons who reside in the county, the governing body may
substitute representatives of the public interest in mental health
who are not full-time or part-time employees of the county mental
health service, the State Department of Mental
Health Care Services , or on the staff of, or a paid
member of the governing body of, a mental health contract agency.
(g) The mental health board may be established as an advisory
board or a commission, depending on the preference of the county.
SEC. 119. Section 5607 of the Welfare
and Institutions Code is amended to read:
5607. The local mental health services shall be administered by a
local director of mental health services to be appointed by the
governing body. He or she shall meet such standards of
training and experience as the State Department of Mental
Health Care Services , by regulation, shall
require. Applicants for such these
positions need not be residents of the city, county, or state, and
may be employed on a full or part-time basis. If a county is unable
to secure the services of a person who meets the standards of the
State Department of Mental Health Care
Services , the county may select an alternate administrator
subject to the approval of the Director of Mental Health
.
SEC. 120. 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
Mental Health Care Services, in consultation with the
California Mental 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 which are necessary. These requirements shall provide
comparability between counties in reports.
(b) The department shall develop, in consultation with the
Performance Outcome Committee , the California Mental Health
Planning Council, and the Mental Health Services Oversight and
Accountability Commission, pursuant to Section 5611, and with
the California Health and Welfare
Human Services Agency, uniform definitions and formats for a
statewide, nonduplicative client-based information system that
includes all information necessary to meet federal mental health
grant requirements and state and federal medicaid
Medicaid reporting requirements, as well as any other
state requirements established by law. The data system, including
performance outcome measures reported pursuant to Section 5613, shall
be developed by July 1, 1992.
(c) Unless determined necessary by the department to comply with
federal law and regulations, the data system developed pursuant to
subdivision (b) shall not be more costly than that in place during
the 1990-91 fiscal year.
(d) (1) The department shall develop unique client identifiers
that permit development of client-specific cost and outcome measures
and related research and analysis.
(2) The department's collection and use of client information, and
the development and use of client identifiers, shall be consistent
with clients' constitutional and statutory rights to privacy and
confidentiality.
(3) Data reported to the department may include name and other
personal identifiers. That information is confidential and subject to
Section 5328 and any other state and federal laws regarding
confidential client information.
(4) Personal client identifiers reported to the department shall
be protected to ensure confidentiality during transmission and
storage through encryption and other appropriate means.
(5) Information reported to the department may be shared with
local public mental health agencies submitting records for the same
person and that information is subject to Section 5328.
(e) All client information reported to the department pursuant to
Chapter 2 (commencing with Section 4030) of Part 1 of Division 4 and
Sections 5328 to 5780 5772.5 ,
inclusive, Chapter 8.9 (commencing with Section 14700),
and any other state and federal laws regarding reporting
requirements, consistent with Section 5328, shall not be used for
purposes other than those purposes expressly stated in the reporting
requirements referred to in this subdivision.
(f) The department may adopt emergency regulations to implement
this section in accordance with 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 adoption of emergency
regulations to implement this section that are filed with the Office
of Administrative Law within one year of the date on which the act
that added this subdivision took effect shall be deemed to be an
emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare and shall remain in
effect for no more than 180 days.
SEC. 121. Section 5650 of the Welfare
and Institutions Code is amended to read:
5650. (a) The board of supervisors of each county, or boards of
supervisors of counties acting jointly, shall adopt, and submit to
the Director of Mental Health Health Care
Services in the form and according to the procedures specified
by the director, a proposed annual county mental health services
performance contract for mental health services in the county or
counties.
(b) The State Department of Mental Health
Health Care Services shall develop and implement the
requirements, format, procedure, and submission dates for the
preparation and submission of the proposed performance contract.
SEC. 122. Section 5651 of the Welfare
and Institutions Code is amended to read:
5651. The proposed annual county mental health services
performance contract shall include all of the following:
(a) The following assurances:
(1) That the county is in compliance with the expenditure
requirements of Section 17608.05.
(2) That the county shall provide services to persons receiving
involuntary treatment as required by Part 1 (commencing with Section
5000) and Part 1.5 (commencing with Section 5585).
(3) That the county shall comply with all requirements necessary
for Medi-Cal reimbursement for mental health treatment services and
case management programs provided to Medi-Cal eligible individuals,
including, but not limited to, the provisions set forth in Chapter 3
(commencing with Section 5700), and that the county shall submit cost
reports and other data to the department in the form and manner
determined by the department State Department
of Health Care Services .
(4) That the local mental health advisory board has reviewed and
approved procedures ensuring citizen and professional involvement at
all stages of the planning process pursuant to Section 5604.2.
(5) That the county shall comply with all provisions and
requirements in law pertaining to patient rights.
(6) That the county shall comply with all requirements in federal
law and regulation pertaining to federally funded mental health
programs.
(7) That the county shall provide all data and information set
forth in Sections 5610 and 5664.
(8) That the county, if it elects to provide the services
described in Chapter 2.5 (commencing with Section 5670), shall comply
with guidelines established for program initiatives outlined in that
chapter.
(9) Assurances that the county shall comply with all applicable
laws and regulations for all services delivered , including all
laws, regulations, and guidelines of the Mental Health Services Act
.
(b) The county's proposed agreement with the department for state
hospital usage as required by Chapter 4 (commencing with Section
4330) of Part 2 of Division 4.
(c)
(b) Any contractual requirements needed for any program
initiatives utilized by the county contained within this part. In
addition, any county may choose to include contract provisions for
other state directed mental health managed programs within this
performance contract.
(c) The State Department of Health Care Services' ability to
monitor the county's three-year program and expenditure plan and
annual update pursuant to Section 5847.
(d) Other information determined to be necessary by the director,
to the extent this requirement does not substantially increase county
costs.
SEC. 123. Section 5652.7 of the Welfare
and Institutions Code is amended to read:
5652.7. A county shall have only 60 days from the date of
submission of an application to review and certify or deny an
application to establish a new mental health care provider. If an
application requires review by the State Department of Health
Care Services, the department shall also have only 60 days from
the date of submission of the application to review and certify or
deny an application to establish a new mental health care provider.
SEC. 124. Section 5653 of the Welfare
and Institutions Code is amended to read:
5653. In developing the county Short-Doyle plan, optimum
Optimum use shall be made of appropriate local
public and private organizations, community professional personnel,
and state agencies. Optimum use shall also be made of federal, state,
county, and private funds which may be available for mental health
planning.
In order that maximum utilization be made of federal and other
funds made available to the Department of Rehabilitation, the
Department of Rehabilitation may serve as a contractual provider
under the provisions of a county Short-Doyle plan
of vocational rehabilitation services for the mentally disordered.
SEC. 125. Section 5653.1 of the Welfare
and Institutions Code is amended to read:
5653.1. In conducting evaluation, planning, and research
activities to develop and implement the county Short-Doyle
plan, counties , counties may contract with
public or private agencies.
SEC. 126. Section 5654 of the Welfare
and Institutions Code is amended to read:
5654. In order to serve the increasing needs of children and
adolescents with mental and emotional problems, county mental health
programs may use funds allocated under the Short-Doyle Act
for the purposes of consultation and training.
SEC. 127. Section 5655 of the Welfare
and Institutions Code is amended to read:
5655. All departments of state government and all local public
agencies shall cooperate with county officials to assist them in
mental health planning. The State Department of Mental
Health Care Services shall, upon request and
with available staff, provide consultation services to the local
mental health directors, local governing bodies, and local mental
health advisory boards.
If the Director of Mental Health Care
Services considers any county to be failing, in a
substantial manner, to comply with any provision of this code or any
regulation, or with the approved county Short-Doyle plan,
the director shall order the county to appear at a hearing,
before the director or the director's designee, to show cause why
the department should not take action as set forth in this section.
The county shall be given at least 20 days' notice of such
the hearing. The director shall consider the
case on the record established at the hearing and make final findings
and decision.
If the director determines that there is or has been a failure, in
a substantial manner, on the part of the county to comply with any
provision of this code or any regulations or the approved
county Short-Doyle plan , and that administrative sanctions
are necessary, the department may invoke any, or any combination of,
the following sanctions:
(a) Withhold part or all of state mental health funds from
such the county.
(b) Require the county to enter into negotiations for the purpose
of assuring ensuring county
Short-Doyle plan compliance with such
those laws and regulations.
(c) Bring an action in mandamus or such
any other action in court as may be appropriate to compel
compliance. Any such action filed in
accordance with this section shall be entitled to a preference
in setting a date for a hearing.
SEC. 128. Section 5664 of the Welfare
and Institutions Code is amended to read:
5664. (a) County
In consultation with the California Mental Health
Directors Association, the State Department of Health Care Services,
the Mental Health Services Oversight and Accountability Commission,
the California Mental Health Planning Council, and the California
Health and Human Services Agency, county mental health systems
shall provide reports and data to meet the information needs of the
state , as necessary .
(b) The department shall not implement this section in a manner
requiring a higher level of service for state reporting needs than
that which it was authorized to require prior to July 1, 1991.
SEC. 129. Section 5664.5 of the Welfare
and Institutions Code is amended to read:
5664.5. (a) County mental health systems shall continue to
provide data required by the State Department of Mental
Health Care Services to establish uniform
definitions and time increments for reporting type and cost of
services received by local mental health program clients.
(b) This section shall remain in effect only until January 1,
1994, and as of that date is repealed, unless a later enacted
statute, which becomes effective on or before January 1, 1994,
deletes or extends the dates on which it is repealed; or until the
date upon which the director informs the Legislature that the new
data system is established pursuant to Section 5610, whichever is
later, unless the provisions of the section are required by the
federal government as a condition of funding for the
Short-Doyle Medi-Cal program .
SEC. 130. Section 5666 of the Welfare
and Institutions Code is amended to read:
5666. (a) The Director of Mental Health
Health Care Services, or his or her designee, shall review each
proposed county mental health services performance contract to
determine that it complies with the requirements of this division.
(b) The director or his or her designee shall require
modifications in the proposed county mental health services
performance contract which he or she deems necessary to bring the
proposed contract into conformance with the requirements of this
division.
(c) Upon approval by both parties, the provisions of the
performance contract required by Section 5651 shall be deemed to be a
contractual arrangement between the state and county.
SEC. 131. Section 5673 of the Welfare
and Institutions Code is repealed.
5673. (a) A five-year pilot program is hereby authorized in Napa
County and Riverside County to establish a 15-bed locked facility in
each county, for the provision of community care and treatment for
mentally disordered persons who are placed in a state hospital or
another health facility because no community placements are available
to meet the needs of these patients. It is the intent of the
Legislature to carefully evaluate this specific approach to determine
its potential for replication in other limited jurisdictions.
Participation in this pilot program by the two counties shall be on a
voluntary basis. The pilot program shall be implemented
notwithstanding the following licensure requirements enforced by the
State Department of Social Services:
(1) Subdivision (a) of Section 1502 of the Health and Safety Code,
which defines a community care facility as providing nonmedical
care.
(2) Subdivision (a) of Section 1505 of the Health and Safety Code,
which exempts any health facility, as defined by Section 1250 of the
Health and Safety Code, from licensure under the California
Community Care Facilities Act (Chapter 3 (commencing with Section
1500) of Division 2 of the Health and Safety Code).
(3) Section 1507 of the Health and Safety Code, which limits the
provision of medical services in community care facilities to
incidental medical services.
(4) Paragraph (5) of subdivision (a) of Section 80001 of Title 22
of the California Code of Regulations, which states that an adult
residential facility provides nonmedical care.
(5) Paragraph (7) of subdivision (a) of Section 80072 of Title 22
of the California Code of Regulations, which relates to a client's
right not to be locked in any room, building, or facility premises.
However, for purposes of this section, a client shall not be locked
in any room.
(b) Clients provided care within these pilot facilities shall be
conservatees as defined by Section 5350 who, prior to the
establishment of this program, either received care at a state
hospital or were placed in facilities for the mentally disordered.
(c) Standards for services provided shall be developed by each
county mental health director, in consultation with, and approved by,
the State Department of Mental Health and monitored regularly by the
department for compliance with these standards. These services shall
be on a 24-hour basis in a therapeutic homelike environment. The
services shall cover the full range of the social rehabilitation
model concept, including, but not limited to, the following:
(1) Counseling.
(2) Day treatment.
(3) Crisis intervention.
(4) Vocational training.
(5) Medication evaluation and management by a licensed physician
and other licensed professional and paraprofessional staff who
possess a valid license or certificate to perform this function.
(d) Administration of medication and monitoring of medication
shall occur notwithstanding statutory and regulatory licensure
requirements for community care facilities to the contrary. Standards
for use of medications shall be developed and monitored by the State
Department of Mental Health.
(e) The facilities shall be licensed and monitored by the State
Department of Social Services and shall comply with all licensing
requirements except those specifically exempted by this section. In
addition, no less than 75 square feet of outdoor space per client
shall be made available for client use. The State Department of
Social Services shall conduct inspections of the facilities pursuant
to Section 1533 of the Health and Safety Code and shall be given
immediate access to the facilities.
(f) In staffing the pilot program, each county board of
supervisors shall give full consideration to each potential means of
implementation, including, but not limited to, the clinical,
programmatic, and economic benefits and advantages of each
alternative. The pilot program shall meet all of the staffing
criteria of subdivision (b) of Section 5670.5. The staff shall use
and document the actions of a multidisciplinary professional
consultation staff to meet the specific diagnostic and treatment
needs of clients. The staff shall include, but need not be limited
to, a licensed psychiatrist, a psychologist, a social worker, and a
psychiatric technician. The staff may also include a licensed
vocational nurse. One or more of the following licensed professionals
shall be present at the facility at all times:
(1) A psychiatrist or psychologist.
(2) A registered psychiatric nurse.
(3) A psychiatric technician.
(4) A licensed vocational nurse.
(g) Protocols and training shall be established for licensed
vocational nurses employed by these facilities.
(h) The State Department of Mental Health shall certify the
program content in each county and monitor the program's functions on
a regular basis and the State Department of Social Services shall
regularly evaluate the facilities in accord with its statutory and
regulatory licensure functions, pursuant to subdivisions (d) and (e).
(i) The pilot program shall be deemed successful if it
demonstrates both of the following:
(1) That costs of the program are no greater than public
expenditures for providing alternative services to the clients served
by the program.
(2) That the benefit to the clients, as described in subdivision
(h), is improved by the program.
(j) Commencement of the pilot program in each county pursuant to
this section shall be contingent upon the county and the department
identifying funds for this purpose, as described in a financial plan
that is approved in advance by the Department of Finance.
SEC. 132. Section 5675 of the Welfare
and Institutions Code is amended to read:
5675. (a) Subject to Section 5768, Placer County and up to 15
other counties may establish a pilot project for up to six years, to
develop a shared mental health rehabilitation center for the
provision of community care and treatment for persons with mental
disorders who are placed in a state hospital or another health
facility because no community placements are available to meet the
needs of these patients. Participation in this pilot project by the
counties shall be on a voluntary basis.
(b) (1) The department shall establish, by emergency regulation,
the standards for the pilot project, and monitor the compliance of
the counties with those standards. Participating counties, in
consultation with the department, shall be responsible for program
monitoring.
(2) The department, in conjunction with the county mental health
directors, shall provide an interim report to the Legislature within
three years of the commencement of operation of the facilities
authorized pursuant to this section regarding the progress and cost
effectiveness demonstrated by the pilot project. The department, in
conjunction with the county mental health directors, shall report to
the Legislature within five years of the commencement of operation of
the facilities authorized pursuant to this section regarding the
progress and cost effectiveness demonstrated by the pilot project.
The report shall evaluate whether the pilot project is effective
based on clinical indicators, and is successful in preventing future
placement of its clients in state hospitals or other long-term health
facilities, and shall report whether the cost of care in the pilot
facilities is less than the cost of care in state hospitals or in
other long-term health facility options. The evaluation report shall
include, but not be limited to, an evaluation of the selected method
and the effectiveness of the pilot project staffing, and an analysis
of the effectiveness of the pilot project at meeting all of the
following objectives:
5675. (a) Mental health rehabilitation centers
shall only be licensed by the State Department of Social Services
subsequent to application by counties, county contract providers, or
other organizations. In the application for a mental health
rehabilitation center, program evaluation measures shall include, but
not be limited to:
(A)
(1) That the clients placed in the facilities show
improved global assessment scores, as measured by preadmission and
postadmission tests.
(B)
(2) That the clients placed in the facilities
demonstrate improved functional behavior as measured by preadmission
and postadmission tests.
(C)
(3) That the clients placed in the facilities have
reduced medication levels as determined by comparison of preadmission
and postadmission records.
(3) The pilot project shall be deemed successful if it
demonstrates both of the following:
(A) The costs of the program are no greater than public
expenditures for providing alternative services to the clients served
by the project.
(B) That the benefit to the clients, as described in this
subdivision, is improved by the project.
(c) The project shall be subject to existing regulations of the
State Department of Health Services applicable to health facilities
that the State Department of Mental Health deems necessary for fire
and life safety of persons with mental illness.
(d) The department shall consider projects proposed by other
counties under Section 5768.
(e) (1) Clients served by the project shall have all of the
protections and rights guaranteed to mental health patients pursuant
to the following provisions of law:
(A) Part 1 (commencing with Section 5000) and this part.
(B) Article 5 (commencing with Section 835), Article 5.5
(commencing with Section 850), and Article 6 (commencing with Section
860) of Chapter 4 of Title 9 of the California Code of Regulations.
(2) Clients shall have access to the services of a county patients'
rights advocates as provided in Chapter 6.2 (commencing with Section
5500) of Part 1.
(b) The State Department of Social Services shall conduct annual
licensing inspections of mental health rehabilitation centers.
(c) All regulations relating to the licensing of mental health
rehabilitation centers, heretofore adopted by the State Department of
Mental Health, shall remain in effect and shall be fully enforceable
by the State Department of Social Services with respect to any
facility or program required to be licensed as a mental health
rehabilitation center, unless and until readopted, amended, or
repealed by the Director of Social Services. The State Department of
Social Services shall succeed to and be vested with all duties,
powers, purposes, functions, responsibilities, and jurisdiction of
the State Department of Mental Health as they relate to licensing
mental health rehabilitation centers.
SEC. 133. Section 5675.1 of the Welfare
and Institutions Code is amended to read:
5675.1. (a) In accordance with subdivision (b), the
department State Department of Social Services and the
State Department of Health Care Services may establish a
system for the imposition of prompt and effective civil sanctions for
long-term care facilities licensed or certified by the
department those departments , including
facilities licensed under the provisions of Sections 5675 and 5768,
and including facilities certified as providing a special treatment
program under Sections 72443 to 72474, inclusive, of Title 22 of the
California Code of Regulations.
(b) If the department determines
departments determine that there is or has been a failure, in a
substantial manner, on the part of any such facility to comply with
the applicable laws and regulations, the director
directors may impose the following sanctions:
(1) A plan of corrective action that addresses all failure
identified by the department departments
and includes timelines for correction.
(2) A facility that is issued a plan of corrective action, and
that fails to comply with the plan and repeats the deficiency, may be
subject to immediate suspension of its license or certification,
until the deficiency is corrected, when failure to comply with the
plan of correction may cause a health or safety risk to residents.
(c) The department departments may
also establish procedures for the appeal of an administrative action
taken pursuant to this section, including a plan of corrective action
or a suspension of license or certification.
SE C. 134. Section 5675.2 of the
Welfare and Institutions Code is amended to read:
5675.2. (a) There is hereby created in the State Treasury the
Licensing and Certification Fund, Mental Health
Facility Licensing Fund , from which money, upon
appropriation by the Legislature in the Budget Act, shall be expended
by the State Department of Mental Health of
Social Services to fund administrative and other activities in
support of the department's Licensing and Certification
Program. mental health licensing and certification
functions of the State Department of Social Services. The
Mental Health Facility Licensing Fund is the successor to the
Licensing and Certification Fund, Mental Health, which fund is hereby
abolished. All references in any law to the Licensing and
Certification Fund, Mental Health shall be deemed to refer to the
Mental Health Facility Licensing Fund.
(b) Commencing January 1, 2005, each new and renewal application
for a license to operate a mental health rehabilitation center shall
be accompanied by an application or renewal fee.
(c) The amount of the fees shall be determined and collected by
the State Department of Mental Health Social
Services , but the total amount of the fees collected shall not
exceed the actual costs of licensure and regulation of the centers,
including, but not limited to, the costs of processing the
application, inspection costs, and other related costs.
(d) Each license or renewal issued pursuant to this chapter shall
expire 12 months from the date of issuance. Application for renewal
of the license shall be accompanied by the necessary fee and shall be
filed with the department at least 30 days prior to the expiration
date. Failure to file a timely renewal may result in expiration of
the license.
(e) License and renewal fees collected pursuant to this section
shall be deposited into the Licensing and Certification
Fund, Mental Health Facility Licensing Fund .
(f) Fees collected by the department State
Department of Social Services pursuant to this section shall
be expended by the department State
Department of Social Services for the purpose of ensuring the
health and safety of all individuals providing care and supervision
by licensees and to support activities of the Licensing and
Certification Program department , including,
but not limited to, monitoring facilities for compliance with
applicable laws and regulations.
(g) The department The State Department of
Social Services may make additional charges to the facilities
if additional visits are required to ensure that corrective action is
taken by the licensee.
SEC. 135. Section 5676 of the Welfare
and Institutions Code is amended to read:
5676. (a) The department, The State
Department of Health Care Services, in conjunction with the
State Department of Public Health Services
, shall develop a state-level plan for a streamlined and
consolidated evaluation and monitoring program for the review of
skilled nursing facilities with special treatment programs. The plan
shall provide for consolidated reviews, reports, and penalties for
these facilities. The plan shall include the cost of, and a timeline
for implementing, the plan. The plan shall be developed in
consultation with stakeholders, including county mental health
programs, consumers, family members of persons residing in long-term
care facilities who have
serious mental illness, and long-term care providers. The plan shall
review resident safety and quality programming, ensure that long-term
care facilities engaged primarily in diagnosis, treatment, and care
of persons with mental diseases are available and appropriately
evaluated, and ensure that strong linkages are built to local
communities and other treatment resources for residents and their
families. The plan shall be submitted to the Legislature on or before
March 1, 2001.
(b) The State Department of Public Health
Services shall forward to the State Department of
Mental Health Care Services copies of citations
issued to a skilled nursing facility that has a special treatment
program certified by the State Department of Mental
Health Care Services .
SEC. 136. Section 5688.6 of the Welfare
and Institutions Code is amended to read:
5688.6. Any and all funds appropriated for the homeless mentally
disabled which have been determined to be unexpended and unencumbered
two years after the date the funds were appropriated shall be
transferred to the Department of Housing and Community Development.
The amount of transfer shall be determined after the State Department
of Mental Health Care Services settles
county cost reports for the fiscal year the funds were appropriated.
The funds transferred to the Department of Housing and Community
Development shall be administered in accordance with that department'
s Special Users Housing Rehabilitation or Emergency Shelter programs
to provide low-income transitional and long-term housing for homeless
mentally disabled persons. Special priority shall be given to
project proposals for homeless mentally disabled persons in the same
county from which the funds for the support of the community support
system were originally allocated.
SEC. 137. Article 2.5 (commencing with Section
5689) of Chapter 2.5 of Part 2 of Division 5 of the
Welfare and Institutions Code is repealed.
SEC. 138. Section 5692 of the Welfare
and Institutions Code is amended to read:
5692. The State Department of Mental Health
Care Services shall, to the extent resources are
available, have responsibility for the provision of technical
assistance, maximizing federal revenue, and ensuring coordination
with other state agencies including implementing and coordinating
interagency agreements between the Department of Rehabilitation and
the State Department of Mental Health Care
Services .
SEC. 139. Section 5701 of the Welfare
and Institutions Code is amended to read:
5701. (a) To achieve equity of funding, available funding for
local mental health programs beyond the funding provided pursuant to
Section 17601 shall be distributed to cities, counties, and cities
and counties pursuant to the procedures described in subdivision (c)
of Section 17606.05.
(b) Funding provided pursuant to Section 6 of Article XIII B of
the California Constitution, funding provided pursuant to subdivision
(c), and funding provided for future pilot projects shall be exempt
from the requirements of subdivision (a).
(c) Effective in the 1994-95 2012-13
fiscal year and each year thereafter:
(1) The State Department of Mental Health
Care Services shall annually identify from mental health block
grant funds provided by the federal government, the maximum amount
that federal law and regulation permit to be allocated to counties
and cities and counties pursuant to this subdivision. This section
shall apply to any federal mental health block grant funds in excess
of the following:
(A) The amount allocated to counties and cities and counties from
the alcohol, drug abuse, and mental health block grant in the 1991-92
fiscal year.
(B)
(A) Funds for departmental support.
(C)
(B) Amounts awarded to counties and cities and counties
for children's systems of care programs pursuant to Part 4
(commencing with Section 5850).
(D) Amounts allocated to small counties for the development of
alternatives to state hospitalization in the 1993-94 fiscal year.
(E)
(C) Amounts appropriated by the Legislature for the
purposes of this part.
(2) Notwithstanding subdivision (a), annually the State Department
of Mental Health Care Services shall
allocate to counties and cities and counties the funds identified in
paragraph (1), not to exceed forty million dollars ($40,000,000) in
any year. The allocations shall be proportional to each county's and
each city and county's percentage of the forty million dollars
($40,000,000) in Cigarette and Tobacco Products Surtax funds that
were allocated to local mental health programs in the 1991-92 fiscal
year.
(3) Monthly, the Controller shall allocate funds from the Vehicle
License Collection Account of the Local Revenue Fund to counties and
cities and counties for mental health services. Allocations shall be
made to each county or city and county in the same percentages as
described in paragraph (2), until the total of the funds allocated to
all counties in each year pursuant to paragraph (2) and this
paragraph reaches forty million dollars ($40,000,000).
(4) Funds allocated to counties and cities and counties pursuant
to paragraphs (2) and (3) shall not be subject to Section 17606.05.
(5) Funds that are available for allocation in any year in excess
of the forty million dollar ($40,000,000) limits described in
paragraph (2) or (3) shall be deposited into the Mental Health
Subaccount of the Local Revenue Fund.
(6) Nothing in this section is intended to, nor shall it, change
the base allocation of any city, county, or city and county as
provided in Section 17601.
SEC. 140. Section 5701.1 of the Welfare
and Institutions Code is amended to read:
5701.1. Notwithstanding Section 5701, the State Department of
Mental Health Care Services , in
consultation with the California Mental Health Directors Association
and the California Mental Health Planning Council , may
utilize funding from the Substance Abuse and Mental Health Services
Administration Block Grant, awarded to the State Department of
Mental Health Care Services , above the
funding level provided in federal fiscal year 1998, for the
development of innovative programs for identified target populations,
upon appropriation by the Legislature.
SEC. 141. Section 5705 of the Welfare
and Institutions Code is amended to read:
5705. (a) It is the intent of the Legislature that the use of
negotiated net amounts, as provided in this section, be given
preference in contracts for services under this division.
(b)
5705. (a) Negotiated net amounts may be
used as the cost of services in contracts between the state
and the county or contracts between the county and a
subprovider of services , or both . A negotiated
net amount shall be determined by calculating the total budget for
services for a program or a component of a program, less the amount
of projected revenue. All participating government funding sources,
except for the Medi-Cal program (Chapter 7 (commencing with Section
14000) of Part 3 of Division 9), shall be bound to that amount as the
cost of providing all or part of the total county mental health
program as described in the county performance contract for each
fiscal year, to the extent that the governmental funding source
participates in funding the county mental health programs. Where the
State Department of Health Care Services promulgates regulations for
determining reimbursement of Short-Doyle mental
health services allowable under the Medi-Cal program, those
regulations shall be controlling as to the rates for reimbursement of
Short-Doyle mental health services allowable
under the Medi-Cal program and rendered to Medi-Cal beneficiaries.
Providers under this subdivision shall report to the State Department
of Mental Health Care Services and
local mental health programs any information required by the State
Department of Mental Health Care Services
in accordance with procedures established by the Director of
Mental Health Care Services .
(c)
(b) Notwithstanding any other provision of this
division or Division 9 (commencing with Section 10000), absent a
finding of fraud, abuse, or failure to achieve contract objectives,
no restrictions, other than any contained in the contract, shall be
placed upon a provider's expenditure pursuant to this section.
SEC. 142. Section 5707 of the Welfare
and Institutions Code is amended to read:
5707. Funds appropriated to the department
State Department of Health Care Services which are
designated for local mental health services and funds which the
department State Department of Health Care
Services is responsible for allocating or administering,
including, but not limited to, federal block grants funds, shall be
expended in accordance with this section and Sections 5708
Sections 5710 to 5717, inclusive, except when
there are conflicting federal requirements, in which case the federal
requirements shall be controlling.
SEC. 143. Section 5708 of the Welfare
and Institutions Code is repealed.
5708. To maintain stability during the transition, counties that
contracted with the department during the 1990-91 fiscal year on a
negotiated net amount basis may continue to use the same funding
mechanism.
SEC. 144. Section 5709 of the Welfare
and Institutions Code is amended to read:
5709. Regardless of the funding source involved, fees shall be
charged in accordance with the ability to pay for specialty
mental health services rendered but not in excess of actual
costs in accordance with Section 5720 14708
.
SEC. 145. Section 5710 of the Welfare
and Institutions Code is amended to read:
5710. (a) Charges for the care and treatment of each patient
receiving service from a county mental health program shall not
exceed the actual cost thereof as determined or approved by the
Director of Mental Health Care Services
in accordance with standard accounting practices. The director may
include the amount of expenditures for capital outlay or the interest
thereon, or both, in his or her determination of actual cost. The
responsibility of a patient, his or her estate, or his or her
responsible relatives to pay the charges and the powers of the
director with respect thereto shall be determined in accordance with
Article 4 (commencing with Section 7275) of Chapter 3 of Division 7.
(b) The Director of Mental Health Care
Services may delegate to each county all or part of the
responsibility for determining the financial liability of patients to
whom services are rendered by a county mental health program and all
or part of the responsibility for determining the ability of the
responsible parties to pay for services to minor children who are
referred by a county for treatment in a state hospital. Liability
shall extend to the estates of patients and to responsible relatives,
including the spouse of an adult patient and the parents of minor
children. The Director of Mental Health Care
Services may also delegate all or part of the responsibility
for collecting the charges for patient fees. Counties may decline
this responsibility as it pertains to state hospitals, at their
discretion. If this responsibility is delegated by the director, the
director shall establish and maintain the policies and procedures for
making the determinations and collections. Each county to which the
responsibility is delegated shall comply with the policy and
procedures.
(c) The director shall prepare and adopt a uniform sliding scale
patient fee schedule to be used in all mental health agencies for
services rendered to each patient. In preparing the uniform patient
fee schedule, the director shall take into account the existing
charges for state hospital services and those for community mental
health program services. If the director determines that it is not
practicable to devise a single uniform patient fee schedule
applicable to both state hospital services and services of other
mental health agencies, the director may adopt a separate fee
schedule for the state hospital services which differs from the
uniform patient fee schedule applicable to other mental health
agencies.
SEC. 146. Section 5711 of the Welfare
and Institutions Code is amended and renumbered to read:
5711. 14707. (a) In the case of
federal audit exceptions, the department shall follow
federal audit appeal processes shall be followed unless the
State Department of Mental Health unless the
department , in consultation with the California
Conference of Local Mental Health Directors
Association , determines that those appeals are not cost
beneficial.
(b) Whenever there is a final federal audit exception against the
state resulting from expenditure of federal funds by individual
counties, the State Department of Mental Health or the State
Department of Health Services department may
offset federal reimbursement and request the Controller's
office to offset the county's allocation
distribution of funds to the counties from the Mental
Health Subaccount of the Sales Tax Account of the Local Revenue Fund
the Mental Health Subaccount, the Mental Health Equity
Subaccount, and the Vehicle License Collection Account of the Local
Revenue Fund, funds from the Mental Health Account and the Behavioral
Health Subaccount of the Local Revenue Fund 2011, and any other
mental health realignment funds from which the Controller makes
distributions to the counties by the amount of the exception.
The Controller shall be provided evidence
department shall provide evidence to the Controller that the
county has been notified of the amount of the audit exception no less
than 30 days before the offset is to occur. The State
Department of Mental Health and the State Department of Health
Services department shall involve the
appropriate counties in developing responses to any draft federal
audit reports which may that directly
impact the counties county .
SEC. 147. Section 5712 of the Welfare
and Institutions Code is repealed.
5712. The department shall contract with counties for the funds
appropriated to, and allocated by, the department pursuant to
paragraph (2) of subdivision (a) of Section 5700 in accordance with
the following:
(a) The net cost of all services specified in the contract between
the counties and the department shall be financed on a basis of 90
percent state funds and 10 percent county funds except for services
to be financed from other public or private sources as indicated in
the contracts.
(b) The cost requirement for local financial participation
pursuant to this section shall be waived for all counties with a
population of 125,000 or less based on the most recent available
estimates of population data as determined by the Population Research
Unit of the Department of Finance.
(c) The cost requirements for local financial participation
pursuant to this section shall be waived for funds provided pursuant
to Part 2.5 (commencing with Section 5775).
SEC. 148. Section 5714 of the Welfare
and Institutions Code is amended to read:
5714. To continue county expenditures for legal proceedings
involving mentally disordered persons, the following costs incurred
in carrying out Part 1 (commencing with Section 5000) of this
division shall not be paid for from funds designated for mental
health services.
(a) The costs involved in bringing a person in for 72-hour
treatment and evaluation.
(b) The costs of court proceedings for court-ordered evaluation,
including the service of the court order and the apprehension of the
person ordered to evaluation when necessary.
(c) The costs of court proceedings in cases of appeal from 14-day
intensive treatment.
(d) The cost of legal proceedings in conservatorship other than
the costs of conservatorship investigation as defined by regulations
of the State Department of Mental Health Care
Services .
(e) The court costs in postcertification proceedings.
(f) The cost of providing a public defender or other
court-appointed attorneys in proceedings for those unable to pay.
SEC. 149. Section 5715 of the Welfare
and Institutions Code is amended to read:
5715. Subject to the approval of the department
State Department of Health Care Services , at
the end of the fiscal year, a county may retain unexpended funds
allocated to it by the department from funds appropriated to the
department, with the exception of block grant funds, exclusive of the
amount required to pay for the care of patients in state hospitals,
for 12 months for expenditure for mental health services in
accordance with this part.
SEC. 150. Section 5716 of the Welfare
and Institutions Code is amended and renumbered to read:
5716. 14705.7. Counties
Mental health plans may contract with providers
on a negotiated net amount basis in the same manner as set forth in
Section 5705. Negotiated net amounts or rates shall not be in
contracts between the state and mental health plans for specialty
mental health services. Reimbursement to mental health plans that
have certified public expenditures shall be consistent with
federal Medicaid requirements for calculating upper payment
limits, as specified in the approved Medicaid state plan and waivers.
SEC. 151. Section 5717 of the Welfare
and Institutions Code is amended to read:
5717. (a) Expenditures that may be funded from amounts allocated
to the county by the department State
Department of Health Care Services from funds appropriated to
the department shall include negotiated rates and net
amounts; , salaries of personnel ;
, approved facilities and services provided
through contract ; , and operation,
maintenance , and service costs , including
insurance costs or departmental charges for participation in a county
self-insurance program if the charges are not in excess of
comparable available commercial insurance premiums and on the
condition that any surplus reserves be used to reduce future year
contributions; depreciation of county facilities as established in
the state's uniform accounting manual, disregarding depreciation on
the facility to the extent it was financed by state funds under this
part; lease of facilities where there is no intention to, nor option
to, purchase; expenses incurred under this act by members of the
California Conference of Local Mental Health
Directors Association for attendance at regular meetings
of these conferences; expenses incurred by either the chairperson or
elected representative of the local mental health advisory boards for
attendance at regular meetings of the Organization of Mental Health
Advisory Boards; expenditures included in approved countywide cost
allocation plans submitted in accordance with the Controller's
guidelines, including, but not limited to, adjustments of prior year
estimated general county overhead to actual costs, but excluding
allowable costs otherwise compensated by state funding; net costs of
conservatorship investigation, approved by the Director of
Mental Health Care Services . Except for
expenditures made pursuant to Article 6 (commencing with Section
129225) of Chapter 1 of Part 6 of Division 107 of the Health and
Safety Code, it shall not include expenditures for initial capital
improvements; the purchaser or construction of buildings except for
equipment items and remodeling expense as may be provided for in
regulations of the State Department of Mental
Health Care Services ; compensation to members of a local
mental health advisory board, except actual and necessary expenses
incurred in the performance of official duties that may include
travel, lodging, and meals while on official business; or
expenditures for a purpose for which state reimbursement is claimed
under any other provision of law.
(b) The director The Director of Health
Care Services may make investigations and audits of
expenditures the director may deem necessary.
(c) With respect to funds allocated to a county by the
department State Department of Health Care Services
from funds appropriated to the department, the county shall
repay to the state amounts found not to have been expended in
accordance with the requirements set forth in this part. Repayment
shall be within 30 days after it is determined that an expenditure
has been made that is not in accordance with the requirements. In the
event that repayment is not made in a timely manner, the department
shall offset any amount improperly expended against the amount of any
current or future advance payment or cost report settlement from the
state for mental health services. Repayment provisions shall not
apply to Short-Doyle funds allocated by the department for fiscal
years up to and including the 1990-91 fiscal year.
SEC. 152. Section 5718 of the Welfare
and Institutions Code , as added by Section 2
of Chapter 651 of the Statutes of 2011, is amended and renumbered to
read:
5718. 14705. (a) (1) This section
and Sections 5719 to 5724, inclusive, shall apply
to specialty mental health services provided by counties
to Medi-Cal eligible individuals. Counties shall provide services to
Medi-Cal beneficiaries and seek the maximum federal reimbursement
possible for services rendered to the mentally ill
persons with mental illnesses .
(2) To the extent permitted under federal law and Section
5892 , funds deposited into the local health and
welfare trust fund from the Sales Tax Account of the Local Revenue
Fund distributed to the counties from the Mental
Health Subaccount, the Mental Health Equity Suba ccount,
and the Vehicle License Collection Account of the Local Revenue Fund,
funds from the Mental Health Account and the Behavioral Health
Subaccount of the Local Revenue Fund 2011, funds from the Mental
Health Services Fund, and any other funds from which the Controller
makes distributions to the counties may be used to
match federal Medicaid funds pay for services provided
by these funds that the counties can then certify as public
expenditures in order to achieve the maximum federal
reimbursement possible for services pursuant to this chapter.
(3) The standards and guidelines for the administration of
specialty mental health services to Medi-Cal eligible persons
shall be consistent with federal Medicaid requirements, as specified
in the approved Medicaid state plan and waivers to ensure full and
timely federal reimbursement to counties for services that are
rendered and claimed consistent with federal Medicaid requirements.
(b) With regard to each person receiving specialty
mental health services from a county mental health program
mental health plan , the county
mental health plan shall determine
verify whether the person is Medi-Cal eligible
and, if determined to be Medi-Cal eligible, the person shall be
referred when appropriate to a facility, clinic, or program
which that is certified for Medi-Cal
reimbursement.
(c) With regard to county operated facilities, clinics, or
programs for which claims are submitted to the department for
Medi-Cal reimbursement for specialty mental health
services to Medi-Cal eligible individuals, the county shall ensure
that all requirements necessary for Medi-Cal reimbursement for these
services are complied with, including, but not limited to,
utilization review and the submission of yearend cost reports by
December 31 following the close of the fiscal year.
(d) Counties shall certify to the state that required
certified they have incurred public expenditures
have been incurred prior to requesting
the reimbursement of federal funds.
(e) This section shall become operative on July 1, 2012.
SEC. 153. Section 5719 of the Welfare
and Institutions Code is amended and renumbered to read:
5719. 14705.5. Each public or
private facility or agency providing local specialty
mental health services pursuant to a county performance contract plan
shall make a written certification within 30 days after a patient is
admitted to the facility as a patient or first given services by
such a facility or agency, to the local mental health director of the
county, stating whether or not each of these patients is presumed to
be eligible for specialty mental health services under
the California Medical Assistance Program
Medi-Cal program .
SEC. 154. Section 5719.5 of the Welfare
and Institutions Code is amended and renumbered to read:
5719.5. 14705.6. (a)
Notwithstanding any other provision of state law, and to the extent
permitted by federal law, the State Department of Mental Health may,
in consultation with the State Department of Health Care
Services, field test major components of a capitated, integrated
service system of Medi-Cal mental health managed care in not less
than two, and not more than five participating counties.
(b) County participation in the field test shall be at the
counties' option.
(c) Counties eligible to participate in the field test described
in subdivision (a) shall include either of the following:
(1) Any county with an existing county organized health system.
(2) Any county that has been designated for the development of a
new county organized health system.
(d) The State Department of Mental Health, in consultation with
the State Department of Health Care Services, the counties
selected for field testing, and groups representing mental health
clients, their families and advocates, county mental health
directors, and public and private mental health professionals and
providers, shall develop, for
the purpose of the field test, major components for an
integrated, capitated service system of Medi-Cal mental health
managed care, including, but not limited to, all of the following:
(1) (A) A definition of medical necessity.
(B) The preliminary definition developed pursuant to this
paragraph shall be submitted to the Legislature no later than
February 1, 1994.
(2) Protocols for facilitating access and coordination of mental
health, physical health, educational, vocational, and other
supportive services for persons receiving services through the field
test.
(3) Procedures for promoting quality assurance, performance
monitoring measures and outcome evaluation, including measures of
client satisfaction, and procedures for addressing beneficiary
grievances concerning service denials, changes, or terminations.
(e) Counties participating in the field test shall report to the
State Department of Mental Health as the department deems necessary.
(f) Counties participating in the field test shall do both of the
following:
(1) (A) Explore, in consultation with the State Department of
Mental Health, the State Department of Health Care
Services, and the California Mental Health Directors Association,
rates for capitated, integrated Medi-Cal mental health managed care
systems, using an actuarially sound ratesetting methodology.
(B) These rates shall be evaluated by the State Department of
Mental Health and the State Department of Health Care
Services to determine their fiscal impact, and shall result in no
increase in cost to the General Fund, compared with the cost that
would occur under the existing organization of Medi-Cal funded mental
health services, except for caseload growth and price increases as
included in the Medi-Cal estimates prepared by the State Department
of Health Care Services and approved by the Department of
Finance. In evaluating the fiscal impact of these rates, the
departments shall take into account any shift in clients between
Medi-Cal programs in which the nonfederal match is funded by state
funds and those in which the match is funded by local funds.
(2) Demonstrate the appropriate fiscal relationship between county
organized health systems for the federal medicaid program and
integrated, capitated Medi-Cal mental health managed care programs.
(3) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute that
is enacted before January 1, 2013, deletes or extends the dates on
which it becomes inoperative and is repealed.
SEC. 155. Section 5720 of the Welfare
and Institutions Code , as added by Section 4 of
Chapter 651 of the Statutes of 2011, is amended and renumbered to
read:
5720. 14708. (a)
Notwithstanding any other provision of law, the director, in the
1993-94 fiscal year and fiscal years thereafter, subject to the
approval of the Director of Health Care Services, shall establish the
amount of reimbursement for services provided by county mental
health programs to Medi-Cal eligible individuals. For
purposes of federal reimbursement to counties that have certified to
the state that they have incurred certified public
expenditures have been incurred , the
reimbursement amounts shall be consistent with federal Medicaid
requirements for calculating federal upper payment limits, as
specified in the approved Medicaid state plan and waivers.
(b) If the reimbursement methodology utilizes federal upper
payment limits and the total cost of services exceeds the state
maximum rates in effect for the 2011-12 fiscal year, a county may use
certified public expenditures to claim the costs of services that
exceed the state maximum rates, up to the federal upper payment
limits. If a county chooses to claim costs that exceed the state
maximum rates with certified public expenditures, the county shall
use only local funds, and not state funds, to claim the portion of
the costs over the state maximum rates. As a condition of receiving
reimbursement up to the federal upper payment limits, a county shall
enter into and maintain an agreement with the department implementing
this subdivision.
(c) Notwithstanding this section, in the event that a health
facility has entered into a negotiated rate agreement pursuant to
Article 2.6 (commencing with Section 14081) of Chapter 7 of Part 4 of
Division 9, the facility's rates shall be governed by that
agreement.
(d) This section shall become operative on July 1, 2012.
SEC. 156. Section 5721 of the Welfare
and Institutions Code is amended and renumbered to read:
5721. 14710. Except as otherwise
provided in this section, in determining the amounts which may be
paid, fees paid by persons receiving services or fees paid on behalf
of persons receiving services by the federal government, by the
California Medical Assistance Program
Medi-Cal program set forth in Chapter 7 (commencing with
Section 14000) of Part 3 of Division 9 , and by
other public or private sources, shall be deducted from the costs of
providing services. However, a county mental
health plan may negotiate a contract which
that permits a specialty mental health care
provider to retain unanticipated funds above the budgeted contract
amount, provided that the unanticipated revenues are utilized for the
specialty mental health services specified in the
contract. If a provider is permitted by contract to retain
unanticipated revenues above the budgeted amount, the specialty
mental health provider shall specify the services funded by
those revenues in the year end yearend
cost report submitted to the county mental
health plan . A county mental health
plan shall not permit the retention of any fees paid by private
resources on behalf of Medi-Cal beneficiaries without having those
fees deducted from the costs of providing services. Whenever
feasible, mentally disordered persons with
mental illness who are eligible for specialty mental
health services under the California Medical Assistance
Program Medi-Cal program shall be treated in a
facility approved for reimbursement in that program. General
unrestricted or undesignated private charitable donations and
contributions made to charitable or nonprofit organizations shall not
be considered as "fees paid by persons" or "fees paid on behalf of
persons receiving services" under this section and the contributions
shall not be applied in determining the amounts to be paid. These
unrestricted contributions shall not be used in part or in whole to
defray the costs or the allocated costs of the California
Medical Assistance Program Medi-Cal program .
SEC. 157. Section 5722 of the Welfare
and Institutions Code is amended and renumbered to read:
5722. 14706. (a) The department
shall have responsibility , as delegated by the State
Department of Health Services, for conducting
investigations and audits of claims and reimbursements for
expenditures for specialty mental health services provided
by county mental health programs
plans to Medi-Cal eligible individuals.
(b) The amount of the payment or repayment of federal funds in
accordance with audit findings pertaining to Short-Doyle
Medi-Cal specialty mental health services shall
be determined by the State Director of Health Services
department pursuant to the existing
administrative appeals process of the State Department of
Health Services department .
SEC. 158. Section 5723 of the Welfare
and Institutions Code is amended and renumbered to read:
5723. 14709. The provisions of
subdivision (a) of Section 14000 shall not be construed to prevent
providers of specialty mental health services pursuant to
this part chapter from also being
providers of medical assistance mental health services for the
purposes of Chapter 7 (commencing with Section 14000) of
Part 3 of Division 9 . Clinics providing Medi-Cal
specialty mental health services pursuant to this part
chapter shall not be
required to be licensed certified as a
condition to reimbursement for providing such
those medical assistance mental health services.
SEC. 159. Section 5723.5 of the Welfare
and Institutions Code is repealed.
5723.5. Notwithstanding any other provision of state law, and to
the extent permitted by federal law and consistent with federal
regulations governing these claims, the state may seek federal
reimbursement for back claims under the Short-Doyle Medi-Cal program.
SEC. 160. Section 5724 of the Welfare
and Institutions Code , as added by Section 6
of Chapter 651 of the Statutes of 2011, is amended and renumbered to
read:
5724. 14711. (a) The department
and the State Department of Health Care Services
shall jointly develop, in consultation with the
California Mental Health Directors Association, a reimbursement
methodology for use in the Short-Doyle Medi-Cal
claims processing and interim payment system that
maximizes federal funding and utilizes, as much as practicable,
federal Medicaid and Medicare reimbursement principles. The
departments department shall work with the
federal Centers for Medicare and Medicaid Services in the development
of the methodology required by this section.
(b) Reimbursement amounts developed through the methodology
required by this section shall be consistent with federal Medicaid
requirements and the approved Medicaid state plan and waivers.
(c) Administrative costs shall be claimed separately in a manner
consistent with federal Medicaid requirements and the approved
Medicaid state plan and waivers and shall be limited to 15 percent of
the total actual cost of direct client services.
(d) The cost of performing quality assurance and utilization
review activities shall be reimbursed separately and shall not be
included in administrative cost.
(e) The reimbursement methodology established pursuant to this
section shall be based upon certified public expenditures, which
encourage economy and efficiency in service delivery.
(f) The reimbursement amounts established for direct client
services pursuant to this section shall be based on increments of
time for all noninpatient services.
(g) The reimbursement methodology shall not be implemented until
it has received any necessary federal approvals.
(h) This section shall become operative on July 1, 2012.
SEC. 161. Section 5750 of the Welfare
and Institutions Code is amended to read:
5750. (a) The State
Department of Mental Health Care Services
shall administer this part and shall adopt standards for
the approval of mental health services, and rules and
regulations necessary thereto. However, these standards, rules, and
regulations shall be adopted only after consultation with the
California Council on Mental Health and the California
Conference of Local Mental Health Directors
Association and the California Mental Health Planning Council .
Adoption of these standards, rules, and regulations shall
require approval by the California Conference of Local Mental Health
Directors by majority vote of those present at an official session
except for regulations pertaining to psychiatric health facilities.
For regulations pertaining to psychiatric health facilities, the vote
by the conference, following consultation, shall be only advisory to
the State Department of Mental Health.
(b) If the conference refuses or fails to approve standards,
rules, or regulations submitted to it by the State Department of
Mental Health for its approval, the State Department of Mental Health
may submit these standards, rules, or regulations to the conference
at its next meeting, and if the conference again refuses to approve
them, the matter shall be referred for decision to a committee
composed of the Secretary of the Health and Welfare Agency, the
Director of Mental Health, the President of the California Conference
of Local Mental Health Directors, the Chairman of the California
Council on Mental Health, and a member designated by the State
Advisory Health Council.
(c) (1) From July 1, 1991, to June 30, 1993, inclusive, the
conference shall not approve regulations of the State Department of
Mental Health. The impact on this subdivision of regulatory timing
shall be included in the department's report to the Legislature on
September 30, 1992.
(2) The department shall continue during that period to involve
the conference in the development of all regulations which affect
local mental health programs, prior to the promulgation of those
regulations pursuant to the Administrative Procedure Act.
SEC. 162. Section 5750.1 of the Welfare
and Institutions Code is repealed.
5750.1. Notwithstanding Section 5750, a standard, rule, or
policy, not directly the result of a statutory or administrative law
change, adopted by the department or county during the term of an
existing county performance contract shall not apply to the
negotiated net amount terms of that contract under Sections 5705 and
5716, but shall only apply to contracts established after adoption of
the standard, rule, or policy.
SEC. 163. Section 5751 of the Welfare
and Institutions Code is amended to read:
5751. (a) Regulations pertaining to the qualifications of
directors of local mental health services shall be administered in
accordance with Section 5607. These standards may include the
maintenance of records of service which shall be reported to the
State Department of Mental Health Care
Services in a manner and at times as it may specify.
(b) Regulations pertaining to the position of director of local
mental health services, where the local director is other than the
local health officer or medical administrator of the county
hospitals, shall require that the director be a psychiatrist,
psychologist, clinical social worker, marriage and family therapist,
professional clinical counselor, registered nurse, or hospital
administrator, who meets standards of education and experience
established by the Director of Mental Health
Care Services . Where the director is not a psychiatrist, the
program shall have a psychiatrist licensed to practice medicine in
this state and who shall provide to patients medical care and
services as authorized by Section 2051 of the Business and
Professions Code.
(c) The regulations shall be adopted in accordance with the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
SEC. 164. Section 5751.1 of the Welfare
and Institutions Code is amended to read:
5751.1. Regulations pertaining to the position of director of
local mental health services, where the local director is other than
the local health officer or medical administrator of the county
hospitals, shall require that the director meet the standards of
education and experience established by the Director of
Mental Health Care Services and that the
appointment be open on the basis of competence to all eligible
disciplines pursuant to Section 5751. Regulations pertaining to the
qualifications of directors of local mental health services shall be
administered in accordance with Section 5607.
Where the director of local mental health services is not a
psychiatrist, the program shall have a psychiatrist licensed to
practice medicine in this state and who shall provide to patients
medical care and services as authorized by Section 2137 of the
Business and Professions Code.
SEC. 165. Section 5751.2 of the Welfare
and Institutions Code is amended to read:
5751.2. (a) Except as provided in this section, persons employed
or under contract to provide mental health services pursuant to this
part shall be subject to all applicable requirements of law regarding
professional licensure, and no person shall be employed in local
mental health programs pursuant to this part to provide services for
which a license is required, unless the person possesses a valid
license.
(b) Persons employed as psychologists and clinical social workers,
while continuing in their employment in the same class as of January
1, 1979, in the same program or facility, including those persons on
authorized leave, but not including intermittent personnel, shall be
exempt from the requirements of subdivision (a).
(c) While registered with the licensing board of jurisdiction for
the purpose of acquiring the experience required for licensure,
persons employed or under contract to provide mental health services
pursuant to this part as clinical social workers, marriage and family
therapists, or professional clinical counselors shall be exempt from
subdivision (a). Registration shall be subject to regulations
adopted by the appropriate licensing board.
(d) The requirements of subdivision (a) shall be waived by the
department State Department of Health Care
Services for persons employed or under contract to provide
mental health services pursuant to this part as psychologists who are
gaining the experience required for licensure. A waiver granted
under this subdivision may not exceed five years from the date of
employment by, or contract with, a local mental health program for
persons in the profession of psychology.
(e) The requirements of subdivision (a) shall be waived by the
department State Department of Health Care
Services for persons who have been recruited for employment
from outside this state as psychologists, clinical social workers,
marriage and family therapists, or professional clinical counselors
and whose experience is sufficient to gain admission to a licensing
examination. A waiver granted under this subdivision may not exceed
three years from the date of employment by, or contract with, a local
mental health program for persons in these four professions who are
recruited from outside this state.
SEC. 166. Section 5751.7 of the Welfare
and Institutions Code is amended to read:
5751.7. For the purposes of this part and the
Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000)),
the department State Department of Social
Services and the State Department of State Hospitals shall
ensure that, whenever feasible, minors shall not be admitted into
psychiatric treatment with adults if the health facility has no
specific separate housing arrangements, treatment staff, and
treatment programs designed to serve children or adolescents. The
director Director of Social Services
shall provide waivers to counties, upon their request, if this policy
creates undue hardship in any county due to inadequate or
unavailable alternative resources. In granting the waivers, the
director Director of Social Services
shall require the county to establish specific treatment protocols
and administrative procedures for identifying and providing
appropriate treatment to minors admitted with adults.
However, notwithstanding any other provision of law, no minor may
be admitted for psychiatric treatment into the same treatment ward as
any adult receiving treatment who is in the custody of any jailor
for a violent crime, is a known registered sex offender, or has a
known history of, or exhibits inappropriate, sexual, or other violent
behavior which would present a threat to the physical safety of
minors.
SEC. 167. Section 5768 of the Welfare
and Institutions Code is amended to read:
5768. (a) Notwithstanding any other provision of law, except as
to requirements relating to fire and life safety of persons with
mental illness, the department State
Department of Social Services , in its discretion, may permit
new programs to be developed and implemented without complying with
licensure requirements established pursuant to existing state law.
(b) Any program developed and implemented pursuant to subdivision
(a) shall be reviewed at least once each six months, as determined by
the department State Department of Social
Services .
(c) The department State Department of
Social Services may establish appropriate licensing
requirements for these new programs upon a determination that the
programs should be continued.
(d) Within six years, any program shall require a licensure
category if it is to be continued. However, in the event that any
agency other than the department State
Department of Social Services is responsible for developing a
licensure category and fails to do so within the six years, the
program may continue to be developed and implemented pursuant to
subdivisions (a) and (b) until such time that the licensure category
is established.
(e) (1) A nongovernmental entity proposing a program shall submit
a program application and plan to the local mental health director
that describes at least the following components: clinical treatment
programs, activity programs, administrative policies and procedures,
admissions, discharge planning, health records content, health
records service, interdisciplinary treatment teams, client
empowerment, patient rights, pharmaceutical services, program space
requirements, psychiatric and psychological services, rehabilitation
services, restraint and seclusion, space, supplies, equipment, and
staffing standards. If the local mental health director determines
that the application and plan are consistent with local needs and
satisfactorily address the above components, he or she may approve
the application and plan and forward them to the department.
(2) Upon the department's State Department
of Social Services ' approval, the local mental
health director shall implement the program and shall be responsible
for regular program oversight and monitoring. The department shall be
notified in writing of the outcome of each review of the program by
the local mental health director, or his or her designee, for
compliance with program requirements. The department shall retain
ultimate responsibility for approving the method for review of each
program, and the authority for determining the appropriateness of the
local program's oversight and monitoring activities.
(f) Governmental entities proposing a program shall submit a
program application and plan to the department
State Department of Social Services that describes at
least the components described in subdivision (e). Upon approval, the
department shall be responsible for program oversight and
monitoring.
(g) Implementation of a program shall be contingent upon the
department's State Department of Social
Services ' approval, and the department may reject
applications or require modifications as it deems necessary. The
department shall respond to each proposal within 90 days of receipt.
(h) The State Department of Health Services shall allow an
applicant approved by the department with a current health facility
license to place its license in suspense for a period of six years.
At that time the department, in consultation with the State
Department of Health Services shall determine the most appropriate
licensure for the program, pursuant to subdivisions (c) and (d).
(i)
(h) The department The State
Department of Social Services shall submit an
evaluation to the Legislature of all pilot projects authorized
pursuant to this section within five years of the commencement of
operation of the pilot project, determining the effectiveness of that
program or facility, or both, based on, but not limited to, changes
in clinical indicators with respect to client functions.
SEC. 168. Section 5770 of the Welfare
and Institutions Code is amended to read:
5770. Notwithstanding any other provision of law, the
department State Department of Health Care Services
may directly, or by contract, with any public or private
agency, provide any of the services under this division when the
director state determines that the
services are necessary to protect the public health, safety, or
welfare.
SEC. 169. Section 5770.5 of the Welfare
and Institutions Code is amended to read:
5770.5. The department The State
Department of Health Care Services shall encourage county
mental health programs to develop and support local programs designed
to provide technical assistance to self-help groups for the purposes
of maintaining existing groups, as well as to stimulate development
of new self-help groups from locally defined needs.
SEC. 170. Section 5771 of the Welfare
and Institutions Code is amended to read:
5771. (a) Pursuant to Public Law 102-321, there is the California
Mental Health Planning Council. The purpose of the planning council
shall be to fulfill those mental health planning requirements
mandated by federal law.
(b) (1) The planning council shall have 40 members, to be
comprised of members appointed from both the local and state levels
in order to ensure a balance of state and local concerns relative to
planning.
(2) As required by federal law, eight members of the planning
council shall represent various state departments.
(3) Members of the planning council shall be appointed in a manner
that will ensure that at least one-half are persons with mental
disabilities, family members of persons with mental disabilities, and
representatives of organizations advocating on behalf of persons
with mental disabilities. Persons with mental disabilities and family
members shall be represented in equal numbers.
(4) The Director of Mental Health Care
Services shall make appointments from among nominees from
various mental health constituency organizations, which shall include
representatives of consumer-related advocacy organizations,
representatives of mental health professional and provider
organizations, and representatives who are direct service providers
from both the public and
private sectors. The director shall also appoint one representative
of the California Coalition on Mental Health.
(c) Members should be balanced according to demography, geography,
gender, and ethnicity. Members should include representatives with
interest in all target populations, including, but not limited to,
children and youth, adults, and older adults.
(d) The planning council shall annually elect a chairperson and a
chair-elect.
(e) The term of each member shall be three years, to be staggered
so that approximately one-third of the appointments expire in each
year.
(f) In the event of changes in the federal requirements regarding
the structure and function of the planning council, or the
discontinuation of federal funding, the State Department of
Mental Health Care Services shall , with
input from state- level advocacy groups, consumers, family
members and providers, and other stakeholders, propose to the
Legislature modifications in the structure of the planning council
that the department deems appropriate.
SEC. 171. Section 5771.3 of the Welfare
and Institutions Code i s amended to read:
5771.3. The California Mental Health Planning Council may utilize
staff of the State Department of Mental Health
Care Services , to the extent they are available, and the
staff of any other public or private agencies that have an interest
in the mental health of the public and that are able and willing to
provide those services.
SEC. 172. Section 5772 of the Welfare
and Institutions Code is amended to read:
5772. The California Mental Health Planning Council shall have
the powers and authority necessary to carry out the duties imposed
upon it by this chapter, including, but not limited to, the
following:
(a) To advocate for effective, quality mental health programs.
(b) To review, assess, and make recommendations regarding all
components of California's mental health system, and to report as
necessary to the Legislature, the State Department of Mental
Health Care Services , local boards, and local
programs.
(c) To review program performance in delivering mental health
services by annually reviewing performance outcome data as follows:
(1) To review and approve the performance outcome measures.
(2) To review the performance of mental health programs based on
performance outcome data and other reports from the State Department
of Mental Health Care Services and
other sources.
(3) To report findings and recommendations on programs'
performance annually to the Legislature, the State Department of
Mental Health Care Services , and the
local boards.
(4) To identify successful programs for recommendation and for
consideration of replication in other areas. As data and technology
are available, identify programs experiencing difficulties.
(d) When appropriate, make a finding pursuant to Section 5655 that
a county's performance is failing in a substantive manner. The State
Department of Mental Health Care Services
shall investigate and review the finding, and report the action
taken to the Legislature.
(e) To advise the Legislature, the State Department of
Mental Health Care Services , and county boards
on mental health issues and the policies and priorities that this
state should be pursuing in developing its mental health system.
(f) To periodically review the state's data systems and paperwork
requirements to ensure that they are reasonable and in compliance
with state and federal law.
(g) To make recommendations to the State Department of
Mental Health Care Services on the award of
grants to county programs to reward and stimulate innovation in
providing mental health services.
(h) To conduct public hearings on the state mental health plan,
the Substance Abuse and Mental Health Services Administration block
grant, and other topics, as needed.
(i) To participate in the recruitment of candidates for the
position of Director of Mental Health and provide advice on the final
selection.
(j)
(i) In conjunction with other statewide and local
mental health organizations, assist in the coordination of training
and information to local mental health boards as needed to ensure
that they can effectively carry out their duties.
(k)
(j) To advise the Director of Mental
Health Care Services on the development of the state
mental health plan and the system of priorities contained in that
plan.
(l)
(k) To assess periodically the effect of realignment of
mental health services and any other important changes in the state's
mental health system, and to report its findings to the Legislature,
the State Department of Mental Health Care
Services , local programs, and local boards, as appropriate.
(m)
(l) To suggest rules, regulations, and standards for
the administration of this division.
(n)
(m) When requested, to mediate disputes between
counties and the state arising under this part.
(o)
(n) To employ administrative, technical, and other
personnel necessary for the performance of its powers and duties,
subject to the approval of the Department of Finance.
(p)
(o) To accept any federal fund granted, by act of
Congress or by executive order, for purposes within the purview of
the California Mental Health Planning Council, subject to the
approval of the Department of Finance.
(q)
(p) To accept any gift, donation, bequest, or grants of
funds from private and public agencies for all or any of the
purposes within the purview of the California Mental Health Planning
Council, subject to the approval of the Department of Finance.
SEC. 173. Section 5775 of the Welfare
and Institutions Code is amended and renumbered to read:
5775. 14712. (a) Notwithstanding
any other provision of state law, the State Department of
Mental Health department shall implement managed
mental health care for Medi-Cal beneficiaries through
fee-for-service or capitated rate contracts with mental
health plans , including . Mental
health plans may include individual counties, counties acting
jointly, any qualified individual or organization, or a
or an organization or nongovernmental entity
determined by the department to meet mental health plan
standards . A contract may be exclusive and may be awarded on a
geographic basis.
(b) Two or more counties acting jointly may agree to deliver or
subcontract for the delivery of specialty mental health
services subject to the approval by the department . The
agreement may encompass all or any portion of the specialty
mental health services provided pursuant to this part
chapter . This agreement shall not relieve the
individual counties of financial fiscal
responsibility for providing these services. Any agreement between
counties shall delineate each county's responsibilities and fiscal
liability for overpayments .
(c) (1) The department shall offer
to contract with each a
county or counties acting jointly for the delivery of
specialty mental health services to that
each county's el igible Medi-Cal
beneficiary population prior to offering to contract with
any other entity, upon terms at least as favorable as any offered to
a noncounty contract provider. If population. If
a county elects decides not to
contract with the department, does not renew its contract, or
does not is unable to meet the
minimum standards set by the department, the
department may elect to contract with any other governmental or
nongovernmental entity for the delivery of mental health services in
that county and may administer the delivery of mental health services
until a contract for a mental health plan is implemented. The county
may not subsequently contract to provide mental health services
under this part unless the department elects to contract with the
county. county shall inform the department of this
decision in writing.
(B)
(2) If the county is unwilling to contract for the
delivery of specialty mental health services, the department shall
ensure that specialty mental health services are provided to Medi-Cal
beneficiaries.
(3) If the department or county determines that the county is
unable to adequately provide specialty mental health services, or
that the county does not meet the standards of a mental health plan,
the department shall ensure that specialty mental health services are
provided to Medi-Cal beneficiaries.
(4) The department may contract with qualifying individual
counties, counties acting jointly, or other qualified entities
approved by the department for the delivery of specialty mental
health services in any county that is unable or unwilling to contract
with the department. The county may not subsequently contract to
provide specialty mental health services under this chapter unless
the department elects to contract with the county.
(d) If a county does not contract with the department or
other department- approved entity to provide
specialty mental health services, the county
department shall transfer the responsibility for
community Medi-Cal reimbursable mental health services and the
anticipated county matching funds needed for community Medi-Cal
mental health services in that county to the department. The amount
of the anticipated county matching funds shall be determined by the
department in consultation with the county, and shall be adjusted
annually. The amount transferred shall be based on historical cost,
adjusted for changes in the number of Medi-Cal beneficiaries and
other relevant factors. The anticipated county matching funds shall
be used by the department to contract with another entity for mental
health services, and shall not be expended for any other purpose but
the provision of those services and related administrative costs. The
county shall continue to deliver non-Medi-Cal reimbursable mental
health services in accordance with this division, and subject to
subdivision (i) of Section 5777 work with the
Department of Finance and the Controller to sequester funds from the
county that is unable or unwilling to contract in accordance with
Section 30027.10 of the Government Code .
(e) Whenever the department determines that a mental health plan
has failed to comply with this part chapter
or any regulations , contractual requirements, state plan,
or waivers adopted pursuant to this part that
implement this part chapter , the department
shall notify the mental health plan in writing within 30 days of
its determination and may impose sanctions, including, but not
limited to, fines, penalties, the withholding of payments, special
requirements, probationary or corrective actions, or any other
actions deemed necessary to prompt and
promptly ensure contract and performance compliance. If
fines are imposed by the department, they may be withheld
from the state matching funds provided to a mental health plan for
Medi-Cal mental health services. the department
imposes fines or penalties, to the extent permitted by federal law
and state law or contract, it may offset the fines from either of the
following:
(1) Funds from the Mental Health
Subaccount, the Mental Health Equity Subaccount, and the Vehicle
License Collection Account of the Local Revenue Fund and funds from
the Mental Health Account and the Behavioral Health Subaccount of the
Local Revenue Fund 2011.
(2) Any other mental health realignment
funds from which the Controller is authorized to make
distributions to the counties, if the funds described in paragraph
(1) are insufficient for the purposes described in this subdivision.
(f) Notwithstanding any other provision of law, emergency
regulations adopted pursuant to Section 14680 to implement the second
phase of mental health managed care as provided in this part shall
remain in effect until permanent regulations are adopted, or June 30,
2006, whichever occurs first.
(g) The department shall convene at least two public hearings to
clarify new federal regulations recently enacted by the federal
Centers for Medicare and Medicaid Services that affect the state's
second phase of mental health managed care and shall report to the
Legislature on the results of these hearings through the 2005-06
budget deliberations.
(h) The department may adopt emergency regulations necessary to
implement Part 438 (commencing with Section 438.1) of Subpart A of
Subchapter C of Chapter IV of Title 42 of the Code of Federal
Regulations, in accordance with Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code. The
adoption of emergency regulations to implement this part, that are
filed with the Office of Administrative Law within one year of the
date on which the act that amended this subdivision in 2003 took
effect, shall be deemed to be an emergency and necessary for the
immediate preservation of the public peace, health, and safety, or
general welfare, and shall remain in effect for no more than 180
days.
(f) The due process and appeals process specified in paragraph (4)
of subdivision (b) of Section 14718 shall be made available to the
mental health plan under the circumstances described in subdivision
(e).
SEC. 174. Section 5776 of the Welfare
and Institutions Code is amended and renumbered to read:
5776. 14713. (a) The department and
its mental health plan contractors
plans shall comply with all applicable federal
laws, regulations, and the guidelines, standards, and
requirements specified in the state plan, waiver, and mental health
plan contract, and, except as provided in this part
chapter , all applicable state statutes and
regulations.
(b) If federal requirements that affect the provisions of this
part chapter are changed, it is the
intent of the Legislature that state requirements be revised to
comply with those changes.
SEC. 175. Section 5777 of the Welfare
and Institutions Code is amended and renumbered to read:
5777. 14714. (a) (1) Except as
otherwise specified in this part chapter
, a contract entered into pursuant to this part
chapter shall include a provision that the
mental health plan contractor shall bear the financial risk for the
cost of providing medically necessary specialty mental
health services to Medi-Cal beneficiaries irrespective of
whether the cost of those services exceeds the payment set forth in
the contract. If the expenditures for services do not exceed the
payment set forth in the contract, the mental health plan contractor
shall report the unexpended amount to the department, but shall not
be required to return the excess to the department .
(2) If the mental health plan is not the county's
administered by a county , the mental health
plan may shall not transfer the
obligation for any specialty mental health services to
Medi-Cal beneficiaries to the county. The mental health plan may
purchase services from the county. The mental health plan shall
establish mutually agreed-upon protocols with the county that clearly
establish conditions under which beneficiaries may obtain
non-Medi-Cal reimbursable services from the county. Additionally, the
plan shall establish mutually agreed-upon protocols with the county
for the conditions of transfer of beneficiaries who have lost
Medi-Cal eligibility to the county for care under Part 2 (commencing
with Section 5600), Part 3 (commencing with Section 5800), and Part 4
(commencing with Section 5850) of Division 5 .
(3) The mental health plan shall be financially responsible for
ensuring access and a minimum required scope of benefits and
services , consistent with state and federal requirements, to
the services to the Medi-Cal beneficiaries
who are residents of that county regardless of where the
beneficiary resides. The department shall require that the same
definition of medical necessity be used, and the
minimum scope of benefits offered , by each mental
health contractor plan be the same,
except to the extent that any variations receive
prior federal approval is received and are
is consistent with state and federal
statutes and regulations laws .
(b) (1) Any contract entered into pursuant
to this part chapter may be renewed if
the mental health plan continues to meet the requirements
of this part chapter , regulations
promulgated pursuant thereto, and the terms and conditions of the
contract. Failure to meet these requirements shall be cause for
nonrenewal of the contract. The department may base the decision to
renew on timely completion of a mutually agreed-upon plan of
correction of any deficiencies, submissions of required information
in a timely manner, or other conditions of the contract. At
the discretion of the department, each contract may be renewed for a
period not to exceed three years.
(2) In the event the contract is not renewed based on the reasons
specified in paragraph (1), the department shall notify the
Department of Finance, the fiscal and policy committees of the
Legislature, and the Controller of the amounts to be sequestered from
the Mental Health Subaccount, the Mental Health Equity Account, and
the Vehicle License Fee Collection Account of the Local Revenue Fund
and the Mental Health Account and the Behavioral Health Subaccount of
the Local Revenue Fund 2011, and the Controller shall sequester
those funds in the Behavioral Health Subaccount pursuant to Section
30027.10 of the Government Code. Upon this sequestration, the
department shall use the funds in accordance with the provisions of
Section 30027.10 of the Government Code.
(c) (1) The obligations of the mental health plan shall be changed
only by contract or contract amendment.
(2) Notwithstanding paragraph (1), the mental health plan shall
comply with federal and state requirements, including the applicable
sections of the state plan and waiver.
(2)
(3) A change may be made during a contract term or at
the time of contract renewal, where when
there is a change in obligations required by federal or state
law or when required by a change in the interpretation or
implementation of any law or regulation. To the extent
permitted by federal law and except as provided under paragraph (10)
of subdivision (c) of Section 5778, if any change in obligations
occurs that affects the cost to the mental health plan of performing
under the terms of its contract, the department may reopen contracts
to negotiate the state General Fund allocation to the mental health
plan under Section 5778, if the mental health plan is reimbursed
through a fee-for-service payment system, or the capitation rate to
the mental health plan under Section 5779, if the mental health plan
is reimbursed through a capitated rate payment system. During the
time period required to redetermine the allocation or rate, payment
to the mental health plan of the allocation or rate in effect at the
time the change occurred shall be considered interim payments and
shall be subject to increase or decrease, as the case may be,
effective as of the date on which the change is effective.
(3)
(4) To the extent permitted by federal law, either the
department or the mental health plan may request that contract
negotiations be reopened during the course of a contract due to
substantial changes in the cost of covered benefits that result from
an unanticipated event.
(d) The department shall immediately terminate a contract when the
director finds that there is an immediate threat to the health and
safety of Medi-Cal beneficiaries. Termination of the contract for
other reasons shall be subject to reasonable notice of the department'
s intent to take that action and notification of
to affected beneficiaries. The plan may request a
public hearing by the Office of Administrative Hearings
and Appeals .
(e) A mental health plan may terminate its contract in
accordance with the provisions in the contract. The mental
health plan shall provide written notice to the department at
least 180 days prior to the termination or nonrenewal of the
contract.
(f) Upon the request of the Director of Mental Health
director , the Director of the Department
of Managed Health Care may exempt a mental health plan
contractor or a capitated rate contract from the
Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code). These exemptions may be subject to conditions the director
deems appropriate. Nothing in this part
chapter shall be construed to impair or diminish the authority
of the Director of the Department of Managed Health Care
under the Knox-Keene Health Care Service Plan Act of 1975, nor shall
anything in this part chapter be
construed to reduce or otherwise limit the obligation of a mental
health plan contractor licensed as a health care service plan to
comply with the requirements of the Knox-Keene Health Care Service
Plan Act of 1975, and the rules of the Director of the
Department of Managed Health Care promulgated thereunder. The
Director of Mental Health director , in
consultation with the Director of the Department of
Managed Health Care, shall analyze the appropriateness of licensure
or application of applicable standards of the Knox-Keene Health Care
Service Plan Act of 1975.
(g) (1) The department
, pursuant to an agreement with the State Department of
Health Care Services, shall provide oversight to the mental
health plans to ensure quality, access, and cost
efficiency , and compliance with data and reporting requirements
. At a minimum, the department shall, through a method
independent of any agency of the mental health plan contractor,
monitor the level and quality of services provided, expenditures
pursuant to the contract, and conformity with federal and state law.
(2) (A) Commencing July 1, 2008, county mental health plans, in
collaboration with the department, the federally required external
review organization, providers, and other stakeholders, shall
establish an advisory statewide performance improvement project (PIP)
to increase the coordination, quality, effectiveness, and efficiency
of service delivery to children who are either receiving at least
three thousand dollars ($3,000) per month in the Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT) Program services or
children identified in the top 5 percent of the county EPSDT cost,
whichever is lowest. The statewide PIP shall replace one of the two
required PIPs that mental health plans must perform under federal
regulations outlined in the mental health plan contract.
(B) The federally required external quality review organization
shall provide independent oversight and reviews with recommendations
and findings or summaries of findings, as appropriate, from a
statewide perspective. This information shall be accessible to county
mental health plans, the department, county welfare directors,
providers, and other interested stakeholders in a manner that both
facilitates, and allows for, a comprehensive quality improvement
process for the EPSDT Program.
(C) Each July, the department, in consultation with the federally
required external quality review organization and the county mental
health plans, shall determine the average monthly cost threshold for
counties to use to identify children to be reviewed who are currently
receiving EPSDT services. The department shall consult with
representatives of county mental health directors, county welfare
directors, providers, and the federally required external quality
review organization in setting the annual average monthly cost
threshold and in implementing the statewide PIP. The department shall
provide an annual update to the Legislature on the results of this
statewide PIP by October 1 of each year for the prior fiscal year.
(D) It is the intent of the Legislature for the EPSDT PIP to
increase the coordination, quality, effectiveness, and efficiency of
service delivery to children receiving EPSDT services and to
facilitate evidence-based practices within the program, and other
high-quality practices consistent with the values of the public
mental health system within the program to ensure that children are
receiving appropriate mental health services for their mental health
wellness.
(E) This paragraph shall become inoperative on September 1, 2011.
(h) County employees implementing or administering a mental health
plan act in a discretionary capacity when they determine whether or
not to admit a person for care or to provide any level of care
pursuant to this part chapter .
(i) If a county chooses to discontinue
discontinues operations as the local mental
health plan, the department shall approve any new
mental health plan. The new mental health plan shall give
reasonable consideration to affiliation with nonprofit community
mental health agencies that were under contract with the county and
that meet the mental health plan's quality and cost efficiency
standards.
(j) Nothing in this part chapter
shall be construed to modify, alter, or increase the obligations of
counties as otherwise limited and defined in Chapter 3 (commencing
with Section 5700) of Part 2 of Division 5 . The county's
maximum obligation for services to persons not eligible for Medi-Cal
shall be no more than the amount of funds remaining in the mental
health subaccount pursuant to Sections 17600, 17601, 17604, 17605,
17606, and 17609 after fulfilling the Medi-Cal
contract obligations.
SEC. 176. Section 5777.5 of the Welfare
and Institutions Code is amended and renumbered to read:
5777.5. 14715. (a) (1) The
department shall require any mental health plan that provides
Medi-Cal specialty mental health services to enter into a
memorandum of understanding with any Medi-Cal managed care plan that
provides Medi-Cal health services to some of the same Medi-Cal
recipients served by the mental health plan. The memorandum of
understanding shall comply with applicable regulations.
(2) For purposes of this section, a "Medi-Cal managed care plan"
means any prepaid health plan or Medi-Cal managed care plan
contracting with the State Department of Health Services
department to provide services to enrolled
Medi-Cal beneficiaries under Chapter 7 (commencing with Section
14000) or Chapter 8 (commencing with Section 14200) of Part
3 of Division 9 , or Part 4 (commencing with Section
101525) of Division 101 of the Health and Safety Code.
(b) The department shall require the memorandum of understanding
to include all of the following:
(1) A process or entity to be designated by the local mental
health plan to receive notice of actions, denials, or deferrals from
the Medi-Cal managed care plan, and to provide any additional
information requested in the deferral notice as necessary for a
medical necessity determination.
(2) A requirement that the local mental health plan respond by the
close of the business day following the day the deferral notice is
received.
(c) The department may sanction a mental health plan pursuant to
paragraph (1) of subdivision (e) of Section
5775 14712 for failure to comply with
this section.
(d) This section shall apply to any contracts entered into,
amended, modified, extended, or renewed on or after January 1, 2001.
SEC. 177. Section 5777.6 of the Welfare
and Institutions Code is amended and renumbered to read:
5777.6. 14716. (a) Each local
mental health plan shall establish a procedure to ensure access to
outpatient specialty mental health services, as required
by the Early Periodic Screening and Diagnostic Treatment program
standards, for any child in foster care who has been placed outside
his or her county of adjudication.
(b) The procedure required by subdivision (a) may be established
through one or more of the following:
(1) The establishment of, and federal approval, if required, of, a
statewide system or procedure.
(2) An arrangement between local mental health plans for
reimbursement for services provided by a mental health plan other
than the mental health plan in the county of adjudication and
designation of an entity to provide additional information needed for
approval or reimbursement. This arrangement shall not require
providers who are already credentialed or certified by the mental
health plan in the beneficiary's county of residence to be
credentialed or certified by, or to contract with, the mental health
plan in the county of adjudication.
(3) Arrangements between the mental health plan in the county of
adjudication and mental health providers in the beneficiary's county
of residence for authorization of, and reimbursement for, services.
This arrangement shall not require providers credentialed or
certified by, and in good standing with, the mental health plan in
the beneficiary's county of residence to be credentialed or certified
by the mental health plan in the county of adjudication.
(c) The department shall collect and keep statistics that will
enable the department to compare access to outpatient specialty
mental health services by foster children placed in their county of
adjudication with access to outpatient specialty mental health
services by foster children placed outside of their county of
adjudication.
SEC. 178. Section 5777.7 of the Welfare
and Institutions Code is amended and renumbered to read:
5777.7. 14717. (a) In order to
facilitate the receipt of medically necessary specialty mental health
services by a foster child who is placed outside his or her county
of original jurisdiction, the State Department of Mental
Health department shall take all of the
following actions:
(1) On or before July 1, 2008, create all of the following items,
in consultation with stakeholders, including, but not limited to, the
California Institute for Mental Health, the Child and Family Policy
Institute, the California Mental Health Directors Association, and
the California Alliance of Child and Family Services:
(A) A standardized contract for the purchase of medically
necessary specialty mental health services from organizational
providers, when a contract is required.
(B) A standardized specialty mental health service authorization
procedure.
(C) A standardized set of documentation standards and forms,
including, but not limited to, forms for treatment plans, annual
treatment plan updates, day treatment intensive and day treatment
rehabilitative progress notes, and treatment authorization requests.
(2) On or before January 1, 2009, use the standardized items as
described in paragraph (1) to provide medically necessary specialty
mental health services to a foster child who is placed outside his or
her county of original jurisdiction, so that organizational
providers who are already certified by a mental health plan are not
required to be additionally certified by the mental health plan in
the county of original jurisdiction.
(3) (A) On or before January 1, 2009, use the standardized items
described in paragraph (1) to provide medically necessary specialty
mental health services to a foster child placed outside his or her
county of original jurisdiction to constitute a complete contract,
authorization procedure, and set of documentation standards and
forms, so that no additional documents are required.
(B) Authorize a county mental health plan to be exempt from
subparagraph (A) and have an addendum to a contract, authorization
procedure, or set of documentation standards and forms, if the county
mental health plan has an externally placed requirement, such as a
requirement from a federal integrity agreement, that would affect one
of these documents.
(4) Following consultation with stakeholders, including, but not
limited to, the California Institute for Mental Health, the Child and
Family Policy Institute, the California Mental Health Directors
Association, the California State Association of Counties, and the
California Alliance of Child and Family Services, require the use of
the standardized contracts, authorization procedures, and
documentation standards and forms as specified in paragraph (1) in
the 2008-09 state-county mental health plan contract and each
state-county mental health plan contract thereafter.
(5) The mental health plan shall complete a standardized contract,
as provided in paragraph (1), if a contract is required, or another
mechanism of payment if a contract is not required, with a provider
or providers of the county's choice, to deliver approved specialty
mental health services for a specified foster child, within 30 days
of an approved treatment authorization request.
(b) The California Health and Human Services Agency shall
coordinate the efforts of the State Department of Mental
Health department and the State Department of
Social Services to do all of the following:
(1) Participate with the stakeholders in the activities described
in this section.
(2) During budget hearings in 2008 and 2009, report to the
Legislature regarding the implementation of this section and
subdivision (c) of Section 5777.6 14716
.
(3) On or before July 1, 2008, establish the following, in
consultation with stakeholders, including, but not limited to, the
California Mental Health Directors Association, the California
Alliance of Child and Family Services, and the County Welfare
Directors Association of California:
(A) Informational materials that explain to foster care providers
how to arrange for specialty mental health services on
behalf of the beneficiary in their care.
(B) Informational materials that county child welfare agencies can
access relevant to the provision of services to children in their
care from the out-of-county local mental health plan that is
responsible for providing those services, including, but not limited
to, receiving a copy of the child's treatment plan within 60 days
after requesting services.
(C) It is the intent of the Legislature to ensure that foster
children who are adopted or placed permanently with relative
guardians, and who move to a county outside their original county of
residence, can access specialty mental health services in
a timely manner. It is the intent of the Legislature to enact this
section as a temporary means of ensuring access to these services,
while the appropriate stakeholders pursue a long-term solution in the
form of a change to the Medi-Cal Eligibility Data System that will
allow these children to receive specialty mental health
services through their new county of residence.
SEC. 179. Section 5778 of the Welfare
and Institutions Code , as added by Section 8 of Chapter
651 of the Statutes of 2011, is amended and renumbered to read:
5778. 14718. (a) This section shall
be limited to specialty mental health services reimbursed
through a fee-for-service payment system to a mental
health plan that certifies public expenditures subject to cost
settlement or specialty mental health services reimbursed through the
department's fiscal intermediary .
(b) The following provisions shall apply to matters related to
specialty mental health services provided under the approved
Medi-Cal specialty mental health services waiver
state plan and the Specialty Mental Health Services
Waiver , including, but not limited to, reimbursement and
claiming procedures, reviews and oversight, and appeal processes for
mental health plans (MHPs) and MHP subcontractors.
(1) During the initial phases of the implementation of
this part, as As determined by the department,
the MHP contractor and subcontractors shall submit claims
under the Medi-Cal program for eligible services on a fee-for-service
basis shall submit claims for reimbursement to the
Medi-Cal program for eligible services .
(2) A qualifying county may elect, with the approval of the
department, to operate under the requirements of a capitated,
integrated service system field test, pursuant to Section 5719.5
rather than this part, in the event the requirements of the two
programs conflict. A county that elects to operate under that section
shall comply with all other provisions of this part that do not
conflict with that section.
(3) (A) No sooner than October 1, 1994, state matching funds for
Medi-Cal fee-for-service acute psychiatric inpatient services, and
associated administrative days, shall be transferred to the
department. No later than July 1, 1997, upon agreement between the
department and the State Department of Health Care Services, state
matching funds for the remaining Medi-Cal fee-for-service mental
health services and the state matching funds associated with field
test counties under Section 5719.5 shall be transferred to the
department.
(B) The department, in consultation with the State Department of
Health Care Services, a statewide organization representing counties,
and a statewide organization representing health maintenance
organizations shall develop a timeline for the transfer of funding
and responsibility for fee-for-service mental health services from
Medi-Cal managed care plans to MHPs. In developing the timeline, the
department shall develop screening, referral, and coordination
guidelines to be used by Medi-Cal managed care plans and MHPs.
(4) (A) (i) A MHP subcontractor providing specialty mental health
services shall be financially responsible for federal audit
exceptions or disallowances to the extent that these exceptions or
disallowances are based on the MHP subcontractor's conduct or
determinations.
(ii) The state shall be financially responsible for federal audit
exceptions or disallowances to the extent that these exceptions or
disallowances are based on the state's conduct or determinations. The
state shall not withhold payment from a MHP for exceptions or
disallowances that the state is financially responsible for pursuant
to this clause.
(iii) A MHP shall be financially responsible for state audit
exceptions or disallowances to the extent that these exceptions or
disallowances are based on the MHP's conduct or determinations. A MHP
shall not withhold payment from a MHP subcontractor for exceptions
or disallowances for which the MHP is financially responsible
pursuant to this clause.
(B) For purposes of subparagraph (A), a "determination" shall be
shown by a written document expressly stating the determination,
while "conduct" shall be shown by any credible, legally admissible
evidence.
(C)
(2) The department and the State Department of
Health Care Services shall work jointly with MHPs in initiating any
necessary appeals. The department may invoice or may
offset the amount of any federal disallowance or
, audit exception , or overpayment
against subsequent claims from the MHP or MHP subcontractor
. The department may offset the amount of any state
disallowance, or audit exception or overpayment against subsequent
claims from the mental health plan, through the 2010-11 fiscal year.
This offset may be done at any time, after the department
has invoiced or otherwise notified the mental health plan
about the audit exception or ,
disallowance has been withheld from the federal financial
participation claim made by the State Department of Health Care
Services , or overpayment . The maximum
department shall determine the amount that may
be withheld from each payment to the mental health plan. The
maximum withheld amount shall be 25 percent of each payment
to the plan or subcontractor as long as the
department is able to comply with the federal requirements for
repayment of federal financial participation pursuant to Section 1903
(d)(2) of the federal Social Security Act (42 U.S.C. Sec. 1396b(d)
(2)). The department may incr ease the maximum amount when
necessary for compliance with federal laws and regulations .
(5)
(3) (A) Oversight by the department of the MHPs
and MHP subcontractors may include client record
reviews of Early Periodic Screening Diagnosis and Treatment (EPSDT)
specialty mental health services rendered by MHPs and MHP
subcontractors under the Medi-Cal specialty mental health
services waiver in addition to other audits or reviews that are
conducted.
(B) The department may contract with an independent,
nongovernmental entity to conduct client record reviews. The contract
awarded in connection with this section shall be on a competitive
bid basis, pursuant to the Department of General Services contracting
requirements, and shall meet both of the following additional
requirements:
(i) Require the entity awarded the contract to comply with all
federal and state privacy laws, including, but not limited to, the
federal Health Insurance Portability and Accountability Act (HIPAA;
42 U.S.C. Sec. 1320d et seq.) and its implementing regulations, the
Confidentiality of Medical Information Act (Part 2.6 (commencing with
Section 56) of Division 1 of the Civil Code), and Section 1798.81.5
of the Civil Code. The entity shall be subject to existing penalties
for violation of these laws.
(ii) Prohibit the entity awarded the contract from using
, selling, or disclosing client records or client
information for a purpose other than the one for which the
record was given.
(iii) Prohibit the entity awarded the contract from selling client
records or client information.
(C) For purposes of this paragraph, the following terms shall have
the following meanings:
(i) "Client record" means a medical record, chart, or similar
file, as well as other documents containing information regarding an
individual recipient of services, including, but not limited to,
clinical information, dates and times of services, and other
information relevant to the individual and services provided and that
evidences compliance with legal requirements for Medi-Cal
reimbursement.
(ii) "Client record review" means examination of the client record
for a selected individual recipient for the purpose of confirming
the existence of documents that verify compliance with legal
requirements for claims submitted for Medi-Cal reimbursement.
(D) The department shall recover overpayments of federal financial
participation from MHPs within the timeframes required by federal
law and regulation and return those funds to the State
Department of Health Care Services for repayment to the
federal Centers for Medicare and Medicaid Services. The
department shall recover overpayments of General Fund moneys
utilizing the recoupment methods and timeframes required by the State
Administrative Manual.
(6)
(4) (A) The department, in consultation with mental
health stakeholders, the California Mental Health Directors
Association, and MHP subcontractor representatives, shall provide an
appeals process that specifies a progressive process for resolution
of disputes about claims or recoupments relating to specialty mental
health services under the Medi-Cal specialty mental health services
waiver.
(B) The department shall provide MHPs and MHP subcontractors the
opportunity to directly appeal findings in accordance with procedures
that are similar to those described in Article 1.5 (commencing with
Section 51016) of Chapter 3 of Subdivision 1 of Division 3 of Title
22 of the California Code of Regulations, until new regulations for a
progressive appeals process are promulgated. When an MHP
subcontractor initiates an appeal, it shall give notice to the MHP.
The department shall propose a rulemaking package consistent
with the department's appeals process that is in effect on July 1,
2012 by no later than the end of the 2008-09
2013- 14 fiscal year to amend the
existing appeals process . The reference in this
subparagraph to the procedures described in Article 1.5 (commencing
with Section 51016) of Chapter 3 of Subdivision 1 of Division 3 of
Title 22 of the California Code of Regulations, shall only apply to
those appeals addressed in this subparagraph.
(C) The department shall develop regulations as necessary to
implement this paragraph.
(7)
(5) The department shall assume the applicable
program oversight authority formerly provided by the State
Department of Health Care Services, including, but not limited to,
the conduct oversight of utilization controls as
specified in Section 14133. The MHP shall include a requirement in
any subcontracts that all inpatient subcontractors maintain necessary
licensing and certification. MHPs shall require that services
delivered by licensed staff are within their scope of practice.
Nothing in this part chapter shall
prohibit the MHPs from establishing standards that are in addition to
the minimum federal and state requirements,
provided that these standards do not violate federal and state
Medi-Cal requirements and guidelines.
(8)
(6) (A) Subject to
federal approval and consistent with state requirements, the MHP may
negotiate rates with providers of specialty mental health
services.
(9) Under the fee-for-service payment system, any
(B) Any excess in the
payment set forth in the contract distribution of
funds over the expenditures for services by the mental
health plan shall be spent for the provision of specialty
mental health services under the Medi-Cal specialty mental
health service waiver and related administrative costs.
(10)
(7) Nothing in this part
chapter shall limit the MHP from being reimbursed the
full and appropriate federal financial participation for
any qualified services even if the total expenditures for
service exceeds the contract amount with the department. Matching
nonfederal public funds shall be provided by the plan for the federal
financial participation matching requirement . To
receive federal financial participation, the mental health plan shall
certify its public expenditures for specialty mental health services
to the department .
(11)
(8) Notwithstanding Section 14115, claims for
federal reimbursement for service pursuant to this
part chapter shall be submitted by MHPs within
the timeframes required by federal Medicaid requirements and the
approved Medicaid state plan and waivers.
(c) This subdivision shall apply to managed mental health care
funding allocations and risk-sharing determinations and arrangements.
(1) The department shall allocate and distribute annually the full
appropriated amount to each MHP for the managed mental health care
program, exclusive of the EPSDT specialty mental health services
program, provided under the mental health services waiver. The
allocated funds shall be considered to be funds of the plan to be
used as specified in this part.
(2) Each fiscal year the state matching funds for Medi-Cal
specialty mental health services shall be included in the annual
budget for the department. The amount included shall be based on
historical cost, adjusted for changes in the number of Medi-Cal
beneficiaries and other relevant factors. The appropriation for
funding the state share of the costs for EPSDT specialty mental
health services provided under the Medi-Cal specialty mental health
services waiver shall only be used for reimbursement payments of
claims for those services.
(3) Initially, the
(9) The MHP shall use the fiscal intermediary of the Medi-Cal
program of the State Department of Health Care Services for the
processing of claims for inpatient psychiatric hospital services
rendered in fee-for-service Medi-Cal hospitals. The department shall
request the Controller to offset the distribution of funds to the
counties from the Mental Health Subaccount, the Mental Health Equity
Subaccount, or the Vehicle License Collection Account of the Local
Revenue Fund, or funds from the Mental Health Account or the
Behavioral Health Subaccount of the Local Revenue Fund 2011 for the
nonfederal financial participation share for these claims.
(c) Counties may set aside funds for self-insurance, audit
settlement, and statewide program risk pools. The counties shall
assume all responsibility and liability for appropriate
administration of the funds. Special consideration may be given to
small counties with a population of less than 200,000. Nothing in the
paragraph shall in any way make the state or department liable for
mismanagement or loss of funds by the entity designated by counties
under this subdivision.
(d) The department shall consult with the
State Department of Health Care Services and the
California Mental Health Directors Association in February and
September of each year to review the methodology used to
forecast future trends obtain data and methodology
necessary to forecast future fiscal trends in the provision of
EPSDT specialty mental health services provided
under the Medi-Cal specialty mental health services waiver, to
estimate these yearly EPSDT yearly
specialty mental health services related costs, and to estimate the
annual amount of funding required for reimbursements for
EPSDT specialty mental health services to ensure relevant factors are
incorporated in the methodology. The estimates of costs and
reimbursements shall include both federal financial participation
amounts and any state General Fund amounts for EPSDT specialty mental
health services provided under the State Medi-Cal specialty mental
health services waiver. The department shall provide the State
Department of Health Care Services the estimate adjusted to a cash
basis federal funding participation to reimburse costs
of specialty mental health services provided under the Medi-Cal
specialty mental health services waiver. This shall include a
separate presentation of the data and methodology necessary to
forecast future fiscal trends in the provision of Early Periodic
Screening, Diagnosis, and Treatment specialty mental health services
provided under the Medi-Cal specialty mental health services waiver,
to estimate annual EPSDT
specialty mental health services related costs, and to estimate the
annual amount of EPSDT specialty mental health services provided
under the state Medi-Cal specialty mental health services waiver,
including federal funding participation to reimburse costs of EPSDT
.
(B) The estimate of annual funding described in subparagraph (A)
shall include, but not be limited to, the following factors:
(i) The impacts of interactions among caseload, type of services,
amount or number of services provided, and billing unit cost of
services provided.
(ii) A systematic review of federal and state policies, trends
over time, and other causes of change.
(C) The forecasting and estimates performed under this paragraph
are primarily for the purpose of providing the Legislature and the
Department of Finance with projections that are as accurate as
possible for the state budget process, but will also be informative
and useful for other purposes. Therefore, it is the intent of the
Legislature that the information produced under this paragraph shall
be taken into consideration under paragraph (10) of subdivision (c).
(e) When seeking federal approval for any federal Medicaid state
plan amendment or waiver associated with Medi-Cal specialty mental
health services, the department shall consult with staff of the
Legislature, counties, providers, and other stakeholders in the
development of the state plan amendment or waiver.
(e)
(f) This section shall become operative on July 1,
2012.
SEC. 180. Section 5778.3 of the Welfare
and Institutions Code is amended and renumbered to read:
5778.3. 14718.5. Notwithstanding
any other law, including subdivision (b) of Section 16310 of the
Government Code, the Controller may use the moneys in the Mental
Health Managed Care Deposit Fund for loans to the General Fund as
provided in Sections 16310 and 16381 of the Government Code. Interest
shall be paid on all moneys loaned to the General Fund from the
Mental Health Managed Care Deposit Fund. Interest payable shall be
computed at a rate determined by the Pooled Money Investment Board to
be the current earning rate of the fund from which loaned. This
subdivision does not authorize any transfer that will interfere with
the carrying out of the object for which the Mental Health Managed
Care Deposit Fund was created.
SEC. 181. Section 5779 of the Welfare
and Institutions Code is amended to read:
5779. (a) This section shall be limited to mental health services
reimbursed through a capitated rate payment system.
(b) Upon mutual agreement, the department and the State Department
of Health Care Services may combine the funds transferred
under this part, other funds available pursuant to Chapter
5 6 (commencing with Section 17600) of Part 5 of
Division 9, and federal financial participation funds to establish a
contract for the delivery of mental health services to Medi-Cal
beneficiaries under a capitated rate payment system. The combining of
funds shall be done in consultation with a statewide organization
representing counties. The combined funding shall be the budget
responsibility of the department.
(c) The department, in consultation with a statewide organization
representing counties, shall establish a methodology for a capitated
rate payment system that is consistent with federal requirements.
(d) Capitated rate payments shall be made on a schedule specified
in the contract with the mental health plan.
(e) The department may levy any necessary fines and audit
disallowances to mental health plans relative to operations under
this part. The mental health plans shall be liable for all federal
audit exceptions or disallowances based on the plan's conduct or
determinations. The mental health plan shall not be liable for
federal audit exceptions or disallowances based on the state's
conduct or determinations. The department shall work jointly with the
mental health plan in initiating any necessary appeals. The
department may offset the amount of any federal disallowance or audit
exception against subsequent payment to the mental health plan at
any time. The maximum amount that may be withheld shall be 25 percent
of each payment to the mental health plan.
(f) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute that
is enacted before January 1, 2013, deletes or extends the dates on
which it becomes inoperative and is repealed.
SEC. 182. Section 5780 of the Welfare
and Institutions Code is amended and renumbered to read:
5780. 14721. (a) This part
chapter shall only be implemented to the extent
that the necessary federal waivers are obtained. The director shall
execute a declaration, to be retained by the director, that a waiver
necessary to implement any provision of this part
chapter has been obtained.
(b) This part chapter shall become
inoperative on the date that, and only if, the director executes a
declaration, to be retained by the director, that more than 10
percent of all counties fail to become mental health plan
contractors, and no acceptable alternative
contractors are not available, or if more than 10 percent
of all funds allocated for Medi-Cal mental health services must be
administered by the department because no an
acceptable plan is not available.
SEC. 183. Section 5781 of the Welfare
and Institutions Code is amended and renumbered to read:
5781. 14722. (a) Notwithstanding
any other provision of law, a mental health plan
may enter into a contract for the provision of specialty
mental health services for Medi-Cal beneficiaries with a hospital
that provides for a per diem reimbursement rate for services that
include room and board, routine hospital services, and all
hospital-based ancillary services and that provides separately for
the attending mental health professional's daily visit fee. The
payment of these negotiated reimbursement rates to the hospital by
the mental health plan shall be considered payment in full for each
day of inpatient psychiatric and hospital care rendered to a Medi-Cal
beneficiary, subject to third-party liability and patient share of
costs, if any.
(b) This section shall not be construed to allow a hospital to
interfere with, control, or otherwise direct the professional
judgment of a physician and surgeon in a manner prohibited by Section
2400 of the Business and Professions Code or any other provision of
law.
(c) For purposes of this section, "hospital" means a hospital that
submits reimbursement claims for Medi-Cal psychiatric inpatient
hospital services through the Medi-Cal fiscal intermediary
as permitted by subdivision (g) of Section 5778 .
SEC. 184. Section 5782 of the Welfare
and Institutions Code is amended to read:
5782. (a) The provisions of this part are
subject to and shall be read as incorporating the authority and
oversight responsibilities of the State Department of Health Care
Services in its role as the single state agency for the Medicaid
program in California. The provisions of this part shall be
implemented only to the extent that federal financial participation
is available.
(b) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute that
is enacted before January 1, 2013, deletes or extends the dates on
which it becomes inoperative and is repealed.
SEC. 185. Section 5783 of the Welfare
and Institutions Code is amended and renumbered to read:
5783. 14723. (a) Each eligible
public agency, as described in subdivision (b), may, in addition to
reimbursement or other payments that the agency would otherwise
receive for Medi-Cal specialty mental health services, receive
supplemental Medi-Cal reimbursement to the extent provided for in
this section.
(b) A public agency shall be eligible for supplemental
reimbursement only if it is a county, city, or city and
county , or the University of California and if,
consistent with Section 5778, it meets either or both of the
following characteristics continuously during a state fiscal year:
14718 it provides as a mental health plan, or
subcontracts for, specialty mental health services to Medi-Cal
beneficiaries pursuant to the Medi-Cal Specialty Mental Health
Consolidation Waiver (Number CA.17), as approved by the federal
Centers for Medicare and Medicaid Services.
(1) Provides, pursuant to the Medi-Cal Specialty Mental Health
Services Consolidation Waiver (Number CA.17), as approved by the
federal Centers for Medicare and Medicaid Services, specialty mental
health services to Medi-Cal beneficiaries in one or more of its
publically owned and operated facilities.
(2) Provides or subcontracts for specialty mental health services
to Medi-Cal beneficiaries as a mental health plan (MHP) pursuant to
this part.
(c) (1) Subject to paragraph (2), an eligible public agency's
supplemental reimbursement pursuant to this section shall be equal to
the amount of federal financial participation received as a result
of the claims submitted pursuant to paragraph (2) of subdivision (f).
(2) Notwithstanding paragraph (1), in computing an eligible public
agency's reimbursement, in no instance shall the expenditures
certified pursuant to paragraph (1) of subdivision (e), when combined
with the amount received from other sources of payment and with
reimbursement from the Medi-Cal program, including expenditures
otherwise certified for purposes of claiming federal financial
participation, exceed 100 percent of actual, allowable costs, as
determined pursuant to California's Medicaid State Plan, for the
specialty mental health services to which the expenditure relates.
Supplemental payment may be made on an interim basis until the time
when actual, allowable costs are finally determined.
(3) The supplemental Medi-Cal reimbursement provided by this
section shall be distributed under a payment methodology based on
specialty mental health services provided to Medi-Cal patients by
each eligible public agency, on a per-visit basis, a per-procedure
basis, a time basis, in one or more lump sums, or on any other
federally permissible basis. The State Department of Health
Care Services department shall seek approval
from the federal Centers for Medicare and Medicaid Services for the
payment methodology to be utilized, and shall not make any payment
pursuant to this section prior to obtaining that federal approval.
(d) (1) It is the intent of the Legislature in enacting this
section to provide the supplemental reimbursement described in this
section without any expenditure from the General Fund. The department
or the State Department of Health Care Services
may require an eligible public agency, as a condition of receiving
supplemental reimbursement pursuant to this section, to enter into,
and maintain, an agreement with the department for the purposes of
implementing this section and reimbursing the department and
the State Department of Health Care Services for the costs
of administering this section.
(2) Expenditures submitted to the department and to the
State Department of Health Care Services for purposes of
claiming federal financial participation under this section shall
have been paid only with funds from the public agencies described in
subdivision (b) and certified to the state as provided in subdivision
(e).
(e) An eligible public agency shall do all of the following:
(1) Certify, in conformity with the requirements of Section 433.51
of Title 42 of the Code of Federal Regulations, that the claimed
expenditures for the specialty mental health services are eligible
for federal financial participation.
(2) Provide evidence supporting the certification as specified by
the department or by the State Department of Health Care
Services .
(3) Submit data as specified by the department to determine the
appropriate amounts to claim as expenditures qualifying for federal
financial participation.
(4) Keep, maintain, and have readily retrievable, any records
specified by the department or by the State Department of
Health Care Services to fully disclose reimbursement
amounts to which the eligible public agency is entitled, and any
other records required by the federal Centers for Medicare and
Medicaid Services.
(f) (1) The State Department of Health Care Services
department shall promptly seek any necessary
federal approvals for the implementation of this section. If
necessary to obtain federal approval, the program shall be limited to
those costs that the federal Centers for Medicare and Medicaid
Services determines to be allowable expenditures under Title XIX of
the federal Social Security Act (Subchapter 19 (commencing with
Section 1396) of Chapter 7 of Title 42 of the United States Code). If
federal approval is not obtained for implementation of this section,
this section shall not be implemented.
(2) The State Department of Health Care Services
department shall submit claims for federal
financial participation for the expenditures described in subdivision
(e) related to specialty mental health services that are allowable
expenditures under federal law.
(3) The State Department of Health Care Services
department shall, on an annual basis, submit any
necessary materials to the federal Centers for Medicare and Medicaid
Services to provide assurances that claims for federal financial
participation will include only those expenditures that are allowable
under federal law.
(4) The department shall collaborate with the State Department of
Health Care Services to ensure that the department's policies,
procedures, data, and other relevant materials are available to the
State Department of Health Care Services as may be required for the
implementation and administration of this section and for the
claiming of federal financial participation.
(g) (1) The director may adopt regulations as are necessary to
implement this section. The adoption, amendment, repeal, or
readoption of a regulation authorized by this subdivision shall be
deemed to be necessary for the immediate preservation of the public
peace, health and safety, or general welfare, for purposes of
Sections 11346.1 and 11349.6 of the Government Code, and the
department is hereby exempted from the requirement that it describe
specific facts showing the need for immediate action.
(2) As an alternative to the adoption of regulations pursuant to
paragraph (1), and notwithstanding Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code, the director may implement and administer this article, in
whole or in part, by means of provider bulletins or similar
instructions, without taking regulatory action, provided that no
bulletin or similar instruction shall remain in effect after June 30,
2011. It is the intent that regulations adopted pursuant to
paragraph (1) shall be in place on or before June 30, 2011.
SEC. 186. Section 5803 of the Welfare
and Institutions Code is amended to read:
5803. (a) The State Department of Mental
Health Care Services shall issue a request for proposals
to develop system of care programs no later than October 1 in any
year in which the state budget provides new funds to expand the
system of care provided for in this chapter. The request for
proposals shall include the following:
(1) Proposals may be submitted as a regional system of care by
counties acting jointly, independent countywide proposals, and
proposals to serve discrete geographic areas within counties or for a
specific integrated services agency team. Nothing in the request for
proposal shall be construed to restrict a county from contracting
for part or all services included in the demonstration project
proposal.
(2) The department shall establish reporting requirements for
direct and indirect costs, and these requirements may be included in
the request for proposals.
(3) The department shall require that proposals identify resources
necessary to measure client and cost outcome and interagency
collaboration. Proposal guidelines shall clearly require
identification of procedures to document outcomes.
(4) Proposals must be approved by the board of supervisors and the
local mental health board or commission.
(b) The director shall prepare a method for rating proposals to
assure objectivity and selection of the best qualified applications.
New proposals shall be selected with consideration of regional
balance across the state.
(c) The State Department of Mental Health
Care Services shall fund counties with integrated service
agencies or countywide systems of care funded under Chapter 982 of
the Statutes of 1988, operating at the time of passage of this part.
Those programs shall be funded under the provisions paragraph (2) of
subdivision (a) of Section 5700 and shall be subject to all of the
requirements and sanctions of this part.
SEC. 187. Section 5804 of the Welfare
and Institutions Code is repealed.
5804. (a) The State Department of Mental Health shall include
funding under this part in the county's performance contracts
required under Section 5650 for existing and new counties selected
under this part to develop an integrated service agency component or
a countywide or regional system of care. The contracts required
pursuant to this part shall be exempt from the requirements of the
Public Contract Code and the State Administrative Manual and shall be
exempt from approval by the Department of General Services.
(b) Projects funded under this part, or continued under the
provisions of subdivision (b) of Section 5802, shall be considered an
ongoing program of service delivery as long as the county and any of
its contractors meet client and cost outcomes as required in the
annual performance contract established by the department.
(c) The department may terminate contracts funded under this part
when the department determines that the county has failed to meet
client and cost outcomes as required in the performance contract or
are no longer able to operate programs under the provisions of this
part.
(d) Counties and their contractors shall provide the department
with all information needed to evaluate the financial and program
performance of participating projects.
SEC. 188. Section 5805 of the Welfare
and Institutions Code is amended to read:
5805. The State Department of Mental 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. 189. Section 5806 of the Welfare
and Institutions Code is amended to read:
5806. The State Department of Mental 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:
(a) A service planning and delivery process that is target
population based and includes the following:
(1) Determination of the numbers of clients to be served and the
programs and services that will be provided to meet their needs. The
local director of mental health shall consult with the sheriff, the
police chief, the probation officer, the mental health board,
contract agencies, and family, client, ethnic, and citizen
constituency groups as determined by the director.
(2) Plans for services, including outreach to families whose
severely mentally ill adult is living with them, design of mental
health services, coordination and access to medications, psychiatric
and psychological services, substance abuse services, supportive
housing or other housing assistance, vocational rehabilitation, and
veterans' services. Plans also shall contain evaluation strategies,
that shall consider cultural, linguistic, gender, age, and special
needs of minorities in the target populations. Provision shall be
made for staff with the cultural background and linguistic skills
necessary to remove barriers to mental health services due to
limited-English-speaking ability and cultural differences. Recipients
of outreach services may include families, the public, primary care
physicians, and others who are likely to come into contact with
individuals who may be suffering from an untreated severe mental
illness who would be likely to become homeless if the illness
continued to be untreated for a substantial period of time. Outreach
to adults may include adults voluntarily or involuntarily
hospitalized as a result of a severe mental illness.
(3) Provision for services to meet the needs of target population
clients who are physically disabled.
(4) Provision for services to meet the special needs of older
adults.
(5) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, where appropriate for the individual.
(6) Provision for services to be client-directed and that employ
psychosocial rehabilitation and recovery principles.
(7) Provision for psychiatric and psychological services that are
integrated with other services and for psychiatric and psychological
collaboration in overall service planning.
(8) Provision for services specifically directed to seriously
mentally ill young adults 25 years of age or younger who are homeless
or at significant risk of becoming homeless. These provisions may
include continuation of services that still would be received through
other funds had eligibility not been terminated due to age.
(9) Services reflecting special needs of women from diverse
cultural backgrounds, including supportive housing that accepts
children, personal services coordinator therapeutic treatment, and
substance treatment programs that address gender-specific trauma and
abuse in the lives of persons with mental illness, and vocational
rehabilitation programs that offer job training programs free of
gender bias and sensitive to the needs of women.
(10) Provision for housing for clients that is immediate,
transitional, permanent, or all of these.
(11) Provision for clients who have been suffering from an
untreated severe mental illness for less than one year, and who do
not require the full range of services but are at risk of becoming
homeless unless a comprehensive individual and family support
services plan is implemented. These clients shall be served in a
manner that is designed to meet their needs.
(12) Provision for services for veterans.
(b) A client shall have a clearly designated mental health
personal services coordinator who may be part of a multidisciplinary
treatment team who is responsible for providing or assuring needed
services. Responsibilities include complete assessment of the client'
s needs, development of the client's personal services plan, linkage
with all appropriate community services, monitoring of the quality
and followthrough of services, and necessary advocacy to ensure that
the client receives those services that are agreed to in the personal
services plan. A client shall participate in the development of his
or her personal services plan, and responsible staff shall consult
with the designated conservator, if one has been appointed, and, with
the consent of the client, consult with the family and other
significant persons as appropriate.
(c) The individual personal services plan shall ensure that
members of the target population involved in the system of care
receive age-appropriate, gender-appropriate, and culturally
appropriate services or appropriate services based on any
characteristic listed or defined in Section 11135 of the Government
Code, to the extent feasible, that are designed to enable recipients
to:
(1) Live in the most independent, least restrictive housing
feasible in the local community, and for clients with children, to
live in a supportive housing environment that strives for
reunification with their children or assists clients in maintaining
custody of their children as is appropriate.
(2) Engage in the highest level of work or productive activity
appropriate to their abilities and experience.
(3) Create and maintain a support system consisting of friends,
family, and participation in community activities.
(4) Access an appropriate level of academic education or
vocational training.
(5) Obtain an adequate income.
(6) Self-manage their illness and exert as much control as
possible over both the day-to-day and long-term decisions that affect
their lives.
(7) Access necessary physical health care and maintain the best
possible physical health.
(8) Reduce or eliminate serious antisocial or criminal behavior
and thereby reduce or eliminate their contact with the criminal
justice system.
(9) Reduce or eliminate the distress caused by the symptoms of
mental illness.
(10) Have freedom from dangerous addictive substances.
(d) The individual personal services plan shall describe the
service array that meets the requirements of subdivision (c), and to
the extent applicable to the individual, the requirements of
subdivision (a).
SEC. 190. Section 5807 of the Welfare
and Institutions Code is amended to read:
5807. (a) The State Department of Mental Health
Health Care Services shall require counties
which receive funding to develop interagency collaboration with
shared
responsibilities for services under this part and achievement of the
client and cost outcome goals and interagency collaboration goals
specified.
(b) Collaborative activities shall include:
(1) Identification of those agencies that have a significant joint
responsibility for the target population and ensuring collaboration
on planning for services to that population.
(2) Identification of gaps in services to members of the target
population, development of policies to assure service effectiveness
and continuity, and setting priorities for interagency services.
(3) Implementation of public and private collaborative programs
whenever possible to better serve the target population.
(4) Provision of interagency case management services to
coordinate resources to target population members who are using the
services of more than one agency.
(5) Coordination with federal agencies responsible for providing
veterans' services, as well as national, state, and local nonprofit
organizations that provide veterans' services, to maximize the
integration of services and to eliminate duplicative efforts.
SEC. 191. Section 5809 of the Welfare
and Institutions Code is amended to read:
5809. The State Department of Mental Health
Health Care Services shall continue to work with
participating counties and other interested parties to refine and
establish client and cost outcome and interagency collaboration goals
including the expected level of attainment with participating system
of care counties. These outcome measures should include specific
objectives addressing the following goals:
(a) Client benefit outcomes.
(b) Client and family member satisfaction.
(c) System of care access.
(d) Cost savings, cost avoidance, and cost-effectiveness outcomes
that measure short-term or long-term cost savings and cost avoidance
achieved in public sector expenditures to the target population.
SEC. 192. Article 3 (commencing with Section 5810)
of Part 3 of Division 5 of the Welfare and Institutions
Code is repealed.
SEC. 193. Section 5813.6 of the Welfare
and Institutions Code is amended to read:
5813.6. (a) At the time of the release of the January 10 budget
plan and the May Revision, the Director of Mental
Health Care Services shall submit to the Legislature
information regarding the projected expenditure of Proposition 63
funding for each state department, and for each major program
category specified in the measure, for local assistance. This shall
include actual past-year expenditures, estimated current-year
expenditures, and projected budget-year expenditures of local
assistance funding. In addition, it shall include a complete listing
of state support expenditures for the current year and for the budget
year by the State Department of Mental Health
Care Services , including the number of state positions
and any contract funds. A description of these state expenditures
shall accompany the fiscal information the director is required to
submit to the Legislature pursuant to this section.
(b) During each fiscal year, the Director of Mental
Health Care Services shall submit to the fiscal
committees of the Legislature, 30 days in advance, written notice of
the intention to expend Proposition 63 local assistance funding in
excess of the amounts presented in its May Revision projection for
that fiscal year. The written notice shall include information
regarding the amount of the additional spending and its purpose.
SEC. 194. Section 5814 of the Welfare
and Institutions Code is amended to read:
5814. (a) (1) This part shall be implemented only to the extent
that funds are appropriated for purposes of this part. To the extent
that funds are made available, the first priority shall go to
maintain funding for the existing programs that meet adult system of
care contract goals. The next priority for funding shall be given to
counties with a high incidence of persons who are severely mentally
ill and homeless or at risk of homelessness, and meet the criteria
developed pursuant to paragraphs (3) and (4).
(2) The director The Director of
Health Care Services shall establish a methodology for
awarding grants under this part consistent with the legislative
intent expressed in Section 5802, and in consultation with the
advisory committee established in this subdivision.
(3) (A) The director The Director of
Health Care Services shall establish an advisory committee for
the purpose of providing advice regarding the development of criteria
for the award of grants, and the identification of specific
performance measures for evaluating the effectiveness of grants. The
committee shall review evaluation reports and make findings on
evidence-based best practices and recommendations for grant
conditions. At not less than one meeting annually, the advisory
committee shall provide to the director written comments on the
performance of each of the county programs. Upon request by the
department, each participating county that is the subject of a
comment shall provide a written response to the comment. The
department shall comment on each of these responses at a subsequent
meeting.
(B) The committee shall include, but not be limited to,
representatives from state, county, and community veterans' services
and disabled veterans outreach programs, supportive housing and other
housing assistance programs, law enforcement, county mental health
and private providers of local mental health services and mental
health outreach services, the Board
Department of Corrections and Rehabilitation , the
State Department of Alcohol and Drug Programs, local substance abuse
services providers, the Department of Rehabilitation, providers of
local employment services, the State Department of Social Services,
the Department of Housing and Community Development, a service
provider to transition youth, the United Advocates for Children of
California, the California Mental Health Advocates for Children and
Youth, the Mental Health Association of California, the California
Alliance for the Mentally Ill, the California Network of Mental
Health Clients, the California Mental Health Planning
Council, the Mental Health Services Oversight and Accountability
Commission, and other appropriate entities.
(4) The criteria for the award of grants shall include, but not be
limited to, all of the following:
(A) A description of a comprehensive strategic plan for providing
outreach, prevention, intervention, and evaluation in a cost
appropriate manner corresponding to the criteria specified in
subdivision (c).
(B) A description of the local population to be served, ability to
administer an effective service program, and the degree to which
local agencies and advocates will support and collaborate with
program efforts.
(C) A description of efforts to maximize the use of other state,
federal, and local funds or services that can support and enhance the
effectiveness of these programs.
(5) In order to reduce the cost of providing supportive housing
for clients, counties that receive a grant pursuant to this part
after January 1, 2004, shall enter into contracts with sponsors of
supportive housing projects to the greatest extent possible.
Participating counties are encouraged to commit a portion of their
grants to rental assistance for a specified number of housing units
in exchange for the counties' clients having the right of first
refusal to rent the assisted units.
(b) In each year in which additional funding is provided by the
annual Budget Act the department State
Department of Health Care Services shall establish programs
that offer individual counties sufficient funds to comprehensively
serve severely mentally ill adults who are homeless, recently
released from a county jail or the state prison, or others who are
untreated, unstable, and at significant risk of incarceration or
homelessness unless treatment is provided to them and who are
severely mentally ill adults. For purposes of this subdivision,
"severely mentally ill adults" are those individuals described in
subdivision (b) of Section 5600.3. In consultation with the advisory
committee established pursuant to paragraph (3) of subdivision (a),
the department shall report to the Legislature on or before May 1 of
each year in which additional funding is provided, and shall
evaluate, at a minimum, the effectiveness of the strategies in
providing successful outreach and reducing homelessness, involvement
with local law enforcement, and other measures identified by the
department. The evaluation shall include for each program funded in
the current fiscal year as much of the following as available
information permits:
(1) The number of persons served, and of those, the number who
receive extensive community mental health services.
(2) The number of persons who are able to maintain housing,
including the type of housing and whether it is emergency,
transitional, or permanent housing, as defined by the department.
(3) (A) The amount of grant funding spent on each type of housing.
(B) Other local, state, or federal funds or programs used to house
clients.
(4) The number of persons with contacts with local law
enforcement and the extent to which local and state incarceration has
been reduced or avoided.
(5) The number of persons participating in employment service
programs including competitive employment.
(6) The number of persons contacted in outreach efforts who appear
to be severely mentally ill, as described in Section 5600.3, who
have refused treatment after completion of all applicable outreach
measures.
(7) The amount of hospitalization that has been reduced or
avoided.
(8) The extent to which veterans identified through these programs'
outreach are receiving federally funded veterans' services for which
they are eligible.
(9) The extent to which programs funded for three or more years
are making a measurable and significant difference on the street, in
hospitals, and in jails, as compared to other counties or as compared
to those counties in previous years.
(10) For those who have been enrolled in this program for at least
two years and who were enrolled in Medi-Cal prior to, and at the
time they were enrolled in, this program, a comparison of their
Medi-Cal hospitalizations and other Medi-Cal costs for the two years
prior to enrollment and the two years after enrollment in this
program.
(11) The number of persons served who were and were not receiving
Medi-Cal benefits in the 12-month period prior to enrollment and, to
the extent possible, the number of emergency room visits and other
medical costs for those not enrolled in Medi-Cal in the prior
12-month period.
(c) To the extent that state savings associated with providing
integrated services for the mentally ill are quantified, it is the
intent of the Legislature to capture those savings in order to
provide integrated services to additional adults.
(d) Each project shall include outreach and service grants in
accordance with a contract between the state and approved counties
that reflects the number of anticipated contacts with people who are
homeless or at risk of homelessness, and the number of those who are
severely mentally ill and who are likely to be successfully referred
for treatment and will remain in treatment as necessary.
(e) All counties that receive funding shall be subject to specific
terms and conditions of oversight and training which shall be
developed by the department, in consultation with the advisory
committee.
(f) (1) As used in this part, "receiving extensive mental health
services" means having a personal services coordinator, as described
in subdivision (b) of Section 5806, and having an individual personal
service plan, as described in subdivision (c) of Section 5806.
(2) The funding provided pursuant to this part shall be sufficient
to provide mental health services, medically necessary medications
to treat severe mental illnesses, alcohol and drug services,
transportation, supportive housing and other housing assistance,
vocational rehabilitation and supported employment services, money
management assistance for accessing other health care and obtaining
federal income and housing support, accessing veterans' services,
stipends, and other incentives to attract and retain sufficient
numbers of qualified professionals as necessary to provide the
necessary levels of these services. These grants shall, however, pay
for only that portion of the costs of those services not otherwise
provided by federal funds or other state funds.
(3) Methods used by counties to contract for services pursuant to
paragraph (2) shall promote prompt and flexible use of funds,
consistent with the scope of services for which the county has
contracted with each provider.
(g) Contracts awarded pursuant to this part shall be exempt from
the Public Contract Code and the state administrative manual and
shall not be subject to the approval of the Department of General
Services.
(h) Notwithstanding any other provision of law, funds awarded to
counties pursuant to this part and Part 4 (commencing with Section
5850) shall not require a local match in funds.
SEC. 195. Section 5815 of the Welfare
and Institutions Code is amended to read:
5815. The State Department of Health Care Services , in
conjunction with the State Department of Mental Health,
shall seek all available federal funding for mental health services
for veterans.
SEC. 196. Section 5851.5 of the Welfare
and Institutions Code is amended to read:
5851.5. For the purposes of this part, a "system of care county"
means a county which has been approved by the State Department of
Mental Health Care Services as having
the capability to provide child- and family-centered services in a
collaborative manner, resulting in quantitative outcome measures.
SEC. 197. Section 5852 of the Welfare
and Institutions Code is amended to read:
5852. There is hereby established an interagency system of care
for children with serious emotional and behavioral disturbances that
provides comprehensive, coordinated care based on the demonstration
project under former Chapter 7 (commencing with Section 5575), as
added by Chapter 160 of the Statutes of 1987, and the former
1983 State Department of Mental Health planning model for
children's services. Each participating county shall adapt the model
to local needs and priorities.
SEC. 198. Section 5852.5 of the Welfare
and Institutions Code is amended to read:
5852.5. The department 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:
(a) The total estimated cost avoidance in all of the following
categories shall equal or exceed the applications for funding award
moneys:
(1) Group home costs paid by Aid to Families with Dependent
Children-Foster Care (AFDC-FC) program.
(2) Children and adolescent state hospital and acute inpatient
programs.
(3) Nonpublic school residential placement costs.
(4) Juvenile justice reincarcerations.
(5) Other short- and long-term savings in public funds resulting
from the applications for funding award moneys.
(b) If the department determines that the total cost avoidance
listed in subdivision (a) does not equal or exceed applications for
funding award amounts, the department shall determine that the county
that has been awarded funding shall achieve substantial compliance
with all of the following goals:
(1) Total cost avoidance in the categories listed in subdivision
(a) to exceed 50 percent of the applications for funding award
moneys.
(2) A 20-percent reduction in out-of-county ordered placements of
juvenile justice wards and social service dependents.
(3) A statistically significant reduction in the rate of
recidivism by juvenile offenders.
(4) A 25-percent reduction in the rate of state hospitalization of
minors from placements of special education pupils.
(5) A 10-percent reduction in out-of-county nonpublic school
residential placements of special education pupils.
(6) Allow at least 50 percent of children at risk of imminent
placement served by the intensive in-home crisis treatment programs,
which are wholly or partially funded by applications for funding
award moneys, to remain at home at least six months.
(7) Statistically significant improvement in school attendance and
academic performance of seriously emotionally disturbed special
education pupils treated in day treatment programs which are wholly
or partially funded by applications for funding award moneys.
(8) Statistically significant increases in services provided in
nonclinic settings among agencies.
(9) Increase in ethnic minority and gender access to services
proportionate to the percentage of these groups in the county's
school-age population.
SEC. 199. Section 5854 of the Welfare
and Institutions Code is amended to read:
5854. The State Department of Mental Health
Care Services may contract with counties whose programs
have been approved by the department and selected pursuant to Article
4 (commencing with Section 5857). A county may request to
participate under this part each year according to the terms set
forth in Section 5705 for the purpose of establishing a three-year
program proposal for developing and implementing a children's
comprehensive mental health services system. The contract shall be
negotiated on a yearly basis, based on the scope of work plan for
each implementation phase.
SEC. 200. Section 5855 of the Welfare
and Institutions Code is amended to read:
5855. The department The State Department
of Health Care Services shall 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 separated from their families or at
risk of separation from their families, as defined in Section 5856.
These comprehensive, interagency systems of care shall seek to
provide the highest benefit to children, their families, and the
community at the lowest cost to the public sector. Essential values
shall be as follows:
(a) Family preservation. Children shall be maintained in their
homes with their families whenever possible.
(b) Least restrictive setting. Children shall be placed in the
least restrictive and least costly setting appropriate to their needs
when out-of-home placement is necessary.
(c) Natural setting. Children benefit most from mental health
services in their natural environments, where they live and learn,
such as home, school, foster home, or a juvenile detention center.
(d) Interagency collaboration and a coordinated service delivery
system. The primary child-serving agencies, such as social services,
probation, education, health, and mental health agencies, shall
collaborate at the policy, management, and service levels to provide
a coordinated, goal-directed system of care for seriously emotionally
disturbed children and their families.
(e) Family involvement. Family participation is an integral part
of assessment, intervention, and evaluation.
(f) Cultural competence. Service effectiveness is dependent upon
both culturally relevant and competent service delivery.
SEC. 201. Section 5855.5 of the Welfare
and Institutions Code is amended to read:
5855.5. (a) Projects funded pursuant to Part 4 (commencing with
Section 5850) of Division 5, as added by Chapter 89 of the Statutes
of 1991, shall continue under the terms of this part.
(b) The department The State Department of
Health Care Services shall negotiate with each
participating county to establish appropriate evaluation measures for
the county's children's system of care program after the initial
three-year implementation funding period as established in Section
5854. The department shall, on an annual basis, negotiate a
performance contract with each county electing to continue its
children's system of care program. The annual performance contract
shall be consistent county to county, and shall include, but not be
limited to, a scope of work plan consistent with the provisions of
this part and shall contain a budget that has sufficient detail to
meet the requirements of the department.
SEC. 202. Section 5863 of the Welfare
and Institutions Code is amended to read:
5863. In addition to the requirements of Section 5862, each
county program proposal shall contain all of the following:
(a) Methods and protocols for the county mental health department
to identify and screen the eligible target population children. These
protocols shall be developed with collaborative partners and shall
ensure that eligible children can be referred from all collaborating
agencies.
(b) Measurable system performance goals for client outcome and
cost avoidance. Outcomes shall be made available to collaborating
partners and used for program improvement.
(c) Methods to achieve interagency collaboration by all publicly
funded agencies serving children experiencing emotional disturbances.
(d) Appropriate written interagency protocols and agreements with
all other programs in the county that serve similar populations of
children. Agreements shall exist with wrap-around programs (Chapter 4
(commencing with Section 18250) of Part 6 of Division 9), Family
Preservation programs (Part 4.4 (commencing with Section 16600) of
Division 9), Juvenile Crime Enforcement and Accountability Challenge
Grant programs (Article 18.7 (commencing with Section 749.2) of
Chapter 2 of Part 1 of Division 1), programs serving children with a
dual diagnosis including substance abuse or whose emotional
disturbance is related to family substance abuse, and programs
serving families enrolled in CalWORKs (Chapter 2 (commencing with
Section 11200.5) of Part 3 of Division 9).
(e) A description of case management services for the target
population. Each county program proposal shall include protocols
developed in the county for case management designed to provide
assessment, linkage, case planning, monitoring, and client advocacy
to facilitate the provision of appropriate services for the child and
family in the least restrictive environment as close to home as
possible.
(f) Mental health services that enable a child to remain in his or
her usual family setting and that offer an appropriate alternative
to out-of-home placement.
(g) Methods to conduct joint interagency placement screening of
target population children prior to out-of-home placement.
(h) Identification of the number and level of county evaluation
staff and the resources necessary to meet requirements established by
the State Department of Mental Health Health
Care Services to measure client and cost outcome and other
system performance measures.
(i) A budget specifying all new and currently funded mental health
expenditures provided as part of the proposed system of care. The
department shall establish reporting requirements for direct and
indirect administrative overhead, to be included in the request for
proposals. Weight shall be given to counties with lower
administrative overhead costs. In no case shall administrative costs
exceed those of existing county mental health programs and services.
Expenditures for evaluation staff and resources shall not be
considered administrative costs for this purpose.
(j) Any requirements for interagency collaboration, agreements, or
protocols contained in this section shall not diminish requirements
for the confidentiality of medical information or information
maintained by a county agency or department.
SEC. 203. Section 5867.5 of the Welfare
and Institutions Code is amended to read:
5867.5. (a) Beginning in
the 1998-99 fiscal year, county mental health departments that
receive full system of care funding, as determined by the State
Department of Mental Health Care Services
in consultation with counties, shall provide to children served
by county social services and probation departments mental health
screening, assessment, participation in multidisciplinary placement
teams and specialty mental health treatment services for children
placed out of home in group care, for those children who meet the
definition of medical necessity, to the extent resources are
available. These counties shall give first priority to children
currently receiving psychoactive medication.
(b) The State Department of Mental Health shall develop, by June
1, 1999, an estimate of the extent to which mental health assessment
and treatment resources are available to meet all of the following
needs:
(1) Children placed in group care by county departments of social
services and probation.
(2) Children placed in out-of-home care by county departments of
social services.
(3) Children at risk of placement out of home who are receiving
services from county departments of social services or probation.
(c) The estimate required by subdivision (b) shall include
identification of specific resource gaps, including human resource
gaps, in the delivery of specialty mental health services to children
identified by county social services and probation.
(d) The State Department of Mental Health shall develop, with the
assistance of the State Department of Social Services and the
Judicial Council, with participation by county mental health
departments, county health departments, and county social services
departments, and in consultation with group home providers and
representatives of current or former foster youth and representatives
of pediatricians and child and adolescent psychiatrists, by July 1,
1999, a procedure for review of treatment plans for children
receiving prescribed psychoactive medication and who are placed in
out-of-home care.
SEC. 204. Section 5868 of the Welfare
and Institutions Code
is amended to read:
5868. (a) The department 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.
(b) The standards shall include, but not be limited to:
(1) Providing a comprehensive assessment and treatment plan for
each target population client to be served, and developing programs
and services that will meet their needs and facilitate client outcome
goals.
(2) Providing for full participation of the family in all aspects
of assessment, case planning, and treatment.
(3) Providing methods of assessment and services to meet the
cultural, linguistic, and special needs of minorities in the target
population.
(4) Providing for staff with the cultural background and
linguistic skills necessary to remove barriers to mental health
services resulting from a limited ability to speak English or from
cultural differences.
(5) Providing mental health case management for all target
population clients in, or being considered for, out-of-home
placement.
(6) Providing mental health services in the natural environment of
the child to the extent feasible and appropriate.
(c) The responsibility of the case managers shall be to ensure
that each child receives the following services:
(1) A comprehensive mental health assessment.
(2) Case planning with all appropriate interagency participation.
(3) Linkage with all appropriate mental health services.
(4) Service plan monitoring.
(5) Client advocacy to ensure the provision of needed services.
SEC. 205. Section 5869 of the Welfare
and Institutions Code is amended to read:
5869. The department The State Department
of Health Care Services shall provide participating
counties with all of the following:
(a) Applications for funding guidelines and format, and
coordination and oversight of the selection process as described in
Article 4 (commencing with Section 5857).
(b) Contracts with each state funded county specifying the
approved budget, performance outcomes, and a scope of work plan for
each year of participation in the children's system of care program.
(c) Technical assistance related to system evaluation.
SEC. 206. Section 5872 of the Welfare
and Institutions Code is amended to read:
5872. In order to offset the cost of services, participating
counties shall collect reimbursement for services from the following
sources:
(a) Fees paid by families, which shall be the same as patient fees
established pursuant to Section 5718 14705
.
(b) Fees paid by private or public third-party payers.
(c) Categorical funds from sources established in state or federal
law, for which persons with mental disorders
illness are eligible.
SEC. 207. Section 5878 of the Welfare
and Institutions Code is amended to read:
5878. (a) (1) The Secretary of the Health and Welfare
Agency California Health and Human Services ,
the Superintendent of Public Instruction, or the Secretary of the
Youth and Corrections Agency Department of
Corrections and Rehabilitation may waive any state regulatory
obstacles to the integration of public responsibilities and resources
required for counties which have been approved as system of care
counties.
(2) The waiver shall remain in effect as long as the local program
continues to meet standards as specified in the scope of work plan
approved by the State Department of Mental Health
Care Services .
(b) The Secretary of Health and Welfare
California Health and Human Services , the Superintendent of
Public Instruction, and the Secretary of the Youth and
Corrections Agency Department of Corrections and
Rehabilitation , and those departments designated as single
state agencies administering federal programs, shall make every
effort to secure federal waivers and any other changes in federal
policy or law necessary to support interagency collaboration and
coordination in a system of care service delivery system.
SEC. 208. Section 5880 of the Welfare
and Institutions Code is amended to read:
5880. For each selected county the department
State Department of Health Care Services shall define and
establish client and cost outcome and other system performance goals,
and negotiate the expected levels of attainment for each year of
participation. Expected levels of attainment shall include a
breakdown by ethnic origin and shall be identified by a county in its
proposal. These goals shall include, but not be limited to, both of
the following:
(a) Client improvement and cost avoidance outcome measures, as
follows:
(1) To reduce the number of child months in group homes,
residential placements pursuant to Chapter 26.5 (commencing with
Section 7570) of Division 7 of Title 1 of the Government Code, and
state hospital placements.
(2) To reduce the cost of AFDC-FC group home care, residential
placements as described in paragraph (1), and state hospital
utilization, by an amount which equals at least 50 percent of the
third year project cost. Cost avoidance shall be based on data
comparisons of statewide average expenditure and population.
(3) To increase school attendance for pupils in targeted programs.
(4) To increase the grade level equivalent of pupils in targeted
programs from admission to discharge.
(5) To reduce the rate of recidivism incurred for wards in
targeted juvenile justice programs.
(6) To show measurable improvement in individual and family
functional status for a representative sample of children enrolled in
the system of care.
(7) To achieve statistically significant increases in services
provided in nonclinic settings among agencies.
(8) To increase ethnic minority and gender access to services
proportionate to the percentage of these groups in the county's
school-age population.
(b) System development and operation measures, as follows:
(1) To provide an integrated system of care that includes
multiagency programs and joint case planning, to children who are
seriously emotionally and behaviorally disturbed as defined in
Section 5856.
(2) To identify and assess children who comprise the target
population in the county evidenced by a roster which contains all
children receiving mental health case management and treatment
services. This roster shall include necessary standardized and
uniform identifying information and demographics about the children
served.
(3) To develop and maintain individualized service plans that will
facilitate interagency service delivery in the least restrictive
environment.
(4) To develop or provide access to a range of intensive services
that will meet individualized service plan needs. These services
shall include, but not be limited to, case management, expanded
treatment services at schoolsites, local juvenile corrections
facilities, and local foster homes, and flexible services.
(5) To ensure the development and operation of the interagency
policy council and the interagency case management council.
(6) To provide culturally competent programs that recognize and
address the unique needs of ethnic populations in relation to equal
access, program design and operation, and program evaluation.
(7) To develop parent education and support groups, and linkages
with parents to ensure their involvement in the planning process and
the delivery of services.
(8) To provide a system of evaluation that develops outcome
criteria and which will measure performance, including client outcome
and cost avoidance.
(9) To gather, manage, and report data in accordance with the
requirements of the state funded outcome evaluation.
SEC. 209. Section 5881 of the Welfare
and Institutions Code is amended to read:
5881. (a) Evaluation shall be conducted by both
participating county evaluation staff and, subject to the
availability of funds, by the department
State Department of Health Care Services and the Mental Health
Services Oversight and Accountability Commission .
(b) Evaluation at both levels shall do all of the following:
(1) Ensure that county level systems of care are serving the
targeted population.
(2) Ensure that the timely performance data related to client
outcome and cost avoidance is collected, analyzed, and reported.
(3) Ensure that system of care components are implemented as
intended.
(4) Provide information documenting needs for future planning.
SEC. 210. Section 5901 of the Welfare
and Institutions Code is amended to read:
5901. (a) The Legislature finds that the following issues
relating to program operation must be resolved prior to the full
assumption of responsibility for institutions for mental disease
program monitoring and reimbursement procedures by the counties:
(1) The information regarding the program is inadequate to
accurately allocate funding to the counties without significant
disruption of patient care.
(2) There is currently no administrative mechanism whereby all
counties can immediately assume these responsibilities without
endangering the health and safety of the persons being served.
(b) (1) During the 1991-92 fiscal year, the sum of eighty-seven
million seven hundred twenty-seven thousand dollars ($87,727,000)
shall be made available from the Mental Health Subaccount of the
Sales Tax Account of the Local Revenue Fund to the department for
support of institutions for mental disease.
(2) For the 1991-92 fiscal year, the department shall issue a
preliminary allocation of at least fifty-seven million four hundred
fifty thousand dollars ($57,450,000) of the amount identified in
paragraph (1). In developing a preliminary allocation, the department
shall utilize a methodology that will minimize disruption of
services to persons being served and that will continue access at the
1990-91 fiscal year level.
(3) During the 1991-92 fiscal year, the department shall
administer institution for mental disease resources remaining from
the amount identified in paragraph (1) after the allocation described
in (2) has been made, as a risk pool on behalf of all the counties.
Effective July 1, 1991, the department shall enter into contracts
with institutions for mental disease providers at the 1990-91 fiscal
year contract bed level. These resources shall be made available to
all counties.
(4) The department shall establish a method for the identification
of persons, by county, residing in institutions for mental disease,
and notification of counties of their program and fiscal
responsibilities.
(c) The Department of Finance may authorize a loan of up to twenty
million dollars ($20,000,000) from the General Fund for deposit into
the Institutions for Mental Disease Account of the Mental Health
Facilities Fund established pursuant to Section 17602.05, for use by
the State Department of Mental Health
department in implementing this part.
SEC. 211. Section 5909 of the Welfare
and Institutions Code is amended to read:
5909. The Director of Mental Health Care
Services shall retain the authority and responsibility to
monitor and approve special treatment programs in skilled nursing
facilities in accordance with Sections 72443 to 72474, inclusive, of
Title 22 of the California Code of Regulations.
SEC. 212. Section 6002.15 of the
Welfare and Institutions Code is amended to read:
6002.15. (a) Prior to accepting the written authorization for
treatment, the facility shall assure that a representative of the
facility has given a full explanation of the treatment philosophy of
the facility, including, where applicable, the use of seclusion and
restraint, the use of medication, and the degree of involvement of
family members in the minor's treatment to the parent, guardian or
other person entitled to the minor's custody. This explanation shall
be given orally and in writing, and shall be documented in the minor'
s treatment record upon completion.
(b) As part of the admission process, the professional person
responsible for the minor's admission shall affirm in writing that
the minor meets the admission criteria as specified above.
(c) Upon admission, a facility specified in Section 6002.10 shall
do all of the following:
(1) Inform the minor in writing of the availability of an
independent clinical review of his or her further inpatient
treatment. The notice shall be witnessed and signed by an appropriate
representative of the facility.
(2) Within one working day, notify the patients' rights advocate,
as defined in Article 2 (commencing with Section 5540) of Chapter
5.2, regarding the admission of the minor.
(3) Provide all minors with a booklet promulgated by the State
Department of Mental Health Care Services
outlining the specific rights of minors in mental health
facilities. The booklet shall include the phone number of the local
advocate and the hours that he or she may be reached.
SEC. 213. Section 6002.40 of the
Welfare and Institutions Code is amended to read:
6002.40. (a) For any insurance contracts entered into after
January 1, 1990, where any private insurer, certified medical plan,
or private health service plan is liable to pay or reimburse a
professional provider or institutional provider for the costs of
medically necessary mental health services provided to the patient,
the costs of the clinical review required by Sections 6002.10 to
6002.40, inclusive, including, but not limited to, the costs of the
interpreter, if any, and the costs of the patients' rights advocate,
shall be borne by the insurer, certified medical plan, or the health
service plan. Payments to providers for the costs of the independent
clinical review shall be made promptly.
For Medi-Cal eligible patients placed in these private facilities,
the costs of the clinical review required by Sections 6002.10 to
6002.40, inclusive, including the costs of the patients rights
advocate, shall be borne by the county.
(b) The Legislature intends that Sections 6002.10 to 6002.40,
inclusive, affect only the rights of minors confined in private
mental health facilities on the consent of their parents or
guardians, where the costs of treatment are paid or reimbursed by a
private insurer or private health service plan.
(c) Mental health facilities shall summarize on an annual basis,
information including, but not limited to, the number of minors
admitted by diagnosis, length of stay, and source of payment, the
number of requests for an independent clinical review by diagnosis,
source of payment, and outcome of the independent clinical review and
submit this information to the State Department of Mental
Health Care Services . This annual
summary shall be made available by the facility to the
The State Department of Public Health
Services which shall monitor compliance of this section
during an inspection of the facility pursuant to Sections 1278 and
1279 of the Health and Safety Code.
(d) The State Department of Mental Health, in consultation with
appropriate organizations, shall develop nonmandatory guidelines for
treatment of mental disorders to be utilized pursuant to this act by
January 1, 1991.
SEC. 214. Section 6007 of the Welfare
and Institutions Code is amended to read:
6007. Any person detained as of June 30, 1969, in a private
institution, pursuant to former Sections 6030 to 6033, inclusive, as
they read immediately preceding July 1, 1969, on the certification of
one physician, may be detained after July 1, 1969, for a period no
longer than 90 days.
Any person detained as of June 30, 1969, in a private institution,
pursuant to such sections, on the certification of two physicians,
may be detained after July 1, 1969, for a period no longer than 180
days.
Any person detained pursuant to this section after July 1, 1969,
shall be evaluated by the facility designated by the county and
approved by the State Department of Mental Health
Social Services pursuant to Section 5150 as a facility for
72-hour treatment and evaluation. Such The
evaluation shall be made at the request of the person in charge
of the private institution in which the person is detained or by one
of the physicians who signed the certificate. If in the opinion of
the professional person in charge of the evaluation and treatment
facility or his or her designee, the evaluation of the
person can be made by such the
professional person or his or her designee at the private
institution in which the person is detained, the person shall not be
required to be evaluated at the evaluation and treatment facility,
but shall be evaluated at the private institution to determine if the
person is a danger to others, himself or herself , or
gravely disabled as a result of mental disorder.
Any person evaluated under this section shall be released from the
private institution immediately upon completion of the evaluation if
in the opinion of the professional person in charge of the
evaluation and treatment facility, or his or her
designee, the person evaluated is not a danger to others, or to
himself or herself , or gravely disabled as a result of
mental disorder, unless the person agrees voluntarily to remain in
the private institution.
If in the opinion of the professional person in charge of the
facility or his or her designee, the person evaluated
requires intensive treatment or recommendation for conservatorship,
such the professional person or his
or her designee shall proceed under Article 4 (commencing
with Section 5250) of Chapter 2, or under Chapter 3 (commencing with
Section 5350), of Part 1 of Division 5.
SEC. 215. Section 6551 of the Welfare
and Institutions Code is amended to read:
6551. If the court is in doubt as to whether the person is
mentally disordered or mentally retarded, the court shall order the
person to be taken to a facility designated by the county and
approved by the State Department of Mental Health
Social Services as a facility for 72-hour treatment and
evaluation. Thereupon, Article 1 (commencing with Section 5150) of
Chapter 2 of Part 1 of Division 5 applies, except that the
professional person in charge of the facility shall make a written
report to the court concerning the results of the evaluation of the
person's mental condition. If the professional person in charge of
the facility finds the person is, as a result of mental disorder, in
need of intensive treatment, the person may be certified for not more
than 14 days of involuntary intensive treatment if the conditions
set forth in subdivision (c) of Section 5250 and subdivision (b) of
Section 5260 are complied with. Thereupon, Article 4 (commencing with
Section 5250) of Chapter 2 of Part 1 of Division 5 shall apply to
the person. The person may be detained pursuant to Article 4.5
(commencing with Section 5260), or Article 4.7 (commencing with
Section 5270.10), or Article 6 (commencing with Section 5300) of Part
1 of Division 5 if that article applies.
If the professional person in charge of the facility finds that
the person is mentally retarded, the juvenile court may direct the
filing in any other court of a petition for the commitment of a minor
as a mentally retarded person to the State Department of
Developmental Services for placement in a state hospital. In such
case, the juvenile court shall transmit to the court in which the
petition is filed a copy of the report of the professional person in
charge of the facility in which the minor was placed for observation.
The court in which the petition for commitment is filed may accept
the report of the professional person in lieu of the appointment, or
subpoenaing, and testimony of other expert witnesses appointed by the
court, if the laws applicable to such commitment proceedings provide
for the appointment by court of medical or other expert witnesses or
may consider the report as evidence in addition to the testimony of
medical or other expert witnesses.
If the professional person in charge of the facility for 72-hour
evaluation and treatment reports to the juvenile court that the minor
is not affected with any mental disorder requiring intensive
treatment or mental retardation, the professional person in charge of
the facility shall return the minor to the juvenile court on or
before the expiration of the 72-hour period and the court shall
proceed with the case in accordance with the Juvenile Court Law.
Any expenditure for the evaluation or intensive treatment of a
minor under this section shall be considered an expenditure made
under Part 2 (commencing with Section 5600) of Division 5 and shall
be reimbursed by the state as are other local expenditures pursuant
to that part.
The jurisdiction of the juvenile court over the minor shall be
suspended during such the time
as that the minor is subject to the jurisdiction
of the court in which the petition for postcertification treatment
of an imminently dangerous person or the petition for commitment of a
mentally retarded person is filed or under remand for 90 days for
intensive treatment or commitment ordered by such
the court.
SEC. 216. Section 7100 of the Welfare
and Institutions Code is amended to read:
7100. The board of supervisors of each county may maintain in the
county hospital or in any other hospital situated within or without
the county or in any other psychiatric health facility situated
within or without the county, suitable facilities and nonhospital or
hospital service for the detention, supervision, care, and treatment
of persons who are mentally disordered , or
developmentally disabled, or who are alleged to be such.
The county may contract with public or private hospitals for
such those facilities and hospital
service when they are not suitably available in any institution,
psychiatric facility, or establishment maintained or operated by the
county.
The facilities and services for the mentally disordered and
allegedly mentally disordered shall be subject to the approval of the
State Department of Mental Health Social
Services , and the facilities and services for the
developmentally disabled and allegedly developmentally disabled shall
be subject to the approval of the State Department of Developmental
Services. The professional person having charge and control of
any such the hospital or psychiatric
health facility shall allow the department whose approval is required
to make such investigations thereof as it deems
necessary at any time.
Nothing in this chapter means that mentally disordered or
developmentally disabled persons may not be detained, supervised,
cared for, or treated, subject to the right of inquiry or
investigation by the department, in their own homes, or the homes of
their relatives or friends, or in a licensed establishment.
SEC. 217. Section 9101 of the Welfare
and Institutions Code is amended to read:
9101. (a) The department shall consist of a director, and any
staff as may be necessary for proper administration.
(b) The department shall maintain its main office in Sacramento.
(c) The Governor, with the consent of the Senate, shall appoint
the director. The Governor shall consider, but not be limited to,
recommendations from the commission.
(d) The director shall have the powers of a head of a department
pursuant to Chapter 2 (commencing with Section 11150) of Part 1 of
Division 3 of Title 2 of the Government Code, and shall receive the
salary provided for by Chapter 6 (commencing with Section 11550) of
Part 1 of Division 3 of Title 2 of the Government Code.
(e) The director shall do all of the following:
(1) Be responsible for the management of the department and
achievement of its statewide goals.
(2) Assist the commission in carrying out its mandated duties and
responsibilities in accordance with Section 9202.
(f) The Secretary of the Health and Welfare Agency
California Health and Human Services shall
ensure effective coordination among departments of the agency in
carrying out the mandates of this division. For this purpose, the
secretary shall regularly convene meetings concerning services to
older individuals that shall include, but not be limited to, the
State Department of Health Care Services, the State
Department of Social Services, the State Department of
Mental Public Health, and the department.
(g) The Secretary of the Health and Welfare Agency
California Health and Human Services shall also
encourage other state departments that have other programs for older
individuals to actively participate in periodic joint meetings for
the joint purpose of coordinating service activities. These
departments shall include, but are not limited to, the Department of
Housing and Community Development and the Department of
Transportation in the Business, Transportation and Housing Agency,
the Department of Parks and Recreation in the Natural
Resources Agency, the California Arts Council, and the Department of
Veterans Affairs.
SEC. 218. Section 11325.7 of the
Welfare and Institutions Code is amended to read:
11325.7. (a) It is the intent of the Legislature in enacting this
section to create a funding stream and program that assists certain
recipients of aid under this chapter to receive necessary mental
health services, including case management and treatment, thereby
enabling them to make the transition from welfare to work. This
funding stream shall be used specifically to serve recipients in need
of mental health services, and shall be accounted for and expended
by each county in a manner that ensures that recipients in need of
mental health services are receiving appropriate services.
(b) The county plan required by Section 10531 shall include a plan
for the development of mental health employment assistance services,
developed jointly by the county welfare department and the county
department of mental health. The plan shall have as its goal the
treatment of mental or emotional disabilities that may limit or
impair the ability of a recipient to make the transition from
welfare-to-work, or that may limit or impair the ability to retain
employment over a long-term period. The plan shall be developed
in a manner consistent with
both the county's welfare-to-work program and the county's
consolidated mental health Medi-Cal services plan. The county may use
community based providers, as necessary, that have experience in
addressing the needs of the CalWORKs population. The county, whenever
possible, shall ensure that the services provided qualify for
federal reimbursement of the nonstate share of Medi-Cal costs.
(c) Subject to specific expenditure authority, mental health
services available under this section shall include all of the
following elements:
(1) Assessment for the purpose of identifying the level of the
participant's mental health needs and the appropriate level of
treatment and rehabilitation for the participant.
(2) Case management, as appropriate, as determined by the county.
(3) Treatment and rehabilitation services, that shall include
counseling, as necessary to overcome mental health barriers to
employment and mental health barriers to retaining employment, in
coordination with an individual's welfare-to-work plan.
(4) In cases where a secondary diagnosis of substance abuse is
made in a person referred for mental or emotional disorders, the
welfare-to-work plan shall also address the substance abuse treatment
needs of the participant.
(5) A process by which the county can identify those with severe
mental disabilities that may qualify them for aid under Chapter 3
(commencing with Section 12000).
(d) Any funds appropriated by the Legislature to cover the
nonfederal costs of the mental health employment assistance services
required by this section shall be allocated consistent with the
formula used to distribute each county's CalWORKs program allocation.
Each county shall report annually to the state the number of
CalWORKs program recipients who received mental health services and
the extent to which the allocation is sufficient to meet the need for
these services as determined by the county. The State Department of
Mental Health Care Services shall
develop a uniform methodology for ensuring that this allocation
supplements and does not supplant current expenditure levels for
mental health services for this population.
SEC. 219. Section 11462.01 of the
Welfare and Institutions Code is amended to read:
11462.01. (a) Commencing July 1, 1994, a group home program shall
be classified at RCL 13 or RCL 14 if the program meets all of the
following requirements:
(1) The group home program is providing, or has proposed to
provide, the level of care and services necessary to generate
sufficient points in the ratesetting process to be classified at RCL
13 if the rate application is for RCL 13 or to be classified at RCL
14 if the rate application is for RCL 14.
(2) (A) (i) The group home provider shall agree not to accept for
placement into a group home program AFDC-FC funded children,
including voluntary placements and seriously emotionally disturbed
children placed out-of-home pursuant to an individualized education
program developed under Section 7572.5 of the Government Code, who
have not been approved for placement by an interagency placement
committee, as described by Section 4096. The approval shall be in
writing and shall indicate that the interagency placement committee
has determined the child is seriously emotionally disturbed, as
defined by Section 5600.3 and subject to Section 1502.4 of the Health
and Safety Code, and that the child needs the level of care provided
by the group home.
(ii) For purposes of clause (i), group home providers who accept
seriously emotionally disturbed children who are assessed and placed
out-of-home pursuant to an individualized education program developed
under Section 7572.5 of the Government Code shall be deemed to have
met the interagency placement committee approval for placement
requirements of clause (i) if the individualized education program
assessment indicates that the child has been determined to be
seriously emotionally disturbed, as defined in Section 5600.3 and
subject to Section 1502.4 of the Health and Safety Code, and needs
the level of care described in clause (i).
(B) (i) Nothing in this subdivision shall prevent the emergency
placement of a child into a group home program prior to the
determination by the interagency placement committee pursuant to
subclause (i) of subparagraph (A) if a licensed mental health
professional, as defined in the department's AFDC-FC ratesetting
regulations, has evaluated, in writing, the child within 72 hours of
placement, and determined the child to be seriously emotionally
disturbed and in need of the care and services provided by the group
home program.
(ii) The interagency placement committee shall, within 30 days of
placement pursuant to clause (i), make the determination required by
clause (i) of subparagraph (A).
(iii) If, pursuant to clause (ii), the placement is determined to
be appropriate, the committee shall transmit the approval, in
writing, to the county placing agency and the group home provider.
(iv) If, pursuant to clause (ii) the placement is determined not
to be appropriate, the child shall be removed from the group home and
referred to a more appropriate placement, as specified in
subdivision (f).
(C) Commencing December 15, 1992, with respect to AFDC-FC funded
children, only those children who are approved for placement by an
interagency placement committee may be accepted by a group home under
this subdivision.
(3) The group home program is certified by the State Department of
Mental Health Care Services pursuant
to Section 4096.5.
(b) The department shall not establish a rate for a group home
requesting a program change to RCL 13 or RCL 14 unless the group home
provider submits a recommendation from the host county or the
primary placing county that the program is needed and that the
provider is willing and capable of operating the program at the level
sought. For purposes of this subdivision, "host county," "primary
placing county," and "program change" mean the same as defined in the
department's AFDC-FC ratesetting regulations.
(c) The effective date of rates set at RCL 13 or RCL 14 shall be
the date that all the requirements are met, but not prior to July 1
of that fiscal year. Nothing in this section shall affect RCL 13 or
RCL 14 ratesetting determinations in prior years.
(d) Any group home program that has been classified at RCL 13 or
RCL 14 pursuant to the requirements of subdivision (a) shall be
reclassified at the appropriate lower RCL with a commensurate
reduction in rate if either of the following occurs:
(1) The group home program fails to maintain the level of care and
services necessary to generate the necessary number of points for
RCL 13 or RCL 14, as required by paragraph (1) of subdivision (a).
The determination of points shall be made consistent with the
department's AFDC-FC ratesetting regulations for other rate
classification levels.
(2) The group home program fails to maintain a certified mental
health treatment program as required by paragraph (3) of subdivision
(a).
(3) In the event of a determination under paragraph (1), the group
home may appeal the finding or submit a corrective action plan. The
appeal process specified in Section 11466.6 shall be available to RCL
13 and RCL 14 group home providers. During any appeal, the group
home shall maintain the appropriate level of care.
(e) The interagency placement committee shall periodically review,
but no less often than that required by current law, the placement
of the child. If the committee determines that the child no longer
needs, or is not benefiting from, placement in a RCL 13 or RCL 14
group home, the committee shall require the removal of the child and
a new disposition.
(f) (1) (A) If, at any time subsequent to placement in an RCL 13
or RCL 14 group home program, the interagency placement committee
determines either that the child is not seriously emotionally
disturbed or is not in need of the care and services provided by the
group home program, it shall notify, in writing, both the county
placing agency and the group home provider within 10 days of the
determination.
(B) The county placing agency shall notify the group home
provider, in writing, within five days from the date of the notice
from the committee, of the county's plan for removal of the child.
(C) The county placing agency shall remove the child from the
group home program within 30 days from the date of the notice from
the interagency placement committee.
(2) (A) If a county placing agency does not remove a child within
30 days from the date of the notice from the interagency placement
committee, the group home provider shall notify the interagency
placement committee and the department, in writing, of the county's
failure to remove the child from the group home program.
(B) The group home provider shall make the notification required
by subparagraph (A) within five days of the expiration of the 30-day
removal period. If notification is made, a group home provider shall
not be subject to an overpayment determination due to failure of the
county placing agency to remove the child.
(3) Any county placing agency that fails to remove a child from a
group home program under this paragraph within 30 days from the date
of the notice from the interagency placement committee shall be
assessed a penalty in the amount of the state and federal financial
participation in the AFDC-FC rate paid on behalf of the child
commencing on the 31st day and continuing until the child is removed.
(g) (1) If any RCL 13 or RCL 14 group home provider discovers that
it does not have written approval for placement of any AFDC-FC
funded child placed on or after December 15, 1992, from the
interagency placement committee, it shall notify the county placing
agency, in writing, and shall request the county to obtain approval
from the interagency placement committee or remove the child from the
group home program. A group home provider shall have 30 days from
the child's first day of placement to discover the placement error
and to notify the county placing agency.
(2) Any county placing agency that receives notification pursuant
to paragraph (2) of subdivision (f) shall obtain approval for
placement from the interagency placement committee or remove the
child from the group home program within 30 days from the date of the
notice from the group home provider. The program shall not be
reclassified to a lower RCL for a violation of the provisions
referred to in this paragraph.
(3) (A) If a county placing agency does not have the placement of
a child approved by the interagency placement committee or removed
from the group home within 30 days from the date of the notice from
the group home provider, the group home provider shall notify the
county placing agency and the department, in writing, of the county's
failure to have the placement of the child approved or remove the
child from the group home program.
(B) The group home provider shall make the notification required
by subparagraph (A) within five days after the expiration of the
30-day approval or removal period. If notification is made, a group
home provider shall not be subject to an overpayment determination
due to failure of the county placing agency to remove the child.
(C) Any group home provider that fails to notify the county
placing agency pursuant to subparagraph (A) shall be assessed a
penalty in the amount of the AFDC-FC rate paid to the group home
provider on behalf of the child commencing on the 31st day of
placement and continuing until the county placing agency is notified.
(4) Any county placing agency that fails to have the placement of
a child approved or to have the child removed from the group home
program within 30 days shall be assessed a penalty in the amount of
the state and federal financial participation in the AFDC-FC rate
paid on behalf of the child commencing on the 31st day of placement
and continuing until the child is removed.
(h) The department shall develop regulations to obtain payment of
assessed penalties as provided in this section. For audit purposes
and the application of penalties for RCL 13 and RCL 14 programs, the
department shall apply statutory provisions that were in effect
during the period for which the audit was conducted.
(i) (1) Nothing in this subparagraph shall prohibit a group home
classified at RCL 13 or RCL 14 for purposes of the AFDC-FC program,
from accepting private placements of children.
(2) In cases where a referral is not from a public agency and no
public funding is involved, there shall be no requirement for public
agency review or determination of need.
(3) Children subject to paragraphs (1) and (2) shall have been
assessed as seriously emotionally disturbed, as defined in Section
5600.3 and subject to Section 1502.4 of the Health and Safety Code,
by a licensed mental health professional, as defined in Sections 629
to 633, inclusive, of Title 9 of the California Code of Regulations.
(j) A child shall not be placed in a group home program classified
at an RCL 13 or RCL 14 if the placement is paid for with county-only
funds unless the child is assessed as seriously emotionally
disturbed, as defined in Section 5600.3, subject to Section 1502.4 of
the Health and Safety Code, by a licensed mental health
professional, as defined in Sections 629 to 633, inclusive, of Title
9 of the California Code of Regulations.
SEC. 220. Section 11495.1 of the
Welfare and Institutions Code is amended to read:
11495.1. (a) The department shall convene a task force including,
but not limited to, district attorney domestic violence units,
county departments of social services, the County Welfare Directors
Association of California, the California State Association of
Counties, statewide domestic violence prevention groups, local
domestic violence prevention advocates, and service providers, the
State Department of Health Care Services, the State
Department of Mental Public Health, and
the Office of Criminal Justice Planning
California Emergency Management Agency . The department shall
develop, in consultation with the task force, protocols on handling
cases in which recipients are past or present victims of abuse. The
protocols shall define domestic abuse, and shall address training
standards and curricula, individual case assessments, confidentiality
procedures, notice procedures and counseling or other appropriate
participation requirements as part of an overall plan to transition
from welfare-to-work. The protocol shall specify how counties shall
do the following:
(1) Identify applicants and recipients of assistance under this
chapter who have been or are victims of abuse, including those who
self-identify, while protecting confidentiality.
(2) Refer these individuals to supportive services.
(3) Waive, on a case-by-case basis, for so long as necessary,
pursuant to a determination of good cause under paragraph (2) of
subdivision (f) of Section 11320.3, any program requirements that
would make it more difficult for these individuals or their children
to escape abuse, and that would be detrimental or unfairly penalize
past or present victims of abuse. Requirements that may be waived
include, but are not limited to, time limits on receipt of
assistance, work requirements, educational requirements, paternity
establishment and child support cooperation requirements.
(b) The department shall issue regulations describing the protocol
identified in subdivision (a) no later than January 1, 1999.
(c) Waivers of time limits granted pursuant to this section shall
not be implemented if federal statutes or regulations clarify that
abuse victims are included in the 20 percent hardship exemptions and
that no good cause waivers of the 20 percent limit will be granted to
the state for victims of abuse, thereby incurring a penalty to the
state.
(d) Waivers of the work requirements granted pursuant to this
section shall not be implemented if federal statutes or regulations
clarify that the state will be penalized for failing to meet work
participation requirements due to granting waivers to abuse victims.
SEC. 221. Section 14021.3 of the
Welfare and Institutions Code , as added by Section 2
of Chapter 1384 of the Statutes of 1987, is amended to read:
14021.3. (a) The department shall amend the
state plan for medical assistance under Medicaid pursuant to Section
1915(g) of Title 19 of the federal Social Security Act,
as amended by Public Law 99-272 (42 U.S.C. Sec. 1396n(g)), to add
case management services as a covered benefit under the
Short-Doyle/Medi-Cal specialty mental health services
Medi-Cal program, and shall submit the plan for federal
approval by December 31, 1988, or, if the plan has not been submitted
by that date, shall submit a letter to the Legislature by that date
explaining the circumstances delaying the plan's submission.
Upon federal approval for federal financial assistance, the
department , in consultation with the State Department of
Mental Health, shall define case management services, shall
establish the standards under which case management services qualify
as a Short-Doyle/Medi-Cal specialty mental
health reimbursable service, and shall develop an appropriate
rate of reimbursement, subject to utilization controls.
It is the intent of the Legislature that at least 50 percent of
the total state dollars that are offset as a result of the federal
funds received for case management services be redirected to services
for those persons identified in Section 14132.44 and that the
remainder of these funds be redirected to services under the
jurisdiction of the California Health and Welfare
Human Services Agency for persons other than
those persons identified in Section 14132.44.
(b) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute,
that becomes operative on or before January 1, 2013, deletes or
extends the dates on which it becomes inoperative and is repealed.
SEC. 222. Section 14021.3 of the
Welfare and Institutions Code , as added by Section 1
of Chapter 1385 of the Statutes of 1987, is amended to read:
14021.3. The department shall amend the state
plan for medical assistance under Medicaid pursuant to Section 1915
(g) of Title 19 of the federal Social Security Act, as
amended by Public Law 99-272 (42 U.S.C. Section 1396n(g)),
to add shall include targeted case management
services as a benefit under the Short-Doyle
specialty mental health services Medi-Cal program for
persons served by the State Department of Mental Health and
Short-Doyle mental health programs .
SEC. 223. Section 14021.4 of the
Welfare and Institutions Code is amended to read:
14021.4. (a) The State Department of Mental Health shall
prepare by January 15, 1991, amendments to California's
plan for federal Medi-Cal grants for medical assistance programs,
pursuant to Subchapter XIX (commencing with Section 1396) of Title 42
of the United States Code, to shall
accomplish the following objectives:
(1) Expansion of the location and type of therapeutic services
offered to the mentally ill persons with
mental illnesses under Medi-Cal by the category of "other
diagnostic, screening, preventative, and rehabilitative services"
which is available to states under the federal Social
Security Act and its implementing regulations (42 U.S.C.
Sec. 1396d(a)(13); 42 C.F.R. 440.130).
(2) Expansion of federal financial participation in the costs of
community special ty mental
health services provided by local Short-Doyle community
mental health programs mental health plans or
under contract to local Short-Doyle community mental health
programs with the mental health plans .
(3) Expansion of the location where reimbursable
Short-Doyle Medi-Cal specialty mental health
services can be provided, including home, school, and community based
sites.
(4) Expansion of federal financial participation for services
which meet the rehabilitation needs of severely mentally ill
consumers persons with mental illnesses ,
including, but not limited to, medication management, functional
rehabilitation assessments of clients, and rehabilitative services
which include remedial services directed at restoration to the
highest possible functional level for persons with
psychiatric disabilities mental illnesses and
maximum reduction of symptoms of mental illness.
(5) Improvement of fiscal systems and accountability structures
for Short-Doyle Medi-Cal and Short-Doyle costs
specialty mental health services, costs, and rates, with
the goal of achieving federal fiscal requirements.
(b) This Short-Doyle Medi-Cal The
department's state plan revision shall be completed with
review and comments by the California Conference of Local
Mental Health Directors Association and other
appropriate groups. The addition of
(c) Services under the
rehabilitative option shall be limited to Short-Doyle
providers specialty mental health plans
certified to provide Medi-Cal under this option.
(c) The State Department of Health Services shall review the state
plan revision for medicaid services as recommended by the State
Department of Mental Health. If the state plan amendment satisfies
published federal requirements for these amendments and if the State
Department of Health Services has approved and submitted to the
Health Care Financing Administration a plan of correction for audit
issues identified for the Short-Doyle Medi-Cal program, then the
department shall promptly pursue federal adoption of the state plan
revision. If the State Department of Health Services does not
recommend adoption of the revision, it shall report on the financial
and programmatic implications of the proposal and the reasons for the
rejection to the Joint Legislative Budget Committee by July 1, 1991.
(d) The state and local funds required to match federal financial
participation shall include, but not be limited to, Short-Doyle and
county matching funds. Additional General Fund moneys for this
purpose shall be subject to appropriation in the annual Budget Act.
(e)
(d) It is the intent of the Legislature that the
rehabilitation option of the state medicaid
Medicaid plan be implemented to expand and provide flexibility
to treatment services and to increase the federal participation
without increasing the costs to the General Fund.
(f) It is the intent of the Legislature that addition of the
rehabilitation option as a Short-Doyle Medi-Cal benefit shall become
operative only after the Health Care Financing Administration has
reviewed and approved the state plan revision submitted by the State
Department of Health Services, a plan of correction approved by the
department for audit issues identified for the Short-Doyle Medi-Cal
program has been submitted, and the requirements of this section have
been fully satisfied.
(g) If the Medi-Cal state plan revision required by this section
is approved by the State Department of Health Services, and submitted
for federal approval, the State Department of Mental Health
(e) The department shall review
and revise the quality assurance standards and guidelines required by
Article 5 (commencing with Section 4070) of Chapter 2 of
Division 4 to meet the necessary standards Section
14725 to assure ensure that
quality services are delivered to the eligible population.
This review Any reviews shall include, but not
be limited to, appropriate use of mental health professionals,
including psychiatrists, in the treatment and rehabilitation of
clients under this model. The existing quality assurance standards
and guidelines shall remain in effect until the adoption of the new
quality assurance standards and guidelines.
(h)
(f) Consistent with services offered to persons
who are mentally ill with mental illnesses
under the Medi-Cal program, as required by this section, it is
the intent of the Legislature for the State Department of
Mental Health, working collaboratively with the department,
department to include care and treatment of persons with
mental disorders illnesses who are
eligible for the Medi-Cal program in facilities with a bed capacity
of 16 beds or less.
SEC. 224. Section 14021.5 of the
Welfare and Institutions Code is amended to read:
14021.5. (a) Notwithstanding any other provision of law, rates
for reimbursing Short-Doyle specialty
mental health and drug substance use disorder
services allowable under the Medi-Cal program and rendered to
Medi-Cal beneficiaries under the Short-Doyle program
shall continue to be based on the upper limits allowable
under federal law and regulations for services provided prior to July
1, 1980, on the lower of reasonable cost and customary charges for
services provided July 1, 1980, through June 30, 1982, and on the
lowest of reasonable cost, customary charges, and rates paid by the
Short-Doyle Medi-Cal program for
services provided July 1, 1982, through June 30, 1984.
(b) The Legislature hereby states and declares that this section
does not constitute a change in, but is declaratory of, existing law
and that rates for reimbursing Short-Doyle
specialty mental health and drug
substance use disorder services to Medi-Cal beneficiaries under
the Short-Doyle Medi-Cal program in
previous fiscal years were based upon the lower of reasonable costs
or customary charges.
(c) The State Department of Health Services, after
consulting with the State Department of Mental Health and the State
Department of Alcohol and Drug Programs, in regard to their
respective programs, department shall promulgate
emergency regulations relating to claims submission and establishing
rates and a ratesetting methodology for determining reimbursement of
Short-Doyle specialty mental health
and drug substance use disorder services
allowable under the
Medi-Cal program and rendered to Medi-Cal beneficiaries
under the State Department of Mental Health and the State Department
of Alcohol and Drug Programs' programs respectively . The
methodology and rates shall reflect the most recently completed cost
reports and shall be effective commencing July 1, 1984.
(d) Notwithstanding any other provision of law,
rates for reimbursing Short-Doyle specialty
mental health services allowable under the Medi-Cal program and
rendered to Medi-Cal beneficiaries under the programs
administered by the State Department of Mental Health shall
be effective from July 1 through June 30 of the fiscal year in which
these rates are established.
(e) Notwithstanding any other provision of law,
rates for reimbursing drug substance use
disorder services allowable under the Medi-Cal program and
rendered to Medi-Cal beneficiaries under the programs
administered by the State Department of Alcohol and Drug Programs
shall be effective from July 1 through June 30 of the
fiscal year in which these rates are established.
SEC. 225. Section 14053.3 of the
Welfare and Institutions Code is amended to read:
14053.3. As (a)
Except as provided under federal law, federal financial
participation reimbursement is not allowed for ancillary services
provided to persons residing in facilities that have been found to be
institutions for mental disease (IMD), and since, consistent with
Part 2 (commencing with Section 5600) of Division 5 and Chapter 6
(commencing with Section 17600) of Part 5, counties are financially
responsible for specialty mental health services and
related ancillary services provided to persons through county mental
health programs when Medi-Cal reimbursement is not available, when it
is determined that Medi-Cal reimbursement has been paid for
ancillary services for residents of IMDs, both the federal financial
participation reimbursement and any state funds paid for the
ancillary services provided to residents of IMDs shall be recovered
from counties by the State Department of Mental Health
department in accordance with applicable state
and federal statutes and regulations.
(b) Mental health plans shall report to the department admission
and discharge dates for Medi-Cal beneficiaries in institutions for
mental diseases on a quarterly basis in a format provided by the
department.
SEC. 226. Section 14108.1 of the
Welfare and Institutions Code is amended to read:
14108.1. Any recipient receiving care in a nursing facility under
this chapter, as part of a certified special treatment program for
mentally disordered persons with mental
illnesses , or as a part of a mental health therapeutic and
rehabilitative program approved and certified by a local mental
health director, is entitled to be temporarily absent from those
facilities. The State Department of Health Services shall,
with consultation from the State Department of Mental Health,
department may develop regulations
within 60 days of the effective date of this act
establishing the periods of time and conditions under which temporary
absences shall be permitted. These regulations shall require that
absences be in accordance with an individual patient care plan and
also provide for absences due to hospitalization for an acute
condition. The limits on temporary leaves of absence established by
the State Department of Health Services
department by regulation shall not be less than 30 days per
year.
During these temporary absences, the State Department of
Health Services department shall reimburse the
facility for the cost of maintaining the vacant accommodations at a
rate to be determined by the department which shall be less than the
normal reimbursement rate.
SEC. 227. Section 14110.15 of the
Welfare and Institutions Code is amended to read:
14110.15. (a) The department shall develop, collect, and
maintain, in an electronic format, all data elements in the minimum
data set specified by the federal government. The data base shall
incorporate the data required for preadmission screening and annual
resident reviews, and Medi-Cal treatment authorization requests. The
department shall make the format of this new data base available to
the public.
(b) All skilled nursing facilities and nursing facilities required
by federal law to complete the minimum data set form shall provide
the data to the department in a manner and form prescribed by the
director. The director may require that the submission of that data
shall be in an electronic format.
(c) The department shall design the minimum data set data base in
a manner that maintains resident confidentiality and that allows the
use of the data by other authorized state agencies, including, but
not limited to, the Office of Statewide Health Planning and
Development and the Department of Mental Health .
To the extent possible, those other state agencies shall obtain the
minimum data set and preadmission screening and annual resident
review data from the department's data base
database established and maintained pursuant to this section.
(d) To the fullest extent possible, the department shall use the
minimum data set data base database to
meet the requirements of the current treatment authorization request
review process and shall automate use of the minimum data set
information for that purpose.
(e) This section shall not be construed to prohibit the department
or any other state agency from requiring additional information that
is not available from the minimum data set data base
database in order to meet other data needs.
(f) The department shall implement this section no later than the
date specified by the federal government for facility completion of
automation of the minimum data set data. The department shall, within
a reasonable time, make necessary system changes to begin the use of
the automated minimum data set data to meet its treatment
authorization and preadmission screening and annual resident review
data requirements. To the fullest extent possible, these system
changes shall be anticipated and commenced in advance of the federal
government's final implementation date.
(g) The system shall be developed and implemented in consultation
with representatives of the long-term care industry and other
interested parties, such as physicians and other health care
professionals.
(h) The department shall implement the development of the minimum
data set data base database only if
federal funds are available for that purpose. Development of the data
system applications for use of the automated minimum data set
data base database by the department
are subject to federal approval and federal financial participation
for the affected systems.
SEC. 228. Section 14131.07 of the
Welfare and Institutions Code is amended to read:
14131.07. (a) Notwithstanding any other provision of this chapter
or Chapter 8 (commencing with Section 14200), the total number of
physician office and clinic visits for physician services provided by
a physician, or under the direction of a physician, that are a
covered benefit under the Medi-Cal program shall be limited to seven
visits per beneficiary per fiscal year, excepting visits that meet
the conditions set forth in subdivision (b). For purposes of this
limit, a visit shall include physician services provided at any
federally qualified health center, rural health clinic, community
clinic, outpatient clinic, and hospital outpatient department. The
department may seek input from consumer organizations and the
provider community, as applicable, prior to implementation.
(b) (1) Visits exceeding seven per beneficiary per fiscal year
shall be required to be certified by the physician, or other medical
professional under the supervision of a physician, attesting that one
or more of the following circumstances is applicable:
(A) The services will prevent deterioration in a beneficiary's
condition that would otherwise foreseeably result in admission to the
emergency department.
(B) The services will prevent deterioration in the beneficiary's
condition that would otherwise result in inpatient admission.
(C) The services will prevent disruption in ongoing medical
therapy or surgical therapy, or both, including, but not limited to,
medications, radiation, or wound management.
(D) The services constitute diagnostic workup in progress that
would otherwise foreseeably result in inpatient or emergency
department admission.
(E) The services are for the purpose of assessment and form
completion for Medi-Cal recipients seeking or receiving in-home
supportive services.
(2) The certification shall consist of a written declaration by
the physician, or other medical professional under the supervision of
the physician, that the visit meets the requirements of any one or
more of the circumstances set forth in paragraph (1), and shall
include a description of the services provided.
(3) The certification shall be maintained onsite at the physician'
s office or clinic location at which the medical records for the
beneficiary are maintained and shall be subject to audit and
inspection by the department.
(4) This subdivision does not authorize or direct a beneficiary to
obtain services at a physician office or clinic visit for an
emergency medical condition or that should properly be provided in
the emergency department or as hospital inpatient services.
(c) Specialty mental health services furnished or arranged for the
provision of mental health services to Medi-Cal beneficiaries
pursuant to Part 2.5 (commencing with Section 5775) of
Division 5 Chapter 8.9 (commencing with Section 14700)
, shall not be subject to the limit provided in subdivision
(a).
(d) Any pregnancy-related visit, or any visit for the treatment of
any other condition that might complicate a pregnancy, shall not be
subject to the limit provided in subdivision (a).
(e) The limit on physician office and clinic visits provided in
subdivision (a) shall not apply to any of the following:
(1) A beneficiary under the Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT) Program.
(2) A beneficiary receiving long-term care in a nursing facility
that is both of the following:
(A) A skilled nursing facility or intermediate care facility as
defined in subdivisions (c), (d), (e), (g), and (h), respectively, of
Section 1250 of the Health and Safety Code, and facilities providing
continuous skilled nursing care to persons with developmental
disabilities under the pilot project established pursuant to Section
14132.20.
(B) Licensed pursuant to subdivision (k) of Section 1250 of the
Health and Safety Code.
(f) For managed health care plans that contract with the
department pursuant to this chapter or Chapter 8 (commencing with
Section 14200), except for the Senior Care Action Network
or AIDS Healthcare Foundation, payments shall be reduced by the
actuarial equivalent amount of the benefit reductions resulting from
the implementation of the benefit cap amounts specified in this
section pursuant to contract amendments or change orders effective on
July 1, 2011, or thereafter.
(g) This section shall be implemented only to the extent permitted
by federal law.
(h) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement this section by means of all-county letters,
provider bulletins, or similar instructions, without taking
regulatory action.
(i) This section shall be implemented on the first day of the
first calendar month following 180 days after the effective date of
the act that added this section, or on the first day of the calendar
month following 60 days after the date the department secures all
necessary federal approvals to implement this section, whichever is
later. If the implementation date occurs after July 1, 2011, then the
benefit caps described in subdivision (a) for the first year of
implementation shall be applied from the implementation date to June
30 of the state fiscal year in which implementation begins.
Thereafter, the benefit caps shall apply on a state fiscal year
basis.
SEC. 229. Section 14132.73 of the
Welfare and Institutions Code is amended to read:
14132.73. The State Department of Health Care Services
shall allow psychiatrists to receive fee-for-service Medi-Cal
reimbursement for services provided through telemedicine
until June 30, 2004, or until the State Department
of Mental Health department and mental health
plans, in collaboration with stakeholders, develop a method for
reimbursing psychiatric services provided through telemedicine that
is administratively feasible for the mental health plans, primary
care providers, and psychiatrists providing the services, whichever
occurs later in accordance with the Medicaid state
plan .
SEC. 230. Section 14167.1 of the
Welfare and Institutions Code is amended to read:
14167.1. For purposes of this article, the following definitions
shall apply:
(a) "Acute psychiatric days" means the total number of
Short-Doyle Medi-Cal specialty mental health service
administrative days, Short-Doyle
Medi-Cal specialty mental health service acute care days, acute
psychiatric administrative days, and acute psychiatric acute days
identified in the Final Medi-Cal Utilization Statistics for the
2008-09 state fiscal year as calculated by the department on
September 15, 2008.
(b) "Converted hospital" means a private hospital that becomes a
designated public hospital or a nondesignated public hospital after
the implementation date, a nondesignated public hospital that becomes
a private hospital or a designated public hospital after the
implementation date, or a designated public hospital that becomes a
private hospital or a nondesignated public hospital after the
implementation date.
(c) "Current Section 1115 Waiver" means California's Medi-Cal
Hospital/Uninsured Care Section 1115 Waiver Demonstration in effect
on the effective date of the article.
(d) "Designated public hospital" shall have the meaning given in
subdivision (d) of Section 14166.1 as that section may be amended
from time to time.
(e) "General acute care days" means the total number of Medi-Cal
general acute care days paid by the department to a hospital in the
2008 calendar year, as reflected in the state paid claims files on
July 10, 2009.
(f) "High acuity days" means Medi-Cal coronary care unit days,
pediatric intensive care unit days, intensive care unit days,
neonatal intensive care unit days, and burn unit days paid by the
department during the 2008 calendar year, as reflected in the state
paid claims files on July 10, 2009.
(g) "Hospital inpatient services" means all services covered under
Medi-Cal and furnished by hospitals to patients who are admitted as
hospital inpatients and reimbursed on a fee-for-service basis by the
department directly or through its fiscal intermediary. Hospital
inpatient services include outpatient services furnished by a
hospital to a patient who is admitted to that hospital within 24
hours of the provision of the outpatient services that are related to
the condition for which the patient is admitted. Hospital inpatient
services do not include services for which a managed health care plan
is financially responsible.
(h) "Hospital outpatient services" means all services covered
under Medi-Cal furnished by hospitals to patients who are registered
as hospital outpatients and reimbursed by the department on a
fee-for-service basis directly or through its fiscal intermediary.
Hospital outpatient services do not include services for which a
managed health care plan is financially responsible, or services
rendered by a hospital-based federally qualified health center for
which reimbursement is received pursuant to Section 14132.100.
(i) (1) "Implementation date" means the latest effective date of
all federal approvals or waivers necessary for the implementation of
this article and Article 5.22 (commencing with Section 14167.31),
including, but not limited to, any approvals on amendments to
contracts between the department and managed health care plans or
mental health plans necessary for the implementation of this article.
The effective date of a federal approval or waiver shall be the
earlier of the stated effective date or the first day of the first
quarter to which the computation of the payments or fee under the
federal approval or waiver is applicable, which may be prior to the
date that the federal approval or waiver is granted or the applicable
contract is amended.
(2) If federal approval is sought initially for only the 2008-09
federal fiscal year and separately secured for subsequent federal
fiscal years, the implementation date for the 2008-09 federal fiscal
year shall occur when all necessary federal approvals have been
secured for that federal fiscal year.
(j) "Individual hospital acute psychiatric supplemental payment"
means the total amount of acute psychiatric hospital supplemental
payments to a subject hospital for a quarter for which the
supplemental payments are made. The "individual hospital acute
psychiatric supplemental payment" shall be calculated for subject
hospitals by multiplying the number of acute psychiatric days for the
individual hospital for which a mental health plan was financially
responsible by four hundred eighty-five dollars ($485) and dividing
the result by 4.
(k) (1) "Managed health care plan" means a health care delivery
system that manages the provision of health care and receives prepaid
capitated payments from the state in return for providing services
to Medi-Cal beneficiaries.
(2) (A) Managed health care plans include county organized health
systems and entities contracting with the department to provide
services pursuant to two-plan models and geographic managed care.
Entities providing these services contract with the department
pursuant to any of the following:
(i) Article 2.7 (commencing with Section 14087.3).
(ii) Article 2.8 (commencing with Section 14087.5).
(iii) Article 2.81 (commencing with Section 14087.96).
(iv) Article 2.91 (commencing with Section 14089).
(B) Managed health care plans do not include any of the following:
(i) Mental health plan contracting to provide mental health care
for Medi-Cal beneficiaries pursuant to Part 2.5 (commencing
with Section 5775) of Division 5 Chapter 8.9
(commencing with Section 14700) .
(ii) Health plan not covering inpatient services such as primary
care case management plans operating pursuant to Section 14088.85.
(iii) Program of All-Inclusive Care for the Elderly
organization s operating pursuant to Chapter 8.75
(commencing with Section 14591).
(l) "Medi-Cal managed care days" means the total number of general
acute care days, including well baby days, listed for the county
organized health system and prepaid health plans identified in the
Final Medi-Cal Utilization Statistics for the 2008-09 state fiscal
year, as calculated by the department on September 15, 2008, except
that the general acute care days, including well baby days, for the
Santa Barbara Health Care Initiative shall be derived from the Final
Medi-Cal Utilization Statistics for the 2007-08 state fiscal year.
(m) "Medicaid inpatient utilization rate" means Medicaid inpatient
utilization rate as defined in Section 1396r-4 of Title 42 of the
United States Code and as set forth in the final disproportionate
share hospital eligibility list for the 2008-09 state fiscal year
released by the department on October 22, 2008.
(n) "Mental health plan" means a mental health plan that contracts
with the State Department of Mental Health
the department to furnish or arrange for the provision of
mental health services to Medi-Cal beneficiaries pursuant to
Part 2.5 (commencing with Section 5775) of Division 5
Chapter 8.9 (commencing with Section 14700) .
(o) "New hospital" means a hospital that was not in operation
under current or prior ownership as a private hospital, a
nondesignated public hospital, or a designated public hospital for
any portion of the 2008-09 state fiscal year.
(p) "Nondesignated public hospital" means either of the following:
(1) A public hospital that is licensed under subdivision (a) of
Section 1250 of the Health and Safety Code, is not designated as a
specialty hospital in the hospital's annual financial disclosure
report for the hospital's latest fiscal year ending in 2007, and
satisfies the definition in paragraph (25) of subdivision (a) of
Section 14105.98, excluding designated public hospitals.
(2) A tax-exempt nonprofit hospital that is licensed under
subdivision (a) of Section 1250 of the Health and Safety Code, is not
designated as a specialty hospital in the hospital's annual
financial disclosure report for the hospital's latest fiscal year
ending in 2007, is operating a hospital owned by a local health care
district, and is affiliated with the health care district hospital
owner by means of the district's status as the nonprofit corporation'
s sole corporate member.
(q) "Outpatient base amount" means the total amount of payments
for hospital outpatient services made to a hospital in the 2007
calendar year, as reflected in state paid claims files on January 26,
2008.
(r) "Private hospital" means a hospital that meets all of the
following conditions:
(1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
(2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2007.
(3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
(4) Is a nonpublic hospital, nonpublic converted hospital, or
converted hospital as those terms are defined in paragraphs (26) to
(28), inclusive, respectively, of subdivision (a) of Section
14105.98.
(s) "Subject federal fiscal year" means a federal fiscal year that
ends after the implementation date and begins before December 31,
2010.
(t) "Subject fiscal quarter" means a fiscal quarter beginning on
or after the implementation date and ending before January 1, 2011.
(u) "Subject fiscal year" means a state fiscal year that ends
after the implementation date and begins before December 31, 2010.
(v) "Subject hospital" shall mean a hospital that meets all of the
following conditions:
(1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
(2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2007.
(3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
(w) "Subject month" means a calendar month beginning on or after
the implementation date and ending before January 1, 2011.
(x) "Upper payment limit" means a federal upper payment limit on
the amount of the Medicaid payment for which federal financial
participation is available for a class of service and a class of
health care providers, as specified in Part 447 of Title 42 of the
Code of Federal Regulations.
SEC. 231. Section 14167.11 of the
Welfare and Institutions Code is amended to read:
14167.11. (a) The department shall increase payments to mental
health plans for the subject fiscal years as set forth in this
section. The aggregate amount of the increased payments for a subject
fiscal quarter shall be the total of the individual hospital acute
psychiatric supplemental payment amounts for all hospitals for which
federal financial participation is available.
(b) For each subject fiscal quarter, the state shall make
increased payments to each mental health plan. The department shall
consider the composition of Medi-Cal enrollees in the mental health
plan, the anticipated utilization of hospital services by the mental
health plan's Medi-Cal enrollees, and other factors that the
department determines are reasonable and appropriate to ensure access
to high-quality hospital services by the mental health plan's
enrollees.
(c) The state shall make increased payments to mental health plans
exclusively for the purpose of making payments to hospitals, in
order to support the availability of hospital specialty
mental health services and ensure access for Medi-Cal beneficiaries
to hospital specialty mental health services. The
increased payments to mental health plans shall be made as follows:
(1) The increased payments shall commence on or before the later
of the last day of the second month of the quarter in which federal
approval is granted or the 45th day following the day on which
federal approval is granted. Subsequent increased payments shall be
made on the last day of the second month of each quarter. The last
increased payments made pursuant to this section shall be made during
November 2010.
(2) The increased payments made for the first quarter for which
increased payments are made under this section shall include the sum
of increased payments for all prior quarters for which payments are
due under subdivision (b).
(3) The increased payments made during November 2010 shall include
payments computed under subdivision (b) for all quarters in the
2010-11 subject fiscal year to the extent that federal financial
participation is available for the payments.
(4) If all necessary federal approvals are not received on or
before September 1, 2010, the department shall make semimonthly
payments starting within one month of receipt of all necessary
federal approvals until December 31, 2010.
(d) Each mental health plan shall expend, in the form of
additional payments to hospitals, the increased payments it receives
under this section, pursuant to Section 14167.12.
(e) In the event federal financial
participation for a subject fiscal year is not available for all of
the increased acute psychiatric payments determined for a quarter
pursuant to this section for any reason, the increased payments
mandated by this section for that quarter shall be reduced
proportionately to the amount for which federal financial
participation is available.
(f) Payments to mental health plans that would be paid in the
absence of the payments made pursuant to this section shall not be
reduced as a consequence of the payments under this section.
(g) Notwithstanding any other provision of this article or Article
5.22 (commencing with Section 14167.31), individual hospital acute
psychiatric supplemental payments under this section and Section
14167.12 may be made directly by the department to hospitals in
accordance with Section 14167.9 when federal law does not require
that the payments be transmitted to the hospitals via mental health
plans.
(h) The department may, as necessary, allocate money appropriated
to it from the Hospital Quality Assurance Revenue Fund to
the State Department of Mental Health for the purposes of
making increased payments to mental health plans pursuant to this
article.
(i) The amount, if any, by which the aggregate individual hospital
acute psychiatric supplemental payment amounts for a subject fiscal
quarter, including any carryover amount under this subdivision,
exceeds the amount for which federal financial participation is
available for that quarter due to the application of a federal upper
payment limit shall be added to the aggregate individual hospital
acute psychiatric supplemental payment amounts for the succeeding
subject fiscal quarter. In the event there is a carryover amount for
the subject fiscal quarter ending December 31, 2010, the amount shall
be payable under this section for the quarter ending March 31, 2011,
and, if necessary due to the application of a federal upper payment
limit, the quarter ending June 30, 2011.
SEC. 232. Section 14168.1 of the
Welfare and Institutions Code is amended to read:
14168.1. For the purposes of this article, the following
definitions shall apply:
(a) "Acute psychiatric days" means the total number of
Short-Doyle Medi-Cal specialty mental health service
administrative days, Short-Doyle
Medi-Cal specialty mental health service acute care days, acute
psychiatric administrative days, and acute psychiatric acute days
identified in the Final Medi-Cal Utilization Statistics for the
2008-09 state fiscal year as calculated by the department on
September 15, 2008.
(b) "Converted hospital" means a private hospital that becomes a
designated public hospital or a nondesignated public hospital on or
after January 1, 2011, a nondesignated public hospital that becomes a
private hospital or a designated public hospital on or after January
1, 2011, or a designated public hospital that becomes a private
hospital or a nondesignated public hospital on or after January 1,
2011.
(c) "Days data source" means the following:
(1) For a hospital that did not submit an Annual Financial
Disclosure Report to the Office of Statewide Health Planning and
Development for a fiscal year ending during 2007, but submitted that
report for a fiscal period ending in 2008 that includes at least 10
months of 2007, the Annual Financial Disclosure Report submitted by
the hospital to the Office of Statewide Health Planning and
Development for the fiscal period in 2008 that includes at least 10
months of 2007.
(2) For a hospital owned by Kaiser Foundation Hospitals that
submitted corrections to reported patient days to the Office of
Statewide Health Planning and Development for its fiscal year ending
in 2007 before July 31, 2009, the corrected data.
(3) For all other hospitals, the hospital's Annual Financial
Disclosure Report in the Office of Statewide Health Planning and
Development files as of October 31, 2008, for its fiscal year ending
during 2007.
(d) "Designated public hospital" shall have the meaning given in
subdivision (d) of Section 14166.1 as of January 1, 2011.
(e) "General acute care days" means the total number of Medi-Cal
general acute care days paid by the department to a hospital in the
2008 calendar year, as reflected in the state paid claims files on
July 10, 2009.
(f) "High acuity days" means Medi-Cal coronary care unit days,
pediatric intensive care unit days, intensive care unit days,
neonatal intensive care unit days, and burn unit days paid by the
department during the 2008 calendar year, as reflected in the state
paid claims files on July 10, 2009.
(g) "Hospital inpatient services" means all services covered under
Medi-Cal and furnished by hospitals to patients who are admitted as
hospital inpatients and reimbursed on a fee-for-service basis by the
department directly or through its fiscal intermediary. Hospital
inpatient services include outpatient services furnished by a
hospital to a patient who is admitted to that hospital within 24
hours of the provision of the outpatient services that are related to
the condition for which the patient is admitted. Hospital inpatient
services do not include services for which a managed health care plan
is financially responsible.
(h) "Hospital outpatient services" means all services covered
under Medi-Cal furnished by hospitals to patients who are registered
as hospital outpatients and reimbursed by the department on a
fee-for-service basis directly or through its fiscal intermediary.
Hospital outpatient services do not include services for which a
managed health care plan is financially responsible, or services
rendered by a hospital-based federally qualified health center for
which reimbursement is received pursuant to Section 14132.100.
(i) "Individual hospital acute psychiatric supplemental payment"
means the total amount of acute psychiatric hospital supplemental
payments to a subject hospital for a quarter for which the
supplemental payments are made. The "individual hospital acute
psychiatric supplemental payment" shall be calculated for subject
hospitals by multiplying the number of acute psychiatric days for the
individual hospital for which a mental health plan was financially
responsible by four hundred eighty-five dollars ($485) and dividing
the result by four.
(j) (1) "Managed health care plan" means a health care delivery
system that manages the provision of health care and receives prepaid
capitated payments from the state in return for providing services
to Medi-Cal beneficiaries.
(2) (A) Managed health care plans include county organized health
systems and entities contracting with the department to provide
services pursuant to two-plan models and geographic managed care.
Entities providing these services contract with the department
pursuant to any of the following:
(i) Article 2.7 (commencing with Section 14087.3).
(ii) Article 2.8 (commencing with Section 14087.5).
(iii) Article 2.81 (commencing with Section 14087.96).
(iv) Article 2.91 (commencing with Section 14089).
(B) Managed health care plans do not include any of the following:
(i) Mental health plan plans
contracting to provide mental health care for Medi-Cal beneficiaries
pursuant to Part 2.5 (commencing with Section 5775) of
Division 5 Chapter 8.9 (commencing with Section 14700)
.
(ii) Health plan plans not covering
inpatient services such as primary care case management plans
operating pursuant to Section 14088.85.
(iii) Program of All-Inclusive Care for the Elderly
organizations operating pursuant to Chapter 8.75 (commencing
with Section 14591).
(k) "Medi-Cal managed care days" means the total number of general
acute care days, including well baby days, listed for the county
organized health system and prepaid health plans identified in the
Final Medi-Cal Utilization Statistics for the 2008-09 fiscal year, as
calculated by the department on September 15, 2008, except that the
general acute care days, including well baby days, for the Santa
Barbara Health Care Initiative shall be derived from the Final
Medi-Cal Utilization Statistics for the 2007-08 fiscal year.
(l) "Medicaid inpatient utilization rate" means Medicaid inpatient
utilization rate as defined in Section 1396r-4 of Title 42 of the
United States Code and as set forth in the final disproportionate
share hospital eligibility list for the 2008-09 fiscal year released
by the department on October 22, 2008.
(m) "Mental health plan" means a mental health plan that contracts
with the State Department of Mental Health
department to furnish or arrange for the provision of mental
health services to Medi-Cal beneficiaries pursuant to Part
2.5 (commencing with Section 5775) of Division 5
Chapter 8.9 (commencing with Section 14700) .
(n) "New hospital" means a hospital operation, business, or
facility functioning under current or prior ownership as a private
hospital that does not have a days data source or a hospital that has
a days data source in whole, or in part, from a previous operator
where there is an outstanding monetary liability owed to the state in
connection with the Medi-Cal program and the new operator did not
assume liability for the outstanding monetary obligation.
(o) "New noncontract hospital" means a private hospital that was a
contract hospital on March 1, 2011, and elects to become a
noncontract hospital at any time between March 1, 2011, and the end
of the program period.
(p) "Nondesignated public hospital" means either of the following:
(1) A public hospital that is licensed under subdivision (a) of
Section 1250 of the Health and Safety Code, is not designated as a
specialty hospital in the hospital's annual financial disclosure
report for the hospital's latest fiscal year ending in 2007, and
satisfies the definition in paragraph (25) of subdivision (a) of
Section 14105.98, excluding designated public hospitals.
(2) A tax-exempt nonprofit hospital that is licensed under
subdivision (a) of Section 1250 of the Health and Safety Code, is not
designated as a specialty hospital in the hospital's annual
financial disclosure report for the hospital's latest fiscal year
ending in 2007, is operating a hospital owned by a local health care
district, and is affiliated with the health care district hospital
owner by means of the district's status as the nonprofit corporation'
s sole corporate member.
(q) "Outpatient base amount" means the total amount of payments
for hospital outpatient services made to a hospital in the 2007
calendar year, as reflected in the state paid claims files
on January 26, 2008.
(r) "Private hospital" means a hospital that meets all of the
following conditions:
(1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
(2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2007.
(3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
(4) Is a nonpublic hospital, nonpublic converted hospital, or
converted hospital as those terms are defined in paragraphs (26) to
(28), inclusive, respectively, of subdivision (a) of Section
14105.98.
(s) "Program period" means the period from January 1, 2011, to
June 30, 2011, inclusive.
(t) "Subject fiscal quarter" means a state fiscal quarter
beginning on or after January 1, 2011, and ending before July 1,
2011.
(u) "Subject hospital" shall mean means
a hospital that meets all of the following conditions:
(1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
(2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2007.
(3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
(v) "Subject month" means a calendar month beginning on or after
January 1, 2011, and ending before July 1, 2011.
(w) "Upper payment limit" means a federal upper payment limit on
the amount of the Medicaid payment for which federal financial
participation is available for a class of service and a class of
health care providers, as specified in Part 447 of Title 42 of the
Code of Federal Regulations.
SEC. 233. Section 14169.1 of the
Welfare and Institutions Code is amended to read:
14169.1. For the purposes of this article, the following
definitions shall apply:
(a) "Acute psychiatric days" means the total number of
Short-Doyle Medi-Cal specialty mental health service
administrative days, Short-Doyle
Medi-Cal specialty mental health service acute care days, acute
psychiatric administrative days, and acute psychiatric acute days
identified in the Tentative Medi-Cal Utilization Statistics for the
2011-12 state fiscal year as calculated by the department as of July
21, 2011.
(b) "Converted hospital" means a private hospital that becomes a
designated public hospital or a nondesignated public hospital on or
after July 1, 2011.
(c) "Days data source" means the hospital's Annual Financial
Disclosure Report filed with the Office of Statewide Health Planning
and Development as of May 5, 2011, for its fiscal year ending during
2009.
(d) "Designated public hospital" shall have the meaning given in
subdivision (d) of Section 14166.1 as of July 1, 2011.
(e) "General acute care days" means the total number of Medi-Cal
general acute care days paid by the department to a hospital for
services in the 2009 calendar year, as reflected in the state paid
claims file on July 15, 2011.
(f) "High acuity days" means Medi-Cal coronary care unit days,
pediatric intensive care unit days, intensive care unit days,
neonatal intensive care unit days, and burn unit days paid by the
department during the 2009 calendar year, as reflected in the state
paid claims file prepared by the department on July 15, 2011.
(g) "Hospital inpatient services" means all services covered under
Medi-Cal and furnished by hospitals to patients who are admitted as
hospital inpatients and reimbursed on a fee-for-service basis by the
department directly or through its fiscal intermediary. Hospital
inpatient services include outpatient services furnished by a
hospital to a patient who is admitted to that hospital within 24
hours of the provision of the outpatient services that are related to
the condition for which the patient is admitted. Hospital inpatient
services do not include services for which a managed health care plan
is financially responsible.
(h) "Hospital outpatient services" means all services covered
under Medi-Cal furnished by hospitals to patients who are registered
as hospital outpatients and reimbursed by the department on a
fee-for-service basis directly or through its fiscal intermediary.
Hospital outpatient services do not include services for which a
managed health care plan is financially responsible, or services
rendered by a hospital-based federally qualified health center for
which reimbursement is received pursuant to Section 14132.100.
(i) "Individual hospital acute psychiatric supplemental payment"
means the total amount of acute psychiatric hospital supplemental
payments to a subject hospital for a quarter for which the
supplemental payments are made. The "individual hospital acute
psychiatric supplemental payment" shall be calculated for subject
hospitals by multiplying the number of acute psychiatric days for the
individual hospital for which a mental health plan was financially
responsible by the amount calculated in accordance with paragraph (2)
of subdivision (b) of Section 14169.3 and dividing the result by
four.
(j) (1) "Managed health care plan" means a health care delivery
system that manages the provision of health care and receives prepaid
capitated payments from the state in return for providing services
to Medi-Cal beneficiaries.
(2) (A) Managed health care plans include county organized health
systems and entities contracting with the department to provide
services pursuant to two-plan models and geographic managed care.
Entities providing these services contract with the department
pursuant to any of the following:
(i) Article 2.7 (commencing with Section 14087.3).
(ii) Article 2.8 (commencing with Section 14087.5).
(iii) Article 2.81 (commencing with Section 14087.96).
(iv) Article 2.91 (commencing with Section 14089).
(B) Managed health care plans do not include any of the following:
(i) Mental health plans contracting to provide mental health care
for Medi-Cal beneficiaries pursuant to Part 2.5 (commencing
with Section 5775) of Division 5 Chapter 8.9
(commencing with Section 14700) .
(ii) Health plans not covering inpatient services such as primary
care case management plans operating pursuant to Section 14088.85.
(iii) Long-Term Care Demonstration Projects
Program for All-Inclusive Care for the Elderly
organizations operating pursuant to Chapter 8.75 (commencing
with Section 14590 14591 ).
(k) "Medi-Cal managed care days" means the total number of general
acute care days, including well baby days, listed for the county
organized health system and prepaid health plans identified in the
Tentative Medi-Cal Utilization Statistics for the 2011-12 fiscal
year, as calculated by the department as of July 21, 2011.
(l) "Medicaid inpatient utilization rate" means Medicaid inpatient
utilization rate as defined in Section 1396r-4 of Title 42 of the
United States Code and as set forth in the final disproportionate
share hospital eligibility list for the 2010-11 fiscal year released
by the department as of May 1, 2011.
(m) "Mental health plan" means a mental health plan that contracts
with the state to furnish or arrange for the provision of mental
health services to Medi-Cal beneficiaries pursuant to Part
2.5 (commencing with Section 5775) of Division 5
Chapter 8.9 (commencing with Section 14700) .
(n) "New hospital" means a hospital operation, business, or
facility functioning under current or prior ownership as a private
hospital that does not have a days data source or a hospital that has
a days data source in whole, or in part, from a previous operator
where there is an outstanding monetary liability owed to the state in
connection with the Medi-Cal program and the new operator did not
assume liability for the outstanding monetary obligation.
(o) "New noncontract hospital" means a private hospital that was a
contract hospital on March 1, 2011, and elects to become a
noncontract hospital at any time between March 1, 2011, and the end
of the program period.
(p) "Nondesignated public hospital" means either of the following:
(1) A public hospital that is licensed under subdivision (a) of
Section 1250 of the Health and Safety Code, is not designated as a
specialty hospital in the hospital's Annual Financial Disclosure
Report for the hospital's latest fiscal year ending in 2009, and
satisfies the definition in paragraph (25) of subdivision (a) of
Section 14105.98, excluding designated public hospitals.
(2) A tax-exempt nonprofit hospital that is licensed under
subdivision (a) of Section 1250 of the Health and Safety Code, is not
designated as a specialty hospital in the hospital's Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2009, is operating a hospital owned by a local health care
district, and is affiliated with the health care district hospital
owner by means of the district's status as the nonprofit corporation'
s sole corporate member.
(q) "Outpatient base amount" means the total amount of payments
for hospital outpatient services made to a hospital in the 2009
calendar year, as reflected in the state paid claims files prepared
by the department on June 2, 2011.
(r) "Private hospital" means a hospital that meets all of the
following conditions:
(1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
(2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2009.
(3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
(4) Is a nonpublic hospital, nonpublic converted hospital, or
converted hospital as those terms are defined in paragraphs (26) to
(28), inclusive, respectively, of subdivision (a) of Section
14105.98.
(s) "Program period" means the period from July 1, 2011, to
December 31, 2013, inclusive.
(t) "Subject fiscal quarter" means a state fiscal quarter
beginning on or after July 1, 2011, and ending before January 1,
2014.
(u) "Subject fiscal year" means a state fiscal year that ends
after July 1, 2011, and begins before January 1, 2014.
(v) "Subject hospital" means a hospital that meets all of the
following conditions:
(1) Is licensed pursuant to subdivision (a) of Section 1250 of the
Health and Safety Code.
(2) Is in the Charitable Research Hospital peer group, as set
forth in the 1991 Hospital Peer Grouping Report published by the
department, or is not designated as a specialty hospital in the
hospital's Office of Statewide Health Planning and Development Annual
Financial Disclosure Report for the hospital's latest fiscal year
ending in 2009.
(3) Does not satisfy the Medicare criteria to be classified as a
long-term care hospital.
(w) "Subject month" means a calendar month beginning on or after
July 1, 2011, and ending before January 1, 2014.
(x) "Upper payment limit" means a federal upper payment limit on
the amount of the Medicaid payment for which federal financial
participation is available for a class of service and a class of
health care providers, as specified in Part 447 of Title 42 of the
Code of Federal Regulations. The applicable upper payment limit shall
be separately calculated for inpatient and outpatient hospital
services.
SEC. 234. Section 14456.5 of the
Welfare and Institutions Code is amended to read:
14456.5. (a) For purposes of this section, Medi-Cal managed care
plan means any prepaid health plan or Medi-Cal managed care plan
contracting with the department to provide services to enrolled
Medi-Cal beneficiaries under Chapter 7 (commencing with Section
14000) or this chapter, or Part 4 (commencing with Section 101525) of
Division 101 of the Health and Safety Code.
(b) The department shall ensure that coverage is provided for
medically necessary prescription medications and related medically
necessary medical services that are prescribed by a local mental
health plan provider, and are within the Medi-Cal scope of benefits,
but are excluded from coverage under Part 2.5 (commencing
with Section 5775) of Division 5 Chapter 8.9
(commencing with Section 14700) , by doing, at least, all of
the following:
(1) Requiring Medi-Cal managed care plans to comply with the
following standards:
(A) The decision regarding responsibility and coverage for a
prescription drug shall be made by the Medi-Cal managed care plan
within 24 hours, or one business day, from the date the request for a
decision is received by telephone or other telecommunication device.
(B) The decision regarding responsibility and coverage for
services, such as laboratory tests, that are medically necessary
because of medications prescribed by a mental health provider, shall
be made by the Medi-Cal managed care plan within seven days following
the date the request for a decision is received by telephone or
other telecommunication device.
(C) If the decision of the Medi-Cal managed care plan on the
request is a deferral because of a determination that the Medi-Cal
managed care plan needs more information, the Medi-Cal managed care
plan shall transmit notice of the deferral, by facsimile or by other
telecommunication system, to the pharmacist or other service
provider, to the prescribing mental health provider, and to a
designated mental health plan representative. The notice shall set
out with specificity what additional information is needed to make a
medical necessity determination.
(D) Any denial of authorization or payment for a prescription
medication or for any services such as laboratory tests that may be
medically necessary because of medications ordered by a mental health
plan provider shall set forth the reasons for the denial with
specificity. The denial notice shall be transmitted by facsimile or
other telecommunication system to the pharmacist or other service
provider, to the prescribing mental health provider, to a designated
mental health plan representative, and by mail to the Medi-Cal
beneficiary.
(E) For purposes of subsequent requests for a medication, the
local mental health plan provider prescribing the prescription
medication shall be treated as a plan provider under subdivision (a)
of Section 1367.22 of the Health and Safety Code.
(F) If the decision cannot be made within five working days
because of a request for additional information, any Medi-Cal managed
care plan licensed pursuant to Division 2 (commencing with Section
1340) of the Health and Safety Code shall inform the enrollee as
required by paragraph (5) of subdivision (h) of Section 1367.01 of
the Health and Safety Code. In regard to any Medi-Cal managed care
plan contract as described pursuant to subdivision (a) that is
issued, amended, or renewed on or after January 1, 2001, with a plan
not licensed pursuant to Division 2 (commencing with Section 1340) of
the Health and Safety Code, if the decision cannot be made within
five working days because of a request for additional information as
specified in subparagraph (C), the plan shall notify the enrollee, in
writing, that the plan cannot make a decision to approve, modify, or
deny the request for authorization. All managed care plans shall,
upon receipt of all information reasonably necessary for making the
decision and that was requested by the plan, approve, modify, or deny
the request for
authorization within the timeframes specified in subparagraph (A) or
(B), whichever applies.
(2) In consultation with the Medi-Cal managed care plans
, the State Department of Mental Health, and local mental
health plans , establishing a process to recognize
credentialing of local mental health plan providers, for the purpose
of expediting approval of medications prescribed by a local mental
health plan provider who is not contracting with the Medi-Cal managed
care plan. In implementing this requirement, the Medi-Cal managed
care plan shall not be required to violate licensure, accreditation,
or certification requirements of other entities.
(3) Requiring any Medi-Cal managed care plan to enter into a
memorandum of understanding with the local mental health plan. The
memorandum of understanding shall comply with applicable regulations.
(c) The department may sanction a Medi-Cal managed care plan for
violations of this section pursuant to Section 14088.23 or 14304.
(d) Every Medi-Cal managed care plan that provides prescription
drug benefits and that maintains one or more drug formularies shall
provide to members of the public, upon request, a copy of the most
current list of prescription drugs on the formulary of the Medi-Cal
managed care plan, by therapeutic category, with an indication of
whether any drugs on the list are preferred over other listed drugs.
If the Medi-Cal managed care plan maintains more than one formulary,
the plan shall notify the requester that a choice of formulary lists
is available.
(e) This section shall apply to any contracts entered into,
amended, modified, or extended on or after January 1, 2001.
SEC. 235. Section 14640 of the Welfare
and Institutions Code is repealed.
14640. (a) The State Department of Mental Health shall allocate
funds for the provision of mental health services to Medi-Cal
eligible persons over 20 years of age to counties of over one million
population that own and operate an acute psychiatric health
facility, and in which the number of general acute care hospital
psychiatric beds is 50 or less. Counties receiving allocations
pursuant to this subdivision may contract with privately operated
psychiatric health facilities, or with freestanding psychiatric
hospitals which have been certified to provide care to Medi-Cal
eligible persons.
(b) Payments made from the allocation established under
subdivision (a) shall be made according to state established
reimbursement formulas for mental health services, and shall be
funded through moneys initially transferred from the State Department
of Health Services and subsequently appropriated to the State
Department of Mental Health under Item 4440-101-001 of the annual
Budget Act.
(c) Allocations made pursuant to subdivision (a) shall not exceed
the General Fund share of expenditures made under the Medi-Cal
program for acute psychiatric inpatient care units in general acute
care hospitals in the subject county during the 1989-90 state fiscal
year. Payments shall be made only to the extent that those inpatient
units have ceased operation in subsequent years and the capacity has
not been replaced by capacity in other general acute care hospitals.
SEC. 236. Section 14680 of the
Welfare and Institutions Code , as added by Section
10 of Chapter 651 of the Statutes of 2011, is amended to read:
14680. (a) The Legislature finds and declares that there is a
need to establish a standard set of guidelines that governs the
provision of managed Medi-Cal specialty mental health
services at the local level, consistent with federal law.
(b) Therefore, in order to ensure quality and continuity, and to
efficiently utilize mental health services under the Medi-Cal
program, there shall be developed mental health plans for the
provision of those services that are consistent with guidelines
established by the State Department of Mental Health
department . The guidelines shall be consistent
with federal Medicaid requirements and the approved Medicaid state
plan and waivers to ensure full and timely federal reimbursement to
mental health plans for services that are rendered and reimbursed
consistent with federal Medicaid requirements.
(c) It is the intent of the Legislature that mental health plans
be developed and implemented regardless of whether other systems of
Medi-Cal managed care are implemented.
(d) It is further the intent of the Legislature that Sections
14681 to 14685, inclusive, shall not be construed to mandate the
participation of counties in Medi-Cal managed mental health care
plans.
(e) This section shall become operative on July 1, 2012.
SEC. 237. Section 14681 of the Welfare
and Institutions Code is amended to read:
14681. The State Department of Health Services, in
consultation with the State Department of Mental Health,
department shall ensure that all contracts for Medi-Cal
managed care include a process for screening, referral, and
coordination with any mental health plan established
pursuant to Section 14682 , of medically necessary
specialty mental health care services.
SEC. 238. Section 14682 of the Welfare
and Institutions Code is amended to read:
14682. (a) Notwithstanding any other provision of state law, and
to the extent permitted by federal law, the State Department of
Mental Health shall be designated as the state agency responsible for
development, consistent with the requirements of Section 4060, and
implementation of mental health plans for Medi-Cal beneficiaries.
(b) The department shall convene a steering committee for the
purpose of providing advice and recommendations on the development of
Medi-Cal mental health managed care systems pursuant to subdivision
(a). The committee shall include work groups to advise the department
of major issues to be addressed in the managed mental health care
plan. Representatives of concerned groups, including, but not limited
to, beneficiaries, their families, providers, mental health
professionals, statewide representatives of health care service
plans, the California Mental Health Planning Council, public and
private organizations, and county mental health directors, shall be
invited to participate in the steering committee process.
(c) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute,
that becomes operative on or before January 1, 2013, deletes or
extends the dates on which it becomes inoperative and is repealed.
SEC. 239. Section 14682.1 is added to the
Welfare and Institutions Code , to read:
14682.1. (a) The State Department of Health Care Services shall
be designated as the state agency responsible for development,
consistent with the requirements of Section 4060, and implementation
of, mental health plans for Medi-Cal beneficiaries.
(b) The department shall convene a steering committee for the
purpose of providing advice and recommendations on the transition and
continuing development of the Medi-Cal mental health managed care
systems pursuant to subdivision (a). The committee shall include work
groups to advise the department of major issues to be addressed in
the managed mental health care plan, as well as system transition and
transformation issues pertaining to the delivery of mental health
care services to Medi-Cal beneficiaries, including services to
children provided through the Early and Periodic Screening, Diagnosis
and Treatment Program.
(c) The committee shall consist of diverse representatives of
concerned and involved communities, including, but not limited to,
beneficiaries, their families, providers, mental health
professionals, substance use disorder treatment professionals,
statewide representatives of health care service plans,
representatives of the California Mental Health Planning Council,
public and private organizations, county mental health directors, and
others as determined by the department. The department has the
authority to structure this steering committee process in a manner
that is conducive for addressing issues effectively, and for
providing a transparent, collaborative, meaningful process to ensure
a more diverse and representative approach to problem-solving and
dissemination of information.
SEC. 240. Section 14683 of the Welfare
and Institutions Code is amended to read:
14683. The State Department of Mental Health
department shall ensure all of the following
in the development of mental health plans :
(a) That mental health plans include a process for screening,
referral, and coordination with other necessary services, including,
but not limited to, health, housing, and vocational rehabilitation
services. For Medi-Cal eligible children, the mental health plans
shall also provide coordination with education programs and any
necessary medical or rehabilitative services, including, but not
limited to, those provided under the California Children's Services
Program (Article 5 (commencing with Section 123800) of Chapter 3 of
Part 2 of Division 106 of the Health and Safety Code) and the Child
Health and Disability Prevention Program (Article 6 (commencing with
Section 124025) of Chapter 3 of Part 2 of Division 106 of the Health
and Safety Code), and those provided by a fee-for-service provider or
a Medi-Cal managed care plan. This subdivision shall not be
construed to establish any higher level of service from a county than
is required under existing law. The county mental health
department and the mental health plan , if it is
not the county department, shall not be liable for the
failure of other agencies responsible for the provision of nonmental
health services to provide those services or to participate in
coordination efforts.
(b) That mental health plans include a system of outreach to
enable Medi-Cal beneficiaries and providers to participate
in and access Medi-Cal specialty mental health services
under the plans, consistent with existing law.
(c) That standards for quality and access developed by the
department , in consultation with the steering
committee established pursuant to Section 14682,
14682.1 are included in mental health plans serving
Medi-Cal beneficiaries .
SEC. 241. Section 14684 of the
Welfare and Institutions Code , as added by Section 12
of Chapter 651 of the Statutes of 2011, is amended to read:
14684. (a) Notwithstanding any other provision of state law, and
to the extent permitted by federal law, mental health plans, whether
administered by public or private entities, shall be governed by the
following guidelines:
(1) State and federal Medi-Cal funds identified for the diagnosis
and treatment of mental disorders illness
shall be used solely for those purposes. Administrative costs
incurred by counties for activities necessary for the administration
of the mental health plan shall be clearly identified and shall be
reimbursed in a manner consistent with federal Medicaid requirements
and the approved Medicaid state plan and waivers. Administrative
requirements shall be based on and limited to federal Medicaid
requirements and the approved Medicaid state plan and waivers, and
shall not impose costs exceeding funds available for that purpose.
(2) The development of the mental health plan shall include a
public planning process that includes a significant role for Medi-Cal
beneficiaries, family members, mental health advocates, providers,
and public and private contract agencies.
(3) The mental health plan shall include appropriate standards
relating to quality, access, and coordination of services within a
managed system of care, and costs established under the plan, and
shall provide opportunities for existing Medi-Cal providers to
continue to provide services under the mental health plan, as long as
the providers meet those standards.
(4) Continuity of care for current recipients of services shall be
ensured in the transition to managed mental health care.
(5) Medi-Cal covered specialty mental health services
shall be provided in the beneficiary's home community, or as close as
possible to the beneficiary's home community. Pursuant to the
objectives of the rehabilitation option described in subdivision (a)
of Section 14021.4, mental health services may be provided in a
facility, a home, or other community-based site.
(6) Medi-Cal beneficiaries whose mental or emotional condition
results or has resulted in functional impairment, as defined by the
department, shall be eligible for covered specialty mental
health services. Emphasis shall be placed on adults with serious and
persistent mental illness and children with serious emotional
disturbances, as defined by the department.
(7) Mental health plans shall provide specialty mental health
services to eligible Medi-Cal beneficiaries, including both adults
and children. Specialty mental health services include Early and
Periodic Screening, Diagnosis, and Treatment Services to eligible
Medi-Cal beneficiaries under the age of 21 pursuant to 42 U.S.C.
Section 1396d(a)(4)(B) of Title 42 of the United States Code.
(7)
(8) Each mental health plan shall include a mechanism
for monitoring the effectiveness of, and evaluating accessibility and
quality of, services available. The plan shall utilize and be based
upon state-adopted performance outcome measures and shall include
review of individual service plan procedures and practices, a
beneficiary satisfaction component, and a grievance system for
beneficiaries and providers.
(8)
(9) Each mental health plan shall provide for
culturally competent and age-appropriate services, to the extent
feasible. The mental health plan shall assess the cultural competency
needs of the program. The mental health plan shall include, as part
of the quality assurance program required by Section 4070
14725 , a process to accommodate the significant
needs with reasonable timeliness. The department shall provide
demographic data and technical assistance. Performance outcome
measures shall include a reliable method of measuring and reporting
the extent to which services are culturally competent and
age-appropriate.
(b) This section shall become operative on July 1, 2012.
SEC. 242. Section 14684.1 of the
Welfare and Institutions Code is amended to read:
14684.1. (a) The State Department of Mental Health
department shall establish a process for second
level treatment authorization request appeals to review and resolve
disputes between mental health plans and hospitals.
(b) When the department establishes an appeals process, the
department shall comply with all of the following:
(1) The department shall review appeals initiated by hospitals and
render decisions on appeals based on findings that are the result of
a review of supporting documents submitted by mental health plans
and hospitals.
(2) If the department upholds a mental health plan denial of
payment of a hospital claim, a review fee shall be assessed on the
provider.
(3) If the State Department of Mental Health
department reverses a mental health plan denial of payment
of a hospital claim, a review fee shall be assessed on the mental
health plan.
(4) If the department decision regarding a mental health plan
denial of payment upholds the claim in part and reverses the claim in
part, the department shall prorate the review fee between the
parties accordingly.
(c) The amount of the review fees shall be calculated and adjusted
annually. The methodology and calculation used to determine the fee
amounts shall result in an aggregate fee amount that, in conjunction
with any other outside source of funding for this function, may not
exceed the aggregate annual costs of providing second level treatment
authorization request reviews.
(d) Fees collected by the department shall be retained by the
department and used to offset administrative and personnel services
costs associated with the appeals process.
(e) The department may use the fees collected, in conjunction with
other available appropriate funding for this function, to contract
for the performance of the appeals process function.
SEC. 243. Section 14685 of the Welfare
and Institutions Code is amended to read:
14685. Counties shall have the right of first refusal to serve as
a mental health plan. If a county elects not to serve as a mental
health plan, the State Department of Mental Health
department shall ensure that these services are provided.
SEC. 244. Section 14685.1 is added to the
Welfare and Institutions Code , to read:
14685.1. Section 14685 is hereby repealed on November 7, 2012, if
Section 36 has been added to Article XIII of the California
Constitution as of that date.
SEC. 245. Section 14702 is added to the
Welfare and Institutions Code , to read:
14702. For purposes of this chapter, the following definitions
shall apply:
(a) "Department" means the State Department of Health Care
Services.
(b) "Director" means the Director of Health Care Services.
SEC. 246. Section 14703 is added to the
Welfare and Institutions Code , to read:
14703. Contracts entered into pursuant to this chapter shall be
exempt from the requirements of Chapter 1 (commencing with Section
10100) and Chapter 2 (commencing with section 10290) of Part 2 of
Division 2 of the Public Contract Code.
SEC. 247. Section 14704 is added to the
Welfare and Institutions Code , to read:
14704. A regulation or order concerning Medi-Cal specialty mental
health services adopted by the State Department of Mental Health
pursuant to Division 5 (commencing with Section 5000), as in effect
preceding the effective date of this section, shall remain in effect
and shall be fully enforceable, unless and until the readoption,
amendment, or repeal of the regulation or order by the department, or
until it expires by its own terms.
SEC. 248. 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 decision making related to the purchase of services.
(b) The State Department of Health Care Services, in collaboration
with the California Health and Human Services Agency, and in
consultation with the Mental Health Services Oversight and
Accountability Commission, shall create a plan for a performance
outcome system for EPSDT mental health services provided to eligible
Medi-Cal beneficiaries under the age of 21 pursuant to 42 U.S.C.
Section 1396d(a)(4)(B).
(1) Commencing no later than September 1, 2012, the department
shall convene a stakeholder advisory committee comprised of
representatives of child and youth clients, family members,
providers, counties, and the Legislature. This consultation shall
inform the creation of a plan for a performance outcome system for
EPSDT mental health services.
(2) In developing a plan for a performance outcomes system for
EPSDT mental health services, the department shall consider the
following objectives, among others:
(A) High quality and accessible EPSDT mental health services for
eligible children and youth, consistent with federal law.
(B) Information that improves practice at the individual, program,
and system levels.
(C) Minimization of costs by building upon existing resources to
the fullest extent possible.
(D) Reliable data that are collected and analyzed in a timely
fashion.
(3) At a minimum, the plan for a performance outcome system for
EPSDT mental health services shall consider evidence-based models for
performance outcome systems, such as the Child and Adolescent Needs
and Strengths (CANS), federal requirements, including the review by
the External Quality Review Organization (EQRO), and, timelines for
implementation at the provider, county, and state levels.
(c) The State Department of Health Care Services shall provide the
performance outcomes system plan, including milestones and
timelines, for EPSDT mental health services described in subdivision
(a) to all fiscal committees and appropriate policy committees of the
Legislature no later than October 1, 2013.
(d) The State Department of Health Care Services shall propose how
to implement the performance outcomes system plan for EPSDT mental
health services described in subdivision (a) no later than January
10, 2014.
SEC. 249. Section 18358.15 of the
Welfare and Institutions Code is amended to read:
18358.15. (a) Each foster family agency participating in the
program shall develop the child's needs and services plan, and have
it agreed to by the county interagency review team, or county placing
agency, and certified foster parents. Each foster family agency
participating in the program shall provide the services and supports
identified in the needs and services plan which are allowable under
California's foster care program in accordance with Sections 11460
and 11463, and their implementing regulations. Each foster family
agency shall also arrange for the services needed by each child and
for which the child meets eligibility criteria under applicable
publicly funded programs, including, but not limited to, mental
health, education, and health services. The foster family agency
shall arrange for these services funded by those publicly funded
programs to be delivered either by the private nonprofit organization
that also operates the foster family agency or by another qualified
provider. Children in the ITFC program who meet the public mental
health system criteria for mental health services and supports shall
have those services and supports funded by the Early Periodic
Screening, Diagnosis, and Treatment (EPSDT) program pursuant to
Section 5778 14718 and other
appropriate mental health system sources. This subdivision shall not
be construed to change the eligibility criteria for EPSDT benefits or
services pursuant to federal law. The services that the foster
family agency shall provide or arrange for include, but are not
limited to, the following:
(1) Individualized needs and services plans that ensure continuity
and stability in the placement of participating children in
certified family homes that meet the needs of eligible children,
including children making the transition from institutional placement
to noninstitutional placement. The needs and services plan for each
child in placement shall describe the specific needs of the child and
the appropriate level of services provided to the child pursuant to
Section 18358.30.
(2) Education and mental health services for children.
(3) In-home and support services necessary to implement the case
plan.
(4) Other necessary services for children in placement, including
medical and dental services.
(b) No more than one emotionally disturbed child or child who has
a serious behavioral problem shall be placed in a certified ITFC
family home unless the participating foster family agency provides
the placing or participating county welfare department with a written
assessment of the risk and compatibility of placing together two
children who are emotionally disturbed or have a serious behavioral
problem. More than two children who are emotionally disturbed or have
serious behavioral problems who are siblings may be placed together
in the same certified family home if the placement is approved by the
county interagency review team or the county placing agency of the
participating county. However, there shall be no more than a total of
five children living in a certified family home with two adults, and
there shall be no more than a total of three children living in a
certified family home with one adult, except in cases where children
living in the home other than those placed pursuant to this chapter
are 15 years of age or older.
(c) Any use of physical contact to manage the behavior of a child
that is reported to the foster family agency pursuant to Section
18538.25 shall in turn be reported by the foster family agency to the
Community Care Licensing Division of the department as a special
incident pursuant to Section 80061 of Title 22 of the California Code
of Regulations.
SEC. 250. Section 18986.40 of the
Welfare and Institutions Code is amended to read:
18986.40. (a) For the purposes of this chapter, "program" or
"integrated children's services programs" means a coordinated
children's service system, operating as a program that is part of a
department or State Department of Mental Health
Care Services initiative, that offers a full range of
integrated behavioral social, health, and mental health services,
including applicable educational services, to seriously emotionally
disturbed and special needs children, or programs established by
county governments, local education agencies, or consortia of public
and private agencies, to jointly provide two or more of the following
services to children or their families, or both:
(1) Educational services for children at risk of dropping out, or
who need additional educational services to be successful
academically.
(2) Health care.
(3) All mental health diagnostic and treatment services, including
medication.
(4) Substance abuse prevention and treatment.
(5) Child abuse prevention, identification, and treatment.
(6) Nutrition services.
(7) Child care and development services.
(8) Juvenile justice services.
(9) Child welfare services.
(10) Early intervention and prevention services.
(11) Crisis intervention services, as defined in subdivision (c).
(12) Any other service which will enhance the health, development,
and well-being of children and their families.
(b) For the purposes of this chapter, "children's
multidisciplinary services team" means a team of two or more persons
trained and qualified to provide one or more of the services listed
in subdivision (a), who are responsible in the program for
identifying the educational, health, or social service needs of a
child and his or her family, and for developing a plan to address
those needs. A family member, or the designee of a family member,
shall be invited to participate in team meetings and decisions,
unless the team determines that, in its professional judgment, this
participation would present a reasonable risk of a significant
adverse or detrimental effect on the minor's psychological or
physical safety. Members of the team shall be trained in the
confidentiality and information sharing provisions of this chapter.
(c) "Crisis intervention services" means early support and
psychological assistance, to be continued as necessary, to children
who have been victims of, or whose lives have been affected by, a
violent crime or a cataclysmic incident, such as a natural disaster,
or who have been involved in school, neighborhood, or family based
critical incidents likely to cause profound psychological effects if
not addressed immediately and thoroughly.
SEC. 251. Section 18987.7 of the Welfare
and Institutions Code is amended to read:
18987.7. (a) The State Department of Social Services shall
convene a workgroup of public and private nonprofit stakeholders that
shall develop a plan for transforming the current system of group
care for foster children or youth, and for children with serious
emotional disorders (SED), into a system of residentially based
services. The stakeholders may include, but not be limited to,
representatives of the department and of the State
Department of Mental Health , the State Department of
Education, the State Department of Health Care Services,
the State Department of Alcohol and Drug Programs, and the Department
of Corrections and Rehabilitation; county child welfare, probation,
mental health, and alcohol and drug programs; local education
authorities; current and former foster youth, parents of foster
children or youth, and children or youth with SED; private nonprofit
agencies operating group homes; children's advocates; and other
interested parties.
(b) The plan developed pursuant to this chapter shall utilize the
reports delivered to the Legislature pursuant to Section 75 of
Chapter 311 of the Statutes of 1998 by the Steering Committee for the
Reexamination of the Role of Group Care in a Family-Based System of
Care in June 2001 and August 2002, and the "Framework for a New
System for Residentially-Based Services in California" published in
March 2006.
(c) In the development, implementation, and subsequent revisions
of the plan developed pursuant to subdivision (a), the knowledge and
experience gained by counties and private nonprofit agencies through
the operation of their residentially based services programs created
under voluntary agreements made pursuant to Section 18987.72,
including, but not limited to, the results of evaluations prepared
pursuant to paragraph (3) of subdivision (c) of Section 18987.72
shall be utilized.
(d) By July 1, 2014, the department shall provide a copy of the
plan developed by the workgroup pursuant to subdivision (a) to the
Legislature. The plan shall include, in addition to other
requirements set forth in this chapter, any statutory revisions
necessary for its implementation.
SEC. 252. Section 18994.9 of the
Welfare and Institutions Code is amended to read:
18994.9. (a) There is hereby established the California Families
and Children Home Visit Program Task Force, which shall be convened
by the Office of Child Abuse Prevention.
(b) The membership of the task force shall include, but need not
be limited to, all of the following:
(1) The head of the Office of Child Abuse Prevention or his or her
designee.
(2) The directors, or designees, of all of the following:
(A) The State Department of Social Services.
(B) The State Department of Public Health
Services .
(C) The State Department of Mental Health.
(D)
(C) The Department of the Youth Authority
Corrections and Rehabilitation, Division of Juvenile
Justice .
(E)
(D) The State Department of Education.
(F) The Office of Criminal Justice Planning.
(E) The California Emergency Management Agency.
(3) At least two county administrators from counties participating
in this program, to be appointed by the director, with the consent
of the county.
(4) The manager of this program from the Office of Child Abuse
Prevention.
(5) Two legislative representatives, who shall be members of
policy committees with jurisdiction over social services issues
pertaining to children, with at least one each to be appointed by the
Speaker of the Assembly and the Senate Committee on Rules.
(c) The task force shall do both of the following:
(1) Identify permanent funding sources from federal and state
programs. Sources from which funding may be integrated for purposes
of this chapter may include, but are not limited to, Medi-Cal
Targeted Case Management and Administrative Program funds, provided
for pursuant to Sections 14132.44 and 14132.47, family preservation
funds, private health care providers, including health maintenance
organizations and nonprofit hospitals, the California Special
Supplemental Food Program for Women, Infants and Children, federal
Individuals with Disabilities Education Act funds, and Healthy
Families Program funds.
(2) Develop recommendations for permanent funding for this
chapter, in order that eligible families who choose to participate
have access to the program.
(d) Each member of the task force shall serve without
compensation, but shall be reimbursed, by his or her employing
agency, for actual and necessary expenses incurred in the performance
of his or her duties.
(e) The task force shall be supported by a reasonable amount of
staff time, which shall be provided by the agencies represented on
the task force, to the extent feasible within an agency's existing
resources. The task force may request data from, and may utilize the
technical expertise of, other state agencies.
(f) The task force, under the guidance of the Office of Child
Abuse Prevention, shall submit its report to the Legislature not
later than November 1, 1999.
SEC. 253. Section 25002 of the Welfare
and Institutions Code is repealed.
25002. To develop the options for achieving universal health care
coverage described in Section 25001, the secretary shall establish a
process by which these options are developed. The process shall at a
minimum include the following:
(a) The examination and utilization of research results from the
study performed by the University of California with regard to
methods of financing, delivering and defining universal health care
coverage, done pursuant to the criteria in Senate Concurrent
Resolution 100 of the 1997-1998 Regular Session of the Legislature.
(b) The examination and utilization of other data and information,
as requested by the secretary or provided to the secretary, with
regard to methods of financing, delivering, or defining universal
health care coverage.
(c) Developing a process by which representatives of health care
consumers, providers, insurers, health care workers, advocates,
counties, and all other interested parties are engaged in discussion
and debate of the issues faced by the state in providing universal
health coverage. The secretary shall develop the methods by which
this discussion occurs, provided that it is broadly inclusive of all
groups with an interest in universal health care coverage.
(d) Interagency participation including, but not limited to, the
State Department of Health Services, the State Department of Mental
Health, the Department of Finance, the Managed Risk Medical Insurance
Board, the Department of Consumer Affairs, the Public Employees'
Retirement System, the State Department of Social Services, the
Department of Managed Health Care, the Department of Insurance, and
any other appropriate agencies which the secretary determines can
contribute to the effort to provide universal health care coverage.
(e) Obtaining information from the United States Health Care
Financing Administration regarding federal waivers or other forms of
federal participation, if necessary.
SEC. 254. (a) The amendments made by this act to
Section 43.7 of the Civil Code, to Section 1343 of the Health and
Safety Code, and to Sections 4070, 4071, 5328, 5718, 5719, 5719.5,
5720, 5721, 5722, 5723, 5724, 5776, 5775, 5777, 5777.5, 5777.6,
5777.7, 5778, 5779, 5780, 5781, 5782, 5783, 14021.3, 14021.4,
14021.5, 14053.3, 14108.1, 14110.15, 14131.07, 14167.1, 14167.11,
14168.1, 14169.1, 14456.5, 14640, 14680, 14681, 14682, 14683, 14684,
14684.1, 14685, and 18358.15 of the Welfare and Institutions Code
shall be operative July 1, 2012.
(b) The provisions of this act repealing Section 5723.5 of, and
the heading of Article 4 (commencing with Section 4070) of Chapter 2
of Part 1 of Division 4 of the Welfare and Institutions Code shall be
operative on July 1, 2012.
SEC. 255. The sum of $1,000 is hereby appropriated
from the General Fund to the State Department of Health Care
Services for administration.
SEC. 256. This act is a bill providing for
appropriations related to the Budget Bill within the meaning of
subdivision (e) of Section 12 of Article IV of the California
Constitution, has been identified as related to the budget in the
Budget Bill, and shall take effect immediately.
SEC. 257. This act shall become operative only if
Assembly Bill 1480 or Senate Bill 1020 of the 2011-12 Regular Session
of the Legislature is enacted and takes effect.
SECTION 1. It is the intent of the Legislature
to enact statutory changes relating to the Budget Act of 2012.
