Bill Text: CA SB1143 | 2021-2022 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Acute Care Psychiatric Hospital Loan Fund.

Spectrum: Partisan Bill (Democrat 5-0)

Status: (Vetoed) 2022-09-27 - In Senate. Consideration of Governor's veto pending. [SB1143 Detail]

Download: California-2021-SB1143-Amended.html

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Amended  IN  Senate  March 16, 2022

CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Senate Bill

No. 1143

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Introduced by Senator Roth

February 16, 2022

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An act to amend Section 5450 of the Welfare and Institutions Code, relating to conservatorships. add Chapter 6 (commencing with Section 7800) to Division 7 of the Welfare and Institutions Code, relating to psychiatric hospitals.

LEGISLATIVE COUNSEL'S DIGEST

SB 1143, as amended, Roth. Conservatorships: serious mental illness and substance use disorders. Acute Care Psychiatric Hospital Loan Fund.

The California Health Facilities Financing Authority Act authorizes the California Health Facilities Financing Authority (authority) to, among other things, make loans from the continuously appropriated California Health Facilities Financing Authority Fund to participating health institutions, as defined, for financing or refinancing the acquisition, construction, or remodeling of health facilities.

Under existing law, 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 services for the detention, supervision, care, and treatment of persons who have a mental health disorder or a developmental disability, or who are alleged to be such. Existing law defines “county psychiatric hospital” as a hospital, ward, or facility provided by the county pursuant to certain provisions.

This bill would establish the California Acute Care Psychiatric Hospital Loan Fund to provide loans, upon appropriation by the Legislature, to qualifying county applicants for the purpose of building acute care psychiatric hospitals. The bill would require the authority to develop an application for county applicants by January 1, 2024. The bill would require initial preliminary applications for projects to be submitted to the authority by an unspecified date and would require the authority to approve the project based on specified criteria. The bill would also require the authority to provide a report to the Department of Finance and the budget committees of the Assembly and Senate by an unspecified date that would include, among other things, the number of projects that are receiving loans and their geographic distribution.

Existing law, until January 1, 2024, establishes a procedure, for the County of Los Angeles, the County of San Diego, and the City and County of San Francisco, if the board of supervisors of the respective county or city and county authorizes the application of these provisions subject to specified requirements, for the appointment of a conservator for a person who is incapable of caring for the person’s own health and well-being due to a serious mental illness and substance use disorder, as specified, for the purpose of providing the least restrictive and most clinically appropriate alternative needed for the protection of the person.

This bill would make a technical, nonsubstantive change to those provisions.

Digest Key

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NOYES   Local Program: NO  

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Bill Text

The people of the State of California do enact as follows:

SECTION 1.

 The Legislature finds and declares all of the following:

(a) Psychiatric beds are an essential infrastructure for meeting the needs of individuals with serious mental health conditions. These beds serve several functions, including enabling safe, stable, and supportive environments for individuals in acute mental health crisis and for those with significant impairment who require ongoing medical monitoring.

(b) Psychiatric bed capacity is severely strained in California and the United States. The present situation may be viewed, in part, as the long tale of an effort to deinstitutionalize psychiatric services throughout the United States during the latter half of the 20th century.

(c) Today, hundreds of Californians in need of psychiatric beds are held in hospital’s emergency departments or county jails awaiting openings in inpatient care settings.

(d) According to data compiled by the Department of Health Care Access and Information, California has lost 37 psychiatric facilities from 1999 to 2016, either through the elimination of psychiatric inpatient care, or complete hospital closure. During this same period, California’s population grew by 24 percent, or 7,600,000 people.

(e) California is home to over 1,000,000 adults who are afflicted with schizophrenia or bipolar disorder, with over 477,000 going untreated.

(f) It is widely presumed that a minimum of 50 beds per 100,000 people is considered necessary to provide minimally adequate treatment for individuals with severe mental illness. In 2016, California had 15.1 psychiatric beds per 100,000 people.

(g) In the rapidly growing and ethnically diverse area of Inland Empire in southern California, the shortage of beds is particularly severe and the Department of Health Care Access and Information’s data in 2016 shows there was a need of an additional 2,264 beds.

(h) For example, the County of Riverside currently has 21 inpatient psychiatric beds per 100,000 people. Based on a countywide population of 2,500,000 in 2020, the County of Riverside is in need of an estimated 1,250 additional beds.

(i) The need for acute psychiatric beds is even greater in northern and southern San Joaquin Valley, with the former having only 9.05 beds per 100,000 people and the latter with 15.37 per 100,000 people.

SEC. 2.

 Chapter 6 (commencing with Section 7800) is added to Division 7 of the Welfare and Institutions Code, to read:

CHAPTER  6. acute care psychiatric hospital loan fund

7800.

 (a) The California Acute Care Psychiatric Hospital Loan Fund is hereby established in the State Treasury to provide zero-interest loans to qualifying county applicants for the purpose of constructing acute care psychiatric hospitals. Moneys in the fund are available upon appropriation by the Legislature.

7801.

 (a) For purposes of Section 7800, the California Health Facilities Financing Authority shall develop an application for county applicants.

(b) The application shall include requests for relevant information, such as project goals, costs, demonstrated need, timeline for the project, financial feasibility of the project, and other information deemed necessary for evaluation of creditworthiness and public benefit criteria established by the authority pursuant to this chapter. The applications shall be available by January 1, 2024, in accordance with the authority’s existing regulations or any necessary amendments, which shall be undertaken as emergency regulations, if necessary.

(c) The initial preliminary applications for projects to be considered pursuant to this chapter shall be submitted to the authority by ____. The authority may also establish subsequent application periods, as necessary.

(d) Applications may be submitted to the authority by county applicants as set forth in this chapter pursuant to certain criteria that shall be determined by the authority.

(e) In the event that the authority receives or anticipates receiving more applications than its allocation of moneys can support, the authority shall consider any of the following criteria in the selection of the projects:

(1) The county’s unmet need for acute care psychiatric hospital infrastructure, with priority given to applicants with greater unmet need.

(2) A local match is available and priority is given to applicants with a local match based on the proposed number of acute psychiatric beds:

(A) For a project with 100 beds, priority shall be given to projects with a 10-percent match.

(B) For a project with 75 beds, priority shall be given to projects with a 20-percent match.

(C) For a project with 50 beds, priority shall be given to projects with a 30-percent match.

(D) For a project with 25 beds, priority shall be given to projects with a 40-percent match.

(E) For a project with fewer than 25 beds, priority shall be given to projects with a 50-percent match.

(3) Medically underserved regions in the state.

(4) When considered as a whole, the applications approved pursuant to this chapter are fairly representative of various geographical regions, including inland regions of the state.

7802.

 The California Health Facilities Financing Authority may adopt, amend, or repeal rules and regulations pursuant to this chapter as emergency regulations. The adoption, amendment, or repeal of these regulations is conclusively presumed to be necessary for the immediate preservation of the public peace, health, safety, or general welfare within the meaning of Section 11346.1 of the Government Code.

7803.

 (a) The California Health Facilities Financing Authority shall provide a report to the Department of Finance and the budget committees of the Assembly and Senate by ____. The report shall include, but shall not necessarily be limited to, all of the following information:

(1) The number of projects receiving loans and their geographic distribution.

(2) The total dollar amount of loans made.

(3) The dollar amount of the loan provided for each project.

(4) The terms of the loan for each project.

(b) The report to be submitted pursuant to subdivision (a) shall be submitted in compliance with Section 9795 of the Government Code.

SECTION 1.Section 5450 of the Welfare and Institutions Code is amended to read:

5450.

(a)Until January 1, 2024, this chapter applies only to the County of Los Angeles, the County of San Diego, and the City and County of San Francisco if the board of supervisors of the respective county or city and county, by resolution or through the county budget process, authorizes the application of this chapter and makes a finding that no voluntary mental health program serving adults, no children’s mental health program, and no services or supports provided in conservatorships established pursuant to Division 4 (commencing with Section 1400) of the Probate Code or conservatorships established pursuant to Chapter 3 (commencing with Section 5350), including availability of conservators, may be reduced as a result of the implementation of this chapter.

(b)(1)Before the county board of supervisors may authorize the application of this chapter, the county mental health department, the county welfare department, and, if one exists, the county department of housing and homeless services shall do both of the following:

(A)Develop a plan to implement this chapter in consultation with representatives of disability rights advocacy groups, a provider of permanent supportive housing services, the county health department, law enforcement, labor unions, and staff from hospitals located in the county or the city and county.

(B)Present before the county board of supervisors on the plan and available resources for the implementation of this chapter.

(2)In order to approve authorization of the application of this chapter, the county board of supervisors shall determine, after a public hearing, based on materials presented, that all of the following services are available in, at a minimum, sufficient quantity, resources, and funding levels to serve the identified population that the county board of supervisors intends to serve, within the county or city and county for utilization in connection with the application of this chapter:

(A)Supportive community housing that provides wraparound services, with adequate beds available.

(B)Public conservators trained on the specifics of how to assess and evaluate individuals for the new form of conservatorship described in this chapter.

(C)Outpatient mental health counseling.

(D)Coordination and access to medications.

(E)Psychiatric and psychological services.

(F)Substance use disorder services.

(G)Vocational rehabilitation.

(H)Veterans’ services.

(I)Family support and consultation services.

(J)A service planning and delivery process that includes all of the following:

(i)Plans for services that contain evaluation strategies, which shall consider cultural, linguistic, gender, sexual orientation, 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 or cultural differences.

(ii)Provision for services to meet the needs of persons who are physically disabled.

(iii)Provision for services to meet the special needs of older adults.

(iv)Provision for family support and consultation services, parenting support and consultation services, and peer support or self-help group support, if appropriate.

(v)Provision for services to be client-directed and to employ psychosocial rehabilitation and recovery principles.

(vi)Provision for psychiatric and psychological services that are integrated with other services and for psychiatric and psychological collaboration in overall service planning.

(vii)Provision for services reflecting special needs of women from diverse cultural and socioeconomic backgrounds.

(viii)Provision for housing for clients that is immediate, transitional, permanent, or all of these.

(ix)Provision for services reflecting special needs of lesbian, gay, bisexual, and transgender (LGBT) individuals.

(K)The individual personal services plan ensures that a person subject to conservatorship pursuant to this chapter receives age-appropriate, gender-appropriate, disability-appropriate, and culturally appropriate services, to the extent feasible and when appropriate, that are designed to enable those persons to do all of the following:

(i)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.

(ii)Engage in the highest level of work or productive activity appropriate to their abilities and experience.

(iii)Create and maintain a support system consisting of friends, family, and participation in community activities.

(iv)Access an appropriate level of academic education or vocational training.

(v)Obtain an adequate income.

(vi)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.

(vii)Access necessary physical health benefits and care and maintain the best possible physical health.

(viii)Reduce or eliminate the distress caused by the symptoms of mental illness.

(3)The county or the city and county shall not seek to conserve any individual pursuant to this chapter unless there is funding and available resources to provide all of the services set forth in paragraph (2).