Bill Text: CA SB551 | 2023-2024 | Regular Session | Amended
Bill Title: Beverage containers: recycling.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed) 2024-03-21 - Read second time and amended. Re-referred to Com. on APPR. [SB551 Detail]
Download: California-2023-SB551-Amended.html
|
Amended
IN
Senate
May 01, 2023 |
| Introduced by Senator Portantino (Coauthors: Senators Roth, Umberg, and Wilk) (Coauthors: Assembly Members Jackson, Lackey, Quirk-Silva, Luz Rivas, and Blanca Rubio) |
February 15, 2023 |
LEGISLATIVE COUNSEL'S DIGEST
Existing law, the Mental Health Services Act (MHSA), an initiative measure enacted by the voters as Proposition 63 in the November 2, 2004, statewide general election, establishes the continuously appropriated Mental Health Services Fund to fund various county mental health programs, including prevention and early intervention programs. The MHSA requires the counties to prepare and submit a 3-year program and expenditure plan, and annual updates, as specified. The act may be amended by the Legislature only by a
This bill would amend the MHSA by requiring
each county to use at least 20% of the prevention and early intervention funds to provide direct services, as defined, on school campuses in collaboration with local educational agencies, as specified.
Existing law requires the Mental Health Services Oversight and Accountability Commission to adopt regulations for programs and expenditures for innovative programs and prevention and early intervention programs established by the act. Existing regulations require at least 51% of prevention and early intervention funds to be used to serve individuals who are 25 years of age or younger.
This bill would require the commission to adopt regulations that require each county to use at least 20% of its prevention and early intervention funds to provide direct services on school campuses in collaboration with local educational agencies.
Existing law requires the commission to establish
priorities for the use of prevention and early intervention funds, including youth outreach and engagement strategies that target secondary school and transition-age youth, with a priority on partnership with college mental health programs. Under existing law, counties may include other priorities, as determined through a stakeholder process, either in place of, or in addition to, the established priorities.
The bill would also establish direct services on school campuses as a priority for prevention and early intervention funds.
Digest Key
Vote:Bill Text
The people of the State of California do enact as follows:
The Legislature finds and declares all of the following:
(a)School-based behavioral health programs are one of the most effective methods of providing provide prevention and intervention services.
(b)Children are 21 times more likely to receive health and mental health services if they are provided on a school campus. An integrated, school-based approach to mental health improves timely access to services and can prevent mental illness in children from becoming severe and disabling.
(c)School-based partnerships are an effective strategy for addressing all eight of the Mental Health Services Act “childhood
trauma prevention and early intervention” categories listed in Section 5840.6 of the Welfare and Institutions Code.
(d)School-based programs can significantly reduce behavioral health stigma by creating a culture of wellness and well-being among students, parents, and teachers.
(e)There are more than 10,000 schools and over 5,800,000 students in California, yet there are only 100 school-based behavioral health partnerships in the state.
(f)Counties are required to spend 51 percent of prevention and intervention funds on individuals who are 25 years of age or younger. Most counties struggle to meet this requirement.
(g)County prevention and intervention providers report difficulty connecting with and increasing participation of children and
youth.
(h)By providing behavioral health services at schools, counties would increase participation of children and youth in prevention and intervention programs, cultivate a positive culture of wellness, reduce stigma in the community, and reduce barriers to accessing behavioral health services.
SEC. 2.SECTION 1.
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 fewer than 80,000 may have a minimum of five members. A county with more than five supervisors shall have at least the same number of members as the size of its board of supervisors. This section does not limit the ability of the governing body to increase the number of members above 15.For purposes of this chapter, the following definitions shall apply:
(a)“Commission” means the Mental Health Services Oversight and Accountability Commission established pursuant to Section 5845.
(b)“County” also includes a city receiving funds pursuant to Section 5701.5.
(c)“Prevention and early intervention funds” means funds from the Mental Health Services Fund allocated for prevention and early intervention programs pursuant to paragraph (3) of subdivision (a) of Section 5892.
(d)“Childhood trauma prevention and early intervention” refers to a program that targets children exposed to, or
who are at risk of exposure to, adverse and traumatic childhood events and prolonged toxic stress in order to deal with the early origins of mental health needs and prevent long-term mental health concerns. This may include, but is not limited to, all of the following:
(1)Focused outreach and early intervention to at-risk and in-need populations.
(2)Implementation of appropriate trauma and developmental screening and assessment tools with linkages to early intervention services to children that qualify for these services.
(3)Collaborative, strengths-based approaches that appreciate the resilience of trauma survivors and support their parents and caregivers when appropriate.
(4)Support from peer support specialists and community health workers trained to provide mental health services.
(5)Multigenerational family engagement, education, and support for navigation and service referrals across systems that aid the healthy development of children and families.
(6)Linkages to primary care health settings, including, but not limited to, federally qualified health centers, rural health centers, community-based providers, school-based health centers, and school-based programs.
(7)Leveraging the healing value of traditional cultural connections, including policies, protocols, and processes that are responsive to the racial, ethnic, and cultural needs of individuals served and recognition of historical trauma.
(8)Coordinated and blended funding streams to ensure individuals and families experiencing toxic stress have comprehensive and integrated supports across systems.
(e)“Early psychosis and mood disorder detection and intervention” has the same meaning as set forth in paragraph (2) of subdivision (b) of Section 5835 and may include programming across the age span.
(f)“Youth outreach and engagement” means strategies that target secondary school and transition-age youth, with a priority on partnerships with college mental health programs that educate and engage students and provide either on-campus, off-campus, or linkages to mental health services not provided through the campus to students who are attending colleges and universities, including, but not
limited to, public community colleges. Outreach and engagement may include, but is not limited to, all of the following:
(1)Meeting the mental health needs of students that cannot be met through existing education funds.
(2)Establishing direct linkages for students to community-based mental health services.
(3)Addressing direct services, including, but not limited to, increasing college mental health staff-to-student ratios and decreasing wait times.
(4)Participating in evidence-based and community-defined best practice programs for mental health services.
(5)Serving underserved and vulnerable populations, including, but not limited to, lesbian, gay, bisexual, transgender, and queer persons, victims of domestic violence and sexual abuse, and veterans.
(6)Establishing direct linkages for students to community-based mental health services for which reimbursement is available through the students’ health coverage.
(7)Reducing racial disparities in access to mental health services.
(8)Funding mental health stigma reduction training and activities.
(9)Providing college employees and students with education and training in early identification, intervention, and referral of students with mental health needs.
(10)Interventions for youth with signs of behavioral or emotional problems who are at risk of, or have had any, contact with the juvenile justice system.
(11)Integrated youth mental health programming.
(12)Suicide prevention programming.
(g)“Culturally competent and linguistically appropriate prevention and intervention” refers to a program that creates critical linkages with community-based organizations, including, but not limited to, clinics licensed or operated under subdivision (a) of Section 1204 of the Health and Safety Code, or clinics exempt from clinic licensure pursuant to subdivision (c) of Section 1206 of the Health and Safety Code.
(1)“Culturally competent and linguistically appropriate” means the ability to reach underserved cultural populations and address specific barriers related to racial, ethnic, cultural, language, gender, age, economic, or other disparities in mental health services access, quality, and outcomes.
(2)“Underserved cultural populations” means those who are unlikely to seek help from any traditional mental health service because of stigma, lack of knowledge, or other barriers, including members of ethnically and racially diverse communities, members of the gay, lesbian, bisexual, and transgender communities, and veterans, across their lifespans.
(h)“Strategies targeting the mental health needs of older adults” means, but is not limited to, all of the following:
(1)Outreach and engagement strategies that target caregivers, victims of elder abuse, and individuals who live alone.
(2)Suicide prevention programming.
(3)Outreach to older adults who are isolated.
(4)Early identification programming of mental health symptoms and disorders, including, but not limited to, anxiety, depression, and psychosis.
(i)“Direct services” means individual or group behavioral health services provided at a location operated by a local educational agency for individuals who are 25 years of age or younger. Direct services include, but are not limited to, all of the following:
(1)School-based health centers.
(2)Student wellness or well-being centers.
(3)Contracts with local educational agencies to provide behavioral health services.
(4)Individualized behavioral health or substance abuse counseling.
(5)Group behavioral health and substance abuse counseling and activities.
(6)Integrated social-emotional learning and systems of support.
(7)Behavior-related services, including activities to increase mindfulness, self-regulation, development of protective factors, calming strategies, and communication skills.
(j)“Local educational agency” means a school district or county office of education.
(a)On or before January 1, 2020, the commission shall establish priorities for the use of prevention and early intervention funds. These priorities shall include, but are not limited to, the following:
(1)Childhood trauma prevention and early intervention to deal with the early origins of mental health needs.
(2)Early psychosis and mood disorder detection and intervention, and mood disorder and suicide prevention programming that occurs across the lifespan.
(3)Youth outreach and engagement strategies that target secondary school and transition-age youth, with a priority on partnership with college mental health programs.
(4)Culturally competent and linguistically appropriate prevention and intervention.
(5)Strategies targeting the mental health needs of older adults.
(6)Direct services on school campuses.
(7)Other programs the commission identifies, with stakeholder participation, that are proven effective in achieving, and are reflective of, the goals stated in Section 5840.
(b)On or before January 1, 2020, the commission shall develop a statewide strategy for monitoring implementation of this part, including enhancing public understanding of prevention and early intervention and creating metrics for assessing the effectiveness of how prevention and early intervention funds are used and the outcomes that are achieved. The commission shall analyze and monitor the established metrics using existing data, if available, and shall propose new data collection and reporting strategies, if necessary.
(c)The commission shall establish a strategy for technical assistance, support, and evaluation to support the successful implementation of the objectives, metrics, data collection, and reporting strategy.
(d)(1)The portion of funds in the county plan relating to prevention and early intervention shall focus on the established priorities, and shall be allocated, as determined by the county, with stakeholder input. A county may include other priorities, as determined through the stakeholder process, either in place of, or in addition to, the established priorities. If the county chooses to include other programs, the plan shall include a description of why those programs are included and metrics by which the effectiveness of those programs is to be measured.
(2)Counties may act jointly to meet the requirements of this section.
(e)(1)On or before January 1, 2025, the commission shall modify
regulations to establish a general requirement that at least 20 percent of the prevention and early intervention funds in each county be used to provide direct services on school campuses in collaboration with local educational agencies in alignment with the priorities established by the commission and the goals stated in Section 5840.
(2)For purposes of this subdivision, “collaboration” means a county proactively working with representatives from a local educational agency to determine how to best provide direct services on school campuses, including, but not limited to, consulting, coordinating contracts, and awarding direct grants.
(f)If the commission requires additional resources for these purposes, it may prepare a proposal for consideration by the appropriate policy committees of the Legislature.
(a)In order to promote efficient implementation of this act, the county shall use funds distributed from the Mental Health Services Fund as follows:
(1)In the 2005–06, 2006–07, and 2007–08 fiscal years, 10 percent shall be placed in a trust fund to be expended for education and training programs pursuant to Part 3.1 (commencing with Section 5820).
(2)In the 2005–06, 2006–07, and 2007–08 fiscal years, 10 percent for capital facilities and technological needs shall be distributed to counties in accordance with a formula developed in consultation with the County Behavioral Health Directors Association of California to implement plans developed pursuant to Section 5847.
(3)(A)Twenty percent of funds distributed to the counties pursuant to subdivision (c) of Section 5891 shall be used for prevention and early intervention programs in accordance with Part 3.6 (commencing with Section 5840).
(B)At least 20 percent of the prevention and early intervention funds in each county shall be used to provide direct services on school campuses in collaboration with local educational agencies in alignment with the priorities established by the commission and the goals stated in Section 5840.
(4)The expenditure for prevention and early intervention may be increased in any county in which the department determines that the increase will decrease the need and cost for additional services to persons with severe mental illness in that county by an amount at least commensurate with the proposed increase.
(5)The balance of funds shall be distributed to county mental health programs for services to persons with severe mental illnesses pursuant to Part 4 (commencing with Section 5850) for the children’s system of care and Part 3 (commencing with Section 5800) for the adult and older adult system of care. These services may include housing assistance, as defined in Section 5892.5, to the target population specified in Section 5600.3.
(6)Five percent of the total funding for each county mental health program for Part 3 (commencing with Section 5800), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850), shall be utilized for innovative programs in accordance with Sections 5830, 5847, and 5848.
(b)(1)In any fiscal year after the 2007–08 fiscal year, programs for services pursuant to Part 3 (commencing with Section 5800) and Part 4 (commencing with Section 5850) may include funds for technological needs and capital facilities, human resource needs, and a prudent reserve to ensure services do not have to be significantly reduced in years in which revenues are below the average of previous years. The total allocation for purposes authorized by this subdivision shall not exceed 20 percent of the average amount of funds allocated to that county for the previous five fiscal years pursuant to this section.
(2)A county shall calculate an amount it establishes as the prudent reserve for its Local Mental Health Services Fund, not to exceed 33 percent of the average community services and support revenue received for the fund in the preceding five years. The county shall reassess the maximum amount of this reserve every five years and certify the reassessment as part of the three-year program and expenditure plan required pursuant to Section 5847.
(3)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the State Department of Health Care Services may allow counties to determine the percentage of funds to allocate across programs created pursuant to Part 4 (commencing with Section 5850) for the children’s system of care and Part 3 (commencing with Section 5800) for the adult and older adult system of care for the 2020–21 and 2021–22 fiscal years by means of all-county letters or other similar instructions without taking further regulatory action.
(c)The allocations pursuant to
subdivisions (a) and (b) shall include funding for annual planning costs pursuant to Section 5848. The total of these costs shall not exceed 5 percent of the total of annual revenues received for the fund. The planning costs shall include funds for county mental health programs to pay for the costs of consumers, family members, and other stakeholders to participate in the planning process and for the planning and implementation required for private provider contracts to be significantly expanded to provide additional services pursuant to Part 3 (commencing with Section 5800) and Part 4 (commencing with Section 5850).
(d)Prior to making the allocations pursuant to subdivisions (a), (b), and (c), funds shall be reserved for the costs for the State Department of Health Care Services, the California Behavioral Health Planning Council, the Office of Statewide Health Planning and Development, the Mental Health Services Oversight and Accountability
Commission, the State Department of Public Health, and any other state agency to implement all duties pursuant to the programs set forth in this section. These costs shall not exceed 5 percent of the total of annual revenues received for the fund. The administrative costs shall include funds to assist consumers and family members to ensure the appropriate state and county agencies give full consideration to concerns about quality, structure of service delivery, or access to services. The amounts allocated for administration shall include amounts sufficient to ensure adequate research and evaluation regarding the effectiveness of services being provided and achievement of the outcome measures set forth in Part 3 (commencing with Section 5800), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850). The amount of funds available for the purposes of this subdivision in
a
fiscal year is subject to appropriation in the annual Budget Act.
(e)In the 2004–05 fiscal year, funds shall be allocated as follows:
(1)Forty-five percent for education and training pursuant to Part 3.1 (commencing with Section 5820).
(2)Forty-five percent for capital facilities and technology needs in the manner specified by paragraph (2) of subdivision (a).
(3)Five percent for local planning in the manner specified in subdivision (c).
(4)Five percent for state implementation in the manner specified in subdivision (d).
(f)Each county shall place all funds received from the State Mental Health Services
Fund in a local Mental Health Services Fund. The Local Mental Health Services Fund balance shall be invested consistent with other county funds and the interest earned on the investments shall be transferred into the fund. The earnings on investment of these funds shall be available for distribution from the fund in future fiscal years.
(g)All expenditures for county mental health programs shall be consistent with a currently approved plan or update pursuant to Section 5847.
(h)(1)Other than funds placed in a reserve in accordance with an approved plan, funds allocated to a county that have not been spent for their authorized purpose within three years, and the interest accruing on those funds, shall revert to the state to be deposited into the Reversion Account, hereby
established in the fund, and available for other counties in future years, provided, however, that funds, including interest accrued on those funds, for capital facilities, technological needs, or education and training may be retained for up to 10 years before reverting to the Reversion Account.
(2)(A)If a county receives approval from the Mental Health Services Oversight and Accountability Commission of a plan for innovative programs, pursuant to subdivision (e) of Section 5830, the county’s funds identified in that plan for innovative programs shall not revert to the state pursuant to paragraph (1) so long as they are encumbered under the terms of the approved project plan, including subsequent amendments approved by the commission, or until three years after the date of approval, whichever is later.
(B)Subparagraph (A) applies to all plans for innovative programs that have received commission approval and are in process at the time of enactment of the act that added this subparagraph, and to all plans that receive commission approval thereafter.
(3)Notwithstanding paragraph (1), funds allocated to a county with a population of less than 200,000 that have not been spent for their authorized purpose within five years shall revert to the state as described in paragraph (1).
(4)(A)Notwithstanding paragraphs (1) and (2), if a county with a population of less than 200,000 receives approval from the Mental Health Services Oversight and Accountability Commission of a plan for innovative programs, pursuant to subdivision (e) of Section 5830, the county’s funds identified in that plan for innovative programs shall not revert to the state pursuant to paragraph (1) so long as they are encumbered under the terms of the approved project plan, including subsequent amendments approved by the commission, or until five years after the date of approval, whichever is later.
(B)Subparagraph (A) applies to all plans for innovative programs that have received commission approval and are in process at the time of enactment of the act that added this subparagraph, and to all plans that receive commission approval thereafter.
(i)Notwithstanding subdivision (h) and Section 5892.1, unspent funds allocated to a county, and interest accruing on those funds, that are subject to reversion as of July 1, 2019, and July 1, 2020, shall be subject to
reversion on July 1, 2021.
(j)If there are revenues available in the fund after the Mental Health Services Oversight and Accountability Commission has determined there are prudent reserves and no unmet needs for any of the programs funded pursuant to this section, including all purposes of the Prevention and Early Intervention Program, the commission shall develop a plan for expenditures of these revenues to further the purposes of this act and the Legislature may appropriate these funds for any purpose consistent with the commission’s adopted plan that furthers the purposes of this act.
