Bill Text: CA SB964 | 2021-2022 | Regular Session | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Behavioral health.
Spectrum: Moderate Partisan Bill (Democrat 9-2)
Status: (Vetoed) 2022-09-27 - In Senate. Consideration of Governor's veto pending. [SB964 Detail]
Download: California-2021-SB964-Amended.html
SECTION 1.
Section 66024.3 is added to the Education Code, to read:SEC. 3. The heading of Chapter 1 (commencing with former Section 127750) of Part 3 of Division 107 of the Health and Safety Code is repealed. SEC. 4. Chapter 1 (commencing with Section 127800) is added to Part 3 of Division 107 of the
Health and Safety Code , to read: 127800. 127805. 127810. request commission consultants from relevant branches of the University of California to enter into a contract with the department to prepare a report providing a landscape analysis of the current behavioral health workforce and the state’s behavioral health workforce needs, and to make recommendations on how to address the state’s behavioral health workforce shortage.
The department shall also convene a stakeholder group, including representatives of relevant professional associations as well as labor unions representing both private and public sector behavioral health clinicians, to participate in the development and drafting of the report. The report shall be delivered to the Legislature on or before January 1, 2024, and shall include all of the following: Mental Behavioral Health Service Provider Education Program within the Department of Health Care Access and Information.
Section 14045.12 of the Welfare and Institutions Code is amended to read:
Section 14045.13 of the Welfare and Institutions Code is amended to read:
Section 14045.14 of the Welfare and Institutions Code is repealed.
Section 14045.18 of the Welfare and Institutions Code is repealed.
Section 14045.18 is added to the Welfare and Institutions Code, to read:
Section 14045.19 of the Welfare and Institutions Code is repealed.
Section 14045.19 is added to the Welfare and Institutions Code, to read:
Bill Title: Behavioral health.
Spectrum: Moderate Partisan Bill (Democrat 9-2)
Status: (Vetoed) 2022-09-27 - In Senate. Consideration of Governor's veto pending. [SB964 Detail]
Download: California-2021-SB964-Amended.html
|
Amended
IN
Assembly
June 06, 2022 |
|
Amended
IN
Senate
May 19, 2022 |
|
Amended
IN
Senate
April 18, 2022 |
|
Amended
IN
Senate
April 04, 2022 |
CALIFORNIA LEGISLATURE—
2021–2022 REGULAR SESSION
Senate Bill
No. 964
| Introduced by Senator Wiener (Principal coauthors: Senators Caballero and Stern) (Coauthors: Senators Dodd and Rubio) (Coauthors: Assembly Members Bauer-Kahan, Gipson, Gray, Lackey, Levine, and Waldron) |
February 09, 2022 |
An act to add Section 66024.3 to the Education Code, to amend Sections 127940 and 128454 of, to add Article 6 (commencing with Section 128560) to Chapter 5 of Part 3 of Division 107 of, to add Chapter 1.6 (commencing with Section 127826) to Part 3 of Division 107 of, and to add and repeal Chapter 1 (commencing with Section 127800) to 127815) of Part 3 of Division 107 of, to repeal Section 127815 of, and to repeal the heading of Chapter 1 (commencing with former Section 127750) of Part 3 of Division 107 of,
the Health and Safety Code, and to amend Sections 14045.12 and 14045.13 of, to repeal Section 14045.14 of, and to repeal and add Sections 14045.18 and 14045.19 of, the Welfare and Institutions Code, relating to behavioral health.
LEGISLATIVE COUNSEL'S DIGEST
SB 964, as amended, Wiener.
Behavioral health.
(1) Existing law establishes various health professions education programs within the Department of Health Care Access and Information, through which scholarships, loan repayment grants, recruitment or training services, or other benefits are provided to certain health professionals, including mental health service providers, physicians, registered nurses, and vocational nurses, if they meet specified criteria. Existing law authorizes the department to award competitive grants to expand the supply of certain behavioral health professionals serving children and youth, as specified. Existing law also establishes the Licensed Mental Health Service Provider Education Program within the department, to provide grants to specified licensed behavioral health service providers, as defined,
who provide direct care in a publicly funded behavioral health facility or a mental health professional shortage area, for reimbursement of educational loans related to a career as a licensed behavioral health service provider.
This bill would establish the Future of California’s Workforce and Surge in Behavioral Health (FOCWS-BH), which would be administered by the department, in collaboration with other departments, as applicable. The bill would set forth specified priorities for the purpose of growing the behavioral health workforce by 1/3 under the FOCWS-BH, including, but not limited to, growing the public behavioral health workforce, targeting regions with longstanding provider shortages as high-need areas, and ensuring that the behavioral health workforce will be better prepared to serve high-acuity clients and provide community-based services. The bill would
require the FOCWS-BH, subject to an appropriation by the Legislature, to include specified initiatives, including, but not limited to, behavioral health diversity workforce initiatives designed to increase culturally congruent care.
The bill would revise the name of the Licensed Mental Health Service Provider Education Program to the Licensed Behavioral Health Service Provider Education Program, and would additionally authorize the department to provide grants to support paid field internships for prelicensees related to a career as a licensed behavioral health service provider. The bill would establish the Nonlicensed Behavioral Health Service Provider Education Program, authorizing the department to provide similar grants to specified nonlicensed behavioral health service workers, as defined, for costs, including, but not limited to, tuition assistance, certification fees, and educational loans related to a career as a nonlicensed behavioral health provider.
The bill would establish the Behavioral Health Education Partnership Program within the department, consisting of 7 targeted programs, to strengthen and expand collaborations between the department and behavioral health educational institutions.
The bill would require the department to commission consultants from the University of California, as specified, to prepare a report for the Legislature, on or before January 1, 2024, that provides a landscape analysis of the current behavioral health workforce and the state’s behavioral health workforce needs, and to make recommendations on how to address the state’s behavioral health workforce shortage.
(1)
(2) Existing law, the Donahoe Higher Education Act, sets forth the missions and functions of the 3 segments comprising the state’s public postsecondary education system. These segments are the University of California, administered by the Regents of the University of California, the California State University, administered by the Trustees of the California State University, and the California Community Colleges, administered by the Board of Governors of the California Community Colleges. Provisions of the act apply to the University of California only to the extent that the regents act, by resolution, to make the provisions applicable.
This bill would amend the act to require the California Community Colleges and the California State University, and to request the University of California, to develop 2 accelerated programs of study related to degrees in social work. The bill would require one program to offer a concurrent bachelor’s and master’s of
social work program that would allow students to combine their last one or 2 years of undergraduate study in social work with their graduate study in social work in order to complete both programs at an accelerated rate. The bill would require the 2nd program to offer an accelerated academic program in which students with experience as peer support specialists, registered or certified alcohol or other drug counselors, community health workers, or psychiatric technicians could receive their associate’s degree, as well as a bachelor’s and master’s degree in social work. The bill would require both programs to require a student to take a course on working with the severely mentally ill, with a focus on working in the public behavioral health system.
(2)
(3) Existing law establishes the Department of Health Care Access and Information and authorizes the department, among other things, to award competitive grants to entities and individuals it deems qualified to expand the supply of behavioral health counselors, coaches, peer supports, and other allied health care providers serving children and youth.
This bill would establish the Behavioral Health Workforce FOCWS-BH Preservation and Restoration Fund as a fund in the State Treasury, to be administered by the department, for the purpose of stabilizing the current licensed, certified, or registered clinical behavioral health workforce. The bill would authorize moneys from the fund to be used, upon appropriation by the Legislature, to provide hiring or
performance-based bonuses, salary augmentation, overtime pay, or hazard pay to licensed, certified, or registered professionals working in the behavioral health sector.
The bill would require moneys from the fund to go only to entities that execute a Memorandum of Agreement with the department, as specified, and would authorize the department to inspect relevant payroll and personnel records of facilities receiving moneys from the fund to ensure that salary, wage, benefit, and staffing increases have been implemented, as specified. The bill would also require the department to establish a stipend program, in addition to and separate from the fund, for students pursuing a master’s degree in social work with a specialized focus on public behavioral health. Under the bill, a student would be eligible for a stipend of $18,500 per year for up to 2 calendar years if specified conditions are met.
This bill would require the department to develop an online jobs board on which licensed public, private, and nonprofit behavioral health providers and facilities in the state may post job openings for behavioral health workers. The bill would also require
the department to request the University of California to enter into a contract with the department to prepare a report for the Legislature, on or before January 1, 2024, that provides a landscape analysis of the current behavioral health workforce and the state’s behavioral health workforce needs, and makes recommendations on how to address the state’s behavioral health workforce shortage.
(3)
(4) Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law establishes a schedule of benefits under the
Medi-Cal program and provides for various services, including behavioral and mental health services that are rendered by Medi-Cal enrolled providers.
Existing law requires the department, by July 1, 2022, to establish statewide requirements for counties to use in developing certification programs for the certification of peer support specialists, as specified. Existing law authorizes a county, or an agency that represents a county, to develop a peer support specialist certification program and certification fee schedule, both of which are subject to department approval.
This bill would repeal those provisions authorizing a county to develop a peer support specialist certification program and instead would require the department, by July 1, 2023, to provide for a statewide certification for peer support specialists. The bill would require the department to amend the Medicaid state plan to include a certified peer support
specialist as a provider type for purposes of the Medi-Cal program and to include peer support specialist services as a distinct service type under the Medi-Cal program. The bill would require Medi-Cal reimbursement for peer support specialist services to be implemented only if, and to the extent that, federal financial participation is available and the department obtains all necessary federal approvals.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
This act shall be known as the Behavioral Health Workforce Revitalization Act.
SEC. 2.SECTION 1.
Section 66024.3 is added to the Education Code, to read:66024.3.
(a) The California Community Colleges and the California State University shall, and the University of California is requested to, develop both of the following accelerated programs of study related to degrees in social work:(1) A concurrent bachelor’s and master’s of social work program that will allow students to combine their last one or two years of undergraduate study in social work with their graduate study in social work in order to complete both programs at an accelerated rate. The program shall require a student to take a course on working with the severely mentally ill, with a focus on working in the public behavioral health system.
(2) An accelerated academic program in which students with experience as peer support specialists, registered or certified alcohol or other drug counselors, community health workers, or psychiatric technicians may receive their associate’s degree, as well as a bachelor’s and master’s degree in social work. The program shall require a student to take a course on working with the severely mentally ill, with a focus on working in the public behavioral health system. The program shall be designed to be completed by a student who is working full-time and may include online, part-time, and night class options.
(b) For purposes of this section, “behavioral health” refers to both mental health and substance use disorder.
SEC. 2.
Chapter 1 (commencing with Section 127815) is added to Part 3 of Division 107 of the Health and Safety Code, to read:CHAPTER 1. Behavioral Health Workforce
(a)The Behavioral Health Workforce Preservation and Restoration Fund is hereby established as a fund in the State Treasury, to be administered by the department, for the purpose of stabilizing the current licensed, certified, or registered clinical behavioral health workforce.
(b)Moneys from the fund may be used, upon appropriation by the Legislature, to provide hiring or performance-based bonuses, salary augmentation, overtime pay, or hazard pay to
licensed, certified, or registered professionals working in the behavioral health sector. Funding shall be prioritized to retain or recruit licensed staff for facilities and programs at risk of closure due to a shortage of licensed staff.
(c)For purposes of this chapter, “behavioral health” refers to both mental health and substance use disorder.
(a)In addition to, and separate from, the Behavioral Health Workforce Preservation and Restoration Fund established by Section 127800, the department shall establish a stipend program for students pursuing a master’s degree in social work with a specialized focus on public behavioral health.
(b)Under the program, a student shall be eligible for a stipend of eighteen thousand five hundred dollars ($18,500) per year for up to two calendar years. A stipend recipient shall be required to complete two calendar years of continuous and satisfactory full-time employment with a public behavioral health agency or a contracted
provider.
The department shall develop an online jobs board on which licensed public, private, and nonprofit behavioral health providers and facilities in the state may post job openings for behavioral health workers, including, but not limited to, psychiatrists, clinical psychologists, psychologists, licensed marriage and family therapists, licensed professional clinical counselors, licensed clinical social workers, psychiatric mental health clinical nurse specialists, psychiatric technicians, peer support specialists, and community health workers.
127815.
(a) The department shall(1) An analysis of the public, private, and nonprofit behavioral health workforce.
labor market, including, but not limited to, employment status and reliance on independent providers, remuneration levels and reimbursement rates by payor type and relative to other health professions and services, workforce turnover and exit rates, health plan and insurer employment of providers and rate setting for contractors, and market failures and other impediments to attracting and maintaining a stable and experienced workforce statewide, as well as in each of California’s geographic regions.
(2) An analysis that includes both licensed and nonlicensed behavioral health workers, including but not limited to, psychiatrists, clinical psychologists, psychologists, licensed marriage and family therapists, licensed professional clinical counselors, licensed clinical social workers, psychiatric mental health clinical nurse specialists, psychiatric
technicians, peer support specialists, registered or certified drug counselors, and community health workers.
(3) A demographic analysis of the workforce, including information on race, ethnicity, sexual orientation, gender identity, age, geographic location, languages spoken, lived experience with one’s own mental illness or substance use disorder or that of a family member, and disability status. Information regarding health history shall be treated as confidential and shall only be collected on a voluntary basis. Only deidentified and aggregated health information shall be included in the report.
(4) An analysis of the number, type, and location of workers needed to meet California’s
behavioral health care needs. needs, including needs for workers to provide culturally and linguistically appropriate care, and care for specific diagnoses that specialized training is necessary to treat.
(5) Short, medium, Short-, medium-, and long-term recommendations on how to increase the state’s behavioral health workforce to meet the current and growing demand.
(6) An analysis of the
educational theories and scope of practice laws for behavioral health workers, as well as health plan hiring and state guidelines and practices for different behavioral health certification and license types. Recommendations shall aim to ensure that an individual
receiving a behavioral health certification or license is able to practice up to their full potential while maintaining a high quality of care. care regardless of payer type.
(7) An analysis of license requirements, including out-of-state license application requirements, and clinical training requirements for behavioral health professionals. The analysis shall compare the state’s license and training requirements for behavioral health professionals to licensing and training requirements in other states and make recommendations.
(8) An analysis of requirements for renewing the license of a behavioral
health professional who has an expired license, including, but not limited to, an individual on extended parental, family, or medical leave, or a retiree. Recommendations may include, but are not limited to, requiring competency exams, continuing education requirements, or other competency demonstrations.
(b) The report required to be submitted to the Legislature pursuant to this section shall be submitted in compliance with Section 9795 of the Government Code.
(c) This section chapter shall remain in effect only until January 1, 2028, and as of that date is repealed.
SEC. 3.
Chapter 1.6 (commencing with Section 127826) is added to Part 3 of Division 107 of the Health and Safety Code, to read:CHAPTER 1.6. Future of California’s Workforce and Surge in Behavioral Health
127826.
(a) This chapter shall be known as the Future of California’s Workforce and Surge in Behavioral Health (FOCWS-BH).(b) The FOCWS-BH shall be administered by the Department of Health Care Access and Information, in collaboration with other departments, as applicable.
(c) The FOCWS-BH seeks to grow the behavioral health workforce by one-third with the following priorities:
(1) Growing the public behavioral health workforce, its contracted providers, and other settings where behavioral health services are provided to low-income communities.
(2) Targeting regions with longstanding provider shortages as high-need areas.
(3) Supporting existing vulnerable communities and new initiatives, including CalAIM, the Children and Youth Behavioral Health Initiative, the 988 mental health and substance use crisis line, and court reforms.
(4) Ensuring that the behavioral health workforce will be better prepared to serve high-acuity clients and provide community-based services.
(5) Ensuring that the behavioral health workforce better reflects the diversity of all Californians, including cultural, linguistic, race and ethnicity, sexual orientation, gender identity, and other characteristics of historically underserved populations.
(6) Ensuring that the growth of the behavioral health
workforce includes professionals to treat substance use disorder on parity with mental health professionals.
(7) Ensuring that robust career pathways will feed into the behavioral health system, from high school through licensure. These pathways will support underserved communities and provide multiple points of entry and reentry to licensed and nonlicensed positions alike.
(d) Subject to an appropriation by the Legislature for this purpose, the FOCWS-BH shall include all of the following components:
(1) Behavioral health diversity workforce initiatives designed to increase culturally congruent care, as described in Sections 127826.1, 127826.3, and 128560.
(2) Behavioral health initiatives focused on increasing the numbers of nonlicensed providers, as
described in Sections 127826.2, 127826.3, 127826.4, and 127827. Nonlicensed providers comprise a significant percentage of the public behavioral health workforce and already reflect the diversity of Californians with behavioral health needs.
(3) Behavioral health initiatives focused on increasing the numbers of licensed providers, as described in Sections 127827, 127828, and 127829. California has a historic shortage of psychiatrists as well as physicians with addiction medicine specialties. Entities serving low-income populations, including county behavioral health agencies, identified licensed clinical social workers, licensed marriage and family therapists, and licensed professional clinical counselors are the hardest professionals to both recruit and retain because of existing shortages.
(4) Behavioral health workforce initiatives focused on partnerships with educational
institutions to establish a workforce pipeline beginning at the high school level and to expand the number of educational slots needed to address existing health professional shortages, as described Section 66024.3 of the Education Code and in Sections 127815 and 127826.
(e) For purposes of this chapter, “behavioral health” refers to both mental health and substance use disorder.
127826.1.
(a) The Legislature finds that the lesbian, gay, bisexual, transgender, queer or questioning, asexual, intersex, or gender nonconforming population is disproportionately experiencing trauma leading to mental health conditions and substance use disorders.(b) (1) The department shall enter into a contract or multiple contracts, if appropriate, with a training entity to provide an evidence-based cultural competency training for licensed and nonlicensed substance use disorder providers and mental health providers, pertinent to the treatment of individuals who identify as lesbian, gay, bisexual, transgender, queer or questioning, asexual, intersex, or gender nonconforming.
(2) An evidence-based cultural competency training implemented pursuant to this subdivision may include both of the following:
(A) Information about the effects, including, but not limited to, ongoing personal effects, of historical and contemporary exclusion and oppression of transgender, gender nonconforming, or intersex (TGI) communities.
(B) Information about communicating more effectively across gender identities, including TGI-inclusive terminology, using people’s correct names and pronouns, even when they are not reflected in records or legal documents, avoiding language, whether verbal or nonverbal, that demeans, ridicules, or condemns TGI individuals, and avoiding making assumptions about gender identity by using gender-neutral language and avoiding language that presumes all individuals are heterosexual,
cisgender, gender conforming, or nonintersex.
127826.2.
(a) As a component of the FOCWS-BH initiative established pursuant to this chapter, and subject to an appropriation from the Legislature, there is hereby created the Nonlicensed Behavioral Health Service Provider Education Program within the Department of Health Care Access and Information.(b) For purposes of this section, “nonlicensed behavioral health service provider” means a registered and certified substance use disorder counselor, certified peer support specialist, and those individuals seeking to become registered and certified.
(c) Any nonlicensed behavioral health service provider, including a behavioral health service provider who is employed at a publicly funded
behavioral health facility or a public or nonprofit private behavioral health facility that contracts with a county behavioral health entity or facility to provide behavioral 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 pay for tuition assistance and test preparation to become certified, certification fees, or their educational loans related to a career as a nonlicensed behavioral health service provider. Grants under the program may also pay for management or supervision training, paid internships, and the costs of supervision to create career pathways for nonlicensed behavioral health providers, including pathways towards licensure as advanced alcohol drug counselors.
(d) The department shall adopt all of the following:
(1) A standard contractual agreement
to be signed by the director and any nonlicensed behavioral health service provider who is serving in a publicly funded facility or a mental health professional shortage area that would require the nonlicensed behavioral 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 nonlicensed behavioral health service provider.
(3) The maximum allowable annual grant amount per individual nonlicensed behavioral health service provider.
(e) The department shall develop the program, which shall comply with all of the following requirements:
(1) The total amount of grants under the program
per individual nonlicensed behavioral health service provider shall not exceed the amount of educational expenses related to a career as a nonlicensed behavioral health service provider incurred by that provider.
(2) A grant may be provided in installments proportionate to the amount of the service obligation that has been completed.
(3) The number of persons who may be considered for the program shall be limited by the funds appropriated by the Legislature for this purpose.
127826.3.
(a) The department, in collaboration with the State Department of Health Care Services, is hereby authorized to award a multiyear grant to a training entity the department deems qualified to provide specialized training for nonnative English speakers to improve behavioral health charting and documentation skills to support participation in the Medi-Cal program while increasing the linguistic capacity of Medi-Cal behavioral health providers. The training shall target registered and certified substance use disorder counselors and certified peer support specialists.(b) The department, in collaboration with the State Department of Health Care Services, shall assess the effectiveness of the training in expanding the capacity to provide
Medi-Cal substance use disorder and peer support services to nonnative English-speaking beneficiaries.
127826.4.
The department is hereby authorized to award grants to support scholarships for training substance use disorder and behavioral health-informed coaches that are national and board-eligible in health and wellness coaching.127827.
(a) The FOCWS-BH Preservation and Restoration Fund is hereby established as a fund in the State Treasury, to be administered by the department, for the purpose of retaining and expanding the current licensed, certified, and registered clinical behavioral health workforce serving patients of public sector providers, Medi-Cal plans, and their contractors.(b) Moneys from the fund may be used, upon appropriation by the Legislature, to provide hiring or performance-based bonuses, salary augmentation, overtime pay, hazard pay, or benefit enhancements to licensed, certified, or registered professionals working in the behavioral health sector, as well as to increase staffing of these positions in order to reduce these professional’s workloads and
expand patients’ access to care. Funding shall be prioritized to retain or recruit licensed and nonlicensed staff for facilities and programs at risk of closure due to a shortage of licensed and nonlicensed staff. Grant applicants shall also be prioritized based upon both of the following:
(1) The engagement of their incumbent behavioral health clinicians in developing proposed workforce development plans.
(2) Proposals that seek other workforce funding sources, leverage multiple funding sources for workforce investments, or provide matching funds.
(c) Moneys from the fund shall go only to entities that execute a Memorandum of Agreement with the department affirming that they are in compliance with all applicable state and federal laws or are successfully implementing plans of correction for any violations thereof,
setting forth a description of the specific needs to be met with grant funds and the specific plans to meet them, committing to maintain their prior level of expenditures for the provision of behavioral health services, with any grant funds supplementing rather than supplanting these expenditures, and agreeing to submit to an audit by the department or its designee to ensure compliance with these provisions, on pain of clawback.
(d) Any finalized audit finding by the department or its designee that a grantee has misspent moneys from the fund shall weigh against consideration of any applications by that grantee for further grants under the provisions of this section.
(e) Moneys provided from the fund may not be used for any salary, wage, benefit, or staffing increases that were committed to by an applicant prior to July 1, 2022, nor may they be used for any salaries, wages,
benefits, or staffing for which a grantee would have paid without the fund.
(f) The baseline from which any salaries, wages, benefits, and staffing levels shall be increased to satisfy commitments made in the Memorandum of Agreement shall be the aggregate salaries, wages, benefits, and staffing levels for the period of July 1, 2021, to June 30, 2022, inclusive, plus any increases in these levels committed prior to July 1, 2022, but scheduled to take effect after that date.
(g) The department may inspect relevant payroll and personnel records of facilities receiving moneys from the fund in order to ensure that the salary, wage, benefit, and staffing increases that were committed in the Memorandum of Agreement have been implemented.
127828.
(a) The department shall establish a stipend program for students pursuing a master’s degree in social work with a specialized focus on public behavioral health.(b) Under the program, a student shall be eligible for a stipend of eighteen thousand five hundred dollars ($18,500) per year for up to two calendar years. A stipend recipient shall be required to complete two calendar years of continuous and satisfactory full-time employment with a public behavioral health agency or a contracted provider. Priority shall be given to students who commit to completing the employment requirement in the San Joaquin Valley or the Inland Empire until the behavioral health provider shortages experienced in these regions are similar to the shortages in
other regions.
127829.
(a) The department shall establish a program to provide grants and stipends to master’s-level and dual master’s- and doctoral-level students seeking degrees in fields associated with behavioral health, excluding social workers.(b) A grant or stipend recipient shall be required to complete two calendar years of continuous and satisfactory full-time employment with a public behavioral health agency or a contracted provider. Priority shall be given to students who commit to completing the employment requirement in the San Joaquin Valley or the Inland Empire until the behavioral health provider shortages experienced in these regions are similar to the shortages in other regions.
127830.
The department shall establish a program for tuition reimbursement and stipends to encourage licensed mental health and medical professionals to complete substance use disorder-specific courses. Courses shall support mental health and medical professionals to care for individuals with cooccurring mental health conditions and substance use disorders.SEC. 4.
Section 127940 of the Health and Safety Code is amended to read:127940.
(a) In administering the National Health Service Corps State Loan Repayment Program in accordance with Section 254q-1 of Title 42 of the United States Code and related federal regulations, the Department of Health Care Access and Information shall strive, whenever feasible, to equitably distribute loan repayment awards between eligible urban and rural program sites, after taking into account the availability of health care services in the communities to be served and the number of individuals to be served in each program site.(b) The department shall set a reasonable deadline for when all applications are required to be received.
(c) All eligible applications shall be given consideration before
any award is granted.
(d) The department shall include all federally qualified health centers located in California in the program’s certified eligible site list.
(e) As part of a program applicant’s initial application, program sites shall agree to provide matching funds.
(f) The Legislature may appropriate funds to increase the number of awards granted to eligible behavioral health providers and primary care awardees providing behavioral health services within their scope of practice.
SEC. 5.
Section 128454 of the Health and Safety Code is amended to read:128454.
(a) There is hereby created the Licensed(b) For purposes of this article, the following definitions shall apply:
(1) “Licensed mental
behavioral
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 Health Care Services waiver pursuant to Section 5751.2 of the Welfare and Institutions Code, marriage and family therapist, associate marriage and family therapist, licensed clinical social worker, associate clinical social worker, licensed professional clinical counselor, and associate professional clinical counselor.
(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
behavioral health service provider, including a mental
behavioral health service provider who is employed at a publicly funded mental behavioral health facility or a public or nonprofit private mental behavioral health facility that contracts with a county mental behavioral health entity or facility to provide mental
behavioral 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 their educational loans and to support paid field internships for prelicensees related to a career as a licensed mental behavioral health service provider.
(d) The department shall adopt all of the following:
(1) A standard contractual agreement for educational loans
to be signed by the director and any licensed mental
behavioral health service provider who is serving in a publicly funded facility or a mental health professional shortage area that would require the licensed mental behavioral 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
behavioral health service provider.
(3) The maximum allowable annual grant amount per individual licensed mental
behavioral health service provider.
(e) The department shall develop the program, program for educational loans, which shall comply with all of the following requirements:
(1) The total amount of grants under the program per individual licensed mental behavioral health service provider shall not exceed the amount of educational loans related to a career as a licensed mental
behavioral 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.
(f)This section shall become operative on July 1, 2018.
(f) (1) The number of persons who may be considered for the paid field internships shall be limited by the funds appropriated by the Legislature for this purpose.
(2) Funds may be appropriated by the Legislature for paid field internship placement opportunities targeting areas of significant shortages, such as the San Joaquin Valley.
SEC. 6.
Article 6 (commencing with Section 128560) is added to Chapter 5 of Part 3 of Division 107 of the Health and Safety Code, to read:Article 6. Behavioral Health Education Partnership Program
128560.
(a) As part of the Future of California’s Workforce and Surge in Behavioral Health (FOCWS-BH) (Chapter 1.6 (commencing with Section 127826)), there is hereby established within the Department of Health Care Access and Information the Behavioral Health Education Partnership Program to strengthen and expand collaborations between the department and behavioral health educational institutions.(b) Subject to an appropriation by the Legislature for this purpose, the following programs shall be established as part of the Behavioral Health Education Partnership Program within the department and operated pursuant to this article:
(1) The CalMedForce Program to fund psychiatry
graduate medical education programs.
(2) The Addiction Psychiatry and Addiction Medicine Fellowship Program.
(3) The Behavioral Health Professional Expansion Program.
(4) The PCP Training and Education in Addiction Medicine Program.
(5) The Public Behavioral Health Pipeline Program.
(6) The Public Behavioral Health Curriculum Program.
(7) The Stanislaus and Merced Educational Partnership Program.
(c) The CalMedForce Program shall establish a competitive grant to fund psychiatry graduate medical education (GME) programs that prioritize serving medically
underserved populations and areas.
(d) The Addiction Psychiatry and Addiction Medicine Fellowship Program shall fund educational institutions that expand the number of fellowships in addiction psychiatry and addiction medicine. Professionals placed in the expanded fellowships shall commit to a service obligation with the public behavioral health delivery system.
(e) The Behavioral Health Professional Expansion Program shall increase the number of licensed behavioral health professionals through grants to university and college training programs. Grants shall require collaboration with the public behavioral health delivery system to facilitate placements. University and college training programs in areas with the greatest shortage of licensed behavioral health providers, such as the Central Valley, shall be prioritized to receive grants.
(f) The PCP Training and Education in Addiction Medicine Program shall fund scholarships for a new workforce training program creating a one-year fellowship at the University of California in Irvine.
(g) The Public Behavioral Health Pipeline Program shall help create a public behavioral health pipeline that reflects the diversity of California’s low-income and underserved communities through establishing partnerships between the public behavioral health delivery system with high schools and community colleges.
(h) The Public Behavioral Health Curriculum Program shall fund colleges and universities with high enrollment of students from underrepresented communities to develop a specialized curriculum focused on working in the public behavioral health delivery system, including a focus on substance use disorders. The
specialized curriculum shall enhance training and prepare professionals to serve justice and system-involved clients.
(i) The Stanislaus and Merced Educational Partnership Program shall fund both of the following:
(1) Additional master’s degree in social work, marriage and family therapist, and licensed professional clinical counselor program slots at California State University, Stanislaus.
(2) Partnerships between the Counties of Stanislaus and Merced and the California State University, Stanislaus Departments of Social Work, Psychology, and Counselor Educational programs for internship placement opportunities for program students.
SEC. 5.SEC. 7.
Section 14045.12 of the Welfare and Institutions Code is amended to read:14045.12.
For purposes of this article, the following definitions apply:(a) “Certification” means the activities related to the verification that an individual has met all of the requirements under this article and that the individual may provide peer support specialist services pursuant to this article.
(b) “Certified” means all federal and state requirements have been satisfied by an individual who is seeking designation under this article, including completion of curriculum and training requirements, testing, and agreement to uphold and abide by the code of ethics.
(c) “Code of
ethics” means the standards to which a peer support specialist is required to adhere.
(d) “Core competencies” means the foundational and essential knowledge, skills, and abilities required for peer specialists.
(e) “Cultural competence” means a set of congruent behaviors, attitudes, and policies that come together in a system or agency that enables that system or agency to work effectively in cross-cultural situations. A culturally competent system of care acknowledges and incorporates, at all levels, the importance of language and culture, intersecting identities, assessment of cross-cultural relations, knowledge and acceptance of dynamics of cultural differences, expansion of cultural knowledge, and adaptation of services to meet culturally unique needs to provide services in
a culturally competent manner.
(f) “Department” means the State Department of Health Care Services.
(g) “Peer support specialist” means an individual who is 18 years of age or older, who has self-identified as having lived experience with the process of recovery from mental illness, substance use disorder, or both, either as a consumer of these services or as the parent or family member of the consumer, and who has been granted certification as a peer support specialist pursuant to this article.
(h) “Peer support specialist services” means culturally competent services that promote engagement, socialization, recovery, self-sufficiency, self-advocacy, development of natural supports, and identification of strengths.
Peer support specialist services include, but are not limited to, prevention services, support, coaching, facilitation, or education that is individualized and is conducted by a certified peer support specialist.
(i) “Recovery” means a process of change through which an individual improves their health and wellness, lives a self-directed life, and strives to reach their full potential. This process of change recognizes cultural diversity and inclusion, and honors the different routes to resilience and recovery based on the individual and their cultural community.
SEC. 6.SEC. 8.
Section 14045.13 of the Welfare and Institutions Code is amended to read:14045.13.
By July 1, 2023, the department shall do all of the following:(a) Establish a certifying body, either through contract or through an interagency agreement, to provide for the certification activities described in this article.
(b) Provide for a statewide certification for peer support specialists, as contained in federal guidance in State Medicaid Director Letter No. 07-011, issued by the federal Centers for Medicare and Medicaid Services on August 15, 2007.
(c) Define the qualifications, range of responsibilities, practice guidelines, and supervision standards for peer
support specialists. The department may utilize best practice materials published by the federal Substance Abuse and Mental Health Services Administration, the United States Department of Veterans Affairs, and related notable experts in the field as a basis for development of these definitions.
(d) Determine curriculum and core competencies required for certification of an individual as a peer support specialist, including curriculum that may be offered in areas of specialization, including, but not limited to, transition-age youth, veterans, gender identity, sexual orientation, and any other areas of specialization identified by the department. Core-competencies-based curriculum shall include, at a minimum, training related to all of the following elements:
(1) The concepts of
hope, recovery, and wellness.
(2) The role of advocacy.
(3) The role of consumers and family members.
(4) Psychiatric rehabilitation skills and service delivery, and addiction recovery principles, including defined practices.
(5) Cultural competence training.
(6) Trauma-informed care.
(7) Group facilitation skills.
(8) Self-awareness and self-care.
(9) Cooccurring disorders of mental health and substance use.
(10) Conflict resolution.
(11) Professional boundaries and ethics.
(12) Preparation for employment opportunities, including study and test-taking skills, application and résumé preparation, interviewing, and other potential requirements for employment.
(13) Safety and crisis planning.
(14) Navigation of, and referral to, other services.
(15) Documentation skills and standards.
(16) Confidentiality.
(e) Specify peer support
specialist employment training requirements, including core-competencies-based training and specialized training necessary to become certified under this article, and require training to include people with lived experience as consumers and family members.
(f) Establish a code of ethics.
(g) Determine continuing education requirements for biennial certification renewal.
(h) Determine the process for initial certification issuance and biennial certification renewal.
(i) Determine a process for investigation of complaints and corrective action, including suspension and revocation of certification and appeals.
(j) Determine a process for an individual employed as a peer support specialist on January 1, 2023, to obtain certification under this article.
(k) Determine requirements for peer support specialist certification for peer support specialists from out of state.
(l) Seek any federal approvals, related to the statewide certification standards, that it deems necessary to implement this article. For any federal approvals that the department deems necessary related to the statewide certification standards, this article shall be implemented only if and to the extent that the department obtains those federal approvals.
SEC. 7.SEC. 9.
Section 14045.14 of the Welfare and Institutions Code is repealed.SEC. 8.SEC. 10.
Section 14045.18 of the Welfare and Institutions Code is repealed.SEC. 9.SEC. 11.
Section 14045.18 is added to the Welfare and Institutions Code, to read:14045.18.
(a) The department shall amend its Medicaid state plan to do both of the following:(1) Include a peer support specialist certified pursuant to this article as a provider type for purposes of this chapter.
(2) Include peer support specialist services as a distinct service type for purposes of this chapter, which may be provided to eligible Medi-Cal beneficiaries who are enrolled in either a Medi-Cal managed care plan or a mental health plan.
(b) The department may seek any federal waivers or other state plan amendments as necessary to implement
the certification program provided for under this article.
