June 21, 2018

As discussed in the Budget Action Bulletin last week, the main health and human services trailer bills were not passed at the same time as the Budget Act. Both the Senate and Assembly budget committees heard these bills this Monday and the full Legislature took action on several of them later that afternoon. Below is an update on the status of the health and human services trailer bills. For full details on all the provisions referenced below, please view our June 14 Budget Action Bulletin.

Human Services Omnibus (AB 1811)

The Legislature adopted the Human Services Omnibus trailer bill on Monday, June 18 by votes of 61-14 in the Assembly and 28-6 in the Senate. The bill has now been enrolled and presented to the Governor. AB 1811 contains the statutory changes needed to enact many of the major human services provisions that were included in the Budget Act. This includes language to provide Continuum of Care Reform (CCR) payments at time of placement, increase CalWORKs grants, end the SSI Cash-Out with a hold harmless, and establish the Home Safe program.

No Place Like Home (AB 1827/SB 861)

AB 1827 would place the No Place Like Home program on the November statewide ballot. But after Senator John Moorlach rasied concerns with the bill’s provision to allow the Legislature to change NPLH and related Mental Health Services Act funding with only a majority vote, the bill was amended yesterday to strike the majority vote provision and replace it with the standard two-thirds vote for statute enacted via initiative. The Senate Budget and Fiscal Review Committee will hear AB 1827 as amended on June 25.

Health (AB 1810)

The Health trailer bill did not include any changes to the 340B Drug Discount Purchasing Program.

CSAC Opposes Bill That Erodes Local Authority

CSAC moved to an oppose position this week on AB 2293, a bill by Assembly Member Eloise Gómez Reyes that would erode the hiring and disciplinary authority of county emergency medical services (EMS) medical directors by requiring counties to certify applicants with serious criminal offenses as Emergency Medical Technicians (EMTs) and paramedics. The Senate Health Committee will hear AB 2293 on June 27. View the CSAC opposition letter here.

Bill on Funding Flexibility Garners County Support

CSAC is pleased to support AB 2821, a bill sponsored by Riverside County and authored by Assembly Member Chad Mayes. The bill would grant counties that operate an integrated health and human services system more flexibility in spending 2011 Realignment revenues to meet their residents’ needs, and it was amended on June 11 to apply to all counties upon approval by the California Health and Human Services Agency.

Assembly Bill 2821 grants additional flexibility between the 2011 Realignment Support Services and Mental Health Accounts. The guiding principle of 2011 Realignment was the integration of services across the behavioral health, human services, and criminal justice systems, and AB 2821 will further this ideal by increasing funding flexibility among services such as foster care, child welfare services, and the specialty mental health and substance use disorder systems. The Senate Human Services Committee will hear the bill on June 26. View the CSAC letter of support here.

Bill Creates Youth Addiction Treatment System

CSAC is pleased to support SB 275, which was recently amended by Senator Anthony Portantino to help create a high-quality, safe, and comprehensive substance use disorder (SUD) treatment system for children and youth.

California currently has very little to offer in the way of treatment for children and youth, despite current federal law requiring SUD services for young people. Senator Portantino’s SB 275, which is sponsored by the American Society of Addiction Medicine, would require the state to take the first steps in creating such a system.

Specifically, SB 275 would:

Convene an Expert Panel: Section 11759.10 outlines the mission and membership of a new expert panel to guide the creation of youth SUD services in California. Counties appreciate the inclusion of county behavioral health directors, county social services directors, and county probation chiefs on this panel. Each of these county departments plays a role in serving children and youth, especially those with severe mental illness, substance use disorders, and those who may be involved with the foster care or juvenile justice systems. These county representatives will add on-the-ground experience and guidance to help inform the expert panel and to benefit all youth in need of substance use disorder treatment.

Require Outcomes and Oversight: Section 11759.20 requires the Department of Health Care Services to create and adopt regulations to establish youth SUD treatment, early intervention, and prevention services, as well as standards for quality based on the recommendations of the expert panel. SB 275 also requires robust outcome reporting and oversight for entities providing substance use disorder services to youth.

Require Counties to Designate an Agency: Section 1159.30 requires each county to designate an agency to administer and/or operate a youth SUD continuum. While counties believe that it is clear that our behavioral health departments, which already operate the adult SUD continuum, are the proper agency at the local level to administer youth substance use disorder services, this section of the bill ensures that each county will designate a county agency that has the most experience with SUD treatment and best meets the unique needs of their residents.

Ensure Quality for Youth SUD Services Providers: Section 1159.40 indicates that counties and providers of public youth SUD services must at least hold state licensure to ensure quality care and oversight. Counties agree with Senator Portantino that county agencies are the correct entities with the experience and resources to help implement a youth substance use disorder system. Under Sb 275, counties may achieve the implementation of safe, quality, evidence-based youth SUD services in a variety of ways, including operating county facilities and/or contracting with licensed providers for these services. This section of SB 275 allows counties the flexibility to work with existing providers, new providers, and a variety of health care partners such as federally qualified health care clinics and short-term residential therapeutic programs (STRTPs), as long as they are a licensed entity. This provision is crafted to ensure that all youth SUD providers are quality providers and not just fly-by-night entities motivated by profit, such as those that attempt to operate in the adult SUD treatment market. Our members are not willing to entrust our most vulnerable children and youth with unlicensed providers.

The Assembly Health Committee will hear SB 275 on June 26. View the CSAC letter of support here.