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TO: BOARD OF SUPERVISORS
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FROM: Nancy C. Fanden Contra
Costa
DATE: July 30 , 1985 County
SUBJECT: CALIFORNIA MENTAL HEALTH SERVICES REFORM ACT OF 1985
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
Recommendation: That the Board of Supervisors endorse
Assembly Bill 2541 , and request that the Governor include
full funding in this budget.
Background: Presently, AB 2541 has passed the Assembly and
is before the Senate Health and Human Services Committee.
The Mental Health Subcommittee will hear it August 20th and
the full committee the 21st.
The Governor has -shown support for AB 2541 by including 20
million dollars in his proposed budget. The Bill as
written, includes 38 million. Certainly a small sum when
you consider that 40% of the homeless are estimated to be
severely mentally ill, and would be hospitalized if the
State hospitals had not been closed. All including the
incarcerated would benefit.
See the attached summary for details.
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CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON _ ___July 30 , 1985 APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
X UNANIMOUS (ABSENT III ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
CC: Health Services Director ATTESTED July. 30, 1985
CountyAdministrator Phil Batchelor,Clerk of the 8oev* -'
Supervisor Fanden i Supervisors and
County Administrator
M382/7-83 BY - DEPUTY
May 9, 1985
CALIFORNIA M .TAL HEALTH SERVICES REFORM ACT OF 1985
-- SUMMARY-- 'g
Assembly Bill 2541 by Assemblymembers Bruce Bronzan (D-Fresno)
and Sunny Mojonnier (R-Encinitas) is a major mental health reform -
act that establishes system priorities and creates innovative
ways to serve the most severely ill adults and children.
The legislation is the product of the Assembly Select Committee
on Mental Health's year-long study 'of mental health care in
California. It is coauthored by the. other members of the Select
Committee as well as a growing number of other interested
legislators and embodies the, panel's major findings and
conclusions.
AB 2541 addresses the state's historic pledge to provide
community-based care to the mentally ill , especially the types of
people who used to be institutionalized in the large state menta?
hospitals. Tragically, severely mentally ill people today
comprise an estimated 40% of the homeless in this state. r
Coming after many years of legislative inattention to mental
health, this bill provides the framework from which to create a
significantly improved and better organized system of care for
the mentally ill. However, it will take many years of continued
legislative interest to bring the state's mental health system to
the level where it belongs.
AB 2541 creates an innovative program to provide basic social
services (housing, food, clothing) to the chronic mentally
ill--the people once housed in state mental hospitals but now
left in the community to fend for themselves. The goals of these
new "social support agencies* would be achieved through ac-t e
.local outreach to these people (many of whom are now ma Bless)
redesigned financial structures to collect the Fede al an s ate
monies due these .people, and ongoing. advocacy on a con Inuous
basis to help the clients survive in the community whichh -m- ay
include help to obtain mental health and other social services as-
appropriate for their individual needs.
AB 2r41 places the county mental health officials at the center
of decision-making about how and where to care for seriously
emotionally disturbed children and adolescents. Currently, when
a child is identified as being seriously emotionally disturbed
and in need of some' special placement, a multi-agency "ping-pong"
process takes place, often without the input of mental health
officials. This bill requires the county mental health director
to be: notified whenever a child is first identified as having a
serious mental health problem, whether the child was first seen
in the schools or was a ward of the courts, or juvenile justice,
or social services.
AB 2541 further requires county mental health departments to plan
fc-- the development of a local system to address the needs of
seriously emotionally disturbed children and their families.
AB 2541 directs the Department of Mental Health to provide a
subsidy to the board and care rate for mentally ill clients.
Unlike the rate structure for developmentally disabled clients,
the rate for the mentally ill is simply the basic SSI/SSP. This
provision is identical to legislation being carried by Senator
Petris, SB 155.
AP 2541 provides funds to counties to divert the mentally ill
petty offenders from inappropriate placement in local jails and
to expand the mental health treatment being, provided in the
jails. In the absence of these programs, many mentally ill are
jail
for nuisance offenses when the best thing for them
and for the community would be mental health treatment.
AB 2541 addresses the important issue of how to care for mentally
ill criminal offenders after they come out of prison.
Specifically, the hill creates a pilot project which allows the
Department of Corrections to place up to 100 parolees in ,
intensive mental treatment and supervision services to help them
make the transition back to the community and to reduce the rate
of reoffense.
AB 2541 provides funding to counties to develop outreach and
services, ,to the isolated elderly. The elderly are often
reluctant to travel to clinics or are too frail to leave their
homes.
AB 2541 over three years increases the mental health dollars
allocated to those counties now receiving less .than their fair
:share of the state total. Currently, funds are distributed based
on historical circumstances and political factors. As a result
manv counties now receive far below what they need to serve their
residents.
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In addition t*o the areas discussed above, this bill does the
following:
1) Expands peer-counseling of Vietnam veterans
2) Promotes self-help groups for mental health clients
3) Provides for treatment of juvenile sex offenders and victims,
4) Develops new public school curriculum on preventing suicide
and incl-dde information on mental illness,
5) Improves Medi-Cal reimbursements for children's' services
6) Determines the number and mental health needs of mentally ill
prison inmates
7) Creates a Special Task Force on Quality of Care to assess
services and needs
8) Provides state funding of research about mental illnesS7
9) Expands Medi-Cal coverage of outpatient care
In total, the bill appropriates over 53 million dollars over
three years. This money would fund programs which address the
needs of the identified priority populations and reduce the
funding inequity between counties. Additional costs associated
with the proposed system reforms and changes will need to be
funded in the statementalhealth budget.
Beginning this year and continuing each year thereafter, funds
should be increased until the system receives the resources it
must have to serve the people of this state.
Growing political interest, expanded media coverage and the
Governor's interest have substantially brightened the outlook for
- improving the mental health system.
The needs of our state's mentally ill citizens will not be met
with one bill or one appropriation. What this bill does is
reassert a state lbadership role in developing sound mental
health policy. While it will take many years to achieve all the
goals for an improved system we can begin now to put the house in
order, to chart a clear course, and to start building for a much
better future.
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