HomeMy WebLinkAboutMINUTES - 03012011 - C.76RECOMMENDATION(S):
REFER SB 662 (DeSaulnier): Integrated Health and Human Services Program to the
Legislation Committee for consideration, as recommended by the County Administrator.
FISCAL IMPACT:
Unknown. The Placer County model of integrating child welfare, mental health, probation,
and education case management "has
resulted in significant efficiencies and improved outcomes reducing the recurrence of abuse
and neglect."
BACKGROUND:
From time to time, Senator DeSaulnier has discussed with Supervisor Gioia the
development of an integrated health and human services program for Contra Costa County.
On February 18, 2011, Senator DeSaulnier introduced a bill, SB 662, to implement such a
program, modelled after a bill that was developed last year for Placer County, AB 2039
(Logue). (AB 2039 was crafted to make permanent a pilot program for Placer County. It
was vetoed by the Governor, who stated in his veto message, "I do not believe it is
appropriate to permanently extend this program without some ability to periodically evaluate
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 03/01/2011 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I Supervisor
Gayle B. Uilkema, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
Federal D. Glover, District V
Supervisor
Contact: Lara DeLaney,
925-335-1097
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board
of Supervisors on the date shown.
ATTESTED: March 1, 2011
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C.76
To:Board of Supervisors
From:David Twa, County Administrator
Date:March 1, 2011
Contra
Costa
County
Subject:SB 662 (DeSaulier): Integrated Health and Human Services Program
its usefulness and effectiveness.")
Existing law authorizes Humboldt County, Mendocino County, Alameda County, and any
additional county or counties, as determined by the Secretary of California Health and
Human Services, to implement, prior to January 1, 2009, a similar pilot program as Placer
County, with requirements for evaluation but with no sunset date.
AB 2039 would have made permanent Placer County's authority for operating its pilot
program to integrate the funding and delivery of services and benefits for the county health
and human services system. The author of the bill stated that in 1996, a pilot program in
Placer County was authorized (SB 1846 (Leslie), Chapter 899, Statutes of 1996) to address
the uncoordinated, separately funded, and narrowly-targeted categorical programs of the
child welfare, probation, and mental health systems, which did not address the broader
needs of children and families.
According to the author, the statute allowed Placer County to create a county child and
family services fund that implemented the California Blue Ribbon Commission's goal of
building an integrated service model for children in multiple service sectors, and also
provided the mechanism to request waivers of regulations and policies to support these
integration efforts. The author noted that Placer County has utilized the statutory authority to
do the following:
BACKGROUND: (CONT'D)
Implement a single, integrated service-planning approach which utilizes child welfare,
mental health, probation and others to have one universal case with a team approach,
rather than one case and one plan in each system.
Authorize the county office of education to operate a school program in the county's
emergency shelter to facilitate a team-based approach to child welfare and education.
Develop and implement a strengths-based outcome tool based on the family's
assessment of its strengths, rather than on the historically determined "sickness" of
the child or parent.
Consolidate claiming for multiple public health programs into one universal
approach.
The author noted that many families that enter the foster care system have multiple issues
that affect the environment for the child, including risk of abuse and neglect, mental
health and substance abuse issues, probation, courts, etc. The author believed the pilot
program had achieved excellent outcomes, including improved service delivery to
children and families, reduced demand for services, and a seamless integrated program
model, in addition to other efficiencies.
According to committee analyses of the first extension of the pilot in 2001, the evaluation
of the pilot, funded by Placer County and completed in July 2000 by the Public Health
Institute, focused primarily on the effectiveness of the pilot program implementation
process and the adjustments necessary to produce desired outcomes in the future. The
evaluation also included recommendations intended to be useful to the state and other
counties in the process of developing similar integrated and coordinated health and
human service delivery systems.
The evaluation included several suggestions for future program operation, none of which
were included in the legislation to extend the sunset. Examples included the creation of
clear communication linkages with the state, increased funding for the development of
consolidated information systems, the creation of a common set of accountability
measures to assist with evaluation efforts, and state-supported training and technical
assistance for county administrators and staff.
According to Placer County Board of Supervisors, the sponsor of the measure, the
County has successfully implemented a family-centered and needs-based model of
services to children and families, including blending the child welfare, mental health,
probation, and education services into a single team approach. The County states the
Placer model of integrating child welfare, mental health, probation, and education case
management has resulted in significant efficiencies and improved outcomes reducing the
recurrence of abuse and neglect. Placer County notes that, since 2005, the integrated
approach has resulted in a 20 percent reduction in the number of children needing to enter
foster care and contributed to more than 100 children finding stable, loving homes with
adoptive parents. The County also notes that it has implemented consolidated claiming of
14 public health programs into one claim, reducing administrative complexity and
prioritizing service delivery to residents.
The California State Association of Counties wrote that the bill would allow Placer
County's nationally-recognized and proven approach to health and human services
claiming and service delivery to operate indefinitely, which would save both the state and
county money, and also ensure the health and welfare of the county's most vulnerable
residents.
The California Medical Association (CMA) wrote that the bill would assist Placer
Nevada County Medical Society members to effectively utilize state and federal funding
streams for an array of services that benefit Placer and Nevada county residents.
Related/prior legislation
AB 1859 (Leslie), Chapter 268, Statutes of 2006, extended Placer County's pilot program
five years to July 1, 2011.
AB 392 (Chan) of 2005 permits any county, with the assistance and participation of the
appropriate state departments, to implement a program for the funding and delivery of
services and benefits through an integrated and comprehensive county health and human
services system, as specified. Provisions were amended out of the bill.
AB 308 (Leslie), Chapter 17, Statutes of 2001, extended Placer County's pilot program
five years to July 1, 2006.
AB 1259 (Strom-Martin), Chapter 705, Statutes of 1999, gave specific authority to
Alameda, Humboldt, and Mendocino Counties, to operate an integration pilot similar to
Placer County's.
AB 866 (Thomson), Chapter 265, Statutes of 1997, gave specific authority to Solano
County to operate an integration pilot similar to Placer County's.
SB 1846 (Leslie), Chapter 899, Statutes of 1996, authorized Placer County's pilot
program to integrate the funding and delivery of services and benefits for the county
health and human services system.
POSITIONS
Support:
Placer County Board of Supervisors (sponsor)
California Medical Association
California State Association of Counties
Child Abuse Prevention Center
County Health Executives Association of California
County Welfare Directors Association of California
Regional Council of Rural Counties
Oppose: None received
CONSEQUENCE OF NEGATIVE ACTION:
If this bill is not referred to a committee of the Board of Supervisors, there will be
opportunity for committee members to analyze and consider the bill prior to action by the
full Board.
CHILDREN'S IMPACT STATEMENT:
Not applicable.
ATTACHMENTS
SB 662 (DeSaulnier)