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MENTAL HEALTH SERVICES ACT
SECTION 1. Title
This Act shall be known and may be cited as the ?Mental Health Services Act.?
SECTION 2. Findings and Declarations
The People of the State of California hereby find and declare all of the following:
(a) Mental illnesses are extremely common; they affect almost every family in California.
They affect people from every background and occur at any age. In any year, between 5%
and 7% of adults have a serious mental illness as do a similar percentage of children ?
between 5% and 9%. Therefore, more than two million children, adults and seniors in
California are affected by a potentially disabling mental illness every year. People who
become disabled by mental illness deserve the same guarantee of care already extended to
those who face other kinds of disabilities.
(b) Failure to provide timely treatment can destroy individuals and families. No parent should
have to give up custody of a child and no adult or senior should have to become disabled or
homeless to get mental health services as too often happens now. No individual or family
should have to suffer inadequate or insufficient treatment due to language or cultural
barriers to care. Lives can be devastated and families can be financially ruined by the costs
of care. Yet, for too many Californians with mental illness, the mental health services and
supports they need remain fragmented, disconnected and often inadequate, frustrating the
opportunity for recovery.
(c) Untreated mental illness is the leading cause of disability and suicide and imposes high
costs on state and local government. Many people left untreated or with insufficient care
see their mental illness worsen. Children left untreated often become unable to learn or
participate in a normal school environment. Adults lose their ability to work and be
independent; many become homeless and are subject to frequent hospitalizations or jail.
State and county governments are forced to pay billions of dollars each year in emergency
medical care, long-term nursing home care, unemployment, housing, and law enforcement,
including juvenile justice, jail and prison costs.
(d) In a cost cutting move 30 years ago, California drastically cut back its services in state
hospitals for people with severe mental illness. Thousands ended up on the streets homeless
and incapable of caring for themselves. Today thousands of suffering people remain on our
streets because they are afflicted with untreated severe mental illness. We can and should
offer these people the care they need to lead more productive lives.
(e) With effective treatment and support, recovery from mental illness is feasible for most
people. The State of California has developed effective models of providing services to
children, adults and seniors with serious mental illness. A recent innovative approach,
begun under Assembly Bill 34 in 1999, was recognized in 2003 as a model program by the
President?s Commission on Mental Health. This program combines prevention services
with a full range of integrated services to treat the whole person, with the goal of selfsufficiency
for those who may have otherwise faced homelessness or dependence on the
state for years to come. Other innovations address services to other underserved
populations such as traumatized youth and isolated seniors. These successful programs,
including prevention, emphasize client-centered, family focused and community-based
services that are culturally and linguistically competent and are provided in an integrated
services system.
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(f) By expanding programs that have demonstrated their effectiveness, California can save
lives and money. Early diagnosis and adequate treatment provided in an integrated service
system is very effective; and by preventing disability, it also saves money. Cutting mental
health services wastes lives and costs more. California can do a better job saving lives and
saving money by making a firm commitment to providing timely, adequate mental health
services.
(g) To provide an equitable way to fund these expanded services while protecting other vital
state services from being cut, very high-income individuals should pay an additional one
percent of that portion of their annual income that exceeds one million dollars
($1,000,000). About 1/10 of one percent of Californians have incomes in excess of one
million dollars ($1,000,000). They have an average pre-tax income of nearly five million
dollars ($5,000,000). The additional tax paid pursuant to this represents only a small
fraction of the amount of tax reduction they are realizing through recent changes in the
federal income tax law and only a small portion of what they save on property taxes by
living in California as compared to the property taxes they would be paying on multimillion
dollar homes in other states.
SECTION 3. Purpose and Intent.
The People of the State of California hereby declare their purpose and intent in enacting this Act
to be as follows:
(a) To define serious mental illness among children, adults and seniors as a condition
deserving priority attention, including prevention and early intervention services and
medical and supportive care.
(b) To reduce the long-term adverse impact on individuals, families and state and local budgets
resulting from untreated serious mental illness.
(c) To expand the kinds of successful, innovative service programs for children, adults and
seniors begun in California, including culturally and linguistically competent approaches
for underserved populations. These programs have already demonstrated their
effectiveness in providing outreach and integrated services, including medically necessary
psychiatric services, and other services, to individuals most severely affected by or at risk
of serious mental illness.
(d) To provide state and local funds to adequately meet the needs of all children and adults
who can be identified and enrolled in programs under this measure. State funds shall be
available to provide services that are not already covered by federally sponsored programs
or by individuals? or families? insurance programs.
(e) To ensure that all funds are expended in the most cost effective manner and services are
provided in accordance with recommended best practices subject to local and state
oversight to ensure accountability to taxpayers and to the public.
SECTION 4. Part 3.6 (commencing with Section 5840) is added to Division 5 of the Welfare
and Institutions Code, to read:
PART 3.6 PREVENTION AND EARLY INTERVENTION PROGRAMS
5840. (a) The Department of Mental Health shall establish a program designed to prevent
mental illnesses from becoming severe and disabling. The program shall
emphasize improving timely access to services for underserved populations.
(b) The program shall include the following components:
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(1) Outreach to families, employers, primary care health care providers, and
others to recognize the early signs of potentially severe and disabling
mental illnesses.
(2) Access and linkage to medically necessary care provided by county mental
health programs for children with severe mental illness, as defined in
Section 5600.3, and for adults and seniors with severe mental illness, as
defined in Section 5600.3, as early in the onset of these conditions as
practicable.
(3) Reduction in stigma associated with either being diagnosed with a mental
illness or seeking mental health services.
(4) Reduction in discrimination against people with mental illness.
(c) The program shall include mental health services similar to those provided under
other programs effective in preventing mental illnesses from becoming severe,
and shall also include components similar to programs that have been successful
in reducing the duration of untreated severe mental illnesses and assisting people
in quickly regaining productive lives.
(d) The program shall emphasize strategies to reduce the following negative
outcomes that may result from untreated mental illness:
(1) Suicide.
(2) Incarcerations.
(3) School failure or dropout.
(4) Unemployment.
(5) Prolonged suffering.
(6) Homelessness.
(7) Removal of children from their homes.
(e) In consultation with mental health stakeholders, the department shall revise the
program elements in Section 5840 applicable to all county mental health
programs in future years to reflect what is learned about the most effective
prevention and intervention programs for children, adults, and seniors.
5840.2 (a) The department shall contract for the provision of services pursuant to this part
with each county mental health program in the manner set forth in Section 5897.
SECTION 5. Article 11 (commencing with Section 5878.1) is added to Chapter 1 of Part 4 of
Division 5 of the Welfare and Institutions Code, to read:
Article 11. Services for Children with Severe Mental Illness.
5878.1 (a) It is the intent of this article to establish programs that assure services will be
provided to severely mentally ill children as defined in Section 5878.2 and that
they be part of the children?s system of care established pursuant to this Part. It
is the intent of this Act that services provided under this Chapter to severely
mentally ill children are accountable, developed in partnership with youth and
their families, culturally competent, and individualized to the strengths and
needs of each child and their family.
(b) Nothing in this Act shall be construed to authorize any services to be provided
to a minor without the consent of the child?s parent or legal guardian beyond
those already authorized by existing statute.
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5878.2 For purposes of this article, severely mentally ill children means minors under
the age of 18 who meet the criteria set forth in subdivision (a) of Section
5600.3.
5878.3 (a) Subject to the availability of funds as determined pursuant to Part 4.5, county
mental health programs shall offer services to severely mentally ill children for
whom services under any other public or private insurance or other mental
health or entitlement program is inadequate or unavailable. Other entitlement
programs include but are not limited to mental health services available
pursuant to MediCal, child welfare, and special education programs. The
funding shall cover only those portions of care that cannot be paid for with
public or private insurance, other mental health funds or other entitlement
programs.
(b) Funding shall be at sufficient levels to ensure that counties can provide each
child served all of the necessary services set forth in the applicable treatment
plan developed in accordance with this Part, including services where
appropriate and necessary to prevent an out of home placement, such as
services pursuant to Chapter 4 of Part 6 of Division 9 (commencing with
Section 18250).
(c) The Department of Mental Health shall contract with county mental health
programs for the provision of services under this article in the manner set forth
in Section 5897.
SECTION 6. Section 18257 is added to the Welfare and Institutions Code to read as follows:
18257. (a) The Department of Social Services shall seek applicable federal approval to make the
maximum number of children being served through such programs eligible for
federal financial participation and amend any applicable state regulations to the
extent necessary to eliminate any limitations on the numbers of children who can
participate in these programs.
(b) Funds from the Mental Health Services Fund shall be made available to the
Department of Social Services for technical assistance to counties in establishing and
administering projects. Funding shall include reasonable and necessary
administrative costs in establishing and administering a project pursuant to this
chapter and shall be sufficient to create an incentive for all counties to seek to
establish programs pursuant to this chapter.
SECTION 7. Section 5813.5 is added to Part 3 of Division 5 of the Welfare and Institutions
Code, to read:
5813.5. Subject to the availability of funds from the Mental Health Services Fund, the
Department of Mental Health shall distribute funds for the provision of services under
Sections 5801, 5802 and 5806 to county mental health programs. Services shall be
available to adults and seniors with severe illnesses who meet the eligibility criteria in
Welfare and Institutions Code Section 5600.3(b) and (c). For purposes of this act,
seniors means older adult persons identified in Part 3.
(a) Funding shall be provided at sufficient levels to ensure that counties can provide
each adult and senior served pursuant to this Part with the medically necessary
mental health services, medications and supportive services set forth in the
applicable treatment plan.
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(b) The funding shall only cover the portions of those costs of services that cannot be
paid for with other funds including other mental health funds, public and private
insurance, and other local, state and federal funds.
(c) Each county mental health programs plan shall provide for services in
accordance with the system of care for adults and seniors who meet the eligibility
criteria in Section 5600.3(b) and (c).
(d) Planning for services shall be consistent with the philosophy, principles, and
practices of the Recovery Vision for mental health consumers:
(1) To promote concepts key to the recovery for individuals who have mental
illness: hope, personal empowerment, respect, social connections, selfresponsibility,
and self-determination.
(2) To promote consumer-operated services as a way to support recovery.
(3) To reflect the cultural, ethnic and racial diversity of mental health consumers.
(4) To plan for each consumer?s individual needs.
(e) The plan for each county mental health program shall indicate, subject to the
availability of funds as determined by Part 4.5, and other funds available for
mental health services, adults and seniors with a severe mental illness being
served by this program are either receiving services from this program or have a
mental illness that is not sufficiently severe to require the level of services
required of this program.
(f) Each county plan and annual update pursuant to Section 5847 shall consider
ways to provide services similar to those established pursuant to the Mentally Ill
Offender Crime Reduction Grant Program. Funds shall not be used to pay for
persons incarcerated in state prison or parolees from state prisons.
(g) The department shall contract for services with county mental health programs
pursuant to Section 5897. After the effective date of this section the term grants
referred to in Sections 5814 and 5814.5 shall refer to such contracts.
SECTION 8. Part 3.1 is hereby added to Division 5 of the Welfare and Institutions Code
commencing with Section 5820 to read:
PART 3.1 EDUCATION AND TRAINING PROGRAM
5820. (a) It is the intent of this Part to establish a program with dedicated funding to
remedy the shortage of qualified individuals to provide services to address severe
mental illnesses.
(b) Each county mental health program shall submit to the department a needs
assessment identifying its shortages in each professional and other occupational
category in order to increase the supply of professional staff and other staff that
county mental health programs anticipate they will require in order to provide the
increase in services projected to serve additional individuals and families
pursuant to Parts 3, 3.2, 3.6, and 4 of this Division. For purposes of this Part,
employment in California?s public mental health system includes employment in
private organizations providing publicly funded mental health services.
(c) The department shall identify the total statewide needs for each professional and
other occupational category and develop a five-year education and training
development plan.
(d) Development of the first five-year plan shall commence upon enactment of the
initiative. Subsequent plans shall be adopted every five years.
(e) Each five-year plan shall be reviewed and approved by the California Mental
Health Planning Council.
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5821. (a) The Mental Health Planning Council shall advise the Department of Mental
Health on education and training policy development and provide oversight for
the department?s education and training plan development.
(b) The Department of Mental Health shall work with the California Mental Health
Planning Council so that council staff is increased appropriately to fulfill its
duties required by Sections 5820 and 5821.
5822. The Department of Mental Health shall include in the five-year plan:
(a) Expansion plans for the capacity of postsecondary education to meet the needs of
identified mental health occupational shortages.
(b) Expansion plans for the forgiveness and scholarship programs offered in return for
a commitment to employment in California?s public mental health system and
make loan forgiveness programs available to current employees of the mental
health system who want to obtain Associate of Arts, Bachelor of Arts, Masters
Degrees, or Doctoral degrees.
(c) Creation of a stipend program modeled after the federal Title IV-E program for
persons enrolled in academic institutions who want to be employed in the mental
health system.
(d) Establishment of regional partnerships among the mental health system and the
educational system to expand outreach to multicultural communities, increase the
diversity of the mental health workforce, to reduce the stigma associated with
mental illness, and to promote the use of web-based technologies, and distance
learning techniques.
(e) Strategies to recruit high school students for mental health occupations, increasing
the prevalence of mental health occupations in high school career development
programs such as health science academies, adult schools, and regional occupation
centers and programs, and increasing the number of human service academies.
(f) Curriculum to train and retrain staff to provide services in accordance with the
provisions and principles of Parts 3, 3.2, 3.6, and 4.
(g) Promotion of the employment of mental health consumers and family
members in the mental health system.
(h) Promotion of the meaningful inclusion of mental health consumers and
family members and incorporating their viewpoint and experiences in the
training and education programs in subdivisions (a) through (f).
(i) Promotion of the inclusion of cultural competency in the training and education
programs in subdivisions (a) through (f).
SECTION 9. Part 3.2 Commencing with Section 5830 is added to Division 5 of the Welfare
and Institutions Code to read:
Part 3.2 Innovative Programs
5830. County mental health programs shall develop plans for innovative programs to be funded
pursuant to paragraph (6) of subdivision (a) of Section 5892.
(a) The innovative programs shall have the following purposes:
(1) To increase access to underserved groups.
(2) To increase the quality of services, including better outcomes.
(3) To promote interagency collaboration.
(4) To increase access to services.
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(b) County mental health programs shall receive funds for their innovation programs
upon approval by the Mental Health Oversight and Accountability Commission.
SECTION 10. Part 3.7 (commencing with Section 5845) is added to Division 5 of the Welfare
and Institutions Code to read:
PART 3.7. OVERSIGHT AND ACCOUNTABILITY
5845. (a) The Mental Health Services Oversight and Accountability Commission is hereby
established to oversee Part 3, the Adults and Older Adults Systems of Care Act;
Part 3.1, Human Resources; Part 3.2, Innovative Programs; Part 3.6, Prevention
and Early Intervention Programs; and Part 4, the Children?s Mental Health
Services Act. The Commission shall replace the advisory committee established
pursuant to Section 5814. The Commission shall consist of 16 voting members
as follows:
(1) The Attorney General or his or her designee.
(2) The Superintendent of Public Instruction or his or her designee.
(3) The Chairperson of the Senate Health and Human Services Committee or
another member of the Senate selected by the President pro Tempore of the
Senate.
(4) The Chairperson of the Assembly Health Committee or another member of
the Assembly selected by the Speaker of the Assembly.
(5) Two persons with a severe mental illness, a family member of an adult or
senior with a severe mental illness, a family member of a child who has or
has had a severe mental illness, a physician specializing in alcohol and
drug treatment, a mental health professional, a county Sheriff, a
Superintendent of a school district, a representative of a labor organization,
a representative of an employer with less than 500 employees and a
representative of an employer with more than 500 employees, and a
representative of a health care services plan or insurer, all appointed by the
Governor. In making appointments, the Governor shall seek individuals
who have had personal or family experience with mental illness.
(b) Members shall serve without compensation, but shall be reimbursed for all actual
and necessary expenses incurred in the performance of their duties.
(c) The term of each member shall be three years, to be staggered so that
approximately one-third of the appointments expire in each year.
(d) In carrying out its duties and responsibilities, the Commission may do all of the
following:
(1) Meet at least once each quarter at any time and location convenient to the
public as it may deem appropriate. All meetings of the Commission shall
be open to the public.
(2) Within the limit of funds allocated for these purposes, pursuant to the laws
and regulations governing state civil service, employ staff, including any
clerical, legal, and technical assistance as may appear necessary.
(3) Establish technical advisory committees such as a committee of consumers
and family members.
(4) Employ all other appropriate strategies necessary or convenient to enable it
to fully and adequately perform its duties and exercise the powers
expressly granted, notwithstanding any authority expressly granted to any
officer or employee of state government.
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(5) Develop strategies to overcome stigma and accomplish all other objectives
of Parts 3.2, 3.6 and the other provisions of the Act establishing this
Commission.
(6) At any time, advise the Governor or the Legislature regarding actions the
state may take to improve care and services for people with mental illness.
(7) If the Commission identifies a critical issue related to the performance of a
county mental health program, it may refer the issue to the Department of
Mental Health pursuant to Section 5655.
5846. (a) The Commission shall annually review and approve each county mental health
program for expenditures pursuant to Parts 3.2 for Innovative Programs and Part
3.6 for Prevention and Early Intervention.
(b) The department may provide technical assistance to any county mental health plan
as needed to address concerns or recommendations of the Commission or when
local programs could benefit from technical assistance for improvement of their
plans submitted pursuant to Section 5847.
(c) The Commission shall ensure that the perspective and participation of members
and others suffering from severe mental illness and their family members is a
significant factor in all of its decisions and recommendations.
5847. Integrated Plans for Prevention, Innovation and System of Care Services.
(a) Each county mental health program shall prepare and submit a three year plan
which shall be updated at least annually and approved by the department after
review and comment by the Oversight and Accountability Commission. The plan
and update shall include all of the following:
(1) A program for prevention and early intervention in accordance with Part 3.6.
(2) A program for services to children in accordance with Part 4 to include a
program pursuant to Chapter 6 of Part 4 of Division 9 commencing with
Section 18250 or provide substantial evidence that it is not feasible to
establish a wrap-around program in that county.
(3) A program for services to adults and seniors in accordance with Part 3.
(4) A program for Innovations in accordance with Part 3.2.
(5) A program for technological needs and capital facilities needed to provide
services pursuant to Parts 3, 3.6 and 4. All plans for proposed facilities with
restrictive settings shall demonstrate that the needs of the people to be served
cannot be met in a less restrictive or more integrated setting.
(6) Identification of shortages in personnel to provide services pursuant to the
above programs and the additional assistance needed from the Education and
Training Programs established pursuant to Part 3.1.
(7) Establishment and maintenance of a prudent reserve to ensure the county
program will continue to be able to serve children, adults and seniors that it is
currently serving pursuant to Parts 3 and 4 during years in which revenues
for the Mental Health Services Fund are below recent averages adjusted by
changes in the state population and the California Consumer Price Index.
(b) The department?s review and approval of the programs specified in paragraphs (1)
and (4) shall be limited to ensuring the consistency of such programs with the other
portions of the plan and providing review and comment to the Mental Health
Services Oversight and Accountability Commission.
(c) The programs established pursuant to paragraphs (2) and (3) of subdivision (a)
shall include services to address the needs of transition age youth ages 16 to 25.
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(d) Each year the Department of Mental Health shall inform counties of the amounts of
funds available for services to children pursuant to Part 4 and to adults and seniors
pursuant to Part 3. Each county mental health program shall prepare expenditure
plans pursuant to Parts 3 and 4 and updates to the plans developed pursuant to this
Section. Each expenditure update shall indicate the number of children, adults and
seniors to be served pursuant to Parts 3 and 4 and the cost per person. The
expenditure update shall include utilization of unspent funds allocated in the
previous year and the proposed expenditure for the same purpose.
(e) The department shall evaluate each proposed expenditure plan and determine the
extent to which each county has the capacity to serve the proposed number of
children, adults and seniors pursuant to Parts 3 and 4; the extent to which there is
an unmet need to serve that number of children, adults and seniors; and determine
the amount of available funds; and provide each county with an allocation from the
funds available. The department shall give greater weight for a county or a
population which has been significantly underserved for several years.
(f) A county mental health program shall include an allocation of funds from a reserve
established pursuant to paragraph (6) of subdivision (a) for services pursuant to
paragraphs (2) and (3) of subdivision (a) in years in which the allocation of funds
for services pursuant to subdivision (c) are not adequate to continue to serve the
same number of individuals as the county had been serving in the previous fiscal
year.
5848. (a) Each plan and update shall be developed with local stakeholders including adults
and seniors with severe mental illness, families of children, adults and seniors with
severe mental illness, providers of services, law enforcement agencies, education,
social services agencies and other important interests. A draft plan and update shall
be prepared and circulated for review and comment for at least 30 days to
representatives of stakeholder interests and any interested party who has requested
a copy of such plans.
(b) The mental health board established pursuant to Section 5604 shall conduct a
public hearing on the draft plan and annual updates at the close of the 30?day
comment period required by subsection (a). Each adopted plan and update shall
include any substantive written recommendations for revisions. The adopted plan
or update shall summarize and analyze the recommended revisions. The mental
health board shall review the adopted plan or update and make recommendations to
the county mental health department for revisions.
(c) The department shall establish requirements for the content of the plans. The plans
shall include reports on the achievement of performance outcomes for services
pursuant to Parts 3, 3.6 and 4 funded by the Mental Health Services Fund and
established by the department.
(d) Mental health services provided pursuant to Parts 3 and 4 shall be included in the
review of program performance by the California Mental Health Planning Council
required by Section 5772(c)(2) and in the local mental health board?s review and
comment on the performance outcome data required by Section 5604.2(a)(7).
Section 11. Section 5771.1 is added to the Welfare and Institutions Code to read:
5771.1 The members of the Mental Health Services Oversight and Accountability Commission
established pursuant to Section 5845 are members of the California Mental Health
Planning Council. They serve in an ex officio capacity when the Council is performing
its statutory duties pursuant to Section 5772. Such membership shall not affect the
composition requirements for the Council specified in Section 5771.
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SECTION 12. Section 17043 is added to the Revenue and Taxation Code to read:
17043. (a) For each taxable year beginning on or after January 1, 2005, in addition to any other
taxes imposed by this part, an additional tax shall be imposed at the rate of 1% on
that portion of a taxpayer?s taxable income in excess of one million dollars
($1,000,000).
(b) For purposes of applying Part 10.2 (commencing with Section 18401), the tax
imposed under this section shall be treated as if imposed under Section 17041.
(c) The following shall not apply to the tax imposed by this section:
(1) The provisions of Section 17039, relating to the allowance of credits.
(2) The provisions of Section 17041, relating to filing status and recomputation of
the income tax brackets.
(3) The provisions of Section 17045, relating to joint returns.
SECTION 13. Section 19602 of the Revenue and Taxation Code is amended to read:
19602. Except for amounts collected or accrued under Sections 17935, 17941, 17948, 19532,
and 19561, and revenues deposited pursuant to Section 19602.5, all moneys and
remittances received by the Franchise Tax Board as amounts imposed under Part 10
(commencing with Section 17001), and related penalties, additions to tax, and interest
imposed under this part, shall be deposited, after clearance of remittances, in the State
Treasury and credited to the Personal Income Tax Fund.
SECTION 14. Section 19602.5 is added to the Revenue and Taxation Code to read:
19602.5 (a) There is in the State Treasury the Mental Health Services Fund (MHS Fund). The
estimated revenue from the additional tax imposed under Section 17043 for the
applicable fiscal year, as determined under subparagraph (B) of paragraph (3) of
subdivision (c), shall be deposited to the MHS Fund on a monthly basis, subject to
an annual adjustment as described in this section.
(b) (1) Beginning with fiscal year 2004-2005 and for each fiscal year thereafter, the
Controller shall deposit on a monthly basis in the MHS Fund an amount equal to
the applicable percentage of net personal income tax receipts as defined in
paragraph (4).
(2) (A) Except as provided in subparagraph (B), the applicable percentage
referred to in paragraph (1) shall be 1.76 percent.
(B) For fiscal year 2004-2005, the applicable percentage shall be 0.70
percent.
(3) Beginning with fiscal year 2006-2007, monthly deposits to the MHS Fund
pursuant to this subdivision are subject to suspension pursuant to subdivision
(f).
(4) For purposes of this subdivision, ?net personal income tax receipts? refers to
amounts received by the Franchise Tax Board and the Employment
Development Department under the Personal Income Tax Law, as reported by
the Franchise Tax Board to the Department of Finance pursuant to law,
regulation, procedure, and practice (commonly referred to as the ?102 Report?)
in effect on the effective date of the Act establishing this section.
(c) No later than March 1, 2006, and each March 1st thereafter, the Department of
Finance, in consultation with the Franchise Tax Board, shall determine the annual
adjustment amount for the following fiscal year.
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(1) The ?annual adjustment amount? for any fiscal year shall be an amount equal
to the amount determined by subtracting the ?revenue adjustment amount?
for the applicable revenue adjustment fiscal year, as determined by the
Franchise Tax Board under paragraph (3), from the ?tax liability adjustment
amount? for applicable tax liability adjustment tax year, as determined by the
Franchise Tax Board under paragraph (2).
(2) (A) (i) The ?tax liability adjustment amount? for a tax year is equal to the
amount determined by subtracting the estimated tax liability
increase from the additional tax imposed under Section 17043 for
the applicable year under subparagraph (B) from the amount of the
actual tax liability increase from the additional tax imposed under
Section 17043 for the applicable tax year, based on the returns
filed for that tax year.
(ii) For purposes of the determinations required under this paragraph,
actual tax liability increase from the additional tax means the
increase in tax liability resulting from the tax of 1% imposed under
Section 17043, as reflected on the original returns filed by October
15th of the year after the close of the applicable tax year.
(iii) The applicable tax year referred to in this paragraph means the 12-
calendar month taxable year beginning on January 1st of the year
that is two (2) years before the beginning of the fiscal year for
which an annual adjustment amount is calculated.
(B) (i) The estimated tax liability increase from the additional tax for the
following tax years is:
Tax Year Estimated Tax Liability Increase from the Additional Tax
2005 $ 634 million
2006 $ 672 million
2007 $ 713 million
2008 $ 758 million
(ii) The ?estimated tax liability increase from the additional tax? for
the tax year beginning in 2009 and each tax year thereafter shall be
determined by applying an annual growth rate of seven (7) percent
to the ?estimated tax liability increase from additional tax? of the
immediately preceding tax year.
(3) (A) The ?revenue adjustment amount? is equal to the amount determined
by subtracting the ?estimated revenue from the additional tax? for the
applicable fiscal year, as determined under subparagraph (B), from the
actual amount transferred for the applicable fiscal year.
(B) (i) The ?estimated revenue from the additional tax? for the following
applicable fiscal years is:
Applicable Estimated Revenue From Additional Tax
Fiscal Year
2004-05 $ 254 million
2005-06 $ 683 million
2006-07 $ 690 million
2007-08 $ 733 million
(ii) The ?estimated revenue from the additional tax? for applicable
fiscal year 2007-08 and each applicable fiscal year thereafter shall
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be determined by applying an annual growth rate of 7 percent to
the ?estimated revenue from the additional tax? of the immediately
preceding applicable fiscal year.
(iii) The applicable fiscal year referred to in this paragraph means the
fiscal year that is two (2) years before the fiscal year for which an
annual adjustment amount is calculated.
(d) The Department of Finance shall notify the Legislature and the Controller of the
results of the determinations required under subdivision (c) no later than ten (10)
business days after the determinations are final.
(e) If the annual adjustment amount for a fiscal year is a positive number, the
Controller shall transfer that amount from the General Fund to the MHS Fund on
July 1 of that fiscal year.
(f) If the annual adjustment amount for a fiscal year is a negative number, the
Controller shall suspend monthly transfers to the MHS Fund for that fiscal year,
as otherwise required by paragraph (1) of subdivision (b), until the total amount
of suspended deposits for that fiscal year equals the amount of the negative
annual adjustment amount for that fiscal year.
SECTION 15. Part 4.5 (commencing with Section 5890) is added to Division 5 of the Welfare
and Institutions Code, to read:
PART 4.5. MENTAL HEALTH SERVICES FUND
5890. (a) The Mental Health Services Fund is hereby created in the State Treasury. The
Fund shall be administered by the department of Mental Health.
Notwithstanding Section 13340 of the Government Code, all monies in the Fund
are continuously appropriated to the Department, without regard to fiscal years,
for the purpose of funding the following programs and other related activities as
designated by other provisions of this Division:
(1) Part 3 commencing with Section 5800, the Adult and Older Adult System
of Care Act.
(2) Part 3.6 commencing with Section 5840, Prevention and Early Intervention
Programs.
(3) Part 4 commencing with Section 5850, the Children?s Mental Health
Services Act.
(b) Nothing in the establishment of this Fund, nor any other provisions of the Act
establishing it or the programs funded shall be construed to modify the obligation
of health care service plans and disability insurance policies to provide coverage
for mental health services, including those services required under Section
1374.72 of the Health and Safety Code and Section 10144.5 of the Insurance
Code, related to mental health parity. Nothing in this Act shall be construed to
modify the oversight duties of the Department of Managed Health Care or the
duties of the Department of Insurance with respect to enforcing such obligations
of plans and insurance policies.
(c) Nothing in this Act shall be construed to modify or reduce the existing authority
or responsibility of the Department of Mental Health.
(d) The Department of Health Services, in consultation with the Department of
Mental Health, shall seek approval of all applicable federal Medicaid approvals
to maximize the availability of federal funds and eligibility of participating
children, adults and seniors for medically necessary care.
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(e) Share of costs for services pursuant to Parts 3 and 4 shall be determined in
accordance with the Uniform Method for Determining Ability to Pay applicable
to other publicly funded mental health services, unless such Uniform Method is
replaced by another method of determining co-payments, in which case the new
method applicable to other mental health services shall be applicable to services
pursuant to Parts 3 and 4.
5891. The funding established pursuant to this Act shall be utilized to expand mental
health services. These funds shall not be used to supplant existing state or county
funds utilized to provide mental health services. The state shall continue to
provide financial support for mental health programs with not less than the same
entitlements, amounts of allocations from the General Fund and formula
distributions of dedicated funds as provided in the last fiscal year which ended
prior to the effective date of this Act. The state shall not make any change to the
structure of financing mental health services, which increases a county?s share of
costs or financial risk for mental health services unless the state includes
adequate funding to fully compensate for such increased costs or financial risk.
These funds shall only be used to pay for the programs authorized in Section
5892. These funds may not be used to pay for any other program. These funds
may not be loaned to the state General Fund or any other fund of the state, or a
county general fund or any other county fund for any purpose other than those
authorized by Section 5892.
5892. (a) In order to promote efficient implementation of this Act allocate the following
portions of funds available in the Mental Health Services Fund in 2005-06 and
each year thereafter:
(1) In 2005-06, 2006-07, and in 2007-08 10% shall be placed in a trust fund to
be expended for education and training programs pursuant to Part 3.1.
(2) In 2005-06, 2006-07 and in 2007-08 10% for capital facilities and
technological needs distributed to counties in accordance with a formula
developed in consultation with the California Mental Health Directors
Association to implement plans developed pursuant to Section 5847.
(3) 20% for Prevention and Early Intervention Programs distributed to counties
in accordance with a formula developed in consultation with the California
Mental Health Directors Association pursuant to Part 3.6. Each county?s
allocation of funds shall be distributed only after its annual program for
expenditure of such funds has been approved by the Oversight and
Accountability Commission established pursuant to Section 5845.
(4) The allocation for Prevention and Early Intervention may be increased in any
county which the department determines that such increase will decrease the
need and cost for additional services to severely mentally ill persons in that
county by an amount at least commensurate with the proposed increase. The
statewide allocation for Prevention and Early Intervention may be increased
whenever the Oversight and Accountability Commission determines that all
counties are receiving all necessary funds for services to severely mentally ill
persons and have established prudent reserves and there are additional
revenues available in the Fund.
(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 for the
Children?s System of Care and Part 3, for the Adult and Older Adult System
of Care.
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(6) 5% percent of the total funding for each county mental health program for
Parts 3, 3.6 and 4 shall be utilized for Innovative Programs pursuant to an
approved plan required by Section 5830 and such funds may be distributed
by the department only after such programs have been approved by the
Oversight and Accountability Commission established pursuant to Section
5845.
(b) In any year after 2007-08, programs for services pursuant to Parts 3 and 4 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%
of the average amount of funds allocated to that county for the previous five
years pursuant to this Section.
(c) The allocations pursuant to subdivisions (a) and (b) shall include funding for
annual planning costs pursuant to Section 5848. The total of such costs shall not
exceed 5% 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 Parts 3 and 4.
(d) Prior to making the allocations pursuant to subdivisions (a), (b) and (c), the
department shall also provide funds for the costs for itself, the Mental Health
Planning Council and the Oversight and Accountability Commission to
implement all duties pursuant to the programs set forth in this section. Such costs
shall not exceed 5% 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 Parts 3, 3.6 and
4.
(e) In 2004-05 funds shall be allocated as follows:
(1) 45% for Education and Training pursuant to Part 3.1.
(2) 45% for Capital Facilities and Technology Needs in the manner specified
by paragraph (2) of subdivision (a).
(3) 5% for Local Planning in the manner specified in Subdivision (c) and
(4) 5% 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 such investments shall be transferred into the Fund. The earnings on
investment of these funds shall be available for distribution from the Fund in
future years.
(g) All expenditures for county mental health programs shall be consistent with a
currently approved plan or update pursuant to Section 5847.
(h) Other than funds placed in a reserve in accordance with an approved plan, any
funds allocated to a county which have not been spent for their authorized
purpose within three years shall revert to the state to be deposited into the Fund
and available for other counties in future years, provided however, that funds for
15
capital facilities, technological needs or education and training may be retained
for up to ten years before reverting to the Fund.
(i) If there are still additional revenues available in the fund after the 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 such revenues to further the purposes of
this Act and the Legislature may appropriate such funds for any purpose
consistent with the Commission?s adopted plan which furthers the purposes of
this act.
5893. (a) In any year in which the funds available exceed the amount allocated to counties,
such funds shall be carried forward to the next fiscal year to be available for
distribution to counties in accordance with Section 5892 in that fiscal year.
(b) All funds deposited into the Mental Health Services Fund shall be invested in the
same manner in which other state funds are invested. The Fund shall be
increased by its share of the amount earned on investments.
5894. In the event that Parts 3 or 4 are restructured by legislation signed into law before the
adoption of this measure, the funding provided by this measure shall be distributed in
accordance with such legislation; provided, however that nothing herein shall be
construed to reduce the categories of persons entitled to receive services.
5895. In the event any provisions of Part 3 or Part 4 of this Division are repealed or modified
so the purposes of this Act cannot be accomplished, the funds in the Mental Health
Services Fund shall be administered in accordance with those sections as they read on
January 1, 2004.
5897. (a) Notwithstanding any other provision of state law, the Department of Mental
Health shall implement the mental health services provided by Parts 3, 3.6 and 4
of this Division through contracts with county mental health programs or
counties acting jointly. A contract may be exclusive and may be awarded on a
geographic basis. As used herein a county mental health program includes a city
receiving funds pursuant to Section 5701.5
(b) Two or more counties acting jointly may agree to deliver or subcontract for the
delivery of such mental health services. The agreement may encompass all or
any part of the mental health services provided pursuant to these parts. Any
agreement between counties shall delineate each county?s responsibilities and
fiscal liability.
(c) The department shall implement the provisions of Parts 3, 3.2, 3.6 and 4 of this
Division through the annual county mental health services performance contract,
as specified in Part 2, Chapter 2, Section 5650 et seq.
(d) When a county mental health program is not in compliance with its performance
contract, the department may request a plan of correction with a specific timeline
to achieve improvements.
(e) Contracts awarded by the Department of Mental Health, the California Mental
Health Planning Council, and the Mental Health Services Oversight and
Accountability Commission pursuant to Parts 3, 3.1, 3.2, 3.6, 3.7, 4, and 4.5 may
be awarded in the same manner in which contracts are awarded pursuant to
Section 5814 and the provisions of subdivisions (g) and (h) of Section 5814 shall
apply to such contracts.
(f) For purposes of Section 5775, the allocation of funds pursuant to Section 5892
which are used to provide services to Medi-Cal beneficiaries shall be included in
calculating anticipated county matching funds and the transfer to the department
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of the anticipated county matching funds needed for community mental health
programs.
5898. The department shall develop regulations, as necessary, for the department or
designated local agencies to implement this Act. In 2005, the director may adopt all
regulations pursuant to this Act as emergency regulations in accordance with Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 2 of Title 2. For the
purpose of the Administrative Procedure Act, the adoption of regulations, in 2005, shall
be deemed an emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare. These regulations shall not be subject to
the review and approval of the Office of Administrative Law and shall not be subject to
automatic repeal until final regulations take effect. Emergency regulations adopted in
accordance with this provision shall not remain in effect for more than a year. The
final regulations shall become effective upon filing with the Secretary of State.
Regulations adopted pursuant to this section shall be developed with the maximum
feasible opportunity for public participation and comments.
SECTION 16
The provisions of this Act shall become effective January 1 of the year following passage of the
Act, and its provisions shall be applied prospectively.
The provisions of this Act are written with the expectation that it will be enacted in November of
2004. In the event that it is approved by the voters at an election other than one which occurs
during the 2004-05 fiscal year, the provisions of this act which refer to fiscal year 2005-06 shall
be deemed to refer to the first fiscal year which begins after the effective date of this Act and the
provisions of this Act which refer to other fiscal years shall refer to the year that is the same
number of years after the first fiscal year as that year is in relationship to 2005-06.
SECTION 17
Notwithstanding any other provision of law to the contrary, the department shall begin
implementing the provisions of this Act immediately upon its effective date and shall have the
authority to immediately make any necessary expenditures and to hire staff for that purpose.
SECTION 18
This Act shall be broadly construed to accomplish its purposes. All of the provisions of this Act
may be amended by a 2/3 vote of the Legislature so long as such amendments are consistent with
and further the intent of this Act. The Legislature may by majority vote add provisions to clarify
procedures and terms including the procedures for the collection of the tax surcharge imposed by
Section 16.
SECTION 19
If any provision of this Act is held to be unconstitutional or invalid for any reason, such
unconstitutionality or invalidity shall not affect the validity of any other provision.
