SB 5

Bill Subjects

Abstract

Existing law, the Bronzan-McCorquodale Act, contains provisions governing the operation and financing of community mental health services for the mentally disordered in every county through locally administered and locally controlled community mental health programs. Existing law, the Mental Health Services Act, an initiative measure enacted by the voters as Proposition 63, establishes the Mental Health Services Fund to fund various county mental health programs. The act may be amended only by a 23 vote of both houses of the Legislature and only so long as the amendment is consistent with and furthers the intent of the act. Provisions that clarify procedures and terms of the act may be added by majority vote. Existing law establishes the Mental Health Services Oversight and Accountability Commission, comprised of specified members, to oversee various programs and provisions of law relating to mental health. The bill would provide that the commission shall administer its operations under the act separate and apart from the State Department of Mental Health. Existing law requires each county mental health program to prepare and submit a 3 year plan to be updated at least annually and approved by the department after review and comment by the commission. Existing law requires the department to evaluate each proposed expenditure plan and determine, among other things, the extent to which each county has the capacity to serve the number of child, adults, and seniors proposed in the plan. This bill would require the department to approve, deny, or request information on a county expenditure plan or update no later than 60 days upon receipt. The bill would provide that the department shall only evaluate those programs in a county expenditure plan or update that have not previously been approved or that have previously identified problems that have been conveyed to the county. Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services, under which qualified low-income persons are provided with health care services. The Medi-Cal program is partially governed and funded by federal Medicaid program provisions. This bill would provide, except as specified, and to the extent permitted by federal law, that certain optional Medi-Cal benefits, including, among others, certain adult dental services, acupuncture services, and audiology and speech therapy services, are excluded from coverage under the Medi-Cal program. This bill would provide that these provisions shall be implemented on the first day of the month following 90 days after this bill becomes effective. The bill would provide that, upon a prescribed notification from the Director of Finance to the Joint Legislative Budget Committee, the above provisions shall become inoperative. Existing law requires the department to establish and maintain a plan, known as the County Administrative Cost Control Plan, for the purpose of effectively controlling costs related to the county administration of the determination of eligibility for benefits under the Medi-Cal program within the amounts annually appropriated for that administration. Under existing law, the Legislature finds and declares that linking appropriate funding for county Medi-Cal administrative operations, including annual cost-of-doing-business adjustments, with performance standards will give counties the incentive to meet the performance standards and enable them to continue to do the work they do on behalf of the state. Existing law provides that it is the intent of the Legislature to not appropriate funds for the cost-of-doing-business adjustment for the 2008–09 fiscal year. This bill would additionally provide that it is the intent of the Legislature to not appropriate funds for the cost-of-doing-business adjustment for the 2009–10 fiscal year. Existing law establishes the Medi-Cal Hospital/Uninsured Care Demonstration Project Act, which revises hospital reimbursement methodologies under the Medi-Cal program in order to maximize the use of federal funds consistent with federal Medicaid law and stabilize the distribution of funding for hospitals that provide care to Medi-Cal beneficiaries and uninsured patients. This demonstration project provides for funding, in supplementation of Medi-Cal reimbursement, to various hospitals, including designated public hospitals, nondesignated public hospitals, and private hospitals, as defined in accordance with certain provisions relating to disproportionate share hospitals. This bill would require that certain payments made to designated public hospitals and to the South Los Angeles Medical Services Preservation Fund for services rendered on or after the first day of the month following 90 days after the effective date of the bill, be reduced by 10%, but that in no event shall the total amount of the reduction exceed $54,200,000. The bill would provide that, upon a prescribed notification from the Director of Finance to the Joint Legislative Budget Committee, the above provisions shall become inoperative. Under existing law, the State Department of Developmental Services contracts with private nonprofit regional centers to provide services and supports to persons with developmental disabilities. This bill would require the department to submit a plan to the Legislature by April 1, 2009, as part of the Governor's Finance Letter process, that shall identify specific cost containment measures to achieve up to $100,000,000 in General Fund reductions for the 2009–10 fiscal year. The bill would provide that in the event that statutory changes are not enacted by September 1, 2009, to achieve a General Fund reduction of $100,000,000, as referenced above, the State Department of Developmental Services shall direct regional centers to reduce all payments for services and supports paid from purchase of services funds for services delivered on or after September 1, 2009, by 7.1%, except as specified. The bill would provide that the 7.1% shall, in subsequent fiscal years, be adjusted to ensure a General Fund reduction of $100,000,000 for that fiscal year. The California Constitution authorizes the Governor to declare a fiscal emergency and to call the Legislature into special session for that purpose. The Governor issued a proclamation declaring a fiscal emergency, and calling a special session for this purpose, on December 19, 2008. This bill would state that it addresses the fiscal emergency declared by the Governor by proclamation issued on December 19, 2008, pursuant to the California Constitution. This bill would declare that it is to take effect immediately as an urgency statute.