BILL NUMBER: SB 804 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY SEPTEMBER 1, 2015
INTRODUCED BY Committee on Health (Senators Hernandez (Chair),
Hall, Mitchell, Monning, Nguyen, Nielsen, Pan, Roth, and Wolk)
MARCH 26, 2015
An act to amend Sections 1366.22, 11801, 11811.6,
11830.1, 11835, 24100, 103577, 104151, and
128456 128456, 130302, and 130304 of, to
amend, repeal, and add Sections 1366.24 and 1366.25 of, and to
repeal Sections 130316 and 130317 of, the Health and Safety Code,
to amend Section 10128.52 of, and to amend, repeal, and add
Sections 10128.54 and 10128.55 of, the Insurance Code, and to
amend Sections 729.12, 4033, 4040, 4095, 4096.5,
4117, 5121, 5150, 5152.1, 5152.2, 5250.1, 5305, 5306.5, 5307, 5308,
5326.95, 5328, 5328.2, 5346, 5400, 5585.22, 5601,
5611, 5664, 5694.7, 5701.1, 5701.2, 5717, 5750,
5814.5, 5845, 5847, 5848, 5848.5, 5892, 5899, 5902,
6002.25, 8103, 11467, 11469, 14021.4, 14124.24, 14251,
14499.71, 14682.1, 14707, 14711, 14717, 14718, 14725,
15204.8, 15847.7, and 17604 and 15847.7
of the Welfare and Institutions Code, relating to health.
public health.
LEGISLATIVE COUNSEL'S DIGEST
SB 804, as amended, Committee on Health. Health.
Public health.
(1) The Knox-Keene Health Care Service Plan Act of 1975 provides
for the licensure and regulation of health care service plans by the
Department of Managed Health Care and makes a willful violation of
the act a crime. Existing law also provides for the regulation of
health insurers by the Department of Insurance. The California
Continuation Benefits Replacement Act (Cal-COBRA) requires health
care service plans and health insurers providing coverage under a
group benefit plan to employers of 2 to 19 eligible employees to
offer a continuation of that coverage for a specified period of time
to certain qualified beneficiaries, as specified. Existing law
requires a group benefit plan that is subject to Cal-COBRA to make
specified disclosures to covered employees, including that a covered
employee who is considering declining continuation of coverage should
be aware that companies selling individual health insurance may
require a review of the employee's medical history that could result
in a higher premium or denial of coverage.
This bill would eliminate the disclosure requirement described
above. If federal law requiring an individual to maintain minimum
health coverage is repealed or amended to no longer apply to the
individual market, as specified, the bill would reenact that
disclosure requirement to become operative 12 months after that
repeal or amendment. The bill would also, under those same
conditions, require a contract between a group benefit plan that is
subject to Cal-COBRA and an employer to require the employer to make
the same disclosure to a qualified beneficiary in connection with a
notice regarding election of continuation coverage. The bill would
require a group benefit plan that is subject to Cal-COBRA and that
issues, amends, or renews a disclosure on or after July 1, 2016, to
include a notice regarding additional health care coverage options in
that disclosure, as specified. The bill would require a group
contract that is issued, amended, or renewed on or after July 1,
2016, between a group benefit plan that is subject to Cal-COBRA and
an employer to require the employer to give that notice regarding
additional health care coverage options to a qualified beneficiary of
the contract in connection with a notice regarding election of
continuation coverage. The bill would make conforming changes to
related provisions.
Because a willful violation of the bill's requirements relative to
health care service plans would be a crime, this bill would impose a
state-mandated local program.
(1)
(2) Existing law regulates provision of programs and
services relating to mental health and alcohol and drug abuse at the
state and local levels and serving various populations. These
provisions contain various obsolete references to the California
Mental Health Directors Association, the County Alcohol and Drug
Program Administrators' Association of California, and similar
entities.
This bill would delete those obsolete references and would refer
instead to the County Behavioral Health Directors Association of
California, and would make additional conforming changes.
changes to certain provisions relating to mental
health directors and alcohol and drug program
administrators.
(2)
(3) Existing law requires the State Department of
Health Care Services to provide, no later than January 10 and
concurrently with the May Revision of the annual budget, the fiscal
committees of the Legislature with an estimate package for the Every
Woman Counts Program for early detection of breast and cervical
cancer.
This bill would require the department additionally to provide to
the fiscal and appropriate policy committees of the Legislature
quarterly updates on caseload, estimated expenditures, and related
program monitoring data for the Every Woman Counts Program, as
prescribed. The bill would declare the intent of the Legislature that
these provisions supersede similar reporting requirements imposed on
the State Department of Public Health by specified uncodified
legislation.
(3)
(4) Existing law, for purposes of Medi-Cal provisions
relating to entities that provide payment for certain covered
services on behalf of eligible persons, enrollees
enrollees, or subscribers, includes a nonprofit hospital
service plan within the descriptions of a fiscal intermediary, a
prepaid health plan, and group health coverage.
This bill would delete a nonprofit hospital service plan from
inclusion as a fiscal intermediary, prepaid health plan, or group
health coverage, under the above circumstances.
(4)
(5) Existing law establishes the State Department of
Public Health and sets forth its powers and duties, including, but
not limited to, duties as State Registrar relating to the uniform
administration of provisions relating to vital records and health
statistics. Existing law requires the State Registrar, local
registrar, or county recorder to, upon request and payment of the
required fee, supply to an applicant a certified copy of the record
of a birth, fetal death, death, marriage, or marriage dissolution
registered with the official. Existing law authorizes the issuance of
certain records without payment of the fee.
Existing law, on and after July 1, 2015, requires each local
registrar or county recorder to issue, without a fee, a certified
record of live birth to any person who can verify his or her status
as a homeless person or a homeless child or youth, as defined.
This bill would specify that no issuance or other related fee
would be changed charged under the
above circumstances.
(5)
(6) Under the Health Insurance Portability and
Accountability Implementation Act of 2001, the Office of HIPAA
Implementation assumes statewide leadership, coordination, policy
formulation, direction, and oversight responsibilities for HIPAA
implementation, and exercises full authority relative to state
entities to establish policy, provide direction to state entities,
monitor progress, and report on implementation efforts. Under
existing law, these duties have been assumed by a successor entity,
the Office of Health Information Integrity. These provisions become
inoperative and are repealed as of June 30, 2016, at which time funds
appropriated for purposes of the act that remain unexpended and
unencumbered, revert to the General Fund.
This bill would indefinitely extend the act and the operation of
the office by deleting the June 30, 2016 repeal date. The bill
would update references to the office to refer instead to the Office
of Health Information Integrity.
(7) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1366.22 of the
Health and Safety Code is amended to read:
1366.22. The continuation coverage requirements of this article
do not apply to the following individuals:
(a) Individuals who are entitled to Medicare benefits or become
entitled to Medicare benefits pursuant to Title XVIII of the United
States Social Security Act, as amended or superseded. Entitlement to
Medicare Part A only constitutes entitlement to benefits under
Medicare.
(b) Individuals who have other hospital, medical, or surgical
coverage or who are covered or become covered under another group
benefit plan, including a self-insured employee welfare benefit plan,
that provides coverage for individuals and that does not impose any
exclusion or limitation with respect to any preexisting condition of
the individual, other than a preexisting condition limitation or
exclusion that does not apply to or is satisfied by the qualified
beneficiary pursuant to Sections 1357 and 1357.06. A group conversion
option under any group benefit plan shall not be considered as an
arrangement under which an individual is or becomes covered.
(c) Individuals who are covered, become covered, or are eligible
for federal COBRA coverage pursuant to Section 4980B of the United
States Internal Revenue Code or Chapter 18 of the Employee Retirement
Income Security Act, 29 Act (29 U.S.C.
Section Sec. 1161 et seq.
seq.).
(d) Individuals who are covered, become covered, or are eligible
for coverage pursuant to Chapter 6A of the Public Health Service
Act, 42 Act (42 U.S.C. Section 300bb-1
et seq. seq.).
(e) Qualified beneficiaries who fail to meet the requirements of
subdivision (b) of Section 1366.24 or subdivision (h)
(i) of Section 1366.25 regarding notification of
a qualifying event or election of continuation coverage within the
specified time limits.
(f) Except as provided in Section 3001 of ARRA, qualified
beneficiaries who fail to submit the correct premium amount required
by subdivision (b) of Section 1366.24 and Section 1366.26, in
accordance with the terms and conditions of the plan contract, or
fail to satisfy other terms and conditions of the plan contract.
SEC. 2. Section 1366.24 of the Health
and Safety Code is amended to read:
1366.24. (a) Every health care service plan evidence of coverage,
provided for group benefit plans subject to this article, that is
issued, amended, or renewed on or after January 1, 1999, shall
disclose to covered employees of group benefit plans subject to this
article the ability to continue coverage pursuant to this article, as
required by this section.
(b) This disclosure shall state that all enrollees who are
eligible to be qualified beneficiaries, as defined in subdivision (c)
of Section 1366.21, shall be required, as a condition of receiving
benefits pursuant to this article, to notify, in writing, the health
care service plan, or the employer if the employer contracts to
perform the administrative services as provided for in Section
1366.25, of all qualifying events as specified in paragraphs (1),
(3), (4), and (5) of subdivision (d) of Section 1366.21 within 60
days of the date of the qualifying event. This disclosure shall
inform enrollees that failure to make the notification to the health
care service plan, or to the employer when under contract to provide
the administrative services, within the required 60 days will
disqualify the qualified beneficiary from receiving continuation
coverage pursuant to this article. The disclosure shall further state
that a qualified beneficiary who wishes to continue coverage under
the group benefit plan pursuant to this article must
shall request the continuation in writing and
deliver the written request, by first-class mail, or other reliable
means of delivery, including personal delivery, express mail, or
private courier company, to the health care service plan, or to the
employer if the plan has contracted with the employer for
administrative services pursuant to subdivision (d) of Section
1366.25, within the 60-day period following the later of (1) the date
that the enrollee's coverage under the group benefit plan terminated
or will terminate by reason of a qualifying event, or (2) the date
the enrollee was sent notice pursuant to subdivision (e) of Section
1366.25 of the ability to continue coverage under the group benefit
plan. The disclosure required by this section shall also state that a
qualified beneficiary electing continuation shall pay to the health
care service plan, in accordance with the terms and conditions of the
plan contract, which shall be set forth in the notice to the
qualified beneficiary pursuant to subdivision (d) of Section 1366.25,
the amount of the required premium payment, as set forth in Section
1366.26. The disclosure shall further require that the qualified
beneficiary's first premium payment required to establish premium
payment be delivered by first-class mail, certified mail, or other
reliable means of delivery, including personal delivery, express
mail, or private courier company, to the health care service plan, or
to the employer if the employer has contracted with the plan to
perform the administrative services pursuant to subdivision (d) of
Section 1366.25, within 45 days of the date the qualified beneficiary
provided written notice to the health care service plan or the
employer, if the employer has contracted to perform the
administrative services, of the election to continue coverage in
order for coverage to be continued under this article. This
disclosure shall also state that the first premium payment
must shall equal an amount sufficient to pay any
required premiums and all premiums due, and that failure to submit
the correct premium amount within the 45-day period will disqualify
the qualified beneficiary from receiving continuation coverage
pursuant to this article.
(c) The disclosure required by this section shall also describe
separately how qualified beneficiaries whose continuation coverage
terminates under a prior group benefit plan pursuant to subdivision
(b) of Section 1366.27 may continue their coverage for the balance of
the period that the qualified beneficiary would have remained
covered under the prior group benefit plan, including the
requirements for election and payment. The disclosure shall clearly
state that continuation coverage shall terminate if the qualified
beneficiary fails to comply with the requirements pertaining to
enrollment in, and payment of premiums to, the new group benefit plan
within 30 days of receiving notice of the termination of the prior
group benefit plan.
(d) Prior to August 1, 1998, every health care service plan shall
provide to all covered employees of employers subject to this article
a written notice containing the disclosures required by this
section, or shall provide to all covered employees of employers
subject to this section a new or amended evidence of coverage that
includes the disclosures required by this section. Any specialized
health care service plan that, in the ordinary course of business,
maintains only the addresses of employer group purchasers of benefits
and does not maintain addresses of covered employees, may comply
with the notice requirements of this section through the provision of
the notices to its employer group purchasers of benefits.
(e) Every plan disclosure form issued, amended, or renewed on and
after January 1, 1999, for a group benefit plan subject to this
article shall provide a notice that, under state law, an enrollee may
be entitled to continuation of group coverage and that additional
information regarding eligibility for this coverage may be found in
the plan's evidence of coverage.
(f) Every A disclosure issued,
amended, or renewed on and after July 1, 2006,
or after July 1, 2016, for a group benefit plan subject to
this article shall include the following notice:
"Please examine your options carefully before declining this
coverage. You should be aware that companies selling individual
health insurance typically require a review of your medical history
that could result in a higher premium or you could be denied coverage
entirely."
"In addition to your coverage continuation options, you may be
eligible for the following:
1. Coverage through the state health insurance marketplace, also
known as Covered California. By enrolling through Covered California,
you may qualify for lower monthly premiums and lower out-of-pocket
costs. Your family members may also qualify for coverage through
Covered California.
2. Coverage through Medi-Cal. Depending on your income, you may
qualify for low- or no-cost coverage through Medi-Cal. Your family
members may also qualify for Medi-Cal.
3. Coverage through an insured spouse. If your spouse has coverage
that extends to family members, you may be able to be added on that
benefit plan.
Be aware that there is a deadline to enroll in Covered California
although you can apply for Medi-Cal anytime. To find out more about
how to apply for Covered California and Medi-Cal, visit the Covered
California Internet Web site at
http://www.coveredca.com."
(g) (1) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of PPACA, is repealed or amended to no longer apply to
the individual market, as defined in Section 2791 of the federal
Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section
shall become inoperative and is repealed 12 months after the date of
that repeal or amendment.
(2) For purposes of this subdivision, "PPACA" means the federal
Patient Protection and Affordable Care Act (Public Law 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), and any rules, regulations, or guidance
issued pursuant to that law.
SEC. 3. Section 1366.24 is added to the
Health and Safety Code , to read:
1366.24. (a) Every health care service plan evidence of coverage,
provided for group benefit plans subject to this article, that is
issued, amended, or renewed on or after January 1, 1999, shall
disclose to covered employees of group benefit plans subject to this
article the ability to continue coverage pursuant to this article, as
required by this section.
(b) This disclosure shall state that all enrollees who are
eligible to be qualified beneficiaries, as defined in subdivision (c)
of Section 1366.21, shall be required, as a condition of receiving
benefits pursuant to this article, to notify, in writing, the health
care service plan, or the employer if the employer contracts to
perform the administrative services as provided for in Section
1366.25, of all qualifying events as specified in paragraphs (1),
(3), (4), and (5) of subdivision (d) of Section 1366.21 within 60
days of the date of the qualifying event. This disclosure shall
inform enrollees that failure to make the notification to the health
care service plan, or to the employer when under contract to provide
the administrative services, within the required 60 days will
disqualify the qualified beneficiary from receiving continuation
coverage pursuant to this article. The disclosure shall further state
that a qualified beneficiary who wishes to continue coverage under
the group benefit plan pursuant to this article must request the
continuation in writing and deliver the written request, by
first-class mail, or other reliable means of delivery, including
personal delivery, express mail, or private courier company, to the
health care service plan, or to the employer if the plan has
contracted with the employer for administrative services pursuant to
subdivision (d) of Section 1366.25, within the 60-day period
following the later of either (1) the date that the enrollee's
coverage under the group benefit plan terminated or will terminate by
reason of a qualifying event, or (2) the date the enrollee was sent
notice pursuant to subdivision (e) of Section 1366.25 of the ability
to continue coverage under the group benefit plan. The disclosure
required by this section shall also state that a qualified
beneficiary electing continuation shall pay to the health care
service plan, in accordance with the terms and conditions of the plan
contract, which shall be set forth in the notice to the qualified
beneficiary pursuant to subdivision (d) of Section 1366.25, the
amount of the required premium payment, as set forth in Section
1366.26. The disclosure shall further require that the qualified
beneficiary's first premium payment required to establish premium
payment be delivered by first-class mail, certified mail, or other
reliable means of delivery, including personal delivery, express
mail, or private courier company, to the health care service plan, or
to the employer if the employer has contracted with the plan to
perform the administrative services pursuant to subdivision (d) of
Section 1366.25, within 45 days of the date the qualified beneficiary
provided written notice to the health care service plan or the
employer, if the employer has contracted to perform the
administrative services, of the election to continue coverage in
order for coverage to be continued under this article. This
disclosure shall also state that the first premium payment must equal
an amount sufficient to pay any required premiums and all premiums
due, and that failure to submit the correct premium amount within the
45-day period will disqualify the qualified beneficiary from
receiving continuation coverage pursuant to this article.
(c) The disclosure required by this section shall also describe
separately how qualified beneficiaries whose continuation coverage
terminates under a prior group benefit plan pursuant to subdivision
(b) of Section 1366.27 may continue their coverage for the balance of
the period that the qualified beneficiary would have remained
covered under the prior group benefit plan, including the
requirements for election and payment. The disclosure shall clearly
state that continuation coverage shall terminate if the qualified
beneficiary fails to comply with the requirements pertaining to
enrollment in, and payment of premiums to, the new group benefit plan
within 30 days of receiving notice of the termination of the prior
group benefit plan.
(d) Prior to August 1, 1998, every health care service plan shall
provide to all covered employees of employers subject to this article
a written notice containing the disclosures required by this
section, or shall provide to all covered employees of employers
subject to this section a new or amended evidence of coverage that
includes the disclosures required by this section. Any specialized
health care service plan that, in the ordinary course of business,
maintains only the addresses of employer group purchasers of benefits
and does not maintain addresses of covered employees, may comply
with the notice requirements of this section through the provision of
the notices to its employer group purchasers of benefits.
(e) Every plan disclosure form issued, amended, or renewed on or
after January 1, 1999, for a group benefit plan subject to this
article shall provide a notice that, under state law, an enrollee may
be entitled to continuation of group coverage and that additional
information regarding eligibility for this coverage may be found in
the plan's evidence of coverage.
(f) Every disclosure issued, amended, or renewed on or after the
operative date of this section for a group benefit plan subject to
this article shall include the following notice:
"Please examine your options carefully before declining this
coverage. You should be aware that companies selling individual
health insurance typically require a review of your medical history
that could result in a higher premium or you could be denied coverage
entirely."
(g) A disclosure issued, amended, or renewed on or after July 1,
2016, for a group benefit plan subject to this article shall include
the following
notice:
"In addition to your coverage continuation options, you may be
eligible for the following:
1. Coverage through the state health insurance marketplace, also
known as Covered California. By enrolling through Covered California,
you may qualify for lower monthly premiums and lower out-of-pocket
costs. Your family members may also qualify for coverage through
Covered California.
2. Coverage through Medi-Cal. Depending on your income, you may
qualify for low- or no-cost coverage through Medi-Cal. Your family
members may also qualify for Medi-Cal.
3. Coverage through an insured spouse. If your spouse has coverage
that extends to family members, you may be able to be added on that
benefit plan.
Be aware that there is a deadline to enroll in Covered California
although you can apply for Medi-Cal anytime. To find out more about
how to apply for Covered California and Medi-Cal, visit the Covered
California Internet Web site at
http://www.coveredca.com."
(h) (1) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of PPACA, is repealed or amended to no longer apply to
the individual market, as defined in Section 2791 of the federal
Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section
shall become operative 12 months after the date of that repeal or
amendment.
(2) For purposes of this subdivision, "PPACA" means the federal
Patient Protection and Affordable Care Act (Public Law 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), and any rules, regulations, or guidance
issued pursuant to that law.
SEC. 4. Section 1366.25 of the Health
and Safety Code is amended to read:
1366.25. (a) Every group contract between a health care service
plan and an employer subject to this article that is issued, amended,
or renewed on or after July 1, 1998, shall require the employer to
notify the plan, in writing, of any employee who has had a qualifying
event, as defined in paragraph (2) of subdivision (d) of Section
1366.21, within 30 days of the qualifying event. The group contract
shall also require the employer to notify the plan, in writing,
within 30 days of the date, when the employer becomes subject to
Section 4980B of the United States Internal Revenue Code or Chapter
18 of the Employee Retirement Income Security Act, 29
Act (29 U.S.C. Sec. 1161 et seq.
seq.).
(b) Every group contract between a plan and an employer subject to
this article that is issued, amended, or renewed on or after July 1,
1998, shall require the employer to notify qualified beneficiaries
currently receiving continuation coverage, whose continuation
coverage will terminate under one group benefit plan prior to the end
of the period the qualified beneficiary would have remained covered,
as specified in Section 1366.27, of the qualified beneficiary's
ability to continue coverage under a new group benefit plan for the
balance of the period the qualified beneficiary would have remained
covered under the prior group benefit plan. This notice shall be
provided either 30 days prior to the termination or when all enrolled
employees are notified, whichever is later.
Every health care service plan and specialized health care service
plan shall provide to the employer replacing a health care service
plan contract issued by the plan, or to the employer's agent or
broker representative, within 15 days of any written request,
information in possession of the plan reasonably required to
administer the notification requirements of this subdivision and
subdivision (c).
(c) Notwithstanding subdivision (a), the group contract between
the health care service plan and the employer shall require the
employer to notify the successor plan in writing of the qualified
beneficiaries currently receiving continuation coverage so that the
successor plan, or contracting employer or administrator, may provide
those qualified beneficiaries with the necessary premium
information, enrollment forms, and instructions consistent with the
disclosure required by subdivision (c) of Section 1366.24 and
subdivision (e) of this section to allow the qualified beneficiary to
continue coverage. This information shall be sent to all qualified
beneficiaries who are enrolled in the plan and those qualified
beneficiaries who have been notified, pursuant to Section 1366.24, of
their ability to continue their coverage and may still elect
coverage within the specified 60-day period. This information shall
be sent to the qualified beneficiary's last known address, as
provided to the employer by the health care service plan or
disability insurer currently providing continuation coverage to the
qualified beneficiary. The successor plan shall not be obligated to
provide this information to qualified beneficiaries if the employer
or prior plan or insurer fails to comply with this section.
(d) A health care service plan may contract with an employer, or
an administrator, to perform the administrative obligations of the
plan as required by this article, including required notifications
and collecting and forwarding premiums to the health care service
plan. Except for the requirements of subdivisions (a), (b), and (c),
this subdivision shall not be construed to permit a plan to require
an employer to perform the administrative obligations of the plan as
required by this article as a condition of the issuance or renewal of
coverage.
(e) Every health care service plan, or employer or administrator
that contracts to perform the notice and administrative services
pursuant to this section, shall, within 14 days of receiving a notice
of a qualifying event, provide to the qualified beneficiary the
necessary benefits information, premium information, enrollment
forms, and disclosures consistent with the notice requirements
contained in subdivisions (b) and (c) of Section 1366.24 to allow the
qualified beneficiary to formally elect continuation coverage. This
information shall be sent to the qualified beneficiary's last known
address.
(f) Every health care service plan, or employer or administrator
that contracts to perform the notice and administrative services
pursuant to this section, shall, during the 180-day period ending on
the date that continuation coverage is terminated pursuant to
paragraphs (1), (3), and (5) of subdivision (a) of Section 1366.27,
notify a qualified beneficiary who has elected continuation coverage
pursuant to this article of the date that his or her coverage will
terminate, and shall notify the qualified beneficiary of any
conversion coverage available to that qualified beneficiary. This
requirement shall not apply when the continuation coverage is
terminated because the group contract between the plan and the
employer is being terminated.
(g) (1) A health care service plan shall provide to a qualified
beneficiary who has a qualifying event during the period specified in
subparagraph (A) of paragraph (3) of subdivision (a) of Section 3001
of ARRA, a written notice containing information on the availability
of premium assistance under ARRA. This notice shall be sent to the
qualified beneficiary's last known address. The notice shall include
clear and easily understandable language to inform the qualified
beneficiary that changes in federal law provide a new opportunity to
elect continuation coverage with a 65-percent premium subsidy and
shall include all of the following:
(A) The amount of the premium the person will pay. For qualified
beneficiaries who had a qualifying event between September 1, 2008,
and May 12, 2009, inclusive, if a health care service plan is unable
to provide the correct premium amount in the notice, the notice may
contain the last known premium amount and an opportunity for the
qualified beneficiary to request, through a toll-free telephone
number, the correct premium that would apply to the beneficiary.
(B) Enrollment forms and any other information required to be
included pursuant to subdivision (e) to allow the qualified
beneficiary to elect continuation coverage. This information shall
not be included in notices sent to qualified beneficiaries currently
enrolled in continuation coverage.
(C) A description of the option to enroll in different coverage as
provided in subparagraph (B) of paragraph (1) of subdivision (a) of
Section 3001 of ARRA. This description shall advise the qualified
beneficiary to contact the covered employee's former employer for
prior approval to choose this option.
(D) The eligibility requirements for premium assistance in the
amount of 65 percent of the premium under Section 3001 of ARRA.
(E) The duration of premium assistance available under ARRA.
(F) A statement that a qualified beneficiary eligible for premium
assistance under ARRA may elect continuation coverage no later than
60 days of the date of the notice.
(G) A statement that a qualified beneficiary eligible for premium
assistance under ARRA who rejected or discontinued continuation
coverage prior to receiving the notice required by this subdivision
has the right to withdraw that rejection and elect continuation
coverage with the premium assistance.
(H) A statement that reads as follows:
"IF YOU ARE HAVING ANY DIFFICULTIES READING OR UNDERSTANDING THIS
NOTICE, PLEASE CONTACT name of health plan] at insert appropriate
telephone number]."
(2) With respect to qualified beneficiaries who had a qualifying
event between September 1, 2008, and May 12, 2009, inclusive, the
notice described in this subdivision shall be provided by the later
of May 26, 2009, or seven business days after the date the plan
receives notice of the qualifying event.
(3) With respect to qualified beneficiaries who had or have a
qualifying event between May 13, 2009, and the later date specified
in subparagraph (A) of paragraph (3) of subdivision (a) of Section
3001 of ARRA, inclusive, the notice described in this subdivision
shall be provided within the period of time specified in subdivision
(e).
(4) Nothing in this section shall be construed to require a health
care service plan to provide the plan's evidence of coverage as a
part of the notice required by this subdivision, and nothing in this
section shall be construed to require a health care service plan to
amend its existing evidence of coverage to comply with the changes
made to this section by the enactment of Assembly Bill 23 of the
2009-10 Regular Session or by the act amending this section during
the second year of the 2009-10 Regular Session.
(5) The requirement under this subdivision to provide a written
notice to a qualified beneficiary and the requirement under paragraph
(1) of subdivision (h) (i) to provide
a new opportunity to a qualified beneficiary to elect continuation
coverage shall be deemed satisfied if a health care service plan
previously provided a written notice and additional election
opportunity under Section 3001 of ARRA to that qualified beneficiary
prior to the effective date of the act adding this paragraph.
(h) A group contract between a group benefit plan and an employer
subject to this article that is issued, amended, or renewed on or
after July 1, 2016, shall require the employer to give the following
notice to a qualified beneficiary in connection with a notice
regarding election of continuation coverage:
"In addition to your coverage continuation options, you may be
eligible for the following:
1. Coverage through the state health insurance marketplace, also
known as Covered California. By enrolling through Covered California,
you may qualify for lower monthly premiums and lower out-of-pocket
costs. Your family members may also qualify for coverage through
Covered California.
2. Coverage through Medi-Cal. Depending on your income, you may
qualify for low- or no-cost coverage through Medi-Cal. Your family
members may also qualify for Medi-Cal.
3. Coverage through an insured spouse. If your spouse has coverage
that extends to family members, you may be able to be added on that
benefit plan.
Be aware that there is a deadline to enroll in Covered California
although you can apply for Medi-Cal anytime. To find out more about
how to apply for Covered California and Medi-Cal, visit the Covered
California Internet Web site at
http://www.coveredca.com."
(h)
(i) (1) Notwithstanding any other provision of
law, a qualified beneficiary eligible for premium
assistance under ARRA may elect continuation coverage no later than
60 days after the date of the notice required by subdivision (g).
(2) For a qualified beneficiary who elects to continue coverage
pursuant to this subdivision, the period beginning on the date of the
qualifying event and ending on the effective date of the
continuation coverage shall be disregarded for purposes of
calculating a break in coverage in determining whether a preexisting
condition provision applies under subdivision (c) of Section 1357.06
or subdivision (e) of Section 1357.51.
(3) For a qualified beneficiary who had a qualifying event between
September 1, 2008, and February 16, 2009, inclusive, and who elects
continuation coverage pursuant to paragraph (1), the continuation
coverage shall commence on the first day of the month following the
election.
(4) For a qualified beneficiary who had a qualifying event between
February 17, 2009, and May 12, 2009, inclusive, and who elects
continuation coverage pursuant to paragraph (1), the effective date
of the continuation coverage shall be either of the following, at the
option of the beneficiary, provided that the beneficiary pays the
applicable premiums:
(A) The date of the qualifying event.
(B) The first day of the month following the election.
(5) Notwithstanding any other provision of law,
a qualified beneficiary who is eligible for the special election
opportunity described in paragraph (17) of subdivision (a) of Section
3001 of ARRA may elect continuation coverage no later than 60 days
after the date of the notice required under subdivision (j).
(k). For a qualified beneficiary who elects
coverage pursuant to this paragraph, the continuation coverage shall
be effective as of the first day of the first period of coverage
after the date of termination of employment, except, if federal law
permits, coverage shall take effect on the first day of the month
following the election. However, for purposes of calculating the
duration of continuation coverage pursuant to Section 1366.27, the
period of that coverage shall be determined as though the qualifying
event was a reduction of hours of the employee.
(6) Notwithstanding any other provision of law,
a qualified beneficiary who is eligible for any other special
election opportunity under ARRA may elect continuation coverage no
later than 60 days after the date of the special election notice
required under ARRA.
(i)
(j) A health care service plan shall provide a
qualified beneficiary eligible for premium assistance under ARRA
written notice of the extension of that premium assistance as
required under Section 3001 of ARRA.
(j)
(k) A health care service plan, or an administrator or
employer if administrative obligations have been assumed by those
entities pursuant to subdivision (d), shall give the qualified
beneficiaries described in subparagraph (C) of paragraph (17) of
subdivision (a) of Section 3001 of ARRA the written notice required
by that paragraph by implementing the following procedures:
(1) The health care service plan shall, within 14 days of the
effective date of the act adding this subdivision, send a notice to
employers currently contracting with the health care service plan for
a group benefit plan subject to this article. The notice shall do
all of the following:
(A) Advise the employer that employees whose employment is
terminated on or after March 2, 2010, who were previously enrolled in
any group health care service plan or health insurance policy
offered by the employer may be entitled to special health coverage
rights, including a subsidy paid by the federal government for a
portion of the premium.
(B) Ask the employer to provide the health care service plan with
the name, address, and date of termination of employment for any
employee whose employment is terminated on or after March 2, 2010,
and who was at any time covered by any health care service plan or
health insurance policy offered to their employees on or after
September 1, 2008.
(C) Provide employers with a format and instructions for
submitting the information to the health care service plan, or their
administrator or employer who has assumed administrative obligations
pursuant to subdivision (d), by telephone, fax, electronic mail, or
mail.
(2) Within 14 days of receipt of the information specified in
paragraph (1) from the employer, the health care service plan shall
send the written notice specified in paragraph (17) of subdivision
(a) of Section 3001 of ARRA to those individuals.
(3) If an individual contacts his or her health care service plan
and indicates that he or she experienced a qualifying event that
entitles him or her to the special election period described in
paragraph (17) of subdivision (a) of Section 3001 of ARRA or any
other special election provision of ARRA, the plan shall provide the
individual with the written notice required under paragraph (17) of
subdivision (a) of Section 3001 of ARRA or any other applicable
provision of ARRA, regardless of whether the plan receives
information from the individual's previous employer regarding that
individual pursuant to Section 24100. The plan shall review the
individual's application for coverage under this special election
notice to determine if the individual qualifies for the special
election period and the premium assistance under ARRA. The plan shall
comply with paragraph (5) if the individual does not qualify for
either the special election period or premium assistance under ARRA.
(4) The requirement under this subdivision to provide the written
notice described in paragraph (17) of subdivision (a) of Section 3001
of ARRA to a qualified beneficiary and the requirement under
paragraph (5) of subdivision (h) (i) to
provide a new opportunity to a qualified beneficiary to elect
continuation coverage shall be deemed satisfied if a health care
service plan previously provided the written notice and additional
election opportunity described in paragraph (17) of subdivision (a)
of Section 3001 of ARRA to that qualified beneficiary prior to the
effective date of the act adding this paragraph.
(5) If an individual does not qualify for either a special
election period or the premium assistance under ARRA, the health care
service plan shall provide a written notice to that individual that
shall include information on the right to appeal as set forth in
Section 3001 of ARRA.
(6) A health care service plan shall provide information on its
publicly accessible Internet Web site regarding the premium
assistance made available under ARRA and any special election period
provided under that law. A plan may fulfill this requirement by
linking or otherwise directing consumers to the information regarding
COBRA continuation coverage premium assistance located on the
Internet Web site of the United States Department of Labor. The
information required by this paragraph shall be located in a section
of the plan's Internet Web site that is readily accessible to
consumers, such as the Web site's Frequently Asked Questions section.
(k)
(l) For purposes of implementing federal premium
assistance for continuation coverage, the department may designate a
model notice or notices that may be used by health care service
plans. Use of the model notice or notices shall not require prior
approval of the department. Any model notice or notices designated by
the department for purposes of this subdivision shall not be subject
to the Administrative Procedure Act (Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code).
(l)
(m) Notwithstanding any other provision of
law, a qualified beneficiary eligible for premium
assistance under ARRA may elect to enroll in different coverage
subject to the criteria provided under subparagraph (B) of paragraph
(1) of subdivision (a) of Section 3001 of ARRA.
(m)
(n) A qualified beneficiary enrolled in continuation
coverage as of February 17, 2009, who is eligible for premium
assistance under ARRA may request application of the premium
assistance as of March 1, 2009, or later, consistent with ARRA.
(n)
(o) A health care service plan that receives an
election notice from a qualified beneficiary eligible for premium
assistance under ARRA, pursuant to subdivision (h),
(i), shall be considered a person entitled to
reimbursement, as defined in Section 6432(b)(3) of the Internal
Revenue Code, as amended by paragraph (12) of subdivision (a) of
Section 3001 of ARRA.
(o)
(p) (1) For purposes of compliance with ARRA, in the
absence of guidance from, or if specifically required for state-only
continuation coverage by, the United States Department of Labor, the
Internal Revenue Service, or the Centers for Medicare and Medicaid
Services, a health care service plan may request verification of the
involuntary termination of a covered employee's employment from the
covered employee's former employer or the qualified beneficiary
seeking premium assistance under ARRA.
(2) A health care service plan that requests verification pursuant
to paragraph (1) directly from a covered employee's former employer
shall do so by providing a written notice to the employer. This
written notice shall be sent by mail or facsimile to the covered
employee's former employer within seven business days from the date
the plan receives the qualified beneficiary's election notice
pursuant to subdivision (h). (i).
Within 10 calendar days of receipt of written notice required by this
paragraph, the former employer shall furnish to the health care
service plan written verification as to whether the covered employee'
s employment was involuntarily terminated.
(3) A qualified beneficiary requesting premium assistance under
ARRA may furnish to the health care service plan a written document
or other information from the covered employee's former employer
indicating that the covered employee's employment was involuntarily
terminated. This document or information shall be deemed sufficient
by the health care service plan to establish that the covered
employee's employment was involuntarily terminated for purposes of
ARRA, unless the plan makes a reasonable and timely determination
that the documents or information provided by the qualified
beneficiary are legally insufficient to establish involuntary
termination of employment.
(4) If a health care service plan requests verification pursuant
to this subdivision and cannot verify involuntary termination of
employment within 14 business days from the date the employer
receives the verification request or from the date the plan receives
documentation or other information from the qualified beneficiary
pursuant to paragraph (3), the health care service plan shall either
provide continuation coverage with the federal premium assistance to
the qualified beneficiary or send the qualified beneficiary a denial
letter which shall include notice of his or her right to appeal that
determination pursuant to ARRA.
(5) No person shall intentionally delay verification of
involuntary termination of employment under this subdivision.
(p)
(q) The provision of information and forms related to
the premium assistance available pursuant to ARRA to individuals by a
health care service plan shall not be considered a violation of this
chapter provided that the plan complies with all of the requirements
of this article.
(r) (1) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of PPACA, is repealed or amended to no longer apply to
the individual market, as defined in Section 2791 of the federal
Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section
shall become inoperative and is repealed 12 months after the date of
that repeal or amendment.
(2) For purposes of this subdivision, "PPACA" means the federal
Patient Protection and Affordable Care Act (Public Law 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), and any rules, regulations, or guidance
issued pursuant to that law.
SEC. 5. Section 1366.25 is added to the
Health and Safety Code , to read:
1366.25. (a) Every group contract between a health care service
plan and an employer subject to this article that is issued, amended,
or renewed on or after July 1, 1998, shall require the employer to
notify the plan, in writing, of any employee who has had a qualifying
event, as defined in paragraph (2) of subdivision (d) of Section
1366.21, within 30 days of the qualifying event. The group contract
shall also require the employer to notify the plan, in writing,
within 30 days of the date, when the employer becomes subject to
Section 4980B of the United States Internal Revenue Code or Chapter
18 of the Employee Retirement Income Security Act (29 U.S.C. Sec.
1161 et seq.).
(b) Every group contract between a plan and an employer subject to
this article that is issued, amended, or renewed on or after July 1,
1998, shall require the employer to notify qualified beneficiaries
currently receiving continuation coverage, whose continuation
coverage will terminate under one group benefit plan prior to the end
of the period the qualified beneficiary would have remained covered,
as specified in Section 1366.27, of the qualified beneficiary's
ability to continue coverage under a new group benefit plan for the
balance of the period the qualified beneficiary would have remained
covered under the prior group benefit plan. This notice shall be
provided either 30 days prior to the termination or when all enrolled
employees are notified, whichever is later.
Every health care service plan and specialized health care service
plan shall provide to the employer replacing a health care service
plan contract issued by the plan, or to the employer's agent or
broker representative, within 15 days of any written request,
information in possession of the plan reasonably required to
administer the notification requirements of this subdivision and
subdivision (c).
(c) Notwithstanding subdivision (a), the group contract between
the health care service plan and the employer shall require the
employer to notify the successor plan in writing of the qualified
beneficiaries currently receiving continuation coverage so that the
successor plan, or contracting employer or administrator, may provide
those qualified beneficiaries with the necessary premium
information, enrollment forms, and instructions consistent with the
disclosure required by subdivision (c) of Section 1366.24 and
subdivision (e) of this section to allow the qualified beneficiary to
continue coverage. This information shall be sent to all qualified
beneficiaries who are enrolled in the plan and those qualified
beneficiaries who have been notified, pursuant to Section 1366.24, of
their ability to continue their coverage and may still elect
coverage within the specified 60-day period. This information shall
be sent to the qualified beneficiary's last known address, as
provided to the employer by the health care service plan or
disability insurer currently providing continuation coverage to the
qualified beneficiary. The successor plan shall not be obligated to
provide this information to qualified beneficiaries if the employer
or prior plan or insurer fails to comply with this section.
(d) A health care service plan may contract with an employer, or
an administrator, to perform the administrative obligations of the
plan as required by this article, including required notifications
and collecting and forwarding premiums to the health care service
plan. Except for the requirements of subdivisions (a), (b), and (c),
this subdivision shall not be construed to permit a plan to require
an employer to perform the administrative obligations of the plan as
required by this article as a condition of the issuance or renewal of
coverage.
(e) Every health care service plan, or employer or administrator
that contracts to perform the notice and administrative services
pursuant to this section, shall, within 14 days of receiving a notice
of a qualifying event, provide to the qualified beneficiary the
necessary benefits information, premium information, enrollment
forms, and disclosures consistent with the notice requirements
contained in subdivisions (b) and (c) of Section 1366.24 to allow the
qualified beneficiary to formally elect continuation coverage. This
information shall be sent to the qualified beneficiary's last known
address.
(f) Every health care service plan, or employer or administrator
that contracts to perform the notice and administrative services
pursuant to this section, shall, during the 180-day period ending on
the date that continuation coverage is terminated pursuant to
paragraphs (1), (3), and (5) of subdivision (a) of Section 1366.27,
notify a qualified beneficiary who has elected continuation coverage
pursuant to this article of the date that his or her coverage will
terminate, and shall notify the qualified beneficiary of any
conversion coverage available to that qualified beneficiary. This
requirement shall not apply when the continuation coverage is
terminated because the group contract between the plan and the
employer is being terminated.
(g) (1) A health care service plan shall provide to a qualified
beneficiary who has a qualifying event during the period specified in
subparagraph (A) of paragraph (3) of subdivision (a) of Section 3001
of ARRA, a written notice containing information on the availability
of premium assistance under ARRA. This notice shall be sent to the
qualified beneficiary's last known address. The notice shall include
clear and easily understandable language to inform the qualified
beneficiary that changes in federal law provide a new opportunity to
elect continuation coverage with a 65-percent premium subsidy and
shall include all of the following:
(A) The amount of the premium the person will pay. For qualified
beneficiaries who had a qualifying event between September 1, 2008,
and May 12, 2009, inclusive, if a health care service plan is unable
to provide the correct premium amount in the notice, the notice may
contain the last known premium amount and an opportunity for the
qualified beneficiary to request, through a toll-free telephone
number, the correct premium that would apply to the beneficiary.
(B) Enrollment forms and any other information required to be
included pursuant to subdivision (e) to allow the qualified
beneficiary to elect continuation coverage. This information shall
not be included in notices sent to qualified beneficiaries currently
enrolled in continuation coverage.
(C) A description of the option to enroll in different coverage as
provided in subparagraph (B) of paragraph (1) of subdivision (a) of
Section 3001 of ARRA. This description shall advise the qualified
beneficiary to contact the covered employee's former employer for
prior approval to choose this option.
(D) The eligibility requirements for premium assistance in the
amount of 65 percent of the premium under Section 3001 of ARRA.
(E) The duration of premium assistance available under ARRA.
(F) A statement that a qualified beneficiary eligible for premium
assistance under ARRA may elect continuation coverage no later than
60 days of the date of the notice.
(G) A statement that a qualified beneficiary eligible for premium
assistance under ARRA who rejected or discontinued continuation
coverage prior to receiving the notice required by this subdivision
has the right to withdraw that rejection and elect continuation
coverage with the premium assistance.
(H) A statement that reads as follows:
"IF YOU ARE HAVING ANY DIFFICULTIES READING OR UNDERSTANDING THIS
NOTICE, PLEASE CONTACT name of health plan] at insert appropriate
telephone number]."
(2) With respect to qualified beneficiaries who had a qualifying
event between September 1, 2008, and May 12, 2009, inclusive, the
notice described in this subdivision shall be provided by the later
of May 26, 2009, or seven business days after the date the plan
receives notice of the qualifying event.
(3) With respect to qualified beneficiaries who had or have a
qualifying event between May 13, 2009, and the later date specified
in subparagraph (A) of paragraph (3) of subdivision (a) of Section
3001 of ARRA, inclusive, the notice described in this subdivision
shall be provided within the period of time specified in subdivision
(e).
(4) Nothing in this section shall be construed to require a health
care service plan to provide the plan's evidence of coverage as a
part of the notice required by this subdivision, and nothing in this
section shall be construed to require a health care service plan to
amend its existing evidence of coverage to comply with the changes
made to this section by the enactment of Assembly Bill 23 of the
2009-10 Regular Session or by the act amending this section during
the second year of the 2009-10 Regular Session.
(5) The requirement under this subdivision to provide a written
notice to a qualified beneficiary and the requirement under paragraph
(1) of subdivision (k) to provide a new opportunity to a qualified
beneficiary to elect continuation coverage shall be deemed satisfied
if a health care service plan previously provided a written notice
and additional election opportunity under Section 3001 of ARRA to
that qualified beneficiary prior to the effective date of the act
adding this paragraph.
(h) A group contract between a group benefit plan and an employer
subject to this article that is issued, amended, or renewed on or
after the operative date of this section shall
require the employer to give the following
notice to a qualified beneficiary in connection with a notice
regarding election of continuation coverage:
"Please examine your options carefully before declining this
coverage. You should be aware that companies selling individual
health insurance typically require a review of your medical history
that could result in a higher premium or you could be denied coverage
entirely."
(i) A group contract between a group benefit plan and an employer
subject to this article that is issued, amended, or renewed on or
after July 1, 2016, shall require the employer to give the following
notice to a qualified beneficiary in connection with a notice
regarding election of continuation coverage:
"In addition to your coverage continuation options, you may be
eligible for the following:
1. Coverage through the state health insurance marketplace, also
known as Covered California. By enrolling through Covered California,
you may qualify for lower monthly premiums and lower out-of-pocket
costs. Your family members may also qualify for coverage through
Covered California.
2. Coverage through Medi-Cal. Depending on your income, you may
qualify for low- or no-cost coverage through Medi-Cal. Your family
members may also qualify for Medi-Cal.
3. Coverage through an insured spouse. If your spouse has coverage
that extends to family members, you may be able to be added on that
benefit plan.
Be aware that there is a deadline to enroll in Covered California
although you can apply for Medi-Cal anytime. To find out more about
how to apply for Covered California and Medi-Cal, visit the Covered
California Internet Web site at http://www.coveredca.com."
(j) (1) Notwithstanding any other law, a qualified beneficiary
eligible for premium assistance under ARRA may elect continuation
coverage no later than 60 days after the date of the notice required
by subdivision (g).
(2) For a qualified beneficiary who elects to continue coverage
pursuant to this subdivision, the period beginning on the date of the
qualifying event and ending on the effective date of the
continuation coverage shall be disregarded for purposes of
calculating a break in coverage in determining whether a preexisting
condition provision applies under subdivision (c) of Section 1357.06
or subdivision (e) of Section 1357.51.
(3) For a qualified beneficiary who had a qualifying event between
September 1, 2008, and February 16, 2009, inclusive, and who elects
continuation coverage pursuant to paragraph (1), the continuation
coverage shall commence on the first day of the month following the
election.
(4) For a qualified beneficiary who had a qualifying event between
February 17, 2009, and May 12, 2009, inclusive, and who elects
continuation coverage pursuant to paragraph (1), the effective date
of the continuation coverage shall be either of the following, at the
option of the beneficiary, provided that the beneficiary pays the
applicable premiums:
(A) The date of the qualifying event.
(B) The first day of the month following the election.
(5) Notwithstanding any other law, a qualified beneficiary who is
eligible for the special election opportunity described in paragraph
(17) of subdivision (a) of Section 3001 of ARRA may elect
continuation coverage no later than 60 days after the date of the
notice required under subdivision (l). For a qualified beneficiary
who elects coverage pursuant to this paragraph, the continuation
coverage shall be effective as of the first day of the first period
of coverage after the date of termination of employment, except, if
federal law permits, coverage shall take effect on the first day of
the month following the election. However, for purposes of
calculating the duration of continuation coverage pursuant to Section
1366.27, the period of that coverage shall be determined as though
the qualifying event was a reduction of hours of the employee.
(6) Notwithstanding any other law, a qualified beneficiary who is
eligible for any other special election opportunity under ARRA may
elect continuation coverage no later than 60 days after the date of
the special election notice required under ARRA.
(k) A health care service plan shall provide a qualified
beneficiary eligible for premium assistance under ARRA written notice
of the extension of that premium assistance as required under
Section 3001 of ARRA.
(l) A health care service plan, or an administrator or employer if
administrative obligations have been assumed by those entities
pursuant to subdivision (d), shall give the qualified beneficiaries
described in subparagraph (C) of paragraph (17) of subdivision (a) of
Section 3001 of ARRA the written notice required by that paragraph
by implementing the following procedures:
(1) The health care service plan shall, within 14 days of the
effective date of the act adding this subdivision, send a notice to
employers currently contracting with the health care service plan for
a group benefit plan subject to this article. The notice shall do
all of the following:
(A) Advise the employer that employees whose employment is
terminated on or after March 2, 2010, who were previously enrolled in
any group health care service plan or health insurance policy
offered by the employer may be entitled to special health coverage
rights, including a subsidy paid by the federal government for a
portion of the premium.
(B) Ask the employer to provide the health care service plan with
the name, address, and date of termination of employment for any
employee whose employment is terminated on or after March 2, 2010,
and who was at any time covered by any health care service plan or
health insurance policy offered to their employees on or after
September 1, 2008.
(C) Provide employers with a format and instructions for
submitting the information to the health care service plan, or their
administrator or employer who has assumed administrative obligations
pursuant to subdivision (d), by telephone, fax, electronic mail, or
mail.
(2) Within 14 days of receipt of the information specified in
paragraph (1) from the employer, the health care service plan shall
send the written notice specified in paragraph (17) of subdivision
(a) of Section 3001 of ARRA to those individuals.
(3) If an individual contacts his or her health care service plan
and indicates that he or she experienced a qualifying event that
entitles him or her to the special election period described in
paragraph (17) of subdivision (a) of Section 3001 of ARRA or any
other special election provision of ARRA, the plan shall provide the
individual with the written notice required under paragraph (17) of
subdivision (a) of Section 3001 of ARRA or any other applicable
provision of ARRA, regardless of whether the plan receives
information from the individual's previous employer regarding that
individual pursuant to Section 24100. The plan shall review the
individual's application for coverage under this special election
notice to determine if the individual qualifies for the special
election period and the premium assistance under ARRA. The plan shall
comply with paragraph (5) if the individual does not qualify for
either the special election period or premium assistance under ARRA.
(4) The requirement under this subdivision to provide the written
notice described in paragraph (17) of subdivision (a) of Section 3001
of ARRA to a qualified beneficiary and the requirement under
paragraph (5) of subdivision (j) to provide a new opportunity to a
qualified beneficiary to elect continuation coverage shall be deemed
satisfied if a health care service plan previously provided the
written notice and additional election opportunity described in
paragraph (17) of subdivision (a) of Section 3001 of ARRA to that
qualified beneficiary prior to the effective date of the act adding
this paragraph.
(5) If an individual does not qualify for either a special
election period or the premium assistance under ARRA, the health care
service plan shall provide a written notice to that individual that
shall include information on the right to appeal as set forth in
Section 3001 of ARRA.
(6) A health care service plan shall provide information on its
publicly accessible Internet Web site regarding the premium
assistance made available under ARRA and any special election period
provided under that law. A plan may fulfill this requirement by
linking or otherwise directing consumers to the information regarding
COBRA continuation coverage premium assistance located on the
Internet Web site of the United States Department of Labor. The
information required by this paragraph shall be located in a section
of the plan's Internet Web site that is readily accessible to
consumers, such as the Web site's Frequently Asked Questions section.
(m) For purposes of implementing federal premium assistance for
continuation coverage, the department may designate a model notice or
notices that may be used by health care service plans. Use of the
model notice or notices shall not require prior approval of the
department. Any model notice or notices designated by the department
for purposes of this subdivision shall not be subject to the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
(n) Notwithstanding any other law, a qualified beneficiary
eligible for premium assistance under ARRA may elect to enroll in
different coverage subject to the criteria provided under
subparagraph (B) of paragraph (1) of subdivision (a) of Section 3001
of ARRA.
(o) A qualified beneficiary enrolled in continuation coverage as
of February 17, 2009, who is eligible for premium assistance under
ARRA may request application of the premium assistance as of March 1,
2009, or later, consistent with ARRA.
(p) A health care service plan that receives an election notice
from a qualified beneficiary eligible for premium assistance under
ARRA, pursuant to subdivision (j), shall be considered a person
entitled to reimbursement, as defined in Section 6432(b)(3) of the
Internal Revenue Code, as amended by paragraph (12) of subdivision
(a) of Section 3001 of ARRA.
(q) (1) For purposes of compliance with ARRA, in the absence of
guidance from, or if specifically required for state-only
continuation coverage by, the United States Department of Labor, the
Internal Revenue Service, or the Centers for Medicare and Medicaid
Services, a health care service plan may request verification of the
involuntary termination of a covered employee's employment from the
covered employee's former employer or the qualified beneficiary
seeking premium assistance under ARRA.
(2) A health care service plan that requests verification pursuant
to paragraph (1) directly from a covered employee's former employer
shall do so by providing a written notice to the employer. This
written notice shall be sent by mail or facsimile to the covered
employee's former employer within seven business days from the date
the plan receives the qualified beneficiary's election notice
pursuant to subdivision (j). Within 10 calendar days of receipt of
written notice required by this paragraph, the former employer shall
furnish to the health care service plan written verification as to
whether the covered employee's employment was involuntarily
terminated.
(3) A qualified beneficiary requesting premium assistance under
ARRA may furnish to the health care service plan a written document
or other information from the covered employee's former employer
indicating that the covered employee's employment was involuntarily
terminated. This document or information shall be deemed sufficient
by the health care service plan to establish that the covered
employee's employment was involuntarily terminated for purposes of
ARRA, unless the plan makes a reasonable and timely determination
that the documents or information provided by the qualified
beneficiary are legally insufficient to establish involuntary
termination of employment.
(4) If a health care service plan requests verification pursuant
to this subdivision and cannot verify involuntary termination of
employment within 14 business days from the date the employer
receives the verification request or from the date the plan receives
documentation or other information from the qualified beneficiary
pursuant to paragraph (3), the health care service plan shall either
provide continuation coverage with the federal premium assistance to
the qualified beneficiary or send the qualified beneficiary a denial
letter which shall include notice of his or her right to appeal that
determination pursuant to ARRA.
(5) No person shall intentionally delay verification of
involuntary termination of employment under this subdivision.
(r) The provision of information and forms related to the premium
assistance available pursuant to ARRA to individuals by a health care
service plan shall not be considered a violation of this chapter
provided that the plan complies with all of the requirements of this
article.
(s) (1) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of PPACA, is repealed or amended to no longer apply to
the individual market, as defined in Section 2791 of the federal
Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section
shall become operative 12 months after the date of that repeal or
amendment.
(2) For purposes of this subdivision, "PPACA" means the federal
Patient Protection and Affordable Care Act (Public Law 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), and any rules, regulations, or guidance
issued pursuant to that law.
SECTION 1. SEC. 6. Section 11801 of
the Health and Safety Code is amended to read:
11801. The alcohol and drug program administrator, acting through
administrative channels designated pursuant to Section 11795, shall
do all of the following:
(a) Coordinate and be responsible for the preparation of the
county contract.
(b) Ensure compliance with applicable laws relating to
discrimination against any person because of any characteristic
listed or defined in Section 11135 of the Government Code.
(c) Submit an annual report to the board of supervisors reporting
all activities of the alcohol and other drug program, including a
financial accounting of expenditures, number of persons served, and a
forecast of anticipated needs for the upcoming year.
(d) Be directly responsible for the administration of all alcohol
or other drug program funds allocated to the county under this part,
administration of county operated programs, and coordination and
monitoring of programs that have contracts with the county to provide
alcohol and other drug services.
(e) Ensure the evaluation of alcohol and other drug programs,
including the collection of appropriate and necessary client data and
program information, pursuant to Chapter 6 (commencing with Section
11825).
(f) Ensure program quality in compliance with appropriate
standards pursuant to Chapter 7 (commencing with Section 11830).
(g) Participate and represent the county in meetings of the County
Behavioral Health Directors Association of California pursuant to
Section 11811.5 for the purposes of representing the counties in
their relationship with the state with respect to policies,
standards, and administration for alcohol and other drug abuse
services.
(h) Perform any other acts that may be necessary, desirable, or
proper to carry out the purposes of this part.
SEC. 7. Section 11811.6 of the Health
and Safety Code is amended to read:
11811.6. The department shall consult with county behavioral
health directors, alcohol and drug program
administrators administrators, or both, in
establishing standards pursuant to Chapter 7 (commencing with Section
11830) and regulations pursuant to Chapter 8 (commencing with
Section 11835), shall consult with alcohol and drug program
administrators on matters of major policy and administration, and may
consult with alcohol and drug program administrators on other
matters affecting persons with alcohol and other drug problems.
The alcohol and drug program administrators may organize,
adopt bylaws, and annually elect officers. The
administrators shall consist of all legally appointed alcohol and
drug administrators in the state as designated pursuant to
subdivision (a) of Section 11800.
SEC. 2. SEC. 8. Section 11830.1 of
the Health and Safety Code is amended to read:
11830.1. In order to ensure quality assurance of alcohol and
other drug programs and expand the availability of funding resources,
the department shall implement a program certification procedure for
alcohol and other drug treatment recovery services. The department,
after consultation with the County Behavioral Health Directors
Association of California, and other interested organizations and
individuals, shall develop standards and regulations for the alcohol
and other drug treatment recovery services describing the minimal
level of service quality required of the service providers to qualify
for and obtain state certification. The standards shall be excluded
from the rulemaking requirements of the Administrative Procedure Act
(Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code). Compliance with these standards
shall be voluntary on the part of programs. For the purposes of
Section 2626.2 of the Unemployment Insurance Code, certification
shall be equivalent to program review.
SEC. 3. SEC. 9. Section 11835 of the
Health and Safety Code is amended to read:
11835. (a) The purposes of any regulations adopted by the
department shall be to implement, interpret, or make specific the
provisions of this part and shall not exceed the authority granted to
the department pursuant to this part. To the extent possible, the
regulations shall be written in clear and concise language and
adopted only when necessary to further the purposes of this part.
(b) Except as provided in this section and Sections 11772, 11798,
11798.2, 11814, 11817.8, and 11852.5, the department may
adopt regulations in accordance with the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of the Title 2 of
the Government Code) necessary for the proper execution of the powers
and duties granted to and imposed upon the department by this part.
However, these regulations may be adopted only upon the following
conditions:
(1) Prior to adoption of regulations, the department shall consult
with the County Behavioral Health Directors Association of
California and may consult with any other appropriate persons
relating to the proposed regulations.
(2) If an absolute majority of the designated county behavioral
health directors who represent counties that have submitted county
contracts, vote at a public meeting called by the department, for
which 45 days' advance notice shall be given by the department, to
reject the proposed regulations, the department shall refer the
matter for a decision to a committee, consisting of a representative
of the county behavioral health directors, the director, the
secretary, and one designee of the secretary. The decision shall be
made by a majority vote of this committee at a public meeting
convened by the department. Upon a majority vote of the committee
recommending adoption of the proposed regulations, the department may
then adopt them. Upon a majority vote recommending that the
department not adopt the proposed regulations, the department shall
then consult again with the County Behavioral Health Directors
Association of California and resubmit the proposed regulations to
the county behavioral health directors for a vote pursuant to this
subdivision.
(3) In the voting process described in paragraph (2), no proxies
shall be allowed nor may anyone other than the designated county
behavioral health director, director, secretary, and secretary's
designee vote at the meetings.
SEC. 10. Section 24100 of the Health
and Safety Code is amended to read:
24100. (a) For purposes of this section, the following
definitions apply:
(1) "ARRA" means Title III of Division B of the federal American
Recovery and Reinvestment Act of 2009 or any amendment to that
federal law extending federal premium assistance to qualified
beneficiaries, as defined in Section 1366.21 of this code or Section
10128.51 of the Insurance Code.
(2) "Employer" means an employer as defined in Section 1366.21 of
this code or an employer as defined in Section 10128.51 of the
Insurance Code.
(b) An employer shall provide the information described in
subparagraph (B) of paragraph (1) of subdivision (j)
(k) of Section 1366.25 of this code or
subparagraph (B) of paragraph (1) of subdivision (j)
(k) of Section 10128.55 of the Insurance Code,
as applicable, with respect to any employee whose employment is
terminated on or after March 2, 2010, and who was enrolled at any
time in a health care service plan or health insurance policy offered
by the employer on or after September 1, 2008. This information
shall be provided to the requesting health care service plan or
health insurer within 14 days of receipt of the notification
described in paragraph (1) of subdivision (j)
(k) of Section 1366.25 of this code or paragraph (1) of
subdivision (j) (k) of Section 10128.55
of the Insurance Code. The employer shall continue to provide the
information to the health care service plan or health insurer within
14 days after the end of each month for any employee whose employment
is terminated in the prior month until the last date specified in
subparagraph (A) of paragraph (3) of subdivision (a) of Section 3001
of ARRA.
SEC. 4. SEC. 11. Section 103577 of
the Health and Safety Code is amended to read:
103577. (a) On or after July 1, 2015, each local registrar or
county recorder shall, without an issuance fee or any other
associated fee, issue a certified record of live birth to any person
who can verify his or her status as a homeless person or a homeless
child or youth. A homeless services provider that has knowledge of a
person's housing status shall verify a person's status for the
purposes of this subdivision. In accordance with all other
application requirements as set forth in Section 103526, a request
for a certified record of live birth made pursuant to this
subdivision shall be made by a homeless person or a homeless child or
youth on behalf of themselves, or by any person lawfully entitled to
request a certified record of live birth on behalf of a child, if
the child has been verified as a homeless person or a homeless child
or youth pursuant to this section. A person applying for a certified
record of live birth under this subdivision is entitled to one birth
record, per application, for each eligible person verified as a
homeless person or a homeless child or youth. For purposes of this
subdivision, an affidavit developed pursuant to subdivision (b) shall
constitute sufficient verification that a person is a homeless
person or a homeless child or youth. A person applying for a
certified record of live birth under this subdivision shall not be
charged a fee for verification of his or her eligibility.
(b) The State Department of Public Health shall develop an
affidavit attesting to an applicant's status as a homeless person or
homeless child or youth. For purposes of this section, the affidavit
shall not be deemed complete unless it is signed by both the person
making a request for a certified record of live birth pursuant to
subdivision (a) and a homeless services provider that has knowledge
of the applicant's housing status.
(c) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code),
the department may implement and administer this section through an
all-county letter or similar instructions from the director or State
Registrar without taking regulatory action.
(d) For the purposes of this section, the following definitions
apply:
(1) A "homeless child or youth" has the same meaning as the
definition of "homeless children and youths" as set forth in the
federal McKinney-Vento Homeless Assistance Act (42 U.S.C. Sec. 11301
et seq.).
(2) A "homeless person" has the same meaning as the definition of
that term set forth in the federal McKinney-Vento Homeless Assistance
Act (42 U.S.C. Sec. 11301 et seq.).
(3) A "homeless services provider" includes:
(A) A governmental or nonprofit agency receiving federal, state,
or county or municipal funding to provide services to a "homeless
person" or "homeless child or youth," or that is otherwise sanctioned
to provide those services by a local homeless continuum of care
organization.
(B) An attorney licensed to practice law in this state.
(C) A local educational agency liaison for homeless children and
youth, pursuant to Section 11432(g)(1)(J)(ii) of Title 42 of the
United States Code, or a school social worker.
(D) A human services provider or public social services provider
funded by the State of California to provide homeless children or
youth services, health services, mental or behavioral health
services, substance use disorder services, or public assistance or
employment services.
(E) A law enforcement officer designated as a liaison to the
homeless population by a local police department or sheriff's
department within the state.
SEC. 5. SEC. 12. Section 104151 of
the Health and Safety Code is amended to read:
104151. (a) Notwithstanding Section 10231.5 of the Government
Code, each year, by no later than January 10 and concurrently with
the release of the May Revision, the State Department of Health Care
Services shall provide the fiscal committees of the Legislature with
an estimate package for the Every Woman Counts Program. This estimate
package shall include all significant assumptions underlying the
estimate for the Every Woman Counts Program's current-year and
budget-year proposals, and shall contain concise information
identifying applicable estimate components, such as caseload; a
breakout of costs, including, but not limited to, clinical service
activities, including office visits and consults, screening
mammograms, diagnostic mammograms, diagnostic breast procedures, case
management, and other clinical services; policy changes; contractor
information; General Fund, special fund, and federal fund
information; and other assumptions necessary to support the estimate.
(b) Notwithstanding Section 10231.5 of the Government Code, each
year, the State Department of Health Care Services shall provide the
fiscal and appropriate policy committees of the Legislature with
quarterly updates on caseload, estimated expenditures, and related
program monitoring data for the Every Woman Counts Program. These
updates shall be provided no later than November 30, February 28, May
31, and August 31 of each year. The purpose of the updates is to
provide the Legislature with the most recent information on the
program, and shall include a breakdown of expenditures for each
quarter for clinical service activities, including, but not limited
to, office visits and consults, screening mammograms, diagnostic
mammograms, diagnostic breast procedures, case management, and other
clinical services. This subdivision supersedes the requirements of
Section 169 of Chapter 717 of the Statutes of 2010 (S.B.
853). (SB 853).
SEC. 6. SEC. 13. Section 128456 of
the Health and Safety Code is amended to read:
128456. In developing the program established pursuant to this
article, the Health Professions Education Foundation shall solicit
the advice of representatives of the Board of Behavioral Sciences,
the Board of Psychology, the State Department of Health Care
Services, the County Behavioral Health Directors Association of
California, the California Mental Health Planning Council,
professional mental health care organizations, the California
Healthcare Association, the Chancellor of the California Community
Colleges, and the Chancellor of the California State University. The
foundation shall solicit the advice of representatives who reflect
the demographic, cultural, and linguistic diversity of the state.
SEC. 14. Section 130302 of the Health
and Safety Code is amended to read:
130302. For the purposes of this division, the following
definitions apply:
(a) "Director" means the Director of the Office of HIPAA
Implementation. Health Information Integrity.
(b) "HIPAA" means the federal Health Insurance Portability and
Accountability Act.
(c) "Office" means the Office of HIPAA Implementation
Health Information Integrity established by the
office of the Governor in the Health and Human Services Agency.
(d) "State entities" means all state departments, boards,
commissions, programs, and other organizational units of the
executive branch of state government.
SEC. 15. Section 130304 of the Health
and Safety Code is amended to read:
130304. The office shall be under the supervision and control of
a director, known as the Director of the Office of HIPAA
Implementation, Health Information Integrity,
who shall be appointed by, and serve at the pleasure of, the
Secretary of the Health and Human Services Agency.
SEC. 7. SEC. 16. Section 130316 of
the Health and Safety Code is repealed.
SEC. 8. SEC. 17. Section 130317 of
the Health and Safety Code is repealed.
SEC. 18. Section 10128.52 of the
Insurance Code is amended to read:
10128.52. The continuation coverage requirements of this article
do not apply to the following individuals:
(a) Individuals who are entitled to Medicare benefits or become
entitled to Medicare benefits pursuant to Title XVIII of the United
States Social Security Act, as amended or superseded. Entitlement to
Medicare Part A only constitutes entitlement to benefits under
Medicare.
(b) Individuals who have other hospital, medical, or surgical
coverage, or who are covered or become covered under another group
benefit plan, including a self-insured employee welfare benefit plan,
that provides coverage for individuals and that does not impose any
exclusion or limitation with respect to any preexisting condition of
the individual, other than a preexisting condition limitation or
exclusion that does not apply to or is satisfied by the qualified
beneficiary pursuant to Sections 10198.6 and 10198.7. A group
conversion option under any group benefit plan shall not be
considered as an arrangement under which an individual is or becomes
covered.
(c) Individuals who are covered, become covered, or are eligible
for federal COBRA coverage pursuant to Section 4980B of the United
States Internal Revenue Code or Chapter 18 of the Employee Retirement
Income Security Act, 29 Act (29 U.S.C.
Section Sec. 1161 et seq.
seq.).
(d) Individuals who are covered, become covered, or are eligible
for coverage pursuant to Chapter 6A of the Public Health Service
Act, 42 Act (42 U.S.C. Section
Sec. 300bb-1 et seq.
seq.).
(e) Qualified beneficiaries who fail to meet the requirements of
subdivision (b) of Section 10128.54 or subdivision (h)
(i) of Section 10128.55 regarding notification
of a qualifying event or election of continuation coverage within the
specified time limits.
(f) Except as provided in Section 3001 of ARRA, qualified
beneficiaries who fail to submit the correct premium amount required
by subdivision (b) of Section 10128.55 and Section 10128.57, in
accordance with the terms and conditions of the policy or contract,
or fail to satisfy other terms and conditions of the policy or
contract.
SEC. 19. Section 10128.54 of the
Insurance Code is amended to read:
10128.54. (a) Every insurer's evidence of coverage for group
benefit plans subject to this article, that is issued, amended, or
renewed on or after January 1, 1999, shall disclose to covered
employees of group benefit plans subject to this article the ability
to continue coverage pursuant to this article, as required by this
section.
(b) This disclosure shall state that all insureds who are eligible
to be qualified beneficiaries, as defined in subdivision (c) of
Section 10128.51, shall be required, as a condition of receiving
benefits pursuant to this article, to notify, in writing, the
insurer, or the employer if the employer contracts to perform the
administrative services as provided for in Section 10128.55, of all
qualifying events as specified in paragraphs (1), (3), (4), and (5)
of subdivision (d) of Section 10128.51 within 60 days of the date of
the qualifying event. This disclosure shall inform insureds that
failure to make the notification to the insurer, or to the employer
when under contract to provide the administrative services, within
the required 60 days will disqualify the qualified beneficiary from
receiving continuation coverage pursuant to this article. The
disclosure shall further state that a qualified beneficiary who
wishes to continue coverage under the group benefit plan pursuant to
this article must shall request the
continuation in writing and deliver the written request, by
first-class mail, or other reliable means of delivery, including
personal delivery, express mail, or private courier company, to the
disability insurer, or to the employer if the plan has contracted
with the employer for administrative services pursuant to subdivision
(d) of Section 10128.55, within the 60-day period following the
later of either (1) the date that the insured's coverage
under the group benefit plan terminated or will terminate by reason
of a qualifying event, or (2) the date the insured was sent notice
pursuant to subdivision (e) of Section 10128.55 of the ability to
continue coverage under the group benefit plan. The disclosure
required by this section shall also state that a qualified
beneficiary electing continuation shall pay to the disability
insurer, in accordance with the terms and conditions of the policy or
contract, which shall be set forth in the notice to the qualified
beneficiary pursuant to subdivision (d) of Section 10128.55, the
amount of the required premium payment, as set forth in Section
10128.56. The disclosure shall further require that the qualified
beneficiary's first premium payment required to establish premium
payment be delivered by first-class mail, certified mail, or other
reliable means of delivery, including personal delivery, express
mail, or private courier company, to the disability insurer, or to
the employer if the employer has contracted with the insurer to
perform the administrative services pursuant to subdivision (d) of
Section 10128.55, within 45 days of the date the qualified
beneficiary provided written notice to the insurer or the employer,
if the employer has contracted to perform the administrative
services, of the election to continue coverage in order for coverage
to be continued under this article. This disclosure shall also state
that the first premium payment must shall
equal an amount sufficient to pay all required premiums and all
premiums due, and that failure to submit the correct premium amount
within the 45-day period will disqualify the qualified beneficiary
from receiving continuation coverage pursuant to this article.
(c) The disclosure required by this section shall also describe
separately how qualified beneficiaries whose continuation coverage
terminates under a prior group benefit plan pursuant to Section
10128.57 may continue their coverage for the balance of the period
that the qualified beneficiary would have remained covered under the
prior group benefit plan, including the requirements for election and
payment. The disclosure shall clearly state that continuation
coverage shall terminate if the qualified beneficiary fails to comply
with the requirements pertaining to enrollment in, and payment of
premiums to, the new group benefit plan within 30 days of receiving
notice of the termination of the prior group benefit plan.
(d) Prior to August 1, 1998, every insurer shall provide to all
covered employees of employers subject to this article written notice
containing the disclosures required by this section, or shall
provide to all covered employees of employers subject to this article
a new or amended evidence of coverage that includes the disclosures
required by this section. Any insurer that, in the ordinary course of
business, maintains only the addresses of employer group purchasers
of benefits, and does not maintain addresses of covered employees,
may comply with the notice requirements of this section through the
provision of the notices to its employer group purchases of benefits.
(e) Every disclosure form issued, amended, or renewed on and after
January 1, 1999, for a group benefit plan subject to this article
shall provide a notice that, under state law, an insured may be
entitled to continuation of group coverage and that additional
information regarding eligibility for this coverage may be found in
the evidence of coverage.
(f) Every disclosure form A disclosure
issued, amended, or renewed on and after July 1, 2006,
or after July 1, 2016, for a group benefit plan
subject to this article shall include the following notice:
"In addition to your coverage continuation options, you may be
eligible for the following:
1. Coverage through the state health insurance marketplace, also
known as Covered California. By enrolling through Covered California,
you may qualify for lower monthly premiums and lower out-of-pocket
costs. Your family members may also qualify for coverage through
Covered California.
2. Coverage through Medi-Cal. Depending on your income, you may
qualify for low- or no-cost coverage through Medi-Cal. Your family
members may also qualify for Medi-Cal.
3. Coverage through an insured spouse. If your spouse has coverage
that extends to family members, you may be able to be added on that
benefit plan.
Be aware that there is a deadline to enroll in Covered California
although you can apply for Medi-Cal at anytime. To find out more
about how to apply for Covered California and Medi-Cal, visit the
Covered California Internet Web site at
http://www.coveredca.com."
(g) (1) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of PPACA, is repealed or amended to no longer apply to
the individual market, as defined in Section 2791 of the federal
Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section
shall become inoperative and is repealed 12 months after the date of
that repeal or amendment.
(2) For purposes of this subdivision, "PPACA" means the federal
Patient Protection and Affordable Care Act (Public Law 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), and any rules, regulations, or guidance
issued pursuant to that law.
"Please examine your options carefully before declining this
coverage. You should be aware that companies selling individual
health insurance typically require a review of your medical history
that could result in a higher premium or you could be denied coverage
entirely."
SEC. 20. Section 10128.54 is added to the
Insurance Code , to read:
10128.54. (a) Every insurer's evidence of coverage for group
benefit plans subject to this article, that is issued, amended, or
renewed on or after January 1, 1999, shall disclose to covered
employees of group benefit plans subject to this article the ability
to continue coverage pursuant to this article, as required by this
section.
(b) This disclosure shall state that all insureds who are eligible
to be qualified beneficiaries, as defined in subdivision (c) of
Section 10128.51, shall be required, as a condition of receiving
benefits pursuant to this article, to notify, in writing, the
insurer, or the employer if the employer contracts to perform the
administrative services as provided for in Section 10128.55, of all
qualifying events as specified in paragraphs (1), (3), (4), and (5)
of subdivision (d) of Section 10128.51 within 60 days of the date of
the qualifying event. This disclosure shall inform insureds that
failure to make the notification to the insurer, or to the employer
when under contract to provide the administrative services, within
the required 60 days will disqualify the qualified beneficiary from
receiving continuation coverage pursuant to this article. The
disclosure shall further state that a qualified beneficiary who
wishes to continue coverage under the group benefit plan pursuant to
this article must request the continuation in writing and deliver the
written request, by first-class mail, or other reliable means of
delivery, including personal delivery, express mail, or private
courier company, to the disability insurer, or to the employer if the
plan has contracted with the employer for administrative services
pursuant to subdivision (d) of Section 10128.55, within the 60-day
period following the later of either (1) the date that the insured's
coverage under the group benefit plan terminated or will terminate by
reason of a qualifying event, or (2) the date the insured was sent
notice pursuant to subdivision (e) of Section 10128.55 of the ability
to continue coverage under the group benefit plan. The disclosure
required by this section shall also state that a qualified
beneficiary electing continuation shall pay to the disability
insurer, in accordance with the terms and conditions of the policy or
contract, which shall be set forth in the notice to the qualified
beneficiary pursuant to subdivision (d) of Section 10128.55, the
amount of the required premium payment, as set forth in Section
10128.56. The disclosure shall further require that the qualified
beneficiary's first premium payment required to establish premium
payment be delivered by first-class mail, certified mail, or other
reliable means of delivery, including personal delivery, express
mail, or private courier company, to the disability insurer, or to
the employer if the employer has contracted with the insurer to
perform the administrative services pursuant to subdivision (d) of
Section 10128.55, within 45 days of the date the qualified
beneficiary provided written notice to the insurer or the employer,
if the employer has contracted to perform the administrative
services, of the election to continue coverage in order for coverage
to be continued under this article. This disclosure shall also state
that the first premium payment must equal an amount sufficient to pay
all required premiums and all premiums due, and that failure to
submit the correct premium amount within the 45-day period will
disqualify the qualified beneficiary from receiving continuation
coverage pursuant to this article.
(c) The disclosure required by this section shall also describe
separately how qualified beneficiaries whose continuation coverage
terminates under a prior group benefit plan pursuant to Section
10128.57 may continue their coverage for the balance of the period
that the qualified beneficiary would have remained covered under the
prior group benefit plan, including the requirements for election and
payment. The disclosure shall clearly state that continuation
coverage shall terminate if the qualified beneficiary fails to comply
with the requirements pertaining to enrollment in, and payment of
premiums to, the new group benefit plan within 30 days of receiving
notice of the termination of the prior group benefit plan.
(d) Prior to August 1, 1998, every insurer shall provide to all
covered employees of employers subject to this article written notice
containing the disclosures required by this section, or shall
provide to all covered employees of employers subject to this article
a new or amended evidence of coverage that includes the disclosures
required by this section. Any insurer that, in the ordinary course of
business, maintains only the addresses of employer group purchasers
of benefits, and does not maintain addresses of covered employees,
may comply with the notice requirements of this section through the
provision of the notices to its employer group purchases of benefits.
(e) Every disclosure form issued, amended, or renewed on or after
January 1, 1999, for a group benefit plan subject to this article
shall provide a notice that, under state law, an insured may be
entitled to continuation of group coverage and that additional
information regarding eligibility for this coverage may be found in
the evidence of coverage.
(f) Every disclosure issued, amended, or renewed on or after the
operative date of this section for a group benefit plan subject to
this article shall include the following notice:
"Please examine your options carefully before declining this
coverage. You should be aware that companies selling individual
health insurance typically require a review of your medical history
that could result in a higher premium or you could be denied coverage
entirely."
(g) A disclosure issued, amended, or renewed on or after July 1,
2016, for a group benefit plan subject to this article shall include
the following notice:
"In addition to your coverage continuation options, you may be
eligible for the following:
1. Coverage through the state health insurance marketplace, also
known as Covered California. By enrolling through Covered California,
you may qualify for lower monthly premiums and lower out-of-pocket
costs. Your family members may also qualify for coverage through
Covered California.
2. Coverage through Medi-Cal. Depending on your income, you may
qualify for low- or no-cost coverage through Medi-Cal. Your family
members may also qualify for Medi-Cal.
3. Coverage through an insured spouse. If your spouse has coverage
that extends to family members, you may be able to be added on that
benefit plan.
Be aware that there is a deadline to enroll in Covered California
although you can apply for Medi-Cal anytime. To find out more about
how to apply for Covered California and Medi-Cal, visit the Covered
California Internet Web site at
http://www.coveredca.com."
(h) (1) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of PPACA, is repealed or amended to no longer apply to
the individual market, as defined in Section 2791 of the federal
Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section
shall become operative 12 months after the date of that repeal or
amendment.
(2) For purposes of this subdivision, "PPACA" means the federal
Patient Protection and Affordable Care Act (Public Law 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), and any rules, regulations, or guidance
issued pursuant to that law.
SEC. 21. Section 10128.55 of the
Insurance Code is amended to read:
10128.55. (a) Every group benefit plan contract between a
disability insurer and an employer subject to this article that is
issued, amended, or renewed on or after July 1, 1998, shall require
the employer to notify the insurer in writing of any employee who has
had a qualifying event, as defined in paragraph (2) of subdivision
(d) of Section 10128.51, within 30 days of the qualifying event. The
group contract shall also require the employer to notify the insurer,
in writing, within 30 days of the date when the employer becomes
subject to Section 4980B of the United States Internal Revenue Code
or Chapter 18 of the Employee Retirement Income Security
Act, 29 Act (29 U.S.C. Sec. 1161 et
seq. seq.).
(b) Every group benefit plan contract between a disability insurer
and an employer subject to this article that is issued, amended, or
renewed after July 1, 1998, shall require the employer to notify
qualified beneficiaries currently receiving continuation coverage,
whose continuation coverage will terminate under one group benefit
plan prior to the end of the period the qualified beneficiary would
have remained covered, as specified in Section 10128.57, of the
qualified beneficiary's ability to continue coverage under a new
group benefit plan for the balance of the period the qualified
beneficiary would have remained covered under the prior group benefit
plan. This notice shall be provided either 30 days prior to the
termination or when all enrolled employees are notified, whichever is
later.
Every disability insurer shall provide to the employer replacing a
group benefit plan policy issued by the insurer, or to the employer'
s agent or broker representative, within 15 days of any written
request, information in possession of the insurer reasonably required
to administer the notification requirements of this subdivision and
subdivision (c).
(c) Notwithstanding subdivision (a), the group benefit plan
contract between the insurer and the employer shall require the
employer to notify the successor plan in writing of the qualified
beneficiaries currently receiving continuation coverage so that the
successor plan, or contracting employer or administrator, may provide
those qualified beneficiaries with the necessary premium
information, enrollment forms, and instructions consistent with the
disclosure required by subdivision (c) of Section 10128.54 and
subdivision (e) of this section to allow the qualified beneficiary to
continue coverage. This information shall be sent to all qualified
beneficiaries who are
enrolled in the group benefit plan and those qualified beneficiaries
who have been notified, pursuant to Section 10128.54 of their ability
to continue their coverage and may still elect coverage within the
specified 60-day period. This information shall be sent to the
qualified beneficiary's last known address, as provided to the
employer by the health care service plan or, disability insurer
currently providing continuation coverage to the qualified
beneficiary. The successor insurer shall not be obligated to provide
this information to qualified beneficiaries if the employer or prior
insurer or health care service plan fails to comply with this
section.
(d) A disability insurer may contract with an employer, or an
administrator, to perform the administrative obligations of the plan
as required by this article, including required notifications and
collecting and forwarding premiums to the insurer. Except for the
requirements of subdivisions (a), (b), and (c), this subdivision
shall not be construed to permit an insurer to require an employer to
perform the administrative obligations of the insurer as required by
this article as a condition of the issuance or renewal of coverage.
(e) Every insurer, or employer or administrator that contracts to
perform the notice and administrative services pursuant to this
section, shall, within 14 days of receiving a notice of a qualifying
event, provide to the qualified beneficiary the necessary premium
information, enrollment forms, and disclosures consistent with the
notice requirements contained in subdivisions (b) and (c) of Section
10128.54 to allow the qualified beneficiary to formally elect
continuation coverage. This information shall be sent to the
qualified beneficiary's last known address.
(f) Every insurer, or employer or administrator that contracts to
perform the notice and administrative services pursuant to this
section, shall, during the 180-day period ending on the date that
continuation coverage is terminated pursuant to paragraphs (1), (3),
and (5) of subdivision (a) of Section 10128.57, notify a qualified
beneficiary who has elected continuation coverage pursuant to this
article of the date that his or her coverage will terminate, and
shall notify the qualified beneficiary of any conversion coverage
available to that qualified beneficiary. This requirement shall not
apply when the continuation coverage is terminated because the group
contract between the insurer and the employer is being terminated.
(g) (1) An insurer shall provide to a qualified beneficiary who
has a qualifying event during the period specified in subparagraph
(A) of paragraph (3) of subdivision (a) of Section 3001 of ARRA, a
written notice containing information on the availability of premium
assistance under ARRA. This notice shall be sent to the qualified
beneficiary's last known address. The notice shall include clear and
easily understandable language to inform the qualified beneficiary
that changes in federal law provide a new opportunity to elect
continuation coverage with a 65-percent premium subsidy and shall
include all of the following:
(A) The amount of the premium the person will pay. For qualified
beneficiaries who had a qualifying event between September 1, 2008,
and May 12, 2009, inclusive, if an insurer is unable to provide the
correct premium amount in the notice, the notice may contain the last
known premium amount and an opportunity for the qualified
beneficiary to request, through a toll-free telephone number, the
correct premium that would apply to the beneficiary.
(B) Enrollment forms and any other information required to be
included pursuant to subdivision (e) to allow the qualified
beneficiary to elect continuation coverage. This information shall
not be included in notices sent to qualified beneficiaries currently
enrolled in continuation coverage.
(C) A description of the option to enroll in different coverage as
provided in subparagraph (B) of paragraph (1) of subdivision (a) of
Section 3001 of ARRA. This description shall advise the qualified
beneficiary to contact the covered employee's former employer for
prior approval to choose this option.
(D) The eligibility requirements for premium assistance in the
amount of 65 percent of the premium under Section 3001 of ARRA.
(E) The duration of premium assistance available under ARRA.
(F) A statement that a qualified beneficiary eligible for premium
assistance under ARRA may elect continuation coverage no later than
60 days of the date of the notice.
(G) A statement that a qualified beneficiary eligible for premium
assistance under ARRA who rejected or discontinued continuation
coverage prior to receiving the notice required by this subdivision
has the right to withdraw that rejection and elect continuation
coverage with the premium assistance.
(H) A statement that reads as follows:
"IF YOU ARE HAVING ANY DIFFICULTIES READING OR UNDERSTANDING THIS
NOTICE, PLEASE CONTACT name of insurer] at insert appropriate
telephone number]."
(2) With respect to qualified beneficiaries who had a qualifying
event between September 1, 2008, and May 12, 2009, inclusive, the
notice described in this subdivision shall be provided by the later
of May 26, 2009, or seven business days after the date the insurer
receives notice of the qualifying event.
(3) With respect to qualified beneficiaries who had or have a
qualifying event between May 13, 2009, and the later date specified
in subparagraph (A) of paragraph (3) of subdivision (a) of Section
3001 of ARRA, inclusive, the notice described in this subdivision
shall be provided within the period of time specified in subdivision
(e).
(4) Nothing in this section shall be construed to require an
insurer to provide the insurer's evidence of coverage as a part of
the notice required by this subdivision, and nothing in this section
shall be construed to require an insurer to amend its existing
evidence of coverage to comply with the changes made to this section
by the enactment of Assembly Bill 23 of the 2009-10 Regular Session
or by the act amending this section during the second year of the
2009-10 Regular Session.
(5) The requirement under this subdivision to provide a written
notice to a qualified beneficiary and the requirement under paragraph
(1) of subdivision (h) (i) to provide
a new opportunity to a qualified beneficiary to elect continuation
coverage shall be deemed satisfied if an insurer previously provided
a written notice and additional election opportunity under Section
3001 of ARRA to that qualified beneficiary prior to the effective
date of the act adding this paragraph.
(h) A group contract between a group benefit plan and an employer
subject to this article that is issued, amended, or renewed on or
after July 1, 2016, shall require the employer to give the following
notice to a qualified beneficiary in connection with a notice
regarding election of continuation coverage:
"In addition to your coverage continuation options, you may be
eligible for the following:
1. Coverage through the state health insurance marketplace, also
known as Covered California. By enrolling through Covered California,
you may qualify for lower monthly premiums and lower out-of-pocket
costs. Your family members may also qualify for coverage through
Covered California.
2. Coverage through Medi-Cal. Depending on your income, you may
qualify for low- or no-cost coverage through Medi-Cal. Your family
members may also qualify for Medi-Cal.
3. Coverage through an insured spouse. If your spouse has coverage
that extends to family members, you may be able to be added on that
benefit plan.
Be aware that there is a deadline to enroll in Covered California
although you can apply for Medi-Cal anytime. To find out more about
how to apply for Covered California and Medi-Cal, visit the Covered
California Internet Web site at
http://www.coveredca.com."
(h)
(i) (1) Notwithstanding any other provision of
law, a qualified beneficiary eligible for premium
assistance under ARRA may elect continuation coverage no later than
60 days after the date of the notice required by subdivision (g).
(2) For a qualified beneficiary who elects to continue coverage
pursuant to this subdivision, the period beginning on the date of the
qualifying event and ending on the effective date of the
continuation coverage shall be disregarded for purposes of
calculating a break in coverage in determining whether a preexisting
condition provision applies under subdivision (e) of Section 10198.7
or subdivision (c) of Section 10708.
(3) For a qualified beneficiary who had a qualifying event between
September 1, 2008, and February 16, 2009, inclusive, and who elects
continuation coverage pursuant to paragraph (1), the continuation
coverage shall commence on the first day of the month following the
election.
(4) For a qualified beneficiary who had a qualifying event between
February 17, 2009, and May 12, 2009, inclusive, and who elects
continuation coverage pursuant to paragraph (1), the effective date
of the continuation coverage shall be either of the following, at the
option of the beneficiary, provided that the beneficiary pays the
applicable premiums:
(A) The date of the qualifying event.
(B) The first day of the month following the election.
(5) Notwithstanding any other provision of law,
a qualified beneficiary who is eligible for the special election
period described in paragraph (17) of subdivision (a) of Section 3001
of ARRA may elect continuation coverage no later than 60 days after
the date of the notice required under subdivision (j).
(k). For a qualified beneficiary who elects
coverage pursuant to this paragraph, the continuation coverage shall
be effective as of the first day of the first period of coverage
after the date of termination of employment, except, if federal law
permits, coverage shall take effect on the first day of the month
following the election. However, for purposes of calculating the
duration of continuation coverage pursuant to Section 10128.57, the
period of that coverage shall be determined as though the qualifying
event was a reduction of hours of the employee.
(6) Notwithstanding any other provision of law,
a qualified beneficiary who is eligible for any other special
election period under ARRA may elect continuation coverage no later
than 60 days after the date of the special election notice required
under ARRA.
(i)
(j) An insurer shall provide a qualified beneficiary
eligible for premium assistance under ARRA written notice of the
extension of that premium assistance as required under Section 3001
of ARRA.
(j)
(k) A health insurer, or an administrator or employer
if administrative obligations have been assumed by those entities
pursuant to subdivision (d), shall give the qualified beneficiaries
described in subparagraph (C) of paragraph (17) of subdivision (a) of
Section 3001 of ARRA the written notice required by that paragraph
by implementing the following procedures:
(1) The insurer shall, within 14 days of the effective date of the
act adding this subdivision, send a notice to employers currently
contracting with the insurer for a group benefit plan subject to this
article. The notice shall do all of the following:
(A) Advise the employer that employees whose employment is
terminated on or after March 2, 2010, who were previously enrolled in
any group health care service plan or health insurance policy
offered by the employer may be entitled to special health coverage
rights, including a subsidy paid by the federal government for a
portion of the premium.
(B) Ask the employer to provide the insurer with the name,
address, and date of termination of employment for any employee whose
employment is terminated on or after March 2, 2010, and who was at
any time covered by any health care service plan or health insurance
policy offered to their employees on or after September 1, 2008.
(C) Provide employers with a format and instructions for
submitting the information to the insurer, or their administrator or
employer who has assumed administrative obligations pursuant to
subdivision (d), by telephone, fax, electronic mail, or mail.
(2) Within 14 days of receipt of the information specified in
paragraph (1) from the employer, the insurer shall send the written
notice specified in paragraph (17) of subdivision (a) of Section 3001
of ARRA to those individuals.
(3) If an individual contacts his or her health insurer and
indicates that he or she experienced a qualifying event that entitles
him or her to the special election period described in paragraph
(17) of subdivision (a) of Section 3001 of ARRA or any other special
election provision of ARRA, the insurer shall provide the individual
with the notice required under paragraph (17) of subdivision (a) of
Section 3001 of ARRA or any other applicable provision of ARRA,
regardless of whether the insurer receives or received information
from the individual's previous employer regarding that individual
pursuant to Section 24100 of the Health and Safety Code. The insurer
shall review the individual's application for coverage under this
special election notice to determine if the individual qualifies for
the special election period and the premium assistance under ARRA.
The insurer shall comply with paragraph (5) if the individual does
not qualify for either the special election period or premium
assistance under ARRA.
(4) The requirement under this subdivision to provide the written
notice described in paragraph (17) of subdivision (a) of Section 3001
of ARRA to a qualified beneficiary and the requirement under
paragraph (5) of subdivision (h) (i) to
provide a new opportunity to a qualified beneficiary to elect
continuation coverage shall be deemed satisfied if a health insurer
previously provided the written notice and additional election
opportunity described in paragraph (17) of subdivision (a) of Section
3001 of ARRA to that qualified beneficiary prior to the effective
date of the act adding this paragraph.
(5) If an individual does not qualify for either a special
election period or the subsidy under ARRA, the insurer shall provide
a written notice to that individual that shall include information on
the right to appeal as set forth in Section 3001 of ARRA.
(6) A health insurer shall provide information on its publicly
accessible Internet Web site regarding the premium assistance made
available under ARRA and any special election period provided under
that law. An insurer may fulfill this requirement by linking or
otherwise directing consumers to the information regarding COBRA
continuation coverage premium assistance located on the Internet Web
site of the United States Department of Labor. The information
required by this paragraph shall be located in a section of the
insurer's Internet Web site that is readily accessible to consumers,
such as the Web site's Frequently Asked Questions section.
(k)
(l) Notwithstanding any other provision of
law, a qualified beneficiary eligible for premium
assistance under ARRA may elect to enroll in different coverage
subject to the criteria provided under subparagraph (B) of paragraph
(1) of subdivision (a) of Section 3001 of ARRA.
(l)
(m) A qualified beneficiary enrolled in continuation
coverage as of February 17, 2009, who is eligible for premium
assistance under ARRA may request application of the premium
assistance as of March 1, 2009, or later, consistent with ARRA.
(m)
(n) An insurer that receives an election notice from a
qualified beneficiary eligible for premium assistance under ARRA,
pursuant to subdivision (h), (i), shall
be considered a person entitled to reimbursement, as defined in
Section 6432(b)(3) of the Internal Revenue Code, as amended by
paragraph (12) of subdivision (a) of Section 3001 of ARRA.
(n)
(o) (1) For purposes of compliance with ARRA, in the
absence of guidance from, or if specifically required for state-only
continuation coverage by, the United States Department of Labor, the
Internal Revenue Service, or the Centers for Medicare and Medicaid
Services, an insurer may request verification of the involuntary
termination of a covered employee's employment from the covered
employee's former employer or the qualified beneficiary seeking
premium assistance under ARRA.
(2) An insurer that requests verification pursuant to paragraph
(1) directly from a covered employee's former employer shall do so by
providing a written notice to the employer. This written notice
shall be sent by mail or facsimile to the covered employee's former
employer within seven business days from the date the insurer
receives the qualified beneficiary's election notice pursuant to
subdivision (h). (i). Within 10
calendar days of receipt of written notice required by this
paragraph, the former employer shall furnish to the insurer written
verification as to whether the covered employee's employment was
involuntarily terminated.
(3) A qualified beneficiary requesting premium assistance under
ARRA may furnish to the insurer a written document or other
information from the covered employee's former employer indicating
that the covered employee's employment was involuntarily terminated.
This document or information shall be deemed sufficient by the
insurer to establish that the covered employee's employment was
involuntarily terminated for purposes of ARRA, unless the insurer
makes a reasonable and timely determination that the documents or
information provided by the qualified beneficiary are legally
insufficient to establish involuntary termination of employment.
(4) If an insurer requests verification pursuant to this
subdivision and cannot verify involuntary termination of employment
within 14 business days from the date the employer receives the
verification request or from the date the insurer receives
documentation or other information from the qualified beneficiary
pursuant to paragraph (3), the insurer shall either provide
continuation coverage with the federal premium assistance to the
qualified beneficiary or send the qualified beneficiary a denial
letter which shall include notice of his or her right to appeal that
determination pursuant to ARRA.
(5) No person shall intentionally delay verification of
involuntary termination of employment under this subdivision.
(p) (1) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of PPACA, is repealed or amended to no longer apply to
the individual market, as defined in Section 2791 of the federal
Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section
shall become inoperative and is repealed 12 months after the date of
that repeal or amendment.
(2) For purposes of this subdivision, "PPACA" means the federal
Patient Protection and Affordable Care Act (Public Law 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), and any rules, regulations, or guidance
issued pursuant to that law.
SEC. 22. Section 10128.55 is added to the
Insurance Code , to read:
10128.55. (a) Every group benefit plan contract between a
disability insurer and an employer subject to this article that is
issued, amended, or renewed on or after July 1, 1998, shall require
the employer to notify the insurer in writing of any employee who has
had a qualifying event, as defined in paragraph (2) of subdivision
(d) of Section 10128.51, within 30 days of the qualifying event. The
group contract shall also require the employer to notify the insurer,
in writing, within 30 days of the date when the employer becomes
subject to Section 4980B of the United States Internal Revenue Code
or Chapter 18 of the Employee Retirement Income Security Act (29
U.S.C. Sec. 1161 et seq.).
(b) Every group benefit plan contract between a disability insurer
and an employer subject to this article that is issued, amended, or
renewed after July 1, 1998, shall require the employer to notify
qualified beneficiaries currently receiving continuation coverage,
whose continuation coverage will terminate under one group benefit
plan prior to the end of the period the qualified beneficiary would
have remained covered, as specified in Section 10128.57, of the
qualified beneficiary's ability to continue coverage under a new
group benefit plan for the balance of the period the qualified
beneficiary would have remained covered under the prior group benefit
plan. This notice shall be provided either 30 days prior to the
termination or when all enrolled employees are notified, whichever is
later.
Every disability insurer shall provide to the employer replacing a
group benefit plan policy issued by the insurer, or to the employer'
s agent or broker representative, within 15 days of any written
request, information in possession of the insurer reasonably required
to administer the notification requirements of this subdivision and
subdivision (c).
(c) Notwithstanding subdivision (a), the group benefit plan
contract between the insurer and the employer shall require the
employer to notify the successor plan in writing of the qualified
beneficiaries currently receiving continuation coverage so that the
successor plan, or contracting employer or administrator, may provide
those qualified beneficiaries with the necessary premium
information, enrollment forms, and instructions consistent with the
disclosure required by subdivision (c) of Section 10128.54 and
subdivision (e) of this section to allow the qualified beneficiary to
continue coverage. This information shall be sent to all qualified
beneficiaries who are enrolled in the group benefit plan and those
qualified beneficiaries who have been notified, pursuant to Section
10128.54 of their ability to continue their coverage and may still
elect coverage within the specified 60-day period. This information
shall be sent to the qualified beneficiary's last known address, as
provided to the employer by the health care service plan or,
disability insurer currently providing continuation coverage to the
qualified beneficiary. The successor insurer shall not be obligated
to provide this information to qualified beneficiaries if the
employer or prior insurer or health care service plan fails to comply
with this section.
(d) A disability insurer may contract with an employer, or an
administrator, to perform the administrative obligations of the plan
as required by this article, including required notifications and
collecting and forwarding premiums to the insurer. Except for the
requirements of subdivisions (a), (b), and (c), this subdivision
shall not be construed to permit an insurer to require an employer to
perform the administrative obligations of the insurer as required by
this article as a condition of the issuance or renewal of coverage.
(e) Every insurer, or employer or administrator that contracts to
perform the notice and administrative services pursuant to this
section, shall, within 14 days of receiving a notice of a qualifying
event, provide to the qualified beneficiary the necessary premium
information, enrollment forms, and disclosures consistent with the
notice requirements contained in subdivisions (b) and (c) of Section
10128.54 to allow the qualified beneficiary to formally elect
continuation coverage. This information shall be sent to the
qualified beneficiary's last known address.
(f) Every insurer, or employer or administrator that contracts to
perform the notice and administrative services pursuant to this
section, shall, during the 180-day period ending on the date that
continuation coverage is terminated pursuant to paragraphs (1), (3),
and (5) of subdivision (a) of Section 10128.57, notify a qualified
beneficiary who has elected continuation coverage pursuant to this
article of the date that his or her coverage will terminate, and
shall notify the qualified beneficiary of any conversion coverage
available to that qualified beneficiary. This requirement shall not
apply when the continuation coverage is terminated because the group
contract between the insurer and the employer is being terminated.
(g) (1) An insurer shall provide to a qualified beneficiary who
has a qualifying event during the period specified in subparagraph
(A) of paragraph (3) of subdivision (a) of Section 3001 of ARRA, a
written notice containing information on the availability of premium
assistance under ARRA. This notice shall be sent to the qualified
beneficiary's last known address. The notice shall include clear and
easily understandable language to inform the qualified beneficiary
that changes in federal law provide a new opportunity to elect
continuation coverage with a 65-percent premium subsidy and shall
include all of the following:
(A) The amount of the premium the person will pay. For qualified
beneficiaries who had a qualifying event between September 1, 2008,
and May 12, 2009, inclusive, if an insurer is unable to provide the
correct premium amount in the notice, the notice may contain the last
known premium amount and an opportunity for the qualified
beneficiary to request, through a toll-free telephone number, the
correct premium that would apply to the beneficiary.
(B) Enrollment forms and any other information required to be
included pursuant to subdivision (e) to allow the qualified
beneficiary to elect continuation coverage. This information shall
not be included in notices
sent to qualified beneficiaries currently enrolled in continuation
coverage.
(C) A description of the option to enroll in different coverage as
provided in subparagraph (B) of paragraph (1) of subdivision (a) of
Section 3001 of ARRA. This description shall advise the qualified
beneficiary to contact the covered employee's former employer for
prior approval to choose this option.
(D) The eligibility requirements for premium assistance in the
amount of 65 percent of the premium under Section 3001 of ARRA.
(E) The duration of premium assistance available under ARRA.
(F) A statement that a qualified beneficiary eligible for premium
assistance under ARRA may elect continuation coverage no later than
60 days of the date of the notice.
(G) A statement that a qualified beneficiary eligible for premium
assistance under ARRA who rejected or discontinued continuation
coverage prior to receiving the notice required by this subdivision
has the right to withdraw that rejection and elect continuation
coverage with the premium assistance.
(H) A statement that reads as follows:
"IF YOU ARE HAVING ANY DIFFICULTIES READING OR UNDERSTANDING THIS
NOTICE, PLEASE CONTACT name of insurer] at insert appropriate
telephone number]."
(2) With respect to qualified beneficiaries who had a qualifying
event between September 1, 2008, and May 12, 2009, inclusive, the
notice described in this subdivision shall be provided by the later
of May 26, 2009, or seven business days after the date the insurer
receives notice of the qualifying event.
(3) With respect to qualified beneficiaries who had or have a
qualifying event between May 13, 2009, and the later date specified
in subparagraph (A) of paragraph (3) of subdivision (a) of Section
3001 of ARRA, inclusive, the notice described in this subdivision
shall be provided within the period of time specified in subdivision
(e).
(4) Nothing in this section shall be construed to require an
insurer to provide the insurer's evidence of coverage as a part of
the notice required by this subdivision, and nothing in this section
shall be construed to require an insurer to amend its existing
evidence of coverage to comply with the changes made to this section
by the enactment of Assembly Bill 23 of the 2009-10 Regular Session
or by the act amending this section during the second year of the
2009-10 Regular Session.
(5) The requirement under this subdivision to provide a written
notice to a qualified beneficiary and the requirement under paragraph
(1) of subdivision (h) to provide a new opportunity to a qualified
beneficiary to elect continuation coverage shall be deemed satisfied
if an insurer previously provided a written notice and additional
election opportunity under Section 3001 of ARRA to that qualified
beneficiary prior to the effective date of the act adding this
paragraph.
(h) A group contract between a group benefit plan and an employer
subject to this article that is issued, amended, or renewed on or
after the operative date of this section shall require the employer
to give the following notice to a qualified beneficiary in connection
with a notice regarding election of continuation coverage:
"Please examine your options carefully before declining this
coverage. You should be aware that companies selling individual
health insurance typically require a review of your medical history
that could result in a higher premium or you could be denied coverage
entirely."
(i) A group contract between a group benefit plan and an employer
subject to this article that is issued, amended, or renewed on or
after July 1, 2016, shall require the employer to give the following
notice to a qualified beneficiary in connection with a notice
regarding election of continuation coverage:
"In addition to your coverage continuation options, you may be
eligible for the following:
1. Coverage through the state health insurance marketplace, also
known as Covered California. By enrolling through Covered California,
you may qualify for lower monthly premiums and lower out-of-pocket
costs. Your family members may also qualify for coverage through
Covered California.
2. Coverage through Medi-Cal. Depending on your income, you may
qualify for low- or no-cost coverage through Medi-Cal. Your family
members may also qualify for Medi-Cal.
3. Coverage through an insured spouse. If your spouse has coverage
that extends to family members, you may be able to be added on that
benefit plan.
Be aware that there is a deadline to enroll in Covered California
although you can apply for Medi-Cal anytime. To find out more about
how to apply for Covered California and Medi-Cal, visit the Covered
California Internet Web site at http://www.coveredca.com."
(j) (1) Notwithstanding any other law, a qualified beneficiary
eligible for premium assistance under ARRA may elect continuation
coverage no later than 60 days after the date of the notice required
by subdivision (g).
(2) For a qualified beneficiary who elects to continue coverage
pursuant to this subdivision, the period beginning on the date of the
qualifying event and ending on the effective date of the
continuation coverage shall be disregarded for purposes of
calculating a break in coverage in determining whether a preexisting
condition provision applies under subdivision (e) of Section 10198.7
or subdivision (c) of Section 10708.
(3) For a qualified beneficiary who had a qualifying event between
September 1, 2008, and February 16, 2009, inclusive, and who elects
continuation coverage pursuant to paragraph (1), the continuation
coverage shall commence on the first day of the month following the
election.
(4) For a qualified beneficiary who had a qualifying event between
February 17, 2009, and May 12, 2009, inclusive, and who elects
continuation coverage pursuant to paragraph (1), the effective date
of the continuation coverage shall be either of the following, at the
option of the beneficiary, provided that the beneficiary pays the
applicable premiums:
(A) The date of the qualifying event.
(B) The first day of the month following the election.
(5) Notwithstanding any other law, a qualified beneficiary who is
eligible for the special election period described in paragraph (17)
of subdivision (a) of Section 3001 of ARRA may elect continuation
coverage no later than 60 days after the date of the notice required
under subdivision (l). For a qualified beneficiary who elects
coverage pursuant to this paragraph, the continuation coverage shall
be effective as of the first day of the first period of coverage
after the date of termination of employment, except, if federal law
permits, coverage shall take effect on the first day of the month
following the election. However, for purposes of calculating the
duration of continuation coverage pursuant to Section 10128.57, the
period of that coverage shall be determined as though the qualifying
event was a reduction of hours of the employee.
(6) Notwithstanding any other law, a qualified beneficiary who is
eligible for any other special election period under ARRA may elect
continuation coverage no later than 60 days after the date of the
special election notice required under ARRA.
(k) An insurer shall provide a qualified beneficiary eligible for
premium assistance under ARRA written notice of the extension of that
premium assistance as required under Section 3001 of ARRA.
(l) A health insurer, or an administrator or employer if
administrative obligations have been assumed by those entities
pursuant to subdivision (d), shall give the qualified beneficiaries
described in subparagraph (C) of paragraph (17) of subdivision (a) of
Section 3001 of ARRA the written notice required by that paragraph
by implementing the following procedures:
(1) The insurer shall, within 14 days of the effective date of the
act adding this subdivision, send a notice to employers currently
contracting with the insurer for a group benefit plan subject to this
article. The notice shall do all of the following:
(A) Advise the employer that employees whose employment is
terminated on or after March 2, 2010, who were previously enrolled in
any group health care service plan or health insurance policy
offered by the employer may be entitled to special health coverage
rights, including a subsidy paid by the federal government for a
portion of the premium.
(B) Ask the employer to provide the insurer with the name,
address, and date of termination of employment for any employee whose
employment is terminated on or after March 2, 2010, and who was at
any time covered by any health care service plan or health insurance
policy offered to their employees on or after September 1, 2008.
(C) Provide employers with a format and instructions for
submitting the information to the insurer, or their administrator or
employer who has assumed administrative obligations pursuant to
subdivision (d), by telephone, fax, electronic mail, or mail.
(2) Within 14 days of receipt of the information specified in
paragraph (1) from the employer, the insurer shall send the written
notice specified in paragraph (17) of subdivision (a) of Section 3001
of ARRA to those individuals.
(3) If an individual contacts his or her health insurer and
indicates that he or she experienced a qualifying event that entitles
him or her to the special election period described in paragraph
(17) of subdivision (a) of Section 3001 of ARRA or any other special
election provision of ARRA, the insurer shall provide the individual
with the notice required under paragraph (17) of subdivision (a) of
Section 3001 of ARRA or any other applicable provision of ARRA,
regardless of whether the insurer receives or received information
from the individual's previous employer regarding that individual
pursuant to Section 24100 of the Health and Safety Code. The insurer
shall review the individual's application for coverage under this
special election notice to determine if the individual qualifies for
the special election period and the premium assistance under ARRA.
The insurer shall comply with paragraph (5) if the individual does
not qualify for either the special election period or premium
assistance under ARRA.
(4) The requirement under this subdivision to provide the written
notice described in paragraph (17) of subdivision (a) of Section 3001
of ARRA to a qualified beneficiary and the requirement under
paragraph (5) of subdivision (j) to provide a new opportunity to a
qualified beneficiary to elect continuation coverage shall be deemed
satisfied if a health insurer previously provided the written notice
and additional election opportunity described in paragraph (17) of
subdivision (a) of Section 3001 of ARRA to that qualified beneficiary
prior to the effective date of the act adding this paragraph.
(5) If an individual does not qualify for either a special
election period or the subsidy under ARRA, the insurer shall provide
a written notice to that individual that shall include information on
the right to appeal as set forth in Section 3001 of ARRA.
(6) A health insurer shall provide information on its publicly
accessible Internet Web site regarding the premium assistance made
available under ARRA and any special election period provided under
that law. An insurer may fulfill this requirement by linking or
otherwise directing consumers to the information regarding COBRA
continuation coverage premium assistance located on the Internet Web
site of the United States Department of Labor. The information
required by this paragraph shall be located in a section of the
insurer's Internet Web site that is readily accessible to consumers,
such as the Web site's Frequently Asked Questions section.
(m) Notwithstanding any other law, a qualified beneficiary
eligible for premium assistance under ARRA may elect to enroll in
different coverage subject to the criteria provided under
subparagraph (B) of paragraph (1) of subdivision (a) of Section 3001
of ARRA.
(n) A qualified beneficiary enrolled in continuation coverage as
of February 17, 2009, who is eligible for premium assistance under
ARRA may request application of the premium assistance as of March 1,
2009, or later, consistent with ARRA.
(o) An insurer that receives an election notice from a qualified
beneficiary eligible for premium assistance under ARRA, pursuant to
subdivision (j), shall be considered a person entitled to
reimbursement, as defined in Section 6432(b)(3) of the Internal
Revenue Code, as amended by paragraph (12) of subdivision (a) of
Section 3001 of ARRA.
(p) (1) For purposes of compliance with ARRA, in the absence of
guidance from, or if specifically required for state-only
continuation coverage by, the United States Department of Labor, the
Internal Revenue Service, or the Centers for Medicare and Medicaid
Services, an insurer may request verification of the involuntary
termination of a covered employee's employment from the covered
employee's former employer or the qualified beneficiary seeking
premium assistance under ARRA.
(2) An insurer that requests verification pursuant to paragraph
(1) directly from a covered employee's former employer shall do so by
providing a written notice to the employer. This written notice
shall be sent by mail or facsimile to the covered employee's former
employer within seven business days from the date the insurer
receives the qualified beneficiary's election notice pursuant to
subdivision (h). Within 10 calendar days of receipt of written notice
required by this paragraph, the former employer shall furnish to the
insurer written verification as to whether the covered employee's
employment was involuntarily terminated.
(3) A qualified beneficiary requesting premium assistance under
ARRA may furnish to the insurer a written document or other
information from the covered employee's former employer indicating
that the covered employee's employment was involuntarily terminated.
This document or information shall be deemed sufficient by the
insurer to establish that the covered employee's employment was
involuntarily terminated for purposes of ARRA, unless the insurer
makes a reasonable and timely determination that the documents or
information provided by the qualified beneficiary are legally
insufficient to establish involuntary termination of employment.
(4) If an insurer requests verification pursuant to this
subdivision and cannot verify involuntary termination of employment
within 14 business days from the date the employer receives the
verification request or from the date the insurer receives
documentation or other information from the qualified beneficiary
pursuant to paragraph (3), the insurer shall either provide
continuation coverage with the federal premium assistance to the
qualified beneficiary or send the qualified beneficiary a denial
letter which shall include notice of his or her right to appeal that
determination pursuant to ARRA.
(5) No person shall intentionally delay verification of
involuntary termination of employment under this subdivision.
(q) (1) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of PPACA, is repealed or amended to no longer apply to
the individual market, as defined in Section 2791 of the federal
Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section
shall become operative 12 months after the date of that repeal or
amendment.
(2) For purposes of this subdivision, "PPACA" means the federal
Patient Protection and Affordable Care Act (Public Law 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), and any rules, regulations, or guidance
issued pursuant to that law.
SEC. 23. Section 729.12 of the Welfare
and Institutions Code is amended to read:
729.12. (a) It is the intent of the Legislature to authorize an
Assessment, Orientation, and Volunteer Mentor Pilot Program in San
Diego County. The pilot project will operate under the authority of
the county Alcohol and Drug Program Administrator
behavioral health director in conjunction with the San
Diego Juvenile Court and the County of San Diego Probation
Department.
(b) Whenever a judge of the San Diego County Juvenile Court or a
referee of the San Diego Juvenile Court finds a minor to be a person
described in Section 601 or 602 for any reason, the minor may be
assessed and screened for drug and alcohol use and abuse; and if the
assessment and screening determines the need for drug and alcohol
education and intervention, the minor may be required to participate
in, and successfully complete, an alcohol and drug orientation, and
to participate in, and successfully complete, an alcohol or drug
program with a local community-based service provider, as designated
by the court.
(c) The Assessment, Orientation, and Volunteer Mentor Pilot
Program may operate for a minimum of three years and may screen and
assess for drug and alcohol problems, minors who are declared wards
of San Diego Juvenile Court.
(d) Drug and alcohol assessments may be conducted utilizing a
standardized instrument that shall be approved by the county
Alcohol and Drug Program Administrator behavioral
health director in conjunction with San Diego Juvenile Court
and the San Diego County Probation Department.
(e) Those minors who are determined to have drug and alcohol
problems, may be required to participate in, and successfully
complete, a drug and alcohol orientation. The orientation may provide
drug and alcohol education and intervention, referral to community
resources for followup education and intervention and arrange for
volunteers to serve as mentors to assist each minor in addressing
their drug and alcohol problem. Parents or guardians of minors will
have the opportunity to participate in the orientation program in
order to help juveniles address drug and alcohol use or abuse
problems.
(f) As a condition of probation, each minor may be required to
submit to drug testing. Drug testing may be conducted on a random
basis by a qualified drug and alcohol service provider in
coordination with the county probation department. All contested drug
tests may be confirmed by a National Institute for Drug Abuse
certified drug laboratory and the findings may be reported to the
probation officer for appropriate action. The drug testing protocol
may be approved by the county Alcohol and Drug Program
Administrator behavioral health director in
conjunction with San Diego Juvenile Court and the County of San Diego
Probation Department.
(g) An evaluation of the pilot program shall be conducted and
results of the program shall be submitted to state alcohol and drug
programs and to the Legislature at the conclusion of the pilot
program. The evaluation shall include, but not be limited to, all of
the following:
(1) The number and percentage of juveniles screened.
(2) The number and percentage of juveniles given followup
education and intervention.
(3) The number of mentors recruited and trained.
(4) The number and percentage of juveniles assigned to a mentor.
(5) The length of time in an education and intervention program.
(6) The program completion rates.
(7) The number of subsequent violations.
(8) The number of re-arrests.
(9) The urine test results.
(10) The subsequent drug or alcohol use.
(11) The participant's perceptions of program utility.
(12) The provider's perceptions of program utility.
(13) The mentor's perceptions of program utility.
SEC. 9. SEC. 24. Section 4033 of the
Welfare and Institutions Code is amended to read:
4033. (a) The State Department of Health Care Services shall, to
the extent resources are available, comply with the Substance Abuse
and Mental Health Services Administration federal planning
requirements. The department shall update and issue a state plan,
which may also be any federally required state service plan, so that
citizens may be informed regarding the implementation of, and
long-range goals for, programs to serve mentally ill persons in the
state. The department shall gather information from counties
necessary to comply with this section.
(b) (1) If the State Department of Health Care Services makes a
decision not to comply with any Substance Abuse and Mental Health
Services Administration federal planning requirement to which this
section applies, the State Department of Health Care Services shall
submit the decision, for consultation, to the County Behavioral
Health Directors Association of California, the California Mental
Health Planning Council, and affected mental health entities.
(2) The State Department of Health Care Services shall not
implement any decision not to comply with the Substance Abuse and
Mental Health Services Administration federal planning requirements
sooner than 30 days after notification of that decision, in writing,
by the Department of Finance, to the chairperson of the committee in
each house of the Legislature that considers appropriations, and the
Chairperson of the Joint Legislative Budget Committee.
SEC. 10. SEC. 25. Section 4040 of
the Welfare and Institutions Code is amended to read:
4040. The State Department of Health Care Services or State
Department of State Hospitals may conduct, or contract for, research
or evaluation studies that have application to mental health policy
and management issues. In selecting areas for study the department
shall be guided by the information needs of state and local
policymakers and managers, and suggestions from the County Behavioral
Health Directors Association of California.
SEC. 11. SEC. 26. Section 4095 of
the Welfare and Institutions Code is amended to read:
4095. (a) It is the intent of the Legislature that essential and
culturally relevant mental health assessment, case management, and
treatment services be available to wards of the court and dependent
children of the court placed out of home or who are at risk of
requiring out-of-home care. This can be best achieved at the
community level through the active collaboration of county social
service, probation, education, mental health agencies, and foster
care providers.
(b) Therefore, using the Children's Mental Health Services Act
(Part 4 (commencing with Section 5850) of Division 5) as a guideline,
the State Department of Health Care Services, in consultation with
the County Behavioral Health Directors Association of California, the
State Department of Social Services, the County Welfare Directors
Association, Association of California,
the Chief Probation Officers of California, and foster care
providers, shall do all of the following:
(1) By July 1, 1994, develop an individualized mental health
treatment needs assessment protocol for wards of the court and
dependent children of the court.
(2) Define supplemental services to be made available to the
target population, including, but not limited to, services defined in
Section 540 and following of Title 9 of the California Code of
Regulations as of January 1, 1994, family therapy, prevocational
services, and crisis support activities.
(3) Establish statewide standardized rates for the various types
of services defined by the department in accordance with paragraph
(2), and provided pursuant to this section. The rates shall be
designed to reduce the impact of competition for scarce treatment
resources on the cost and availability of care. The rates shall be
implemented only when the state provides funding for the services
described in this section.
(4) By January 1, 1994, to the extent state funds are available to
implement this section, establish, by regulation, all of the
following:
(A) Definitions of priority ranking of subsets of the court wards
and dependents target population.
(B) A procedure to certify the mental health programs.
(c) (1) Only those individuals within the target population as
defined in regulation and determined to be eligible for services as a
result of a mental health treatment needs assessment may receive
services pursuant to this section.
(2) Allocation of funds appropriated for the purposes of this
section shall be based on the number of wards and dependents and may
be adjusted in subsequent fiscal years
to reflect costs.
(3) The counties shall be held harmless for failure to provide any
assessment, case management, and treatment services to those
children identified in need of services for whom there is no funding.
(d) (1) The State Department of Health Care Services shall make
information available to the Legislature, on request, on the service
populations provided mental health treatment services pursuant to
this section, the types and costs of services provided, and the
number of children identified in need of treatment services who did
not receive the services.
(2) The information required by paragraph (1) may include
information on need, cost, and service impact experience from the
following:
(A) Family preservation pilot programs.
(B) Pilot programs implemented under the former Children's Mental
Health Services Act, as contained in Chapter 6.8 (commencing with
Section 5565.10) of Part 1 of Division 5.
(C) Programs implemented under Chapter 26 (commencing with Section
7570) of Division 7 of Title 1 of the Government Code and Section
11401.
(D) County experience in the implementation of Section 4096.
SEC. 12. SEC. 27. Section 4096.5 of
the Welfare and Institutions Code is amended to read:
4096.5. (a) The State Department of Health Care Services shall
make a determination, within 45 days of receiving a request from a
group home to be classified at RCL 13 or RCL 14 pursuant to Section
11462.01, to certify or deny certification that the group home
program includes provisions for mental health treatment services that
meet the needs of seriously emotionally disturbed children. The
department shall issue each certification for a period of one year
and shall specify the effective date the program met the
certification requirements. A program may be recertified if the
program continues to meet the criteria for certification.
(b) The State Department of Health Care Services shall, in
consultation with County Behavioral Health Directors Association of
California and representatives of provider organizations, develop the
criteria for the certification required by subdivision (a) by July
1, 1992.
(c) (1) The State Department of Health Care Services may, upon the
request of a county, delegate to that county the certification task.
(2) Any county to which the certification task is delegated
pursuant to paragraph (1) shall use the criteria and format developed
by the department.
(d) The State Department of Health Care Services or delegated
county shall notify the State Department of Social Services Community
Care Licensing Division immediately upon the termination of any
certification issued in accordance with subdivision (a).
(e) Upon receipt of notification from the State Department of
Social Services Community Care Licensing Division of any adverse
licensing action taken after the finding of noncompliance during an
inspection conducted pursuant to Section 1538.7 of the Health and
Safety Code, the State Department of Health Care Services or the
delegated county shall review the certification issued pursuant to
this section.
SEC. 28. Section 4117 of the Welfare
and Institutions Code , as amended by Section 47 of
Chapter 26 of the Statutes of 2015, is amended to read:
4117. (a) Whenever a trial is had of any person charged with
escape or attempt to escape from a state hospital, whenever a hearing
is had on the return of a writ of habeas corpus prosecuted by or on
behalf of any person confined in a state hospital except in a
proceeding to which Section 5110 applies, whenever a hearing is had
on a petition under Section 1026.2, subdivision (b) of Section
1026.5, Section 2966, or Section 2972 of the Penal Code, Section 7361
of this code, or former Section 6316.2 of this code for the release
of a person confined in a state hospital, whenever a hearing is had
for an order seeking involuntary treatment with psychotropic
medication, or any other medication for which an order is required,
of a person confined in a state hospital pursuant to Section 2962 of
the Penal Code, and whenever a person confined in a state hospital is
tried for a crime committed therein, the appropriate financial
officer or other designated official of the county in which the trial
or hearing is had shall make out a statement of all mental health
treatment costs and shall make out a separate statement of all
nontreatment costs incurred by the county for investigation and other
preparation for the trial or hearing, and the actual trial or
hearing, all costs of maintaining custody of the patient and
transporting him or her to and from the hospital, and costs of
appeal. The statements shall be properly certified by a judge of the
superior court of that county. The statement of mental health
treatment costs shall be sent to the State Department of State
Hospitals and the statement of all nontreatment costs, except as
provided in subdivision (c), shall be sent to the Controller for
approval. After approval, the department shall cause the amount of
mental health treatment costs incurred on or after July 1, 1987, to
be paid to the county mental behavioral
health director or his or her designee where
when the trial or hearing was held out of the money
appropriated for this purpose by the Legislature. In addition, the
Controller shall cause the amount of all nontreatment costs incurred
on and after July 1, 1987, to be paid out of the money appropriated
by the Legislature, to the county treasurer of the county where the
trial or hearing was had.
(b) Commencing January 1, 2012, the nontreatment costs associated
with Section 2966 of the Penal Code and approved by the Controller,
as required by subdivision (a), shall be paid by the Department of
Corrections and Rehabilitation pursuant to Section 4750 of the Penal
Code.
(c) The nontreatment costs associated with any hearing for an
order seeking involuntary treatment with psychotropic medication, or
any other medication for which an order is required, of a person
confined in a state hospital pursuant to Section 1026, 1026.5, or
2972 of the Penal Code, as provided in subdivision (a), shall be paid
by the county of commitment. As used in this subdivision, "county of
commitment" means the county seeking the continued treatment of a
mentally disordered offender pursuant to Section 2972 of the Penal
Code or the county committing a patient who has been found not guilty
by reason of insanity pursuant to Section 1026 or 1026.5 of the
Penal Code. The appropriate financial officer or other designated
official of the county in which the proceeding is held shall make out
a statement of all of the costs incurred by the county for the
investigation, preparation, and conduct of the proceedings, and the
costs of appeal, if any. The statement shall be certified by a judge
of the superior court of the county. The statement shall then be sent
to the county of commitment, which shall reimburse the county
providing the services.
(d) (1) Whenever a hearing is held pursuant to Section 1604, 1608,
1609, or 2966 of the Penal Code, all transportation costs to and
from a state hospital or a facility designated by the community
program director during the hearing shall be paid by the Controller
as provided in this subdivision. The appropriate financial officer or
other designated official of the county in which a hearing is held
shall make out a statement of all transportation costs incurred by
the county. The statement shall be properly certified by a judge of
the superior court of that county and sent to the Controller for
approval. The Controller shall cause the amount of transportation
costs incurred on and after July 1, 1987, to be paid to the county
treasurer of the county where the hearing was had out of the money
appropriated by the Legislature.
(2) As used in this subdivision, "community program director"
means the person designated pursuant to Section 1605 of the Penal
Code.
SEC. 29. Section 5121 of the Welfare
and Institutions Code is amended to read:
5121. The county mental behavioral
health director may develop procedures for the county's designation
and training of professionals who will be designated to perform
functions under Section 5150. These procedures may include, but are
not limited to, the following:
(a) The license types, practice disciplines, and clinical
experience of professionals eligible to be designated by the county.
(b) The initial and ongoing training and testing requirements for
professionals eligible to be designated by the county.
(c) The application and approval processes for professionals
seeking to be designated by the county, including the timeframe for
initial designation and procedures for renewal of the designation.
(d) The county's process for monitoring and reviewing
professionals designated by the county to ensure appropriate
compliance with state law, regulations, and county procedures.
SEC. 30. Section 5150 of the Welfare
and Institutions Code is amended to read:
5150. (a) When a person, as a result of a mental health disorder,
is a danger to others, or to himself or herself, or gravely
disabled, a peace officer, professional person in charge of a
facility designated by the county for evaluation and treatment,
member of the attending staff, as defined by regulation, of a
facility designated by the county for evaluation and treatment,
designated members of a mobile crisis team, or professional person
designated by the county may, upon probable cause, take, or cause to
be taken, the person into custody for a period of up to 72 hours for
assessment, evaluation, and crisis intervention, or placement for
evaluation and treatment in a facility designated by the county for
evaluation and treatment and approved by the State Department of
Health Care Services. At a minimum, assessment, as defined in Section
5150.4, and evaluation, as defined in subdivision (a) of Section
5008, shall be conducted and provided on an ongoing basis. Crisis
intervention, as defined in subdivision (e) of Section 5008, may be
provided concurrently with assessment, evaluation, or any other
service.
(b) The professional person in charge of a facility designated by
the county for evaluation and treatment, member of the attending
staff, or professional person designated by the county shall assess
the person to determine whether he or she can be properly served
without being detained. If in the judgment of the professional person
in charge of the facility designated by the county for evaluation
and treatment, member of the attending staff, or professional person
designated by the county, the person can be properly served without
being detained, he or she shall be provided evaluation, crisis
intervention, or other inpatient or outpatient services on a
voluntary basis. Nothing in this subdivision shall be interpreted to
prevent a peace officer from delivering individuals to a designated
facility for assessment under this section. Furthermore, the
assessment requirement of this subdivision shall not be interpreted
to require peace officers to perform any additional duties other than
those specified in Sections 5150.1 and 5150.2.
(c) Whenever a person is evaluated by a professional person in
charge of a facility designated by the county for evaluation or
treatment, member of the attending staff, or professional person
designated by the county and is found to be in need of mental health
services, but is not admitted to the facility, all available
alternative services provided pursuant to subdivision (b) shall be
offered as determined by the county mental
behavioral health director.
(d) If, in the judgment of the professional person in charge of
the facility designated by the county for evaluation and treatment,
member of the attending staff, or the professional person designated
by the county, the person cannot be properly served without being
detained, the admitting facility shall require an application in
writing stating the circumstances under which the person's condition
was called to the attention of the peace officer, professional person
in charge of the facility designated by the county for evaluation
and treatment, member of the attending staff, or professional person
designated by the county, and stating that the peace officer,
professional person in charge of the facility designated by the
county for evaluation and treatment, member of the attending staff,
or professional person designated by the county has probable cause to
believe that the person is, as a result of a mental health disorder,
a danger to others, or to himself or herself, or gravely disabled.
If the probable cause is based on the statement of a person other
than the peace officer, professional person in charge of the facility
designated by the county for evaluation and treatment, member of the
attending staff, or professional person designated by the county,
the person shall be liable in a civil action for intentionally giving
a statement which that he or she knows
to be false.
(e) At the time a person is taken into custody for evaluation, or
within a reasonable time thereafter, unless a responsible relative or
the guardian or conservator of the person is in possession of the
person's personal property, the person taking him or her into custody
shall take reasonable precautions to preserve and safeguard the
personal property in the possession of or on the premises occupied by
the person. The person taking him or her into custody shall then
furnish to the court a report generally describing the person's
property so preserved and safeguarded and its disposition, in
substantially the form set forth in Section 5211, except that if a
responsible relative or the guardian or conservator of the person is
in possession of the person's property, the report shall include only
the name of the relative or guardian or conservator and the location
of the property, whereupon responsibility of the person taking him
or her into custody for that property shall terminate. As used in
this section, "responsible relative" includes the spouse, parent,
adult child, domestic partner, grandparent, grandchild, or adult
brother or sister of the person.
(f) (1) Each person, at the time he or she is first taken into
custody under this section, shall be provided, by the person who
takes him or her into custody, the following information orally in a
language or modality accessible to the person. If the person cannot
understand an oral advisement, the information shall be provided in
writing. The information shall be in substantially the following
form:
My name is ___________________________________ .
I am a _____________________________
(peace officer/mental health
______________ .
professional)
with __________________ .
(name of agency)
You are not under criminal arrest, but I am
taking you for an examination by mental health
professionals at _____________________________ .
____________________
(name of facility)
You will be told your rights by the mental
health staff.
(2) If taken into custody at his or her own residence, the person
shall also be provided the following information:
You may bring a few personal items with you, which I will have to
approve. Please inform me if you need assistance turning off any
appliance or water. You may make a phone call and leave a note to
tell your friends or family where you have been taken.
(g) The designated facility shall keep, for each patient
evaluated, a record of the advisement given pursuant to subdivision
(f) which shall include all of the following:
(1) The name of the person detained for evaluation.
(2) The name and position of the peace officer or mental health
professional taking the person into custody.
(3) The date the advisement was completed.
(4) Whether the advisement was completed.
(5) The language or modality used to give the advisement.
(6) If the advisement was not completed, a statement of good
cause, as defined by regulations of the State Department of Health
Care Services.
(h) (1) Each person admitted to a facility designated by the
county for evaluation and treatment shall be given the following
information by admission staff of the facility. The information shall
be given orally and in writing and in a language or modality
accessible to the person. The written information shall be available
to the person in English and in the language that is the person's
primary means of communication. Accommodations for other disabilities
that may affect communication shall also be provided. The
information shall be in substantially the following form:
My name is ____________________________________.
My position here is____________________________.
You are being placed into this psychiatric
facility because it is our professional opinion
that, as a result of a mental health disorder,
you are likely to (check applicable):
( ) Harm
yourself.
( ) Harm someone
else.
( ) Be unable to take care of your own food,
clothing, and housing
needs.
We believe this is true because
________________________________________________
(list of the facts upon which the
allegation of dangerous
or gravely disabled due to mental health
disorder is based, including pertinent
facts arising from the admission interview).
You will be held for a period up to 72 hours.
During the 72 hours you may also be transferred
to another facility. You may request to be
evaluated or treated at a facility of your
choice. You may request to be evaluated or
treated by a mental health professional of your
choice. We cannot guarantee the facility or
mental health professional you choose will be
available, but we will honor your choice if we
can.
During these 72 hours you will be evaluated by
the facility staff, and you may be given
treatment, including medications. It is
possible for you to be released before the end
of the 72 hours. But if the staff decides that
you need continued treatment you can be
held for a longer period of time. If you are
held longer than 72 hours, you have the right
to a lawyer and a qualified interpreter and a
hearing before a judge. If you are unable to
pay for the lawyer, then one will be provided
to you free of charge.
If you have questions about your legal rights,
you may contact the county Patients' Rights
Advocate at _____________________________
(phone number for the county
__________________________________.
Patients' Rights Advocacy office)
Your 72-hour period began _____________.
(date/time)
(2) If the notice is given in a county where weekends and holidays
are excluded from the 72-hour period, the patient shall be informed
of this fact.
(i) For each patient admitted for evaluation and treatment, the
facility shall keep with the patient's medical record a record of the
advisement given pursuant to subdivision (h), which shall include
all of the following:
(1) The name of the person performing the advisement.
(2) The date of the advisement.
(3) Whether the advisement was completed.
(4) The language or modality used to communicate the advisement.
(5) If the advisement was not completed, a statement of good
cause.
SEC. 31. Section 5152.1 of the Welfare
and Institutions Code is amended to read:
5152.1. The professional person in charge of the facility
providing 72-hour evaluation and treatment, or his or her designee,
shall notify the county mental behavioral
health director or the director's designee and the peace
officer who makes the written application pursuant to Section 5150 or
a person who is designated by the law enforcement agency that
employs the peace officer, when the person has been released after
72-hour detention, when the person is not detained, or when the
person is released before the full period of allowable 72-hour
detention if all of the following conditions apply:
(a) The peace officer requests such notification at the time he or
she makes the application and the peace officer certifies at that
time in writing that the person has been referred to the facility
under circumstances which, based upon an allegation of facts
regarding actions witnessed by the officer or another person, would
support the filing of a criminal complaint.
(b) The notice is limited to the person's name, address, date of
admission for 72-hour evaluation and treatment, and date of release.
If a police officer, law enforcement agency, or designee of the
law enforcement agency, possesses any record of information obtained
pursuant to the notification requirements of this section, the
officer, agency, or designee shall destroy that record two years
after receipt of notification.
SEC. 32. Section 5152.2 of the Welfare
and Institutions Code is amended to read:
5152.2. Each law enforcement agency within a county shall arrange
with the county mental behavioral
health director a method for giving prompt notification to peace
officers pursuant to Section 5152.1.
SEC. 33. Section 5250.1 of the Welfare
and Institutions Code is amended to read:
5250.1. The professional person in charge of a facility providing
intensive treatment, pursuant to Section 5250 or 5270.15, or that
person's designee, shall notify the county mental
behavioral health director, or the director's designee,
and the peace officer who made the original written application for
72-hour evaluation pursuant to Section 5150 or a person who is
designated by the law enforcement agency that employs the peace
officer, that the person admitted pursuant to the application has
been released unconditionally if all of the following conditions
apply:
(a) The peace officer has requested notification at the time he or
she makes the application for 72-hour evaluation.
(b) The peace officer has certified in writing at the time he or
she made the application that the person has been referred to the
facility under circumstances which, based upon an allegation of facts
regarding actions witnessed by the officer or another person, would
support the filing of a criminal complaint.
(c) The notice is limited to the person's name, address, date of
admission for 72-hour evaluation, date of certification for intensive
treatment, and date of release.
If a police officer, law enforcement agency, or designee of the
law enforcement agency, possesses any record of information obtained
pursuant to the notification requirements of this section, the
officer, agency, or designee shall destroy that record two years
after receipt of notification.
SEC. 34. Section 5305 of the Welfare
and Institutions Code is amended to read:
5305. (a) Any person committed pursuant to Section 5300 may be
placed on outpatient status if all of the following conditions are
satisfied:
(1) In the evaluation of the superintendent or professional person
in charge of the licensed health facility, the person named in the
petition will no longer be a danger to the health and safety of
others while on outpatient status and will benefit from outpatient
status.
(2) The county mental behavioral
health director advises the court that the person named in the
petition will benefit from outpatient status and identifies an
appropriate program of supervision and treatment.
(b) After actual notice to the public officer, pursuant to Section
5114, and to counsel of the person named in the petition, to the
court and to the county mental behavioral
health director, the plan for outpatient treatment shall become
effective within five judicial days unless a court hearing on that
action is requested by any of the aforementioned parties, in which
case the release on outpatient status shall not take effect until
approved by the court after a hearing. This hearing shall be held
within five judicial days of the actual notice required by this
subdivision.
(c) The county mental behavioral
health director shall be the outpatient supervisor of persons placed
on outpatient status under provisions of this
section. The county mental behavioral
health director may delegate such outpatient
supervision responsibility to a designee.
(d) The outpatient treatment supervisor shall, where
when the person is placed on outpatient status
at least three months, submit at 90-day intervals to the court, the
public officer, pursuant to Section 5114, and counsel of the person
named in the petition and to the supervisor or professional person in
charge of the licensed health facility, where
when appropriate, a report setting forth the status and
progress of the person named in the petition. Notwithstanding the
length of the outpatient status, a final report shall be submitted by
the outpatient treatment supervisor at the conclusion of the 180-day
commitment setting forth the status and progress of the person.
SEC. 35. Section 5306.5 of the Welfare
and Institutions Code is amended to read:
5306.5. (a) If at any time during the outpatient period, the
outpatient treatment supervisor is of the opinion that the person
receiving treatment requires extended inpatient treatment or refuses
to accept further outpatient treatment and supervision, the county
mental behavioral health director shall
notify the superior court in either the county which
that approved outpatient status or in the county
where outpatient treatment is being provided of such
that opinion by means of a written request for
revocation of outpatient status. The county mental
behavioral health director shall furnish a copy of this
request to the counsel of the person named in the request for
revocation and to the public officer, pursuant to Section 5114, in
both counties if the request is made in the county of treatment,
rather than the county of commitment.
(b) Within 15 judicial days, the court where the request was
filed shall hold a hearing and shall either approve or disapprove the
request for revocation of outpatient status. If the court approves
the request for revocation, the court shall order that the person be
confined in a state hospital or other treatment facility approved by
the county mental behavioral health
director. The court shall transmit a copy of its order to the county
mental behavioral health director or a
designee and to the Director of State Hospitals. Where
When the county of treatment and the county of
commitment differ and revocation occurs in the county
of treatment, the court shall enter
the name of the committing county and its case number on the order of
revocation and shall send a copy of the order to the committing
court and the public officer, pursuant to Section 5114, and counsel
of the person named in the request for revocation in the county of
commitment.
SEC. 36. Section 5307 of the Welfare
and Institutions Code is amended to read:
5307. If at any time during the outpatient period the public
officer, pursuant to Section 5114, is of the opinion that the person
is a danger to the health and safety of others while on outpatient
status, the public officer, pursuant to Section 5114, may petition
the court for a hearing to determine whether the person shall be
continued on outpatient status. Upon receipt of the petition, the
court shall calendar the case for further proceedings within 15
judicial days and the clerk shall notify the person, the county
mental behavioral health director, and
the attorney of record for the person of the hearing date. Upon
failure of the person to appear as noticed, if a proper affidavit of
service and advisement has been filed with the court, the court may
issue a body attachment for such that
person. If, after a hearing in court the judge determines that the
person is a danger to the health and safety of others, the court
shall order that the person be confined in a state hospital or other
treatment facility which that has been
approved by the county mental behavioral
health director.
SEC. 37. Section 5308 of the Welfare
and Institutions Code is amended to rea d:
5308. Upon the filing of a request for revocation of outpatient
status under Section 5306.5 or 5307 and pending the court's decision
on revocation, the person subject to revocation may be confined in a
state hospital or other treatment facility by the county
mental behavioral health director when it is the
opinion of that director that the person will now be a danger to
self or to another while on outpatient status and that to delay
hospitalization until the revocation hearing would pose a
demonstrated danger of harm to the person or to another. Upon the
request of the county mental behavioral
health director or a designee, a peace officer shall take, or cause
to be taken, the person into custody and transport the person to a
treatment facility for hospitalization under this section. The county
mental behavioral health director
shall notify the court in writing of the admission of the person to
inpatient status and of the factual basis for the opinion that
such immediate return to inpatient treatment was
necessary. The court shall supply a copy of these documents to the
public officer, pursuant to Section 5114, and counsel of the person
subject to revocation.
A person hospitalized under this section shall have the right to
judicial review of the detention in the manner prescribed in Article
5 (commencing with Section 5275) of Chapter 2 and to an explanation
of rights in the manner prescribed in Section 5252.1.
Nothing in this section shall prevent hospitalization pursuant to
the provisions of Section 5150, 5250, 5350, or 5353.
A person whose confinement in a treatment facility under Section
5306.5 or 5307 is approved by the court shall not be released again
to outpatient status unless court approval is obtained under Section
5305.
SEC. 13. SEC. 38. Section 5326.95 of
the Welfare and Institutions Code is amended to read:
5326.95. The Director of State Hospitals shall adopt regulations
to carry out the provisions of this chapter, including standards
defining excessive use of convulsive treatment
treatment, which shall be developed in consultation with
the State Department of Health Care Services and the County
Behavioral Health Directors Association of California.
SEC. 39. Section 5328 of the Welfare
and Institutions Code is amended to read:
5328. All information and records obtained in the course of
providing services under Division 4 (commencing with Section 4000),
Division 4.1 (commencing with Section 4400), Division 4.5 (commencing
with Section 4500), Division 5 (commencing with Section 5000),
Division 6 (commencing with Section 6000), or Division 7 (commencing
with Section 7100), to either voluntary or involuntary recipients of
services shall be confidential. Information and records obtained in
the course of providing similar services to either voluntary or
involuntary recipients prior to 1969 shall also be confidential.
Information and records shall be disclosed only in any of the
following cases:
(a) In communications between qualified professional persons in
the provision of services or appropriate referrals, or in the course
of conservatorship proceedings. The consent of the patient, or his or
her guardian or conservator, shall be obtained before information or
records may be disclosed by a professional person employed by a
facility to a professional person not employed by the facility who
does not have the medical or psychological responsibility for the
patient's care.
(b) When the patient, with the approval of the physician and
surgeon, licensed psychologist, social worker with a master's degree
in social work, licensed marriage and family therapist, or licensed
professional clinical counselor, who is in charge of the patient,
designates persons to whom information or records may be released,
except that nothing in this article shall be construed to compel a
physician and surgeon, licensed psychologist, social worker with a
master's degree in social work, licensed marriage and family
therapist, licensed professional clinical counselor, nurse, attorney,
or other professional person to reveal information that has been
given to him or her in confidence by members of a patient's family.
Nothing in this subdivision shall be construed to authorize a
licensed marriage and family therapist or licensed professional
clinical counselor to provide services or to be in charge of a
patient's care beyond his or her lawful scope of practice.
(c) To the extent necessary for a recipient to make a claim, or
for a claim to be made on behalf of a recipient for aid, insurance,
or medical assistance to which he or she may be entitled.
(d) If the recipient of services is a minor, ward, dependent, or
conservatee, and his or her parent, guardian, guardian ad litem,
conservator, or authorized representative designates, in writing,
persons to whom records or information may be disclosed, except that
nothing in this article shall be construed to compel a physician and
surgeon, licensed psychologist, social worker with a master's degree
in social work, licensed marriage and family therapist, licensed
professional clinical counselor, nurse, attorney, or other
professional person to reveal information that has been given to him
or her in confidence by members of a patient's family.
(e) For research, provided that the Director of Health Care
Services, the Director of State Hospitals, the Director of Social
Services, or the Director of Developmental Services designates by
regulation, rules for the conduct of research and requires the
research to be first reviewed by the appropriate institutional review
board or boards. The rules shall include, but need not be limited
to, the requirement that all researchers shall sign an oath of
confidentiality as follows:
Date
As a condition of doing research concerning persons who have
received services from ____ (fill in the facility, agency or person),
I, ____, agree to obtain the prior informed consent of such persons
who have received services to the maximum degree possible as
determined by the appropriate institutional review board or boards
for protection of human subjects reviewing my research, and I further
agree not to divulge any information obtained in the course of such
research to unauthorized persons, and not to publish or otherwise
make public any information regarding persons who have received
services such that the person who received services is identifiable.
I recognize that the unauthorized release of confidential
information may make me subject to a civil action under provisions of
the Welfare and Institutions Code.
(f) To the courts, as necessary to the administration of justice.
(g) To governmental law enforcement agencies as needed for the
protection of federal and state elective constitutional officers and
their families.
(h) To the Senate Committee on Rules or the Assembly Committee on
Rules for the purposes of legislative investigation authorized by the
committee.
(i) If the recipient of services who applies for life or
disability insurance designates in writing the insurer to which
records or information may be disclosed.
(j) To the attorney for the patient in any and all proceedings
upon presentation of a release of information signed by the patient,
except that when the patient is unable to sign the release, the staff
of the facility, upon satisfying itself of the identity of the
attorney, and of the fact that the attorney does represent the
interests of the patient, may release all information and records
relating to the patient except that nothing in this article shall be
construed to compel a physician and surgeon, licensed psychologist,
social worker with a master's degree in social work, licensed
marriage and family therapist, licensed professional clinical
counselor, nurse, attorney, or other professional person to reveal
information that has been given to him or her in confidence by
members of a patient's family.
(k) Upon written agreement by a person previously confined in or
otherwise treated by a facility, the professional person in charge of
the facility or his or her designee may release any information,
except information that has been given in confidence by members of
the person's family, requested by a probation officer charged with
the evaluation of the person after his or her conviction of a crime
if the professional person in charge of the facility determines that
the information is relevant to the evaluation. The agreement shall
only be operative until sentence is passed on the crime of which the
person was convicted. The confidential information released pursuant
to this subdivision shall be transmitted to the court separately from
the probation report and shall not be placed in the probation
report. The confidential information shall remain confidential except
for purposes of sentencing. After sentencing, the confidential
information shall be sealed.
(l) (1) Between persons who are trained and qualified to serve on
multidisciplinary personnel teams pursuant to subdivision (d) of
Section 18951. The information and records sought to be disclosed
shall be relevant to the provision of child welfare services or the
investigation, prevention, identification, management, or treatment
of child abuse or neglect pursuant to Chapter 11 (commencing with
Section 18950) of Part 6 of Division 9. Information obtained pursuant
to this subdivision shall not be used in any criminal or delinquency
proceeding. Nothing in this subdivision shall prohibit evidence
identical to that contained within the records from being admissible
in a criminal or delinquency proceeding, if the evidence is derived
solely from means other than this subdivision, as permitted by law.
(2) As used in this subdivision, "child welfare services" means
those services that are directed at preventing child abuse or
neglect.
(m) To county patients' rights advocates who have been given
knowing voluntary authorization by a client or a guardian ad litem.
The client or guardian ad litem, whoever entered into the agreement,
may revoke the authorization at any time, either in writing or by
oral declaration to an approved advocate.
(n) To a committee established in compliance with Section 14725.
(o) In providing information as described in Section 7325.5.
Nothing in this subdivision shall permit the release of any
information other than that described in Section 7325.5.
(p) To the county mental behavioral
health director or the director's designee, or to a law enforcement
officer, or to the person designated by a law enforcement agency,
pursuant to Sections 5152.1 and 5250.1.
(q) If the patient gives his or her consent, information
specifically pertaining to the existence of genetically handicapping
conditions, as defined in Section 125135 of the Health and Safety
Code, may be released to qualified professional persons for purposes
of genetic counseling for blood relatives upon request of the blood
relative. For purposes of this subdivision, "qualified professional
persons" means those persons with the qualifications necessary to
carry out the genetic counseling duties under this subdivision as
determined by the genetic disease unit established in the State
Department of Health Care Services under Section 125000 of the Health
and Safety Code. If the patient does not respond or cannot respond
to a request for permission to release information pursuant to this
subdivision after reasonable attempts have been made over a two-week
period to get a response, the information may be released upon
request of the blood relative.
(r) When the patient, in the opinion of his or her
psychotherapist, presents a serious danger of violence to a
reasonably foreseeable victim or victims, then any of the information
or records specified in this section may be released to that person
or persons and to law enforcement agencies and county child welfare
agencies as the psychotherapist determines is needed for the
protection of that person or persons. For purposes of this
subdivision, "psychotherapist" means anyone so defined within Section
1010 of the Evidence Code.
(s) (1) To the designated officer of an emergency response
employee, and from that designated officer to an emergency response
employee regarding possible exposure to HIV or AIDS, but only to the
extent necessary to comply with provisions of the federal Ryan White
Comprehensive AIDS Resources Emergency Act of 1990 (Public Law
101-381; 42 U.S.C. Sec. 201).
(2) For purposes of this subdivision, "designated officer" and
"emergency response employee" have the same meaning as these terms
are used in the federal Ryan White Comprehensive AIDS Resources
Emergency Act of 1990 (Public Law 101-381; 42 U.S.C. Sec. 201).
(3) The designated officer shall be subject to the confidentiality
requirements specified in Section 120980, and may be personally
liable for unauthorized release of any identifying information about
the HIV results. Further, the designated officer shall inform the
exposed emergency response employee that the employee is also subject
to the confidentiality requirements specified in Section 120980, and
may be personally liable for unauthorized release of any identifying
information about the HIV test results.
(t) (1) To a law enforcement officer who personally lodges with a
facility, as defined in paragraph (2), a warrant of arrest or an
abstract of such a warrant showing that the person sought is wanted
for a serious felony, as defined in Section 1192.7 of the Penal Code,
or a violent felony, as defined in Section 667.5 of the Penal Code.
The information sought and released shall be limited to whether or
not the person named in the arrest warrant is presently confined in
the facility. This paragraph shall be implemented with minimum
disruption to health facility operations and patients, in accordance
with Section 5212. If the law enforcement officer is informed that
the person named in the warrant is confined in the facility, the
officer may not enter the facility to arrest the person without
obtaining a valid search warrant or the permission of staff of the
facility.
(2) For purposes of paragraph (1), a facility means all of the
following:
(A) A state hospital, as defined in Section 4001.
(B) A general acute care hospital, as defined in subdivision (a)
of Section 1250 of the Health and Safety Code, solely with regard to
information pertaining to a person with mental illness subject to
this section.
(C) An acute psychiatric hospital, as defined in subdivision (b)
of Section 1250 of the Health and Safety Code.
(D) A psychiatric health facility, as described in Section 1250.2
of the Health and Safety Code.
(E) A mental health rehabilitation center, as described in Section
5675.
(F) A skilled nursing facility with a special treatment program
for individuals with mental illness, as described in Sections 51335
and 72445 to 72475, inclusive, of Title 22 of the California Code of
Regulations.
(u) Between persons who are trained and qualified to serve on
multidisciplinary personnel teams pursuant to Section 15610.55,
15753.5, or 15761. The information and records sought to be disclosed
shall be relevant to the prevention, identification, management, or
treatment of an abused elder or dependent adult pursuant to Chapter
13 (commencing with Section 15750) of Part 3 of Division 9.
(v) The amendment of subdivision (d) enacted at the 1970 Regular
Session of the Legislature does not constitute a change in, but is
declaratory of, the preexisting law.
(w) This section shall not be limited by Section 5150.05 or 5332.
(x) (1) When an employee is served with a notice of adverse
action, as defined in Section 19570 of the Government Code, the
following information and records may be released:
(A) All information and records that the appointing authority
relied upon in issuing the notice of adverse action.
(B) All other information and records that are relevant to the
adverse action, or that would constitute relevant evidence as defined
in Section 210 of the Evidence Code.
(C) The information described in subparagraphs (A) and (B) may be
released only if both of the following conditions are met:
(i) The appointing authority has provided written notice to the
consumer and the consumer's legal representative or, if the consumer
has no legal representative or if the legal representative is a state
agency, to the clients' rights advocate, and the consumer, the
consumer's legal representative, or the clients' rights advocate has
not objected in writing to the appointing authority within five
business days of receipt of the notice, or the appointing authority,
upon review of the objection has determined that the circumstances on
which the adverse action is based are egregious or threaten the
health, safety, or life of the consumer or other consumers and
without the information the adverse action could not be taken.
(ii) The appointing authority, the person against whom the adverse
action has been taken, and the person's representative, if any, have
entered into a stipulation that does all of the following:
(I) Prohibits the parties from disclosing or using the information
or records for any purpose other than the proceedings for which the
information or records were requested or provided.
(II) Requires the employee and the employee's legal representative
to return to the appointing authority all records provided to them
under this subdivision, including, but not limited to, all records
and documents from any source containing confidential information
protected by this section, and all copies of those records and
documents, within 10 days of the date that the adverse action becomes
final except for the actual records and documents or copies thereof
that are no longer in the possession of the employee or the employee'
s legal representative because they were submitted to the
administrative tribunal as a component of an appeal from the adverse
action.
(III) Requires the parties to submit the stipulation to the
administrative tribunal with jurisdiction over the adverse action at
the earliest possible opportunity.
(2) For the purposes of this subdivision, the State Personnel
Board may, prior to any appeal from adverse action being filed with
it, issue a protective order, upon application by the appointing
authority, for the limited purpose of prohibiting the parties from
disclosing or using information or records for any purpose other than
the proceeding for which the information or records were requested
or provided, and to require the employee or the employee's legal
representative to return to the appointing authority all records
provided to them under this subdivision, including, but not limited
to, all records and documents from any source containing confidential
information protected by this section, and all copies of those
records and documents, within 10 days of the date that the adverse
action becomes final, except for the actual records and documents or
copies thereof that are no longer in the possession of the employee
or the employee's legal representatives because they were submitted
to the administrative tribunal as a component of an appeal from the
adverse action.
(3) Individual identifiers, including, but not limited to, names,
social security numbers, and hospital numbers, that are not necessary
for the prosecution or defense of the adverse action, shall not be
disclosed.
(4) All records, documents, or other materials containing
confidential information protected by this section that have been
submitted or otherwise disclosed to the administrative agency or
other person as a component of an appeal from an adverse action
shall, upon proper motion by the appointing authority to the
administrative tribunal, be placed under administrative seal and
shall not, thereafter, be subject to disclosure to any person or
entity except upon the issuance of an order of a court of competent
jurisdiction.
(5) For purposes of this subdivision, an adverse action becomes
final when the employee fails to answer within the time specified in
Section 19575 of the Government Code, or, after filing an answer,
withdraws the appeal, or, upon exhaustion of the administrative
appeal or of the judicial review remedies as otherwise provided by
law.
(y) To the person appointed as the developmental services
decisionmaker for a minor, dependent, or ward pursuant to Section
319, 361, or 726.
SEC. 40. Section 5328.2 of the Welfare
and Institutions Code is amended to read:
5328.2. Notwithstanding Section 5328, movement and identification
information and records regarding a patient who is committed to the
department, state hospital, or any other public or private mental
health facility approved by the county mental
behavioral health director for observation or for an
indeterminate period as a mentally disordered sex offender, or for a
person who is civilly committed as a sexually violent predator
pursuant to Article 4 (commencing with Section 6600) of Chapter 2 of
Part 2 of Division 6, or regarding a patient who is committed to the
department, to a state hospital, or any other public or private
mental health facility approved by the county mental
behavioral health director under Section 1026 or
1370 of the Penal Code or receiving treatment pursuant to Section
5300 of this code, shall be forwarded immediately without prior
request to the Department of Justice. Except as otherwise provided by
law, information automatically reported under this section shall be
restricted to name, address, fingerprints, date of admission, date of
discharge, date of escape or return from escape, date of any home
leave, parole or leave of absence and, if known, the county in which
the person will reside upon release. The Department of Justice may in
turn furnish information reported under this section pursuant to
Section 11105 or 11105.1 of the Penal Code. It shall be a misdemeanor
for recipients furnished with this information to in turn furnish
the information to any person or agency other than those specified in
Section 11105 or 11105.1 of the Penal Code.
SEC. 41. Section 5346 of the Welfare
and Institutions Code is amended to read:
5346. (a) In any county in which services are available as
provided in Section 5348, a court may order a person who is the
subject of a petition filed pursuant to this section to obtain
assisted outpatient treatment if the court finds, by clear and
convincing evidence, that the facts stated in the verified petition
filed in accordance with this section are true and establish that all
of the requisite criteria set forth in this section are met,
including, but not limited to, each of the following:
(1) The person is 18 years of age or older.
(2) The person is suffering from a mental illness as defined in
paragraphs (2) and (3) of subdivision (b) of Section 5600.3.
(3) There has been a clinical determination that the person is
unlikely to survive safely in the community without supervision.
(4) The person has a history of lack of compliance with treatment
for his or her mental illness, in that at least one of the following
is true:
(A) The person's mental illness has, at least twice within the
last 36 months, been a substantial factor in necessitating
hospitalization, or receipt of services in a forensic or other mental
health unit of a state correctional facility or local correctional
facility, not including any period during which the person was
hospitalized or incarcerated immediately preceding the filing of the
petition.
(B) The person's mental illness has resulted in one or more acts
of serious and violent behavior toward himself or herself or another,
or threats, or attempts to cause serious physical harm to himself or
herself or another within the last 48 months, not including any
period in which the person was hospitalized or incarcerated
immediately preceding the filing of the petition.
(5) The person has been offered an opportunity to participate in a
treatment plan by the director of the local mental health
department, or his or her designee, provided the treatment plan
includes all of the services described in Section 5348, and the
person continues to fail to engage in treatment.
(6) The person's condition is substantially deteriorating.
(7) Participation in the assisted outpatient treatment program
would be the least restrictive placement necessary to ensure the
person's recovery and stability.
(8) In view of the person's treatment history and current
behavior, the person is in need of assisted outpatient treatment in
order to prevent a relapse or deterioration that would be likely to
result in grave disability or serious harm to himself or herself, or
to others, as defined in Section 5150.
(9) It is likely that the person will benefit from assisted
outpatient treatment.
(b) (1) A petition for an order authorizing assisted outpatient
treatment may be filed by the county mental
behavioral health director, or his
or her designee, in the superior court in the county
in which the person who is the subject of the petition is present or
reasonably believed to be present.
(2) A request may be made only by any of the following persons to
the county mental health department for the filing of a petition to
obtain an order authorizing assisted outpatient treatment:
(A) Any person 18 years of age or older with whom the person who
is the subject of the petition resides.
(B) Any person who is the parent, spouse, or sibling or child 18
years of age or older of the person who is the subject of the
petition.
(C) The director of any public or private agency, treatment
facility, charitable organization, or licensed residential care
facility providing mental health services to the person who is the
subject of the petition in whose institution the subject of the
petition resides.
(D) The director of a hospital in which the person who is the
subject of the petition is hospitalized.
(E) A licensed mental health treatment provider who is either
supervising the treatment of, or treating for a mental illness, the
person who is the subject of the petition.
(F) A peace officer, parole officer, or probation officer assigned
to supervise the person who is the subject of the petition.
(3) Upon receiving a request pursuant to paragraph (2), the county
mental behavioral health director
shall conduct an investigation into the appropriateness of the filing
of the petition. The director shall file the petition only if he or
she determines that there is a reasonable likelihood that all the
necessary elements to sustain the petition can be proven in a court
of law by clear and convincing evidence.
(4) The petition shall state all of the following:
(A) Each of the criteria for assisted outpatient treatment as set
forth in subdivision (a).
(B) Facts that support the petitioner's belief that the person who
is the subject of the petition meets each criterion, provided that
the hearing on the petition shall be limited to the stated facts in
the verified petition, and the petition contains all the grounds on
which the petition is based, in order to ensure adequate notice to
the person who is the subject of the petition and his or her counsel.
(C) That the person who is the subject of the petition is present,
or is reasonably believed to be present, within the county where the
petition is filed.
(D) That the person who is the subject of the petition has the
right to be represented by counsel in all stages of the proceeding
under the petition, in accordance with subdivision (c).
(5) The petition shall be accompanied by an affidavit of a
licensed mental health treatment provider designated by the local
mental health director who shall state, if applicable, either of the
following:
(A) That the licensed mental health treatment provider has
personally examined the person who is the subject of the petition no
more than 10 days prior to the submission of the petition, the facts
and reasons why the person who is the subject of the petition meets
the criteria in subdivision (a), that the licensed mental health
treatment provider recommends assisted outpatient treatment for the
person who is the subject of the petition, and that the licensed
mental health treatment provider is willing and able to testify at
the hearing on the petition.
(B) That no more than 10 days prior to the filing of the petition,
the licensed mental health treatment provider, or his or her
designee, has made appropriate attempts to elicit the cooperation of
the person who is the subject of the petition, but has not been
successful in persuading that person to submit to an examination,
that the licensed mental health treatment provider has reason to
believe that the person who is the subject of the petition meets the
criteria for assisted outpatient treatment, and that the licensed
mental health treatment provider is willing and able to examine the
person who is the subject of the petition and testify at the hearing
on the petition.
(c) The person who is the subject of the petition shall have the
right to be represented by counsel at all stages of a proceeding
commenced under this section. If the person so elects, the court
shall immediately appoint the public defender or other attorney to
assist the person in all stages of the proceedings. The person shall
pay the cost of the legal services if he or she is able.
(d) (1) Upon receipt by the court of a petition submitted pursuant
to subdivision (b), the court shall fix the date for a hearing at a
time not later than five days from the date the petition is received
by the court, excluding Saturdays, Sundays, and holidays. The
petitioner shall promptly cause service of a copy of the petition,
together with written notice of the hearing date, to be made
personally on the person who is the subject of the petition, and
shall send a copy of the petition and notice to the county office of
patient rights, and to the current health care provider appointed for
the person who is the subject of the petition, if any such provider
is known to the petitioner. Continuances shall be permitted only for
good cause shown. In granting continuances, the court shall consider
the need for further examination by a physician or the potential need
to provide expeditiously assisted outpatient treatment. Upon the
hearing date, or upon any other date or dates to which the proceeding
may be continued, the court shall hear testimony. If it is deemed
advisable by the court, and if the person who is the subject of the
petition is available and has received notice pursuant to this
section, the court may examine in or out of court the person who is
the subject of the petition who is alleged to be in need of assisted
outpatient treatment. If the person who is the subject of the
petition does not appear at the hearing, and appropriate attempts to
elicit the attendance of the person have failed, the court may
conduct the hearing in the person's absence. If the hearing is
conducted without the person present, the court shall set forth the
factual basis for conducting the hearing without the person's
presence.
(2) The court shall not order assisted outpatient treatment unless
an examining licensed mental health treatment provider, who has
personally examined, and has reviewed the available treatment history
of, the person who is the subject of the petition within the time
period commencing 10 days before the filing of the petition,
testifies in person at the hearing.
(3) If the person who is the subject of the petition has refused
to be examined by a licensed mental health treatment provider, the
court may request that the person consent to an examination by a
licensed mental health treatment provider appointed by the court. If
the person who is the subject of the petition does not consent and
the court finds reasonable cause to believe that the allegations in
the petition are true, the court may order any person designated
under Section 5150 to take into custody the person who is the subject
of the petition and transport him or her, or cause him or her to be
transported, to a hospital for examination by a licensed mental
health treatment provider as soon as is practicable. Detention of the
person who is the subject of the petition under the order may not
exceed 72 hours. If the examination is performed by another licensed
mental health treatment provider, the examining licensed mental
health treatment provider may consult with the licensed mental health
treatment provider whose affirmation or affidavit accompanied the
petition regarding the issues of whether the allegations in the
petition are true and whether the person meets the criteria for
assisted outpatient treatment.
(4) The person who is the subject of the petition shall have all
of the following rights:
(A) To adequate notice of the hearings to the person who is the
subject of the petition, as well as to parties designated by the
person who is the subject of the petition.
(B) To receive a copy of the court-ordered evaluation.
(C) To counsel. If the person has not retained counsel, the court
shall appoint a public defender.
(D) To be informed of his or her right to judicial review by
habeas corpus.
(E) To be present at the hearing unless he or she waives the right
to be present.
(F) To present evidence.
(G) To call witnesses on his or her behalf.
(H) To cross-examine witnesses.
(I) To appeal decisions, and to be informed of his or her right to
appeal.
(5) (A) If after hearing all relevant evidence, the court finds
that the person who is the subject of the petition does not meet the
criteria for assisted outpatient treatment, the court shall dismiss
the petition.
(B) If after hearing all relevant evidence, the court finds that
the person who is the subject of the petition meets the criteria for
assisted outpatient treatment, and there is no appropriate and
feasible less restrictive alternative, the court may order the person
who is the subject of the petition to receive assisted outpatient
treatment for an initial period not to exceed six months. In
fashioning the order, the court shall specify that the proposed
treatment is the least restrictive treatment appropriate and feasible
for the person who is the subject of the petition. The order shall
state the categories of assisted outpatient treatment, as set forth
in Section 5348, that the person who is the subject of the petition
is to receive, and the court may not order treatment that has not
been recommended by the examining licensed mental health treatment
provider and included in the written treatment plan for assisted
outpatient treatment as required by subdivision (e). If the person
has executed an advance health care directive pursuant to Chapter 2
(commencing with Section 4650) of Part 1 of Division 4.7 of the
Probate Code, any directions included in the advance health care
directive shall be considered in formulating the written treatment
plan.
(6) If the person who is the subject of a petition for an order
for assisted outpatient treatment pursuant to subparagraph (B) of
paragraph (5) of subdivision (d) refuses to participate in the
assisted outpatient treatment program, the court may order the person
to meet with the assisted outpatient treatment team designated by
the director of the assisted outpatient treatment program. The
treatment team shall attempt to gain the person's cooperation with
treatment ordered by the court. The person may be subject to a
72-hour hold pursuant to subdivision (f) only after the treatment
team has attempted to gain the person's cooperation with treatment
ordered by the court, and has been unable to do so.
(e) Assisted outpatient treatment shall not be ordered unless the
licensed mental health treatment provider recommending assisted
outpatient treatment to the court has submitted to the court a
written treatment plan that includes services as set forth in Section
5348, and the court finds, in consultation with the county
mental behavioral health director, or his or her
designee, all of the following:
(1) That the services are available from the county, or a provider
approved by the county, for the duration of the court order.
(2) That the services have been offered to the person by the local
director of mental health, or his or her designee, and the person
has been given an opportunity to participate on a voluntary basis,
and the person has failed to engage in, or has refused, treatment.
(3) That all of the elements of the petition required by this
article have been met.
(4) That the treatment plan will be delivered to the county
director of mental health, behavioral health
director, or to his or her appropriate designee.
(f) If, in the clinical judgment of a licensed mental health
treatment provider, the person who is the subject of the petition has
failed or has refused to comply with the treatment ordered by the
court, and, in the clinical judgment of the licensed mental health
treatment provider, efforts were made to solicit compliance, and, in
the clinical judgment of the licensed mental health treatment
provider, the person may be in need of involuntary admission to a
hospital for evaluation, the provider may request that persons
designated under Section 5150 take into custody the person who is the
subject of the petition and transport him or her, or cause him or
her to be transported, to a hospital, to be held up to 72 hours for
examination by a licensed mental health treatment provider to
determine if the person is in need of treatment pursuant to Section
5150. Any continued involuntary retention in a hospital beyond the
initial 72-hour period shall be pursuant to Section 5150. If at any
time during the 72-hour period the person is determined not to meet
the criteria of Section 5150, and does not agree to stay in the
hospital as a voluntary patient, he or she shall be released and any
subsequent involuntary detention in a hospital shall be pursuant to
Section 5150. Failure to comply with an order of assisted outpatient
treatment alone may not be grounds for involuntary civil commitment
or a finding that the person who is the subject of the petition is in
contempt of court.
(g) If the director of the assisted outpatient treatment program
determines that the condition of the patient requires further
assisted outpatient treatment, the director shall apply to the court,
prior to the expiration of the period of the initial assisted
outpatient treatment order, for an order authorizing continued
assisted outpatient treatment for a period not to exceed 180 days
from the date of the order. The procedures for obtaining any order
pursuant to this subdivision shall be in accordance with subdivisions
(a) to (f), inclusive. The period for further involuntary outpatient
treatment authorized by any subsequent order under this subdivision
may not exceed 180 days from the date of the order.
(h) At intervals of not less than 60 days during an assisted
outpatient treatment order, the director of the outpatient treatment
program shall file an affidavit with the court that ordered the
outpatient treatment affirming that the person who is the subject of
the order continues to meet the criteria for assisted outpatient
treatment. At these times, the person who is the subject of the order
shall have the right to a hearing on whether or not he or she still
meets the criteria for assisted outpatient treatment if he or she
disagrees with the director's affidavit. The burden of proof shall be
on the director.
(i) During each 60-day period specified in subdivision (h), if the
person who is the subject of the order believes that he or she is
being wrongfully retained in the assisted outpatient treatment
program against his or her wishes, he or she may file a petition for
a writ of habeas corpus, thus requiring the director of the assisted
outpatient treatment program to prove that the person who is the
subject of the order continues to meet the criteria for assisted
outpatient treatment.
(j) Any person ordered to undergo assisted outpatient treatment
pursuant to this article, who was not present at the hearing at which
the order was issued, may immediately petition the court for a writ
of habeas corpus. Treatment under the order for assisted outpatient
treatment may not commence until the resolution of that petition.
SEC. 14. SEC. 42. Section 5400 of
the Welfare and Institutions Code is amended to read:
5400. (a) The Director of Health Care Services shall administer
this part and shall adopt rules, regulations, and standards as
necessary. In developing rules, regulations, and standards, the
Director of Health Care Services shall consult with the County
Behavioral Health Directors Association of California, the California
Mental Health Planning Council, and the office of the Attorney
General. Adoption of these standards, rules, and regulations shall
require approval by the County Behavioral Health Directors
Association of California by majority vote of those present at an
official session.
(b) Wherever feasible and appropriate, rules, regulations, and
standards adopted under this part shall correspond to comparable
rules, regulations, and standards adopted under the
Bronzan-McCorquodale Act. These corresponding rules, regulations, and
standards shall include qualifications for professional personnel.
(c) Regulations adopted pursuant to this part may provide
standards for services for persons with chronic alcoholism that
differ from the standards for services for persons with mental health
disorders.
SEC. 15. SEC. 43. Section 5585.22 of
the Welfare and Institutions Code is amended to read:
5585.22. The Director of Health Care Services, in consultation
with the County Behavioral Health Directors Association of
California, may develop the appropriate educational materials and a
training curriculum, and may provide training as necessary to ensure
that those persons providing services pursuant to this part fully
understand its purpose.
SEC. 16. SEC. 44. Section 5601 of
the Welfare and Institutions Code is amended to read:
5601. As used in this part:
(a) "Governing body" means the county board of supervisors or
boards of supervisors in the case of counties acting jointly; and in
the case of a city, the city council or city councils acting jointly.
(b) "Conference" means the County Behavioral Health Directors
Association of California as established under former Section 5757.
(c) Unless the context requires otherwise, "to the extent
resources are available" means to the extent that funds deposited in
the mental health account of the local health and welfare fund are
available to an entity qualified to use those funds.
(d) "Part 1" refers to the Lanterman-Petris-Short Act (Part 1
(commencing with Section 5000)).
(e) "Director of Health Care Services" or "director" means the
Director of the State Department of Health Care Services.
(f) "Institution" includes a general acute care hospital, a state
hospital, a psychiatric hospital, a psychiatric health facility, a
skilled nursing facility, including an institution for mental disease
as described in Chapter 1 (commencing with Section 5900) of Part 5,
an intermediate care facility, a community care facility or other
residential treatment facility, or a juvenile or criminal justice
institution.
(g) "Mental health service" means any service directed toward
early intervention in, or alleviation or prevention of, mental
disorder, including, but not limited to, diagnosis, evaluation,
treatment, personal care, day care, respite care, special living
arrangements, community skill training, sheltered employment,
socialization, case management, transportation, information,
referral, consultation, and community services.
SEC. 17. SEC. 45. Section 5611 of
the Welfare and Institutions Code is amended to read:
5611. (a) The Director of Mental Health
State Hospitals shall establish a Performance Outcome
Committee, to be comprised of representatives from the PL
Public Law 99-660 Planning Council and the
County Behavioral Health Directors Association of California. Any
costs associated with the performance of the duties of the committee
shall be absorbed within the resources of the participants.
(b) Major mental health professional organizations representing
licensed clinicians may participate as members of the committee at
their own expense.
(c) The committee may seek private funding for costs associated
with the performance of its duties.
SEC. 18. SEC. 46. Section 5664 of
the Welfare and Institutions Code is amended to read:
5664. In consultation with the County Behavioral Health Directors
Association of California, the State Department of Health Care
Services, the Mental Health Services Oversight and Accountability
Commission, the California Mental Health Planning Council, and the
California Health and Human Services Agency, county mental
behavioral health systems shall provide reports
and data to meet the information needs of the state, as necessary.
SEC. 47. Section 5694.7 of the Welfare
and Institutions Code is amended to read:
5694.7. When the director of mental
behavioral health in a county is notified pursuant to Section
319.1 or 635.1, or Section 7572.5 of the Government Code about a
specific case, the county mental behavioral
health director shall assign the responsibility either directly
or through contract with a private provider, to review the
information and assess whether or not the child is seriously
emotionally disturbed as well as to determine the level of
involvement in the case needed to assure access to appropriate mental
health treatment services and whether appropriate treatment is
available through the minor's own resources, those of the family or
another private party, including a third-party payer, or through
another agency, and to ensure access to services available within the
county's program. This determination shall be submitted in writing
to the notifying agency within 30 days. If in the course of
evaluating the minor, the county mental
behavioral health director determines that the minor may be
dangerous, the county mental behavioral
health director may request the court to direct counsel not to
reveal information to the minor relating to the name and address of
the person who prepared the subject report. If appropriate treatment
is not available within the county's Bronzan-McCorquodale program,
nothing in this section shall prevent the court from ordering
treatment directly or through a family's private resources.
SEC. 19. SEC. 48. Section 5701.1 of
the Welfare and Institutions Code is amended to read:
5701.1. Notwithstanding Section 5701, the State Department of
Health Care Services, in consultation with the County Behavioral
Health Directors Association of California and the California Mental
Health Planning Council, may utilize funding from the Substance Abuse
and Mental Health Services Administration Block Grant, awarded to
the State Department of Health Care Services, above the funding level
provided in federal fiscal year 1998, for the development of
innovative programs for identified target populations, upon
appropriation by the Legislature.
SEC. 20. SEC. 49. Section 5701.2 of
the Welfare and Institutions Code is amended to read:
5701.2. (a) The State Department of Mental Health, or its
successor, the State Department of State Hospitals, shall maintain
records of any transfer of funds or state hospital beds made pursuant
to Chapter 1341 of the Statutes of 1991.
(b) Commencing with the 1991-92 fiscal year, the State Department
of Mental Health, or its successor, the State Department of State
Hospitals, shall maintain records that set forth that portion of each
county's allocation of state mental health moneys that represent the
dollar equivalent attributed to each county's state hospital beds or
bed days, or both, that were allocated as of May 1, 1991. The State
Department of Mental Health, or its successor, the State Department
of State Hospitals, shall provide a written summary of these records
to the appropriate committees of the Legislature and the County
Behavioral Health Directors Association of California within 30 days
after the enactment of the annual Budget Act.
(c) Nothing in this section is intended to change the counties'
base allocations as provided in subdivisions (a) and (b) of Section
17601.
SEC. 21. SEC. 50. Section 5717 of
the Welfare and Institutions Code is amended to read:
5717. (a) Expenditures that may be funded from amounts allocated
to the county by the State Department of Health Care Services from
funds appropriated to the department shall include, salaries of
personnel, approved facilities and services provided through
contract, and operation, maintenance, and service costs, including
insurance costs or departmental charges for participation in a county
self-insurance program if the charges are not in excess of
comparable available commercial insurance premiums and on the
condition that any surplus reserves be used to reduce future year
contributions; depreciation of county facilities as established in
the state's uniform accounting manual, disregarding depreciation on
the facility to the extent it was financed by state funds under this
part; lease of facilities where there is no intention to, nor option
to, purchase; expenses incurred under this act by members of the
County Behavioral Health Directors Association of California for
attendance at regular meetings of these conferences; expenses
incurred by either the chairperson or elected representative of the
local mental health advisory boards for attendance at regular
meetings of the Organization of Mental Health Advisory
Boards; organization of mental health advisory boards;
expenditures included in approved countywide cost allocation
plans submitted in accordance with the Controller's guidelines,
including, but not limited to, adjustments of prior year estimated
general county overhead to actual costs, but excluding allowable
costs otherwise compensated by state funding; net costs of
conservatorship investigation, approved by the Director of Health
Care Services. Except for expenditures made pursuant to Article 6
(commencing with Section 129225) of Chapter 1 of Part 6 of Division
107 of the Health and Safety Code, it shall not include expenditures
for initial capital improvements; the purchaser or construction of
buildings except for equipment items and remodeling expense as may be
provided for in regulations of the State Department of Health Care
Services; compensation to members of a local mental health advisory
board, except actual and necessary expenses incurred in the
performance of official duties that may include travel, lodging, and
meals while on official business; or expenditures for a purpose for
which state reimbursement is claimed under any other provision of
law.
(b) The Director of Health Care Services may make investigations
and audits of expenditures the director may deem necessary.
(c) With respect to funds allocated to a county by the State
Department of Health Care Services from funds appropriated to the
department, the county shall repay to the state amounts found not to
have been expended in accordance with the requirements set forth in
this part. Repayment shall be within 30 days after it is determined
that an expenditure has been made that is not in accordance with the
requirements. In the event that repayment is not made in a timely
manner, the department shall offset any amount improperly expended
against the amount of
any current or future advance payment or cost report settlement from
the state for mental health services. Repayment provisions shall not
apply to Short-Doyle funds allocated by the department for fiscal
years up to and including the 1990-91 fiscal year.
SEC. 22. SEC. 51. Section 5750 of
the Welfare and Institutions Code is amended to read:
5750. The State Department of Health Care Services shall
administer this part and shall adopt standards for the approval of
mental health services, and rules and regulations necessary thereto.
However, these standards, rules, and regulations shall be adopted
only after consultation with the County Behavioral Health Directors
Association of California and the California Mental Health Planning
Council.
SEC. 52. Section 5814.5 of the
Welfare and Institutions Code is amended to read:
5814.5. (a) (1) In any year in which funds are appropriated for
this purpose through the annual Budget Act, counties funded under
this part in the 1999-2000 fiscal year are eligible for funding to
continue their programs if they have successfully demonstrated the
effectiveness of their grants received in that year and to expand
their programs if they also demonstrate significant continued unmet
need and capacity for expansion without compromising quality or
effectiveness of care.
(2) In any year in which funds are appropriated for this purpose
through the annual Budget Act, other counties or portions of
counties, or cities that operate independent public mental health
programs pursuant to Section 5615 of the Welfare and Institutions
Code, are eligible for funding to establish programs if a county or
eligible city demonstrates that it can provide comprehensive
services, as set forth in this part, to a substantial number of
adults who are severely mentally ill, as defined in Section 5600.3,
and are homeless or recently released from the county jail or who are
untreated, unstable, and at significant risk of incarceration or
homelessness unless treatment is provided.
(b) (1) Counties eligible for funding pursuant to subdivision (a)
shall be those that have or can develop integrated adult service
programs that meet the criteria for an adult system of care, as set
forth in Section 5806, and that have, or can develop, integrated
forensic programs with similar characteristics for parolees and those
recently released from county jail who meet the target population
requirements of Section 5600.3 and are at risk of incarceration
unless the services are provided. Before a city or county submits a
proposal to the state to establish or expand a program, the proposal
shall be reviewed by a local advisory committee or mental health
board, which may be an existing body, that includes clients, family
members, private providers of services, and other relevant
stakeholders. Local enrollment for integrated adult service programs
and for integrated forensic programs funded pursuant to subdivision
(a) shall adhere to all conditions set forth by the department,
including the total number of clients to be enrolled, the providers
to which clients are enrolled and the maximum cost for each provider,
the maximum number of clients to be served at any one time, the
outreach and screening process used to identify enrollees, and the
total cost of the program. Local enrollment of each individual for
integrated forensic programs shall be subject to the approval of the
county mental behavioral health
director or his or her designee.
(2) Each county shall ensure that funds provided by these grants
are used to expand existing integrated service programs that meet the
criteria of the adult system of care to provide new services in
accordance with the purpose for which they were appropriated and
allocated, and that none of these funds shall be used to supplant
existing services to severely mentally ill adults. In order to ensure
that this requirement is met, the department shall develop methods
and contractual requirements, as it determines necessary. At a
minimum, these assurances shall include that state and federal
requirements regarding tracking of funds are met and that patient
records are maintained in a manner that protects privacy and
confidentiality, as required under federal and state law.
(c) Each county selected to receive a grant pursuant to this
section shall provide data as the department may require, that
demonstrates the outcomes of the adult system of care programs, shall
specify the additional numbers of severely mentally ill adults to
whom they will provide comprehensive services for each million
dollars of additional funding that may be awarded through either an
integrated adult service grant or an integrated forensic grant, and
shall agree to provide services in accordance with Section 5806. Each
county's plan shall identify and include sufficient funding to
provide housing for the individuals to be served, and shall ensure
that any hospitalization of individuals participating in the program
are coordinated with the provision of other mental health services
provided under the program.
SEC. 23. SEC. 53. Section 5845 of
the Welfare and Institutions Code is amended to read:
5845. (a) The Mental Health Services Oversight and Accountability
Commission is hereby established to oversee Part 3 (commencing with
Section 5800), the Adult and Older Adult Mental Health System of Care
Act; Part 3.1 (commencing with Section 5820), Human Resources,
Education, and Training Programs; Part 3.2 (commencing with Section
5830), Innovative Programs; Part 3.6 (commencing with Section 5840),
Prevention and Early Intervention Programs; and Part 4 (commencing
with Section 5850), 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 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. The commission shall administer its
operations separate and apart from the State Department of Health
Care Services and the California Health and Human Services Agency.
(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.
(5) Enter into contracts.
(6) Obtain data and information from the State Department of
Health Care Services, the Office of Statewide Health Planning and
Development, or other state or local entities that receive Mental
Health Services Act funds, for the commission to utilize in its
oversight, review, training and technical assistance, accountability,
and evaluation capacity regarding projects and programs supported
with Mental Health Services Act funds.
(7) Participate in the joint state-county decisionmaking process,
as contained in Section 4061, for training, technical assistance, and
regulatory resources to meet the mission and goals of the state's
mental health system.
(8) Develop strategies to overcome stigma and discrimination, and
accomplish all other objectives of Part 3.2 (commencing with Section
5830), Part 3.6 (commencing with Section 5840), and the
other provisions of the act establishing this commission.
(9) 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.
(10) If the commission identifies a critical issue related to the
performance of a county mental health program, it may refer the issue
to the State Department of Health Care Services pursuant to Section
5655.
(11) Assist in providing technical assistance to accomplish the
purposes of the Mental Health Services Act, Part 3 (commencing with
Section 5800), 5800) and Part 4
(commencing with Section 5850) in collaboration with the State
Department of Health Care Services and in consultation with the
County Behavioral Health Directors Association of California.
(12) Work in collaboration with the State Department of Health
Care Services and the California Mental Health Planning Council, and
in consultation with the County Behavioral Health Directors
Association of California, in designing a comprehensive joint plan
for a coordinated evaluation of client outcomes in the
community-based mental health system, including, but not limited to,
parts listed in subdivision (a). The California Health and Human
Services Agency shall lead this comprehensive joint plan effort.
SEC. 24. SEC. 54. Section 5847 of
the Welfare and Institutions Code is amended to read:
5847. Integrated Plans for Prevention, Innovation, and System of
Care Services.
(a) Each county mental health program shall prepare and submit a
three-year program and expenditure plan, and annual updates, adopted
by the county board of supervisors, to the Mental Health Services
Oversight and Accountability Commission within 30 days after
adoption.
(b) The three-year program and expenditure plan shall be based on
available unspent funds and estimated revenue allocations provided by
the state and in accordance with established stakeholder engagement
and planning requirements as required in Section 5848. The three-year
program and expenditure plan and annual updates shall include all of
the following:
(1) A program for prevention and early intervention in accordance
with Part 3.6 (commencing with Section 5840).
(2) A program for services to children in accordance with Part 4
(commencing with Section 5850), to include a program pursuant to
Chapter 4 (commencing with Section 18250) of Part 6 of Division 9 or
provide substantial evidence that it is not feasible to establish a
wraparound program in that county.
(3) A program for services to adults and seniors in accordance
with Part 3 (commencing with Section 5800).
(4) A program for innovations in accordance with Part 3.2
(commencing with Section 5830).
(5) A program for technological needs and capital facilities
needed to provide services pursuant to Part 3 (commencing with
Section 5800), Part 3.6 (commencing with Section 5840), and Part 4
(commencing with Section 5850). 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 (commencing with Section 5820).
(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 Part 3
(commencing with Section 5800), the Adult and Older Adult Mental
Health System of Care Act, Part 3.6 (commencing with Section 5840),
Prevention and Early Intervention Programs, and Part 4 (commencing
with Section 5850), the Children's Mental Health Services Act, 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.
(8) Certification by the county mental
behavioral health director, which ensures that the county has
complied with all pertinent regulations, laws, and statutes of the
Mental Health Services Act, including stakeholder participation and
nonsupplantation requirements.
(9) Certification by the county mental
behavioral health director and by the county auditor-controller
that the county has complied with any fiscal accountability
requirements as directed by the State Department of Health Care
Services, and that all expenditures are consistent with the
requirements of the Mental Health Services Act.
(c) The programs established pursuant to paragraphs (2) and (3) of
subdivision (b) shall include services to address the needs of
transition age youth ages 16 to 25. 16 to 25
years of age. In implementing this subdivision, county mental
health programs shall consider the needs of transition age foster
youth.
(d) Each year, the State Department of Health Care Services shall
inform the County Behavioral Health Directors Association of
California and the Mental Health Services Oversight and
Accountability Commission of the methodology used for revenue
allocation to the counties.
(e) Each county mental health program shall prepare expenditure
plans pursuant to Part 3 (commencing with Section 5800) for adults
and seniors, Part 3.2 (commencing with Section 5830) for innovative
programs, Part 3.6 (commencing with Section 5840) for prevention and
early intervention programs, and Part 4 (commencing with Section
5850) for services for children, 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 Part
3 (commencing with Section 5800), and Part 4 (commencing with
Section 5850), 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.
(f) A county mental health program shall include an allocation of
funds from a reserve established pursuant to paragraph (7) of
subdivision (b) for services pursuant to paragraphs (2) and (3) of
subdivision (b) in years in which the allocation of funds for
services pursuant to subdivision (e) are not adequate to continue to
serve the same number of individuals as the county had been serving
in the previous fiscal year.
SEC. 25. SEC. 55. Section 5848 of the
Welfare and Institutions Code is amended to read:
5848. (a) Each three-year program and expenditure 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, veterans,
representatives from veterans organizations, providers of alcohol and
drug services, health care organizations, and other important
interests. Counties shall demonstrate a partnership with constituents
and stakeholders throughout the process that includes meaningful
stakeholder involvement on mental health policy, program planning,
and implementation, monitoring, quality improvement, evaluation, and
budget allocations. 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 the draft plans.
(b) The mental health board established pursuant to Section 5604
shall conduct a public hearing on the draft three-year program and
expenditure plan and annual updates at the close of the 30-day
comment period required by subdivision (a). Each adopted three-year
program and expenditure plan and update shall include any substantive
written recommendations for revisions. The adopted three-year
program and expenditure 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 plans shall include reports on the achievement of
performance outcomes for services pursuant to Part 3 (commencing with
Section 5800), Part 3.6 (commencing with Section 5840), and Part 4
(commencing with Section 5850) funded by the Mental Health Services
Fund and established jointly by the State Department of Health Care
Services and the Mental Health Services Oversight and Accountability
Commission, in collaboration with the County Behavioral Health
Directors Association of California.
(d) Mental health services provided pursuant to Part 3 (commencing
with Section 5800), 5800) and Part 4
(commencing with Section 5850), 5850)
shall be included in the review of program performance by the
California Mental Health Planning Council required by paragraph (2)
of subdivision (c) of Section 5772 and in the local mental health
board's review and comment on the performance outcome data required
by paragraph (7) of subdivision (a) of Section 5604.2.
SEC. 26. SEC. 56. Section 5848.5 of
the Welfare and Institutions Code is amended to read:
5848.5. (a) The Legislature finds and declares all of the
following:
(1) California has realigned public community mental health
services to counties and it is imperative that sufficient
community-based resources be available to meet the mental health
needs of eligible individuals.
(2) Increasing access to effective outpatient and crisis
stabilization services provides an opportunity to reduce costs
associated with expensive inpatient and emergency room care and to
better meet the needs of individuals with mental health disorders in
the least restrictive manner possible.
(3) Almost one-fifth of people with mental health disorders visit
a hospital emergency room at least once per year. If an adequate
array of crisis services is not available, it leaves an individual
with little choice but to access an emergency room for assistance
and, potentially, an unnecessary inpatient hospitalization.
(4) Recent reports have called attention to a continuing problem
of inappropriate and unnecessary utilization of hospital emergency
rooms in California due to limited community-based services for
individuals in psychological distress and acute psychiatric crisis.
Hospitals report that 70 percent of people taken to emergency rooms
for psychiatric evacuation evaluation
can be stabilized and transferred to a less intensive level of crisis
care. Law enforcement personnel report that their personnel need to
stay with people in the emergency room waiting area until a placement
is found, and that less intensive levels of care tend not to be
available.
(5) Comprehensive public and private partnerships at both local
and regional levels, including across physical health services,
mental health, substance use disorder, law enforcement, social
services, and related supports, are necessary to develop and maintain
high quality, patient-centered, and cost-effective care for
individuals with mental health disorders that facilitates their
recovery and leads towards wellness.
(6) The recovery of individuals with mental health disorders is
important for all levels of government, business, and the local
community.
(b) This section shall be known, and may be cited, as the
Investment in Mental Health Wellness Act of 2013. The objectives of
this section are to do all of the following:
(1) Expand access to early intervention and treatment services to
improve the client experience, achieve recovery and wellness, and
reduce costs.
(2) Expand the continuum of services to address crisis
intervention, crisis stabilization, and crisis residential treatment
needs that are wellness, resiliency, and recovery oriented.
(3) Add at least 25 mobile crisis support teams and at least 2,000
crisis stabilization and crisis residential treatment beds to
bolster capacity at the local level to improve access to mental
health crisis services and address unmet mental health care needs.
(4) Add at least 600 triage personnel to provide intensive case
management and linkage to services for individuals with mental health
care disorders at various points of access, such as at designated
community-based service points, homeless shelters, and clinics.
(5) Reduce unnecessary hospitalizations and inpatient days by
appropriately utilizing community-based services and improving access
to timely assistance.
(6) Reduce recidivism and mitigate unnecessary expenditures of
local law enforcement.
(7) Provide local communities with increased financial resources
to leverage additional public and private funding sources to achieve
improved networks of care for individuals with mental health
disorders.
(c) Through appropriations provided in the annual Budget Act for
this purpose, it is the intent of the Legislature to authorize the
California Health Facilities Financing Authority, hereafter referred
to as the authority, and the Mental Health Services Oversight and
Accountability Commission, hereafter referred to as the commission,
to administer competitive selection processes as provided in this
section for capital capacity and program expansion to increase
capacity for mobile crisis support, crisis intervention, crisis
stabilization services, crisis residential treatment, and specified
personnel resources.
(d) Funds appropriated by the Legislature to the authority for
purposes of this section shall be made available to selected
counties, or counties acting jointly. The authority may, at its
discretion, also give consideration to private nonprofit corporations
and public agencies in an area or region of the state if a county,
or counties acting jointly, affirmatively supports this designation
and collaboration in lieu of a county government directly receiving
grant funds.
(1) Grant awards made by the authority shall be used to expand
local resources for the development, capital, equipment acquisition,
and applicable program startup or expansion costs to increase
capacity for client assistance and services in the following areas:
(A) Crisis intervention, as authorized by Sections 14021.4, 14680,
and 14684.
(B) Crisis stabilization, as authorized by Sections 14021.4,
14680, and 14684.
(C) Crisis residential treatment, as authorized by Sections
14021.4, 14680, and 14684.
(D) Rehabilitative mental health services, as authorized by
Sections 14021.4, 14680, and 14684.
(E) Mobile crisis support teams, including personnel and
equipment, such as the purchase of vehicles.
(2) The authority shall develop selection criteria to expand local
resources, including those described in paragraph (1), and processes
for awarding grants after consulting with representatives and
interested stakeholders from the mental health community, including,
but not limited to, the County Behavioral Health Directors
Association of California, service providers, consumer organizations,
and other appropriate interests, such as health care providers and
law enforcement, as determined by the authority. The authority shall
ensure that grants result in cost-effective expansion of the number
of community-based crisis resources in regions and communities
selected for funding. The authority shall also take into account at
least the following criteria and factors when selecting recipients of
grants and determining the amount of grant awards:
(A) Description of need, including, at a minimum, a comprehensive
description of the project, community need, population to be served,
linkage with other public systems of health and mental health care,
linkage with local law enforcement, social services, and related
assistance, as applicable, and a description of the request for
funding.
(B) Ability to serve the target population, which includes
individuals eligible for Medi-Cal and individuals eligible for county
health and mental health services.
(C) Geographic areas or regions of the state to be eligible for
grant awards, which may include rural, suburban, and urban areas, and
may include use of the five regional designations utilized by the
County Behavioral Health Directors Association of California.
(D) Level of community engagement and commitment to project
completion.
(E) Financial support that, in addition to a grant that may be
awarded by the authority, will be sufficient to complete and operate
the project for which the grant from the authority is awarded.
(F) Ability to provide additional funding support to the project,
including public or private funding, federal tax credits and grants,
foundation support, and other collaborative efforts.
(G) Memorandum of understanding among project partners, if
applicable.
(H) Information regarding the legal status of the collaborating
partners, if applicable.
(I) Ability to measure key outcomes, including improved access to
services, health and mental health outcomes, and cost benefit of the
project.
(3) The authority shall determine maximum grants awards, which
shall take into consideration the number of projects awarded to the
grantee, as described in paragraph (1), and shall reflect reasonable
costs for the project and geographic region. The authority may
allocate a grant in increments contingent upon the phases of a
project.
(4) Funds awarded by the authority pursuant to this section may be
used to supplement, but not to supplant, existing financial and
resource commitments of
the grantee or any other member of a collaborative effort that has
been awarded a grant.
(5) All projects that are awarded grants by the authority shall be
completed within a reasonable period of time, to be determined by
the authority. Funds shall not be released by the authority until the
applicant demonstrates project readiness to the authority's
satisfaction. If the authority determines that a grant recipient has
failed to complete the project under the terms specified in awarding
the grant, the authority may require remedies, including the return
of all or a portion of the grant.
(6) A grantee that receives a grant from the authority under this
section shall commit to using that capital capacity and program
expansion project, such as the mobile crisis team, crisis
stabilization unit, or crisis residential treatment program, for the
duration of the expected life of the project.
(7) The authority may consult with a technical assistance entity,
as described in paragraph (5) of subdivision (a) of Section 4061, for
purposes of implementing this section.
(8) The authority may adopt emergency regulations relating to the
grants for the capital capacity and program expansion projects
described in this section, including emergency regulations that
define eligible costs and determine minimum and maximum grant
amounts.
(9) The authority shall provide reports to the fiscal and policy
committees of the Legislature on or before May 1, 2014, and on or
before May 1, 2015, on the progress of implementation, that
includes, include, but are not limited to, the
following:
(A) A description of each project awarded funding.
(B) The amount of each grant issued.
(C) A description of other sources of funding for each project.
(D) The total amount of grants issued.
(E) A description of project operation and implementation,
including who is being served.
(10) A recipient of a grant provided pursuant to paragraph (1)
shall adhere to all applicable laws relating to scope of practice,
licensure, certification, staffing, and building codes.
(e) Funds appropriated by the Legislature to the commission for
purposes of this section shall be allocated for triage personnel to
provide intensive case management and linkage to services for
individuals with mental health disorders at various points of access.
These funds shall be made available to selected counties, counties
acting jointly, or city mental health departments, as determined by
the commission through a selection process. It is the intent of the
Legislature for these funds to be allocated in an efficient manner to
encourage early intervention and receipt of needed services for
individuals with mental health disorders, and to assist in navigating
the local service sector to improve efficiencies and the delivery of
services.
(1) Triage personnel may provide targeted case management services
face to face, by telephone, or by telehealth with the individual in
need of assistance or his or her significant support person, and may
be provided anywhere in the community. These service activities may
include, but are not limited to, the following:
(A) Communication, coordination, and referral.
(B) Monitoring service delivery to ensure the individual accesses
and receives services.
(C) Monitoring the individual's progress.
(D) Providing placement service assistance and service plan
development.
(2) The commission shall take into account at least the following
criteria and factors when selecting recipients and determining the
amount of grant awards for triage personnel as follows:
(A) Description of need, including potential gaps in local service
connections.
(B) Description of funding request, including personnel and use of
peer support.
(C) Description of how triage personnel will be used to facilitate
linkage and access to services, including objectives and anticipated
outcomes.
(D) Ability to obtain federal Medicaid reimbursement, when
applicable.
(E) Ability to administer an effective service program and the
degree to which local agencies and service providers will support and
collaborate with the triage personnel effort.
(F) Geographic areas or regions of the state to be eligible for
grant awards, which shall include rural, suburban, and urban areas,
and may include use of the five regional designations utilized by the
County Behavioral Health Directors Association of California.
(3) The commission shall determine maximum grant awards, and shall
take into consideration the level of need, population to be served,
and related criteria, as described in paragraph (2), and shall
reflect reasonable costs.
(4) Funds awarded by the commission for purposes of this section
may be used to supplement, but not supplant, existing financial and
resource commitments of the county, counties acting jointly, or city
mental health department that received the grant.
(5) Notwithstanding any other law, a county, counties acting
jointly, or city mental health department that receives an award of
funds for the purpose of supporting triage personnel pursuant to this
subdivision is not required to provide a matching contribution of
local funds.
(6) Notwithstanding any other law, the commission, without taking
any further regulatory action, may implement, interpret, or make
specific this section by means of informational letters, bulletins,
or similar instructions.
(7) The commission shall provide a status report to the fiscal and
policy committees of the Legislature on the progress of
implementation no later than March 1, 2014.
SEC. 27. SEC. 57. Section 5892 of
the Welfare and Institutions Code is amended to read:
5892. (a) In order to promote efficient implementation of this
act, the county shall use funds distributed from the Mental Health
Services Fund as follows:
(1) In 2005-06, 2006-07, and in 2007-08
2007-08, 10 percent 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 2006-07, and
in 2007-08 2007-08, 10 percent for
capital facilities and technological needs distributed to counties in
accordance with a formula developed in consultation with the County
Behavioral Health Directors Association of California to implement
plans developed pursuant to Section 5847.
(3) Twenty percent of funds distributed to the counties pursuant
to subdivision (c) of Section 5891 shall be used for prevention and
early intervention programs in accordance with Part 3.6 (commencing
with Section 5840) of this division.
(4) The expenditure for prevention and early intervention may be
increased in any county in which the department determines that the
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.
(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 (commencing with Section 5850),
5850) for the children's system of care and Part 3
(commencing with Section 5800), 5800)
for the adult and older adult system of care.
(6) Five percent of the total funding for each county mental
health program for Part 3 (commencing with Section 5800), Part 3.6
(commencing with Section 5840), and Part 4 (commencing with Section
5850) of this division, shall be utilized for innovative programs in
accordance with Sections 5830, 5847, and 5848.
(b) In any year after 2007-08, programs for services pursuant to
Part 3 (commencing with Section 5800), 5800)
and Part 4 (commencing with Section 5850) of this division 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 percent 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 these costs shall not exceed 5 percent 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 Part 3 (commencing with
Section 5800), 5800) and Part 4
(commencing with Section 5850) of this division.
(d) Prior to making the allocations pursuant to subdivisions (a),
(b), and (c), funds shall be reserved for the costs for the State
Department of Health Care Services, the California Mental Health
Planning Council, the Office of Statewide Health Planning and
Development, the Mental Health Services Oversight and Accountability
Commission, the State Department of Public Health, and any other
state agency to implement all duties pursuant to the programs set
forth in this section. These costs shall not exceed 5 percent 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 Part 3
(commencing with Section 5800), Part 3.6 (commencing with Section
5840), and Part 4 (commencing with Section 5850) of this division.
The amount of funds available for the purposes of this subdivision in
any fiscal year shall be subject to appropriation in the annual
Budget Act.
(e) In 2004-05 2004-05, funds shall
be allocated as follows:
(1) Forty-five percent for education and training pursuant to
Part 3.1 (commencing with Section 5820) of this division.
(2) Forty-five percent for capital facilities and technology
needs in the manner specified by paragraph (2) of subdivision (a).
(3) Five percent for local planning in the manner specified in
subdivision (c).
(4) Five percent 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 the
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 that 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 capital
facilities, technological needs, or education and training may be
retained for up to 10 years before reverting to the fund.
(i) If there are still additional revenues available in the fund
after the Mental Health Services 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
these revenues to further the purposes of this act and the
Legislature may appropriate these funds for any purpose consistent
with the commission's adopted plan that furthers the purposes of this
act.
(j) For the 2011-12 fiscal year, General Fund revenues will be
insufficient to fully fund many existing mental health programs,
including Early and Periodic Screening, Diagnosis, and Treatment
(EPSDT), Medi-Cal Specialty Mental Health Managed Care, and mental
health services provided for special education pupils. In order to
adequately fund those programs for the 2011-12 fiscal year and avoid
deeper reductions in programs that serve individuals with severe
mental illness and the most vulnerable, medically needy citizens of
the state, prior to distribution of funds under paragraphs (1) to
(6), inclusive, of subdivision (a), effective July 1, 2011, moneys
shall be allocated from the Mental Health Services Fund to the
counties as follows:
(1) Commencing July 1, 2011, one hundred eighty-three million six
hundred thousand dollars ($183,600,000) of the funds available as of
July 1, 2011, in the Mental Health Services Fund, shall be allocated
in a manner consistent with subdivision (c) of Section 5778 and based
on a formula determined by the state in consultation with the County
Behavioral Health Directors Association of California to meet the
fiscal year 2011-12 General Fund obligation for Medi-Cal Specialty
Mental Health Managed Care.
(2) Upon completion of the allocation in paragraph (1), the
Controller shall distribute to counties ninety-eight million five
hundred eighty-six thousand dollars ($98,586,000) from the Mental
Health Services Fund for mental health services for special education
pupils based on a formula determined by the state in consultation
with the County Behavioral Health Directors Association of
California.
(3) Upon completion of the allocation in paragraph (2), the
Controller shall distribute to counties 50 percent of their 2011-12
Mental Health Services Act component allocations consistent with
Sections 5847 and 5891, not to exceed four hundred eighty-eight
million dollars ($488,000,000). This allocation shall commence
beginning August 1, 2011.
(4) Upon completion of the allocation in paragraph (3), and as
revenues are deposited into the Mental Health Services Fund, the
Controller shall distribute five hundred seventy-nine million dollars
($579,000,000) from the Mental Health Services Fund to counties to
meet the General Fund obligation for EPSDT for fiscal year
2011-12. the 2011-12 fiscal year. These revenues
shall be distributed to counties on a quarterly basis and based on a
formula determined by the state in consultation with the County
Behavioral Health Directors Association of California. These funds
shall not be subject to reconciliation or cost settlement.
(5) The Controller shall distribute to counties the remaining
2011-12 Mental Health Services Act component allocations consistent
with Sections 5847 and 5891, beginning no later than April 30, 2012.
These remaining allocations shall be made on a monthly basis.
(6) The total one-time allocation from the Mental Health Services
Fund for EPSDT, Medi-Cal Specialty Mental Health Managed Care, and
mental health services provided to special education pupils as
referenced shall not exceed eight hundred sixty-two million dollars
($862,000,000). Any revenues deposited in the Mental Health Services
Fund in fiscal year the 2011-12
fiscal year that exceed this obligation shall be distributed to
counties for remaining fiscal year 2011-12 Mental Health Services
Act component allocations, consistent with Sections 5847 and 5891.
(k) Subdivision (j) shall not be subject to repayment.
( l ) Subdivision (j) shall become inoperative on July
1, 2012.
SEC. 28. SEC. 58. Section 5899 of
the Welfare and Institutions Code is amended to read:
5899. (a) The State Department of Health Care Services, in
consultation with the Mental Health Services Oversight and
Accountability Commission and the County Behavioral Health Directors
Association of California, shall develop and administer instructions
for the Annual Mental Health Services Act Revenue and Expenditure
Report. This report shall be submitted electronically to the
department and to the Mental Health Services Oversight and
Accountability Commission.
(b) The purpose of the Annual Mental Health Services Act Revenue
and Expenditure Report is as follows:
(1) Identify the expenditures of Mental Health Services Act (MHSA)
funds that were distributed to each county.
(2) Quantify the amount of additional funds generated for the
mental health system as a result of the MHSA.
(3) Identify unexpended funds, and interest earned on MHSA funds.
(4) Determine reversion amounts, if applicable, from prior fiscal
year distributions.
(c) This report is intended to provide information that allows for
the evaluation of all of the following:
(1) Children's systems of care.
(2) Prevention and early intervention strategies.
(3) Innovative projects.
(4) Workforce education and training.
(5) Adults and older adults systems of care.
(6) Capital facilities and technology needs.
SEC. 29. SEC. 59. Section 5902 of
the Welfare and Institutions Code is amended to read:
5902. (a) In the 1991-92 fiscal year, funding sufficient to cover
the cost of the basic level of care in institutions for mental
disease at the rate established by the State Department of Health
Care Services shall be made available to the department
for skilled nursing facilities, plus the rate established for special
treatment programs. The department may authorize a county to
administer institutions for mental disease services if the county
with the consent of the affected providers makes a request to
administer services and an allocation is made to the county for these
services. The department shall continue to contract with these
providers for the services necessary for the operation of the
institutions for mental disease.
(b) In the 1992-93 fiscal year, the department shall consider
county-specific requests to continue to provide administrative
services relative to institutions for mental disease facilities when
no viable alternatives are found to exist.
(c) (1) By October 1, 1991, the department, in consultation with
the County Behavioral Health Directors Association of California and
the California Association of Health Facilities, shall develop and
publish a county-specific allocation of institutions for mental
disease funds that will take effect on July 1, 1992.
(2) By November 1, 1991, counties shall notify the providers of
any intended change in service levels to be effective on July 1,
1992.
(3) By April 1, 1992, counties and providers shall have entered
into contracts for basic institutions for mental disease services at
the rate described in subdivision (e) for the 1992-93 fiscal year at
the level expressed on or before November 1, 1991, except that a
county shall be permitted additional time, until June 1, 1992, to
complete the processing of the contract, when any of the following
conditions are met:
(A) The county and the affected provider have agreed on all
substantive institutions for mental disease contract issues by April
1, 1992.
(B) Negotiations are in process with the county on April 1, 1992,
and the affected provider has agreed in writing to the extension.
(C) The service level committed to on November 1, 1991, exceeds
the affected provider's bed capacity.
(D) The county can document that the affected provider has refused
to enter into negotiations by April 1, 1992, or has substantially
delayed negotiations.
(4) If a county and a provider are unable to reach agreement on
substantive contract issues by June 1, 1992, the department may, upon
request of either the affected county or the provider, mediate the
disputed issues.
(5) Where When contracts
for service at the level committed to on November 1, 1991, have not
been completed by April 1, 1992, and additional time is not permitted
pursuant to the exceptions specified in paragraph (3) the funds
allocated to those counties shall revert for reallocation in a manner
that shall promote equity of funding among counties. With respect to
counties with exceptions permitted pursuant to paragraph (3), funds
shall not revert unless contracts are not completed by June 1, 1992.
In no event shall funds revert under this section if there is no harm
to the provider as a result of the county contract not being
completed. During the 1992-93 fiscal year, funds reverted under this
paragraph shall be used to purchase institution for mental
disease/skilled nursing/special treatment program services in
existing facilities.
(6) Nothing in this section shall apply to negotiations regarding
supplemental payments beyond the rate specified in subdivision (e).
(d) On or before April 1, 1992, counties may complete contracts
with facilities for the direct purchase of services in the 1992-93
fiscal year. Those counties for which facility contracts have not
been completed by that date shall be deemed to continue to accept
financial responsibility for those patients during the subsequent
fiscal year at the rate specified in subdivision (a).
(e) As long as contracts with institutions for mental disease
providers require the facilities to maintain skilled nursing facility
licensure and certification, reimbursement for basic services shall
be at the rate established by the State Department of Health Care
Services. Except as provided in this section, reimbursement
rates for services in institutions for mental diseases shall be the
same as the rates in effect on July 31, 2004. Effective July 1, 2005,
through June 30, 2008, the reimbursement rate for institutions for
mental disease shall increase by 6.5 percent annually. Effective July
1, 2008, the reimbursement rate for institutions for mental disease
shall increase by 4.7 percent annually.
(f) (1) Providers that agree to contract with the county for
services under an alternative mental health program pursuant to
Section 5768 that does not require skilled nursing facility licensure
shall retain return rights to licensure as skilled nursing
facilities.
(2) Providers participating in an alternative program that elect
to return to skilled nursing facility licensure shall only be
required to meet those requirements under which they previously
operated as a skilled nursing facility.
(g) In the 1993-94 fiscal year and thereafter, the department
shall consider requests to continue administrative services related
to institutions for mental disease facilities from counties with a
population of 150,000 or less based on the most recent available
estimates of population data as determined by the Population Research
Unit of the Department of Finance.
SEC. 60. Section 6002.25 of the Welfare
and Institutions Code is amended to read:
6002.25. The independent clinical review shall be conducted by a
licensed psychiatrist with training and experience in treating
psychiatric adolescent patients, who is a neutral party to the
review, having no direct financial relationship with the treating
clinician, nor a personal or financial relationship with the patient,
or his or her parents or guardian. Nothing in this section shall
prevent a psychiatrist affiliated with a health maintenance
organization, as defined in subdivision (b) of Section 1373.10 of the
Health and Safety Code, from providing the independent clinical
review where the admitting, treating, and reviewing psychiatrists are
affiliated with a health maintenance organization that predominantly
serves members of a prepaid health care service plan. The
independent clinical reviewer shall be assigned, on a rotating basis,
from a list prepared by the facility, and submitted to the county
mental behavioral health director prior
to March 1, 1990, and annually thereafter, or more frequently when
necessary. The county mental behavioral
health director shall, on an annual basis, or at the request of the
facility, review the facility's list of independent clinical
reviewers. The county mental behavioral
health director shall approve or disapprove the list of reviewers
within 30 days of submission. If there is no response from the county
mental behavioral health director, the
facility's list shall be deemed approved. If the county
mental behavioral health director disapproves
one or more of the persons on the list of reviewers, the county
mental behavioral health director shall
notify the facility in writing of the reasons for the disapproval.
The county mental behavioral health
director, in consultation with the facility, may develop a list of
one or more additional reviewers within 30 days. The final list shall
be mutually agreeable to the county mental
behavioral health director and the facility. Sections 6002.10
to 6002.40, inclusive, shall not be construed to prohibit the
treatment of minors prior to the existence of an approved list of
independent clinical reviewers. The independent clinical reviewer may
be an active member of the medical staff of the facility who has no
direct financial relationship, including, but not limited to, an
employment or other contract arrangement with the facility except for
compensation received for the service of providing clinical reviews.
SEC. 61. Section 8103 of the Welfare
and Institutions Code is amended to read:
8103. (a) (1) No person who after October 1, 1955, has been
adjudicated by a court of any state to be a danger to others as a
result of a mental disorder or mental illness, or who has been
adjudicated to be a mentally disordered sex offender, shall purchase
or receive, or attempt to purchase or receive, or have in his or her
possession, custody, or control a firearm or any other deadly weapon
unless there has been issued to the person a certificate by the court
of adjudication upon release from treatment or at a later date
stating that the person may possess a firearm or any other deadly
weapon without endangering others, and the person has not, subsequent
to the issuance of the certificate, again been adjudicated by a
court to be a danger to others as a result of a mental disorder or
mental illness.
(2) The court shall notify the Department of Justice of the court
order finding the individual to be a person described in paragraph
(1) as soon as possible, but not later than one court day after
issuing the order. The court shall also notify the Department of
Justice of any certificate issued as described
in paragraph (1) as soon as possible, but
not later than one court day after issuing the certificate.
(b) (1) No person who has been found, pursuant to Section 1026 of
the Penal Code or the law of any other state or the United States,
not guilty by reason of insanity of murder, mayhem, a violation of
Section 207, 209, or 209.5 of the Penal Code in which the victim
suffers intentionally inflicted great bodily injury, carjacking or
robbery in which the victim suffers great bodily injury, a violation
of Section 451 or 452 of the Penal Code involving a trailer coach, as
defined in Section 635 of the Vehicle Code, or any dwelling house, a
violation of paragraph (1) or (2) of subdivision (a) of Section 262
or paragraph (2) or (3) of subdivision (a) of Section 261 of the
Penal Code, a violation of Section 459 of the Penal Code in the first
degree, assault with intent to commit murder, a violation of Section
220 of the Penal Code in which the victim suffers great bodily
injury, a violation of Section 18715, 18725, 18740, 18745, 18750, or
18755 of the Penal Code, or of a felony involving death, great bodily
injury, or an act which poses a serious threat of bodily harm to
another person, or a violation of the law of any other state or the
United States that includes all the elements of any of the above
felonies as defined under California law, shall purchase or receive,
or attempt to purchase or receive, or have in his or her possession
or under his or her custody or control any firearm or any other
deadly weapon.
(2) The court shall notify the Department of Justice of the court
order finding the person to be a person described in paragraph (1) as
soon as possible, but not later than, one court day after issuing
the order.
(c) (1) No person who has been found, pursuant to Section 1026 of
the Penal Code or the law of any other state or the United States,
not guilty by reason of insanity of any crime other than those
described in subdivision (b) shall purchase or receive, or attempt to
purchase or receive, or shall have in his or her possession,
custody, or control any firearm or any other deadly weapon unless the
court of commitment has found the person to have recovered sanity,
pursuant to Section 1026.2 of the Penal Code or the law of any other
state or the United States.
(2) The court shall notify the Department of Justice of the court
order finding the person to be a person described in paragraph (1) as
soon as possible, but not later than one court day after issuing the
order. The court shall also notify the Department of Justice when it
finds that the person has recovered his or her sanity as soon as
possible, but not later than one court day after making the finding.
(d) (1) No person found by a court to be mentally incompetent to
stand trial, pursuant to Section 1370 or 1370.1 of the Penal Code or
the law of any other state or the United States, shall purchase or
receive, or attempt to purchase or receive, or shall have in his or
her possession, custody, or control, any firearm or any other deadly
weapon, unless there has been a finding with respect to the person of
restoration to competence to stand trial by the committing court,
pursuant to Section 1372 of the Penal Code or the law of any other
state or the United States.
(2) The court shall notify the Department of Justice of the court
order finding the person to be mentally incompetent as described in
paragraph (1) as soon as possible, but not later than one court day
after issuing the order. The court shall also notify the Department
of Justice when it finds that the person has recovered his or her
competence as soon as possible, but not later than one court day
after making the finding.
(e) (1) No person who has been placed under conservatorship by a
court, pursuant to Section 5350 or the law of any other state or the
United States, because the person is gravely disabled as a result of
a mental disorder or impairment by chronic alcoholism, shall purchase
or receive, or attempt to purchase or receive, or shall have in his
or her possession, custody, or control, any firearm or any other
deadly weapon while under the conservatorship if, at the time the
conservatorship was ordered or thereafter, the court that imposed the
conservatorship found that possession of a firearm or any other
deadly weapon by the person would present a danger to the safety of
the person or to others. Upon placing a person under conservatorship,
and prohibiting firearm or any other deadly weapon possession by the
person, the court shall notify the person of this prohibition.
(2) The court shall notify the Department of Justice of the court
order placing the person under conservatorship and prohibiting
firearm or any other deadly weapon possession by the person as
described in paragraph (1) as soon as possible, but not later than
one court day after placing the person under conservatorship. The
notice shall include the date the conservatorship was imposed and the
date the conservatorship is to be terminated. If the conservatorship
is subsequently terminated before the date listed in the notice to
the Department of Justice or the court subsequently finds that
possession of a firearm or any other deadly weapon by the person
would no longer present a danger to the safety of the person or
others, the court shall notify the Department of Justice as soon as
possible, but not later than one court day after terminating the
conservatorship.
(3) All information provided to the Department of Justice pursuant
to paragraph (2) shall be kept confidential, separate, and apart
from all other records maintained by the Department of Justice, and
shall be used only to determine eligibility to purchase or possess
firearms or other deadly weapons. A person who knowingly furnishes
that information for any other purpose is guilty of a misdemeanor.
All the information concerning any person shall be destroyed upon
receipt by the Department of Justice of notice of the termination of
conservatorship as to that person pursuant to paragraph (2).
(f) (1) No person who has been (A) taken into custody as provided
in Section 5150 because that person is a danger to himself, herself,
or to others, (B) assessed within the meaning of Section 5151, and
(C) admitted to a designated facility within the meaning of Sections
5151 and 5152 because that person is a danger to himself, herself, or
others, shall own, possess, control, receive, or purchase, or
attempt to own, possess, control, receive, or purchase any firearm
for a period of five years after the person is released from the
facility. A person described in the preceding sentence, however, may
own, possess, control, receive, or purchase, or attempt to own,
possess, control, receive, or purchase any firearm if the superior
court has, pursuant to paragraph (5), found that the people of the
State of California have not met their burden pursuant to paragraph
(6).
(2) (A) For each person subject to this subdivision, the facility
shall, within 24 hours of the time of admission, submit a report to
the Department of Justice, on a form prescribed by the Department of
Justice, containing information that includes, but is not limited to,
the identity of the person and the legal grounds upon which the
person was admitted to the facility.
Any report submitted pursuant to this paragraph shall be
confidential, except for purposes of the court proceedings described
in this subdivision and for determining the eligibility of the person
to own, possess, control, receive, or purchase a firearm.
(B) Commencing July 1, 2012, facilities shall submit reports
pursuant to this paragraph exclusively by electronic means, in a
manner prescribed by the Department of Justice.
(3) Prior to, or concurrent with, the discharge, the facility
shall inform a person subject to this subdivision that he or she is
prohibited from owning, possessing, controlling, receiving, or
purchasing any firearm for a period of five years. Simultaneously,
the facility shall inform the person that he or she may request a
hearing from a court, as provided in this subdivision, for an order
permitting the person to own, possess, control, receive, or purchase
a firearm. The facility shall provide the person with a form for a
request for a hearing. The Department of Justice shall prescribe the
form. Where the person requests a hearing at the time of discharge,
the facility shall forward the form to the superior court unless the
person states that he or she will submit the form to the superior
court.
(4) The Department of Justice shall provide the form upon request
to any person described in paragraph (1). The Department of Justice
shall also provide the form to the superior court in each county. A
person described in paragraph (1) may make a single request for a
hearing at any time during the five-year period. The request for
hearing shall be made on the form prescribed by the department or in
a document that includes equivalent language.
(5) A person who is subject to paragraph (1) who has requested a
hearing from the superior court of his or her county of residence for
an order that he or she may own, possess, control, receive, or
purchase firearms shall be given a hearing. The clerk of the court
shall set a hearing date and notify the person, the Department of
Justice, and the district attorney. The people of the State of
California shall be the plaintiff in the proceeding and shall be
represented by the district attorney. Upon motion of the district
attorney, or on its own motion, the superior court may transfer the
hearing to the county in which the person resided at the time of his
or her detention, the county in which the person was detained, or the
county in which the person was evaluated or treated. Within seven
days after the request for a hearing, the Department of Justice shall
file copies of the reports described in this section with the
superior court. The reports shall be disclosed upon request to the
person and to the district attorney. The court shall set the hearing
within 30 days of receipt of the request for a hearing. Upon showing
good cause, the district attorney shall be entitled to a continuance
not to exceed 14 days after the district attorney was notified of the
hearing date by the clerk of the court. If additional continuances
are granted, the total length of time for continuances shall not
exceed 60 days. The district attorney may notify the county
mental behavioral health director of the hearing
who shall provide information about the detention of the person that
may be relevant to the court and shall file that information with
the superior court. That information shall be disclosed to the person
and to the district attorney. The court, upon motion of the person
subject to paragraph (1) establishing that confidential information
is likely to be discussed during the hearing that would cause harm to
the person, shall conduct the hearing in camera with only the
relevant parties present, unless the court finds that the public
interest would be better served by conducting the hearing in public.
Notwithstanding any other law, declarations, police reports,
including criminal history information, and any other material and
relevant evidence that is not excluded under Section 352 of the
Evidence Code shall be admissible at the hearing under this section.
(6) The people shall bear the burden of showing by a preponderance
of the evidence that the person would not be likely to use firearms
in a safe and lawful manner.
(7) If the court finds at the hearing set forth in paragraph (5)
that the people have not met their burden as set forth in paragraph
(6), the court shall order that the person shall not be subject to
the five-year prohibition in this section on the ownership, control,
receipt, possession, or purchase of firearms, and that person shall
comply with the procedure described in Chapter 2 (commencing with
Section 33850) of Division 11 of Title 4 of Part 6 of the Penal Code
for the return of any firearms. A copy of the order shall be
submitted to the Department of Justice. Upon receipt of the order,
the Department of Justice shall delete any reference to the
prohibition against firearms from the person's state mental health
firearms prohibition system information.
(8) Where the district attorney declines or fails to go forward in
the hearing, the court shall order that the person shall not be
subject to the five-year prohibition required by this subdivision on
the ownership, control, receipt, possession, or purchase of firearms.
A copy of the order shall be submitted to the Department of Justice.
Upon receipt of the order, the Department of Justice shall, within
15 days, delete any reference to the prohibition against firearms
from the person's state mental health firearms prohibition system
information, and that person shall comply with the procedure
described in Chapter 2 (commencing with Section 33850) of Division 11
of Title 4 of Part 6 of the Penal Code for the return of any
firearms.
(9) Nothing in this subdivision shall prohibit the use of reports
filed pursuant to this section to determine the eligibility of
persons to own, possess, control, receive, or purchase a firearm if
the person is the subject of a criminal investigation, a part of
which involves the ownership, possession, control, receipt, or
purchase of a firearm.
(g) (1) No person who has been certified for intensive treatment
under Section 5250, 5260, or 5270.15 shall own, possess, control,
receive, or purchase, or attempt to own, possess, control, receive,
or purchase, any firearm for a period of five years.
Any person who meets the criteria contained in subdivision (e) or
(f) who is released from intensive treatment shall nevertheless, if
applicable, remain subject to the prohibition contained in
subdivision (e) or (f).
(2) (A) For each person certified for intensive treatment under
paragraph (1), the facility shall, within 24 hours of the
certification, submit a report to the Department of Justice, on a
form prescribed by the department, containing information regarding
the person, including, but not limited to, the legal identity of the
person and the legal grounds upon which the person was certified. A
report submitted pursuant to this paragraph shall only be used for
the purposes specified in paragraph (2) of subdivision (f).
(B) Commencing July 1, 2012, facilities shall submit reports
pursuant to this paragraph exclusively by electronic means, in a
manner prescribed by the Department of Justice.
(3) Prior to, or concurrent with, the discharge of each person
certified for intensive treatment under paragraph (1), the facility
shall inform the person of that information specified in paragraph
(3) of subdivision (f).
(4) A person who is subject to paragraph (1) may petition the
superior court of his or her county of residence for an order that he
or she may own, possess, control, receive, or purchase firearms. At
the time the petition is filed, the clerk of the court shall set a
hearing date and notify the person, the Department of Justice, and
the district attorney. The people of the State of California shall be
the respondent in the proceeding and shall be represented by the
district attorney. Upon motion of the district attorney, or on its
own motion, the superior court may transfer the petition to the
county in which the person resided at the time of his or her
detention, the county in which the person was detained, or the county
in which the person was evaluated or treated. Within seven days
after receiving notice of the petition, the Department of Justice
shall file copies of the reports described in this section with the
superior court. The reports shall be disclosed upon request to the
person and to the district attorney. The district attorney shall be
entitled to a continuance of the hearing to a date of not less than
14 days after the district attorney was notified of the hearing date
by the clerk of the court. The district attorney may notify the
county mental behavioral health
director of the petition, and the county mental
behavioral health director shall provide information about
the detention of the person that may be relevant to the court and
shall file that information with the superior court. That information
shall be disclosed to the person and to the district attorney. The
court, upon motion of the person subject to paragraph (1)
establishing that confidential information is likely to be discussed
during the hearing that would cause harm to the person, shall conduct
the hearing in camera with only the relevant parties present, unless
the court finds that the public interest would be better served by
conducting the hearing in public. Notwithstanding any other law, any
declaration, police reports, including criminal history information,
and any other material and relevant evidence that is not excluded
under Section 352 of the Evidence Code, shall be admissible at the
hearing under this section. If the court finds by a preponderance of
the evidence that the person would be likely to use firearms in a
safe and lawful manner, the court may order that the person may own,
control, receive, possess, or purchase firearms, and that person
shall comply with the procedure described in Chapter 2 (commencing
with Section 33850) of Division 11 of Title 4 of Part 6 of the Penal
Code for the return of any firearms. A copy of the order shall be
submitted to the Department of Justice. Upon receipt of the order,
the Department of Justice shall delete any reference to the
prohibition against firearms from the person's state mental health
firearms prohibition system information.
(h) (1) For all persons identified in subdivisions (f) and (g),
facilities shall report to the Department of Justice as specified in
those subdivisions, except facilities shall not report persons under
subdivision (g) if the same persons previously have been reported
under subdivision (f).
(2) Additionally, all facilities shall report to the Department of
Justice upon the discharge of persons from whom reports have been
submitted pursuant to subdivision (f) or (g). However, a report shall
not be filed for persons who are discharged within 31 days after the
date of admission.
(i) Every person who owns or possesses or has under his or her
custody or control, or purchases or receives, or attempts to purchase
or receive, any firearm or any other deadly weapon in violation of
this section shall be punished by imprisonment pursuant to
subdivision (h) of Section 1170 of the Penal Code or in a county jail
for not more than one year.
(j) "Deadly weapon," as used in this section, has the meaning
prescribed by Section 8100.
(k) Any notice or report required to be submitted to the
Department of Justice pursuant to this section shall be submitted in
an electronic format, in a manner prescribed by the Department of
Justice.
SEC. 30. SEC. 62. Section 11467 of
the Welfare and Institutions Code is amended to read:
11467. (a) The State Department of Social Services, with the
advice and assistance of the County Welfare Directors
Association, Association of California, the
Chief Probation Officer's Association,
Officers of California, the County Behavioral Health Directors
Association of California, research entities, foster youth and
advocates for foster youth, foster care provider business entities
organized and operated on a nonprofit basis, tribes, and other
stakeholders, shall establish a working group to develop performance
standards and outcome measures for providers of out-of-home care
placements made under the AFDC-FC program, including, but not limited
to, foster family agency, group home, and THP-Plus providers, and
for the effective and efficient administration of the AFDC-FC
program.
(b) The performance standards and outcome measures shall employ
the applicable performance standards and outcome measures as set
forth in Sections 11469 and 11469.1, designed to identify the degree
to which foster care providers, including business entities organized
and operated on a nonprofit basis, are providing out-of-home
placement services that meet the needs of foster children, and the
degree to which these services are supporting improved outcomes,
including those identified by the California Child and Family Service
Review System.
(c) In addition to the process described in subdivision (a), the
working group may also develop the following:
(1) A means of identifying the child's needs and determining which
is the most appropriate out-of-home placement for a child.
(2) A procedure for identifying children who have been in
congregate care for one year or longer, determining the reasons each
child remains in congregate care, and developing a plan for each
child to transition to a less restrictive, more family-like setting.
(d) The department shall provide updates regarding its progress
toward meeting the requirements of this section during the 2013 and
2014 budget hearings.
(e) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
13340) of Part 1 of Division 3 of Title 2 of the Government Code),
until the enactment of applicable state law, or October 1, 2015,
whichever is earlier, the department may implement the changes made
pursuant to this section through all-county letters, or similar
instructions from the director.
SEC. 31. SEC. 63. Section 11469 of
the Welfare and Institutions Code is amended to read:
11469. (a) The department, in consultation with group home
providers, the County Welfare Directors Association,
Association of California, the Chief Probation
Officers of California, the County Behavioral Health Directors
Association of California, and the State Department of Health Care
Services, shall develop performance standards and outcome measures
for determining the effectiveness of the care and supervision, as
defined in subdivision (b) of Section 11460, provided by group homes
under the AFDC-FC program pursuant to Sections 11460 and 11462. These
standards shall be designed to measure group home program
performance for the client group that the group home program is
designed to serve.
(1) The performance standards and outcome measures shall be
designed to measure the performance of group home programs in areas
over which the programs have some degree of influence, and in other
areas of measurable program performance that the department can
demonstrate are areas over which group home programs have meaningful
managerial or administrative influence.
(2) These standards and outcome measures shall include, but are
not limited to, the effectiveness of services provided by each group
home program, and the extent to which the services provided by the
group home assist in obtaining the child welfare case plan objectives
for the child.
(3) In addition, when the group home provider has identified as
part of its program for licensing, ratesetting, or county placement
purposes, or has included as a part of a child's case plan by mutual
agreement between the group home and the placing agency, specific
mental health, education, medical, and other child-related services,
the performance standards and outcome measures may also measure the
effectiveness of those services.
(b) Regulations regarding the implementation of the group home
performance standards system required by this section shall be
adopted no later than one year prior to implementation. The
regulations shall specify both the performance standards system and
the manner by which the AFDC-FC rate of a group home program shall be
adjusted if performance standards are not met.
(c) Except as provided in subdivision (d), effective July 1, 1995,
group home performance standards shall be implemented. Any group
home program not meeting the performance standards shall have its
AFDC-FC rate, set pursuant to Section 11462, adjusted according to
the regulations required by this section.
(d) Effective July 1, 1995, group home programs shall be
classified at rate classification level 13 or 14 only if all of the
following are met:
(1) The program generates the requisite number of points for rate
classification level 13 or 14.
(2) The program only accepts children with special treatment needs
as determined through the assessment process pursuant to paragraph
(2) of subdivision (a) of Section 11462.01.
(3) The program meets the performance standards designed pursuant
to this section.
(e) Notwithstanding subdivision (c), the group home program
performance standards system shall not be implemented prior to the
implementation of the AFDC-FC performance standards system.
(f) By January 1, 2016, the department, in consultation with the
County Welfare Directors Association,
Association of California, the Chief Probation Officers of
California, the County Behavioral Health Directors Association of
California, research entities, foster youth and advocates for foster
youth, foster care provider business entities organized and operated
on a nonprofit basis, Indian tribes, and other stakeholders, shall
develop additional performance standards and outcome measures that
require group homes to implement programs and services to minimize
law enforcement contacts and delinquency petition filings arising
from incidents of allegedly unlawful behavior by minors occurring in
group homes or under the supervision of group home staff, including
individualized behavior management programs, emergency intervention
plans, and conflict resolution processes.
SEC. 32. SEC. 64. Section 14021.4 of
the Welfare and Institutions Code is amended to read:
14021.4. (a) California's plan for federal Medi-Cal grants for
medical assistance programs, pursuant to Subchapter XIX (commencing
with Section 1396) of Title 42 of the United States Code, shall
accomplish the following objectives:
(1) Expansion of the location and type of therapeutic services
offered to persons with mental illnesses under Medi-Cal by the
category of "other diagnostic, screening, preventative, and
rehabilitative services" that is available to states under the
federal Social Security Act and its implementing regulations (42
U.S.C. Sec. 1396d(a)(13); 42 C.F.R. 440.130).
(2) Expansion of federal financial participation in the costs of
specialty mental health services provided by local mental health
plans or under contract with the mental health plans.
(3) Expansion of the location where reimbursable specialty mental
health services can be provided, including home, school, and
community based community-based sites.
(4) Expansion of federal financial participation for services
that meet the rehabilitation needs of persons with mental illnesses,
including, but not limited to, medication management, functional
rehabilitation assessments of clients, and rehabilitative services
that include remedial services directed at restoration to the highest
possible functional level for persons with mental illnesses and
maximum reduction of symptoms of mental illness.
(5) Improvement of fiscal systems and accountability structures
for specialty mental health services, costs, and rates, with the goal
of achieving federal fiscal requirements.
(b) The department's state plan revision shall be completed with
review and comments by the County Behavioral Health Directors
Association of California and other appropriate groups.
(c) Services under the rehabilitative option shall be limited to
specialty mental health plans certified to provide Medi-Cal under
this option.
(d) It is the intent of the Legislature that the rehabilitation
option of the state Medicaid plan be implemented to expand and
provide flexibility to treatment services and to increase the federal
participation without increasing the costs to the General Fund.
(e) The department shall review and revise the quality assurance
standards and guidelines required by Section 14725 to ensure that
quality services are delivered to the eligible population. Any
reviews shall include, but not be limited to, appropriate use of
mental health professionals, including psychiatrists, in the
treatment and rehabilitation of clients under this model. The
existing quality assurance standards and guidelines shall remain in
effect until the adoption of the new quality assurance standards and
guidelines.
(f) Consistent with services offered to persons with mental
illnesses under the Medi-Cal program, as required by this section, it
is the intent of the Legislature for the department to include care
and treatment of persons with mental illnesses who are eligible for
the Medi-Cal program in facilities with a bed capacity of 16 beds or
less.
SEC. 33. SEC. 65. Section 14124.24
of the Welfare and Institutions Code is amended to read:
14124.24. (a) For purposes of this section, "Drug Medi-Cal
reimbursable services" means the substance use disorder services
described in the California State Medicaid
Medicaid State Plan and includes, but is not limited to, all of
the following services, administered by the department, and to the
extent consistent with state and federal law:
(1) Narcotic treatment program services, as set forth in Section
14021.51.
(2) Day care rehabilitative services.
(3) Perinatal residential services for pregnant women and women in
the postpartum period.
(4) Naltrexone services.
(5) Outpatient drug-free services.
(6) Other services upon approval of a federal Medicaid state plan
amendment or waiver authorizing federal financial participation.
(b) (1) While seeking federal approval for any federal Medicaid
state plan amendment or waiver associated with Drug Medi-Cal
services, the department shall consult with the counties and
stakeholders in the development of the state plan amendment or
waiver.
(2) Upon federal approval of a federal Medicaid state plan
amendment authorizing federal financial participation in the
following services, and subject to appropriation of funds, "Drug
Medi-Cal reimbursable services" shall also include the following
services, administered by the department, and to the extent
consistent with state and federal law:
(A) Notwithstanding subdivision (a) of Section 14132.90, day care
habilitative services, which, for purposes of this paragraph, are
outpatient counseling and rehabilitation services provided to persons
with substance use disorder diagnoses.
(B) Case management services, including supportive services to
assist persons with substance use disorder diagnoses in gaining
access to medical, social, educational, and other needed services.
(C) Aftercare services.
(c) (1) The nonfederal share for Drug Medi-Cal services shall be
funded through a county's Behavioral Health Subaccount of the Support
Services Account of the Local Revenue Fund 2011, and any other
available county funds eligible under federal law for federal
Medicaid reimbursement. The funds contained in each county's
Behavioral Health Subaccount of the Support Services Account of the
Local Revenue Fund 2011 shall be considered state funds distributed
by the principal state agency for the purposes of receipt of the
federal block grant funds for prevention and treatment of substance
abuse found at Subchapter XVII of Chapter 6A of Title 42 of the
United States Code. Pursuant to applicable federal Medicaid law and
regulations including Section 433.51 of Title 42 of the Code of
Federal Regulations, counties may claim allowable Medicaid federal
financial participation for Drug Medi-Cal services based on the
counties certifying their actual total funds expenditures for
eligible Drug Medi-Cal services to the department.
(2) (A) If the director determines that a county's provision of
Drug Medi-Cal treatment services are disallowed by the federal
government or by state or federal audit or review, the impacted
county shall be responsible for repayment of all disallowed federal
funds. In addition to any other recovery methods available,
including, but not limited to, offset of Medicaid federal financial
participation funds owed to the impacted county, the director may
offset these amounts in accordance with Section 12419.5 of the
Government Code.
(B) A county subject to an action by the director pursuant to
subparagraph (A) may challenge that action by requesting a hearing in
writing no later than 30 days from receipt of notice of the
department's action. The proceeding shall be conducted in accordance
with Chapter 5 (commencing with Section 11500) of Part 1 of Division
3 of Title 2 of the Government Code, and the director has all the
powers granted therein. Upon a county's timely request for hearing,
the county's obligation to make payment as determined by the director
shall be stayed pending the county's exhaustion of administrative
remedies provided herein but no longer than will ensure the
department's compliance with Section 1903(d)(2)(C) of the federal
Social Security Act (42 U.S.C. Sec. 1396b).
(d) Drug Medi-Cal services are only reimbursable to Drug Medi-Cal
providers with an approved Drug Medi-Cal contract.
(e) Counties shall negotiate contracts only with providers
certified to provide Drug Medi-Cal services.
(f) The department shall develop methods to ensure timely payment
of Drug Medi-Cal claims.
(g) (1) A county or a contracted provider, except for a provider
to whom subdivision (h) applies, shall submit accurate and complete
cost reports for the previous fiscal year by November 1, following
the end of the fiscal year. The department may settle Drug Medi-Cal
reimbursable services, based on the cost report as the final
amendment to the approved county Drug Medi-Cal contract.
(2) Amounts paid for services provided to Drug Medi-Cal
beneficiaries shall be audited by the department in the manner and
form described in Section 14170.
(3) Administrative appeals to review grievances or complaints
arising from the findings of an audit or examination made pursuant to
this section shall be subject to Section 14171.
(h) Certified narcotic treatment program providers that are
exclusively billing the state or the county for services rendered to
persons subject to Section 1210.1 or 3063.1 of the Penal Code or
Section 14021.52 of this code shall submit accurate and complete
performance reports for the previous state fiscal year by November 1
following the end of that fiscal year. A provider to which this
subdivision applies shall estimate its budgets using the uniform
state daily reimbursement rate. The format and content of the
performance reports shall be mutually agreed to by the department,
the County Behavioral Health Directors Association of California, and
representatives of the treatment providers.
(i) Contracts entered into pursuant to this section shall be
exempt from the requirements of Chapter 1 (commencing with Section
10100) and Chapter 2 (commencing with Section 10290) of Part 2 of
Division 2 of the Public Contract Code.
(j) Annually, the department shall publish procedures for
contracting for Drug Medi-Cal services with certified providers and
for claiming payments, including procedures and specifications for
electronic data submission for services rendered.
(k) If the department commences a preliminary criminal
investigation of a certified provider, the department shall promptly
notify each county that currently contracts with the provider for
Drug Medi-Cal services that a preliminary criminal investigation has
commenced. If the department concludes a preliminary criminal
investigation of a certified provider, the department shall promptly
notify each county that currently contracts with the provider for
Drug Medi-Cal services that a preliminary criminal investigation has
concluded.
(1) Notice of the commencement and conclusion of a preliminary
criminal investigation pursuant to this section shall be made to the
county behavioral health director or his or her equivalent.
(2) Communication between the department and a county specific to
the commencement or conclusion of a preliminary criminal
investigation pursuant to this section shall be deemed confidential
and shall not be subject to any disclosure request, including, but
not limited to, the Information Practices Act of 1997
1977 (Chapter 1 (commencing with Section 1798)
of Title 1.8 of Part 4 of Division 3 of the Code of Civil
Procedure), Civil Code), the California Public
Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7
of Title 1 of the Government Code), requests pursuant to a subpoena,
or for any other public purpose, including, but not limited to,
court testimony.
(3) Information shared by the department with a county regarding a
preliminary criminal investigation shall be maintained in a manner
to ensure protection of the confidentiality of the criminal
investigation.
(4) The information provided to a county pursuant to this section
shall only include the provider name, national provider identifier
(NPI) number, address, and the notice that an investigation has
commenced or concluded.
(5) A county shall not take any adverse action against a provider
based solely upon the preliminary criminal investigation information
disclosed to the county pursuant to this section.
(6) In the event of a preliminary criminal investigation of a
county owned or operated program, the department has the option to,
but is not required to, notify the county pursuant to this section
when the department commences or concludes a preliminary criminal
investigation.
(7) This section shall not limit the voluntary or otherwise
legally mandated or contractually mandated sharing of information
between the department and a county of information regarding audits
and investigations of Drug Medi-Cal providers.
(8) "Commenced" means the time at which a complaint or allegation
is assigned to an investigator for a field investigation.
(9) "Preliminary criminal investigation" means an investigation to
gather information to determine if criminal law or statutes have
been violated.
SEC. 34. SEC. 66. Section 14251 of
the Welfare and Institutions Code is amended to read:
14251. (a) (1) "Prepaid health plan" means a plan that meets all
of the following criteria:
(A) Is licensed as a health care service plan by the Director of
the Department of Managed Health Care pursuant to the Knox-Keene
Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with
Section 1340), 1340) of Division
2, 2 of the Health and Safety Code),
other than a plan organized and operating pursuant to Section 10810
of the Corporations Code that substantially indemnifies subscribers
or enrollees for the cost of provided services, or has an application
for licensure pending and was registered under the Knox-Mills Health
Plan Act prior to its repeal.
(B) Meets the requirements for participation in the Medicaid
Program (Title XIX of the Social Security Act) on an at risk basis.
(C) Agrees with the State Department of Health Care Services to
furnish directly or indirectly health services to Medi-Cal
beneficiaries on a predetermined periodic rate basis.
(2) "Prepaid health plan" includes any organization that is
licensed as a plan pursuant to the Knox-Keene Health Care Service
Plan Act of 1975 and is subject to regulation by the Department of
Managed Health Care pursuant to that act, and that contracts with the
State Department of Health Care Services solely as a fiscal
intermediary at risk.
(b) (1) Except for the requirement of licensure pursuant to the
Knox-Keene Act, Health Care Service Plan Act
of 1975, the State Director of Health Care Services may waive
any provision of this chapter that the director determines is
inappropriate for a fiscal intermediary at risk. An exemption or
waiver shall be set forth in the fiscal intermediary at risk
at-risk contract with the State Department of
Health Care Services.
(2) "Fiscal intermediary at risk" means any entity that entered
into a contract with the State Department of Health Care Services on
a pilot basis pursuant to subdivision (f) of Section 14000, as in
effect June 1, 1973, in accordance with which the entity received
capitated payments from the state and reimbursed providers of health
care services on a fee-for-service or other basis for at least the
basic scope of health care services, as defined in Section 14256,
provided to all beneficiaries covered by the contract residing within
a specified geographic region of the state. The fiscal intermediary
at risk shall be at risk for the cost of administration and
utilization of services or the cost of services, or both, for at
least the basic scope of health care services, as defined in Section
14256, provided to all beneficiaries covered by the contract residing
within a specified geographic region of the state. The fiscal
intermediary at risk may share the risk with providers or reinsuring
agencies or both. Eligibility of beneficiaries shall be determined by
the State Department of Health Care Services and capitation payments
shall be based on the number of beneficiaries so determined.
SEC. 35. SEC. 67. Section 14499.71
of the Welfare and Institutions Code is amended to read:
14499.71. For the purposes of this article, "fiscal intermediary"
means an entity that agrees to pay for covered services provided to
Medi-Cal eligibles in exchange for a premium, subscription charge, or
capitation payment; to assume an underwriting risk; and is licensed
by the Director of the Department of Managed Health Care under the
Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code).
SEC. 68. Section 14682.1 of the Welfare
and Institutions Code is amended to read:
14682.1. (a) The State Department of Health Care Services shall
be designated as the state agency responsible for development,
consistent with the requirements of Section 4060, and implementation
of, mental health plans for Medi-Cal beneficiaries.
(b) The department shall convene a steering committee for the
purpose of providing advice and recommendations on the transition and
continuing development of the Medi-Cal mental health managed care
systems pursuant to subdivision (a). The committee shall include work
groups to advise the department of major issues to be addressed in
the managed mental health care plan, as well as system transition and
transformation issues pertaining to the delivery of mental health
care services to Medi-Cal beneficiaries, including services to
children provided through the Early and Periodic Screening, Diagnosis
and Treatment Program.
(c) The committee shall consist of diverse representatives of
concerned and involved communities, including, but not limited to,
beneficiaries, their families, providers, mental health
professionals, substance use disorder treatment professionals,
statewide representatives of health care service plans,
representatives of the California Mental Health Planning Council,
public and private organizations, county mental
behavioral health directors, and others as determined by
the department. The department has the authority to structure this
steering committee process in a manner that is conducive for
addressing issues effectively, and for providing a transparent,
collaborative, meaningful process to ensure a more diverse and
representative approach to problem-solving and dissemination of
information.
SEC. 36. SEC. 69. Section 14707 of
the Welfare and Institutions Code is amended to read:
14707. (a) In the case of federal audit exceptions, the
department shall follow federal audit appeal processes unless the
department, in consultation with the County Behavioral Health
Directors Association of California, determines that those appeals
are not cost beneficial.
(b) Whenever there is a final federal audit exception against the
state resulting from expenditure of federal funds by individual
counties, the department may offset federal reimbursement and request
the Controller's office to offset the distribution of funds to the
counties from the Mental Health Subaccount, the Mental Health Equity
Subaccount, and the Vehicle License Collection Account of the Local
Revenue Fund, funds from the Mental Health Account and the Behavioral
Health Subaccount of the Local Revenue Fund 2011, and any other
mental health realignment funds from which the Controller makes
distributions to the counties by the amount of the exception. The
department shall provide evidence to the Controller that the county
has been notified of the amount of the audit exception no less than
30 days before the offset is to occur. The department shall involve
the appropriate counties in developing responses to any draft federal
audit reports that directly impact the county.
SEC. 37. SEC. 70. Section 14711 of
the Welfare and Institutions Code is amended to read:
14711. (a) The department shall develop, in consultation with the
County Behavioral Health Directors Association of California, a
reimbursement methodology for use in the Medi-Cal claims processing
and interim payment system that maximizes federal funding and
utilizes, as much as practicable, federal Medicaid and Medicare
reimbursement principles. The department shall work with the federal
Centers for Medicare and Medicaid Services in the development of the
methodology required by this section.
(b) Reimbursement amounts developed through the methodology
required by this section shall be consistent with federal Medicaid
requirements and the approved Medicaid state plan and waivers.
(c) Administrative costs shall be claimed separately in a manner
consistent with federal Medicaid requirements and the approved
Medicaid state plan and waivers and shall be limited to 15 percent of
the total actual cost of direct client services.
(d) The cost of performing quality assurance and utilization
review activities shall be reimbursed separately and shall not be
included in administrative cost.
(e) The reimbursement methodology established pursuant to this
section shall be based upon certified public expenditures, which
encourage economy and efficiency in service delivery.
(f) The reimbursement amounts established for direct client
services pursuant to this section shall be based on increments of
time for all noninpatient services.
(g) The reimbursement methodology shall not be implemented until
it has received any necessary federal approvals.
(h) This section shall become operative on July 1, 2012.
SEC. 38. SEC. 71. Section 14717 of
the Welfare and Institutions Code is amended to read:
14717. (a) In order to facilitate the receipt of medically
necessary specialty mental health services by a foster child who is
placed outside his or her county of original jurisdiction, the
department shall take all of the following actions:
(1) On or before July 1, 2008, create all of the following items,
in consultation with stakeholders, including, but not limited to, the
California Institute for Mental Health, the Child and Family Policy
Institute, Institute of California, the
County Behavioral Health Directors Association of California, and
the California Alliance of Child and Family Services:
(A) A standardized contract for the purchase of medically
necessary specialty mental health services from organizational
providers, providers when a contract is
required.
(B) A standardized specialty mental health service authorization
procedure.
(C) A standardized set of documentation standards and forms,
including, but not limited to, forms for treatment plans, annual
treatment plan updates, day treatment intensive and day treatment
rehabilitative progress notes, and treatment authorization requests.
(2) On or before January 1, 2009, use the standardized items as
described in paragraph (1) to provide medically necessary specialty
mental health services to a foster child who is placed outside his or
her county of original jurisdiction, so that organizational
providers who are already certified by a mental health plan are not
required to be additionally certified by the mental health plan in
the county of original jurisdiction.
(3) (A) On or before January 1, 2009, use the standardized items
described in paragraph (1) to provide medically necessary specialty
mental health services to a foster child placed outside his or her
county of original jurisdiction to constitute a complete contract,
authorization procedure, and set of documentation standards and
forms, so that no additional documents are required.
(B) Authorize a county mental health plan to be exempt from
subparagraph (A) and have an addendum to a contract, authorization
procedure, or set of documentation standards and forms, if the county
mental health plan has an externally placed requirement, such as a
requirement from a federal integrity agreement, that would affect one
of these documents.
(4) Following consultation with stakeholders, including, but not
limited to, the California Institute for Mental Health, the Child and
Family Policy Institute, Institute of
California, the County Behavioral Health Directors Association
of California, the California State Association of Counties, and the
California Alliance of Child and Family Services, require the use of
the standardized contracts, authorization procedures, and
documentation standards and forms as specified in paragraph (1) in
the 2008-09 state-county mental health plan contract and each
state-county mental health plan contract thereafter.
(5) The mental health plan shall complete a standardized contract,
as provided in paragraph (1), if a contract is required, or another
mechanism of payment if a contract is not required, with a provider
or providers of the county's choice, to deliver approved specialty
mental health services for a specified foster child, within 30 days
of an approved treatment authorization request.
(b) The California Health and Human Services Agency shall
coordinate the efforts of the department and the State Department of
Social Services to do all of the following:
(1) Participate with the stakeholders in the activities described
in this section.
(2) During budget hearings in 2008 and 2009, report to the
Legislature regarding the implementation of this section and
subdivision (c) of Section 14716.
(3) On or before July 1, 2008, establish the following, in
consultation with stakeholders, including, but not limited to, the
County Behavioral Health Directors Association of California, the
California Alliance of Child and Family Services, and the County
Welfare Directors Association of California:
(A) Informational materials that explain to foster care providers
how to arrange for specialty mental health services on behalf of the
beneficiary in their care.
(B) Informational materials that county child welfare agencies can
access relevant to the provision of services to children in their
care from the out-of-county local mental health plan that is
responsible for providing those services, including, but not limited
to, receiving a copy of the child's treatment plan within 60 days
after requesting services.
(C) It is the intent of the Legislature to ensure that foster
children who are adopted or placed permanently with relative
guardians, and who move to a county outside their original county of
residence, can access specialty mental health services in a timely
manner. It is the intent of the Legislature to enact this section as
a temporary means of ensuring access to these services, while the
appropriate stakeholders pursue a long-term solution in the form of a
change to the Medi-Cal Eligibility Data System that will allow these
children to receive specialty mental health services through their
new county of residence.
SEC. 39. SEC. 72. Section 14718 of
the Welfare and Institutions Code is amended to read:
14718. (a) This section shall be limited to specialty mental
health services reimbursed to a mental health plan that certifies
public expenditures subject to cost settlement or specialty mental
health services reimbursed through the department's fiscal
intermediary.
(b) The following provisions shall apply to matters related to
specialty mental health services provided under the approved Medi-Cal
state plan and the Specialty Mental Health Services Waiver,
including, but not limited to, reimbursement and claiming procedures,
reviews and oversight, and appeal processes for mental health plans
(MHPs) and MHP subcontractors.
(1) As determined by the department, the MHP shall submit claims
for reimbursement to the Medi-Cal program for eligible services.
(2) The department may offset the amount of any federal
disallowance, audit exception, or overpayment against subsequent
claims from the MHP. The department may offset the amount of any
state disallowance, or audit exception or overpayment against
subsequent claims from the mental health plan, through the 2010-11
fiscal year. This offset may be done at any time, after the
department has invoiced or otherwise notified the mental health plan
about the audit exception, disallowance, or overpayment. The
department shall determine the amount that may be withheld from each
payment to the mental health plan. The maximum withheld amount shall
be 25 percent of each
payment as long as the department is able to comply with the federal
requirements for repayment of federal financial participation
pursuant to Section 1903(d)(2) of the federal Social Security Act (42
U.S.C. Sec. 1396b(d)(2)). The department may increase the maximum
amount when necessary for compliance with federal laws and
regulations.
(3) (A) Oversight by the department of the MHPs may include client
record reviews of Early and Periodic Screening
Diagnosis Screening, Diagnosis, and Treatment
(EPSDT) specialty mental health services rendered by MHPs and MHP
subcontractors under the Medi-Cal specialty mental health services
waiver in addition to other audits or reviews that are conducted.
(B) The department may contract with an independent,
nongovernmental entity to conduct client record reviews. The contract
awarded in connection with this section shall be on a competitive
bid basis, pursuant to the Department of General Services contracting
requirements, and shall meet both of the following additional
requirements:
(i) Require the entity awarded the contract to comply with all
federal and state privacy laws, including, but not limited to, the
federal Health Insurance Portability and Accountability Act (HIPAA;
42 U.S.C. Sec. 1320d et seq.) and its implementing regulations, the
Confidentiality of Medical Information Act (Part 2.6 (commencing with
Section 56) of Division 1 of the Civil Code), and Section 1798.81.5
of the Civil Code. The entity shall be subject to existing penalties
for violation of these laws.
(ii) Prohibit the entity awarded the contract from using or
disclosing client records or client information for a purpose other
than the one for which the record was given.
(iii) Prohibit the entity awarded the contract from selling client
records or client information.
(C) For purposes of this paragraph, the following terms shall have
the following meanings:
(i) "Client record" means a medical record, chart, or similar
file, as well as other documents containing information regarding an
individual recipient of services, including, but not limited to,
clinical information, dates and times of services, and other
information relevant to the individual and services provided and that
evidences compliance with legal requirements for Medi-Cal
reimbursement.
(ii) "Client record review" means examination of the client record
for a selected individual recipient for the purpose of confirming
the existence of documents that verify compliance with legal
requirements for claims submitted for Medi-Cal reimbursement.
(D) The department shall recover overpayments of federal financial
participation from MHPs within the timeframes required by federal
law and regulation for repayment to the federal Centers for Medicare
and Medicaid Services.
(4) (A) The department, in consultation with mental health
stakeholders, the County Behavioral Health Directors Association of
California, and MHP subcontractor representatives, shall provide an
appeals process that specifies a progressive process for resolution
of disputes about claims or recoupments relating to specialty mental
health services under the Medi-Cal specialty mental health services
waiver.
(B) The department shall provide MHPs and MHP subcontractors the
opportunity to directly appeal findings in accordance with procedures
that are similar to those described in Article 1.5 (commencing with
Section 51016) of Chapter 3 of Subdivision 1 of Division 3 of Title
22 of the California Code of Regulations, until new regulations for a
progressive appeals process are promulgated. When an MHP
subcontractor initiates an appeal, it shall give notice to the MHP.
The department shall propose a rulemaking package consistent with the
department's appeals process that is in effect on July 1,
2012 2012, by no later than the end of the
2013-14 fiscal year. The reference in this subparagraph to the
procedures described in Article 1.5 (commencing with Section 51016)
of Chapter 3 of Subdivision 1 of Division 3 of Title 22 of the
California Code of Regulations, shall only apply to those appeals
addressed in this subparagraph.
(C) The department shall develop regulations as necessary to
implement this paragraph.
(5) The department shall conduct oversight of utilization controls
as specified in Section 14133. The MHP shall include a requirement
in any subcontracts that all inpatient subcontractors maintain
necessary licensing and certification. MHPs shall require that
services delivered by licensed staff are within their scope of
practice. Nothing in this chapter shall prohibit the MHPs from
establishing standards that are in addition to the federal and state
requirements, provided that these standards do not violate federal
and state requirements and guidelines.
(6) (A) Subject to federal approval and consistent with state
requirements, the MHP may negotiate rates with providers of specialty
mental health services.
(B) Any excess in the distribution of funds over the expenditures
for services by the mental health plan shall be spent for the
provision of specialty mental health services and related
administrative costs.
(7) Nothing in this chapter shall limit the MHP from being
reimbursed appropriate federal financial participation for any
qualified services. To receive federal financial participation, the
mental health plan shall certify its public expenditures for
specialty mental health services to the department.
(8) Notwithstanding Section 14115, claims for federal
reimbursement for service pursuant to this chapter shall be submitted
by MHPs within the timeframes required by federal Medicaid
requirements and the approved Medicaid state plan and waivers.
(9) The MHP shall use the fiscal intermediary of the Medi-Cal
program of the State Department of Health Care Services for the
processing of claims for inpatient psychiatric hospital services
rendered in fee-for-service Medi-Cal hospitals. The department shall
request the Controller to offset the distribution of funds to the
counties from the Mental Health Subaccount, the Mental Health Equity
Subaccount, or the Vehicle License Collection Account of the Local
Revenue Fund, or funds from the Mental Health Account or the
Behavioral Health Subaccount of the Local Revenue Fund 2011 for the
nonfederal financial participation share for these claims.
(c) Counties may set aside funds for self-insurance, audit
settlement, and statewide program risk pools. The counties shall
assume all responsibility and liability for appropriate
administration of the funds. Special consideration may be given to
small counties with a population of less than 200,000.
Nothing in the paragraph shall in any way This
subdivision shall not make the state or department liable for
mismanagement or loss of funds by the entity designated by counties
under this subdivision.
(d) The department shall consult with the California
Mental Health Directors Association County Behavioral
Health Directors Association of California in February and
September of each year to obtain data and methodology necessary to
forecast future fiscal trends in the provision of specialty mental
health services provided under the Medi-Cal specialty mental health
services waiver, to estimate yearly specialty mental health services
related costs, and to estimate the annual amount of federal funding
participation to reimburse costs of specialty mental health services
provided under the Medi-Cal specialty mental health services waiver.
This shall include a separate presentation of the data and
methodology necessary to forecast future fiscal trends in the
provision of Early Periodic Screening, Diagnosis, and Treatment
specialty mental health services provided under the Medi-Cal
specialty mental health services waiver, to estimate annual EPSDT
specialty mental health services related costs, and to estimate the
annual amount of EPSDT specialty mental health services provided
under the state Medi-Cal specialty mental health services waiver,
including federal funding participation to reimburse costs of EPSDT.
(e) When seeking federal approval for any federal Medicaid state
plan amendment or waiver associated with Medi-Cal specialty mental
health services, the department shall consult with staff of the
Legislature, counties, providers, and other stakeholders in the
development of the state plan amendment or waiver.
(f) This section shall become operative on July 1, 2012.
SEC. 40. SEC. 73. Section 14725 of
the Welfare and Institutions Code is amended to read:
14725. (a) The State Department of Health Care Services shall
develop a quality assurance program to govern the delivery of
Medi-Cal specialty mental health services, in order to
assure ensure quality patient care based on
community standards of practice.
(b) The department shall issue standards and guidelines for local
quality assurance activities. These standards and guidelines shall be
reviewed and revised in consultation with the County Behavioral
Health Directors Association of California, as well as other
stakeholders from the mental health community, including, but not
limited to, individuals who receive services, family members,
providers, mental health advocacy groups, and other interested
parties. The standards and guidelines shall be based on federal
Medicaid requirements.
(c) The standards and guidelines developed by the department shall
reflect the special problems that small rural counties have in
undertaking comprehensive quality assurance systems.
SEC. 41. SEC. 74. Section 15204.8 of
the Welfare and Institutions Code is amended to read:
15204.8. (a) The Legislature may appropriate annually in the
Budget Act funds to support services provided pursuant to Sections
11325.7 and 11325.8.
(b) Funds appropriated pursuant to subdivision (a) shall be
allocated to the counties separately and shall be available for
expenditure by the counties for services provided during the budget
year. A county may move funds between the two accounts during the
budget year for expenditure if necessary to meet the particular
circumstances in the county. Any unexpended funds may be retained by
each county for expenditure for the same purposes during the
succeeding fiscal year. By November 20, 1998, each county shall
report to the department on the use of these funds.
(c) Beginning January 10, 1999, the Department of Finance shall
report annually to the Legislature on the extent to which funds
available under subdivision (a) have not been spent and may
reallocate the unexpended balances so as to better meet the need for
services.
(d) No later than September 1, 2001, the department in
consultation with relevant stakeholders, which may include the County
Welfare Directors Association and the County Behavioral Health
Directors Association of California, shall develop the allocation
methodology for these funds, including the specific components to be
considered in allocating the funds.
SEC. 42. SEC. 75. Section 15847.7 of
the Welfare and Institutions Code is amended to read:
15847.7. (a) For purposes of Sections 15847, 15847.3, and
15847.5, "group health coverage" includes any health care service
plan, self-insured employee welfare benefit plan, or disability
insurance providing medical or hospital benefits.
(b) This section shall become operative on July 1, 2014.
SEC. 43. Section 17604 of the Welfare and
Institutions Code is amended to read:
17604. (a) All motor vehicle license fee revenues collected in
the 1991-92 fiscal year that are deposited to the credit of the Local
Revenue Fund shall be credited to the Vehicle License Fee Account of
that fund.
(b) (1) For the 1992-93 fiscal year and fiscal years thereafter,
from vehicle license fee proceeds from revenues deposited to the
credit of the Local Revenue Fund, the Controller shall make monthly
deposits to the Vehicle License Fee Account of the Local Revenue Fund
until the deposits equal the amounts that were allocated to
counties, cities, and cities and counties as general purpose revenues
in the prior fiscal year pursuant to this chapter from the Vehicle
License Fee Account in the Local Revenue Fund and the Vehicle License
Fee Account and the Vehicle License Fee Growth Account in the Local
Revenue Fund.
(2) Any excess vehicle fee revenues deposited into the Local
Revenue Fund pursuant to Section 11001.5 of the Revenue and Taxation
Code shall be deposited in the Vehicle License Fee Growth Account of
the Local Revenue Fund.
(3) The Controller shall calculate the difference between the
total amount of vehicle license fee proceeds deposited to the credit
of the Local Revenue Fund, pursuant to paragraph (1) of subdivision
(a) of Section 11001.5 of the Revenue and Taxation Code, and
deposited into the Vehicle License Fee Account for the period of July
16, 2009, to July 15, 2010, inclusive, and the amount deposited for
the period of July 16, 2010, to July 15, 2011, inclusive.
(4) Of vehicle license fee proceeds deposited to the Vehicle
License Fee Account after July 15, 2011, an amount equal to the
difference calculated in paragraph (3) shall be deemed to have been
deposited during the period of July 16, 2010, to July 15, 2011,
inclusive, and allocated to cities, counties, and a city and county
as if those proceeds had been received during the 2010-11 fiscal
year.
(c) (1) On or before the 27th day of each month, the Controller
shall allocate to each county, city, or city and county, as general
purpose revenues the amounts deposited and remaining unexpended and
unreserved on the 15th day of the month in the Vehicle License Fee
Account of the Local Revenue Fund, in accordance with paragraphs (2)
and (3).
(2) For the 1991-92 fiscal year, allocations shall be made in
accordance with the following schedule:
Allocation
Jurisdiction Percentage
Alameda .................... 4.5046
Alpine ..................... 0.0137
Amador ..................... 0.1512
Butte ...................... 0.8131
Calaveras .................. 0.1367
Colusa...................... 0.1195
Contra Costa ............... 2.2386
Del Norte .................. 0.1340
El Dorado .................. 0.5228
Fresno ..................... 2.3531
Glenn ...................... 0.1391
Humboldt ................... 0.8929
Imperial ................... 0.8237
Inyo ....................... 0.1869
Kern ....................... 1.6362
Kings ...................... 0.4084
Lake ....................... 0.1752
Lassen ..................... 0.1525
Los Angeles ................ 37.2606
Madera ..................... 0.3656
Marin....................... 1.0785
Mariposa ................... 0.0815
Mendocino .................. 0.2586
Merced ..................... 0.4094
Modoc ...................... 0.0923
Mono ....................... 0.1342
Monterey ................... 0.8975
Napa ....................... 0.4466
Nevada ..................... 0.2734
Orange ..................... 5.4304
Placer ..................... 0.2806
Plumas ..................... 0.1145
Riverside .................. 2.7867
Sacramento ................. 2.7497
San Benito ................. 0.1701
San Bernardino.............. 2.4709
San Diego .................. 4.7771
San Francisco .............. 7.1450
San Joaquin ................ 1.0810
San Luis Obispo ............ 0.4811
San Mateo .................. 1.5937
Santa Barbara .............. 0.9418
Santa Clara ................ 3.6238
Santa Cruz ................. 0.6714
Shasta ..................... 0.6732
Sierra ..................... 0.0340
Siskiyou.................... 0.2246
Solano ..................... 0.9377
Sonoma ..................... 1.6687
Stanislaus ................. 1.0509
Sutter ..................... 0.4460
Tehama ..................... 0.2986
Trinity .................... 0.1388
Tulare ..................... 0.7485
Tuolumne ................... 0.2357
Ventura .................... 1.3658
Yolo ....................... 0.3522
Yuba ....................... 0.3076
Berkeley ................... 0.0692
Long Beach ................. 0.2918
Pasadena ................... 0.1385
(3) For the 1992-93, 1993-94, and 1994-95 fiscal years and fiscal
years thereafter, allocations shall be made in the same amounts as
were distributed from the Vehicle License Fee Account and the Vehicle
License Fee Growth Account in the prior fiscal year.
(4) For the 1995-96 fiscal year, allocations shall be made in the
same amounts as distributed in the 1994-95 fiscal year from the
Vehicle License Fee Account and the Vehicle License Fee Growth
Account after adjusting the allocation amounts by the amounts
specified for the following counties:
Alpine .......................... $(11,296)
Amador .......................... 25,417
Calaveras ....................... 49,892
Del Norte ....................... 39,537
Glenn ........................... (12,238)
Lassen .......................... 17,886
Mariposa ........................ (6,950)
Modoc ........................... (29,182)
Mono ............................ (6,950)
San Benito ...................... 20,710
Sierra .......................... (39,537)
Trinity ......................... (48,009)
(5) (A) For the 1996-97 fiscal year and fiscal years thereafter,
allocations shall be made in the same amounts as were distributed
from the Vehicle License Fee Account and the Vehicle License Fee
Growth Account in the prior fiscal year.
(B) Initial proceeds deposited in the Vehicle License Fee Account
in the 2003-04 fiscal year in the amount that would otherwise have
been transferred pursuant to former Section 10754 of the Revenue and
Taxation Code for the period June 20, 2003, to July 15, 2003,
inclusive, shall be deemed to have been deposited during the period
June 16, 2003, to July 15, 2003, inclusive, and allocated to cities,
counties, and a city and county during the 2002-03 fiscal year.
(d) The Controller shall make monthly allocations from the amount
deposited in the Vehicle License Collection Account of the Local
Revenue Fund to each county in accordance with a schedule to be
developed by the State Department of State Hospitals in consultation
with the County Behavioral Health Directors Association of
California, which is compatible with the intent of the Legislature
expressed in the act adding this subdivision.
(e) Before making the monthly allocations in accordance with
paragraph (5) of subdivision (c) and subdivision (d), and pursuant to
a schedule provided by the Department of Finance, the Controller
shall adjust the monthly distributions from the Vehicle License Fee
Account to reflect an equal exchange of sales and use tax funds from
the Social Services Subaccount to the Health Subaccount, as required
by subdivisions (d) and (e) of Section 17600.15, and of Vehicle
License Fee funds from the Health Account to the Social Services
Account. Adjustments made to the Vehicle License Fee distributions
pursuant to this subdivision shall not be used in calculating future
year allocations to the Vehicle License Fee Account.
SEC . 76. No reimbursement is required
by this act pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.