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Final Deadlines, Priority Bills, Fiscal Impacts

May 4, 2024

 

Switching focus. It’s that time of year when there is a mad rush to hear bills in policy committees as final deadlines approach, and a ramping up of fiscal review processes. Today, for instance, is the last day for policy committees to hear and report to the floor nonfiscal bills introduced in their house. What that means is that bills that will cost state or local authorities nothing (or next to nothing) go to the floor of their respective houses for a vote without having to undergo extensive review for cost impacts.

One of PPAC’s sponsored bills luckily bypassed the dreaded Appropriation Committee suspense file and went straight to the floor:  

Antipsychotic medication continuity. Amended at the request of the Senate Judiciary Committee, SB 1184 still requires the determination of incapacity to refuse antipsychotic medication to remain in effect but only until a new hearing for that purpose is held in the transition from one hold to the next in a sequence of LPS holds, including several 14-day and 30 day holds. Thus, assuring medication continuity without interruption. I provided testimony for this bill, SB 1184 (Eggman) in Senate Judiciary Committee on April 30 where it passed 11-0. SB 1184 bypassed the Appropriations Committee and is currently pending a vote on the floor of the Senate where we expect it to pass handily despite opposition from the ACLU, Disability Rights California, and several consumer rights organizations.

Expanding SUD Capacity: On suspense because of potential fiscal impact is PPAC’s sponsored SB 1238 (Eggman) which removes regulatory restrictions on admitting solely substance-abusing individuals on LPS holds to psychiatric health facilities, mental health rehabilitation centers, and skilled nursing facilities with a mental health treatment program accreditation  - thus creating immediate capacity expansion as new facilities are developed with Proposition 1 grants. (Two SUD treatment facilities opened in the last two weeks using state grants – see more below).  SB 1238 now resides on the suspense file where the Committee deemed that though its fiscal costs are unknown, it expects there to be ongoing General Fund costs for the Department of Health Care Services for state administration. This is a not unexpected and it's a good outcome for a fiscal analysis, indicating a good chance of moving forward to a floor vote in the Senate.

Bed registry, SB 1017 (Eggman) would require state departments to develop a solution to collect, aggregate, and display information about beds in specified facilities to identify the availability of inpatient and residential mental health or substance use disorder treatment.

Currently, SB 1017 is in the Senate Appropriations Committee on the suspense file where the Committee ascribes an aggregation of potential,


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unknown costs to the state in developing and administering a platform and enforcing data collection from hospitals necessary for successful operation. Fingers crossed.

Beds. Creating behavioral health treatment and recovery options, the Behavioral Health Crisis Infrastructure (BHCIP) grant program last year awarded the first grants as part of the $4.4 billion program, which is now funding new facilities in 49 counties. The bond funds in recently approved Proposition 1 will continue this program adding another $4.38 billion for a total of nearly $9 billion for housing and facility beds. The first two programs opened using BHCIP grants recently in Sonoma and Los Angeles Counties, with over 100 new treatment slots, providing a variety of services including outpatient mental health, prevention, screening, diagnosis and treatment -  management of mental health and SUDs. The focus will be on justice-involved individuals and people experiencing or at risk of homelessness.

More Beds. Speaking of the BHCIP program and its pipeline of facility expansion, I took a deep dive into a succession of rounds of BHCIP  awards where I unearthed a total of 830 beds in locked facilities granted across facility types: 295 Acute Psychiatric Hospital beds; 358 Mental Health Rehabilitation Center beds; 135 Psychiatric Health Facility beds; and 42 psychiatric beds for General Acute Care Hospitals. Great news with one more round of grants to be awarded out of the original $4.4 billion. Proposition 1 bonds will add another $4.4 billion to it starting later this year as bonds are sold and funds start becoming available. We’ve only just begun.

 

Up Next - The Legislature switches gears to focus on fiscal issues for next two weeks. Stay tuned -

Thanks for your attention and support, as always - 

Randall Hagar

PPAC Policy Advocate

Contact me HERE.

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