AMENDED IN SENATE OCTOBER 19, 2004

SENIOR SENATE PROPOSAL NO. 16

INTRODUCED BY SENIOR SENATOR LEVY

(COAUTHOR:  SENATOR BETTIO)

(COAUTHORS:  ASSEMBLY MEMBERS AGOR, EDGAR, ERMAN, AND MEADE)

LEGISLATIVE COUNSEL'S DIGEST

SP 16: ADULT DAY HEALTH CARE.

UNDER EXISTING LAW, THE BRONZAN-MCCORQUODALE ACT, LOCAL MENTAL HEALTH SERVICES ARE MADE AVAILABLE FOR PERSONS WITH MENTAL DISORDERS PURSUANT TO STANDARDS DEVELOPED BY THE STATE DEPARTMENT OF MENTAL HEALTH.

THIS MEASURE WOULD MEMORIALIZE THE LEGISLATURE AND THE GOVERNOR TO ENACT LEGISLATION THAT WOULD DEVELOP RECOMMENDED STANDARDS OF PRACTICE FOR PROGRAMS SERVING ADULTS WITH MENTAL HEALTH NEEDS AND TO TAKE RELATED ACTION ON BEHALF OF THOSE ADULTS.

VOTE: MAJORITY.

SP 16: RELATING TO ADULT DAY HEALTH CARE

WHEREAS, OLDER ADULTS ARE ONE OF THE MOST UNDERSERVED GROUPS IN CALIFORNIA'S MENTAL HEALTH SYSTEM, YET THEY ARE THE FASTEST GROWING SEGMENT OF THE STATE'S2 POPULATION; AND

WHEREAS, A 1999 REPORT, PREPARED BY THE SURGEON GENERAL AND ENTITLED "MENTAL HEALTH: A REPORT OF THE SURGEON GENERAL," UNDERSCORES THE URGENT NEED TO PROMOTE MENTAL HEALTH IN OUR SOCIETY ON AN EQUAL BASIS WITH PHYSICAL HEALTH, AND TO TREAT AND PREVENT MENTAL DISORDERS; AND

WHEREAS, A NATIONAL GERIATRIC MENTAL-HEALTH CRISIS LOOMS AS THE NUMBER OF PEOPLE WHO ARE OLDER THAN 65 YEARS OF AGE WITH PSYCHIATRIC DISORDERS WILL INCREASE FROM 4 MILLION IN 1970 TO A PROJECTED 15 MILLION IN 2030; AND

WHEREAS, PHYSICIANS AND COUNTY MENTAL HEALTH WORKERS ARE INCREASINGLY REFERRING ADULTS WITH CHRONIC MENTAL DISORDERS TO ADULT DAY HEALTH CARE (ADHC) PROGRAMS; AND

WHEREAS, IT IS BECOMING INCREASINGLY DIFFICULT FOR PATIENTS WITH A PRIMARY MENTAL HEALTH DIAGNOSIS TO ACCESS ADHC SERVICES BECAUSE MEDI-CAL FIELD OFFICES OFTEN LIMIT THE AUTHORIZATION OF SERVICES FOR THESE AT-RISK INDIVIDUALS, EITHER BY DENYING SERVICES OR REDUCING THE NUMBER OF REQUESTED DAYS OF CARE; AND

WHEREAS, THIS CREATES AN UNNECESSARY AND INAPPROPRIATE OBSTACLE TO CARE, AND IS AT ODDS WITH THE INCREASING DEMAND FOR SUCH CARE; AND

WHEREAS, IN ,THE CASE OP ELIGIBILITY FOR ADULT DAY HEATH CARE SERVICES, EXISTING LAW PROVIDES THAT A MENTAL CONDITION, STANDING ALONE, QUALIFIES PARTICIPANTS FOR ADHC SERVICES; AND

WHEREAS, ADHC INTERDISCIPLINARY STAFF MEMBERS ARE TRAINED TO IDENTIFY SUBTLE SYMPTOMS OF DECOMPENSATION ON PHYSICAL HEALTH CHANGES AND TO INITIATE INTERVENTIONS TO PREVENT UNNECESSARY HOSPITALIZATIONS; AND

WHEREAS, ADHC PROGRAMS HAVE TRADITIONALLY SERVED AN ELDERLY POPULATION; AND

WHEREAS, THE COUNTY MENTAL HEALTH SYSTEMS ARE PRIMARILY EQUIPPED TO RESPOND TO ACUTE CRISES OR PROVIDE SHORTER-TERM TREATMENT AND REHABILITATION, AND ARE UNABLE TO MEET CHRONIC CARE NEEDS; AND

WHEREAS, IT IS IMPORTANT TO IMPROVE ACCESS TO ADHC SERVICES, WHICH ARE APPROPRIATE PREVENTATIVE AND TREATMENT SETTINGS FOR ELIGIBLE INDIVIDUALS WITH MENTAL DISORDERS; NOW, THEREFORE, BE IT

RESOLVED BY THE SENIOR SENATE AND THE SENIOR ASSEMBLY JOINTLY, THAT THE SENIOR LEGISLATURE OF ^THE STATE OF CALIFORNIA AT ITS 2004 REGULAR SESSION, A MAJORITY OF THE MEMBERS VOTING THEREFOR, HEREBY PROPOSES THAT THE STATE OF CALIFORNIA DEVELOP RECOMMENDED STANDARDS OF PRACTICE FOR PROGRAMS SERVING THE SPECIALIZED POPULATION OF ADULTS WITH MENTAL HEALTH NEEDS, ADDRESSING ISSUES SUCH AS STANDARDS OF ASSESSMENT, STAFF COMPETENCY LEVELS, CARE COORDINATION PROTOCOLS AND PROGRAMMING; AND BE IT FURTHER

RESOLVED, THAT THE CAPACITY OF THE LOCAL FIELD OFFICES BE INCREASED TO EVALUATE CLIENT MENTAL HEALTH NEEDS AND TO APPROVE SERVICES IN A MANNER THAT PROMOTES PARITY OF MENTAL AND PHYSICAL HEALTH NEEDS; AND BE IT FURTHER

RESOLVED, THAT ADULT DAY HEALTH CARE REGULATIONS BE REVISED TO PERMIT MENTAL HEALTH SERVICES PROVIDED BY TRAINED PARAPROFESSIONALS, UNDER THE SUPERVISION OF AUTHORIZED PROFESSIONAL STAFF, TO BE COUNTED AS ALLOWABLE THERAPY HOURS; AND BE IT FURTHER

RESOLVED, THAT THESE REVISIONS CONFORM TO THE STATUTE THAT ALLOWS EQUAL ACCESS TO PERSONS WITH MENTAL OR PHYSICAL PROBLEMS; AND BE IT FURTHER

RESOLVED, THAT COORDINATION AND COMMUNICATION BE IMPROVED BETWEEN THE MENTAL HEALTH SYSTEM AND ADULT DAY HEALTH CARE SERVICES FOR INDIVIDUALS WHO ARE APPROPRIATELY SERVED IN BOTH SETTINGS; AND BE IT FURTHER

RESOLVED, THAT THE STATE URGE THE FEDERAL GOVERNMENT TO MAINTAIN EXISTING FUNDING AND WAIVERS FOR ADULT DAY HEALTH CARE SERVICES; AND BE IT FURTHER

RESOLVED, THAT THE SENIOR LEGISLATURE OF THE  STATE OF CALIFORNIA RESPECTFULLY MEMORIALIZES THE LEGISLATURE AND THE GOVERNOR OF THE STATE OF CALIFORNIA TO ENACT APPROPRIATE LEGISLATION THAT WOULD ADDRESS THE CONCERNS SET FORTH IN THIS MEASURE; AND BE IT FURTHER RESOLVED, 

THAT A COPY OF THIS MEASURE BE TRANSMITTED TO THE SPEAKER OF THE ASSEMBLY, THE PRESIDENT PRO TEMPORE OF THE SENATE, AND THE GOVERNOR OF THE STATE OF CALIFORNIA.