CSAC Bulletin Article

Health and Human Services Legislative Spotlight

April 6, 2023

While members of the Legislature returned home to their districts for Spring Recess this week, legislative staff and advocates are gearing up for long hearing days in the coming weeks as the deadline for policy committees to hear and report fiscal bills approaches at the end of April. As bills continue to take shape in their house of origin, the CSAC Health and Human Services (HHS) team is actively engaged on dozens of bills that impact county administration and delivery of critical health, behavioral health, and social services.

The following bills provide a snapshot of what the HHS team will be working on this year:

AB 799 (L. Rivas) – This measure would aim to create an ongoing state-funded program to meet identified goals for the existing Homeless Housing, Assistance and Prevention (HHAP) program. The bill would modify some of the HHAP allocations to emphasize performance and collaboration. For accountability, it would require participating entities to set specific outcome goals with the potential for corrective action plans and reallocation of funding for entities not achieving half of their goals. CSAC has not taken an official position on this bill but continues to engage with the author and sponsors of the measure in alignment with the CSAC AT HOME Plan.

AB 1168 (Bennett) – This measure, which is sponsored by Cal Cities, seeks to overturn case law record that has repeatedly affirmed county responsibility for the administration of emergency medical services and would ultimately result in fragmented and inequitable delivery of emergency medical services. Under the measure, cities and fire districts could opt to back out of longstanding agreements with counties; counties would then be forced to open up already complex ambulance contracting processes while scrambling to provide continued services to impacted residents. CSAC joins the County Health Executives Association of California (CHEAC), Rural County Representatives of California (RCRC), and Urban Counties of California (UCC) in opposition to AB 1168.

AB 1672 (Haney) – This bill would shift the employer of record for the In-Home Supportive Services (IHSS) program from counties to the state for the purposes of collective bargaining. Specifically, the state would be charged with negotiating with a recognized employee organization regarding the wages, health benefits, and other benefits for IHSS providers. In partnership with the County Welfare Directors Association of California (CWDA) and the California Association of Public Authorities (CAPA), CSAC has engaged with the sponsors, SEIU and UDW, and author’s office regarding this bill. While not yet taking a position on AB 1672, we have provided specific feedback on certain provisions of the bill and overarching comments focused on three key aspects that would be needed if bargaining were to be transferred to the state:

  1. The state must be responsible for the full cost of any negotiated wage and benefit increases agreed to in state bargaining and must fully fund any negotiated new mandates on counties and public authorities;
  2. The key functions and services that public authorities provide outside of collective bargaining must be preserved and strengthened; and
  3. Counties and public authorities should be involved in some manner and have input on any changes that relate to the work required of counties and public authorities.

SB 43 (Eggman) – This measure seeks to broaden the definition of “gravely disabled” for the purposes of the Lanterman-Petris-Short (LPS) Act, which provides for the involuntary detention and/or conservatorship and treatment of individuals who have been determined to be, as the result of a mental health disorder or impairment by chronic alcoholism, unable to provide for their basic personal needs for food, clothing, or shelter. As currently drafted, the measure does not provide resources to counties to implement this expanded caseload. CSAC has not taken an official position on SB 43 and will continue to engage on this measure and advocate for additional, ongoing funding to support the activities and supply of placement options for the existing and new clients. 

SB 551 (Portantino) – This measure would divert 20 percent of the prevention and early intervention funds from the Mental Health Services Fund to provide direct services on school campuses. Although counties do not take issue with the policy of establishing and improving the provision of behavioral health services to students in school settings, counties do oppose efforts to redirect Mental Health Services Act (MHSA) funding to other services. Additionally, it is unclear how the Governor’s proposed MHSA reforms will impact prevention and early intervention funds, as well as funding aimed at serving children and youth. CSAC joins RCRC and UCC in opposition to SB 551.

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