Health care: state hospitals.

This bill would require that certain factors be considered in determining whether an offender poses a substantial danger of physical harm to others, including, but not limited to, a history of violent behavior and prior history of state hospital commitment.

Existing law allows a prisoner to request a hearing before the Board of Parole Hearings for the purpose of proving that the prisoner meets the criteria to be treated by the State Department of State Hospitals. Existing law allows a prisoner who disagrees with the determination of the Board of Parole Hearings to file a petition in court for a hearing on whether they met the criteria and, if the court reverses the determination of the Board of Parole Hearings, existing law authorizes the court to require the parties to return to court to ensure that the entities involved in the release of the prisoner have coordinated an exit plan for the prisoner.

This bill would require that an exit plan include the submission of an application for Medi-Cal benefits and a recommendation, as appropriate, to the supervising county's behavioral health department by a licensed behavioral health professional, as specified, supervising the treatment of, or treating, the prisoner for a mental health disorder for certain resources and programs, including substance use disorder treatment, assisted outpatient treatment, and early psychosis intervention services.

Existing law, the Mental Health Services Act (MHSA), an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, funds a system of county mental health plans for the provision of mental health services, as specified. The MHSA establishes the Mental Health Services Fund, a continuously appropriated fund, which is administered by the State Department of Health Care Services (department), to fund specified county mental health programs. Existing law, the Behavioral Health Services Act (BHSA), a legislative act amending the MHSA that was approved by the voters as Proposition 1 at the March 5, 2024, statewide primary election, recast the MHSA by, among other things, renaming the fund to the Behavioral Health Services Fund and reallocating how moneys from that fund may be spent. The BHSA requires each county to establish and administer a full-service partnership program that includes, among other things, outpatient behavioral health services, as specified, and housing interventions.

Existing law establishes criteria for an individual with a serious mental illness to be presumptively eligible for a full-service partnership, including, among other things, the person is transitioning to the community after 6 months or more in the state prison or county jail.

This bill would add to the criteria for presumptively eligibility for a full-service partnership an individual transitioning to the community after 6 months or more in a state hospital.

Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law, the California Advancing and Innovating Medi-Cal (CalAIM) Act, supports the stated goals of identifying and managing the risk and needs of Medi-Cal beneficiaries, transitioning and transforming the Medi-Cal program to a more consistent and seamless system, and improving quality outcomes. Existing law makes a qualifying inmate of a public institution eligible, commencing no sooner than January 1, 2023, to receive targeted Medi-Cal services, limited to those services approved in the CalAIM Terms and Conditions for 90 days, as specified.

This bill would also make a qualifying inmate of a state hospital eligible to receive targeted Medi-Cal services, as described.

By expanding the population receiving benefits under the BHSA and to the extent that the bill would create new duties for counties relating to Medi-Cal eligibility determinations, the bill would impose a state-mandated local program.

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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.