5803-5809

WELFARE AND INSTITUTIONS CODE
SECTION 5803-5809




5803.  (a) The State Department of Mental Health shall issue a
request for proposals to develop system of care programs no later
than October 1 in any year in which the state budget provides new
funds to expand the system of care provided for in this chapter. The
request for proposals shall include the following:
   (1) Proposals may be submitted as a regional system of care by
counties acting jointly, independent countywide proposals, and
proposals to serve discrete geographic areas within counties or for a
specific integrated services agency team. Nothing in the request for
proposal shall be construed to restrict a county from contracting
for part or all services included in the demonstration project
proposal.
   (2) The department shall establish reporting requirements for
direct and indirect costs, and these requirements may be included in
the request for proposals.
   (3) The department shall require that proposals identify resources
necessary to measure client and cost outcome and interagency
collaboration. Proposal guidelines shall clearly require
identification of procedures to document outcomes.
   (4) Proposals must be approved by the board of supervisors and the
local mental health board or commission.
   (b) The director shall prepare a method for rating proposals to
assure objectivity and selection of the best qualified applications.
New proposals shall be selected with consideration of regional
balance across the state.
   (c) The State Department of Mental Health shall fund counties with
integrated service agencies or countywide systems of care funded
under Chapter 982 of the Statutes of 1988, operating at the time of
passage of this part. Those programs shall be funded under the
provisions paragraph (2) of subdivision (a) of Section 5700 and shall
be subject to all of the requirements and sanctions of this part.




5804.  (a) The State Department of Mental Health shall include
funding under this part in the county's performance contracts
required under Section 5650 for existing and new counties selected
under this part to develop an integrated service agency component or
a countywide or regional system of care. The contracts required
pursuant to this part shall be exempt from the requirements of the
Public Contract Code and the State Administrative Manual and shall be
exempt from approval by the Department of General Services.
   (b) Projects funded under this part, or continued under the
provisions of subdivision (b) of Section 5802, shall be considered an
ongoing program of service delivery as long as the county and any of
its contractors meet client and cost outcomes as required in the
annual performance contract established by the department.
   (c) The department may terminate contracts funded under this part
when the department determines that the county has failed to meet
client and cost outcomes as required in the performance contract or
are no longer able to operate programs under the provisions of this
part.
   (d) Counties and their contractors shall provide the department
with all information needed to evaluate the financial and program
performance of participating projects.



5805.  The State Department of Mental Health shall require counties
to use available state and matching funds for the client target
population as defined in Section 5600.3 to develop a comprehensive
array of services as defined in Sections 5600.6 and 5600.7.




5806.  The State Department of Mental Health shall establish service
standards that ensure that members of the target population are
identified, and services provided to assist them to live
independently, work, and reach their potential as productive
citizens. The department shall provide annual oversight of grants
issued pursuant to this part for compliance with these standards.
These standards shall include, but are not limited to, all of the
following:
   (a) A service planning and delivery process that is target
population based and includes the following:
   (1) Determination of the numbers of clients to be served and the
programs and services that will be provided to meet their needs. The
local director of mental health shall consult with the sheriff, the
police chief, the probation officer, the mental health board,
contract agencies, and family, client, ethnic, and citizen
constituency groups as determined by the director.
   (2) Plans for services, including outreach to families whose
severely mentally ill adult is living with them, design of mental
health services, coordination and access to medications, psychiatric
and psychological services, substance abuse services, supportive
housing or other housing assistance, vocational rehabilitation, and
veterans' services. Plans also shall contain evaluation strategies,
that shall consider cultural, linguistic, gender, age, and special
needs of minorities in the target populations. Provision shall be
made for staff with the cultural background and linguistic skills
necessary to remove barriers to mental health services due to
limited-English-speaking ability and cultural differences. Recipients
of outreach services may include families, the public, primary care
physicians, and others who are likely to come into contact with
individuals who may be suffering from an untreated severe mental
illness who would be likely to become homeless if the illness
continued to be untreated for a substantial period of time. Outreach
to adults may include adults voluntarily or involuntarily
hospitalized as a result of a severe mental illness.
   (3) Provision for services to meet the needs of target population
clients who are physically disabled.
   (4) Provision for services to meet the special needs of older
adults.
   (5) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, where appropriate for the individual.
   (6) Provision for services to be client-directed and that employ
psychosocial rehabilitation and recovery principles.
   (7) Provision for psychiatric and psychological services that are
integrated with other services and for psychiatric and psychological
collaboration in overall service planning.
   (8) Provision for services specifically directed to seriously
mentally ill young adults 25 years of age or younger who are homeless
or at significant risk of becoming homeless. These provisions may
include continuation of services that still would be received through
other funds had eligibility not been terminated due to age.
   (9) Services reflecting special needs of women from diverse
cultural backgrounds, including supportive housing that accepts
children, personal services coordinator therapeutic treatment, and
substance treatment programs that address gender-specific trauma and
abuse in the lives of persons with mental illness, and vocational
rehabilitation programs that offer job training programs free of
gender bias and sensitive to the needs of women.
   (10) Provision for housing for clients that is immediate,
transitional, permanent, or all of these.
   (11) Provision for clients who have been suffering from an
untreated severe mental illness for less than one year, and who do
not require the full range of services but are at risk of becoming
homeless unless a comprehensive individual and family support
services plan is implemented. These clients shall be served in a
manner that is designed to meet their needs.
   (12) Provision for services for veterans.
   (b) A client shall have a clearly designated mental health
personal services coordinator who may be part of a multidisciplinary
treatment team who is responsible for providing or assuring needed
services. Responsibilities include complete assessment of the client'
s needs, development of the client's personal services plan, linkage
with all appropriate community services, monitoring of the quality
and followthrough of services, and necessary advocacy to ensure that
the client receives those services that are agreed to in the personal
services plan. A client shall participate in the development of his
or her personal services plan, and responsible staff shall consult
with the designated conservator, if one has been appointed, and, with
the consent of the client, consult with the family and other
significant persons as appropriate.
   (c) The individual personal services plan shall ensure that
members of the target population involved in the system of care
receive age-appropriate, gender-appropriate, and culturally
appropriate services or appropriate services based on any
characteristic listed or defined in Section 11135 of the Government
Code, to the extent feasible, that are designed to enable recipients
to:
   (1) Live in the most independent, least restrictive housing
feasible in the local community, and for clients with children, to
live in a supportive housing environment that strives for
reunification with their children or assists clients in maintaining
custody of their children as is appropriate.
   (2) Engage in the highest level of work or productive activity
appropriate to their abilities and experience.
   (3) Create and maintain a support system consisting of friends,
family, and participation in community activities.
   (4) Access an appropriate level of academic education or
vocational training.
   (5) Obtain an adequate income.
   (6) Self-manage their illness and exert as much control as
possible over both the day-to-day and long-term decisions that affect
their lives.
   (7) Access necessary physical health care and maintain the best
possible physical health.
   (8) Reduce or eliminate serious antisocial or criminal behavior
and thereby reduce or eliminate their contact with the criminal
justice system.
   (9) Reduce or eliminate the distress caused by the symptoms of
mental illness.
   (10) Have freedom from dangerous addictive substances.
   (d) The individual personal services plan shall describe the
service array that meets the requirements of subdivision (c), and to
the extent applicable to the individual, the requirements of
subdivision (a).


5807.  (a) The State Department of Mental Health shall require
counties which receive funding to develop interagency collaboration
with shared responsibilities for services under this part and
achievement of the client and cost outcome goals and interagency
collaboration goals specified.
   (b) Collaborative activities shall include:
   (1) Identification of those agencies that have a significant joint
responsibility for the target population and ensuring collaboration
on planning for services to that population.
   (2) Identification of gaps in services to members of the target
population, development of policies to assure service effectiveness
and continuity, and setting priorities for interagency services.
   (3) Implementation of public and private collaborative programs
whenever possible to better serve the target population.
   (4) Provision of interagency case management services to
coordinate resources to target population members who are using the
services of more than one agency.
   (5) Coordination with federal agencies responsible for providing
veterans' services, as well as national, state, and local nonprofit
organizations that provide veterans' services, to maximize the
integration of services and to eliminate duplicative efforts.



5808.  In order to reduce the state and county cost of a mental
health system of care, participating counties shall collect
reimbursement for services from clients which shall be the same as
patient fees established pursuant to Section 5710, fees paid by
private or public third-party payers, federal financial participation
for Medicaid or Medicare services or veterans' services, and other
financial sources when available.



5809.  The State Department of Mental Health shall continue to work
with participating counties and other interested parties to refine
and establish client and cost outcome and interagency collaboration
goals including the expected level of attainment with participating
system of care counties. These outcome measures should include
specific objectives addressing the following goals:
   (a) Client benefit outcomes.
   (b) Client and family member satisfaction.
   (c) System of care access.
   (d) Cost savings, cost avoidance, and cost-effectiveness outcomes
that measure short-term or long-term cost savings and cost avoidance
achieved in public sector expenditures to the target population.