The Steinberg Institute began 2021, our seventh year of operation, with an ambitious legislative agenda and an elevated awareness of the urgency of our task. This past year was a year none of us will ever forget, a year when millions of people across the state experienced enormous stress and dislocation as well as physical and psychological suffering as a result of the COVID-19 pandemic.
This pandemic is still far from over, disproportionately impacting communities of color, causing pain that may be with us for years to come. That knowledge fuels our determination to create policies that will ease the suffering and address the inequities.
This year, we had two overarching priorities for our work. One, to create a statewide crisis response system to handle mental health emergencies. We need to transform the ways local authorities in California respond to people experiencing mental health emergencies so that we stop asking police officers to do a job they are ill-equipped for, and we stop sending people suffering from mental health crises to jails.
The second, to get the state and local governments to act with a greater sense of urgency in the effort to provide housing and care for homeless people. We have seen during this pandemic that large numbers of people can be brought indoors, and they can be provided with the social supports and mental health care they need. It shouldn’t require the threat of a deadly disease to make this happen.
2021 was another big state budget year, with billions of dollars in increased revenues flowing from income taxes. We were grateful for Governor Gavin Newsom’s continued leadership on mental health, demonstrated through unprecedented funding focused on mental health. The institute’s successful advocacy on the FY 21-22 budget delivered:
- $2 billion for the Homeless Housing, Assistance, and Prevention Program. We partnered with more than 20 organizations under the Bring California Home banner to make the case for more housing, shelters, and outreach services for our unhoused neighbors – combined with increased accountability from the cities and counties that receive the funding.
- $805 million to buy, repair, and refurbish “board and care” homes that provide an affordable place to live and critical services for people living with severe mental illness or substance use disorders.
- $20 million to launch the new 9-8-8 mental health crisis line by expanding and training call center staff and integrating 988 with the existing 911 system.
In 2021 Governor Newsom also launched the $4.4 billion Children and Youth Behavioral Health Initiative. There are many facets to this transformative effort, including $1 billion advocated for by the Steinberg Institute dedicated to school-based “coaches,” an online platform, and new crisis facilities.
Our 2021 sponsored and supported bills:
Will transform the way California responds to mental health emergencies to ensure those in crisis receive the urgent care they need. The new system will use a three-digit, easy-to-remember phone number — 988 — that people can call when they, a family member, or a friend are experiencing severe mental distress.
AB 988 will implement federal legislation passed in 2020 establishing a new national phone line for suicide prevention and mental health crises. Call centers will connect people calling or texting 988 with trained counselors and dispatch mobile crisis support teams – staffed by mental health professionals and trained peers instead of police officers — to help a person in crisis.
The Act is named for Miles Hall, a 23-year-old African American man who was shot and killed by officers in 2019 while in the midst of a mental health crisis. His mother, Taun Hall, had spoken to police officers about her son numerous times over several years and had called the local police department the day before the shooting to warn that Miles was having an unstable period. Ms. Hall writes about the pain of losing her son, Miles, and why we need AB 988 in this CalMatters article.
AB 988 takes a monumental step forward in addressing these systemic inequities in our mental health system by decriminalizing our response to mental health, dismantling a major source of systemic injustice, and addressing a major driver of homelessness.
The legislation is authored by Assemblymember Rebecca Bauer-Kahan, who represents the district where Miles lived and died; is jointly authored by Marc Berman (D-Menlo Park), Sharon Quirk-Silva (D-Fullerton), Philip Ting (D-San Francisco), Mike Gipson (D-Garden), and James Ramos (D-Rancho Cucamonga); and co-authored by more than two dozen other legislators. It is sponsored by the Steinberg Institute, The Kennedy Forum, Los Angeles County, Contra Costa County, Mental Health American of California, NAMI California, the Miles Hall Foundation, and NAMI of Contra Costa County.
This bill became a 2-year bill, giving us time to work with the Newsom administration on crafting a final version that ensures that people in crisis receive the care they need. In the interim, to ensure call centers are prepared to handle the expected influx of calls when 9-8-8 launches next July, the Steinberg Institute and our partners worked with the Administration to identify $20 million of existing funding for staffing and technology enhancements to prepare for the July 16, 2022 launch date of 988.
Before the coronavirus pandemic, an estimated 150,000 people in California were homeless and at least 24% of them were living with a severe mental illness. The numbers also reflect unacceptable racial disparities: African Americans, for example, make up just 6.5 percent of the state’s overall population but almost 40 percent of the homeless population. These are simply unacceptable numbers.
AB 816 will dedicate upwards of $130 million annually to build apartments for people living with severe mental illness and experiencing homelessness, including wrap-around services.
AB 816 is authored by Assemblymember David Chiu and jointly authored by Richard Bloom (D-Santa Monica), Rob Bonta (D-Oakland), Sharon Quirk-Silva (D-Fullerton), Miguel Santiago (D-Los Angeles), and Buffy Wicks (D-Oakland) and sponsored by the Steinberg Institute, the Corporation for Supportive Housing, Housing California, and Sacramento Mayor Darrell Steinberg, co-chair of the Governor’s Council of Regional Homeless Advisors.
This bill was passed by the legislature and signed by Governor Newsom.
Also addresses California’s crisis of homelessness by increasing corporate tax rates on companies with annual profits of $5 million or more and dedicating the revenue to building housing and other proven strategies that reduce homelessness – and prevent more Californians from falling into it.
The bill will generate at least $2.4 billion annually to fund housing development, divided between cities and counties. It also will restructure the state’s Homeless Coordinating and Financing Council so that it is composed of the directors of various state agencies, instead of people appointed by the governor and legislature.
The council will collect data on housing providers serving homeless people and on the number of people experiencing homelessness in local jurisdictions, including their racial and ethnic backgrounds, as well as other information about their backgrounds and needs. The council will work with the State Department of Housing and Community Development to allocate the funds in two-year cycles.
The bill is authored by Assemblymember Rivas and jointly authored by Richard Bloom (D-Santa Monica), David Chiu (D-San Francisco, and Buffy Wicks (D-Oakland). AB 71 is sponsored by the Steinberg Institute; Corporation for Supportive Housing; Housing California; the City of Los Angeles and Mayor Eric Garcetti; the City of San Francisco and Mayor London Breed; the City of Oakland and Mayor Libby Schaaf; All Home; Brilliant Corners; Episcopal Community Services-San Francisco; HOPICS; John Burton Advocates for Youth; National Alliance to End Homelessness; Non-Profit Housing Assn. of Northern California; and United Way of Greater Los Angeles.
This bill was turned into a two-year bill.
2021 Full Legislative Package
Would require Medi-Cal, the state health insurance program for low-income people, to pay for health care services furnished by an enrolled clinic using telehealth technology on the same basis and at the same rate as if those services had been provided in person. During the coronavirus pandemic, health care providers were given greater flexibility to use telehealth to provide care to patients while reducing the risk of infection. This bill would continue indefinitely that flexibility and require the State Department of Health Care Services to seek expert input, conduct an evaluation, and provide recommendations to the legislature on how telehealth should best be used and paid for in the future.
The bill is authored by Cecilia Aguiar-Curry and co-authored by Assembly Members Arambula, Bauer-Kahan, Burke, Cunningham, Cristina Garcia, Petrie-Norris, Quirk-Silva, Blanca Rubio, and Santiago.Sponsors include the California Association of Public Hospitals and Health Systems, California Health+ Advocates/California Primary Care Association, California Medical Association, Essential Access Health, and Planned Parenthood Affiliates of California.
This bill was turned into a two-year bill because the author and co-sponsors were able to reach an agreement to extend telehealth flexibilities in the budget.
Increases access to emergency psychiatric services by requiring all psychiatric facilities with appropriate services to accept transfers from emergency rooms regardless of a patient’s ability to pay. Four years in the making, this vital legislation was pushed forward by Assemblymember Arambula and the California Chapter of the American College of Emergency Physicians. The law ensures Californians in crisis aren’t turned away from the care they need to recover.
This bill was passed by the legislature and signed by Governor Newsom.
Would establish a 15-member state youth mental health board within the Health and Human Services Agency to advise the Governor and Legislature on challenges facing youth with mental health needs and suggest improvements. The members must be aged 15 to 23, at least half of whom are consumers of mental health services or their siblings. It would also require community mental health service agencies to have their own youth mental health boards, also made up of young mental health consumers.
This bill was turned into a two-year bill.
Serves as the legislative vehicle for several statutory changes to implement the proposed Medi-Cal behavioral health changes contained in Governor Newsom’s California Advancing and Innovating Medi-Cal (CalAIM) proposals. CalAIM is a long-term commitment to transform and strengthen Medi-Cal, offering Californians a more equitable, coordinated, and person-centered approach to maximizing their health and life trajectory.
This bill died on the Assembly Floors as CalAIM was implemented in the budget.
Would require health insurers to cover all medically necessary prescription drugs approved by the FDA for treating substance use disorders and to place those drugs on the lowest cost-sharing tier of the insurer’s plan or drug formulary. It also restricts insurers’ ability to impose barriers such as requirements for prior authorization or step therapy. The bill is co-authored by Scott Wiener (D-San Francisco).
This bill was turned into a two-year bill.
Strengthens, clarifies, and updates the foster youth presumptive transfer law to ensure a youth-centered, case-by-case decision is made regarding responsibility for the provision of or arrangement for specialty mental health services for foster youth placed out of county for a short term or time-limited placement.
This bill was turned into a two-year bill.
Would eliminate the requirement for prior authorization for prescription drugs for treating severe mental illness and allow for a 90-day supply of medications to a patient.
This bill was turned into a two-year bill.
Would clarify that students can take an excused absence for behavioral health conditions. Would also require school districts to provide training on youth behavioral health to at least half of their classified and certificated school employees who have direct contact with pupils, using a state-identified evidence-based training program. Principal coauthor: Assemblymember Low. Coauthors: Senators Pan, Rubio, and Umberg; Assembly Members Cunningham, Lee, and Quirk-Silva. Sponsors: Disability Rights California and California Behavioral Health Agencies.
This bill was passed by the legislature and signed by Governor Newsom.
Will make it easier for counties to spend hundreds of millions of dollars from the Mental Health Services Act (MHSA) that were earmarked for “Innovation” programs but have gone unspent and are sitting in county accounts. SB 106 eliminates the requirement that county mental health programs obtain Mental Health Services Oversight and Accountability Commission approval to use innovation dollars to establish or expand full-service partnership programs – the gold standard for “whatever it takes” care. With more and more Californians suffering from untreated mental illness and dying in despair, it is unconscionable to leave money on the table.
The bill is co-authored by Senator Eggman.
This bill died in the Senate Appropriations Committee.
Would require that health providers and insurers schedule follow-up appointments with psychotherapists or other non-physician specialists within ten days of an initial appointment for a non-urgent mental health or substance use disorder.
Providers are now required to schedule an initial appointment with a clinician within 10 days of a person seeking help. But after that first appointment, it can often take weeks for people to get a follow-up appointment, seriously disrupting their ability to get the help they need. If a health plan is unable to set up a follow-up appointment within 10 days using their own contracted providers, they would be required to provide access to clinicians outside their network at network rates. The bill also establishes a timeline for other types of behavioral health services.
The bill is co-authored by Senators Leyva, Kamlager and Newman and Assemblymembers Arambula and Waldron. It is sponsored by the National Union of Healthcare Workers.
This bill was passed by the legislature and signed by Governor Newsom.
Would require K-12 students in public schools to receive mental health education from a qualified instructor at least once during elementary school, once during middle school or junior high, and once during high school. The instruction would address, in an age-appropriate way, overarching themes and core principles of mental health.
The bill is co-authored by Senators Cortese, Glazer, Hueso, Hurtado, Laird, Nielsen, Ochoa Bogh, and Umberg, and Assemblymembers Burke, Frazier, Cristina Garcia, Lackey, Nguyen, Rodriguez, and Santiago. It is Sponsored by CA Youth Empowerment Network, CA Alliance of Child and Family Services, CA Children’s Partnership, National Alliance on Mental Illness, and National Center for Youth Law.
This bill was passed by the legislature and signed by Governor Newsom.
Would expand the number of emergency response workers eligible to receive workers’ compensation benefits when they develop post-traumatic stress disorder in the course of their jobs and work. Under current California law, when firefighters and police officers develop PTSD on the job, the disorder is presumed to be work-related, and they are entitled to full worker’s compensation benefits. This bill would extend these benefits to a list of other public employees including public safety dispatchers, public safety telecommunicators, and emergency response communication employees, among others.
This bill was turned into a two-year bill.
Would require private health insurers to cover screening for adverse childhood experiences (ACEs).
This bill was passed by the legislature and signed by Governor Newsom.
Would require private health insurers to cover screening for adverse childhood experiences (ACEs).
This bill was passed by the legislature and signed by Governor Newsom.
Would allow those exiting or having recently exited conservatorships to be eligible for involuntary assisted outpatient mental health treatment programs by allowing county behavioral health directors to file a petition in Superior Court seeking an order to compel assisted outpatient treatment for a person exiting a conservatorship.
This bill was turned into a two-year bill.