(a)The State Department of Health Care Services shall establish service standards so that adults and older adults in the target population are identified and receive needed and appropriate services from qualified staff in the least restrictive environment to assist them to live independently, work, and thrive in their communities. This section shall not apply to services covered by the Medi-Cal program and services covered by a health care service plan or other insurance coverage. These standards shall include, but are not limited to, all of the following:
(1)For services funded pursuant to subdivision (a) of Section 5892, the county may consult with the stakeholders listed in paragraph (1) of subdivision (a) of Section 5963.03.
(2)
(A)Outreach to adults with a serious mental illness or
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(a)
The State Department of Health Care Services shall establish service standards so that adults and older adults in the target population are identified and receive needed and appropriate services from qualified staff in the least restrictive environment to assist them to live independently, work, and thrive in their communities. This section shall not apply to services covered by the Medi-Cal program and services covered by a health care service plan or other insurance coverage. These standards shall include, but are not limited to, all of the following:
(1)
For services funded pursuant to subdivision (a) of Section 5892, the county may consult with the stakeholders listed in paragraph (1) of subdivision (a) of Section 5963.03.
(2)
(A)
Outreach to adults with a serious mental illness or a substance use disorder to provide coordination and access to behavioral health services, medications, housing interventions pursuant to Section 5830, supportive services, as defined in subdivision (g) of Section 5887, and veterans’ services.
(B)
Service planning shall include evaluation strategies that consider cultural, linguistic, gender, age, and special needs of the target populations.
(C)
Provision shall be made for a workforce with the cultural background and linguistic skills necessary to remove barriers to mental health services and substance use disorder treatment services due to limited-English-speaking ability and cultural differences.
(D)
Recipients of outreach
services may include families, the public, primary care physicians, hospitals, including emergency departments, behavioral health urgent care, and others who are likely to come into contact with individuals who may be
experiencing either an untreated serious mental illness or substance use disorder, or both, who would likely become homeless or incarcerated if the illness continued to be untreated for a substantial period of time.
(E)
Outreach to adults may include adults voluntarily or involuntarily hospitalized as a result of a serious mental illness.
(3)
Provision for services for populations with identified disparities in behavioral health outcomes.
(4)
Provision for full participation of the family in all aspects of assessment, service planning, and treatment, including, but not limited to, family support and consultation services, parenting support and consultation services, and peer support or self-help group support, where appropriate and when supported by the individual.
(5)
Treatment for clients who have been
experiencing an untreated serious mental illness or substance use disorder, or both, for less than one year and who do not require the full range of services but are at risk of becoming homeless or incarcerated unless comprehensive individual and family support services are provided consistent with the planning process specified in subdivision (d). This includes services that are available and designed to meet their needs, including housing for clients that is immediate, transitional, permanent, or all of these services.
(6)
(A)
Provision for services to be client-directed and to employ psychosocial rehabilitation and recovery principles.
(B)
Services may be integrated with other services and may include psychiatric and psychological collaboration in overall service planning.
(7)
Provision for services specifically directed to young adults 25 years of age or younger with either a serious mental illness or substance use disorder, or both, who are chronically homeless, experiencing homelessness or are at risk of homelessness, as defined in subdivision (j) of Section 5892, or experiencing first episode psychosis. These provisions may include continuation of services that still would be received through other funds had eligibility not been terminated due to age.
(8)
Provision for services for frequent users of behavioral health urgent care, crisis stabilization units, and hospitals or emergency room services as the primary resource for mental health and substance use disorder treatment.
(9)
Provision for services to meet the special needs of clients who are physically disabled, clients who are
intellectually or developmentally disabled, veterans, or persons of American Indian or Alaska Native descent.
(10)
Provision for services to meet the special needs of women from diverse cultural backgrounds, including supportive housing that accepts children and youth, personal services coordinators, therapeutic treatment, and substance use disorder treatment programs that address gender-specific trauma and abuse in the lives of persons with either a serious mental illness or a substance use disorder, or both, and vocational rehabilitation programs that offer job training programs free of gender bias and sensitive to the needs of women.
(b)
Each adult or older adult shall have a clearly designated personal services coordinator, or case manager who may be part of a multidisciplinary treatment team who is responsible for providing case management services. The personal services
coordinator may be a person or entity formally designated as primarily responsible for coordinating the services accessed by the client. The client shall be provided information on how to contact their designated person or entity.
(c)
A personal services coordinator shall perform all of the following:
(1)
Conduct a comprehensive assessment and periodic reassessment of a client’s needs. The assessment shall include all of the following:
(A)
Taking the client’s history.
(B)
Identifying the individual’s needs, including reviewing available records and gathering information from other sources, including behavioral health service providers, medical providers, family members, social workers, and others needed to form a complete assessment.
(C)
Assessing the client’s living arrangements, employment status, and training needs.
(2)
Plan for services using information collected through the assessment. The planning process shall do all of the following:
(A)
Identify the client’s goals and the behavioral health, supportive, medical, educational, social, prevocational, vocational, rehabilitative, housing, or other community services needed to assist the client to reach their goals.
(B)
Include active participation of the client and others in the development of the client’s goals.
(C)
Identify a course of action to address the client’s needs.
(D)
Address the transition of
care when a client has achieved their goals.
(3)
Assist the client in accessing needed behavioral health, supportive, medical, educational, social, prevocational, vocational, rehabilitative, housing, or other community services.
(4)
Coordinate the services the county furnishes to the client between settings of care, including appropriate discharge planning for short-term hospital and institutional stays.
(5)
Coordinate the services the county furnishes to the client with the services the client receives from managed care organizations, the Medicaid fee-for-service delivery system, other human services agencies, and community and social support providers.
(6)
Ensure that, in the course of coordinating care, the client’s privacy is protected in accordance
with all federal and state privacy laws.
(d)
The county shall ensure that each provider furnishing services to clients maintains and shares, as appropriate, client health records in accordance with professional standards.
(e)
The service planning process shall ensure that adults and older adults receive age-appropriate, gender-appropriate, and culturally appropriate services, or appropriate services based on a characteristic listed or defined in Section 11135 of the Government Code, to the extent feasible, that are designed to enable recipients to:
(1)
(A)
Live in the most independent, least restrictive housing feasible in the local community and for clients with children and youth, to live in a supportive housing environment that strives for reunification with their children and youth or
assists clients in maintaining custody of their children and youth, as appropriate.
(B)
Assist individuals to rejoin or return to a home that had previously been maintained with a family member or in a shared housing environment that is supportive of their recovery and stabilization.
(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 justice system.
(9)
Reduce or eliminate the distress caused by the symptoms of either serious mental illness or substance use disorder, or both.
(10)
Utilize trauma-informed approaches to reduce trauma and avoid retraumatization.
(f)
(1)
(A)
The client’s clinical record shall describe the
service array that meets the requirements of subdivisions (c) and (e) and, to the extent applicable to the individual, the requirements of subdivisions (a) and (b).
(B)
The State Department of Health Care Services may develop and revise documentation standards for service planning to be consistent with the standards developed pursuant to paragraph (3) of subdivision (h) of Section 14184.402.
(2)
Documentation of the service planning process in the client’s clinical record pursuant to paragraph (1) may fulfill the documentation requirements for both the Medi-Cal program and this section.
(g)
For purposes of this section, “behavioral health services” shall have the meaning as defined in subdivision (j) of Section 5892.
(h)
For purposes of this section,
“substance use disorder” shall have the meaning as defined in subdivision (c) of Section 5891.5.
(i)
This section shall become operative on July 1, 2026, if amendments to the Mental Health Services Act are approved by the voters at the March 5, 2024, statewide primary election.