Report 2012-122 Recommendation 3 Responses

Report 2012-122: Mental Health Services Act: The State's Oversight Has Provided Little Assurance of the Act's Effectiveness, and Some Counties Can Improve Measurement of Their Program Performance (Release Date: August 2013)

Recommendation #3 To: Health Care Services, Department of

To ensure that counties have the needed guidance to implement and evaluate their MHSA programs, Health Care Services should coordinate with the Accountability Commission and issue guidance or regulations, as appropriate, for Facilities programs and for other MHSA requirements, such as a prudent reserve.

Annual Follow-Up Agency Response From October 2019

DHCS submitted proposed fiscal regulations to the OAL on March 8, 2019. The Notice of Proposed Rulemaking was posted on March 22, 2019. DHCS held the public hearing on May 7, 2019, and closed the 45-day comment period on May 17, 2019. DHCS has one-year from the date when the Notice of Proposed Rulemaking was posted to promulgate the fiscal regulations.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From August 2019

DHCS submitted proposed fiscal regulations to the Office of Administrative Law on March 8, 2019. The Notice of Proposed Rulemaking was posted on March 22, 2019. DHCS held the public hearing on May 7, 2019 and closed the 45-day comment period on May 17, 2019. DHCS has one-year from the date when the Notice of Proposed Rulemaking was posted to promulgate the fiscal regulations.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Health Care Services has submitted proposed regulations to the Office of Administrative Law and is engaged in the regulatory process.

Annual Follow-Up Agency Response From November 2018

Department of Health Care Services (DHCS) continues to update the regulations to reflect changes to reversion statutes implemented by the passage of Chapter 38, Statutes of 2017 (AB 114). DHCS is finalizing the draft fiscal regulation text and the initial statement of reasons. By January 2019, DHCS intends to submit the public notice that announces these proposed fiscal regulations and initiate the 45-day public comment period to the Office of Administrative Law for publication in the California Regulatory Notice Register. DHCS expects to fully implement this recommendation by Summer 2019, when regulations are fully promulgated.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From August 2017

DHCS is developing MHSA fiscal regulations and the initial statement of reasons. The regulations will focus on three main areas: maintenance of records; prudent reserve; and reversion. DHCS convened a workgroup with representatives from the MHSOAC and the County Behavioral Health Directors Association to discuss the issues and provide input. DHCS expects the regulations to be available for public comment by December 2017 and promulgated during Summer 2018. Once regulations have been promulgated, this recommendation will be fully implemented.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From September 2016

DHCS submitted draft regulations for the Workforce Education and Training component to California Health and Human Services Agency for review. Upon review by Agency, and with input from the Office of Statewide Planning and Development, it was determined the proposed regulation changes were no longer necessary. DHCS continues to draft regulations for fiscal policies. A workgroup comprised of DHCS staff, MHSOAC staff, and counties has been developed to gather input for MHSA fiscal policies and regulations.

DHCS expects to complete draft regulations by December 2016, and fully promulgate the regulations by mid-2018. Once these regulations have been promulgated, this recommendation will be fully implemented

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2015

DHCS is currently working with the Office of Statewide Health Planning and Development to promulgate regulations on the Workforce Education and Training component. DHCS is also working on drafting regulations to provide more guidance to counties regarding other MHSA requirements, such as the prudent reserve. Once these regulations have been promulgated, this recommendation will be fully implemented.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

DHCS continues to finalize the MHSA audit and appeals regulations, as well as draft the Initial Statement of Reasons. Draft regulations were provided to the County Behavioral Health Director's Association and the Mental Health Services Oversight and Accountability Commission for review and comment and DHCS is continuing to make revisions. These regulations will provide increased clarity to the audit and appeals process at the county level. DHCS is also working internally with the Office of Administration Hearings and Appeals to update the appeals regulations. The department expects to complete this regulation process by December 2015.

After drafting the audit and appeals regulations, DHCS will begin drafting fiscal regulations, CSS regulations, CFTN regulations, and, finally, WET regulations. DHCS anticipates completing all regulations by March 2018.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

6-Month Agency Response

DHCS completed the initial draft of MHSA audit and appeals regulations. The draft regulations will be provided to the California Mental Health Directors Association (CMHDA) by late February 2014 for review and comment. DHCS continues to work with the Mental Health Services Oversight and Accountability Commission to develop and update Community Services and Supports (CSS) regulations. When the CSS regulations are completed, fiscal regulations, Capital Facilities and Technological Needs (CF/TN), and Workforce Education and Training (WET) components will follow.

Draft regulations will be made available for public comment in the spring of 2014. We anticipate that final regulations will be adopted during the fall of 2014.

Per AB 82 (Chapter 23, Statutes of 2013) the Mental Health Services Oversight and Accountability Commission (Accountability Commission) is responsible for completing Prevention and Early Intervention (PEI) and Innovation (INN) regulations.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

60-Day Agency Response

DHCS is meeting with the Accountability Commission bi-weekly to review current MHSA regulations and to develop additional regulations. DHCS is currently reviewing regulations for Community Services and Supports (CSS), Capital Facilities/Technological Needs (CF/TN), fiscal policies including prudent reserve and reversion, and Workforce Education and Training (WET). DHCS is also developing program oversight and fiscal audit regulations.

Draft regulations will be made available for public comment in the spring of 2014. We anticipate that final regulations will be adopted during the fall of 2014.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

All Recommendations in 2012-122

Agency responses received are posted verbatim.