Numerous special populations exist in California society that requires particular or unique approaches to address historically unmet needs
300.0. Intent: CALTCHA shall cover care in supportive, individualized service settings, career and vocational training therapies and services, and ongoing needed medical, mental health, psychiatric, psychological, counseling, and case management services within or outside institutional setting for persons with mental illness or substance abuse illness, emphasizing quality individualized care and early preventive services and interventions. CALTCHA will rectify the historical absence of coverage parity for mental illness and substance-related illness when compared with physical conditions. This Act aims to ameliorate the coronavirus pandemic's short- and long-term emotional trauma, front-line worker stress, and related depression. Licensed mental health clinicians shall be paid in the same manner as specified for other health professionals, emphasizing global budgeting models.
300.1. Community Based versus institutional-based care: : In all instances, efforts to provide services in the least restrictive home and community-based, noninstitutional, and individualized settings shall be emphasized.
Examples for individuals with serious mental illness include:
300.1.1. Case management services
300.1.2. Crisis and suicide prevention hotlines
300.1.3 Certified crisis intervention home and community teams
300.1.4 P Crisis shelters
300.1.5 Clubhouse programs
300.1.6. Psychosocial rehabilitation programs
300.1.7Sheltered workshop and vocational rehabilitation programs
300.1.8 Skilled and secure transitional residential care services when indicated Examples for individuals with substance abuse problems include:
300.1.9. Residential care
300.1.10. Dual diagnosis programs for individuals with other serious mental illness and substance abuse problems
300.1.11. A. Intensive outpatient programs, and
300.1.12. Certified substance abuse counselors provide follow-up counseling.
300.2. Prohibition against discharging any patients from a health institution or entity without safe and secure housing. The Board and the Office of the Secretary shall work in partnership with the California Association of Housing Authorities and other responsible agencies to advocate for a comprehensive housing plan and system to ensure that no person discharged from a mental health or hospital setting will be rendered homeless, or placed in a dangerous or unsanitary living condition, including housing programs that fail to provide safe, decent, and affordable "permanent" housing and comprehensive mental health aftercare services. Practical accommodation shall exist for those who refuse such assistance.
300.3. The Program will partner to create a "Housing First" policy for those discharged from mental health, drug, and alcohol programs, including transitional housing and wraparound, comprehensive services for those recently discharged. CALTCHA shall collaborate with the local County Housing Authority to provide annual funds for safe and decent housing for this population, and that includes trained and licensed mental health social work, and a comprehensive array of culturally competent mental health and substance abuse services, vocational training, counseling, and recreational services.
300.4. Programs to provide relevant specialty consultation to primary care practices, such as the Psychiatric Collaborative Care model, and to facilitate the care of complex patient problems in primary care settings.
301.0 Intent: To strengthen the physical, mental, dental, and social health of our youth from preschool through graduate school by partnering with the K-12 and postsecondary education systems to provide diagnostic, nurturing primary and preventive care in school settings. CALTCHA shall coordinate with agencies in the Departments of Education, Public Health, and Health and Human Services, including the Child Health and Disability Prevention Program, Children’s Medical-Services and Behavioral Health Treatment, Department of Social Services and the Department of Developmental Services, and constituency advocacy organizations to accomplish the above.
301.1. Standards shall be promulgated, within one (1) year of adoption of CALTCHA, via an extended partnership between the Secretary, State Superintendent of Education, Chancellors of the University of California, State Universities and Community Colleges, the Trust Fund Board with the state Professional and Technical Council with relevant professional unions’ input, and then confirmed by representative local health officers, local liaison offices, and Neighborhood Assemblies, to define the needed school health service workforce. No less than one (1) full multidisciplinary team shall serve an upper limit of 800 children, or fraction thereof, irrespective of geographic locations, and be oriented to address the needs of California’s diverse student populations effectively.
301.2. CALTCHA shall ensure that pediatricians, family physicians, nurses, psychologists, social workers, and teams of specialty therapists, dentists, speech and hearing, sensory health clinicians, nutritionists, social workers, and substance abuse clinicians function in ratios proper to school populations and possess relevant skills including those needed to serve children with special needs. School -based care teams shall be constituted in standards-based dialogue with health professionals, parent-teacher organizations, and District and County School Boards in each educational venue.
301.3. Interdict bullying and identify and treat early depressive and suicidal signs, substance abuse, and the full spectrum of developmental and reproductive health care and awareness challenges in children in all primary and secondary school settings.
301.4. A pediatrician-led, multidisciplinary school health team shall perform annual evaluations on every child in California to identify physical, emotional, sensory, or developmental conditions and prompt appropriate interventions and specialty referrals for definitive care. Quantitative and qualitative summaries of these evaluations shall be part of regular public health officer reports to the Board and the Legislature and used to direct resources within localities.
301.5. Graduates of medical, dental, nursing, and public health schools who participate in the California Health Services Corp program will be prioritized in staffing school-based health programs.
302.0 Intent: Californias large rural and agricultural sector employs a considerable population of permanent and or seasonal employees, many undocumented, poor, itinerant, non-English speaking, lacking acceptable housing and health care, and subject to a variety of toxic and extreme environmental and weather conditions. Grower health care costs and workers' compensation cost escalate annually with adverse economic consequences. CALTCHA will address this system of inequity, indignity, and flagrant dangers.
302.1. With adequate specialized staff and expansion of public health laboratories in every county, local health officers shall investigate and mitigate toxic environmental, chemical, and infectious conditions are affecting these vulnerable workers and their families.
302.2. Rural hospitals and clinics shall receive global budgets and development funding prioritized to reverse recent and long-term contractions in facility and health care workforce availability.
303.0 Intent: The unique needs of disabled Californians require services and policy (developed in a participatory fashion) that guarantee community-based (i.e., non -institutional) health care, resource-parity, and all necessary durable physical and communication equipment- including orthotic, prosthetic, assistive, and accommodative equipment, and services, including quality vocational rehabilitation, secure and socially independent and family living, and habilitation services designed to maximize social valorization and well being of Californians who are aging or who have disabilities. CALTCHA programs shall exceed Federal Olmstead's ruling standard minimums. CALTCHA shall also:
303.1. Comply with and creatively enhance the purposes and mandates of the Americans with Disabilities Act in meaningful collaboration with relevant Health and Human Services Agency Department Directorates and existing state programs to achieve this intent.
303.2. Assure persons with disabilities have maximum control and complete choice over their care, including hiring, training, directing and firing personal care and home health aides.
303.3. Operate to avoid the impoverishment of families and overemphasis on congregate, segregated institutional placements driven by Medicaid funded services and policies by individualizing those services and policies.
303.4 Prioritize non-medical habilitation services that prevent illness, infirmity, and psychosocial debility among Californians with disabilities.
303.5. Coordinate with the Departments of Education, Developmental Services, Vocational Rehabilitation, Social Services, Employment Development, and the Developmental Disabilities Council and constituency voluntary organizations to improve the lives of disabled Californians by maximizing health, independence, and social inclusion, and social supports.
303.6 6 Fund an annual All Disability Planning Conference to host representatives from all disability constituencies and report to the Legislature and the Board on this new system's successes, needs, and deficiencies.
304.0 Intent: : Care in prisons and jails in California with incarcerated persons medical, mental health, dental, substance abuse, addiction, pharmacy, social services, rehabilitation, habilitation, and case management needs shall be fully covered by the CALTCHA Trust Fund and provided for in a manner equal to care of the general public. State Public Health Department professionals – independent of the penal system - shall participate in active oversight of the conditions under which incarcerated persons are confined and cared for and shall have the authority to set benchmarks and standards for conditions of confinement and provide health recommendations and advocacy contributory to case-based decarceration.
304.1. All transitional health and social support services from existing local and State resources shall be coordinated for youth and adult individuals released from locked detention shall be include but not limited to mental health services, transitional housing, vocational rehabilitation, employment development, and case management targeted to minimize recidivism.
304.2. Procedures shall be established to ensure and structure such public, and private interagency coordination is expected to optimize health and anti-recidivism interventions for youth and adults experiencing locked detention during and after their detention.
305.0. Intent: An essential social determinant of health is housing, which is generally supported by many public and private agencies. Clinical and public health circumstances exist that require housing critical to short-term health challenges, prevent the spread of infection, or assure patient and community stability and safety. Special populations that may require direct CALTCHA-funded housing include but are not necessarily limited to those with infectious disease, mental health crises, substance abuse recovery, crisis shelter (for elders, adults, and children experiencing domestic violence or neglect), maternity, toxic-environmental crisis, and temporary post-hospital discharge needs. CALTCHA can and shall use its local assessment targeted funds for these specific purposes.
305.1. The Board and local health departments must establish standard criteria to identify where those situations in which the health system must assume primary (as opposed to interagency coordinating responsibility) to fund medically indicated temporary shelter. Such medically prescribed housing must offer private and group rooms with available separate lockers, showers, bathrooms, laundry facilities, and suitable dining areas, especially during infectious disease epidemics.
305.2 Local health departments shall broadly deploy social workers and other clinicians trained in evaluating home environments and sanitation engineers to promote optimal health.
306.0 Intent: Specific categories of patients with dual or multiple diagnoses require coordinated interdisciplinary community-based health care teams. CALTCHA shall fund (using global operating budgets directed by local health officers) interdisciplinary health care teams to:
306.1 Care for complex medical-surgical patients in-home or other community settings in lieu of hospitalization.
306.2. Address the complex needs of patients who are frequent users of emergency rooms or who experience frequent preventable hospitalization.