Early Psychosis Intervention Plus (Epi Plus) Program - Community Mental Health Services - CA Welfare And Institutions

Section § 5835

This law, called the Early Psychosis Intervention (EPI) Plus Program, is designed to help identify and treat early signs of psychosis and mood disorders. It aims to support individuals in recovering and maintaining their health by using evidence-based methods. This includes programs like therapy, family support, educational and employment aid, medication management, and innovative technology to enhance mental health care. A commission will oversee the initiative, which will be operational from July 2026 if voters approve changes to the Mental Health Services Act in March 2024.

(a) This part shall be known, and may be cited, as the Early Psychosis Intervention (EPI) Plus Program to encompass early psychosis and mood disorder detection and intervention.

(b) As used in this part, the following definitions shall apply:

(1) “Commission” means the Behavioral Health Services Oversight and Accountability Commission established pursuant to Section 5845.

(2) “Early psychosis and mood disorder detection and intervention” refers to a program that utilizes evidence-based approaches and services to identify and support clinical and functional recovery of individuals by reducing the severity of first, or early, episode psychotic symptoms, other early markers of serious mental illness, such as mood disorders, keeping individuals in school or at work, and putting them on a path to better health and wellness. This may include, but is not limited to, all of the following:

(A) Focused outreach to at-risk and in-need populations as applicable.

(B) Recovery-oriented psychotherapy, including cognitive behavioral therapy focusing on cooccurring disorders.

(D) Supported education and employment.

(E) Pharmacotherapy and primary care coordination.

(F) Use of innovative technology for mental health information feedback access that can provide a valued and unique opportunity to assist individuals with mental health needs and to optimize care.

(G) Case management.

(3) “County” includes a city receiving funds pursuant to Section 5701.5.

(c) 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.

Early Psychosis Intervention mood disorder detection clinical recovery mental illness support recovery-oriented psychotherapy cognitive behavioral therapy family psychoeducation supported education supported employment pharmacotherapy primary care coordination mental health technology case management Behavioral Health Services Oversight Mental Health Services Act

(Repealed (in Sec. 45) and added by Stats. 2023, Ch. 790, Sec. 46. (SB 326) Effective October 12, 2023. Operative July 1, 2026, by its own provisions.)

Section § 5835.1

The Early Psychosis and Mood Disorder Detection and Intervention Fund is a special fund in California created to support programs for detecting and treating early signs of psychosis and mood disorders. The money in the fund can come from private donations, grants, or any interest earned. The state commission manages the fund and can use a portion for its administrative costs, but not more than $500,000 yearly. The money from this fund is in addition to any other funds counties receive for mental health services, and it must be specifically used for these early intervention programs. There's no obligation to spend if the funds are not sufficient, and no money for this purpose will come from the state's General Fund.

(a) The Early Psychosis and Mood Disorder Detection and Intervention Fund is hereby created within the State Treasury. The moneys in the fund shall be available, upon appropriation by the Legislature, to the commission for the purposes of this part. The commission may use no more than five hundred thousand dollars ($500,000) of the amount deposited annually into the fund for administrative expenses in implementing this part, including providing technical assistance.

(b) There may be paid into the fund all of the following:

(1) Any private donation or grant.

(2) Any other federal or state grant.

(3) Any interest that accrues on amounts in the fund and any moneys previously allocated from the fund that are subsequently returned to the fund.

(d) Distributions from the fund shall be supplemental to any other amounts otherwise provided to county behavioral health departments for any purpose and shall only be used to fund early psychosis and mood disorder detection and intervention programs.

(e) The commission may elect not to make awards if available funds are insufficient.

(f) Funds shall not be appropriated from the General Fund for the purposes of this part.

Early Psychosis Detection Mood Disorder Intervention State Treasury Fund Administrative Expenses Technical Assistance Private Donations Federal Grants State Grants Interest Accrual Fund Allocation County Behavioral Health Supplemental Funding Mental Health Programs Grant Funding Insufficient Funds

(Added by Stats. 2017, Ch. 414, Sec. 2. (AB 1315) Effective January 1, 2018.)

Section § 5835.2

This law sets up an advisory committee to provide advice and recommendations to the Behavioral Health Services Oversight and Accountability Commission on early psychosis and mood disorder programs. The committee includes a diverse range of members, such as mental health experts, representatives from health plans and non-profits, industry specialists, and individuals with lived experience. Their role includes advising on program approaches, making recommendations on guidelines, advising the competitive selection process for funding, and suggesting standardized measures for funded programs. The committee also aids in informing programs about research opportunities and ensuring data sharing. The law becomes effective on July 1, 2026, only if specific amendments are approved by voters in March 2024.

(a) There is hereby established an advisory committee to the commission. The Behavioral Health Services Oversight and Accountability Commission shall accept nominations and applications to the committee, and the chair of the Behavioral Health Services Oversight and Accountability Commission shall appoint members to the committee, unless otherwise specified. Membership on the committee shall be as follows:

(1) The chair of the Behavioral Health Services Oversight and Accountability Commission, or their designee, who shall serve as the chair of the committee.

(2) The president of the County Behavioral Health Directors Association of California, or their designee.

(3) The director of a county behavioral health department that administers an early psychosis and mood disorder detection and intervention-type program in their county.

(4) A representative from a nonprofit community mental health organization that focuses on service delivery to transition-aged youth and young adults.

(5) A psychiatrist or psychologist.

(6) A representative from the Behavioral Health Center of Excellence at the University of California, Davis, or a representative from a similar entity with expertise from within the University of California system.

(7) A representative from a health plan participating in the Medi-Cal managed care program and the employer-based health care market.

(8) A representative from the medical technologies industry who is knowledgeable in advances in technology related to the use of innovative social media and mental health information feedback access.

(9) A representative knowledgeable in evidence-based practices as they pertain to the operations of an early psychosis and mood disorder detection and intervention-type program, including knowledge of other states’ experiences.

(10) A representative who is a parent or guardian caring for a young child with a mental illness.

(11) An at-large representative identified by the chair.

(12) A representative who is a person with lived experience of a mental illness.

(13) A primary care provider from a licensed primary care clinic that provides integrated primary and behavioral health care.

(14) A school social worker, school psychologist, or school counselor holding a pupil personnel services credential.

(15) A California public school administrator.

(16) A representative knowledgeable in community-defined evidence practices and reducing behavioral health disparities.

(b) The advisory committee shall be convened by the chair and shall, at a minimum, do all of the following:

(1) Provide advice and guidance broadly on approaches to early psychosis and mood disorder detection and intervention programs from an evidence-based perspective.

(2) Review and make recommendations on the commission’s guidelines or regulations in the development, design, and selection of awards pursuant to this part, and the implementation or oversight of the early psychosis and mood disorder detection and intervention competitive selection process established pursuant to this part.

(3) Assist and advise the commission in the overall evaluation of the early psychosis and mood disorder detection and intervention competitive selection process.

(4) Provide advice and guidance as requested and directed by the chair.

(5) Recommend a core set of standardized clinical and outcome measures that the funded programs would be required to collect, subject to future revision. A free data sharing portal shall be available to all participating programs.

(6) Inform the funded programs about the potential to participate in clinical research studies.

(c) 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.

advisory committee Behavioral Health Services Oversight early psychosis mood disorder detection mental health intervention psychiatrist psychologist Medi-Cal managed care innovative social media mental health technology evidence-based practices mental illness primary care integration school social worker community-defined practices clinical research studies standardized measures data sharing portal

(Repealed (in Sec. 47) and added by Stats. 2023, Ch. 790, Sec. 48. (SB 326) Effective October 12, 2023. Operative July 1, 2026, by its own provisions.)

Section § 5835.3

This law is designed to improve mental health services in California by enhancing early detection and intervention for psychosis and mood disorders among young people. It creates a competitive process for selecting projects that can expand and improve these services, ensuring they are evidence-based and effectively reach youth at risk.

The objectives include increasing access to high-quality care, measuring program outcomes, improving the client experience, and reducing unnecessary hospital stays. The law also encourages the use of innovative technologies, increases financial resources for communities, and promotes collaboration between mental health and medical services.

Funds from the commission are provided to counties or other entities, but recipients must also contribute local funds. The awarded projects should be cost-effective and sustainable, with clear plans for implementation and measuring success.

An advisory committee may allocate funds for clinical research, with all studies complying with privacy laws to protect patient information.

(a) It is the intent of the Legislature to authorize the commission to administer a competitive selection process as provided in this part to create new, and to expand and improve the fidelity of existing, service capacity for early psychosis and mood disorder detection and intervention services in California.

(b) The core objectives of this competitive selection process include, but are not limited to, all of the following:

(1) Expanding the provision of high-quality, evidence-based early psychosis and mood disorder detection and intervention services within California.

(2) Improving access to effective services for transition-aged youth and young adults at high risk for, or experiencing, psychotic symptoms, including the prodromal phase, or psychotic disorders.

(3) More comprehensively and effectively measuring programmatic effectiveness and enrolled client outcomes of programs receiving awards in the competitive selection process.

(4) Improving the client experience in accessing services and in working toward recovery and wellness.

(5) Increasing participation in school attendance, social interactions, physical health, personal bonding relationships, and active rehabilitation, including employment and daily living function development for clients.

(6) Reducing unnecessary hospitalizations and inpatient days by appropriately utilizing community-based services and improving access to timely assistance to early psychosis and mood disorder detection and intervention services.

(7) Expanding the use of innovative technologies for mental health information feedback access that can provide a valued and unique opportunity to optimize care for the target population. This may include technologies for treatment and symptom monitoring.

(8) Providing local communities with increased financial resources to leverage additional public and private funding sources to achieve improved networks of care for the target population, including transition-aged youth and young adults.

(9) Improving whole-person care by increasing access to, and coordination of, mental health and medical care services.

(c) Funds allocated by the commission shall be made available to selected counties, or counties acting jointly, through a competitive selection process, or to other entities for research, evaluation, technical assistance, and other related purposes.

(d)

(1) Notwithstanding any other law, a county, or counties acting jointly, that receive an award of funds shall be required to provide a contribution of local funds.

(2) Upon approval of the commission, after consultation with the Department of Finance and the State Department of Health Care Services, other locally acquired funding, such as federal grants or allocations, or other special funds, may also be recognized for the purpose of contributing toward any contribution requirements.

(e) Awards made by the commission shall be used to create, or expand existing capacity for, early psychosis and mood disorder detection and intervention services and supports. The commission shall ensure that awards result in cost-effective and evidence-based services that comprehensively address identified needs of the target population, including transition-aged youth and young adults, in counties and regions selected for funding. The commission shall also take into account at least the following criteria and factors when selecting recipients of awards and determining the amount of awards:

(1) A description of need, including, at a minimum, a comprehensive description of the early psychosis and mood disorder detection and intervention services and supports to be established or expanded, community need, target population to be served, linkage with other public systems of health and mental health care, linkage with schools and community social services, and related assistance as applicable, and a description of the request for funding.

(2) A description of all programmatic components, including outreach and clinical aspects, of the local early psychosis and mood disorder detection and intervention services and supports.

(3) A description of any contractual relationships with contracting providers as applicable, including any memorandum of understanding between project partners.

(4) A description of local funds, including the total amounts, that would be contributed toward the services and supports as required by the commission through the competitive selection process, implementing guidelines, and regulations.

(5) The project timeline.

(6) The ability of the awardee to effectively and efficiently implement or expand an evidence-based program as referenced in this part.

(7) A description of core data collection and the framework for evaluating outcomes, including improved access to services and supports and a cost-benefit analysis of the project.

(8) A description of the sustainability of program services and supports in future years.

(f) The commission shall determine any minimum or maximum awards, and shall take into consideration the level of need, the population to be served, and related criteria as described in subdivision (e) and in any guidance or regulations, and shall reflect the reasonable costs of providing the services and supports.

(g) Funds awarded by the commission may be used to supplement, but not supplant, existing financial and resource commitments of the county or counties acting jointly, that receive the award.

(h) The commission may consult with a technical assistance entity, as described in paragraph (5) of subdivision (a) of Section 4061, initiate an interagency agreement with another public entity, including the University of California system, or contract for necessary technical assistance to implement this part.

(i) The advisory committee may coordinate and recommend an allocation of funding to the commission for clinical research studies. The committee may recommend an amount not to exceed 10 percent of the total amount deposited in the Early Psychosis and Mood Disorder Detection and Intervention Fund for clinical research studies. The committee may recommend, in conjunction with the principal investigators, the data elements to be included in clinical research studies funded pursuant to this subdivision. The results of the clinical research studies shall be made available annually to the members of the public, including stakeholders and Members of the Legislature. The results of clinical research studies shall be deidentified in accordance with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Public Law 104-191), including Section 164.514 of Title 45 of the Code of Federal Regulations, and shall not contain any personally identifiable information according to the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code).

(j) The county and all award recipients shall comply with all applicable state and federal privacy laws that govern medical information, including, but not limited to, HIPAA and its implementing regulations, the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), and Section 10850.

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(Amended by Stats. 2018, Ch. 92, Sec. 227. (SB 1289) Effective January 1, 2019.)

Section § 5835.4

This law allows the commission to start carrying out the tasks in this section immediately without going through the usual rulemaking processes. However, they must have formal regulations in place by January 1, 2019.

Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the commission may implement this part without taking regulatory action until regulations are adopted. The commission shall adopt regulations implementing this part on or before January 1, 2019.

commission implementation regulatory action rulemaking exception regulations deadline Administrative Procedure Act immediate execution regulations adoption January 1 2019 rulemaking provisions without regulatory action temporary implementation Government Code Section 11340 formal regulations execution flexibility

(Added by Stats. 2017, Ch. 414, Sec. 2. (AB 1315) Effective January 1, 2018.)

Section § 5835.5

This law section states that the grant program and related regulations can only be put into action if at least $500,000 is allocated by the Legislature or added to a specific fund. This amount covers both grant funding and administration costs.

Implementation of the grant program established pursuant to Section 5835.3 and the adoption of regulations pursuant to Section 5835.4 is contingent upon appropriation by the Legislature, or the deposit into the fund established pursuant to Section 5835.1, of at least five hundred thousand dollars ($500,000) for the purpose of funding grants and administrative costs for the commission pursuant to this part.

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(Amended by Stats. 2019, Ch. 26, Sec. 1. (SB 79) Effective June 27, 2019.)