Gazing Into the Crystal Ball Budget and Legislative Update March 23, 2018 www.pacounties.org

Budget Governor’s FY 2018-2019 Proposal Agency consolidation Process Overall Human Services Agency consolidation Process Budget hearings Vehicle – HB 2121 Flat funding – no room for increases (election year) About 3.1 percent increase – about a third is new initiatives ($225M for education, $50M for workforce development); rest is mandatory costs, about half for pensions HS - $74 million increase in ID/autism with $16 million waiting list initiative to move 965 individuals with ID/autism into services, and assure services to another 800 adults who will graduate in June 2019; state and federal funding to address opioid epidemic ($26.5M for year two of federal Cures Act funding); block grant lines; generally flat for MH base, BHSI (which includes COE funding). ID community slight state increase, larger federal, similar slight increases for base and intermediate care facilities. EI slight reduction on both state and federal. What are we hearing from leaders re special funds, tell us how we can make things better for you, use dollars more effectively As you know, our priority about HS funding is….. www.pacounties.org

Legislation HB 1233 – assisted outpatient SB 391, HB 384, HB 713 – involuntary commitment HB 478 – outpatient psychiatric oversight regulations SB 21 – Employment First Second half of a two year cycle – note ending in October HB 1233 (note companion SB 599) – new standard for court-ordered assisted outpatient treatment, leaves in place the clear and present danger standard for involuntary hospitalization. Amended in committee on Tuesday, your organization actively involved and had a lot of influence in the development, remained neutral but got to something implementable. Specifically, clarifies that nothing requires a county to include in an individual treatment plan for AOT a service that is not available in that county or for which no funding source is available. County may also decide not to offer AOT, individual has been offered and not likely to commit to voluntary treatment Needs to go to Approps SB 391 – involuntary commitment for substance abuse disorders (MHPA) (both at beginning of 2017, no movement). No facilities available to commit individuals dependent on drugs HB 478 – reached out to House Human Services staff that new outpatient regs were being developed – new OMSHAS regs would address concerns, but conflict with bill. Reported by Senate committee back in November, just this week received second consideration, went to Approps SB 21 – promotes employment of people with disabilities at competitive wages in PA businesses and public agencies. Passed Senate unanimously in February, similar HB 1641 passed House in December www.pacounties.org

Other Initiatives Governor’s School Safety Task Force House Education Committee hearing Task Force – examining effectiveness of student support and physical/mental health programs and information sharing, strengthening information and best practice sharing among local schools, law enforcement, health care providers, human services programs; planning to hold regional meetings over next several months. Hearing March 15 – how can they encourage mental health screening, support behavioral/mental health needs of students www.pacounties.org

Current Atmosphere It’s Election Year! In the House, currently 119-81, with 3 vacancies that will be filled at the special election www.pacounties.org

Current Atmosphere It’s Election Year! There are 19 House members retiring – 13 R, 6 D Another 6 R are running for other office Another 5 D are running for current seat and other office At least 5 of those R seats are moderate SE Rs www.pacounties.org

Current Atmosphere It’s Election Year! Senate 34-16 (2/3 majority is 34) www.pacounties.org

Current Atmosphere It’s Election Year! 2 R retiring (SE Rs), 2 R running for other office, 1 R running for other office but not up for re-election www.pacounties.org

Medical Marijuana Task Force Act 16 of 2016 Report – Conversation tool for counties Impacts from disagreement between state and federal law Operations Human Services Includes a list of 17 serious medical conditions for which MM may be recommended, includes PTSD and autism Report – not a position on MM or legal advice – to engage staff and solicitors, to be aware of potential impacts and to review policies that may need to be updated Operations – “under the influence,” restrictions on employment duties Human services – rely on a combination of state and federal funding, so questions for counties who encounter individuals using medical marijuana who are also enrolled in county services Generally speaking – if MM is sole purpose of service being funded, service unlikely to be eligible for federal funds DHS was required to promulgate regulations for possession/use of MM by employee of child care or “social service center” licensed/operated by DHS Counties should consider whether federal regulations, licensing requirements or funding are involved when evaluating any service where individuals being treated with medical marijuana may present themselves www.pacounties.org

Advocacy Re-engaging the state-county partnership Legislative Action Center Priorities PA Counties Are Make it local National County Government Month www.pacounties.org

Questions? Lisa Schaefer Director of Government Relations lschaefer@pacounties.org www.pacounties.org