Bill Text: CA AB2193 | 2017-2018 | Regular Session | Amended

California Assembly Bill 2193 (Prior Session Legislation)

NOTE: There are more recent revisions of this legislation. Read Latest Draft

Bill Title: Maternal mental health.

Spectrum: Bipartisan Bill

Status: (Passed) 2018-09-26 - Chaptered by Secretary of State - Chapter 755, Statutes of 2018. [AB2193 Detail]

Download: California-2017-AB2193-Amended.html

Amended IN Senate June 21, 2018

Amended IN Assembly April 30, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill

No. 2193

Introduced by Assembly Member Maienschein
(Coauthors: Assembly Members Gonzalez Fletcher, Lackey, Rodriguez, and Voepel)

February 12, 2018

An act to add Section 1367.625 to, and to add Article 6 (commencing with Section 123640) to Chapter 2 of Part 2 of Division 106 to, the Health and Safety Code, and to add Section 10123.867 to the Insurance Code, relating to health care.

LEGISLATIVE COUNSEL'S DIGEST

AB 2193, as amended, Maienschein. Maternal mental health.

Existing law provides for the licensure and regulation of various healing arts professions, including, but not limited to, physicians and surgeons, by various boards within the Department of Consumer Affairs. Existing law imposes certain fines and other penalties for, and authorizes these boards to take disciplinary action against licensees for, violations of the provisions governing those professions.

This bill would make it the duty of obstetrician-gynecologists or licensed health care practitioners supervised by obstetrician-gynecologists who treat or attend the mother or child, or both, to screen the mother for maternal mental health conditions, as defined, during pregnancy or during the postpartum period, or both, and to report the findings of the screening to the mother’s primary care physician if the obstetrician-gynecologist or health care practitioner supervised by an obstetrician-gynecologist is not the mother’s primary care physician. require, by July 1, 2019, a licensed health care practitioner who provides prenatal or postpartum care for a patient, or pediatric care for an infant, to offer to screen a mother for maternal mental health conditions. The bill would require a licensed health care practitioner to appropriately screen for maternal mental health conditions during pregnancy and the postpartum period if the mother agrees to be screened.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of that act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plan contracts and health insurance policies that provide hospital, medical, or surgical coverage to provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses, as defined, of a person of any age.

This bill would require health care service plans and health insurers to provide specified information regarding maternal mental health treatment and case management utilization to existing quality management programs by July 1, 2019 and annually thereafter. The bill would require the information to be used to develop resources to ensure contracting obstetric providers receive screening support and to ensure that health care service plans and health insurance policies meet their obligation to make all services readily available at reasonable times to each enrollee or insured, as specified. insurers, by July 1, 2019, to develop, consistent with sound clinical principles and processes, a maternal mental health clinical case management program to address mental and behavioral issues, as specified. The bill would, among other things, require the health care service plan and health insurer to annually update the clinical guidelines and criteria related to the maternal mental health clinical case management program, as may be appropriate. Because a willful violation of the bill’s requirement by a health care service plan would be a crime, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES

The people of the State of California do enact as follows:

SECTION 1.

Section 1367.625 is added to the Health and Safety Code, to read:

1367.625.
~~(a)(1)By July 1, 2019, a health care service plan shall provide all of the following information to existing quality management programs:~~
~~(A)The number, ratio, and geographical distance of behavioral providers trained to treat maternal mental health conditions, including therapists and psychiatrists.~~
~~(B)Case management utilization, if applicable, including utilization by individual providers.~~
~~(C)The effectiveness of the program in reducing symptoms.~~
~~(D)Enrollee and provider satisfaction with the program, if available.~~
(2)The information in paragraph (1) shall be reported to a quality assurance committee of the health care service plan on an annual basis, and the plan shall institute corrective actions when warranted.
(3)The information in paragraph (1) shall be used to develop resources to ensure contracting obstetric providers receive screening support and to ensure that the health care service plan meets its obligation to make all services readily available at reasonable times to each enrollee, consistent with good professional practice, and in a manner providing continuity of care and ready referral of patients to other providers at times as may be appropriate, consistent with good professional practice.

1367.625.

(a) By July 1, 2019, a health care service plan shall develop a maternal mental health clinical case management program to address mental and behavioral issues. The health care service plan shall support efficacious treatment for the reduction of symptoms. The program shall be developed consistent with sound clinical principles and processes. The health care service plan shall annually update the clinical guidelines and criteria related to the maternal mental health clinical case management program, as may be appropriate, and these guidelines and criteria shall be made available upon request to medical providers, including a contracting obstetric provider.

(b) For the purposes of this section, the following terms have the following meanings:

(1) “Contracting obstetric provider” means an individual who is certified or licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or an initiative act referred to in that division, and who is contracted with the enrollee’s health care service plan to provide services under the enrollee’s plan contract.

(2) “Maternal mental ~~health condition”~~ health” means a mental health condition that occurs during pregnancy or during the postpartum period and includes, but is not limited to, postpartum depression.

SEC. 2.

Article 6 (commencing with Section 123640) is added to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, to read:

Article 6. Maternal Mental Health

123640.
(a)It is the duty of an obstetrician-gynecologist, or any health care practitioner supervised by an obstetrician-gynecologist, and within the scope of practice, who treats and attends a mother or child, or both, to screen the mother for maternal mental health conditions during pregnancy or during the postpartum period, or both, unless the obstetrician-gynecologist or health care practitioner has received confirmation from a treating psychiatrist that the mother will remain under the treating psychiatrist’s care during pregnancy and the postpartum period, as applicable. The obstetrician-gynecologist or health care practitioner supervised by an obstetrician-gynecologist shall, in a manner consistent with applicable federal privacy law, report the findings of that screening to the mother’s primary care physician if the obstetrician-gynecologist or health care practitioner supervised by an obstetrician-gynecologist is not the mother’s primary care physician.
~~(b)This section does not prohibit another provider type from screening for maternal mental health conditions.~~

123640.

(a) By July 1, 2019, a licensed health care practitioner who provides prenatal or postpartum care for a patient, or pediatric care for an infant, shall ensure that the mother is offered screening for maternal mental health conditions. If the mother agrees to the screening, then the licensed health care practitioner shall appropriately screen for maternal mental health conditions during pregnancy and the postpartum period.

(b) This section shall not apply to emergency services or care, as defined in Section 1317.1.

(c) This section does not preclude any licensed or certified provider acting within his or her scope of practice from screening for maternal mental health conditions.

~~(c)~~

(d) For purposes of this section, the following definitions apply:

(1) “Maternal mental health condition” means a mental health condition that occurs during pregnancy or during the postpartum period and includes, but is not limited to, postpartum depression.

(2) “Health care practitioner” means ~~an individual who is certified or~~ a physician and surgeon, nurse practitioner, physician assistant, nurse midwife, or a midwife licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code or an initiative act referred to in that division and is acting within his or her scope of practice.

SEC. 3.

Section 10123.867 is added to the Insurance Code, to read:

10123.867.
~~(a)(1)By July 1, 2019, a health insurer shall provide all of the following information to existing quality management programs:~~
~~(A)The number, ratio, and geographical distance of behavioral providers trained to treat maternal mental health conditions, including therapists and psychiatrists.~~
~~(B)Case management utilization, if applicable, including utilization by individual providers.~~
~~(C)The effectiveness of the program in reducing symptoms.~~
~~(D)Insured and provider satisfaction with the program, if available.~~
(2)The information in paragraph (1) shall be reported to a quality assurance committee of the health insurer on an annual basis, and the health insurer shall institute corrective actions when warranted.
(3)The information in paragraph (1) shall be used to develop resources to ensure contracting obstetric providers receive screening support and to ensure that the health insurer meets its obligation to make all services readily available at reasonable times to each insured, consistent with good professional practice, and in a manner providing continuity of care and ready referral of patients to other providers at times as may be appropriate, consistent with good professional practice.

10123.867.

(a) By July 1, 2019, a health insurer that provides a policy of health insurance that provides coverage for the essential health benefits as set forth in the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), shall develop a maternal mental health clinical case management program to address mental and behavioral issues. The health insurer shall support efficacious treatment for the reduction of symptoms. The program shall be developed consistent with sound clinical principles and processes. The health insurer shall annually update the clinical guidelines and criteria related to the maternal mental health clinical case management program, as may be appropriate, and these guidelines and criteria shall be made available upon request to medical providers, including a contracting obstetric provider.

(b) For the purposes of this section, the following terms have the following meanings:

(1) “Contracting obstetric provider” means an individual who is certified or licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or an initiative act referred to in that division, and who is contracted with the insured’s health insurer to provide services under the insured’s health insurance policy.

SEC. 4.

No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.