Bill Text: CA AB2668 | 2019-2020 | Regular Session | Amended
Bill Title: Integrated School-Based Behavioral Health Partnership Program.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Introduced - Dead) 2020-05-06 - In committee: Set, first hearing. Hearing canceled at the request of author. [AB2668 Detail]
Download: California-2019-AB2668-Amended.html
|
Amended
IN
Assembly
May 04, 2020 |
CALIFORNIA LEGISLATURE—
2019–2020 REGULAR SESSION
Assembly Bill
No. 2668
| Introduced by Assembly Members Quirk-Silva and Weber (Coauthor: Assembly Member Nazarian) |
February 20, 2020 |
An act to add Article 3 (commencing with Section 49440) to Chapter 9 of Part 27 of Division 4 of Title 2 of the Education Code, relating to pupil health.
LEGISLATIVE COUNSEL'S DIGEST
AB 2668, as amended, Quirk-Silva.
Integrated School-Based Behavioral Health Partnership Program.
Existing law requires the governing board of any school district to give diligent care to the health and physical development of pupils and authorizes the governing board of a school district to employ properly certified persons for the work.
The School-Based Early Mental Health Intervention and Prevention Services for Children Act of 1991 authorizes the Director of Health Care Services, in consultation with the Superintendent of Public Instruction, to award matching grants to local educational agencies to pay the state share of the costs of providing school-based early mental health intervention and prevention services to eligible pupils at schoolsites of eligible pupils, subject to the availability of funding each year.
Existing law establishes the Mental
Health Student Services Act as a mental health partnership competitive grant program for the purpose of establishing mental health partnerships between a county’s mental health or behavioral health departments and school districts, charter schools, and the county office of education within the county, as provided.
This bill would establish the Integrated School-Based Behavioral Health Partnership Program to provide early intervention for, and access to, behavioral health services for pupils. The bill would authorize a county behavioral health agency and the governing board or governing body of a local educational agency to agree to collaborate on and implement an integrated school-based behavioral health partnership program and to develop a memorandum of understanding outlining the requirements for the partnership program. The bill would require a county behavioral health agency to provide
provide, through its own staff or through its network of contracted community-based organizations, one or more behavioral health professionals that meet specified licensing requirements to serve pupils with serious emotional disturbances or substance use disorders, or who are at risk of developing a serious behavioral health condition. The bill would require a local educational agency to provide school-based locations, including space at schools, appropriate for the delivery of behavioral health services, and would additionally authorize these services to be provided at locations that are not at the school-based location, for purposes of accommodating the individual needs of a pupil. The bill would establish processes for delivering services and would specify the types of services that may be provided pursuant to the partnership program. The bill would provide processes and requirements for serving pupils with private insurance, including requirements related to
reimbursement for services by private insurers. The bill would require the Department of Managed Health Care to have trained staff available to address any disputes arising from the partnership program and to create a workgroup with a specified membership to recommend policies to expedite payments to county behavioral health agencies serving privately insured pupils under the partnership program. The bill would require the partnership program to annually report specified information to the State Department of Education, the State Department of Health Care Services, the Mental Health Services Oversight and Accountability Commission, and the Legislature.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
The Legislature finds and declares all of the following:(a) In any given year, the percentage of young people with behavioral health disorders is estimated to be between 14 and 20 percent.
(b) One-half of all mental illness develops by 14 years of age and three quarters by 24 years of age. Early intervention and prevention of behavioral health conditions are critical to the success of an individual’s health, educational goals, and social relationships.
(c) Pupils with emotional disturbances have the highest
increase in absenteeism and dropout rates when compared to any other disability, according to studies.
(d) In 2017, a child in the United States was 10.1 times more likely to be seen by an out-of-network provider than a primary care office visit, which is more than twice the disparity seen for adults, according to a Milliman report.
(e) Under mental health parity, services treating behavioral health conditions at the onset to prevent these conditions from becoming more serious should be part of every health plan’s benefits. Because of the importance of early intervention for children, private health plans do or should cover these services for children.
(f) Schools have been identified as a crucial place to provide behavioral
health services and improve access to services for pupils, including for pupils in underserved communities, but also for pupils who are privately insured.
SEC. 2.
Article 3 (commencing with Section 49440) is added to Chapter 9 of Part 27 of Division 4 of Title 2 of the Education Code, to read:Article 3. Integrated School-Based Behavioral Health Partnership Program
49440.
For purposes of this article, the following definitions apply:(a) “Local educational agency” means a school district, county office of education, or charter school.
(b) “Participating entity” means a community-based organization or other entity that has contracted with a county behavioral health agency to provide services and that participates in a partnership program pursuant to this article.
(b)
(c) “Partnership program” means an integrated school-based behavioral health partnership program established by a county behavioral health agency and the governing board or governing body of a local educational agency pursuant to this article. A partnership program may include one or more participating entities.
49440.1.
The Integrated School-Based Behavioral Health Partnership Program is hereby established to provide early intervention for, and access to, behavioral health services for pupils with serious emotional disturbances or substance use disorders, or who are at risk of developing a serious behavioral health condition.49440.2.
A county behavioral health agency and the governing board or governing body of a local educational agency may agree to collaborate on and implement an integrated school-based behavioral health partnership program pursuant to this article, and may develop a memorandum of understanding outlining the requirements for the partnership program, as provided in this article. Multiple local educational agencies within a single county may join to form a partnership program with the county behavioral health agency. The county behavioral health agency and the local educational agency are encouraged, when appropriate, to formalize the memorandum of understanding through an organizational provider arrangement, as defined in Section 1810.231 of Title 9 of the California Code of Regulations, or any successor regulation.49440.3.
(a) To support services provided under the partnership program, the local educational agency may use funding apportioned pursuant to the local control funding formula.(b) To support services provided under the partnership program, the county behavioral health agency may use funding apportioned pursuant to the Mental Health Services Act, enacted by Proposition 63 at the November 2, 2004, statewide general election, as amended, consistent with an existing authorized use of that funding, or other county funds.
(c) The county behavioral health agency and local educational agency shall develop a plan of
financial participation that outlines the process for leveraging county behavioral health and school-based funding to provide integrated behavioral health services to pupils.
49440.4.
(a) (1) The county behavioral health agency shall designate and(2) “At risk of developing a
serious behavioral health condition” shall be defined, for purposes of this article, by the county behavioral health agency and the local educational agency.
(b) A behavioral health professional who provides services pursuant to a partnership program shall hold an active license with one of the following mental health classifications:
(1) A licensed clinical social worker or registered associate social worker as described in Section 4996.18 of the Business and Professions Code.
(2) A licensed marriage and family therapist (MFT) or MFT associate, as described in subdivision (b) of Section 4980.03 of the Business and Professions Code.
(3) A licensed professional
clinical counselor (LPCC) or LPCC associate, as described in subdivision (f) of Section 4999.12 of the Business and Professions Code.
(4) A licensed clinical psychologist or psychological intern.
(5) A licensed psychiatrist or psychiatric resident.
(6) A licensed psychiatric mental health nurse practitioner.
(c) A behavioral health professional who meets the licensing requirements of subdivision (b) may supervise other trained county behavioral health professionals, such as peer specialists, participating in the partnership program.
49440.5.
(a) The local educational agency shall provide school-based locations, including space at schools, appropriate for the delivery of behavioral health services.(b) The county behavioral health agency and participating entities, as appropriate, shall collaborate with the local educational agency to establish hours of service at mutually agreed upon school-based locations or a process for ensuring timely interventions when needed, or both. Additional service delivery models that
address local needs may be developed under the partnership program.
(c) The partnership program shall identify whether mental health services or substance use disorder services, or both, shall be provided at school-based locations. If the partnership program determines that only mental health or only substance use disorder services shall be provided at school-based locations, the partnership program shall develop a plan for each pupil who has been identified as needing behavioral health services that are not offered at school-based locations. The plan shall include a process for appropriate referral for the services not offered at a school-based location.
(c) The
(d) Except as provided in subdivision (c), the choice of setting for the delivery of behavioral health services shall be made in consultation with the pupil and the pupil’s parent or guardian and shall include consideration of the specified needs expressed by the pupil and the pupil’s parent or guardian. Behavioral health services may be provided at locations that are not at the school-based location for purposes of accommodating the individual needs of a pupil.
(d)
(e) If necessary and appropriate, as determined in consultation with the parent or guardian of the pupil being served and in compliance with state and federal law protecting the pupil’s right to privacy and parental rights, Medi-Cal covered behavioral health services may continue to be delivered at the school-based location beyond the delivery of brief initial interventions.
49440.6.
(a) The local educational(b) To support educators and school administrators in making appropriate referrals, the county behavioral health agency or participating entity shall provide mental health first aid and trauma-informed trainings to school personnel employed by the local educational agency. The local educational agency shall determine the appropriate school personnel to receive the training.
49440.7.
(a) To ensure timely access to behavioral health interventions at the earliest onset of a behavioral health condition, the designated(b) Brief initial interventions, for purposes of this article, consist of Medi-Cal covered behavioral health services that are essential health benefits, as defined in state and federal law, including Section 1300.67.005 of Title 28 of the California Code
of Regulations, or any successor regulation, and the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Public Law 110-343), and include, but are not limited to, mental health and substance use disorder services specified in California’s essential health benefits benchmark plan.
49440.8.
(a) (1) The array of behavioral health services provided pursuant to the partnership program shall be primarily Medi-Cal covered mental health services, and shall include prevention, intervention, and, if necessary, intensive intervention services.(2) “Intervention” and “intensive intervention services,” as used in paragraph (1), includes select Medi-Cal specialty mental health services that would be appropriately provided at the school-based location, such as assessments, plan developments, therapy, rehabilitation, collateral services, medication support services, therapeutic behavioral services, and intensive care coordination.
(3) The partnership program shall incorporate any changes to the “medical necessity” criteria adopted by the Healthy California for All Commission through the California Advancing and Innovating Medi-Cal process and approved by the federal Centers for Medicare and Medicaid Services.
(b) At the discretion of the partnership program, services developed using funding from the Mental Health Services Act, enacted by Proposition 63 at the November 2, 2004, statewide general election, as amended, that are appropriate for a school-based setting may be provided under the partnership program.
(c) Prevention services provided by the partnership program may include, but are not limited to, youth mental health first aid, suicide prevention and response training, trauma-informed practices, self-care for educators, parent training and support, critical incident stress management, mindfulness training, and screening and triage for crises.
(d) Behavioral health interventions provided to pupils through the partnership program shall comply with all applicable state and federal laws protecting a pupil’s right to privacy and parental rights.
49440.9.
(a) The local educational(b) (1) For privately insured pupils, the partnership program shall contact the private plan upon initiating the brief initial intervention services described in Section 49440.7 to facilitate a referral to the private plan’s network providers, as appropriate and consistent with professionally recognized standards of practice, and in consultation with the pupil and their parent or guardian, in compliance with all applicable state and federal laws protecting a pupil’s right to privacy and parental rights.
(2) If the private
plan is unable to meet timely access standards for care delivery required by state law, including Section 1300.67.2.2 of Title 28 of the California Code of Regulations, or any successor regulation, the designated county behavioral health professional shall continue and complete the brief initial intervention services.
(3) The private plan shall reimburse services provided by the designated county behavioral network health professional to pupils at the rate required by state and federal law for noncontracted providers.
(4) The private plan
shall meet requirements for the timely payment of claims for a contracted provider. If the private plan disputes the services provided or the amount, the private plan may submit a dispute to the Department of Managed Health Care, but the private plan shall comply with requirements for timely payment, including for services or amounts in dispute. The Department of Managed Health Care shall have trained staff available to address any disputes arising from the partnership program.
(c) If necessary and appropriate, as determined in consultation with the parent or guardian of the pupil being served and in compliance with all applicable state and federal laws protecting a pupil’s right to privacy and parental rights, the following shall occur:
(1) If the private plan can meet timely
access standards for care delivery, the designated behavioral health professional shall make a referral to the private plan provider.
(2) If the private plan cannot meet timely access standards for care delivery, the private plan and the county behavioral health agency shall negotiate a single case agreement to provide behavioral health services beyond the brief initial intervention services to determine reimbursement for additional services. If an agreement cannot be reached, the private plan shall report to the Department of Managed Health Care how it will ensure the pupil receives the necessary services in compliance with state and federal laws, including the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Public Law 110-343).
(d) Private plans are encouraged to contract with county behavioral health agencies and participating entities to serve pupils who are receiving services from the partnership program.
(e) The Department of Managed Health Care shall create a workgroup to recommend policies to expedite payments to county behavioral health agencies serving privately insured pupils under the partnership program. The workgroup shall consist of, but not be limited to, representatives from the County Behavioral Health Directors Association, local educational agencies, the California Association of Health Plans, and consumer groups representing children.
49441.
A partnership program shall annually report to the department, the State Department of Health Care Services, the Mental Health Services Oversight and Accountability Commission, and the Legislature, in compliance with Section 9795 of the Government Code, all of the following:(a) A brief description of the partnership program, including the service delivery model.
(b) The financial contribution made by the county behavioral health agency and local educational agency participating in the partnership program.
(c) The definition the partnership program uses to identify
pupils “at risk of developing a serious behavioral health condition,”
pursuant to paragraph (2) of subdivision (a) of Section 49440.4.
(d) The number of school-based locations involved in the partnership program.
(e) The number of pupils served in the last year.
(f) The number of pupils who receive school-based services beyond the brief initial intervention described in Section 49440.7.
(g) (1) The number of pupils who participate in the program who report functional improvement, as measured by the Child and Adolescent Needs and Strengths (CANS) assessment tool, broken down by those pupils who receive only the brief initial intervention described in Section 49440.7 and those that receive additional school-based
services.
(2) Only the relevant components of the CANS assessment tool, as determined by the treating designated county behavioral health professional, shall be required to be completed for non-Medi-Cal beneficiaries who receive brief initial interventions.
(h) The number of pupils who are identified with behavioral health problems who report a decrease in behavioral health symptoms between the start of the partnership program and after completing the brief initial intervention described in Section 49440.7.
(i) The number of pupils participating in the partnership program who are diagnosed with mental health disorders, including, but not
limited to, conduct disorder, oppositional defiant disorder, or disruptive behavior disorder, when they begin the program who report improvement after completing the brief initial intervention described in Section 49440.7.
(j) The number of pupils who are identified with behavioral health problems who report a decrease in behavioral health symptoms between the start of the partnership program and after completing services beyond the brief initial intervention described in Section 49440.7.
(k) The percentage of pupils and parents or guardians that report satisfaction with the services provided through the partnership program.
49441.1.
(a) (1) The requirements of this article are separate from the requirements that apply to pupils with individualized education programs, pursuant to Chapter 4 (commencing with Section 56300) of Part 30, and requirements related to special education local plan areas.(2) The partnership program shall establish a process that distinguishes the local policies, responsibilities, and interventions that are required through individualized education programs and relating to special education local plan areas. This process shall clearly distinguish through guidance and policies which pupils receive services as required by individualized education
programs and special education local plan areas, and which pupils have been
identified as needing services through the partnership program.
(b) (1) This article does not replace current county requirements related to crisis intervention protocols and the partnership program shall not provide crisis interventions. The county behavioral health agency and local educational agency shall establish processes for timely interventions that identify nonurgent, urgent, and crisis-related circumstances. The process shall include guidelines for when county crisis intervention is needed instead of timely interventions related to urgent or nonurgent needs.
(2) The partnership program shall not create a siloed delivery system. The partnership program shall establish a process to leverage community-based services and other resources, and a process
to identify local resources related to crisis intervention protocols and services.
