Amended  IN  Assembly  March 23, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 492

Introduced by Assembly Member Pellerin
(Coauthor: Assembly Member Schiavo)

February 07, 2023

An act relating to behavioral health. to add Article 5.52 (commencing with Section 14184.811) to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 492, as amended, Pellerin. Reproductive Medi-Cal: reproductive and behavioral health integration pilot program. programs.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services, including comprehensive perinatal services, among other reproductive health services, and specialty or nonspecialty mental health services and substance use disorder services, among other behavioral health services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law establishes the Family Planning, Access, Care, and Treatment (Family PACT) Program pursuant to a federal waiver, as part of the schedule of Medi-Cal benefits. Under existing law, the Family PACT Program provides comprehensive clinical family planning services to a person who has a family income at or below 200% of the federal poverty level and who is eligible to receive those services pursuant to the waiver. Under the Family PACT Program, comprehensive clinical family planning services include, among other things, contraception and general reproductive health care, and exclude abortion. Abortion services are covered under the Medi-Cal program.
This bill would, on or before July 1, 2024, subject to an appropriation, require the department to make grants, incentive payments, or other financial support available to Medi-Cal managed care plans to develop and implement reproductive and behavioral health integration pilot programs in partnership with identified qualified providers, in order to improve access to behavioral health services for beneficiaries with mild-to-moderate behavioral health conditions.
The bill would define “qualified provider” as a Medi-Cal provider that is enrolled in the Family PACT Program and that provides abortion- and contraception-related services. For funding eligibility, the bill would require a Medi-Cal managed care plan to identify the qualified providers and the services that will be provided through the pilot program, as specified.
The bill would, on or before July 1, 2024, subject to an appropriation, require the department to make grants or other financial support available to qualified providers for reproductive and behavioral health integration pilot programs, in order to support development and expansion of services, infrastructure, and capacity for the integration of behavioral health services for beneficiaries with mild-to-moderate behavioral health conditions.
For funding eligibility, the bill would require a qualified provider to identify both the patient population or gap in access to care and the types of services provided, as specified.
The bill would require the department to convene a working group, with a certain composition, to develop criteria for evaluating applications and awarding funding, to conduct an evaluation of the pilot programs, and to submit a report to the Legislature, as specified.

Existing law sets forth various reproductive health provisions within the jurisdiction of the State Department of Public Health and the State Department of Health Care Services, among other entities. Existing law governs various behavioral health services within the jurisdiction of the State Department of Health Care Services, the State Department of Public Health, the California Behavioral Health Planning Council, the Department of Health Care Access and Information, and county public health or behavioral health departments, among other entities. Under existing law, the State Department of Public Health licenses and regulates community clinics.

Existing law, the Maternal Mental Health Conditions Education, Early Diagnosis, and Treatment Act, requires a general acute care hospital or special hospital that has a perinatal unit to develop and implement a program to provide education and information to appropriate health care professionals and patients about maternal mental health conditions, as defined. Existing law sets forth other provisions relating to screening for those conditions.

This bill would state the intent of the Legislature to enact legislation that would establish a reproductive and behavioral health integration pilot program to support community clinics that are developing or expanding programs to provide screening, referrals, and interventions for Californians at risk for mild-to-moderate mental health conditions in reproductive health services facilities.

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

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


SECTION 1.

 Article 5.52 (commencing with Section 14184.811) is added to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, to read:
Article  5.52. Reproductive and Behavioral Health Integration Pilot Programs

14184.811.
 For purposes of this article, the following definitions apply:
(a) “Department” means the State Department of Health Care Services, unless otherwise specified.
(b) “Qualified provider” means a Medi-Cal provider that meets both of the following conditions:
(1) Is enrolled in the Family Planning, Access, Care, and Treatment (Family PACT) Program, as described in subdivision (aa) of Section 14132.
(2) Provides abortion- and contraception-related services.

14184.812.
 (a) On or before July 1, 2024, subject to an appropriation made by the Legislature for the purpose of this section, the department shall make grants, incentive payments, or other financial support available to Medi-Cal managed care plans to develop and implement reproductive and behavioral health integration pilot programs in partnership with identified qualified providers, in order to improve access to behavioral health services for beneficiaries with mild-to-moderate behavioral health conditions.
(b) To be eligible for grants, incentive payments, or other financial support, as described in subdivision (a), a Medi-Cal managed care plan shall identify both of the following:
(1) The qualified provider or providers that will provide services as part of the pilot program.
(2) The specific services that will be provided through the pilot program, which may include, but are not limited to, any of the following:
(A) Individual or group behavioral health evaluation and treatment, including counseling, psychotherapy, family therapy, and dyadic services.
(B) Psychological testing, when clinically indicated to evaluate a behavioral health condition.
(C) Outpatient services for purposes of monitoring drug therapy.
(D) Psychiatric consultation.
(E) Outpatient laboratory, drugs, supplies, and supplements.
(F) Screening for behavioral health concerns, including perinatal and postpartum conditions.
(G) Patient navigation, including to identify and access specialty mental health services.

14184.813.
 (a) On or before July 1, 2024, subject to an appropriation made by the Legislature for the purpose of this section, the department shall make grants or other financial support available to qualified providers for reproductive and behavioral health integration pilot programs, in order to support development and expansion of services, infrastructure, and capacity for the integration of behavioral health services for beneficiaries with mild-to-moderate behavioral health conditions.
(b) To be eligible for grants or other financial support, as described in subdivision (a), a qualified provider shall identify both of the following:
(1) The patient population that will be served or the gap in access to care that will be addressed through the pilot program.
(2) The types of services that will be provided or for which infrastructure or capacity will be expanded through the pilot program. Services may include, but are not limited to, any of the services listed in paragraph (2) of subdivision (b) of Section 14184.812.

14184.814.
 (a) The department shall convene a working group to do all of the following:
(1) Develop criteria for evaluating applications and awarding grants, incentive payments, or other financial support available pursuant to Sections 14184.812 and 14184.813.
(2) Conduct an evaluation of the pilot programs funded pursuant to Sections 14184.812 and 14184.813.
(3) Submit a report to the Legislature, in accordance with Section 9795 of the Government Code, that summarizes the pilot programs funded pursuant to Sections 14184.812 and 14184.813, and the outcomes of each pilot program, and that identifies best practices for integrating behavioral health services in reproductive health care settings.
(b) The working group convened pursuant to subdivision (a) shall include representatives of all of the following:
(1) The department.
(2) The Department of Managed Health Care.
(3) The Department of Health Care Access and Information.
(4) The California Health and Human Services Agency.
(5) Qualified providers.
(6) Consumer advocates.
(7) Other stakeholders that the department deems appropriate.

SECTION 1.

It is the intent of the Legislature to enact legislation that would establish a reproductive and behavioral health integration pilot program to support community clinics that are developing or expanding programs to provide screening, referrals, and interventions for Californians at risk for mild-to-moderate mental health conditions in reproductive health services facilities.