Bill Text: CA AB763 | 2019-2020 | Regular Session | Amended


Bill Title: Medi-Cal specialty mental health services.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Engrossed) 2019-08-12 - In committee: Referred to APPR. suspense file. [AB763 Detail]

Download: California-2019-AB763-Amended.html

Amended  IN  Senate  July 01, 2019
Amended  IN  Senate  June 18, 2019
Amended  IN  Assembly  May 16, 2019
Amended  IN  Assembly  April 11, 2019
Amended  IN  Assembly  March 25, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill No. 763


Introduced by Assembly Member Gray

February 19, 2019


An act to amend Section 14683 of, and to add Section 14682.2 to, the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 763, as amended, Gray. Medi-Cal specialty mental health services.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, including specialty mental health services, and Early and Periodic Screening, Diagnosis, Diagnostic, and Treatment services for an individual under 21 years of age. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, one of the methods by which Medi-Cal services are provided is pursuant to contracts with various types of managed care health plans, including mental health plans that provide specialty mental health services. Existing law requires the department to ensure that Medi-Cal managed care contracts include a process for screening, referral, and coordination with mental health plans of specialty mental health services. Existing law requires the department to convene a steering committee to provide advice on the transition and continuing development of the Medi-Cal mental health managed care systems, and to ensure that the mental health plans comply with various standards, such as maintaining a system of outreach to enable Medi-Cal beneficiaries and providers to participate in and access Medi-Cal specialty mental health services under the mental health plans.
This bill would require, on or before March 31, 2020, the department to convene a stakeholder workgroup, including representatives from the County Behavioral Health Directors Association of California, to identify all forms currently used by mental health plan contractors for purposes of determining eligibility and reimbursement for specialty mental health services that are provided under Early and Periodic Screening, Diagnosis, Diagnostic, and Treatment Program, and to develop standard forms. The bill would also authorize the department and the workgroup to develop a list of department-approved nonstandard forms. The bill would require the standard forms to be completed by January 1, 2021. The bill would require representatives from the department and the workgroup to provide, on or before July 1, 2021, regional trainings for mental health plans and their provider networks on the standard forms. The bill would require mental health plan contractors to distribute the training material and standard forms to their provider networks, and, to commence, by July 1, 2021, exclusively using the standard forms, unless they use department-approved nonstandard forms.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 14682.2 is added to the Welfare and Institutions Code, to read:

14682.2.
 (a) (1) On or before March 31, 2020, the department shall convene a stakeholder workgroup to identify all forms currently used by county mental health plan contractors for purposes of determining eligibility and reimbursement for specialty mental health services that are provided under the Early and Periodic Screening, Diagnosis, Diagnostic, and Treatment Program, and to develop standard forms. The standard forms shall include forms for the intake of, assessment of, and the treatment planning for, Medi-Cal beneficiaries who are eligible for those services. The standard forms shall be used by all county mental health plan contractors, and providers who render services under those contracts, when serving eligible Medi-Cal beneficiaries. The standard forms shall be completed by January 1, 2021.
(2) The department and the stakeholder workgroup may develop and maintain a list of department-approved nonstandard forms (nonstandard forms list). The nonstandard forms list may be used by county mental health plan contractors, in addition to the standard forms described in paragraph (1), to determine eligibility and reimbursement for specialty mental health services provided under the Early and Periodic Screening, Diagnosis, Diagnostic, and Treatment Program. The department shall post this list on its internet website.
(3) The department shall ensure that all forms developed pursuant to this section comply with the federal Medicaid program law and regulations and applicable state and federal privacy laws that govern medical information, including the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code) and the federal Health Insurance Portability and Accountability Act of 1996.
(b) (1) The stakeholder workgroup shall include representatives from the County Behavioral Health Directors Association of California, the County Counsels’ Association of California, the County Welfare Directors Association of California, and associations that represent children’s hospitals, foster youth, parents and caregivers, community-based children’s mental health providers, and children’s health legal advocates. The stakeholder workgroup shall also include at least one representative each from the behavioral health program of a small county, a medium county, and a large county.
(2) For purposes of this subdivision, the following definitions shall apply:
(A) “Small county” means a county with a population of less than 300,000 people.
(B) “Medium county” means a county with a population of 300,000 people to 700,000 people, inclusive.
(C) “Large county” means a county with a population of greater than 700,000 people.
(c) (1) On or before July 1, 2021, representatives from the department and the workgroup shall provide regional trainings for mental health plans and their provider networks on the standard forms, as described in paragraph (1) of subdivision (a), to ensure that individuals receive adequate training to appropriately complete these forms.
(2) (A) Training material developed pursuant to paragraph (1) shall be made available to county mental health plan contractors, as determined appropriate by the department, for use in local trainings.
(B) County mental health plan contractors shall distribute the training material and standard forms, as described in paragraph (1) of subdivision (a), to their provider networks.

SEC. 2.

 Section 14683 of the Welfare and Institutions Code is amended to read:

14683.
 The department shall ensure all of the following:
(a) Mental health plans include a process for screening, referral, and coordination with other necessary services, including, but not limited to, health, housing, and vocational rehabilitation services. For Medi-Cal eligible children, the mental health plans shall provide coordination with education programs and any necessary medical or rehabilitative services, including, but not limited to, those provided under the California Children’s Services Program (Article 5 (commencing with Section 123800) of Chapter 3 of Part 2 of Division 106 of the Health and Safety Code) and the Child Health and Disability Prevention Program (Article 6 (commencing with Section 124025) of Chapter 3 of Part 2 of Division 106 of the Health and Safety Code), and those provided by a fee-for-service provider or a Medi-Cal managed care plan. This subdivision does not establish any higher level of service from a county than is required under existing law. The mental health plan shall not be liable for the failure of other agencies responsible for the provision of nonmental health services to provide those services or to participate in coordination efforts.
(b) Mental health plans include a system of outreach to enable Medi-Cal beneficiaries and providers to participate in and access Medi-Cal specialty mental health services under the plans, consistent with existing law.
(c) Standards for quality and access developed by the department in consultation with the steering committee established pursuant to Section 14682.1 are included in mental health plans serving Medi-Cal beneficiaries.
(d) (1) Mental health plans and the provider networks of these plans utilize the standard forms developed by the department and stakeholder workgroup, as described in paragraph (1) of subdivision (a) of Section 14682.2, for performing the intake of, the assessment of, and the treatment planning for, Medi-Cal beneficiaries who are eligible for specialty mental health services under the Early and Periodic Screening, Diagnosis, Diagnostic, and Treatment Program.
(2) No later than July 1, 2021, mental health plans shall commence using the standard forms described in paragraph (1). After July 1, 2021, mental health plans shall not use any other forms related to intake, assessment, treatment planning, eligibility determination, or reimbursement for specialty mental health services provided under the Early and Periodic Screening, Diagnosis, Diagnostic, and Treatment Program, except as specified in paragraph (2) of subdivision (a) of Section 14682.2.

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