California Senate Bill 1019 expands mental health benefits

To expand access to mental health services, on September 30, 2022, the Governor of California approved Senate Bill 1019, which amends the California Welfare & Institutions Code with respect to Medi-Cal Managed Care Plans (“MMCP”). By January 1, 2025, MMCPs must develop and implement an annual awareness and education plan for their enrollees regarding the mental health benefits covered by MMCPs. MMCPs will also be required to conduct annual outreach and education activities to inform primary care providers of the mental health benefits covered by the MMCP.

Current law requires MMCPs to cover certain mental health services. These services include individual and group mental health assessment and treatment, psychological testing, outpatient services for drug therapy monitoring, outpatient psychiatric consultations and laboratory services, medications and supplies. Under the new law, MMCPs will seek input from plan stakeholders, including a community advisory committee established by MMCP, and local stakeholders representing diverse racial and ethnic communities to inform the development of the outreach plan and of education. The outreach and education plan should also incorporate the results of the MMCP population needs assessment and an assessment of the utilization of covered mental health benefits by race, ethnicity, language, age, sexual orientation, gender identity and disability. Additionally, the MMCP must meet cultural and linguistic appropriateness standards while incorporating best practices in stigma reduction and increasing enrollees’ access to mental health benefits. The outreach and education plan will be subject to review and approval by the California Department of Health Services (DHCS) prior to implementation.

Under the new law, MMCPs will be subject to additional oversight by DHCS. Once every 3 years, DHCS will assess enrollees’ experience with mental health benefits covered by MMCPs. By January 1, 2025, DHCS will have adopted survey tools and methodologies to assess consumer experience across a number of factors, including receipt of timely treatment, cultural competence providers, communicating with the MMCP, and receiving treatment and information from the MMCP. Beginning in April 2026, the DHCS will release its findings every 3 years, which will include recommendations to MMCPs to improve access to covered mental health benefits.

Going forward, MMCPs should ensure they have access to the necessary tools to capture the required data regarding mental health utilization across a diverse demographic. MMCPs will also need to update plan communication policies and invest in staff training to disseminate information about the mental health benefits of the MMCP to enrollees and primary care providers.

Andrew Yu-Chih also contributed to this article.

© Copyright 2022 Squire Patton Boggs (USA) LLPNational Law Review, Volume XII, Number 294

Norman D. Briggs