On Sept. 25, California Gov. Gavin Newsom signed a package of bills designed to help close gaps in behavioral care, including a bill that requires health plans and insurers to cover medically necessary treatment for all mental health and substance use disorders.
Newsom signed SB 855 authored by Sen. Scott Wiener (D-San Francisco), which strengthens California’s mental health parity statute by requiring commercial health plans and insurers to provide full coverage for the treatment of all mental health conditions and substance use disorders and establishes specific standards for what constitutes medically necessary treatment and criteria for the use of clinical guidelines.
According to a news story on the website Cal Matters, “current state law requires health plans to cover medically necessary treatment of just nine serious mental illnesses; the new law would expand that coverage to include a much broader array of mental health issues, notably substance use disorder and addiction, among others. Current state law requires health plans to cover medically necessary treatment of just nine serious mental illnesses; the new law would expand that coverage to include a much broader array of mental health issues, notably substance use disorder and addiction, among others.”
The California Association of Health Plans had expressed opposition to the bill. In a statement after the Legislature approved the bill, it said, “This bill recklessly defines medical necessity in a way that will undermine the ability of providers to determine what is clinically appropriate for their patients. The bill also opens the door for unlicensed providers and facilities to treat those suffering from mental health and substance use disorders, which puts vulnerable patients at risk.”
In a statement, Sen. Wiener described why he thought the legislation was necessary. “Mental healthcare is essential to a person’s overall health, and today, we reaffirmed that people must have access to care for mental health and addiction challenges. California’s mental health parity law has huge loopholes — which the insurance industry has used to deny critically important care — and today that loophole was closed. SB 855 sends a powerful message to the nation that California prioritizes the mental health of its residents. I’m proud of my colleagues and the governor for getting it and enacting this legislation into law.”
And in a press release, Newsom’s office said the bill expands on the governor’s efforts to improve the state’s behavioral health delivery system and help better serve individuals experiencing mental illness.
In January, Newsom formed a Behavioral Health Task Force to address the urgent mental health and substance use disorder needs across California.
In his State of the State address, the governor said Mental Health Services Act (MHSA) funds should be used for substance abuse treatment and not just mental healthcare. The governor signed AB 2265 by Assemblymember Sharon Quirk-Silva (D-Fullerton), which clarifies that specified MHSA funds can be used for treatment of co-occurring mental health and substance use disorders. Counties will now be able to use MHSA funds to assess and treat individuals with a co-occurring disorder, increasing access to substance use disorder treatment, improving care coordination and leading to a more integrated behavioral health care system.
Other bills in this package will also divert, when appropriate, individuals in crisis at emergency rooms to sobering centers and mental health facilities and encourage the creation of a state office to identify and address causes of suicide.
SB 803 by Sen. Jim Beall (D-San Jose) supports statewide standards for behavioral health “peer support specialists” and adds these services as an option in Medi-Cal. Peer support specialists are people with lived experience with mental health and/or substance use disorders and are in a unique position to earn trust and build bridges for people on the path to recovery. Statewide standards will ensure consistency and quality of service while offering a level of validity and respect to the position, while satisfying a federal requirement to allow Medi-Cal billing.
Newsom also signed AB 1976 by Assemblymember Susan Talamantes Eggman (D-Stockton), which expands county use of court-ordered outpatient treatment.
“The Assisted Outpatient Treatment demonstration project started by Laura’s Law has shown for many years that we have the tools to provide effective, community-based mental health treatment to those with the greatest need. As a social worker I’ve long fought for the extension of these critical services, and expanding this program and finally making it permanent will ensure greater care for the people of California,” said Assemblymember Eggman, in a statement.