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AB-470 Medi-Cal: specialty mental health services: performance outcome dashboard.(2017-2018)

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Date Published: 03/29/2017 04:00 AM
AB470:v97#DOCUMENT

Amended  IN  Assembly  March 28, 2017
Amended  IN  Assembly  March 23, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 470


Introduced by Assembly Member Arambula

February 13, 2017


An act to add Section 14719 to the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 470, as amended, Arambula. Medi-Cal: specialty mental health services: performance outcome dashboard.
Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which basic health care services are provided to qualified low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that speciality mental health services are covered under the Medi-Cal program for eligible Medi-Cal beneficiaries, including both adults and children, and coverage for those services is provided through mental health managed care plans. Existing law requires the department to develop a performance outcome system for Early and Periodic Screening, Diagnosis, and Treatment mental health services provided to eligible Medi-Cal beneficiaries under 21 years of age.
This bill would require the department, in collaboration with the California Health and Human Services Agency, to create a performance outcome dashboard, as specified, for specialty mental health services provided to eligible Medi-Cal beneficiaries 20 years of age and older. beneficiaries. The bill would require the department, commencing no later than January 15, 2018, and quarterly thereafter, to convene a stakeholder advisory committee comprised of specified representatives, including representatives of providers, consumers, and counties, to inform the creation of the performance outcome dashboard for specialty mental health services. The bill would require the department to consider specified objectives, including high-quality and accessible specialty mental health services for eligible adults, in developing the performance outcome dashboard, and would require the dashboard to include both statewide and plan-specific data, disaggregated by specified categories, in certain areas, including, among others, mental health disparities and quality indicators.
This bill would require the department to provide the dashboard to all fiscal committees and appropriate policy committees of the Legislature no later than December 31, 2018. The bill would require the department, commencing January 1, 2019, to consult with the stakeholder advisory committee to incorporate additional components into the dashboard and to make recommendations for statewide quality improvement and efforts to reduce mental health disparities, as specified. The bill, commencing January 1, 2019, would require the department to provide quarterly updates to the dashboard and to post the updated report on the department’s Internet Web site. The bill would authorize the department to implement, interpret, or make specific the requirements of the bill by all-county letters, plan letters, plan or provider bulletins, or similar instructions.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 14719 is added to the Welfare and Institutions Code, to read:

14719.
 (a) It is the intent of the Legislature to develop a performance outcome dashboard for specialty mental health services that will reduce mental health disparities, improve outcomes at the individual and system levels, and inform fiscal decisionmaking related to the purchase of services.
(b) Consistent with the Special Terms and Conditions of the Medi-Cal Specialty Mental Health Services Waiver, as approved pursuant to Section 1915(b) of the Social Security Act (42 U.S.C. Sec. 1396n(b)), the State Department of Health Care Services, in collaboration with the California Health and Human Services Agency, shall create a performance outcome dashboard for specialty mental health services provided to eligible Medi-Cal beneficiaries 20 years of age and older. beneficiaries.
(1) Commencing no later than January 15, 2018, and quarterly thereafter, the department shall convene a stakeholder advisory committee comprised of representatives of providers, consumer advocates, consumers, family members, counties, and the Legislature. This consultation shall inform the creation of the performance outcome dashboard for specialty mental health services.
(2) In developing the performance outcome dashboard for specialty mental health services, the department shall consider the following objectives, among others:
(A) High-quality and accessible specialty mental health services for eligible adults, consistent with federal law.
(B) Information that improves practice at the individual, program, and system levels.
(C) Minimization of costs by building upon existing resources to the fullest extent possible.
(D) Reliable data that are collected and analyzed in a timely fashion.
(E) Elimination or reduction of mental health disparities and strategies for addressing the social determinants of mental health.
(3) The performance outcome dashboard for specialty mental health services shall consider evidence-based models for performance outcome systems, federal requirements, including the Special Terms and Conditions of the Medi-Cal Specialty Mental Health Services Waiver, as approved pursuant to Section 1915(b) of the Social Security Act (42 U.S.C. Sec. 1396n(b)), the review by the External Quality Review Organization (EQRO), and the Medicaid Managed Care Quality Rating System, and timelines for implementation at the provider, county, and state levels.
(4) At a minimum, the performance outcome dashboard for specialty mental health services shall include both statewide and plan-specific data in the following areas:
(A) Mental health disparities.
(B) Measurement of timely access to services, including waiting time to assessment and waiting time to first appointment.
(C) Language capacity and access.
(D) Quality indicators, including beneficiary experience and clinical outcomes.
(E) Utilization and penetration rates.
(5) (A) Data required pursuant to paragraph (4) shall be disaggregated by age, sex, gender identity, race, ethnicity, primary language, sexual orientation, ZIP Code, and any other factors for which there is peer-reviewed evidence of mental health disparities.
(B) The department shall not report any demographic data under paragraph (4) or this paragraph that would permit identification of individuals.
(6) (A) The department shall provide the performance outcome performance outcome dashboard for specialty mental health services described in this section to all fiscal committees and appropriate policy committees of the Legislature no later than December 31, 2018.
(B) Commencing January 1, 2019, the department shall provide quarterly updates to the performance outcome dashboard for specialty mental health and shall post the updated report on the department’s Internet Web site.
(7) Commencing January 1, 2019, the department shall consult with the stakeholder advisory committee specified in paragraph (1) to do both of the following:
(A) Incorporate additional components into the performance outcome dashboard, including, but not limited to, components concerning the reduction of mental health disparities, timely access to services, language access, and quality and utilization measures, relating to mental health services obtained through Medi-Cal managed care plans.
(B) Make recommendations for statewide quality improvement and efforts to reduce mental health disparities based on information reported in the performance outcome dashboard.
(8) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this subdivision by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action.