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AB-2360 Telehealth: mental health.(2019-2020)

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Date Published: 05/07/2020 09:00 PM
AB2360:v98#DOCUMENT

Amended  IN  Assembly  May 07, 2020

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 2360


Introduced by Assembly Member Maienschein

February 18, 2020


An act to add Part 4.2 (commencing with Section 5887) of Division 5 to the Welfare and Institutions Section 1367.626 to the Health and Safety Code, and to add Section 10123.868 to the Insurance Code, relating to mental health.


LEGISLATIVE COUNSEL'S DIGEST


AB 2360, as amended, Maienschein. Maternal and child mental health: telepsychiatry pilot project. Telehealth: mental health.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of that act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plan contracts and health insurance policies that provide hospital, medical, or surgical coverage to provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses, as defined, of a person of any age. Existing law also requires health care service plans and health insurers, by July 1, 2019, to develop maternal mental health programs, as specified.
This bill would require health care service plans and health insurers, by January 1, 2021, to establish a telehealth consultation program that provides providers who treat children and pregnant and postpartum persons with access to a psychiatrist, as specified, in order to more quickly diagnose and treat children and pregnant and postpartum persons suffering from mental illness. The bill would require the consultation to be done by telephone or telehealth video, and would authorize the consultation to include guidance on providing triage services and referrals to evidence based treatment options, including psychotherapy. The bill would require health care service plans and insurers to communicate information relating to the telehealth program at least twice a year in writing. The bill would require health care service plans and health insurers to maintain records and data pertaining to the utilization of the program and the availability of psychiatrists in order to facilitate ongoing changes and improvements, as necessary. The bill would exempt certain specialized health care service plans and health insurers from these provisions. Because a willful violation of the bill’s requirement by a health care service plan would be a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.

Existing law requires the State Department of Public Health to develop and maintain a statewide community-based comprehensive perinatal services program to, among other things, ensure the appropriate level of maternal, newborn, and pediatric care services necessary to provide the healthiest outcomes for mothers and infants. Existing law also requires the department, until January 1, 2023, to investigate and apply for federal funding opportunities to support maternal mental health.

Existing law requires licensed health care practitioners providing prenatal or postpartum care to screen or offer to screen mothers for maternal mental health conditions, and health care service plans and health insurers to develop maternal mental health programs, as specified. Existing law also requires each general acute care hospital with a perinatal unit to develop and implement a program to provide education and information to postpartum women, families, and specified hospital employees regarding maternal mental health conditions, including postpartum depression.

This bill would require the State Department of Health Care Services to contract with a third-party provider to establish and administer a centralized telepsychiatry doctor-to-doctor consultation service to provide primary care physicians with specialized information regarding the mental health issues of children and perinatal women. The bill would require the department to choose 3 to 5 counties to participate in the program on or before July 1, 2021. The bill would require the department to contract with an outside evaluation firm to evaluate the pilot program and to issue a report on the program on or before November 1, 2023.

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

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


SECTION 1.

 Section 1367.626 is added to the Health and Safety Code, to read:

1367.626.
 (a) In order to more quickly diagnose and treat children and pregnant and postpartum persons suffering from mental illness, by January 1, 2021, a health care service plan shall establish a telehealth consultation program that provides providers who treat children and pregnant and postpartum persons with access to a psychiatrist during standard provider hours, which may include evenings and weekends. The telehealth consultation program shall provide consultation by telephone or telehealth video, and may include guidance on providing triage services and referrals to evidence-based treatment options, including psychotherapy.
(b) A health care service plan shall communicate information relating to the telehealth program and its availability to contracting medical providers who treat children and pregnant and postpartum persons, including pediatricians, obstetricians, and primary care providers, at least twice a year in writing.
(c) A health care service plan shall maintain records and data pertaining to the utilization of its telehealth consultation program and the availability of psychiatrists in order to facilitate ongoing changes and improvements to the program, as necessary.
(d) This section does not apply to a specialized health care service plan, except a specialized behavioral health-only plan offering professional mental health services.

SEC. 2.

 Section 10123.868 is added to the Insurance Code, to read:

10123.868.
 (a) In order to more quickly diagnose and treat children and pregnant and postpartum persons suffering from mental illness, by January 1, 2021, a health insurer shall establish a telehealth consultation program that provides providers who treat children and pregnant and postpartum persons with access to a psychiatrist during standard provider hours, which may include evenings and weekends. The telehealth consultation program shall provide consultation by telephone or telehealth video, and may include guidance on providing triage services and referrals to evidence-based treatment options, including psychotherapy.
(b) A health insurer shall communicate information relating to the telehealth program and its availability to contracting medical providers who treat children and pregnant and postpartum persons, including pediatricians, obstetricians, and primary care providers, at least twice a year in writing.
(c) A health insurer shall maintain records and data pertaining to the utilization of its telehealth consultation program and the availability of psychiatrists in order to facilitate ongoing changes and improvements to the program, as necessary.
(d) This section does not apply to a specialized health insurer, except a specialized behavioral health-only insurer offering professional mental health services.

SEC. 3.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.
SECTION 1.Part 4.2 (commencing with Section 5887) is added to Division 5 of the Welfare and Institutions Code, to read:
4.2.Child and Perinatal Women Telepsychiatry Program
5887.

(a)The State Department of Health Care Services shall contract with a third-party provider, as specified in Section 5887.2, to establish and administer a centralized telepsychiatry doctor-to-doctor consultation service to provide primary care physicians with specialized information regarding the mental health issues of children and perinatal women.

(b)The department shall establish a process by which counties may apply and the department shall choose three to five counties to participate in the pilot program and receive access to the telepsychiatry consultation services. Participating counties shall be selected on or before July 1, 2021. The department shall use the following criteria to choose the participating counties:

(1)At least one large county, one medium-sized county, and one small county shall be selected.

(2)Diversity of demographics, including both urban and rural counties and counties of varying sizes and locations in the state, shall be considered.

(3)The department shall prioritize counties that lack accessibility to mental health providers for children and perinatal women.

(4)The county’s ability to comply with the requirements of Section 5887.4 and the reporting requirements necessary to produce the report required in Section 5887.6.

5887.2.

(a)The department shall require all of the following from the third-party entity with which it contracts to provide the telepsychiatry consultation services:

(1)The entity shall establish and administer a call-in or video conference line that is free to enrolled providers in the participating counties.

(2)Consulting staff shall be available in real time, 24 hours a day, 7 days a week.

(3)Consulting staff shall be mental health professionals, including psychiatrists or psychologists, with adequate training in maternal and child mental health.

(4)The entity shall create and distribute marketing materials and training tools to educate frontline providers in participating counties about enrolling in and accessing the telepsychiatry consultation services line.

(5)The entity shall provide metrics to the department and the evaluation firm contracted pursuant to Section 5887.6 relating to use of telepsychiatry services, by county, and any other information required to produce the report required in Section 5887.6.

(b)(1)Services provided through the telepsychiatry consultation services program shall include, but not be limited to, all of the following:

(A)Assistance in understanding the range of mental health disorders that can affect children and perinatal women.

(B)Signs and symptoms of mental health disorders in children and perinatal women.

(C)Important nuances between disorders.

(D)A menu of treatment options to offer the patient.

(E)Safe medications and dosing guidelines.

(2)The consulting staff shall assist the primary care physician to develop a treatment plan in line with patient preferences and needs.

5887.4.

Counties that are chosen to participate in the pilot program may use county mental health funds, including innovation funds provided pursuant to Section 5892 to the extent those funds are available and may be used in accordance with the provisions of the Mental Health Services Act, to do all of the following:

(a)Train providers on the need for, and availability of, the telepsychiatry consultation services line and enroll providers in the service.

(b)Create and make available lists of in-network or contracted therapists and support groups for both parents and children and perinatal women, and lists of providers available via telepsychiatry.

(c)Coordinate with other mental health services for children and perinatal women.

(d)Establish local support groups for children and perinatal women in need of mental health services.

5887.6.

(a)The department shall contract with an outside evaluation firm to evaluate the pilot program and shall issue a report on the program on or before November 1, 2023.

(b)(1)A report to be submitted pursuant to this section shall be submitted in compliance with Section 9795 of the Government Code.

(2)Pursuant to Section 10231.5 of the Government Code, this section is repealed on January 1, 2028.