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AB-2193 Maternal mental health.(2017-2018)

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Date Published: 07/02/2018 02:00 PM
AB2193:v96#DOCUMENT

Amended  IN  Senate  July 02, 2018
Amended  IN  Senate  June 21, 2018
Amended  IN  Assembly  April 30, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 2193


Introduced by Assembly Member Maienschein
(Coauthors: Assembly Members Gonzalez Fletcher, Lackey, Rodriguez, and Voepel)

February 12, 2018


An act to add Section 1367.625 to, and to add Article 6 (commencing with Section 123640) to Chapter 2 of Part 2 of Division 106 to, the Health and Safety Code, and to add Section 10123.867 to the Insurance Code, relating to health care.


LEGISLATIVE COUNSEL'S DIGEST


AB 2193, as amended, Maienschein. Maternal mental health.
Existing law provides for the licensure and regulation of various healing arts professions, including, but not limited to, physicians and surgeons, by various boards within the Department of Consumer Affairs. Existing law imposes certain fines and other penalties for, and authorizes these boards to take disciplinary action against licensees for, violations of the provisions governing those professions.
This bill would require, by July 1, 2019, a licensed health care practitioner who provides prenatal or postpartum care for a patient, or pediatric care for an infant, patient to offer to screen or appropriately screen a mother for maternal mental health conditions. The bill would require a licensed health care practitioner to appropriately screen for maternal mental health conditions during pregnancy and the postpartum period if the mother agrees to be screened.
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.
This bill would require health care service plans and health insurers, by July 1, 2019, to develop, consistent with sound clinical principles and processes, a maternal mental health clinical case management program to address mental and behavioral issues, program, as specified. The bill would, among other things, require the health care service plan and health insurer to annually update the clinical guidelines and criteria related to the maternal mental health clinical case management program, as may be appropriate. 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.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

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


SECTION 1.

 Section 1367.625 is added to the Health and Safety Code, to read:

1367.625.
 (a) By July 1, 2019, a health care service plan shall develop a maternal mental health clinical case management program to address mental and behavioral issues. designed to ensure timely access to services and promote quality and cost-effective outcomes. The health care service plan shall support efficacious treatment for the reduction of symptoms. The program shall be developed consistent with sound clinical principles and processes. The health care service plan shall annually update the clinical guidelines and criteria related to the maternal mental health clinical case management program, as may be appropriate, and these The program guidelines and criteria shall be made available upon request to medical providers, including a contracting obstetric provider.
(b) For the purposes of this section, the following terms have the following meanings:
(1) “Contracting obstetric provider” means an individual who is certified or licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or an initiative act referred to in that division, and who is contracted with the enrollee’s health care service plan to provide services under the enrollee’s plan contract.
(2) “Maternal mental health” means a mental health condition that occurs during pregnancy or during the postpartum period and includes, but is not limited to, postpartum depression.

SEC. 2.

 Article 6 (commencing with Section 123640) is added to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, to read:
Article  6. Maternal Mental Health

123640.
 (a) By July 1, 2019, a licensed health care practitioner who provides prenatal or postpartum care for a patient, or pediatric care for an infant, patient shall ensure that the mother is offered screening or is appropriately screened for maternal mental health conditions. If the mother agrees to the screening, then the licensed health care practitioner shall appropriately screen for maternal mental health conditions during pregnancy and the postpartum period.
(b) This section shall not apply to emergency services or care, as defined in Section 1317.1.
(c) This section does not preclude any licensed or certified provider acting within his or her scope of practice from screening for maternal mental health conditions.
(d) For purposes of this section, the following definitions apply:
(1) “Maternal mental health condition” means a mental health condition that occurs during pregnancy or during the postpartum period and includes, but is not limited to, postpartum depression.
(2) “Health care practitioner” means a physician and surgeon, nurse practitioner, physician assistant, nurse midwife, or a midwife licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code or an initiative act referred to in that division and is acting within his or her scope of practice.

SEC. 3.

 Section 10123.867 is added to the Insurance Code, to read:

10123.867.
 (a) By July 1, 2019, a health insurer that provides a policy of health insurance that provides coverage for the essential health benefits as set forth in the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), shall develop a maternal mental health clinical case management program to address mental and behavioral issues. designed to ensure timely access to services to promote quality and cost-effective outcomes. The health insurer shall support efficacious treatment for the reduction of symptoms. The program shall be developed consistent with sound clinical principles and processes. The health insurer shall annually update the clinical guidelines and criteria related to the maternal mental health clinical case management program, as may be appropriate, and these The program guidelines and criteria shall be made available upon request to medical providers, including a contracting obstetric provider.
(b) For the purposes of this section, the following terms have the following meanings:
(1) “Contracting obstetric provider” means an individual who is certified or licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or an initiative act referred to in that division, and who is contracted with the insured’s health insurer to provide services under the insured’s health insurance policy.
(2) “Maternal mental health” means a mental health condition that occurs during pregnancy or during the postpartum period and includes, but is not limited to, postpartum depression.

SEC. 4.

 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.