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

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Date Published: 10/09/2017 09:00 PM
AB470:v93#DOCUMENT

Assembly Bill No. 470
CHAPTER 550

An act to add Section 14707.7 to the Welfare and Institutions Code, relating to Medi-Cal.

[ Approved by Governor  October 07, 2017. Filed with Secretary of State  October 07, 2017. ]

LEGISLATIVE COUNSEL'S DIGEST


AB 470, Arambula. Medi-Cal: specialty mental health services: performance outcome reports.
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 specialty 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, commencing no later than January 15, 2018, and as needed thereafter, in consultation with specified stakeholders, to inform the updates to, and build upon, the performance outcomes system reports for specialty mental health services developed for Early and Periodic Screening, Diagnosis, and Treatment mental health services provided to eligible Medi-Cal beneficiaries under 21 years of age and under the Special Terms and Conditions of the Medi-Cal Specialty Mental Health Services Waiver in order to provide data to inform strategies to reduce mental health disparities for specialty mental health services provided to all eligible Medi-Cal beneficiaries. The bill would require the department to consider specified objectives, including high-quality, culturally and linguistically competent, and accessible specialty mental health services for all eligible beneficiaries, in building upon the performance outcomes reports for specialty mental health services, and would require the performance outcomes report for specialty mental health services to be produced using existing data collected by the state, stratified at statewide and county levels and by specified data elements in certain areas, including, among others, access and quality.
This bill would require the department to publish, by December 31, 2018, the performance outcomes reports based on available data for specialty mental health services on the department’s Internet Web site, and to provide the performance outcomes reports to the Legislature by December 31, 2018. The bill would require the department, commencing January 1, 2019, and on an as-needed basis thereafter, to consult with specified stakeholders to incorporate additional components into the performance outcomes reports and to make recommendations for statewide quality improvement and efforts to reduce mental health disparities, as specified. The bill, commencing January 1, 2019, and annually thereafter, would require the department to update the performance outcomes reports for specialty mental health services and to post the updated reports 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 14707.7 is added to the Welfare and Institutions Code, to read:

14707.7.
 (a) It is the intent of the Legislature to build upon performance outcomes system reports the department has developed pursuant to Section 14707.5 and the Special Terms and Conditions of the Medi-Cal Specialty Mental Health Services Waiver, as approved pursuant to Section 1915(b) of the federal Social Security Act (42 U.S.C. Sec. 1396n(b)), in order to provide data to inform strategies to reduce mental health disparities.
(b) (1) Commencing no later than January 15, 2018, and as needed thereafter, the department shall consult with stakeholders, including, but not limited to, subject-matter experts who represent providers, consumer advocates, consumers, family members, counties, and the Legislature, to inform the updates to the performance outcomes reports for specialty mental health that the department developed pursuant to Section 14707.5 and the Special Terms and Conditions of the Medi-Cal Specialty Mental Health Services Waiver. The stakeholder consultation shall continuously inform the development of performance outcome and disparities reduction measures.
(2) In building upon the performance outcomes reports for specialty mental health services, the department shall also consider both of the following objectives, among others:
(A) High-quality, culturally and linguistically competent, and accessible specialty mental health services for all eligible beneficiaries, consistent with federal law.
(B) Strategies to reduce mental health disparities.
(3) The performance outcomes reports for specialty mental health services shall also consider the Special Terms and Conditions of the Medi-Cal Specialty Mental Health Services Waiver, as approved pursuant to Section 1915(b) of the federal Social Security Act (42 U.S.C. Sec. 1396n(b)) and the Medicaid Managed Care Quality Rating System.
(4) In order to identify mental health disparities, at a minimum, the performance outcomes reports for specialty mental health services shall be produced using existing data collected by the state, stratified by both the statewide and county levels in the following areas:
(A) Access, such as timely access to services, including waiting time to assessment and waiting time to first appointment.
(B) Language capacity and language access.
(C) Quality.
(D) Utilization and penetration.
(5) (A) Data required pursuant to paragraph (4) shall be stratified by age, sex, gender identity, race, ethnicity, primary language, sexual orientation, and any other data elements for which there is peer-reviewed evidence to assess performance outcomes related to 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 publish the performance outcomes reports based on available data for specialty mental health services described in this section on the department’s Internet Web site by December 31, 2018. The department shall also provide the performance outcomes reports to the Legislature by December 31, 2018.
(B) Commencing January 1, 2019, and annually thereafter, the department shall update the performance outcomes reports for specialty mental health and shall post the updated reports on the department’s Internet Web site.
(7) Commencing January 1, 2019, the department shall consult, as needed, with the stakeholders specified in paragraph (1) to do both of the following:
(A) Incorporate additional components into the performance outcomes reports, including, but not limited to, components concerning the reduction of mental health disparities, such as 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 outcomes reports.
(8) Upon completion of the activities specified in paragraph (7), the department shall consult with stakeholders on an as-needed basis.
(9) 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.