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AB-1450 Behavioral health: behavioral health and wellness screenings: notice.(2023-2024)

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Date Published: 01/03/2024 02:00 PM
AB1450:v98#DOCUMENT

Amended  IN  Assembly  January 03, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 1450

Introduced by Assembly Member Jackson

February 17, 2023

An act to add Section 49600.5 to the Education Code, relating to pupil health. An act to add Article 12.7(commencing with Section 840) to Chapter 1 of Division 2 of the Business and Professions Code, to add Sections 1259.7 and 1368.017 to the Health and Safety Code, to add Section 10123.1991 to the Insurance Code, and to amend Section 14190.1 of the Welfare and Institutions Code, relating to behavioral health.


LEGISLATIVE COUNSEL'S DIGEST


AB 1450, as amended, Jackson. Pupil health: universal screenings: adverse childhood experiences and dyslexia. Behavioral health: behavioral health and wellness screenings: notice.
Existing law, the Medical Practice Act, provides for the licensing and regulation of physicians and surgeons by the Medical Board of California. Existing law requires the board, in determining its continuing education requirements, to consider including a course in integrating mental and physical health care in primary care settings, especially as it pertains to early identification of mental health issues and exposure to trauma in children and young adults and their appropriate care and treatment. Existing law requires a physician and surgeon to provide notice to patients at an initial office visit regarding a specified database.
Existing law requires the State Department of Public Health to license and regulate health facilities, including general acute care hospitals. A violation of those provisions is generally a crime. Existing law requires a general acute care hospital to establish and adopt written policies and procedures to screen patients who are 12 years of age and older for purposes of detecting a risk for suicidal ideation and behavior.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance.
This bill would require a physician and surgeon, a general acute care hospital, a health care service plan, and a health insurer to provide to each legal guardian of a patient, enrollee, or insured, 10 to 18 years of age, a written or electronic notice regarding the benefits of a behavioral health and wellness screening. The bill would require the providers to provide the notice at least once every 2 years in the preferred method of the legal guardian. Because a violation of the bill’s requirements relative to health care service plans and health facilities would be crimes, the bill would impose a state-mandated local program.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law requires a Medi-Cal managed care plan, no later than January 1, 2025, to conduct annual outreach and education for its enrollees, based on a plan that the Medi-Cal managed care plan develops and submits to the department, as specified, regarding the mental health benefits that are covered by the Medi-Cal managed care plan.
This bill would require a Medi-Cal managed care plan to include the above-described notice requirement in their outreach and education plan.
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 governing board of any school district to give diligent care to the health and physical development of pupils and authorizes the governing board of a school district to employ properly certified persons for the work. Existing law authorizes the governing board of a school district to provide a comprehensive educational counseling program for all pupils enrolled in the school district.

Existing law prohibits specified medical professionals, including psychiatrists, not employed in that capacity by the State Department of Health Care Services from being employed or permitted to supervise the health and physical development of pupils unless that person holds a services credential with a specialization in health or a valid credential, as provided.

Existing law prohibits any person who is an employee of a school district from administering psychological tests or engaging in other psychological activities involving the application of psychological principles, methods, or procedures unless (1) the person holds a valid and current credential as a school psychologist issued by the Commission on Teacher Credentialing that permits the holder to administer psychological testing to, or engage in psychological activities with, pupils, or (2) psychological assistants or school psychology interns perform the testing or activities under the supervision of a person described in (1).

Under existing law, parents and guardians of pupils enrolled in public schools have the right and should have the opportunity, as mutually supportive and respectful partners in the education of their children within the public schools, to be informed by the school, and to participate in the education of their children, including, among others, the right to receive information about any psychological testing the school does involving their child and to deny permission to give the test.

This bill would require a school district, county office of education, or charter school to employ or contract with at least one mental health clinician, as defined, and at least one case manager, as defined, for each schoolsite of the local educational agency, and to conduct universal screenings for adverse childhood experiences, as defined, and dyslexia, pursuant to a graduated schedule by grade span, as specified. The bill would require a mental health clinician who conducts a screening to develop, and provide to the pupil and their parent or guardian, an action plan based upon findings from the screening, as appropriate, and would require case managers to help implement approved action plans. By imposing additional requirements on local educational agencies, 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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

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

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


SECTION 1.

 Article 12.7 (commencing with Section 840) is added to Chapter 1 of Division 2 of the Business and Professions Code, to read:
Article  12.7. Behavioral Health and Wellness Screening Notices

840.
 For purposes of this article, the following definitions apply:
(a) “Behavioral health and wellness screening” means a screening, test, or assessment to identify indicators or symptoms of behavioral health issues in an individual, including, but not limited to, depression or anxiety.
(b) “Physician and surgeon” includes a physician and surgeon licensed pursuant to the Medical Practice Act (Chapter 5 (commencing with Section 2000)) or an osteopathic physician and surgeon licensed by the Osteopathic Medical Board of California under the Osteopathic Act.

841.
 (a) A physician and surgeon shall provide to each legal guardian of a patient, 10 to 18 years of age, at least once every two years, a written or electronic notice regarding the benefits of a behavioral health and wellness screening.
(b) The physician and surgeon shall provide notice in the preferred method of the legal guardian, including, but not limited to, any of the following:
(1) A hard copy mailed to the legal guardian.
(2) A hard copy provided to the legal guardian in person at a visit.
(3) An electronic transmission including, but not limited to, text message or email.
(c) The notices shall provide information regarding the benefits of behavioral health and wellness screenings for both depression and anxiety.

SEC. 2.

 Section 1259.7 is added to the Health and Safety Code, to read:

1259.7.
 (a) Beginning January 1, 2025, a general acute care hospital shall establish and adopt written policies and procedures to provide to each legal guardian of a patient, 10 to 18 years of age, a written or electronic notice regarding the benefits of a behavioral health and wellness screening. “Behavioral health and wellness screening” has the same meaning as defined in Section 840 of the Business and Professions Code.
(b) The procedures established pursuant to this section shall accomplish all of the following:
(1) Notice shall be provided in the preferred method of the legal guardian, including, but not limited to, a hard copy sent by mail or given in person at a visit, or by an electronic transmission such as text message or email.
(2) The notice shall provide information regarding the benefits of behavioral health and wellness screenings for both depression and anxiety.
(c) After the adoption of written policies and procedures pursuant to subdivision (a), a general acute care hospital shall routinely provide notice, at least once every two years, in compliance with those policies and procedures.

SEC. 3.

 Section 1368.017 is added to the Health and Safety Code, to read:

1368.017.
 (a) (1) A health care service plan shall provide to each legal guardian of an enrollee, 10 to 18 years of age, a written or electronic notice regarding the benefits of a behavioral health and wellness screening.
(2) “Behavioral health and wellness screening” has the same meaning as defined in Section 840 of the Business and Professions Code.
(b) A health care service plan shall provide notice in the preferred method of the legal guardian, including, but not limited to, a hard copy sent by mail or given in person at a visit, or by an electronic transmission including, but not limited to, text message or email.
(c) The notice shall provide information regarding the benefits of behavioral health and wellness screenings for both depression and anxiety.
(d) A health care service plan shall provide notice pursuant to this section at least once every two years.

SEC. 4.

 Section 10123.1991 is added to the Insurance Code, to read:

10123.1991.
 (a) (1) A health care service plan shall provide to each legal guardian of an insured, 10 to 18 years of age, a written or electronic notice regarding the benefits of a behavioral health and wellness screening.
(2) “Behavioral health and wellness screening” has the same meaning as defined in Section 840 of the Business and Professions Code.
(b) A health care service plan shall provide notice in the preferred method of the legal guardian, including, but not limited to, a hard copy sent by mail or given in person at a visit, or by an electronic transmission including, but not limited to, text message or email.
(c) The notice shall provide information regarding the benefits of behavioral health and wellness screenings for both depression and anxiety.
(d) A health care service plan shall provide notice pursuant to this section at least once every two years.

SEC. 5.

 Section 14190.1 of the Welfare and Institutions Code is amended to read:

14190.1.
 (a) Subject to subdivision (b), and no later than January 1, 2025, a Medi-Cal managed care plan shall conduct annual outreach and education for its enrollees, based on a plan that the Medi-Cal managed care plan develops and submits to the department upon the department’s approval of the Medi-Cal managed care plan’s Population Needs Assessment, regarding the mental health benefits that are covered by the Medi-Cal managed care plan pursuant to Section 14189 and paragraph (1) of subdivision (b) of Section 14184.402.
(1) The outreach and education plan shall be informed by the Medi-Cal managed care plan’s stakeholder engagement, including the community advisory committee established by the Medi-Cal managed care plan, and by local stakeholders representing diverse racial and ethnic communities.
(2) The outreach and education plan shall be informed by the Medi-Cal managed care plan’s Population Needs Assessment and an assessment of utilization of covered mental health benefits by race, ethnicity, language, age, sexual orientation, gender identity, and disability, and shall ensure that materials and messaging are appropriate for the diversity of the plan enrollee membership. The Medi-Cal managed care plan shall submit the utilization assessment to the department.
(3) The outreach and education plan shall meet cultural and linguistic appropriateness standards, in alignment with the National Standards for Culturally and Linguistically Appropriate Services, shall incorporate best practices in stigma reduction, and shall provide multiple points of contact for enrollees to access mental health benefits.
(4) (A) The outreach and education plan shall provide written or electronic notice to each legal guardian of an enrollee, 10 to 18 years of age, regarding the benefits of a behavioral health and wellness screening.
(B) “Behavioral health and wellness screening” has the same meaning as defined in Section 840 of the Business and Professions Code.
(C) The Medi-Cal managed care plan shall meet all of the following requirements:
(i) The notice shall include information regarding the benefits of behavioral health and wellness screenings for both depression and anxiety.
(ii) The Medi-Cal managed care plan shall provide notice in the preferred method of the legal guardian, including, but not limited to, a hard copy sent by mail or given in person at a visit, or by an electronic transmission including, but not limited to, text message or email.
(iii) The Medi-Cal managed care plan shall provide notice pursuant to this paragraph at least once every two years.
(b) (1) The department shall review the new or updated outreach and education plan submitted by each Medi-Cal managed care plan as described in this section and shall approve or modify the plan within 180 calendar days since submission, to ensure appropriate local stakeholder engagement, alignment with the Population Needs Assessment, and cultural and linguistic appropriateness.
(2) Implementation of a Medi-Cal managed care plan’s outreach and education plan described in this section shall be subject to approval by the department pursuant to paragraph (1).
(3) Each Medi-Cal managed care plan shall publicly post, on its internet website and in an accessible manner, its approved outreach and education plan and its utilization assessment described in paragraph (2) of subdivision (a), excluding any personally identifiable information.
(c) The department shall consult with stakeholders representative of diverse racial and ethnic communities, including, but not limited to, consumer advocates, mental health stigma reduction experts, community-based organizations, and Medi-Cal managed care plan stakeholders, to develop the standards by which outreach and education plans will be reviewed and approved.
(d) Approval standards may include, but are not limited to, any of the following:
(1) Outreach and education methods that include, but are not limited to, online outreach, mail, telephone, partnerships with community-based organizations, partnerships with primary care providers, and use of navigators, community health workers, and other providers trained to conduct outreach and education.
(2) Alignment of the culturally and linguistically tailored outreach and education strategies with the National Standards for Culturally and Linguistically Appropriate Services, utilization assessment and Population Needs Assessment.
(3) Inclusion of consumer-friendly information in existing member-facing communication channels, including the Medi-Cal managed care plan’s internet website.
(4) An independent evaluation plan to assess and improve outreach to enrollees related to nonspecialty mental health services upon the department’s approval of a Medi-Cal managed care plan’s Population Needs Assessment.
(e) A Medi-Cal managed care plan shall also conduct annual outreach and education, based on a plan that the Medi-Cal managed care plan develops, to inform primary care providers regarding the mental health benefits covered by the Medi-Cal managed care plan pursuant to Section 14189 and paragraph (1) of subdivision (b) of Section 14184.402.
(f) 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 section, in whole or in part, by means of all-county letters, plan letters, provider bulletins, information notices, or other similar guidance, until any necessary regulations are adopted.
(g) For purposes of implementing this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this section shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services.

SEC. 6.

 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.Section 49600.5 is added to the Education Code, to read:
49600.5.

(a)Notwithstanding Section 49422, a local educational agency shall employ or contract with at least one mental health clinician and at least one case manager for each schoolsite of the local educational agency, pursuant to the following schedule:

(1)For elementary school schoolsites, on or before July 1, 2026.

(2)For middle school schoolsites, on or before July 1, 2028.

(3)For high school schoolsites, on or before July 1, 2030.

(b)Notwithstanding Section 49422, but consistent with the requirements of the Section 51101, a local educational agency shall conduct universal screenings for adverse childhood experiences (ACEs) and dyslexia, pursuant to the following schedule:

(1)For elementary school schoolsites, on or before July 1, 2026.

(2)For middle school schoolsites, on or before July 1, 2028.

(3)For high school schoolsites, on or before July 1, 2030.

(c)Notwithstanding Section 49422, but consistent with the requirements of the Section 51101, a mental health clinician who conducts a screening pursuant subdivision (b) shall develop and provide to the pupil and their parent or guardian an action plan based upon findings from the screening, as appropriate, and case managers shall help implement the approved action plans.

(d)For purposes of this section, the following definitions apply:

(1)“Case manager” means any of the following:

(A)A person with a doctoral degree in social work.

(B)A person with a master’s degree in social work.

(C)A marriage and family therapist, as defined in Chapter 13 (commencing with Section 4980) of Division 2 of the Business and Professions Code.

(2)“Local educational agency” means a school district, county office of education, or charter school.

(3)“Mental health clinician” means a person certified and trained to conduct screenings for, and to identify and diagnose the presence of, adverse childhood experiences, and who is at least one of following:

(A)A California board-certified, or board-eligible, psychiatrist.

(B)A marriage and family therapist, as defined in Chapter 13 (commencing with Section 4980) of Division 2 of the Business and Professions Code.

(C)A licensed educational psychologist, as defined in Chapter 13.5 (commencing with Section 4989.10) of Division 2 of the Business and Professions Code.

(D)A credentialed school psychologist, as described in Section 49424.

(E)A clinical psychologist licensed under Chapter 6.6 (commencing with Section 2900) of Division 2 of the Business and Professions Code.

(F)A registered psychological associate, as described in Section 2913 working under the supervision of a licensed professional specified in Section 2902 of the Business and Professions Code.

(G)A licensed clinical social worker, as defined in Chapter 14 (commencing with Section 4991) of Division 2 of the Business and Professions Code.

(H)A licensed professional clinical counselor, as defined in Chapter 16 (commencing with Section 4999.10) of Division 2 of the Business and Professions Code.

(I)A person registered as an associate professional clinical counselor, as defined in Chapter 16 (commencing with Section 4999.10) of Division 2 of the Business and Professions Code, while working under the supervision of a licensed professional specified in subdivision (h) of Section 4999.12 of the Business and Professions Code.

(J)A credentialed school nurse, as described pursuant to Section 49426.

SEC. 2.

If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.