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AB-1124 Department of Managed Health Care: employee assistance programs. (2023-2024)

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Date Published: 04/24/2023 02:00 PM
AB1124:v97#DOCUMENT

Amended  IN  Assembly  April 24, 2023
Amended  IN  Assembly  March 23, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 1124

Introduced by Assembly Member Low

February 15, 2023

An act to add Section 1345.6 to the Health and Safety Code, relating to health care.


LEGISLATIVE COUNSEL'S DIGEST


AB 1124, as amended, Low. Department of Managed Health Care: employee assistance programs.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, establishes the Department of Managed Health Care to ensure that health care service plans provide enrollees with access to quality health care services and to protect and promote the interests of enrollees.
This bill would require the department to create a report that that, among other things, examines and analyzes limitations to employee access to behavioral health treatment for employee assistance programs and the significance and impact of excepted-benefit regulations, for employee assistance programs, as defined, and makes related findings and recommendations. The bill would require the department to issue the report to specified members and committees of the Legislature and to post the report on the department’s public internet website no later than June 30, 2024.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 The Legislature finds and declares all of the following:
(a) Even before the pandemic, our nation was facing a mental health crisis. Regardless of race, ethnicity, gender, religion, sexual orientation, education, or income, mental health disorders do not discriminate. The problem is now so pervasive in the United States that 44,000,000 adults have a mental health disorder.
(b) One-half of all mental illness develops by 14 years of age and three-quarters by 24 years of age. Early intervention and prevention of behavioral health conditions are critical to the success of an individual’s health, educational goals, and social relationships.
(c) The state has made significant strides to preserve both the incentives for providers to offer their services and for the patients to be able to access the important mental health care they need, but more work needs to be done.
(d) Many employers have stepped up to provide support for their employees by increasing the availability and accessibility of behavioral health benefits, whether in-person or virtually.
(e) One part of the solution is ensuring access to remotely available and immediate resources through employee assistance programs (EAPs).
(f) The United States Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration explains the importance of EAPs, stating they help employees with personal problems in part by helping them identify and address a wide range of health, financial, and social issues, including mental or substance use disorders, and by offering services and resources to help people with assessments, referrals to treatment, and short-term counseling.
(g) All federal executive branch agencies are required to make EAPs available, according to the United States Office of Personnel Management. Approximately 44 percent of employers with more than 100 employees and 25 percent of worksites with 15 to 99 employees, inclusive, also offered EAPs or similar health promotion programs to their employees as of 2019, according to a study by the American Journal of Health Promotion.
(h) There is an urgent need in the health care landscape for models that can provide high-quality and cost-effective mental health resources, but current state health care law and regulation regarding EAPs do not meet the urgent need for accessible, quality, short-term mental health care options. The law needs review and updating to ensure that the state can take advantage of new technology and improved opportunities for California’s employers and working families to receive timely and effective treatment.

SEC. 2.

 Section 1345.6 is added to the Health and Safety Code, to read:

1345.6.
 (a) For purposes of this section, “employee assistance program” or “EAP” means a plan that meets both of the following conditions:
(1) Is exempt from this chapter only if the plan complies with all provisions of Section 1300.43.14 of Title 28 of the California Code of Regulations.
(2) Provides coverage that is supplemental to minimum essential coverage as described in Sections 1345.5 and 1399.849.
(b) The department shall create a report that does all of the following:
(1) Examines and analyzes limitations to employee access to behavioral health treatment for employee assistance programs (EAPs) under Section 1300.43.14 of Title 28 of the California Code of Regulations. programs.

(2)Examines and analyzes the significance and impact of excepted-benefit regulations promulgated by the United States Department of Labor for EAPs under the Employee Retirement Income Security Act of 1974 (Public Law 93-406) (ERISA), as amended (29 U.S.C. Sec. 1001 et seq.) since the passage of the Affordable Care Act.

(2) Examines how consumers who receive EAP services are connected to coverage through their health care service plan.
(3) Examines how EAPs subject to Section 1300.43.14 of Title 28 of the California Code of Regulations can provide notice to purchasers that EAP benefits are in addition to existing requirements for health plans to cover comprehensive behavioral health benefits under Senate Bill 855 of the 2019–20 Regular Session (Chapter 151 of the Statutes of 2020) and Assembly Bill 988 of the 2021–22 Regular Session (Chapter 747 of the Statutes of 2022).

(3)

(4) Makes findings and recommendations regarding EAPs and potential improvements for California workers based on the department’s analysis of paragraphs (1) and (2). this subdivision.

(b)

(c) The department may coordinate with the State Department of Health Care Services’ Mental Health Services Division to develop its analysis and report.

(c)

(d) The department shall issue the report required by this section to the President pro Tempore of the Senate, the Speaker of the Assembly, the Senate Committee on Health, and the Assembly Committee on Health and post the report on the department’s public internet website no later than June 30, 2024.