A package of mental health-related bills that passed the California legislature this week and headed to the desk of Governor Gavin Newsom will – if the governor signs them — create the most sweeping set of changes to state mental health policies since voters approved Proposition 63, the Mental Health Services Act, in 2004, creating an ongoing source of funds for recovery-oriented mental health services.The new suite of bills, all sponsored or supported by the Steinberg Institute, is headlined by one, SB 855 (Wiener), which would require commercial health insurers to cover treatment for mental health conditions on the same basis that they cover physical ailments. Another vital bill, SB 803 (Beall), helps address the shortage of mental health workers in California by establishing a formal system for training and certifying peer support specialists – people who have personal experience with mental health challenges and want to use that experience to help others facing similar issues.
A third bill, AB 1766 (Bloom) would help preserve the dwindling number of board-and-care homes that house people with severe mental illness by directing the state to track and report on the status and inventory of existing board-and-care homes. And AB 890 (Wood) will allow highly trained nurse practitioners (NPs) to expand their roles, enabling them to prescribe medications and provide a fuller range of treatments to patients – including those with mental health conditions – without the direct supervision of a physician. Twenty-three other states and the Department of Veterans Affairs now allow this; if signed by the governor, California will join them.
“This package of legislation is a game changer,” said Steinberg Institute Executive Director Maggie Merritt. “The fact that all these bills passed at a time when the legislative process was so greatly limited by the pandemic shows that our elected leaders understand how important mental health services are at this vital moment.”
“The broad sweep of this legislative package once again puts California at the forefront of mental health policy reform,” said Sacramento Mayor Darrell Steinberg. He founded the Steinberg Institute in 2015 and was the principal author of Prop. 63 back when he was a member of the State Assembly.
“If we’re going to address the mental health crisis that is taking such a devastating toll on our state and our country, everyone at all levels needs to do their part,” Steinberg said. “This package of bills does just that. It requires more from the health insurance industry. And it helps address the shortage of mental health workers by expanding the ability of peer support specialists and nurse practitioners to do their vital work.”
Here’s a breakdown of eight bills passed by the legislature and headed to Governor Newsom:
SB 855 (Wiener, D-San Francisco), would expand the ability of Californians who buy insurance or get it from their employers to obtain treatment for a wide array of mental health and substance use disorders. It would require commercial health insurers to pay for medically necessary treatment of any behavioral health or substance use disorder listed in the DSM-5, the American Psychiatric Association manual that defines mental health conditions. The bill is authored by Senator Scott Wiener (D-San Francisco), and sponsored by the Steinberg Institute and The Kennedy Forum, a national mental health policy group founded by former Congressman Patrick Kennedy.
SB 803 (Beall, D-San Jose), would require the state to establish statewide requirements for certifying peer support specialists –people with personal experience with the mental health system who are trained to support and assist others who are going through mental health challenges. Counties that choose to do so would be responsible for implementing and managing the program and could access federal funds to partially cover the cost of employing peers, helping expand the workforce of people who can respond to the state’s mental health crisis. It was authored by Senator Jim Beall (D-San Jose) and co-sponsored by the Steinberg Institute, the California Association of Mental Health Peer Run Organizations, the California County Behavioral Health Directors Association and Los Angeles County.
AB 1766 (Bloom, D-Santa Monica), would require the state Department of Social Services to annually report the number of board-and-care homes that serve low-income Californians living with a severe mental illness, track their closures, and notify county behavioral health departments within three days of receiving notice that an operator plans to close a home. Board-and-care homes are a crucial piece of the housing spectrum for people living with severe mental illness. AB 1766 would provide policymakers statewide data to address the loss of these homes and help counties identify appropriate living options for people with severe mental illness.
AB 890 (Wood, D-Santa Rosa), would allow nurse practitioners (NPs) to work to the full scope of their license by expanding their ability to treat patients, including those affected by mental health challenges, without a physician’s supervision. It would help address the large and growing workforce shortage of primary care physicians in California. The US Dept. of Veterans Affairs gives 6,000 NPs working in the VA system this authority, and the California Future Health Workforce Commission has urged California to do the same. California today is the only western state that restricts NPs from practicing without physician oversight.
AB 1845 (Luz Rivas, D-Los Angeles), would create a Secretary of Homelessness in the Governor’s Cabinet to coordinate and consolidate multiple programs aimed at ending homelessness. We know that the huge and growing number of Californians experiencing long-term homelessness includes a large number of people living with severe mental illness.
AB 1976 (Eggman, D-Stockton), would amend the bill known as Laura’s Law, making it permanent and requiring all counties to implement the program, unless they formally opt out of doing so. The original 2002 law authorized counties to start programs to provide intensive assisted outpatient treatment (AOT) to people suffering from severe mental illness and enabled judges to order treatment for those who declined to accept offered services.
AB 2112 (Ramos, D-Highland), would create within the Department of Public Health an Office of Suicide Prevention to advise the state and regional partners on best practices for suicide prevention.
AB 2054 (Kamlager, D-Los Angeles), would create a demonstration pilot grant program to expand and test community-based responses to all types of crises, including those caused by mental health challenges, for the state’s most vulnerable populations.
AB 2360 (Maienschein, D-San Diego), requires health insurers to provide psychiatric consultations to primary care physicians, pediatricians, and ob/gyns to support their provision of mental health treatment to children and mothers.
The governor has until the end of the month to sign these bills into law or to veto them.