Posted on Friday, June 19, 2020
The Steinberg Institute is thrilled by the votes today in the Appropriation Committee of the California Senate advancing two important mental health bills.
The bills are:
–SB 803, authored by Senator Jim Beall (D-San Jose), would require the state to set up a process for certifying peer support specialists, people with lived experience with the mental health system who are trained to support and assist people going through mental health problems. More than 6,000 peer support specialists already work in California. The bill would enable counties to be partially reimbursed by the federal government for services they provide and incentivize the hiring or more, expanding the workforce of people who can help respond to the state’s worsening mental health crisis. It passed 7-0.
–SB 855, authored by Senator Scott Wiener (D-San Francisco), would require commercial health insurers in California to take a big step toward fulfilling the often-hollow promise of previous federal and state parity laws. Those laws required health insurers to cover mental health treatment on the same basis as treatment for physical health. The bill sets evidence-based standards for insurers to use in deciding if treatment recommended by doctors and other healthcare professionals is medically necessary. It passed 5-2.
“At a time when California is facing an unprecedented mental health crisis, made much, much worse by the economic dislocation and isolation caused by the COVID-19 pandemic, it is vital that California take these steps to improve our mental health response and expand our mental health workforce,” said Sacramento Mayor Darrell Steinberg, the founder of the Steinberg Institute. “I urge the full Senate to pass these measures and their colleagues in the State Assembly to do the same.”
Both bills will now advance to the full Senate and must be passed by the chamber next Friday in order to advance. They would then go to the Assembly, to be heard in policy committees.
More on SB 803
California is one of only two states (in addition to South Dakota) that does not have a state process for certifying peer support specialists, even though the federal government will partially reimburse through the Medicaid program services provided by peers — if they’ve been certified by a competent state body. SB 803 would direct the Dept. of Health Care Services to create a certification program and to recognize certified peer support specialists as providers eligible to treat patients through the Medi-Cal program.
A similar bill passed the Legislature unanimously last year but was vetoed by Governor Gavin Newsom, who said in his veto message that he wanted the bill to be handled through the regular budget process.
“The Steinberg Institute, with our allies in the peer support movement, have been fighting for four years to advance legislation that will allow this dedicated group of people to be of service to people in need,” said Maggie Merritt, the Steinberg Institute’s executive director. “We know from research that peers can be enormously effective in helping people suffering from mental health struggles to feel supported and to stay out of hospitals, lowering costs. We call upon the Governor and the Legislature to include the modest up-front cost of setting up this program, knowing that the state will more than recoup what it lays out.”
More on SB 855
In 1996 Congress passed the Mental Health Parity Act, a landmark law that was supposed to usher in a new era in which treatment for mental health would no longer be stigmatized and would be covered in the same way as other health services. That promise has never been fully realized and states have struggled to achieve the promise of that earlier legislation.
Today, in California, health insurers frequently refuse to pay for mental health and substance abuse treatments – particularly if the treatment needs to continue over a period of months, or it requires inpatient treatment. Insurers also subject mental health professionals to lengthy and expensive review processes, requiring them to prove the medical necessity of a proposed treatment. As a result, patients must frequently pay for services outside their insurance network, with minimal reimbursement from their insurer.
A study released last year by Milliman, a risk management consulting firm, found that in 2017 people seeking inpatient care for behavioral health issues were 5.2 times more likely to be relegated to an out-of-network provider than if they were getting medical or surgical care and were 10 times more likely to go out-of-network if they were seeking substance abuse treatment.
Experts say that recovery from mental health and substance use disorders including post-traumatic stress disorder, moderate and severe depression and opioid addiction often requires longer-term treatment. SB 855 would prohibit insurers from covering only short-term or acute treatment. If needed services aren’t available from an insurance plan’s network providers, SB 855 requires insurers to reimburse out-of-network coverage at in-network rates.
“We know that millions of people across the state are feeling deep distress and anxiety,” Merritt said. “If private insurers won’t pay for them to get the help they need, the results can be catastrophic. They will fall into deeper distress. Some will take their own lives. And greater burdens will shift to local governments. Insurers are supposed to pay for health services. What could be more important than paying for services needed to keep people mentally healthy?”