Amended  IN  Assembly  March 04, 2021

CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 822

Introduced by Assembly Member Rodriguez

February 16, 2021

An act to amend Section 3500 14021 of the Welfare and Institutions Code, relating to public social services. Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 822, as amended, Rodriguez. Public social services: state plans: federal waivers: public notice. Observation services.
Existing law provides for 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, such as mental health and substance use disorder services, which are delivered through various delivery systems, including fee-for-service and managed care. Under existing law, mental health plans provide specialty mental health services, and Medi-Cal managed health care plans and the fee-for-service Medi-Cal program provide nonspecialty mental health services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
To the extent funds are made available in the annual Budget Act, this bill would expand mental health services to include observation services, as defined, for emergency psychiatric treatment when provided in an observation unit, as defined, subject to utilization controls. The bill would provide that observation services are not specialty mental health services, and would require a Medi-Cal managed health care plan or the fee-for-service Medi-Cal program to reimburse the provider for rendering those services. The bill would authorize the department to implement these provisions by various means, including provider bulletin, without taking regulatory action, and would condition the implementation of these provisions to the extent permitted by federal law, the availability of federal financial participation, and the department securing federal approval.

Existing law establishes the California Health and Human Services Agency, and includes within that agency, the State Department of Social Services, the State Department of Public Health, and the State Department of Health Care Services, among other departments. Existing law requires a department within the agency that has received approval of an operational state plan by a federal agency, or that has applied and has been approved for a waiver from a federal law or federal regulation, to make any and all approved plans and waivers available to the public by publishing a hyperlink to that information on the homepage of the department’s internet website.

This bill would make a technical, nonsubstantive change to that provision.

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

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


SECTION 1.

 Section 14021 of the Welfare and Institutions Code is amended to read:

14021.
 Notwithstanding any other provision of this chapter, health care shall include the following mental health and substance use disorder services:
(a) Mental health services provided by a county or a city.
(b) Mental health services provided in a community mental health service or in a community mental health center organized under the federal Community Mental Health Centers Act of 1963. No amount shall be paid for that portion of the total costs of care and services in a federally funded community mental health center which may be compensated by the United States government under the federal Community Mental Health Centers Act of 1963. No amount shall be paid to a community mental health service or a federally funded community mental health center unless the community mental health service or the federally funded community mental health center participates in a county or city mental health performance contract pursuant to Section 5650.
(c) Drug Medi-Cal outpatient substance use disorder services under the jurisdiction of the department provided by a county provider certified under this chapter or a private provider certified under this chapter which that has an approved contract with the county or with the department to provide covered substance use disorder services.
(d) (1) Inpatient hospital services in an institution for mental diseases to persons of all ages, provided that the institution for mental diseases is certified as a psychiatric hospital under Title XVIII of the federal Social Security Act and regulations issued thereunder.
(2) Notwithstanding Section 14157, no money in the State Health Care Deposit Fund shall be expended for the purposes of this section unless the Legislature specifically appropriates money for the purposes of this section.
(3) The amendment of this subdivision enacted at the 1972 Regular Session of the Legislature does not constitute a change in, but is declaratory of, the preexisting law.
(e) (1) Other diagnostic, screening, preventive, or remedial rehabilitative services for the maximum restoration of an individual to the best possible functional level.
(2) Paragraph (1) includes any medical or remedial services provided in a facility, home, or other setting, that are recommended by a physician or other licensed practitioner of the healing arts within the scope of his or her their practice under state law.
(f) (1) (A) To the extent funds are made available in the annual Budget Act for this express purpose, and for purposes of providing mental health treatment, observation services, as defined under subdivision (a) of Section 1253.7 of the Health and Safety Code, for emergency psychiatric treatment when provided in an observation unit, as defined in subdivision (c) of Section 1253.7 of the Health and Safety Code, are covered under the Medi-Cal program, subject to utilization controls.
(B) Observation services shall not be considered specialty mental health services. If the patient is enrolled in a Medi-Cal managed health care plan, that plan shall reimburse the provider who renders these services. If the patient is not enrolled in a plan, the provider shall be reimbursed by the fee-for-service Medi-Cal program.
(2)  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 this section by means of a provider bulletin or similar instruction, without taking regulatory action.
(3) For purposes of implementing this section, the department shall seek any necessary federal approvals, including approvals of any state plan amendments or federal waivers, by the federal Centers for Medicare and Medicaid Services.
(4) (A) This section shall only be implemented to the extent permitted by federal law.
(B) This section shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained.

SECTION 1.Section 3500 of the Welfare and Institutions Code is amended to read:
3500.

If a department within the California Health and Human Services Agency has received approval of an operational state plan by a federal agency, or has applied and has been approved for a waiver from a federal law or federal regulation, the department shall make any and all approved plans and waivers available to the public by publishing a hyperlink to that information on the homepage of the department’s internet website.