On the surface, 2022

On the surface, 2022 has been a significant year for supporters of more timely access to mental health care in California. Not only did a law take effect July 1 that requires providers to schedule follow-up appointments that fall within 10 business days of a mental health care patient’s last session, but the one currently sitting at the desk of Gov. Doing so does not dramatically increase penalties in a bill.

Both are remedies with few teeth - assuming they are applicable. But there are already reports that the agency controlling the state's managed care plans hasn't moved on from the first, which will substantially limit the bite of the second.

Fight to Make Mental Health Care

"As with so many things with consumer protection, implementation is key," said Anthony Wright, executive director of California consumer advocacy group Health Access. "You need strong enforcement, and it needs to be actively implemented. You don't want to wait until people are actively complaining."

According to multiple sources, this is what is happening. State Sen. Scott Wiener (D-San Francisco) wrote Senate Bill 221, which mandates quick turnaround times for follow-up mental health appointments. But since the law went into effect in July, sources say, Wiener's office has been getting calls from consumers who say their health care providers aren't following it.

Seven weeks ago more than 2,000 mental health care workers went on strike, frustrated by Kaiser's refusal to negotiate reforms to a system that has been scrutinized and fined for lax mental health services and Workers say there are dangerously long wait times for patients.

“California has the strongest mental health parity laws in the nation, but that won’t help anyone if they’re not vigorously enforced.”
                                                         ~ Sal Rosselli, president, National Union of Healthcare Workers

Another measure backed by Wiener, Senate Bill 858, seeks to ease pressure on giant providers -- Kaiser, Health Net, Anthem and others -- to bring those wait times into compliance. Under SB 858, the civil penalty is increased from $2,500 to a maximum of $25,000 for individuals who are denied timely access to multiple types of care.

But even if that measure is signed into law by Newsom, its effect will remain muted until the state's Department of Managed Health Care (DMHC) uses both SB 221 and SB 858 to change the landscape for mental health patients. Those who currently are not able to do so often wait weeks or months between appointments.

Sal Rosseli, president of the National Union of Healthcare Workers, which represents the striking Kaiser workers, said, "California has some of the strongest mental health equality laws in the country, but it won't help anyone if they aren't strictly enforced." " "State regulators are saying all the right things, but they need to start taking action." (Disclosure: NUHW is a financial backer of Capital & Maine.)

While NUHW sponsored a bill mandating quick follow-up for most mental health and substance use disorder appointments, Health Access pushed for SB 858, which increased fines. Wright notes that those fine amounts had not been adjusted since 1975, while annual deductions in job-based health plans quadrupled nationally between 2007 and 2019.

SB 858 covers a wide range of grounds, increasing penalties on providers who deny or delay access to medically necessary care, behavioral health services, gender-affirming care "or other important consumer protections," according to Wiener's office. Is. Without question, however, providers like Kaiser will keep the DMHC busy with the mental health care aspect of the law – once a violation is filed.

"As with so many things with consumer protection, implementation is key," said Anthony Wright, executive director of California consumer advocacy group Health Access. "You need strong enforcement, and it needs to be actively implemented. You don't want to wait until people are actively complaining."

According to multiple sources, this is what is happening. State Sen. Scott Wiener (D-San Francisco) wrote Senate Bill 221, which mandates quick turnaround times for follow-up mental health appointments. But since the law went into effect in July, sources say, Wiener's office has been getting calls from consumers who say their health care providers aren't following it.

Seven weeks ago more than 2,000 mental health care workers went on strike, frustrated by Kaiser's refusal to negotiate reforms to a system that has been scrutinized and fined for lax mental health services and Workers say there are dangerously long wait times for patients.

“California has the strongest mental health parity laws in the nation, but that won’t help anyone if they’re not vigorously enforced.”</strong>
                                                         ~ Sal Rosselli, president, National Union of Healthcare Workers

Another measure backed by Wiener, Senate Bill 858, seeks to ease pressure on giant providers -- Kaiser, Health Net, Anthem and others -- to bring those wait times into compliance. Under SB 858, the civil penalty is increased from $2,500 to a maximum of $25,000 for individuals who are denied timely access to multiple types of care.

But even if that measure is signed into law by Newsom, its effect will remain muted until the state's Department of Managed Health Care (DMHC) uses both SB 221 and SB 858 to change the landscape for mental health patients. Those who currently are not able to do so often wait weeks or months between appointments.

Sal Rosseli, president of the National Union of Healthcare Workers, which represents the striking Kaiser workers, said, "California has some of the strongest mental health equality laws in the country, but it won't help anyone if they aren't strictly enforced." " "State regulators are saying all the right things, but they need to start taking action." (Disclosure: NUHW is a financial backer of Capital &amp; Maine.)

While NUHW sponsored a bill mandating quick follow-up for most mental health and substance use disorder appointments, Health Access pushed for SB 858, which increased fines. Wright notes that those fine amounts had not been adjusted since 1975, while annual deductions in job-based health plans quadrupled nationally between 2007 and 2019.

SB 858 covers a wide range of grounds, increasing penalties on providers who deny or delay access to medically necessary care, behavioral health services, gender-affirming care "or other important consumer protections," according to Wiener's office. Is. Without question, however, providers like Kaiser will keep the DMHC busy with the mental health care aspect of the law – once a violation is filed.

Almost three months after the passage of SB 221, there is no record of the DMHC reporting any violation of the 10-day follow-up law by a health provider, although realistically, such violations are occurring regularly. Asked about it by Capital & Maine, a spokeswoman for the department, Rachel Arrezzola, said DMHC is "monitoring compliance with SB 221."
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