Senator Wiener’s Legislation to Strengthen Timely Care for Mental Health and Substance Use Disorders Passes Senate Health Committee

March 17, 2021

SACRAMENTO - Senator Scott Wiener (D-San Francisco)’s legislation, SB 221, which would require health plans and insurers to provide patients with timely follow-up care for mental health issues and substance use disorders, passed the Senate Health Committee by a vote of 9-0. It will now head to the Senate Appropriations Committee. 

California’s current law requires that Health Maintenance Organizations (HMOs) and insurers provide initial care for patients within ten business days following enrollment. But, under current interpretation of the law, health plans and insurers are not required to provide timely subsequent care for patients after an initial appointment. This loophole means that those suffering from mental health issues (from depression and anxiety to schizophrenia) and addiction may not be given adequate mental health care that they need to get better, or even a second appointment. With significant delays in accessing mental health care, we have seen a number of tragic suicides. In Santa Rosa, Elizabeth Brown and Barbara Ragan took their own lives after facing long delays in accessing care. Mental health care and substance use disorder treatment is urgent and necessary, and people should have timely access to it before they go into crisis and their situations escalate.

SB 221 will establish clear timely access standards for HMOs who operate under Department of Managed Health Care (DMHC) and health insurers who fall under the jurisdiction of the California Department of Insurance (CDI), requiring them to provide follow-up appointments and other forms of care within ten business days, unless a provider believes a longer gap is appropriate. 

In the California Health Care Foundation's most recent survey of Californians’ health care priorities, 52% of those who tried to make a mental health appointment believe they waited longer than was reasonable to get one. 

With COVID-19 exacerbating an already dire mental health and substance use crisis facing our country, timely access to mental health care is more important than ever. National survey data shows that the rate of anxiety and depression has tripled over the last year, and a recent CDC study found that an astounding one in four people age 18 to 24 has seriously considered suicide in the past 30 days. Additionally, substance use and overdose deaths are on the rise nationally since the beginning of the pandemic, and San Francisco has seen a record number of overdose deaths. In San Francisco, overdose deaths outpaced COVID-19 deaths by a margin of three to one. 

SB 221 is sponsored by the National Union of Healthcare Workers (NUHW), which represents more than 4,000 mental health and substance use disorder clinicians in California.

"Mental health must be a top priority for our state as we come out of a brutal year, during which we’ve seen a terrifying rise in mental health crises," said Senator Wiener. "Healthcare companies need to provide adequate care – including follow-up care – for anyone experiencing mental health or substance use issues. Mental health care is health care, and we need to treat it as such."

"Today's vote brings California closer than ever to achieving real parity for mental health care," said Sal Rosselli, president of the National Union of Healthcare Workers, the state's largest union representing private sector mental health clinicians. "Delaying mental health and substance use disorder treatment can be as life-threatening as delaying chemotherapy or dialysis. Our members are confronting an unprecedented surge in demand for mental health care, and they will do everything in their power to enact this law, so their patients won't have to keep waiting weeks or months for their next therapy appointment." 

"Teenagers struggling with depression, anxiety and serious trauma should not have to wait four-to six weeks to get follow-up care," said Michael Torres, a child psychologist at Kaiser Permanente's San Leandro clinic. "There is no nationally recognized standard practice that suggests four to six weeks between sessions is OK. It's dangerous, and we need to pass SB 221 into law to protect our patients and provide them with the care they need."