Senator Wiener’s Legislation to Strengthen Timely Care for Mental Health and Substance Use Disorders Passes Senate
SACRAMENTO - Senator Scott Wiener’s (D-San Francisco) 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 by a vote of 32-7. It will now head to the Assembly to be heard in policy committees.
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.
“There is no other way to say it: this has been a tough year, particularly when it comes to mental health and addiction,” said Senator Wiener. “People must be able to access the mental health care they need, and in a timely fashion. Right now, some healthcare companies aren’t providing timely follow-up mental health and addiction care, and SB 221 will address that. Mental health care is health care, and it’s critical that all Californians be able to access the care they need.”