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

September 10, 2021

SACRAMENTO - Senator Scott Wiener’s (D-San Francisco) legislation, SB 221, which requires health plans and insurers to provide patients with timely follow-up care for mental health issues and substance use disorders, passed the Assembly by a bipartisan vote of 76-0 and the Senate on a bipartisan concurrence vote of 35-1. It now heads to the Governor’s desk for final approval.

Current California law requires that Health Maintenance Organizations (HMOs) and insurers provide initial mental health 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 (whether depression, anxiety, schizophrenia) and addiction may have to wait months for each subsequent appointment, resulting in inadequate care. 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 are urgent and necessary, and people should have timely access to care before they go into crisis and their situations escalate.

SB 221 establishes clear timely access standards for HMOs that operate under Department of Managed Health Care (DMHC) and health insurers that 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, among many other healthcare workers.

“At the end of the day, health care delayed is health care denied,” said Senator Wiener. “That’s why we worked closely with frontline mental health clinicians to ensure patients can access the mental health and addiction care they need. Addiction, overdoses, and mental health problems have spiked during the pandemic, and we can’t afford to let people suffer alone as they wait for a follow-up appointment to get the support they need. It’s unconscionable for California to let so many people struggle without care. SB 221 makes this right, and will ensure access to follow-up care for those who need it.”

“Today’s vote is a huge victory for mental health parity,” said Sal Rosselli, President of the National Union of Healthcare Workers. “SB 221 would close the biggest remaining loophole in state law that prevents Californians with mental health and substance use disorders from receiving the timely, ongoing care they need to get better. We thank the legislators of both parties who voted for the bill, and look forward to securing the governor's signature in the days ahead.”