AB 1550

Version: Amended+Assembly
Author: Asm. Rob Bonta (D-CA)



Introduced by Assembly Member Bonta

February 22, 2019


An act to add Section 14724 to the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 1550, as amended, Bonta. Crisis stabilization units: psychiatric patients.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, the department and counties provide specialty mental health services for Medi-Cal beneficiaries through mental health managed care plans, as specified. Under existing law, these services may include crisis stabilization services and inpatient psychiatric care.

Existing law establishes 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, including specialty mental health services and nonspecialty mental health services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law requires the department to implement managed mental health care for Medi-Cal beneficiaries through contracts with county mental health plans. Under existing law, the county mental health plans are responsible for providing specialty mental health services to enrollees.
This bill would authorize a certified crisis stabilization unit designated by a mental health managed care plan, at the discretion of the mental health managed care plan, to provide medically necessary crisis stabilization services to individuals beyond the service time of 24 hours, but not for more than 36 hours, when the individual needs inpatient psychiatric care or outpatient care and inpatient psychiatric beds or outpatient services are not reasonably available. The bill would require a person who is placed under, or who is already under, a 72-hour involuntary hold because the person, as a result of a mental disorder, is a danger to themselves or others, or is gravely disabled, to be credited for the time detained at a certified crisis stabilization unit. The bill would require the department to amend its contract with a mental health plan to include a provision authorizing the provision of crisis stabilization services for more than 24 hours if the mental health plan elects to provide crisis stabilization services under these provisions. The bill would require the department to require these mental health plans to establish establish, only if the plan opts to offer extended services, treatment protocols, documentation standards, and administrative procedures, consistent with best practices and other evidence-based medicine, to be followed by a certified crisis stabilization unit for appropriate treatment to individuals who are provided crisis stabilization services for more than 24 hours. The bill would require a certified crisis stabilization unit that provides crisis stabilization services under these provisions to comply with specified requirements, including ensuring that a psychiatrist is available at all times to address psychiatric emergencies. The bill would require the department to seek any state plan amendments or waivers, or amendments to existing waivers, that are necessary to implement these provisions.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 14724 is added to the Welfare and Institutions Code, to read:

14724.
 (a) A certified crisis stabilization unit designated by a mental health plan under Article 5 (commencing with Section 14680) or this chapter, and authorized pursuant to Sections 14021.4, 14680, and 14684, may, at the discretion of the mental health plan, provide medically necessary crisis stabilization services to individuals beyond the service time of 24 hours, but not for more than 36 hours, if the individual needs inpatient psychiatric care or outpatient care and inpatient psychiatric beds or outpatient services are not reasonably available. If a person is placed under, or is already under, a 72-hour hold pursuant to Section 5150, the person shall be credited for the time detained at a certified crisis stabilization unit addressed by this section. This section shall not be construed to encourage the placement of a 72-hour hold pursuant to Section 5150 for an individual who is at a certified crisis stabilization unit on a voluntary basis.
(b) The department shall amend its contract with a mental health plan to include a provision authorizing the provision of crisis stabilization services as described in this section if the mental health plan elects to provide crisis stabilization services pursuant to this section.
(c) The department shall require each mental health plan to establish establish, only if the plan opts to offer extended services described in this section, treatment protocols, documentation standards, and administrative procedures, consistent with best practices and other evidence-based medicine, to be followed by a certified crisis stabilization unit for appropriate treatment to individuals who are provided crisis stabilization services for more than 24 hours.
(d) A certified crisis stabilization unit that provides medically necessary crisis stabilization services to individuals for more than 24 hours shall do all of the following:
(1) Provide the basic services identified in paragraph (1) of subdivision (a) of Section 1250.2 of the Health and Safety Code.
(2) Ensure that a psychiatrist is available at all times to address psychiatric emergencies.
(3) Provide the individual a room with a suitable mattress.
(e) The department shall seek any state plan amendments or waivers, or amendments to existing waivers, that are necessary to implement this section.