Governor Newsom Signs Bills to Expand Access to Quality Behavioral Health Care for all Californians & Help Homeless Californians Suffering Extreme Mental Illness on Our Streets & Sidewalks

Statement

Governor Gavin Newsom today signed a package of bills that will improve access to quality mental health and substance use disorder services for all Californians, as well as measures that help homeless Californians suffering from behavioral health challenges access the help they need.

Governor Newsom devoted the entirety of his 2020 State of the State address to the interwoven challenges of homelessness, housing insecurity and behavioral health and proposed a number of specific reforms -- some of which he is signing into law today.

"The bills I am signing today will help Californians access the behavioral health services they need to recover," said Governor Newsom. "Earlier this year, I pledged to put these critical services within reach of more Californians, through reforming our Mental Health Services Act and laws that allow loved ones and service providers to ask courts to compel those who need treatment into community-based outpatient care. Today, we do just that."

In his 2020 State of the State address, Governor Newsom directly called for reforms to behavioral health laws that were ahead of their time when originally implemented decades ago, but now require improvements. Specifically, the Governor stated his support for removing conditions imposed on counties trying to implement Laura's Law. AB 1976 by Assemblymember Susan Talamantes Eggman (D-Stockton), which Governor Newsom signed today, accomplishes this by expanding county use of court-ordered outpatient treatment.

"The Assisted Outpatient Treatment demonstration project started by Laura's Law has shown for many years that we have the tools to provide effective, community-based mental health treatment to those with the greatest need. As a social worker I've long fought for the extension of these critical services, and expanding this program and finally making it permanent will ensure greater care for the people of California," said Assemblymember Eggman.

In his State of the State address, the Governor said Mental Health Services Act (MHSA) funds should be used for substance abuse treatment and not just mental health care. The Governor today signed AB 2265 by Assemblymember Sharon Quirk-Silva (D-Fullerton), which clarifies that specified MHSA funds can be used for treatment of co-occurring mental health and substance use disorders. Counties will now be able to use MHSA funds to assess and treat individuals with a co-occurring disorder, increasing access to substance use disorder treatment, improving care coordination and leading to a more integrated behavioral health care system.

"The effects and uncertainty of the COVID-19 pandemic, economic loss, and devastating wildfires, have brought upon a crisis of stress, depression, and anxiety to Californians. Today Governor Newsom took an important step forward by signing AB 2265, which will provide much needed clarity to existing statute in order for counties to treat those who are experiencing mental health issues in addition to substance use or alcohol disorders," said Assemblymember Quirk-Silva.

Bills in this package will also divert, when appropriate, individuals in crisis at emergency rooms to sobering centers and mental health facilities and encourage the creation of a state office to identify and address causes of suicide.

SB 803 by Senator Jim Beall (D-San Jose) supports statewide standards for behavioral health Peer Support Specialists and adds these services as an option in Medi-Cal. Peer Support Specialists are people with lived experience with mental health and/or substance use disorders and are in a unique position to earn trust and build bridges for people on the path to recovery. Statewide standards will ensure consistency and quality of service while offering a level of validity and respect to the position, while satisfying a federal requirement to allow Medi-Cal billing. A signing message for SB 803 can be found here

"Peer support services are evidence-based, and a cost-effective model of care proven to reduce cost and increase participation in treatment. Forty-eight other states have seen the benefit and value of peer support services; now it is time for California to catch up and establish a peer support specialist certification process," said Senator Beall.

In addition, the Governor signed SB 855 by Senator Scott Wiener (D-San Francisco), a long-sought reform that strengthens California's mental health parity statute by requiring commercial health plans and insurers to provide full coverage for the treatment of all mental health conditions and substance use disorders and establishes specific standards for what constitutes medically necessary treatment and criteria for the use of clinical guidelines.

"Mental healthcare is essential to a person's overall health, and today, we reaffirmed that people must have access to care for mental health and addiction challenges. California's mental health parity law has huge loopholes -- which the insurance industry has used to deny critically important care -- and today that loophole was closed. SB 855 sends a powerful message to the nation that California prioritizes the mental health of its residents. I'm proud of my colleagues and the Governor for getting it and enacting this legislation into law," said Senator Wiener.

This legislation builds on Governor Newsom's efforts to improve the state's behavioral health delivery system and help better serve individuals experiencing mental illness. In January, the Governor formed a Behavioral Health Task Force to address the urgent mental health and substance use disorder needs across California. Additionally, the 2020-2021 state budget approved strategies to strengthen enforcement of behavioral health parity laws including focused investigations of commercial health plans regulated by the Department of Managed Health Care to further evaluate plan compliance with parity and assess whether enrollees have consistent access to medically necessary behavioral health care services. In his State of the State address earlier this year, Governor Newsom said Mental Health Services Act funds should be used for substance abuse treatment and not just mental health care.

Governor Newsom also signed the following bills:

AB 465 Assemblymember Susan Talamantes Eggman (D-Stockton) -- Mental health workers: supervision.
AB 1544 by Assemblymember Mike Gipson (D-Carson) -- Community Paramedicine or Triage to Alternate Destination Act. A signing message can be found here.
AB 1766 by Assemblymember Richard Bloom (D-Santa Monica) -- Licensed adult residential facilities and residential care facilities for the elderly: data collection: residents with a serious mental disorder.
AB 1979 by Assemblymember Laura Friedman (D-Glendale) -- Foster youth: housing.
AB 2112 by Assemblymember James C. Ramos (D-Highland) -- Suicide prevention. A signing message can be found here.
AB 2174 by Assemblymember James Gallagher (R-Yuba City) -- Homeless multidisciplinary personnel teams.
AB 2275 by Assemblymember Adrin Nazarian (D-North Hollywood) -- State armories: homeless shelters: security.
AB 2377 by Assemblymember David Chiu (D-San Francisco) -- Residential facilities.
AB 2553 by Assemblymember Philip Ting (D-San Francisco) -- Shelter crisis declarations.
AB 2960 by Assemblymember Mike Gipson (D-Carson) -- Shelter crises: fire and life safety standards.
AB 3242 by Assemblymember Jacqui Irwin (D-Thousand Oaks) -- Mental health: involuntary commitment.
SB 1065 by Senator Robert Hertzberg (D-Van Nuys) -- CalWORKs: homeless assistance.

The Newsom Administration has prioritized behavioral health over the last two years -- expanding access and addressing the evolving needs of at-risk Californians.

The Behavioral Health Task Force, established this year, while working to plan for and implement a behavioral health system that meets the diverse needs of all Californians, is also focusing on the specific needs of children, people at risk of or experiencing homelessness, and people with criminal justice system involvement. Additionally, as societal and economic circumstances have changed -- with COVID-19, the resulting recession, and heightened attention to racial injustice -- the Behavioral Health Task Force is, in turn, working to adjust its own mission and objectives to identify and address related needs.
In September 2020, the Office of Statewide Health Planning and Development awarded $17.3 million in grants to seven programs to help further build the pipeline of public mental health professionals in California. Collectively, the grantees will add 36 Psychiatry Residency slots and fund 336 Psychiatric Mental Health Nurse Practitioner slots. The funding will also help launch a new Child and Adolescent Psychiatry Fellowship program.
In response to the current public emergency, the Department of Health Care Services (DHCS) launched the CalHOPE Warm Line at 1-833-317-HOPE (4673) and website at www.calhope.dhcs.ca.gov. The State COVID-19 and CalHOPE websites have a new page, Together for Wellness, with additional resources for children and families.
DHCS submitted an $82 million proposal to the Federal Emergency Management Agency (FEMA) to launch an expansive program of crisis counseling support for all California, with a special focus on communities hardest hit by the pandemic and the experience of racism. The proposal also includes support for schools to reach children and youth suffering from the impact of the emergency, a robust media campaign and more website resources to help get people the support they need to manage the crisis. The state expects grant approval within the next month.
DHCS has leveraged over $260 million in federal opioid funding to support the Medication Assisted Treatment (MAT) Expansion Project, allowing easy access to opioid addiction treatment in emergency departments and hospitals, primary care clinics, drug treatment programs, jails and prisons, and other health care settings. DHCS also supports a media campaign, Choose Change California, to lower stigma about using medications for opioid use disorder. To date, over 19,000+ overdose reversals have been reported, over 650 new MAT access points have been created, and 30,000 new patients have been served.
To positively impact behavioral health care delivery, DHCS is using Proposition 56 funds to create the Value-Based Payment Behavioral Health Integration (BHI) Incentive Program. The program aims to improve physical and behavioral health outcomes, care delivery efficiency and the patient experience by establishing or expanding fully integrated care into provider networks. DHCS anticipates completing the award process and beginning program implementation in 2020.
DHCS also used Proposition 56 funds to support behavioral health navigators in over 200 California hospitals, to allow addiction treatment to be provided immediately for patients arriving at an emergency department. This project is part of the California Bridge program, which integrates addiction treatment into care at hospitals and emergency departments.
DHCS, CDPH and the Surgeon General of California sent a letter to guide suicide screening and prevention strategies to all health care providers in the state, providing simple instructions and resources about what to do if they identify someone who is at risk.
California's behavioral health professional associations have collaborated to develop a web-based resource, Covid19CounselingCA.org, to provide free counseling to health care workers in need of emotional support.