SB 1238

Bill Subjects

Abstract

(1) Existing law defines "health facility" to include a "psychiatric health facility" that is licensed by the State Department of Health Care Services and provides 24-hour inpatient care for people with mental health disorders. Existing law requires that such care include, but is not limited to, psychiatry, clinical psychology, psychiatric nursing, social work, rehabilitation, drug administration, and food services for persons whose physical health needs can be met in an affiliated hospital or in outpatient settings. This bill would expand the definition of "psychiatric health facility" to also include a facility that provides 24-hour inpatient care for people with severe substance use disorders, or cooccurring mental health and substance use disorders. The bill would expand that 24-hour inpatient care also include substance use disorder services, as medically necessary and appropriate. The bill would specify that psychiatric health facilities to only admit persons with stand-alone severe substance use disorders involuntarily pursuant to specified requirements. The bill would authorize a psychiatric health facility to admit persons diagnosed only with a severe substance use disorder when specified conditions are met. The bill would authorize the department to implement, interpret, or make specific these provisions, in whole or in part, by means of plan or county letters, information notices, plan or provider bulletins, or other similar instructions, until the time when regulations are adopted no later than December 31, 2027. (2) Under existing law, regulations adopted by the department are to include standards appropriate for 2 levels of disorder: (1) involuntary ambulatory psychiatric patients, and (2) voluntary ambulatory psychiatric patients. This bill would instead require regulations to include standards appropriate for 3 levels of disorder: (1) involuntary ambulatory patients receiving treatment for a mental health disorder, (2) voluntary ambulatory patients receiving treatment for a mental health disorder, and (3) involuntary ambulatory patients receiving treatment for a severe substance use disorder. (3) Existing law requires the program aspects of a psychiatric health facility to be reviewed and approved by the department to include, among others, activities programs, interdisciplinary treatment teams, and rehabilitation services. Existing law requires proposed changes in the standards or regulations affecting health facilities that serve persons with mental health disorders to be effected only with review and coordination of the California Health and Human Services Agency. This bill would expand these program aspects to also include substance use disorder services, if the psychiatric health facility admits persons diagnosed only with a severe substance use disorder. The bill would also require proposed changes in the standards or regulations affecting health facilities that serve persons with severe substance use disorders, or cooccurring mental health and severe substance use disorders, to be effected only with review and coordination of the California Health and Human Services Agency. (4) Under existing law, the Lanterman-Petris-Short Act (act) , when a person, as a result of a mental health disorder, is a danger to others or to themselves, or gravely disabled, as defined, the person may, upon probable cause, be taken into custody for a period of up to 72 hours for assessment, evaluation, and crisis intervention, or placement for evaluation and treatment in a facility designated by the county for evaluation and treatment and approved by the State Department of Health Care Services. Existing law defines the above-described designated facility as a facility that is licensed or certified as a mental health treatment facility or a hospital by the State Department of Public Health, and may include, but is not limited to, a licensed psychiatric hospital, a licensed psychiatric health facility, and a certified crisis stabilization unit. Existing law authorizes each county to designate facilities, which are not hospitals or clinics, as 72-hour evaluation and treatment facilities and as 14-day intensive treatment facilities if the facilities meet requirements as the Director of Health Care Services may establish by regulation. This bill would define "designated facility," "facility designated by the county for evaluation and treatment," or "facility designated by the county to provide intensive treatment" to mean a facility that meets designation requirements established by the department to include, but not be limited to, enumerated facilities, including psychiatric health facilities licensed by the department, general acute care hospitals licensed by the department, and chemical dependency recovery hospitals licensed by the department. The bill would authorize counties to designate facilities to provide evaluation and treatment, as specified, and intensive treatment, as specified. The bill would authorize counties to designate appropriate facilities that are not hospitals or clinics, subject to requirements established by the department. The bill would require the department to approve county designation of facilities to provide these treatments. The bill would require the State Department of Health Care Services, in consultation with the County Behavioral Health Directors Association of California, provider representatives, substance use treatment representatives, patients' rights advocates, disability rights advocates, and other relevant stakeholders, to establish updated regulations for the purpose of developing designation requirements for facilities who are admitting and treating persons involuntarily, as specified. The bill would authorize the department to implement, interpret, or make specific these provisions, in whole or in part, by means of county letters, information notices, plan or provider bulletins, or other similar instructions, until the time regulations are adopted no later than December 31, 2027. (5) Existing law requires an application by counties, county contract providers, or other organizations in order for a mental health rehabilitation center to be licensed by the department. Existing law requires the department to conduct annual licensing inspections of mental health rehabilitation centers. This bill would authorize the department to adopt, amend, or repeal regulations regarding the licensing of mental health rehabilitation centers. The bill would authorize a mental health rehabilitation center to admit clients diagnosed only with a severe substance use disorder only when the mental health rehabilitation center meets specified requirements, including either offering medications for addiction treatment (MAT) or having an effective referral process in place to other MAT providers. The bill would also authorize the department to implement, interpret, or make specific these provisions, in whole or in part, by means of county letters, information notices, plan or provider bulletins, or other similar instructions, until the time regulations are adopted no later than December 31, 2027. This bill would require the department to issue guidance regarding Medi-Cal reimbursement for covered Medi-Cal services provided to an individual receiving involuntary treatment for a severe substance use disorder, as specified. The bill would authorize the department to implement, interpret, or make specific these provisions, in whole or in part, by means of information notices, provider bulletins, or other similar instructions, without taking further regulatory action. The bill would make conforming and nonsubstantive changes. This bill would generally authorize the department to implement, interpret, or make specific these provisions, in whole or in part, by means of information notices, provider bulletins, or other similar instructions, until the time regulations are adopted.