MHAC Archives - Page 2 of 8 - Mental Health America of California

Joint Sunset Review – Board of Psychology – Exception to Psychotherapist-Patient Privilege for Board Investigations—OPPOSE

May 19^th, 2025

Marc Berman
Chair, Assembly Committee on Business and Professions
1020 N Street, Room 379
Sacramento, CA 95814

Angelique Ashby
Chair, Senate Committee on Business, Professions, and Economic Development
1021 O Street, Room 3320
Sacramento, CA 95814

RE: Joint Sunset Review – Board of Psychology – Exception to Psychotherapist-Patient Privilege for Board Investigations—OPPOSE

Dear Chair Berman and Chair Ashby,

Mental Health America of California (MHAC) would like to express opposition to the California Board of Psychology’s proposed exception to the psychotherapist-patient privilege in Board investigations (Proposal #1 of Section 10 of the Sunset Review Report, page 97) and request that proposal not move forward. The proposal would establish a psychotherapist-patient privilege exception for Board investigations.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues. The people and communities we aim to serve include those of all ages; sexual orientation, gender identity or expression; language, racial and ethnic backgrounds, national origin, and immigration status; spirituality and religious affiliations; or socioeconomic status. Our communities rely on the expectation of privacy when accessing mental health care.

Currently, if a patient refuses to disclose records in a Board investigation, the Board has recourse to obtain the records through a subpoena and obtain a civil court order to enforce the subpoena. This ensures that the Board demonstrates compelling interest that the disclosure of such records is relevant and material to the issue. This court process offers the Board an avenue to obtain records while upholding the psychotherapist’s duty to patient privilege and protecting the patient’s constitutional right to privacy.

Confidentiality is essential to successful psychotherapy because it allows for open dialogue between the Psychologist and the patient on extremely personal and sensitive issues. Patients rely on the expectation of privacy every time they attend a therapy session, and without the guarantee of privacy, patients will be less likely to be forthcoming with their therapist and possibly be less likely to seek care.

In addition, this proposal has the potential to severely undermine the quality and effectiveness of psychotherapy. If Psychotherapists fear that their client records could be seized without proper protections, this could result in less than accurate and potentially reductive work products.

The Board has reported that over the last four years it has had to close only three cases due to an inability to access records. The low number of cases being closed does not provide any significant or compelling arguments for a psychotherapist-patient privilege exception. It is for these reasons that MHAC asks you not to move forward with the Board’s proposal. If you have any questions, or if MHAC can provide any assistance on this issue or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community,

Heidi L. Strunk

President & CEO

Cc: Honorable Members, Assembly Business and Professions Committee
Honorable Members, Senate Business and Professions and Economic Development Committee
Kaitlin Curry, Consultant, Assembly Business and Professions Committee
Anna Billy, Consultant, Senate Business and Professions and Economic Development Committee

Re: Proposition 36 Behavioral Health Treatment Implementation Recommendations

May 7, 2025

The Honorable Scott Wiener, Chair
Senate Budget Committee
1020 N Street, Room 502
Sacramento, CA 95814

The Honorable Jesse Gabriel, Chair
Assembly Budget Committee
1021 O Street, Suite 8230
Sacramento, CA 95814

The Honorable Laura Richardson, Chair
Senate Budget Subcommittee No. 5
1020 N Street, Room 502
Sacramento, CA 95814

The Honorable James Ramos, Chair
Assembly Budget Subcommittee No. 6
1021 O Street, Suite 8230
Sacramento, CA 95814

Re: Proposition 36 Behavioral Health Treatment Implementation Recommendations

Dear Chairs Wiener, Gabriel, Richardson and Ramos:

The below signed coalition of advocates representing behavioral health treatment providers and advocates for safe and healthy communities, respectfully request the Legislature provide funding to expand the capacity to deliver more behavioral health treatment, including for individuals charged with treatment-mandated felony offenses created by Proposition 36. As organizations dedicated to improving behavioral health outcomes across the state, we recognize the urgent need to provide individuals charged with treatment-mandated felonies and those voluntarily seeking treatment and supportive services that often serve as pathways to treatment the comprehensive and accessible treatment and support they need and deserve.

In November, voters sent a clear message that treatment must be part of a successful public safety strategy. Ensuring the availability of appropriate, on-demand behavioral health services for anyone seeking them is essential to meeting needs created by Proposition 36 and reducing entry into the criminal legal system. To do so, we recommend the Legislature take the following actions:

Invest $105 Million in Behavioral Health Treatment for Proposition 36: California’s behavioral health treatment system, particularly for substance use disorders, remains under-resourced and oversubscribed. Without additional funding, many individuals eligible for treatment under Proposition 36 will be unable to access the care they need. There is a significant need for substance use disorder treatment capacity across the continuum, particularly acute need for residential treatment capacity given the current wait times can be weeks or even months long.

While it is difficult to estimate the treatment needs under Proposition 36 only a few months into implementation, based on the Judicial Council’s Proposition 36 survey, we anticipate an additional $105 million in treatment investments is needed.1 This investment is critical to ensuring that treatment programs statewide can meet demand, improve outcomes, and provide a path of recovery and opportunity that ultimately create safer communities.
Build Out the Forensic Behavioral Health Continuum of Care with Focused Workforce and Infrastructure Investments: California faces a devastating behavioral health workforce crisis. Estimates from the Steinberg Institute suggest that we need to add 375,000 workers over the next decade to meet the demand for care. This estimate does not include the increased need for services being driven by Proposition 36. While the state is poised to invest billions into the build-out of new capacity through the Bond BHCIP and Proposition 1 workforce investments, it is important that a portion of these dollars are prioritized for the buildout of a forensic behavioral health continuum of care with a focus on individuals in the criminal legal system who have behavioral health needs.
Ensure Behavioral Health Clinicians Perform Evaluations and Make Level of Care
Recommendations: Clinical evaluations and decisions regarding the appropriate level of treatment for individuals should be made by qualified behavioral health clinicians working within the county behavioral health safety net and using the criteria and guidelines set forth in the most recent versions of treatment criteria developed by the nonprofit professional association for the relevant clinical specialty, such as the ASAM criteria for substance use disorders. This will ensure that those mandated to treatment under Proposition 36 receive care that is evidence-based, appropriately tailored to their individual needs, and in compliance with insurance-based medical necessity requirements.
Direct Treatment Funds to State and Local Behavioral Health Agencies: To maximize the effectiveness and accountability of Proposition 36 funding, all treatment dollars should be allocated to appropriate state and local behavioral health entities, specifically the Department of Health Care Services and county behavioral health departments. These entities have the expertise necessary to deliver high-quality treatment services and oversee program implementation.
Require Reimbursement by Commercial Insurance: Proposition 36 is payer agnostic and not all those who meet criteria for the treatment-mandated felony will qualify for Medi-Cal County behavioral health services. County behavioral health agencies do not have the infrastructure nor funding to serve additional populations within the county behavioral health delivery system. The Legislature should leverage existing commercial insurance requirements for behavioral health care (SB 855, Wiener, 2020) and further clarify that commercial insurance is required to cover treatment provided under Proposition 36, similar to the language included in the CARE Act (SB 1338, Umberg, 2022), will ensure that county behavioral health agencies and providers are reimbursed for the services provided to individuals who may not meet Medi-Cal eligibility criteria.
Implement Robust Spending and Outcomes Reporting: To ensure that Proposition 36 achieves its intended goals, all new funds should be accompanied by clear spending and outcomes reporting requirements. Transparency and accountability measures should not duplicate existing reporting, outcomes, and accountability requirements and leverage existing reporting mechanisms to the extent possible in order to reduce the documentation burden on providers and plans. Requiring reporting will help track the success of the various investments made by the state, identify areas for improvement, and demonstrate the positive impact of investing in behavioral health services.

These recommendations can help ensure that individuals charged with treatment-mandated felonies receive the care they need. However, there is also a need to build out our substance use treatment system beyond these recommendations to ensure Californians get care before they are involved in the justice system. We would urge the Legislature to continue to invest in substance use treatment and support services. Our coalition stands ready to collaborate with the Legislature and the Administration to advance these vital improvements. Should you have any questions, please feel free to contact Tara Gamboa-Eastman with the Steinberg Institute at tara@steinberginstitute.org.

Sincerely,

Karen Larsen
Chief Executive Officer
Steinberg Institute

Le Ondra Clark Harvey
Chief Executive Officer
California Behavioral Health Association

Robb Layne
Executive Director
California Association of Alcohol and Drug
Program Executives

Pete Nielsen
President and Chief Executive Officer
California Consortium of Addiction Programs and
Professionals

Michelle Doty Cabrera
Executive Director
County Behavioral Health Directors Association

Heid Strunk
President and CEO
Mental Health America of California

Anne Irwin
Founder and Director
Smart Justice

Anthony Di Martino
Government Affairs Director
Californians for Safety and Justice

Grey Gardiner
State Director, California
Drug Policy Alliance

Claire Simonich
Associate Director
Vera Institute for Justice

Paul Yoder
Legislative Advocate
California State Association of Psychiatrists

Selena Liu Raphael
Senior Policy Advocate
California Alliance of Child and Family Services

Chad Costello
Executive Director
California Association of Social Rehabilitation
Agencies

Tyler Rinde
Director of Government Affairs
California Psychological Association

Meron Agonafer
Policy Director
CalVoices

CC:
Senator Akilah Weber, Senate Subcommittee No. 1 Chair
Assemblymember Dawn Addis, Assembly Subcommittee No. 1 Chair
Scott Ogus, Senate Budget Deputy Staff Director
Nora Brackbill, Senate Budget Subcommittee No. 5 Consultant
Jennifer Kim, Assembly Budget Subcommittee No. 6 Consultant
Patrick Le, Assembly Budget Subcommittee No. 1 Consultant
Eric Dang, Principal Consultant, Office of President Pro Tempore Mike McGuire
Marjorie Swartz, Principal Consultant, Office of President Pro Tempore Mike McGuire
Shaun Naidu, Policy Consultant, Office of Speaker Robert Rivas
Rosielyn Pulmano, Policy Consultant, Office of Speaker Robert Rivas

1 This estimate was determined by estimating the annual number of treatment-mandated felonies to be 13,164 people per year based on the data from the Judicial Council Proposition 36 Survey. This estimate assumes that treatment costs will be $20,000 per person on average and that 80% percent of those charged with treatment mandated felonies will be Medi-Cal eligible and, therefore, 50% of the costs will be covered by the federal government. The formula used was (13,164)*(0.8)*(0.5)*($20,000) = $105,312,000.3

AB 539 (SCHIAVO) Extended Health Care Authorizations – Support

June 11^th, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

RE: Support for AB 539 (Schiavo)

Dear Chair Menjivar,

Mental Health America of California (MHAC) is pleased to support Assembly Bill 539 (Schiavo), legislation that would allow prior authorizations for health care services to remain valid for one year from the date of approval or throughout the course of treatment if less than a year.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. Prior authorization procedures can create significant barriers to accessing voluntary mental health and substance use services.

The prior authorization process requires providers to obtain approval from health plans before delivering certain supports or services, including mental healthcare. However, it can take anywhere from one to five days before receiving approval. Additionally, prior authorizations are not permanent. How long an authorization remains active is determined by and varies across health plans and may need to be renewed multiple times for the same care within a given year. These delays create unnecessary barriers to addressing known health challenges and widen the gap in access to vital support and services intended to help individuals before they reach a point of crisis.

This bill helps ensure continuity of care by reducing disruptions caused by repeated prior authorization requests by standardizing the length of approval for at least one year. It is for these reasons MHAC supports AB 539 (Schiavo) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community,

Heidi L. Strunk
President & CEO

SB 306 (BECKER) Honoring Physician Decisions Act – Support

April 16^th, 2025

The Honorable Caroline Menjivar
Chair, Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

RE: MHAC Support for SB 306 (Becker)

Dear Chair Menjivar,

Mental Health America of California (MHAC) is pleased to support Senate Bill 306 (Becker), legislation that would exempt commonly approved healthcare services from requiring prior authorization.

Commonly covered mental health and substance use services include various forms of therapy or counseling and medication management. This bill ensures that health plans that approve 90% or more of prior authorization requests for a given service in the previous year must exempt that service from prior authorization for the following year. This will help streamline access to commonly utilized mental health and substance use services and ensure more timely care.

It is for these reasons MHAC supports SB 306 (Becker) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community,

Heidi L. Strunk
President & CEO

SB 338 (BECKER) Mobile Health for Rural Communities Pilot Program – Support

April 16^th, 2025

The Honorable Caroline Menjivar
Chair, Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

RE: Support for Senate Bill 338 (Becker)

Dear Chair Menjivar,

Mental Health America of California (MHAC), the California Youth Empowerment Network (CAYEN) and LGBTQ+ Inclusivity, Visibility, and Empowerment (LIVE) are pleased to support Senate Bill 338 (Becker), legislation that would establish the Mobile Health for Rural Communities Pilot Program with the goal of increasing access to health services, including mental health, for rural communities.

MHAC, CAYEN, and LIVE are dedicated to advancing mental health, wellness, and equity through community-led advocacy, education, and empowerment. By centering the voices of those with lived experience, including youth, LGBTQ+ individuals, and people living with mental health and substance use challenges, we aim to reduce stigma, influence public policy, and create inclusive environments where everyone has access to vital community-based culturally responsive mental health and substance use supports and services.

Access to these services is extremely challenging for individuals in the rural communities, especially youth and the LGBTQ+ community. People often travel for hours for in-person services. Additionally, rural communities lack the appropriate internet infrastructure to support telehealth or virtual services. Senate Bill 338 (Becker) invests in mobile health, bringing services directly to communities in need, reducing barriers to access in-person and virtual health services.

It is for these reasons MHAC, CAYEN, and LIVE support SB 338 (Becker) and respectfully ask for your “Aye” vote. If you have any questions or need further assistance, please do not hesitate to contact MHAC’s Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org, CAYEN’s Public Policy Coordinator Danny Thirakul at dthirakul@mhac.org, or LIVE’s Project Manager Anthony Garibay-Mena at agaribaymena@mhac.org.

In Community,

Heidi L. Strunk
President & CEO

Danny Thirakul
California Youth Empowerment Network
Public Policy Coordinator

Anthony Garibay-Mena
LGBTQ+ Inclusivity, Visibility, and Empowerment
Project Manager

SB 691 (WAHAB) Prohibition on Body-Worn Cameras – Support

April 22^nd, 2025

The Honorable Jesse Arreguín
Senate Public Safety Committee
1020 N Street, Room 545
Sacramento, CA 95814

RE: Support for Senate Bill 691 (Wahab)

Dear Chair Arreguín,

Mental Health America of California (MHAC) is pleased to support Senate Bill 691 (Wahab), legislation that would require guidance to law enforcement personnel who wear body-worn cameras to limit the recording of medical or psychological evaluations, procedures, or treatment that may cause embarrassment or humiliation to the patient. The bill would also require a procedure for emergency service personnel to request the redaction of evidentiary recordings of a patient undergoing medical or psychological evaluation, procedure, or treatment.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. The types of services and supports individuals receive during a mental health crisis require trust, rapport with providers, and an assurance of confidentiality.

People experiencing a mental health crisis are often in an immensely vulnerable, isolating, and sometimes life-threatening situation. In the event an individual must be forced into treatment, their right to privacy must be prioritized and upheld. Furthermore, recordings and sharable videos of individuals without their consent during moments of crisis may be used to further inflame and stigmatize individuals during assessments or conservatorship investigations. These potentially singular moments of crisis should not be used to define the entirety of an individual’s journey towards wellness.

MHAC is committed to reducing stigma and empowering individuals to seek and accept support and services for mental health challenges. A moment of crisis should not define them or prohibit their ability to establish a path towards recovery that works for them. It is for these reasons MHAC supports SB 691 (Wahab) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community,

Heidi L. Strunk
President & CEO

AB 1032 (HARABEDIAN) Coverage for Behavioral Health Visits – Support

July 1^st, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

RE: MHAC Support for Assembly 1032 (Harabedian)

Dear Chair Menjivar,

Mental Health America of California (MHAC) is pleased to support AB 1032 (Harabedian), legislation that will allow health plan enrollees to be reimbursed for up to 12 visits with a behavioral health provider if they reside in a county where a state of emergency has been declared due to wildfires. This bill would also require health plans to notify enrollees of their eligibility and ensure these benefits would not be subject to utilization review.

During moments of crisis, especially ones brought about from natural disasters such as wildfires, access to proper support and services can be extremely difficult. The recent Los Angeles fires have displaced hundreds of thousands of people without proper access to critical mental health and substance use supports. The American Addiction Centers notes that natural disasters often lead to increased substance use.[1] As displaced individuals attempt to access mental health and substance use supports and services, cost and insurance coverage should not prevent them from accessing care.

This bill ensures that individuals who experience a crisis due to a natural disaster can receive critical care without cost becoming a barrier to continuity of care. It is for these reasons MHAC supports AB 1032 (Harabedian) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any other behavioral health legislation, please do not hesitate to contact me at kvicari@mhac.org or our Public Policy Coordinator, Danny Thirakul, at dthirakul@mhac.org.

In Community,

Karen Vicari
Director of Public Policy
Mental Health America of California

[1] Stacy Mosel, L. M. S. W. (2025, April 4). The impact of natural disaster on Substance Use Disorders: AAC. American Addiction Centers.

MHAC Behavioral Health Services Act County Policy Manual Module 3 Recommendations

April 25th, 2025

Department of Health Care Services
Behavioral Health Transformation
1501 Capitol Ave
Sacramento, CA 95814

RE: Behavioral Health Services Act County Policy Manual Module 3

To Whom It May Concern,

Mental Health America of California (MHAC) is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. Below are MHAC’s recommendations regarding the proposed Behavioral Health Services Act County Policy Manual Module 3.

Section E.2.1 IP Requirements

Recommendation #1: Add language encouraging meaningful stakeholder engagement in annual updates.

Reasoning: Although the Behavioral Health Services Act (BHSA) does not require a full stakeholder process for annual updates, language in the Act implies ongoing involvement of stakeholders. For instance, Welfare & Institutions Code Section 5892 (e) (1) (A-C) requires counties to include funding for annual planning costs to fund stakeholder participation:

(e) (1) (A) Notwithstanding subdivision (a) of Section 5891, the allocations pursuant to subdivision (a) shall include funding for annual planning costs pursuant to Sections 5963.02 and 5963.03.

(B) The total of these costs shall not exceed 5 percent of the total of annual revenues received for the Local Behavioral Health Services Fund.

(C) The planning costs shall include funds for county mental health and substance use disorder programs to pay for the costs of consumers, family members, and other stakeholders to participate in the planning process.

Additionally, Welfare & Institutions Code Section 5963.03 (a)(2)(A)(i) retains original MHSA language which states:

(2) (A) (i) A county shall demonstrate a partnership with constituents and stakeholders throughout the process that includes meaningful stakeholder involvement on mental health and substance use disorder policy, program planning, and implementation, monitoring, workforce, quality improvement, health equity, evaluation, and budget allocations.

Meaningful stakeholder involvement in processes such as program planning, implementation, quality improvement and evaluation are not one-time processes that can occur once every three years, these are ongoing processes that must be implemented throughout a 3-year period as programs are rolled out and eventually evaluated.

Recommendation #2: Strengthen the language in this section to clearly state that the local agency must “provide an annual report of written explanations to the local governing body and the department for substantive recommendations made by the local behavioral health board that are not included in the final integrated plan or update.”[1]

Reasoning: This is a key section of the BHSA which ensures that Behavioral Health Board (BHB) recommendations are carefully considered. Behavioral Health Board meetings are an open and transparent forum for stakeholder involvement and their impact in the planning process should be maintained.

Section E3.4 Exemption Approval

Recommendation # 3: The manual should state that DHCS will provide counties with specific feedback on why exemption requests are denied.

Reasoning: Exemptions will allow counties to more effectively plan for services that meet local needs. Clarity in how to obtain these exemptions is vital.

Section E4.2 DHCS Review Standards

Recommendation #4: Require BHB review of revised IPs that are found to inadequately address local needs.

Reasoning: The Draft Module 3 states that DHCS may require counties to revise their IP if it fails to address local needs, including prevalence of mental health and substance use disorder and unmet need for mental health and substance use disorder treatment in the county, among others. Revisions to an IP for reasons as substantive as failing to address local needs should be subject to some form of stakeholder review. The input of stakeholders who are intricately involved in the system is vital to ensuring the appropriate use of funds to address local needs and BHB review would provide the opportunity for stakeholder input into revised IPs without unduly burdening the local agency.

E.5.3 Approval Process for Joint Integrated Plans

See recommendation #2

We ask these recommendations be included in the final version of the Behavioral Health Services Act County Policy Manual Module 3. If you have any questions, or if MHAC can provide any assistance regarding the implementation of the Behavioral Health Services Act please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community,

Heidi L. Strunk
President & CEO

[1] WIC Section 5963.03 (b)

Coalition Re: Mental Health and Substance Use Disorder Coverage Requirements

April 11, 2025

California Department of Insurance

Attn: Stesha Hodges, Assistant Chief Counsel, Kayte Fisher, Attorney V

Health Equity and Access Office
300 Capitol Mall, Suite 1700
Sacramento, CA 95814

Via email <CDIRegulations@insurance.ca.gov>

Re: Mental Health and Substance Use Disorder Coverage Requirements, Article 15.2 (commencing with section 2652.1) of Subchapter 3 of Chapter 5 of Title 10 of the California Code of Regulations, pursuant to the authority granted by Insurance Code sections 10144.4, 10144.5, 10144.51, 10144.52, 10144.53, and 10144.57

We thank the California Department of Insurance for its ongoing progress towards finalizing its Mental Health and Substance Use Disorder Parity in Health Insurance Rulemaking (REG-2021-00008), to implement Senate Bill 855 (Wiener, Chapter 151, 2020) and Assembly Bill 988 (Bauer-Kahan, Chapter 747, 2022). We are grateful for the Department’s continued engagement with us on numerous issues related to implementation of the law and its drafted regulations. The Department’s proposed Rule lessens the possibility that disability insurers will exploit ambiguities to inappropriately limit insureds’ access to mental health and substance use disorder (MHSUD) care.

We encourage this comprehensive Rulemaking to be finalized as soon as possible and offer support for the Department’s April 3, 2025 additions to its drafted Rulemaking dated May 24, 2024. Specifically, we are supportive of the following key additions, as currently drafted:

Network adequacy monitoring. We support the Department’s added clarity as to what an insurer needs to do once someone has requested assistance identifying a health care provider including by adding that if an insurer cannot identify more than three in-network providers, that it must refer the person to those three and notify the Department of the service requested, type of provider, and location. This is an important mechanism for ensuring the Department has proactive insight into possible weakening parts of networks that could lead to or show existing network inadequacies. We applaud the Department for this forward-thinking change which we believe will protect insureds.
Defining coordinated specialty care. Providing a definition of Coordinated Specialty Care makes it much harder for insurers to deny or partially deny medically necessary services for individuals experiencing first and early episodes of psychosis. We applaud the Department’s further defining of these life-saving but seldom reimbursed services.

We encourage the swift promulgation of comprehensive regulations. Once promulgated, we encourage the Department to issue notices, bulletins, and/or general opinion letters regarding particular areas of enforcement concern. Our organizations stand ready to assist you in the identification of MH/SUD access issues and comprehensive implementation of the Rule in any way we can.

If you have any questions, please contact Lauren Finke (lauren@thekennedyforum.org). For matters requiring physical or printed communication, please send to 1121 L Street, Sacramento, California 95814 suite #300.

Sincerely,

Adrienne Shilton
California Alliance of Child and Family Services

Robb Layne
California Association of Alcohol and Drug Program Executives, Inc

Joy Alafia
California Association of Marriage and Family Therapists

Chad Costello
California Association of Social Rehabilitation Agencies

Carli Stelzer
California Behavioral Health Association

Tyler Rinde
California Psychological Association

Paul Yoder
California State Association of Psychiatrists

Danny Thirakul
California Youth Empowerment Network

Alison Ivie
REDC Consortium
Eating Disorders Coalition for Research, Policy, & Action

Karen Fessel
Mental Health & Autism Insurance Project

Heidi Strunk
Mental Health America of California

Héctor Hernández-Delgado
National Health Law Program

Benjamin Eichert
NUHW

Samia H. Rafeedie
Occupational Therapy Association of California

Randall Hagar
Psychiatric Physicians Alliance of California

Tara Gamboa-Eastman
Steinberg Institute

Lauren Finke
The Kennedy Forum

CC:
Ricardo Lara, Stesha Hodges, Kayte Fisher, Department of Insurance
Senator Scott Wiener
Assemblymember Bauer-Kahan

SB 367 (ALLEN) Expand the Lanterman Petris Short (LPS) Act – Oppose

April 4^th, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento , CA 95814

RE: OPPOSE Senate Bill 367 (Allen)

Dear Chair Menjivar,

Mental Health America of California (MHAC) respectfully opposes Senate Bill 367 (Allen), which would expand Lanterman Petris Short (LPS) Act involuntary commitment and conservatorship statutes by: 1) Requiring information about the historical course of a person’s medical, psychological, educational, social, financial, and legal conditions to be included in the assessment for an involuntary hold; 2) Authorizing conservatorships for people who have accepted voluntary care; and 3) Expanding the list of individuals or entities that can recommend conservatorship. These expansions of current law will risk infringing on peoples’ civil rights by inappropriately increasing conservatorships.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. In accordance with our mission, MHAC supports increasing the availability of voluntary, accessible, culturally responsive, community-based services.

MHAC is opposed to SB 367 for the following reasons:

Requiring information about the historical course of a person’s medical, psychological, educational, social, financial, and legal conditions to be included in the assessment for an involuntary hold is an egregious and inappropriate expansion of involuntary commitment statute. Current law requires information on the historical course of a person’s mental disorder be considered only if it is determined that the information has a “reasonable bearing” on whether the individual meets criteria for involuntary treatment. Furthermore, current statute specifies limited sources of the historical information.[1] In contrast, SB 367 requires information on the historical course of a broad range of factors that are not relevant to an immediate mental health crisis, including educational, social, financial, and legal. We struggle to understand how the historical course of an individual’s education, for example, bears on their potential status as currently gravely disabled. Requiring this information in assessments risks wrongful involuntary commitments based on bias and prejudice rather than immediate mental health needs, and threatens the privacy of the individual. Furthermore, by not limiting or specifying the sources of this information, the bill would create excessive burdens on evaluation staff who are now required to collect this historical information.

Allowing conservatorships for individuals who have “demonstrated an inability to follow through with stated plans of self-care” is untenably broad and will likely result in wrongful conservatorships. Self-care is a term that can encompass a wide range of activities, including simple things like getting outside, getting enough sleep, meditating, etc.. Moreover, “stated plans” is a vague term that implies an unwritten expression of self-care goals.

Conservatorships remove individuals’ rights, autonomy and self-determination and should only be used when absolutely necessary and only after significant evaluation of the individual’s mental health. SB 326 expands authority to recommend conservatorships to a judicial officer, a treating physician or an emergency physician. These individuals are not likely to have sufficient knowledge of an individual’s mental health history to make an accurate conservatorship recommendation, which runs the risk of inappropriately increasing unnecessary conservatorships.

It is for these reasons MHAC is opposed to SB 326 (Allen). If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community,

Heidi L. Strunk
President & CEO

[1] California Welfare & Institutions Code Section 5150.05