Supervisors Push for Access to Mental Health Care

SUPERVISORS PUSH FOR ACCESS TO MENTAL HEALTH CARE

SAN JOSE – Today, the Santa Clara County Board of Supervisors directed County staff to develop options to improve access to mental health care in Santa Clara County.

Proposed by County Supervisor Joe Simitian, chair of the County’s Health and Hospital Committee, the Board’s direction is designed to help ensure that residents are aware of their “mental health parity rights” and are better able to access services. California Senate Bill (SB) 855 established the right to parity and requires insurers to cover medically necessary treatment for all mental health and substance use disorders. “Many patients, however, are not aware of their rights,” said Simitian. “And frankly, not all insurers are stepping up as they should.” The phrase “mental health parity” means that mental health and substance use issues get equal treatment as other health conditions.

“When people need mental health or substance use help—for themselves, a friend, or a family member—they need services right away. Folks often spend a lot of time trying to figure out how to access services, worrying if their insurance covers the services, and working out how to pay for it all,” said Simitian. “County residents should know SB 855 exists, and be aware of the mental health services they can access.”

Senate Bill 855 prohibits limits on mental health coverage, including denial of treatment because services could be covered by a public entitlement program, such as Medi-Cal. This landmark new law affirms the obligation of health insurers to monitor clinical review criteria and allows individuals to file administrative grievances if they are denied medically necessary treatment.

“All this sounds bureaucratic and administrative, I know that. But SB 855 will make lives better because it dramatically expands mental health coverage and removes barriers to getting treatment,” said Simitian. 

Simitian noted at the May 3, 2022 Board of Supervisors meeting that, “Laws are only as good as their implementation and enforcement, however. In 2020, the California Health Care Foundation found that 14 out of 25 health care plans were noncompliant with state mental health parity laws. Our County has an opportunity to ensure that our residents know that health insurance companies have a responsibility to cover metal health care so they can get the care they need and are entitled to.”

“Funds for treatment and care facilities must be equal to those facilities that treat other bodily illnesses and diseases… the issue is about coming into compliance in dollars spent, facilities dedicated to caring for those with brain illnesses, available treatment beds and available therapies," said Uday Kapoor, president of National Alliance on Mental Illness (NAMI) Santa Clara County.

High cost and red tape are significant barriers to accessing mental health care.  Some people can pay for the care they need out of pocket, some qualify for Medi-Cal or other government programs, and many others rely on employer-provided commercial insurance for care. Each presents its own challenges, and many people find it nearly impossible to obtain mental health care. For those mental health professionals who do accept insurance, patients often need to pay up front and then fight to get reimbursed or face exorbitant co-pays. All of which can lead to people delaying or avoiding treatment altogether and fewer mental health professionals being available.

“It can be hard enough for folks to acknowledge they need help, or that someone they care about is in crisis,” said Simitian. “By ensuring mental health parity, we can make it easier, less time consuming, and more affordable for our residents and their loved ones to get the mental health and substance use care they need.”

It is expected County staff will report back to the Health and Hospital Committee on June 22, 2022, and the Board of Supervisors on August 30, 2022, with options to improve mental health parity in Santa Clara County.  This might include, among other things, said Simitian, “an education and outreach campaign to ensure that residents are aware of their rights under SB 855, and a program to help residents navigate the insurance process to receive mental health care for themselves or a family member.”

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