New Jobs
Hiring RN | $65/hr | Weekend Shift | SSM Health On-Demand | ED/ER job in Saint Louis, ... Legal Trademark War Erupts Over “Anesthesiology” Title Between Anesthesiologists & CRNAs Elevate Medical Solutions to Exhibit at AHIMA24 in Salt Lake City, Showcasing Medical ... Biotecnika Times Newsletter 10.10.2024 - Freshers Jobs Behind-the-scenes workers help LMH Health run smoothly - Lawrence Journal-World Registered Nurse RN - Up to $45.85/hour - Tuition Payback Program job in Big Rapids, MI Healthcare Job Growth Rebounds, Sorta, in September Campbell school district gets $250K grant for health care training - The Vindicator Campbell City School District receives over $200000 for medical training program Campbell City School District receives over $200000 for medical training program CVS to lay off 2.9K 'primarily corporate' roles | HealthLeaders Media MSc Biotech JRF Job at Amrita School of Nanosciences and Molecular Medicine, Apply Now See today's jobs list for Saline County & Central Arkansas 09262024 - MySaline NMCC's online medical coding program receives national accreditation through 2027 50 workers to be transferred Hancock Health in midst of changes to revenue cycle team WIC Celebrates 50 Years of Women, Children Assistance - iBerkshires.com Free community college a boon for students, workforce and local economy - iBerkshires.com Biotecnika Times Newsletter 19.09.2024 - Freshers Life Sciences How genAI can help solve major pain points in the rev cycle | Healthcare IT News Freshers Literature Specialist Intern at GSK – Apply Now! - BioTecNika ScribeEMR Presents AI Scribing, Medical Coding at NRHA's Critical Access Hospital ... St. John's Professor Awarded Grant to Study Use of AI in Medical Coding Nurse Is What You Do, It's Not Who You Are: Seeing Your License as a Tool For Opportunity COMMENTARY: Shining a spotlight on adult education and literacy - Waterbury Roundabout Hospitals Seeing Relief from Declining Wage Inflation, Job Openings | HealthLeaders Media KAYLA KROL | News, Sports, Jobs - The Times Leader CMCC® – Certified Medical Coding Consultant: The Premier Credential for Medical ... - WKRN Clinical Research Training: Your Path to a Successful Career - PharmiWeb.com Opinion: Profits over patient care is bad medicine | HealthLeaders Media Choosing the Right Clinical Research Institute: A Step-by-Step Guide with Fusion ... Choosing the Right Clinical Research Institute: A Step-by-Step Guide with Fusion ... Best Clinical Research Courses in Pune by Fusion Technology Solutions - PharmiWeb.com Commonwealth University Workforce Development announces fall 2024 training schedule Finance Officer (Masvingo) at International Medical Corps - Pindula Jobs Weekly Rounds: UV-C Disinfecting Ultrasound Probes, Reducing C difficile Testing, and More Remote, HCC Medical Coders (Full-time) Job Opening in Irvine, California - HIMSS JobMi... 'It's a Good Time to Be a Plumber': A Look Inside Charlotte's New Public Trade High School Need help finding remote LVN work or deciding to inactivate license - All Nurses KBOCC excited about record-breaking enrollment | News, Sports, Jobs - The Mining Gazette Acute Care APRN - Days 7on/7off - Hospitalists - Enid Hospital - Nurse.org CNA Central Facilities job in Sarasota, FL - Nurse.org Nurse Practitioner, Advanced Practice Provider job in Jamaica, NY - Nurse.org CRNA Schools in Virginia | 2024 - Nurse.org Top nonclinical jobs in healthcare for the squeamish CRNA Schools in Ohio | 2024 - Nurse.org Amazon software engineers may be forced to learn skills besides coding thanks to AI: Cloud ch... Healthtech promising growth avenues to mid-career professionals - The Economic Times Nym's Autonomous Medical Coding Engine Listed in Epic Toolbox | News | bakersfield.com Nym's Autonomous Medical Coding Engine Listed in Epic Toolbox - Chronicle-Tribune Nym's Autonomous Medical Coding Engine Listed in Epic Toolbox - Yahoo Finance
News

California Law Aims to Strengthen Access to Mental Health Services

The number of people with symptoms of depression and anxiety has nearly quadrupled during the covid pandemic, which has made it even more maddeningly difficult to get timely mental health care, even if you have good insurance.

A California law signed Oct. 8 by Gov. Gavin Newsom could help. It requires that mental health and substance abuse patients be offered return appointments no more than 10 days after a previous session, unless their provider OKs less frequent visits.

Current insurance regulations already require giving patients an initial mental health visit no more than 10 days after they request it. But there’s been nothing on the books specifically about follow-up care until now.

The law doesn’t take effect until July, which lawmakers said will give health plans time to comply — mainly by hiring or contracting with more therapists. Proponents say that, with effective enforcement, the new law will help a lot of people get the care they need.

The law, SB 221, “will ensure that people can actually use their insurance to get mental health treatment,” says Sen. Scott Wiener (D-San Francisco), the law’s author. “For far too long, health plans have frequently made people wait long periods of time to get mental health appointments, which undermines their care.”

If you are not getting the care you need, there are already ways you can seek redress. When the law takes effect in eight months, it will strengthen your hand. More on that in a moment.

There are two competing explanations for why it’s so hard to get consistent mental health care. Insurers say there’s a shortage of therapists. Therapists say insurers are too cheap to pay them adequately. Many therapists decline to join insurance networks and set their own fees, which a lot of people can’t afford.

The National Union of Healthcare Workers, which sponsored the legislation, has been particularly critical of Kaiser Permanente, the state’s largest commercial health insurer, for its well-publicized mental health care deficiencies.

Kaiser Permanente, with over 9 million members in California, was fined $4 million by state regulators in 2013 for failure to provide timely mental health care. It was cited twice after that for failure to resolve the problems.

Former and current KP therapists say the managed-care giant has addressed the complaint by trying to ensure that members seeking mental health treatment get an initial appointment quickly. But that has only made it harder for those patients to get subsequent sessions, the therapists say.

“Any available appointment would be given to a person needing to initiate services,” says Susan Whitney, a marriage and family therapist who worked for Kaiser Permanente in Bakersfield for 18 years before leaving the organization in September. “Our schedules would be fully booked for six to eight weeks — so follow-up appointments were difficult to make, to say the least.”

The American Psychological Association recommends weekly therapy for people with depression and twice weekly for post-traumatic stress disorder. In a letter to California’s Department of Managed Health Care last year, the association said the long waits for follow-up care reported by KP patients and therapists “fall far below what is appropriate care for most patients.”

Because of the shortage of available therapists, Kaiser Permanente often refers its members to an outside network of providers for mental health treatment. But members, therapists and public officials say those networks often fail to deliver.

Maya Polon, a KP member in Sacramento, began feeling emotionally frayed in March, after caring for her terminally ill grandmother. She tried to get help through Kaiser but had to make numerous calls and kept getting conflicting information about how to get care.

Finally, after more than a month, a Kaiser Permanente therapist told Polon, 27, that her depression, anxiety and panic attacks qualified her for a year of therapy. But if she wanted to do it through Kaiser, it would take six months to get her first appointment.

KP referred her to an outside mental health contractor, Beacon Health Options, which took two weeks to send her a list of therapists. She called all 20 providers on the list, during breaks in her workday, and left messages.

“As someone with anxiety and who suffers from depression, having to actively sit down and call people who are over and over again telling you, ‘Oh, I’m not actually taking new patients,’ is an overwhelmingly defeating process,” Polon says. “I walked away from that thinking, ‘Do I even want to do therapy if this is what I am going to have to go through to even get there?’”

She ended up seeing the one therapist who had space for her, but she wasn’t contracted with Beacon. Polon had to wrangle with Kaiser Permanente for months over the paperwork.

In June, San Diego’s city attorney, Mara Elliott, sued Kaiser over what she termed “ghost networks” that “falsely describe the breadth of an insurer’s provider network, promising consumers access to health care that in reality is unavailable under the plan.” Elliott sued Molina Healthcare and Health Net on similar grounds.

Dr. Yener Balan, vice president of behavioral health and specialty services at Kaiser Permanente in Northern California, says the organization could do better, but claims that it meets the follow-up appointment recommendations of its mental health clinicians 84% of the time — a figure hotly contested by union officials and therapists.

Balan says SB 221’s July implementation date is helpful, “given the shortage of mental health clinicians faced by all health care organizations.”

Critics of the health insurance industry question whether a shortage of therapists is the main problem. Wiener says health plans aren’t paying mental health practitioners enough to join their networks.

A 2019 report by the California Future Health Workforce Commission projected that within a decade there would be 41% fewer psychiatrists than needed and 11% fewer psychologists, marriage and family therapists, and other mental health workers.

But a report the same year by the state Legislative Analyst’s Office said the number of graduates of mental health programs had grown significantly — although there was, it reported, a shortage of psychiatrists.

The Department of Managed Health Care, which regulates health plans covering a large majority of Californians, will monitor compliance with the new law and investigate consumer complaints, says Rachel Arrezola, an agency spokesperson.

What You Can Do

If you believe your health plan is shortchanging you on mental health treatment, you don’t have to wait for the new law. You can challenge your insurer under existing regulations. Once the law takes effect, however, it will offer additional ballast for any challenges and allow regulators to pursue health plans for violations.

To contest a lack of coverage, you must first appeal directly to your health plan. If you are in a private plan, you must file the appeal within six months of care being denied. The insurer must decide on your appeal within 30 days.

If you don’t get a satisfactory decision, take your case to the agency that regulates your insurer for an independent review. And if there’s an urgent health risk, you don’t need to wait 30 days. Contact your regulator immediately.

To find out what agency that is, call the customer service line of your health plan. If it is the Department of Managed Health Care, you can request an independent review by calling 888-466-2219 or logging on to HealthHelp.ca.gov. If your regulator is the California Department of Insurance, call 800-927-4357.

If you are in managed-care Medi-Cal and your plan is regulated by the Department of Managed Health Care, you can ask that department for an independent review. You can also seek a “fair hearing” through the state, as can any Medi-Cal beneficiary, by going online or calling 855-795-0634.

Of course, all this takes time and effort. But if the delay is making it impossible for you to get treatment, it may be worth it.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

USE OUR CONTENT

This story can be republished for free (details).

Syndicated from https://khn.org/news/article/california-law-aims-to-strengthen-access-to-mental-health-services/