Medi-Cal: specialty mental health services: foster children.

Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services (department) , under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, specialty mental health services include federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services provided to eligible Medi-Cal beneficiaries under 21 years of age. Existing law requires each local mental health plan to establish a procedure to ensure access to outpatient specialty mental health services, as required by the EPSDT program standards, for youth in foster care who have been placed outside their county of adjudication, as described. Existing law requires the department to issue policy guidance concerning the conditions for, and exceptions to, presumptive transfer of responsibility for providing or arranging for specialty mental health services to a foster youth from the county of original jurisdiction to the county in which the foster youth resides, as prescribed. Under this bill, commencing July 1, 2023, in the case of placement of foster children in short-term residential therapeutic programs, community treatment facilities, or group homes, or in the case of admission of foster children to children's crisis residential programs, the presumptive transfer provisions would apply only if certain circumstances exist. These circumstances would include (1) that the case plan for the foster child specifies that the child will transition to a less restrictive placement in the same county as the facility in which the child has been placed, or (2) that the placing agency determines, as specified, that the child will be negatively impacted if responsibility for providing or arranging for specialty mental health services is not transferred to the same county as the facility in which the child has been placed. The bill would impose various notification and documentation requirements on the placing agency. By creating new duties for county agencies with regard to processing requests for presumptive transfer, the bill would impose a state-mandated local program. The bill would require the department and the State Department of Social Services to adopt regulations by July 1, 2027, to implement these provisions, as specified, and would authorize those departments to implement the provisions through county letters, information notices, or similar written instructions until regulations are adopted. The bill would condition implementation of these provisions on the availability of federal financial participation and receipt of all necessary federal approvals. The bill would require the department to make a request for any necessary federal approvals no later than July 1, 2024. In cases of no transfer of responsibility for the foster child's specialty mental health services, the bill would authorize the mental health plan in the county of original jurisdiction and the specialty mental health services provider to utilize an existing contract or to establish one, in order to ensure timely payment for the services provided to the foster child, as specified, or else payment for the services would be made by the mental health plan in the county of original jurisdiction or through an agreement between the mental health plans in the 2 counties. The bill would require the department and the State Department of Social Services to collect data on the receipt of specialty mental health services by foster children who are placed outside of their county of original jurisdiction. The bill would require the inclusion of these data in the department's Medi-Cal specialty mental health services performance dashboard, as specified. The bill would define "foster children" for purposes of the above-described provisions to mean Medi-Cal eligible children younger than 21 years of age who have been placed into foster care by a county child welfare agency or a county probation department. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.