Qualified youth drop-in center health care coverage.

Plain English Breakdown

The official source does not mention making non-compliance with the bill's requirements a criminal offense.

Health Care Coverage at Youth Drop-In Centers

The bill requires health insurance and Medi-Cal plans to cover mental health and substance use disorder treatments provided at qualified youth drop-in centers for individuals up to age 25.

What This Bill Does

• Expands the definition of 'schoolsite' to include qualified youth drop-in centers.
• Requires health care service plan contracts or policies to cover medically necessary mental health and substance use disorder treatments given at these centers for people aged 25 or younger.
• Reimburses providers who offer such services at youth drop-in centers through Medi-Cal managed care plans.

Who It Names or Affects

• People up to age 25 seeking mental health and substance use disorder treatment at youth drop-in centers.
• Health insurance companies providing coverage for these treatments.
• Medi-Cal managed care plans that reimburse providers offering such services.

Terms To Know

schoolsite

A place where educational activities take place, now including qualified youth drop-in centers under this bill.

Medi-Cal

California's Medicaid program that provides health care services to low-income individuals.

Limits and Unknowns

• The bill does not specify the exact details of how reimbursement will be handled for providers at youth drop-in centers.
• It is unclear what qualifications are needed for a center to be considered 'qualified' under this legislation.

Official Summary Text

SB 812, as amended, Allen.
Qualified youth drop-in center health care coverage.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or health insurance policy issued, amended, renewed, or delivered on or after January 1, 2024, that provides coverage for medically necessary treatment of mental health and substance use disorders to cover the provision of those services to an individual 25 years of age or younger when delivered at a schoolsite.
This bill would
expand the definition of schoolsite to
additionally require a contract or policy that provides coverage for medically necessary treatment of mental health and substance use disorders to cover the provision of those services to an individual 25 years of age or younger when delivered at a qualified youth drop-in center. Because a violation of this requirement relative to health care service plans would be a crime, the bill would create a state-mandated local program.
Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and 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. Existing law requires a Medi-Cal managed care plan or Medi-Cal behavioral health delivery system to reimburse providers of medically necessary outpatient mental health or substance use disorder treatment provided at a schoolsite to a student 25 years of age
or younger who is an enrollee of the plan or delivery system, as specified.
This
Because of the expansion of the definition of schoolsite to include qualified youth drop-in centers, this
bill would expand the above-described reimbursement requirement to those services when provided at a qualified youth drop-in center, as specified.
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.

Current Bill Text

Download Bill PDF