Medi-Cal Managed Care Plan Mental Health Benefits

Cal. WIC § 14190.1

California Statutes

(

a) Subject to subdivision (b), and no later than January 1, 2025, a Medi-Cal managed care plan shall conduct annual outreach and education for its enrollees, based on a plan that the Medi-Cal managed care plan develops and submits to the department upon the department’s approval of the Medi-Cal managed care plan’s Population Needs Assessment, regarding the mental health benefits that are covered by the Medi-Cal managed care plan pursuant to

Section and paragraph (1) of subdivision (

b) of

Section 14184.402.

(1) The outreach and education plan shall be informed by the Medi-Cal managed care plan’s stakeholder engagement, including the community advisory committee established by the Medi-Cal managed care plan, and by local stakeholders representing diverse racial and ethnic communities.

(2) The outreach and education plan shall be informed by the Medi-Cal managed care plan’s Population Needs Assessment and an assessment of utilization of covered mental health benefits by race, ethnicity, language, age, sexual orientation, gender identity, and disability, and shall ensure that materials and messaging are appropriate for the diversity of the plan enrollee membership. The Medi-Cal managed care plan shall submit the utilization assessment to the department.

(3) The outreach and education plan shall meet cultural and linguistic appropriateness standards, in alignment with the National Standards for Culturally and Linguistically Appropriate Services, shall incorporate best practices in stigma reduction, and shall provide multiple points of contact for enrollees to access mental health benefits. (b)

(1) The department shall review the new or updated outreach and education plan submitted by each Medi-Cal managed care plan as described in this

section and shall approve or modify the plan within calendar days since submission, to ensure appropriate local stakeholder engagement, alignment with the Population Needs Assessment, and cultural and linguistic appropriateness.

(2) Implementation of a Medi-Cal managed care plan’s outreach and education plan described in this

section shall be subject to approval by the department pursuant to paragraph (1).

(3) Each Medi-Cal managed care plan shall publicly post, on its internet website and in an accessible manner, its approved outreach and education plan and its utilization assessment described in paragraph (2) of subdivision (a), excluding any personally identifiable information. (

c) The department shall consult with stakeholders representative of diverse racial and ethnic communities, including, but not limited to, consumer advocates, mental health stigma reduction experts, community-based organizations, and Medi-Cal managed care plan stakeholders, to develop the standards by which outreach and education plans will be reviewed and approved. (

d) Approval standards may include, but are not limited to, any of the following:

(1) Outreach and education methods that include, but are not limited to, online outreach, mail, telephone, partnerships with community-based organizations, partnerships with primary care providers, and use of navigators, community health workers, and other providers trained to conduct outreach and education.

(2) Alignment of the culturally and linguistically tailored outreach and education strategies with the National Standards for Culturally and Linguistically Appropriate Services, utilization assessment and Population Needs Assessment.

(3) Inclusion of consumer-friendly information in existing member-facing communication channels, including the Medi-Cal managed care plan’s internet website.

(4) An independent evaluation plan to assess and improve outreach to enrollees related to nonspecialty mental health services upon the department’s approval of a Medi-Cal managed care plan’s Population Needs Assessment. (

e) A Medi-Cal managed care plan shall also conduct annual outreach and education, based on a plan that the Medi-Cal managed care plan develops, to inform primary care providers regarding the mental health benefits covered by the Medi-Cal managed care plan pursuant to

Section and paragraph (1) of subdivision (

b) of

Section 14184.402. (

f) Notwithstanding

Chapter 3.5 (commencing with

Section 11340) of Part of Division of Title of the Government Code, the department may implement, interpret, or make specific this section, in whole or in part, by means of all-county letters, plan letters, provider bulletins, information notices, or other similar guidance, until any necessary regulations are adopted. (

g) For purposes of implementing this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this

section shall be exempt from

Chapter 6 (commencing with

Section 14825) of

Part 5.5 of Division of Title of the Government Code,

Section of the Government Code, and

Part 2 (commencing with

Section 10100) of Division of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services.

Document details

CollectionCalifornia Statutes
CitationCal. WIC § 14190.1
Date2023-01-01
Typestatute
Languageen
SourceCA_STAT
IdentifierWIC14190.1.20228791

Medi-Cal Managed Care Plan Mental Health Benefits

Cal. WIC § 14190.1

California Statutes

Medi-Cal Managed Care Plan Mental Health Benefits

Cal. WIC § 14190.1

California Statutes

(

a) Subject to subdivision (b), and no later than January 1, 2025, a Medi-Cal managed care plan shall conduct annual outreach and education for its enrollees, based on a plan that the Medi-Cal managed care plan develops and submits to the department upon the department’s approval of the Medi-Cal managed care plan’s Population Needs Assessment, regarding the mental health benefits that are covered by the Medi-Cal managed care plan pursuant to

Section and paragraph (1) of subdivision (

b) of

Section 14184.402.

(1) The outreach and education plan shall be informed by the Medi-Cal managed care plan’s stakeholder engagement, including the community advisory committee established by the Medi-Cal managed care plan, and by local stakeholders representing diverse racial and ethnic communities.

(2) The outreach and education plan shall be informed by the Medi-Cal managed care plan’s Population Needs Assessment and an assessment of utilization of covered mental health benefits by race, ethnicity, language, age, sexual orientation, gender identity, and disability, and shall ensure that materials and messaging are appropriate for the diversity of the plan enrollee membership. The Medi-Cal managed care plan shall submit the utilization assessment to the department.

(3) The outreach and education plan shall meet cultural and linguistic appropriateness standards, in alignment with the National Standards for Culturally and Linguistically Appropriate Services, shall incorporate best practices in stigma reduction, and shall provide multiple points of contact for enrollees to access mental health benefits. (b)

(1) The department shall review the new or updated outreach and education plan submitted by each Medi-Cal managed care plan as described in this

section and shall approve or modify the plan within calendar days since submission, to ensure appropriate local stakeholder engagement, alignment with the Population Needs Assessment, and cultural and linguistic appropriateness.

(2) Implementation of a Medi-Cal managed care plan’s outreach and education plan described in this

section shall be subject to approval by the department pursuant to paragraph (1).

(3) Each Medi-Cal managed care plan shall publicly post, on its internet website and in an accessible manner, its approved outreach and education plan and its utilization assessment described in paragraph (2) of subdivision (a), excluding any personally identifiable information. (

c) The department shall consult with stakeholders representative of diverse racial and ethnic communities, including, but not limited to, consumer advocates, mental health stigma reduction experts, community-based organizations, and Medi-Cal managed care plan stakeholders, to develop the standards by which outreach and education plans will be reviewed and approved. (

d) Approval standards may include, but are not limited to, any of the following:

(1) Outreach and education methods that include, but are not limited to, online outreach, mail, telephone, partnerships with community-based organizations, partnerships with primary care providers, and use of navigators, community health workers, and other providers trained to conduct outreach and education.

(2) Alignment of the culturally and linguistically tailored outreach and education strategies with the National Standards for Culturally and Linguistically Appropriate Services, utilization assessment and Population Needs Assessment.

(3) Inclusion of consumer-friendly information in existing member-facing communication channels, including the Medi-Cal managed care plan’s internet website.

(4) An independent evaluation plan to assess and improve outreach to enrollees related to nonspecialty mental health services upon the department’s approval of a Medi-Cal managed care plan’s Population Needs Assessment. (

e) A Medi-Cal managed care plan shall also conduct annual outreach and education, based on a plan that the Medi-Cal managed care plan develops, to inform primary care providers regarding the mental health benefits covered by the Medi-Cal managed care plan pursuant to

Section and paragraph (1) of subdivision (

b) of

Section 14184.402. (

f) Notwithstanding

Chapter 3.5 (commencing with

Section 11340) of Part of Division of Title of the Government Code, the department may implement, interpret, or make specific this section, in whole or in part, by means of all-county letters, plan letters, provider bulletins, information notices, or other similar guidance, until any necessary regulations are adopted. (

g) For purposes of implementing this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this

section shall be exempt from

Chapter 6 (commencing with

Section 14825) of

Part 5.5 of Division of Title of the Government Code,

Section of the Government Code, and

Part 2 (commencing with

Section 10100) of Division of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services.

Document details

CollectionCalifornia Statutes
CitationCal. WIC § 14190.1
Date2023-01-01
Typestatute
Languageen
SourceCA_STAT
IdentifierWIC14190.1.20228791