Amended
IN
Assembly
May 05, 2020 |
Introduced by Assembly Member Aguiar-Curry |
February 19, 2020 |
This bill would establish a grant program for purposes of establishing and funding a statewide pediatric behavioral telehealth network, subject to a competitive grant process. The California Health and Human Services Agency shall implement the grant program. The bill would require funding made available for these purposes to be expended to build the clinical infrastructure to
support 10 telehealth hubs, as defined, throughout the state. The bill would make children’s hospitals and community-based behavioral health providers, as defined, eligible to participate in the grant program. The bill would require program applicants to demonstrate the ability to, among other things, direct telemedicine services from a hub to the patients of primary care providers.
The Legislature finds and declares all of the following:
(a)California, along with many other states, is suffering from a lack of access to specialized mental health professionals, especially access to child psychiatrists. This shortage comes at a time when the prevalence of mental health issues in children and teens has risen at an alarming rate. According to the American Academy of Pediatrics, the number of child psychiatrists in the nation has increased over the past 10 years by 21 percent, from 8.01 to 9.75 per 100,000 children. However, 70 percent of the counties in the nation still have no child psychiatrists and many of these tend
to be counties that are predominantly low income.
(b)While the American Academy of Child and Adolescent Psychiatry recommends 47 child psychiatrists per 100,000 children, California has only 13. Currently, less than 5 percent of children enrolled in Medi-Cal receive even a single mental health treatment and only 3 percent receive ongoing clinical behavioral health treatment. Many California children, whether covered by Medi-Cal or private insurance, can wait months or longer to obtain needed behavioral health care.
(c)While efforts should continue to train, recruit, and retain more specialty mental health providers in California, training new providers will take time and some underserved areas of the state will likely never recruit a sufficient number of behavioral health providers
to meet the needs of their local populations. In addition, many children and adolescents whose mental health needs could be effectively managed in a primary care setting currently go untreated until their conditions deteriorate because their primary care providers lack the training and resources to adequately meet the mental health needs of their patients.
(d)Accordingly, California must undertake a multifaceted approach to make better use of the limited supply of specialty mental health providers in the state by deploying them strategically using telehealth and provider-to-provider consultation services to address the unmet need for pediatric behavioral health services across the state.
(b)“Community-based behavioral health provider” means any provider with clinical expertise in pediatric behavioral health that has the capacity to serve as a hub in a particular region.
(c)
(d)“Hub” means a distinct geographic region of the
state for which a participant is authorized to implement the grant program.
(e)“Hub-and-spoke system” means the linking of specialists at a hub to primary care clinicians in local communities pursuant to, among other things, telemedicine and videoconferencing, to facilitate case-based learning, dissemination of best practices, and evaluation of outcomes.
(f)
(a)There is hereby established a grant program for purposes of establishing and funding a statewide pediatric behavioral telehealth network. The network shall be comprised of a hub-and-spoke system, subject to a competitive grant process. The California Health and Human Services Agency shall implement the grant program.
(b)Funding made available for the grant program shall be expended to build the clinical infrastructure to support 10 telehealth hubs throughout the state. These hubs shall be established to do all of the following:
(1)Reach out to community-based providers, including pediatricians, family practitioners, and nurse practitioners to educate them about the services that the hub can provide and solicit participation in the hub’s network.
(2)Provide ongoing education to participating providers to build their capacity to identify and manage common pediatric behavioral health conditions, when appropriate, and when to refer to specialty care providers.
(3)Provide case consultation to participating providers to assist them in managing the behavioral health needs of particular patients.
(4)Provide timely telephonic or televideo behavioral health services directly to patients located in rural areas within the hub’s region, as needed.
(c)Participants shall place a priority on working with community providers that predominantly serve low-income populations or those serving in rural or underserved areas of the
state.
(a)The following entities are eligible to apply to be a participant in the grant program:
(1)Children’s hospitals.
(2)Community-based behavioral health providers.
(b)Program applicants shall demonstrate their capacity to provide all of the following services:
(1)Teleconsultations for primary care providers.
(2)Direct telemedicine services from the hub to patients of the primary care providers.
(3)Virtual educational forums with hub to multiple primary care providers to teach everyone using case studies brought by the primary care providers.
(4)In-person education events that meet continuing education requirements for primary care providers and training on how to better address the mental health needs of their patients.