County of Santa Clara Cosponsors Bill Aimed at Helping Youth Get Needed Mental Health Services

SANTA CLARA COUNTY, Calif. – A bill recently cosponsored by the County of Santa Clara aims to help the county’s children and young adults access any behavioral health services they may need by requiring an automatic review of any provider denials of care for mental health disorders among youth aged 26 and under.

County leaders have prioritized Mental Health Parity: Putting behavioral health disorders on equal footing with physical maladies. To achieve that goal, the County cosponsored SB 294, authored by Senator Scott Wiener (D-San Francisco).

SB 294 would require that if a healthcare provider denies a request for mental health treatment – such as a desire for ongoing inpatient or outpatient treatment – a review would automatically ensue, either through a grievance process for nonurgent cases or through an Independent Medical Review for urgent or life-threatening cases. SB 294 is also cosponsored by Children Now, a non-partisan research, policy, and advocacy organization working to ensure all children can reach their full potential.

“This is a health care issue plain and simple. It is long past time to get serious about it,” said County of Santa Clara Supervisor Joe Simitian, who has been a longtime champion of mental health parity. “Mental health issues need to be treated with the same urgency that we provide someone who has a debilitating disease, or a broken bone, or any physical condition that would result in medical attention — with no questions asked. SB 294 will help us reach this important goal. I appreciate Senator Wiener’s leadership on this issue and am excited that the County is partnering with Children Now to make mental health parity happen!” 

Across Santa Clara County, about half of the clients that receive mental health treatment from a medical provider are 26 years old or younger. Currently, when a denied claim is challenged, it is overturned in more than two-thirds of the cases – that means the client ultimately gets the help they were initially refused. This demonstrates that commercial health plans are improperly denying medically necessary mental health treatment at alarmingly high rates.

Moreover, the current system requires advocacy of the patient at a level that may be daunting to family members. The consumer must first file a grievance and go through a 30-day process with the provider; if there is no resolution the consumer can then file a complaint with the Department of Managed Health Care, which assigns an independent provider not affiliated with the plan in question to review the matter.

Because of the process, denials are often not contested – and it can be further complicated if there are language barriers, a lack of knowledge about the health system, or time constraints. As a result, the youth remains untreated for an ongoing disorder. SB 294 will ensure families who do not have the time or ability to file a complaint — or who simply don’t know about the process — would have their claims automatically reviewed and young people will receive faster access to treatment. Such help can be critical; cases can involve youth having suicidal ideations or other self-destructive behavior. 

The bill strengthens existing laws that require health plans to provide medically necessary mental health treatment, such as landmark legislation authored by Senator Wiener and passed in 2020 that expanded the number of behavioral health conditions that insurers are required to cover. However, time and again it has been demonstrated that providers fail to give patients timely access to mental health care. 

“Mental health challenges have exploded among our young people, and we urgently need to provide relief for them,” said Senator Wiener. “SB 294 levels the playing field, allowing young people and their families to access mental healthcare that would otherwise be denied. I’m thrilled to see more and more local leaders getting involved in this critical issue.”

Sherri Terao, director of the County’s Behavioral Health Services Department, said the legislation is in line with the County efforts to improve mental health services. 

“Removing barriers to mental health services for youth and families is a priority, and this bill will help ensure families have access to life-saving treatment,” Terao said.

ABOUT THE COUNTY OF SANTA CLARA, CALIFORNIA 

The County of Santa Clara government serves a diverse, multicultural population of 1.9 million residents in Santa Clara County, Calif., making it more populous than 14 states in the United States. The County provides essential services to its residents, including public health protection, environmental stewardship, medical services through the County of Santa Clara Health System, child and adult protection services, homelessness prevention and solutions, roads, park services, libraries, emergency response to disasters, protection of minority communities and those under threat, access to a fair criminal justice system, and many other public benefits.

MEDIA CONTACTS:

María Leticia Gómez / Eric Kurhi, Office of Communications and Public Affairs

408-299-5119, [email protected]