Statewide Fee Schedule Pilot Program.

Existing law establishes the Children and Youth Behavioral Health Initiative, administered by the California Health and Human Services Agency and its departments, as applicable. Under existing law, the purpose of the initiative is to transform the state's behavioral health system into an innovative ecosystem in which all children and youth 25 years of age and younger, regardless of payer, are screened, supported, and served for emerging and existing behavioral health needs. Existing law requires, as a part of the initiative, the State Department of Health Care Services to develop and maintain a school-linked statewide fee schedule for outpatient mental health or substance use disorder treatment provided to a student who is 25 years of age or younger at a schoolsite. Existing law requires providers of medically necessary schoolsite services to be reimbursed by health care service plans, insurers, and Medi-Cal managed care plans, at a minimum, at the fee schedule rate or rates, regardless of network provider status. This bill would establish the Statewide Fee Schedule Pilot Program. The bill would require the pilot lead, the Monterey County Office of Education, in coordination with the State Department of Health Care Services, to, no later than April 1, 2027, select 25 entities to participate in the pilot program and prioritize certain applicants, including, among others, applicants who will increase the number of transition-age youth receiving behavioral health services. The bill would require the pilot lead, starting no later than April 1, 2027, and ending no earlier than July 1, 2030, to provide intensive technical assistance and support to the participating entities in participating in the school-linked statewide fee schedule, including technical assistance and support with specified activities, including, among others, providing training and coaching for behavioral health service providers related to documentation of services, proper coding and noting procedures, obtaining required consents, applicable privacy laws and disclosure requirements, and referral protocols. The bill would require the pilot lead to submit a progress report by January 1, 2028, and submit a summative report by January 1, 2031, regarding the pilot program to the appropriate policy and fiscal committees of the Legislature. The bill would require the State Department of Education, upon appropriation and subject to the terms of the appropriation, allocate funds the pilot lead to administer the pilot program. By requiring the Monterey County Office of Education to serve as the pilot lead, this bill would impose a state-mandated local program. 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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.