California Psychiatric Association
Legislative Priority Results for 2000
The status of legislative bills
changes often.
To get up-to-date information on the status of bills discussed on this web
site go to:
California
State Senate Bill Information
Legislative Priority Results for
2000
1. Psychologists practicing medicine: Oppose psychologists' efforts
to practice medicine without full medical training. Action:
In June, AB 1144 (Aanestad) was amended to give broad prescribing authority
to 10 military Psychopharmacology Demonstration Project graduates. CPA
and CMA undertook a full-court-press opposition campaign, together with
over 20 allies, including NAMI California and DMDA, and stopped the bill
in the Senate Appropriations Committee.
2. Parity: Implementation of AB 88, enacted in 1999, which provides
non-discriminatory health coverage for serious mental disorders. Action: CPA has an implementation task force to maximize
the likelihood of appropriate implementation of AB 88. On June 23, CPA
co-sponsored, with the California Medical Foundation and NAMI California,
a conference on implementation of AB 88.
3. LPS Reform: Pursue updating and revision of the Lanterman Petris
Short Act (LPS) in light of today's circumstances. Support legislation
that would revise LPS and allow for mandatory outpatient treatment in certain
well-defined circumstances. (AB 1800, Thomson) Action:
CPA and CMA supported AB 1800, sponsored by NAMI California. AB 1800 provided
for mandatory community treatment, for combining required hearings on involuntary
hospitalization and medication, and for involuntary treatment of a person
who presents, as a result of a mental disorder, an acute risk of physical
or psychiatric harm if untreated. AB 1800 died in the Senate Rules Committee.
Assemblywoman Thomson and Senator Burton will probably both carry bills
on the subject next year.
4. Public Mental Health System: Assure the integrity of, and adequate
funding for, the public mental health system, including assuring that funding
includes proper funding for medical treatment and full utilization of the
skills of psychiatrists. Priorities to include assuring that all programs
have good outcome evaluations, full funding for AB 1800 and AB 2034 programs,
early diagnosis and treatment for foster kids (AB 866, Aroner), funding
for dual diagnosis programs ( SB 1623, Perata), police training (AB 1718
and 1762), and full funding for the Children's System of Care. Action: CPA supported all the listed bills and the funding
needed to implement them, and worked with the authors to assure that the
programs enacted by these bills will provide for full and appropriate psychiatric
and other medical treatment for persons in the programs instituted by AB1800,
AB 2034 and SB 1623. AB 2034 received $65 million in added funding, Children's
Systems of Care received $15.5 million to fund it fully statewide. AB 1718
was enacted, but without added funding. The rest were not funded.
5. Formularies: Advocate with respect to Medi-Cal and managed care
formulary issues consistent with the policy adopted by the CPA Council at
its March, 1997 meeting. Activity will include California and other states.
Action: CPA continues to advocate for open formularies.
Medi-Cal has been reviewing its antidepressant formulary, and has added
some medications, while dropping none. It is now negotiating with the manufacturers
of the antipsychotic medications on renewal of their contracts. CPA also
supported SB 1755 (Kelley), which required Medi-Cal, when determining the
medications to treat mental illness that will be on the formulary, to seek
input from provider organizations and the Department of Mental Health, and
to only compare each medication to others that are therapeutically comparable.
The Governor vetoed the bill, saying that the Department of Health Services
already does what it called for. CPA also sponsored a meeting at the APA
annual meeting to coordinate with other states.
6. Penal System: Advocate with respect to issues relating to the severely
mentally ill and the penal system in such a way as to assure that the severely
mentally ill and sexual predators are not confused with one another, and
to assure adequate psychiatric treatment for mentally ill prisoners. Action: CPA supported both AB 1718 by Speaker Hertzberg,
and AB 1762 by former Speaker Villaraigosa. Both these bills provided
better training to police in interfacing with mentally ill persons. AB
1718 was enacted, and AB 1762 was held in the Senate Appropriations Committee
because of costs. CPA also supported SB 1769 (Chesbro), which would have
expanded mental health courts into additional counties. The state budget
included $50 million to fund mentally ill offender crime reduction grants,
but no money for the police training bills or the mental health court bill.
Because of this, the Governor vetoed SB 1769.
7. Medi-Cal: Seek adjustments to Medi-Cal and managed care fee schedules
that assure adequate payment to psychiatrists for their services. Action: CPA participated in a medicine-wide coalition seeking
a 25% increase in physician fees in the Medi-Cal system. Since psychiatrists'
fees are determined county by county, this is primarily to set a precedent
to assist local psychiatrists in negotiating more equitable fees. The state
budget gave an average 16.7% doctor increase, with the schedule that has
been adopted having an average fee increase of 12.2%, and emergency room
physician (including doctors on-call) fee increase of 40%. The effort will
continue next year.
8. Violence Prevention: Support legislation that embodies reasoned regulatory
action relating to violence. Support legislation that discourages the purchase
of handguns and places strong controls on availability of all types of firearms
to private citizens. CPA's legislative focus on domestic violence is on
the negative impacts of domestic violence and prevention, not legal and
criminal aspects. Focus on prevention of school violence through removing
disincentives to the identification and treatment of severely emotionally
disturbed children who may potentially be violent. Action:
CPA is supporting several bills directed toward decreasing school violence.
9. MICRA: Protect the integrity of the Medical Injury Compensation
Reform Act (MICRA). (AB 1380, Villaraigosa). Action:
CPA participated in the coalition opposing any change in MICRA. Villaraigosa
dropped the bill at the request of the trial lawyers after it was narrowed
by committees.
10. Foster Children: Assuring adequate psychiatric and other medical
care for foster children, including creating an informal advisory group
of child and adolescent psychiatrists. Action:
CPA supported AB 866 (Aroner), a bill designed to provide such care. The
author used the bill for a different purpose, because she was unable to
get the support of the administration.
11. Antitrust protection for doctors, so that doctor groups can negotiate
with HMOs. (SB 2007, Speier). Action: CMA sponsored
SB 2007. CPA supported it. The author dropped the bill for this year,
but CMA will likely sponsor similar legislation in the future.
1999 priorities which are either in abeyance or are priorities at
the federal level:
- managed care reform (many reforms enacted in 1999, and being implemented
now)
- confidentiality (federal)
- seclusion and restraint (federal)
To find the full text and the history of a legislative proposal, go to
the California Senate's web site, www.sen.ca.gov,
choose legislation, and follow the instructions.
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