BILL NUMBER: AB 1253 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 2, 2001
AMENDED IN ASSEMBLY MARCH 27, 2001
INTRODUCED BY Assembly Members Matthews and Thomson
FEBRUARY 23, 2001
An act to amend Section 1010 of the Evidence Code, to add Section
13960.7 to the Government Code, to amend Sections 1373 and 1373.8 of
the Health and Safety Code, and to amend Sections 10176 and 10177 of
the Insurance Code, relating to nursing , and declaring the
urgency thereof, to take effect immediately .
LEGISLATIVE COUNSEL'S DIGEST
AB 1253, as amended, Matthews. Nursing.
Existing law, the Nursing Practice Act, requires that a nurse
satisfy specified requirements in order to practice as a clinical
nurse specialist. Various other provisions of law include within
their application a registered nurse with education or experience in
psychiatric-mental health nursing.
This bill would recast those provisions, specifying that
the registered nurse be including within their
application an advanced practice registered nurse certified as
a clinical nurse specialist who participates in expert clinical
practice in the specialty of psychiatric-mental health nursing.
This bill would declare that its provisions would become effective
immediately as an urgency statute.
Vote: majority 2/3 .
Appropriation: no. Fiscal committee: no. State-mandated local
program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1010 of the Evidence Code is amended to read:
1010. As used in this article, "psychotherapist" means:
(a) A person authorized, or reasonably believed by the patient to
be authorized, to practice medicine in any state or nation who
devotes, or is reasonably believed by the patient to devote, a
substantial portion of his or her time to the practice of psychiatry.
(b) A person licensed as a psychologist under Chapter 6.6
(commencing with Section 2900) of Division 2 of the Business and
Professions Code.
(c) A person licensed as a clinical social worker under Article 4
(commencing with Section 4996) of Chapter 14 of Division 2 of the
Business and Professions Code, when he or she is engaged in applied
psychotherapy of a nonmedical nature.
(d) A person who is serving as a school psychologist and holds a
credential authorizing that service issued by the state.
(e) A person licensed as a marriage, family, and child counselor
under Chapter 13 (commencing with Section 4980) of Division 2 of the
Business and Professions Code.
(f) A person registered as a psychological assistant who is under
the supervision of a licensed psychologist or board certified
psychiatrist as required by Section 2913 of the Business and
Professions Code, or a person registered as a marriage, family, and
child counselor intern who is under the supervision of a licensed
marriage, family, and child counselor, a licensed clinical social
worker, a licensed psychologist, or a licensed physician certified in
psychiatry, as specified in Section 4980.44 of the Business and
Professions Code.
(g) A person registered as an associate clinical social worker who
is under the supervision of a licensed clinical social worker, a
licensed psychologist, or a board certified psychiatrist as required
by Section 4996.20 of the Business and Professions Code.
(h) A person exempt from the Psychology Licensing Law pursuant to
subdivision (d) of Section 2909 of the Business and Professions Code
who is under the supervision of a licensed psychologist or board
certified psychiatrist.
(i) A psychological intern as defined in Section 2911 of the
Business and Professions Code who is under the supervision of a
licensed psychologist or board certified psychiatrist.
(j) A trainee, as defined in subdivision (c) of Section 4980.03 of
the Business and Professions Code, who is fulfilling his or her
supervised practicum required by subdivision (b) of Section 4980.40
of the Business and Professions Code and is supervised by a licensed
psychologist, board certified psychiatrist, a licensed clinical
social worker, or a licensed marriage, family, and child counselor.
(k) An A person licensed as a registered
nurse pursuant to Chapter 6 (commencing with Section 2700) of
Division 2 of the Business and Professions Code, who possesses a
master's degree in psychiatric-mental health nursing and is listed as
a psychiatric-mental health nurse by the Board of Registered
Nursing.
(l) An advanced practice registered nurse who is certified
as a clinical nurse specialist pursuant to Article 9 (commencing with
Section 2838) of Chapter 6 of Division 2 of the Business and
Professions Code and who participates in expert clinical practice in
the specialty of psychiatric-mental health nursing.
(l)
(m) A person rendering mental health treatment or counseling
services as authorized pursuant to Section 6924 of the Family Code.
SEC. 2. Section 13960.7 is added to the Government Code, to read:
13960.7. As used in this article, "pecuniary loss" also means the
amount of counseling related expenses as specified in paragraph (2)
of subdivision (d) of Section 13960, provided by an
either of the following for which the victim or
derivative victim has not been and will not be reimbursed from any
other source:
(a) A person licensed as a registered nurse pursuant to Chapter 6
(commencing with Section 2700) of Division 2 of the Business and
Professions Code, who possesses a master's degree in
psychiatric-mental health nursing and is listed as a
psychiatric-mental health nurse by the Board of Registered Nursing.
(b) An advanced practice registered nurse certified as a
clinical nurse specialist under Article 9 (commencing with Section
2838) of Chapter 6 of Division 2 of the Business and Professions
Code, who participates in expert clinical practice in the specialty
of psychiatric-mental health nursing, for which the victim
or derivative victim has not been and will not be reimbursed from any
other source. psychiatric-mental health nursing.
SEC. 3. Section 1373 of the Health and Safety Code is amended to
read:
1373. (a) A plan contract may not provide an exception for other
coverage if the other coverage is entitlement to Medi-Cal benefits
under Chapter 7 (commencing with Section 14000) or Chapter 8
(commencing with Section 14200) of Part 3 of Division 9 of the
Welfare and Institutions Code, or medicaid benefits under Subchapter
19 (commencing with Section 1396) of Chapter 7 of Title 42 of the
United States Code.
Each plan contract shall be interpreted not to provide an
exception for the Medi-Cal or medicaid benefits.
A plan contract shall not provide an exemption for enrollment
because of an applicant's entitlement to Medi-Cal benefits under
Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing
with Section 14200) of Part 3 of Division 9 of the Welfare and
Institutions Code, or medicaid benefits under Subchapter 19
(commencing with Section 1396) of Chapter 7 of Title 42 of the United
States Code.
A plan contract may not provide that the benefits payable
thereunder are subject to reduction if the individual insured has
entitlement to the Medi-Cal or medicaid benefits.
(b) A plan contract that provides coverage, whether by specific
benefit or by the effect of general wording, for sterilization
operations or procedures shall not impose any disclaimer, restriction
on, or limitation of, coverage relative to the covered individual's
reason for sterilization.
As used in this section, "sterilization operations or procedures"
shall have the same meaning as that specified in Section 10120 of the
Insurance Code.
(c) Every plan contract that provides coverage to the spouse or
dependents of the subscriber or spouse shall grant immediate accident
and sickness coverage, from and after the moment of birth, to each
newborn infant of any subscriber or spouse covered and to each minor
child placed for adoption from and after the date on which the
adoptive child's birth parent or other appropriate legal authority
signs a written document, including, but not limited to, a health
facility minor release report, a medical authorization form, or a
relinquishment form, granting the subscriber or spouse the right to
control health care for the adoptive child or, absent this written
document, on the date there exists evidence of the subscriber's or
spouse's right to control the health care of the child placed for
adoption. No plan may be entered into or amended if it contains any
disclaimer, waiver, or other limitation of coverage relative to the
coverage or insurability of newborn infants of, or children placed
for adoption with, a subscriber or spouse covered as required by this
subdivision.
(d) Every plan contract that provides that coverage of a dependent
child of a subscriber shall terminate upon attainment of the
limiting age for dependent children specified in the plan, shall also
provide in substance that attainment of the limiting age shall not
operate to terminate the coverage of the child while the child is and
continues to be both (1) incapable of self-sustaining employment by
reason of mental retardation or physical handicap and (2) chiefly
dependent upon the subscriber for support and maintenance, provided
proof of the incapacity and dependency is furnished to the plan by
the member within 31 days of the request for the information by the
plan or group plan contractholder and subsequently as may be required
by the plan or group plan contractholder, but not more frequently
than annually after the two-year period following the child's
attainment of the limiting age.
(e) A plan contract that provides coverage, whether by specific
benefit or by the effect of general wording, for both an employee and
one or more covered persons dependent upon the employee and provides
for an extension of the coverage for any period following a
termination of employment of the employee shall also provide that
this extension of coverage shall apply to dependents upon the same
terms and conditions precedent as applied to the covered employee,
for the same period of time, subject to payment of premiums, if any,
as required by the terms of the policy and subject to any applicable
collective bargaining agreement.
(f) A group contract shall not discriminate against handicapped
persons or against groups containing handicapped persons. Nothing in
this subdivision shall preclude reasonable provisions in a plan
contract against liability for services or reimbursement of the
handicap condition or conditions relating thereto, as may be allowed
by rules of the director.
(g) Every group contract shall set forth the terms and conditions
under which subscribers and enrollees may remain in the plan in the
event the group ceases to exist, the group contract is terminated or
an individual subscriber leaves the group, or the enrollees'
eligibility status changes.
(h) (1) A health care service plan or specialized health care
service plan may provide for coverage of, or for payment for,
professional mental health services, or vision care services, or for
the exclusion of these services. If the terms and conditions include
coverage for services provided in a general acute care hospital or
an acute psychiatric hospital as defined in Section 1250 and do not
restrict or modify the choice of providers, the coverage shall extend
to care provided by a psychiatric health facility as defined in
Section 1250.2 operating pursuant to licensure by the State
Department of Mental Health. A health care service plan that offers
outpatient mental health services but does not cover these services
in all of its group contracts shall communicate to prospective group
contractholders as to the availability of outpatient coverage for the
treatment of mental or nervous disorders.
(2) No plan shall prohibit the member from selecting any
psychologist who is licensed pursuant to the Psychology Licensing Law
(Chapter 6.6 (commencing with Section 2900) of Division 2 of the
Business and Professions Code), any optometrist who is the holder of
a certificate issued pursuant to Chapter 7 (commencing with Section
3000) of Division 2 of the Business and Professions Code or, upon
referral by a physician and surgeon licensed pursuant to the Medical
Practice Act (Chapter 5 (commencing with Section 2000) of Division 2
of the Business and Professions Code), (i) any marriage, family, and
child counselor who is the holder of a license under Section 4980.50
of the Business and Professions Code, (ii) any licensed clinical
social worker who is the holder of a license under Section 4996 of
the Business and Professions Code, or (iii)
any registered nurse licensed pursuant to Chapter 6 (commencing with
Section 2700) of Division 2 of the Business and Professions Code, who
possesses a master's degree in psychiatric-mental health nursing and
is listed as a psychiatric-mental health nurse by the Board of
Registered Nursing, or (iv) any advanced practice registered
nurse certified as a clinical nurse specialist pursuant to Article 9
(commencing with Section 2838) of Chapter 6 of Division 2 of the
Business and Professions Code who participates in expert clinical
practice in the specialty of psychiatric-mental health nursing, to
perform the particular services covered under the terms of the plan,
and the certificate holder is expressly authorized by law to perform
these services.
(3) Nothing in this section shall be construed to allow any
certificate holder or licensee enumerated in this section to perform
professional mental health services beyond his or her field or fields
of competence as established by his or her education, training and
experience.
(4) For the purposes of this section, "marriage, family, and child
counselor" means a licensed marriage, family, and child counselor
who has received specific instruction in assessment, diagnosis,
prognosis, and counseling, and psychotherapeutic treatment of
premarital, marriage, family, and child relationship dysfunctions
which is equivalent to the instruction required for licensure on
January 1, 1981.
(5) Nothing in this section shall be construed to allow a member
to select and obtain mental health or psychological or vision care
services from a certificate or licenseholder who is not directly
affiliated with or under contract to the health care service plan or
specialized health care service plan to which the member belongs.
All health care service plans and individual practice associations
that offer mental health benefits shall make reasonable efforts to
make available to their members the services of licensed
psychologists. However, a failure of a plan or association to comply
with the requirements of the preceding sentence shall not constitute
a misdemeanor.
(6) As used in this subdivision, "individual practice association"
means an entity as defined in subsection (5) of Section 1307 of the
federal Public Health Service Act (42 U.S.C. Sec. 300e-1, subsec.
(5)).
(7) Health care service plan coverage for professional mental
health services may include community residential treatment services
that are alternatives to inpatient care and that are directly
affiliated with the plan or to which enrollees are referred by
providers affiliated with the plan.
(i) If the plan utilizes arbitration to settle disputes, the plan
contracts shall set forth the type of disputes subject to
arbitration, the process to be utilized, and how it is to be
initiated.
(j) A plan contract that provides benefits that accrue after a
certain time of confinement in a health care facility shall specify
what constitutes a day of confinement or the number of consecutive
hours of confinement that are requisite to the commencement of
benefits.
SEC. 4. Section 1373.8 of the Health and Safety Code is amended to
read:
1373.8. A health care service plan contract where the plan is
licensed to do business in this state and the plan provides coverage
that includes California residents but that may be written or issued
for delivery outside of California and where benefits are provided
within the scope of practice of a licensed clinical social worker,
a registered nurse licensed pursuant to Chapter 6 (commencing
with Section 2700) of Division 2 of the Business and Professions
Code, who possesses a master's degree in psychiatric-mental health
nursing and is listed as a psychiatric-mental health nurse by the
Board of Registered Nursing, an advanced practice registered
nurse who is certified as a clinical nurse specialist pursuant to
Article 9 (commencing with Section 2838) of Chapter 6 of Division 2
of the Business and Professions Code who participates in expert
clinical practice in the specialty of psychiatric-mental health
nursing, or a marriage, family, and child counselor who is the holder
of a license under Section 4980.50 of the Business and Professions
Code, shall not be deemed to prohibit persons covered under the
contract from selecting those licensed persons in California to
perform the services in California that are within the terms of the
contract even though the licensees are not licensed in the state
where the contract is written or issued for delivery.
It is the intent of the Legislature in amending this section in
the 1984 portion of the 1983-84 Legislative Session that persons
covered by the contract and those providers of health care specified
in this section who are licensed in California should be entitled to
the benefits provided by the plan for services of those providers
rendered to those persons.
SEC. 5. Section 10176 of the Insurance Code is amended to read:
10176. In disability insurance, the policy may provide for
payment of medical, surgical, chiropractic, physical therapy, speech
pathology, audiology, acupuncture, professional mental health,
dental, hospital, or optometric expenses upon a reimbursement basis,
or for the exclusion of any of those services, and provision may be
made therein for payment of all or a portion of the amount of charge
for these services without requiring that the insured first pay the
expenses. The policy shall not prohibit the insured from selecting
any psychologist or other person who is the holder of a certificate
or license under Section 1000, 1634, 2050, 2472, 2553, 2630, 2948,
3055, or 4938 of the Business and Professions Code, to perform the
particular services covered under the terms of the policy, the
certificate holder or licensee being expressly authorized by law to
perform those services.
If the insured selects any person who is a holder of a certificate
under Section 4938 of the Business and Professions Code, a
disability insurer or nonprofit hospital service plan shall pay the
bona fide claim of an acupuncturist holding a certificate pursuant to
Section 4938 of the Business and Professions Code for the treatment
of an insured person only if the insured's policy or contract
expressly includes acupuncture as a benefit and includes coverage for
the injury or illness treated. Unless the policy or contract
expressly includes acupuncture as a benefit, no person who is the
holder of any license or certificate set forth in this section shall
be paid or reimbursed under the policy for acupuncture.
Nor shall the policy prohibit the insured, upon referral by a
physician and surgeon licensed under Section 2050 of the Business and
Professions Code, from selecting any licensed clinical social worker
who is the holder of a license issued under Section 4996 of the
Business and Professions Code or any occupational therapist as
specified in Section 2570.2 of the Business and Professions Code, or
any marriage, family and child counselor who is the holder of a
license under Section 4980.50 of the Business and Professions Code,
to perform the particular services covered under the terms of the
policy, or from selecting any speech-language pathologist or
audiologist licensed under Section 2532 of the Business and
Professions Code or any registered nurse licensed pursuant to
Chapter 6 (commencing with Section 2700) of Division 2 of the
Business and Professions Code, who possesses a master's degree in
psychiatric-mental health nursing and is listed as a
psychiatric-mental health nurse by the Board of Registered Nursing or
any advanced practice registered nurse certified as a clinical
nurse specialist pursuant to Article 9 (commencing with Section
2838) of Chapter 6 of Division 2 of the Business and Professions Code
who participates in expert clinical practice in the specialty of
psychiatric-mental health nursing, or any respiratory care
practitioner certified pursuant to Chapter 8.3 (commencing with
Section 3700) of Division 2 of the Business and Professions Code to
perform services deemed necessary by the referring physician, that
certificate holder, licensee or otherwise regulated person, being
expressly authorized by law to perform the services.
Nothing in this section shall be construed to allow any
certificate holder or licensee enumerated in this section to perform
professional mental health services beyond his or her field or
fields of competence as established by his or her education,
training, and experience. For the purposes of this section,
"marriage, family and child counselor" means a licensed marriage,
family and child counselor who has received specific instruction in
assessment, diagnosis, prognosis, and counseling, and
psychotherapeutic treatment of premarital, marriage, family, and
child relationship dysfunctions that is equivalent to the instruction
required for licensure on January 1, 1981.
An individual disability insurance policy, which is issued,
renewed, or amended on or after January 1, 1988, which includes
mental health services coverage may not include a lifetime waiver for
that coverage with respect to any applicant. The lifetime waiver of
coverage provision shall be deemed unenforceable.
SEC. 6. Section 10177 of the Insurance Code is amended to read:
10177. A self-insured employee welfare benefit plan may provide
for payment of professional mental health expenses upon a
reimbursement basis, or for the exclusion of those services, and
provision may be made therein for payment of all or a portion of the
amount of charge for those services without requiring that the
employee first pay those expenses. The plan shall not prohibit the
employee from selecting any psychologist who is the holder of a
certificate issued under Section 2948 of the Business and Professions
Code or, upon referral by a physician and surgeon licensed under
Section 2135 of the Business and Professions Code, any licensed
clinical social worker who is the holder of a license issued under
Section 4996 of the Business and Professions Code or any marriage,
family, and child counselor who is the holder of a certificate or
license under Section 4980.50 of the Business and Professions Code,
or any registered nurse licensed pursuant to Chapter 6
(commencing with Section 2700) of Division 2 of the Business and
Professions Code, who possesses a master's degree in
psychiatric-mental health nursing and is listed as a
psychiatric-mental health nurse by the Board of Registered Nursing or
any advanced practice registered nurse certified as a clinical
nurse specialist pursuant to Article 9 (commencing with Section
2838) of Chapter 6 of Division 2 of the Business and Professions Code
who participates in expert clinical practice in the specialty of
psychiatric-mental health nursing, to perform the particular services
covered under the terms of the plan, the certificate or license
holder being expressly authorized by law to perform these services.
Nothing in this section shall be construed to allow any
certificate holder or licensee enumerated in this section to perform
professional services beyond his or her field or fields of competence
as established by his or her education, training, and experience.
For the purposes of this section, "marriage, family, and child
counselor" shall mean a licensed marriage, family, and child
counselor who has received specific instruction in assessment,
diagnosis, prognosis, and counseling, and psychotherapeutic treatment
of premarital, marriage, family, and child relationship dysfunctions
which is equivalent to the instruction required for licensure on
January 1, 1981.
A self-insured employee welfare benefit plan, which is issued,
renewed, or amended on or after January 1, 1988, that includes mental
health services coverage in nongroup contracts may not include a
lifetime waiver for that coverage with respect to any employee. The
lifetime waiver of coverage provision shall be deemed unenforceable.
SEC. 7. This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect. The facts constituting the necessity are:
The current shortage of registered nurses licensed to practice in
this state requires the expansion of the scope of the description of
this profession to include all nurses who are able to provide the
services described in this act.