The Challenge of Finding Providers of Mental Health Care in California

Posted: July 21, 2016

by John Hansen

At the CAHU Capital Summit on May 18, a California insurance agent asked Mary Watanabe, Deputy Director of the Department of Managed Health Care, about the difficulties he is having finding providers for the mental health care that is supposed to be included on the Obamacare California plans.

The insurance broker questioned, “Regarding the mental health component of new ACA plans, I’m finding it challenging for clients to access mental health benefits [in California]. Have you seen a trend related to this?”

Watanabe acknowledged right away that this has been a problem, especially in the more rural areas of California. She said, “My biggest advice would be to come to us early through the two-step process.” The process she was referring to was that of filing an Independent Medical Review (IMR).

Watanabe said that the Department of Managed Health Care has a separate group working on mental health care in California and the group is struggling to find solutions. In some areas of California, there are no mental health providers.

However, she implied that the impetus is on the California health insurance plans to have providers nearby for all their members. She said, “We will ask the plan, ‘How are you going to take care of your member?’”

Also, these providers of mental health care in California need to be able to schedule appointments with insured in a timely manner, which means within 15 days.

Watanabe emphasized the power of the DMHC saying, “Some say they haven’t had to call us. They just threaten to call us [and things get taken care of].” She mentioned cases where California insured have struggled for months or where children have had to travel hundreds of miles to get mental health care in California.

She encouraged agents, “Don’t let this happen. Get the DMHC involved.”