Policy At A Glance: November 2018 INSTITUTE FOR HEALTH POLICY AND LEADERSHIP

AB 1968 Mental Health: Firearms

AB 2193 Maternal Mental Health

AB 2639 Pupil Suicide Prevention Policies: Reviews: Updates

AB 3067 Internet: Marketing: Minors: Cannabis

SB 1004 Mental Health Services Act: Prevention and Early Intervention

New California Behavioral Health Laws

New 2019 California Behavioral Health Legislation

AB 1968. Mental Health: Firearms

Under existing California law, individuals are allowed to own firearms five years after they are released from an involuntary treatment facility. Effective January 1, 2020, AB 1968 places a lifetime ban on gun ownership for mentally-ill individuals treated involuntarily more than once in a single year because they are a danger to themselves or others. Those prohibited to owning guns under AB 1968 will be allowed to challenge the lifetime ban at court hearings every five years.

Bringing wholeness to individuals and communities, the Institute for Health Policy and Leadership (IHPL) strives to integrate health policy research and education with

leadership development. Our goal is to improve the health of our communities by building on our strong heritage of health promotion and disease prevention.

To learn more, visit us at www.IHPL.llu.edu

In October, Governor Brown signed 1,016 out of 1,217 bills passed by California’s legislature during its regular session. In this issue of ‘Policy At A Glance,’ we will provide a

roundup of five notable behavioral health bills going into effect in 2019.

Governor Jerry Brown signed over 1,000 bills in his final year in office, ranging from cyber bullying to price gouging on rental homes after natural disasters to including women in corporate boards.

He also signed a number of bills related to behavioral and mental health. Below is a summary of five notable behavioral health laws, listed in numerical order by Assembly Bill (AB) or Senate Bill (SB). The effective date is January 1, 2019 unless otherwise noted.

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INSTITUTE FOR HEALTH POLICY AND LEADERSHIP November 2018

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The California Psychological Association, Coalition Against Gun Violence and others support AB 1968. Disability Rights California (DRC) opposes AB 1968 because it “imposes firearm restrictions based on disability status rather than actual findings of violence and dangerous behavior.”1 AB 2193. Maternal Mental Health

Postpartum depression is depression that happens after having a baby. With one in nine women experiencing its symptoms, postpartum depression is the most common pregnancy complication in the United States.2 Postpartum blues - a milder form of postpartum depression - is more prevalent, affecting 50 to 85 percent of women during the first few weeks after delivery.3 Postpartum psychosis – the severest form of mental condition suffered after childbirth – affects only one to two out of 1,000 women.3 Mothers suffering from postpartum psychosis may display symptoms of bipolar disease.3 Maternal Mental Health (MMH) conditions include depression, anxiety, and postpartum psychosis. In California, one in five mothers experience a mental health disorder during pregnancy or within the first year following childbirth.4 While all women can develop MMH disorders, screening is not routine in health care. Even when MMH disorders are identified, further assessment and treatment occur in less than 25 percent of the cases.4

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Starting July 1, 2019, AB 2193 requires licensed health care practitioners who provide prenatal or postpartum care (physicians, surgeons, naturopathic doctors, nurse practitioners, physician assistants, nurse midwives, and midwives) to screen new or expectant mothers for MMH disorders. AB 2193 also requires health insurance plans to develop a maternal mental health program. Governor Brown also signed AB 3032 this year. AB 3032 requires general acute care hospitals with perinatal units to develop and implement MMH programs by January 1, 2020. Maternal Mental Health programs under AB 3032 are required to include education and information about MMH conditions for women, families, and hospital perinatal unit staff. AB 2639. Pupil Suicide Prevention Policies: Reviews: Updates The Centers for Disease Control and Prevention (CDC) reported in June 2018 that suicide rates are increasing across the United States.5 For American youths between the ages of 10 and 24, suicide is the third leading cause of death, with nearly 4,600 lives lost every year and 157,000 treated in emergency rooms for self-inflicted injuries.6 In California, 495 youths between the ages of 5 and 24 died from suicide in 2015.7 Of the 495, 371 (75 percent) were males; 186 (38 percent)

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INSTITUTE FOR HEALTH POLICY AND LEADERSHIP November 2018

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were Hispanic and Latino youths followed by 181 white youths (37 percent); 301 (61 percent) were older than 20 years but 23 (5 percent) were younger than 14 years.7 Between 2013 and 2015, 19 percent of 9th graders and 18.1 percent of 11th graders in California reported thinking about or planning suicide (“suicide ideation”).7 While a recently adopted law (AB 2246) orders schools that serve students grade 7 through 12 to adopt a policy on suicide prevention, AB 2639 requires schools to review and update their policies on pupil suicide prevention at least every five years to make sure that these policies remain relevant. A similar law, SB 972, goes into effect on July 1, 2019 for schools serving grades 7 through 12 as well as institutions of higher education. SB 972 requires school identification cards to include telephone numbers of:

• The National Suicide Prevention Lifeline (required)

• Crisis Text Line (optional) • The local suicide prevention hotline

(optional) • Campus police or security (optional)

Schools may continue to issue identification cards that are not compliant with SB 972 requirements until their current supply of cards is depleted. AB 3067. Internet: Marketing: Minors: Cannabis In 1996, California became the first state to

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legalize medical marijuana. In 2016, California became the fifth state after Colorado, Washington, Oregon, and Alaska to legalize recreational marijuana for adults.8 Because California started issuing licenses to marijuana shops on January 1, 2018, legal sale and consumption of recreational marijuana did not begin until this date. Currently, the Privacy Rights for California Minors in the Digital World (PRCMDC) prohibits online marketing or advertising of tobacco, e-cigarettes, and alcohol to minors. Under PRCMDC, a minor is a person under 18 years of age who lives in California. Proposition 64, the Adult Use of Marijuana Act, which legalized recreational marijuana in California, protects individuals under 21 years of age from the marketing of recreational marijuana by “restricting broadcast, cable, radio, print, and digital advertising of marijuana to audiences where at least 71.6 percent of the audience is reasonably expected to be 21 years of age or older.”9 AB 3067 further protects minors from online marketing or advertising of marijuana by adding marijuana (including marijuana products, businesses, instrument, and paraphernalia) to the list of products or services subject to PRCMDC. SB 1004. Mental Health Services Act: Prevention and Early Intervention The California Mental Health Services Oversight and Accountability Commission (MHSOAC) oversees the provision of

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INSTITUTE FOR HEALTH POLICY AND LEADERSHIP November 2018

Prevention and Early Intervention (PEI) funds created under Proposition 63, the Mental Health Services Act (MHSA) of 2004. MHSA collects a one percent income tax on individuals with incomes above $1 million and has five components: community services and support; prevention and early intervention; innovation; capital facilities and technological needs; and workforce education and training. Counties use PEI funds to expand mental health services, develop innovative behavioral health programs, and integrate service plans for mentally ill children, adults, and older adults. In order to establish a strategic, statewide focus for how counties utilize PEI funds, SB 1004 requires the MHSOAC to establish priorities for the use of PEI funds. This includes:

• Childhood trauma prevention and early intervention • Early psychosis and mood disorder detection and

intervention • Outreach and engagement strategies for secondary

school and transition-age youth • Culturally competent and linguistically appropriate

prevention and intervention • Mental health needs of older adults

References

1. https://www.disabilityrightsca.org/system/files/file-attachments/AB1968LowMentalHealthFirearmsOpposeMarch272018.pdf https://www.cdc.gov/reproductivehealth/depression/index.htm

2. https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/

3. https://www.calhospital.org/sites/main/files/file-attachments/report-cataskforce-proofv7.pdf

4. https://www.cdc.gov/media/releases/2018/p0607-suicide-prevention.html 5. https://www.cdc.gov/healthcommunication/toolstemplates/entertainment

ed/tips/SuicideYouth.html 6. https://www.kidsdata.org/topic/209/suicides-

race/table#fmt=124&loc=2,127,347,1763,331,348,336,171,321,345,357,332,324,369,358,362,360,337,327,364,356,217,353,328,354,323,352,320,339,334,365,343,330,367,344,355,366,368,265,349,361,4,273,59,370,326,333,322,341,338,350,342,329,325,359,351,363,340,335&tf=84&ch=7,11,8,10,9,73,219

7. http://time.com/4565438/california-marijuana-faq-rules-prop-64/ 8. https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=20

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Questions? Please contact Helen Jung, DrPH, MPH. Senior Health Policy Analyst at the Institute for Health Policy & Leadership (helenjung@llu.edu)