California and the West : Legislature OKs Managed Care Reforms : Health: Bills would allow easier access to second medical opinions and mandate coverage of nine severe mental illnesses.


Californians would have easier access to second medical opinions and coverage for treatment of severe mental illness under measures passed by the Legislature on Thursday.

Accelerating efforts to reform managed care as the lawmaking year ends, the Senate approved a bill, sponsored by the consumer group Health Access of California, requiring providers to pay for a second doctor’s opinion if a patient or primary physician requests one.

The legislation, approved 25 to 11 as part of a patients “bill of rights,” was returned to the Assembly for a final OK.

Also poised for final approval was a measure requiring that employers who offer health care plans include coverage for medication, therapy, hospital stays and other necessary treatment for severe mental illness such as schizophrenia, just as they do for heart disease, diabetes and other physical ailments.


Most health care plans approve requests for second opinions, but some restrict them in ways that endanger the quality of care, say backers of AB 12 by Assemblywoman Susan A. Davis (D-San Diego).

Under her measure, a patient or treating physician could request a second opinion from another qualified doctor in the same medical group. If none was available, a doctor outside the network could be called in and the patient’s plan would pay a negotiated fee, said Sen. Jackie Speier (D-Fremont).

In cases of an “imminent or serious” threat to the patient’s health or life, the health plan would have to approve the request for a second opinion within 72 hours.

Californians “really want to see this happen,” said Sen. Jackie Speier (D-Fremont). Speier said she believes Gov. Gray Davis would sign the bill.


The bill drew criticism from Sen. Richard Mountjoy (R-Arcadia). He said it represents a calculated attempt by Democrats to drive the costs of health care so high that HMOs and insurers would be forced out of business. Then, he said, government would take over.

“That’s the goal of all these mandates,” he told Speier.

Speier shot back that Mountjoy doesn’t understand the issue of second opinions, which she insisted would not increase costs.

Taking personal aim at Mountjoy, a grandfather of six, Speier suggested that if his doctor recommended a vasectomy for him, Mountjoy might “decide that you want to get a second opinion. This [bill] would provide you the opportunity.”


Davis has not said whether he will sign the mental health coverage legislation. Many business groups oppose the measure, which would take effect in July.

The mental health “parity” proposal lists nine illnesses to be covered: schizophrenia; major depression; bipolar disorder; panic disorder; schizoaffective disorder; obsessive compulsive disorder; pervasive developmental disorder or autism; anorexia and bulimia. Scientists have little doubt that severe mental illnesses are brain diseases and can be treated medically.

The legislation would also require that health insurance companies offer broad mental health care for children.

“Finally, with this bill we take a step toward solving the problem of discrimination against people with mental illness,” said Carla Jacobs, a Long Beach-based board member of the National Alliance for the Mentally Ill. “This will help prevent families from mortgaging their homes and going into bankruptcy to care for their loved ones.”


The Senate approved the bill (AB 88) by Assemblywoman Helen Thomson (D-Davis), on a 30-6 vote. The Assembly was expected to follow later Thursday.

Last year, Gov. Pete Wilson vetoed similar legislation, saying it would increase costs to employers and cause many small employers to drop health care coverage altogether.

Also Thursday, the Senate approved a bill that would empower Atty. Gen. Bill Lockyer to intervene in mergers of nonprofit HMOs to investigate whether the proposed transaction would reduce competition. The bill (AB 351) by Assemblyman Darrell Steinberg (D-Sacramento) was approved 21 to 14 and sent back to the Assembly for approval of Senate changes.

In other legislative action:


* After an emotional debate, the Assembly passed 58 to 12 a requirement that data on race and traffic stops be collected by the California Highway Patrol and local law enforcement agencies. SB 78 by Democratic Sen. Kevin Murray of Los Angeles, which went back to the Senate for final OK, was prompted by complaints from minority motorists, including Murray himself, that they were unfairly stopped because of their race or ethnicity.

“It deals with an effort to prevent racial profiling” by a relatively few law enforcement officers, said Assemblyman Rod Pacheco (R-Riverside), a former county prosecutor who is Latino. Almost shouting, Pacheco told his colleagues: “I can take it. I can go through those experiences, but I’ve got four kids and they look like me and I don’t want them to go through that in their lives.”

Some Republicans voiced concerns that police would not have time to collect the data and the program would be too costly.

* Also with vigorous debate, the Senate approved a bill to ban discrimination against gays in public schools. AB 537 is a resurrected version of a measure defeated in the Assembly in June. As with its predecessor, this bill, by Assemblywoman Sheila Kuehl (D-Santa Monica), has sparked spirited opposition from religious groups and others who say it gives a single group unwarranted special protection.


“To single out a group just because they have uncontrollable passion in one direction or another is absolutely wrong,” said Mountjoy.

Supporters said the bill merely adds sexual orientation to the list of categories--such as gender, race and ancestry--that the Education Code protects from discrimination.

“It’s about giving all of California’s children a fair chance at education and . . . showing our children that no matter how different a person is from us, we have no right to harm, intimidate or discriminate against them,” said Sen. Deirdre Alpert (D-Coronado).

The bill was headed back for a final vote, expected to be close, in the Assembly.


* A Los Angeles senator’s two-year battle to ensure that health standards protect children from air pollution has paid off, with SB 25 clearing the Legislature and awaiting action by the governor. The bill requires California’s Environmental Protection Agency to review air pollution standards to ensure they adequately protect infants and children. It also requires the California Air Resources Board to evaluate its air monitoring program and make changes to more accurately measure the exposure of infants and children to pollutants.

It also creates a Children’s Environmental Health Center to advise the governor on environmental health threats to children.

Last year the bill was dubbed a “job killer” by the California Chamber of Commerce and was vetoed by Wilson.

* Two bills regulating the use of laser pointers are on their way to the governor. The gadgets have become increasingly popular among teenagers who point them at friends, vehicles and athletes during sporting events. Recently, the U.S. Food and Drug Administration warned parents and school officials about the possibility of eye damage from laser pointers.


A bill by Assemblyman Scott Wildman (D-Los Angeles) makes it a misdemeanor to use one in a threatening manner. Pointing a laser at a police officer with the same intention could result in up to six months in jail under AB 221. A second measure by Assemblyman Herb Wesson (D-Los Angeles) forbids the sale of laser pointers to minors who are not accompanied by an adult. Wesson’s bill (AB 293) also bans minors from using lasers on school grounds except for educational or employment purposes.

* Schools must notify parents and staff before spraying pesticides, under a bill by Assemblyman Kevin Shelley (D-San Francisco). AB 1207 began as an attempt to ban the use of pesticides on campuses, but was heavily amended due to protests from agriculture and the chemical industry. It also requires the state Department of Pesticide Regulation to help schools with nonchemical methods to control pests and sets up a task force to study other potential environmental hazards at school sites.

* Lawmakers, Gov. Davis and representatives of Native Americans neared a deal that would allow expansion of gambling on Indian land. The deal would permit tribes to legally operate card games and have more than 40,000 slot machines, up from 23,500. Now, most tribes with casinos are operating in violation of the law, and face the prospect of being shut down by federal law enforcement.

Tribal leaders were conferring late Thursday with Davis’ aides on a key piece of the deal--whether labor unions can organize workers at the casinos. Tribes and the Hotel Employees and Restaurant Employees have had bitter battles over the issue, with Indians insisting that unions have little right to organize on their sovereign land.


As details of the compact between the state and tribes were being worked out, Senate President Pro Tem John Burton (D-San Francisco) was preparing to push for legislative approval of a state constitutional amendment that would permit Indians to legally operate slot machines and card games. Voters would be asked to approve it in March.


Times staff writers Mark Gladstone, Amy Pyle and Jenifer Warren contributed to this report.