Ins. Code, § 12693.61 · Chapter 5. Health Benefits and Copayments
Ins. Code, § 12693.61
Text — As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
The following provisions apply for subscribers who have been identified by the participating health plans as potentially seriously emotionally disturbed.
(a) Participating plans, to the extent feasible, including plans receiving purchasing credits shall develop memoranda of understanding, consistent with criteria established by the board in consultation with the State Department of Health Care Services, for referral of subscribers who are seriously emotionally disturbed to a county mental health department. This referral does not relieve a participating plan from providing the mental health coverage specified in its contract, including assessment of, and development of, a treatment plan for serious emotional disturbance. Plans may contract with county mental health departments to provide for all, or a portion of, the services provided under the program’s mental health benefit.
(b) The board shall establish an accounting process under which counties providing services to subscribers who have been determined to be seriously emotionally disturbed pursuant to Section 5600.3 of the Welfare and Institutions Code can claim federal reimbursement for the services. The board shall reimburse counties pursuant to the rates set by the State Department of Health Care Services in accordance with Sections 5705, 14705.7, 14705, 14708, 14711, and 14718 of the Welfare and Institutions Code. The actual amount reimbursed by the board shall be the federal share of the cost of the subscriber.
(c) This section shall only become operative with federal approval of the State Child Health Plan and the approval of federal financial participation.
(d) Counties choosing to enter into a memorandum of understanding pursuant to subdivision (a) shall provide the nonfederal share of cost for the subscriber.
Notes and commentary — not statutory text
History
Amended by Stats. 2012, Ch. 34, Sec. 38. (SB 1009) Effective June 27, 2012. Section conditionally operative as provided in subd. (c).
Source of truth
- Edition
- As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
- Official file
- https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=INS§ionNum=12693.61.
- Text hash
- sha256 efa904e626d674aca06ba26f94ef55a8b96ab3a2ae0714bb79e93d3a1e08150b
- Composed by
- compose_ca.py 2026-10-22: the Legislative Counsel's CAML content files read by a tokenizer (caml_readers.reader_a); an independent xml.etree reading (caml_readers.reader_b) agrees on every section
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Welfare and Institutions Code
- Welf. & Inst. Code, § 5600.3Printed as Section 5600.3 of the Welfare and Institutions Code
- Welf. & Inst. Code, § 5705Printed as Sections 5705, 14705.7, 14705, 14708, 14711, and 14718 of the Welfare and Institutions Code
- Welf. & Inst. Code, § 14705Printed as Sections 5705, 14705.7, 14705, 14708, 14711, and 14718 of the Welfare and Institutions Code
- Welf. & Inst. Code, § 14705.7Printed as Sections 5705, 14705.7, 14705, 14708, 14711, and 14718 of the Welfare and Institutions Code
- Welf. & Inst. Code, § 14708Printed as Sections 5705, 14705.7, 14705, 14708, 14711, and 14718 of the Welfare and Institutions Code
- Welf. & Inst. Code, § 14711Printed as Sections 5705, 14705.7, 14705, 14708, 14711, and 14718 of the Welfare and Institutions Code
- Welf. & Inst. Code, § 14718Printed as Sections 5705, 14705.7, 14705, 14708, 14711, and 14718 of the Welfare and Institutions Code
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.