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Understanding California’s Senate Bill 221

Discover what outpatient mental health providers should know about California's Senate Bill 221 and its impact on your practice.

Updated over a week ago

What is Senate Bill (SB 221)?


Senate Bill 221 (SB 221) is a California law that took effect July 1, 2022, requiring timely access to follow-up mental health and substance use disorder (MH/SUD) appointments for enrollees of commercial health plans and Medi-Cal managed care. The law aims to address delays in access to care by mandating that non-urgent follow-up appointments be offered within 10 business days of the prior visit—unless the treating provider determines a longer wait is clinically appropriate.


Why is SB 221 important?


SB 221 was passed to reduce long wait times that compromise care continuity and worsen mental health outcomes. For therapists in outpatient settings, the law supports your efforts to provide consistent, timely care—and empowers you to advocate for the scheduling flexibility your clients need. It also emphasizes clinical discretion, allowing providers to determine when longer intervals are clinically appropriate.


Key requirements

  • Timely access: Clients must be offered non-urgent follow-up appointments within 10 business days of their previous session.

  • Clinical discretion: If a longer interval is appropriate, document your clinical reasoning clearly in the progress note or treatment plan.

  • Applies to: Licensed mental health professionals working with clients covered by commercial health plans or Medi-Cal managed care plans in California.

  • Exclusions: The rule does not apply to inpatient services, crisis services, or when a client cancels or reschedules on their own.


How Grow supports providers with SB 221


To support California providers with documentation required by SB221, Grow Therapy templates will include the prompt: “Does this client need to be seen within 10 business days?” in the "Follow–up" section of the initial assessment and progress note templates.

Follow-up plan section, therapist notes

If a provider answers “no,” the statement “This clinical timeframe will not have a detrimental impact on the client” will be automatically added to the note. If the provider answers “yes,” a pop-up will surface for the provider to indicate additional details related to scheduling.

This clinical timeframe will not have a detrimental impact on the client note addition

Select a reason for no scheduled follow-up SB 221

Key takeaways


SB 221 protects timely access to care, but also respects your clinical judgment. With thoughtful documentation and awareness of scheduling timelines, you can stay compliant with state requirements while continuing to meet your clients’ individual needs.

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