The implementation of the Affordable Care Act in California, and its inclusion of coverage for mental health and substance use treatment as part of its "10 essential benefits" has created an unprecedented expansion in access to behavioral healthcare. The state's "Medi-Cal 2020 Waiver" also offers an array of new opportunities for California's counties to transform their systems and practices to deliver integrated care to low-income patients. These include the Whole Person Care Pilots, Public Hospital Redesign and Incentives in Medi-Cal, and the Drug Medi-Cal Organized Delivery System. A Health Homes Program for Patients with Complex Needs is also in development.

 

While all of these programs and policies are helping to transform care in California, few, if any, will address an underlying structural barrier that remains - the "carved out" nature of how behavioral healthcare is financed and delivered. Counties have been working to find innovative solutions around this challenge, but more work is needed to ensure that all patients and families can access the care they need, and our systems can effectively measure the quality and cost of behavioral healthcare for the population.

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Partners leading this work across California include:

 

National Health Law Program

Center for Health Care Strategies

California Pan-Ethnic Health Network

John Snow, Inc.

 

• Navigating The Challenges of Medi-Cal’s Mental Health Services in California: An Examination of Care Coordination, Referrals and Dispute Resolution

• Issue Brief: Mental Health Services in Medi-Cal

• Improving Mental Health Services Integration in Medi-Cal: Strategies for Consideration

• Promising Practices to Integrate Mental Health for Medi-Cal Members

• Drug Medi-Cal Organized Delivery System Waiver Forum

• Advancing Whole Person Care in California (briefs and publications)

• Disrupting the Pathway - A Prevention Approach to Medical High Utilization

• Webinars

  • Medi-Cal Coverage of Mild-to-Moderate Mental Health Conditions: The Current Landscape and Opportunities for Improvement​

• Additional tools and examples of innovations in this area:

  • Medi-Cal 2020 Waiver (includes links to Whole Person Care Pilot Program, Public Hospital Redesign and Incentives in Medi-Cal, and the Drug Medi-Cal Organized Delivery System)

  • Health Home for Patients with Complex Needs

  • Issue Brief: Aligning Performance Measures Across Medi-Cal Initiatives

  • Physical and Behavioral Health Integration: State Policy Approaches to Support Key Infrastructure

  • Key Reasons to Integrate Physical and Behavioral Health Services in Medicaid (infographic)

  • Integrating Behavioral Health into Medicaid Managed Care: Lessons from State Innovators

  • State Strategies for Integrating Physical and Behavioral Health Services in a Changing Medicaid Environment

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