For many Californians with mental illness, depression, or a substance use disorder, it can be nearly impossible to understand and use the coverage benefits that could lead them to healthier, more productive lives. In my 30 years as a practicing psychologist and a behavioral health services leader for medical delivery systems, I have seen countless instances where this lack of understanding of and access to mental and behavioral health services interfered with a patient's stabilization and recovery. After many years in behavioral health care planning and delivery, it's clear to me that a well-functioning, patient-focused health care system can only be realized through wider adoption of team-based care models that integrate physical and mental health care.
I remember a young teen with a severe eating disorder who was hospitalized for intensive nutritional support and refeeding because she had lost so much weight that her life was in danger. After weeks of therapy, she gained enough weight to be ready for discharge from the med-surg floor, but there was no referral system in place to ensure she received the intensive mental and nutritional health care she needed. Our bifurcated behavioral and physical health Medi-Cal system does not meet the intertwined physical and behavioral needs of complex health care conditions like this teen's severe eating disorder.
Like many Medi-Cal patients with multiple mental and physical issues who can't navigate the health care system and lack resources to go outside the safety net, she did not receive sufficient outpatient care and was rehospitalized a few months later. We worked hard to assemble a patchwork of customized services, held together by intensive care management, to increase her chances of reaching her 30th birthday. Years later, this problem remains unresolved, and every time we see another teen in the hospital for refeeding, we face the same crisis because Medi-Cal is not yet structured to provide whole-person care.
This is why I'm so energized about recently joining the California Health Care Foundation as senior vice president of program strategy and innovation. In this position, I can think in larger terms about ways to support and inspire the health system's ongoing transformation into a more integrated model of care that works for all Californians.
Since I began working in CHCF's Oakland headquarters, I've had the opportunity to learn more from its talented and experienced program staff about the foundation's goals and methods. I am eager to collaborate with them and with stakeholders from all corners of the state's health care system. The chance to help chart the foundation's strategy in this era of health policy change was irresistible. I've learned over the years that there's no substitute for building partnerships and collaborating with those who have the power to make meaningful, measurable change to our system of care. I hope to use my experiences to encourage health plans and providers to create innovative care models that will deliver better outcomes and better care to underserved Californians.
I come to the foundation from Inland Empire Health Plan (IEHP), a public health plan serving more than 1.2 million Medi-Cal, Healthy Kids, and Medicare dual-eligible members in San Bernardino and Riverside Counties. I worked as clinical director of behavioral health at IEHP from 2009 to 2015, then became the plan's senior director of clinical transformation and integration.
At IEHP I learned of the urgent need to create and implement integrated complex-care models to address the needs of Medicaid members who can't navigate our siloed systems of care. We forged a partnership program to help plan members with severe mental health and substance use conditions that interfere with health and wellness. Most of these folks also have chronic physical conditions, including diabetes, high blood pressure, and high cholesterol.
We established an interdisciplinary team of health care providers who worked with the patient, the primary care provider, and a health plan care coordinator to identify the patient's goals, ﬁgure out how to achieve them, and provide the support needed to do so. In the process, we looked not only at mental health or physical health but also addressed social determinants (such as housing) that affect the health status of our members. Our care managers and navigators made sure patients stayed connected with relevant resources and ensured all care was coordinated.
I've been aware of CHCF's work for a long time. In 2012, I was fortunate enough to be selected for a two-year fellowship with the CHCF Health Care Leadership Program, which enabled me to observe the organization up close. My experience convinced me that the foundation is positioned to launch and inspire the clinical transformation needed to move from a fragmented system to one that integrates the care that the most vulnerable Californians need to live healthier lives.
I am honored to have been chosen to take on this new leadership role and to work with the skillful team that built CHCF's excellent reputation. Over the past seven years, IEHP afforded me the opportunity to learn about the needs of the Medi-Cal population from my work at the health plan and from participating in multiple statewide workgroups. I have worked closely with the California Department of Health Care Services and more recently the Department of Managed Health Care to see how stakeholders can collaborate and shape better health benefits and move our delivery system toward integrated, whole-person care.
Now I have the opportunity to learn what works across California and focus CHCF's resources on high-value clinical transformation efforts. I hope you will share with me your ideas and innovations so we can make a difference together.