Delta Center California seeks to improve care and health outcomes for people with behavioral health needs, meet the goals of individuals and families, and address racial and economic inequities.
Building more equitable systems and policies means addressing factors such as structural racism and stigma against mental illness and substance use that have resulted in disparities in outcomes. To accomplish these goals, the initiative brings together behavioral health and primary care leaders in California in a neutral venue to examine recent policy and practice changes, identify opportunities to sustain what has worked, and explore and implement payment and practice change going forward.
Why This Work Matters
The need for improvement is great. People with behavioral health conditions — that is, mental illness and/or substance use disorder — often experience poor health overall. Those with a diagnosis of serious mental illness or substance use disorder die on average over 20 years earlier than those without such a diagnosis, often from preventable physical illnesses. People insured through Medi-Cal who have complex behavioral and physical health issues face a fragmented system that is challenging to navigate.
Too often, people with behavioral health needs never receive treatment. Only one-third of people with any type of mental illness receive treatment, and just 10% of people with substance use disorder are treated. In addition, there are dramatic racial and ethnic inequities in care. Within Medi-Cal, in most cases, Black, Latinx, and Asian Californians receive needed care at lower rates than their White counterparts. These unmet behavioral health needs are both a health and health equity crisis in California.
Today, this already-dire situation has been made worse by the COVID-19 pandemic. Rates of depression and anxiety have increased, leaving millions needing treatment.
Addressing behavioral health issues is also a financial imperative. Clinicians, behavioral health and primary care providers, counties, and plans face a fragmented payment system that makes it challenging for them to deliver the care their patients need. Individual people and single organizations cannot dismantle deep systemic barriers on their own. Delta Center California works from the premise that statewide groups working collectively can drive change.
Delta Center California’s overarching goals are to:
- Foster collaboration and collective action between primary care and behavioral health at the state and county level in California.
- Build knowledge and ability of state associations to ensure that changes in incentives and care systems meet the goals and needs of individuals and families.
- Accelerate payment and care integration through on-the-ground projects in selected sites across California.
Delta Center California is supported by the California Health Care Foundation and the Robert Wood Johnson Foundation. The initiative is led by JSI Research & Training Institute and runs through December 2022.
Delta Center California Activities
To advance policy and practice change to improve behavioral health care, Delta Center California supports two programs that reinforce each other.
First, it brings together the following California associations in a statewide roundtable to determine a collective path forward to break down barriers to care integration:
- California Alliance of Children & Family Services
- California Association of Public Hospitals/Safety Net Institute
- California Council of Community Behavioral Health Agencies
- California Institute for Behavioral Health Solutions
- California Primary Care Association
- County Behavioral Health Directors Association
- Local Health Plans of California
- NAMI (National Alliance on Mental Illness) California
Second, Delta Center California supports a learning lab, which launched in June 2021. The learning lab is a 16-month program that brings competitively selected local teams together with the state association partners listed above. One of Delta Center California’s key goals is for local teams and state partners to be better connected so they can learn from each other and more effectively drive change.
Local teams are composed of behavioral health (including mental health and substance use) and primary care providers. The six selected teams are:
- California LGBTQ Health and Human Services Network, and Marin County Behavioral Health and Recovery Services
- Community Health Center Network, LifeLong Medical Care, and Axis Community Health
- Integral Community Solutions Institute, Fresno Barrios Unidos, Centro La Familia, NAMI Fresno, UCSF Fresno
- Fresno County Department of Behavioral Health, Fresno County Department of Public Health, UCSF Fresno, and Fresno County Administrative Office
- Gateways Hospital and Mental Health Center, and Los Angeles Christian Health Center
- Uplift Family Services, Pacific Clinics, and School Health Clinics of Santa Clara County
Through participation in the learning lab, each team will complete a project focused on improving access, care experience, and/or outcomes for adults who have specialty mental health and/or substance use disorder needs. Delta Center California will provide one-on-one coaching and other direct technical support to teams to advance their individual projects.
In addition, teams will:
- Develop increased capacity to apply a racial equity lens to practice change
- Enhance skills and commitment to integrated, consumer-centered care
- Share and learn best practices and strategies for overcoming challenges
- Build relationships with one another and with other teams in the cohort
Through participation in the program, teams will develop an understanding of statewide care integration and payment efforts as well as value-based payment and care, including behavioral health quality and access metrics.
Each team will receive $50,000 to support its participation in the learning lab.
Delta Center for a Thriving Safety Net
Delta Center California is inspired by a larger coalition effort — Delta Center for a Thriving Safety Net — and adapted to the California setting. The national effort was launched in 2017 by the Robert Wood Johnson Foundation to bring together state-level behavioral health and primary care associations from 13 states to drive value-based payment and care. The project has proven to be a successful model for advancing integration through coordinated action on state advocacy and policy.