Delta Center California was a three-year initiative cofunded with the Robert Wood Johnson Foundation that brought together behavioral health and primary care leaders and practitioners in California to accelerate care improvement and integration through policy and practice change. The initiative ran from July 2020 to June 2023.

Delta Center California had two primary components:

• A statewide roundtable of behavioral health and primary care leaders that focused on policy
• Local learning lab teams that focused on practice

Delta Center California was led by a program office managed by JSI Research & Training Institute (JSI), with guidance from CHCF and an advisory group of experts and leaders in the primary care and behavioral health fields. The program office engaged in a co-design process throughout the initiative with a team representing behavioral health, primary care, and lived experience with mental health conditions.

Delta Center California (DCC) was conceived and planned before the onset of the COVID-19 pandemic — and launched when California was in lockdown. Numerous other changes, including the launch of the CalAIM (California Advancing and Innovating Medi-Cal) initiative and myriad behavioral health policy changes, rolled out during the project’s three years. Perhaps the most important lesson from Delta Center California was about flexibility, as the program’s structure and focus both changed from what had been planned in 2019, as all those involved pivoted to pay more attention to racial equity and inclusion of people with lived experience.

Read the full story of Delta Center California on JSI’s Delta Center California site, which includes all the project resources, events, and updates.

The Center for Community Health and Evaluation was the independent learning and evaluation partner for DCC. Its evaluation found that DCC offered a unique opportunity to build collaboration between primary care and behavioral health organizations at both the state and local levels — the foundation for policy and practice change. Participants took collaborative action on policy and practice, and they cited both centering people with lived experience and advancing racial equity as strengths of DCC.

Delta Center California Activities

Delta Center California brought together a wide range of stakeholders, including community-based organizations, Federally Qualified Health Centers, county behavioral health departments, people with lived experience seeking and receiving behavioral health care in the Medi-Cal system, and statewide associations representing behavioral health, primary care, public hospitals, LGBTQI+ communities, Medi-Cal managed care plans, individuals, and families.

These partners worked together through two structures.

Statewide Roundtable

The statewide roundtable, which met monthly throughout the three years of the project:

• Laid the groundwork with level-setting activities related to primary care and behavioral health opportunities and challenges
• Built close working relationships across organizations and fields
• Focused on advancing racial equity and involving people with lived experience in meaningful ways

The roundtable’s work was significant because it was the first time these organizations joined to identify shared priorities and speak across behavioral health and primary care associations.

The participating organizations were the following:

• Alameda County Behavioral Health, Office of Peer Support Services
• 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

More information on the roundtable’s activities related to telehealth, workforce, the state budget, and legislation is on the JSI-DCC website.

Learning Lab

The Learning Lab, which launched in June 2021, supported five competitively selected teams of primary care and/or behavioral health providers and community-based organizations through virtual learning events and coaching. Each team worked to complete a project focused on advancing the integration of primary care and behavioral health. Projects included these:

• Collection and analysis of race, ethnicity, and language (REAL) data in integrated behavioral health services (Axis Community Health, Alameda County; Community Health Center Network; LifeLong Medical Care)
• Development of a toolkit to guide collection and use of sexual orientation and gender identity and expression (SOGIE) data (California LGBTQ Health and Human Services Network, and Marin County Behavioral Health and Recovery Services)
• Strengthening of collaboration across a network of community-based organizations serving migrant and immigrant communities (Centro La Familia, Fresno Barrios Unidos, Integral Community Solutions Institute, NAMI Fresno, UCSF Fresno)
• Explorations of sustainability and best practices for a Certified Community Behavioral Health Clinic partnership (Pacific Clinics, School Health Clinics of Santa Clara County, and Uplift Family Services)
• Gateways Hospital and Mental Health Center, and Los Angeles Christian Health Center

Delta Center for a Thriving Safety Net

Delta Center California was inspired by a national 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.