Behavioral Health - California Health Care Foundation

Behavioral Health
The burden of untreated behavioral health conditions — encompassing mental health and substance use disorders — is both a major public health problem and a delivery system challenge. CHCF works to improve systems of behavioral health care and to focus on integrating mental health, substance use, and physical health services to achieve the best outcomes for Californians with low incomes.

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Behavioral Health Quality Framework: A Roadmap for Using Measurement to Promote Joint Accountability and Whole-Person Care

Behavioral Health

There is a critical need for a clear framework to measure quality and outcomes in behavioral health care. The approach described in this paper provides a testable model for guiding these efforts.

How Legal Changes in Response to COVID-19 Can Improve Access to Community Behavioral Health

Robert Belfort, Julian Polaris

Behavioral Health, Medi-Cal

This report discusses the impact of temporary legal reforms on outpatient and residential behavioral health services in California and identifies the most promising candidates for long-term reform.

Mental Health Disparities by Race and Ethnicity for Adults in Medi-Cal

California Pan-Ethnic Health Network

Behavioral Health, Medi-Cal, Health Equity

A 2017 California law requires robust tracking and evaluation measures for mental health services in Medi-Cal. This report demonstrates mental health access disparities for adults enrolled in Medi-Cal.

Delta Center California: Fostering Collaboration and Collective Action for Better Care

Behavioral Health

Delta Center California brings together behavioral health and primary care leaders across California to advance behavioral health integration. Local teams are invited to apply to a funded learning lab.

Equal Treatment: A Review of Mental Health Parity Enforcement in California

Behavioral Health

Researchers at Georgetown University's Center on Health Insurance Reforms assessed California's progress in enforcing the 2008 federal parity law.

Cracking the Codes: State Medicaid Approaches to Reimbursing Psychiatric Collaborative Care

Health Management Associates

Behavioral Health

This paper summarizes the approaches taken and lessons learned by the first 15 state Medicaid programs to reimburse for collaborative care, an evidence-based model of integrating behavioral health into primary care. An accompanying fact sheet outlines the benefit in Medi-Cal.

Washington State’s Transition to Integrated Physical and Behavioral Health Care in Medicaid

Center for Health Care Strategies

Behavioral Health

Between 2016 and 2020, Washington State transitioned from three separate Medicaid systems for managing physical health, mental health, and substance use disorder services into one integrated system. This case study offers lessons to other states seeking to advance physical-behavioral health integration.

How Medi-Cal Expanded Substance Use Treatment and Access to Care

Allison Valentine, Patricia Violett, Molly Brassil

Behavioral Health, Medi-Cal

Five years after the pilot program was implemented, 96% of Californians insured through Medi-Cal live in a county with a program. More people who need substance use disorder treatment are accessing it, and patient surveys of treatment are very positive.

Behavioral Health Integration

Behavioral Health

The California Health Care Foundation is deeply committed to fostering behavioral health integration — the knitting together of mental health care and substance use disorder treatment with health care as a whole.

External Resource

Together for Wellness

This website brings together all kinds of resources including apps, articles, videos, and links to other sites to help people maintain emotional wellness during the COVID-19 pandemic and beyond. It was created by a collaborative group representing mental health services, nonprofits, academic institutions, health agencies, and consumers across California. CHCF is proud to support this work.

Training Psychiatric Mental Health Nurse Practitioners — Fact Sheet

Workforce, Behavioral Health

With California facing a growing shortage of mental health professionals, a new online certificate program will prepare 300 psychiatric mental health nurse practitioners by 2025. Three schools of nursing within the University of California system (UCSF, UCLA, and UC Davis) launched the program in January 2021.

Clinicians Call for Making COVID-19 Emergency Telehealth Benefits Permanent

August 21, 2020

Elizabeth Morrison, Elizabeth Horevitz

Behavioral Health, Telehealth

Telehealth has shown itself to be a critical tool for increasing access to vital behavioral health services and reducing health inequity.

External Resource

KCBS Radio: The Coronavirus Pandemic’s Impact on Mental Health

On July 14 KCBS Radio Anchors Patti Reising and Jeff Bell and KCBS Radio Political Reporter Doug Sovern spoke with Catherine Teare, associate director at the California Health Care Foundation, about the impact the coronavirus pandemic has on depression and mental health.

Behavioral Health in California — Almanac Collection

Behavioral Health

The Almanac publications in this collection provide an overview of mental health and substance use in California. Using the most recent data available, these reports paint a picture of prevalence, supply and use of treatment providers, quality of care, and spending.

Weaving Together Mental and Physical Health Care Outside the Safety Net

California Quality Collaborative

Behavioral Health, Medi-Cal

Research shows that integrating mental health into primary care services can increase access to mental health care, improve patient outcomes, and reduce health care costs. While many safety-net providers have made strides toward offering integrated services, most people covered by Medi-Cal get their care outside the safety net, where such integration has not yet taken hold. This paper focuses on opportunities to support practice change in these settings.

Mental Health in California

Adriana Ramos-Yamamoto, Scott Graves

Behavioral Health, Medi-Cal, Homelessness & Health Care

This chartbook from the California Budget & Policy Center provides a detailed look at California's public mental health system, which serves more than a million California children, youth, and adults annually.

CIBHS Webinar Series for Behavioral Health Providers

Behavioral Health, Telehealth

The California Institute for Behavioral Health Solutions hosted webinar series for behavioral health providers. Their 11-week series from April through July 2020 focused on telehealth. A five-week series from August through September 2020 discussed strategies for eliminating inequities in behavioral health care.

Paying for Value in Behavioral Health

Robert Belfort, Adam Striar

Behavioral Health, Medi-Cal

State Medicaid programs are actively pursuing models of behavioral health value-based purchasing. This paper reviews well-publicized initiatives in three state Medicaid programs that have adopted different types of behavioral health value-based purchasing models.

Mental Health Tops Californians’ Health Care Priorities in Statewide Poll

Eran Ben-Porath, Emily Hachey, Jazmyne Sutton, Jennifer Su

Behavioral Health, Health Care Costs, Coverage Trends, Medi-Cal, Workforce, Homelessness & Health Care

The survey offers detailed insight into Californians’ views on a range of critical health issues, including health care affordability and access, perceptions on homelessness, the health care workforce, Medi-Cal, and the experiences of the uninsured.

February 18, 2020

Briefing: Behavioral Health Integration in Medi-Cal

Behavioral Health

February 18, 2020

Join this CHCF briefing to learn about efforts to integrate physical and behavioral health care in Medicaid programs across the country and within Medi-Cal in California.

Making Behavioral Health Integration Work

Logan Kelly, Allison Hamblin

Behavioral Health

This paper synthesizes insights from organizational leaders representing Medicaid-based partnerships in four states: Arizona, Arkansas, Colorado, and Oregon.

Medi-Cal Waivers and State Plan Amendments

Two short documents provide an overview of Medicaid waivers and State Plan Amendments, and how they are used in California. A one-page comparison chart shows the differences between these two policy instruments.

Concert Health Aims to Scale Collaborative Mental Health Care

January 30, 2020

Behavioral Health, Investing in Innovation, Telehealth, Workforce

Patients served by small and rural primary care physicians may benefit from a remote version of this increasingly popular model for providing mental health care.

Behavioral Health Integration in Medi-Cal: A Blueprint for California

Logan Kelly, Allison Hamblin, Stephen Kaplan

Behavioral Health

People in Medi-Cal with complex behavioral and physical health needs face a fragmented system that is challenging to navigate. This paper offers recommendations to build an integrated system of care in Medi-Cal, bringing together physical health, mental health, and substance use services to treat the whole person.

Placing Bets in a Complex Environment: One Foundation’s Approach to the Opioid Epidemic

This article describes CHCF's five-year opioid safety initiative and the impact it had on California's efforts to combat the opioid crisis. It is published in The Foundation Review, a peer-reviewed journal of philanthropy.

Concert Health

Behavioral Health, Telehealth, Investing in Innovation

Concert Health integrates remote behavioral health managers and psychiatrists into primary care practices, making it possible to effectively manage mild-to-moderate mental health conditions without referrals.

Voluntary Behavioral Health Integration in Medi-Cal: What Can Be Achieved Under Current Law

Anil Shankar, Diane Ung

Behavioral Health, Medi-Cal

This paper was prepared by two attorneys with extensive experience in structuring Medicaid financing for safety-net providers. It explores different contracting structures through which a county could lead efforts to create opportunities for integration of physical and behavioral health care.

Integrated Physical and Behavioral Health in Medicaid Managed Care

Logan Kelly, Michelle Conway, Michelle Herman Soper

Behavioral Health

This brief distills insights from providers in three states — Arizona, New York, and Washington — that have recently transitioned to integrated managed care for physical and behavioral health conditions. It was written by the Center for Health Care Strategies with support from the Blue Shield of California Foundation and CHCF.

Mental Health and Substance Use Disorder Parity Under the ACA

Caroline Au Yeung, Colin Planalp

Behavioral Health

The ACA mandated mental health and addiction coverage parity to beneficiaries in the individual and small-group markets and to Medicaid expansion beneficiaries. This brief, prepared by SHADAC with CHCF support, details how the ACA applied these mandates and presents estimates of the number of people affected.

September 23, 2019

Briefing — An Introduction to California’s Public Mental Health System

Behavioral Health

September 23, 2019

At this CHCF briefing participants learned the fundamentals of the history and financing of the mental health system for people insured through Medi-Cal.

In LA, Exciting Era Dawns for Addiction Treatment

December 11, 2018

Medi-Cal, Behavioral Health

A groundbreaking Medi-Cal program is enabling substance use disorder treatment facilities to say yes to more patients seeking care, yes to more flexibility regarding treatment plans, and yes to hiring more workers to treat people in need.

2018 Edition — Substance Use in California

Behavioral Health

About 8% of Californians met criteria for substance use disorder, but only 10% of people with a substance use disorder received any type of treatment. CHCF's first Almanac publication to address this topic provides an overview of substance use and addiction in the state.

Transforming Mental Health Patients into Providers

January 13, 2019

Behavioral Health, Workforce

An innovative program in Washington connects peer support counselors whose personal experience of recovery from mental illness or addiction helps them deliver behavioral health services to patients — at pivotal moments in their lives.

Medi-Cal Moves Addiction Treatment into the Mainstream

Molly Brassil, Carol Backstrom, Erynne Jones

Behavioral Health, Medi-Cal

A fundamental shift is underway in California to expand, improve, and reorganize Medi-Cal’s system for treating people with substance use disorders. This report summarizes the experiences of the first counties to implement this new approach.

California’s Current and Future Behavioral Health Workforce

Janet Coffman, Timothy Bates, Igor Geyn, Joanne Spetz

Behavioral Health, Workforce

This report synthesizes data about California’s behavioral health workforce. California needs to make substantial investments to meet future demand for behavioral health professionals.

Drug Medi-Cal Organized Delivery System

Behavioral Health, Medi-Cal

In Medi-Cal, treatment for patients with substance use disorder has long been run out of a separate program. Now California is implementing a broad move to modernize this system of care.

2018 Edition — Mental Health in California

Behavioral Health

Mental Health in California: For Too Many, Care Not There provides an overview of mental health in California: disease prevalence, suicide rates, supply and use of treatment providers, and mental health in the correctional system. This Almanac report also includes available data on spending and quality of care.

Overcoming Data-Sharing Challenges in the Opioid Epidemic

Robert Belfort, Alex Dworkowitz

Behavioral Health

Federal confidentiality rules, such as the "Part 2" rules, can be a stumbling block for primary care practices seeking to integrate substance use disorder treatment. This paper summarizes the rules and outlines steps that practices can take to coordinate care and stay within the law.

Fine Print: Rules for Exchanging Behavioral Health Information in California

Deven McGraw, Robert Belfort, Alex Dworkowitz

Behavioral Health, Data Exchange

The exchange of behavioral health information is constrained by operational challenges and legal concerns. Manatt Health describes the regulatory framework for sharing such data in California.

External Resource

Moving Toward Value-Based Payment for Medicaid Behavioral Health Services

Medi-Cal, Behavioral Health

This brief from the Center for Health Care Strategies describes how innovative states and Medicaid managed care organizations are building on models developed for physical health services and incorporating value-based payment arrangements into behavioral health programs.