MHAC Initial Thoughts and Considerations of Pending Change in California’s Delivery Services for People Enrolled in Medi-Cal Coverage

October 30, 2019

This paper is presented as part of a dialog of pending change in California’s delivery of services for people enrolled in Medi-Cal coverage. The challenges of the bifurcated system, across health, mental health and substance use disorder (SUD) have been highlighted for many years—in California as well as in other State systems– including the following core aspects:

  • Potential for inadequate physical health care for patients with serious mental illness, such as high prevalence of co-morbidities and high-risk for social determinants of health factors;
  • Lack of continuity of care for patients moving across systems (from health, mental health and SUD);
  • Lack of patient data sharing across systems;
  • Misplaced financial incentives for patient care due to limits of the system design, including potential conflict in determining financial responsibility;
  • Need to breakdown silos in the payment and administration of behavioral health care (across mental health and SUD), as well as across health system;
  • Competitive behaviors by counties and Health Plans to monopolize a provider’s availability, such as disallowing co-certification;
  • Need for capacity building across the continuum of mental health and SUD services, including for children.
  • Need to update facility and provider licensing due to potential barriers; and
  • Concerns with workforce, including shortages, as well as interdisciplinary education and training.

Reference Materials

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