Treatment

Critical Improvements to Behavioral Health Services in California Getting Ready to Take Place

By Pete Nielsen, LAADC, SAP

California Assemblyman Jim Wood has set out to initiate significant and positive change with the introduction and hopeful passing of Assembly Bill 942. The bill will implement behavioral health components into the Department of Health Care Services’ (DHCS) California Advancing and Innovating Medi-Cal (CalAIM) initiative. It is designed to help and guarantee there will be insurance coverage and easy deliverability for the treatment of individuals with mental health or substance use disorder (SUD). Furthermore, the bill will, “Prohibit the existing Medi-Cal medical necessity requirements from precluding coverage for, reimbursement of, a clinically appropriate and covered mental health or SUD assessment, screening, or treatment service in specified situations, such as before a provider renders a diagnosis.” If the bill passes, it will ensure an easier process without barriers for those who seek treatment.

The bill will also require the DHCS to assist counties in preparing for the statewide implementation of the CalAIM program. “CalAIM is a multi-year initiative by DHCS to improve the quality of life and health outcomes of our population by implementing broad delivery system, program and payment reform across the Medi-Cal program.” Additionally, this bill will establish the Behavioral Health Quality Improvement Program (QIP) to help ensure funding for the CalAIM program, to which DHCS would have to make sure the funds are appropriately dispersed for the program. The QIP program will assist county mental health plans and counties that administer the Drug Medi-Cal Treatment Program or the Drug Medi-Cal organized delivery system for purposes of preparing those entities for implementation of the behavioral health components included in the initiative CalAIM program. CalAIM will help address many of the complex challenges facing California’s most vulnerable populations.

If this bill is to pass as expected, the process for people to get treated will be exceptionally better because of many unnecessary obstacles being removed from the process. Many health and behavioral health providers support the passage of this bill, specifically citing how it will reduce barriers to care and simplify administration. AB 942 will eliminate restrictions that limit the accessibility to mental health and SUD services, such as allowing a person to still be able to get treatment before a “required” diagnosis from a provider. In addition to removing barriers, AB 942 also will make the DHCS develop standardize screening tools and create transition tools for better transitions between delivery systems that supports the needs of a person.

California Consortium of Addiction Programs and Professionals (CCAPP) Vice President of Education and Strategic Development Kristina Padilla states, “It is extremely important that we begin to prioritize and increase access to services for those who experience mental health and/or substance use disorders. AB 942 is an asset to removing the barriers that have traditionally kept individuals from receiving the treatment that they need, allowing those who are seeking help to be screened, assessed, and treated in an effective manner. Support of AB 942 is essential in making these services obtainable to all populations and communities.”

Passing of AB 942 will create a smoother pipeline for a person’s ability to receive the help they need, which cannot be undervalued. The amount of people needing help and not being able to get it due to a broken system cannot continue to be allowed. Everyone must have the option of getting the help they need if they want it, in an easily accessible manner.  

CCAPP’s Board Chair, Rose Wheeler emphasizes, “There are thousands of people who are untreated and unable to get help because of a broken insurance system. AB 942 will help remove the stigma and give more people the ability to get help without embarrassment. Can you imagine going to get help and being told your insurance doesn’t cover this? Sorry. That’s devastating. We hope everyone can get behind AB 942 to help people with full mental health and substance abuse coverage.” It should be definite that people be able to get the help they need without stigma and obstacles in the way.

AB 942 will be a critical development in California’s health care services as it will greatly aid in the process of patients getting screened, assessed and treated for help. This will make sure it will not be difficult for people to receive their Medi-Cal specialty mental health and SUD services by facing unnecessary obstacles, and guarantee the necessary funds will be given to counties to ensure easy rollout of this system.

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