Category Archives: Disparities and Equity

First Female Senate Pro Tem Takes Office Amidst National Storm of Workplace Sexual Assault

This is normally a very quiet time in the legislature – but not this year.

The year of workplace sexual assault reaches the State Capitol with two legislators resigning; Toni Atkins named first woman president pro tem of state Senate

December is ordinarily a very quiet month in Sacramento. There’s only about two weeks of work activity followed by vacation for just about all those around the capitol. This break in activity prepares all of us for the very hectic pace that starts in January.

But this is a very different year in so many ways. Time magazine, which I guess is only still relevant to those of us over 50, named five women who came forward to tell their stories of sexual assault in the workplace as “person of the year”. Continue reading First Female Senate Pro Tem Takes Office Amidst National Storm of Workplace Sexual Assault

AHCA approved by House. What does its passage mean in California?

Last week the House of Representatives passed the American Health Care Act by the narrowest of margins, with all Democrats and 20 Republicans voting no.  It succeeded because of amendments to satisfy the so-called “Freedom Caucus” of very conservative Republicans who objected to the bill in March because it left too much of the Affordable Care Act intact.

The key amendment was to allow states to eliminate pre-existing condition protections replacing that with high risk pools that could be subsidized with federal funds.

The focus on pre-existing conditions got all the news media attention and certainly will adversely affect people with mental illnesses and substance use disorders both of which would be considered pre-existing conditions – even if the only treatment was one or two visits to a therapist, or a single prescription for an antidepressant. Continue reading AHCA approved by House. What does its passage mean in California?

Another Attempt to Weaken the Affordable Care Act

Another Attempt to Weaken the Affordable Care Act?

Grassroots advocacy is making a difference.

As widely reported, there is a new version of Trump care/House Republican efforts to weaken the Affordable Care Act (ACA).  The changes give states additional freedom to eliminate protections for people with pre-existing health conditions. Anyone who has ever received a prescription for an antidepressant or seen a therapist is considered one of those high risk individuals. The new bill also authorizes elimination of 10 essential benefits.  These include behavioral health as well as habilitation and rehabilitation services important to people with behavioral health problems.

All of the Medicaid cuts there were in the original proposal are still there. The changes satisfied the so-called freedom Caucus of extreme conservative Republicans.  On the other hand it has strengthened the opposition of so-called moderate Republicans.  Here is a brief presentation summarizing the status of this effort and other related possible health policy changes. Note especially the charts on pages three and 13.

When the original bill was considered last month all 14 California Republicans were reported to be in support. Now we have heard that Congressman Jeff Denham from the northern San Joaquin Valley is not supporting the bill.  This means that the grassroots efforts of organizations like ours are making a difference. See Sacramento Bee Article.

Unless the bill has been passed by the house before you read this, those of you who provide services in areas represented by Republicans in Congress should redouble your efforts to remind these members of the consequences of cuts in behavioral health services and access to insurance which includes these benefits.

There has never been a time when there’s been so much public attention on how health care systems work. This is the time for all of you to continue to expand your efforts to educate your political leaders and build relationships that will impact policy support beyond this year. These efforts will pay off, even if it doesn’t appear that way in terms of immediate change of position.

Continue reading Another Attempt to Weaken the Affordable Care Act

After 10 Years, Fine Tuning is Needed for the Mental Health Services Act

After about ten years of implementation some fine tuning is needed for the Mental Health Services Act to better achieve its goals

This Thursday May 26th the Little Hoover Commission will hold its Prop-63-Logosecond hearing on the Mental Health Services Act (MHSA). At issue is its conclusion that state officials have not implemented the recommendations they made in January 2015.

At the same time legislators are taking unprecedented steps to earmark funds (Senate No Place Like Home budget proposal; AB 2017 McCarty – College Students; AB 2279 – Fiscal Reporting). CCCBHA and I support these efforts and join other stakeholders in recognizing the need for some fine tuning of this act.

Continue reading After 10 Years, Fine Tuning is Needed for the Mental Health Services Act

California Well Positioned for Excellence Act (CCBHC) Certification, Management and PPS

December 20, 2015

On Monday, December 7th, I participated in the National Council for Behavioral Health’s second all day training for state associations to support state planning to develop proposal under the Excellence in Mental Health Act Certified Community Behavioral Health Centers program which will significantly increase funding and significantly reduce documentation requirements for outpatient behavioral healthcare. See my paper documenting that the value of this is about $1 Billion statewide in the first year and growing.

A centerpiece of that training was the review of a new and expanded “Integrated CCBHC Certification Criteria Feasibility and Readiness Tool (I-CCFRT)”.
In studying that tool and discussions with other state association representatives I learned that the structure of county mental health in California (not yet the case for substance use disorders- but should eventually be with the implementation of the Organized Delivery System) is well aligned with the requirements for CCBHC certification, management and establishment of a prospective payment system.

Continue reading California Well Positioned for Excellence Act (CCBHC) Certification, Management and PPS

Closing the Gaps and Disparities in Continuity of Care

Closing the Gaps and Disparities in Continuity of Care

Actions and discussions this year indicate a serious effort on the  part of state leaders and interest groups to address one of the remaining major disparities affecting behavioral healthcare which is the lack of a commitment to continuity of care that is much more prevalent in attending to purely physical health conditions. Continue reading Closing the Gaps and Disparities in Continuity of Care

July 2015 Blog – Data shows wide disparities among counties and ethnicities

Data shows wide disparities among counties and ethnicities

Will Data Drive Policy?

CCCMHA has had the support of a summer intern, Chelsea Parker, who compiled data about MediCal penetration rate among counties age groups and ethnicities and also developed reports about how readily different populations access mental health services. Continue reading July 2015 Blog – Data shows wide disparities among counties and ethnicities