California’s Efforts to Facilitate Access to Medi-Cal Mental Health Services

Californians, like the rest of the country, are facing significant mental health challenges in the aftermath of the pandemic. The need for new and enhanced behavioral health supports and interventions has come into strong focus in recent years and states are leveraging their Medicaid programs to respond. Over the last two years, Aurrera Health Group has supported the California Department of Health Care Services (DHCS) in the development of a set of standardized Screening and Transition of Care Tools for Medi-Cal Mental Health Services. The tools, which were field tested before release, went live across the state in January 2023. They are part of an array of initiatives the state is advancing to support timely and coordinated access to mental health care.California’s Medi-Cal program covers mental health services through two distinct delivery systems. Specialty mental health services, designed to support individuals with serious mental illness, are delivered by county Mental Health Plans (MHPs), while non-specialty mental health services are provided by the state’s Medi-Cal Managed Care Plans (MCPs). Prior to the launch of the new tools, MHP and MCP screening and referral processes across these delivery systems varied widely. The new Screening and Transition of Care Tools seek to streamline these processes to ensure individuals are seamlessly connected to the right system of care to meet their needs, while minimizing inconsistencies and unnecessary burden.

Two Types of Tools

The Screening and Transition of Care Tools each serve a distinct purpose. The Screening Tools are used when someone who is not currently receiving mental health services reaches out to the MCP or MHP to request care. The tools, which include a version for adults and another for youth under age 21, identify initial indicators of an individual’s mental health needs through a brief set of questions to determine the most appropriate delivery system for a full clinical assessment. The Screening Tools will be used in a variety of settings, including MCP call centers and county access lines. When an individual contacts one of these settings requesting services, they will be screened and referred to a provider who can provide a complete clinical assessment and determine which services – such as psychotherapy, medication support, or residential treatment – may best address their mental health needs. The goal of the screening is to provide a quick, standardized process that helps ensure the individual reaches the most appropriate system for assessment and treatment with minimal burden.The Transition of Care Tool is used with individuals who are already receiving mental health services when their needs change. It provides a standardized approach to documentation and referral that supports timely and coordinated care when services are being transitioned or added across delivery systems.  For example, if during the course of treatment, an individual experiences a change in their condition, such as new or improved symptoms, the Transition of Care Tool would be completed to help adjust the treatment to meet their evolving needs. This process recognizes the dynamic nature of mental health conditions and treatment, and the tool provides a standard way for plans to share information about the individual’s health needs, how they’ve changed, and why they require new or transitioned services.

Aurrera Health Group’s Role

Aurrera Health group supported DHCS in developing the Screening and Transition of Care Tools, including a robust stakeholder engagement process followed by several rounds of testing in the field. Positive results from testing and support from key stakeholders and advocates are signals for a successful statewide rollout of the tool. Aurrera Health Group continues to assist DHCS in providing guidance and technical assistance to support implementation. The development and statewide use of these standardized tools offer a path to improved access for the roughly two million Californians who seek mental health services through Medi-Cal each year and support DHCS’s broader aim to make Medi-Cal a more coordinated, consistent and seamless system for individuals to navigate.

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Authors

Brianna Nielson [Deputy Director]

Kate Johnson [Director]