How Medi-Cal Transformation is Expanding Access to Behavioral Health Care Services | 5/16/24

How Medi-Cal Transformation is Expanding Access to Behavioral Health Care Services | 5/16/24

welcome to today’s briefing the topic how medical transformation is expanding access to Behavioral Health Care Services I’m Sandy close director of ethnic Media Services EMS and California black media are partnering with the Department of healthc care services dhcs to present this third in a series of briefings over the next two months about how medical is transforming Health Care Services in this state our research director senen ozerk who will be moderating our call today will now give an introduction to the briefing and to our speakers senen I turn the microphone over to you I’ll be here all week uh try the ve uh hi as the department of healthc care services uh continues this multi-year initiative to transform medical um the state’s addressing Behavioral Health needs like mental health care and substance use disorder treatment through healthare uh and California’s in the Vanguard of this medical our Medicaid Program provides coverage for one in three or 15 million Californians I read this time last year that 40% of Youth are also insured under it um and medical now includes expanded services to meet uh Healthcare needs well beyond the doctor’s office like mental healthare and substance use disorder treatment at this briefing dhcs leaders and Community Healthcare Providers will share how medical is helping Californians needing these Services lead healthier lives our speakers include Autumn boan who’s the deputy director of The dhcs Office of strategic partners ships who will be speaking with Paula Wilhelm who’s the interim deputy director of Behavioral Health at dhcs um to provide some boots on the ground perspective we also have Jennifer olant uh Clinical Director of the Hope For Tomorrow two feathers Native American Family Services Program all the way up in humbl county and uh Trisha noan uh the CEO of Southland integrated Services formerly Vietnamese community of Orange County we ask reporters to enter questions in the chat our speakers are also encouraged to answer questions in the chat through the conference so I’ll field everything I can um we’ll send a video of today’s briefing along with expanded bios for each speaker later today and we’ll send video excerpts of the presentations early next week and now we welcome Autumn boand from dhcs and Paula Wilhelm also from dhcs and they’re going to be giving us an overview of how medical is expanding its Behavioral Healthcare including a new Children and Youth Behavioral Health Initiative that’s transforming the way California supports kids needs good morning everyone um as senen mentioned my name is Paula Wilhelm and I’m the interim deputy director for Behavioral Health for the California Department of healthc care services or dhcs and I’m really excited to um get to join you today and talk about Behavioral Health Services for our medical members so as a department we know that mental health is just as important as physic iCal health and all of our health outcomes are intertwined so a member may use alcohol or drugs to cope with their mental health needs they may have medical problems that make it hard to get up and do what you want to do in the morning or they may face challenges meeting basic food and housing needs and so dhcs has been um working hard to partner with our medical managed care plans and our care providers to transform the way mental health care and substance use disorder services and together we refer to mental health and substance use as Behavioral Health are delivered to Medical members and first you know we just want to call out that there are many services available through medical for Behavioral Health that not everybody knows about and that’s why we really appreciate the opportunity to do a briefing like this so we want our medical members to know that care is available if for example you’re experiencing postpartum depression or dealing with anxiety and stress because of school or work issues or if you need help dealing with drug or alcohol addiction um to provide a little more context about medical Behavioral Health Services dhcs works with managed care plans and County Behavioral Health agencies um who serve as managed care plans to provide a wide range of Behavioral Health Services for our medical members so these include um things like prevention and wellness Services um I’ll mention community health workers who can provide health education and help members navigate and access care um Services includes screening and assessment of mental health and substance use needs an array of outpatient and community- based Treatment Services um including individual group and family therapy medical also covers more intensive treatment services including Crisis Care residential treatment or inpatient for those who need them and of course we cover mental health and substance use medications so this includes treatment for opioid use and uh harm reduction tools like nxone which can reverse overdoses and Fentanyl cust strips today we also particularly wanted to talk about several ongoing and new initiatives that we’re undertaking to improve our medical mental health and substance use disorder services so in partnership with our managed care plans counties and behavior Health Providers we want to improve the quality of care that we offer in medical and create a more person- centered and Equitable delivery system so our overarching goal is to make it easier for medical members to Access Behavioral Health Care and all the services they need to live healthier lives um this includes the newly updated Behavioral Health Services act which was passed by the California voters as proposition one so you may be hearing about this we also refer to um proposition one as Behavioral Health transformation and this effort is really going to reorganize and transform the way we plan finance and deliver our publicly funded Behavioral Health Services to better support our populations living with the most significant mental health and substance use needs so just a few key elements um of Behavioral Health transformation include reforming Behavioral Healthcare funding um so that we’re uh equitably in treatment for those with substance use disorders and prioritizing care for those with the most serious conditions we’re also expanding Services um including prevention and early intervention services and making new investments in housing and the Behavioral Health Care Workforce and then critically we’re um continuing to focus on outcomes accountability and Health Equity so this includes supporting culturally responsive services and Community defined practices and developing a behavioral health Workforce that reflects the diverse communities we serve in California and is consistently equipped to provide culturally and linguistically appropriate care so as we undertake ambitious new reforms like implementing proposition one we are also trying to continue building on the work we’ve done in the past few years in medical to really strengthen our fundamentals one thing we continue to hear from our medical members is that the complexity of navigating the Health Care system can keep people from accessing care one of the key initiatives we um have implemented to address this is our no wrong door approach um and this is a series of policies that are intended to ensure that no matter where you live or which door you enter to seek care you can find a compassionate provider who will connect you to the appropriate Mental Health Services investing in the behavioral health care of our members also means um that we are looking at adapting how we organize and pay for care so beginning in 2023 we implemented um Behavioral Health Payment reform and this was intended to um align the way we pay for care with industry standards create opportunities for payment models that reward quality and the reason we’re mentioning this is um obviously appropriate uh payment and sort of simplified Administration can be a tool to get more providers into our medical system um and we want again uh accessible and um vast and diverse Network serving our members Paula um could I ask you uh before we go to Autumn that was a fantastic overview um do you have uh just to you know put it in the context of medical and trying to integrate all these services do you have an estimate of the overall demand for Behavioral Health um just how it fits in yeah I think um we we could we we’d be happy to follow up and provide um statistics about sort of the numbers that we serve in our Behavioral Health System um cool cool um and how much is it County specific uh so if I’m you know reading about these services and how you’re rolling them out I’m on medical and need mental health substance use care I know someone who does um how do I get them you know do I reach out to the county or go straight to one of these local clinics Great question um our team I think can put this link in the chat but um all so the covered Behavioral Health Services are administered by every County and all of the counties have a 24-hour access line which um members can call um at any time to get connected to care and we have a list list of those lines that we can link to wonderful I’ll definitely include that in our coverage um yeah well definitely uh please stay on for more questions that people may have but uh I’m going to transition it now to Autumn boin from dhcs who will continue this overview um focusing a bit more on the Children and Youth Behavioral Health Initiative you senen and thank you to Paula for setting the stage for our medical Behavioral Health Services I am so happy to be here with you all this morning um I am going to talk about the governor’s master plan for kids mental health which was announced by Governor Nome on in August of 2022 and a Cornerstone of that master plan is the Children and Youth Behavioral Health Initiative an over $4 billion investment in youth Mental Health Services and support for emerging and existing behavioral health conditions for over a decade um outcomes for Children and Youth of all ethnic backgrounds um and um and identities has been unfortunately worsening um what we know is that half of all lifetime cases of diagnosable mental illnesses emerge for our young people by the age of 14 and 75% of uh lifetime diagnosable mental illnesses Begin by the age of 24 so focusing on Children and Youth from ages 0 to 25 is critically important to ensure that we are providing preventative Services and intervening early when symptoms of mental health conditions or substance use disorder conditions begin to emerge as our young people are developing we also know that in California specifically um almost 300,000 or 284,000 youth are coping with major depression and 66% of those young people do not get treatment access in the way that they should or timely access to care um we also know in 2021 U UCLA or the University of California at Los Angeles published a study indicating that a third of californ young people in the prior years had expressed significant psychological distress um this is happening for a number of reasons our young people are stressed out um of course the public health uh pandemic um contributed um and exacerbated some of those outcomes but it is not the sole cause of some of these challenges that our young people are facing young people today experience the world in ways that many adults of my gener generation for example just didn’t experience they have access to 24 hours a day 7 day a week information in the palm of their hands through their phones they engage in interactions healthy and unhealthy through social media they are um bombarded with information about the world around them including climate change and the political world around them and there are just many things um including school shootings and other circumstances that are contributing to the stressors that young people today face and as their developing brains are coping with all of these different challenges in the world today um it is leading to uh this youth Mental Health crisis which um the Surgeon General of the United States has been very publicly talking about um the youth Mental Health crisis as being one of the greatest challenges an epidemic of our time Governor Nome in the master plan for kids mental health also speaks to the Paramount nature of um addressing this youth Mental Health crisis and uh one of the ways in which we’re doing that is through the Children and Youth behavioral health initiative so in addition to all of the things that Paula mentioned in her overview um we are also focusing not just on Health Care settings and Clinics where young people and their families can go to get support although of course those services are available and all of our health plans are required under federal law to provide Mental Health Services as part of the essential health benefits but we’re also focusing on strengthening the network of support for our young people where they spend most of their time so we’re working um very closely with our County offices of Education school districts and schools throughout the state to strengthen the netork of care and supports that available in school settings uh both at the K through2 as well as the California Community College University of California and California State University Systems to help people deal with the stressors of school so making sure that there are more school counselors available School psychologists that services are reimbursed by the health plans uh for their enrolled members we’re implementing programs related to well-being and mindfulness and focusing on social and emotional learning and support to ensure that the entire School climate is focused on addressing mental well-being and emotional health we are also focusing on community- Based Services by investing in evidence-based interventions and strategies and Community defined practices that are known to be of um of benefit and Achieve better outcomes for our young people of color for our uh lowincome populations I ask you to uh speak a little slower for the interpreters but uh you’re going into a question I really want to ask you um go on for thank you I will try to slow down all right thank you for the prompt um and uh so focusing on community Define evidence strategies that are known to be effective in um in communities for um for ethnic populations for youth experiencing homelessness and housing um challenges um and for justice involved youth or our lgbtq populations um finally we are focusing on a digital Health strategy so we know that uh while it’s a challenge that kids spend so much time on their phones um it’s a reality of the world that we live in today not just for kids but also for parents and caregivers and so we have launched uh two mental health apps that are free for all Califoria orans uh regardless of insurance status so not required to have medical to access these services but for all kids in California we have the brightlife kids app available today for our young children ages 0 to 12 and parents and caregivers we also have the saluna app which provides free mental health coaching support as well as a a host of resources for our teens and Young adults ages 13 to 25 if someone could put a link to those apps in the chat that would be great we will thank you are they in multiple languages uh so the both of the apps are available uh and provide services in in the app with U video appointments or inapp chat um in both English and Spanish but they also both offer telephone coaching support in all medical threshold languages so up to 20 languages to provide the services and supports and again it’s brightlife kids and saluna and I see that we’re adding information on the chat about both of those apps we also just released a series of parenting videos called positive parenting thriving kids in both English and Spanish and it’s 20 different videos actually 40 in each 20 in each language um that provides information to parents about how to communicate with their children about um some common issues that young people face that contribute to their overall well-being we’ll also add information in the chat about those resources as well so we’re really trying to think about you know how we deliver care in the community in the home in our phones and in a manner that will be more accessible to children youth and families across the state thank you uh you know we over the past few years I’m sure the pandemic had much to do with that um we aren’t talking about you know epidemics we’re facing whether that’s a literal pandemic epidemic of mental health Youth Without also talking about um a shortage of practitioners to uh meet these challenges um you touched a bit on how Medical’s focus on community- based uh support meets that but are we seeing similar challenges in the mental health field um where you know we need more culturally competent therapists um you know substance abuse Crisis Intervention coordinators Etc uh yes and I think Paula also addressed some of this in terms of the workforce Investments that we’re making to ensure that we have a more diverse Workforce um people want to be uh matched with a provider that um shares their worldview and experience and speaks their language and um there are many Investments both through the cim program as well as through the Children and Youth Behavioral Health Initiative to strengthen and diversify our overall Workforce that’s also true in our digital Health strategy we want to make sure that these apps that we’ve released uh feel like it’s a home for all children and youth in California of all ethnic backgrounds of gender identity sexual orientation um and um and languages and we want to make sure that people are getting access to to care but there are challenges and outcomes for uh children of color uh youth of color uh for lgbtq youth are worse than they are for uh for uh other for white children and um and um and that’s something that we we definitely need to address and we’re trying to do uh through multiple channels including this work through calim and cbhi but also through our Health Equity Road mapap at d H CS thank you um in the interest of time I’m going to move on but I do see some questions I’ll ask toward the end about how common loopholes and coverage are medical I know is making great strides to simplify that you know when you go between insurance plans and certain services are available or not um but I’ll hold that um thank you otum and Paula we now welcome our third speaker Jennifer olant who’s the Clinical Director of the Hope For Tomorrow program at two feathers Native American Family Services up in kinleyville in Humble County she’s going to be talking about how uh they’re helping indigenous indigenous youth up there with mental health and substance use disorder of treatment on the ground uh Jennifer please go ahead hi thank you so much um so just to reiterate Jennifer olant um I go by she her and I’m The Clinical Director at two feathers Native American Family Services um as mentioned we serve Humble County so it’s a a northern California county um a large rural County that’s really known as the heart of California IND Indian Country um we have eight ferally recognized tribes um and a few more that are non not federally recognized um so we have a large indigenous population here and our agency is a tribally chartered nonprofit but we serve all indigenous people in Humble County so whether they’re from Humble County or not um and that’s self-report as well so we don’t require any proof um we focus on the youth and families but we have a very kind of community organizing approach as well so I’m just really excited to talk to you all about how we’ve actually used medical so we have a contract to Bill medical to provide services and we’ve mixed it with some grant funding to provide um services that we feel are just more appropriate to the population that we’re serving than we have seen historically in the area um and so I’ll dive into kind of what our agency offerings are um I just want to say I get really excited talking about our work here so feel free to interrupt if I go over my time um or if you need to redirect me at all I can get a little carried away because um it’s just I think it’s really wonderful um so at our nonprofit agency we’ve just had immense growth in the last couple of years and our medical contract has really helped us to do that um and so so I’m as mentioned I’m The Clinical Director so we have a clinical program that provides mental health and substance use services to youth we kind of focus on ages 10 to 24 um we are interested in expanding that down the road um but that is the the age group that we’re looking at right now we do also include families as much as possible so sometimes there will be younger siblings or parents involved um we have 14 clinicians right now which for our rural County it’s actually one of the larger clinical programs in the county um in that in my same program we have um clinical managers and uh an intensive care coordinator as well um and we don’t just provide me mental health counseling and substance abuse counseling we also have a equin program which is horse therapy um that we’re able to build through our medical contract which is a really wonderful offering to the community um we also have some um collaborations set up with the local universities to take interns to train kind of the next uh Workforce um so I there’s more that we do in that program but I also want to capture the other things that we do I want to write like 10 stories interview you about that horse Therapy Program alone beautiful or I’ll ask you two later go on yeah it’s really wonderful we piloted it last year um and got a really fabulous um feedback and response and yeah I could talk a lot about that but we’ve got some other things to cover so thank you um we this year is kind of our first year of we are really trying to hit an integrated model pretty hard so we have other departments um which I’m going to share with you but I think in like growing agencies maybe some of you can relate but sometimes departments can kind of become a little bit siloed and so we felt that we needed to really integrate all of our programming to be the most effective and to really engage Eng our community um and so within the the clinical program we’re actually launching a peer specialist service stream and some of the peer specialist folks will live in some of the other programs so that’s one example um but we have a cultural department and we also have an Outreach department and these two departments essentially um facilitate kind of community Gathering opportunities workshops to come and learn about culture or ceremony and just be with Community um and then our other programs really jump in and support and bring Youth and these are part of the services that we deliver um and then the final program that I haven’t mentioned but this one we are kind of planning on being one of our core programming offers is Our Youth Development leadership program um this is really exciting we started about two years ago we kind of piloted this idea uh where we were really thinking about how do we engage the teens a little bit better like we’ve we’ve managed to get them in the door with some creative approaches but it can be a little bit spotty and and how do we offer them just a little bit more like an additional layer of that um kind of Wellness skill building um sense of community and so our executive director actually came up with this idea of what if we paid them and so our youth development um leadership program is really cool because we actually employ teenagers so the structure is there there will be about five to seven of them in a pod per um leader and they come and they engage in a curriculum where they learn not only how to be future employees that’s kind of the context we set up but they get social emotional skill building um they get to go on college tours they get to access their culture and learn about um local cultural practices so it’s just a really well-rounded um develop the youth and and so like I said we’re doing that um in kind of a full integration with our other programming um and I I wanted to give you guys a a real example of of kind of what this looks like if I have time I I think I do uh yeah a minute minute and a half okay I knew that was gonna happen um yeah so I I just thought of an example we had one youth come in a couple years ago um they were really struggling they’ve been through just so much they were kind of on the fence about whether they wanted to do counseling or not um and we were starting to see some substance use unfortunately was um taking hold of it and so there was a high level of worry about this young person we thought how can we get them in our programming and really work with them um and so they were actually able to enter into the the work pod program the youth leadership and development program because I got to tell you that paycheck is really incentivizing the teenagers we found so we we got this young person in the door um they got connected with kind of a peer group they’re connected with a pod leader now all of a sudden they’re very open to going to counseling so we were able to get them um established with one of our um in-house counsellors um and they were helping to facilitate and come to some of our other programming and I can say I think they’ve been with us a year almost two years the change has been just absolutely remarkable so being able to layer some of those more traditional approaches like the the counseling one-on-one services but include that in into our other programming that includes this really um building of connection and community and then learning some of those um doing some more kind of focused skill building work in addition to the counseling we are just seeing huge huge um leaps and bounds by these Youth and it it’s been very profound and so I just wanted to share that example um with you all medical what was that this is all part of the medical uh expanded services so the med yes yes I would say what the medical um expanded Services act has allowed us to do is have a um sustainable funding stream that we’ve used in partnership with some of our grant funding so the grant funding um does cover some of these more creative services but the um when the youth are engaged in our counseling services or even our peer specialist service stream we’re able to use that medical funding which has has really allowed for us to expand include more youth um and get them to some of these other program offerings because we have the money to do them because our our mental health services are covered now there’s uh this dichotomy um I’m sure everyone on here who works in any capacity with LC’s between you know hardly reached areas with low uh coverage and a rising crisis particularly in this these uh what these Services try to treat you know the fenel um in increase the comes to mind um so how have you guys been dealing with that um just targeting your substance abuse disorder services to address that huge increase in ventional use especially humal County yeah great question it’s been really devastating to see how impacted um a lot of the youth in communities are by the fentanyl crisis um we don’t actually have a separate substance use treatment service stream what we’ve done is we’ve included it in our Mental Health Services is and we found um well the short answer maybe would be what what we really focused on is we operate out of a relational framework and we try to break down barriers to accessing services and so we found having kind of separate service streams that had a process for getting into the service just didn’t really work for our agency and our model um and we do a lot of really creative things to get in front of our clients too I mean we have a huge spread out County and so we have clinicians who are putting in four hours of travel time a day just to see some of their their um clients and so we built that into our model and tried to make it sustainable and whatnot um but to kind of bring it back to your question it is very much included in the mental health services that we provide um and there is a lot of trainings offered to the the clinicians the community members all of our staff um inhouse and I would say that the other programming that we do we really see it as prevention for substance use um challenges so I I think that when folks feel you know we have an epidemic right now in this country of of young people feeling isolated um and you know kind of getting sucked into some of that social media um stuff and um other presenters were kind of talking about that and I thought you guys summarized it well we’re very much seeing that and we believe that it it leads to substance use it can and so when we’re able to have a community event and get a lot of Youth to the community event they’re able to connect with their culture they they’re able to build more relationships we believe that’s a very preventative um measure so we do a lot of that so it’s kind of weave through out I think is the easiest answer I would say I’m seeing this trend and uh with how medical is addressing these problems Upstream on our last call about the unhoused someone brought up the um you know if someone on the street has diabetes how can they treat it if they don’t have a fridge and thing in this case um it really starts with the youth and U empowerment cultural connection um thank you please stay on for questions at the end thank you so much of course we’re now gonna hear from Trisha NN who’s the CEO of Southland integrated services and she’s going to be talking about the behavioral health needs specific to the Vietnamese community of ore County um specifically but from Reckoning with the trauma of the Vietnam War to Rising mental health issues among students and she’s going to be talking about how Southland is meeting these issues across Generations uh Trisha please go ahead hi everyone good morning um just want a little bit about background on Southland a little bit um we were established in 1979 as a refugee resment Support Agency in the city of Westminster California and how it came about is a group of volunteers actually get together because we lost our country the fall of Saigon if you know April 30th was like a black um you know black April they call it we lost our country and a lot of the Vietnamese immigrated to different countries Vietnam um moved to here and I think Orange County due to the weather and the ethnic food is actually one of the popular um destination we’re actually the largest Vietnamese um demographic wise outside of Vietnam so when we started we actually do a lot of a culturation assimilation citizenship we actually now naturalize over 300,000 Vietnamese um that came over here and then after that the board of directors and volunteer decided you know let’s create a program where the senior so we have a senior center that um open it up and for them to come in with activities because they’re very isolated they didn’t have family members so we provide hot meals and we provide games for them to play daily and then with that in the late 90s we you know created a heal Center and it was called Asian Health Center our original name was Vietnamese Community Orange County because that’s how we were founded and then in 2015 we got our designation as Federal qualified Health Center shortage for fqac and um a little bit after that the board and myself asked if we can change our name to Southland integrated Services because a lot of things we do are truly integrated between Medical Dental Behavior Health and when we when I first started in 20 um 2008 we didn’t have any mental health program at all but because I feel that there’s a need because in our cultes especially the Asian a lot of time you hear that it’s um tiger mom right our parents sacrifice a lot in Vietnam they have a lot of access houses so they actually put in the guilt to the kids I’m I’m one of the kid actually felt that constantly have to be successful my dad say if you have to be a doctor dentist lawyer pharmacist engineer if you don’t belong into those five it’s considered a failure which apparently I was not belonging to those five and when I first started my dad’s like what are you going to do with your degree are you going to do anything that is going to even make money so that’s how they want to is their kids to be highly educated so that they would not suffer the way that you know our parents suffer but throughout that they didn’t know that they created a generation gap I’m actually the 1.5 generation that is unfortunate that I have a good group of peer support you know my friends because we’re so confused at school they teach you one thing right individualism when you came back home your parents like no you cannot do this you have to listen to what I want and so we got very confused in the middle of it because we came here like right in the smack of the generation between both culture and I think because of that we have a lot of Youth a lot of folks who don’t know what to do they basically I have staff who basically says my parents want me to be a dentist but I want to be a psychiatrist I said did you not tell your parents that psychiatrists actually are in need it right there’s so many people that need it but she says no I cannot fight my parents which so I’m going to be a a dentist then be a psychiatrist later so I think that’s the thing that um for us we have a lot of the programs through the medic Cal expansion we’re able to create a lot of the workshops education work groups we actually have a lot of programs for the seniors where it’s Zumba yoga taii digital literacy because especially after the covid the pandemic they became more depressed they’re isolated they don’t have anybody to talk to and I think that’s the main thing is you know communication right right and during that time that I’m sure you know about anti-asian hate we experienced a lot of anti-asian hate when we did covid vaccination we were actually one of the health center vaccinate over 40,000 vaccines throughout the U pandemic but we actually have a few incidents that actually came to us and says you guys were the C the one who caus the virus you guys supposed to provide the vir you know the the vaccine for free which is very shocking that we experience it in gar growth and so I think the education part the youth program that we actually ask you to talk a bit slower and remember to do so myself sorry um does Medical cover the Zumba classes by the way um it does not we actually provide that through our grants program okay so during that time um it was not available so we have one of the grant that actually covered the wellness Workshop sorry I tend to speak a little fast I’ll slow down and then um we also have a lot of um parents ask why don’t you have youth um workshops so last summer we created a youth program where it’s like six weeks of the summer program where we incorporate Arts we have um you know speakers talk about sleep and eating healthy habits of course social media is the biggest if you have kids all of the parents have to deal with social media constantly on the phone they’re no longer socialized like the way when we go eat you know four of us sitting on the dinner table having conversation now you see four people on the phone and nobody talking to anybody so I think the socialization of the communication is very lacking and I think that’s that’s one thing that we’re trying to do is how to get the parents to communicate to the children because the parents feel like I sacrifice you know everything right for you to have a future education the kids tell us well my parents don’t care anything except straight A they don’t care about how my well-being I’m depressed I’m not happy they don’t care about anything except they want me to get good grades but if I don’t want to live why would I care about grades and I think we expend um experience um I know personally somebody who actually committed suicide about a year year and a half ago um jump off of a building very close to where where we’re located because he felt like he just wanted to be a bird and he felt like he’s a burden to his family and all they care about it school so he wrote kind of like a goodbye note to his friends and family but then the parents and the family never detected that he was depressed and I think that’s the thing that we um you know able to add a lot of the prr programs the Community Support Program the Su Matt HIV we have through our Managed Care um Cal Optima we’re the only cal cal Optima is the only Managed Care in Orange County so we’re able to add a lot of the programs they have the homeless and housing incentive program the cow aim enhanced Care Management so there’s a lot of program and recently as of last year we were the only um Health Center actually got funded by Samsung for the certified Community Behavior Health clinic so it’s actually very a certification that it’s really really difficult to actually get it’s very similar to the fqac for medical but this is more on the behavior health side where we have to provide them a wraparound like one stop integrated services that include crisis outpatient mental health and substance abuse service we have to provide them personal um person and Family Center treatment planning we provide Community Based mental health care for the veterans we also do peer family supportting counseling services and then it has to be targeted case management as well as providing outpatient Primary Care screening and monitoring and along with that we also provide psychiatric rehabilitation services and also diagnose and risk assessment and I think what we find is a lot of time um the no door wrong door approach we can also find patients through our Dental that refer back to Behavior Health Medical to Behavior Health sometime Behavior Health they have not seen a doctor for about diabetes for years so I think for us um we truly believe the word integration so we actually even have a weekly meeting with all the providers within the health center to actually meet and talk about the patient like what do they need a lot of time we find that you know for administrators we say oh we’re going to waste a lot of time talking about you know the patient care but if you actually spend one hour and talking about it you save a lot of hours from you know doing double duplicating work triple communication and I think that’s something that for us we’re a very small Health Center located in um Garden Grove but we’re truly we’re able to integrate it truly integrated care and we have about you know 3500 um patient visits with like 500 um Behavior Health but then not only we provide Behavior Health we actually help them with apartment Care Dental Woman’s Health Acupuncture if they need transportation or if they need like a telephone assistant utilities we provide food commodities so we’re trying to be a One-Stop shop where the patient come and they don’t have to be like you have to go to this place to get that service go to another place to get a service and a lot of them they have child care and transportation issues you uh I’m already seeing messages in the chat of media that would love to speak to you so I’ll let that speak to her itself we talked last September I remember two things very vividly one was that the CDC had reported just to put this into context in 2020 that suicide was the leading cause of death for aapi youth age 10 to 19 um to you frame this as a communication uh issue where you know the parents know what it’s like to have nothing they came here with nothing and worked so hard to make a life for their kids who they may feel are lazy but you said you know you don’t have to be a doctor to be somebody particularly if the kid hates the path they’re forced to be on um which is to ask you how have you seen the stigma change um in your time it did change um I think it changed a bit where when we do Outreach before people would be so afraid to tell them that I have a mental health condition you know when they say I have cancer I have diabetes I have a hypertension they’re very open but when they have a mental illness they basically don’t want to open up um also another thing that we actually um experienced but no we talk about is domestic violence and that’s something where we don’t have concrete data we have a lot of our patients come in tell our providers that my husband just beat me up we tell them to do reporting but it’s Financial dependent on the spouse so they they refuse to do you know like fing and make a complaint what we find is it takes a long time we added our mental health program in 2008 that was actually our first program now they’re more open up to mental health they will be like I think my kid has you know um Down syndrome I think something is off with my children can you actually see if you have a therapist available so we do see that that change on the mental health behavioral health but in terms of other conditions where gambling you know alcohol um substance abuse mat HIV those are still very taboo um so I think that’s one thing my my Moto is whatever is difficult Southland going to tackle it so we start tackling the sud the mat the HIV and we’re slowly seeing even within our staff the stigma still exists right our providers like oh we’re doing HIV oh we’re doing you know LGBT training um but it takes time so I think at the end of the day I mentioned communication training and have them not to be scared of the unknown right we’re just human we’re never going to admit that we’re stereotypes and we make a comment but when we see somebody we’re never admit that we’re already making a judgment of that person whether it’s hair color um you know um the way they look the way they dress and I kid you not with my hair a lot of people make assumptions like oh she must you know like she must be XYZ when they find out what you actually work at a health center it actually changed their perspective yeah I’ll be asking similar question to all the speakers but what are you able to do now to address these issues thanks to Medical that um I think we’ve been able to do a lot of the one-on-one we’re able to do because of medical expansion for the AG wise we’re able to see a lot more we actually help them able to apply for recertification for medical um we also help with you know creating a lot more conversation we’re able to a lot of education on the public um relations in terms of media social um social media media channels on it okay well thank you for joining us and please stay on as we open up questions to all speakers um and you know Q&A is open to reporters as well so I’ll ask uh Jennifer what I just asked you um what’s the key thing that you’re able to do now um thanks to Medical that you weren’t able to before I think having more opportunities I think with the clients or the patient they don’t understand any of the changes right and how do we transform um how do we transform that to actually having programs sorry yeah thank you oh that’s wonderful um and Jennifer okay well done great answer um yeah I think for me it’s hard to there’s a few things but I would say if I had to land on kind of the main thing medical has just enabled us to have a really sustainable and um larger clinical program for the Youth in our very rural County whereas previously you know it was difficult to kind of have enough providers to meet the need um in a sustainable way like we would maybe have some temporary grant funding um and that is one thing that we see in our community is providers frequently coming in and out and it’s build up this incredible system mistrust along with other things of course um and so being able to have a consistent clinical roster has been um really profound for our community and I’ll ask uh all speakers I think Autumn and Paula may have a answer more from the policy perspective but what are the biggest challenges that you see um among youth or anyone you serve regarding mental health and substance abuse what’s the big hurdle ahead uh I think that oh go ahead Paula no said please start yeah then I’ll add I was gonna say I mean I think one of the hurdles and challenges that we still face is stigma unfortunately um around mental illness and substance use disorders um I think the covid-19 pandemic actually did a lot to um move us forward um in terms of stigma and people are more willing to talk about their own experiences with emotional well-being mental health challenges substance use disorders but there still is a stigma not just um in society but in communities and within families and sometimes that leads to young people not getting access to care when they need it or not wanting their friends to know or you know not talking about things that are um bothering them that could ultimately uh manifest as more um you know significant clinical challenges later in life and so the more we can uh talk about um and normalize seeking help for mental health and substance use disorder Services the more that we can normalize the concept that it’s okay to not be okay that we all have mental Health um that our mental health and wellness strategies like sleep and exercise and diet are all very much interrelated to our emotional well-being the better off we’ll be and I think the better off our young people will be you know as as they develop when when we could just normalize that this is stress is something we all deal with and um and we all need help um and it’s okay to talk about the things that are challenged to you and it’s okay to get help from other people wonderful and our you know utumn and Paula are um two feathers in Southland are fantastically representative of the kind of community work that DHS uh works with to implement these Services um within the interest of the hour we couldn’t include uh more could you talk about a few of the other clinics that may be at the Forefront of Behavioral Health I’ll um without you know mentioning specific providers um I’ll call out a couple so one thing we really try to do is um listen to our medical members and listen to our providers about what is and isn’t working in medical and so um you know I think earlier I mentioned um community health workers as a newly covered um benefit and type of provider and we also um just in the last couple of years have added peer support specialists um and part of the reason that we did that was hearing um from a lot of our community- based programs um you know we use community health workers or or promotoras or um peers um in our programs and that is who medic members and uh folks who need Behavioral Health Services want to connect with and that is the way to get people um in the door help with stigma keep them engaged Etc um and we weren’t yet covering those things and so we’ve made that change um and I think you know folks have mentioned some of the community defined um evidence practices today which um we can cover to an extent under Medical but there are still some limitations and so we’re really trying to take that feedback and um just build and build and build so that we can uh put our medical dollars um where they’re going to be most impactful and help people and you know follow the lead of those who are the boots on the ground as you said yeah a few of our speakers today touched on certain factors that may predispose particularly youth you know being unhoused and the juvenile justice system and Foster Care I think uh Behavioral Health is a perfect example of how we have to meet this issue from all ends um I just want to add um one quick comment I think the bilingual I think the struggle for all of us is hiring by lingual providers it’s very difficult so how do we you know able to recruit more folks right into the nonprofit the healthc care world it’s very difficult I think the pandemic and then after it got worse in terms of us hiring providers Behavioral Health Providers very difficult medical providers very difficult um I think that’s the thing that somehow how can we streamline the process to actually you know entice them to go into the medical field because a lot of our providers actually retired and a lot of the ones they end up being specialist and they don’t want to go to primary care because it’s so much requirement and of course the pay and the you know it’s not great for us to entice I think that’s something we want to see if there’s something on um DHS and to look into a little bit further on that I think that’s that would be the our greatest need I’m speaking from all providers we’re struggling with it every day gotcha I’m seeing a question uh speaking of struggles faced by providers about the budget deficit we see in the news so much lately um do you see that impacting Medical’s expansion or delaying it you know how much resilience do you foresee us needing to have one of the things that I think um you’ve all heard the governor emphasize in his um budget briefing um was the extent to which the state is working to um protect core services in medical um and so we are you know continuing Behavioral Health Coverage um even as we s navigate the um vagaries of the budget um and we’re really continuing to look at um where are the best places to invest our dollars um and so you know medical um Services housing Workforce Development um so I just to say the the budget environment is challenging but I think we’re um finding Solutions great to hear and what can ethnic media um those who are on this call do to get the word out about these expanded approaches to mental health and substance used to sorder of services think helping to tell people that these services are available there are managed care plans there are counties there are community- based providers um through the apps you know and helping to spread the word helping to address stigma within communities um there’s a lot I think that we can all do collectively to uh make resources more accessible available and raise awareness and it is mental health awareness month um so I think you know raising awareness not just in May but all year long um is an incredible opportunity to partner with uh with all of you who are on on the call today wonderful thank you Autumn and for all our speakers now if you add one message for the media you know what would the headline be or what do you wish um would Garner more Focus uh okay let’s start with uh Jennifer oh man the first thing that came to mind when you other than horse therapy yeah yeah I I would say um we need the ability to be creative and think outside of the box to do this work so however the funding can support that because I think that there does need to be um an an overhaul and kind of improvement for how some of these Services have been delivered to bip communities just in general so I think allowing for Community voice you know a little bit of autonomy and flexibility with how with you know within reason with how we’re um delivering our services and meeting the needs of our community the more that we can do that it just leads to more engagement more quality um I could go on but you said a headline so I’ll stop there thank you um Trisha I would say um our community is very resilient and I think the nonprofits and all of the agencies are very resilient and as long as you show compassion so I think the media you know just work with us on getting the messages out because there’s a lot of programs that the community or the agencies have but a lot of you know also um a lot of false information right false data so I think just work with us on getting the programs out to the community and I think we’re very resilient and very passionate about helping so anything of that nature would definitely can can help our community even more absolutely uh Paula and Autumn I think you’re hearing a theme around the need to um be creative and Innovative um and really um modernize the way we serve people um to meet a variety of needs and I think to to go back to the point about the budget question um you know that’s exactly what we need to do right now too is make sure we’re getting the best use out of every dollar that we put into these programs um and some of that is identifying the outcomes we want to see and um using both both data and people’s experiences to get us there um so there’s there’s a lot of promise right now even though we have a lot of challenges yeah I see uh how well this promise is paying off already thank you everybody for joining and telling us about it we’re almost at the hour um you know Healthcare often has associations of being a real bureaucracy to navigate there should be no wrong door to get it and frankly no other state is doing as well what California is through dhcs to successfully make that happen by actually simplifying the way that Californians can get care and actually expanding the balance of what public health means as you’ve seen today um I want to thank dhcs and thank each of our speakers for giving some living Dimension to what this means to provide this behavioral healthare on the ground and helping our media share it with their with their audiences so we can all see how groundbreaking this is for the way we think about whole person Health thank you so much uh this conference is now adjourned

As the Department of Health Care Services (DHCS) continues to transform Medi-Cal, the state is addressing #behavioralhealth needs, like #mentalhealth care and #substanceusedisorder services, through #healthcare. Medi-Cal, #California’s #Medicaid program, provides coverage for one in three — or 15 million — Californians, and now includes expanded services to meet their #healthcare needs well beyond the doctor’s office.

DHCS leaders and community health care providers share how Medi-Cal is helping Californians needing mental health and substance use disorder treatment lead healthier lives.

Guest Speakers
– Autumn Boylan, Deputy Director, Office of Strategic Partnerships, California Department of Health Care Services
– Paula Wilhelm, Interim Deputy Director, Behavioral Health Services, California Department of Health Care Services
– Jennifer Oliphant, LCSW, Chekws: Hope for Tomorrow Program Director at Two Feathers Native American Family Services
– Tricia Nguyen, CEO, Southland Integrated Services (formerly Vietnamese Community of Orange County)

https://ethnicmediaservices.org/