Improving Medi-Cal Mental Health Services ITUP Pre-Conference - PowerPoint PPT Presentation

Improving Medi-Cal Mental Health Services ITUP Pre-Conference February 4, 2019 Catherine Teare, California Health Care Foundation Logan Kelly, Center for Health Care Strategies Alfredo Aguirre, San Diego County Kiran Savage-Sangwin, California Pan-Ethnic Health Network

California County Behavioral Health Funding Federal Mental Health Medicaid Matching Funds $3.04 billion Mental Health Services Act $1.77 billion 2011 Realignment $1.39 billion 1991 MH Realignment $1.31 billion 16% 37% Federal SAPT Block Grant $225.6 million Other (MH Block Grant, County MOE, County GF) $212.8 million 17% Federal SUD Medicaid Matching Funds $190.5 million State General Fund $14.7 million 22% *Amounts based on FY16/17 Estimated Behavioral Health Funding. Does not reflect projected increases in federal matching funds and state general fund spending on SUD services under the DMC-ODS. Source: CBHDA

National Overview of Physical and Mental Health Integration  States are pursuing greater integration in financing, delivery, and coordination of mental and physical health services.  Increasing number of states are including specialty MH services in MCO contracts. Coverage of Specialty Outpatient MH in Medicaid, 2018 Key Included in MCO (22) Varies (7) Carved out into PHP or FFS (10) 3 Kathleen Gifford et al., States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019 , Kaiser Family Foundation, 2018,.

Examples of State Approaches Massachusetts: Community Partner Program and Medicaid ACOs Behavioral Health Community Partners work with Medicaid ACOs to provide care management and coordination to individuals with BH needs. New York: Health and Recovery Plans (HARPs) Integrated MCOs serve general population, and manage separate specialty HARPs for individuals with SMI and SUD diagnoses. Washington: Fully Integrated Managed Care Initiated comprehensive carve-in approach with phased implementation based on region. 4

Key Components of State Approaches to Integration of Financing  Phasing by population and/or region  Delegation  Number of plans available  Procurement of new or existing plans  Dually eligible beneficiaries  Management of non-Medicaid services  Management of services for non-Medicaid populations  Ensuring smooth system transition 5