Dear Friends and Allies,

As we emerge from a year of crisis and despair, we are lifted by the hope of a new administration and the growing state and national consensus that we must respond at scale to the social and emotional challenges facing children. Challenges clearly driven by structural racism, the stabilization of poverty, and a culture that equates wealth with value, and fame with merit.

CCT and our allies are doubling down on our commitment to reimagine children’s mental health as a support for healthy development, not a response to pathology. Centered on Equity and Justice. We encourage all our allies to revisit our Foundation and Belief Statement and we remain indebted to our coalition leaders who crafted it.

The challenges before us are clear, and the urgent need to act is evidenced by shocking statistics showing that the mental health needs of our children and youth remain unaddressed. This just-released CMS report, which includes data through July 2020, highlights California as having one of the worst declines in mental health care usage in children in the country.

An additional indicator of the mental health crisis comes from our partners at the Children’s Hospital Association. Emergency departments and acute care facilities are seeing striking increases in utilization and acuity—increases that preceded the pandemic but are now being dramatically exacerbated. Rady Children's Hospital in San Diego reported a 1746% increase in Mental Health emergency department visits between 2011-2020. By comparison, total emergency department visits at Rady have increased by only 23%, consistent with data recently reported by the CDC.

Many thanks to Ann Kuhns at Children’s Hospital Association for her leadership and service as a founding steering committee member for CCT, and the many leaders, including the late great Bert Lubin among Children’s Hospitals statewide who have joined our coalition and supported our work.

Despite these numbers—which are so startling that they must be used carefully so as not to diminish the preventable suffering they represent—there have been important signs of hope over the last year, including the following:

• Creation of the new Family Therapy Benefit.
• A formal commitment from DHCS to remove diagnosis as a prerequisite for care.
• An open and extensive re-procurement process with health plans that will administer Medi-Cal, with an emphasis on equity. See this excellent Q&A with Kiran Savage-Sangwan of CPEHN for framing and detail.
• A dramatic practice transformation for mental health services driven by technology (see our Telehealth brief below).

The Governor's Budget and the CCT Agenda

On January 8, Governor Newsom released his proposed budget which includes several significant one time investments in children’s mental health reflecting our advocacy to center schools outlined in our Practical Guide for Financing Social, Emotional, and Mental Health in Schools (viewed over 10,000 times since it was released in Fall 2020).

Specifically, the Governor’s budget includes a total of over $750 million to support student mental health through several programs, including:

• $400 million one-time multi-year funding to incentivize Medi-Cal MCOs, county behavioral health and schools to develop school programs and infrastructure for mental health intervention and prevention programs
• $264.9 million to expand existing networks of community schools and establish new community schools with priority given to those in high-poverty communities
• $25 million one-time 5-year funding for the MHSOAC to augment the Mental Health Student Services Act Partnership Grant Program to facilitate partnerships between county mental health plans and school districts
• $25 million proposition 98 funding to fund innovative partnerships with county behavioral health departments to support student mental health programs
• $50 million one-time funding for professional development on social-emotional learning and trauma-informed practices.
• $5 million one-time Proposition 98 General Fund to establish professional learning networks to increase local educational agency capacity to access federal Medi-Cal funds, and additional support for a lead county office of education to provide guidance for Medi-Cal billing within the statewide system of support.

Another significant signal of hope was the updated CalAIM proposal which revives the initiative that was put on hold last year due to the demands of the pandemic. It is now moving forward with funds in the Governor’s proposed budget for implementation effective January 1, 2022. Notable changes include many reforms that CCT and our partners outlined in our analysis and letters, including:

• Removal of a diagnosis for treatment.
• Clarification of EPSDT protections for youth under age 21, including criteria for children to access specialty mental health services based on experience of trauma and risk of developing future mental health conditions.
• Streamlined mental health documentation.

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CRITICAL CONVERSATIONS

Webinar: January 28, 2-3pm PST
DHCS will present the revised CalAIM proposal, highlight key changes from the original October 2019 proposal, and discuss the implementation timeline. Register

Webinar: February 2, 12:00-1:30pm PST
CCT, NCYL, and NHeLP will provide an overview of the recently released report, Meeting the Moment: Addressing California’s Growing Youth Mental Health Needs, discuss the Medi-Cal mental health entitlement, and present specific recommendations for how California can better fulfill its obligation to our children and youth. They will be joined by experts including youth with experience and insights relating to California’s mental health system. Register

Webinar Save the Date: Tuesday, February 23rd, 10 - 11:15 am, Alex Briscoe joins leadership from CDE and DHCS to discuss specific recommendations for securing Medi-Cal School Mental Health funding as detailed in CCT’s Practical Guide.