In recent days Governor Newsom signed into law three bills that take important steps to improve access to mental health care in California:

• AB 2112 establishes a state office of suicide prevention
• SB 803 will certify and train Peer Support Specialists that can bill Medi-Cal
• SB 855 increases mental health parity requirements commercial health plans

Together these bills acknowledge our racialized crisis of despair (AB 2112), launch the formal integration and honoring of lived experience in our mental health system (SB 803), and take an important step towards keeping the 2008 parity promise (SB 855).   

As we fully support the implementation of all three bills, The California Children's Trust (CCT) will also lead continued advocacy on behalf of the 5 of 10 children in the state (81% who are black and brown) who are enrolled in Medi-Cal and specifically excluded from provisions of SB 855. Under federal law, these young people are already entitled to an extraordinarily broad mental health benefit (broader in fact than what SB 855 offers). But the hard truth is that we have collectively failed to deliver on this benefit, and the promise made to our nation’s children in a 1967 Amendment to the Social Security act. 

To read a fascinating history of EPSDT, please see Sarah Rosenbaum’s famous article on the national security origins of the entitlement. 

Also, watch for two upcoming papers CCT is co-authoring with the National Center for Youth Law, National Health Law Program, Mental Health America, and the Well Being Trust on the national landscape and strategy for EPSDT and what it means for California.

These three vital pieces of new legislation complement the recent win achieved by the Trust through our advocacy to increase access to Dyadic Therapy. This work resulted in the removal of medical diagnosis as a prerequisite to care under the Family Therapy Benefit, and the formal integration of Social Determinants of Health as qualifying criteria. The full Family Therapy policy can be found on pages 4-6 of the Psychological Services section of the provider manual. Thank you to new leadership in the Governor’s Office, Office of the Surgeon General, and the Health and Human Service Agency (DHCS in particular) for their leadership and partnership in the creation of this new benefit.

These wins speak to the growing power and voice of everyone involved in this work as we together seek to advance a response at scale to the social and emotional needs of children. 

We at CCT gratefully accept and celebrate these critical incremental changes....while we impatiently and persistently await the revolution.   

- Alex Briscoe, Principal, and the CCT Team

Critical Conversations

Read this just-released: California’s September 2020 Youth Suicide Prevention report which shows that youth suicides have increased dramatically over the past 10 years across our state, and yet schools are not resourced to provide the services and supports that can prevent this terrible tragedy. 

School-age children and adolescents have the lowest rate of primary care access of any demographic in the Medi-Cal program. Schools are thus essential actors in any solution at scale, but they are simply not funded or prepared to play this role. Access to caring adults, mental health professionals, and strong peer relationships decrease the likelihood of youth suicide.

The report finds that very few Local Education Agencies (LEAs) meet a recommended ratio for the number of health and mental health staff to students. While we do have some concerns that the report unfairly targets school district employment of staff as the essential metric of suicide prevention - seemingly failing to address additional culturally relevant and relationship-centered strategies including partnerships with Medi-Cal funded partners and providers - the report does highlight the hard truth that schools are ground zero for the youth mental health crisis and no reasonable assessment of their capacity suggests they are prepared to respond.

CCT’s Work To Expand the Availability of School-Based Services: 

In August, in partnership with Breaking Barriers, we released a “Practical Guide for Financing Social, Emotional and Mental Health in Schools,” designed to help education leaders in California access millions of dollars of Medi-Cal funding that students are entitled to in order to support their social and emotional needs.

Find out how to advocate for these resources at upcoming webinars to discuss the five specific ways school districts can integrate Medi-Cal funded services for students. On October 15, from 9-10 am, the Trust will present our analysis in a webinar hosted by Superintendent Tony Thurmond of the California Department of Education.

Keep an eye on the CCT newsletter for additional upcoming webinars. 

We are also partnering with DHCS and CDE on SB75 Medi-Cal for Students Workgroup to explore systems change strategies to address how schools access Medi-Cal funding. For more information on SB75 reports and progress, please see the Medi-Cal for Students webpage. Our partners at WestEd are ably facilitating this diverse coalition through a challenging policy landscape and public systems who must learn a lot about each other.