Finance Reform

Capturing the Promise of Medi-Cal and EPSDT

We are committed to putting a spotlight on the unfulfilled promise of Medi-Cal funding to address the striking acuity of the children’s mental health crisis. The need to access these resources and services is critical, now more than ever, when we are seeing dramatic increases in suicide and other indicators of a mental health crisis. In a June 2020 CDC study, 1 in 4 youth ages 18 to 24 said they had “seriously considered” suicide in the past 30 days— more than twice as high as any other age group.

Issue Briefs

January 2021: MEETING THE MOMENT: Understanding EPSDT and Improving Implementation in California

This report, developed in partnership with the National Center for Youth Law (NCYL) and the National Health Law Program (NHeLP), offers advocates and policymakers specific recommendations for how California can fulfill its obligation under the Medi-Cal entitlement to provide mental health services and support for our children and youth.

December 2020: Coverage of Services to Promote Children’s Mental Health

This issue brief, developed in partnership with national experts Mental Health America and the Well Being Trust, lays out the analysis of how current state Medicaid and commercial health insurance payment policies fail to adequately reimburse for effective interventions to promote positive child and family mental health.

July 2019: Financing New Approaches to Achieve Child Well-Being

This brief outlines fiscal opportunities to initiate and invest in a fundamental reimagining of how public child-serving systems approach and support children’s social, emotional, mental, and developmental health in California.

Continuing What CalAIM Started

California has a generational opportunity to reform our state’s troubled Medicaid program. In October 2019 the Department of Health Care Services (DHCS) presented a reform agenda through the CalAIM proposal. We released our analysis of the proposal in November 2019.

An astonishing amount of progress has been made in a short period of time, but current events jeopardize that momentum. COVID-19 and demands for racial injustice underscore the urgent need to advance CalAIM’s children’s behavioral health reform effort.

Issue Briefs

June 2020: The Urgent Need to Advance CalAIM’s Children’s Behavioral Health Reform Effort

This brief and the accompanying presentation from CMHACY 2020 outline the path forward to realize the behavioral health sector reforms that will enable California to better serve vulnerable children and families.

November 2019: CCT’s Analysis of CalAIM

CalAIM proposes real and substantive changes for specialty mental health. It is far and away the most ambitious and courageous action by DHCS on mental health in more than 20 years. However, the proposal does not do enough to center racial justice, or properly or effectively clarify how it will promote or incentivize delivery system reform and child-serving system integration and expansion.

DHCS Updates

June 2020: DHCS Signals Intent to Reform Medical Necessity and Expand Access

On June 19 the California Department of Health Care Services (DHCS) published a new “game-changing” Family Therapy Benefit Guide. These guidelines are the most fundamental reform to medical necessity criteria in the history of the state’s mental health system. They allow for Z codes (psychosocial concerns) and the criteria are trauma-informed and relevant to our state’s efforts to respond to the impact of adverse childhood experiences on the social and emotional health of children. These changes were an essential recommendation that the California Children’s Trust and its partners made during the CalAIM process. Read.

Response Letters to DHCS: December 2019 – March 2020

With our reform partners, we have been carefully monitoring updates to the CalAIM proposal and submitting written feedback to DHCS. Following are our response letters.