4. • BH and PC providers:
– share the same facility
– have systems in common (e.g., financing, documentation,
EMR, etc)
– regular face-to-face communication
Integrated
Behavioral Health
and Primary Care
System
Toward a New System: Integrated Services
The Primary Care
Services
Substance use
and Mental
health services
5. Policy Recommendations from Survey
• Expand workforce who can bill for SUD services.
In particular add MFTs. Currently only Licensed
Clinical Social Workers (LCSWs) and psychologists
can bill for behavioral health. “We do not have
enough LCSW providers to be able to go into all the
community health centers as we would like.”
– This would require legislation and a Medicaid
waiver from the federal government.
– Same would apply for SUD counselors.
6. • Allow same-day billing for two services.
“It would be very helpful if we could bill for mental
health and physical health visits on the same day.
The current restriction impedes access for our
patients.”
Would allow “warm hand-offs” between primary care
and SUD or MH. Otherwise they tend to become “no
shows”.
• 28 states currently allow same-day billing, but
California does not.
Policy Recommendations from Survey
7. Policy Recommendations from Survey
• Stabilize funding.
“Our integrated effort . . . is funded wholly by grants
and MHSA, making it feel precarious and temporary
by comparison with other primary care services.”
“allow for reimbursement of case management
services. Currently, important roles such as a
navigator and peer partner, must be funded by
grants, but in the long term these roles must be
funded through FQHC or Medi-Cal reimbursement.”
8. So what’s stopping us?
Primary barrier seems to be concern over additional
State general fund expenditures. For example, AB
1785 (Lowenthal) would have added MFTs as
reimbursable providers and passed 17-0 out of the
Assembly Health Committee, but it is currently held
under submission by Assembly Appropriations
Committee
Translation: probably dead, due to concerns over costs.
How about a pilot project, like CMSP and other states?
