State legislation aims to improve access to mental health care

The San Diego health care community is known for innovation and collaboration. Programs such as the Low Income Health Program helped many sectors of the health care delivery system. For community health centers and clinics, the county incentivized the establishment of the patient-centered medical home model and provided performance payments for the care of individuals with chronic diseases. This program also sought to increase the capacity of our community clinics and health centers to provide behavior health services, an important step to increase access to such services in the community.

Yet, at a time where the United States has voiced passionate concerns about identifying and treating behavioral health issues, California has a barrier to better accessing behavioral health care: the prohibition on Medi-Cal payments for what are known as “same-day visits.” These situations occur when a health center medical provider sees a patient for regular visit and identifies a behavioral health need. Best practice dictates what’s termed a “warm handoff” between the provider and a behavior health professional at the health center. This process would help assure that the patient receives timely access to the needed behavioral health services on the spot. Currently, a health center engaged in this practice would not be reimbursed for such a same-day visit. The visit would likely be brief to introduce the patient to the psychologist or social worker, but not long enough to engage in treatment. Why?