Earlier this week, Paul Yoder and I were able to attend a round table discussion hosted by the Steinberg Institute to start a dialogue about how we can establish a mental health “right to care” in California. A truly multidisciplinary group of folks representing providers across the behavioral health continuum of care as well as dedicated legislative and patient advocates was present and provided key insights from many perspectives. The idea behind the initiative is that individuals with mental illness should have a right to receive high-quality, evidence-based treatment services. For instance, the questions “what should be considered a minimum set of services?” and “is a right to housing necessary?” were brought up. Many stakeholders pointed out that we should consider focusing first on fully funding adequate behavioral health care that incorporates substance use disorders. And, this concern was echoed in discussions about how CalAIM may and may not improve behavioral health services. Overall, it was a collaborative and productive meeting that suggests 2023-24 could be another big legislative cycle for mental health care in California.
There continue to be reports of controlled substance prescribing issues and we want to keep hearing from you about the issues as they arise. We are collecting your problematic pharmacy encounters with our survey to better understand the situation in California for discussions with state and federal regulators. A recent Reuters article with quotes from 2 SoCal psychiatrists explains how the crackdown on opioids has spilled over into other controlled substances. In an attempt to decrease their liability, distributors are limiting supplies to pharmacies and patients based on arbitrary quotas with little clinical basis. At the same time, stimulants are increasingly difficult to find due to supply chain issues and record prescriptions by online providers. We will continue to advocate for you and your patients in these matters.
In other news, all 5 of our district branches approved our high-level policy platform which will be published in next week’s newsletter. Over the coming year, we will flesh out many of these points into a more comprehensive platform and utilize it to direct our statements on specific policies. For some background on the platform language choices, you can read my recent article in the December 2022 SCPS Newsletter, where you’ll also find a Q&A with Paul Yoder.
Thank you for your involvement and continued support of CSAP and its advocacy. I wish all of you and your loved ones holidays of love, peace, hope, and joy!
Steinberg Institute / Right to Care
Per Emily’s note above, the following questions were posed to the group convened by the Steinberg Institute:
1. What should the minimum set of services be as part of a right to care? Are there models we can look to as we establish what this standard set of services should include?
2. For Medicaid services, do you see any gaps or implementation challenges in CalAIM that could be addressed through legislation to support a right to care?
3. What barriers do you experience in trying to deliver services to people who need care in California?
General Questions for Consideration
1. Are there other entitlement models (i.e. education, developmental disabilities, physical health etc.) in the country or around the globe that could serve as a foundation for a right to mental health and substance use care?
2. Are there any failed entitlements that might shed a light on what pitfalls to avoid?
3. For people covered by Medicare/Medicaid/commercial insurance, what needs to change to ensure access to care?
4. What non-traditional services should be included in a right to care (e.g. housing, employment services, community supports)?
5. What remedy(ies) would ensure a right to care is fully realized?
6. How does the workforce shortage affect how impactful establishing a right to care would be?
7. What specific outcome measures and/or fiscal information should be in place to support a right to care?