California Moves Toward Mental Health Equality for Kids

Last week, the Department of Health Care Services (DHCS) released an informational notice* announcing the formula that will be used to allocate over $60 million of growth funds from the Behavioral Health Services Growth Special Account to county mental health programs in California.  

The announcement marks a significant win for youth with mental health needs and their allies.

The allocation formula, set by the Department of Finance (DOF), breaks down like this: around $26 million has been used to reimburse the 20 counties that overspent fiscal 2013-14 funds for two entitlement programs:

  • Medi-Cal Specialty Mental Health Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)
  • Drug Medi-Cal (DMC)

The remaining almost $34 million was distributed using Medi-Cal enrollment data.

This represents a meaningful shift in mental health policy in California for young people. Here’s why:

Further demonstrates there’s no cap on EPSDT services.

EPSDT is an entitlement program, which means no full-scope Medi-Cal eligible youth may be denied medically necessary services under federal and state law.  However, many county providers and other stakeholders have testified that because funding to counties is limited to tax receipts allocated by the state each year, the services are “capped.” They contend that when a county spends all of its annual allocation for specialty mental health services, youth can be turned away. This is not only wrong, it’s also illegal. No money is no excuse when it comes to the EPSDT entitlement.

By reimbursing counties that overspent last year’s EPSDT allocation, DOF sends a strong message that there are no caps on EPSDT services and all youth in need must be served.

Funds will be distributed based on need rather than “business-as-usual.”

Historically, growth funds were allocated based on counties’ previous spending. That approach perpetuates a “business-as-usual” mentality, where high-performing counties receive the majority of growth funds while low performing ones receive much less. On the ground that means youth in Fresno, for example, have far less access to mental health care than young people in San Francisco.

Thus, while all children in California have the same entitlement to care, actual access to services depends largely on where they live. This is not only morally wrong, it also violates federal and state law that requires services to be comparable statewide.

The change made by the DOF means counties with more low-income youth will get more funds. That should make the distribution of funding more equitable across all counties in California, and improve access to care in counties that have historically provided less.

Overall, the DOF’s decision represents a measurably positive shift in mental health policy for young people—one that prioritizes the needs of youth over “business-as-usual” by the bureaucracy. We applaud the department on its leadership and determination to do the right thing for young people.

This positive development is a direct result of months of advocacy by Young Minds and our dedicated allies. The allocation of $60 million based entirely on policy goals that are pro-youth and families is a big deal. It is also a demonstration of what can be accomplished when children’s stakeholders are united and insistent that mental health policies and programs reflect the needs of the children they are intended to serve.

Annabelle Gardner is the director of communications for Young Minds Advocacy Project.

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Young Minds Advocacy is a nonprofit organization based in San Francisco, California that uses strategic advocacy and communications to help youths and their families to access mental health services and supports, and improve mental health system performance and accountability.