California’s counties find themselves at the center of the complex responsibility to provide, integrate and finance critical behavioral health services in California.

Behavioral health is at the centerpoint of the most vexing policy challenges facing California’s counties today; from combatting homelessness, recovering from disasters, bending the criminal justice recidivism curve and cultivating a resilient workforce, each of these local challenges hinge on the county role in providing behavioral health services.  

The intersection of these urgent policy efforts is complicated as expectations around behavioral health access and integration evolve – while requirements and funding streams become more fragmented.

For counties, ensuring access to behavioral health services is a primary concern. New federal regulations requiring time and distance standards for patients are stacked on top of a massive shortage of behavioral health professionals. Add in the state’s unparalleled diversity in both people and geography and the challenges in providing behavioral health and substance use disorder services become clear.

This complex landscape requires system change and innovation.  A recent trend in health care may also provide part of the solution: care integration. Right now, Counties are working every day to build partnerships with local health care systems, such as hospitals and nonprofits, to integrate care in a way that best serves each patient.

CSAC Recently recognized a program in Yuba and Sutter Counties that illustrates the importance of care integration and collaboration. The Emergency Department at Adventist Health/Rideout Hospital in Marysville was struggling to care for the increasing numbers of patients who arrived at their doors in crisis, and while the hospital provided necessary medical care, it struggled to link its patients with critical behavioral health services. Yuba and Sutter County’s solution was to collaborate with the hospital to embed county behavioral health workers in the Emergency Department, which allowed the county to start working with the patients and their families right away. This collaborative and award-winning effort by the counties and the hospital is providing better care and costing less, including the patients who are receiving both the physical health and behavioral health care they need. See more about the program here.

Counties also continue to be at the forefront of integrated care with the Whole Person Care pilot program. More than two dozen counties work across local siloes to provide wraparound services and housing to those who frequently access health and behavioral health services. The early metrics of the Whole Person Care pilot program are promising, and counties are building on the service integration concept to help combat the homelessness crisis in our communities.

It is clear that the world of behavioral health is as complex as ever and success requires county and community-based partnerships. No single entity can prevent, treat, and support our residents living with behavioral health issues alone – we must come together as a state and with our local communities to deliver on the promise of good behavioral health for all. 

This is why CSAC is beginning a conversation and best-practice sharing between counties at our upcoming Regional Meeting in Napa County scheduled for September 27. CSAC is committed to partner with our members and our service partners to discuss how counties can adapt to the evolving behavioral health landscape and navigate the complex fiscal challenges to best meet the unique needs of each community. This includes state-level dialogue and county focus on policies and practices that leverage the strengths of the behavioral system and the cross-sectional collaboration needed to improve our communities.

We know that collaboration leverages our members’ strengths and leads to much better outcomes for the people we all serve. I hope you’ll join us in September as we discuss this very important issue.