California, alongside Arizona, New Mexico, and Oregon, has
received approval from the Centers for Medicare & Medicaid
Services (CMS) to expand access to culturally-based substance use
disorder (SUD) treatment services. Two new categories of
interventions will now be covered by Medi-Cal, as developed by
the state in partnership with tribal partners:
The first, provided by traditional healers, includes music
therapy (i.e., traditional music, songs, dancing, and drumming)
and spiritual interventions (i.e., ceremonies, rituals, and
herbal remedies). A traditional healer is any person currently
recognized as a spiritual leader with at least two years of
experience practicing in a setting recognized by a Native
American tribe and who is contracted or employed by an Indian
Health Care Provider (IHCP).
The second, provided through natural helpers, includes
navigational support, psychological skill building,
self-management, and trauma support. A natural helper is a health
advisor who delivers health, recovery, and social supports in the
context of tribal cultures. Natural helpers can be spiritual
leaders, elected officials, or paraprofessionals who are trusted
members of a Native American tribe.
According to the Governor’s announcement, this marks a
significant milestone in the state’s ongoing efforts to recognize
the valuable contributions of traditional healing practices
within the health care system. Traditional healing services have
been trusted and tested methods of care for Native Americans for
generations. They are deeply rooted in cultural practices and
have been shown to improve health outcomes, particularly for
individuals with SUDs.
Starting January 1, 2025, IHCPs can request Medi-Cal
reimbursement for Traditional Healer and Natural Helper Services
provided to residents of qualifying counties. In the coming
months, the state will consult with tribes and tribal partners to
develop guidance.
