DOF Allocates Growth Funds Based on Youth-Centered Policy Goals Rather Than Business-As-Usual
By Annabelle Gardner, Director of Communications
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 in FY 2013-14 on two entitlement programs, Medi-Cal Specialty Mental Health Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) and 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:
1) 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 over spent 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.
2) Funds will be distributed based on need rather than “business-as-usual.”
Historically, as described in Part 1 & 2 of this series, growth funds were allocated based on counties’ previous spending. However, this approach perpetuates “business-as-usual” 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.
Our job isn’t done, however. In FY 2015-16 there will be far more growth funding at stake—more than $200 million, all tolled. Young Minds is committed to continued advocacy to make these youth-centered policies the norm. We urge others to join us. Clearly a concerted effort by committed people can achieve positive outcomes. Together we can ensure that adequate funding is available to meet all of the mental health needs of young people in California.
*Visit the DHCS website here to view the enclosures included with the informational notice (15-040). For more posts about this issue visit here.