DATE:
April 9, 2024
20
TO:
Board of Supervisors
SUBJECT
Title
UPDATE ON THE REGIONAL CAPACITY AND NEED FOR BOARD AND CARE AND SUBACUTE SERVICES TO SUPPORT MEDI-CAL ELIGIBLE ADULTS WITH BEHAVIORAL HEALTH CONDITIONS, AUTHORIZE AMENDMENTS TO EXTEND EXISTING CONTRACTS, AND AUTHORIZE SUNSET OF REPORTING ON UPDATES TO ADDRESS THE BEHAVIORAL HEALTH WORKER SHORTAGE (DISTRICTS: ALL)
Body
OVERVIEW
In California, counties are responsible for administering specialty mental health and substance use services to residents eligible for Medi-Cal. In order to optimize access to care and quality as a health plan, the County of San Diego Health and Human Services Agency, Behavioral Health Services (BHS) is required to maintain a local network of mental health and substance use services and providers that meets the needs of Medi-Cal beneficiaries. Recent work by BHS has sought to rebalance the entire care system using a more upstream approach that emphasizes prevention and connects people to care within least restrictive settings.
On September 27, 2022 (23), the San Diego County Board of Supervisors (Board) received an update on the Behavioral Health Continuum of Care that outlined strategies to rebalance the system and address the historical lack of equity within long-term care through enhancements to community-based care and shifts within subacute services. These strategies were informed by the Behavioral Health Optimal Care Pathways (OCP) model, a data-informed algorithm that quantifies utilization across three key service areas: community crisis diversion, subacute care, and community-based care.
Further building on the OCP model, on September 12, 2023 (23), the Board directed staff to assess the capacity of board and care and subacute beds that serve Medi-Cal eligible adults with behavioral health conditions in San Diego County. The Board also directed staff to report back with estimates on the capacity needed to adequately support individuals within the region a...
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