Hearing Examines States’ Behavioral Health Restructuring

The state has big plans for restructuring the behavioral health system in California. State legislators held a rare four-committee joint hearing this week to hear about the details of that reorganization, and to raise concerns about it.

“We understand the need to streamline and cut costs,” Sen. Ed Hernandez (D-West Covina) said, “but at what cost?”

Assembly member Holly Mitchell (D-Los Angeles) said California’s consumers must be at the center of all discussion about changing health care policies and programs.

“I think it is critical to pause, as a body,” Mitchell said, “to make sure consumers aren’t harmed by this streamlining of our departments.”

The state is moving to eliminate the Department of Mental Health, essentially folding it into the Department of Health Care Services. According to state HHS undersecretary Michael Wilkening, almost all the functions of the current Department of Alcohol and Drug Programs also will shift to DHCS.

“We think there will be efficiencies gained from elimination of those two departments,” Wilkening said. “At the Department of Alcohol and Drug Programs, approximately 90% of those functions will transfer to DHCS.” Bringing mental health and substance use disorders under the umbrella of overall health could strengthen coverage, not diminish it, Wilkening said. “We need to think more holistically about health, and not siloing departments,” he said.

DHCS director Toby Douglas echoed that assessment in his presentation at the hearing.

“Our vision for reorganizing mental health services in California includes the transfer of Medi-Cal specialty services into the Department of Health Care Services,” Douglas said. “There was some concern that this transfer would weaken the mental health and substance use programs, but DHCS feels just the opposite. We feel it will make the health care system that much stronger. It strengthens our ability to integrate health care in California.”

The hearing Tuesday convened four different legislative committees: the Senate and Assembly Committees on Health, and the two budget subcommittees on Health and Human Services.

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