Health Matters: Expanding Behavioral Healthcare

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Health Matters: Expanding Behavioral Healthcare

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Recent changes to California state law are allowing community health centers to expand behavioral health care so we can meet the growing demand for services. Behavioral Health is an umbrella term that includes mental health care and substance use disorder (addiction) treatment. If you’ve been thinking about a career in this field, now is a great time to pursue it.  Historically, community clinics like MCHC Health Centers have employed Ph.D. psychologists and licensed clinical social workers (LCSWs) to provide counseling. These folks work in partnership with medically trained behavioral health professionals like psychiatrists and psychiatric nurse practitioners, who manage psychiatric prescriptions. 

Post-COVID Rule Changes 

Historically, rules about who we could hire and how we provided care were very rigid. But when the pandemic hit and people were restricted to their homes, lawmakers realized they needed to make some exceptions so patients could safely get the care they needed.  Lawmakers allowed health centers to charge for telehealth visits via video conferencing or telephone calls, and they began to see the wisdom of paying qualified folks for their service before they completed a full two-year clinical internship. In California, to become a licensed clinical psychologist or licensed clinical social worker, you must complete more than 1,000 hours of supervised clinical practice (1,500 hours for clinical psychologists and 3,000 hours for clinical social workers) after graduate school. Traditionally, health centers did not get fully reimbursed for care provided by behavioral health professionals until they completed these hours–even though these clinicians were well-trained and carefully monitored.  After the pandemic ended, I worked in partnership with the California Primary Care Association to advocate for the needs of patients in rural Lake and Mendocino Counties, where we don’t have enough therapists and where getting to an in-person appointment can be far more inconvenient than receiving care via telehealth.  To his credit, the senator from San Francisco, Scott Weiner, supported us and worked to make temporary COVID exceptions permanent for patients covered by Partnership HealthPlan of California (MediCal). Now, we’re working on making these exceptions permanent for all patients, regardless of their insurance carrier or status. That is, we’re hoping we can soon get fully reimbursed for care provided by therapists who are in the process of completing their clinical hours and taking their licensing exams. We also hope to be reimbursed for all telehealth appointments so anyone who wants to meet via phone or video has that option.   

Expanding to Meet Local Needs

With the post-pandemic rules, MCHC can hire more qualified professionals to expand access to behavioral health care for our patients.  Federally qualified health centers like ours use an integrated model. That means we provide medical, dental, and behavioral health services for our patients, and the healthcare team can talk to each other to support the patient without breaking confidentiality rules. We know that mental health and physical health are connected, so an integrated model makes the most sense. While we prefer to support the whole patient with all of our services, we are opening up our behavioral health services to patients who do not get their medical and dental care at MCHC. We know how hard it is to find well-trained, affordable therapists for children and adults, so we’ll do everything we can to streamline coordination with outside providers. Happily, we were able to get grant funding for a bilingual case manager who helps us with that coordination.  If you or someone you care about is struggling with feelings of depression or anxiety, if they can’t sleep, if they want help with addiction or other behavioral health issues, please reach out. Help is available.  Ben Anderson, LCSW, is the behavioral director at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental, and behavioral health care to people in Lake and Mendocino Counties.