NEWSLETTER
Volume 1, Issue 19 - May 7, 2021
Race and Psychiatry
As many of you know, and as recently reported in the New York Times, in January, the American Psychiatric Association (APA) issued an apology about racism, acknowledging “appalling past actions” on the part of the profession. Furthermore, the APA's governing board committed the association to “identifying, understanding, and rectifying our past injustices,” and pledged to institute “anti-racist practices” aimed at ending the inequities of the past in care, research, education and leadership.
Last weekend, the APA devoted its annual meeting to the theme of equity. Work is ongoing at the national level through the APA's Structural Racism Task Force.
This week, CSAP Board Member Doctor Eric Rafla-Yuan, along with Drs. Divya K. Chhabra and Michael O. Mensah, had the following article published in the New England Journal of Medicine, "Decoupling Crisis Response from Policing — A Step Toward Equitable Psychiatric Emergency Services".
The article begins as follows, "As young psychiatrists of color, we bear witness to the failings of the U.S. mental health emergency response system. We reluctantly counsel our patients to trust this system, though we’re fully aware that it may harm them rather than ensure their safety. Our fears intensify when we undertake emergency planning with Black patients, whose ensnarement in systems of social control has been reinforced by centuries of racism in policing in particular and White supremacy more broadly. Obtaining care in a mental health crisis should be as routine and assistive as calling an ambulance for other health crises. Yet for too long, calling 911 for psychiatric aid has been fraught with the possibility of lethal consequences."
CSAP is keeping these issues at the forefront of its advocacy and will continue to fight for the enactment of bills such as AB 988 and AB 118.
AB 988 now has almost 30 authors and co-authors, which is nearly one-quarter of the entire California State Legislature!
"Blueprint for Behavioral Health" Released
On Wednesday, dozens of interest groups released a "Blueprint for Behavioral Health" that will "transform California's behavioral health care system". Their press conference, which you can view on YouTube, was led by Carmela Coyle, California Hospital Association, Jessica Cruz, NAMI California, and Steve Fields, of the Progress Foundation. A link the Blueprint can be found at: https://www.behavioralhealthaction.org/.
The Blueprint contains:
- A vision for behavioral health care (Page 6)
- Guiding principles to ensure the vision best serves those in need (Page 9)
- All Californians (Pages 11-26)
- A description of a recommended standard of community-based behavioral health care that should be available to.
The Blueprint states that, "Underpinning all this work is the fact that California has, to date, invested heavily in reactive responses to behavioral health challenges rather than in prevention and intervention at the earliest opportunities. To be successful in addressing California’s behavioral health crisis, strategies must mirror those made in primary health care, where the goal is to prevent illness and detect early warning signs as soon as possible. By investing in prevention, early intervention, and a continuum of services available in every community, Californians with behavioral health needs can avoid the need for acute care, hospitalization, incarceration, and institutionalization."
Mental Health, Equity Should Be Schools' Focus as Students Return, Report Says
EdSource recently discussed a new report, “Reimagine and Rebuild: Restarting school with equity at the center,” which was co-published by Policy Analysis for California Education (PACE) and an array of other groups, including the California PTA, the California Teachers Association, Association for California School Administrators and numerous social justice and youth advocacy groups.
According to EdSource, "California schools will receive more than $35.7 billion in state and federal pandemic funding over the next few months, which they can use to can pay for services like mental health counseling and tutoring for students. Although most of the funding is not permanent, schools can invest the money in some one-time ventures that could have lasting impacts, such as partnerships with mental health and community groups, said Heather Hough, executive director of PACE.
The report was based on interviews with teachers, administrators and researchers, as well as students of all backgrounds. “In education, we talk a lot about students, but rarely do we talk with them. The brief was developed by working with Black, brown, Asian Pacific Islander and low-income students to lay out their blueprint for an education system that is built to support every student to thrive,” said Taryn Ishida, executive director of Californians for Justice, which advocates for young people of color." The report focuses on summer and the first six weeks of school but also calls for longer-term improvements in K-12 education."
Legislative Update
Reminder that the next CSAP GA Committee will be May 20. In the meantime, each District Branch's GA Committee will be reviewing bills. The list of bills for possible consideration on May 20 is here. If you feel strongly about any of the bills on this list, please contact Paul Yoder at SYASL by May 14.
Of particular note is the nurse practitioners (NPs) follow up (AB 852 - Wood) to last year's AB 890 (Wood). Nurse practitioners have been arguing for reduced oversight in wake of AB 890. CSAP continues to work with the CMA, legislators, California Medical Board, and California Board of Registered Nursing to educate regulators on what is required for safe independent practice.
CalAIM Bill Package
CalAIM will reshape much of the public health, mental health, and substance abuse systems in California. The Urban Counties Coalition (an organization that represents California's largest counties) recently reported the following regarding the package of bills pertaining to CalAIM, "The CalAIM bill package moved out of the Senate and Assembly Health Committees this week and will now be heard in the relevant Appropriations Committees. During his bill presentations, Assembly Member Jim Wood, chair of the Assembly Health Committee, announced that he had conferred with Senator Richard Pan, chair of the Senate Health Committee, on the CalAIM measures and process. The chairs’ plan is to have policy committees hear and discuss the major CalAIM components. As agreement is reached with stakeholders and the Administration on language, those agreed upon components will move into a budget trailer bill. The CalAIM measures are:
- AB 875 (Wood): This measure includes: 1) the transition from the PRIME program to the Quality Improvement Program, as PRIME is being phased out of the current 1115 waiver; 2) the Global Payment Program; 3) jail services; and 4) state monitoring of county performance for county eligibility work for Medi-Cal. The measure, via future amendments, will also include state monitoring of county performance for California Children’s Services (CCS) and Child Health Disability Prevention (CHDP) program.
- AB 942 (Wood): Behavioral health components of CalAIM, including the funding change from certified public expenditures to Intergovernmental Transfers (IGTs).
- AB 1132 (Wood): Medicare Advantage Dual Special Needs Plan (D-SNP) components.
- SB 256 (Pan): Population Health Management, Enhanced Care Management and In Lieu of Services components. SB 256 also contains the authority for incentive payments to Medi-Cal managed care plans.
- SB 279 (Pan): Health Homes sunset, dental services, and health plan accreditation."
CSAP / APA Advocacy Training Day
CSAP / APA Advocacy Training Day: CSAP and it's state advocates at SYASL Inc., in conjunction with the APA, will be holding an advocacy training day on June 3 from 6 - 7:30 pm. If you ever wondered about the do's and dont's of advocacy, you will want to participate. This training will also include updates on state and federal legislation. CME credits will available. To register, contact Erica Smith at SYASL.
Reminder: CAL-ACAP Virtual Advocacy Day: Please join CALACAP, Children Now, and the National Alliance on Mental Illness (NAMI) of California for the 2021 Virtual Children's Mental Health Spring Advocacy Day on Monday, May 17th, via Zoom. The meeting is tentatively scheduled for 8:30 am to 4:00 pm PDT. This is a chance to join your fellow mental health community members to discuss important issues with State legislators and their staff. For questions, please contact CALACAP at 800-549-8495 or info@calacap.org.
Homelessness and Mental Health
California’s Big City Mayors Boldly Ask State Leaders for Record Level Funds to End Homelessness
Historic $4 Billion per year, multi-year state investment would become the largest allocation of funds in the country
The Big City Mayors (BCM), a coalition of the mayors from California’s 13 largest cities, came together virtually today to ask the Governor and Legislative Leadership to include a historic $4 billion per year, multi-year investment, for a total of $20 billion, in the state budget to permanently house nearly every Californian who entered a homeless shelter in 2020. With the combination of the $26 billion California received from the American Rescue Plan, and the state’s record surplus, the coalition sees a unique opportunity to measurably impact the homelessness crisis in California. Read Full Article
Expanding Full-Scope Medi-Cal Regardless of Immigration Status
CSAP's advocates are hearing rumblings that with the State's projected surplus the Legislature may attempt to expand Medi-Cal to all undocumented persons in California. For an analysis of what this could mean see the recently released report by the Legislative Analyst’s Office, “Estimated Cost of Expanding Full-Scope Medi-Cal Coverage to All Otherwise-Eligible Californians Regardless of Immigration Status,” which finds the cost of expanding comprehensive Medi-Cal coverage to all eligible Californians regardless of immigration status would be $790 million to the General Fund and $870 million in total in 2021-22 budget year if change became effective Jan. 1, 2022, while ongoing cost to General Fund would be $2.1 billion annually and $2.4 in total.
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