How CalCare would be transformative for substance abuse programs in CA

CalCare would significantly impact substance abuse and mental health programs by integrating these services into a comprehensive, publicly funded, and universally accessible health care system.

Summary of how CalCare would impact substance abuse and mental healthcare treatment:

Comprehensive Coverage

• Covers inpatient and outpatient mental health and substance use disorder (SUD) treatment services.
• Includes counseling, detoxification, rehabilitation, and medication-assisted treatment (MAT).
• Benefits extend to all residents regardless of immigration or employment status.

No Cost Barriers

• Eliminates copays, deductibles, coinsurance, and out-of-pocket costs.
• Improves early access to care by removing financial deterrents.
• Reduces long-term costs by enabling preventive and continuous treatment access.

Integrated Care Delivery

• Merges mental health, substance use disorder, and primary care under a single-payer system.
• Encourages whole-person treatment for co-occurring conditions.
• Coordinates care through shared provider networks and unified health records.

Equity and Access

• Targets underserved communities and rural areas with provider incentives.
• Mandates culturally and linguistically appropriate care practices.
• Focuses on reducing disparities in treatment outcomes.

Provider Support

• Establishes stable funding via global budgets or negotiated rates.
• Reduces administrative burden tied to billing multiple insurers.
• Provides training and workforce development to expand behavioral health services.

Data and Accountability

• Requires reporting on treatment outcomes, patient demographics, and service use.
• Enables quality monitoring and system-wide performance analysis.
• Promotes transparency through publicly accessible data portals.

CalCare proposes a transformative approach to addressing substance abuse and mental healthcare needs in underserved communities by removing systemic barriers and actively building infrastructure where it’s currently inadequate.

Here’s how the CalCare would address these gaps:

1. Guaranteed Access Regardless of Geography

• Universal coverage ensures that residents in all regions—including rural and historically underserved communities—have access to mental health and substance use disorder (SUD) treatment services.
• By eliminating financial barriers (no premiums, copays, or deductibles), CalCare enables low-income individuals in underserved areas to seek care without cost-related deterrents.

2. Health Workforce Development in Underserved Areas

• Establishes a Health Workforce Working Group tasked with evaluating shortages and creating incentives for behavioral health professionals to work in high-need communities.
• Includes support for training, recruitment, and retention of providers, especially those from underrepresented backgrounds or with cultural/linguistic alignment with local populations.

3. Funding for Infrastructure Expansion

• Through global budgets and negotiated payments, CalCare would fund the creation or expansion of clinics and treatment centers where service networks are sparse or nonexistent.
• Resources would be directed based on population health needs, not profit potential—unlike under the current fragmented insurance system.

4. Community-Based and Culturally Competent Care

• CalCare requires care delivery to be culturally and linguistically appropriate, crucial for trust-building and effectiveness in marginalized communities.
• The law promotes the use of home- and community-based services, especially for people with chronic conditions or co-occurring disorders.

5. Data-Driven Planning and Oversight

• The CalCare Board would collect regional service utilization and outcomes data to identify where gaps persist and target resources accordingly.
• This ensures that underserved communities aren’t overlooked and that investments are directed toward areas of greatest need.

In Summary

CalCare aims to build a behavioral health safety net where one may not currently exist, by ensuring funding, staffing, cultural competence, and system-wide accountability. It shifts care delivery from a reactive, market-driven model to a proactive, needs-based public health approach—critical for addressing substance abuse and mental health disparities in underserved communities.

CalCare is a visionary policy framework for where we must move in CA (and the country), including for how we address substance abuse and mental health well-being in our communities. Please join Asians and Pacific Islanders for CalCare in our quest to eliminate the primacy of private insurance profiteering as the determining factor in how substance abuse and mental healthcare services are inadequate in our communities. Join our email list today and ask us how you can become involved in this fight to win healthcare for all.