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    Reasons Gas Stations Charge for Compressed Air

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    What To Consider Before Repainting Your Classic Car

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    Top Ways To Upgrade Your Electric Vehicle

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    4 Helpful Tips for Giving Your Car a Glossy Finish

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    Signs That It Might Be Time To Get a New Car

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    Mistakes To Avoid When Starting Your Online Store

    Mistakes To Avoid When Starting Your Online Store

    Ways To Reduce Safety Hazards in the Office

    Ways To Reduce Safety Hazards in the Office

    How To Realistically Invest in Apartment Complexes

    How To Realistically Invest in Apartment Complexes

    Fighting housing shortage: Airbnb & Co should share more data with authorities to prevent fraud 

    Fighting housing shortage: Airbnb & Co should share more data with authorities to prevent fraud 

    How To Transition to Mass-Producing Your Product

    How To Transition to Mass-Producing Your Product

    How To Choose the Right Outdoor Lighting for Your Business

    How To Choose the Right Outdoor Lighting for Your Business

    Tips for Designing an Industrial-Style Restaurant

    Tips for Designing an Industrial-Style Restaurant

    Los Angeles implemented a new tax on luxurious real estate to finance affordable housing and combat homelessness

    Los Angeles implemented a new tax on luxurious real estate to finance affordable housing and combat homelessness

    Working shorter hours: 38 companies in the USA are testing the 4-day week

    Working shorter hours: 38 companies in the USA are testing the 4-day week

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    • Fashion
      Essential Tips for Planning a Great Fashion Show

      Essential Tips for Planning a Great Fashion Show

      Signs That Your Tuxedo Doesn’t Fit Right

      Signs That Your Tuxedo Doesn’t Fit Right

      Make a Bold Style Statement With These Wide-Leg Pants

      Make a Bold Style Statement With These Wide-Leg Pants

      Power Your Winter Workouts With The Best Zip Hoodies for Men

      Power Your Winter Workouts With The Best Zip Hoodies for Men

      The Ultimate Watch Buying Guide

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      Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

      Our 7 Favorite Field Jackets for Tackling Fall Weather

      Our 7 Favorite Field Jackets for Tackling Fall Weather

      The Best Leather Jackets for Guys – No Matter Your Budget

      The Best Leather Jackets for Guys – No Matter Your Budget

      Campus-Ready Backpacks for Storing *All* the Books

      Campus-Ready Backpacks for Storing *All* the Books

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        Energizing Foods and Drinks To Consume Before a Workout

        Energizing Foods and Drinks To Consume Before a Workout

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        Classic Beer Styles You Should Know How to Brew

        The Best Flour Alternatives That Work in Any Recipe

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        Cheese Tortellini in Creamy Marinara

        Cheese Tortellini in Creamy Marinara

        Unusual Products That Come From Animals and Their Uses

        Unusual Products That Come From Animals and Their Uses

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          Florida Gov. Ron DeSantis Injects Presidential Politics Into the Covid Vaccine Debate

          Florida Gov. Ron DeSantis Injects Presidential Politics Into the Covid Vaccine Debate

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          Tips for Fitting a Doctor’s Visit Into Your Busy Schedule

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          The Shrinking Number of Primary Care Physicians Is Reaching a Tipping Point

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          Activist Misuses Federal Data to Make False Claim That Covid Vaccines Killed 676,000

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          Illustrated Report: How Gun Violence Goes Viral

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          A New Medicare Proposal Would Cover Training for Family Caregivers

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          New Alzheimer’s Drug Raises Hopes — Along With Questions

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            Common Dog Owner Mistakes and How To Avoid Them

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            3 Reasons To Give an Antique or Vintage Engagement Ring

            Tim Ferris

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            Why the Friend of My Enemy is My Enemy

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            Energizing Foods and Drinks To Consume Before a Workout

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              Carbon capture draws millions in lobbying, billions in federal subsidies

              Carbon capture draws millions in lobbying, billions in federal subsidies

              United leads soaring airline industry lobbying spending

              United leads soaring airline industry lobbying spending

              Deep-pocketed dairy industry continues war on plant-based milk as FDA hears comments on new draft guidance

              Deep-pocketed dairy industry continues war on plant-based milk as FDA hears comments on new draft guidance

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              Shein’s lobbying spending soars amid supply chain probes

              Virginia legislative candidates in Richmond and Hampton Roads raked in millions in final primary sprint

              Virginia legislative candidates in Richmond and Hampton Roads raked in millions in final primary sprint

              Manchin outraises GOP challengers but has yet to announce 2024 plans

              Manchin outraises GOP challengers but has yet to announce 2024 plans

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              Gallego outraises Sinema but falls far short of incumbent’s war chest in Arizona Senate race

              Elon Musk outmuscled by Mark Zuckerberg’s money in politics

              Elon Musk outmuscled by Mark Zuckerberg’s money in politics

              Amazon lobbyists tout workplace safety improvements ahead of Senate investigation

              Amazon lobbyists tout workplace safety improvements ahead of Senate investigation

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                Ways To Invest in Real Estate With No Experience

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                How To Make Your Rental Property More Eco-Friendly

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                Things To Consider Before Investing in Real Estate Overseas

                Incredible Areas in Florida To Buy a Vacation Home

                Incredible Areas in Florida To Buy a Vacation Home

                Helpful Home Staging Tips for Virtual Tours

                Helpful Home Staging Tips for Virtual Tours

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                Ways To Decorate and Design a Lake House

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                Challenges To Managing a Rental Property

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                The Best Landlord: How To Show Tenants You Care

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                The Best Locations To Invest in a Second Home

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                  Reasons Gas Stations Charge for Compressed Air

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                  What To Consider Before Repainting Your Classic Car

                  What To Consider Before Repainting Your Classic Car

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                  Top Ways To Upgrade Your Electric Vehicle

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                  Tips for Crossing Water in Your Jeep Wrangler

                  4 Helpful Tips for Giving Your Car a Glossy Finish

                  4 Helpful Tips for Giving Your Car a Glossy Finish

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                  4 Common Mistakes To Avoid With Car Restorations

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                  Signs That It Might Be Time To Get a New Car

                  Mercedes-Benz Charging Network

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                • Business
                  Mistakes To Avoid When Starting Your Online Store

                  Mistakes To Avoid When Starting Your Online Store

                  Ways To Reduce Safety Hazards in the Office

                  Ways To Reduce Safety Hazards in the Office

                  How To Realistically Invest in Apartment Complexes

                  How To Realistically Invest in Apartment Complexes

                  Fighting housing shortage: Airbnb & Co should share more data with authorities to prevent fraud 

                  Fighting housing shortage: Airbnb & Co should share more data with authorities to prevent fraud 

                  How To Transition to Mass-Producing Your Product

                  How To Transition to Mass-Producing Your Product

                  How To Choose the Right Outdoor Lighting for Your Business

                  How To Choose the Right Outdoor Lighting for Your Business

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                  Tips for Designing an Industrial-Style Restaurant

                  Los Angeles implemented a new tax on luxurious real estate to finance affordable housing and combat homelessness

                  Los Angeles implemented a new tax on luxurious real estate to finance affordable housing and combat homelessness

                  Working shorter hours: 38 companies in the USA are testing the 4-day week

                  Working shorter hours: 38 companies in the USA are testing the 4-day week

                  Trending Tags

                  • Fashion
                    Essential Tips for Planning a Great Fashion Show

                    Essential Tips for Planning a Great Fashion Show

                    Signs That Your Tuxedo Doesn’t Fit Right

                    Signs That Your Tuxedo Doesn’t Fit Right

                    Make a Bold Style Statement With These Wide-Leg Pants

                    Make a Bold Style Statement With These Wide-Leg Pants

                    Power Your Winter Workouts With The Best Zip Hoodies for Men

                    Power Your Winter Workouts With The Best Zip Hoodies for Men

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                    The Ultimate Watch Buying Guide

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                    Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

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                    Our 7 Favorite Field Jackets for Tackling Fall Weather

                    The Best Leather Jackets for Guys – No Matter Your Budget

                    The Best Leather Jackets for Guys – No Matter Your Budget

                    Campus-Ready Backpacks for Storing *All* the Books

                    Campus-Ready Backpacks for Storing *All* the Books

                    Trending Tags

                    • Food & Drink
                      Energizing Foods and Drinks To Consume Before a Workout

                      Energizing Foods and Drinks To Consume Before a Workout

                      Classic Beer Styles You Should Know How to Brew

                      Classic Beer Styles You Should Know How to Brew

                      The Best Flour Alternatives That Work in Any Recipe

                      The Best Flour Alternatives That Work in Any Recipe

                      Cheese Tortellini in Creamy Marinara

                      Cheese Tortellini in Creamy Marinara

                      Unusual Products That Come From Animals and Their Uses

                      Unusual Products That Come From Animals and Their Uses

                      Tips for Creating a Homemade Wine Cellar

                      Tips for Creating a Homemade Wine Cellar

                      How the wine you choose can help you have an eco-friendly home

                      How the Wine You Choose Can Help You have an Eco-Friendly Home

                      Rum and Cola Holiday Ham

                      Special Centerpieces for Holiday Celebrations

                      ChefsGiving 2020

                      This Holiday Season, How about Cooking for a Cause?

                      Trending Tags

                      • Health
                        Florida Gov. Ron DeSantis Injects Presidential Politics Into the Covid Vaccine Debate

                        Florida Gov. Ron DeSantis Injects Presidential Politics Into the Covid Vaccine Debate

                        Tips for Fitting a Doctor’s Visit Into Your Busy Schedule

                        Tips for Fitting a Doctor’s Visit Into Your Busy Schedule

                        The Shrinking Number of Primary Care Physicians Is Reaching a Tipping Point

                        The Shrinking Number of Primary Care Physicians Is Reaching a Tipping Point

                        Activist Misuses Federal Data to Make False Claim That Covid Vaccines Killed 676,000

                        Activist Misuses Federal Data to Make False Claim That Covid Vaccines Killed 676,000

                        Illustrated Report: How Gun Violence Goes Viral

                        Illustrated Report: How Gun Violence Goes Viral

                        A New Medicare Proposal Would Cover Training for Family Caregivers

                        A New Medicare Proposal Would Cover Training for Family Caregivers

                        New Alzheimer’s Drug Raises Hopes — Along With Questions

                        New Alzheimer’s Drug Raises Hopes — Along With Questions

                        Blood Test That Screens for Cancer Raises Hopes, and Worries

                        Blood Test That Screens for Cancer Raises Hopes, and Worries

                        Medical Debt Is Making Americans Angry. Doctors and Hospitals Ignore This at Their Peril.

                        Medical Debt Is Making Americans Angry. Doctors and Hospitals Ignore This at Their Peril.

                        Trending Tags

                        • Lifestyle
                          Common Dog Owner Mistakes and How To Avoid Them

                          Common Dog Owner Mistakes and How To Avoid Them

                          3 Reasons To Give an Antique or Vintage Engagement Ring

                          3 Reasons To Give an Antique or Vintage Engagement Ring

                          Tim Ferris

                          Tim Ferriss’ Lifestyle Design: Unleashing Human Potential and Redefining Success

                          Outdoor Luxuries To Add to Your Backyard

                          Outdoor Luxuries To Add to Your Backyard

                          Strategy and business planning ideas. Chess gold on the board.

                          Why the Friend of My Enemy is My Enemy

                          Huge Money Mistakes New Parents Fall For

                          Huge Money Mistakes New Parents Fall For

                          Energizing Foods and Drinks To Consume Before a Workout

                          Energizing Foods and Drinks To Consume Before a Workout

                          Hobbies That Stimulate Cognitive Function

                          Hobbies That Stimulate Cognitive Function

                          How To Prevent Mold from Growing in a Sauna

                          How To Prevent Mold from Growing in a Sauna

                          Trending Tags

                          • Politics
                            Carbon capture draws millions in lobbying, billions in federal subsidies

                            Carbon capture draws millions in lobbying, billions in federal subsidies

                            United leads soaring airline industry lobbying spending

                            United leads soaring airline industry lobbying spending

                            Deep-pocketed dairy industry continues war on plant-based milk as FDA hears comments on new draft guidance

                            Deep-pocketed dairy industry continues war on plant-based milk as FDA hears comments on new draft guidance

                            Shein’s lobbying spending soars amid supply chain probes

                            Shein’s lobbying spending soars amid supply chain probes

                            Virginia legislative candidates in Richmond and Hampton Roads raked in millions in final primary sprint

                            Virginia legislative candidates in Richmond and Hampton Roads raked in millions in final primary sprint

                            Manchin outraises GOP challengers but has yet to announce 2024 plans

                            Manchin outraises GOP challengers but has yet to announce 2024 plans

                            Gallego outraises Sinema but falls far short of incumbent’s war chest in Arizona Senate race

                            Gallego outraises Sinema but falls far short of incumbent’s war chest in Arizona Senate race

                            Elon Musk outmuscled by Mark Zuckerberg’s money in politics

                            Elon Musk outmuscled by Mark Zuckerberg’s money in politics

                            Amazon lobbyists tout workplace safety improvements ahead of Senate investigation

                            Amazon lobbyists tout workplace safety improvements ahead of Senate investigation

                            Trending Tags

                            • Real Estate
                              Ways To Invest in Real Estate With No Experience

                              Ways To Invest in Real Estate With No Experience

                              How To Make Your Rental Property More Eco-Friendly

                              How To Make Your Rental Property More Eco-Friendly

                              Things To Consider Before Investing in Real Estate Overseas

                              Things To Consider Before Investing in Real Estate Overseas

                              Incredible Areas in Florida To Buy a Vacation Home

                              Incredible Areas in Florida To Buy a Vacation Home

                              Helpful Home Staging Tips for Virtual Tours

                              Helpful Home Staging Tips for Virtual Tours

                              Ways To Decorate and Design a Lake House

                              Ways To Decorate and Design a Lake House

                              Challenges To Managing a Rental Property

                              Challenges To Managing a Rental Property

                              The Best Landlord: How To Show Tenants You Care

                              The Best Landlord: How To Show Tenants You Care

                              The Best Locations To Invest in a Second Home

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                              Sacramento and Solano Counties Square Off With State Over Mental Health Duties

                              by Staff Writer
                              March 15, 2023
                              in Health
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                              SACRAMENTO — Sacramento and Solano counties are in a standoff with the state over mental health coverage for a portion of Medicaid patients in those counties — a dispute that threatens to disrupt care for nearly 50,000 low-income residents receiving treatment for severe mental illness.

                              The Department of Health Care Services, which administers Medi-Cal, the state’s Medicaid program, says Sacramento and Solano counties must take over managing and providing specialty mental health care for thousands of Medi-Cal patients enrolled in Kaiser Permanente plans. It insists on shifting the responsibility because California’s remaining 56 counties already operate this way. State officials argue the switch would simplify the state’s disjointed mental health system and is needed to implement a larger transformation of Medi-Cal, an initiative known as CalAIM.

                              State health officials gave counties until March 15 to accept Kaiser Permanente patients, so California can properly transfer their specialty mental health care to counties by July 1. But the two counties are rebuffing the transfer, arguing that without more funding they can’t adequately care for a major influx of Medi-Cal patients with severe mental health conditions, such as schizophrenia or bipolar disorder. Medi-Cal officials, meanwhile, are threatening steep penalties or potentially terminating mental health contracts with those counties.


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                              Local officials warn that if the state follows through with its plan, about 39,000 patients in Sacramento County and about 8,000 in Solano County could see their care disrupted and, for instance, may be forced to find a new psychiatrist.

                              “For someone who has schizophrenia or another serious mental health disorder, it has taken a long time to build a trusted relationship with their provider, and now they are going to see that care disrupted or have to find a different provider,” said Debbie Vaughn, assistant county administrator for Solano County. “There will be risks of people going into crisis.”

                              Ryan Quist, director of behavioral health services for Sacramento County, said the counties need not only more funding, but also more time to transfer the patients’ care. “The state is playing chicken with their lives,” he said.

                              Under state law, counties are responsible for administering and delivering specialty care to Medi-Cal patients with severe mental illness. Medi-Cal managed-care insurers are responsible for providing treatment for mild or moderate mental health conditions, such as anxiety or low-level depression.

                              But under a decades-old arrangement between the state and the counties of Sacramento and Solano, California has been paying Kaiser Permanente to provide all mental health care for the health care giant’s Medi-Cal enrollees. Now the state is dissolving that arrangement, forcing roughly 7,000 specialty mental health patients in those two counties to move out of Kaiser Permanente and into county-run mental health plans.

                              State officials argue that the two counties are legally obligated to provide care for Medi-Cal patients with severe mental illness and that county behavioral health agencies would be the ones putting patients in danger if the counties continue refusing the shift. Medi-Cal patients enrolled in health plans other than Kaiser Permanente get their specialized mental health care directly from counties.

                              “Sacramento and Solano counties’ failure to engage in this process places Medi-Cal members at risk of losing access to critical Medi-Cal entitlement services,” said Tony Cava, a spokesperson for the Department of Health Care Services. “DHCS will have no choice but to take action if the counties continue to refuse to fulfill their obligations.”

                              The state is considering sanctions or terminating the counties’ contracts, but Cava said that “contract termination is not DHCS’ preferred approach.” He declined to elaborate, adding only that the agency would “identify solutions to continue coverage” for Kaiser Permanente patients.

                              He said transferring patients to the counties will provide “a more consistent and seamless health system by reducing complexity and increasing flexibility.”

                              Counties currently receive a portion of state sales tax revenue and vehicle license fees to fund specialty mental health care, but under the agreement in Sacramento and Solano, the state has been paying Kaiser Permanente from its general fund to serve a portion of the insurer’s overall Medi-Cal enrollees’ mental health needs.

                              Under the shift, California would stop distributing general-fund money to the counties. Instead, counties would receive a greater share of existing sales tax and vehicle license fee revenues set aside by a 2011 arrangement. But Kaiser Permanente’s specialty mental health patients, the counties argue, were not under their purview at the time that agreement was reached, underscoring their legal argument that the state should cover the costs of their care.

                              The state is offering an additional $11.6 million a year to Sacramento and $7.7 million a year to Solano, which would draw down additional federal funding. That money would be siphoned from revenue other counties rely on for behavioral health treatment.

                              “The insult to injury is this takes money from other counties,” said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association, “and across California we’re seeing a greater demand for services, especially after the pandemic.”

                              Sacramento County wants $36 million more each year to cover a 16% increase in patients, or 4,836 people. Solano County seeks nearly $17 million more each year for increasing its load by 50%, or 2,091 patients.

                              Behavioral health officials say counties are also struggling to recruit and retain mental health professionals willing to serve Medi-Cal patients.

                              “Our system is already bursting at the seams,” said Le Ondra Clark Harvey, CEO of the California Council of Community Behavioral Health Agencies, which represents local mental health providers.

                              State officials believe that both counties have an adequate number of mental health providers, with the small exception of Sacramento County’s need for two to three additional psychiatrists to serve kids.

                              Kaiser Permanente told KHN that it did not ask to move patients out of its network of care and that it told the state it wanted to continue serving them. Yet it ultimately agreed to transfer care to the counties.

                              “While we had expressed our preference to continue to provide specialty care to this vulnerable population,” said spokesperson Gerri Ginsburg, “we respect the state’s long-term objectives.”

                              Angela Hart:
                              ahart@kff.org,
                              @ahartreports

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