How Can We Help Low-Income Families Get Access to Care?

Author: Shelly Tregembo

With the passage of the Affordable Care Act and Medicaid expansion, California now boasts more than 12 million people insured through the Medi-Cal program– the largest number of insured individuals in our State’s history. And amazingly, finally, these millions of newly-insured Californians have coverage that includes mental health services. As much as we wish that adding the coverage suddenly allowed for everyone who needed care to get it, that’s sadly not the case.

At PHA, we’ve heard from dozens of providers about the challenging reality of finding affordable, low-income treatment for women and families. Whether the family has health insurance through Medi-Cal or are paying out of pocket, mental health treatment often takes a back seat for a family that is struggling financially to meet their basic needs. And even when families are ready and able to seek help, they are met with a system that is stretched so thin that it can take upwards of 3 months to get a visit.While Medi-Cal does provide for mental health services and even mandates that insurance providers have adequate networks to assist their customers, a lack of mental health professionals willing to take Medi-Cal has muted this benefit considerably. Numerous reasons abound for this. Most commonly, we hear that the paperwork and regulations involved in providing and subsequently billing (and getting paid!) are so onerous that it fails to be a viable option, especially for those providers who maintain small practices.

Unfortunately, we know that low-income families are particularly vulnerable to mental health challenges associated with pregnancy and research shows that they experience the effects at 2 to 3 times the rate of the general population.

So what can be done?

One of the first things that we can all do is to be better educated about what options do exist in our community. A newly expanded program of Vista Hill’s SmartCare provides screening, assessment and referral for women who are pregnant and postpartum. Through a partnership with primary care and pediatric offices, low-income families are referred to SmartCare for screening and assessment and then referred to further treatment and additional services if needed. As is often the case, families may need more than mental health services. SmartCare works with each client to identify and refer for a variety of services including substance abuse treatment, housing, food assistance and other social service needs.

Many community clinics (also known as Federally-Qualified Health Centers- FQHCs) also offer mental health services for free, or sliding scale rates for families and are conveniently located throughout the county. These clinics often have the added advantage of being located in the same place as physical healthcare services as well.

PHA will be working in the coming months to provide more information on available resources for low income families and also continuing our mission to educate providers to recognize, understand and respond effectively to the mental health challenges of pregnant and postpartum women and their families.

What kinds of information would you find useful in understanding more about Medi-Cal and low-cost treatment options? Do you have resources to share? Tell us more in the comments section!