CADPAAC September 2013 Clara Boyden Manager , Behavioral Health & Recovery Services

1. San Mateo County Low Income Health Program:Learnings in Reaching and Enrolling Behavioral Health Clients CADPAAC September 2013 Clara Boyden Manager , Behavioral Health & Recovery Services San Mateo County Behavorial Health Srija Srinivasan Director of Strategic Operations San Mateo County Health System

2. Our LIHP journey builds on an aspiration of universal coverage Coverage?

3. Key LIHP design features influenced our strategy • Robust behavioral health benefit • Distributed network of community-based treatment providers • Enrollment and eligibility assistance by network of Health Department-based/ contracted/ trained advocates

4. Operational, financial constraints shaped our approach • Leveraging non-federal match that was “in” provider organizations • Eligibility and enrollment staff in clinics, public hospital, targeted “hard to reach” communities • Worked to simplify and streamline existing processes

5. Behavioral Health – Health Coverage Unit partnership to plan, do, check… • Survey of health insurance among AOD treatment clients • Meetings to obtain feedback from treatment and homeless providers • Tailored “universal” health coverage referral to collect info needed for all programs from treatment providers

6. We learned what matters to clients… • Clients trust their providers • No “added” enrollment visit for client after pre-screen by registration staff • Options for treatment provider to attest to identity and address • No copay = reduced barrier

7. We learned what matters to the treatment providers… • Collection of client information “built into” registration process • Needed to test amount of staff time and have detailed, clear policies • Needed enrollment point person to be available to providers in ramp up • Tracked and fed back data to support successful billing

8. We saw our success grow with time, training, follow-up… AFTER BEFORE 1,000 uninsured clients of Behavioral Health and Recovery Services 500 Behavioral Health and Recovery Services LIHP enrollments

9. Monthly Enrollment into Health Coverage at SUD Provider Sites

10. We’re adapting our approach based on what we have learned • Welcoming “front end”; making “no wrong door” a reality • Advocacy-oriented, and data-driven “back end”; we’ll make it work • Earn and keep clients’ trust to achieve a “culture of coverage” • Tight connections to providers and eligibility/enrollment staff matter

11. We see major opportunities with ACA rollout in CA • MCE enrollment through December 31, with “seamless” transfer to Medi-Cal • Improved behavioral health coverage! • CalHEERS, resources for community-based enrollments (Covered CA, TCE) • Continued evolution of partnerships with County Social Services

12. Questions? THANK YOU We look forward to learning from others

13. For More Information Clara Boyden 650-802-5101 cboyden@smcgov.org