Californians, like the rest of the country, are facing significant mental health challenges in the aftermath of the pandemic. The need for new and enhanced behavioral health supports and interventions has come into strong focus in recent years and states are leveraging their Medicaid programs to respond.

Recruitment and retention of the direct care workforce has been a longstanding challenge among states. Low wages are a particular barrier because direct care worker wages often compete with gig employment, where the work is less physically and emotionally taxing.

Thanks to tireless advocacy combined with impressive outcomes data, funding was allocated in the California state budget to support the continuation of the program. This is a prime example of how initial federal investments can ultimately lead to long-term sustainability of successful programs.

When Aurrera Health launched the ACEs Aware initiative on behalf of the California Department of Health Care Services (DHCS) and the Office of the California Surgeon General (CA-OSG) in late 2019, we knew we were on the forefront of change.

A core element of all Medicaid Section 1115 “research and demonstration” waivers is an evaluation of the demonstration program and its efficacy in meeting the demonstration’s goals. Historically, however, Section 1115 waiver evaluations have been an afterthought for states and CMS, limiting their ability to inform future Medicaid policy and financing approaches.

States are leveraging American Rescue Plan Act (ARPA) dollars to support a multi-faceted policy approach to strengthening state health care infrastructure and the health workforce.

Last year, Aurrera Health Group teamed up with the California Department of Health Care Services to provide early education and targeted technical assistance for providers on implementing Enhanced Care Management and Community Support services, two key parts of the CalAIM initiative. This experience revealed several promising practices for other states pursuing whole-person approaches to health care delivery.

Federally Qualified Health Centers (FQHCs) are a critical provider of health care, particularly for communities of color and Medicaid beneficiaries. It is vital that health centers are financially and operationally stable so they can continue to effectively provide patients with primary care, behavioral health, and dental services.

Since the fall of 2019, Aurrera Health Group has been working closely with the Office of the California Surgeon General (CA-OSG) and the California Department of Health Care Services (DHCS) to launch the ACEs Aware initiative – a first-in-the-nation, statewide effort to promote screening for early detection of Adverse Childhood Experiences (ACEs) and mitigate against the health and societal impacts of ACEs and toxic stress.