CalAIM (California Advancing and Innovating Medi-Cal) enables managed care plans to offer 14 Community Supports, services not traditionally covered by Medi-Cal that address health-related social needs. Some of these services, like housing navigation and medically tailored meals, have been readily adopted by participating health plans since the launch of Community Supports in 2022, while others have gotten off to a slower start. This fact sheet profiles one of these services with relatively low adoption — sobering centers. Sobering centers provide a safe, alternative destination for those ..read more

For many Californians living with serious mental illness or substance use disorders, accessing treatment beds and housing with supportive services is critical. It can also be very challenging. Gaps in resources can prevent people from transitioning to less restrictive, community-based settings once they are ready to be discharged from more intensive treatment facilities. Conversely, housing that lacks robust supportive services can undermine stability and recovery for people with serious behavioral health conditions. To address these gaps, California has invested significant funding to expand ..read more

At the Clubhouse of Westside Community Services in San Francisco, members LaMonte, left, and Ayana talk about their shared interest in video and filmmaking. Photo: Kori Suzuki In a spacious sunlit room on a midsummer day, 11 people are gathered at San Francisco’s Westside Community Services, one of the nation’s oldest community mental health providers. Everyone is watching staff member Marcellus Ducreay demonstrate the preparation of his cherished black bean salad recipe. But this gathering is about much more than a delicious meal. It’s one of many weekly activities for Westside clients who ar ..read more

Stacey Berardino, interim director of forensics at the Orange County Health Care Agency, speaks to community members about CARE Court. Photo: Lauren Justice for CalMatters Under the low hum of cold fluorescent lights in a nondescript office park in Orange County, dozens of Californians gathered to find out if they could get help for their loved ones under the state’s new CARE Court system. Unless that loved one has a medical diagnosis specific to schizophrenia or some other psychotic disorders, the answer was probably not. The mid-August meeting was one of a series held by a mental health advo ..read more

Established in the early 1990s, street medicine is the provision of health care directly to people who are unsheltered, in their own environment, and has evolved from a fringe movement of health care providers to an organized area of medicine, with programs that span the globe. With the largest concentration of people experiencing unsheltered homelessness in the nation, California is well positioned to scale the street medicine model to reach more people experiencing unsheltered homelessness. The California Street Medicine Landscape Survey and Report is the first to examine and report on the c ..read more

Soraya Azari, MD, uses contingency management techniques to help people overcome methamphetamine addiction. Photo: Constanza Hevia H. On November 30, 2021, JC was admitted to Zuckerberg San Francisco General Hospital for symptoms of heart failure. His legs were swollen, which can be a sign that the heart isn’t pumping properly, and he was having trouble breathing. He ended up spending seven days in the hospital with no one to talk to but the hospital staff. That’s when he decided it was time to turn his life around. “Spending a week in a hospital room by yourself will do that to you. I had a l ..read more

Increasingly, California’s primary care safety net is striving to provide whole-person care, which requires that providers be able to identify, manage, and address a patient’s physical, behavioral (mental health and SUD), and social needs. However, less than half of adult Medi-Cal enrollees with mental illness received a mental health service, and there remain significant racial/ethnic disparities in access and outcomes. For example, Latino/x and Black Californians report higher rates of unmet needs for behavioral health care compared to their White and Asian counterparts. COVID-19 has exacerb ..read more

The overdose epidemic in California has changed significantly in the last decade. While opioid overdose deaths dominate headlines, an increasing number of people in California are dying from stimulant overdoses, most commonly methamphetamine and cocaine. In 2020, the number of Californians who died from stimulants eclipsed those who died of an opioid overdose. There are currently no Food and Drug Administration–approved medications to address stimulant use disorder, but contingency management is a proven, effective nonmedication approach. In contingency management, providers give patients posi ..read more

Methadone is a gold-standard medication effective in reducing the risk of death for people with opioid use disorder. In the US, patients can only access methadone treatment through outpatient treatment programs, or OTPs (colloquially, “methadone clinics”). Before COVID-19, federal and state restrictions required patients to visit clinics daily to receive their methadone doses, ostensibly to guard against methadone overdose and misuse. Only people meeting strict criteria had access to methadone “take-home doses” or “take-homes.” The history of many methadone treatment policies and regulations i ..read more

San Francisco Chronicle photojournalist Stephen Lam and reporter Trisha Thadani spent a year as part of a large team that produced a multimedia project exploring soaring numbers of fentanyl overdose deaths in the city. They told the story through the lives of people caught up in the crisis. Photo: Marissa Leshnov In the year following the arrival of COVID-19, more than 100,000 people died of a drug overdose in the US. In San Francisco in 2020 and 2021, a total of 1,300 people died of a drug overdose — twice the number who died of COVID-19. A common culprit was the illicit drug fentanyl. To hel ..read more