Behavioral Health

About Behavioral Health

An estimated 7.5 million people in California experience a mental health disorder in any given year, but only one-third of adults who experience mental illness are getting treatment. The caregivers at hospitals know the obstacles people with behavioral health conditions face and the challenges in getting them the treatment they need. While hospitals embrace the essential role they play in addressing this crisis, more needs to be done. Solutions like payment reform, resource allocation, more outpatient and community-based services, a bolstered behavioral health workforce, and a statewide set of standardized core services will help Californians with behavioral health conditions access the care they deserve.

VA Issues Final Rule Implementing Veterans Community Care Program

The Department of Veterans Affairs (VA) has issued its final rule implementing the criteria for determining when covered veterans may elect to receive necessary hospital, medical, and extended care services from non-VA entities or providers under the Veterans Community Care Program. The final rule became effective June 6, when the Veterans Community Care Program replaced the Veterans Choice Program, as required by the MISSION Act of 2018.

VA Issues Veterans Community Care Program Proposed Rule

The Department of Veterans Affairs (VA) has issued a proposed rule implementing provisions of the Veterans Community Care Program — authorized by the MISSION Act — which allows covered veterans to receive necessary hospital, medical and extended care services from non-VA providers.

Under the MISSION Act, veterans enrolled in the VA health system can seek care from non-VA providers if they meet one of the following six conditions:

VA does not offer the required care or services.
VA does not operate a full-service medical facility in the state where the veteran resides.
The veteran was eligible to receive care under the Veterans Choice Program and is eligible to receive care under certain grandfathering provisions.
VA is not able to furnish care or services to a veteran in a manner that complies with VA’s proposed access standards.
The veteran and the referring clinician determine it is in the veteran’s best medical interest to receive care or services from an eligible entity or provider based on consideration of proposed criteria.
The veteran is seeking care or services from a VA medical service line that VA has determined is not providing care that complies with VA’s standards of quality.

The proposed rule also defines which non-VA entities and providers are eligible to participate in the program and clarifies payment rates and methodologies for those community providers. VA previously issued a separate proposed rule implementing urgent care provisions for the new program. Comments on the proposed rule are due March 25.