Sonoma County's Department of Health and Human Services has partnered with the Alexander Valley Health Center in Cloverdale to bring "essential mental health and substance abuse treatment services" to Northern Sonoma County through its Path2Health program, but its future is now somewhat clouded with the prospect of health care reform being struck down by the Supreme Court.
Path2Health, which is part of the state-run County Medical Services Program, has been described by health officials as a "bridge to health reform." It was implemented at the start of this year, with some 2,500 uninsured county residents projected to gain coverage under the program.
The most recent collaboration with Alexander Valley Health Center aims to offer mental health and substance abuse services that were expanded under the Patient Protection and Affordable Care Act, improving upon the current available services in North County.
"This innovative new partnership will ensure that the residents of Cloverdale, unlike ever before, will have access to vital mental health and substance abuse treatment services," Supervisor Mike McGuire said in a statement announcing the collaboration.
But Path2Health, a two-year pilot project created under health care reform, faces an uncertain future if the federal health overhaul is overturned, according to Rod Stroud, an administrative services officer for Sonoma County Public Health.
Last week, justices for the U.S. Supreme Court heard arguments on the constitutionality of the health bill's mandate requiring individuals to purchase health insurance. At issue is whether or not the rest of the Affordable Care Act could remain in place if the individual mandate is thrown out on the grounds that it violates the U.S. Commerce Clause. The Supreme Court will issue a decision sometime in June this year. Sharp questioning by some of the justices has led many health experts to wonder whether the bill would survive.
Path2Health would last through 2014, when many of the bill's main provisions take effect. One such provision is an expansion of Medi-Cal, the state's version of Medicaid, which would enable those enrolled in Path2Health to obtain coverage. Now that the bill is in doubt, the County Medical Services Program's Governing Board would have to decide on whether the program would continue, since those enrolled in it would lose coverage after 2014 without the Medicaid expansion, Mr. Stroud said.
"How CMSP developed Path2Health is as a two-year pilot project," he said. "They viewed the programs as going away with the Medicaid expansion."
Each month, approximately 6,000 county residents are enrolled in CMSP, with about 80 percent covered under the Path2Health program, according to the county.
Sonoma County spends roughly $13.5 million every year for the County Medical Services Program, Mr. Stroud said, but receives close to $30 million in services provided. Counties that participate in CMSP also receive federal matching grants to help with the cost.
The Affordable Care Act also placed an emphasis on mental health, substance abuse and primary care.
"From our perspective, I thought is was a great thing when they added behavioral health and substance abuse services, and definitely hope that would continue," Mr. Stroud said.
"Path2Health opens access to patients previously unable to obtain insurance coverage and usually went without much needed services. It is amazing and it’s about time," said Alexander Valley Health Center CEO Debbie Howell.
The governing board for the County Medical Services Program projects that Path2Health would extend coverage to 30,000 individuals across the state. Sonoma County, one of 34 counties to take part in the program, comprises nearly 9 percent of the state program's case load.***