NEW REPORT: Opportunities for Policymakers to Work with Community Defined Evidence Practices to Center BIPOC and LGBTQ+ Health and Wellbeing

Author Details

Monika Lee

Senior Communications Manager
(858) 353-7271

California Pan-Ethnic Health Network 
For Immediate Release 
April 20, 2021 
Contact: Monika Lee (858) 353-7271 

Sacramento, CA – Today, the California Pan-Ethnic Health Network and members of the Community-Defined Evidence Practice (CDEP) Integration Advisory Group released its final report detailing the successes and policy recommendations coming out of the California Reducing Disparities Project. The California Reducing Disparities Project is funded by the Office of Health Equity within the California Dept of Public Health. Elected officials, policy makers, state administrations, and local behavioral health departments must consider policy strategies outlined in the report, to prepare for the enormous mental health needs of BIPOC and LGBTQ+ communities exacerbated by COVID-19 pandemic and racism. 

Throughout the 5-year process, 35 implementation pilot projects across the state were chosen for their success in demonstrating different approaches to addressing the behavioral health needs of communities of color and LGBTQ+ communities behavioral health and wellbeing outside of the mainstream medical model. While California has taken great strides to address inequities in behavioral health, disparities persist and are exacerbated due to the pandemic.  

The report states, “Through decades of data, there is a clear need for new strategies to help reduce behavioral health disparities in BIPOC and LGBTQ+ communities. Community-defined evidence practices (CDEPs) can offer a role in the State’s efforts to reduce behavioral health disparities and advance behavioral health equity. The term ‘community defined evidence practice’ derives from what a community considers healing as well as their cultural, linguistic or traditional practices” The Office of Health Equity in the California Department of Public Health has invested significantly in these types of services through the California Reducing Disparities Project (CRDP) in order to build an evidence-based for their effectiveness.  

The Community-Defined Evidence Practice (CDEP) Integration Advisory Group brought together diverse stakeholders including community-based organizations, local public health officials, and state department officials to develop and shape these policy recommendations for these innovative behavioral health strategies.  

Policymakers must act on these opportunities to address and take into account the numerous systemic barriers communities of color and LGBTQ+ communities face in accessing adequate mental and behavioral health programs. Barriers like structural racism, language, lack of understanding around cultural needs, microaggressions and implicit bias, and stigma exist. CDEPs are successfully providing behavioral health interventions outside of the mainstream medical model, and must be taken into consideration and funded and resourced to address inequity. 

The policy recommendations include:  

  1. Facilitate relationships and partnership between county and health plan leadership and community based behavioral health providers. Stronger linkages between organizations implementing community defined evidence practices (CDEPs), counties, health plans and providers are needed in order to increase awareness and access to the full continuum of behavioral health services (including access to CDEPs) for referring clinicians, schools, peer specialists, local community-based organizations, managed care providers, county providers, and consumers. 
  2. Make Medi-Cal reforms, including the California Advancing and Innovating Medi-Cal (CalAIM) framework, more flexible to allow for the addition of community-defined evidence practices (CDEPs) to the suite of outpatient behavioral health services available to BIPOC and LGBTQ+ Medi-Cal consumers. Despite individual actions and intentions, California’s health care system, as designed, often makes health outcomes worse for BIPOC and LGBTQ+ communities by perpetuating the very inequities it seeks to address. For example, in 2014, California implemented portions of the Affordable Care Act that expanded the range of behavioral health services available to adult Medi-Cal enrollees in both fee-for-service and Medi-Cal managed care. 
  3. Advocate for the State and local agencies to conduct internal audits of exclusionary practices and create action plans to drive internal change and accountability. There is a clear need for California to develop a plan to educate counties, Medi-Cal managed care plans, the dominant culture, and state agencies on examples of systemic racism. Since the onset of the COVID-19 pandemic, the nation has witnessed how the brunt of the COVID-19 pandemic has fallen on BIPOC and LGBTQ+ communities. As a result, cities and counties across the country have been making declarations on racism as a public health emergency or crisis. The imperative to address systemic inequities is urgent, particularly against the backdrop of COVID-19 disparities, continued violence against BIPOC and LGBTQ+ communities, and protests against anti-Black racism sparked by the murder of George Floyd. Behavioral health leaders around the country have spoken out on the connection between racism and behavioral health. 
  4. Leverage the Mental Health Services Act and Medi-Cal, with some modifications, to build toward broader structural reform. Although the Mental Health Services Act (MHSA) pays for access to community-defined evidence practices (CDEPs), this dedicated funding stream could be improved to better suit the needs of BIPOC and LGBTQ+ communities. CDEPs should be a customary benefit or service under the MHSA or the Medi-Cal program. 

More about the California Reducing Disparities Project: 

The California Reducing Disparities Project (CRDP) is a first of its kind, PEI (Prevention and Early Intervention) initiative funded by the Mental Health Services Act (MHSA, or Proposition 63). This statewide initiative aims to pair community driven mental health solutions with rigorous data for each of the 35 pilot projects. In doing this, the data and evaluation works to identify solutions for the communities in California that have historically been underserved, excluded, and offered inappropriate care.