Behavioral Health

CenCal Health members who have mental health symptoms that are not affecting their daily life majorly, such as depression or anxiety, can get services with a CenCal Health-contracted mental health provider. CenCal Health covers these services:

• Individual, family or group therapy provided by a Licensed Clinical Social Worker, Licensed Marriage and Family Therapist, Licensed Professional Clinical Counselor or Licensed Psychologist. Treatment sessions will usually be 1x/week or bi-weekly or monthly, depending on the recommendation of the treatment provider. Services are available either in-office or via telehealth. For these services you do not need a referral from your PCP.
• Psychiatric medication management services provided by a Psychiatrist or Psychiatric Nurse Practitioner or Physician’s Assistant. Treatment services initially may be weekly or bi-weekly but usually are every 3 -6 months and are available either in-office or via telehealth. For these services you do not need a referral from your PCP.
• Psychological testing with a Clinical Psychologist to diagnose certain conditions and make treatment recommendations. An example will be if you are concerned that your child may have Autism Spectrum Disorder. These services require a referral from your PCP or existing mental health provider.
• Neurological Testing with a Neuropsychologist to assess for certain medical or cognitive conditions i.e. Alzheimer’s, Traumatic Brain Injury. These services require a referral from your PCP or mental health provider.

The mental health services covered by CenCal Health is available for treatment purposes only. Medi-Cal does not cover evaluation services focused on educational needs or custody disputes.

To access psychotherapy or medication management services, please call our Member Services at 1-877-814-1861 or review our mental health provider list to find a provider and contact them to set-up an initial appointment.

Specialty mental health services

Some mental health services are provided by county mental health plans instead of CenCal Health. These include specialty mental health services (SMHS) for Medi-Cal members who meet medical necessity rules. SMHS may include these outpatient, residential, and inpatient services:

Outpatient services:

• Mental health services (assessments, plan development, therapy, rehabilitation and collateral)
• Medication support services
• Day treatment intensive services
• Day rehabilitation services
• Crisis intervention services
• Crisis stabilization services
• Targeted case management services
• Therapeutic behavioral services (covered for members under 21 years old)
• Intensive care coordination (ICC) (covered for members under 21 years old)
• Intensive home-based services (IHBS) (covered for members under 21 years old)
• Therapeutic foster care (TFC) (covered for members under 21 years old

Residential services:

• Adult residential treatment services
• Crisis residential treatment services

Inpatient services:

• Acute psychiatric inpatient hospital services
• Psychiatric inpatient hospital professional services
• Psychiatric health facility services

To contact County Mental Health services:

Santa Barbara County: 1-888-868-1649
San Luis Obispo County: 1-800-838-1381

CenCal Health covers Behavioral Health Treatment services under Ealy and Periodic Screening, Diagnostic, and Treatment Benefit for children under the age of 21 when medically necessary

Members may be eligible if the following criteria is met:

• Under 21 years of age
• Have a recommendation from a licensed physician, surgeon or psychologist
• Are medically stable
• Do not need for 24-hour medical/nursing monitoring or procedures provided in a hospital or intermediate care facility

Behavioral Health Treatment services teach skills using behavioral observation and reinforcement, or through prompting to teach each step of targeted behavior. BHT services are based on reliable evidence. Treatment may or may not include Applied Behavioral Analysis (ABA).

ABA treatment can help:

• Increase language
• Improve attention, focus, social skills and cooperative behaviors
• Decrease problem behaviors

ABA services must be recommended by a Physician, Psychologist or Surgeon.

Please contact your child’s pediatrician or other treatment providers to request a referral for ABA services.

To learn more about ABA services, please call Member Services at (877) 814-1861.

CenCal Health members who are concerned about alcohol and substance use problems can talk with their primary care provider (PCP). Their PCP can provide education and referrals, and may help manage withdrawal symptoms for certain substances. County Alcohol and Drug Services provides an many alcohol and substance use services to CenCal Health members, including:

• Outpatient and Intensive Outpatient Treatment Services
• Residential Treatment Services
• Medication Assisted Treatment (MAT) for management of Opioid Dependence

For Alcohol and Drug services in Santa Barbara call, 1-888-868-1649. For drug and alcohol services in San Luis Obispo County call 1-800-838-1381. For more information for alcohol and drug services provided by County Behavioral Health, click on the links below.

• Santa Barbara County
• San Luis Obispo County