UCSF, DHCS Partner on $17M Investment in Behavioral Health Support
UC San Francisco and the California Department of Health Care Services (DHCS) are partnering on a $17 million program to expand access to behavioral health support for parents and children statewide.
The program employs dyadic care, which enables health providers to treat children and caregivers together in pediatric primary care settings. During routine visits, clinicians address behavioral health needs such as child development, caregiver well-being, and family stress.
The Scaling Dyadic Care Grant Program is funding the program, which is part of California’s Children and Youth Behavioral Health Initiative (CYBHI) to improve how children, youth, and families access behavioral health services and support. Dyadic care was adopted by DHCS in 2023 as a Medi-Cal benefit.
Piloted by a UCSF team at Zuckerberg San Francisco General Hospital (ZSFG) six years ago in partnership with local Medi-Cal managed care plans, San Francisco Health Plan and Anthem, the dyadic care program targets a gap in preventive behavioral health care services and now reaches 40% of eligible families at the ZSFG Children’s Health Center.
Translating lessons directly from this innovative ZSFG clinical practice, the UCSF Center for Advancing Dyadic Care in Pediatrics (CADP) partners with clinicians to develop and disseminate best practices to early adopters outside San Francisco. The new state investment will enable CADP to support provider sites to adopt and scale the dyadic care model across California.
“With 13 routine visits in the first three years of life, pediatric primary care represents a unique opportunity to identify challenges earlier and help families build a healthier foundation for the years ahead,” said Kate Margolis, PhD, UCSF professor, CADP director, and director of the Division of Integrated Behavioral Health at the ZSFG Department of Psychiatry and Behavioral Sciences.
The statewide effort builds upon a decade of collaboration among the UCSF Departments of Psychiatry and Behavioral Sciences and Pediatrics, ZSFG’s Children’s Health Center, and the San Francisco Health Network, the city’s public health care system. This collaboration predates the new DHCS investment.
“Infant development depends on the environments in which they grow up, making the health and well-being of infant parents and caregivers vitally important,” said Margolis. “Supporting caregivers of young children is an urgent population health need and an important strategy for advancing child health equity.”
Overcoming barriers to behavioral health
For many families, a child’s pediatrician is one of their most trusted and consistent connections to the health care system. Dyadic care uses well-child visits to identify concerns that might otherwise go untreated.
That can be particularly important for families who face barriers to accessing and navigating behavioral health care.
“Rather than asking caregivers to navigate another system or make another appointment, dyadic care brings support into a setting that families already know and use. When needed, they can also make direct connections to ongoing care,” Margolis said, since dyadic care complements — and does not replace — individual behavioral health services when they are needed.
The longstanding partnership between UCSF and the ZSFG Children’s Health Center has provided a real-world setting for developing and testing ways to integrate dyadic care into everyday clinical practice. UCSF researchers contribute expertise in behavioral health prevention science and Medicaid policy and financing, while ZSFG clinicians bring experience caring for families in San Francisco’s public health care system. Feedback from patients, families and clinicians has helped refine the model and develop tools that can be adopted by other health care organizations.
For example, UCSF helped develop new forms of electronic medical record documentation, which has proven essential for incorporating new models of care into clinical practice. When standardized documentation for dyadic care did not exist, CADP translated guidance from DHCS policy into usable templates that clinicians used during patient visits. The Children’s Health Center piloted and refined the templates before UCSF made them available to other practices. They are now being used in electronic medical records at sites across California.
“Over the past decade at ZSFG, we’ve learned that meaningful innovation has to work not just in theory, but in reality for families, clinicians, and the health systems that support them,” said Shonul Jain, MD, UCSF professor and vice chair of pediatrics at ZSFG. “Now we are ready to share those lessons across the state.”