Whole Person Care Pilots
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The overarching goal of the Whole Person Care (WPC) Pilots is the coordination of health, behavioral health, and social services, as applicable, in a patient-centered manner with the goals of improved beneficiary health and wellbeing through more efficient and effective use of resources. WPC Pilots will provide an option to a county, a city and county, a health or hospital authority, or a consortium of any of the above entities serving a county or region consisting of more than one county, or a health authority, to receive support to integrate care for a particularly vulnerable group of Medi-Cal beneficiaries who have been identified as high users of multiple systems and continue to have poor health outcomes. Through collaborative leadership and systematic coordination among public and private entities, WPC Pilot entities will identify target populations, share data between systems, coordinate care real time, and evaluate individual and population progress – all with the goal of providing comprehensive coordinated care for the beneficiary resulting in better health outcomes.
CMS Approval of Whole Person Care Waiver Amendment
On December 8, 2016, the Centers for Medicare and Medicaid Services (CMS) approved an amendment to the Special Terms and Conditions of California's Medi-Cal 2020 Demonstration for the WPC pilots program. The amendment allows Federally Recognized Tribes and Tribal Health Programs to act in a lead entity role in the design, application, and operation of a WPC pilot program. The addition of these entities promotes the intent and goals of the WPC program in California.
CMS Approval Letter
DHCS Releases Whole Person Care Draft Evaluation Design
On November 7, 2016, the Department of Health Care Services (DHCS) submitted the Draft Evaluation Design for the Whole Person Care program to CMS as required by Special Terms and Conditions section 211 of California's Medi-Cal 2020 Demonstration. DHCS invites the public to provide comments on the draft evaluation design concurrently with CMS' review. Please send all questions or comments to 1115WholePersonCare@dhcs.ca.gov.
Whole Person Care Draft Evaluation Design
Cover Letter to CMS
Notice of Public Comments
Resources and Information
In 2016, DHCS completed a first round WPC application process and approved 18 lead entities to operate WPC pilots.
In early 2017, DHCS will conduct a second application process to expand current pilots and/or approve additional entities to operate WPC pilots.
- Current Medi-Cal 2020 Special Terms & Conditions (STCs) - Refer to STCs 110-126 [pages 80-88] for information relevant to WPC
*Please note that the Budget Summary Templates and Samples are ADA-compliant documents, which have limited functionality due to certain modifications. Please send a request to the WPC Program Inbox at 1115WholePersonCare@dhcs.ca.gov to receive the fully-functional version of the template and sample.
Past Stakeholder Webinars
Please direct your comments, questions or suggestions regarding the Whole Person Care Pilots to the following email address: 1115WholePersonCare@dhcs.ca.gov