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 WPC City Amendment and Second Round of Pilot Applications
On June 1, 2017, 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 technical amendment enables the State to accept applications from and designate a city to be a lead entity for the WPC Pilot Program.
CMS Approval Letter for Amendment
On June 8, 2017, CMS also approved the second round of WPC pilot applications. CMS find the applications from the specific counties and city to be in accordance with the Medi-Cal 2020 Demonstration Special Terms and Conditions (STCs) and approval protocols for the WPC program. The approved pilots are listed in CMS' approval letter below.
CMS Approval Letter for Second Round of Pilot Applications
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 conducted a second application process to expand current pilots and/or approve additional entities to operate WPC pilots.
- Current Medi-Cal 2020 Special Terms & Conditions - Refer to STCs 114-130 [pages 87-95] for information relevant to WPC
Publications & Reports
Whole Person Care Enrollment Data for Program Year 2017 - January to September 2017
Whole Person Care Enrollment Data for Program Year 2017 - January to December 2017
*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