Date: Thursday, March 12, 2026

Time: 10 a.m. – 2 p.m.

Type of Meeting: Hybrid

Members Present: 13

Public Attendees: 96

DHCS Staff Presenters: Michelle Baass, Director; Pamela Riley, MD, MPH, Assistant Deputy Director and Chief Health Equity Officer, Quality and Population Health Management; Autumn Boylan, Deputy Director, Office of Strategic Partnerships; Joshua Armstrong, MPA, Supervisor I, Office of Strategic Partnerships, School-Based Services Branch; Punreep Sahota, Associate Governmental Program Analyst, Population Health Management; David Tian, MD, MPP, Branch Chief, Clinical Population Health Care Management

External Presenters: Petra Steinbuchel, MD, Director, University of California, San Francisco, Cal-MAP

Additional Information: Please refer to the PowerPoint presentation used during the meeting for additional context and details. 

Member Attendance: 

• Nancy Netherland; Present; In Person
• Michael Weiss, M.D.; Present; Virtual
• Ellen Beck, M.D.; Present; Virtual
• Elizabeth Stanley Salazar; Present; Virtual
• Diana Vega; Present; Virtual
• Jeff Ribordy, MD, MPH, FAAP; Present; Virtual
• Karen Lauterbach; Present; In Person
• Kenneth Hempstead, M.D.; Not Present
• William Arroyo, M.D.; Present; Virtual
• Ron DiLuigi; Not Present
• Lesley Latham, D.D.S., MS; Present; Virtual
• Alison Beier; Present; Virtual
• Jovan Salama Jacobs, Ed.D; Present; In Person
• Kelly Motadel, M.D.; Present; In Person
• Jan A. Schumann; Present; Virtual

Time	Topic
10:00 – 10:15	Welcome, Opening Comments, Roll Call, and Agenda
10:15 – 10:50	Director’s Update
10:50 – 11:35	California’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Review: Challenges and Opportunities to Improve Children’s Health Services
11:35 – 12:20	Children and Youth Behavioral Health Initiative (CYBHI) Fee Schedule Program Update
12:20 – 12:50	Break
12:50 – 1:35	The Newly Released California Children’s Services (CCS) Enhanced Care Management (ECM) Resource “Lessons from the Field: Delivering ECM for CCS Populations”
1:35 – 1:45	Public Comment
1:45 – 2:00	Final Comments and Adjourn

Welcome and Introductions

Type of Action: Action

Recommendation: Review and approve the November 6, 2025, meeting minutes.

• Presenter: Nancy Netherland, Chair, welcomed meeting participants and read the legislative charge for the advisory panel.

Materials/Attachments: MCHAP Meeting Minutes – November 6, 2025

Action: Approve the minutes from November 6, 2025

• Aye: 12 (Weiss, Netherland, Latham, Lauterbach, Jacobs, Motadel, Salazar, Beck, Vega, Arroyo, Beier, Schumann)
• Didn’t Vote: 1 (Ribordy)
• Members Absent: 2 (Hempstead, DiLuigi)
• Abstentions: 0

Motion Outcome: Passed

Director’s Update

Type of Action: Information

Presenter: Michelle Baass, Director

Discussion Topics:

• The Director provided an overview of the Governor’s proposed budget for fiscal year 2026-2027, emphasizing continued support for equitable access to quality health care and outlining major policy issues affecting DHCS programs. The presentation highlighted impacts from federal H.R. 1, including changes to Medi-Cal eligibility, new work and community engagement requirements, and projected shifts in enrollment. It also covered DHCS’ guiding principles for implementing H.R. 1, such as automating eligibility processes, improving communications, and enhancing training for county partners. Additional updates included the release of the revised Single Streamlined Application, upcoming changes to dental benefits for certain adults without satisfactory immigration status, and recent federal action affecting the Managed Care Organization Tax, which remains in place through the end of 2026.
• A member expressed appreciation for DHCS’ efforts to navigate the changes associated with H.R. 1 and suggested that improving access to case numbers could significantly reduce barriers for Medi-Cal members. The member explained that case numbers are often required to access systems, such as BenefitCal, yet members rarely have this information and, in some counties, the only way to obtain it is through call centers with long wait times. The member noted that case numbers already appear on certain materials, such as Electronic Benefits Transfer (EBT) cards and provider portals, and suggested exploring options to automate access to this information to help members understand issues, such as benefit interruptions. DHCS acknowledged the suggestion and noted it had not been raised previously.
• A member expressed concern about widespread fear and confusion in the community and sought clarification about upcoming changes for Medi-Cal members with certain immigration statuses, including when individuals currently receiving full‑scope Medi-Cal may transition to limited‑scope coverage, whether emergency and limited‑scope services will remain available, and how community workers, such as promotores and social workers, can access clear guidance or direct support. The member also asked if there is a dedicated helpline for those assisting members and acknowledged legislative efforts underway to preserve coverage. DHCS directed participants to its “What Medi‑Cal Members Need to Know” webpage, which outlines timelines for changes under both the state budget and H.R. 1. DHCS explained that federal changes affecting qualified non‑citizens, including asylees and refugees, take effect in October 2026 noted that decisions about whether these individuals remain in full‑scope Medi‑Cal are part of ongoing state budget deliberations. DHCS clarified that emergency and limited‑scope services for individuals without satisfactory immigration status will continue. Members were also encouraged to use the Coverage Ambassadors program to stay informed and access outreach materials. The member followed up to ask if individuals with serious health conditions, such as those undergoing chemotherapy, would receive any temporary continuity of care if they lose coverage. DHCS responded that under current rules, there is no required continuity period once an individual is disenrolled, and services end upon loss of Medi-Cal eligibility.
• A member asked if the budget details presented were based on the administration’s projected deficit and expressed concern about reports of a significantly larger shortfall from independent sources. The member also raised concerns about the proposal to eliminate the Medi-Cal community-based mobile crisis benefit by making it optional for counties, noting that this could lead to uneven access to crisis services, increased strain on emergency departments, and potential impacts on the 988 crisis response system. The member also requested clarification about what services the current mobile crisis benefit includes. DHCS responded that updated fiscal information would be available at the May Revision and, while not commenting on specific deficit figures, acknowledged significant fiscal challenges in the coming years. DHCS explained that the budget proposal would make community-based mobile crisis services an optional benefit and described it generally as a mobile response to behavioral health crises. The member reiterated concerns about how counties would manage these responsibilities if required to absorb additional costs. DHCS acknowledged the comment and noted that the proposal reflects the state’s broader fiscal situation.
• A member asked if DHCS had a plan to support individuals who may lose Medi-Cal coverage under the work and community engagement requirements or the six‑month redetermination process, noting that a large number of members are projected to be affected and referencing the successful post‑COVID redetermination transition process that helped some individuals obtain Covered California coverage. The member asked if similar assistance would be available for those who become ineligible. DHCS responded that individuals who lose Medi-Cal due to not meeting the work and community engagement requirements are not eligible under federal law to receive marketplace coverage, including through Covered California. DHCS clarified that this restriction does not apply to those who lose coverage as part of the six‑month redetermination process; for those individuals, if they qualify for Covered California, the standard automated transition process would occur.
• A member thanked DHCS for its collaborative work on H.R. 1 and efforts to protect uninterrupted coverage for members with unsatisfactory immigration status, and raised concerns about counties’ limited capacity to resolve member issues quickly, particularly during a period when many individuals may lose coverage due to administrative challenges. The member asked what proportion of the projected disenrollments (from approximately 233,000 to 1.4 million) might result from administrative barriers and suggested exploring a real‑time hotline to help resolve issues more efficiently. The member also shared a personal experience illustrating the value of mobile crisis teams, noting that trained, culturally concordant responders had successfully de‑escalated behavioral health crises involving their own family, in contrast to instances where law enforcement responses resulted in physical restraint and injury. The member expressed concern that making the mobile crisis benefit optional could reduce access to these services, particularly for individuals with intellectual and developmental disabilities who are at higher risk of adverse outcomes during crises, and emphasized the importance of creating opportunities for families to share the real‑world implications of such budget decisions.

California’s EPSDT Review: Challenges and Opportunities to Improve Children’s Health Services

Type of Action: Information

Presenter: Pamela Riley, MD, MPH, Assistant Deputy Director and Chief Health Equity Officer, Quality and Population Health Management

Discussion Topics:

• The presentation covered the California EPSDT desk review and highlighted statewide challenges and opportunities to strengthen preventive and primary care services for Medi-Cal children and youth. It covered such areas as foster care coordination, network access barriers in certain regions, delays in newborn enrollment, variability in well‑child visit performance, and the need for clearer family navigation support. The presentation also outlined recommendations from the federal Centers for Medicare & Medicaid Services (CMS), along with DHCS’ planned improvement efforts, including enhancing data quality, improving access through expanded provider hours, participating in quality improvement collaboratives, and showcasing the Medi-Cal for Kids and Teens outreach and provider training to help families better understand and use EPSDT services.
• A member sought clarification about the use of the term “Medi-Cal fee‑for‑service,” noting that not all foster youth are in fee‑for‑service and that those enrolled in managed care plans do receive care coordination and, when applicable, Whole Child Model services. The member expressed concern about reported data showing that 17 percent of infants under age 1 had no well‑child visits, stating that this figure seems unusually high and is likely the result of data capture limitations, particularly for infants whose early visits occurred before they were assigned their own Medi-Cal. The member also questioned the wait times for accessing primary care, observing that even in expansive or frontier regions, long wait times are more commonly associated with specialty care rather than primary care. The member explained that previous data gaps caused undercounting of early well‑child visits, and that improved methods for capturing provider‑reported visits significantly increased their reported rates. DHCS acknowledged the member’s points and noted that these concerns aligned with DHCS’ own reactions when reviewing the findings. DHCS clarified that while foster youth are not exclusively in fee‑for‑service, the findings point to opportunities to improve their experience across both delivery systems. DHCS agreed that the 17 percent figure is likely driven by data capture issues and emphasized that such indicators help identify where further analysis, improvements in access, or enhancements to data collection may be needed.
• A member thanked DHCS for the thorough presentation and shared that delays in newborn Medi-Cal enrollment may contribute to missing early well‑child visit data, noting that infants are often initially covered under their mother’s insurance and may not be enrolled in Medi-Cal until weeks after birth, even in hospital settings, such as the neonatal intensive care unit (NICU). The member emphasized the importance of identifying opportunities to enroll newborns earlier and suggested leveraging managed care plan case managers, who already contact families after hospitalizations, to support enrollment. The member also raised vaccine hesitancy as a potential factor influencing early well‑child visit rates. DHCS agreed that these issues reflect the challenges the state is aiming to address, stating that delayed or incomplete capture of newborn data is a known barrier and that this work is being examined through the CMS affinity group, which is focused on improving enrollment processes, data capture, and coordination with managed care plans. The member added that providers who see newborns under the mother’s coverage may be able to help collect data earlier.
• A member thanked DHCS for the report and asked if data is available for foster youth identified as high‑risk. DHCS explained that this information is not yet available, but that work is underway to better identify and analyze the foster youth population served across different systems. The member noted that foster youth consistently face poorer outcomes in education, including lower academic performance and higher chronic absenteeism, and expressed concern that similar disparities likely affect their health and access to services. The member asked when information on improvement opportunities, particularly those involving collaboration with the California Department of Social Services, would be released. DHCS responded that work with the California Department of Social Services is ongoing and that the state is still determining next steps after reviewing recent federal findings.
• A member thanked DHCS for the presentation and expressed concern about the reported 17 percent of infants receiving no well‑child visits, asking whether additional geographic or demographic details were available to help understand the finding. DHCS explained that the data was presented in aggregate by CMS and is not currently broken down by geography or demographics, noting that the figure is being treated as an indicator prompting further examination rather than a definitive measure of unmet care. DHCS emphasized the need to determine whether the issue reflects true gaps in care or limitations in enrollment and data capture. The member agreed and suggested that analyzing geographic or demographic patterns could help identify whether the issue is concentrated in specific areas or systems and therefore more likely tied to data challenges. The member also noted that vaccine hesitancy may affect early well‑child visit rates and recommended leveraging promotores and community health workers to help identify and engage families if access or education is contributing to the problem.
• A member thanked DHCS for the presentation and focused on the importance of improving newborn enrollment, suggesting that hospital staff may assume newborns are fully covered under their mother’s insurance for the first three months and may not realize that separate Medi-Cal enrollment is required, leading to delays. The member recommended providing education to hospital teams and exploring opportunities for in‑hospital enrollment support, including prenatal or pre‑delivery visits when families may be more receptive to information. The member also suggested leveraging doulas, who now receive Medi-Cal reimbursement, as well as promotores and other community health workers, to reinforce the importance of timely newborn enrollment and to support families postpartum. The member further noted the value of school‑based programs and peer educators for engaging adolescents. DHCS agreed that these are important considerations and confirmed that identifying hospital‑level and plan‑level opportunities to support earlier enrollment is part of the improvement work underway through the CMS affinity group.
• A member thanked DHCS for the presentation and expressed concern that children in foster care consistently experience poor outcomes across multiple systems, including education and health. The member asked whether DHCS had data on the percentage of foster youth enrolled in managed care versus fee‑for‑service, noting that this information could inform strategies to improve access and coordination. The member also asked if DHCS is examining other states that perform better in supporting foster youth for potential lessons learned, and raised broader concerns about federal public health funding cuts and whether the reduction of public health clinic capacity could affect the EPSDT benefit in California. DHCS responded that it has not yet conducted a full analysis of foster youth enrollment across delivery systems, but noted that, as of 2024, approximately 55 percent were in managed care and 45 percent in fee‑for‑service. DHCS explained that collaboration with the California Department of Social Services is important because that department oversees coordination for foster youth and former foster youth. Lastly, DHCS stated that it has not yet explored comparative analyses with other states, but agreed it’s an important suggestion.
• A member, speaking as a foster parent and adoptive parent of children with special health needs, shared their perspective on the challenges foster youth face in both fee‑for‑service and managed care systems. The member noted that cross‑stakeholder groups, including a foster youth health task force and a workgroup led by Jim Cooler, have developed recommendations on improving care for foster youth, including lessons drawn from other states, and offered to share these resources with DHCS. The member also highlighted the work of a San Francisco Department of Public Health physician who has contributed innovative ideas in this area. In addition, the member encouraged DHCS to consider partnering with California’s network of family resource centers and Family Voices of California to support family engagement, navigation, and dissemination of information.
• A member shared that foster caregivers are expected to ensure children receive required services, but the process can be confusing, and paperwork does not always clearly connect to where information is ultimately routed. The member noted that foster parents vary widely in their experience with Medi-Cal, and many are navigating the system for the first time while also adapting to the responsibilities of caregiving, which can create gaps in accessing needed services. The member emphasized that most caregivers want to support children effectively, but may need more guidance and support to do so and offered to share personal experiences that illustrate these challenges. DHCS thanked the member for their input and emphasized the importance of incorporating caregiver perspectives into improvement efforts.

Children and Youth Behavioral Health Initiative (CYBHI) Fee Schedule Program Update

Type of Action: Information

Presenter: Autumn Boylan, Deputy Director, Office of Strategic Partnerships; Joshua Armstrong, MPA, Supervisor I, Office of Strategic Partnerships, School-Based Services Branch

Discussion Topics:

• The CYBHI Fee Schedule program update highlighted the significant growth in program participation and activity, including increases in the number of Local Educational Agencies (LEA) and Institutions of Higher Education (IHE) submitting claims, the volume of claims paid, and the number of students served. The presentation outlined key program updates, such as finalized participation and data‑use agreements, program onboarding materials, updates to the program manual, and the approved State Plan Amendments (SPA) that expand eligible provider types and reimbursable services. It also provided information on new resources developed for parents, caregivers, and community providers, as well as guidance to support compliance with federal privacy laws in school‑based behavioral health settings. Finally, DHCS shared information from a working group meeting held on March 18, 2026, to gather input from educational partners, managed care plans, and behavioral health providers to support continued implementation and improvement of the program.
• A member asked if any data were available on the types of school‑based interventions being delivered through the CYBHI Fee Schedule program, including diagnoses, services provided, and any early outcomes. DHCS explained that claims data received from the third‑party administrator includes diagnosis codes, but in school settings most services are preventive and do not require a diagnosis, resulting in many claims using non‑diagnostic Z codes. DHCS noted that billing practices among school districts are still developing, meaning current claims may not fully reflect all services being provided. DHCS shared that an external evaluator, Mathematica, is assessing the program as part of a broader CYBHI evaluation, with upcoming county profiles and a Fee Schedule Spotlight Report expected to provide early insights into service patterns. DHCS added that the evaluation will also examine broader initiative outcomes, such as trends in behavioral health indicators, and that as more data become available, DHCS will continue working on technical assistance, monitoring, and public reporting to better understand service delivery and impact.
• A member praised the ambition of the CYBHI Fee Schedule program and noted strong national interest in California’s progress. They then asked several questions about the types of services being delivered in schools, support for youth with substance use disorders, the extent to which alternative and nontraditional school settings are being reached, and if recent federal updates to 42 Code of Federal Regulations (CFR) Part 2 might affect data‑sharing considerations alongside the Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA). The member also emphasized the need to understand service penetration for students with high behavioral health needs, including those with substance use disorders and those in alternative school environments. DHCS responded that services billed through the Fee Schedule program primarily align with non‑specialty mental health benefits, including psychoeducation, screening and assessment, preventive counseling, psychotherapy, dyadic services, crisis intervention, community health worker services, and certified wellness coach services. DHCS explained that schools typically rely on non‑diagnostic Z codes due to the preventive nature of services and the scope of practice of school‑based personnel, and that early billing patterns do not yet fully reflect all services being delivered. DHCS noted that limited substance use-related services, such as screening, brief intervention, and referral to treatment, are included in the benefit and that schools coordinate with county behavioral health agencies when a higher level care is needed. DHCS also confirmed that alternative and court schools are within the scope of the Fee Schedule program, with work underway to clarify referral pathways and ensure students requiring county‑level services are appropriately connected. DHCS added that broader evaluation efforts through Mathematica will provide additional insights on service patterns and outcomes, and acknowledged the relevance of recent federal updates to 42 CFR Part 2, noting that DHCS is incorporating this into related data‑sharing guidance.
• A member asked how school‑based mental health initiatives under the CYBHI might affect the “child find” process for identifying students with disabilities under the Individuals with Disabilities Education Act, and how school districts provide and communicate about mental health services, including the role of parents. DHCS explained that the initiative’s Fee Schedule program excludes services required under an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP) because school districts are responsible for those services, and managed care plans do not reimburse for them. DHCS clarified that if mental health services are included in a student’s plan due to a disability‑related need, they are not reimbursable under the Fee Schedule program, but may be reimbursed through the LEA Billing Option Program. Initial behavioral health assessments, however, may be reimbursed through the Fee Schedule if a plan has not yet been established. DHCS also explained that parental consent remains required under federal law, including FERPA, regardless of whether services are linked to a plan, with school districts responsible for obtaining consent through existing procedures. When the member asked if districts might bypass required assessments by providing services through the initiative, DHCS responded that it does not anticipate this occurring, but noted that oversight of the child find process falls outside the scope of the Fee Schedule program.
• A member expressed appreciation for the CYBHI Fee Schedule program and shared a positive experience in which their child’s guidance counselor promptly recognized a mental health need and quickly connected the family to school‑based supports, demonstrating strong coordination and timely follow‑up. The member noted that the school district’s partnership with outside organizations enabled rapid outreach and assessment, and highlighted this as an example of the initiative functioning effectively at the local level. DHCS responded that while it cannot take credit for the actions of individual school districts, many districts are partnering with organizations that help facilitate care coordination and connections to services, and DHCS has established pathways within the program to ensure those providers can receive reimbursement when working with schools to support students.
• A member thanked DHCS for the information and asked how many of the 129 participating education entities were school districts versus other types of institutions. DHCS explained that the large majority are school districts, with a smaller number of universities and school‑affiliated providers submitting claims. The member then asked whether charter schools are considered LEAs, and DHCS confirmed that they are included under state statute and that some charter schools are already participating. The member also asked if DHCS had observed regional patterns in participation. DHCS responded that all 58 county offices of education received grant funding to support implementation, and that school districts of various sizes across the state are participating, including through consortia models that help small or rural districts manage administrative requirements. DHCS highlighted ongoing communities of practice, office hours, and technical assistance to support implementation. The member then referenced earlier discussion regarding IEPs and noted the complexity schools face in determining when mental health services fall under special education responsibilities versus the Fee Schedule program. DHCS agreed that these distinctions can be complicated and explained the state aims to apply the statute as flexibly as possible so schools can receive reimbursement for appropriate services while ensuring that students receive needed care and that IEP determinations are made properly, neither avoided nor overused solely for funding reasons.
• A member thanked DHCS for its work to expand school‑based behavioral health services and emphasized the importance of ensuring that students with IEPs continue to receive appropriate support, noting that many students with the highest needs are those with existing plans. The member expressed appreciation that family therapy is included as a covered service and asked how colleges or universities interested in participating could connect with DHCS. DHCS responded that interested institutions may contact the program through its dedicated email address or by reaching out directly for connection to the appropriate team. DHCS added that although services required under an IEP cannot be reimbursed through the Fee Schedule program, the program provides an additional revenue source for schools, which can help free up local funds to better support students whose services fall outside the program’s reimbursable scope. DHCS also noted that the program’s design aims to help schools balance responsibilities across all tiers of student support, and that impacts will continue to evolve as state and local budgets change.
• A member thanked DHCS for its work and emphasized that students with IEPs often have significant mental health needs that directly affect their learning and emotional well‑being, noting this as the reason for concerns about ensuring comprehensive assessments for students who already qualify for services. The member reiterated appreciation for the ongoing attention to this issue. DHCS agreed and stated that it will continue to push boundaries as much as possible to ensure student needs are met, emphasizing that supporting students remains the top priority.

The Newly Released CCS ECM Resource “Lessons from the Field: Delivering ECM for CCS Populations”

Type of Action: Information

Presenter: Punreep Sahota, Associate Governmental Program Analyst, Population Health Management Division

Discussion Topics:

• The presentation introduced a new resource designed to support the delivery of ECM for children and youth enrolled in CCS, describing the state’s commitment to sustaining and strengthening the benefit as part of ongoing Medi-Cal transformation efforts. It summarized current enrollment trends showing that only a small portion of eligible children are receiving ECM and described the feedback gathered from providers and stakeholders about the need for clearer guidance, stronger referral pathways, and better alignment with existing case management programs. The update discussed common implementation challenges, including uncertainty about eligibility, limited awareness of the benefit, and the need to expand provider training and competencies. It also previewed key components of the technical assistance resource. Finally, the presentation outlined ways that provider organizations can use the resource and noted that additional implementation supports are planned.
• A member asked what type of support ECM provides to families pursuing conservatorship, as well as how CCS assists youth transitioning into adulthood. DHCS explained that ECM focuses on helping families navigate systems and access necessary resources rather than serving as experts in the conservatorship process, though providers working with the CCS population are generally more familiar with the steps involved. DHCS added that managed care plans have an important role in coordinating care as youth age into adult services, recognizing that access to adult specialists may be limited in some areas. ECM providers, working together with families, managed care plans, and CCS case managers, help identify providers and support a smooth transition. The member then asked when transition planning should begin and how needs, such as applying for Supplemental Security Income, conservatorship, or establishing power of attorney, are addressed. DHCS responded that early planning is essential and that timelines vary based on the child’s needs, with collaboration among ECM providers, CCS case managers, medical providers, and care teams guiding the process.
• A member shared that their family’s experience with ECM for a child enrolled in CCS has been challenging and noted that families currently have limited avenues to provide feedback outside of the grievance process and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, which may not fully capture the experiences of those receiving services. The member emphasized the importance of including direct member perspectives to improve the program and offered to support efforts to bring those voices forward. DHCS acknowledged the value of this feedback and agreed that member input is essential to understanding engagement and outcomes. DHCS noted that it is actively discussing how to more effectively gather member feedback at both the state and local levels, and encouraged families to contact DHCS when they are unable to resolve issues through their managed care plan. DHCS added that it is committed to developing more sustainable and meaningful ways to incorporate member experience into ongoing improvements to the ECM program.
• A member noted that their organization, which represents hospitals and manages a large population of children enrolled in CCS through a Whole Child Model county, faces challenges determining the added value of ECM when Whole Child Model programs already provide comprehensive care management, including support with housing, food insecurity, and other needs. The member explained that because health networks in these counties may also serve as ECM providers, families can end up with duplicative services, multiple care coordinators, and unclear benefit distinctions, making it difficult to determine whether participation in ECM meaningfully improves patient experience or outcomes. The member asked DHCS to consider a side‑by‑side comparison of what ECM offers relative to the Whole Child Model to help clarify roles and avoid unnecessary overlap. DHCS acknowledged this feedback and asked if the organization had discussed potential funding alignment with its managed care plan, noting that the Whole Child Model’s robust case management structure may extend beyond traditional CCS responsibilities. The member confirmed that funding exists, but reiterated that the core concern is ensuring that services are not duplicative and that care remains centered on patient needs. DHCS thanked the member and agreed that better integration between ECM and the Whole Child Model is an important goal, noting that DHCS intends for Whole Child Model care managers to serve as ECM providers where appropriate to better align the two programs.
• A member expressed appreciation for DHCS’ work and emphasized the importance of incorporating the perspectives of older youth, particularly those ages 18 to 21, as they prepare to transition from childhood to adulthood. The member noted that national models exist in which care teams support young people through this transition and continue providing continuity of care, and shared past clinical experience demonstrating the value of providers who serve patients across all ages. The member encouraged DHCS and ECM providers to consider how transition support can be strengthened so that young people with significant medical needs are not simply handed off, but are guided by a coordinated team that bridges pediatric and adult care.
• A member explained that their organization already provides extensive care coordination, including transportation, early transition planning beginning at age 11, and support across multiple service needs. The member noted that ECM capacity in rural counties is limited and that many ECM providers lack familiarity with CCS, making it difficult for them to coordinate complex specialty appointments. As a result, the plan has seen little added benefit from ECM for CCS members and very low enrollment, especially given the risk of duplicative case management. DHCS thanked the member for the feedback and acknowledged that ECM should not create unnecessary overlap or second care managers when Whole Child Model programs already provide robust services. DHCS affirmed that ECM is intended to be a complementary, optional benefit and agreed that the unique needs of medically complex children require ECM providers with appropriate expertise. DHCS stated that it will take this feedback into account, especially for Whole Child Model and rural counties, and emphasized that ECM provider networks should be strengthened to better support the CCS population.

Public Comment

Type of Action: Public Comment

Discussion Topics:

• Doug Major from the California Children’s Vision Coalition expressed concern about the lack of access to vision care in California, noting that the state remains the lowest‑ranked nationally in children’s vision services. He emphasized that although EPSDT requires vision screening at every well‑child visit and coverage for basic services, such as eyeglasses, many children receive no care due to the absence of public health metrics and reporting for vision services. He highlighted AB 2756 as a proposed solution to support DHCS in collecting and sharing existing claims data with managed care plans so they can identify gaps and improve children’s vision outcomes. Major described recent school‑based screenings in communities with high unmet need, where untreated vision problems correlate with lower academic performance, and underscored that many of these disparities persist in areas where local vision programs have collapsed. He urged DHCS and the advisory group to support and refine AB 2756 to help ensure that vision care data is available and actionable, emphasizing that behind each data point are real children whose education and wellbeing are affected.
• Kristine Shultz from the California Optometric Association shared new data, developed in partnership with Children Now, showing significant gaps in vision services for children enrolled in Medi-Cal. She explained that a recent public information request revealed that only 16 percent of children statewide received any eye care service over a two‑year period from 2022 to 2024, with many counties reporting utilization in the single digits. She noted that this represents a decline from a similar analysis conducted a decade ago, which found a 19 percent utilization rate, despite the fact that at least one in four children has a vision problem. She emphasized that this low rate of care means many children with vision issues are likely going undiagnosed and untreated. In response, she noted that the California Optometric Association is sponsoring AB 2756 to strengthen oversight, improve accountability, and expand access to vision care. The bill would improve data tracking to monitor timely exams and eyeglasses, require reporting of vision‑related complaints from all sources, and establish performance measures to drive improvement. She encouraged DHCS and individuals participating in the meeting to consider supporting AB 2756 to help ensure that no child struggles in school because they cannot see.

Member Updates

Type of Action: Information

Discussion Topics:

• A member noted that a Commission on the Future of Medi-Cal had been established late the previous year and suggested that, given the advisory panel’s role, it might be valuable to receive a presentation from the commission at a future meeting. DHCS clarified that the commission was not convened by the Governor, but by the California Health Care Foundation and is, therefore, an external, independent body. When the member asked whether there was any connection between DHCS and the commission, DHCS confirmed that the Department is not participating in the effort.

Upcoming MCHAP Meeting and Next Steps

Type of Action: Information

Presenter: Nancy Netherland, Chair

Discussion Topics:

• Nancy thanked members for attending the meeting.
• The next meeting is scheduled for June 11, 2026.
• MCHAP will continue to be a hybrid meeting until further notice.

Adjournment of Meeting

Name of person who adjourned the meeting: Nancy Netherland

Time Adjourned: 2 p.m.