CalAIM Workgroups
DHCS established five topic-specific stakeholder workgroups to further explore specific sections of the CalAIM proposal. With the exception of the Full Integration Plan and Foster Care Model of Care Workgroups, the workgroup process has now ended.
The five workgroups listed below met from November 2019- February 2020:
- Population Health Management and Managed Care Plan Annual Enrollment;
- Enhanced Care Management and In Lieu of Services;
- Behavioral Health/Behavioral Health Payment Reform;
- Full Integration Pilots; and
- NCQA Accreditation.
This workgroup will provide input on the proposal to require Medi-Cal managed care plans to develop and maintain population health management strategies and provide input on the proposal to implement annual Medi-Cal health plan open enrollment.
This workgroup will provide input on the proposal to implement an enhanced care management benefit statewide and incorporate “in lieu of” services as part of the Medi-Cal managed care plan population health management strategies.
This workgroup will provide input on the proposal to integrate county-level mental health and substance use disorder (SUD) programs under a single contract; proposed revisions to the medical necessity criteria for behavioral health services; and, the possibility of pursuing the mental health IMD waiver opportunity. A sub-workgroup will provide input on proposed changes to the reimbursement structure of county-level mental health and SUD services.
This workgroup will discuss the full integration of physical health, behavioral health, and oral health under one entity.
This workgroup will provide input on the proposal to require Medi-Cal managed care plans to obtain NCQA accreditation and feedback on the NCQA Medicaid module, the long-term services and supports distinction survey, and accreditation deeming policies.