Frequently Asked Questions​

How will DHCS measure and evaluate member-reported outcomes associated with EBPs?

DHCS recognizes that member-reported data is essential to understanding if EBPs are effectively supporting the recovery of participating members. The EBP Training and Fidelity Manual includes an overview of data collection requirements for ACT, FACT, CSC and IPS. DHCS will use outcomes data to identify how EBPs are impacting member care and will reward counties for improving outcomes associated with EBPs through the Access, Reform and Outcomes Incentive Program.​​

My county has limited workforce availability to implement EBPs. Is there any flexibility in the EBPs to account for small population size and workforce constraints?

DHCS and the COEs will work with counties to support fidelity implementation of EBPs, recognizing that there are unique workforce and resource constraints in small counties and rural areas. The EBP Training and Fidelity Manual includes information about implementation standards in small counties and rural areas. Small counties with a population of <200,000 individuals may also apply for exemptions from fidelity implementation of ACT, FACT and/or IPS under BHSA policy.  In addition, DHCS encourages counties and behavioral health providers to utilize funding available through the BH-CONNECT Workforce Initiative​ to support the recruitment and retention of a robust behavioral health workforce.  

How do ECHW Services differ from other Medi-Cal CHW Services?

ECHW Services include the same service components as other Medi-Cal CHW Services and are provided by CHWs with the same qualifications. ECHW Services are specifically for Medi-Cal members who meet the access criteria for SMHS and/or DMC/DMC-ODS services. The ECHW Services benefit provides a mechanism for county behavioral health delivery systems to be paid for Medi-Cal-covered services provided by CHWs.

How do ECHW Services differ from Peer Support Services?

ECHW Services are distinct from Peer Support Services. Both ECHW Services and Peer Support Services are community-based interventions to support members living with significant behavioral health needs. CHWs are community members who typically act as a bridge between members and the healthcare system and provide system navigation and health education support. Peer Support Specialists, on the other hand, use their personal lived experience to support members in their recovery from a behavioral health condition and provide skill-building, coaching, and other therapeutic activities.

While both CHWs and Peer Support Specialists rely on their lived experience, lived experience is defined more broadly for CHWs. CHWs must have lived experience that aligns with and provides a connection between the CHW and the member or community being served. This may include, but is not limited to, experience related to incarceration, military service, pregnancy and birth, disability, foster system placement, homelessness, mental health conditions or substance use disorders, or being a survivor of domestic or intimate partner violence or abuse and exploitation. Lived experience may also include shared race, ethnicity, sexual orientation, gender identity, language, or cultural background with one or more linguistic, cultural, or other groups in the community for which the CHW is providing services. Peer Support Specialists must have lived experience specific to mental health and/or substance use disorder recovery. 

Peer Support Specialists who are separately trained and certified as CHWs may also provide ECHW Services to eligible members, and CHWs who are separately trained and certified as Peer Support Specialists may also provide Peer Support Services. In this scenario, the individual practitioner may provide only one service at a time and all applicable Medi-Cal policies for documentation and claiming of services must be observed.

What are the requirements to provide ECHW Services?

ECHW Services are delivered by practitioners that meet the following qualifications:  

• CHWs must have lived experience that aligns with and provides a connection between the CHW and the community being served.  
• CHWs must demonstrate minimum qualifications through the Certificate Pathway and/or Work Experience Pathway defined in SPA 24-0052.
• CHWs must complete a minimum of 6 hours of continuing education training annually.
• CHWs must be supervised by a Medi-Cal-enrolled community-based organization, local health jurisdiction, licensed provider, pharmacy, hospital, or clinic as defined in 42 CFR 440.90.   

Are counties restricted from providing multiple EBPs to members concurrently? 

ACT, FACT, and CSC are comprehensive outpatient services. A member receiving one of these services should generally not require any additional SMHS outpatient services beyond those delivered by their ACT, FACT, or CSC team; however, other services may be provided if clinically appropriate and the provider has coordinated care to ensure services are complementary and not duplicative. Members may receive ACT or FACT and CSC concurrently during a period of transition between the EBPs. On an ongoing basis, members may receive ACT and IPS Supported Employment concurrently, or CSC and IPS Supported Employment concurrently. Members can also receive Clubhouse Services or ECHW Services concurrently with any team-based EBPs.  

I understand that a member cannot receive Medi-Cal-covered IPS Supported Employment if they also have access to IPS Supported Employment through the Department of Rehabilitation. How will providers know if a member is eligible for IPS Supported Employment through the Department of Rehabilitation? 

The IPS Supported Employment COE will provide counties with technical assistance on how to effectively coordinate delivery of IPS Supported Employment across the Medi-Cal and Vocational Rehabilitation programs when IPS Supported Employment is available through both programs.

Is coverage of ACT, FACT, CSC and IPS Supported Employment required for members under age 21?

Yes, consistent with Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements, counties must cover EBPs for members under age 21, if the service is medically necessary, even if the county has not opted to cover the EBP as part of BH-CONNECT.

How does coverage of ACT, FACT, CSC and IPS Supported Employment under BH-CONNECT differ from the requirements under the BHSA to offer ACT, FACT, CSC and IPS Supported Employment?

Under the BHSA, all counties are required to provide ACT, FACT, and IPS Supported Employment in their Full Service Partnership (FSP) and CSC in their Early Intervention programs. Counties that do not opt in to cover EBPs under BH-CONNECT must still meet all BHSA requirements. See the BHSA Policy Manual for more information on BHSA requirements.

Under BH-CONNECT, counties have the option to provide ACT, FACT, CSC, and IPS Supported Employment as bundled Medi-Cal services.

All ACT, FACT, CSC and IPS Supported Employment services will be held to the same fidelity standards regardless of whether the county opts to cover the service under Medi-Cal.  

Can my county use other available funds, including BHSA funds, to support implementation of EBPs?

Yes, counties may use other available funds, including BHSA funds, to support the implementation of EBPs under Medi-Cal. In addition, counties must expend some BHSA FSP dollars on each required FSP EBP: ACT, FACT and IPS Supported Employment.​ BHSA funds should not be used for activities that are covered by Medi-Cal. BHSA funds must comply with all BHSA requirements and must be used for activities that are not otherwise covered under Medi-Cal, including outreach and engagement to individuals not enrolled in Medi-Cal and other recovery supports (e.g., items that offer emotional support, like a musical instrument).

EBPs for Children and Youth: Multisystemic Therapy (MST), Functional Family Therapy (FFT), Parent-Child Interaction Therapy (PCIT), and High Fidelity Wraparound (HFW)

Are BH-CONNECT EBPs for children and youth required or optional?

All counties are required to provide MST, FFT PCIT, and HFW to Medi-Cal members under age 21 when necessary pursuant to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements, consistent with DHCS standards. In addition, under the BHSA, counties must include HFW in their FSP programs; see the BHSA Policy Manual​ for more information on BHSA requirements.​

Though eligible children and youth under age 21 can already receive MST, FFT, PCIT, and HFW through Medi-Cal, DHCS is committed to ensuring that these EBPs are provided with fidelity to the evidence-based models. Under BH-CONNECT, DHCS is clarifying existing Medi-Cal coverage requirements for these EBPs to align with national practice standards and implements updated payment models within the SMHS system.

Are there Medi-Cal rates for EBPs for children and youth? ​

What training and technical assistance is available to support implementation of EBPs for children and youth?​

​​DHCS has contracted with PCIT International, MST Services,  FFT, LLC, and The Resource Center for Family-Focused Practice (RCFFP) at UC Davis to serve as COEs for PCIT, MST, FFT, and HFW, respectively.  The COEs provide counties and contracted and county-operated behavioral health practitioners with training, technical assistance, and fidelity monitoring or certification support free of charge.  More information about COEs can be found on the COE Resource Hub or by emailing bhcoe.info@dhcs.ca.gov.  

Do providers in my county need to be trained by a COE to claim and receive Medi-Cal payment for PCIT, FFT, MST, and/or HFW? ​

How do the EBPs for children and youth under BH-CONNECT intersect with the EBPs and community-defined evidence practices (CDEPs) under the Children and Youth Behavioral Health Initiative (CYBHI)?

Under CYBHI, counties may access up to $381 million in grant funding over five rounds to launch a set of EBPs and CDEPs, which include the EBPs for children and youth under BH-CONNECT. Counties may use any grant funding they receive under CYBHI to cover training start-up costs incurred while implementing MST, FFT, PCIT and HFW.

How do the EBPs for children and youth under BH-CONNECT intersect with the EBPs available through the Family First Prevention Services Act (FFPSA)?

MST, FFT, and PCIT are recognized as EBPs in California's FFPSA five-year implementation plan (2024-2029) and abide by the same fidelity standards and referral pathways. Counties must claim Medi-Cal first for covered services but may use Title IV-E funds available through FFPSA to cover other complementary services not covered by Medi-Cal as a “payer of last resort."

As described in ACL-25-47/BHIN-25-027 California's model of HFW, based on the California Wraparound Standards, is the designated model for the FPSA Part IV aftercare services requirement. 

Can counties claim for other crisis services in conjunction with EBPs for children and youth?

Will all youth receiving HFW have a Child and Family Team (CFT)? For youth with an existing CFT, how does this team intersect with HFW team?

All youth receiving HFW will have a CFT, even if they are not involved with child welfare and/or juvenile probation. If a youth has a pre-existing CFT, the HFW staff become part of the CFT, so there is only one CFT for the youth inclusive of formal support systems and community-based and natural supports. ​

Are flexible funds required as part of the HFW model?​

 Yes, HFW requires timely access to flexible funding to address the urgent and individualized needs of youth when these needs are not readily met by other resources (i.e., Medi-Cal services or other community-based resources). Counties may use BHSA funding or other local funding sources for flexible funds.​​​

Mental Health IMD FFP Program

My county is very interested in participating in the MH IMD FFP Program. How do I apply to participate?

Counties must submit an IMD FFP Plan that is approved by DHCS to participate in the MH IMD FFP Program. The IMD FFP Plan can be found on the DHCS website and may be submitted to DHCS at any time.

How quickly will DHCS review and approve our county's IMD FFP Plan? If our IMD FFP Plan is not approved, will we have an opportunity to revise and re-submit it?

DHCS will review IMD FFP Plans as they are submitted. There is no set review timeframe. Counties will have the opportunity to revise and resubmit IMD FFP Plans if not approved after the initial submission.

Will there be technical assistance available if my county has questions while completing the IMD FFP Plan?

Counties can reach out to BH-CONNECT@dhcs.ca.gov with any questions that arise while completing the IMD FFP Plan.

When can my county begin billing for services provided in participating IMDs?

Counties may submit claims for qualifying IMD stays after their IMD FFP Plan has been approved. Counties should wait until the end of an eligible stay to submit claims, to ensure claims are not submitted for lengths of stay that are greater than 60 days. Eligible services may be claimed retroactively, back to the earliest date the county can demonstrate it provided both Peer Support Services and ECHW Services, as indicated in claims data. ​

How can my county spend FFP received through the MH IMD FFP Program?

Counties must reinvest any FFP to support and expand services and activities that benefit Medi-Cal members served by the behavioral health delivery system. FFP received for care provided in IMDs shall not supplant current funding sources for behavioral health services. ​​

What types of IMDs are eligible for FFP?

Freestanding Acute Psychiatric Hospitals (APHs), Mental Health Rehabilitation Centers (MHRCs), and Psychiatric Health Facilities (PHFs) are the facility types eligible for FFP through the MH IMD FFP Program. These facilities that participate in the MH IMD FFP Program are collectively referred to as “Participating Psychiatric Settings."

Do I need to identify which IMDs in my county will be eligible for FFP?

Yes, as part of the IMD FFP Plan, counties must complete a Participating Psychiatric Settings List, which indicates which IMDs they would like to participate in the MH IMD FFP Program. There is no limit to the number of IMDs a county may include in the list. However, BHPs must ensure the Participating Psychiatric Settings are licensed or otherwise authorized by the State to provide primarily mental health treatment and must ensure ongoing compliance with state licensing and certification requirements, including through unannounced visits.  The Participating Psychiatric Settings List must be submitted to DHCS as part of counties’ IMD FFP Plan submissions. Counties can contact BH-CONNECT@dhcs.ca.gov​ for the Participating Psychiatric Settings List template. 

My county works with an IMD that serves members from multiple counties. Can my county be paid for services provided in that IMD?  ​

Yes, counties may claim for services provided to their member in an IMD in a different county, so long as the out-of-county IMD is included in the participating county’s Participating Psychiatric Settings List that is submitted as part of the IMD FFP Plan. Only the county who is responsible for the member (county of responsibility) may claim FFP for services.  ​​

What types of services delivered in an IMD are eligible for FFP?

All Medi-Cal-covered services provided to adult Medi-Cal members ages 21 to 64 during short-term stays in Participating Psychiatric Settings (classified as IMDs if they meet the specified requirements in 42 CFR Section 435.1010) are eligible for FFP.

​Which IMD stays are eligible for FFP?

Counties may claim FFP for stays of 60 days or fewer. Stays of 61 days or more are not eligible for FFP under any circumstances. ​

If a member has an inpatient or residential stay that extends longer than 60 days, are the first 60 days of the stay eligible for FFP?

No, if a stay in an IMD exceeds 60 days, FFP is not available for any day of the treatment episode.

How often is the statewide average length of stay (ALOS) calculated? Are all stays in my county's Participating Psychiatric Settings included in the ALOS calculation, or just stays for which my county is receiving FFP? 

DHCS will calculate the statewide ALOS at least annually. Only stays for which FFP is claimed – not all stays in Participating Psychiatric Settings – will be included in ALOS calculations.

Will my county become ineligible for FFP for IMD stays if our county-wide ALOS exceeds 30 days?

Counties participating in the MH IMD FFP Program must monitor their county-wide ALOS on a regular basis. If a county is unable to maintain a county-wide ALOS of 30 days or fewer, DHCS may reduce the maximum length of stay eligible for FFP in that county from 60 to 45 days or may disallow the county from continuing to participate in the MH IMD FFP Program.

How will DHCS monitor the MH IMD FFP Program requirements related to member screenings, discharge planning, and post-discharge contact?

As part of the IMD FFP Plan, counties must describe how they will meet requirements related to screenings, discharge planning, and post-discharge contact. DHCS will use information in the IMD FFP Plan to ensure requirements are being met and may follow up with participating counties for additional information about how they meet requirements. Counties must also  submit an IMD FPP Progress Report every two years using a template provided by DHCS. These reports will  build on initial plans described in each county’s approved IMD FFP Plan. Upon request from DHCS, counties must be prepared to provide documentation that supports the new or updated policies described in the IMD FFP Plan upon request from DHCS.​

Which EBPs does my county need to cover to be eligible to participate in the MH IMD FFP Program? Do these EBPs need to be fully implemented in advance of billing for services provided in mental health IMDs?

To participate in the MH IMD FFP Program, counties must opt to cover ACT, FACT, CSC, IPS Supported Employment, ECHW Services, and Peer Support Services, including the forensic specialization.

Counties must demonstrate they are delivering ECHW Services and Peer Support Services prior to claiming FFP for IMD stays, as indicated in claims data. Counties must cover ACT and Peer Support Services with a forensic specialization within 1 year of claiming FFP for IMD stays; FACT and CSC within 2 years of claiming FFP for IMD stays; and IPS Supported Employment within 3 years of claiming FFP for IMD stays.

Does my county need to complete a Letter of Commitment in advance of covering each EBP if my county is also participating in the MH IMD FFP Program?

Yes, counties must submit a letter of commitment to opt in to required EBPs in addition to the IMD FFP Plan. Letters of commitment for EBPs may be submitted on a rolling basis after initial submission of the IMD FFP Plan, so long as the county meets the timeline requirements described in the answer above and in BHIN 25-011. Letters of commitment for EBPs may be submitted on the DHCS website.

Access Reform and Outcomes Incentive Program

Does my county need to participate in the MH IMD FFP Program to be eligible for the Incentive Program?

No, counties that participate in the Incentive Program are not required to participate in the MH IMD FFP program. Additional information about participation in the Incentive Program is in BHIN 25-006 and information about the opportunity to receive FFP for IMD stays is in BHIN 25-011.

Does my county need to cover all BH-CONNECT EBPs to be eligible for the Incentive Program?

No, counties are not required to cover any BH-CONNECT EBPs to participate in the Incentive Program. However, counties are only eligible for incentive funding related to increased utilization of EBPs and improved member outcomes related to EBPs if they opt in to cover those EBPs. For example, a county must cover and implement ACT to be eligible to earn any incentive payments for measures related to ACT. Counties cannot earn incentive dollars for measures related to an EBP until the county covers and implements that EBP.

Can my county receive an incentive payment tied to an EBP if we are providing the EBP under BHSA and not opting in to cover the EBP under Medi-Cal?

No, counties must cover EBPs under Medi-Cal to receive incentive payments tied to the EBPs.

Can my county still complete the targeted Managed Behavioral Healthcare Organization (MBHO) self-assessment with the National Committee for Quality Assurance (NCQA) and participate in the Incentive Program?

No, counties must have completed the NCQA MBHO self-assessment in 2024 to participate in the Incentive Program, as described in BHIN 24-019.

Can my county participate in the Incentive Program if it did not submit a letter of intent by March 31, 2025?

No, counties must have submitted a letter of commitment by March 31, 2025, to participate in the Incentive Program, as described in BHIN 25-006.

How much incentive program funding may a county earn by participating in the Incentive Program?

DHCS has received expenditure authority from CMS for $1.9 billion total computable over five years for the Incentive Program. Each participating county will be eligible to earn up to a specified, capped amount of Incentive Program funding each demonstration year based upon achievement of specified performance targets. County-specific funding allocations (total computable) are posted on the DHCS website.​

​How can my county spend earned Incentive Program funding?

Counties must use any earned incentive payments to support and expand services and activities that benefit Medi-Cal members served by the behavioral health delivery system. Earned Incentive Program funding cannot supplant funding for existing benefits.  

How were measures selected for the Incentive Program?

DHCS selected measures for the Incentive Program based on an analysis of key areas for improvement, including the results from the NCQA MBHO assessment, access to behavioral health services, outcomes among Medi-Cal members living with significant behavioral health needs, and behavioral health delivery system reforms. Where possible, measures were selected from nationally recognized sources and measure sets as well as existing DHCS initiatives. Where existing measure sets did not fully address BH-CONNECT goals, new measures were developed.

Where will detailed technical specifications be available for the Incentive Program measures?

DHCS issued technical specifications for measures that are pay-for-performance in 2025 in December 2025. Specifications are available in the BH-CONNECT Incentive Program Technical Specifications Manual. Technical specifications for measures that become pay-for-performance in later years are forthcoming and will be posted publicly on the DHCS website.

Will DHCS share how performance on each measure will be calculated?

DHCS issued scoring methodology and performance benchmarks for measures that are pay-for-performance in 2025 in December 2025. Benchmarks are described in the BH-CONNECT Incentive Program Benchmarks Manual. Benchmarks for measures that become pay-for-performance in later years are forthcoming and will be posted publicly on the DHCS website. 

Will DHCS calculate measures for the Incentive Program? Is my county expected to provide data and/or calculate measures ourselves?

Wherever possible, DHCS will calculate Incentive Program measures on behalf of participating counties. Counties will develop and submit all narrative submissions. DHCS will release instructions for all narrative submissions.

When are Incentive Program submissions due?

Incentive Program submissions are due every year on June 30, from 2025 through 2030, beginning with Submission 1, which was due on June 30, 2025. The full Incentive Program submission and payment timeline is outlined in BHIN 25-006.

Is my county required to complete every Incentive Program submission? Are there penalties for not completing submissions?

No, counties are not required to complete every submission and there are no financial penalties for counties for not completing submissions. However, counties are not eligible for Incentive Program funding for benchmarks that are not met or submissions that are not completed. DHCS strongly encourages counties to complete all Incentive Program submissions, as the Incentive Program measures are designed to build upon each other over the course of the five-year program.  

What training and technical assistance is available to support my county's participation in the Incentive Program?

DHCS is holding monthly office hours in partnership with NCQA to provide technical assistance to counties participating in the Incentive Program. ​

Workforce Initiative

Do counties need to “opt in" to participate in the Workforce Initiative?

No, counties do not need to “opt in" to participate in the Workforce Initiative. Workforce Initiative funding will be awarded to grantees through an application process.

What are the different programs available as part of the Workforce Initiative?

The Workforce Initiative includes five workforce programs to address shortages in qualified practitioners serving Medi-Cal members and uninsured individuals who are living with or at-risk for behavioral health conditions:

1. Medi-Cal Behavioral Health Student Loan Repayment Program
2. Medi-Cal Behavioral Health Scholarship Program
3. Medi-Cal Behavioral Health Recruitment and Retention Program
4. Medi-Cal Behavioral Health Community-Based Provider Training Program
5. Medi-Cal Behavioral Health Residency/Fellowship Training Program

Additional information about all Workforce Initiative programs is available on the HCAI website.

What does my county need to do to be eligible for funding through the Workforce Initiative?

Different entities that support the county behavioral health system may be eligible for different Workforce Initiative programs. For example, county-operated and county-contracted organizations may be eligible for recruitment and retention funding (e.g., hiring and retention bonuses; backfill costs). Educational institutions, training programs and community-based organizations that educate and train future Medi-Cal behavioral health providers may be eligible for funding through the community-based provider training program or residency training program. When available, specific eligibility criteria and application instructions for each Workforce Initiative program will be posted on the HCAI website.

When will funding for Workforce Initiative programs be available?

Applications for available Workforce Initiative programs are posted on the HCAI website.

Where can I learn more about the Workforce Initiative?

Counties can learn more about the Workforce Initiative on the DHCS website and the HCAI website.

Community Transition In-Reach Services

Are members with co-occurring behavioral and developmental needs eligible for In-Reach Services?

Yes, members with co-occurring behavioral and developmental needs may receive In-Reach Services if they also meet other eligibility criteria.

What does the clinical evaluation consist of when assessing members exhibiting “severe functional impairment”?​​

DHCS recommends that the clinical evaluation should consider the updated DSM-5 criterion for clinical significance, which requires that the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. This standard is consistent with the approach applied by DHCS to SMHS access criteria, as defined in BHIN 21-073 or subsequent guidance.​

Are members who frequently cycle between inpatient and residential care eligible for In-Reach Services if they do not meet the 120 consecutive day requirement (are experiencing extended length of stay of 120 days or more)?

Yes, members who frequently transition between inpatient and residential settings may receive In-Reach Services if they otherwise meet the eligibility criteria, including being at risk of experiencing an extended length of stay of 120 days or more. DHCS defines members “at risk of experiencing extended length of stay” as members in inpatient, residential, or subacute settings with lengths of stay shorter than 120 days but who have clinical presentation and progress similar to the patient profiles of individuals whose lengths of stay exceed 120 days.​

​Who is responsible for determining whether a member is at risk of an extended length of stay?​

The determination of whether a member is at risk of an extended length of stay should be made through coordination between the facility clinician and the Community Transition Team. This includes jointly reviewing the non-exhaustive list of patient profiles in BHIN 25-041 to support consistent eligibility determinations.

How will additional patient profiles be determined to assess whether a member is at risk of an extended length of stay, and do providers have discretion in making this determination?​​

Providers may consider additional patient profiles beyond the non-exhaustive list in the BHIN 25-041 when assessing whether a member is at risk of an extended length of stay as part of the broader eligibility determination. Ultimately, the county has discretion to determine whether an additional patient profile may be applied in making the prior authorization decision for In-Reach Services as long as the member also meets the other eligibility criteria.

Which licensed facilities can qualify to participate in In-Reach Services?​​

The following licensed facility types may participate in In-Reach Services:

• Acute Psychiatric Hospitals (APHs)
• General Acute Care (GAC) hospitals with psychiatric units
• Psychiatric Health Facilities (PHFs)
• Social Rehabilitation Facilities (SRFs)
• Mental Health Rehabilitation Centers (MHRCs)
• Skilled Nursing Facilities with Special Treatment Programs (SNF/STP)
  

In addition to a comprehensive assessment and periodic reassessment of member needs, what other examples of assessment activities should be included when identifying a member’s needs?​

Assessment activities may include, but are not limited to, evaluating the member's food and nutritional needs, transportation requirements, and employment supports.

Does the list of areas that must be addressed in the member's individualized care plan (e.g., medical, social, educational, and other services) in BHIN 25-041 represent an exhaustive list?​

No, this list is not exhaustive. In addition to addressing the member’s medical, social, educational, and other service needs, the individualized care plan can also identify and support the member’s employment or vocational needs, if applicable. Community Transition Teams and counties are encouraged to take a holistic approach that reflects the member’s unique goals, preferences, and readiness for community living when developing the care plan.

What are examples of referrals that the Community Transition Team can provide to address the identified needs and achieve the goals specified in the member’s care plan?

Referral activities may include, but are not limited to, obtaining prior authorizations, arranging transportation, and connecting members to Enhanced Community Health Worker Services.​

What are the requirements and responsibilities related to the enrollment, certification, and tracking of Community Transition Teams and organizational providers of In-Reach Services?

Counties are responsible for certifying their organizational providers and notifying DHCS of the services those providers are authorized to deliver. This certification information is recorded in the Provider Information Management System (PIMS), which is used to validate provider eligibility during claims adjudication in the Short-Doyle Medi-Cal (SD/MC) system. For Community Transition In-Reach Services, counties should:

• Ensure organizational providers are certified under Targeted Case Management (TCM) or mental health services in PIMS so claims can be verified against provider certifications.
• Ensure licensed practitioners within organizational providers serving as members of the Community Transition Team are enrolled in the Provider Application and Validation for Enrollment (PAVE) system to ensure compliance with federal requirements.
  

​Do counties need full-time equivalents (FTEs) for every practitioner on the Community Transition Team?​

No, counties are not required to dedicate a FTE for each practitioner type on the Community Transition Team.

​Must the entire Community Transition Team participate in the required contacts?​​

No, at least one Community Transition Team member must participate in each required contact.

​My county is requesting an Occupational Therapist (OT) exemption. How can my county  demonstrate a good-faith effort to expand the availability of OTs within our provider network?​

Counties seeking an OT exemption are expected to submit a plan outlining strategies to expand the availability of OTs within the licensed mental health professional provider network. To demonstrate good-faith recruitment efforts, the plan may include, but is not limited to, the following activities:

• Partnering with the Occupational Therapy Association of California (OTAC) to support recruitment and identify qualified candidates.
• Leveraging HCAI workforce development resources to expand OT capacity, as done successfully in other health professions.
• Partnering with OTAC and workforce entities to build OT pipelines (e.g., internships, fieldwork, loan repayment incentives).
• Sharing their recruitment plan to enable stakeholder collaboration.
• Establishing consultation contracts with OTs (in-person or telehealth) so OT-informed assessments remain part of service delivery.

​Will DHCS consider counties' existing network adequacy certifications and timely access requirements as demonstrating that the county has an appropriate behavioral health continuum of care for purposes of the Readiness Assessment?​

DHCS will evaluate the behavioral health care continuum through the county's Integrated Plan (IP). Completion and approval of the IP is required for approval of the Readiness Assessment. Counties that opt in to In-Reach Services prior to the IP due date must attest that they will complete the IP. If all other requirements of the BHP Readiness Assessment are satisfied, DHCS will issue conditional approval for counties to render In-Reach Services and access FFP until the IP is completed and approved by DHCS.

How long will conditional approval be granted for counties that have not yet submitted or received approval of their IP? What happens if a county fails to submit an IP or if the IP is not compliant?

All counties are required to submit a draft IP by March 31, 2026, and their final IP by June 30, 2026. Conditional approval will only be available until the final IP due date. 

What does the bed reporting requirement for In-Reach Services entail?

As part of the opt-in requirements for In-Reach Services, counties must attest that they will track and report data and trends in the number and utilization of beds across qualifying inpatient, subacute, and residential facilities (including IMDs) in which the county places members. Opt-in counties will be required to submit the following data elements to DHCS:

• Population Tracked
• Medi-Cal members under county responsibility who are utilizing In-Reach Services
• For comparison, counties will also be asked to report on:
• All Medi-Cal members under county responsibility within qualifying facilities, and
• Conserved Medi-Cal members under county responsibility utilizing In-Reach Services
• Data Elements
• Average length of stay (ALOS)
• Separate reporting for each bed type: inpatient, subacute, and residential (LOS will vary by facility type)
• Post-discharge placement (e.g., another facility or community placement)
• Cadence
• Data broken down monthly (at minimum quarterly) and provided to DHCS annually.

When does the timeline for implementing EBPs, such as ACT, FACT, IPS Supported Employment, and Peer Support Services (including Forensic Specialization), begin?

To offer In-Reach Services, counties must implement EBPs on the following timeline:

• ACT: Within one year of claiming for In-Reach Services.
• FACT: Within two years of claiming for In-Reach Services.
• IPS Supported Employment: Within three years of claiming for In-Reach Services.
• Peer Support Services: Prior to claiming for In-Reach Services.
• Peer Support Services with Forensic Specialization: Within one year of claiming for In-Reach Services.

If my county opts in to In-Reach Services, do we need to provide In-Reach Services? 

Counties that opt in must provide In-Reach Services to all members who meet the established eligibility criteria. Counties can retract their commitment to participate in In-Reach Services by emailing BH-CONNECT@dhcs.ca.gov. 

Why did DHCS establish a bundled rate for In-Reach Services?

The bundled rate ensures maximum flexibility for the allocation of the Community Transition Team's time regardless of factors such as the physical location of the members being served, the clinical interventions best suited to be delivered by various members of the team, and the fluctuation of intensity of services throughout the treatment episode.

Activity Funds

​​Overview

Activity Funds can provide eligible children and youth who are enrolled in Medi-Cal, diagnosed with or at risk of a behavioral health condition, and involved in Child Welfare, with up to $1,000 per year to participate in allowable activities. Activities can include camps, sports, dance and music lessons, related activity equipment and supplies, and more. 

Activity Funds information and resources are available on the DHCS Activity Funds Initiative webpage. Below are answers to frequently asked questions. Final policy guidance will be shared for public comment in spring 2026. 

Who is eligible to receive Activity Funds?

Activity Funds services and/or items are available to Medi-Cal members who are involved in child welfare and have a behavioral health condition or are at risk of a behavioral health condition.

What are eligible activities and items that may be covered by Activity Funds?

Activity Funds may be used for services and items that promote physical wellness and a healthy lifestyle (e.g., sports club fees and gym memberships, bicycles, scooters, roller skates and related safety equipment) and strengths-developing activities (e.g., music lessons, art lessons, therapeutic summer camps).

Activity Funds must be used for services and/or items that directly align with assessed clinical needs and: 

• Promote inclusion in the community, and/or increase the member's safety in their home environment; and/or 

• Facilitate the member's age-appropriate participation or autonomy to make decisions to improve their physical or behavioral health outcomes. 
  

​​What activities and items are not eligible to be covered by the Activity Funds Initiative?

Is DHCS working with a contractor to support implementation of the program?​

Yes, DHCS is contracting with a Fiscal Intermediary, Public partnerships LLC (PPL) to support counties in implementing Activity Funds. Among its responsibilities, the Fiscal Intermediary, PPL will develop and maintain a list of enrolled activity provider types that meet requirements to receive Activity Funds and disburse Activity Funds to approved activity providers. DHCS will provide additional details on PPL's responsibilities in forthcoming guidance. ​

What organization did DHCS select as the fiscal intermediary for this initiative and what is their role?

DHCS is contracting with Public Partnerships LLC (PPL). PPL is responsible for:

• Developing and maintaining an online portal for counties, Licensed Mental Health Professionals (LMHPs), members and their caregiver(s), and Activity Providers

• Tracking LMHP referrals and member eligibility for Activity Funds

• Enrolling and managing Activity Providers

• Fund disbursement

• Reporting​
  

Activity Funds Portal​

What is the Activity Funds portal?

The Activity Funds Portal is the system that LMHPs, Activity Providers, and members and their caregivers will use to access Activity Funds. Its functions will enable:

• Licensed Mental Health Professionals (LMHPs) to recommend eligible children and youth for Activity Funds;

• Eligible children, youth, and their caregivers to identify Activity Providers;

• Activity Providers to enroll in the provider directory; and
  

• Payment processing and tracking for activities and necessary equipment or supplies.

The portal will improve and expand over time, as the Provider Directory grows and awareness for Activity Funds builds among children and youth, caregivers, social workers, and LMHPs.​

How will LMHPs access the portal?

LMHPs enrolled as Medi-Cal providers will be able to access their portal by providing their credentials. PPL will provide LMHPs with support to access and learn how to navigate the portal. LMHPs will receive more information directly from PPL and the counties in which they are contracted. LMHP Trainings will begin in Spring 2026. ​

What codes should LMHPs use for time spent enrolling in the Activity Funds portal and connecting members to Activity Funds?

LMHPs should use existing Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) codes for Specialty Mental Health Services (SMHS) assessments.

 Will the portal manage requests for equipment and supplies needed for participation in activities?

Yes, requests and payment for equipment and supplies will be managed through the portal.

Will BHPs submit claims for Activity Funds?

No. All payments related to Activity Funds will be managed through PPL's portal.​

Activity Funds and Other Children and Youth Initiatives

How does Activity Funds align High-Fidelity Wraparound services?

The Activity Funds Initiative is designed to complement the goals and services of High-Fidelity Wraparound. While Activity Funds are not limited to children and youth in High-Fidelity Wraparound, the two programs are intended to work hand in hand. ​

Policy and Program Guidance ​

When will DHCS release additional guidance?

DHCS will release additional guidance in spring 2026. The guidance will be released for public comment and stakeholders will have the opportunity to provide feedback before it is finalized.

How will a member know if an activity or item is allowable?

Activities and items are allowable if they directly align with assessed clinical need as indicated in a member's clinical record and meet one of the below criteria:  

• Promote inclusion in the community; and/or  

• Increase the member's safety in their home environment; and/or 

• Facilitate the member's age-appropriate participation or autonomy to make decisions to improve their physical or behavioral health outcomes. 

Funds cannot be used for: 

• Items used solely for recreational or entertainment purposes; 

• Tobacco or alcoholic products; 

• Items of the same type for the same member, unless there is a documented change in the member's needs that warrant replacement; 

• Activities that are illegal or otherwise prohibited by federal or state regulations; 

• Activities that duplicate what is available to an individual under the Medicaid State Plan; 

• Items that are non-transportable (e.g., construction or building improvements that cannot relocate with the child or youth); or 

• Large electronics (e.g., laptops, tablets, or portable monitors) that do not exclusively support an allowable activity.​
  

Can unused Activity Funds roll over from year to year?

No, if there are funds remaining from the $1000 benefit, any remaining funds cannot roll over.'

Will the one-year period for the $1,000 stipend be based on the calendar year or when a member begins their activity/purchases equipment?

Activity Funds are available for one year (defined as 365 days) from the date a child or youth is authorized to participate in the program by an LMHP.

Is transportation to and from activities provided?

Transportation costs cannot be covered by Activity Funds. Caregivers, members (as appropriate), and the Child and Family Team (if applicable) should work together to arrange needed transportation.

Technical Assistance

How should LMHPs, children and youth, caregivers, and others request technical assistance on participating in Activity Funds?

Anyone who is involved with implementing or participating in Activity Funds can reach out via email to BH-CONNECT@dhcs.ca.gov or caactivityfunds-cs@pplfirst.com to request support and technical assistance.

How will you ensure that Activity Providers take a trauma-informed approach?

DHCS will provide resources, trainings, and materials specific to the unique needs of children and youth in the foster care system to Activity Providers. ​

What training and support will be available for LMHPs?

DHCSand PPL will provide technical assistance materials and trainings. This initiative is a new and exciting tool for LMHPs to use to support the clinical needs of children and youth they work with. LMHPs will be alerted to new trainings via emails from DHCS, PPL, the counties they are contracted with. Scheduled training dates may also appear in the “Announcement" section of the weekly DHCS BH Stakeholder Updates and Information Notices email and on the Activity Funds webpage.

How will BHPs access information, outreach materials, and trainings on Activity Funds?

DHCS will provide resources, technical assistance, and outreach materials for BHPs to use. PPL will host trainings and will be available for questions on navigating the portal.​

Child and Adolescent Needs and Strengths (CANS) Tool Alignment​​

​What is the purpose of aligning the CANS tool across child welfare and behavioral health?

The goal of aligning CANS across child welfare and behavioral health is to ensure that all counties use the same CANS tool in the same way, so that children and youth served by multiple systems receive coordinated, streamlined care. Alignment will reduce duplication, improve communication, and support better treatment and case planning.

​​What is the CANS tool and how is it different than the IP-CANS?

The CANS tool is a multipurpose, communimetric* tool used to measure well-being, identify social and behavioral needs and strengths, inform individualized treatment planning, and track improvements and changes in a child or youth's functioning over time. It is designed to support collaborative decision-making among professionals, youth, and families.

DHCS utilizes the CANS-50 which includes 50 core items to assess child and youth functioning. The California Department of Social Services (CDSS) utilizes the IP-CANS, which includes the same 50 core items as the CANS-50 but also allows for the assessment of up to four caregivers and includes a 12-item Trauma/Adverse Childhood Experiences domain. For children ages Birth–5, the IP-CANS is comprised of the Early Childhood module.

*Note: The term “communimetric" refers to how the tool measures information about a child or youth, their parents, and caregivers, and presents that information in a way that is easy to communicate.​

​​​What certification is required to administer the CANS?

All counties administering the CANS must be certified or recertified through the Praed Foundation's online learning platform regardless of any formal agreement that may support their relationship with placing agencies. Counties completing the IP-CANS under the terms of a formal agreement with a placing agency must complete a CDSS-approved IP-CANS training.​

​​Do providers need a professional license to administer the CANS?

​When must the CANS be completed?

The CANS must be completed:

• At case opening (beginning of SMHS treatment or before a case plan in child welfare/probation/foster care);
• Every six months after the first administration;
• Within 30 days of determining that there is a “triggering," or significant or sudden, change in condition; and
• At the end of treatment (at case closure for SMHS or no more than 60 days before case closure for open child welfare cases, in probation foster care placements, or foster care placements)