CalAIM News & Updates

CalAIM Corner

Transforming Behavioral Health

(June 28, 2022) CalAIM is strengthening the state's behavioral health continuum of care for all Californians, including Medi-Cal beneficiaries living with serious mental illness, serious emotional disturbance, or substance use disorder. The goal is to improve outcomes for people living with the most complex needs through better coordinated treatment, and to allow providers to respond in a patient-centered manner. Read More >>

What is Providing Access and Transforming Health (PATH)?

(April 27, 2022) PATH supports California's efforts to build, maintain, and scale the capacity necessary to implement CalAIM. It is a five-year, $1.85B initiative to help fund community-based organizations (CBOs), public hospitals, county agencies, Medi-Cal Tribal and Designees of Indian Health Programs, and others to successfully participate in Medi-Cal and serve members. To learn more about PATH, we spoke with Susan Philip, DHCS Deputy Director of Health Care Delivery Systems. Read more > >

What is Population Health Management?

(February 28, 2022) CalAIM’s Population Health Management program is about proactively helping people stay well by identifying illnesses before they worsen and anticipating member needs before they increase. According to Dr. Palav Babaria, Chief Quality Officer and Deputy Director of Quality and Population Health Management at DHCS, “it’s about moving from a reactive health care system that cares for individuals when they are sick or hospitalized, to a proactive statewide system that understands member needs, even when they don’t feel sick or don’t need to see a doctor.” Read More >>

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CalAIM News

Implement County-Based Model Changes in the Medi-Cal Managed Care Program

On Friday, August 12th, the Department of Health Care Services (DHCS) launched 30 day public comment and Tribal public comment periods to solicit feedback on proposed amendments to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration and the Section 1915(b) waiver. DHCS is seeking the CalAIM Section 1115 and 1915(b) amendment approvals from the Centers for Medicare & Medicaid Services (CMS) to implement county-based model changes in the Medi-Cal Managed Care (MCMC) program. Through the Section 1915(b) waiver amendment, DHCS also plans to add or update language on policies or programs in the approved CalAIM 1915(b) waiver, including to reflect the MCMC model changes in select counties and direct contracts with the Kaiser Foundation Health Plan available for enrollment of certain Medi-Cal beneficiary populations in select counties. The following materials have been shared for public comment:

The 30-day public comment and Tribal public comment periods will be open from Friday, August 12, 2022 until Monday, September 12, 2022. Comments may be emailed to CalAIMWaiver@dhcs.ca.gov. Please indicate “CalAIM Section 1115 & 1915(b) Waiver Amendments” in the subject line of the email message.

More information can be found on the CalAIM 1115 Demonstration & 1915(b) Waiver webpage.

Supporting Enhanced Care Management and Community Supports

DHCS has launched an online application for funding to enable the transition, expansion, and development of capacity to support the delivery of Enhanced Care Management and Community Supports services. The funding is provided by Capacity and Infrastructure Transition, Expansion and Development (or CITED), and this is the first round. Please visit ca-path.com/cited for information on eligibility and application submission and email cited@ca-path.com with any questions about the application process.

CalAIM Section 1115 Demonstration Amendment Approval

On June 29, 2022, DHCS received approval from the Centers for Medicare and Medicaid Services (CMS) to amend the CalAIM Section 1115 demonstration to increase the asset limit and subsequently eliminate the asset test for certain populations. Along with amending the demonstration, CMS also issued technical corrections to the CalAIM demonstration Special Terms and Conditions (STCs). For more information, visit the CalAIM 1115 Demonstration & 1915(b) Waiver webpage.

Final Population Health Management Strategy and Roadmap

On July 5, 2022, DHCS released the Final Population Health Management Strategy and Roadmap, which incorporates stakeholder feedback on all components of the PHM Framework. DHCS appreciates thoughtful comments from stakeholders that have helped to improve the Department's vision for PHM. As a reminder, DHCS will launch the PHM Program, a cornerstone of CalAIM, in January 2023. The PHM Program will establish a cohesive, statewide approach that ensures all Medi-Cal members have access to a comprehensive program that leads to longer, healthier and happier lives, improved health outcomes, and health equity. The Final Roadmap outlines key policy initiatives and accountability mechanisms, defines and describes PHM concepts and terminology, and details requirements for Medi-Cal managed care plans (MCMC Plans) for 2023 and 2024. The Final PHM Strategy and Roadmap is available at the DHCS CalAIM Population Health Management webpage. For any questions, please email CalAIM@dhcs.ca.gov

Assessing Behavioral Health Services in California

(January 11, 2022) The COVID-19 pandemic has exacerbated behavioral health challenges—both mental health and substance use disorder—and placed significant demands on the existing system of care and workforce capacity. With behavioral health a top priority of the Newsom Administration and the inequities across the health care system further exacerbated by the COVID-19 pandemic, it is the optimal time for the Department of Health Care Services (DHCS) to produce an updated assessment of California's behavioral health system. While DHCS will use the assessment to inform its work on initiatives such as the BHCIP and the SMI/SED 1115 waiver application, it is not the single source of information that will be used nor is it a description of the Administration's specific positions and plans. DHCS is committed to continuing to work closely with stakeholders to implement critical initiatives underway and develop future policy as behavioral health initiatives evolve.

California’s Historic Medi-Cal Transformation Begins with Federal Government Approval

(December 29, 2021) DHCS received the go-ahead to launch its long-term commitment to transform and strengthen Medi-Cal. The federal Centers for Medicare & Medicaid Services (CMS) approved the CalAIM Section 1115 demonstration and the Section 1915(b) waivers and Medi-Cal State Plan Amendments on December 29, 2021. CalAIM launched January 1, 2022 and made Medi-Cal more equitable, coordinated, and person-centered to help people maximize their health and life trajectory. Learn more about the waivers on the CalAIM 1115 Demonstration & 1915(b) Waiver Webpage.

CalAIM Webinars

For additional information on CalAIM Workgroups and past stakeholder meetings, visit  Additional Resources.

Providing Access and Transforming Health (PATH) Webinar

On June 29, DHCS will host a webinar to provide interested stakeholders with detailed updates on the following PATH initiatives: Collaborative Planning and Implementation; Capacity and Infrastructure Transition, Expansion, and Development (CITED); and Technical Assistance Marketplace. The webinar will also serve as a venue to answer general questions from stakeholders about PATH initiatives. Interested stakeholders are encouraged to submit questions in advance to 1115path@dhcs.ca.gov. Attendees will also have an opportunity to ask questions. Advance registration is required.

PATH is a five-year initiative to build and expand the capacity and infrastructure of city, county, and other government agencies and county and community-based providers, including public hospitals, community-based organizations, tribes and designees of Indian health programs, and others to successfully participate in the delivery of Enhanced Care Management, Community Supports, and justice-involved services under CalAIM.

CalAIM Enhanced Care Management & Community Supports Technical Assistance Meetings

On Tuesday, June 14, DHCS hosted the second of three webinars on ECM. The “ECM in Rural California" webinar provided an overview of ECM intended for providers and community-based organizations located in rural areas. DHCS was joined by Hill Country Clinic in Shasta County to share their experience on providing ECM.

On Tuesday, June 21, DHCS hosted the final June webinar on ECM. The “ECM & Community Supports Intersection" webinar included speakers from Illumination Foundation in California to share their experience about being both an ECM and Community Supports provider. The webinar also included “myth-busting" on misconceptions between the two programs.

CalAIM Enhanced Care Management & Community Supports Technical Assistance Meetings

On June 2, DHCS hosted the first in a series of webinars on Enhanced Care Management (ECM). The goal of the first webinar, “ECM: A New Vision for Whole Person Care", was to explain the vision for the CalAIM ECM benefit, provide an example of implementation in Alameda County, and address frequently asked questions.

CalAIM Population Health Management (PHM) – May Meetings

On May 23, 2022, DHCS hosted a webinar to discuss DHCS' PHM Service. As described in DHCS' recently released Draft PHM Strategy and Roadmap, the PHM service will support DHCS' vision by:

Collecting and integrating disparate information.
Performing key population health management functions.
Providing authorized users with access to more timely, accurate, and comprehensive data on members' health history and needs.

The webinar included a discussion of key planned functionalities of the PHM Service as well as time for questions and answers.

On May 31, 2022, DHCS also hosted the third meeting of the PHM Advisory Group. PHM Advisory Group Meetings are open to the public and meeting information and materials will be available on the PHM webpage.

Population Health Management (PHM) Advisory Group Meeting

On April 26, 2022, the PHM Advisory Group provided an overview of the purpose of the Advisory Group, member introductions, and a deeper dive into updated policy regarding screening and assessments. The PHM Service was not a focus area for this meeting. The PHM Advisory Group launched in March 2022 to provide input on the PHM program and service components of CalAIM, scheduled to go live on January 1, 2023. Members include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups. Visit the PHM webpage to access Advisory Group meeting information and materials from past sessions.

Questions about the PHM Advisory Group may be directed to CalAIM@dhcs.ca.gov. To receive relevant updates on PHM Advisory Group meetings, sign up for the DHCS Stakeholder Announcements.

Draft Population Health Management Strategy and Roadmap Release

On April 25, 2022, DHCS released the Draft Population Health Management Strategy and Roadmap for public comment. As a cornerstone of CalAIM, DHCS will launch Population Health Management (PHM) in January 2023. The PHM Program will establish a cohesive, statewide approach that ensures all Medi-Cal members have access to a comprehensive program that leads to longer, healthier and happier lives, improved health outcomes, and health equity. The Draft PHM Strategy and Roadmap document describes the Department's vision for PHM, outlining key policy initiatives and accountability mechanisms, defining and describing PHM concepts and terminology, and detailing requirements for Medi-Cal managed care plans (MCPs) for 2023 and 2024. Comments were accepted until May 16, 2022.

Population Health Management (PHM) Advisory Group Launch

On March 18, 2022, DHCS hosted the first meeting of the PHM Advisory Group. The stakeholder advisory group provides input on the PHM program and service components of CalAIM, which are scheduled to go live on January 1, 2023. Members include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups. Materials from the advisory group meeting can be found on the Population Health Management website.

Medi-Cal’s Strategy to Support Health and Opportunity for Children and Families

On March 14, 2022, DHCS hosted a webinar on Medi-Cal’s Strategy to Support Health and Opportunity for Children and Families. DHCS shared more about the strategy to support children and families enrolled in Medi-Cal that will unify the common threads of existing and newly proposed child and family health initiatives and strengthen DHCS’ accountability and oversight of children’s services. Presenters provided an overview of eight action areas and detailed initiatives underpinning DHCS’ strategy and expected timelines and responded to attendee questions. Review the webinar presentation slides, recording, and transcript.

Medi-Cal Dental Facebook Live Events

On March 10 and 11, 2022, DHCS’ Medi-Cal Dental program hosted two Facebook Live events for Medi-Cal members, one in English and one in Spanish. Presenters provided an overview of Medi-Cal Dental benefits and responded to Medi-Cal member questions about their dental benefits, provided background on the Medi-Cal Dental program and reviewed frequently asked questions. View the recording of the English Facebook Live event and the Spanish Facebook Live event. For questions or comments, email Dental@dhcs.ca.gov.

Medi-Cal Managed Care Procurement and Updated Contract

On February 15, 2022, DHCS staff shared how the Department will leverage the Medi-Cal managed care plan Request for Proposal (RFP) and managed care contracts to further DHCS’ goals to enhance how care is delivered to Medi-Cal enrollees by advancing health equity, quality, access, accountability, and transparency of the health care delivery system. DHCS released the RFP on February 9 to commercial Medi-Cal managed care plan (MCP) contractors. This webinar provided interested stakeholders an overview of new requirements of MCPs, impact on Medi-Cal members’ experience, and MCP accountability. The webinar materials can be found on the Medi-Cal Managed Care Procurement and Updated Contract Page. Additional information about the procurement and updated contract can also be found on the Medi-Cal Managed Care Procurement and Updated Contract page.

Update on Detailed PATH Program Design

On January 28, 2022, DHCS hosted the first in a series of webinars focused on the “Providing Access and Transforming Health" or “PATH" initiative. California recently received federal approval to implement the PATH initiative as part of the state's 1115 demonstration waiver. PATH will support implementation of CalAIM (starting this year with Enhanced Care Management, or “ECM," and Community Supports) by making funding opportunities available to its “on the ground" partners including: providers, counties, former Whole Person Care (WPC) Lead Entities, community-based organizations, tribes and others working to implement ECM/Community Supports. The purpose of the webinar is to provide interested stakeholders with post-waiver approval updates and a detailed overview of the following PATH initiatives:

Technical Assistance Marketplace Initiative
Collaborative Planning and Implementation Initiative
Capacity and Infrastructure Transition, Expansion and Development (CITED) Initiative

This webinar was also used as a venue to answer general questions from stakeholders on PATH initiatives. The webinar materials can be found on the PATH website.  For questions or comments, email 1115path@dhcs.ca.gov.

Behavioral Health Assessment Report

On January 21, 2022, DHCS hosted a webinar to review the findings from its assessment report on California's behavioral health system: Assessing the Continuum of Care for Behavioral Health Services in California: Data, Stakeholder Perspectives, and Implications. The report reviews data and stakeholder perspectives as DHCS implements major behavioral health initiatives, including: the Behavioral Health Continuum Infrastructure Program; the Department's response to new federal funding opportunities; and its proposal for a Section 1115 Medicaid demonstration waiver in 2022 to strengthen mental health services for people living with serious mental illness and children and youth living with serious emotional disturbance.

CalAIM Approved Waivers

On January 14, 2022, DHCS hosted a webinar to provide a status update on and overview of the recently approved CalAIM Section 1115 and 1915(b) waivers. CMS approved the waivers on December 29, 2021. Together, the CalAIM waivers move the tested pilot initiatives from prior federal demonstrations to a comprehensive, integrated Medi-Cal system. This webinar reviewed the approved initiatives and components in the CalAIM waivers, as well as provided an update on pending CalAIM waiver requests. The webinar presentation materials can be found on the CalAIM 1115 Demonstration and 1915(b) Waiver Website. Email CalAIMWaiver@dhcs.ca.gov with any questions.

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Last modified date: 8/16/2022 3:30 PM

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