Behavioral Health Administrative Integration
Medi-Cal Specialty Mental Health (SMH) and substance use disorder (SUD) treatment services are currently administered through separate, unique structures at the county level, which creates many challenges for members, counties, and providers. DHCS is requiring counties to combine the administration of SMH and SUD services into one, integrated specialty behavioral health program by January 1, 2027. Administrative Integration is distinct from the CalAIM Full Integration Plan proposal that would integrate physical, behavioral, and oral health care into comprehensive managed care plans.
The primary goals of Behavioral Health Administrative Integration are to improve health care outcomes and the experience of care for Medi-Cal members—particularly those living with co-occurring mental health and SUD issues—by reducing administrative burden for members, counties, providers, and the state.
This initiative is a multi-year effort that begins with the implementation of related CalAIM behavioral health policies, starting in 2022, including updated Criteria for Specialty Mental Health Services, Drug Medi-Cal Organized Delivery System (DMC-ODS) Policy Improvements, and Behavioral Health Payment Reform. By January 2027, DHCS will implement a single, integrated behavioral health plan in each county or region responsible for providing or arranging for the provision of SMH and SUD. Behavioral Health Administrative Integration will include both Drug Medi-Cal (DMC) and Drug Medi-Cal Organized Delivery System (DMC-ODS) counties, and both state-level and county-level activities will be required to achieve this goal.
Concept Paper for CalAIM Behavioral Health Administrative Integration
In January 2023, DHCS released a Concept Paper describing Behavioral Health Administrative Integration, one of several CalAIM initiatives to transform and strengthen the Medi-Cal behavioral health delivery system.
The Behavioral Health Administrative Integration concept paper, which was developed with input from counties and other stakeholders, provides detail regarding this initiative's framework, goals, the steps needed at the state and county level to achieve those goals, and a phased approach for sequencing these steps between now and 2027. DHCS has accepted stakeholder feedback on the approach described in the concept paper, which will inform DHCS' policy decisions, implementation strategy, and consideration of potential guidance and other technical assistance materials.
Initiative Timeline
Timeline (Subject to Change)| Date | Policy Update |
| January 23, 2023 | Concept Paper Released |
July 2023
| REOI Process for Integrated Contract Early Implementation
|
September 15, 2023
| Launch of Integrated Contract Early Implementers Workgroup |
September 30, 2024*
| Deadline for Integrated Contract Early Implementers Workgroup Counties to Commit to Voluntary Early Integrated DHCS-County Contracts |
| January 1, 2025 | Implementation of Early Integration DHCS-County Contracts Take Effect |
January 1, 2027
| Implementation of Integrated DHCS-County Contracts with All Counties
|
* Revised Date
2025 Integrated Contracts
Informational and Technical Assistance Webinars
- Concept Paper
- January 26, 2023, 3:00 - 4:00pm
- Early Contract Integration
- July 13, 2023, 10:30 - 11:30am
- Medi-Cal Behavioral Health: Updated County Contracts and Refresher on CalAIM Administrative Integration Webinar
- April 28, 2025, 2:00 - 2:50pm
Resources
Frequently Asked Questions
