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DHCS Director Michelle Baass' Message on the End of the COVID-19 Public Health Emergency (PHE)  

DHCS expresses gratitude to our plans, providers, stakeholders, and other partners for their commitment and partnership during the COVID-19 PHE. We worked together and adapted quickly to the pandemic's challenges and difficulties to care for millions of Californians. Our joint efforts enabled us to navigate the PHE with resilience and perseverance, and we are grateful for your ongoing engagement.  

The health care industry, particularly hospitals, behavioral health facilities, and skilled nursing facilities, faced the brunt of the PHE's impact. The surge in COVID-19 cases placed immense strain on those facilities, stretching resources to their limits and challenging our workforce as never before seen with overwhelming patient volumes, shortages of critical supplies and equipment, and the need for additional staff. Despite these challenges, our collective efforts enabled us to continue providing vital services. Some examples include, making permanent telehealth policies implemented during the PHE, including payment parity, flexibilities for FQHC partners and expanding telehealth to all delivery systems, stabilizing and retaining California's health care workforce by providing retention payments to workers in qualifying facilities and clinics, and launching a Coverage Ambassadors program and Renewal Campaign to ensure that Medi-Cal members know how best to retain their health coverage, we have demonstrated our commitment to serving Californians.   

Rebuilding and strengthening our health care system requires a continued collaborative effort. We must focus on implementing strategies to bolster our system and workforce. We've learned a lot from this pandemic, and how we can better protect the health and well-being of all Californians, now and in the future.   

As a reminder, the end of the federal COVID-19 PHE has implications for Medicaid and the Children's Health Insurance Program (CHIP). DHCS acted to make permanent several flexibilities implemented over the course of the PHE. Below is a summary of end dates for key federal Medicaid provisions, with additional details on how DHCS unwound the PHE in the Medi-Cal program.  

Medicaid and CHIP COVID-19 provisions under the American Rescue Plan Act (ARPA):  

  • No-Cost Coverage for COVID-19 Vaccines, Testing, and Treatment for Medi-Cal Members: Medicaid is required to cover COVID-19 vaccines, testing, and treatment with no cost-sharing for members through the end of the ARPA coverage period on September 30, 2024.  DHCS is electing to permanently extend coverage for COVID-19 vaccines, testing, and treatment beyond the ARPA coverage period.    
  • Optional COVID-19 Group for Uninsured Individuals: California has taken advantage of the “optional COVID-19 group," also referred to as the COVID-19 Uninsured Group, that provided uninsured individuals with coverage for COVID-19 vaccines, testing, and treatment. This coverage expires on May 31 and DHCS began sending notices to individuals enrolled in the COVID-19 Uninsured Group about the program's sunset along with a Single Streamlined Application to apply for Medi-Cal or Covered California coverage in late April 2023.   
  • Enhanced Federal Match for COVID-19 Vaccines and Vaccine Administration: States receive 100 percent federal matching funds for coverage of vaccines and vaccine administration, as enacted by ARPA. These matching funds also end on September 30, 2024. As described above, Medi-Cal will continue to cover COVID-19 vaccines.     

Statutory flexibilities made possible by the PHE:   

Section 1135 waivers will expire on May 11 and Medicaid programs were unable to extend those flexibilities beyond the end of the PHE. Additionally, DHCS elected to discontinue emergency Medi-Cal provider enrollment flexibilities before the end of the PHE, effective March 29, 2023.  

The Medicaid Disaster Relief State Plan Amendments (SPAs) also will expire on May 11, except for those that DHCS made permanent. For details on the specific policies that were made permanent through the traditional SPA process, please see Part I of the Medi-Cal COVID-19 PHE and Continuous Coverage Operational Unwinding Plan.  Additionally, DHCS recently updated All Plan Letter 20-004 which provides guidance to Medi-Cal managed care plans on unwinding the temporary changes provided under the PHE.   

Section 1915(c) Appendix K or Section 1115 Attachment K termination dates vary by waiver, but typically will be no later than six months after the end of the PHE. Similarly, DHCS intends to make permanent some 1915(c) and 1115 flexibilities.  For details on these policies, please see part I of the Medi-Cal COVID-19 PHE and Continuous Coverage Operational Unwinding Plan.  

Moving Forward   

COVID-19 may no longer be classified as a public health emergency, however, COVID-19 will continue to be an ongoing health issue and California's SMARTER Plan is specifically designed to effectively manage this ongoing reality. SMARTER, which stands for Shots, Masks, Awareness, Readiness, Testing, Education and Rx, is the next phase of the state's COVID-19 response. It retains California's operational preparedness and will continue to guide our work in supporting communities throughout the state. With the knowledge gained over the past few years, we understand the steps that we must take to prepare for future COVID-19 surges or variants, which includes reducing the burden on health care systems. The SMARTER Plan acknowledges and builds upon California's previous successes and is designed to be adaptable. Additionally, this website hosted by the California Health & Human Services Agency, provides resources for Californians about various services and programs that are impacted by the end of the COVID-19 PHE, including flexibilities and other policy changes.  

Moving forward, working together we can confidently address the challenges that COVID-19 poses while keeping Californians healthy. ​

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Last modified date: 9/14/2023 12:48 PM