Memoranda of Understanding Between Medi-Cal Managed Care Plans and Third-Party Entities
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Medi-Cal Managed Care Plans (MCPs) contract with the Department of Health Care Services (DHCS) to provide high-quality, accessible, and cost-effective health care through managed care delivery systems. The MCP Contract requires MCPs to build partnerships with the following Third-Party Entities to ensure Member care is coordinated and Members
have access to community-based resources in order to support whole-person care:
Local Health Departments;
Local educational and governmental agencies, such as county behavioral health departments for Specialty Mental Health Care and Substance Use Disorder (SUD) Treatment Services; and
Other local programs and services, including
- Social services;
- Child Welfare Departments;
- First 5 County Commissions
- Regional Centers;
- Women, Infants, and Children Supplemental Nutrition Programs; and
- California Department of Corrections and
Rehabilitation, county jails, and youth correctional facilities
The Memoranda of Understanding (MOUs) requirements can be found in the MCP Contract, Exhibit A, Attachment III, Section 5.6 (MOUs with Third Parties). The
MOUs are intended to be effective tools to clarify roles and responsibilities between
MCPs and Third Parties, support local engagement, and facilitate care
coordination and the exchange of information necessary to enable care
coordination and improve the referral processes between MCPs and Third-Party
Entities. The MOUs are also intended to improve transparency and accountability
by setting forth certain existing requirements for each party as they relate to
service or care delivery and coordination so that the parties to the MOU are
aware of each other’s obligations.
The purpose of the MOU is to:
- List the minimum MOU components required by the MCP Contract;
- Clarify roles and responsibilities for coordination of the delivery of care and services of all Members, particularly across MCP carved-out services, which may be provided by the Third-Party Entity;
- Establish negotiated and agreed upon processes for how MCPs and Third-Party Entities will collaborate and coordinate on population health and/or other programs and initiatives;
- Memorialize what data will be shared between MCPs and Third-Party Entities and how the data will be shared to support care coordination and enable monitoring;
- Provide public transparency into relationships and roles/responsibilities between MCPs and Third-Party Entities; and
- Provide mechanisms for the parties to resolve disputes and ensure overall oversight and accountability under the MOU.
MCP Contracts require MCPs to execute an MOU with each of the Third-Party Entities outlined below. DHCS has developed MOU Templates for MCPs and Third-Party Entities to utilize in this process to
ensure that all MCP Contract provisions for MOUs are captured and provide
standardization in reporting. Each MOU is a binding, contractual agreement between the MCP and a Third-Party Entity which outlines the responsibilities and obligations of the MCP and a Third-Party Entity to coordinate and facilitate whole-system, person-centered care for Members.
The Base MOU Template is meant to provide context for the Bespoke MOUs. It includes each of the elements required to be included in all MOUs as set forth in the 2024 MCP Model Contract. The Base MOU Template includes the minimum requirements; MCPs and Third-Party Entities may include additional provisions so long as they do not conflict with the minimum required provisions.
MOUs Effective January 1, 2024
*MCPs participating in the Whole Child Model (WCM) Program should not utilize the California Children’s Services Exhibit F of the LHD MOU and instead should utilize the WCM MOU.
The
WCM MOU can be found at the California
Children’s Services Whole Child Model website.
MOUs Effective July 1, 2024
MOUs Effective January 1, 2025
MOUs Effective January 1, 2026
California Department of Corrections and Rehabilitations, county jails, and youth correctional facilities (Justice Involved) (Template forthcoming)
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Important Updates
DHCS will post important updates as they become available.
DHCS has revised the effective date for the MOUs with California Department of Corrections and Rehabilitations, county jails, and youth correctional facilities and Local Educational Agencies from January 1, 2025, to January 1, 2026.
- DHCS has finalized and published the First 5 MOU County Commissions template.
- DHCS has removed the contract requirement for MCPs to establish MOUs with Continuums of Care (CoC). As DHCS continues stakeholder engagement for Transitional Rent policies, including CoCs and MCPs, DHCS will evaluate the feasibility of MOUs for 2026.
- DHCS has removed the contract requirement for MCPs to establish MOUs with Area Agencies on Aging, and California Caregiver Resource Centers. After careful evaluation, in partnership with other State departments, DHCS determined that this programs' goals can be more effectively achieved through alternative approaches, such as MCP contracts or future program developments.
- DHCS has removed the Home and Community-Based Services Waiver Agencies and Programs MOU requirement for 2025. DHCS may align future HCBS MOU requirements with upcoming decisions on Managed Long-Term Services and Supports integration and waiver periods.
- DHCS will update the MCP Contract/MOU APL 23-029 to reflect to reflect the removal of the MOUs above.
- Additional information will be forthcoming regarding the California Department of Corrections and Rehabilitations, county jails, and youth correctional facilities (Justice Involved) and Local Education Agency MOUs.
Key Documents
DHCS will post key documents as they become available, including:
Informational Webinars
DHCS will post information about upcoming webinars as the information becomes available.
Previous Informational Webinars
- The First 5 County Commissions MOU Post-Release Webinar
- The IHSS MOU Stakeholder Webinar.
- The Regional Center MOU Stakeholder Webinar.
- The Mental Health Plan and Drug Medi-Cal ODSMOU with MCPs Webinar.
- The Child County Welfare MOU Webinar.
- The LHD MOU Webinar
- The WIC MOU Webinar
- The TCM MOU Webinar
- The DMC-SP MOU Webinar
- The CoC MOU Webinar
- The First 5 MOU Webinar
Additional Resources
Listed below are additional resources:
Questions and Comments
Contact DHCS with any questions or comments about the MOUs at MCPMOUS@dhcs.ca.gov.