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
Agency/Entity Type | Program(s) |
|---|---|
| Local Government Agency (LGA) | In-Home Supportive Services (IHSS) |
| LGA/County Behavioral Health Departments | Specialty Mental Health Services in Medi-Cal Mental Health Plans |
| LGA/County Behavioral Health Departments | SUD Treatment Services in Drug Medi-Cal Organized Delivery System (ODS) Counties |
| Regional Centers | Intermediate Care Facility for Developmentally Disabled |
| Local Health Departments | Including, without limitation, California Children’s Services*, Maternal and Child and Adolescent Health, Tuberculosis Direct Observed Therapy |
| LGA/County Social Services Department | County Social Services Programs and Child Welfare |
| Local Health Departments | Women, Infants, & Children (WIC) |
*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
Agency/Entity Type | Program(s) |
|---|---|
| LGA | County-Based Targeted Case Management (TCM) |
| LGA/County Behavioral Health Departments | SUD Treatment Services in Drug Medi-Cal State Plan Counties (DMC-SP) |
MOUs Effective January 1, 2025
MOU Effective January 1, 2026
County Jails and Youth Correctional Facilities (Justice Involved)
California Department of Corrections and Rehabilitations (Justice Involved) (Template forthcoming)
MOU Effective January 1, 2027
Local Educational Agencies (Template forthcoming)
Important Updates
DHCS will post important updates as they become available.
DHCS has released updated MOU Frequently Asked Questions (FAQS) which can be found in the “Key Documents” section below.
On January 16, DHCS participated in a webinar hosted by the UC Davis California Children and Youth System of Care technical assistance team, that highlighted the importance and benefits of Child Welfare MOUs and MCP Child Welfare Liaisons. Information about this webinar can be found at: Silos to Synergy: Transforming Child Welfare Health Through Partnerships With Managed-Care Plans
On December 12, DHCS released the MOU template for county jails and youth correctional facilities and hosted a post-release webinar, at 10:00am. Please see the “Previous Informational Webinars” section below for webinar materials.
A separate MOU template for use between MCPs and California Department of Corrections and Rehabilitations is forthcoming.
On August 12, DHCS hosted a California Department of Corrections and Rehabilitations, county jails, and youth correctional facilities webinar to gain valuable feedback on the Correctional Facility MOU Template. Please see the “Informational Webinar” section below for meeting materials.
DHCS has revised the effective date for the Local Educational Agencies MOU from January 1, 2026, to January 1, 2027.
DHCS has released the California Department of Corrections and Rehabilitations, county jails, and youth correction facilities MOU template. Stakeholder feedback is due back August 22, 2025.
California Department of Social Services has created the following IHSS training videos to support the training provisions outlined in the IHSS MOU.
IHSS Part 1: Introduction to the IHSS Program
IHSS Part 2: Understanding the IHSS Eligibility and the Application Process Section
IHSS Part 3: Understanding the Needs Assessment Section
IHSS Part 4: Understanding IHSS Recipient and Provider Responsibilities
Closed- Loop Referral (CLR) Update
CLR is a referral initiated on behalf of a Medi-Cal Managed Care Member to a service or support that is supported, tracked and monitored and results in a Known Closure. Effective July 1, 2025, CLR Requirements for Managed Care Plans (MCP) will apply to referrals made only to Enhanced Care Management (ECM) and Community Supports. MCPs must comply with Department of Health Care Services (DHCS) CLR Implementation Guidance. More information on CLR requirements can be found here in the Population Health Management Policy Guide.
DHCS did not make updates to the MOU Templates based on this new CLR policy and does not plan to re-issue new MOU Templates. The following MOU provision is intended to help third parties understand MCP requirements to implement CLR and to encourage third parties to collaborate with MCPs’ to incorporate CLR notice requirements into existing referral pathways. DHCS also encourages MCPs to incorporate the updated CLR provision into their MOUs with third parties that are not yet executed.
Updated CLR MOU Provision: Effective July 1, 2025, MCP must comply with DHCS CLR Implementation Guidance. For all referrals made to ECM, Community Supports, and future CLR-applicable services, MCP must implement procedures to track, support, and monitor referrals submitted by [Other Party] through referral closure. MCP must also adhere to requirements for notifying the [Other Party] of the authorization status, referral loop closure reason and closure date within timeframes outlined in the guidance to support [Other Party] in their awareness of referral status and outcomes for Members referred to CLR services. The Parties will work together collaboratively to establish the means and methods for MCP notifications for CLRs. DHCS requires MCPs to use electronic methods to notify referring entities of a referral’s status, not paper-based methods.
Key Documents
DHCS will post key documents as they become available, including:
- All Plan Letter 23-029
- Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Medi-Cal Mental Health Plans Behavioral Health Information Notice (BHIN)
- Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Drug Medi-Cal Organized Delivery System Counties BHIN
- Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Drug Medi-Cal State Plan Counties BHIN
- Base MOU Template
- Frequently Asked Questions
Informational Webinars
DHCS will post information about upcoming webinars as the information becomes available.
Previous Informational Webinars
County Jails and Youth Correctional Facilities MOU Post-Release Webinar
Presentation – December 12, 2025 10:00 – 11:00 AM PT
Webinar Recording- Correctional Facility MOU Template Post-Release Webinar- Youtube
Transcript
California Department of Corrections and Rehabilitations, County Jails, and Youth Correctional Facilities Webinar
Presentation – August 12, 2025 11:00 – 12:00 AM PT
Webinar recording – Correctional Facility MOU Webinar
Transcript
The First 5 County Commissions MOU Post-Release Webinar
Presentation – December 16, 2024 from 10:00 – 11:00AM PT.
Webinar recording- First 5 County Commission MOU Post-Release Webinar- Youtube
Transcript
The IHSS MOU Stakeholder Webinar.
Presentation – October 27, 2023 from 2:00 – 3:00PM PT.
The Regional Center MOU Stakeholder Webinar.
Presentation – November 15, 2023 from 8:30 – 9:30AM PT.
The Mental Health Plan and Drug Medi-Cal ODSMOU with MCPs Webinar.
Presentation – November 28, 2023 from 3:00 – 4:00PM PT.
The Child County Welfare MOU Webinar.
Presentation – December 5, 2023 from 3:00 – 4:00PM PT.
Webinar recording- County Child Welfare MOU Template Webinar – YouTube
Transcript
The LHD MOU Webinar
Presentation – December 15, 2023 from 9:30 – 10:30AM PT.
Webinar recording- Local Health Department (LHD) MOU Template Webinar – YouTube
The WIC MOU Webinar
Presentation – January 26, 2024 from 11:30 – 12:30PM PT.
Webinar Recording – WIC MOU Template Post-Release Webinar – YouTube
Transcript
The TCM MOU Webinar
Presentation – April 15, 2024 from 9:30 – 10:30 AM PT.
Webinar recording- TCM MOU Template Post-Release Webinar – YouTube
Transcript
The DMC-SP MOU Webinar
Presentation was held on May 16, 2024 from 4:00 – 5:00PM PT
Webinar recording – DMC-SP MOU Template Webinar – Youtube
The CoC MOU Webinar
Presentation was held on June 25, 2024 from 11:30AM – 12:30PM PT
Webinar recording – CoC MOU Template Webinar – Youtube
Transcript
The First 5 MOU Webinar
Presentation was held on July 2, 2024 from 11:30AM – 12:30PM PT.
Webinar recording – First 5 MOU Template Webinar
Transcript
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.