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​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​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 DepartmentsSpecialty 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


Program(s)​
First 5 County Commissions​

MOUs Effective January 1, 2026​

Program(s)​
California Department of Corrections and Rehabilitations, county jails, and youth correctional facilities (Justice Involved) (Template forthcoming)
​​Local Educational Agencies (Template forthcoming)

​​Important Updates 

​​DHCS will post important updates as they become available.

  • 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.​
  • DHCS anticipates releasing the California Department of Corrections and Rehabilitations, county jails, and youth correction facilities MOU template in Summer of 2025 for stakeholder feedback.
  • 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.​​​

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

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.

Last modified date: 6/24/2025 10:10 AM