Date: Wednesday, May 20, 2026

الوقت: 9:30 صباحًا — الساعة 3 مساءً

DHCS Staff Presenters: Michelle Baass, Director; Palav Babaria, Deputy Director, Chief Quality and Medical Officer, Quality and Population Health Management; Rafael Davtian, Deputy Director, Health Care Financing; Marlies Perez, Chief, Community Services; Autumn Boylan, Deputy Director, Office of Strategic Partnerships; Erika Cristo, Assistant Deputy Director, Behavioral Health; Ivan Bhardwaj, Chief, Medi-Cal Behavioral Health Policy Division

SAC Members in Attendance: Adam Dorsey, Al Senella, Anna Leach-Proffer, Beth Malinowski, Bill Barcellona, Chris Perrone, Janice Rocco, Jarrod McNaughton, Jennifer Ruiz, Katie Rodriguez, Kim Lewis, Kiran Savage-Sangwan, Le Ondra Clark Harvey, Linda Nguy, Marina Owen, Michelle Cabrera, Ryan Witz, William Walker

BH-SAC Members in Attendance: Adrienne Shilton, Al Senella, Catherine Teare, Dannie Ceseña, Gary Tsai, Hector Ramirez, Jason Robinson, Jei Africa, Jennifer Ruiz, Kirsten Barlow, Kim Lewis, Kiran Savage-Sangwan, Le Ondra Clark Harvey, Michelle Cabrera, Leticia Galyean, Rebecca Sullivan, Robert Harris, Rose Veniegas, Samuel Jain, Sara Gavin, Vitka Eisen, William Walker

معلومات إضافية: يرجى الرجوع إلى عرض PowerPoint التقديمي المستخدم أثناء الاجتماع للحصول على سياق وتفاصيل إضافية.

مقدمة وملخص للمحتوى

• The joint SAC/BH-SAC meeting addressed topics related to Medi-Cal and California’s behavioral health landscape. Panel members received a Director’s update on the changes to the Governor’s 2026-27 proposed budget (May Revision) based upon the latest economic forecasts. The following topics were also covered during the meeting:
  • استراتيجية DHCS الشاملة للجودة والإنصاف الصحي: التحديات والفرص في عصر متطور
  • تحديث التحول الصحي السلوكي
  • Children and Youth Behavioral Health Initiative (CYBHI) Fee Schedule Program and BrightLife Kids and Soluna
  • تحديثات الشبكات المنظمة القائمة على المجتمع للصحة السلوكية للرعاية والعلاج العادل (BH-CONNECT): صناديق النشاط ومبادرة القوى العاملة وتنفيذ المقاطعة
• واختُتم الاجتماع بفترة تعليقات عامة، مما أتاح للحضور تقديم ملاحظاتهم إلى إدارة خدمات الرعاية الصحية وأعضاء اللجنة.

الموضوعات التي تمت مناقشتها

Director’s Update

ميشيل باس، مديرة

DHCS opened the meeting by providing an overview of the Governor’s May Revision Budget Proposal for fiscal year 2026-27, highlighting a total allocation of $334.2 billion for health and human services, with $223.2 billion designated for DHCS and 4,749.5 positions. DHCS detailed major budget issues and proposals, including changes to the Managed Care Organization (MCO) Tax, work and community engagement requirements, adjustments to Medi-Cal eligibility and administration, and efficiency measures. Additional solutions involve premium increases for certain adults, asset test limits, program caps, and elimination of optional benefits. The presentation also directed viewers to official resources for further information on budget highlights and legislative language.

مناقشة

• A member asked for clarification on expected Medi‑Cal coverage losses due to policy changes, including the reinstated asset test and upcoming federal work requirements, noting concerns that future federal guidance could further increase disenrollment. They also asked whether a $1.1 billion Centers for Medicare & Medicaid Services (CMS) deferral would affect the current budget. DHCS confirmed that its estimates are based on current information and conversations with CMS, acknowledging that upcoming federal rules could change the numbers. They reiterated that approximately 25,000 individuals are expected to lose coverage in the first year of the asset test reinstatement, growing to about 37,000 in later years, based on prior analyses of seniors who gained eligibility when the asset test was eliminated. DHCS also stated that no changes have been made to mobile crisis or 2025 Budget Act proposals, and that the CMS deferral does not impact this year’s budget.
• A member asked whether DHCS would consider pursuing a three‑fourths vote bill to keep the initial 2027 MCO Tax proposal compliant with Proposition 35 before shifting to a new two‑thirds structure, if necessary. DHCS responded that Proposition 35 requires a tax structure substantially like the current one, but federal approval is unlikely due to changes under H.R. 1. For that reason, DHCS is moving forward with an alternative structure designed to generate $2.3 billion to support Medi‑Cal. They clarified that Proposition 35 does not prevent the state from implementing an MCO Tax outside its provisions, noting that California already operates components of the MCO Tax outside Proposition 35 under Assembly Bill (AB) 119.
• A member voiced concerns about Medi-Cal asset test reinstatement and asked whether updated termination data is available, while also requesting more details on changes to Enhanced Care Management (ECM) and Community Supports. DHCS explained that asset test data from January and February are still preliminary and will be shared once more complete. DHCS outlined upcoming changes in the 1115 waiver renewal, including transitioning recuperative care from a short‑term post‑hospitalization benefit to in lieu of services (ILOS) authority, with updated requirements based on provider feedback. DHCS also described refinements to Community Supports, such as limiting referral sources for asthma remediation and medically tailored meals to primary care or specialists, adjusting payment levels for housing‑related services to match service intensity, and maintaining ECM’s high‑touch, in‑person model. They emphasized that all Community Supports must remain medically appropriate, cost‑effective alternatives to State Plan services and noted that ongoing cost‑effectiveness analyses continue to shape these refinements.
• A member asked about the upcoming reinstated Medi-Cal asset test and expressed interest in understanding its impact on different age and disability populations. They also raised concerns about the transition to fee‑for‑service, emphasizing the need for a stable provider network and sustained support for public hospitals, including resolving payment challenges for services delivered to populations shifting into fee‑for‑service. Lastly, they requested clarification on the state’s approach to indigent care funding. DHCS responded that they are focused on ensuring the transition succeeds and acknowledged the broader eligibility workload shared with the California Department of Social Services (DSS), noting that while some funding is included, it remains short of stakeholder estimates. DHCS added that the May Revision does not provide funding for indigent care programs and that they are proposing overall reductions within Medi-Cal, with further discussions expected as policy and budget considerations evolve.
• A member expressed concern that recent May Revision decisions, combined with H.R. 1 changes, will reduce Medi‑Cal coverage and access, and questioned why the state would submit an MCO Tax proposal known to be out of compliance with federal rules under Proposition 35. They also asked how individuals with Unsatisfactory Immigration Status (UIS) who are unbanked would be able to pay new monthly premiums. DHCS responded that the state will provide cash‑payment options like those used for utility or phone bills, allowing people to pay premiums at common retail locations, such as grocery stores or Walmart.
• A member expressed concerns about the shift of the UIS population to fee‑for‑service, noting the challenges posed by low provider rates, network instability, and premium increases, as well as the substantial impact on public hospitals that serve large UIS populations. They urged the administration to avoid further Medi‑Cal cuts and consider alternative solutions, emphasizing the need to maintain access to care and support safety net providers. They also sought clarification on inpatient rate and payment issues for public hospitals under the upcoming transition. DHCS acknowledged the advocacy and reiterated its shared commitment to protecting the Medi-Cal program, expressing appreciation for stakeholders’ continued engagement.
• A member voiced deep concern that recent budget decisions and policy shifts send a harmful message to vulnerable communities, especially immigrants and people with disabilities, who already face profound barriers. They described how the Medi-Cal asset test previously kept them in poverty and highlighted broader worries about equity, cultural responsiveness, stakeholder exclusion, and the risk that current changes will again leave the most impacted populations behind. They urged the state to uphold its commitments and ensure that equity remains central to California’s values. DHCS responded by reaffirming that equity remains a core departmental priority, noting ongoing efforts to use data to guide improvements, and emphasizing that the difficult May Revision proposals reflect the need to preserve existing programs. DHCS thanked the member for their advocacy and encouraged continued engagement.
• A member voiced strong concerns about the May Revision proposal to shift UIS Medi‑Cal members, including children, older adults, and people with complex needs, out of managed care and into fee‑for‑service, arguing that the fee‑for‑service network lacks the infrastructure, coordination, and partnerships needed to provide comprehensive care. They emphasized the risks to continuity of care, local provider networks, and community‑based support, urging the state to pursue an alternative approach that keeps UIS members in managed care while still meeting federal requirements. DHCS responded that the proposal is driven entirely by new federal guidance and the loss of roughly $6 billion in federal funding for emergency services, which the state cannot backfill with General Funds. They noted that DHCS is actively working on continuity‑of‑care strategies, analyzing managed care plan (MCP) and fee‑for‑service provider networks, and preparing for scheduled services in 2027, while acknowledging the need for ongoing dialogue as the transition moves forward.
• A member asked about three issues: whether maintaining upcoming MCO Tax rate increases is a CMS requirement or a state policy choice, why savings from shifting UIS members to fee‑for‑service cannot be used to preserve full‑scope Medi‑Cal coverage for humanitarian immigrants who would otherwise lose benefits, and whether limiting referral pathways for asthma remediation will restrict access for members who do not regularly engage with primary care. DHCS clarified that the rate increases are required under statute and tied to BH‑CONNECT requirements, not mandated directly by CMS. They acknowledged the concern about humanitarian immigrants and encouraged continued advocacy, but did not provide a definite policy path. On asthma remediation and other Community Supports, DHCS emphasized that many plans already use population‑health approaches and that they do not intend to restrict plans from identifying eligible members or generating referrals based on data‑driven care management.
• A member asked whether the proposed reductions to ECM and Community Supports are separate from, or in addition to, expected enrollment declines under H.R. 1, and requested clarity on which Community Supports DHCS is targeting for refinement. DHCS explained that the estimates already account for projected caseload changes, and the reductions are indeed additive, reflecting policy refinements rather than enrollment‑driven adjustments alone. They noted that, after four years of experience with 14 Community Supports, DHCS is evaluating which services are producing meaningful outcomes and which are not. Examples include housing transition navigation services being billed month after month without resulting in placements, and low‑intensity ECM delivered without fidelity to its intended high‑touch model. DHCS stated that the proposed adjustments aim to ensure services are effective, appropriately intensive, and aligned with program goals while preventing taxpayer dollar waste.
• A member thanked DHCS for the discussion and echoed concerns about carving out UIS members from managed care, urging continued dialogue on alternative approaches. They emphasized that federal guidance does allow states to operate state‑only funded services through separate contracts, suggesting this could offer a path to preserving the coordinated systems that have been built over many years. The member encouraged DHCS and stakeholders to keep exploring options that maintain stability, protect vulnerable members, and build on the existing infrastructure that best supports communities.

استراتيجية DHCS الشاملة للجودة والإنصاف الصحي: التحديات والفرص في عصر متطور

Palav Babaria, Deputy Director, Chief Quality and Medical Officer, Quality and Population Health Management; Rafael Davtian, Deputy Director, Health Care Financing

DHCS outlined the Department’s comprehensive strategy to advance quality and health equity in Medi-Cal. The strategy emphasizes engaging members in their own care, eliminating health disparities, and improving outcomes through data-driven, transparent, and community-based approaches. Key priorities include children’s preventive care, behavioral health integration, and maternity outcomes. The strategy sets bold goals to reduce disparities and improve screening and care, with ongoing measurement and accountability. DHCS highlighted improved community involvement, public transparency, and incentive programs, while accelerating transformation through data exchange, value-based purchasing, and primary care investment. The presentation also detailed initiatives for behavioral health, hospital and skilled nursing facility value strategies, and payment redesigns to ensure sustainable, high-quality care for all Medi-Cal members.

مناقشة

• A member expressed appreciation for finally seeing tangible behavioral health data, but raised concerns about its accuracy, noting that reported metrics, such as access, timeliness, and outcomes, often do not reflect lived experience, especially in counties like Los Angeles. They emphasized the need for better data quality and highlighted persistent accessibility barriers for people with disabilities, particularly deaf and hard‑of‑hearing individuals who often must rely on urban Indian health centers for accommodations. They urged DHCS to build accessibility and accountability into data systems and enforcement processes, explaining that complaint pathways frequently fail their community. DHCS acknowledged the concerns, noting that data undergoes validation and auditing, but may still miss encounters that were not billed or reported correctly. They explained that transparency and improved reporting should strengthen accuracy over time and shared that DHCS is working with the National Committee for Quality Assurance (NCQA) on ways to better identify and measure disability status at a national level.
• A member thanked DHCS for the committee improvements and highlighted the success of quality initiatives, such as the pediatric visual and plan collaboration. They noted that UIS members have shown strong gains in key quality measures, such as well‑child visits, cervical cancer screening, and asthma medication adherence, and warned that shifting these members to fee‑for‑service, combined with H.R. 1 cuts, would reverse that progress. They stressed that fee‑for‑service lacks the coordinated infrastructure that made these improvements possible and shared that many providers are overwhelmed, financially strained, and considering leaving California altogether. The member urged the state to preserve the progress achieved in quality and access, emphasizing that maintaining the current managed care structure is critical for both patients and providers.
• A member expressed appreciation for DHCS’ leadership and transparency, noting the value of seeing progress toward major quality goals. They also shared concerns that some underlying data trends, such as rising rates of Medi‑Cal members without a usual source of care, persistent low plan quality scores, and ongoing racial disparities in well‑child visits, appear less encouraging than the presentation suggests. The member asked for underlying data behind the “on track” assessments and raised disappointment that the long‑promised Health Equity Roadmap report and updates to the MCP dashboard have not been published. DHCS acknowledged these concerns, committing to follow up on the missing report and emphasizing that while some measures show improvement relative to benchmarks, broader national challenges, like declining primary care access and lower immunization rates, affect overall performance. DHCS noted remaining disparities and underscored the need for value‑based care reforms to address deeper systemic issues beyond quality measurement alone.
• A member acknowledged DHCS’ efforts to maintain focus on quality and equity despite broader pressures on Medicaid and asked how real‑time data exchange and closed‑loop referrals could meaningfully improve care, given longstanding data lags and fragmentation across systems. DHCS explained that the goal of real‑time data exchange is to ensure members receive timely services, such as connecting someone in a mental health crisis in the emergency department (ED) to county behavioral health before their condition worsens rather than waiting weeks or months for claim‑based information. They noted that timely, local data‑sharing between EDs, county behavioral health, and other care partners will directly improve measures like seven‑ and 30‑day follow‑up after ED visits. While DHCS ultimately hopes to integrate with statewide health information exchanges, they emphasized that it is most critical for providers to access actionable, real‑time information to support member care.
• A member expressed appreciation for DHCS’ growing focus on health equity, but highlighted the challenges behavioral health systems face in meeting new expectations while simultaneously navigating major federal and state funding shifts. They noted that many improvements in behavioral health data reflect both better data collection and early impacts of recent reforms, but emphasized that the field is still catching up and is being asked to perform at levels comparable to MCPs despite starting from behind and experiencing prevention funding cuts. The member urged DHCS to balance bold equity goals with the realities of system disruption, provider fear, and resource loss, and requested more transparency, such as displaying all five bold goals by health plan and disparities on the dashboard. DHCS agreed, stressing the need to embed equity into the foundation of program design, ensure spending aligns with what truly serves members, and continue advancing the Health Equity Roadmap work.
• A member expressed appreciation for DHCS’ leadership and noted that, despite the many challenges facing Medi‑Cal members, providers, and organizations, it is important to recognize the progress being made. They shared that their plan in San Bernardino and Riverside counties has achieved its highest quality performance in 30 years on Managed Care Accountability Set (MCAS) measures and accreditation, crediting DHCS’ statewide push for accountability and quality improvement. The member emphasized that strong incentives and, when necessary, sanctions have helped drive meaningful improvement and urged DHCS to continue prioritizing equitable access and high‑quality care. They closed by thanking DHCS, acknowledging that their organization’s successes reflect a true partnership with the Department.
• A member asked DHCS to provide a high‑level roadmap for future behavioral health payment reform, noting that counties like theirs have already begun implementing outcome‑focused incentive payments and need clarity on the timeline for potential shifts, such as capitation. They emphasized the importance of allowing counties flexibility to design alternative payment models (APM) that match their local networks, provider strengths, and operational realities, rather than imposing prescriptive statewide structures. DHCS agreed, acknowledging lessons learned from recent behavioral health payment reform efforts and the need to support counties with both flexibility and innovation as systems evolve. While DHCS does not yet have a long‑term roadmap, they committed to continued dialogue and highlighted that APMs are intended to be plan‑to‑provider arrangements, not DHCS‑mandated models.
• A member emphasized the importance of recognizing regional variation in provider networks and urged DHCS to account for these differences as payment reforms evolve. They also raised concerns about how comparisons to Medicare equivalent rates might affect equity, noting that hospitals across regions vary widely in how close they are to Medicare benchmarks. They cautioned that applying a single statewide Medicare‑equivalency standard without considering geographic disparities could create inequitable impacts. DHCS agreed with the concern, explaining that under H.R. 1, Medicare rate comparisons are expected to occur at an aggregate statewide level rather than region‑specific, but also emphasized that many details remain unclear pending future CMS guidance. DHCS acknowledged that regional differences must be carefully considered once federal rules are finalized.
• A member expressed strong support for Office of Health Care Affordability’s (OHCA) primary care work and optimism about developing a hospital value‑based payment strategy, noting its importance given the financial distress many California hospitals face. They encouraged DHCS to consider broader alignment across payers and suggested revisiting the Healthy California Commission’s financing recommendations to identify opportunities for strengthening hospital sustainability. The member also urged that the upcoming stakeholder group include diverse representation beyond hospitals and plans to ensure California can move toward a more effective and equitable system.
• A member thanked DHCS for recent management guidance and asked whether the proposed value‑based payment strategy applies only to general acute care hospitals receiving state‑directed payments or could also include inpatient psychiatric facilities. They also urged DHCS to encourage plans to invest in upstream, non‑specialty care, especially important amid H.R. 1 impacts, to help members retain coverage and access preventive services through primary care rather than specialty settings. DHCS explained that the initial phase of the hospital value‑based strategy focuses on managed care and compliance with new federal rules for state‑directed payments, but that future work will be part of a broader, multi‑year roadmap covering the full care continuum. They added that new behavioral health transformation measures now allow better tracking of non‑specialty versus specialty mental health utilization, enabling earlier interventions, and emphasized that the upcoming stakeholder workgroup will include diverse voices beyond hospitals and plans.
• A member thanked DHCS for fostering effective collaboration between behavioral health departments and health plans on quality alignment, and voiced strong support for the primary care spend initiative. They flagged data accuracy concerns with OHCA’s methodology, noting that spend is identified via taxonomy‑based claims rather than dollars, which produced a 33% discrepancy in their initial report. They also highlighted billing differences across safety net clinics that can artificially depress the apparent primary care spend in rural areas, urging improvements so reports more accurately reflect true investment.

التحول الصحي السلوكي

مارليس بيريز، رئيسة الخدمات المجتمعية

DHCS provided an update on California’s Behavioral Health Transformation, focusing on county-level integrated planning, transparency, and infrastructure expansion. All California counties have submitted draft Integrated Plans, with most under review and some already approved or revised. The process emphasizes stakeholder engagement, public comment, and oversight to ensure plans address local needs and priorities. DHCS presented on the new Behavioral Health Public County Profile platform, which offers accessible, standardized behavioral health data for oversight and comparison. DHCS also highlighted the Bond Behavioral Health Continuum Infrastructure Program (BHCIP), which exceeded goals for beds and slots, awarding more than $4 billion to expand facilities and services statewide, including innovative projects for Tribal and underserved communities. Thirty-six new facilities are now open, projected to serve nearly one million people annually.

مناقشة

• A member asked whether DHCS is monitoring how Proposition 1 is affecting cuts to community-based behavioral health services, noting reports of significant losses in peer support contracts statewide. DHCS explained that tracking county contracting decisions is not part of the Integrated Plan and that counties independently determine which services to continue, though certain Proposition 1 requirements must still be met. While DHCS does not receive formal data on contract changes, they have heard anecdotal reports, particularly related to population-based prevention services no longer eligible under the Behavioral Health Services Act (BHSA) and noted that the California Department of Public Health (CDPH) will soon release final funding guidance. DHCS added that some counties may draw on other funding sources, such as the opioid settlement or Substance Abuse and Mental Health Services Administration (SAMHSA) funds, and that the full impact of Proposition 1 may be unclear until implementation settles.
• A member asked for more detailed information about how BHCIP‑funded beds and slots are categorized by service type and also wondered whether any themes emerged among counties whose Integrated Plans required additional clarification. DHCS explained that detailed BHCIP information is currently available on the administrative entities website and will be consolidated on the DHCS website this summer, along with new data from their Licensing and Certification Portal (LCP) that identifies facilities tied to BHCIP and enables long‑term monitoring of required behavioral health services. Regarding Integrated Plans, DHCS noted that counties faced a significant “lift and shift” in adapting to the new process, and much of the follow‑up involved clarifying requirements, ensuring information was submitted in the correct sections, and reviewing statutory funding distribution between mental health and substance use disorder treatment. DHCS continues to work closely with counties through technical assistance and acknowledged their substantial effort in submitting all Integrated Plans on time.
• A member expressed appreciation for DHCS’ support and acknowledged the significant effort counties have made to adapt to the new Integrated Plan process. They explained that a major ongoing challenge is helping communities understand the complexity of the changes, especially as new requirements and last‑minute additions, such as recent CARE Court guidance, continue to emerge. They noted that some county feedback centered on clarifying issues like funding for substance use disorder services and misunderstandings about priorities. As counties work to finalize their plans, the member emphasized that community confusion remains high, particularly regarding the shift of prevention funds to CDPH, and highlighted the need for continued communication and support to address this uncertainty.
• A member expressed appreciation for the collaborative work with DHCS, but raised concerns about the county profile template, noting that behavioral health systems vary widely and that standardized profiles may lead to misleading comparisons without proper context, especially given differences in Medi-Cal populations and available funding streams. They emphasized the unpredictability of current budget and federal policy environments and urged DHCS to remain flexible and open to modifying requirements as new information emerges. DHCS responded that the first release of county profiles is final and based on publicly available data, but additional behavioral health metrics will be added in future phases. They noted that the profiles aim to provide a broad view of county behavioral health, not just director-level data, and reiterated their commitment to continued collaboration and feedback before the summer release.
• A member asked how DHCS reviews Integrated Plans before sending them back to counties and emphasized the importance of monitoring what services may be lost due to Proposition 1, particularly early intervention and prevention programs. They also requested more detailed BHCIP data on specific populations served and asked how the state handles BHCIP funds that are returned. DHCS explained that its review process includes checking narrative and budget alignment, ensuring statutory requirements are met, and evaluating measures and county explanations. Because this is the first cycle of Integrated Plan reviews under BHSA, DHCS noted that all parties are still learning and adjustments will occur annually through the update process. For BHCIP, DHCS stated that detailed information will continue to be published, and any relinquished funds from Round 2 will be reallocated to other strong Round 2 applications, given the high demand and significant number of unfunded proposals.
• A member praised the long-term impact of BHCIP investments and asked whether DHCS has considered how facilities might be affected if populations decline due to H.R. 1, noting that demand projections were built on high utilization levels. DHCS responded that they have planned for such shifts through a project scope change process already used in earlier rounds, which allows facilities to modify their service type, such as shifting from a Children’s Crisis Residential Programs (CCRP) to a Psychiatric Residential Treatment Facility (PRTF), when needs evolve. DHCS explained that over the 30-year commitment period, counties may need to adjust facility types as local behavioral health needs change, and as long as the services remain behavioral health-focused and counties agree, DHCS supports those transitions.
• A member asked for clarification on how to access county profile information and what behavioral health data, such as mental health and Drug Medi-Cal service metrics, is currently available through DHCS or the California Health and Human Services (CalHHS) open data portal. DHCS explained that the county profiles are not posted yet but will be released soon as part of the spring launch, with a more limited initial dataset followed by a more comprehensive summer update that will include Integrated Plan information and Phase 2 performance measures. DHCS noted that mental health Medi-Cal member data will be included first, while substance use data will follow a few weeks later to incorporate more recent updates. DHCS emphasized that the goal is to provide a single, centralized location on the DHCS website where counties and the public can access up‑to‑date behavioral health information, including Medi-Cal data, BH-CONNECT participation, CARE Court details, and other key indicators.
• A member expressed appreciation for the impact of BHCIP projects in the community, particularly for disabled individuals who often struggle to access mental health services but raised concerns about the long-term sustainability of facilities located in isolated areas and asked who is responsible for ensuring patient safety and responding when individuals in programs like CARE Court report lack of support. DHCS explained that the Department oversees licensing for most behavioral health facility types and maintains a complaint line for reporting issues with care, which triggers an investigation. They added that DHCS is working closely with CDPH and the Department of Health Care and Access and Information (HCAI) on workforce expansion efforts supported by Prop 1 and BH-CONNECT, noting that a strong and growing workforce is essential to maintaining high-quality, safe behavioral health services statewide.

CYBHI Fee Schedule Program and BrightLife Kids and Soluna

أوتومن بويلان، نائب مدير مكتب الشراكات الاستراتيجية

DHCS highlighted the progress and impact of the CYBHI Fee Schedule program, which reimburses schools and colleges for specified outpatient behavioral health services provided to students. As of March 2026, 169 local educational agencies and providers have submitted claims, resulting in more than 121,000 reimbursed claim lines and $6.84 million in new revenue for participating institutions. The program has supported more than 43,000 students, with a diverse provider mix, including licensed practitioners, school counselors, nurses, and wellness coaches. Most claims are for treatment and psychoeducation services, with additional support for screening, assessment, and care coordination. The presentation also featured BrightLife Kids and Soluna, digital behavioral health services offering free, confidential behavioral health coaching and resources to children, youth, and families statewide, expanding access and reducing barriers to care. The 2025 Impact Report highlighted how BrightLife Kids and Soluna have expanded access and support for more than 500,000 children, youth, and families across all 58 California counties. Both platforms delivered more than 112,000 coaching sessions and made more than 5,200 referrals to community-based services, helping users access higher-acuity care when needed. The programs continue to reach historically underserved communities, offering culturally responsive, multilingual support and reducing barriers like cost, wait times, transportation, and stigma.

مناقشة

• A member asked whether the Fee Schedule’s claims, encounter data, and provider counts include all payers and if the data can be stratified by payer source, as well as whether the provider manual for certified wellness coaches is available. DHCS responded that payer‑mix data is not yet available because plans with multiple lines of business have not finished exchanging enrollment files indicating each child’s coverage type. This exchange is expected to be completed next year, after which payer‑mix calculations can begin. DHCS noted they are starting Medi‑Cal data‑matching to better identify Medi‑Cal members. Preliminary guidance for wellness coaches has been released, and the provider manual was expected to be posted in mid‑May.
• A member asked about language access and utilization for BrightLife Kids and Soluna, as well as how well handoffs to traditional services are tracked. DHCS explained that while the services are available in English and Spanish, users can access coaching in any of the 19 Medi-Cal threshold languages through a language line. Most reported utilization so far is in English, though community partners note strong engagement among Spanish speaking families, particularly in the Central Valley. DHCS is working to improve data transparency on language use. The department also noted that vendors track warm handoffs, with more than 5,000 closed-loop referrals made to community partners during the reporting period. These partners have formal agreements for handoffs, while additional community organizations support outreach, and DHCS recently published county specific profiles detailing utilization and partnerships.
• A member asked whether DHCS could share a geographic “heat map” showing where school‑based fee schedule activity is concentrated and inquired about a recent spike in BrightLife Kids and Soluna utilization. DHCS explained that while they operate in 43 counties and have begun publishing information on high‑reimbursement “Fee Schedule champions,” they do not yet have a reimbursement heat map, but can provide one in the future. DHCS noted that claims volume under the Fee Schedule has surged since January, with reimbursements reaching about $1 million from mid‑April to now and roughly $500,000 per week, suggesting that the reported spike in utilization is indeed linked to increased Fee Schedule activity.

BH-CONNECT Updates: Activity Funds, Workforce Initiative, and County Implementation

Erika Cristo, Assistant Deputy Director, Behavioral Health; Ivan Bhardwaj, Chief, Medi-Cal Behavioral Health Policy Division

DHCS provided updates on the BH-CONNECT initiative, focusing on Activity Funds, workforce programs, and county opt-in status across multiple efforts. The Activity Funds program offers up to $1,000 for eligible Medi-Cal youth to support an eligible member’s inclusion in the community and promote improved physical and behavioral health outcomes through activities like sports and arts, with eligibility determined by clinical need and child welfare involvement. The fiscal intermediary, Public Partnerships, LLC, manages provider enrollment, payments, and portal support. The workforce initiative, in partnership with HCAI, invests up to $1.9 billion in programs, such as student loan repayment, scholarships, and training, to strengthen the behavioral health workforce, with nearly 1,800 awards distributed across California for the Student Loan Repayment Program. The presentation also highlighted county opt-in status for evidence-based practices (EBP), the Institutions for Mental Disease Federal Financial Participation (IMD FFP) program, and resources for further information. Public comment guidelines and upcoming meeting dates were provided.

مناقشة

• Due to time constraints, the discussion portion of this presentation did not occur. Members and attendees were advised to submit any questions, comments, or feedback to DHCS at BH-CONNECT@dhcs.ca.gov.

تعليقات الجمهور

خلال فترة التعليق العام، سُمح للحاضرين بالتعبير عن مخاوفهم وتقديم التعليقات إلى DHCS وأعضاء اللجنة.

• A member of the public expressed appreciation for the Department’s engagement with providers during a period of significant change and overlapping initiatives. They emphasized the need for practical and sustainable program approaches, noting that providers are struggling with fragmented data systems, inconsistent reporting requirements, and limited interoperability. The member also echoed concerns about sustainable financing and timely reimbursement, particularly for ECM and Community Supports services, and affirmed their organization continues to be committed to partnering with DHCS throughout these initiatives.
• A member of the public thanked DHCS for its work on CalAIM, the Data Exchange Framework, behavioral health, and other major initiatives, noting the significant progress made in recent years and the ongoing opportunities ahead. The speaker emphasized the importance of prioritizing older adults and individuals with disabilities in planning, budgeting, and program development, highlighting concerns about asset limits contributing to homelessness among older adults. The speaker also cautioned that lowering Programs of All-Inclusive Care for the Elderly (PACE) reimbursement rates could undermine the program’s ability to keep high‑acuity older adults in their homes.
• A member of the public expressed gratitude for the opportunity to share stakeholder feedback and represent the voices of both the board she represents and Community Health Workers (CHW). The member expressed opposition the DHCS May Revision proposal to transition members to state‑run fee‑for‑service, noting it would reduce access to care and jeopardize the comprehensive benefits and robust provider networks currently offered by local plans. They emphasized that this change would particularly harm immigrant communities and the large population of children and adults with UIS in Santa Barbara County. They warned that the transition would have severe effects across physical and behavioral health, disrupting a well‑established network of culturally responsive CHW providers and eroding local trust and continuity of care.
• A member of the public thanked the committee for the opportunity to share feedback and highlighted that Indigenous communities are being heavily affected by recent Medi-Cal changes. The member opposed the transition to state‑run fee‑for‑service, warning that it would reduce access to care, leaving many, including farmworkers, without preventive services until emergencies arise. The speaker noted significant confusion in the community and emphasized the importance of partnerships between community‑based organizations and local plans like CenCal in reducing harm. They stressed that immigrant communities are already under attack nationwide and urged collaboration to ensure California makes positive, protective changes for vulnerable populations.
• A member of the public explained that their organization works with DHCS plans and providers to implement asthma remediation and complementary preventive services and expressed serious concern about the May Revision proposal limiting referrals to a member’s health care team. They noted that utilization of asthma remediation has already been extremely low due to challenges in generating referrals and warned that the proposed restriction would further reduce access to these important services. The speaker emphasized that DHCS originally implemented asthma remediation because strong evidence showed it reduced costly ED visits and hospitalizations, and encouraged DHCS to reconsider the proposal while offering to discuss the negative implications in more detail.
• A member of the public addressed the CYBHI and the Activity Funds program, acknowledging California’s recognition of the behavioral health crisis affecting children, youth, and families. They stressed the need for these programs to reach families most impacted by trauma, poverty, foster care involvement, reunification challenges, and community violence. They expressed concern that access to Activity Funds and behavioral health supports appeared tied only to Medi‑Cal, county behavioral health, providers, or child welfare pathways, emphasizing that families should not have had to enter formal systems to receive prevention and healing services. Drawing from their own experience navigating reunification, the speaker noted that families often lacked adequate support after children returned home and needed trauma‑informed care, peer support, youth wellness activities, transportation, housing stabilization, and long‑term healing resources. They urged DHCS to recognize the work of grassroots and lived‑experience‑led organizations and to ensure equitable funding and participation opportunities for smaller community‑based groups, emphasizing that the behavioral health crisis cannot be solved without centering the voices of those who have lived through these systems.
• A member of the public expressed that Medi-Cal MCPs have served as a safety net by helping members navigate the health care system. They explained that if the state shifts members to fee‑for‑service, that support would disappear, leaving undocumented adults to manage a very complex system alone. As a result, many community members will likely disenroll or delay seeking care because the health system is confusing and intimidating.
• A member of the public emphasized the value their community and local support have, highlighting CenCal Health as a trusted partner that has invested financially and through active participation in National Association for the Advancement of Colored People events and community initiatives. They stated that health equity is central to the organization’s mission and expressed strong opposition to the May Revision proposal to transition members to fee‑for‑service, respectfully requesting that the decision be reversed. The speaker affirmed their commitment to dismantling racism and disrupting inequality and urged DHCS to share that commitment.

رفع الجلسة والاجتماع القادم للجنة الاستشارية العلمية/لجنة الاستشارات العلمية التابعة للهيئة العامة للصحة

شكرت إدارة الصحة والخدمات المجتمعية أعضاء اللجنة والجمهور على مشاركتهم قبل أن تقدم تذكيراً بالاجتماع القادم.

• The next meeting is scheduled for August 19, 2026. Register here.
• ستظل اللجنة المشتركة بين SAC وBH-SAC تعمل بنظام هجين حتى إشعار آخر.