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California refuerza la responsabilidad en las calificaciones de calidad de Medi-Cal

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California refuerza la responsabilidad en las calificaciones de calidad de Medi-Cal

DHCS’ Quality Improvement Strategies Are Driving Measurable Progress Across Medi-Cal

SACRAMENTO — The California Department of Health Care Services (DHCS) today released the 2024 quality ratings for Medi-Cal managed care plans (MCP) and county behavioral health plans (BHP), highlighting measurable improvements in care quality, expanded oversight, and a deepening commitment to health equity across the state’s Medi-Cal delivery system.

This is the fourth year of MCP ratings and the third for BHPs. The ratings are based on performance against the Managed Care Accountability Set and Behavioral Health Accountability Set measures for services delivered from January to December 2024. These measures evaluate how well plans deliver high-quality, equitable care across key domains, such as preventive services, behavioral health, maternal health, and chronic disease management. They also inform DHCS’ oversight of managed care and county behavioral health systems, supporting enforcement actions, such as monetary sanctions and Corrective Action Plans (CAP), when performance standards are not met. Among the key findings:

BHPs are being held accountable through CAPs, with 10 of 56 Mental Health Plans and 29 of 38 Drug Medi-Cal Organized Delivery System plans receiving CAPs based on performance calculated using Medi-Cal Connect, DHCS’ statewide data analytics platform.

“These results reflect our shared commitment to advancing quality and equity across the Medi-Cal delivery system,” said DHCS Director Michelle Baass. “We are seeing real progress in areas like children’s preventive care, dental services, and behavioral health performance. We know there’s more work to do, and we’re holding ourselves and our partners accountable every step of the way.”

DHCS is transitioning to performance-based oversight with a strong emphasis on equity and data-driven progress. For example, in 2025, the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECTAccess, Reform and Outcomes Incentive Program began offering payments to BHPs that demonstrate progress on key behavioral health measures.

“This isn’t just about numbers; it’s about making real, positive changes in the way care is delivered,” said Dr. Palav Babaria, Chief Quality and Medical Officer and Deputy Director of Quality and Population Health Management. “We’re doing it in partnership with our MCP and BHP partners, and I’m incredibly proud of the progress we’ve made so far. Every step we take is about building a Medi-Cal health care delivery system that works for all members.”

Dr. Babaria added, “By leveraging data, aligning incentives, and listening to the voices of Medi-Cal members, we’re creating a system that not only measures performance, but also supports continuous learning and improvement. Our goal is to ensure that every Californian, regardless of geography or background, has access to high-quality, coordinated care.”

Updated fact sheets, enforcement reports, and sanction letters are available on the Medi-Cal Managed Care Monitoring page.

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Elevate Youth California: New Grants Strengthen Community-Based Prevention Across the State

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Elevate Youth California: New Grants Strengthen Community-Based Prevention Across the State

California financia 57 organizaciones para apoyar el liderazgo juvenil y reducir el consumo de sustancias

SACRAMENTO — The Department of Health Care Services (DHCS) today awarded nearly $47 million in grants to 57 community-based and Tribal organizations throughout California to help prevent substance use among youth. These grants support programs that focus on mentoring, peer support, and civic engagement for young people in communities that have historically faced barriers to accessing these services. 

“This funding empowers youth to lead change in their communities,” said DHCS Director Michelle Baass. “By supporting culturally responsive, peer-led programs, we’re investing in the resilience and long-term wellness of California’s young people.”  

Each organization will receive up to $1 million in total over a three-year period, from January 1, 2026, through December 31, 2028, to implement the Elevate Youth California (EYC) program. EYC is designed to help youth ages 12 to 26 build leadership skills, connect with mentors, and access culturally responsive support services.  

WHY THIS MATTERS:This funding is part of a larger effort by DHCS to strengthen California’s substance use disorder prevention programs. EYC helps youth-serving organizations use evidence-based and community-driven approaches to support young people. Programs funded through EYC are healing-centered, trauma-informed, and culturally and linguistically responsive. EYC prioritizes substance use prevention and public health strategies that build resilience. 

This investment also supports Governor Gavin Newsom’s Path & Purpose executive order, which calls on state agencies to support young men and boys in service and leadership and provide meaningful and caring adult relationships for young people living in the highest need communities. All awarded organizations welcome young men and boys. While EYC requires that funded initiatives focus on underserved communities, all genders may participate. DHCS’ 2024 Annual Report shows that 37 percent of the population served by EYC programs are boys. 

WHAT THEY ARE SAYING: “Elevate Youth California funding has been more than just support, but transformative in our practices as a program,” said Ilien Tolteca, Youth Coordinator for the Mixteco Indigena Community Organizing Project. “This funding has allowed us to create and enhance our satellite sites across our city, serving and fostering community with 60 to 100 Indigenous youth from the Mixteco, Zapotec, and many other Diasporic communities throughout the Central Coast. It has strengthened autonomous youth leadership, cultural knowledge, and accessibility to higher education resources/tools for our youth.” 

“The EYC grant has allowed us to provide vital prevention services to foster youth, youth on probation, and others in our community,” said Anthony Hughey, Executive Director of The Young People’s Foundation, Inc. “We’ve built long-term relationships with youth from underserved Black and brown communities and developed peer leaders who are driving change.” 

ABOUT EYC: Since EYC launched in 2019, DHCS has awarded more than $370 million through 517 grants. EYC is funded by Proposition 64, passed by voters in November 2016, which legalized adult non-medical marijuana use in California and created a tax system to regulate cannabis sales. A portion of that tax revenue supports EYC through DHCS, funding youth-focused prevention and leadership programs statewide. These grants support youth development, civic engagement, and peer-led support in 56 of California’s 58 counties.    

PATH AND PURPOSE: In July, Governor Gavin Newsom issued an executive order to address a growing issue — the alarming rise in suicides and disconnection among California’s young men and boys. The order directs a coordinated statewide response to improve mental health outcomes, reduce stigma, and expand access to meaningful education, work, and mentorship opportunities. The full executive order can be found here. The executive order helps address this crisis, directing state agencies to create a new focus on this issue and developing new pathways to help reconnect men and boys with the support, assistance, and help they need. 

To see the full list of EYC grant recipients and learn more about EYC, visit www.elevateyouthca.org.

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California Awards $145 Million To Expand Provider Capacity to Deliver CalAIM Services

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California Awards $145 Million To Expand Provider Capacity to Deliver CalAIM Services

Los fondos ayudarán a los proveedores a implementar una coordinación integral de atención centrada en la persona para los miembros

SACRAMENTO — The California Department of Health Care Services (DHCS) today announced $145.5 million in awards to 153 organizations across all 58 counties to strengthen services for Medi-Cal members. Enhanced Care Management (ECM) and Community Supports are core components of California Advancing and Innovating Medi-Cal (CalAIM), DHCS’ broad transformation of Medi-Cal to create a more coordinated, person-centered, and equitable health system that works for all Californians. They offer tailored, community-based services, including in-person care coordination, housing support, and other vital resources for Medi-Cal members with complex needs. The awards are part of the Providing Access and Transforming Health (PATH) Capacity and Infrastructure, Transition, Expansion, and Development (CITED) initiative, which helps local providers grow their ability to deliver whole-person, community-based care.

Para apoyar la expansión de ECM y Apoyos Comunitarios, DHCS otorgó más de 1.660 millones de dólares a más de 2.200 organizaciones a través de sus iniciativas PATH, incluyendo CITED, Planeación e Implementación Colaborativa y el Mercado de Asistencia Técnica. Estos esfuerzos ya alcanzaron a más de 373.000 inscritos en ECM, prestaron más de un millón de servicios de apoyo comunitario y ampliaron significativamente el acceso para niños y jóvenes, con un aumento interanual del 120% solo a principios de 2025.

“PATH CITED represents a vital investment in the future of Medi-Cal and the health of California,” said DHCS Director Michelle Baass. “By empowering local providers, many of whom serve historically under-resourced communities, we are strengthening the foundation of a more equitable, person-centered delivery system. Together, we’re creating lasting change that connects Medi-Cal members to the care and support they need to live healthier, more fulfilling lives. I’m proud of the progress we’ve made and the partnerships that made it possible.”

Recent data show that investments like these are resulting in long-term savings for California’s Medi-Cal program. Community Supports have been proven cost-effective, reducing avoidable emergency department visits, hospitalizations, and long-term care use. By investing now, DHCS is helping ensure a more sustainable, efficient, and equitable health care system for the future.

Mira el siguiente breve video para escuchar directamente a anteriores galardonados cómo la financiación de PATH CITED los ayudó a ampliar los servicios, contratar personal y fortalecer los lazos con sus comunidades.

WHY THIS IS IMPORTANT: ECM and Community Supports offer tailored, community-based services, including in-person care coordination, housing support, and other vital resources for Medi-Cal members with complex needs. PATH CITED is helping ECM and Community Supports providers transition, expand, and develop their capacity to provide local, coordinated care for member communities. Awardees will use funds to:

WHAT THEY’RE SAYING: “ECM and Community Supports are transforming how we care for Medi-Cal members with diverse and often intensive needs,” said Susan Philip, Deputy Director of DHCS’ Health Care Delivery Systems. “Just like in prior PATH CITED rounds, we are investing in the infrastructure and workforce that make whole-person care possible, ensuring that providers have the tools they need to deliver timely, compassionate, and coordinated care.”

“Thanks to PATH CITED support, Sanctuary Centers of Santa Barbara has turned an idea into a thriving clinic that continues to expand its reach and impact,” said Sanctuary Centers of Santa Barbara Interim CEO Stephanie R. Drake, PhD. “The Integrated Health Clinic is a model for collaborative, patient-centered care, bridging critical gaps in services and ensuring that Medi-Cal members receive the timely, high-quality, and compassionate care they deserve.”

“We did not have the staffing to follow up with people once they were housed, which led to more instability,” said Ronni Duncan, Care Management Manager at Adventist Health, a CITED awardee from previous rounds. “PATH CITED funds have allowed us to expand staffing, fill service gaps, and let case managers focus on their specific roles. Most of all, these programs have helped build community and provide hope and healing to people who may not have had access to the healing support we offer.”

“Thanks to PATH CITED funding, we are building a growing team of skilled case managers to meet our patients where they are – in homes, coffee shops, and throughout their communities to build trust and transform care,” said Jeniffer Zamora, Community Health Program Manager at Peach Tree Health, a CITED awardee from previous rounds.

“Supported by PATH CITED funding, Rady Children’s Hospital’s ECM program has expanded from San Diego County to also serve Riverside County,” said Russell Gagui, ECM Manager at Rady Children’s Hospital, a CITED Round 2 awardee. “As we grow, we remain committed to the principles that make pediatric ECM work: hiring from within the communities we serve, designing systems that support families’ real-world needs, and centering every effort around improving the lives of children with complex medical and social needs.” 

“Through the CITED grants, we have been able to expand access to recuperative care and strengthen care coordination by hiring additional staff as well as updating our internal data systems, which has allowed us more time to focus on the acute needs of our clients,” said Tracy Wilson, Co-Founder and CEO of Rooted Life, a CITED Round 3 awardee. “CITED grants have been pivotal in allowing us to create robust program where we can focus on the stability and recovery of our clients.”

HOW WE GOT HERE: PATH is a five-year, $1.85 billion initiative launched in 2022, providing funds for community-based organizations, county agencies, hospitals, Tribes, and other community providers to support improved health care management and delivery through the Medi-Cal system. Recipients of PATH CITED awards are committed to serving historically under-resourced and underserved populations.

WHAT’S NEXT: Round 4 is the final PATH CITED funding round. DHCS will continue to listen to Medi-Cal members and providers to improve service delivery, making care more accessible, effective, and responsive to California’s diverse communities. This also includes utilizing the other PATH workstreams to listen intentionally and provide technical assistance, such as through the Technical Assistance Marketplace and the regional Collaborative Planning Implementation convenings. For more information about the PATH CITED initiative, visit the PATH website.

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Un modelo de financiamiento innovador ayuda a las escuelas a mantener los servicios de salud mental

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Un modelo de financiamiento innovador ayuda a las escuelas a mantener los servicios de salud mental

El Program de reembolso estatal se basa en resultados tempranos positivos con nuevos recursos

SACRAMENTO — California schools have long worked to meet student mental health needs, and the Department of Health Care Services (DHCS) is supporting these efforts through a new sustainable funding program that is already showing promising results.  

Through the Children and Youth Behavioral Health Initiative (CYBHI) Fee Schedule program, local educational agencies (LEA), which includes California public K-12 school districts, charter schools, and county offices of education, and public institutions of higher education (IHE), including public community colleges and universities, can sign up to participate in a reimbursement pathway for mental health and substance use screenings, treatment, and case management. This creates a sustainable funding source for school-based care. This innovative multi-payer program breaks down barriers and puts students first, creating a more seamless experience for youth seeking help with mental health. More than 500 LEAs and IHEs have already signed up and are actively onboarding. 

Aunque aún es temprano en implementación, este esfuerzo pionero en la nación ya está demostrando resultados positivos: las escuelas y sus socios recibieron más de $1.8 millones en nuevos fondos para servicios prestados a más de 5,000 estudiantes. Hasta el 15 de octubre, 55 LEA e IHE presentaron más de 26,000 reclamos a través de la Program, lo que representa 32 planes Medi-Cal Managed Care y otras aseguradoras, incluidos los planes comerciales. Estos resultados reflejan un progreso significativo logrado en poco más de un año desde que los participantes se volvieron elegibles para facturar los servicios. 

“Schools are often the first place students turn to for support,” said DHCS Director Michelle Baass. “Through the CYBHI Fee Schedule program, we’re helping schools meet that need by easing financial pressures and building a sustainable foundation for student mental health services, so every student has access to care when and where they need it.” 

“We were lucky enough to be the first to successfully submit a service for billing, and we actually got our first check. It was only $77, but it was a big milestone,” said Nevada Joint Union High School District Director of Pupil Services Timothy Reid. As of November 3, the district had been reimbursed more than $30,000. Since the first claim was submitted in December 2024, the average reimbursement for an LEA/IHE is nearly $50,000, and multiple LEAs are nearing being reimbursed $1 million through the program. 

NEW RESOURCES AND AWARENESS CAMPAIGN: To support program implementation, DHCS launched new public-facing and provider-facing information and resources to help schools and families navigate the program:

ABOUT THE CYBHI FEE SCHEDULE PROGRAM: The program requires Medi-Cal managed care plans, Medi-Cal fee-for-service providers, commercial health insurance plans, and disability insurers to reimburse school-linked providers for behavioral health services provided to students under age 26, with no out-of-pocket costs for families. As a result, schools now have a sustainable funding source through which to hire, train, and retain staff, increasing access to behavioral health services.

WHY THIS IS IMPORTANT: Youth mental needs have risen significantly in the last decade. California falls short of the recommended ratio of one school psychologist per 500 students, largely due to cost barriers. By creating a sustainable funding mechanism for providing these services, the CYBHI Fee Schedule program addresses this gap by funding school-based services, prioritizing early intervention, and expanding opportunities for the behavioral health workforce to meet growing demand. Research has shown an association between students who access services through a school-based health center and positive school attendance, particularly for students with a mental health diagnosis, suggesting that increased mental health support through school may improve school attendance. 

WHAT THEY’RE SAYING: “We’ve heard from California students across the state about the need to increase behavioral health support where they spend time – at schools. The CYBHI Fee Schedule program is answering the call,” said CYBHI Director Dr. Sohil Sud. “Through partnerships and deeper connections between schools and health plans, along with sustainable funding, schools can meet the behavioral health needs of students who need it most.”

“Together, we have made significant strides in our efforts to transform school-based behavioral health care in California. Our progress to date is a testament to the commitment and the collaborative efforts of our school-district, managed care plan and community partners,” said Autumn Boylan, Deputy Director of DHCS’ Office of Strategic Partnerships. “With the foundation we’ve built, I am confident we will continue to succeed in making a lasting impact on the lives of students across the state.”

“Through the CYBHI Fee Schedule, our school district can continue to provide comprehensive, school-based behavioral health services, including assessments, counseling, prevention, and wellness programs, all at no cost to students and families. These funds will sustain and strengthen the vital program we have built to nurture the mental and emotional well-being of our students, while extending care to their families and our broader community,” said Jesus Chavarria, Anaheim Elementary School District Superintendent.

“CYBHI’s involvement allows us to expand the services and support we can provide,” said Matthew Zavala, Mental Health Therapist at Silver Springs High School in Grass Valley. “When I started working at this school, mental health programming was very grassroots. Now, it’s more stable and secure. It really feels like mental health is part of the school system. On a smaller scale, it’s just nice to see students find a place where they feel welcome and have a positive school experience. Seeing both of those things happen simultaneously is a very rewarding part of this job.”

BIGGER PICTURE: The CYBHI Fee Schedule is part of the state’s broader effort to transform youth mental health care into a coordinated, equitable, and prevention-focused system. The CYBHI Fee Schedule program is the CYBHI’s flagship, a more than $4 billion investment to transform behavioral health services for children, youth, and families, and it is central to the Governor’s Master Plan for Kids’ Mental Health. Learn more on the CYBHI Fee Schedule webpage

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Oficina de Comunicaciones
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Los afiliados a Medi-Cal y los líderes de salud unen fuerzas en un nuevo grupo asesor

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Los afiliados a Medi-Cal y los líderes de salud unen fuerzas en un nuevo grupo asesor

El Consejo de Voces y Visión proporciona un camino para que los afiliados a Medi-Cal y los profesionales de la salud den forma a la política de Medi-Cal

Sacramento — Dando un importante paso adelante en la formulación de políticas inclusivas, el Department of Health Care Services (DHCS)) lanzó el Consejo de Voces y VisiónMedi-Cal , un grupo asesor pionero que reúne a miembros Medi-Cal , cuidadores, proveedores, organizaciones comunitarias, grupos de defensa y socios del condado para dar forma al futuro de las políticas, Program y la implementación de Medi-Cal . Al incorporar la experiencia vivida directamente en el proceso de formulación de políticas, el consejo garantiza que las políticas y Program Medi-Cal se basen en las necesidades reales de las personas a las que sirven y se perfeccionen mediante la colaboración con expertos en atención médica y líderes del sistema.

The Voices and Vision Council held its inaugural meeting alongside the established Medi-Cal Member Advisory Committee to launch a new collaborative structure that brings together lived experience and system expertise to shape Medi-Cal policy.

“The Medi-Cal Voices and Vision Council is a vital platform for ensuring that Medi-Cal members and community partners help shape how we deliver care,” said DHCS Director Michelle Baass. “We are committed to strengthening our Medi-Cal program so it is more equitable, responsive, and grounded in the voices of the people we serve. This council reflects our belief that meaningful change and innovation begin with listening and acting on what people tell us they need.”

“Medi-Cal provides the nursing care that keeps my son healthy and safe at home with our family,” said Jenny McLelland, a parent and member of the Voices and Vision Council. “The council gives me the opportunity to share my experiences as a caregiver and ensures that families like mine have a voice in making Medi-Cal better for all Californians.”

WHY THIS IS IMPORTANT: The Voices and Vision Council and the Medi-Cal Member Advisory Committee help ensure that Medi-Cal members remain at the heart of policy development and program administration. These two advisory bodies work in close partnership with DHCS leaders and policy experts to co-design equity-centered programs and policy solutions that reflect the real needs of members.

Al interactuar directamente con los miembros y las partes interesadas, DHCS está construyendo la infraestructura necesaria para actuar en función de lo que más importa a las personas a las que sirve. Cada reunión trimestral se centra en las ideas compartidas por miembros y cuidadores. Estas conversaciones ayudan al DHCS a traducir los comentarios en mejoras tangibles, fortaleciendo así
apoyo
Medi-Cal brinda a las comunidades de toda California.ANTECEDENTES: En 2023, el DHCS estableció el Comité Asesor de Afiliados a Medi-Cal, uno de los primeros grupos asesores formales del país compuesto íntegramente por afiliados a Medi-Cal y personas que los apoyan, como familiares y cuidadores. En 2024, los Centros federales de Servicios de Medicare y Medicaid emitieron la Regla para garantizar el acceso a los servicios de Medicaid, que exige a todos los estados crear dos órganos asesores: un Consejo Asesor de Beneficiarios compuesto por miembros y cuidadores, y un Comité Asesor de Medicaid que incluya proveedores y que obtenga al menos el 25 por ciento de sus miembros del Consejo Asesor de Beneficiarios para julio 10, 2027.

To meet this requirement, California designated its existing Medi-Cal Member Advisory Committee as the state’s Beneficiary Advisory Council and created the Medi-Cal Voices and Vision Council as its Medicaid Advisory Committee. Together, these groups are designed to create a continuous feedback loop: The Medi-Cal Member Advisory Committee will meet first each quarter to surface themes and priorities from members and caregivers, which will then inform the Voices and Vision Council’s policy and operational discussions. Potential topics include access to care, service delivery, communication, and other issues that influence how Medi-Cal works for the people it serves.

WHAT’S NEXT: The first public meeting of the Medi-Cal Voices and Vision Council will be held on March 18, 2026. Meeting schedules, agendas, minutes, and membership lists for both groups will be publicly available. For more information, including how to register for the first public meeting, please visit the Voices and Vision Council webpage.
 
ABOUT THE VOICES AND VISION COUNCIL MEMBERS: The Voices and Vision Council is made up of 16 Medi-Cal members and leaders from across California who bring experience from advocacy groups, community-based organizations, health centers, county health and social services departments, managed care plans, and health plan associations.

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California expande los planes Medi-Medi a 29 nuevos condados a medida que comienza la inscripción abierta de Medicare

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California expande los planes Medi-Medi a 29 nuevos condados a medida que comienza la inscripción abierta de Medicare

Los planes Medi-Medi son Health Plan especiales para personas que tienen Medicare y Medi-Cal

SACRAMENTO — As Medicare open enrollment begins on October 15, the Department of Health Care Services (DHCS) is expanding access to Medi-Medi Plans––integrated health plans for people who have both Medicare and Medi-Cal—to 29 additional counties. This expansion brings the total to 41 counties that offer Medi-Medi Plans, nearly quadrupling access to these plans. This means Californians who are eligible for both Medicare and Medi-Cal will have the option to enroll in a Medi-Medi Plan to receive additional support to help manage chronic conditions, disabilities, or long-term care needs. Enrollment runs from October 15 to December 7, with coverage starting on January 1, 2026.

“California is building upon the success of Medi-Medi Plans that have already made a real difference in people’s lives,” said DHCS Director Michelle Baass. “By expanding access to these plans, we’re helping more Californians with complex health needs get the care they need—more easily, more consistently, and with greater support. This is about making health care work better for the people who rely on it most.”

The 29 new counties are: Alameda, Alpine, Amador, Calaveras, Contra Costa, El Dorado, Imperial, Inyo, Kern, Marin, Mariposa, Merced, Mono, Monterey, Napa, Placer, San Benito, San Francisco, San Joaquin, San Luis Obispo, Santa Barbara, Santa Cruz, Solano, Sonoma, Stanislaus, Tuolumne, Ventura, Yolo, and Yuba.

These 29 counties will join the 12 counties where Medi-Medi Plans are currently available: Fresno, Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Mateo, Santa Clara, and Tulare. For more details, visit the Medicare Medi-Cal Plan List webpage, Joining a Medi-Medi Plan information sheet, and the Medi-Medi Plan Expansion Fact Sheet.

WHY THIS IS IMPORTANT: For the first time, Californians who qualify for both Medicare and Medi-Cal will have access to Medi-Medi Plans in 29 additional counties. Members with both Medicare and Medi-Cal often face serious health challenges, need help with daily activities, and deal with barriers like low income or limited transportation. They typically rely on many different services, but must navigate two separate systems to get care.

“This expansion is about making health care work better for the people who need it most,” said Lauren Solis, Chief of DHCS’ Office of Medicare Innovation and Integration.

Medi-Medi Plans combine Medicare and Medi-Cal benefits into one plan and provide specialized care coordination and wraparound Medi-Cal services. This model simplifies care with one card, one care team, and integrated services across medical, behavioral health, and long-term services and supports.

Currently, about 330,000 people are enrolled in these plans across 12 counties. As a result of this expansion, an additional 461,000 Californians will now have the choice to enroll in a Medi-Medi Plan. Meanwhile, nearly a quarter of Medicare members in California – 1.7 million people – also have Medi-Cal.

ABOUT MEDI-MEDI PLANS: Medi-Medi Plans are available to individuals who have both Medicare Part A and B, are enrolled in Medi-Cal, are 21 or older, and live in a participating county. Medi-Medi Plans coordinate all services across both Medicare and Medi-Cal, including:

Los miembros también se benefician de:

PARA MÁS INFORMACIÓN: Los californianos elegibles pueden inscribir en un plan Medi-Medi durante el periodo de inscripción abierta de Medicare del 15 de octubre al 7 de diciembre. La cobertura comenzará 2026 1 de enero de 2017. Para más información sobre los planes Medi-Medi y cómo inscribir, visite el sitio web del Plan Medi-Medi.

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La gestión mejorada de la atención y los apoyos comunitarios continúan creciendo

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La gestión mejorada de la atención y los apoyos comunitarios continúan creciendo

Los nuevos datos muestran un aumento de la inscripción, asociaciones de proveedores más estables y una mejor coordinación de la atención para los afiliados a Medi-Cal con necesidades complejas

SACRAMENTO — The Department of Health Care Services (DHCS) today released new data showing continued growth and impact from Enhanced Care Management (ECM) and Community Supports as part of the state’s Medi-Cal transformation under California Advancing and Innovating Medi-Cal (CalAIM). These services help Medi-Cal members stay healthier and avoid other, costlier health care services, such as emergency department visits and hospital stays. 

En solo los primeros tres meses de este año: 

"Así es como se ve Medi-Cal transformación", dijo Michelle Baass, directora del Department of Health Care Services. "No solo estamos expandiendo los servicios. Estamos llegando a más personas que nunca". 

ECM ayuda a las personas con necesidades sociales y de salud complejas, incluida la falta de vivienda, enfermedades mentales graves o visitas frecuentes al hospital, a obtener la atención que necesitan, dondequiera que estén. Un administrador de atención principal ayuda a coordinar todos los aspectos de la atención, desde visitas al médico y servicios de salud mental hasta apoyo nutricional y de vivienda. Desde su lanzamiento en enero de 2022, ECM conectó a más de 372,000 afiliados a Medi-Cal con atención centrada en la persona y de alto contacto.  

Community Supports are also growing rapidly. These services offer cost-effective, community-based alternatives to traditional medical care, addressing housing, nutrition, and other social drivers of health. As of early 2025: 

"Detrás de cada número hay una historia: un padre que encontró una vivienda estable, un adolescente que recibió atención de salud mental, una persona mayor que recibió comidas adaptadas a su condición", dijo el director estatal de Medicaid, Tyler Sadwith. "Así es como construimos una California más saludable". 

WHY THIS IS IMPORTANT: The growth in ECM and Community Supports comes as California rolls out historic policies under the Behavioral Health Services Act (BHSA), aimed at reducing homelessness and expanding behavioral health care. ECM and Community Supports are proving to be vital tools to help people navigate housing, nutrition, and health systems with dignity and support. From ECM and Community Supports to Transitional Rent and permanent housing, California is building a continuum of care that supports people across every stage of their recovery journey. 

Para respaldar esta expansión, el DHCS otorgó más de 1430 millones de dólares a través de sus iniciativas "Proporcionar acceso y transformar la salud" (PATH), que incluyen "Transición, expansión y desarrollo de capacidad e infraestructura" (CITED), "Planeación e implementación colaborativas" y el "Mercado de asistencia técnica". Estos fondos ayudan a organizaciones comunitarias, clínicas y agencias locales a aumentar su capacidad para ofrecer ECM y Apoyos Comunitarios mediante la contratación de personal, la mejora de sistemas y la coordinación de la atención. La ronda final de financiación CITED cerró en mayo de 2025, con nuevos galardonados que se anunciarán más adelante este año. 

WHAT’S NEXT: DHCS will continue listening to Medi-Cal members who use ECM and Community Supports. Member feedback, gathered through surveys, focus groups, and other outreach, will help improve how these services are delivered, making them easier to access, more effective, and more responsive to different cultures and communities. 

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Oficina de Comunicaciones
(916) 440-7660
DHCSPress@dhcs.ca.gov

California y el condado de San Joaquin amplían los servicios de salud conductual con su nuevo campus

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California y el condado de San Joaquin amplían los servicios de salud conductual con su nuevo campus

El campus atenderá a 72,000 personas anualmente

SACRAMENTO — On September 10, 2025, the Department of Health Care Services (DHCS) and San Joaquin County Behavioral Health Services Department celebrated the groundbreaking of the Be Well Campus, a new facility in French Camp that will expand access to mental health and substance use disorder treatment in the Central Valley. The campus will include 10 facility types, with 116 behavioral health treatment beds and 1,205 outpatient slots, enabling care for more than 72,000 individuals annually.

“Este proyecto representa un poderoso ejemplo del compromiso de California con la construcción de un sistema de salud conductual que atienda a las personas en su propia situación”, dijo la directora del DHCS, Michelle Baass. “A través del Program de Infraestructura para la Atención Integral de la Salud Mental, estamos invirtiendo en infraestructura local y ayudando a las comunidades a ampliar el acceso a la atención médica.”

This transformative project is supported by more than $149 million through the Behavioral Health Continuum Infrastructure Program (BHCIP), including Round 5: Crisis and Behavioral Health Continuum and Bond BHCIP Round 1: Launch Ready (a conditional award made possible by the Behavioral Health Infrastructure Bond Act), part of California’s voter-approved reform to expand behavioral health care and housing. This project is one of several in California that will combine earlier BHCIP rounds with bond funds to support both immediate needs and long-term infrastructure.

Be Well campus groundbreaking
Inauguración del campus Be Well

BHCIP is a key component of Mental Health for All, California’s ongoing commitment to build a stronger and more equitable behavioral health system. With the passage of Proposition 1, even more behavioral health treatment facilities will be funded and built in 2025 and 2026.

“We are pleased to see the Behavioral Health Infrastructure Bond Act in action,” said DHCS Community Services Division Chief Marlies Perez. “San Joaquin County is building a model that brings together multiple levels of care in one place, making it easier for people to get the care they need when they need it.”

Marlies Pérez habla en el evento de inauguración de Be Well Campus
Marlies Pérez habla en el evento de inauguración de Be Well Campus

INVESTING IN BEHAVIORAL HEALTH CARE CAPACITY: More than 1.2 million adults in California live with a serious mental illness, and 1 in 10 residents meet the criteria for a substance use disorder. Additionally, shortages of behavioral health treatment sites contribute to rising rates of homelessness and incarceration among people with mental health disorders.

To address this, DHCS launched BHCIP to fund the construction, acquisition, and expansion of behavioral health facilities and mobile crisis services. Since 2021, the state has awarded more than $2.2 billion through BHCIP Rounds 1–5, including $430 million in Round 5 to expand crisis care statewide. California is investing billions more through Bond BHCIP to build long-term behavioral health and housing infrastructure. In May 2025, DHCS conditionally awarded $3.3 billion through Bond BHCIP Round 1: Launch Ready to 121 projects across 42 counties, supporting 4,895 residential beds and 21,402 outpatient slots.

WHAT’S NEXT: The Be Well Campus project received a conditional award through Bond BHCIP Round 1: Launch Ready, and the next step is to finalize that funding. San Joaquin County will work with DHCS to complete a Program Funding Agreement, confirm matching funds and property ownership, and wrap up other required documentation before the award becomes final.

Mientras tanto, DHCS se está preparando para otorgar más de 800 millones de dólares a través de la segunda ronda del programa Bond BHCIP: Necesidades no cubiertas. Esta ronda está abierta a solicitantes elegibles en todo el estado, con solicitudes que vencen el 28de octubre 2025y se esperan las becas en la primavera de 2026.

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Oficina de Comunicaciones
(916) 440-7660
DHCSPress@dhcs.ca.gov

California invierte $26 millones para abordar las necesidades de tratamiento del trastorno por uso de sustancias y salvar vidas

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California invierte $26 millones para abordar las necesidades de tratamiento del trastorno por uso de sustancias y salvar vidas

Las subvenciones crearán asociaciones comunitarias y aumentarán el acceso al tratamiento

SACRAMENTO — The Department of Health Care Services (DHCS) has awarded $26 million to more than 70 organizations to combat the opioid crisis in California. These grants are designed to expand access to treatment, strengthen community partnerships, and save lives. The grants represent a critical part of the State’s Opioid Response (SOR) initiative.

“Addressing the opioid crisis requires a comprehensive, compassionate, and community-driven approach. That’s why DHCS is pleased to partner with so many organizations to offer access to this life-changing care,” said DHCS Director Michelle Baass. “We must expand access to treatment, invest in prevention, and dismantle the stigma surrounding addiction. Lives are at stake, and we are committed to doing everything we can to support recovery.”

REDUCCIÓN DE LAS NECESIDADES NO SATISFECHAS Y LAS SOBREDOSIS RELACIONADAS CON OPIOIDES EN LAS COMUNIDADES TRIBALES: DHCS otorgó $2.1 millones a 12 organizaciones para implementar el Program de Coalición Local Tribal contra los Opioides (TLOC) SOR IV. TLOC apoya a las comunidades indígenas tribales y urbanas aumentando el acceso al tratamiento, proporcionando servicios de recuperación con raíces culturales y reduciendo las muertes relacionadas con sobredosis mediante la prevención y la atención. El Program refuerza los esfuerzos de recuperación para el trastorno por consumo de opioides y estimulantes mediante la creación de alianzas entre los afiliados a la comunidad, las partes interesadas y los proveedores de servicios.

“DHCS is pleased to support Tribal communities with resources that reflect their unique needs and strengths. The TLOC program empowers local partnerships to expand treatment, prevent substance use, and promote culturally grounded healing,” said Baass.

EXPANDING ACCESS TO MEDICATIONS FOR ADDICTION TREATMENT: DHCS also awarded nearly $3 million to four DHCS-licensed Narcotic Treatment Programs (NTP) to create satellite facilities, called medication units, that provide access to addiction treatment. These medication units will serve people who otherwise struggle to access care, including people in rural areas, justice-involved communities, and people without reliable transportation, and support care integration.

“Geographically isolated communities often face compounded challenges to accessing care, including transportation barriers and systemic inequities. Establishing medication units addresses these gaps by improving access, enhancing retention, and advancing health equity in the areas that need it most,” said Sarah Khawaja-Laljiani, Senior Director of Grants and Patient Services of Pinnacle Treatment Center, a recipient of funding to expand access to Medications for Addiction Treatment (MAT).

“This funding opportunity aligns with our commitment to expanding access to evidence-based treatment in underserved communities, said Evelyn Sosa, Senior Vice President of BayMark Health Services. “This support will help us meet patients where they are, removing barriers to care and improving outcomes for people most at risk of overdose.”

AMPLIACIÓN DEL ACCESO A LA TRATAMIENTO AUXILIAR CONSUMIDOR: Además, DHCS otorgó más de 21 millones de dólares a 59 Programresidenciales de tratamiento de trastornos por consumo de sustancias con licencia DHCS para poner en marcha o ampliar los servicios de tratamiento asistido con medicamentos (MAT) basados en la evidencia, disponibles en el mismo centro para personas con un trastorno por consumo de opioides.

“As the opioid and fentanyl crisis continues to devastate lives across the country, expanding access to MAT services in residential programs is not only a clinical necessity, but a moral imperative,” said Dr. BJ Davis, Executive Director, Gateway House for Women and Sacramento Recovery House for Men. “This funding allows us to meet people where they are with the full continuum of evidence-based care.”

"Nuestros clientes necesitan acceso oportuno a MAT para gestionar los antojos y comenzar su camino hacia la recuperación y la estabilidad", dijo Lindsey Purdie, MBA, directora ejecutiva de The Crossroads Foundation. “Gracias a nuestra colaboración con DHCS, tuvimos la oportunidad de ampliar nuestros servicios y satisfacer mejor las necesidades de las personas a las que apoyamos. Estamos profundamente agradecidos por esta financiación y por la colaboración continua."

POR QUÉ ES IMPORTANTE: En 2023, hubo 11.359 muertes por sobredosis relacionadas con drogas. De esos, 8.000 estaban relacionados con opioides, y 7.000 específicamente con fentanilo. Aunque una parte significativa de los californianos cumple los criterios para un trastorno por consumo de sustancias, solo un pequeño porcentaje recibe tratamiento, a menudo debido al acceso limitado a servicios como MAT y naloxona en zonas rurales.

BIGGER PICTURE: These grants are part of DHCS’ Opioid Response, a key element of Governor Newsom’s Master Plan for Tackling the Fentanyl and Opioid Crisis. For more information about opioids and how you can protect yourself and loved ones, visit Opioids.ca.gov, a one-stop shop for Californians seeking resources around prevention and treatment.

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Oficina de Comunicaciones
(916) 440-7660
DHCSPress@dhcs.ca.gov

Medi-Cal Reports Strong Growth in Enhanced Care Management and Community Supports

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Medi-Cal Reports Strong Growth in Enhanced Care Management and Community Supports

La matrícula de niños y jóvenes en la administración de atención mejorada casi se triplicó; Cerca de 1 millón de servicios de apoyo comunitario prestados a los miembros desde su lanzamiento

Sacramento — El Department of Health Care Services (DHCS)) compartió hoy nuevos datos que muestran cómo la Gestión de Atención Mejorada (ECM) y los Apoyos Comunitarios están aumentando y ayudando a más personas como parte de la transformación de Medi-Cal del estado bajo California Advancing and Innovating Medi-Cal (CalAIM).

“The trends reflected in the data demonstrate the real and growing impact of CalAIM in supporting the health and well-being of Medi-Cal members,” said DHCS Director Michelle Baass. “We’re seeing especially strong progress in reaching children and youth, expanding access to critical supports like housing and food, and growing the provider networks needed to deliver these services. Together, these efforts are helping more Californians live healthier, more stable lives.”

WHAT THE NUMBERS SHOW: Since ECM launched in January 2022, more than 326,000 unique Medi-Cal members have enrolled in this benefit that provides comprehensive, person-centered care coordination for members with complex needs. In the last three months of 2024 alone, more than 149,400 members received ECM services, including more than 31,000 children and youth under 21, nearly four times more than when ECM launched for these groups in July 2023.

Los Apoyos Comunitarios también están llegando a más miembros de Medi-Cal. A finales de 2024, aproximadamente 368.400 miembros habían utilizado estos servicios, con más de 920.000 servicios totales prestados. Estos apoyos ofrecen alternativas rentables y basadas en la comunidad a la atención médica tradicional, abordando los factores sociales que afectan la salud. De los que accedieron a los apoyos de la comunidad en el cuarto trimestre de 2024:

WHY THIS MATTERS: More Medi-Cal members with complex medical and social needs are accessing ECM and Community Supports. Key drivers of growth include:

PROVIDER NETWORKS ARE GROWING: The number of providers delivering ECM and Community Supports has grown significantly. Managed care plans now hold approximately 2,600 provider contracts for Community Supports alone, up from about 750 in early 2022. This reflects a strong commitment from community-based organizations, housing providers, and local health systems to support CalAIM’s goals.

COMMUNITY SUPPORTS ARE COST-EFFECTIVE: DHCS’ June 2025 cost-effectiveness report shows that Community Supports help reduce overall health care costs by preventing avoidable hospitalizations, emergency room visits, and long-term institutional care, while improving health outcomes.

WHAT’S NEXT: Starting January 1, 2026, Transitional Rent will become a mandatory Community Support and will be available to provide up to six months of rental assistance to members who are experiencing or at risk of homelessness, are experiencing significant behavioral health needs, and meet certain risk factors. This is another important step in making sure Medi-Cal members have the support they need to live healthy, stable lives in their communities.

DHCS will continue to center feedback from Medi-Cal members to ensure ECM and Community Supports are responsive, accessible, and equitable. By listening closely to people who are directly impacted, California aims to enhance the effectiveness of these programs and better support members’ health and well-being.

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Oficina de Comunicaciones
(916) 440-7660
DHCSPress@dhcs.ca.gov