January 27, 2025

​Top News

​DHCS Helps Medi-Cal Members and Providers Affected by the Southern California Wildfires

In response to the Southern California wildfires, DHCS applied for and received several dozen Medicaid Section 1135 waivers and Appendix K flexibilities to prevent disruptions in health care delivery so patients can continue to receive needed care. These actions are designed to reduce administrative burdens and provide flexibility in the delivery of health care during a critical time. Key provisions of California's Medicaid Section 1135 waivers and Appendix K flexibilities include:

• Protections for Medi-Cal Members: Extends timelines for fair hearing requests and benefit reinstatements, giving Medi-Cal members additional time to resolve eligibility or benefits issues. Adjusts home health service requirements to allow delays in face-to-face encounters due to current constraints.
• Flexibility in Provider Enrollment: Expedites and streamlines provider enrollment to make it easier for providers to offer care to impacted members.
• Flexibility for Home and Community-Based Services: Extends timelines for initial evaluations, reassessments, and care plan reviews to ensure uninterrupted care for individuals who need ongoing support due to age, disability, or chronic illness. Allows delivery of long-term services and supports in alternative locations, such as shelters or hotels.
• Support for Clinics: Allows clinics to deliver care in alternative settings, such as mobile clinics or temporary locations, when primary facilities are damaged or inaccessible.

DHCS understands recovering from these wildfires will be challenging and has developed an online resource to help answer questions from Medi-Cal members, partners, providers, and health plans during this emergency. DHCS remains committed to supporting communities during this difficult time and is grateful to the emergency responders and health care workers on the ground. Stay safe, see official updates for the latest information, and follow evacuation orders issued by local officials.​

Program Updates​

Smile, California to Celebrate National Children's Dental Health Month

On February 1, Smile, California will celebrate National Children's Dental Health Month (NCDHM) with the new "Healthy Smile Adventure" campaign. Designed to alleviate fears associated with dental visits, the campaign reimagines dental offices as "Healthy Smile Land," complete with themed stops like Fluoride Falls, Sealant Island, and X-Ray Cove. These imaginative stations highlight preventive care while making dental visits approachable and enjoyable for families. A new homepage banner and dedicated NCDHM webpages in English and Spanish will launch on SmileCalifornia.org and SonrieCalifornia.org, providing resources and materials for members and providers.​

Join Our Team

DHCS is seeking a talented and motivated individual to serve as:

• Assistant Division Chief for the Quality Health Equity Division. The Assistant Division Chief provides strategic leadership to advance quality and health equity for Medi-Cal's nearly 15 million members. The Assistant Division Chief oversees policy implementation, program operations, budget management, and staff supervision. Responsibilities include leading special projects, driving performance improvement, and fostering collaboration with internal and external stakeholders. Experience in health policy, program management, and equity-focused initiatives is highly desired. Applications must be submitted by January 28.

• Chief of the Pharmacy Benefits Division. The Chief is responsible for overseeing the development and implementation of policy, services, and coverage criteria for outpatient pharmacy services for the state's Medi-Cal program. This includes providing policy direction for Medi-Cal Rx as well as invoicing and collecting federal and state supplemental drug rebates. The Chief of PBD also leads the development of nutrition, vision care, and medical supply benefits and oversees the administration of the Medi-Cal Pharmacy and Vision Benefit programs. A licensed pharmacist is desired, but not required. Applications must be submitted by February 7.

DHCS is also hiring for its accounting/financing, behavioral health, eligibility, legislative and governmental affairs, and other teams. For more information, please visit the CalCareers website.​

Upcoming Stakeholder Meetings and Webinars ​

Coverage Ambassador Webinar: Justice-Involved Reentry Initiative and Children and Youth Behavioral Health Initiative

On January 30, from 11 to 11:45 a.m. PST, DHCS will host a webinar for DHCS Coverage Ambassadors (advance registration required). The webinar will provide updates on the Justice-Involved Reentry Initiative and the Children and Youth Behavioral Health Initiative (CYBHI). It will convey information on justice-involved individuals who are now, or have spent time, in jails, youth correctional facilities, or prisons and who are at higher risk for poor health outcomes, injury, and death than the public. It will focus on significant steps California is taking to improve poor health outcomes for individuals as they prepare to reenter their communities by working to ensure they have continuity of coverage upon their release. Additionally, Coverage Ambassadors will learn how early childhood wraparound services will be expanded through the CYBHI, which will provide mental health services to children, youth, and families. Find out more about DHCS Coverage Ambassadors, or sign up to become a Coverage Ambassador.

DHCS Harm Reduction Summits

DHCS collaborates with communities across the state to promote harm reduction and low-barrier, patient-centered care within California's substance use disorder treatment system. DHCS encourages substance use disorder treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in substance use disorder treatment settings) to attend and learn about incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in San Diego County (February 11) and Los Angeles County (February 27). Register on the event website.

Closed-Loop Referral Implementation Guidance and All-Comer Webinar

On February 13, from 10 to 11 a.m. PST., DHCS will hold an all-comer webinar (advance registration required) to provide an overview of the Closed-Loop Referral (CLR) Implementation Guidance for managed care plans. The webinar is open to the public and will be of special interest to Medi-Cal managed care plans (MCP), Enhanced Care Management and Community Supports providers, and entities making referrals to the benefit/services. The CLR Implementation Guidance outlines requirements for MCPs in implementing CLRs, including tracking, supporting, and monitoring CLRs. The member's initial referral loop is completed with a known closure reason, such as the member receiving services. These new requirements will ensure more members are connected to the care they need by identifying and addressing gaps in referral paths. MCPs must implement CLR requirements by July 1, 2025. Requirements will first apply to referrals made to priority Enhanced Care Management and Community Supports services. Please send your questions about the new guidance to PHMSection@dhcs.ca.gov.

Stakeholder Advisory Committee (SAC)/Behavioral Health (BH)-SAC Meeting

On February 19, from 9:30 a.m. to 3 p.m. PST, DHCS will host the hybrid SAC/BH-SAC meeting (advance registration required for online and in-person participation) at 1700 K Street (first-floor conference room 17.1014), Sacramento. SAC provides DHCS with valuable input on ongoing California Advancing and Innovating Medi-Cal (CalAIM) implementation efforts and helps DHCS further its efforts to provide high-quality, equitable care. BH-SAC provides DHCS with input regarding behavioral health activities and was created as part of the ongoing effort to integrate behavioral health with the greater health care system. For more information, please email SACinquiries@dhcs.ca.gov or BehavioralHealthSAC@dhcs.ca.gov.

In Case You Missed It

Now Open: Providing Access and Transforming Health (PATH) Capacity and Infrastructure Transition, Expansion, and Development (CITED) Round 4 Application

On January 6, DHCS opened the PATH CITED Round 4 application window, including the Transitional Rent Community Support. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. Nearly $158 million is available for Round 4.