April 1, 2025

Top News 

DHCS Releases Latest Enhanced Care Management and Community Supports Quarterly Report

On March 27, DHCS released the latest Enhanced Care Management (ECM) and Community Supports quarterly report summarizing utilization data from July 2024 through September 2024. Key highlights from the report include:

• Consistent growth: Since ECM launched in January 2022, 279,824 unique Medi-Cal members have successfully enrolled in ECM benefits. In the third quarter of 2024 alone, 143,188 unique members accessed ECM benefits, an increase of 13 percent from the second quarter of 2024.
• Youth participation: In Q3 2024, 28,342 children and youth under age 21 accessed ECM benefits, marking a 13 percent increase from Q2 2024.
• Community Supports usage: Approximately 296,500 unique Medi-Cal members have utilized Community Supports, with more than 754,000 total services delivered. In the third quarter of 2024 alone, 136,031 unique members received Community Supports, an increase of 7.5 percent from the second quarter of 2024.
• Increased service access: By Q3 2024, nearly 90 percent of Medi-Cal members had access to at least 10 of the 14 Community Supports services. More than 41 percent of members have access to the full suite of services.
• Key services utilized: More than 61 percent of members using Community Supports accessed Medically Tailored Meals/Medically Supportive Foods, and approximately 32 percent used one or more services from the Housing Trio (Housing Transition Navigation Services, Housing Tenancy and Sustaining Services, and Housing Deposits).

This latest ECM and Community Supports implementation report shows a sustained increase in utilization quarter-over-quarter as additional populations of focus have become eligible for ECM and additional Community Supports services are offered in counties across the state. DHCS expects to see more enrollment growth across ECM and Community Supports in the coming months and years. In 2025, DHCS will continue to support and sustain this growth through expanded ECM and Community Supports program monitoring efforts, robust stakeholder engagement, and policy design refinements.

​Program Updates

Community Health Workers

Effective April 1, DHCS updated Medi-Cal's existing Community Health Worker (CHW) policy to allow supervising Medi-Cal providers to bill for covered CHW services provided by CHWs using two new Healthcare Common Procedure Coding System (HCPCS) codes recently added by the Centers for Medicare & Medicaid Services (CMS). DHCS is updating this policy to allow CHWs to better address the economic and social conditions that influence Medi-Cal members and community health, such as food, housing, and transportation insecurities and access to essential utilities. DHCS' updated CHW policy aims to more effectively support and promote improved health outcomes for Medi-Cal members by addressing needs affected by social drivers of health. DHCS also issued a State Plan Amendment Public Notice to set the rates for these two codes to 100 percent of the Medicare rate, pursuant to Welfare & Institutions Code Section 14105.25.

Additionally, on April 1, DHCS issued a statewide standing recommendation that all Medi-Cal members who meet defined eligibility criteria for receiving CHW services would benefit from CHW services. This standing recommendation, issued to improve access and reduce barriers to Medi-Cal members receiving and Medi-Cal providers rendering CHW services, is signed by Dr. Karen Mark, DHCS' Medical Director for Policy and Evaluation. Consistent with existing policy, this standing recommendation authorizes CHWs to provide covered Medi-Cal CHW services, including health education, health navigation, screening and assessment, and individual support and advocacy.

​Join Our Team

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

• Chief of the Benefits Division (BD). The Chief of BD leads the development, implementation, and administration of medical coverage policies for health care services provided by the state's Medi-Cal program. The Chief also oversees several specialty programs within Health Care Benefits and Eligibility, including Every Woman Counts, Prostate Cancer Treatment, and Hearing Aid Coverage for Children. Applications must be submitted by April 18.

DHCS is also hiring for its contracts, audits, managed care, population health management, and other teams. For more information, please visit the CalCareers website.

​Upcoming Stakeholder Meetings and Webinars

DHCS posts upcoming public meetings on the Calendar of Events. 

Strong Start & Beyond Partner Webinar

On April 2, from 12 to 12:45 p.m. PDT, California Surgeon General Dr. Diana E. Ramos will host the next Strong Start & Beyond partner webinar on prevention to improve lifelong health. Strong Start & Beyond is a bold movement to reduce California's maternal mortality rate by 50 percent by December 2026. By leveraging the state's investments and partnerships, we can foster awareness, encourage active participation in health, and build access to resources for mothers, pregnant people, and their families. Joining Dr. Ramos are Dr. Erica Pan, California Department of Public Health Director and State Public Health Officer; Dr. Bernadette Lim, Founder and Executive Director of the Freedom Community Clinic; and Dr. Atul Nakhasi, Transformational Physician Executive. Please contact the Office of the California Surgeon General if you have any questions.

Consumer Focused Stakeholder Workgroup (CFSW)

On April 4, from 10 to 11:30 a.m. PDT, DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted by April 2 on the DHCS Consumer-Focused Stakeholder Workgroup webpage. 

California Children's Services (CCS) Advisory Group Meeting 

On April 9, from 1 to 4 p.m. PDT, DHCS will host the CCS Advisory Group quarterly meeting (advance registration required). DHCS and the CCS Advisory Group partner to ensure children in the CCS/Whole Child Model (WCM) program receive appropriate and timely access to quality care. Agenda topics include updates on 2025 priorities, including the 2025 WCM expansion; county compliance, monitoring and oversight; and Medi-Cal Rx pediatric integration. Additional information and meeting details are available on the CCS Advisory Group webpage.  

Doula Implementation Stakeholder Workgroup

On April 11, from 10 a.m. to 12 p.m. PDT, DHCS will host the next Doula Implementation Stakeholder Workgroup meeting, as required by Senate Bill 65 (Statutes of 2021, Chapter 449), to examine the implementation of the Medi-Cal doula benefit, in accordance with section 14132.24 of the Welfare and Institutions Code. The meeting will be held at 1501 Capitol Avenue, Sacramento, CA, and is open to the public. The link for this meeting will be available on the DHCS Doula Implementation Stakeholder Workgroup webpage. The workgroup will discuss ways to minimize barriers to doula services and continue discussions regarding the workgroup's report to the Legislature, which must be posted on DHCS' website by July 1, 2025.

Protect Access to Health Care Act (PAHCA)-Stakeholder Advisory Committee (SAC) 

On April 14, from 11:30 a.m. to 3:30 p.m. PDT, DHCS will host the PAHCA-SAC meeting (advance registration for online participation required) at 1700 K Street (first-floor conference room 17.1014), Sacramento. The committee is responsible for advising DHCS on developing and implementing components of the Protect Access to Health Care Act of 2024 (Proposition 35). For general inquiries or to receive more information about meetings, please email DHCSPAHCA@dhcs.ca.gov.

Traditional Health Care Practices Benefit Implementation

On April 22, DHCS will present an overview of Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support Indian Health Care Providers and Drug Med-Cal Organized Delivery System counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation." For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.

​In Case You Missed It

DHCS Announces Opioid Use Disorder Treatment Awards

On March 25, DHCS awarded $800,000 to two Local Emergency Medical Service Agencies to foster low-barrier access to clinically proven opioid use disorder (OUD) treatment for patients in an emergency medical services (EMS) setting who are at risk of overdose and often do not have access to services in other settings. The grants—awarded through the Emergency Medical Services Buprenorphine Use Pilot Program (EMSBUP) to the Stanislaus County EMS Agency and Ventura County EMS Agency—will enable these two agencies to address substance use disorder as a treatable emergency condition, utilizing paramedics to identify and treat patients who would benefit from medications for addiction treatment (MAT). MAT is the use of medications in combination with counseling and behavioral therapies, which is effective in treating OUDs and helping some people sustain recovery.

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, which includes funding opportunities to support the implementation of the new 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. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.

The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PDT on May 2, 2025. The guidance document and application are available on the PATH CITED webpage. Please send any questions to cited@ca-path.com.