April 14, 2025

Top News 

DHCS Approved to Participate in Medi-Cal Cell and Gene Therapy Access Model

The Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS) approved DHCS' participation in the groundbreaking Cell and Gene Therapy (CGT) Access Model beginning on July 1, 2025. This multi-year initiative will expand Medi-Cal members' access to lifesaving gene therapies for sickle cell disease (SCD), a severe genetic blood disorder that disproportionately affects people of African descent. These therapies have the potential to transform lives, and this initiative helps ensure that cost is not a barrier for Californians who need them most.

Initially, the CGT Access Model will focus on access to gene therapy treatments for people living with SCD, specifically targeting therapies like Vertex's Casgevy and Bluebird's Lyfgenia. It aims to improve health care outcomes for Medi-Cal members by facilitating access to transformative therapies, while managing costs through outcomes-based agreements between CMS, manufacturers, and state Medicaid agencies. DHCS will work with CMS on onboarding activities in the coming weeks and will share more detailed information as it becomes available.

​Program Updates

California's 1115 Waiver Approvals Remain Unaffected

DHCS partners may be aware that on April 10, CMS announced it will not approve new requests from states for federal matching funds for state expenditures on Designated State Health Programs (DSHP) and Designated State Investment Programs (DSIP). These funds, approved by CMS, allow states to support health care delivery system transformations not typically covered by Medicaid.

This announcement does not affect California's previously approved DSHP funding, including initiatives under the California Advancing and Innovating Medi-Cal (CalAIM) and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) 1115 waivers, which remain federally approved and operational. Specifically, the Providing Access and Transforming Health (PATH) initiative under CalAIM will continue. In BH-CONNECT, DSHP funds support the implementation of the Behavioral Health Workforce Initiative program, which is expanding the supply and competencies of behavioral health providers who commit to serving Medi-Cal members. This initiative is designed specifically to support the Medi-Cal behavioral health workforce with strong requirements for participating in high-volume Medi-Cal provider settings and is not a general student loan repayment program.

DHCS remains committed to serving Californians with equitable access to quality health care, leading to a healthy California for all. We appreciate our Medi-Cal providers and community partners, and together we will push full steam ahead to transform our health system and improve health outcomes.

​Join Our Team

DHCS is seeking talented and motivated individuals 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.

• Chief of the Investigations Division (ID). The Chief of ID leads all investigation activities for DHCS programs, including Medi-Cal. These activities include fraud data analytics, the Medi-Cal Fraud Hotline, complaint intake, investigative audits, and provider and member fraud investigations. Additionally, the Chief of ID is responsible for developing and implementing policies and processes related to fraud, waste, and abuse investigations under the division's purview and ensuring compliance with all applicable federal and state laws, rules, and regulations. Applications must be submitted by April 25.

DHCS is also hiring for its accounting, behavioral health, 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. 

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 Tribal and Indian Health Program Representatives meeting (1 to 4 p.m. PDT, advance registration required). The presentation is open to the public and will review policy guidance to support Indian Health Care Providers and Drug Medi-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.

DHCS hosts the quarterly Tribal and Indian Health Program Representatives meeting to facilitate early engagement and discussion with Tribal partners on the development of DHCS initiatives that specifically impact Tribes, Indian health programs, and American Indian Medi-Cal members. For more information, please see the Indian Health Program webpage.

Chosen Family, Part 2: Contraception and Fertility for Transgender and Gender Diverse People 

On May 5, from 10 to 11:30 a.m. PDT, DHCS will host the Chosen Family, Part 2: Contraception and Fertility for Transgender and Gender Diverse People webinar (advanced registration required). Transgender and gender-diverse (TGD) people represent a growing subset of patient populations, but many continue to report a lack of provider knowledge when it comes to TGD health. This session will build on TGD health terminology and competency essentials presented in Part 1 of this webinar series by reviewing evidence-based recommendations for contraception, fertility, and family-building counseling. If you are unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website at a later date.

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

On May 21, from 9:30 a.m. to 3 p.m. PDT, 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 and feedback on efforts to provide equitable access to quality health care. BH-SAC provides DHCS with input on behavioral health initiatives and was created as part of the ongoing effort to integrate behavioral health with the greater health care system. The agenda and other meeting materials will be posted as the meeting date approaches. For more information, please email SACinquiries@dhcs.ca.gov or BehavioralHealthSAC@dhcs.ca.gov.

​In Case You Missed It

Proposition 35: Protect Access to Health Care Act-SAC 

Today, DHCS held the first Protect Access to Health Care Act-SAC meeting. This committee is responsible for advising DHCS on developing and implementing components of the Protect Access to Health Care Act of 2024 (Proposition 35). This meeting marked the beginning of the formal stakeholder consultation process required under Proposition 35. Please see the Protect Access to Health Care Act-SAC webpage for more information about the meeting. Also, to help clarify the facts about California's Managed Care Organization Tax and outline how Proposition 35 implementation is progressing, DHCS published frequently asked questions. For general inquiries, please email DHCSPAHCA@dhcs.ca.gov.

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.​​