September 30, 2024 - Stakeholder Update​​

Top News

Dental Managed Care (DMC) Procurement

On August 3, 2023, DHCS released a Request for Proposal for DMC plans to operate in Sacramento and Los Angeles counties. On September 27, DHCS awarded three contracts per county. The awardees for both Sacramento and Los Angeles counties are current contractors LIBERTY Dental Plan of California and Health Net Community Solutions and new contractor California Dental Network. DHCS anticipates that these DMC plans will be operational by July 1, 2025. Additional communication will be provided to members in preparation for the implementation of the new contracts. Medi-Cal DMC provides high-quality, accessible, and cost-effective oral health care through managed care delivery systems. Medi-Cal DMC contracts provide health care services through established networks of organized systems of care, which emphasize preventive and consistent dental care.

Program Updates

Mandatory Enrollment of Foster Children and Youth in Single Plan Counties

Beginning January 1, 2025, DHCS will mandatorily enroll current and former foster children and youth in single plan counties (Alameda, Contra Costa, and Imperial) who are currently in fee-for-service (FFS) Medi-Cal into a Medi-Cal managed care plan (MCP). FFS Medi-Cal will not be available in single plan counties after January 1. This will align policies in all MCP models where there is a single plan operating in the county, per Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023).

Impacted members in single plan counties will receive 60- and 30-day member notices informing them of the upcoming transition. All notices will include a web link and quick response code for members to navigate to the Notice of Additional Information, which includes more information about the transition to managed care and what it means for current and former foster children and youth in single plan counties. For additional information and resources, visit the Mandatory Enrollment for Foster Children and Youth in Single Plan Counties 2025 webpage.

MCPs coordinate Medi-Cal member benefits, maintain a network of Medi-Cal providers, and provide key benefits and services not available in FFS Medi-Cal, such as Enhanced Care Management (ECM) and Community Supports. The 2024 MCP contract includes features that directly benefit foster children and youth, including a new dedicated Child Welfare Liaison position to serve as a dedicated point of contact at a MCP for children, youth, families, and local child welfare agencies. The Child Welfare Liaison will serve as a leader within the MCP to advocate on behalf of children and youth involved in child welfare by serving as a point of contact escalation to identify and resolve escalated case-specific, systematic, and operational obstacles for accessing services. The 2024 MCP contract also requires MCPs to build partnerships with county child welfare agencies and enter into Memorandums of Understanding (MOUs) to coordinate and facilitate the provision of medically necessary services. The MOUs clarify roles and responsibilities among county child welfare agencies and MCPs, support local engagement, and facilitate the exchange of information necessary to enable care coordination and improve referrals.

PATH Technical Assistance (TA) Marketplace Video Tutorial

On September 20, DHCS released a new video resource for organizations seeking assistance with qualifying for free services on the Providing Access and Transforming Health (PATH) TA Marketplace. The step-by-step video walkthrough is intended to help organizations navigate the TA Marketplace, create an account, and submit a TA Recipient Eligibility Application. The PATH TA Marketplace is a one-stop website where entities can access free TA services from curated and approved vendors. These services are designed to help approved TA recipients successfully implement ECM and Community Supports. Services offered through the TA Marketplace are provided at no cost to the TA recipient. 

Join Our Team

DHCS is seeking highly skilled, exceptionally motivated individuals to serve as:

• Chief, Local Governmental Financing Division (LGFD) to provide organizational leadership and develop policy in support of Medi-Cal Behavioral Health and Local Educational Agency service programs as well as other local and county governmental federal reimbursement and financing oversight activities. (Final filing date: October 4)

• Chief, Provider Enrollment Division (PED) to lead the development and implementation of policies, processes, and services related to provider enrollment, including screening, enrolling, and recertifying Medi-Cal providers. Additionally, the Chief of PED has full responsibility for the development and implementation of regulatory and process changes to business requirements and enhancements for the Provider Application and Validation for Enrollment system. (Final filing date: October 14)

DHCS is also hiring for its communications, auditing, health policy, information technology, and other teams. For more information, please visit the CalCareers website.

Upcoming Stakeholder Meetings and Webinars

Improving Access to ECM

DHCS is pleased to highlight new policies that will allow members to access ECM more quickly and will standardize administrative practices across MCPs. DHCS worked extensively with stakeholders to develop an updated ECM presumptive authorization policy in the ECM Policy Guide (page 107), which allows qualified ECM providers to offer services immediately upon meeting a member for up to 30 days while a formal referral is made. In addition, DHCS released statewide ECM Referral Standards that will require streamlined, uniform practices across MCPs, including new guidance prohibiting certain types of information collection that could delay the timely receipt of ECM services. The standards and policy take effect on January 1, 2025, and MCPs are currently operationalizing the new guidance.

These standards and policy are key outcomes of a 12-month process to engage community-based organizations, providers, advocates, MCPs, and others on the continuous improvement of ECM and Community Supports, from which the ECM/Community Supports action plan was developed. For example, DHCS combined ECM provider feedback from a listening tour with an analysis of all ECM referral forms used across the state to create proposed referral standards. These standards were then workshopped extensively with MCPs and other stakeholders. The standards and policy are major outputs of the action plan, and more will follow, including updated Community Supports definitions.

On October 9, from 11 a.m. to 12 p.m. PDT, DHCS will host an all-comer webinar to share details on the standards and policy. Advance webinar registration is required. This webinar is open to all and will be of special interest to MCPs, providers, community partners, and organizations referring members to ECM. Stakeholders may also direct questions about the new guidance to CalAIMECMILOS@dhcs.ca.gov.

Updated Integrated Core Practice Model (ICPM) Guide and Integrated Training Guide (ITG) Webinars

The University of California, Davis will host an informational webinar to support the launch of the new ICPM Guide and ITG. These resources will help managers, service coordinators, social workers, foster youth liaisons, youth probation officers, and others who support the local System of Care for Children and Youth in enhancing and improving sustainable safety, permanency, and well-being for children and families across California.

The webinar, on October 9, from 11 a.m. to 12:30 p.m. PDT, will provide a general overview of the updated ICPM Guide and ITG and practice-level content (advance registration required). A prior webinar held on September 18 provided a general overview of the updated ICPM Guide and ITG, leadership behaviors, and implementation for members of local Interagency Leadership Teams.

California Children's Services Advisory Group Meeting

On October 9, DHCS will host the quarterly meeting of the California Children's Services (CCS) Advisory Group. 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 a post-transition update on the Kaiser Permanente January 1, 2024, WCM implementation and the WCM January 2025 expansion progress, as well as updates from Blue Shield Promise Health Care Plan on childhood lead poisoning prevention services; the CCS Compliance, Monitoring, and Oversight Workgroup; and the CCS Redesign Performance Measure Quality Subcommittee. Additional information and meeting details are available on the CCS Advisory Group webpage.

Behavioral Health Task Force (BHTF) Webinar

On October 15, from 12 to 1:30 p.m. PDT, the BHTF will hold a webinar on population-based prevention (advanced registration is required). Participants include Dr. Tomás Aragón, MD, DrPH, Director of the California Department of Public Health (CDPH) and State Public Health Officer, and Julie Nagasako, Deputy Director of the Office of Policy and Planning at CDPH. This webinar will help prepare attendees for an in-depth discussion at the November 13 BHTF quarterly meeting. The webinar will be recorded and posted on the BHTF website. For questions and comments​ or to join the BHTF listserv, please email BehavioralHealthTaskForce@chhs.ca.gov.

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

On October 16, from 9:30 a.m. to 3 p.m. PDT, DHCS will host the SAC/BH-SAC meeting (advance registration required) 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), also known as Medi-Cal Transformation, 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. It incorporates existing groups that have advised DHCS on behavioral health topics. For more information, please email SACinquiries@dhcs.ca.gov or BehavioralHealthSAC@dhcs.ca.gov.

DHCS Harm Reduction Summits

Registration is currently open for the first two DHCS Harm Reduction Summits in Shasta County (October 24) and San Mateo County (November 19). Through these convenings, DHCS aims to collaborate with communities across the state to promote harm reduction within California's substance use disorder (SUD) treatment system and create low-barrier, patient-centered care. DHCS encourages SUD treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in SUD treatment settings) to attend and learn about best practices for incorporating the tenets of harm reduction into SUD treatment. Additional summits will be held in Fresno County, Los Angeles County, and San Diego County in winter 2025. Register on the event website.

Hearing Aid Coverage for Children Program (HACCP) Webinar for Medical Providers and Hearing Professionals

On November 12, from 12 to 1 p.m. PST, DHCS will host the quarterly HACCP webinar for medical providers and hearing professionals. For more information and to register, please visit DHCS' HACCP webpage.

In Case You Missed It

Critical Funding Opportunity Available to Expand Behavioral Health Services

On July 17, DHCS released the Bond Behavioral Health Continuum Infrastructure Program (BHCIP) Round 1: Launch Ready Request for Applications. Eligible organizations can apply for funding to construct, acquire, and rehabilitate properties for behavioral health services for Medi-Cal members. Interested parties can find application instructions on the BHCIP website and must sign up for a pre-application consultation by October 15 in order to be eligible. Applications must be submitted by December 13. This initiative, part of Proposition 1, seeks to transform California's mental health and substance use disorder systems, providing more comprehensive care for the state's most vulnerable populations. For more information, contact DHCS at BHTinfo@dhcs.ca.gov.